Ganelon, the push to reduce liability is partly being done on behalf of doctors (i.e. politically throwing a bone); it hasn't been an area adding appreciable cost to the system, no matter what Republicans charge (wrongly, as usual). It's fine to limit liability but we must remember that it won't add much savings, and we can't forget what it's meant to prevent. The real reason is to get rid of defensive medicine, which has been (as far as I can tell) a significant structural cost.
professor ganson wrote:Amazing stuff happening. Investing in the health of the workforce rather than starting pointless wars? A remarkable strategy! It's nice to have someone intelligent in charge again.
And it actually will reduce the deficit in coming years, and free up more of Americans' money to do things we have traditionally enjoyed rather than investing a greater and greater share in health care. Well, hopefully, that is. It's promised to be $950BN over ten years and reduces the deficit by some $138BN. Whether this is realistic remains to be seen; there are some
rather credible voices out there criticizing it. What I will say on this point is that the US really does not have "crippling" debt (look at Greece, Iceland, and Portugal or Spain, can't remember which - all in varying degrees of danger of defaulting on debts - even the UK is worse off than the US on finances at the moment), and that this is still a worthwhile thing to do. We still ought to work within bounds, but if you ask me health care adds to the strength of the nation and is a worthwhile, even mandatory, investment - just as the public roads, education, and those subsidies farmers love so much.
States' rights and being forced to buy a service
The "zomg it's being farced on uzz" argument is puerile and ridiculous. People hated the public schooling movement too (SOCIALISMS actually that was before that became a rallying scare phrase in the US), but that wasn't the end of the country either (far from it actually). Nobody was forcing people to go to the hospital either, so maybe if the uninsured had been good free choicers and had suffered and died quietly instead of being a burden on the system we wouldn't have had to make this (admittedly tough) choice.
Let's not forget that the Attorneys General of 10 states (led by Florida and including Michigan) are filling a suit to challenge the constitutionality of this bill and to opt out of the system altogether. There may end up being states where you're not forced to buy insurance after all. So come to states with wonderful futures like Florida and Michigan...I love Florida and Michigan, but our public servants are doing a terrible job.
Medicare Advantage is pretty horribly cost ineffective and really does deserve to die in favor of better plans.
Cadillac Plans
The so-called "Cadillac Plans" being targeted were meant to be those high-cost plans that an individual would never actually pay for themselves, but which an employer - getting tax breaks to provide them - would pay for instead. These plans are adding to costs and allowing doctors and patients to schedule medically unnecessary procedures and visits without a second thought. They are a structural deficiency in the current health care system. The bottom line is that people ought to take more responsibility for the procedures they're having done, already at appreciable public expense.
This January article in the NY Times rightly points out that there is an obvious potential harm in people not going to the doctor when they should in order to try to save money, and suggests a solution. I think we have to be realistic here; health care costs money and while people worldwide view it as a right, it has to be paid for, and people ought to think of alternatives to using doctor visits and prescriptions to "fix" everything. Hence the push for ways of rewarding healthy behavior - we shouldn't pretend that a good health care plan is a substitute for healthy living.
As I understand it, the "attack" on "Cadillac Plans" is merely a bid to make those benefits taxable. Woe!
Cost to the poor
As it stands today, you will get a subsidy to buy health care if you are making less than four times the poverty line. Starting out, penalties for not having health care are 1% of income or $95, whichever is higher. Later that amount may rise to 2.5% or $695 (iirc), so you really aren't forced to buy health care, but there is still a recognition that the uninsured cost the system money. Additionally, it must be remembered that in states like Massachusetts there are already folks going uninsured and buying health care when they need it (in fact I did this myself recently).
How to sink health care
Aside from the obvious Republican bids to derail these reforms, members of the insurance industry have been making out like bandits so far, so despite this widening their base, the various companies might dick around with rates and such. There has been talk about forcing competition across state lines and the like. They seem to have a clear motive for doing what the credit card companies did recently in response to pro-consumer legislation: hike costs and blame the government.
(Edit: added last point and a summary for "Cadillac Plans")
