I just have to ask you to explain one sentence that underscores your entire argument here:
“Most people can see how this bill will rapidly reduce private insurance plans and rapidly expand government plan patients.”
How exactly do the current house and senate bills do this?
The current and future uninsured will be purchasing private insurance via exchanges and these premiums will be subsidized by our tax dollars...but it is still private insurance (which will be expanded). There is no public option or new government run insurance plan. Yes, Medicaid will be expanded to cover those at 133% of the poverty line but that isn’t a very big percentage of the uninsured. Those poorer are already on Medicaid.
Mandating the uninsured to purchase private insurance with subsidies will actually expand greatly the private insurance market by forcing millions of new customers to into the private insurance market and increase the risk pool as a whole and therefore strengthen private insurance from a financial standpoint.
Yes, those making over $250,000 will take it in the gut with a .9% increase in their medicare tax on their paychecks and investments under either of the bills considered but I don’t quite see how “government patients” will increase as a result of this plan.
Government patients WILL increase due to a vast increase in Medicare patients (baby boomers) about to hit the government dole and/or a further increase in unemployment due to national and global economic conditions which results in more Medicaid patients. But neither of those scenarios have anything to do with the bills being considered by either the house or senate....at least directly.
Is there a new government insurance plan that I am not aware of in the bills?
The system runs on such narrow margins that even a 5% increase in Medicaid will be rapidly fatal.
And even before that, any responsible insurance company board will shut down their about to be company-destroying health insurance subsidiary.
These shell "health insurers" won't last 60 days.
Your question is excellent and indeed poignant and fundmental to the argument.
A few points to consider.
1) As is in the Senate Bill (No verion of the slaughter fix up yet,no?)- all people will be required to buy a “GOVERNMENT APPROVED HEALTHCARE INSURANCE PLAN.”
“GOVERNMENT APPROVED” is puporsely left undefined in the bill, stating that definition is left to be determined by the Secretary of DSHS. So A government approved plan can theoretically be private or public. There is nothing eliminating a public option. As we know they have kicked araound expanding the enrollemnt criteron to Medicare / Medicaid.
Their staretgy is to make private insurance companies non-viable first. They are the direct barrier to single payer. Private insruance must be destroyed for govermnet to be the ultimate insurer.
So, how to do this?
Lets look at the banks: Hello Mr Banks. You must make bad loans because we said so - and here is an incentive to do so, and nything that goes under - dont worry, we’ll hide it in Freddie and Fannie.
Today: Hello Mr insurance companies. You must write bad policies. - youo no longer can underwrite your patients. ie your business model must die. Bad loans = Bad insurance policies. Eventually they fail.
Or make the analogy to auto insurance. Pre-existing conditions = 3 DUIS, 9 speeding tickets and 5 accidents.
In this bill, the analogous health insurance company is forced to say yes. Underwriting risk - the life blood of the fundamental concept of insurance is stripped.
And like Fannie and Fae there to sweep up the pieces; so too will the clause of “gov approved health cae plans to be determined in the future by Secretart of DSHS - be the dumping grounds for these failures. Think about it.
When current private heath insurance business show systemic failures, there is nothing in the Senate bill preventing the DSHS secretary deeming a series of new government programs the new “approved health care plans”; or in such a crises - DHSH secretary deeming the expension to new enrolees to both Medicare and Medicaid. It was not long ago that the expansion to Medicare to an age of 50 was kicked around. And that that was just tailgaiting. Do we believe for one minute that once insurance co’s show failures, that the rationale to resurrect, expand create and ‘deem’ gov backed plans to be the fall back position?
Of course it will.
The only other alternatives would be:
1) Hey, we’re breaking private insrance companies - damn that could lead to single payer gov system - lets lay off and pass legislation to get these guys back ontheir feet. Something tells me thats a very cold day in hell.
2) Well, we did say vaguely, “no public option”. Of course the wording is here to allow it to occur; but we have to stick to our word and we’ll let the private sector develop a new creative way of insuring people and we’ll just stand aside while the private system figues it out.
Call me a pessimist - but that is just not gonna happen. They have clearly shown that their fundamental intentions are to assume and absorb the private sector into their public and governmental bureaucracies. Nd this is there most prozed posession.
So yes jackmercer, you are correct in that as is there is no obvous public options clearly constructed. But the language is there to create it, and the war is being fully waged against the private insurers. Public option is inevitable. It will will be over-run with all the patients dropped by the businesses willing to take the penalty over the tax; over-run by the patients dropped from a failed private insurance plan.
This goverment insurance policy migration is inevitable,and will be exponentially faster and more massive than anyone will predict, and the subsequent lethal business effects on the private healthcare delivery systems will be swift and thourough.
Thank you everyone so far with you kind and supportive comments.
This is the real tragedy. insuance companies are the life blood to the healthcare system.
Kill the life blood, you kill the system.