Jul 3, 2012 6:10 PM
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Perhaps not surprisingly, the Supreme Court’s 5-4 vote on Thursday upholding most of President Barack Obama’s landmark health care reform was greeted warmly in the East End medical community and with mixed reactions from East End congressional candidates.
The court largely let stand the Affordable Care Act that called for the creation of a nationwide insurance system that would greatly lower the number of Americans who lack coverage.
One main issue was the so-called individual mandate, which would require all Americans to get health insurance or pay a fine. The Obama administration said the mandate is necessary to fix flaws in the insurance market as well as to allow those with “pre-existing conditions” to get insurance. Republicans, on the other hand, claimed the health care reform, which they often refer to derogatorily... more
The court largely let stand the Affordable Care Act that called for the creation of a nationwide insurance system that would greatly lower the number of Americans who lack coverage.
One main issue was the so-called individual mandate, which would require all Americans to get health insurance or pay a fine. The Obama administration said the mandate is necessary to fix flaws in the insurance market as well as to allow those with “pre-existing conditions” to get insurance. Republicans, on the other hand, claimed the health care reform, which they often refer to derogatorily... more
Unless you're a woman.
sound familiar?
I might support it if the rates young people paid reflected accounted for their own health care, but it is designed to make them pay for everyone else too.
Everyone pays into it,either through employment sponsored plans or through subsdised premiums.No one will go to the emergeny room without some kind of insurance,so costs of the uninsured will stop being a factor in premiums.
You and others here love to talk about taking personal responsibility,but when you are required to,you reveal your
"Double Standard".
Get over it!!!
For now at least.... it might now be called a tax.
Be careful,we don't want to get stuck paying your medical bills.
Alternative headline:
"Chief Justice Roberts gets libs to gut Obamacare from the inside out."
Yesterday a 5-4 decision would be political. Today a 5-4 decision is magnificent. Just because the SC says it’s a tax and not unconstitutional, contrary to the claims of Obama that it’s a penalty, still doesn’t make it a good law.
When does the Affordable piece of Obamcare kick in?
Seems to me, cut the subsidies for "finance", and industry, and you can provide for the people.
You're a freeloader.
The republicans have nothing to run on except that they want to take away the health insurance that people now have.They have no pln except to repeal it and return to the system of rationed care that exsted before.
Republicans have plenty to run on. Economy, unemployment, deficit... Should I go on?
they declared war on women and womens' health rights
they alienated hispanics by not supporting immigration reform
they're trying to limit voting rights for minorities,the elderly and the young
they were against the repeal of DADT and gay rights
they want to cut funding to education and environmental preservation
they tried to trump up charges against Erik Holder
they've blocked any attempt to rebuild our infrastrutre
they ...more have yet to create any jobs.
now the want to take healthcare away from people who need it most.
Sounds like quite a platform.
They wage class warfare and war on individual rights.
They play politics with immigration reform.
They want to jeaprdize the integrity of the election process.
They choose to weaken the military and eliminate DADT - a policy that allowed gays to freely perform their duty and has proven to be an effective and successful policy, balancing military needs and gay rights.
The left wants you to think only they are for clean ...more air and water, health care and programs for the elderly.
Eric Holder lied to Congress and has obstructed inquiry and is intentionally hiding particulars behind a mudered Border Patrol Agent to provide political cover.
They have increase the debt by trillions and spent billions on infrasture with little improvement in the economy or jobs.
Stimulus is a failure even by Obama's promises and goals.
Now they want to celebrate the biggest tax in history with a health care program that won't create affordable health care or solve the health care problems of the country - it will make them worse.
Sounds like quite a platform.
Bigot.
did he ship more jobs overseas?.
try something new
't make it so.
Any questions?
Are the monster due yet, on Maple St.?
Oh, do I love Rod Serling's work...
Nothing like a SCOTUS decision to expose the extreme paranoia from some of the posters here.
want to see it?
The CBO found that more individuals will lose their employer-provided coverage than originally anticipated, and the government will collect $99 billion more in taxes and penalties. CBO also finds that there are more uninsured individuals. The CBO found that this continues the trend of Obamacare becoming increasingly expensive and decreasingly effective with each new scoring update.
It also costs more to cover individuals who ...more receive subsidized insurance from the government. CBO says that because the Obama Administration is forcing insurers to cover more provisions—such as birth control—the initial per capita cost of coverage for people on the exchanges will increase.
CBO found that there would be 3 million FEWER people receiving employer-provided coverage, as many of these individuals and companies will choose to pay the tax penalties. LESS people covered that had insurance previously.
If you actually read the CBO report,it is an analysis of several possible employer behaviors when the ACA is actually implemented.
This explains a lot of what will happen when the ACAs fully implemented-
"The differences in the estimated number of people receiving health insurance coverage through various sources lead ...more to differences in the estimated budgetary impact of the insurance coverage provisions of the ACA. If a firm chose not to
offer insurance coverage under the ACA, some of its workers and their families might enroll in Medicaid or CHIP or be eligible to receive subsidies through the insurance exchanges; as a result, the cost of those programs would increase. At
the same time, the reduction in that firm’s compensation to workers that was
provided in the form of health benefits would generally be offset by an increase in
the compensation it provided in the form of wages and salaries. Because health benefits are generally not taxed but wages and salaries are, that shift in the
composition of compensation would raise federal revenues. In addition, the federal government would generally receive penalty payments from the employer and from any employees who ended up without health insurance."
"....If an additional firm with a large share of low-income workers chose not to offer insurance coverage, the net effect would tend to be an increase in the federal budgetary cost of the ACA’s coverage provisions; if an additional firm with a small share of low-income workers chose not to offer insurance coverage,
the net effect would tend to be a decrease in the federal budgetary cost of the
ACA’s coverage provisions."
So small businesses would affect the budgetary increase in a positive manner by actually lowering the cost of the ACA
"In the March 2012 baseline projections, the insurance coverage provisions of the ACA have an estimated net cost to the federal government of $1,252 billion over the eleven-year period from 2012 through 2022. Under the four alternative scenarios examined here, that projected net cost ranges from $1,170 billion to
$1,297 billion, representing differences relative to the baseline projections that range from a decrease of $82 billion (or 7 percent) to an increase of $45 billion
(or 4 percent). The scenarios with the larger estimated costs are the ones in which additional reductions in employment-based coverage relative to the baseline projections are concentrated among low-income workers. In contrast, the scenario
with the largest reduction in employment-based coverage actually lowers the cost of the ACA to the federal government relative to the baseline projections because
the extra costs for Medicaid and exchange subsidies are more than offset by the
increased revenues resulting from higher taxable compensation among workers who receive higher wages in lieu of health benefits."
That,of course,depends on whether employers increase salaries n lieu of providing healthcare.
"About 11 million people who would have had an offer of employment-based coverage under prior law will not have an offer under the ACA. That estimate represents about 7 percent of the roughly 161 million people projected to have employment-based coverage under prior law.5 The businesses that choose not to offer coverage as a result of the ACA will tend to be smaller employers and employers with predominantly lower-wage workers; those workers and their families are more likely to be eligible for Medicaid, CHIP, or subsidies through the health insurance exchanges.
Another 3 million people who would have had employment-based insurance
under prior law and will still have an offer of such coverage under the ACA will instead choose to obtain coverage from another source. Under the legislation, workers with an offer of employment-based coverage will generally be ineligible for exchange subsidies, but that “firewall” will
presumably be enforced imperfectly, and an explicit exception to it will be made for workers whose offer of employment-based coverage is deemed unaffordable.
About 9 million people who would not have been covered by an employment-
based plan under prior law will have that coverage under the ACA. That change reflects the combined impact of the insurance mandate, the penalties that will be imposed on employers who do not offer insurance, and the tax credits for certain small employers who provide insurance for their workers—
which will lead some employers who would not have offered coverage in the absence of the ACA to offer it and will lead some people who would not have taken up their employer’s offer of insurance to do so."
So most workers will have options to get health insurance,either through their employers or through the exchanges,and the penalties and tax incentives will help pay for them.
"Beginning in 2014, individuals and families will be able to purchase health
insurance through new exchanges at prices that will not depend on their health
status. Currently, the nongroup health insurance market in most states does not offer such “community-rated, guaranteed-issue” insurance coverage.8
■ Beginning in 2014, workers and their families who have family income below 138 percent of the federal poverty level (projected to be about $33,000 for a family of four in 2014) will be eligible for coverage through Medicaid. In
addition, workers who have family income above that level but below roughly 200 percent of the federal poverty level will be eligible for significant subsidies through the insurance exchanges if their employer does not offer health insurance. In contrast, workers with family income between roughly 200 percent and 400 percent of the federal poverty level will be eligible for smaller subsidies through the exchanges if their employer does not offer coverage, and workers with higher family income will not be eligible for any subsidies for insurance purchased through exchanges.9
■ Most large firms—which are the predominant source of employment-based health insurance now—have a mix of higher-income and lower-income
workers, so not all of their employees and their dependents would be eligible for Medicaid, CHIP, or exchange subsidies if those employers decided not to
offer coverage. And nondiscrimination provisions in the Internal Revenue Code and the Public Health Service Act discourage firms from offering healthinsurance benefits to more highly paid employees while not offering them to
lower-paid employees.10
■ Employment-based health insurance will continue to receive a significant subsidy through the tax exclusion for employer-paid premiums and tax provisions that allow a large portion of employees’ shares of premiums to be paid out of pretax income. Those tax preferences will provide an ongoing
incentive for employers to offer coverage, even after certain high-premium plans face an excise tax beginning in 2018. The value of the tax exclusion for workers who obtain health insurance through their employer is usually proportional to their combined marginal tax rates for payroll taxes and for federal and state income taxes. For higher-income workers, that tax subsidy typically amounts to more than 25 percent of the cost of premiums. The tax subsidy will not be available to workers whose employers drop coverage and
who end up purchasing insurance through exchanges.
