The "Cadillac Tax" is intended to LOWER premium costs

[Capn Sunshine]

Hysteria aside , folks taxes sometimes are intended to create that effect. I've seen a LOT of quoting around here of the Kaiser Family Foundation Study, which has as it's primary assumption that THINGS WILL NOT CHANGE AND WILL STAY EXACTLY AS THEY ARE TODAY as far as scenario. We all know that things are about to change. The old parameters will be just that. Responding to a Bob Herbert column which was slathered all over DU in various incarnations, my old friend Ezra Klien expresses this notion well: (Bold emphasis mine)

Herbert argues that the excise tax will push people toward less expensive insurance premiums and begin to tax some portion of some health-care plans. Both are true. I'd say this is a good thing. He says it's a bad one. Distilled to its essentials, Herbert is arguing that, even at the high end, more expensive insurance policies are better insurance policies, and that the government should be subsidizing their purchase. Does that sound like a world in which we're going to control costs?

Cost control is based on precisely opposite premises, in fact. First, more insurance is not always better. Health-care outcomes in Canada and England -- both of which have strong pressures against overuse -- are not worse than those in America. More to the point, health outcomes in Kaiser Permanente, which is a managed-care organization, are not worse than those in Aetna's more expensive PPO plans.

This is precisely what Krugman is talking about, along with http://economix.blogs.nytimes.com/2009/11/17/economists-letter-to-obama-on-health-care-reform/">23 other noted economists two of which are nobel winners. Economics and its function are defined by more than the knee-jerk solipsism one encounters here at DU.

This post was inspired by an excellent Diary at DKos which should be read by all at DU. But it has lots of logical argument and factual data, and I've noticed that sort of argument doesn't work well as it goes against the "HealthCare Sellout Obama Failure" meme so many are desperate to foist on us.

[yourout]

1. It's going to lower benefits packages but it wont do shit to lower premiums.

[stray cat]

2. You mean the insurance companies will love to pay the extra taxes?

Benefits will be decreased but companies will try to stay below the trigger for 40%taxes

[johnaries]

6. companies will try to stay below the 40% trigger, but that does not

necessarily mean that all benefits will decrease. The increased competition of the exchanges (including the non-profit co-ops - not as strong as a PO but still added competition) will both help keep premiums down as well as benefits up. However, the "Cadillac" benefits that encourage overuse will probably decrease which is a good thing.

It's all part of the shift to outcome rather than (possibly unnecesary) procedure.

[Skittles]

4. I'm not sure why so many DUers cannot understand this

[JVS]

8. Because they choose not to.

[Capn Sunshine]

14. so, three nobel-winning economists, and 20 other leading economists are wrong

and YOU are right.
Let's see your argument then

[Hello_Kitty]

70. Milton Friedman won a Nobel prize.

He was wrong about a lot of things. Economists are smart people, but they're not always right.

[Cha]

3. Another great post by deaniac..

thank you Capn Sunshine.

[janx]

27. I can think of no one who was more of an early and involved Dean

supporter as the Capn. He was into that campaign up to his eyeballs and has stuck with DFA ever since.

[dkf]

5. The road to hell is paved with good intentions.

Predicting and shaping good corporate behavior is not so easy.

[blue neen]

7. I appreciate your post.

I'm trying to educate myself as much as possible, and it's nice to see a post that actually helps to do that.

I still don't know what to think, but every little bit of information (not just speculation) helps. :)

[levander]

10. As a man seeking real information on this bill...

I encourage you to read post #9 in this thread.

[blue neen]

39. Thank you.

I will check it out.

[Capn Sunshine]

17. It's not like I just concluded this out of thin air

When this was first brought up, almost a year ago, I was very dubious. I studied both sides of this. I don't get a memo every morning; these are my actiual thoughts.

I'm not accusing anyone but certainly the discord and confusion sown here with regularity should give a you a clue as to actual motives.

