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Obama's health care plan?

Someone explain to me how forcing people who are already poor to buy insurance (which I suspect will not offer much) is a big win for anyone besides the insurance companies? I'm sorry to have to ask, but from way over here it's been hard to follow this story as closely as I should given that Tiger Woods has received far more coverage.



( 24 comments — Leave a comment )
Mar. 22nd, 2010 08:21 am (UTC)
I'm more impressed with forbidding the insurance companies from dropping people who are ill, and from refusing to insure people who are ill. (As long as that doesnt just mean the price goes up impossibly high).

Some of the insurance companies have been downright evil over dropping people who are HIV+, for example - they've been fined for it, but the fines are tiny compared to what they get away with.

I havent been able to see the details of the insurance for all provision - in theory, in the UK you have to pay insurance (National Insurance), but the devil is in the details of course.
Mar. 22nd, 2010 09:39 am (UTC)
I think the points are:

1) if they get insurance, they are more likely to get treatment when they are ill, and therefore more likely to be able to return to the workforce;
2) if people who aren't insured do get treatment anyway they distort the prices for those who are insured;
3) Medicaid is being expanded to cover more of the very poor, who therefore won't have to pay extra

Of course the real answer is, unless you have a single-payer system or some other universal healthcare system, the people with least power are likely to be the ones whose interests come last in any interim reform.
Mar. 22nd, 2010 09:51 am (UTC)
I'm confused because I've got friends who are unemployed and have had to drop their insurance because they can't afford it anymore. So how does this help them pay rent, buy food AND take care of their insurance? A fine makes it cheaper?
Mar. 22nd, 2010 10:03 am (UTC)
Low income doesn't pay.
Mar. 22nd, 2010 11:31 am (UTC)
It just sounds on the face of it like a giveaway to the insurance companies, so they make even more money. And I wonder how low the low income is. Shall have to research. If people still have to sell their houses to pay insurance premiums than it's still a broken system.
Mar. 22nd, 2010 12:01 pm (UTC)
Um... how can exempting low paid people from paying this possibly be a giveaway to the insurance companies? Incidentally the insurance companies are forced to insure people with pre-existing conditions.

In my opinion, the scheme is in the interests of the low paid and it should be a moral obligation for the high paid. It dismays me to find anyone is against this.
Mar. 22nd, 2010 01:10 pm (UTC)
And who are you dismayed by? Like I said, I don't want a giveaway for the insurance companies, and I'm going to dig to have to find out what the financing is, if the insurance people are going to be forced to buy is actually going to help or just leave them broker than before. There are all sorts of inadequate health policies out there already and forcing people to buy them isn't going to make things better for anyone other than the insurance companies.
Mar. 22nd, 2010 10:03 am (UTC)
Um... because health care for all is an incredibly important goal? Because America has a really shocking record on health at the moment. Because this system is the nearest to a humane health care system that the US population seem willing to allow themselves?

Just looking at the opposition to this bill has me shaking my head and wondering.

Oh, and incidentally, if you are on low income you don't have to pay.
Mar. 22nd, 2010 06:25 pm (UTC)
Who gets to decide "low income" and does it take into account that you can be earning minimum wage in SF, be _way_ above the national poverty line (mostly set by places like Boise), but still can't pay rent and buy food. Actually, that was true when I was making about $4/hr more than minimum wage.

It's not a question of "why are people happy that we have healthcare reform?" it's "why are people happy that we have _this_ healthcare reform?"

And yes, I understand that it's good for society as a whole, but if you still can't afford to get health insurance and then they _fine_ you for not having insurance, well, that's a Poor Tax and trust me we already have too many of those.

So knowing the specifics of how this is going to impact people makes a difference.
Mar. 22nd, 2010 07:04 pm (UTC)
I know there are a number of people who oppose this because they want something that goes further... it's just like that song "can't get there from here". See it as a first step on the way. Yes with any law you can find some specific group that might hypothetically be worse of but you don't have to look at all far to find hundreds of thousands who will be much better off.

So, pass the legislation and in a few years when people realise "good lord, it isn't the communist Armageddon after all" then alter it a bit more include a few more people, raise the limits for what counts as not getting health insurance. Opposing it because it's not perfectly the health care reform you would ideally want is hugely counter productive in a country where 40% of the people seem to think that nothing at all needs to change about health care.

