About 1,500 small-business owners used an Internet link to tell President Obama what they thought about the latest healthcare-reform proposals. You can have your turn, too.
The White House wants small-business owners to support reform. So the Chair of the Council of Economic Advisors, Christina Romer, initiated an online discussion on LinkedIn.com. Here’s the question she and the president want answered:
“The White House wants to know: What are the most important issues for small businesses when it comes to health care?”
The question drew more than 1,500 posts in four days. Some sample posts:
- “Small businesses should be able to hire the workers they need, without thought to benefits and perks that larger companies can afford…”
- “The biggest problem is the expense of health insurance. We should get all employers out of the health insurance game and either let the ‘free market’ provide insurance to all (which will be hopelessly expensive), or expand Medicare to all at a far reduced expense…”
- “One of the key issues is people with no prior coverage. They are excluded by current law from coverage for “pre-existing” prior conditions for 12 months…” -
- “The only thing I would like to know is how will those employees I have to lay off to pay for health care for those I retain be better off?”
- “The most important issue is that government stays out of our business. Medical benefits are just that BENEFITS, offered to be competitive in the market…”
- “There is a huge disincentive for uninsured individuals to obtain routine preventive health care- any new diagnoses will just reduce the likelihood further that they can qualify for affordable health insurance…”
- “The problem with healthcare for small businesses is the per-employee cost is much higher than it is for large businesses: most insurance carriers price based on the size of the group and because small businesses by definition have small groups, small businesses end up paying substantially more per person…”
You can have your turn, too. Go to the LinkedIn page, click on the “Answer Questions” tab, register and then post your answer.
BusinessBrief.com delivers the latest business news once a week to the inboxes of over 180,000 executives.
Click here to sign up and start your FREE subscription to BusinessBrief!
advertisement
Tags: Christina Romer, Council of Economic Advisors, Health care, Obama
August 5th, 2009 at 9:45 am
Please do not kill the golden goose that made this country prosperous in the first place. The burdens government (both parties) continue to put on small business are and will continue to drive business and wealth to other countries. I wonder where my kids and grandchildren will be living. I hope it’s here in the US. We must reduce the burdens and shrink the federal governement.
August 6th, 2009 at 1:17 pm
The hand of politics in the economy is driving us to mediocrity that will be paid for by generations to come. We must continue to have options, especially in private sector providers, in order to have the most competitive products. My Senators cannot even respond appropriately to my correspondence, leaving me no doubt that the bureaucracy will devastate health care, education, energy, finance and just about anything else they touch, beyond the military. Stop this agenda now!
August 6th, 2009 at 1:30 pm
We’ve seen what’s happened in the years since the Clinton proposal was defeated. Big insurance companies have increased their profitability while the number of uninsured and underinsured has continued to grow. I seen friends after having treatment denied by their insurer. It’s time to put all Americans on an equal basis for access to life saving health care. Mr. Obama, please don’t let the lobbyists and insurance companies stand between America and adequate health care for all. We need a national plan that takes the profit out of denying health care.
August 6th, 2009 at 1:47 pm
I do not want government run healthcare, Medicare and social security are broken, and another government program is not likely to be any better. Healthcare reform should not include a governement run agency. For small business, we need to have access to the same rates as larger groups. A person should be able to choose their own plan and take their health care with them to new jobs, just like auto insurance. Premiums should be based on the individuals health, not the size of the group they are in. The employer can pay any or all of the employees plan as a benefit. All working people should be required to carry health insurance, just like drivers are required to carry auto insurance. For very low income or unemployed, a catastrophic program should be available, but it shouldn’t be as good or the same as what you can have with private insurance.
August 6th, 2009 at 1:58 pm
I’ve owned a small business for 25 years. We provide employer paid major medical and hospitalization coverage to all five employees. I do not need, nor do I want, more government interference in my business or my life. 1984 was a fantasy world — please do not make it a reality!
August 6th, 2009 at 2:26 pm
Arizona (a Red state) has a perfectly good state-run plan for small business that is very low on paperwork and affordable. Essentially all of the major providers are signed up. I can’t tell you how much easier this plan is to use for both the employer and the employee compared to the private insurers. Everyone should stop sticking up for the private insurance companies because they all deserve to go out of business.
August 6th, 2009 at 2:38 pm
Fix and build the roads and protect the boarders and they stay the heck out of my life.
