Dems: GOP rollback of HCR would increase the deficit.
 

The nonpartisan Congressional Budget Office (CBO) just released an estimate of the Republican bill to repeal the Affordable Care Act and finds the GOP plan explodes the deficit and will have a devastating impact on the health of millions of Americans.

According to CBO, here’s what the GOP repeal bill means for Americans:

Adds $230 billion to the deficit over the first ten years and more than $1.2 trillion in the second decade (around one-half percent of GDP)

32 million Americans will lose health coverage

Americans will get fewer health benefits for their money

Americans purchasing health insurance on their own will see their costs rise

Health care premiums for Americans getting coverage through large employers will go up

http://www.democraticleader.gov/blog/?p=3308

That's nice and all but they don't have the senate and the house or enough votes in either to override a veto, so this is all just bull anyway.

Not as crass as how you put it, but the cost at large cap companies have already gone up with the passage of the bill, and the companies have already passed it on. Repeal will do no such thing. This is for many companies an excuse to not offer as much in terms of cost in relation to coverage and place the blame elsewhere.

that's from the letter. i doubt that the GOP or Speaker Boehner will consider anything the CBO has put forth until their detailed estimate comes out. the letter was cc'd to one of my senators, Mitch McConnell, and i doubt he'll even read the letter, let alone entertain any notion that the democrats might have a better plan.

that said, i'd just as soon there be no movement on H.R. 2 until the detailed analysis and budgetary impact are released. but i like the contrast in the names of the bills:
...............H.R. 2, the Repealing the Job-Killing Health Care Law Act
.................................................. .......vs
...............Patient Protection and Affordable Care Act (PPACA, Public Law 111-148)

http://reason.com/archives/2009/12/08/the-gatekeeper/1

I don't personally like the corporatist bill that was passed. But I doubt the Republican plan is much better.

I wouldn't want a law passed or rejected based on the estimates coming from the CBO. CBO is always off. Like way off. Look up their past projections VS actual costs for Medicare. The real costs ended up tens of billions more than the projections.

Not having a fix to healthcare obviously does cost us all. Who do you think pays for all the free care that is provided to people right now in ERs all across America? ERs cannot turn away anyone, no matter what their insurance status. When hospitals can't collect from patients' without insurance and no ability to pay (including illegal immigrants that everyone was so interested to make sure were not included in any healthcare plan, btw) they pass that cost on to the rest of us through increased fees to self-pay patients and to health insurance companies. This means that health insurance companies then increase their rates. There is no free lunch. And you don't even get good care at the ER since there is not continuity of care and many ER facilities are overrun with patients meaning they have excessively long waits, and patient care suffers.

You're right, there is no free lunch( unless of course you're one of the people mentioned who don't pay for their healthcare). When ObamaCare goes into full effect I'll be subsidizing the people who can't afford to buy their own insurance thru higher premiums and potentially higher taxes. If ObamaCare is repealed, I'll still be subsidizing the un-insured via higher insurances premiums and higher medical costs. To be honest, it kind of makes me apathetic to whole issue.

Actually, it would be better to have people insured going to see primary care providers who can take care of problems before they get out of control rather than to provide emergency-only medicine as the alternative. ER visits are the most expensive type of medical care we have in our system. It is much more expensive than providing everyone with standard of care preventative care because we don't then bill them by the minute. The two options are not equivalent even though you are still paying for the same people.

AMEN!!! Great post :)

What most people don't realize is we are already paying for much of the healthcare for uninsured people!

I disagree

I think a lot of people realize that we are covering the uninsured and its because of that fact they wonder, "what's the point?". Why reconstruct the healthcare industry when something like opening up eligibility to Medicare would seem like a better solution to dealing with the uninsured. We also can't assume that people WILL take preventative care or see a primary care physician (do they still exist?) VS a hospital or an urgent care if they have any health issues. I'm insured, but I haven't been to an actual Dr.s office in YEARS, but I have been to the hospital/urgent care several times.

I love the Urgent Care places too!

Hopefully if they are able to offer people lower cost private insurance plans, and large employers have to expand their benefits...more people will have privatized heathcare, as opposed to none or Medicaid. An HMO is totally different than free services because people will have to adhere to the rules of an insurance plan. Which means use your benefits wisely or else be charged for what you've used. But maybe I'm an optomist, who knows?

