Read the damn document: Hillary's health plan would be a huge improvement over what we have now

[Herman Munster]

No, it's not single payer. Yes, It's a hell of a lot better than what we have now. Yes, it's a politically feasible solution.

http://www.hillaryclinton.com/feature/healthcareplan/americanhealthchoicesplan.pdf

- A Choice of Health Plan Options: Businesses, employees, and the uninsured will have
the option of buying group insurance through a new Health Choices Menu. This Menu
will give all Americans the same set of insurance options that their Member of Congress
has. Without creating new bureaucracy, the Menu will be part of the Federal Employee
Health Benefit Program (FEHBP), which includes numerous, high-quality private health
insurance options. The Health Choices Menu will have the purchasing power of millions
of Americans in securing high-quality and affordable insurance. States will also have the
option of banding together to offer the same type of choices in a region of the country if
they wish. The benefits will be as good as those offered to Members of Congress. Such
coverage includes mental health parity, and many plans offer dental coverage. In addition,
as a condition of doing business with the federal government, insurers must cover highpriority
preventive services that experts agree are proven and effective. This focus on
prevention will improve health and lower costs in the long run.

- A Choice of a Public Plan Option: In addition to the array of private insurance choices
offered, the Health Choices Menu will also provide Americans with a choice of a public
plan option, which could be modeled on the traditional Medicare program, but would
cover the same benefits as guaranteed in private plan options in the Health Choices Menu
without creating a new bureaucracy. The alternative will compete on a level playing field
with traditional private insurance plans. It will provide a more affordable option, in part
through greater administrative savings. It will not be funded through the Medicare trust
fund.

- Eliminating Insurance Discrimination: The plan creates rules that all insurers must
follow, ensuring that no American is denied coverage, refused renewal of an insurance
policy, unfairly priced out of the market, or charged excessive insurance premiums.
Health plans will compete on cost and quality rather than avoiding patients who need
insurance the most. The plan will:

- Require Guarantee Issue: Insurers must offer coverage to anyone who applies and
pays their premium. This protection, known as guarantee issue, will ensure that no one
is ever denied coverage because they are sick or an insurer fears they will be.

- Require Automatic Renewal: Insurers will be required to automatically renew
policies if the enrollee wishes to stay in the plan.

- Require Strong Rating Protections: Insurers would be prohibited from charging
large premium differences based on age, gender, or occupation (for example, a
standard set of modified community-rating protections).

- Require Minimum Stop-Loss Ratios: Premiums collected by insurers must be
dedicated to the provision of high-quality care, not excessive profits and marketing.

- Limiting Premium Payments to a Percentage of Income: This credit will ensure that
securing quality health care is never a crushing burden for any working family. This
guarantee will be achieved through a premium affordability tax credit that ensures that
health premiums never rise above a certain percentage of family income. The tax credit
will be indexed over time, and designed to maintain consumer price consciousness in
choosing health plans, even for those who reach the percentage of income limit.

- Strengthening Medicaid and the State Children’s Health Insurance Program to Serve
All Low-Income Individuals: These programs serve over 55 million Americans, and have
done so successfully through federal-state and private-public collaborations. The holes in
this safety net (e.g., lack of coverage of poor, childless adults) will be fixed to ensure that
the most vulnerable populations receive affordable, quality care. Similarly, the other part
of the safety net, like public hospitals and community health centers, will continue to
receive support to serve vulnerable populations.

- Ensuring Premium Affordability Through Refundable Tax Credits: Premiums have
skyrocketed over the last several years – nearly double since 2000. The American Health
Choices Plan helps working families afford coverage through refundable, income-related
tax credits to ensure that accessible, high-quality health coverage is affordable to all.

[cobalt1999]

1. I agree. Give me a good plan...

that will be implemented over a great dream plan that has no chance of seeing the light of day.

[Warren DeMontague]

2. I still think Single Payer is the way to go, but stopping denial of coverage for pre-existing

conditions; and it looks like this would do that, but maybe I'm not reading it right- is huge. It's gotta get done. I'd want more details, but I would support the plan for that reason alone.

[calimary]

41. So would I. I know people who've been utterly screwed by that.

Uninsurable just because of that. That one's gotta go.

Health insurance should be reclassified as a public utility.

[renie408]

44. Speaking as one of those screwed people, I agree. I will go for ANYTHING that gets me closer to

health coverage.

[Warren DeMontague]

47. I know. It's an obscenity, the way it is now. nt

[backscatter712]

3. Question about Guarantee Issue.

Basically, they can't turn anyone away, which is a good thing. Can insurers under this plan still jack up premiums because of medical conditions?