August 6th, 2009 at 2:41 pm
Mr Organizer, now is not the time for your grand social experiment. If you’d like to pursue this agenda further, you may do so shortly after January 20th of 2013, when you’ll have some leisure time on your hands. Perhaps Kenya could use a socialized healthcare system.
August 6th, 2009 at 2:42 pm
As a small business employer, I am unable to compete with larger businesses on the health care benefits that I can provide. We made the call 2 years ago to stop offering health care to our employees. We have our employees go get healthcare on their own, and are willing to provide a monthly “allowance” to help cover their costs. We were paying over $500 per month per employee for the coverage in our small group as an employer. My employees can get health care coverage that is as good in the free marketplace at a cheaper rate.
The employees who cannot are those with pre-existing conditions, and they are in a tougher spot.
I think the free market can work for health insurance if the pools were nationalized, rather than limited to the group concept that puts our company into it’s own group. What if health insurance wasn’t an employer benefit, but was an American benefit? Take it out of the realm of the employer, and put it into the realm of the individual.
But no matter what happens — and I believe it’s been proven over and over, Government run programs end up being much less efficient than when run in the private sector.
That being said, I also believe that the third-party payer system is broken. If drug companies can run their ads to individuals for all manner of new conditions and symptoms, and individuals go to their doctors – both the individual and the doctor are not the “payers” — so the doctor writes the scrip, the individual gets their new designer drug, and the insurance co. pays the tab — at the price the drug companies are charging — where is the free market in all of that? If the individual knew that the new drug cost an exhorbitant rate for the bottle of pills, would they choose to spend “their” money that way? In the “free” market, most of those drug prices would come down. But that gets eliminated with the 3rd party payer system.
I know there are a lot of angles on this, and lots of arguments that could be made. But those are some of the perspectives that are real for me.
August 6th, 2009 at 2:56 pm
If this legislation goes through, it will most likely put me out of business.
The fallacy of the Obama campaign was that he was looking out for the “working man” and for the middle class. This really couldn’t be farther from the truth. It’s too bad that so many of the general public know nothing about what it’s like to run a business and they just continue to drink the Kool-aid while waiting for their own bail-out check. They’ll be waiting a long time.
August 6th, 2009 at 2:59 pm
WHAT WAS WRONG WITH COMPETITIVE PRICING. ANYTIME THE GOVERNMENT GETS INVOLVED WE LOSE OUR FREEDOM TO CHOOSE AND FREEDOM FIND COMPETITIVE CHOICE. I HAD TO CLOSE ONE BUSINESS BECAUSE OF INSURANCE ISSUES AND PUT PEOPLE OUT OF WORK. LET US NOT DO THAT TO ANOTHER ONE BECAUSE THE “NEW” ADMINISTRATION WANTS TO DISTROY AMERICA AT ITS CORE.
NO BENIFITS FOR ILLEGALS UNTIL THE REGISTER TO BECOME AMERICANS. IF IT IS TOO MUCH PAPERWORK , FIX THAT
NO BENIFITS FOR TERRORIST UNTIL WE REGISTER THEM AND SEE THEIR FACES- TOO MUCH PAPERWORK -FIX THAT
CONGRESS DOES NOT A RAISE AND NEITHER DOES AMERICA NEED A BAIL OUT. FIX YOUR HOUSE BEFORE YOU TAKE “OURS”!
August 6th, 2009 at 3:01 pm
The government has already ineffectively handled Medicare, Social Security and need I say more? We are now how many trillions of dollars in debt? The banking bailout was a joke. The only folks that seemed to get that money were the CEOs who got millions of dollars and left their failing banks. I am sorry – but, if I ran a business and it failed – would I get millions of dollars? I know that some of that needed to happen to keep the world as a whole afloat – but, it was also inefficiently handled. We need to get back to free competition – which is what this country was founded on. We ran away from England because they tried to have the government control everything and overtax the masses. Healthcare is the last thing that I would want to see the government running. Just think how long it takes you to go get your license renewed at the DMV or your social security number at the SS office. If the government wants to get involved in removing the fraud involved with Healthcare – that would be a great start. I think if we take all the $$ that the fraud is costing businesses and the american people – we would see a definite decrease in the costs. But, they don’t need to be running healthcare and our lives to that extent. Socialism has not worked in other countries – why would you think it would work here? We want personal choice. We want to keep our personal freedoms. We don’t want to be taxed 50% or more like the other countries who have socialized medicine in place. I don’t want the government deciding if my mom will live or die or if I will for that matter. What needs to die is this Healthcare Reform bill. Free enterprise with good regulation is the answer.
