Sen. Franken Nails It

[berni_mccoy]

From his blog at Kos:

A Historic Step Forward: Why I’m Supporting The Senate Health Reform Bill
by Al Franken


Sun Dec 20, 2009 at 09:24:47 AM PST

In 1917, progressives in America began a quest to create a system to provide health insurance to all Americans. Today, almost a century later, we are poised to take a giant step toward realizing that goal. Viewed through the lens of history, this is truly an amazing accomplishment.

To earn my vote, health insurance reform must improve access to affordable health care for Minnesota families – and this bill clears that bar with room to spare. This bill does not fix all the problems with our health care system, and I will not stop working to improve the quality and lower the costs of health care for all Americans. But progressives can be proud of the Patient Protection and Affordable Care Act, and take a large measure of credit for important provisions it will codify as the law of the land.

Requiring insurance companies to spend 85% of premiums on actual health services -- not administrative costs, TV ads, or gargantuan CEO bonuses -- is a big victory. Senator Rockefeller and I worked hard to get that provision included because it holds insurance companies accountable and will put an end to exploding premiums and obscene profits – a huge win for progressives.
...

More at the link. His words, while they do not resolve the issues I have with the bill, certainly do help me accept it.

[saltpoint]

1. good on ya, berni. And good on Al Franken.

Recommended.

[grantcart]

2. Franken, Krugman, Saunders, Klein all selling out to the powerful

interests of unions - those bastards!

Also the MLR at 80/85 is a high floor - it can go higher but never lower.

[habitual]

3. think you forgot the link (or i am blind) n/t

[dmr]

11. Here's a link from Franken's website:

http://blog.alfranken.com/2009/12/20/al-franken-a-historic-step-forward-why-i%E2%80%99m-supporting-the-senate-health-reform-bill/

[berni_mccoy]

16. Sorry about that, it's too late to edit

But the person above got it.

[WhiteTara]

22. snark

why be nasty? Just a simple "link please" will do.

[Dogmudgeon]

4. Let the Whining Begin!

And remember, "whore" is spelled with a "W".

--d!

[eridani]

5. That kind of back door regulation is usless. What if we regulated utilities that way?

Enron witholds power from CA to jack up the prices, and grandma dies because her respirator gets shut off. But there's wonderful news! At the end of the year, the government determines that Enron did not spend enough of its gross on actual energy, and grandma gets a rebate! Big whoop.

If insurance companies ruin your health or kill you, getting a rebate after the government has determined that they fail the MLR test does not help.

[defendandprotect]

6. Let's see . . . what's easier . . . to support the Dems corporate agenda or fight?

That's simply what these people are doing --

I like Franken but this is all meaningless -- the bill is garbage and they should

oppose it.

Very hard to do when the Democatic Party and its leadership have made clear that they

are joined with the corproatists/fascists.

Sad --

[coyote]

7. And what happens if they don't süpend 85% of premiums on healthcare

a slap on the wrist? A strongly worded letter from Harry Reid?

[ixion]

8. way to buy into the spin...

have another glass of Kool-Aid®

[napi21]

9. Al is proving to be a very good Senator! I know a lot of people

on both sides thought a comedian from Laugh In couldn't possivly be an intelligent person worthy of a Senate seat, but I like what I've seen so far! I hope the people from his State do too!

[lapfog_1]

10. Except, of course, it doesn't do anything of the sort.

"Requiring insurance companies to spend 85% of premiums on actual health services -- not administrative costs, TV ads, or gargantuan CEO bonuses -- is a big victory. Senator Rockefeller and I worked hard to get that provision included because it holds insurance companies accountable and will put an end to exploding premiums and obscene profits – a huge win for progressives."

They just converted insurance companies into COST PLUS AWARD FEE CONTRACTORS.

They have now established a "profit MARGIN", not a profit amount. The margin is 15% (which is very generous).

What is the financial model of current insurance companies???

Premiums (from everyone) - costs (providers, claims processing, etc) = Profits.

There is huge incentive here to control costs and increase premiums. Everyone can see that. That is what they've been doing. And since they are an unregulated monopoly, there really isn't anything to stop them (unlike almost all other businesses in America).

What's the new model?

Premiums X .15 = profits and Premiums X .85 = costs. Seems simple. Big change.

They still want more profits (greedy bastards that they are), now how to do it? Well, again, premiums need to rise. But premiums are now part of two simple equations, and the Premiums are the same in both. Premiums X .85 = costs. Nothing says that costs are fixed. If I increase costs... then Premiums go up and, therefore, Profits rise. Presto.

They now have incentive to INCREASE COSTS (whereas before, they had incentive to DECREASE COSTS, usually by denying claims or dropping patients that were TOO COSTLY.

Government contracts are often COST PLUS AWARD FEE contracts. Very common in the military industrial complex. The reason you have $150 hammers and $1000 toilets. Because if you tell me "you make 10% on everything you buy for me and every service you procure for me", I'll make damn sure that I purchase the most expensive items I can find. And if they don't exist, I'LL GET SOMEONE TO CREATE THEM.