[levander]

23. This is the crux of the argument in that article you posted...

The excise tax will help curtail the growth of private health insurance premiums by creating incentives to limit the costs of plans to a tax-free amount.

Now, do you think they're going to lower premiums by reducing benefits or by offering the same benefits at a lower price?

If it's by reducing benefits, I don't see how that lower health care costs, it just reduces the availability of them. Needless to say, this is by far the more likely outcome in my opinion.

It's just intuitive, just think about it for a second when you're not dealing with people playing politics. The economists signing those letters could have done a thorough study and published the outcome. But, they chose not to. They chose to enter the political arena with a simple letter to the politician running this whole she-bang. There's no proof that they put any more thought into the issue than what I've presented you above. And, there's no proof that they're simply offering up straw men as an attempt to hype up their opinions. They certainly don't go into a lot of detail explaining their position. They very well could just be like Krugman who is very up-front about his concerns over the financial issues behind this bill, but wants the bill due to political expediency thinking this is the best we can get from Washington. He says things like, "we'll be fixing this bill for years to come". Those economists could very well just be campaigning for their political beliefs, throwing up a few economic realities that have very little impact on the real situation. If they'd done a thorough study of the issue, there'd be more credence to what they say. I've linked to in this thread, and heard of a couple of other thorough studies in this thread, that indicate there are no cost controls. To put a brief letter that very well could just be campaigning on the same level as these studies doesn't make much sense.

[blue neen]

38. I found this part of the article particularly interesting:

"Excise tax on high-cost insurance plans. The Senate Finance Committee’s bill includes an excise tax on high-cost health insurance plans. Like any tax, the excise tax will raise federal revenues, but it has additional advantages for the health care system that are essential. The excise tax will help curtail the growth of private health insurance premiums by creating incentives to limit the costs of plans to a tax-free amount. In addition, as employers and health plans redesign their benefits to reduce health care premiums, cash wages will increase. Analysis of the Senate Finance Committee’s proposal suggests that the excise tax on high-cost insurance plans would increase workers’ take-home pay by more than $300 billion over the next decade. This provision offers the most promising approach to reducing private-sector health care costs while also giving a much needed raise to the tens of millions of Americans who receive insurance through their employers."

It would be nice to think that this would be true, and I hope that it is. It is such a shame that we are in such a place in this country that we no longer trust what anyone in government tells us...and that's not our fault.

[dkf]

44. Employers Increasing cash wages increases taxes paid too.

You will probably need those wage increases to pay higher Copays and deductibles. Who knows if you can claim those on your tax return so odds are you may be paying with after tax dollars. Just a sneaky little way to increase taxes for us all.

[levander]

9. There is next to no cost controls in this bill...

And that my friends is why this bill is just a giant corporate give-away. 10's of millions of new customers, but no controls over the ridiculous level of costs we pay in this country.

The complete lacking of cost controls in this bill is a giant embarrassment for our Democratic party. And, that's why you'll see a bunch of smoke and mirrors as to why there are various things in the bill are there to control costs, but in reality these things are horribly minor.

For professional analysis, and not just a bunch of politicians and pundits running their mouth, I encourage you to read the "Impact of Proposals on the Rate of Growth in Health Care Costs" section of the Center for Medicare Services' analysis of the Reid bill. The section doesn't end till you get to the section entitled "CLASS Program". You have to read the whole section to understand what the Center for Medicare Services thinks of the cost controls in the Reid bill: http://www.cms.hhs.gov/ActuarialStudies/Downloads/S_PPACA_2009-12-10.pdf">Click

[levander]

11. Also, the Section "National Health Expenditure Impacts"...

Directly talks about how this bill will make health care costs in this country grow faster than they currently are...

[Capn Sunshine]

20. and yet the EXACT OPPOSITE of what you say is stated in this paper

The Congressional Budget Office and Joint Committee on Taxation have estimated that the total net amount of Medicare savings and additional tax and other revenues would somewhat more than offset the cost of the national coverage provisions, resulting in an overall reduction in the Federal deficit through 2019.