August 6th, 2009 at 3:37 pm
I don’t think you care about small business and the middle class families! You have your own agenda and do NOT listen to what the majority of Americans want. I do not want healthcare socialism. I work very hard to have health insurance and to be able to get the doctors and the healthcare my family needs. YOU are taking this away from me!!! What happened to free enterprise that this country was built on. All you liberal Democrats and Obama want is power and to pad your pockets even at the cost of selling America up the river. The silent majority are sick and tired and are finally STANDING UP and fighting back!! The news media needs to go too!
August 6th, 2009 at 3:48 pm
I encourage Congress to work on the real issues: Tort reform, portability for everyone and better oversight but do not get the govenment involved in running an alternative program. The quality of our healthcare itself is not broken but the way the care is administered.
August 6th, 2009 at 3:50 pm
As several have pointed out, one of the key issues with health insurance affordability is the cost variance based on group status and size. Otherwise, the private health insurers provide a good product and encourage good health and cost containment. To resolve the downside of the present insurance market, instead of replacing it with a government health care system, simple remove roadblocks to the creation of group plan options outside the present employer focused model. Allow and encourage group coverage thru other non-employment related entities. (NAACP, NRA, AARP, Sam’s Club, chambers of commerce, etc.) This would afford more options for the benefits of group coverage to everyone, and not be vulnerable if employment changes. Costs would be better contained, fewer individuals would need to be on government programs, (help save the deficit) The present laws which aid for transition between plans would serve to protect as coverage when coverage changes for whatever reason. HR3200 is not drafted to improve or make more affordable health insurance available, but to replace it with health care provided by the government or mirrored to the government plan. Several provisions serve to encourage elimination of private insurance. If you haven’t read this bill, I highly encourage it. http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3200 Obama says he isn’t going to take away our coverage if we like it, but it is Congress who drafted the legislation. So he might not, but are they? Read for yourself…
August 6th, 2009 at 4:20 pm
Ditto to all the above.
August 6th, 2009 at 4:21 pm
The government should stay out of healthcare. No person or thing can be all things to everybody. The government is now a car dealer and next an insurance salesman? How do they plan on funding all of this nonsense.
Perhaps they could quit paying for illegial or legal alien’s health and welfare benifits and come up with a substantial amount. Just because there is a company it does not mean that they can afford to pay more. I am not responsible for my employees 24 hour a day life and neither should the government. All I see are new tricks to tax everyone more. I do not work for my self but the government.
Why is it that the Senate and Congress get better healthcare than the average guy? We might not elect you any more. Polititions generally have never had a job in the real world, vote themselves a raise, get free healthcare and regardless get paid the same amount per year. How can these people even begin to understand the real world.
August 6th, 2009 at 4:26 pm
My small business strongly SUPPORTS HEALTH CARE legislation and we want health care to be more widespread. We are at a competitive disadvantage because we do cover our employees. This socialism scare talk is reactionary and does not reflect reality. One reason our employees stay with us is because of our health care plan. We emphatically support a public option.
August 6th, 2009 at 4:40 pm
Mr. Obama,
Quit trying to get involved in everything America and just fix government. Try putting some pay cuts in place like every other business and try trimming the fat like you said in your campaign. Just stay out of everything else and let capitalism work even though you don’t like that thought.
August 6th, 2009 at 4:48 pm
What was sold to us Obama voters was health care “reform”, turns out to be health care “take-over”! Goverment run health care has not improved health care in ANY other country, what makes Congress think it would work here? And if they are not willing to be on the same plan as the rest of the country, that makes me suspect.
August 6th, 2009 at 4:53 pm
Naomi – Wake up. The socialism talk is exactly what it is – not reactionary at all. Go look at Canada, England, etc. and their health care socialized programs. And, then come back and say all the talk is reactionary. All I am saying is go and do the research. All the stats are there.
August 6th, 2009 at 5:06 pm
The Govt needs to lead the change on Health Care reform, we cannot continue going down the same path. We plain cannot afford NOT to change.
