[Vision2020] Story in Chicago Tribune Oct.15, 2012

Ron Force rforce2003 at yahoo.com
Thu Oct 17 13:07:15 PDT 2013 

http://www.washingtonmonthly.com/political-animal-a/2013_10/americas_projected_deficit_is047340.php#


October 16, 2013 11:39 AM
America’s Projected Deficit Is Entirely About Health Care Costs
By Ryan Cooper
FacebookTwitterDiggRedditStumbleUponDelicious
My colleague Paul Glastris was on the McLaughlin Group the other day, and made a good point regarding the doom-and-gloom debt projections that everyone always talks about. By 2072 interest payments will consume 40 percent of the federal budget, according to the CBO! Setting aside the inherent absurdity of trying to make meaningful predictions about the federal budget six decades from now, the important point is as Paul says: these predictions are entirely about health care. The CBO’s model has a factor which assumes that health care costs will continue to grow much faster than the economy forever—which means that if we get health care cost growth under control, our deficit “problem” will vanish entirely.
The conservative reply is that the way to get health care costs under control is to simply have less health care. We must “reform” entitlements; meaning raise the Medicare retirement age, cut Medicaid, etc. We can’t afford to be generous, and some people are just going to have to go endure hardship or we’re going to bankrupt the state.
But as the Monthly has long shown, this is nonsense. In fact, the United States’ world-record health care costs are driven by a combination of policy factors, both on the private and the government side. In 2010 Mariah Blake showedhow a cabal of medical supply behemoths keep the innovations of smaller companies off the market. In 2011 Phillip Longman showed how getting Medicare out of the fee-for-service business would improve things, and earlier this year showed how a GOP effort that kept cost-benefit research out of Obamacare is harming the health care system. Finally, again this year Haley Sweetland Edwards showed how a secret committee of doctors heavily weighted with specialists fixes the prices of Medicare.
The stories are complicated, but what they all have in common is that they don’t have anything to do with cutting off people’s access. “Centrist” elites don’t seem to think that something counts as reform unless it’s punishing a poor person somewhere, but the real action is in the policy design. Health care is expensive because of inefficiency, monopoly politics, lack of research, and interest group lobbying, not because Medicare is too generous. In fact, health care cost growth has slowed considerably since the passage of Obamacare, so if the administration manages to fix its IT disaster we could be in good shape already.
Other countries manage to have both universal coverage and much, much lower costs. There’s no reason we can’t have the same.
Ryan Cooper is the web editor of the Washington Monthly. Find him on Twitter:@ryanlcooper.



On Thursday, October 17, 2013 10:54 AM, Nicholas Gier <ngier006 at gmail.com> wrote:
 
