Jacob Hacker's take on the Senate Bill...

[damonm]

http://www.tnr.com/blog/the-treatment/why-i-still-believe-bill

OK, anybody want to call THIS guy a "corporate sellout"? The author of Health At Risk: America’s Ailing Health System and How to Heal It (2008)?

Now that the core demand of progressives has been removed from the Senate health care bill--namely, the public health insurance option--should progressives continue to support the effort?

For me, the question is particularly difficult. I have been the thinker most associated with the public option, which I’ve long argued is essential to ensuring accountability from private insurers and long-term cost control. I was devastated when it was killed at the hands of Senator Joe Lieberman, not least because of what it said about our democracy -- that a policy consistently supported by a strong majority of Americans could be brought down by a recalcitrant Senate minority.

(snip)

As weak as it is in numerous areas, the Senate bill contains three vital reforms. First, it creates a new framework, the “exchange,” through which people who lack secure workplace coverage can obtain the same kind of group health insurance that workers in large companies take for granted. Second, it makes available hundreds of billions in federal help to allow people to buy coverage through the exchanges and through an expanded Medicaid program. Third, it places new regulations on private insurers that, if properly enforced, will reduce insurers’ ability to discriminate against the sick and to undermine the health security of Americans.

These are signal achievements, and they all would have been politically unthinkable just a few years ago.

[rpannier]

1. Let's be honest here for a minute

Point 3 is where he hits the nail on the head and why this reform will be a failure in the end

...new regulations on private insurers that, if properly enforced,

They aren't going to enforce it, except if it's to the benefit of the people who stuff millions into their campaign coffers

[damonm]

2. "They aren't going to enforce it,"

Conjecture - I believe differently.

Time will tell.

[kirby]

3. Time will have to tell because...

The Insurance Exchanges wont even be operational until 2013. Pre-existing condition discrimination wont be disallowed until 2014.

I do not understand all this delay. The public is going to sour when this becomes law and people do not see real benefits for 3-4 years. The current administration and congress most likely will be voted out and the next bunch will repeal it. Since no one benefited, people will not care.

[damonm]

4. When all you've been given are half-truths, I can see...

why you believe as you do.

The delay is to set up the exchanges, in effect restructuring a large segment of the economy.
Here's what kicks in as of 1/1/10 - assuming it's signed into law by then:

1. BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE - Reduces the donut hole by $500 and institutes a 50% discount on brand-name drugs, effective January 1. 2010.

2. IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH-RISK POLL) - Creates a temporary insurance program until the Exchange is available for individuals who have been uninsured for several months or have been denied a policy because of pre-existing conditions.

3. BANS LIFETIME LIMITS ON COVERAGE - Prohibits health insurance companies from placing lifetime caps on coverage.

4. ENDS RESCISSIONS - Prohibits insurers from nullifying or rescinding a patient's policy when they file a claim for benefits, except in the case of fraud.

5. EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 27TH BIRTHDAY THROUGH PARENT'S INSURANCE - Requires health plans to allow young people through age 26 to remain n their parents' insurance policy, at the parents' choice.

6. ELIMINATES COST-SHARING FOR PREVENTATIVE SERVICES IN MEDICARE - Eliminates co-payments for preventative services and exempts preventative services from deductibles from the Medicare program.

7. IMPROVES HELP FOR LOW-INCOME MEDICARE BENEFICIARIES - Improves the low-income protection programs in Medicare to assure more individuals are able to access this vital help.

8. PROVIDES NEW CONSUMER PROTECTIONS IN MEDICARE ADVANTAGE - Prohibits Medicare Advantage plans from charging enrollees higher cost-sharing for services in their private plan than what is charged in traditional Medicare.

9. IMMEDIATE SUNSHINE ON PRICE GOUGING - Discourages excessive price increases by insurance companies through review and disclosure of insurance rate increases.

10. CONTINUITY FOR DISPLACED WORKERS - Allows Americans to keep their COBRA coverage until the Exchange is in place and they can access affordable coverage.

11. CREATES NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM - Creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled.

12. HELP FOR EARLY RETIREES - Creates a $10 billion fund to finance a temporary reinsurance program to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55-64.

13. COMMUNITY HEALTH CENTERS - Increases funding for Community Health Centers to allow for a doubling of the number of patients seen by the centers over the next 5 years.

14. INCREASING NUMBER OF PRIMARY CARE DOCTORS - Provides new investment in training programs to increase the number of primary doctors, nurses, and public health professionals.

[kirby]

5. Why would you label the truth as half-truths...

The two facts I posted are the provisions that will impact the most people and the far off future dates are a problem.

The Interim high-risk pool is not a true substitute for eliminating pre-existing condition discrimination and I predict it is underfunded in the bill. The high risk pool will most likely be an expensive catastrophic plan with high deductible and out of pocket expenses. It will not be very affordable. The bill allocates $5B to subsidize the this plan which needs to operate between now and 2014 with a separate program in each of the 50 states.

[babylonsister]

6. You must have missed this; not a done deal, but promising...

Earlier Benefits Could Be On The Table In House/Senate Health Care Conference

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=433x86524

[VMI Dem]

7. Selling the bill with "as weak as it is"

Now thats strong. LMAO.

[WeDidIt]

8. The Exchange is the foot in the door for single payer

It'll take one helluva lot more work to get there than had a public option been included, but the foot is still in the door.

The insurance companies can only put off the inevitable by behaving properly, but they cannot stop it. It will come.