August 6th, 2009 at 5:13 pm
Mr. Obama,
Since you asked, I hope you will actually listen to the responses. I have read many of them and feel like they do – please stay out of our business. You are not helping but hurting us and the people who work for us if we have to reduce our staff due to the burdens government is trying to place on us. We want to provide as much as possible for our employees and health insurance should be a benefit we offer if we can and not something mandatory that may force us to decrease our staff because of the cost. Do you not understand that small businesses provide jobs for people and when a small business has to downsize it means more people on unemployment???? Please don’t socialize us we are a democracy. I don’t want to wait in line for months to get treated. I don’t want to be like Canada whose people come here so they can see a specialist right away and not in 6 months (they might die before then!). If you think this plan is so great then why won’t you and congress participate???????? Health coverage needs some improvements but not a government run program.
August 6th, 2009 at 5:17 pm
I think the talk here is too much about health insurance and not enough about healthcare. Certainly, health insurance has become a major part of our national economy, and nationalizing such a thing would cause some serious economic problems. At the same time, health insurers have unquestionably taken advantage of their situation, and healthcare itself has become significantly more expensive BECAUSE of health insurers.
Too high a profit has been taken, and too many health care decisions are based on whether the health insurance company “covers” a procedure. The whole process is not right.
Now the trillion dollar question – can the feds do it right? I doubt it. I have been a Republican, but am falling away from this party as it fails to support small businesses and most businessmen in America, and has proven the be the real big government part, deny it as they might. The Democrats are just as bad or worse, and the problem is that all have become District of Columbians more than they are Americans.
If more states could accomplish a local solution and had the politicians with the backbone to pull it off, (yeah, there would probably be some tax increase to cover it), that would be a better solution. But, too little backbone. Too many bought legislators in DC. Too much money in health insurance, and too much inefficiency across the board.
August 6th, 2009 at 5:33 pm
It is quite clear that any “revision” of the current system will require government rationing of health care in one form or another.
It is quite clear that any “revision” of the current system will be enormously expensive, and somebody will be paying for it.
It is quite clear that when the perceived cost of health care is zero or near zero — the expense hidden in taxes in one form or another, the demand of that health care will approach infinity.
Were the government to face up to and admit to these facts, the proposed reforms would be
much more acceptable.
It seems to me if health care reform is to be inflicted upon the American public, it should be done at a gradual pace that would enable the American public to pay for it.
August 6th, 2009 at 5:50 pm
The reality of the Obama White House and this so-called public option is this. It’s not health care reform. It is a take-over of health care insurance. Nothing in this legislation reforms health care. It does not lower the cost of education. Lower the cost of litigation. Lower insurance costs. It does not put more doctors, nurses, care-providers in the system that is currently short an estimated 100,000 specialized physicians, 300,000 medical doctors, and an estimated 400,000 other care-providers. This legislation will diminish the number of doctors available to the public. It will create mega treatment centers and hurt rural areas that are in desperate need of care providers. It will diminish the quality of care by reducing the numbers of doctors and increasing the number of patients.
It does not address the issue of technology reform and cost improvement. What it does is state that the government can “counsel elderly” patients and their families on “end of life.” This means that my parents, your parents, and eventually us, will not be able to get quality of life treatment. The number one cost to health care is an individual’s last 5 years of life. It makes up 87% of all health care costs and in-direct cost.
So do we do what Nazi Germany did during the war and those individuals in poor health were “counseled” on end of life so the troops could get medical attention and equipment necessary?
This plan will cost jobs it is that simple. In the beginning if your employer has coverage then they will be taxed because they offer coverage. So the government is going to penalize an employer because they have coverage. If your employer does not have coverage they will be taxed. Damned if you do damned if you don’t. If you are an employer and the government feels your plan is not adequate then you will be taxed. If it’s an excellent plan then you will get a luxury tax.
So an employer will get taxed. How will these costs be covered? A number of ways. First an employer will have to reduce salaries. Salaries, benefits, bonuses, etc will all be cut to make up the cost of the tax. Then an employer will have to lay some people off and limit expenditures such as advertising, equipment upgrades, office improvements, travel, new cars, office supplies will get bird-dogged etc.
The Obama legislation is also a morale killer. People will become nervous because they will not know if they are going to have a job or for how long or even if their employer can survive. Small employers will shrink and fade away and large employers will become larger. So in essence the legislation begins to dwarf the middle class the same people they claim to be helping.