As far as I'm concerned, if we're going to go with this plan, the 50-year-old heart failure patient needing a heart transplant should be able to go up to an insurance company, and pay exactly the same premium as the 25-year-old male with no medical conditions. They both pay the same, and neither of them can be turned away. Yes, that means that for the heart transplant patient, the insurer gets to eat a huge financial loss. If they don't like it, they can suck it! That's the price they pay for getting this feeding trough.

Also, I'm not sure how this plan will help to address the insanely high prices that are being charged for medical care these days.

Still, even though it's not HR 676, it would be an improvement.

[Herman Munster]

6. even if you can't find a private insurer in that situation

you will be able to buy through the two new programs opening up from the government: medicare for all, and buying through the federal employee health benefits insurance program.

[backscatter712]

10. Hmmm. I could live with this.

I'm just hoping that this plan will keep people from falling through the cracks, like 50 million people are today.

Or as said in SiCKO, not just fallen through the cracks, but actively swept towards the cracks by insurers who know that letting you die is cheaper.

[Dawgs]

4. HillaryCare, HillaryCare, HillaryCare. That's all you'll ever hear about this plan.

I wish it wasn't true, but that's how the right will play this.

'Remember how bad she almost screwed up health-care in the nineties. Well she's at it again.'. Unfortunately, many Democrats and Independants will buy it.

It doesn't matter how much better it is than the current system.

[William769]

15. As compared to Obama care, Obama care, Obama care,

Or Edwards care, Edwards care, Edwards care?

[Warren DeMontague]

48. How bad she almost screwed it up in the 90s? That's ridiculous. It couldn't be much more screwed up

than it is now.

The thing was torpedoed by the Insurance industry. The American People weren't convinced anything needed to be done in 1993. Now they are.

Frankly, I'm not a HRC booster, but I'm glad she's stepping up to the plate on this. :thumbsup:

[jgraz]

5. Wait - she's had 14 years to work on this and she still can't get rid of the insurance companies???

This woman isn't qualified to be fucking dogcatcher. Can we please flush her in favor of an actual Democrat? :banghead:

[DemocratSinceBirth]

21. What Do You Propose?

I don't think you can get thirty votes in the Senate for HR676...

[jgraz]

37. I propose we elect a real Democrat with actual vision

Get back to me once we do that.

[renie408]

45. Unless we elect him DICTATOR, he would still have to get the plan past Congress.

So what the FUCK good does it do to have something that would be, admittedly, ideal, but doesn't have a snowball's chance in hell of getting passed?

[endarkenment]

7. It has merit, but medicare for everyone has more merit.

Once again complexity brings incomprehensibility and vulnerability to attack from the right. A simple 'expand medicare to everyone, pay for it through the payroll tax' is easy to understand and puts everyone in the same boat with the same plan.

[Solon]

8. If those credits aren't monthly, but annual, then they are useless...

What good would a tax credit at the end of the fiscal year do for a family that has a premium to pay every month. In addition, what about co-pays and deductibles, those can be killer, all by themselves. Also, I don't see how the Public Plan WOULDN'T create a new bureaucracy, it would have to, its separate from every other public program.

[CTyankee]

31. I asked this question a few weeks ago, about the creation of Medicare.

It was a big government program, created through SSI. It was handled pretty smoothly, even with Republican and some Dem opposition, and went into operation without civil disturbances breaking out!

HC is trying to do the same thing with regard to the Medicare portion of her plan or the Fed Employees Plan. It simply enlarges to encompass more people than previously.

As for the co-pay and deductible issue, there might have to be an expansion upward in the current Medicaid program, like the sChip plan for children is doing now. It, too, can be done without creating an entirely new government bureaucracy.

The question will be adequate funding. When people tell you that you can't "throw tax money" at a problem, point to the fact that our country has the most powerful military the world has ever known. Then ask them how did we got such a military.

[Cleita]

9. Wow! It sounds like she's been talking to Arnold Schwarzenegger.

That's the same health industry crafted plan they sold to Arnold for California. I love Republicans in my party as if we haven't had enough of them since the turn of the millenium.

There's nothing like taking a simple plan like extending and improving Medicare for all and making a big, complicated, byzantine mess out of health care coverage for all instead, which of course, will cost the taxpayer way more money than necessary and efficient, down the line.

The health insurance industry is the problem. Why would anyone want to feed it?

[pinto]

11. I agree. While I advocate Medicare for all, I realize it won't happen tomorrow.

And, as noted in other threads, any proposed plan, from any Democratic presidential candidate, will be hammered out in Congress, once we have the White House and it gets presented for consideration.