Either way, I think reform is inevitable.

Why do you do that? Probably because you are young and healthy. Many people who aren't insured would actually like to go to a regular doctor because they aren't so young and healthy and would actually benefit from preventative care. For a lot of problems, they get little help from the ER. High blood pressure, diabetes, etc are poorly controlled in an ER management setting, and the end result is renal failure needing dialysis, heart attacks, heart failure and strokes. Many of these people end up costing us more in disability payments when they can't work because they are completely decompensated by their congestive heart failure, etc. This is one example of why ER care is inappropriate for anything other than EMERGENCIES. It also prevents people who really need emergency care from getting prompt care if the waiting room is full of people who need a prescription refill or treatment for an ingrown toenail or a runny nose or a headache last week that went away after ten minutes (don't laugh, it happens.) These people get seen for 10x the cost of the same visit at a primary care physicians office (and yes, these guys still exist-- some of them are actually struggling to find patients in this economy.)

If you had my insurance, you would be required to see your primary care doctor at least once per year and get specific tests done annually or else you'd have a huge annual deductible and extremely high co-pays. You would re-think that hospital/urgent care visit because the co-pay is 5 times as much as going to your primary care.

As someone pro-single-party health care I support opening up eligibility to Medicare for all. Rep. Anthony Weiner, NY is in favor of this idea and I'm a fan of him too. But people are even more against that because of the spectre of socialism and death panels.

Your insurance company is smart.

My new coverage requires NO co-pay for preventative care at all. More of the carrot than the stick of AGDee's but it's very encouraging.

Our preventative care visits are also free. However, the pediatrician won't bill any of my daughter's visits as "well child" visits because she has asthma so it is always billed as asthma care since it always has to be addressed. That irks me a little.

This is a gradual thing they are implementing, with different pieces of it true in different years, but by 2013, we will have the following requirements to get the "cheap" healthcare:

1) Blood pressure below 140/90 or, if diabetic, 130/90
2) Non tobacco user
3) BMI less than 30 (not in the "obese range") or have lost 5% of your body weight since your last annual visit
4) Fasting blood sugar <120 or A1C <8 (the A1C is if you're diabetic)
5) Cholesterol: Acceptable LDL-C level, which, I believe will be below 159.

And, your spouse or domestic partner must meet all the requirements as well. Children are exempt.

It has caused quite an uproar, honestly.

I don't like that, there are a lot of reasons why you can't control some of that. And hard and fast lines are not necessarily reflective of actual health. I understand their reasoning, and I'm not sure I have a better measure of health myself, but I wouldn't be thrilled by it. (Which is why I'm pro single-payer. If you put everyone in the same pool you distribute the risk.)

Which is why it has caused an uproar. Add to it the fact that our employer owns the HMO and people are claiming conflict of interest, concerns about HIPAA, etc. Here I sit with Crohn's Disease, which will cost my insurance company a lot over the years, if I stay with them, yet my co-worker with uncontrolled diabetes will be paying the big bucks. As I said, they are phasing it in. Last year, we only had to agree to follow our doctor's treatment plans for these conditions. Each year the requirements become more stringent.

Last year, when they were first giving us information about this plan (with NO hint of it getting more stringent), I went to an info meeting and asked for information on the deductible and increased co-pays. The representative said "Why? You don't have to pay those, just follow these steps". That really ticked me off...lol. I said "What if I have a spouse who will refuse to quit smoking?" He replied, "Just show him how much more it will cost and he will quit." :rolleyes: I said "I was giving you a hypothetical but if you think that those increased costs will get a smoker to quit, you're wrong. Cigarettes now cost %600 more than they did when most adults started smoking but they are still smoking." He said "But smokers cost us a lot of money." I said "I quit smoking a year ago so this doesn't apply to me BUT, I was never in my life treated for a smoking related illness." He said "But if you kept smoking, you would eventually." I pointed out to him that the minute I'm that sick, I'll be on disability and no longer employed by that system and, therefore would not HAVE their insurance anymore. He didn't know what to say to that. Sorry but, my employer's HMO isn't paying for any really, really serious disease of mine.