How does this study show NO COST SAVINGS? It doesn't. Pretty disingenuous.
Oh and welcome to DU :sarcasm:

[levander]

25. That's the part where they're accepting what the bill says as gospel...

There's plenty of quotes where they acknowledge what the bill says about Medicare savings are in reality, not likely...

That's a major critique of the CBO studies on the Reid bill. The CBO was honest in their analysis. But, according to their mandate, they have to accept what it says in the legislation as true. So, the CBO report is just based on assumptions that are false. The big assumption many have said is not true they are basing their analysis on the fact that this bill says it will cut Medicare costs by half a trillion dollars over the next ten years. That CMS report says it's "not probable" that they'll cut expenses that much. The report is worded fragiley for a confrontational city like Washington. But, my interpretation of the report, they make it pretty clear how aggressive the cuts in Medicare are supposed to be are silly.

Give me a few minutes and I'll find you a specific quote. I'm in the middle of something else right now. Might take 15-20 minutes.

[Capn Sunshine]

29. OK

Look, why in the world would you posit that we can't cut any waste from Medicare? That's like saying there's no waste in the Defense budget.

The resistance to this bill is based in part by what the corporations see as stealth attacks on their padded cushy contracts within Medicare. You better believe that we're going to cut some fraud and waste.

[levander]

33. Not that we can't cut any costs from Medicare...

But, half a trillion is a ridiculous number, see post #31 where I have quotes from the CMS study indicating how drastic those cuts are.

They just say half a trillion because they have to come up with a number that big to pay for this bill.

[janx]

30. Look, though I laugh at your response downthread, I think your

concern is a valid one. But you're making some assumptions here that sound a bit out of touch.

[levander]

32. No, you're just dismissing what I say because it doesn't fit what you already believe...

n/t

[janx]

34. As a matter of fact, when I first found out about the plans

for the mandate, I was livid.

[levander]

31. Found the quotes.

Here's a link to the CMS report again: http://www.cms.hhs.gov/ActuarialStudies/Downloads/S_PPACA_2009-12-10.pdf">Click.

This is one place where they talk about how drastic the cuts to Medicare are:

The PPACA would introduce permanent annual productivity adjustments to price updates for most providers (such as hospitals, skilled nursing facilities, and home health agencies), using a 10-year moving average of economy-wide productivity gains. While such payment update reductions would provide a strong incentive for providers to maximize efficiency, it is doubtful that many could improve their own productivity to the degree achieved by the economy at large. Over time, a sustained reduction in payment updates, based on productivity expectations that are difficult to attain, would cause Medicare payment rates to grow more slowly than, and in a way that was unrelated to, the providers’ costs of furnishing services to beneficiaries. Thus, providers for whom Medicare constitutes a substantive portion of their business could find it difficult to remain profitable and, absent legislative intervention, might end their participation in the program (possibly jeopardizing access to care for beneficiaries). Simulations by the Office of the Actuary suggest that roughly 20 percent of Part A providers would become unprofitable within the 10-year projection period as a result of the productivity adjustments.

Now the cuts proposed by the Reid bill are so drastic, 20% of the providers become unprofitable. Are we supposed to believe the other 80% are going to be raking in the cash? Are we supposed to believe the Medicare enrollees benefits' aren't going to be effected?

Here's a part where they talk about national health care expenditures:

In aggregate, we estimate that for calendar years 2010 through 2019, NHE would increase by $234 billion, or 0.7 percent, over the updated baseline projection that was released on June 29, 2009. Year by year, the relative increases are largest in 2016, when the coverage expansions would be fully phased in (1.6 percent), and gradually decline thereafter, as the effects of the Medicare market basket reductions compound and as the excise tax on high-cost employer health plans affects more policies, reaching 0.5 percent in 2019. The NHE share of GDP is projected to be 20.9 percent in 2019, compared to 20.8 percent under current law.