The administrative costs involved in operating and managing health insurance plans will be higher in the exchanges than they will be for large employers, principally because administering plans (including handling enrollment and collecting premiums) for many individual policyholders is more expensive than administering them for a single employer. (However, the administrative costs for health insurance plans offered in the exchanges under the ACA will be lower than the administrative costs in the nongroup market without the
ACA.)
The requirement that individuals obtain health insurance coverage and the penalties that will apply to many individuals if they do not obtain it will lead more workers to seek health insurance coverage. Because employers design benefit packages to appeal to their current and potential workers, greater demand for health insurance will increase the incentive for employers to offer insurance as well as for employees to take up insurance offered by employers.
The ACA applies both “sticks” and “carrots” to employers to encourage them to offer health insurance to their employees. Starting in 2014, firms with more than 50 employees that do not offer insurance and have at least one employee who receives an exchange subsidy will be subject to a penalty; that penalty will initially be as much as $2,000 per full-time worker (beyond the first 30 such workers) and in subsequent years is set to increase at the rate of growth in per capita health insurance premiums. Firms with up to 25 full-
time-equivalent employees and with average annual wages of less than
$50,000 may be eligible for a tax subsidy that covers a percentage of their contributions to health insurance premiums. To be eligible, employers must contribute at least 50 percent of the cost of premiums for single coverage for their employees. The maximum credit is available to employers with 10 or fewer full-time-equivalent employees and average annual wages of up to
$25,000, and it phases out as average wages and the number of employees rise. Before 2014, the maximum credit covers up to 35 percent of an employer’s payments for premiums; for 2014 and later, the credit will cover up to 50 percent of an employer’s payments but only for two years. (The average wage limits will be adjusted for inflation starting in 2014, and the rules for the tax credit include some additional details as well.)
Employers who drop coverage, leaving their employees to purchase insurance on their own, will generally have to raise the cash compensation of their employees to compete with employers who continue to offer health insurance.
Evidence of such substitution has been found in studies that examine the wages of workers with differing job-related insurance benefits.11 Further
evidence of such substitution can be seen at the aggregate level: Despite
rapidly rising costs of health benefits during the past few decades, slow
growth of wages and salaries has caused the share of national income devoted
to total compensation to decline slightly.
"Some observers have argued that employers’ decisions about whether to offer health insurance coverage under the ACA will not be based on the kind of rigorous assessment of costs and benefits—to themselves and their employees—
that are captured by the models used by CBO and JCT and by the other analysts
just mentioned. Instead, some have argued, firms will choose not to offer coverage based simply on ...more the following observations: All of their workers can
purchase coverage through the new exchanges, which will be better in important respects than the current individual insurance market; some of those workers will receive subsidies if they buy insurance through the exchanges; the penalties facing firms that do not offer coverage are much smaller than the costs of insurance; and not offering insurance allows firms to avoid some complexity and
uncertainty.
As discussed above, those observations form a very incomplete picture of the consequences of an employer’s decision not to offer health insurance. In
particular, many employees will not be eligible for significant exchange subsidies under the ACA (a point that is quantified later in this report), and the employers who do not offer insurance will ultimately not realize significant savings because they will generally need to pay higher cash compensation to attract the same
workforce. Still, is it possible that some firms will choose not to offer health insurance, regardless of the full consequences for themselves or their workers? Certainly, not all firms will behave as the calculations underlying CBO and JCT’s
models would predict. However, just as some employers may base a decision not to offer coverage on nonfinancial reasons or may not take into account all of the factors that CBO and JCT think are relevant, other employers may decide to keep
offering coverage because they and their employees are accustomed to their doing so. And given the importance of health insurance to people and the cost of obtaining that insurance, it seems likely that most firms will ultimately make considered and informed decisions. Therefore, CBO and JCT expect that, once all of the key provisions in the ACA have taken effect, most firms will analyze carefully the opportunities and incentives that they and their workers will have."
D you provide access to health insurance to your employees?
I hope L'il Timmy has the guts to debate Randy, how can he defend his position on Obamacare and Amnesty for Illegals? You can't make this stuff up!
I guess you want to be let off the hook?
If you want to allow people without insurance to continue to go to the emergency room so the costs are passed on to the rest of us because you're against people taking personal responsibility (especially when 'personal responsibility' is so important to the right),by Cappies description,you're a hippocrate.
Can you people get together and actually come up with some new ...more material?
Do you contribute to your HC plan?
Have you ever had to provide HC for someone?
Have you ever considered the direct relationship between HC costs and hiring?
You see the world through as you want to, not as it is. For whatever reason you have zero ability to see the big picture.
Yes,I contributer to my health plan.Always have.
I find your last two lines to be very revealing about you;your words are very introspective.
Show him that he cannot buy a Congressional seat in NY-1!!
2.Obama promised to lower the bill by 2500 per family per year. An analysis by the CBO shows the cost will INCREASE by 2,100.
3. Obama said he would not support a bill that arrives from congress that is not controlling costs. Chief Medicare actuary Richard Foster stipulated that Obama care will increase health care expendetures by 311 billion over the next 10 years.
4. Obama said flat out (numerous times) ...more that to waive the mandate you would be fined not taxed and then argued the opposite of what he claimed.
No wonder the CBO called the democrats gimmickry in scoring Obamacare "difficult to sustain for a long period". Ive been saying it from the start Obamacare is a budget buster
Affordable for who? Paid for by who? Mandated by the Govt.
Again, mandated by the govt simply because you exist!!!
What is fixed?
This is a victory? I don't think so. This is nothing more than an opportunity to scream "my side beat your side" while losing sight of the fact that healthcare is still not fixed. So many are so willing to eat the garbage they are presented with and then ask for seconds. What is fixed???
All you're demonstrating is that you're a crybaby doing exactly what you yourself described.
You've demonstrated that you're as or more partisan as I am.The difference is I admit it while you hide behind a cloak of lies about how you're a 'centrist'.
A lot of crying about having to provide it,whining about the costs (I guess you wanted it to be free) but no support for reform.
All anyone has to do is click on the number next to your name to find them.
"Funny how the lawyers in govt don't include tort reform in the bill.
Mr. Bishop, if you continue to take away from the producers of the world they will eventually have no incentive to keep producing. Then what happens???" Nov 11, 09 7:01 PM
For dagdavid
FYI I am a small business owner. This will hurt me ...more and subsequently my employees. Here is the example you asked for...
Don't be so quick to line up for socialism people - it's going to hurt you.
"The 1,990-page bill the House leadership unveiled Thursday would impose a dizzying barrage of new regulations on employers, and force them to either provide government-specified health insurance or pay a penalty of up to 8 percent of their payroll."
Source: Grace-Marie Turner is president of the Galen Institute, a nonprofit research organization focusing on health policy." Nov 12, 09 11:09 AM
Many call Razza names and say he is "beyond enlightenment"
But none of you offer anything resembling an argument. For a moment look past your righteousness and consider the data.
I assure you, an 8% increase on payroll tax will result in lower wages and less hiring. It may very well send people to the unemployment line.
Call people names as much as you like, but do not ignore the data. If you work for or own a small business you will be negatively effected by the proposed health care bill. This has NOTHING to do with party affiliation and everything to do with what is best for the country.
" Nov 12, 09 11:51 AM
Nope. I don't listen to propaganda Sir.
Let's stay on topic
True or False
The bill would impose new regulations on employers, and force them to either provide government-specified health insurance or pay a penalty of up to 8 percent of their payroll
" Nov 12, 09 11:59 AM
BTW - if you need another source
Under the House measure, employers with payrolls exceeding $400,000 a year would have to provide health insurance or pay the 8% penalty.
Wall Street Journal" Nov 12, 09 12:13 PM
I did offer you another source and the data remains the same.
The answer to my question is TRUE
Under the House measure, employers with payrolls exceeding $400k a year would have to provide health insurance or pay the 8% penalty. Employers with payrolls between $250k and $400k a year would pay a smaller penalty.
