Questions on the "Health Care" proposals.

[SoCalDem]

1. Who determines "affordable"?
2. If it's "mandated" and you do not buy it, what happens?
.......a. are you fined?
.......b. prosecuted?
.......c. refused medical care?
3. Will there be a mechanism to prevent employers from "dumping" coverage they now offer?
4. How will high-cost areas be regulated to comply with the plans?
5. In two-income families, will there be a "family plan", or will both be required to sign on?
6. Who bears the responsibility for kids, in a divorce situation?
7. What ARE the minimum standards of coverage?
8. How are co-pays & coverage limits determined?
9. What would prevent the glut of scammers who would come into the market to "offer" policies?
10. To get the tax-credit, do you have to be eligible to file a long form?
11. What about prescription. dental, vision,mental health, hearing?

There are bound to be more, but these are the ones I thought of first..

Here in California, car insurance is required, but I know that millions of people glomb onto some bullshit minimum policy when they register their vehicle, and then just quit paying the premiums.. People drive without coverage at all, and just hope they never get stopped or get into an accident. This is what would happen here, I'm afraid.. Do you refuse care to a 6yr old whose Daddy decided not to pay a premium for insurance he could not afford?


Unless it's a plan for single-payer,government run truly universal coverage,middle class people (and below) will see little benefit for yet another bill they may have to charge on their credit card..

Insurance is the PROBLEM...not the solution.. UNLESS..

A separate "insurance style fund" was set to ..Totally non-profit, with the whole country as one big group policy membership.. that might work...but hey.. that's like one we already have.. Medicare :)


..................$110B per year spending is not that much when you consider this

SNACK FOOD MANUFACTURING INDUSTRY
http://www.marketresearch.com/product/display.asp?productid=1546494&g=1
The industry's revenue for the year 2006 was approximately $21,590,000,000.

We also spend lots on other "non-necessities".

[papau]

1. 13% profit ($22B)after 20% expenses - good questions - the

answers are obviously not known - but many would also not be known for a single payer proposal either - such as what is covered under the premium or tax being paid (your "affordable" question).

Mandated usually means a premium deducted from wages that you must sign up for when you get a job - or if not employed, you are signed up by the state. In Mass it amounts to the loss of a tax deduction.

Only unions prevent employers from doing anything - so "dumping current coverage" is possible now and will be later (but later Hillary has a yearly monetary penalty if they do not provide coverage).

The plan is nationwide - there are no ratings (premium increases) by where you live unless your ins company chooses to have such a method - the plan does not set premium rates.

The mandate I am sure will be like our current W-4 process where you can take into account your spouses job when signing up for benefits and their corresponding payroll deductions (W-4 is the withholding tax for the FIT which allows a bit of flexibility).

As to kids in divorce - there is no change from current situation - Hillary only deals with coverage and collection method for premium - every thing else stays the same.

As to "What ARE the minimum standards of coverage?" only Mass has faced this question - it will be interesting how the Federal Law defines it - I hope it requires more than Mass.

As to "What would prevent the glut of scammers who would come into the market to "offer" policies?" it appears all the state regulation stays in place.

As to the tax-credit and long form FIT filing I'd guess short form deduction would be the approach - but I have not seen it in writing.

As coverage for prescription. dental, vision,mental health, hearing - again the only minimums we have in the US to date are the Mass minimums - there are no maximums as ins co's can offer whatever coverage they want.

[SoCalDem]

4. I'm guessing that the penalty an employer might pay

would somehow end up less than what the medical coverage cost, so I'm thinking they would dump people or arrange their benefit's package to start eliminating people ..When it comes to money, they get quite creative :(

[papau]

5. I agree - the likely level is 6 to 8% of payroll - and health can be a 20% burden for

lower and low middle income workers.

But I do like the public option - medicare like but "not medicare" - that is front and center.

[rurallib]

2. Many of the same questions I have been asking. Also notice

how, particularly in recent days, how the discussion has turned from "health care" to 'affordable health insurance."
Since HRC's announcement Monday, my first thoughts have been just how Repubs can set it up so insurance companies can seem to go along while setting up the capability of either scuttling it or ripping it off in the future.
One payer is really the only way to go. If we have to get stuck with insurance, to me it looks like Edward's is the best of a bad idea.

[SoCalDem]

3. "Affordable" is so subjective..

I can imagine so many different situations..

"ferinstance"

a middle class person with a $50K income gets outsourced.. they have a house that they are desperately trying to hang onto, and are spending down savings to stay afloat..

What would be "affordable" to them? Surely their equity in their house would have to be counted as an "asset"...but a higher payment would only exacerbate their problems. Is it fair for them to pay a lower fee that matches someone who has a lot less than they do?
or an $80K a year self-employed person who cares for (out of pocket) for a few elderly family members, or a handicapped grown child.. how do THEY "afford" mandated coverage?

The whole part of WHO decides is the issue..

and would the WHOLE premium and out of pocket expense be deducted from the TAX owed..not from the "adjusted gross".. or would it have to meet some "percentage"?

This is a fiasco waiting to happen, and could actually set BACK any plan for a REAL solution..

The problem is this.. No one is brave enough to spell out the problem..

They spent all the "babyboomer money" we have been faithfully pouring into the treasury for FOUR DECADES, and since we are the largest bulge in the belly of the snake, they will need to wait util we have been shat out..dead..from that snake's ass, until they can really even afford to set up a true universal coverage plan..

and by then perhaps people will be desperate enough to agree to the stringent ID that will be necessary for it to actually work..