And, that estimate is still based on the idea that we're going to reduce Medicare costs by half a trillion dollars.

And, an extra increase of 0.1% doesn't sound like much. But, you've got to remember US GDP is one of the largest numbers in the financial universe that has any meaning at all. The US is the largest GDP on the planet. Probably the only larger financial number that would have any meaning is the GDP of the entire planet.

And, health care costs are already spiraling up too fast in this country. You've seen those charts that compare how much the US is spending vs. what other countries spend and get just as good health care? For this bill to make costs go up even faster than they already are is just awful.

And, note that of the "10 year" period, they're saying when the services under the bill really kick in, in 2016, that's when the cost increases really begin. So, it's not even a 10 year period that this bill makes costs go up this much. It's just, mostly, a 4 year period, 2016-2019. Which, coincidentally, is after many of the current politicians in Washington will ever have to run for office again.

[grytpype]

46. Wrong. Just wrong. Totally wrong.

I think the crying libs on this board think "cost control" means "free health care."

The Senate bill has every cost control measure anyone has proposed except med mal "reform."

[levander]

53. Things getting a little out of order in this thread...

gryptype, please see posts #31 and #52 where I've responded to what you're saying here.

[last1standing]

12. How many times does this propaganda have to be proved false?

Klein is nothing more than a shill for this administration and the corporations for which it stands.

[Capn Sunshine]

13. everyone who disagrees with you is a "shill"

DU definition of propaganda= "argument I have no factual response for"

[last1standing]

16. Nope. Just those who continue to spread propaganda that has been proved false.

Another poster created this same thread yesterday and the responses were very enlightening. How many more times do we have to rehash and shoot down the same lies?

[Capn Sunshine]

21. Propaganda= "Facts I can't refute with hysteria"

I'm just laying out what we know-not what "could" happen. Sorry if that doesn't fit your convenient "Health Care Bill Bad " box, or jive with your "Obama is a failure" meme.

What's the point of your negativity again?

[last1standing]

55. Propaganda is the act of spewing out "facts" that aren't facts at all like Klein does here.

Too bad you're more interested if propping up your favorite political personality than actually dealing with policy on a real level. The facts state that even the best columns supporting this tax, like Krugman's, leave gaping holes that need to be resolved before this would be anything less than a way to put the burden of insurance care onto the backs of the working class.

[dionysus]

64. coming from you that's rich...

:rofl:

[janx]

15. And these people, who put in their two cents--

are they shills as well?

Dr. Henry Aaron, The Brookings Institution
Dr. Kenneth Arrow, Stanford University, Nobel Laureate in Economics
Dr. Alan Auerbach, University of California, Berkeley
Dr. Katherine Baicker, Harvard University
Dr. Alan Blinder, Princeton University
Dr. David Cutler, Harvard University
Dr. Angus Deaton, Princeton University
Dr. J. Bradford DeLong, University of California, Berkeley
Dr. Peter Diamond, Massachusetts Institute of Technology
Dr. Victor Fuchs, Stanford University
Dr. Alan Garber, Stanford University
Dr. Jonathan Gruber, Massachusetts Institute of Technology
Dr. Mark McClellan, The Brookings Institution
Dr. Daniel McFadden, University of California, Berkeley, Nobel Laureate in Economics
Dr. David Meltzer, University of Chicago
Dr. Joseph Newhouse, Harvard University
Dr. Uwe Reinhardt, Princeton University
Dr. Robert Reischauer, The Urban Institute
Dr. Alice Rivlin, The Brookings Institution
Dr. Meredith Rosenthal, Harvard University
Dr. John Shoven, Stanford University
Dr. Jonathan Skinner, Dartmouth College
Dr. Laura D’Andrea Tyson, University of California, Berkeley

[last1standing]

18. There's a longer list of scientists who dispute global warming.

And there's a nice long list of doctors who don't think smoking has a causative link to lung cancer. Your point?

