AP sources: Dems reach deal to drop gov't-run plan

I suggest govt. simply buy land and build what they need, or buy existing buildings. No need for eminent domain, much.

 

No one said they wouldn't save money. It just won't be $54 billion/year that they save.

If the healthcare bill costs $100B/year, and healthcare overall costs $2.2T/year, and the $2.2T overall would be reduced by $54B with tort reform, then the government plan should save about 100B * 54B/2.2T = $2.45B.

Which is a substantial amount of money to save. I'm in favor of saving it.

I am opposed, however, to pretending like the government would save $54B/year, like you were doing in earlier posts.

barfo

 

Ok. Do we need more hospitals? Is that the key problem with healthcare in the US?

Are you saying we don't have enough clinics now? Evidence?

Really. Let's look at your local transit system.

Is 50% of the budget not much? Not to worry, my local transit system is even less user-supported:

It's true. You have to bring your own lunch when you ride the bus.

Uh, and what about the people who actually get sick? $200-$300 per year aint gonna cut it for them. Sounds like you are proposing that instead of buying insurance, people should just be healthy. Why didn't anyone ever think of that before?

barfo

 

Sounds to me like you confuse insurance with health care. Again.

Health care is about patients seeing doctors and getting the treatment they need.

Insurance is about paying a premium to assure you aren't wiped out in the case of some catastrophe.

What's the purpose of government getting involved here? To provide access to health care for people that need it or to assure insurance companies profit from charging people more for premiums than they pay out for care?

The former is what it should be about. The latter is a transfer of taxpayer money to insurance companies (and lawyers since that $54B is off limits).

The former is the means of controlling costs - you can only afford to pay doctors what people can afford to pay vs. paying them whatever they want to charge since they have a gun to our collective heads (pay up or die!). And containing costs means reducing that $54B and every other $50B or $5B or $5M item that contributes to the overall expense.

If people want to pay as they go, $300 or whatever is the likely cost for the vast majority. If you pay as you go and need a $50,000 operation, you'd pay the $50,000. But that $50,000 would be what the govt's cost are, even subsidized. If people want to buy into a govt. HMO plan, then it's like $1400, and the $1100 per person not spent on that person would subsidize others paying the $1400 for their $50,000 costs.

What you missed in the MTS business is that they charge people who ride the bus. I've not seen anything in any of the proposed govt. "health care" bills that charges people for the govt. service. It's yet another typical tax (elsewhere) and spend (big, no make that HUGE) for nothing more than brownie points.

 

I massively overstated the cost on purpose. To point out we could build hospitals out of marble and gold with plenty of the latest and greatest gear.

 

http://www.reuters.com/article/idUSN1114313420091211?type=marketsNews

U.S. agency sees more health spending with reform

Fri, Dec 11 2009
* Report says overhaul would raise health spending
* Raises doubts about cost savings in Senate bill
By Donna Smith

WASHINGTON, Dec 11 (Reuters) - U.S. healthcare spending would rise by about $234 billion over the next decade under the Senate Democrats' overhaul bill and some of the proposed savings might never be achieved, a U.S. agency said in a report released on Friday.

It was the latest in a series of reports issued by the agency that oversees Medicare that cast doubt on some of the savings claims made by Democrats about one of President Barack Obama's top domestic priorities.

Republican opponents on Friday seized on the report to underscore their message the sweeping healthcare reform will raise costs and hurt Medicare benefits.

"This report confirms what we've long known -- the Democrat plan will increase costs, raise premiums, and slash Medicare," said Republican Leader Mitch McConnell. "That's not reform. This analysis speaks for itself. This bill is a sham."

But Democrats said many of the potential cost savings in the bill were hard to estimate and that the bill would extend the financial life of the Medicare health program for the elderly and result in lower premiums and out-of-pocket expenses.

"The report shows that health reform will ensure both the federal government and the American people spend less on health care than if this bill doesn't pass, helping get a hold of America's debt and keep more money in people's pockets," said Senate Finance Committee Chairman Max Baucus, who helped write the legislation.

The report, written by Richard Foster, the chief actuary at the Centers for Medicare and Medicaid Services, said the increase in healthcare spending reflected the impact of millions of newly covered people seeking medical care.

"Although several provisions would help to reduce healthcare cost growth, their impact would be more than offset through 2019 by the higher health expenditures resulting from the coverage expansions," the report said.

Foster acknowledged his analysis of the sweeping reform had a "greater degree of uncertainty than is usually the case with more routine health care proposals."

SOME COST-SAVING PROPOSALS 'MAY BE UNREALISTIC'

The healthcare revamp seeks to rein in soaring costs and provide medical coverage to millions of uninsured people. The report said about 57 million people would be without health insurance in 2019 under current laws. The number would be reduced by 24 million if the Senate bill is enacted, it said.

The report, similar to one issued by the agency on the healthcare bill passed by the House of Representatives in November, went on to say the added demand for health services at first may be difficult to meet and could lead to price increases and a reluctance by providers to treat patients with low-reimbursement health coverage.

Medicare has significantly lower reimbursement rates than private insurers. Doctors, clinics and hospitals that rely heavily on Medicare patients for business "could find it difficult to remain profitable and, absent legislative intervention, might end their participation in the program," the report said.

Congress would probably find that politically unacceptable and the report concluded some of the Medicare cost saving proposals "may be unrealistic."

Democrats argued the $2.5 trillion U.S. healthcare system is fraught with wasteful spending and the savings from wellness programs and payment system reforms that would reward quality rather than quantity of treatments and services would be greater than estimated.

