Thursday, July 2, 2009

Barack on health care plan:

President Barack Obama said so many reassuring things yesterday and did his best to keep the naysayers and the fear mongerers calm.

"We want to allow people who are happy to keep their doctor and keep their insurance."

He wants a program that will invest in prevention. As he said, helping someone with obesity will help to prevent them from getting diabetes. Along these lines, the new health care reform should save money in the long run. He was clear that "more care is not better. The right care is better. Some rural areas have health care that is way below the costs of health care other places." He explained when a questioner said that Texas laws help to hold down rates, that this was not so. At the Mayo clinic, the primary care doctor calls in any needed specialists for a meeting. At that meeting they order all the tests that will be needed. This saves money because with the system we have now, each specialist orders his own set of tests -- doubling or tripling the cost of care. The way we reimburse now, prevents doctors from doing this in the community.

He wants the priorities to be on keeping people well, or minimizing illness. He said, "If we can get a system where people are getting regular checkups and mamograms - this will allow us to catch things early and to save costs for you and us."

He was reassuring that "None of these plans will be allowed to cut you out for a pre-existing condition."

He continued to explain that he believes "that there should be a public plan to keep admin costs low, provide good service, and to keep the private insurers honest. They will not be allowed to drop people. They will not be allowed to play with the charges; charging some more than others."

This was good news to us at Trends. You see that we have not approved of the way the private insurers have been happily taking the profits while cheating their customers.

There are always the questions: How do we pay for it? President Obama explained that they have a commitment to keep it deficit neutral.

2/3 will be a reallocation of money that's already being spent. For example, $177 billion will be given to private insurance over the next ten years as subsidy, Medicare advantage. This doesn't help families. We can give that to families so that they can have insurance.

1/3 we will pay for with increased revenues. Cap the itemized deductions so that very wealthy people don't get more of a deduction on their house, just because they have a bigger house.

And, we're going to have a savings from prevention. This will drive down costs.

They are working at identifying ways on Capital Hill to make it more user friendly. He explained that "the hardest part is yet to come. The ney-sayers are lining up. I ask them, "What's your alternative? To stand pat while more and more families lose their insurance and businesses have to chose between closing their doors or giving up health insurance for their workers."

President Obama does not accept the status quo on energy, health care or schools. We are all ready to move into the future and have to have courage for change. He is asking ordinary Americans to stand up and insist that now is the time. If we don't, then the lobbyists will win.

He explained the reason that single payer is off the table, which we have been wondering.

Single player plan works pretty well in other countries. Eliminates bureaucracy. Our plan evolved differently. For us to transition completely, could be hugely disruptive. We are looking for a uniquely American plan.

This is 1/6th of our economy.... We don't want to just upend it.
Ohhh, that's it.

Remember Compassionate Conservatism?

Apparently the conservative blogs and talk shows have been attacking a woman with kidney cancer. What jerks! Debby, who had a Kidney tumor irradiated while she was caring for her father asked a question. She lost her job due to damage from the radiation. Then she developed another tumor after her father's death. She doesn't yet qualify for social security, and lost her chance for disability. What can she do?

The president called her over to give her a hug. He said he didn't want her to feel alone. His staff would take her name and they would get back to her. He has compassion and the "compassionate conservatives" clearly don't and can't stand it.

Re: small businesses

This has been a big problem we know. This keeps people in jobs they don't like just for the insurance, whereas they would otherwise be starting their own businesses.

The insurance companies charge them way more than they charge bigger pools from large corporations. They are too small to be able to get the best deals from the insurance companies. The health care exchange will have many plans available. This will enable the small or independent business person to join a big pool that will help to drive down costs. If needed, subsidies will be available from the federal government.

Small companies with 25 or more employees will be required to contribute toward their employees insurance if they don't offer to pay for it up front. Companies smaller than that will be exempt from this requirement.

To All Those Who Say WAIT!

About Health Care affordability....He was clear: "If the health care system was working well, I'd be happy to leave it alone. Some employers see it going up 8, 10, 12% per year. Our salaries are not going up like that. Your employer has raised your out of pocket costs, and they have increased your deductible etc... Are you happy now, and will you be happy 5 years from now?"

He went on about the deficit in general:

Don't let people tell you that the deficit is from the Recovery Act. Most of the deficit is because of Medicare and Medicaid. A tiny, tiny part is the Recovery Act which was designed to keep firefighters and teachers and policemen on the job. It did that. But we have so much uncompensated care at hospitals, this is a big part of the deficit.

The Recovery Act helps people keep their insurance on Cobra, but it is so costly.... It was the right thing to do, but we can't afford to do it indefinitely.... We need something that enables the self employed to have insurance.

He reassured us that he is going to keep on pressing until it gets done.

A question on health care coverage being taxed was asked. He admitted that this is a huge coverage. Some have suggested eliminating the tax exclusion to employers. The idea was that if the tax payer were shopping on his own, he could get the credit. However, the individual tax payer is not going to be able to buy insurance for the same price that the pool was paying for him.

"If you are older or sicker, the price really gets jacked up.

So, we're not going to tax these benefits or eliminate the exclusion. Congress is talking about capping the exclusion. Those Cadillac plans would be taxed above the cost that a regular family is paying. Barack's one stipulation is that no one's insurance costs will go up as a result of health insurance reform.

As they used to say in X Files, "The Truth shall set you free."

He wants the American people to be well enough informed that the scare tactics don't work.

He doesn't want to give the insurance companies $177 billion for no reason as we are doing now. And, he doesn't want to pay for five tests when he could pay for two....

People worrying about rationing didn't surprise him because this is one of the conservative talking points. The truth is that he will make available information to doctors. If the blue pill has the best effect on z, and is less expensive than the red pill made by a different pharmaceutical company, he would like you and your doctor to have that information.

He is hoping that people can generate the necessary political will. No one wanted to do social security, but people didn't want older Americans on the street after working hard all their lives. Americans found a way to do something about it. The conservatives are still complaining about social security....

This is one of those times when Americans have to come together. Let's go after the future. We want a system that gives you choice; allows you to keep your doctor and drives down costs.

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