In the health insurance racket, what I would do is hold conferences where I tell doctors and hospital administrators that patients NEED more tests, you can never be TOO careful, and that I will be paying top dollar for those services. And why would the doctors revolt? They are getting more money too. And when that happens, the insurance companies will go to the OPM or any other oversight board and tell them "ohh, last year, for this type of disease, our costs increased by 12%, therefore we will need an overall premium increase of 5% to offset our increased cost." And they have the numbers to PROVE IT... they aren't cheating, just gaming the system. The system this legislation sets up. Let's say they take in $50 B in premiums right now... under this rule that Al is so proud of, they make a maximum of $7.5 Billion. Which is a lot of profit to begin with, but that's the 15% rule. Now, with their game they just played, premiums go up an average of 5 % for the year. Now they make $52.5 Billion in premiums. With the 15% rule, they make $7.875 Billion in profits, or $375 MILLION more dollars. And where did that extra money come from? Us. either in what we pay them directly, what our employers pay them (which is really out of the workers pockets), or from our taxes (in the form of subsidies). Only it won't be 5% per year, count on 8% or 9%... or MORE.

This is one of the WORST PROVISIONS in the bill.

Think it through. Don't accept things on face value. Think like a greedy corporate bastard.

[jeanpalmer]

14. And that's what they will do

to get bigger bonuses. If Franken wanted to limit bonuses, he should have put a clause in the bill to that effect. What chance would such a clause have of passing in the Senate? As we've found with Wall Street, these characters will always find a way to get their bonuses.

Under the current setup, insurers at least have to consider whether premium increases will cause people to cancel their policies. Under the mandate, doesn't seem like they will have to make that calculation. The sky's the limit. More premium, more profit.

[girl gone mad]

15. Simple logic is all that's required to understand how destructive this bill is.

The provision mentioned does nothing to cut costs, yet by mandating that everyone purchase private insurance, we are effectively removing the single biggest cost control measure currently in place.

In order to attract customers, particularly the young and healthy ones, insurers must offer somewhat reasonable rates. If the rates are too high, people will simply choose to pay for health care out of pocket and take their chances that catastrophe won't hit them. This certainly isn't the optimal situation, but the fact that everyone has that choice gives these companies an incentive to keep premiums down. With that incentive removed, Insurers are free to raise rates much more aggressively.

[tinrobot]

20. Right on the money.

This needs to be a separate thread so it gets seen.

[lapfog_1]

21. I've posted pretty much this same thing

over and over in response to other threads, and once in it's own thread (as part of a larger argument against passing this bill).

Not once, in over 12 to 15 such postings in the last few days, has any of the "cheer leaders" for this bill been able to either prove me wrong or even disagree with my assertions. There have been a few that simply parrot the talking points ("it will cover 30 million more Americans, it's a small step in the right direction, etc) but they can't tell me why I'm wrong about this.

If I thought it would do any good, I'd start another thread... but the deal is done, the MSM is declaring "victory" for liberals, and many that were initially against it are climbing on the bandwagon.

For a lot of people here and elsewhere, it seems much more important to "defeat" the Republicans than it is to actually read the damn bill and figure out what it means.

[coti]

24. And there it is. nt

[Chulanowa]

12. AL FRANKEN IS DEAD TO ME!!!!

:sarcasm:

[Jeff In Milwaukee]

17. He's not good enough. He's not smart enough.

And, gosh darn it, I don't like him!

:sarcasm: Big Time

[midnight]

13. RJ Eskow a consultant to the health care industry says he is not against the Senate

version of the bill that comes from the state of Mass. model. He does say this model has a problem in that they were not able to control costs. Yet they are wanting to use this model for the whole country. He explains that the insurance co. play the numbers. They continue to make "mad money".

He says the cap of profit at 10 % gives the appearance that insurance industry profit will be low, but infact they calculate that profit of the overall bill so they can earn more money via their accounting. They play the numbers. I believe the insurance co. are required to spend 90 % on premiums of actual health services. This is not a cost containing incentive..... It is an incentive to drive up costs.. This is a huge win for the insurance co. and not the progressives.


When controlling costs: this bill is a "Faith Based Imitative" You have to pay this tax when bill kicks in, but the kick in of services come in years down the road.



http://www.youtube.com/watch?v=-_oVK7iXkgo&feature=player_embedded

[Toots]

18. What Profits, Gross, Adjusted Gross, or Net Profits?

It makes a Huge difference.. Net Profits are after all expenses are paid including huge Salaries...

[Motown_Johnny]

23. Spend 85% of premiums..........

They are not saying that the companies get to make X amount of profits. If that were true your point would be valid.

[Vinca]

19. Actually, this might be an incentive for insurance companies

to raise premiums drastically. The whole problem with health care costs stems from a provider charging a price and big insurance telling them what percentage they are willing to pay. Next time the provider raises the price so the percentage will meet their original number. What's to stop big insurance from raising their rates so they can spend 85% and still keep the same profit? That's where the anti-trust legislation would have been important, but thanks to Joe they're free to rape and pillage.

[TorchTheWitch]

27. And of course they will do just that

Why wouldn't they? There's nothing that says they can't and there's no cheaper competition to stop them like a cheaper government health system anyone could get into.

We wanted reasonably priced health care and we got manditory more expensive health insurance that doesn't actually provide care unless you're wealthy enough to pay not only the more expensive premiums but also the more expensive co-pays and deductibles. And if you get your insurance through your job now you also have to pay a tax as though getting insurance through your job is some kind of gift.

This is far worse than doing nothing. Look at how much stock prices for the health insurance industry have gone suddenly gone up, and Goldman Sachs just announced they're going into the health insurance business.

[JimWis]

25. K&R - And thanks for sharing it Berni ..

[applegrove]

26. Way to go Franken!