Here are a couple of government insurance programs now. Flood insurance, Medicaid, and Medicare. All are broke. Our other safety net is supposed to be social security. Well our government has spent every penny of these funds. The program has never been solvent. It was not solvent when Clinton left office either. The CBO “projected” a solvent fund with “new revenue.” That is like going shopping for a new car and writing the check for it and hoping those “new funds” hit your bank before the check does.
The difference is the government never defaults because you pay the bill. Another government agency and I applaud the people that work there, are the U.S. Postal Service. This agency is broke. The funds they receive from sales of stamps, goods and services do not cover the cost of running the post office. This year it is projected that they will need another 24.2 billion dollars to cover costs. Most of these costs are benefits for retired workers, aging facilities and equipment.
Does anyone really believe in their heart that the government can effectively run healthcare for the American people when they cannot efficiently run the U.S. Postal Services, Medicare, Medicaid, Veterans Administration, Flood Insurance Program or even the U.S. Treasury? But you will put them in charge of your healthcare coverage?
August 6th, 2009 at 6:13 pm
Dear President Obama:
I am a small business owner and each year at renewal my premiums increase 110% even though I do not use the insurance only once a year for exams and regular diagnostic services yearly. I do not cost the insurance company a dime. I ask at renewal why do I constantly have an increase in my premium, I m told because of my age. I amvery healthy never sick.
Please put a stop to big insurance company tactics of continuing to rob the small guy!!! We need help in being able to afford good benefits without the big price tag!!! Let figure out a way to make this work for the good of all people.
GOD BLESS AND GOOD LUCK WITH THESE ONE!!! If anyone can do this YOU CAN!!!
August 6th, 2009 at 6:36 pm
I do not know where Kim is located or his “company” but the national average for healthcare coverage for a female is $187. For a male it is $209 per month. That is a full service policy. Regional coverage is about the same. I have SIF for my employees. They chose their own plan. Group coverage is expensive. Does not matter the size of the group. Most large employers have a SIF program. Other companies are sold first dollar programs. Which are always more expensive, benefit restrictive, and “limited market competitive.” Anyone that has a first dollar program has a fool for an employer.
I suspect that Kim either has a very poor agent or just spewing garbage.
August 6th, 2009 at 6:43 pm
We are so highly segregated economically and socially that it seems that neither side of this issue is actually talking with anybody on the other side of this issue. While the current expensive and inefficient health care system works for the wealthier folks in our society, it is terribly broken for most of the middle class and for all of the lower class. At the core, the problem is greed — greed of the health care providers, drug industry, health insurance companies, hospital administrators, and most doctors. Their demand for excessive profits and high salaries cause high health care costs. Until those are under control, we’ll never fix the system.
But in the meantime, there’s really little doubt that a single-payer system would reduce administrative costs by billions of dollars every year. While that is just not politically achievable, a public option would provide the competition that could get the greed merchants to become much more cost-efficient and actually compete for customers. That would be a welcome change of pace. The only way a public option could put the private health insurers out of business is if the private sector cannot adapt and better police itself. I have enough faith in the private sector to feel confident that its leaders might actually wake up and reform themselves when faced with the competition of a public option. And if they can’t reform themselves, then they do deserve to go out of business.
August 6th, 2009 at 6:55 pm
I have heath care insurance! I pay for 50% of the premium for my employees! we dont need nationalized health care, we need a system that encourages employers and employees to take personal responsibility and buy insurance on their own! why should I or my employees buy insurance for people that dont care enough to buy it on their own? President Obama, I thought you were going to make a difference in the lives of 300 million Americans! WHAT HAPPENED TO YOU? I am absolutely shocked that you have turned out to be one of them. We need real leadership in this country, we need a government of the people for the people. THIS IS INSANE!!!!
August 6th, 2009 at 7:18 pm
I was born and raised in England and had to wait three years for a medical procedure that “wasn’t necessary”.
I am an American citizen and will confirm that the American health sytem isn’t perfect, but very good. I own my own business, work hard and provide medical insurance for our full-time employees. The last thing we need is another goverment takeover. It never has worked and wont work now. Thank you.
August 6th, 2009 at 10:05 pm
The emphasis of health care reform is suppose to focus on reducing the cost and covering the uninsurred. However, it appears the planned proposed will cost more (therefore the need for higher taxes) and still leaves many citizens uninsured (but not illegal aliens).