We can debate this forever, but we'll still disagree. If this passes I hope I'm wrong and we have found the greatest thing since butter and toast. If I am right I will hold those who voted for the bill accountable with my vote." Nov 12, 09 1:59 PM
Clever that you have chosen to attack the source, so I have offered you another source. I can offer you about 100 sources on this issue and you can determine which one you like. In the end you have not proven the data to be false at all.
" Nov 12, 09 2:04 PM
You will probably wait forever.
If not, you will likely be called a name and someone will throw their ideology at you and assume that you are stupid because you disagree with them.
Those who claim to be the most enlightened are usually the most closed minded." Nov 12, 09 2:11 PM
This message board is really a microcosm of what is going on w/ our fed govt.
2 sides screaming and insulting each other with neither side at all interested in consensus. Maybe we deserve the horrible representation that we have at all levels of govt. Maybe the divide between the republicans and democrats represents the divide between Americans. I always hoped that the intention was to get things right and do what is best for the country. I don't see much reason to remain hopeful of that anymore. It is pretty sad, our government is who we are. So everyone carry on with the insults and false accusations. Perhaps you may find yourself in the senate one day." Nov 13, 09 8:54 AM
The Right has Palin and Beck types and the left has Pelosi and Reid types.
A quick look at this short list should tell you that mediocrity is not even on the radar. " Nov 13, 09 11:24 AM "
I don't see any support for reform,but I do see a lot of whining about it.
But,as usual,you go off on some tangent about me because you don't have a leg to stand on.
Just more hippocracy from you.
And while you are cut and paste happy, go luck up President Obama's quotes re. a healthcare mandate prior to Obamacare. Please paste that in here and chew on your shoe in the process.
You are so selective with what you read. It has to fit your preconceived opinion. You are funny, Phil. I always enjoy our little chats.
"This message board is really a microcosm of what is going on w/ our fed govt.
2 sides screaming and insulting ...more each other with neither side at all interested in consensus." I think I nailed that.
Obama didn't design the mandate as a tax-that was the result of the decision by the SCOTUS. But you'll blame Obama,of course. It couldn't possibly be the decision of a conservative judge.
Like Social Security?
We already know that the right hates social contracts that require them to actually cotribute to society.
Like Social Security: going bankrupt.
Obamacare: $650 billion in new taxes, yay!
Phil: thank you for your view, it is nice to know that you think the time I put into charities and my gifts are as worthless as the taxes I pay and are contributions to society.
I don't beleive you anyway.
why is social security going broke? gross fiscal negligence. there is no trust. all that money was spent on tax cuts, a war, and 20 years of deficit spending.
they are all corrupt, regardless of the party. the longer you let them divide us, the longer it will take to set things right.
I have the popcorn amd soda right here;watching all of you hyperventilate about this decision is great entertainment.
HAPPY BIRTHDAY,ROMNEYCARE!
Mit Romney deserves credit for the Affordable Care Act;he gave the President the idea for it and Romney even said that he beleived that the whole country should have it.
I guess he shook the etch-a-sketch and changed positions again.
Obama - for same sex marriage
Obama - against a healthcare mandate
Obama - for a healthcare mandate
Why don't you apply the same harsh criticism to those you support? After all, if you hold them in high regard they should earn it. Right? Right? Right. Oh, you hate hate everything Right. Sorry.
Obama - for same sex marriage"
Evolved.
"Obama - against a healthcare mandate
Obama - for a healthcare mandate"
the mandate was the only way to assure that everyone would be required to buy health insurance.Any other way would just leave people uninsured.
Don't think I don't have my critiscisms of Obama,I do.
But I leave them out of re because all the vitriol and hatred puked out by you and ohers here make Obama ...more look so much better than the alternative.
To take personal responsibility.Are you against that (now)?
They don't believe evolution is a valid theory...
I read "Idiot America" ;)
It's far more well written, and the author tends not to use the word "statist" like a child using the word "very" in a 1,000 word essay assignment.
I think for myself.
Rush Limbaugh prides himself on 'telling his audience what the news is,then telling them what to think about it."
(That's a direct quote from him)
While you're at ti,look up Romney's views on healthcare.
Then look up his views on the poor.
then,on corporate personhood.
and education.
saving infrastructure.
taxes regarding the rich vs. the poor.
Civil rights
Womens' rights
etc.,etc.,etc.
But don't worry,in August Iet three weeks off- with pay.
As a partisan, I'm cheering long and loud, but for the bulk of the people, it's just not a big thing, much as it should be.
Thanks for that post...
Randy, CAN YOU STOP THE CORRUPTION!!!!!!
Or, do you subsist on it?
Right Wing Randy would like to turn the East End into his favorite place, India, where he ships jobs and millions of people, except the super rich, are without health care.
Stop ...more the Republican War against women and the middle class.
Vote Bishop - and send Randy, the Koch brother/ExxonMobile puppet, back to New Jersey
When exploitaion defines "freedom" in your society...
How truly lawful is it?
Guess that makes him a good Demokrat.
Pile on the debt, crush business tax the daylights out of the ones who provide jobs.
STOP THE MADNESS, VOTE RANDY
He made millions Outsourcing godd American jobs to India.
Shame on you for supporting such a man!
That kind of disparity IS MADNESS.
Your boy Randy is sponsored by a pair of brothers who make a despot look preferable. They are so "free market", their company is privately held, and not traded on Wall St. I hope for this nation's ...more sake, most of it's citizens are more well informed, and smarter than you...
What's the solution?
GOOD LUCK FOLKS!!!!!
I found the Federal Reserve "Changes in U.S. Family ...more Finances Report" a real page turner.
My question is if the big financial players contribute to campaigns, then favors are owed. Wealth = power and we don't have either. I doubt those who do are looking to give either away.
Money is the lowest common denominator which drives the function of our society. To find the problem, folla' the dolla'. There was a woman named Brooksley ...more Borne who was a former head of the CFTC. She put out a "concept release" in 1998 regarding derivatives, synthetic investment vehicles, and their danger to the market. If you look at what went down, it was absolute, blow by blow prophecy. Yet, it meant nothing because she was blackballed by Greenspan, Rubin (Golf @ the Bridge), and Summers.
I've said it before, and I'll say it until it's not true:
"Power corrupts. Absolute power corrupts absolutely. And what is money in modern America but power incarnate?
Our biggest problem is "corporate personhood". Without that, those who would corrupt our democratic process by contributions to politics would need to create another channel like SuperPACs. I really think that is their "Plan B". The prostitutes on K Street have got to go as well (lobbyists). Until we remove the influence of a few and their "wealth", there will be no liberty, or justice for all.
Their biggest line of BS at the Federal Reserve is that they "create wealth". The question is, for whom? If "trickle down economics" works, where is the [expletive deleted] growth?
Especially brick oven pizza...
They take great pleasure in saying that they are going to take helth insurance from millions who need it.they're going to take food stamps away from the hungry,they're going to put people out of work and de-fund education. They're no only happy about it,they're practically wetting their pants.
Is that the definition of 'compassionate conservatives'?
As a health care industry former Vice President of corporate communications at CIGNA, he is WELL qualified to speak on the subject.
"Since I walked away as head of communications at a top health insurance company in May 2008, I've worked tirelessly as an outspoken ...more critic of corporate PR and the distortion and fear manufactured by America’s health insurance industry. It is a PR juggernaut that is bankrolled by millions of dollars, rivaling lobbying budgets and underwriting many "non-partisan" and "grassroots" organizations."
"It’s to the insurers’ advantage for it to be complicated and confusing and hard to deal with insurance companies. They profit as a result of the confusion."
This health care bill is nothing more than an huge expansion of GVT authority.
Otherwise, your opinion is uninformed, uneducated, horse puckey.
Ridiculous. Do you include national defense in your list of "horrible" govt programs? Of course Congress can mandate healthcare, just as it can mandate food safety. The only ineptitude in economics has been manifested by George W. Bush and his colleagues still in Congress. Had the Democrats been able to pass a stimulus package twice the size of the current one, the economy would now be growing vigorously. The logical mind of President Obama is perhaps his most ...more obvious quality. Ideology rather than logic, reason, or national stewardship is the quality manifested by the Republicans in Congress. They are determined to sabotage any attempts to rebuild from the wreckage left by George W. Bush because their main goal is to defeat the President in November. They were even prepared to throw the national government into default to get their way. The only "misstep" that President Obama has made to date is his continuing attempt to treat the Republican kamikazes on Capitol Hill as colleagues.
Thank god that we finally have a national healthcare law. It's not great but at least all of our fellow citizens will have decent medical care. Its such a noble achievement, especially when compared to the principle Republican goals of dealing ever more perks to the stupendously wealthy and rehabilitating the economic vision of Herbert Hoover.
It would annihilate millions of U.S. jobs in healthcare but just think of how many new ones it would create in the air travel industry (which could themselves be outsourced!) If history repeats, Randy would carve out a ...more significant hunk of this market for himself. Visualize "Med Tiger".
As usual, you don't "get it"...
Magic Act: Making the Super Rich Disappear
"The Federal Reserve has once again counted up America’s personal wealth — and omitted the nation’s 400 richest from the final tally. But the new figures, even with that omission, show a divide still deepening.