Hi Roger,
>
>
>With your example of the one nurse I believe that you have committed the fallacy of generalizing from a very small sample.  See the story from the Chicago Tribune appended below.  Premiums in Illinois under Obamacare will be lower than the national average.
>
>
>You speak of employers who will cut their workers hours but do not condemn them.  There will be only one whammy, and it won't be Obama's fault.  If they had a union they would be protected from such arbitrary actions. And your second whammy would be avoided by subsidies, which could be avoided if employers didn't cut their hours in the first place.
>
>
>You forgot to mention that many poor single people will not be eligible for Medicaid in those states where the GOP has refused to take fed's offer of extended Medicaid for three years paid at 90%. The result will be that the Red States will fall further and further behind in general health, eventually to Third World levels.  We are already below Cuba in infant mortality rates. 
>
>
>Yours for better facts and better arguments,
>
>
>Nick
>
>
>Illinois insurance exchange rates lower
than U.S. average
>
>Plans under health care law expected to provide 'fairly
competitive prices'
>September 25, 2013|By Peter Frost, Chicago Tribune
reporter
>Illinois
residents will pay slightly less than the national average for health insurance
offered under President Barack Obama's health care law, according to rates
released Tuesday by state and federal officials.
>The snapshot provides an
early yet incomplete look at how much consumers might pay in premiums and comes
a week before the launch of new insurance exchanges, the online marketplaces in
which individuals, families and small businesses can compare and buy coverage,
often with the help of federal tax credits.
>While
state and federal officials released broad details on how much those plans
might cost in certain areas, they did not release exact figures for each of the
165 health plans being sold in Illinois, explaining that rates will
not be final until Tuesday. They also did not reveal the specific copays and
deductibles that most consumers will face when they see a doctor, visit an
emergency room or undergo surgery.
>Despite that missing
information, the new data provide an important overview of the kind of options
consumers will have. The report also demonstrates that many consumers will
likely find an affordable option, though some may face higher premiums, as
critics are quick to point out.
>"We are seeing, across
the board, fairly competitive prices," said Caroline Pearson, vice
president of Avalere Health, a consulting firm closely following the rollout of
the marketplaces. "The health plans are convinced that people will buy
based on price, and they are working very hard to put low-cost products in the
markets."
>The federal analysis also
includes specific data only from the 36 states that have elected to have the
federal government run their marketplaces, including Illinois, which is
operating in a federal partnership. (Premium information from the 14 states
operating their own insurance marketplaces, including California, Maryland and
Connecticut, in most cases is available through state websites.)
>In
Illinois, the average consumer will be able to choose from 58 health plans
offered by as many as five insurance companies. In all, eight insurers will
offer plans in the state, though not all will sell coverage in each region.
>State officials were
hesitant to release even a broad overview of rates until now because federal
regulators were working with insurance companies to tweak plans and rates as
late as last week, said Andrew Boron, director of the Illinois Department of
Insurance.
>"We decided to take a
conservative approach," Boron said. "But today, what we're all really
excited to announce is that consumers in Illinois are going to have robust
options and affordable options."
>According to state and
federal data:
>•A single 30-year-old who
lives in Cook County and has annual income of $23,000 will be able to buy
coverage for as little as $69 a month next year with the help of $67 in federal
tax credits.
>•A Cook
County couple, both age 55 and with household income of $40,000, can buyhealth insurance for
$70 a month after a $463 tax credit. If that same couple lived in Peoria, their
monthly premium would be free.
>•A family of four in
Illinois with household income of $50,000 will be able to buy coverage for $84
a month after a $400 tax credit.
>The health care law
established four broad categories of coverage — platinum, gold, silver and
bronze — where premiums vary based on the amount of out-of-pocket health care
expenses consumers are required to pay.
>
>The above rates are based
on a bronze plan, the least expensive, which requires policyholders to cover 40
percent of the cost of their health care. A platinum plan has much higher
monthly premiums, but the patient share is only 10 percent.
>Illinois insurance
officials expect most consumers to choose plans in either the silver or bronze
category.
>All plans offered on the
exchanges require insurers to cover 10 basic services called essential health
benefits, including maternity care, prescription drugs, emergency services,
mental health, laboratory services and hospitalization. Insurers also must
offer plans to all applicants, even if they have a pre-existing medical
condition like cancer, diabetes or hypertension.
>"There have been a lot
of products on the market where people would find out that they thought they
had health insurance, but then they would find out that it wouldn't cover
hospital visits, for example," said Gary Cohen, who oversees the online
marketplaces for the federal Department of Health and Human Services.
"It's important to understand that, because of the Affordable Care Act,
the health insurance that people will be buying will actually cover them in the
case of them getting sick."
>Premiums also vary by
family size, income, where people live and whether they smoke.
>Some plans offered in
Chicago, for example, are less expensive than identical coverage in Peoria and
other parts of Illinois, largely because Cook County has more so-called narrow-network
plans, which limit the number of doctors and hospitals available to consumers
and tend to be less expensive, state officials said.
>A 40-year-old tobacco user
in Cook County would pay $196 for the lowest level of coverage, versus $152 for
a nonsmoker.
>Illinoisans who make
between 138 and 400 percent of the federal poverty level — up to $94,200 for a
family of four — and aren't offered qualified insurance through their employer