If health care is a human right, then all humans should participate in the expense of having such a right – not just business and those that create jobs (i.e. the wealthy).
Focus first on reducing the costs by 1. eliminated the need for workmans comp insurance if an employer provides medical insurance to the employees 2. control the trail lawyers from frivolous lawsuits by a “loser pays” system 3. regulate the trail lawyers by applying most of the successful claim proceeds to the victim 4. eliminated much of the additional administrative regulatory requirements, such as HIPAA, placed on the medical insurance industry over the past few years 5. eliminate medical insurance coverage requirements for procedures that are not wellness related (such as birth control and mental stress). 6. empower the consumer over controlling medical cost by providing them with a set amount each year for routine medical procedures that they pay from as they go. People value what they pay for. Unused amounts can be accumulated and used in later years. And there are more cost saving solutions…
August 7th, 2009 at 12:04 am
Bubba,
FYI, “Kim” is actually a female business owner. When we stopped our health care plan, and went to individual plans purchased separately, I now pay $192/mo with a $2850 deductible HSA plan. It is in the state of Minnesota. Prior to that, we were with Blue Cross/Blue Shield of Minnesota and had a PPM plan. We covered 100% of our employee’s health care and it was a very good plan. We also included full dental coverage.
The premiums we payed were $524 per employee (which was a little higher or lower based on the age group the employee fell into), and it would have been $950 for a family option for my employees (which might explain why it was really hard to get someone who needed family coverage to work for us).
I am not “spewing garbage” — that is actually how it is. We had our plans priced competitively and all of the quotes came back comparable to that. Our business is 10 years old, and we are a small business – and YES, we happened to have an employee who needed a liver transplant – and got one (which is terrific) – but if you’re a small employer, and your employees actually USE their coverage, you end up in the HIGH bracket, with the insurance companies raising your rates the maximum % allowed by law. You must not have any experience with this sort of thing, or are not a small business employer.
So why is health care something that employers need to provide anyway? I think it’s just because of history. Something about when the Labor movement started, and wanted to provide health care to their members, business chose to provide it instead (because it was cheap back then). And now it’s institutionalized.
But we don’t provide car insurance for our employees (yet they have to get to work, righ?) Why can’t we take the entire deal out of the realm of employers, and provide options (private or public sector offerings – whoever can manage the business and options most effectively) and enable people to get their own insurance?
As employers, we can’t control how people choose to live their lives, and based on what I’m reading in these posts, people don’t want big brother (either in the form of Government or Employers), so why don’t people just want to provide their own health insurance for themselves? Might be because they’d say, “I couldn’t afford it” — which puts us all in the same boat, then.
I think there’s got to be a solution out there — and it might be a big change, which most of the status quo will resist – it’s just human nature — but if it doesn’t alter the manner in which costs are arrived at and payments are issued, then it won’t really fix much.
I’m all for captialism and private enterprise, but for both the financial sectors and the healthcare sectors I think GREED has gotten in the way and created a lot of problems that all of us as Americans are dealing with. And something has to change that status quo.
August 7th, 2009 at 1:29 am
Here is the “Actual Text” of HR3200, which has been introduced in Congress – for the portion of how Employers will be impacted (this is a long and involved bill), and how “small” employers will be impacted (and it dictates what percentage of the premiums we must pay, including a percentage of family plans to reduce the employee cost). It also imposes a “tax” payment that employers will make for any employee who opts not to enroll in a plan. Read it for yourself, and make up your own mind (then send emails to your representatives in Congress, and let your voices be heard:
PART 1–HEALTH COVERAGE PARTICIPATION REQUIREMENTS
SEC. 311. HEALTH COVERAGE PARTICIPATION REQUIREMENTS.
An employer meets the requirements of this section if such employer does all of the following:
(1) OFFER OF COVERAGE- The employer offers each employee individual and family coverage under a qualified health benefits plan (or under a current employment-based health plan (within the meaning of section 102(b))) in accordance with section 312.
(2) CONTRIBUTION TOWARDS COVERAGE- If an employee accepts such offer of coverage, the employer makes timely contributions towards such coverage in accordance with section 312.