I like the buy in to Medicare implicated in this plan, as well as the pre-existing condition stipulation, automatic renewal, and the stop-loss provision (though that's pretty vague). A proposed step in the right direction and worth a look.

Sen. Clinton knows the obstacles from the debacle she headed during Pres. Clinton's administration. This looks to be a sincere attempt to make some *doable* headway.

Does it go far enough? Not imho. Yet I see the politics of moving an agenda forward. These proposals would be an improvement over the truly disastrous situation we have now.

(aside) One of the many side effects of the primary need to address the Iraq war, defense funding, civil liberties, etc. in Congress right now is the effect on our domestic agenda concerns.

[Mojorabbit]

19. It would be simpler

to say one can either join medicare for all or buy insurance. Simple, everyone can understand it, people would have a choice. If more people opt for the medicare program, insurance companies would still serve a niche market for those who want more coverage. Easy for the public to understand. This is too complicated and will be ripped apart by both sides.

[sandnsea]

12. mandates & tax credits

The right will pounce on the mandates and the poor will reject mandates with no help except an unknown tax credit at the end of the year. This is dead and could very well lose us the presidency next year.

[Herman Munster]

13. READ

- Strengthening Medicaid and the State Children’s Health Insurance Program to Serve
All Low-Income Individuals: These programs serve over 55 million Americans, and have
done so successfully through federal-state and private-public collaborations. The holes in
this safety net (e.g., lack of coverage of poor, childless adults) will be fixed to ensure that
the most vulnerable populations receive affordable, quality care. Similarly, the other part
of the safety net, like public hospitals and community health centers, will continue to
receive support to serve vulnerable populations.

[Solon]

17. What about those who are "almost poor"...

Make too much to qualify for Medicaid, but can't afford private insurance premiums? In addition, what is the out of pocket cost for the public system?

[Herman Munster]

18. Again it's addressed

- Limiting Premium Payments to a Percentage of Income: This credit will ensure that
securing quality health care is never a crushing burden for any working family. This
guarantee will be achieved through a premium affordability tax credit that ensures that
health premiums never rise above a certain percentage of family income. The tax credit
will be indexed over time, and designed to maintain consumer price consciousness in
choosing health plans, even for those who reach the percentage of income limit.

[Solon]

22. Is that credit to be paid monthly or yearly?

That's the make it or break it part of the deal. If someone can't afford a MONTHLY premium without the credit, what good will it do them at the end of the fiscal year?

[Herman Munster]

28. I don't know the answer to that question

But Hillary will have a live net meeting tomorrow at 8pm/e on her website. Why not listen to what she has to say.

http://www.hillaryclinton.com/

[melody]

24. Define "a crushing burden"

Sorry, this plan may be a little better than what we have now, but only a little.

[sandnsea]

30. yeah, unspecified tax credits

Working people have been fucked by the promise of tax credits, over and over. You earn too much to qualify for "poor" benefits, not enough for the tax credit to do you any good. Same with college, private school, every other tax credit that people like the Clintons have fed us over the years. It's another reason I don't support her. I've lost track of the number of reasons by now.

[Herman Munster]

25. also

here is a link to the federal government employee's health insurance page.

You can see how much it costs currently per government employee and the different types of coverage provided.

http://www.opm.gov/insure/07/spmt/plansearch.aspx

[Solon]

32. Well, I chose 4 different insurance companies to compare to each other...

I chose Monthly premiums and "non-postal" as occupation, for lack of better options, and the CHEAPEST premium is over 71 bucks. That's just for ONE person, for a family, its $163.56. Not to mention the co-pays, deduct, and catastrophic limit are way too high, no way in hell I could afford that.

Here's a link to the Plans:

http://www.opm.gov/insure/07/spmt/PlanProfiles.aspx?plans=221MOCDPC474AAFFSC104AAFFSS9G1MOHMOH&rates=a&benefits=x&quality=abcdefg&general=abcdefghij&emptype=a&payperiod=a&

Its better than what I could get on my own, but that doesn't help when I couldn't afford THESE plans either.

[Herman Munster]

34. but that's only one piece of the puzzle

you get savings by picking the government plan, you get more savings by having tax credits, and if you are completely destitute and can't afford anything you get coverage under expanded medicaid.

