Real Healthcare Reform in 2 Sentences (vs 1502 pages). . . . . .

[Faryn Balyncd]

Standing at a crossroads, we see the basic problem with the Baucus bill is not its 1502 pages of lobbyist obfuscation, but that it takes us down the wrong path. It moves not towards, but directly away from, Medicare-for-All.

Expanding Medicare is not only the will of most Americans, not only what Howard Dean says we must do to deliver true reform and avoid catastrophe in 2010, but has even been suggested as an alternative worthy of consideration by a leading Blue Dog. . . . . . . . . . And Robert Reich warns that insulting the American people with corporate welfare dressed up as “reform” will have a price that will “fall like an avalanche on middle class Americans” and “mean an ugly 2012 election”.



Our current system both forces insured Americans to pay excessive administrative costs, but then shamelessly charges those denied insurance 250%to 600% more than insurance companies pay for the same service.





Is the problem of explosive costs, brazenly discriminatory and opaque pricing, and predatory insurance exclusions really too complex to address? . . . Here’s a one sentence proposal:

1. Comprehensive medical care under Medicare shall be offered to Americans younger than 65 at a community rated premium, based upon revenue-neutral actuarial studies & Medicare provider rates.

But since insurance companies would like nothing better than to continue to overcharge low risk groups, and dump the sick into the public plan (thereby driving up the premiums for the public plan), a second sentence is needed:

2. All entities, public & private, which sell health insurance policies, must offer Open Enrollment using community ratings for premiums (no pre-existing condition exclusion).

The essence of this 2 sentence proposal is that addresses the fundamental problem of excessive, discriminatory, and opaque pricing that now corrupts our healthcare complex.

It does so by use of Medicare provider pricing (which happens to be the price the insurers with the biggest clout frequently demand of providers).

And, if insurance companies are to compete, it forces them to do so by actually providing value, rather than by scheming to deny payments retroactively or exclude sick patients from their plans.

It offers needed relief to millions of middle class Americans who are one illness away from bankruptcy, and for American industry that is struggling to compete internationally, and unable to employ our workers.





But there is a problem with this proposal:


It does not address the Americans who cannot afford to purchase a plan, even a plan with premiums based upon Medicare provider rates.

Notice, however, that while President Obama has set a goal of $900 billion for the cost of health reform, that the above 2 sentence plan costs the taxpayer, and the U. S. Treasury, exactly nothing.

If Americans are offered the opportunity to buy in to Medicare pricing for a revenue neutral premium, it will force significant belt tightening by insurance CEO’s, and by many, including myself, in the medical profession. But, to the extent that premiums for younger Americans are actuarially set at a revenue-neutral price, such changes will cost the taxpayer, and treasury, exactly zero.

And that will leave $900 billion dollars available for plans to help needy Americans who cannot afford to purchase a Medicare buy in. . . . and, with the Medicare buy-in option available, that $900 billion will buy a lot more insurance for the poor than in the Baucus plan.

What the Baucus plan does is precisely the opposite: The Baucus plan uses the $900 to try to buy insurance for our most needy from our overpriced, inefficient and corrupt insurance industry, while mandating that middle class Americans buy rapidly rising insurance many already cannot afford. The Baucus plan, while making an attempt to place more of the needy into inefficient private plans, plan leaves the middle class, and struggling American industry, facing the avalanche of unaffordable, mandatory insurance. And our Democratic Party facing failure and rejection.





"Two roads diverge in a yellow wood……"







:kick:

[CaliforniaPeggy]

1. Finally, a voice of reason.

K&R

[clear eye]

2. K & R

:kick:

On edit--just added you to my "buddies" so I can keep up w/ your posts. Thanks for the info included.

[Ms. Toad]

3. You would need to beef up the second sentence

it doesn't really require guarantee issue.

As written, it probably requires them to charge community rates for anyone the choose to accept - without setting the rates based on pre-existing conditions. It doesn't require them to actually issue a policy to all who apply.

An additional problem is that the second provision would still permit capping payouts - another way of forcing costly patients into the public option and driving up those costs while lowering private insurance rates.

Other than that, it's not a bad idea.

[Faryn Balyncd]

4. You're right. It should specify "Open Enrollment" with community premium rating.

(added in edit)

Thanks.

[Faryn Balyncd]

5. .