(3) CONTRIBUTION IN LIEU OF COVERAGE- Beginning with Y2, if an employee declines such offer but otherwise obtains coverage in an Exchange-participating health benefits plan (other than by reason of being covered by family coverage as a spouse or dependent of the primary insured), the employer shall make a timely contribution to the Health Insurance Exchange with respect to each such employee in accordance with section 313.
SEC. 312. EMPLOYER RESPONSIBILITY TO CONTRIBUTE TOWARDS EMPLOYEE AND DEPENDENT COVERAGE.
(a) In General- An employer meets the requirements of this section with respect to an employee if the following requirements are met:
(1) OFFERING OF COVERAGE- The employer offers the coverage described in section 311(1) either through an Exchange-participating health benefits plan or other than through such a plan.
(2) EMPLOYER REQUIRED CONTRIBUTION- The employer timely pays to the issuer of such coverage an amount not less than the employer required contribution specified in subsection (b) for such coverage.
(3) PROVISION OF INFORMATION- The employer provides the Health Choices Commissioner, the Secretary of Labor, the Secretary of Health and Human Services, and the Secretary of the Treasury, as applicable, with such information as the Commissioner may require to ascertain compliance with the requirements of this section.
(4) AUTOENROLLMENT OF EMPLOYEES- The employer provides for autoenrollment of the employee in accordance with subsection (c).
(b) Reduction of Employee Premiums Through Minimum Employer Contribution-
(1) FULL-TIME EMPLOYEES- The minimum employer contribution described in this subsection for coverage of a full-time employee (and, if any, the employee’s spouse and qualifying children (as defined in section 152(c) of the Internal Revenue Code of 1986) under a qualified health benefits plan (or current employment-based health plan) is equal to–
(A) in case of individual coverage, not less than 72.5 percent of the applicable premium (as defined in section 4980B(f)(4) of such Code, subject to paragraph (2)) of the lowest cost plan offered by the employer that is a qualified health benefits plan (or is such current employment-based health plan); and
(B) in the case of family coverage which includes coverage of such spouse and children, not less 65 percent of such applicable premium of such lowest cost plan.
(2) APPLICABLE PREMIUM FOR EXCHANGE COVERAGE- In this subtitle, the amount of the applicable premium of the lowest cost plan with respect to coverage of an employee under an Exchange-participating health benefits plan is the reference premium amount under section 243(c) for individual coverage (or, if elected, family coverage) for the premium rating area in which the individual or family resides.
(3) MINIMUM EMPLOYER CONTRIBUTION FOR EMPLOYEES OTHER THAN FULL-TIME EMPLOYEES- In the case of coverage for an employee who is not a full-time employee, the amount of the minimum employer contribution under this subsection shall be a proportion (as determined in accordance with rules of the Health Choices Commissioner, the Secretary of Labor, the Secretary of Health and Human Services, and the Secretary of the Treasury, as applicable) of the minimum employer contribution under this subsection with respect to a full-time employee that reflects the proportion of–
(A) the average weekly hours of employment of the employee by the employer, to
(B) the minimum weekly hours specified by the Commissioner for an employee to be a full-time employee.
(4) SALARY REDUCTIONS NOT TREATED AS EMPLOYER CONTRIBUTIONS- For purposes of this section, any contribution on behalf of an employee with respect to which there is a corresponding reduction in the compensation of the employee shall not be treated as an amount paid by the employer.
(c) Automatic Enrollment for Employer Sponsored Health Benefits-
(1) IN GENERAL- The requirement of this subsection with respect to an employer and an employee is that the employer automatically enroll suchs employee into the employment-based health benefits plan for individual coverage under the plan option with the lowest applicable employee premium.
(2) OPT-OUT- In no case may an employer automatically enroll an employee in a plan under paragraph (1) if such employee makes an affirmative election to opt out of such plan or to elect coverage under an employment-based health benefits plan offered by such employer. An employer shall provide an employee with a 30-day period to make such an affirmative election before the employer may automatically enroll the employee in such a plan.
(3) NOTICE REQUIREMENTS-
(A) IN GENERAL- Each employer described in paragraph (1) who automatically enrolls an employee into a plan as described in such paragraph shall provide the employees, within a reasonable period before the beginning of each plan year (or, in the case of new employees, within a reasonable period before the end of the enrollment period for such a new employee), written notice of the employees’ rights and obligations relating to the automatic enrollment requirement under such paragraph. Such notice must be comprehensive and understood by the average employee to whom the automatic enrollment requirement applies.
