Starting Over

[RoyGBiv]

Starting Over

— By Kevin Drum
| Tue Dec. 15, 2009 3:10 PM PST

I don't want to blog endlessly about healthcare reform today because, really, there's not all that much to say. I think the Senate bill in its present state is well worth passing, other people don't, and that's that.

...

If healthcare reform dies this year, it dies for a good long time. Say what you will about the Democratic leadership, but Harry Reid, Barack Obama, Rahm Emanuel, Nancy Pelosi, and Steny Hoyer all know this perfectly well. So do John Boehner and Mitch McConnell. (Boy do they know it.) But if it passes, here's what we get:

* Insurers have to take all comers. They can't turn you down for a preexisting condition or cut you off after you get sick.
* Community rating. Within a few broad classes, everyone gets charged the same amount for insurance.
* Individual mandate. I know a lot of liberals hate this, but how is it different from a tax? And its purpose is sound: it keeps the insurance pool broad and insurance rates down.
* A significant expansion of Medicaid.
* Subsidies for low and middle income workers that keeps premium costs under 10% of income.
* Limits on ER charges to low-income uninsured emergency patients.
* Caps on out-of-pocket expenses.
* A broad range of cost-containment measures.
* A dedicated revenue stream to support all this.

http://motherjones.com/kevin-drum/2009/12/starting-over

Starting over is exactly what Republicans want. They know starting over means not starting at all or starting from an even more conservative baseline. I have absolutely no idea why anyone is behind this silly notion, least of all Howard Dean, whom I generally respect.

[elehhhhna]

1. capping premium costs at 10% of income leaves a big fat hole --

b/c it doesn't cap total annual outlay for the policyholder.

We have fairly good insurance through his employer, thank god. But: copays are exempt from our annual personal outlay cap of 2K. Hubs had his spleen removed and the surgery, tests, and visits are over 3K for this year. This doesn't count against this year's outlay for orthodontia (2.5 K this year), general dentistry (1.5K), the kids & my doc visits (nominal, not worth adding) and copays for meds @ approx. 500. Sheesh. I haven't added it up before. Total: $7500.00, not including about 4K in premiums (our end).

DAMN! NO WONDER WE'RE relatively BROKE this year.

A 10% premium means we'd pay around 10k versus about 4K/yr. now. HC costs for my family was more than our mortgage cost this year. A 10% premium plus the above is over 17K for one year versus 11.5K.