Uncontrolled diabetics are more likely to cost your insurance carrier more over time than a single patient with Crohn's disease. I think the idea is a good one, but unfortunately, like the weight, there should be some phase in. If you have an A1C of 10, a decrease of 1 point each time you come demonstrating progress is helpful. Patient's don't do well with all or nothing. Saying they must be Less than and A1C of 8 to get the benefits is tough, especially if you are giving the obese a way to keep their lower rates by decreasing their weight over time. The whole point is to encourage improved health over time. For those who can't control it, there are medications that when taken (like for cholesterol) will bring them into those ranges.

I think what we all found most interesting was the blurb written before the detailed requirements for the upcoming years, which said "We are informing you of these changes now so that you can plan for the financial impact." NOT "So that you can work on your health improvements" ...LOL. Duly noted Employer Sir!

Ideally medication would solve that, but not always. I don't know how reasonable the numbers are, but my mom has HBP, the only thing that has actually lowered her BP was a low-carb diet. She's tried everything, but staying low carb dropped her weight, her BP and her cholesterol and has kept it there. Someone who is trying to figure out WHY their numbers are high and a successful treatment hasn't been found for that individual yet is going to be rather unfairly punished. So would someone who is an outlier and is incredibly healthy despite not falling in those ranges.

Yes, but it is in the best interest of the patient and definitely in the best interest of cost containment (the only interest of the health insurance company) to control these variables which are all markers of future complications. HBP, Diabetes, cigarette smoking and cholesterol are all risk factors for heart disease, stroke, renal disease, peripheral artery disease, which are the biggest preventable costs in health care. Cancer, genetic diseases, auto immune disease, etc are pretty much uncontrollable risks for the insurance companies. If your patient population can't decrease their controllable risk factors, then they potentially cost the company more money. It's one of the ways to distribute cost while also improving health. It came into vogue earlier this decade. Who knows how well it works. Haven't really seen any data, but it puts some of the responsibility of health back with the patient. AGDee's insurance scheme seems a little harsh to me, though.

Yeah as I said, I get it, but I'd argue that those factors are not always controllable. In general they are, but not for everyone.

And they don't care. It's all the bottom line.

In the end, I think we are essentially on the same page about HCR, Drole.

My mother has been struggling to control her type II diabetes since she was diagnosed with it nearly 10 years ago. First the doctor and dietitians worked with her on controlling it just with diet. She made a ton of progress, lost a lot of weight, eventually retired (which happened to also improve her health), but even after all that work, her blood sugar readings and organ functioning tests still aren't good enough. So now she's finally on insulin...after all this time. Diabetes is extremely hard to control, even with medication. And to punish people for trying to control it is WRONG. Since your company owns the HMO I'm sure they know what happens to their employees when they don't treat their diabetes.

I would be furious if my company went with an insurance plan with a list of qualifications like that. Pretty much the only group of people that qualify for those low rates are young employees, since high blood pressure, high cholesterol, weight gain and diabetes are common in older demographics.

I feel the same way emotionally about it, honestly I do, but I understand the overall rationale also. For every other type of insurance, higher risk factors make your insurance go up but this has not been true of health insurance. If you have tickets, drive a certain type of car (high theft risk) or drive a lot of miles for your work, live in a certain area.. your auto insurance rates go up. If you live far from a fire hydrant and fire station, in a shady neighborhood, or if you are a smoker, your home owners insurance goes up. If you make frequent claims on either, your rates go up. We are used to that and never complain about it. Should healthcare be different? I was spitting nails when they first announced it, and when they released all the increases in expectations over the next few years too.

I believe this is a trend that you can expect to see grow. Blue Cross in this area started it with their Healthy Blue Living plan. Then our system's HMO picked up on it and implemented it. It started with us getting a bonus if we completed a health risk assessment and did some online educational modules that addressed the areas where we were lacking. The next year, we had to do the risk assessment, complete a module and see our PCP once and do our annual screenings (pap, mammogram.. nothing for men, I might note) to get the bonus. Then they switched it to "You have a $1000 deductible and your co-pays are doubled but you can stay at the same old rates if you do..."