By Sam Pizzigati
In the middle ...more of middle America — in a suburb just outside of Dayton, Ohio — funeral home owner Anne Dunbar has noticed a rather unnerving new trend.
Families used to want the obituary notices that Dunbar writes up to include a pitch for donations to their dear departed’s favorite charity. Some families are now requesting notices that ask for donations toward their funeral expenses.
You won’t find Anne Dunbar’s story — or any other anecdote about the collapse of America’s middle class — in the latest Changes in U.S. Family Finances study the Federal Reserve Board released last Monday.
What you will find: the most exhaustive set of numbers yet on the devastation that the Great Recession and decades of rising inequality have wreaked on average American families.
Most Americans, the new data help make plain, have essentially spent the last 20 years on a go-nowhere treadmill. They’re working longer and harder and have zero new wealth to show for their labor.
In 2010, the net worth of the median, or most typical, American family stood at $77,300, about the same net worth, after taking inflation into account, that the typical American family held back in the early 1990s.
Most U.S. families today have the bulk of their net worth sitting as equity in their homes. The pop of the housing bubble has zapped that equity. Between 2007 and 2010, notes the new Fed study, typical American families lost 40 percent of their total net worth. The housing crash accounted for three-quarters of that plummet.
But home values, the Fed study reports, haven’t been the only aspect of middle class economic life to take a significant hit. Incomes have plunged as well. The take-home of the typical American family, after taking inflation into account, dropped 7.7 percent in the three years after 2007, down to $45,800.
All these numbers come from the Federal Reserve’s Survey of Consumer Finances, an intense series of field interviews the Fed conducts every three years. The interviews usually run an hour and a half, but can last — for families with complicated financial situations — twice that long.
Fed researchers completed just under 6,500 of these in-depth interviews for the 2010 Survey of Consumer Finances. The Fed selected 5,000 of these families through a random sampling of American households.
But random samplings don’t generate enough wealthy households to give a statistically rich enough sense of life at America’s economic summit. To help spotlight that summit, Fed researchers supplemented their basic 2010 sample with a list of another 1,500 families, all affluent, identified through tax records.
The resulting data from all these interviews paint the most statistically comprehensive portrait of personal wealth in America available anywhere. But this portrait has one gaping hole. For confidentiality reasons, the Federal Reserve excludes from the Survey of Consumer Finances interview process any family that appears on the annual Forbes 400 list of America’s richest.
That exclusion means that the new Federal Reserve numbers for 2010 understate — by $1.37 trillion, the total wealth of that year’s Forbes 400 — America’s actual level of wealth concentration.
The Federal Reserve Changes in U.S. Family Finances report released last week doesn’t much concentrate on that concentration. The report offers no specific wealth and income breakouts for America’s top 1 percent. Analyses at that level will have to wait until scholars get their hands on the micro data that the Fed’s 2010 Survey of Consumer Finances has generated.
The new Fed study does give us income and wealth breakdowns for America’s top 10 percent, those families that made over $142,000 in 2010. These families averaged $2.9 million in net worth, about 15 times the $199,000 average net worth of families in America’s middle 20 percent.
Between 2001 and 2010, America’s top 10 percent gained net worth. Over that same span, all income brackets below the top 10 percent lost net worth.
Major swatches of American families below the top 10 percent tier, the Fed numbers also show, remain deep in debt. In 2007, only 56.4 percent of the nation’s families found themselves able to do any saving. In 2010, even fewer families — just 52 percent of the total — saved any money.
Those families struggling the hardest? The new Fed data give that unsought distinction to families headed by 35- to 44 year-olds. Just 47.8 percent of these families did any saving in 2010. Between 2007 and 2010, their net worth fell a stunning 54 percent, down to $42,100.
Add together the net worth of over 80,000 of these families in 2010 and you’ll have a fortune that equals the net worth of a single average deep pocket on that 2010 Forbes list of America’s 400 richest.
So he'd let insurance companies set a dollar limit on the coverage they provide, regardless of how much care the patient needs.
So he'd cut loose young adults (the ones who can't get jobs in the present economy) from their parents' health insurance.
So he'd abandon people with pre-existing conditions to the uninsured crapshoot of their pre-existing ...more conditions.
Sounds like a program. Run with it, Randy!
1. Did it ever occur to you that some people are uninsured because they chose to be?
2. People who are uninsured can not be denied coverage in this country (neither can illegals for that matter).
3. In the states (such as Texas) with the highest uninsured rates the % of people overwhelming do not want this plan.
4. Obamacare is nothing but a giant money grab by insurance companies and big pharma
5. Obama has lied about this plan right from the start. From the transparency ...more with open door negotiations, to the cost, to the tax on middle class
Its not about loving thy neighbor. Its about GVT over reach of authority and providing another enitlement we cant afford
People choose not to have insurance, then need emergency medical care or an operation and they can't be denied medical care. They rack up huge medical bills and go bankrupt. Those with insurance end up absorbing the cost of providing the care for the uninsured. This ...more raises the price of insurance, which leads to more people choosing not to be covered, and the cycle continues.
"Okay, explained like you're a five year-old (well, okay, maybe a bit older), without too much oversimplification, and (hopefully) without sounding too biased:
What people call "Obamacare" is actually the Patient Protection and Affordable Care Act. However, people were calling it "Obamacare" before everyone even hammered out what it would be. It's ...more a term mostly used by people who don't like the PPACA, and it's become popularized in part because PPACA is a really long and awkward name, even when you turn it into an acronym like that.
Anyway, the PPACA made a bunch of new rules regarding health care, with the purpose of making health care more affordable for everyone. Opponents of the PPACA, on the other hand, feel that the rules it makes take away too many freedoms and force people (both individuals and businesses) to do things they shouldn't have to.
So what does it do? Well, here is everything, in the order of when it goes into effect (because some of it happens later than other parts of it):
(Note: Page numbers listed in citations are the page numbers within the actual document, not the page numbers of the PDF file)
Already in effect:
•It allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices) ( Citation: An entire section of the bill, called Title VII, is devoted to this, starting on page 747 )
•It increases the rebates on drugs people get through Medicare (so drugs cost less) ( Citation: Page 216, sec. 2501 )
•It establishes a non-profit group, that the government doesn't directly control, PCORI, to study different kinds of treatments to see what works better and is the best use of money. ( Citation: Page 665, sec. 1181 )
•It makes chain restaurants like McDonalds display how many calories are in all of their foods, so people can have an easier time making choices to eat healthy. ( Citation: Page 499, sec. 4205 )
•It makes a "high-risk pool" for people with pre-existing conditions. Basically, this is a way to slowly ease into getting rid of "pre-existing conditions" altogether. For now, people who already have health issues that would be considered "pre-existing conditions" can still get insurance, but at different rates than people without them. ( Citation: Page 30, sec. 1101, Page 45, sec. 2704, and Page 46, sec. 2702 )
•It forbids insurance companies from discriminating based on a disability, or because they were the victim of domestic abuse in the past (yes, insurers really did deny coverage for that) ( Citation: Page 47, sec. 2705 )
•It renews some old policies, and calls for the appointment of various positions.
•It creates a new 10% tax on indoor tanning booths. ( Citation: Page 923, sec. 5000B )
•It says that health insurance companies can no longer tell customers that they won't get any more coverage because they have hit a "lifetime limit". Basically, if someone has paid for health insurance, that company can't tell that person that he's used that insurance too much throughout his life so they won't cover him any more. They can't do this for lifetime spending, and they're limited in how much they can do this for yearly spending. ( Citation: Page 14, sec. 2711 )
•Kids can continue to be covered by their parents' health insurance until they're 26. ( Citation: Page 15, sec. 2714 )
•No more "pre-existing conditions" for kids under the age of 19. ( Citation: Page 45, sec. 2704 and Page 57, sec. 1255 )
•Insurers have less ability to change the amount customers have to pay for their plans. ( Citation: Page 47, sec. 2794 )
•People in a "Medicare Gap" get a rebate to make up for the extra money they would otherwise have to spend. ( Citation: Page 379, sec. 3301 )
•Insurers can't just drop customers once they get sick. ( Citation: Page 14, sec. 2712 )
•Insurers have to tell customers what they're spending money on. (Instead of just "administrative fee", they have to be more specific).
•Insurers need to have an appeals process for when they turn down a claim, so customers have some manner of recourse other than a lawsuit when they're turned down. ( Citation: Page 23, sec. 2719 )
•Anti-fraud funding is increased and new ways to stop fraud are created. ( Citation: Page 699, sec. 6402 )
•Medicare extends to smaller hospitals. ( Citation: Starting on page 344, the entire section "Part II" seems to deal with this )
•Medicare patients with chronic illnesses must be monitored more thoroughly.