"There is a very significant cost savings target that can be achieved," Democratic Senator Sheldon Whitehouse said in a telephone conference with reporters.

"You could get a number down if you just went in and cut benefits," he said. "The problem (in the system) is not that benefits are too high, the problem is that it is managed poorly, it has enormous waste and duplication and error and resolving those things are just plain harder to cost by its nature." (Reporting by Donna Smith; Editing by Peter Cooney)

 

I found this post very informative. (And no, I'm not being snarky). While I don't plan to build any hospitals myself, it's interesting to know what it takes to do so. The points about operating costs and financing are useful as well.

barfo

 

http://www.nytimes.com/2009/12/14/health/policy/14health.html?_r=1

Lieberman Rules Out Voting for Health Bill

By ROBERT PEAR and DAVID M. HERSZENHORN

WASHINGTON — In a surprise setback for Democratic leaders, Senator Joseph I. Lieberman, independent of Connecticut, said on Sunday that he would vote against the health care legislation in its current form.

The bill’s supporters had said earlier that they thought they had secured Mr. Lieberman’s agreement to go along with a compromise they worked out to overcome an impasse within the Democratic Party.

But on Sunday, Mr. Lieberman told the Senate majority leader, Harry Reid, to scrap the idea of expanding Medicare and abandon any new government insurance plan or lose his vote.

On a separate issue, Mr. Reid tried over the weekend to concoct a compromise on abortion that would induce Senator Ben Nelson, Democrat of Nebraska, to vote for the bill. Mr. Nelson opposes abortion. Any provision that satisfies him risks alienating supporters of abortion rights.

In interviews on the CBS News program “Face the Nation,” Mr. Lieberman and Mr. Nelson said the bill did not have the 60 votes it would need in the Senate.

Senate Democratic leaders, including Mr. Reid and Senator Charles E. Schumer of New York, said they had been mindful of Mr. Lieberman’s concerns in the last 10 days and were surprised when he assailed major provisions of the bill on television Sunday. He reiterated his objections in a private meeting with Mr. Reid.

A Senate Democratic aide, perplexed by Mr. Lieberman’s stance, said, “It was a total flip-flop, and leaves us in a predicament as to what to do.”

Democrats are desperately trying to round up 60 votes and conclude Senate debate on the health care bill before Christmas.

Mr. Reid could not immediately figure out how to achieve that goal at a meeting he held Sunday with senior Democratic senators and White House officials, including Mr. Obama’s chief of staff, Rahm Emanuel, according to Senate Democratic aides.

Marshall H. Wittmann, a spokesman for Mr. Lieberman, said the Connecticut senator “notified Senator Reid on Friday that he had severe misgivings about the Medicare buy-in proposal, so his comments on ‘Face the Nation’ should not have come as a surprise to the leadership.”

The Senate Republican leader, Mitch McConnell of Kentucky, said that passage of the bill was looking less and less inevitable. The Democrats “are in serious trouble on this,” he said, “and the core problem is the American people do not want us to pass it.”

On television Sunday, Mr. Lieberman said: “We’ve got to stop adding to the bill. We’ve got to start subtracting some controversial things. I think the only way to get this done before Christmas is to bring in some Republicans who are open-minded on this, like Olympia Snowe.”

Senator Snowe, of Maine, has tried to find common ground with Democrats, but has rejected Mr. Reid’s proposal to let uninsured people 55 to 64 years old purchase coverage under Medicare.

“You’ve got to take out the Medicare buy-in,” Mr. Lieberman said. “You’ve got to forget about the public option. You probably have to take out the Class Act, which was a whole new entitlement program that will, in future years, put us further into deficit.”

Class Act refers to a federal insurance program for long-term care, known as the Community Living Assistance Services and Supports Act.

Mr. Lieberman said he would have “a hard time” voting for a bill with the Medicare buy-in.

“It has some of the same infirmities that the public option did,” he said. “It will add taxpayer costs. It will add to the deficit. It’s unnecessary. The basic bill, which has a lot of good things in it, provides a generous new system of subsidies for people between ages 55 and 65, and choice and competition.”

Mr. Nelson said he wanted to know the cost of the Medicare buy-in. “I am concerned that it’s the forerunner of single payer, the ultimate single-payer plan, maybe even more directly than the public option,” he said.

Mr. Lieberman said: “The bill itself does a lot to bring 30 million people into the system. We don’t need to keep adding onto the back of this horse, or we’re going to break the horse’s back and get nothing done.”

Even if Senate Democratic leaders were prepared to meet Mr. Lieberman’s demands, they would still need to resolve intraparty disputes over insurance coverage for abortion.

Aides to Mr. Reid met Saturday with advocates of abortion rights to explore ideas for a compromise.

Details were sketchy. Under one idea, some health plans receiving federal subsidies could offer optional coverage for abortion, but they could not use federal money to pay for the procedure. They would have to use money taken from premiums paid by subscribers and would have to keep it separate from federal money.

Critics of abortion say such requirements for the segregation of funds are an accounting gimmick.

In hopes of placating opponents of abortion, Mr. Reid is also considering an increase in the federal tax credit for adoption of children and a new program to provide services to pregnant high school and college students.

Both ideas were proposed by Senator Bob Casey, Democrat of Pennsylvania, who opposes abortion but generally supports the overall bill.

“Many teens and women who face an unplanned pregnancy do so with little or no support,” Mr. Casey said.

 

Lieberman's a hoot. Has the same need for attention as the balloon-boy people. Marginally more sophisticated about getting it.

barfo

 

I hope Obama says the same thing to him. That'll really give him incentive to vote for the bill, any bill, since the particulars don't seem to matter much.