In Senate Health Showdown, Round Goes to G.O.P.

[TomCADem]

Source: NY Times

Senator Jim DeMint, Republican of South Carolina, said, “If Senator Reid won’t slow down this debate, we will do it for him.”

Mr. Sanders was sputtering. “The best the Republicans can do is to try to bring the United States government to a halt,” he said. “It’s an outrage, a disgrace. It explains why so many people have contempt for Washington.”

***
Senate Democratic leaders said they would probably accept two contentious proposals by Senator John D. Rockefeller IV, Democrat of West Virginia. One would increase the powers of a proposed new agency to limit the growth of health spending, including payments to hospitals.

The other proposal would require insurers to spend a specified share of premiums — at least 85 percent — on clinical services and activities that improve the quality of care. This would, in effect, limit the profits of insurers.



Read more: http://www.nytimes.com/2009/12/17/health/policy/17health.html

[Cha]

1. Elephant shit..since when do assholes

win the round just bc they're assholes?

Not in my book. Round One goes to the Dems who worked freakin' hard on this.

"Sanders sputtering"..if that's not a hack clue I don't know what is.

[lapfog_1]

2. Sigh, here we go again...

"The other proposal would require insurers to spend a specified share of premiums — at least 85 percent — on clinical services and activities that improve the quality of care. This would, in effect, limit the profits of insurers."

No, it makes their entire business model a "cost plus award fee" contract. that does NOT limit the profits of the insurance companies. And it does not hold down health care costs. In fact, just the opposite. They now have incentive to INCREASE COSTS since their margin is fixed. Only by increasing the costs can they make more money. The costs are passed onto consumers or the government. The profit margin is fixed. So now you have hammers that "cost" $100 and toilet seats that "cost" $1500, because they make 15% if the cost was $10 or $100. And $15 bucks profit on that hammer is a *lot* better than $1.50.

This is a bad amendment.

[TwilightGardener]

3. Who sets prices on aspects of health care, though--is it insurers or

is it facilities and manufacturers and care providers? Can an insurance company inflate the price of drugs, or labs, or nursing care to make a bigger profit?

[lapfog_1]

4. Yup, they sure can.

And there isn't anything in the bill to prevent this. And no doctor or medical facility will turn down the new "negotiated rate" with the insurer. Insurance being a near monopoly (without any low profit or non profit plan to compete with), they can just as easily UP the price that health care "costs"... why, because you have now told them that they make $15 on every $100 they charge in premiums and that the other $85 must go to pay actual health care costs. Fine. Double the "cost" on everything delivered via this vehicle and you've doubled the gross profit for the company.

For those of you old enough to remember... it's the phone company and long distance calls (from like the 1960s). Only now it's health care. You could always fight Ma Bell before by simply not using it. There was no mandate to make 100 long distance calls a month. Not so with health insurance. There is now (or will be if this bill passes) a mandate to buy insurance. And no cost containment. None. And worse, it's subsidized for the very poor. That's like "free money" to the health care industry. "Order all the tests you want. In fact, order some more. Generic versus brand name... Ha, no problem, give them the brand name. After all, it's only government money. Shoot doc, your reimbursement rate is under the national norm, why don't you kick it up 10% next year!"

Every dollar more in premiums that they can charge, is another $.15 to their bottom line. So rack up the charges boys.

The wonders of cost plus contracting. Shit, you'd think that this was the same thing as the Halliburton Iraq contracts or something. Oh wait...