•Reduces the costs for some companies that handle benefits for the elderly. ( Citation: Page 492, sec. 4202 )
•A new website is made to give people insurance and health information. (I think this is it: http://www.healthcare.gov/ ). ( Citation: Page 36, sec. 1103 )
•A credit program is made that will make it easier for business to invest in new ways to treat illness by paying half the cost of the investment. (Note - this program was temporary. It already ended) ( Citation: Page 830, sec. 9023 )
•A limit is placed on just how much of a percentage of the money an insurer makes can be profit, to make sure they're not price-gouging customers. ( Citation: Page 22, sec. 1101 )
•A limit is placed on what type of insurance accounts can be used to pay for over-the-counter drugs without a prescription. Basically, your insurer isn't paying for the Aspirin you bought for that hangover. ( Citation: Page 800, sec. 9003 )
•Employers need to list the benefits they provided to employees on their tax forms. ( Citation: Page 800, sec. 9002 )
•Any new health plans must provide preventive care (mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge. ( Citation: Page 14, sec. 2713 )
1/1/2013
•If you make over $200,000 a year, your taxes go up a tiny bit (0.9%). Edit: To address those who take issue with the word "tiny", a change of 0.9% is relatively tiny. Any look at how taxes have fluctuated over the years will reveal that a change of less than one percent is miniscule, especially when we're talking about people in the top 5% of earners. ( Citation: Page 818, sec. 9015 )
1/1/2014
This is when a lot of the really big changes happen.
•No more "pre-existing conditions". At all. People will be charged the same regardless of their medical history. ( Citation: Page 45, sec. 2704, Page 46, sec. 2701, and Page 57, sec. 1255 )
•If you can afford insurance but do not get it, you will be charged a fee. This is the "mandate" that people are talking about. Basically, it's a trade-off for the "pre-existing conditions" bit, saying that since insurers now have to cover you regardless of what you have, you can't just wait to buy insurance until you get sick. Otherwise no one would buy insurance until they needed it. You can opt not to get insurance, but you'll have to pay the fee instead, unless of course you're not buying insurance because you just can't afford it. (Note: On 6/28/12, the Supreme Court ruled that this is Constitutional, as long as it's considered a tax on the uninsured and not a penalty for not buying insurance... nitpicking about wording, mostly, but the long and short of it is, it looks like this is accepted by the courts) ( Citation: Page 145, sec. 5000A, and here is the actual court ruling for those who wish to read it. )
Question: What determines whether or not I can afford the mandate? Will I be forced to pay for insurance I can't afford?
Answer: There are all kinds of checks in place to keep you from getting screwed. Kaiser actually has a webpage with a pretty good rundown on it, if you're worried about it. You can see it here.
Okay, have we got that settled? Okay, moving on...
•Medicaid can now be used by everyone up to 133% of the poverty line (basically, a lot more poor people can get insurance) ( Citation: Page 179, sec. 2001 )
•Small businesses get some tax credits for two years. (It looks like this is specifically for businesses with 25 or fewer employees) ( Citation: Page 138, sec. 1421 )
•Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty.
•Insurers now can't do annual spending caps. Their customers can get as much health care in a given year as they need. ( Citation: Page 14, sec. 2711 )
•Limits how high of an annual deductible insurers can charge customers. ( Citation: Page 62, sec. 1302 )
•Cut some Medicare spending
•Place a $2500 limit on tax-free spending on FSAs (accounts for medical spending). Basically, people using these accounts now have to pay taxes on any money over $2500 they put into them. ( Citation: Page 801, sec. 9005 )
•Establish health insurance exchanges and rebates for the lower and middle-class, basically making it so they have an easier time getting affordable medical coverage. ( Citation: Page 88, sec. 1311 )
•Congress and Congressional staff will only be offered the same insurance offered to people in the insurance exchanges, rather than Federal Insurance. Basically, we won't be footing their health care bills any more than any other American citizen. ( Citation: Page 81, sec. 1312 )
•A new tax on pharmaceutical companies.
•A new tax on the purchase of medical devices.
•A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more they'll get taxed.
•The amount you can deduct from your taxes for medical expenses increases.
1/1/2015
•Doctors' pay will be determined by the quality of their care, not how many people they treat. Edit: a_real_MD addresses questions regarding this one in far more detail and with far more expertise than I can offer in this post. If you're looking for a more in-depth explanation of this one (as many of you are), I highly recommend you give his post a read.
1/1/2017
•If any state can come up with their own plan, one which gives citizens the same level of care at the same price as the PPACA, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the PPACA. So if they can get the same results without, say, the mandate, they can be allowed to do so. Vermont, for example, has expressed a desire to just go straight to single-payer (in simple terms, everyone is covered, and medical expenses are paid by taxpayers). ( Citation: Page 98, sec. 1332 )
2018
•All health care plans must now cover preventive care (not just the new ones).
•A new tax on "Cadillac" health care plans (more expensive plans for rich people who want fancier coverage).
2020
•The elimination of the "Medicare gap"
.
Aaaaand that's it right there.
The biggest thing opponents of the bill have against it is the mandate. They claim that it forces people to buy insurance, and forcing people to buy something is unconstitutional. Personally, I take the opposite view, as it's not telling people to buy a specific thing, just to have a specific type of thing, just like a part of the money we pay in taxes pays for the police and firemen who protect us, this would have us paying to ensure doctors can treat us for illness and injury.
Plus, as previously mentioned, it's necessary if you're doing away with "pre-existing conditions" because otherwise no one would get insurance until they needed to use it, which defeats the purpose of insurance.
Of course, because so many people are arguing about it, and some of the people arguing about it don't really care whether or not what they're saying is true, there are a lot of things people think the bill does that just aren't true. Here's a few of them:
Obamacare has death panels!: That sounds so cartoonishly evil it must be true, right? Well, no. No part of the bill says anything about appointing people to decide whether or not someone dies. The decision over whether or not your claim is approved is still in the hands of your insurer. However, now there's an appeals process so if your claim gets turned down, you can challenge that. And the government watches that appeals process to make sure it's not being unfair to customers. So if anything the PPACA is trying to stop the death panels. ( Citation: Page 23, sec. 2719 )
What about the Independent Medical Advisory Board? Death Panels!: The Independent Medical Advisory Board is intended to give recommendations on how to save Medicare costs per person, deliver more efficient and effective care, improve access to services, and eliminate waste. However, they have no real power. They put together a recommendation to put before Congress, and Congress votes on it, and the President has power to veto it. What's more, they are specifically told that their recommendation will not ration health care, raise premiums or co-pays, restrict benefits, or restrict eligibility. In other words, they need to find ways to save money without reducing care for patients. So no death panels. In any sense of the (stupid) term. ( Citation: Page 407, sec. 3403 )
Obamacare gives free insurance to illegal immigrants!: Actually, there are multiple parts of the bill that specifically state that the recipient of tax credits and other good stuff must be a legal resident of the United States. And while the bill doesn't specifically forbid illegals from buying insurance or getting treated at hospitals, neither did the laws in the US before the PPACA. So even at worst, illegals still have just as much trouble getting medical care as they used to. ( Citations: Page 122, sec. 1402, Page 123, sec. 1411, Page 125, sec. 1411, Page 132, sec. 1412 )
Obamacare uses taxpayer money for abortions!: One part of the bill says, essentially, that the folks who wrote this bill aren't touching that issue with a ten foot pole. It basically passes the buck on to the states, who can choose to allow insurance plans that cover abortions, or they can choose to not allow them. Obama may be pro-choice, but that is not reflected in the PPACA. ( Citation: Page 64, sec. 1303 )
Obamacare won't let me keep the insurance I have!: The PPACA actually very specifically says you can keep the insurance you have if you want. ( Citation: Page 55, sec. 1251 )
Obamacare will make the government get between me and my doctor!: The PPACA very specifically says that the Secretary of Health and Human Services (who is in charge of much of the bill), is absolutely not to promote any regulation that hinders a patient's ability to get health care, to speak with their doctor, or have access to a full range of treatment options. ( Citation: Page 165, sec. 1554 )
Obamacare has a public option! That makes it bad!: The public option (which would give people the option of getting insurance from a government-run insurer, thus the name), whether you like it or not, was taken out of the bill before it was passed. You can still see where it used to be, though. ( Citation: Page 92, sec. 1323 (the first one) )
Obamacare will cost trillions and put us in massive debt!: The PPACA will cost a lot of money... at first. $1.7 Trillion. Yikes, right? But that's just to get the ball rolling. You see, amongst the things built into the bill are new taxes - on insurers, pharmaceutical companies, tanning salons, and a slight increase in taxes on people who make over $200K (an increase of less than 1%). Additionally, the bill cuts some stuff from Medicare that's not really working, and generally tries to make everything work more efficiently. Also, the increased focus on preventative care (making sure people don't get sick in the first place), should help to save money the government already spends on emergency care for these same people. Basically, by catching illnesses early, we're not spending as much on emergency room visits. According to the Congressional Budget Office, who studies these things, the ultimate result is that this bill will reduce the yearly deficit by $210 billion. By the year 2021, the bill will actually have paid itself and started bringing in more money than it cost.