[Capn Sunshine]

19. Straw man argument. I guess you can't find any facts then?

You can straw man this all you want. The Cadillac tax is intended to lower premium costs. Find an academnic study or some facts that dispute this.

[levander]

24. I've already linked to an academic study that refutes this...

See post #9 in this thread. That section in the CMS report has a couple of paragraphs on the Cadillac excise tax. It says it won't do much.

[Capn Sunshine]

26. ah yes the one that quotes the massive cost savings the bill has

that will bring donw the deficit.

[janx]

28. But it's all a conspiracy!

:rofl: It only counts if you believe what's in the bill, because the CBO based its response on the bill, but the bill is lying!

[levander]

36. Now you're getting it...

You don't believe it, but you are starting to understand.

This is all a political game. And, like usual there are smoke and mirrors in politics. See post #31 where I've supplied quotes from the CMS study on this Reid bill.

[janx]

57. OK.

[last1standing]

42. So the previous poster is fine but I'm offering a strawman. Get your propaganda straight.

You're looking foolish.

[janx]

22. Yes, and there are many more people, in fact,

who believe that the earth is 6,000 years old. But that has nothing to do with the topic. ;-)

[last1standing]

43. It refutes the idea of throwing out a bunch of names in support of insurance care.

But I notice you don't post this to that poster, only me. Interesting.

[janx]

47. Look at the institutions those names are affiliated with. n/t

[last1standing]

48. Better yet, look at the names themselves.

Most are centrists who could be expected to fall in line with this travesty. I would be more surprised if they didn't support it.

[janx]

50. Which ones are centrists and why do you think so? n/t

[last1standing]

51. You have all the information you need to check on it. Go ahead.

I'm not going to waste hours presenting info that you're very likely to dismiss without reading so that you can go elsewhere and make the same charges.

[janx]

56. No, I'm really interested. Do these people have some ideology

that we should be aware of?

[last1standing]

58. I've already stated so. Since you don't believe me now, you won't believe me later.

Go check for yourself and see if these are progressives or centrists.

[janx]

60. No, you haven't. You have said:

"Most are centrists who could be expected to fall in line with this travesty. I would be more surprised if they didn't support it."

Where are you getting this information, and why do you think so?

[last1standing]

61. Read what you asked then read my post again.

I had already stated these are centrist economists for the most part. Once again, I'm not going to waste hours to post what you can easily google for yourself if you're honestly interested.

[janx]

62. You provide no proof and act as if centrist Democrats are bad

for the Democratic party. And then you say that I should look it up? Nay, pioneer. If you are going to make an accusation like that, I think that YOU should be the one to back it up.

At first you said they were like "global warming" (climate change) deniers...now you accuse them of being "centrists," whatever that means.

[last1standing]

63. You asked whether I was claiming they had an ideology. I said "yes".

I'm just not going to waste any more time on this. Go read it yourself or not. I don't care.

[janx]

65. If you claim they have one, please show us what it is./ nt

[Alcibiades]

66. I don't know about all those people

But Kenneth Arrow favors single-payer.

[brentspeak]

74. Oh, right...the "experts"

Same "experts" who told us that things like NAFTA and cheap imports from China wouldn't result in total catastrophe for the United States' economy?

[TheKentuckian]

35. It will over time reduce virtually all plans to the minimum allowed benefit (if they can enforce it)

Its a squeeze play, the pressures of inflation will drive up the bottom while the Max Tax effectively puts a cap on what will be offered and eventually everyone but the wealthy will have near junk insurance.

The desperation seems to be with the bill spinners, you've got the votes, you think you're right, you think the people will get onboard, you think the people are getting a good deal, and you think the plan will reinvent the system we have now but you're still pitching, spinning, and trying to change minds.