THIS is also the reason I'm against a single payer system. I believe competition among health insurers is important in helping keep costs down and giving consumers a choice. I would like to see this totally removed from the employer though. When you work for an employer that owns a HMO, guess what insurance you get? We have the option of Blue Cross, but it is so incredibly expensive in comparison that nobody can afford it, except maybe the doctors/PhDs. I would like to see employers give health insurance vouchers that are good for the insurance of your choice instead of giving you the options that they choose and that are cheapest for them.

Also new this year is that we can only use system pharmacies to fill our prescriptions or they will not be covered. We used to get significant discounts if we filled a 'script at a system pharmacy but now it's required. There are a couple exceptions, like urgent medications such as antibiotics needed, so you don't have to drive in to work to fill your prescription when you have pnuemonia. We can fill 3 prescriptions over our LIFETIME at another pharmacy. So, if you're on vacation and you run out of meds, you can get it filled elsewhere. But only 3 times.. lifetime.

I understand the idea of supporting the system you work for.. the "I work at Ford, I drive a Ford" mentality and I very well might do that anyway, but I want a choice, especially since 70% of my co-workers have access to my health information.

Also Peppy, African Americans have significantly higher rates of hypertension demographically.

On the flip side, there are several people in my department who have become motivated to lose significant amounts of weight. It may be most effective among that group. I was a little peeved that I lost my 58 pounds right before this went into effect..lol. I gained some when I broke my foot earlier this year. I'm trying to get down now to the weight I was the last time I saw the doc so that I'm breaking even for this year. Interestingly, some co-workers have been overheard talking that they are going for exactly 5% of their body weight each year because they are afraid if they lose too much in one year, they won't be able to qualify the next year. Losing 10 pounds a year sounds reasonable to them. I'm taking the opposite approach, I just want to get to the acceptable range this year so I don't have to worry about it anymore. I wanted to do that anyway :)

The folks in D.C. who kept the tax cuts for the wealthy whilst extending unemployment benefits from ridiculous to ludicrous length are complaining that something might negatively impact the deficit?

Not sure which articles you were reading, but everything that I read indicated that the original bill by the Dems did NOT include those tax cuts for the wealthy but that one failed because the Republicans insisted that they'd only vote for it if it included an extension of all the Bush tax cuts, not just the ones for the middle and lower class.

Additionally, the Republicans argument for rolling this back is that the plan itself would increase the deficit too much. This is the counter argument that rolling it back would increase it.

Lastly, the title of this thread is actually not very accurate because it wasn't the Dems who said this, it was the CBO:

You're looking at this wrong. No one is punishing anyone. The company is combining a group and individual insurance policy method. To give you an example, I have chronic migraines. Recently I had to try to buy medical insurance on the individual market in Arizona. I was turned down by every single carrier in the state despite having $1000 a month stipend from my employer to pay my premiums. $1000! If your mother tried to buy insurance on the individual market, she would be uninsurable. The only reason she has insurance is because she has group insurance. The other employees could argue that she is punishing them with higher premiums because of her bad health. The company has made the decision to split the difference and give small breaks to people who meet specific markers and increase premiums for people who don't. Is it fair? What is fair? While I wish that I could get an insurance policy, I can understand why no one will insure me. When and if I get an individual policy under HCR, it will cost my an arm and a leg. I also know how much it costs to insure a poorly controlled diabetic on insulin, whether or not her poorly controlled state is all "her fault." In the end, we both still cost a lot to insure.

I'm becoming more and more convinced that frodobaggybutt and madmax are the same.

I still disappointed with frodo. I thought we understood each other. He posts repetitive comments about accepting Jesus, we utterly ignore him... those were the happy times.

Now I know he's a freeper.

So the Dems and Reps combined to select the least responsible option of all. Bravo to both of them.

I'm starting to suspect that he's also one of live-in's crazy family members. I guess we won't know for sure until he calls me a lefty libral Palin-hatin' feminazi that thinks wimminz should be paid more than men though.

It really would be nice if you could get past the one line zingers and tell us how you would do it if you were the ruler of the world instead. These one liners are the epitome of what is wrong with politics. Everybody has an insult, nobody has a suggestion on how to do it differently.

What is the most responsible option in your opinion?

She was asing Kevin. No one cares what you think.

Ok am I the only person who wonders exactly how he expects us to deport United States Citizens? Max, if you hate African AMERICANS so much, why don't you leave yourself to a country that has less of them.

We're still arguing with MM, huh?

Thank you :)