Obamacare is twice as long as War and Peace!: War and Peace is 587,287 words long. The Patient Protection and Affordable Care Act, depending on which version you're referring to, is between 300,000-400,000 words long. Don't get me wrong, it's still very long, but it's not as long as War and Peace. Also, it bears mention that bills are often long. In 2005, Republicans passed the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users, 2005, which was almost as long as the PPACA, and no one raised a stink about it.
The people who passed Obamacare didn't even read it!: Are you kidding? They had been reading it over and over for a half a year. This thing was being tossed around in debates for ages. And it went through numerous revisions, but every time it was revised, it was just adding, removing, or changing small parts of it, not rewriting the whole thing. And every time it was revised, the new version of the bill was published online for everyone to see. The final time it was edited, there may not have been time to re-read the entire thing before voting on it, but there wasn't a need to, because everyone had already read it all. The only thing people needed to read was the revision, which there was plenty of time to do.
Pelosi said something like, "we'll have to pass the bill before reading it"!: The actual quote is "we have to pass the bill so that you can find out what is in it, away from the fog of controversy", and she's talking about all the lies and false rumors that were spreading about it. Things had gotten so absurd that by this point many had given up on trying to have an honest dialogue about it, since people kept worrying about things that had no basis in reality. Pelosi was simply trying to say that once the bill is finalized and passed, then everyone can look at it and see, without question, what is actually in the thing (as opposed to some new amendment you heard on the radio that they were going to put in).
I think those are some of the bigger ones. I'll try to get to more as I think of them.
Whew! Hope that answers the question!
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Simply stunning...
Simply stunning ......... [expletives, and references to the next American Revolution, deleted]
"30 million Americans without health insurance aren't the issue"
the republicans want to repeal but don 't have an alternative.
Reason I as ask is it really seems to me that those that are the most in favor of Obamacare are the least affected by it. One of my best friends is a really liberal school teacher. He's going GaGa for Obamacare. He even told me how great it will be for women to "get free contraception." Free??? Nothing is free. He can afford to be excited about Obamacare. A ...more lot of us, not so much.
Tell me what standard do you apply to things, Phil? My guess is the standard that fits your blind allegiance to your party. Every Shepherd needs his sheep.
Obviously,our standards are not the same.
I would never take away healthcare from those who need it and take pleasure in it. We all have a moral obligation to take care of those who need help.
At least those of us with morals feel we do. I won't try to speak for you,you've illustrated where you stand quite well.
That meqans that if you want to repeal it,you are willing to let the difference suffer without insurance,and just continue to allow the costs to be shifted o the rest of us because the only way those without will get healthcare will be to go to the emergecy room and the costs will be shited onto us.
At least you want everybody to suffer ...more equally,but suffer just the same.
He doesn't have a plan,just like the rest of the republican party.
Just take away health insurance from everybody who needs it.
Compassionate conservatism.
Huh? you posted elements of the plan just a day after this nonsense.
No politican would ever have the courage to say it but this would kick start the dismall employment rate in this country as well as help to make America more competitive globally .
The republicans don't have a plan,except to repeal the healthcare law and let hings go back to the way they were
Throw everybody under the bus. That's their plan.
What you're proposing is that the government pay the insurance companies-corporate welfare.There will be no incentive to control prices because the insurance companies will be on the governemnt dole.I don't support a plan that the government doesn't regulate and control directly.Insurance companies can't be trusted,we learned that from our present system.
"Obama says Heritage Foundation is source of health exchange idea
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EDITOR'S NOTE: An analysis of this comment by President Barack Obama was published on April 1, 2010. After it appeared, the Heritage Foundation's communications office contacted us to argue that our rating of Mostly True was too generous to the president. We did some additional reporting to review our ruling. Our second round of reporting -- primarily ...more talking to conservative policy experts outside of Heritage -- solidified our initial conclusions. Below is the updated version of our story, which retains the rating of Mostly True, published April 26, 2010.
Democrats like to parry Republican criticism of the recently passed health care law by talking about how it includes ideas that originated with conservatives. During an interview on NBC's Today show on March 30, 2010, President Barack Obama offered a specific example.
Obama told host Matt Lauer that "when you actually look at the bill itself, it incorporates all sorts of Republican ideas. I mean a lot of commentators have said this is sort of similar to the bill that Mitt Romney, the Republican governor and now presidential candidate, passed in Massachusetts. A lot of the ideas in terms of the exchange, just being able to pool and improve the purchasing power of individuals in the insurance market, that originated from the Heritage Foundation. ..."
We zeroed in on the notion that the Heritage Foundation, a conservative think tank that is no fan of Obama's health care law as a whole, might have "originated" the idea of the health insurance exchange -- a virtual marketplace where individuals can purchase health insurance. Our interest only grew after we received an e-mail from Heritage president Ed Feulner that blasted Obama's claim.
"President Obama this morning cited the Heritage Foundation's research in an attempt to sell his health care package as a 'middle-of-the-road, centrist approach,'" Feulner wrote. "We take great exception to this misuse of our work and abuse of our name. This is but the latest act in a campaign to sell this big-government program as a moderate law that incorporates conservative ideas. Americans should not be fooled."
Feulner went on to argue that "the president knows full well — or he ought to learn before he speaks — that the exchanges we and most others support are very different from those in his package. True exchanges are simply a market mechanism to enable families to choose their health insurance. President Obama’s exchanges, by contrast, are a vehicle to introduce sweeping regulation and federal standardization on health insurance."
Heritage continued its campaign against Obama's claim in an April 19, 2010, op-ed column in the Washington Post. The director of Heritage's Center for Health Policy Studies, Robert Moffit, wrote that "the version of the exchange we did develop couldn't be more different than that embodied in this law." He charged that "the Obama health-care law 'builds' on the Heritage health reform model only in the sense that, say, a double-quarter-pounder with cheese 'builds' on the idea of a garden salad. Both have lettuce and tomato and may be called food, but the similarities end there."
We see two related, but distinct, questions here. The first is whether Heritage did in fact "originate" the idea of health insurance exchanges. The second is whether the exchange prescribed by the new law mirrors the one that Heritage has supported.
• Did Heritage originate the idea? Our research suggests that while Heritage has advocated for health insurance exchanges for many years, others did, too. Scholars credit Alain C. Enthoven -- an emeritus professor at the Stanford University Graduate School of Business who worked in the Defense Department during the Kennedy and Johnson administrations -- with popularizing the idea for an exchange as many as three decades ago.
Still, there's little doubt that Heritage has been a consistent and eager promoter of the exchange idea, especially during the effort to design a new health care system for Massachusetts. That effort concluded with the Democratic legislature joining with the Republican governor, Romney, to implement a system that includes a health insurance exchange.
On numerous occasions, Heritage scholars wrote approvingly of the exchange system in Massachusetts, known as the Connector. In a paper about the Massachusetts plan published on April 11, 2006, Edmund Haislmaier, a Heritage fellow in health care policy, wrote of the "truly significant and transformative health system changes that the legislation would set in motion."
Specifically, Haislmaier wrote that "this concept of organizing a state's insurance markets around a central clearinghouse represents a dramatic departure from recent state health insurance reform proposals. States have spent the past 15 years trying to expand health care coverage to small-business employees, with virtually no positive results. The Massachusetts legislation represents a bipartisan commitment to move away from the policies that have largely failed to make progress in covering the uninsured for the past 15 years."
In another paper, titled, "The Rationale for a Statewide Health Insurance Exchange," and published on Oct. 5, 2006, Heritage scholar Robert Moffit wrote that "the best option is a health insurance market exchange." Comparing it to a farmers' market or the used-car dealer CarMax, Moffit said the exchange "would expand coverage and choice" and would represent "a revolutionary change in the health insurance market."
Journalists seemed to give Heritage credit, as well. During 2006, columns and articles citing Heritage's role in promoting the health exchange idea ran in such publications as the Washington Post, the Dallas Morning News, the New Orleans Times-Picayune and the National Review.
We feel the president is largely right on this point. The idea for exchanges may have "originated" outside Heritage, but in well over a decade leading up to the introduction of the president's health care plan, Heritage clearly took a high-profile role in touting it, culminating in the proposal enacted in Massachusetts. And given that, they can hardly be shocked that the president is noting the think tank's role in developing the overall concept (even if he did so in a self-serving way).
• Is it the same idea? After Obama made his comment, we spoke to both Haislmaier and to Stuart Butler, Heritage's vice president for domestic policy. Both argued that the plan now enacted into law is fundamentally different in structure than the one Heritage advocated.
"What Obama and Capitol Hill did was to take a mainstream idea and push it toward a much more interventionist, regulatory model, as opposed to the original idea, which was more market-based," Butler said in an interview.
To prevent Heritage scholars from moving the goalposts after the fact, we decided to analyze how similar the proposals are only by referring to policy stances that can be documented in briefing papers published prior to Obama's election. We found at least four papers that spoke directly to the health insurance exchange idea, and in these papers, we noticed several passages that advocated elements of an exchange that differ from how the bill was ultimately written.