[yourout]

54. Ding...ding....ding......we have a winner. That is exactly what will happen.

[boppers]

59. Eventually, everybody but the wealthy will have equal insurance.

That much seems clear, just like in every other industrial nation, there is a minimum standard provided for, and required.

Those used to less will have more, and those used to more will have less.

Kind of like schools having to adjust, so everybody gets a fair amount.

[stuart68]

37. ridiculous

Why did Toyota for Lexus ? because delivering essentially the same product for a luxury price results in larger profits for the corporation. Larger profits allow them to keep the cost down and quality high for Toyotas (most would argue that the corresponding Toyota is better than a Lexus).

I cannot believe that Cadillac plans invite more consumption, driving helath care costs higher. I believe the opposite is true. This is the perversion of a tax-the-rich mentality. When you run such a high deficit, the definition of rich keeps getting lower. It has now dropped to the level of a blue-collar worker. Don;t believe me ? then explain how we are now taxing union worker health care plans.

Wake up folks ...

[depakid]

40. You're going to end up with worse coverage and declining health outcomes-

along with lower and lower scores on major health indicators.

That's the effect of increasing the prevalence of junk insurance that people can't afford to use- and that will continue throwing people into medical bankruptcy.

Fortunately for people in Canada, Britain and Australia- our health outcomes will continue to improve- our people will live longer and be healthier over time, all the while knowing that they're fully covered in the event that they or a family member fall ill or is injured.

[quaker bill]

41. Thanks for the thoughtful presentation.

A 40 percent tax, in the current tax structure, is obviously intended to be punitive and diminish undesired behavior. A 40 percent rate is not set to collect revenue but to discourage spending at or above that level. A few of the wealthy will not care and will pay the tax, most folks will opt for plans at least a bit under the threshold. I have decent coverage and am well below the threshold.

The same hysterics you mention are also puored all over "mandates". People seem unwilling to notice that any socialized plan with a modest chance of success would also have been mandatory, and that there never was a free lunch in the offing. You cannot insure and provide healthcare for an additional 30 to 40 million people for free. It needs doing and was always going to cost money.

[janx]

49. Thanks, QB!

Any socialized plan will cost taxpayers money. The fact that we're using the current insurance companies rather than creating new ones means very little. It goes back to what Howard Dean said about the system in Switzerland.

When government (taxpayer) money goes into any private company, that company becomes owned by the government. The taxpayers are paying for it.

Okay, I said it. Shoot me. The way this is being set up means that the government will essentially own the insurance companies. Insurance companies don't like that. This goes back to Speaker Pelosi, when she said that when all is said and done, insurance companies are going to WISH that we had gone with the public option.

[levander]

52. But, you can do it for less than we're paying now...

You cannot insure and provide healthcare for an additional 30 to 40 million people for free.

No, you can't. But, you can do it for less than we're paying now when those people aren't insured. Check out the Healthy Americans Act, which is a bill that has broad bipartisan support. Note that the Reid bill only gets 94% of the nation covered. The Healthy Americans act gets 99% of the population covered. It eliminates Medicaid and S-CHIP in favor of providing lower income people subsidies so they can go buy their own health insurance. It doesn't touch Medicare with ridiculous claims that it will cut the program by half a trillion dollars and keep current benefits in tact. It, in fact, doesn't touch Medicare at all. And, it does it for less than we are paying now. Read about it here:

http://www.huffingtonpost.com/lanny-davis/the-healthy-americans-act_b_301962.html
http://www.huffingtonpost.com/lanny-davis/the-wyden---bennett-healt_b_293117.html
http://www.huffingtonpost.com/lanny-davis/a-plan-for-universal-cove_b_309513.html

America pays a lot more for health care than other countries. There are ways to reduce spending and get more people covered. The Reid bill just isn't one of them.

[angee_is_mad]

45. kick

and keep kicking.

[janx]

67. kick

[FrenchieCat]

68. So glad to see some willing to have an informed conversation,

less those who have participated in the thread but offered nothing but generalized strawmen arguments.