[Solon]

35. First the Credits don't help if I don't get it every month, for the entire premium...

In addition to some way to pay for the deductible and catastrophic, in addition to drugs. Hell, my Dad makes over 50k a year, and my parents are now living literally paycheck to paycheck because of my Dad's stroke last year. He's still working, about a decade and a half from retirement, and has insurance. The Deducts and co-pays are literally killing them. Not to mention my Mom's medical needs. Its not like they live extravagantly either, in a 40 year old home with a single car that is 20 years old, they are "making it" barely, yet wouldn't qualify for Medicaid.

I'd have to see details on the public plan before I can be even remotely convinced. It would have to have NO DEDUCTS OR CO-PAYS, nor should it be that expensive per month, preferably FAR less than the cheapest insurance companies, preferably so cheap you could scrounge up change from the couch to pay for it. This isn't a choice between being destitute or not, its a choice as to what is ACTUALLY affordable, especially when things go wrong.

The only positive in this plan is that it MAY cover me, see, I need fixing, surgery to be exact, and have no insurance to pay for it. Being a single, childless, male, I'm screwed, basically. If the Medicaid plan actually will cover me, without too many qualifications(I have 10 bucks to my name), then that would be good. However, I'm loathe to sign on to a plan that would leave my parents out in the cold.

[Herman Munster]

38. have you looked into medical tourism

Mexico, Panama are the closest options. Your surgery would cost maybe 1/10th what it will here, maybe even less.

[Solon]

39. I thought about it...

Its either that or marry a Canadian. :)

[kineneb]

49. I hate to say it, but that is a better deal than I have

All I can get as a rural low-income childless adult in CA is CMSP (County Medical Services Program). The income cut-off for a family with two adults is $934. All income above that, even from Hubby's SSDI, is subject to share-of-cost.

I do not have any medical coverage until I spend $280 of our income each month. Put more simply, on an annual income of $14,856, if I needed medical care for a chronic disease, we would have to spend $3360 before I would have any coverage. One of my medications is over $100, and I have no coverage for it.

Yes, this is totally hosed. A household of two people has to struggle to live on $934; food pantries, anyone?

[shifting_sands]

14. Read it

I read the "damn" report and this is disgusting. It's still an insurer world, we pay through our "tax credits" Who is going to "police" the insurance companies, another government department? What happens to a family below the poverty line? Does "Hillary" understand that even 50 cents is precious to a family of four making under $25,000 a year and all they get is tax credits? They need real money in real time to pay every month. This is a piece of s... Vote for the GOP and you'll get GOP, vote for Hillary and you'll get GOP.

[Herman Munster]

16. Obviously your reading comprehension needs some help

Please read Reply #13. It addresses the people who are destitute and cannot afford 50 cents for health care.

[Milo_Bloom]

20. Its an extension of the same problem we have now.

And the problem is that once this is passed, we end up with the exact same crappy care we see in Sicko and no ability to fix it in the future.

The 47 million w/o health care allow us to have this debate... if we bring them into the crappy system we have now, the debate will be over.

That is the problem.

[HockeyMom]

23. Add another nail in the coffin

as to why I am not voting for my former (moved out of state) Senator.

[bain_sidhe]

26. AHA! It has the feature I was looking for as a minimum...

#3:

- A Choice of a Public Plan Option: In addition to the array of private insurance choices offered, the Health Choices Menu will also provide Americans with a choice of a public plan option, which could be modeled on the traditional Medicare program, but would cover the same benefits as guaranteed in private plan options in the Health Choices Menu without creating a new bureaucracy. The alternative will compete on a level playing field with traditional private insurance plans. It will provide a more affordable option, in part through greater administrative savings. It will not be funded through the Medicare trust fund.

I understand political reality. It would be nearly impossible to pass a plan that cut out the insurance companies completely (not that I don't wish we *could*!). Just look at the ideological opposition to expanding the S-CHIP program, and that has the PR value of being for children. But a "public plan buy-in" with lower costs and equivalent coverage will achieve virtually the same thing in the long run. In order to match the price of the public not-for-profit plan, they'd have to sacrifice their exorbitant profits, and if they have to do that, I suspect they'd just as soon find another business.

Thanks for the info, Herman!

[shimmergal]

51. Yes. Already about 1/3 of the population

is covered by govt. plans--Medicaid, Medicare, VA, etc. If we're going to get to single-payer, we need a stealth strategy to make the public plans much more favorable to patients, and at least sa profitable and less of a hassle than the commercial plans are to doctors, esp. the first line practitioners like G.P.s, internists, etc.

[Vinca]

27. There is no way in hell we can ever have decent universal healthcare

unless the insurance industry is taken out of the mix. They make billions and billions of dollars in profit EACH QUARTER. That doesn't come from paying for treatment. Just having "any old policy" you can afford won't do. Everyone needs to be treated the same. Everyone needs to have the same coverage. If people with money want additional insurance to have private rooms, private nurses or a violin trio in their hospital rooms, fine. This is absolute, total pandering to the insurance industry. I suppose there will be some gifts for big pharma, too. I'm so frigging annoyed I can hardly stand it.