Here are some of those differences:
-- Who can use the exchange? In a 2006 paper, Moffit wrote, "Ideally, an exchange should be open to all state residents and all interested employers, regardless of the size of the firm, who want to arrange health insurance through the exchange."
That's not the case with the exchanges in the new law -- at least not any time soon. When the exchanges go live in 2014, they will only be open to people already buying insurance on the individual market (that is, those buying insurance independent of their employer) and to employees of small businesses with up to 100 employees. A provision does allow employees of businesses with more than 100 employees to purchase coverage from the exchange, but not until 2017, and only if their state decides to allow it. (The exception is that employees who are paying too large a percentage of their income on their employer-based health insurance will be eligible in 2014.)
-- How much federal regulation will there be? Heritage scholars have regularly argued that the key regulatory role for the exchanges should be handled by the states, rather than the federal government.
In a 2007 paper, Butler wrote that "each state would determine on its own such features as the infrastructure for handling premiums, as well as the regulations and requirements for accepting insurance plans into the exchange. The state also would be responsible for determining pooling, reinsurance, and risk adjustment arrangements and the degree to which firms would, if at all, be required to offer plans available through the exchange to their employees."
It's true that the new health care law will create state-based exchanges. However, they will have to adhere to many federal requirements.
For instance, the federal law requires the Secretary of Health and Human Services to define an "essential health benefits package" (and update its details every year). This will become the minimum package offered on the exchanges. The law also limits plans sold on the exchange to charging differential premiums only based on age (in a 3-to-1 ratio), geography, family composition and tobacco use (on a 1.5-to-1 ratio). And health plans on the exchange will have to abide by an assortment of other rules governing marketing requirements, provider networks and standards for presenting information to consumers.
-- How portable will insurance be? In a 2007 paper published by Heritage, researcher Connie Marshner argued that health insurance exchanges would promote portability of health insurance. "When individuals are able to purchase health insurance for themselves in an (exchange) marketplace, the insurance belongs to them," Marshner wrote. "Even if they change jobs, move, or quit working and retire, they own the policy and can keep the same health insurance if they so choose."
That should be the case for many people on the health care law's exchange, especially those who bought their insurance individually, as long as states don't erect high barriers that bar people from moving from one state's exchange to another. But full portability will be unlikely for those who purchased insurance on the exchange with the help of their employer. While the exchange should make it easier for those switching jobs to find new insurance, there will most likely be a disruption when that employee switches companies -- and whenever there's a disruption in coverage, there's a likelihood that their plan will have to change to one degree or another.
So where does this leave us?
Edwin Park, a senior fellow with the liberal Center on Budget and Policy Priorities, sees significant similarities in approach despite the differences outlined above. Park said the differences involved "rules of the road within the exchange, rather than fundamental differences in the underlying concept or structure."
Henry Aaron, a fellow with the centrist-to-liberal Brookings Institution, called the new health care law "a close relative" of Heritage's plan -- "not identical to be sure, but a sibling or at least a first cousin. The essence is that you have a government or nonprofit entity that regulates the sale of insurance to individuals or businesses in order to standardize offerings and to control selling methods in order to produce real, head-to-head competition and to provide customers information in forms they can readily understand. ... Yes, they are all different; but they are all of the same family. "
We also solicited the views of conservative policy experts beyond Heritage.
One -- Tevi Troy, a visiting senior fellow at the Hudson Institute -- thought Heritage had a legitimate gripe. "In the policy world, there is often a vast gulf between theoretical ideas and policies as implemented, and this case is no exception," Troy said. "While Heritage had been a leading advocate for health insurance exchanges, the law as written creates something so different from what Heritage sought that I understand why they want to remove their name from the list of proponents."
However, we heard from nine people affiliated with conservative policy organizations other than Heritage who thought that the president's statement was reasonably accurate.
Seven of them declined to publicly express their differences with Heritage for fear of making waves within the tight-knit conservative policy world. But two did allow their names to be used. One was Dan Miller, executive vice president of the Chicago-based Heartland Institute, who acknowledged that Obama's statement was so carefully worded that the president "was able to exploit" the issue "for his own ends."
The other was Daniel McCarthy, senior editor of the American Conservative magazine who has written recently about the conservative origins of the president's health care plan.
"Every think tank on the left and right knows that its recommendations will undergo some deformation before they make their way into law, if they ever do," McCarthy told PolitiFact. "Heritage might prefer state insurance exchanges with greater individual choice, including for workers already covered by their employers. But I don't imagine Ed Feulner would be complaining at all if a Republican president or a Republican Congress had passed a plan that deviated from the Heritage blueprint to the same degree that Obama's bill has. While it's not true that 'lots of' the specifics in the Obama plan were dreamed up by Heritage, the overall approach is similar to policies Heritage has long championed, including the individual mandate as well as the insurance exchanges. This is only controversial because the wrong party happened to pass the law, and it's poison for any conservative to be identified with it."
We agree with Heritage that the differences between its original vision and the version enacted into law are not trivial, and are enough to undercut the president's effort to secure a Heritage Foundation seal of approval for his bill. But the president helped his case by wording his statement with extreme care. Intentionally or not, he gave himself subtle linguistic running room by saying that "a lot of the ideas" for the exchange came from Heritage, including the concept of "just being able to pool and improve the purchasing power of individuals in the insurance market." Even if not all of the ideas in the two plans are identical, we feel that it was fair of him to say that "a lot of the ideas" are in common, including the notion of pooling. So we conclude that the president's statement qualifies as Mostly True."
2. To say that the heritage plan and Obamacare are the same is a flat out lie that has been perpetuated by the left. Its true the Heritage foundation has run for political cover by even being associated with it. The orginal Heritage plan was as I indicated above. IT is a political unreality (even most of the GOP wouldnt accept it). It strips ALL employees (GVT,union and private sector) from their benefits and forces them to buy it personnaly. Profits from the private sector will rise because they dont need to provide employee medical any longer and GVT debt will drop. If you think thats what Obama care is doing you are grossly mistaken.
I'm sure the armed forces would take issue with that statement.
"To say that the heritage plan and Obamacare are the same is a flat out lie that has been perpetuated by the left. "
No,it's a fact that you can research yourself.You do know how to do that,don't you?
From my above post-
"On numerous occasions, Heritage scholars wrote approvingly of the ...more exchange system in Massachusetts, known as the Connector. In a paper about the Massachusetts plan published on April 11, 2006, Edmund Haislmaier, a Heritage fellow in health care policy, wrote of the "truly significant and transformative health system changes that the legislation would set in motion."
You should read my above post again.
The Heritage plan that was proposed in the 90's,a plan advocated and endorsed by republicans,is what we have now.
But the republicans flip-flopped and won't supoport it now.
Its also not my fault that you cant understand the difference between the heritage plan and Obamacare. The heirtage foundation is a conservative think tank. They are the equivalant to progressnow for the dems. It is true that many parts including the exchange were part of the plan with one huge exception. People must purchase through the exchange individually. NO MORE EMPLOYER sponsered ...more health care. Fiscally it is very practical idea. Profits would increase and GVT would decrease. People like you would lose your cushy tax payer paid benefits and be forced to buy it on your own through the the exchange. The heritage plan in its true form was never seriously considered. It would be political suicide but it makes sense
1-Tort reform (releiving doctors insurance companies of the risk of paying for their mistakes)
2-Selling insurance across state lines. (would allow insurance companies to operate from the states with the fewest regulations,like credit card companies do)
3-High-risk pools. (so sick people can all be gouged in the same place)
4-Grants to state to 'experiment' with their own solutions.
1-Tort reform – reducing ambulance chasing style law suits
2-Selling insurance across state lines. – allowing competition to free market to keep prices down.
3-High-risk pools. –reform high-risk pools to guarantee that all Americans, regardless of pre-existing conditions or past illnesses, have access to affordable care – while lowering ...more costs for all Americans.
4-Grants to state to 'experiment' with their own solutions. - providing incentive payments to states that reduce premiums and the number of uninsured.
