Coakley vs. Brown

[KDAngel]

So glad to see this thread. I worked for Brown via the RNC up in MA, and despite having worked on dozens of other elections this was by far the most exciting one to date.

5 days out I kept saying, "I think we have it. Of course it's MA and I could be completely wrong, but omigosh, I think we have it."

Proudest political moment to date thus far.

[KSigkid]

Originally Posted by bignasty

Is that like a New England Republican?

Haha, interesting counterpoint, although there are a LOT of Republicans in New England. Even in the Democrat-heavy areas, there are a lot of fiscally-conservative Dems (i.e. for low taxes).

Originally Posted by KDAngel

So glad to see this thread. I worked for Brown via the RNC up in MA, and despite having worked on dozens of other elections this was by far the most exciting one to date.

5 days out I kept saying, "I think we have it. Of course it's MA and I could be completely wrong, but omigosh, I think we have it."

Proudest political moment to date thus far.

That's awesome that you worked on the campaign. I'll shoot you a PM, I know a couple of people who've worked on his state and US Senate campaigns.

[AnchorAlum]

So interesting that I can come on this site and find what's basically a very good discussion that reveals a spectrum of thought and opinion - and glad to find it, by the way.

I think that the angry poster - nasty? - has some positions that hold merit. It's just that it's conveyed in a manner that's not conducive to getting folks to agree. Seems to lead to just shouting noise past the other's ear.

Health care provided by the employer was one of the ways a company could gain the loyalty of an experienced work force, back when jobs were plentiful and there was real competition for you and I to join one company over the other.

How many of us are old enough to have heard our parents or even our peers (if we're of a certain age) say that they would leave XYZ but that they couldn't get a job anywhere else that matched the benefits of their current employer?

Can you imagine an auto worker leaving their job to go into another field with an HMO that the rest of the industrialized world is familiar with? I lived in the Detroit 'burbs for a few years and sat in waiting rooms, watched patients check out at the window and pay next to nothing for their care, while I paid a co-pay that was more in line with what everyone else outside of the UAW universe paid.
If you saw that on a regular basis, you'd understand what a "cadillac" plan is.

Now I have private insurance, for which I pay about $8500 a year. I have a $2500 deductible, yet the proposed plan determined that I had a "cadillac" plan for which I'd have to pay taxes. I can assure you, at my age, with private insurance, many of those in my age bracket pay that much for insurance. (My employer gives me about half of that to help with the premiums, and if I raised my deductible to $5000 it would drop my premium by about $1800 a year)

One of the things that always seem to be absent in these comparisons to European plans is that their governments have much higher tax rates than the US, and they don't have the tort situation we have, and moreover, they don't spend the billions and billions we've obligated ourselves to militarily to defend....the Europeans. Sure frees up dollars to spend on other things, like health services.

Now, as to illegals being in the US and some - gasp - having jobs, I have two things -
number one, that's changed a good bit. Otherwise, they have jobs that Americans should have to reduce our 10% unemployment rate. Secondly, if they do have jobs, it doesn't matter. The conversation should stop at the word illegal. Otherwise eliminate the world illegal. Either it means something, or it doesn't. Change the law or observe it.

That's my two cents. Carry on.

[PiKA2001]

Originally Posted by AnchorAlum

Can you imagine an auto worker leaving their job to go into another field with an HMO that the rest of the industrialized world is familiar with? I lived in the Detroit 'burbs for a few years and sat in waiting rooms, watched patients check out at the window and pay next to nothing for their care, while I paid a co-pay that was more in line with what everyone else outside of the UAW universe paid.
If you saw that on a regular basis, you'd understand what a "cadillac" plan is.

They want to exempt unions from the cadillac plan tax for the first ten years of this gaggle. I think its bullshit that I have to pay a higher tax because I choose to participate in a high option plan but a union member with a comparable health plan is exempt purely because of POLITICS! This along with the Nebraska Medicare deal and the other vote buying favors is really making me question if government health care is going to help us or make the problem even worse. Pick your Devil, big business or big government.

[Kevin]

Originally Posted by PiKA2001

They want to exempt unions from the cadillac plan tax for the first ten years of this gaggle. I think its bullshit that I have to pay a higher tax because I choose to participate in a high option plan but a union member with a comparable health plan is exempt purely because of POLITICS! This along with the Nebraska Medicare deal and the other vote buying favors is really making me question if government health care is going to help us or make the problem even worse. Pick your Devil, big business or big government.

I'm still convinced that the purpose of this bill is to 1) make us feel entitled to health care; and 2) drive the cost of private insurance up so high and create such a boondoggle that the public will overwhelmingly support a public system.

[PiKA2001]

Originally Posted by Kevin

I'm still convinced that the purpose of this bill is to 1) make us feel entitled to health care; and 2) drive the cost of private insurance up so high and create such a boondoggle that the public will overwhelmingly support a public system.