are eligible for federal tax credits to help offset the cost of insurance
premiums.
>To receive those subsidies,
which vary on a sliding scale based on income and age, they must buy a plan
offered on the exchange.
>Those
whose income falls below that range will be newly eligible for Medicaid, the
state-federal health insurance program
for the poor and disabled.
>The
marketplace, or exchange, is scheduled to open Oct. 1; coverage begins Jan. 1
for those who buy plans before Dec. 15. Open enrollment lasts until March 31.
Consumers who do not have health insurance
in 2014 will pay an income tax penalty next year, starting at $95 or 1 percent
of household income, whichever is greater.
>Of nearly 1 million in the
state eligible for federal tax subsidies to help offset the cost of buying
insurance, state officials expect only about 337,000 to purchase subsidized
coverage in 2014.
>While
both reports lay out the broad strokes of how much coverage will cost, the data
do not include the size of an insurer's network
of providers like doctors, specialists, health centers and hospitals.
>"Everyone
wants to do the political thing and talk about rates,
but no one knows what you're buying yet," said Rich Fahn, president of
Excell Benefit Group in Northbrook. "Just providing the premium is giving
an incomplete picture."
>Fahn and
Jim Smith, a senior vice president at the health care consulting
firm The Camden Group, said the lower premiums on the exchange-based insurance
products likely indicate consumers will have more limited access to certain
physicians and hospitals than those covered under more expensive,
employer-based plans.
>"Carriers are putting
together smaller networks to squeeze bigger discounts out of providers,"
Smith said.
>While state and federal
officials acknowledge those concerns and said some of the plans offered on the
exchanges will have narrow networks, they say all plans were subject to state
and federal requirements that ensure an adequate selection of providers.
>"We feel comfortable,
as do the feds, that the networks are sufficient," Boron said.
>Tribune Newspapers reporters Ameet Sachdev and Noam Levey
contributed.
>pfrost at tribune.com
>Twitter @peterfrost
> 
>
>
>
>On Thu, Oct 17, 2013 at 10:24 AM, lfalen <lfalen at turbonet.com> wrote:
>
>Sunil
>>I think you are right. All government employees(Federal, State and local) have employer sponsored health insurance. So do most of those who work for larger companies. Obamacare would cover those who cannot afford insurance and those in the low income brackets. The potential problems are that some companies will convert some employees to part time. They will be hit with a double whammy. Getting insurance on their own will is most cases cost them more and they will have a reduced income to pay for it because they are now part time. Older folks and the disabled can get Medicare. the Indigent get Medicaid. Some of the money to pay for Obamacare is to come out of Medicare. Just how or where, I do not know.  I pay a little over $100.00 per month for Medicare and $66.33 to the University for Part D and Dental, which Medicare does not cover. My doctor and has just quit taking Medicare. I assume this means I will have to change doctors.
>> 
>>Roger
>> 
>> 
>>
>> 
>>
>>
>>>________________________________
>>>-----Original Message-----
>>>From: "Sunil Ramalingam" <sunilramalingam at hotmail.com>
>>>Cc: "vision 2020" <vision2020 at moscow.com>
>>>Date: 10/15/13 17:27
>>>Subject: Re: [Vision2020] Story in Chicago Tribune Oct.15, 2012
>>>
>>>
>>>Wayne,
>>>
>>>If they are not covered under the Act, isn't it because their insurance is covered as an employment benefit? Isn't the same true for University of Idaho employees?
>>>
>>>Or am I wrong about this?
>>>
>>>Sunil
>>>
>>>
>>>
>>>________________________________
>>>From: bear at moscow.com
>>>Date: Tue, 15 Oct 2013 17:15:59 -0700
>>>To: lfalen at turbonet.com
>>>CC: vision2020 at moscow.com
>>>Subject: Re: [Vision2020] Story in Chicago Tribune Oct.15, 2012
>>>
>>>
>>>Roger,And this is a surprise ?
>>>Why do you seriously think that neither the White House nor Congress is part of  "Affordable Health Care"?
>>>
>>>
>>>Wayne
>>>
>>>
>>>
>>>
>>>
>>>
>>>
>>>
>>>
>>>
>>>
>>>
>>>
>>>
>>>
>>>
>>>On Oct 15, 2013, at 5:08 PM, lfalen wrote:
>>>
>>> 
>>>>
>>>>Adam  Weldzius, A Nurse Practitioner is privately insured. His monthly insurance premium  of $233(deductible of $3,500) will more than double.  For the same coverage his deductible will be $12,500.
>>>>A Tribune analysis shows that 21 pf the 22 lowest plans on the Illinois health exchange for Cook County would have annual deductibles of over $4,000 for individuals and $8,000 for family coverage.
>>>>People who have health insurance threw their employer have an average deductible of $1,100 according to The Kaiser Family Foundation.
>>>> 
>>>>This is from a story in the Chicago Tribune. They are not my figures.
>>>>Roger =======================================================
>>>>List services made available by First Step Internet,
>>>>serving the communities of the Palouse since 1994.
>>>>              http://www.fsr.net
>>>>         mailto:Vision2020 at moscow.com
>>>>=======================================================  
>>>  
>>>======================================================= List services made available by First Step Internet, serving the communities of the Palouse since 1994. http://www.fsr.net mailto:Vision2020 at moscow.com =======================================================
 
>>>________________________________
>>>=======================================================
>>>List services made available by First Step Internet,
>>>serving the communities of the Palouse since 1994.
>>>              http://www.fsr.net
>>>         mailto:Vision2020 at moscow.com
>>>=======================================================
>>=======================================================
>> List services made available by First Step Internet,
>> serving the communities of the Palouse since 1994.
>>               http://www.fsr.net
>>          mailto:Vision2020 at moscow.com
>>=======================================================
>>
>
>
>=======================================================
>List services made available by First Step Internet,
>serving the communities of the Palouse since 1994.
>              http://www.fsr.net
>          mailto:Vision2020 at moscow.com
>=======================================================
>
>
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://mailman.fsr.com/pipermail/vision2020/attachments/20131017/091bb3c6/attachment-0001.html>

More information about the Vision2020 mailing list