That's why it really gets my goat when people are insisting on seeing this this as "forced" and "have to pay a fine"... you already have to pay taxes to support much less important things. I'd happily pay a lot more tax for our NHS because it's simply damn good even though I am "forced" to pay and if I don't pay then I would (in extremis) be sent to prison for not doing so.
Mar. 22nd, 2010 07:16 pm (UTC)
I also think it's poor form in a democracy to accept anything blindly as good because it's being sold with a name that you think means something different from what it is, I.e. "nochild left behind" and "homeland security." The devil is in the details and it's inexcusable to not examine them thoroughly. In fact, it's an obligation, as a good citizen, to do so.
Mar. 22nd, 2010 07:18 pm (UTC)
I think you can claim many things about this legislation but "accepted blindly" is not one of them. For me it's an absolute no brainer to pass this but it seems to have been examined with the thoroughness of a salad you've been assured has a slug in it.

Sad really -- I think in current America the New Deal would be thrown out as dangerous socialism.
Mar. 22nd, 2010 11:41 am (UTC)
Paul Krugman explains this well, and repeatedly, on his blog. The mandate has to be there to stop the market from imploding when insurers are barred from refusing people - if it isn't then 'healthier' people opt out of insurance, raising the average, which leads to more people at the healthy end opting out, which raises prices further etc. But in order for a mandate to work, there has to be financial support for people who simply haven't got the money. Which there is.
Mar. 22nd, 2010 12:03 pm (UTC)
Exactly... that is one of the things so iniquitous about the current US healthcare system. At the moment the US healthcare system is only useful if you never get seriously ill.
Mar. 22nd, 2010 01:11 pm (UTC)
I haven't been reading Krugman's blog, just his editorials, and not all of them. He's a good economist, though.
Mar. 22nd, 2010 01:24 pm (UTC)
There'll be subsidies available to families with incomes of less than $88,000. I imagine this is a on sliding scale.
Mar. 22nd, 2010 03:21 pm (UTC)
Mar. 22nd, 2010 07:23 pm (UTC)
But will it work for you?
Given your personal situation, I am particularly interested in your opinion. What do you think?
Mar. 22nd, 2010 03:26 pm (UTC)
As a "needs health insurance to live" person, let me just say that while I'm not happy with the way it was passed, I'm breathing a little easier knowing that it did. The main benefit of the "everybody must have insurance" law is that the health insurance companies should then have a big enough member pool to spread out the costs of covering those who use insurance most. Like, say, me. I'm really glad to see the insurance exchanges being created too, because now those who are in the individual market due to lack of coverage through their work have very few places to go to shop for coverage. In washington state, there are THREE insurers who will do individual policies, and that's it. When it's too expensive for them (say, more than the cost of paying out of pocket for a couple doctor appointments per year), healthier people will just opt to go without. Meaning that only the sickest people are those who purchase individual coverage. And the insurance industry only gets the power to negotiate good treatment rates when they have a large pool to bargain with.

If you're interested and have a couple hours of free time, NPR did a FANTASTIC 2-part series about the US health care situation last fall. I think it was on All Things Considered.

Edit: Just found the first of the two shows. http://www.npr.org/templates/story/story.php?storyId=112440591
Mar. 22nd, 2010 04:06 pm (UTC)
iirc, there's also a limitation on the profit margin of insurance companies now. Combined with subsidies for poor people. Keep in mind that if we went to single payer that cost goes up in the form of taxes instead of mandated insurance. The newly passed bill is a somewhat less efficient way of doing the same thing. But the political reality here is that we couldn't go directly to single payer.
Mar. 23rd, 2010 07:32 am (UTC)
You're right. First steps and all.

Will it lead to large employers ceasing to offer health insurance?

Edited at 2010-03-23 07:33 am (UTC)
Mar. 23rd, 2010 07:36 am (UTC)
I know there was some worry about that. I don't recall anything on the economics of that question to be able to form an opinion on it.
Mar. 22nd, 2010 04:07 pm (UTC)
Because the Democrats, despite having a majority, actually got something done. That's how it's a win for someone other then the insurance companies.
Mar. 22nd, 2010 06:15 pm (UTC)
If your insurance is more than 8% of your income, you get government subsidized insurance.

But yeah, it's not like car insurance where, if you can't afford it you can choose to not drive.
( 24 comments — Leave a comment )


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