In response to your post; 1) I think a majority of people are already there; 2) so true. One of the AM radio shows constantly plays a clip of Pelosi stating " until the people DEMAND a public option" or something of that nature. Unless you're lucky enough to get your mandatory insurance policy subsidized, this monster is most likely going to be the average American's most costly expense after housing and transportation. I don't see how anyone Making anywhere from 25-45k can afford this without a public option.

[Kevin]

Originally Posted by shimano

The purpose is redistribution of wealth.

He said so himself during the campaign.

He can only do so much though, and with a Republican legislature (which'll happen in 2-4 years, both houses), he won't be able to accomplish any of that.

[AGDee]

Your employer is using an astronomical insurer if the cost is $8500 for an individual with a $2500 deductible. You would pay less if you sought private insurance on your own rather than going with your employer's plan. If you had real choice, you would be able to pick whatever insurance you wanted and you could get a much better deal than that!

[AnchorAlum]

Originally Posted by AGDee

Your employer is using an astronomical insurer if the cost is $8500 for an individual with a $2500 deductible. You would pay less if you sought private insurance on your own rather than going with your employer's plan. If you had real choice, you would be able to pick whatever insurance you wanted and you could get a much better deal than that!

I'm sorry I was not as clear as I should have been - I have private insurance, which I opted to retain when I went to work for my current employer because the plan offered at work is not good. It costs him about $400 a month for each employee, and instead he just gives me a check for that much, which I use to defray the cost of a preferred PPO.

I'm of an age where I would not be able to get a much better deal than that. My brother is in the business and I know that for a fact.

[AGDee]

I see adding a public option differently. In my health care system, we are reimbursed for approximately 30% of total charges annually. Hundreds of millions of dollars of care are absorbed by the system annually. As a result, the charges for each procedure have increased to compensate. When I use that 30% number, that is not just uninsured people. That also includes negotiated contracts with the insurers to accept a lower payment for some services as "paid in full", even when it is significantly lower than what we charge. Health care systems/hospitals are railroaded into doing this because it's better than having no patients at all from an insurer. I'll use a concrete example here from when I worked on an adolescent psych day treatment program and was privvy to this info:

Our actual cost per patient was $250/day. Blue Cross negotiated with the hospital to pay certain amounts for certain services. They paid full price for cardiac care, for example, but agreed to only pay $150/day for our outpatient adolescent day treatment program. They made these kinds of arrangements for every type of service offered. Clearly, a hospital cannot exist if they don't accept Blue Cross, so they negotiate as best they can but the insurer will only go so far and the hospital is stuck then. Medicaid paid us $125/day. There was an HMO that paid full price. But guess what? Most of our patients were medicaid or were uninsured altogether. We got $50 a day from community mental health for patients who were uninsured. Our charge for full price? $450/day. We had to make up the difference for the lower payments from Blue Cross, Medicaid and the uninsured through those insurances that would pay full price. Had they all paid, we could have lowered our full charge to $250/day and the unit would still be open today. Instead, we lost a huge amount annually and the program was closed because we couldn't break even. All we needed to do was break even. If we were getting $250/day from every funding source, the HMOs costs would drop significantly and ultimately then, their premiums should drop.

So, when I say we get reimbursed at 30% of what is charged, that's probably equivalent to being reimbursed for about 70-80% of the actual cost to the hospital. Hospitals will not be able to continue to remain open if this continues.

To me, the ideal would be to move to a voucher system giving people a choice beyond what their employer decides is the best insurance plan for them. While health care benefits are a way for employers to try to attract the best, those funds could be channeled into health care vouchers or actual salary increases to compensate. I do believe costs would come down. I know for a fact that there have only been about 4 years of my 22 years in the work force where I used more health care services than the health insurance company received in premiums. That is true for most people. That is what insurance companies bank on. They have pools, currently based on employer, and work on the premise that within a given pool, there will be people who are expensive and people who cost them next to nothing and it will all balance out. This is why individual insurance is higher, because there is not a pool to balance you out if you end up being an expensive person. So, these pools, instead of being employer based, could be region based/state based, etc., like they are for home owners and auto insurances.

I see adding a public option to a system like this as a competitor to the existing insurances to make them provide real competition. I also think there would be a more competitive market with the voucher system. Ultimately, it would provide more competition among health care providers too, so you would see an increase in quality and a decrease in cost overall. I think it would be a MORE capitalistic system than the current system, at the level of the people, rather than at the level of the employer. We as individuals would have choice where we don't truly have choice now.

[AGDee]

Ahhh, ok. That's nice that he gives you that full amount. If we opt out of our $8000 a year plan, we only get $500 for the whole year. Kind of crazy.