"World Health Organization Ranking; The World’s Health Systems
1 France
2 Italy
3 San Marino
4 Andorra
5 Malta
6 Singapore
7 Spain
8 Oman
9 Austria
10 Japan
11 Norway
12 Portugal
13 Monaco
14 Greece
15 Iceland
16 Luxembourg
17 Netherlands
18 United Kingdom
19 Ireland
20 Switzerland
21 Belgium
22 Colombia
23 Sweden
24 Cyprus
25 Germany
26 Saudi ...more Arabia
27 United Arab Emirates
28 Israel
29 Morocco
30 Canada
31 Finland
32 Australia
33 Chile
34 Denmark
35 Dominica
36 Costa Rica
***37 USA
38 Slovenia
39 Cuba
40 Brunei
41 New Zealand
42 Bahrain
43 Croatia
44 Qatar
45 Kuwait
46 Barbados
47 Thailand
48 Czech Republic
49 Malaysia
50 Poland
51 Dominican Republic
52 Tunisia
53 Jamaica
54 Venezuela
55 Albania
56 Seychelles
57 Paraguay
58 South Korea
59 Senegal
60 Philippines
61 Mexico
62 Slovakia
63 Egypt
64 Kazakhstan 65 Uruguay
66 Hungary
67 Trinidad and Tobago
68 Saint Lucia
69 Belize
70 Turkey
71 Nicaragua
72 Belarus
73 Lithuania
74 Saint Vincent and the Grenadines
75 Argentina
76 Sri Lanka
77 Estonia
78 Guatemala
79 Ukraine
80 Solomon Islands
81 Algeria
82 Palau
83 Jordan
84 Mauritius
85 Grenada
86 Antigua and Barbuda
87 Libya
88 Bangladesh
89 Macedonia
90 Bosnia-Herzegovina
91 Lebanon
92 Indonesia
93 Iran
94 Bahamas
95 Panama
96 Fiji
97 Benin
98 Nauru
99 Romania
100 Saint Kitts and Nevis
101 Moldova
102 Bulgaria
103 Iraq
104 Armenia
105 Latvia
106 Yugoslavia
107 Cook Islands
108 Syria
109 Azerbaijan
110 Suriname
111 Ecuador
112 India
113 Cape Verde
114 Georgia
115 El Salvador
116 Tonga
117 Uzbekistan
118 Comoros
119 Samoa
120 Yemen
121 Niue
122 Pakistan
123 Micronesia
124 Bhutan
125 Brazil
126 Bolivia
127 Vanuatu 128 Guyana
129 Peru
130 Russia
131 Honduras
132 Burkina Faso
133 Sao Tome and Principe
134 Sudan
135 Ghana
136 Tuvalu
137 Ivory Coast
138 Haiti
139 Gabon
140 Kenya
141 Marshall Islands
142 Kiribati
143 Burundi
144 China
145 Mongolia
146 Gambia
147 Maldives
148 Papua New Guinea
149 Uganda
150 Nepal
151 Kyrgystan
152 Togo
153 Turkmenistan
154 Tajikistan
155 Zimbabwe
156 Tanzania
157 Djibouti
158 Eritrea
159 Madagascar
160 Vietnam
161 Guinea
162 Mauritania
163 Mali
164 Cameroon
165 Laos
166 Congo
167 North Korea
168 Namibia
169 Botswana
170 Niger
171 Equatorial Guinea
172 Rwanda
173 Afghanistan
174 Cambodia
175 South Africa
176 Guinea-Bissau
177 Swaziland
178 Chad
179 Somalia
180 Ethiopia
181 Angola
182 Zambia
183 Lesotho
184 Mozambique
185 Malawi
186 Liberia
187 Nigeria
188 Democratic Republic of the Congo
189 Central African Republic
190 Myanmar
Source: World Health Organization
Filed under Canadian Health Care Information · Tagged with Health System Rankings, World Health Organization
From Factcheck.org-
"Home • Ask FactCheck • A 3.8 Percent “Sales Tax” on Your Home? A 3.8 Percent “Sales Tax” on Your Home?
Posted on April 22, 2010
Q: Does the new health care law impose a 3.8 percent tax on profits from selling your home?
A: No, with very few ...more exceptions. The first $250,000 in profit from the sale of a personal residence won’t be taxed, or the first $500,000 in the case of a married couple. The tax falls on relatively few — those with high incomes from other sources.
FULL QUESTION
I received this e-mail:
This should help stimulate the Real Estate market!
UNDER THE NEW HEALTH CARE BILL – DID YOU KNOW THAT ALL REAL ESTATE TRANSACTIONS ARE SUBJECT TO A 3.8% “SALES TAX”?
YOU CAN THANK NANCY, HARRY & BARACK (AND YOUR LOCAL CONGRESSMAN) FOR THIS ONE.
IF YOU SELL YOUR $400,000 HOME, THIS WILL BE A $15,200 TAX.
Verified
Higher taxes on real estate investments. The 3.8% Medicare surtax would hit average, middle-class investors in real estate. A middle-class taxpayer who happens to sell real estate for a gain in a particular year would be liable for this new tax, regardless of how low her income might be in other, more typical years.
FULL ANSWER
We’ve been flooded with queries about this one ever since the health care bill became law. At the last minute, Democratic lawmakers decided on a new 3.8 percent tax on the net investment income of high-income persons. But the claim that this would amount to a $15,200 tax on the sale of a typical $400,000 home is utterly false.
The truth is that only a tiny percentage of home sellers will pay the tax. First of all, only those with incomes over $200,000 a year ($250,000 for married couples filing jointly) will be subject to it. And even for those who have such high incomes, the tax still won’t apply to the first $250,000 on profits from the sale of a personal residence — or to the first $500,000 in the case of a married couple selling their home.
We can understand how this misconception got started. The law itself is couched in highly technical language that only a qualified tax expert can fully grasp. (This provision begins on page 33 of the reconciliation bill that was passed and signed into law.) And it does say the tax falls on "net gain … attributable to the disposition of property." That would include the sale of a home. But the bill also says the tax falls only on that portion of any gain that is "taken into account in computing taxable income" under the existing tax code. And the fact is, the first $250,000 in profit on the sale of a primary residence (or $500,000 in the case of a married couple) is excluded from taxable income already. (That exclusion doesn’t apply to vacation homes or rental properties.)
The Joint Committee on Taxation, the group of nonpartisan tax experts that Congress relies on to analyze tax proposals, underscores this in a footnote on page 135 of its report on the bill. The note states: "Gross income does not include … excluded gain from the sale of a principal residence."
And just to be sure, we checked with William Ahern, director of policy and communications for the nonprofit, pro-business Tax Foundation. "Some home sales would see a tax increase under this bill," Ahern told us, "but it would have to be a second home or a principal residence generating [a gain of] more than $250,000 ($500,000 for a couple)."
So, again as bf notes, what does this have to do with health care? More taxes on the middle class by Obama.
Primary residences for those making less than $250,000 are exempt,which mans mst working people/families.
Did you even read it?
"CEO gets cool $44M severance package for one day of work"
How much severance would you expect after one day on the job? Not a lot, right? Well, the now ex-CEO of Duke Energy Corp., Bill Johnson, is getting up to a cool $44.4 million for his one day at the helm. Johnson had previously been CEO of another energy company that merged with Duke and signed a contract to be Duke's chief officer when the merger took effect. That was July 2. Suddenly, on July 3, he ...more resigned (though rumors speculate it was more of a firing). Either way, Johnson stands to collect $7.4 million in severance, a $1.4 million bonus and some hefty stock awards to round out the rest. A quick look at the calculator shows that's an hourly rate of $5.5 million. Not bad for a day's work.
Aww, but Phil, at first you say it was a myth, now you say "IF"... your debunking has been debunked...
Daley, a former state senator, made it happen by briefly rejoining the legislative pension plan in 1991. He stayed there just one month before returning to Chicago's municipal pension fund, but the switches made him eligible for benefits worth 85 percent of his ...more mayoral salary -- a better rate than all other city employees receive.
Hey, look at my thumb...
It's relative because of who the tax applies to.
~ Patrick Stewart, as Professor Charles Xavier
"The Doctor Patient Medical Association (DPMA) and the Patient Power Alliance (PPA) work to repeal health care reform[1] and call themselves a "a nonpartisan association of doctors and patients dedicated to preserving free choice in medicine."[2] The organization is a member of the National Tea Party Federation[3] and the "American Grassroots Coalition."[
It isn't all that different from the right creating an organisation opposes to everything the AARP supports.It's all based on deception and misinformation.
~ Matt Miller, The Washington Post
The market just hasn't noticed yet...
As for ignorance and and uneducated,what we've seen is that the opposition has made sure that it used that to assure republican opposition to the plan-stayiong on familiar territory since it's clear that as ...more people learn more about the ACA,its popularity increases (the latest polls show that Americans are evenly divided over it).
Obama will be re-elected,especially since Romney has proven to flip flop on issues,have no plan to replace the healthcare law,is ignorant of foreign policy (did you know that he has most of Bush and Cheney's advisors working for him?Sounds like if elected,we can expect a return to the era of Bush policies).
Romney is a poor choice by the republican party-s0 poor a choice that 20% of repblicans won't vote for him.Obama has appealed to blacks,Hispanics,Women and gays-all constituencies that the republicans have made sure that they alineated in the last few years.The republican party is the party of the angry old white man,and that's about all who will vote for it.This isn't the republican party of your fathers,it's been taken over by the radical right wing that is willing to hold the country hostage to get its way.It started with Reagan,but Bush made sure that the republican party would consume itself through bigotry,hatred and indifference.
And that is exactly what it did,
Well which is it, they do or don't? On the one hand you say they don't, but then you post laundry list criticisms of it. Must have been the other philathome.
That isn't a plan.
NICE!!!!!!!
LOVE IT LOVE IT LOVE IT.
Call me a raciest now Little Phil !
Another Palin.
It is refreshing that he is considering someone who is both proaffirmative action and pro-choice.
This should be interesting...
sorry,read your previous posts.It'll take more than that to convince me.
and others.