[dflprincess]

29. It's a gift to the insurance companies

People who don't qualify for any subsidies or tax credits (and I'll bet the income limits will be as realistic as they usually are when government programs are involved) are going to wind up buying high deductible, major medical policies. They still won't get preventative care and an appendectomy may still send them into bankruptcy. Meanwhile, the insurance companies will get to pocket the premiums paid and still do their best to avoid paying claims.

Fourteen years and this is the best she can do? So much for leadership.

[MadHound]

33. Read it, got it, it is simply another way that she is paying back her corporate masters

At least the ones in Big Insurance and Big Pharma. Sorry, but this is another giveaway to the insurance industry and is a piss poor plan. Just another reason I won't support her.

I'm continually amazed at how many people are willing to settle for so little. I'm also amazed at how many people will call a shit sandwich caviar all in the name of promoting their candidate.

[killbotfactory]

36. A new bill for the working poor.

Oh wait, we get tax credits. Woohoo!

[renie408]

46. Well, without insurance, 18,000 of them a year get to be the dead poor.

So, if this would work, I would go for it.

[avrdream]

40. I just read everything I could find about her plan and I love it.

I have made more comments in other threads but I think the "public plan" option in the menu is what is ultimately going to become Medicare for all. Let's get everyone we know to choose this option and we effectively put private insurance companies out of business.

This is Hillary working within the system, taking the small steps to get to what she really wants: full health care benefits for every citizen.

Yes, there are many details to still work out but this is a great overall plan.

[ericgtr]

42. Another case for universal health care

this plan, like most others are all about catering to big insurance and their multi-billion dollar industry. We need someone to step up and get rid of these sharks and overhaul the system. As for Hillary, I have really been trying to be more open minded about here but she's just too far right for my taste and I can't get past that.

[BattyDem]

43. Will insurance companies still pick your doctors ...

or can you see any doctor you damn well please? Can they still deny payment for a test/treatment that your doctor recommends? Can they still deny payment for medication prescribed by your doctor and force you to choose a medication from their "approved" list? Will you still have to deal with referrals before seeing a specialist and pre-approval before tests, treatment or emergency room coverage?

As long as the insurance companies get to decide which doctors you see, which tests you have, which treatment you get and which medications you take, people will still have to "fight" with them just to get their "mandatory" coverage.

Limiting premium payments to a percentage of income doesn't really help if a family's expenses are not considered. A childless couple making $30,000 a year doesn't have the same expenses as a couple making the same money while raising 2 children. They'll both pay the same percentage based on their income, but it will be a greater burden on the couple with children.

Once again, we'll have a tiered system: one for the people who can afford the best coverage, another for people who can't afford any coverage and a third for the people who are stuck in the middle of those two groups ... and that group in the middle is going to have the same financial burden they have now.

Democrats need to stop thinking about health insurance OPTIONS and start thinking about health care RIGHTS!

[middleclassman]

50. The government needs to regulate the price

I lived in Tokyo for many years. Every morning people commute from the suburb to work by train. Train is their only choice because the city is too crowded to have any real highway system.

In theory, the train company can charge as high price as they wish and people would still have to use the train. Fortunately, the train ticket price is controlled by government.

The broken health care system in US is similar to the case in Tokyo when the train ticket price is not under government regulation.

Health care simply does not work by free-market, because the demand curve in a quantity-price chart will go straight up in price because it cannot go below a certain quantity. The health insurance companies, pharmacies, doctors naturally try to maximize profit by charging very high price, because the demand cannot drop no matter how high the price is (actually when the price is so high that the demand starts to drop is when people starts to die and is the equilibrium today in US)

Suppose Hillary Clinton gives everybody $10000 to buy health insurance. The health provider will simply raise the price by $10000 and pocket every penny, and the same health care problem stays. It's only natural for Hillary Clinton to do so since she receive massive donation from health care companies. Probably the wise choice for us now is to start buying health care stocks.

In Japan and many other countries, the government sets the price paid to doctors for each type of operation they perform, and price for each type of medicine, the same way as they regulate the price of train tickets. It of course comes at the cost of doctors and drug companies. But that's the only choice when free-market principle does not work unless you want people to die in exchange for high stock price. It amazes me that I have never once heard anybody mentioning this on TV, it's just so telling how "un-democratic" america really is.