The way I see it, I really don't trust the consistent historical naysayers here to analyze the HCR bill without including their heavy bias, which of course, they have.

When I read the arguments, most of the HCR Bill foes want us to be so cynical about this bill, that we are only supposed to factor in the worse of the worse scenarios, because....well, because they say so. On something this important, I'd rather go with the Nobel Prize winners, the CBO, the President, the Democrats in Congress who spent 30 years or so working on such a bill (Like Ted Kennedy), and as well as folks that have some experience in the matter. In otherwords, I choose to hang my hat on the side of those who have been trained and have studied the matter, rather than some Keyboard warriors who also didn't believe that Obama could win the election, and therefore shouldn't have been the nominee. In fact, their "The Sky is falling" campaign, is becoming quite tiresome, and is starting to smell like a propaganda campaign against reforms that are truly badly needed, asap. The lashing out smells of desperation. This bill could have been better, but it ain't going to be keeping the status quo, and those who want to underestimate how much this bill will benefit millions, obviously don't really care.

Thank you for your input. It is much appreciated.

[donheld]

69. Who gets to decide what's a Cadillac plan and what's a used Ford Pinto plan?

[backscatter712]

71. How dare you use logic and reason here!

You can't use economics and cite Nobel-Prize-winning economists here if it's in favor of something unpopular!

[freddie mertz]

72. I put a lot of faith in Dr. Dean.

Health-care bill wouldn't bring real reform

By Howard Dean
Thursday, December 17, 2009
If I were a senator, I would not vote for the current health-care bill. Any measure that expands private insurers' monopoly over health care and transfers millions of taxpayer dollars to private corporations is not real health-care reform. Real reform would insert competition into insurance markets, force insurers to cut unnecessary administrative expenses and spend health-care dollars caring for people. Real reform would significantly lower costs, improve the delivery of health care and give all Americans a meaningful choice of coverage. The current Senate bill accomplishes none of these.


http://www.washingtonpost.com/wp-dyn/content/article/2009/12/16/AR2009121601906.html?hpid=opinionsbox1

[blueworld]

73. As usual, Ezra's logic causes me vertigo

I think Mr. Herbert's point is that the government will be subsidizing CRUMMY insurance policies, not expensive ones. WE'LL be subsidizing the expensive ones.

And unless Mr. Klein is unfamiliar with capitalism altogether, the more expensive insurance policies ARE the better ones and those issued in more expensive (a.k.a. "BLUE") states. So the rich states will be taxed to subsidize the poorer ones - yet God forbid rich taxpayers are asked to subsidize poorer ones. Vertigo.

Lastly, it's true that certain treatments can be effective wherever you get them, but I'd still like the option of sending my spouse to the Mayo Clinic IF I & the DOCTOR felt it necessary. That's not an option under the "cheap-ass, one-size fits all" insurance plans he calls "effective". They offer extremely limited choice. That's why they're cheap.

I can't write another word about this or Klein or Krugman. I've lost so much respect for both of them, I need to go get some perspective back & tolerate their opinions without indigestion. God Bless Bob Herbert. Good luck, brothers & sisters.

(edited spelling).

[Zomby Woof]

75. ZombyKick

:hi:

[Warren Stupidity]

76. By reducing care and increasing out of pocket expenses.

Thanks.

[last1standing]

77. It's INTENDED to lower health care costs by upping co-pays and reducing treatment.

It's this administration's way of pushing down expected benefits so that their crappy, insurance care doesn't seem as bad to the masses and doesn't break the bank. It's important to understand that Obama and congress are guaranteeing corporate profits but not actual health care.

[FrenchieCat]

78. No, it isn't intended to do what you are speaking of......

in fact, I'm totally sure that you don't know what in the fuck you are talking about.
But then that wouldn't be anything new with you. You're addicted to the sound of your own voice....
talk loud and carrying a pixie stick! That would be you.