(B) INCLUSION OF SPECIFIC INFORMATION- The written notice under subparagraph (A) must explain an employee’s right to opt out of being automatically enrolled in a plan and in the case that more than one level of benefits or employee premium level is offered by the employer involved, the notice must explain which level of benefits and employee premium level the employee will be automatically enrolled in the absence of an affirmative election by the employee.
SEC. 313. EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE.
(a) In General- A contribution is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment (determined by taking into account all employees of the employer and in such manner as the Commissioner provides, including rules providing for the appropriate aggregation of related employers). Any such contribution–
(1) shall be paid to the Health Choices Commissioner for deposit into the Health Insurance Exchange Trust Fund, and
(2) shall not be applied against the premium of the employee under the Exchange-participating health benefits plan in which the employee is enrolled.
(b) Special Rules for Small Employers-
(1) IN GENERAL- In the case of any employer who is a small employer for any calendar year, subsection (a) shall be applied by substituting the applicable percentage determined in accordance with the following table for `8 percent’:
——————————————————————————————————————–
——————————————————————————————————————–
If the annual payroll of such employer for the preceding calendar year: The applicable percentage is:
Does not exceed $250,000 0 percent
Exceeds $250,000, but does not exceed $300,000 2 percent
Exceeds $300,000, but does not exceed $350,000 4 percent
Exceeds $350,000, but does not exceed $400,000 6 percent
——————————————————————————————————————–
(2) SMALL EMPLOYER- For purposes of this subsection, the term `small employer’ means any employer for any calendar year if the annual payroll of such employer for the preceding calendar year does not exceed $400,000.
(3) ANNUAL PAYROLL- For purposes of this paragraph, the term `annual payroll’ means, with respect to any employer for any calendar year, the aggregate wages paid by the employer during such calendar year.
(4) AGGREGATION RULES- Related employers and predecessors shall be treated as a single employer for purposes of this subsection.
August 7th, 2009 at 10:05 am
Mr. President,
I am so glad you asked for input. Now, please listen to it. Not only is HR3200 a threat to small business, it is a threat to everyone’s health. I could go into all the reasons why but I believe most of them have been very well stated in previous comments. It appears that you are lacking in education in this area. We are happy to help you here. If you listen to the people who run small businesses that employ 70% of the population and actually deal with these issues on a daily basis, you will be more informed and can then make an educated decision rather than a populist, ideological one.
Tort reform, portability and the related private market competition are the ONLY areas legislation should occur. And that legislation should be aimed at taking down walls and mandates, not putting them up. Unencumbered, free market competition ensure the necessary efficiencies that a centralized, government run, single payer (formerly known in economics as “third party payer”) system never could and never will. And I hesitate to even bring legislators into this in any way. I have learned through first-hand dealings with our state legislators, that once the government puts its hands in something, it simply keeps “touching” it until it becomes this impossible bureaucracy with more and bigger problems than what it intended to solve.
Listen to these people, Mr. President. They have far more experience in running businesses that affect real, hard-working citizens than you do…than Congress does…than your Czars do…than Christina does…..The majority of these participants absolutely, positively do NOT want the government more involved in their health care or their health care insurance. Listen to them.
August 7th, 2009 at 10:17 am
We need health reform badly. Every year we experience double digit increases in the cost of our health insurance and higher co-pays and deductibles. We are small social service agency. We start our workers out at a salary of $25000. A family plan costs 13, 485.00 per year. More than half.
Something has to be done about costs.
Also since we deal with elders, we see many 55-65year olds who struggle to have coverage. Just because the retirement age for Medicare is 65, doesn’t mean that everyone will remain healthy and on the job until then. what about people who can’t work anymore but are not disabled accordinng to Soc Sec guidelines.
The power of the rich and influential should not stand in the way of addressing a serious problem and planning prudently for the future when 20% of our population will be 65+.
August 7th, 2009 at 11:22 am
The question should be What should the administration do to improve health care and reduce costs. Answer: First we must cap malpractice insurance. Most cases that are brought against doctors are because of an unexpected result that has nothing to do with the care provided by the physician. The most any patient should receive is the cost of medical expenses and out of pocket expenses. Lawyers currently get 30% of the revenue so the more they get the more insurance for all of goes up.
Second: To become a doctor you must go to school. Undergraduate, medical school, internship, residency, and then perhaps fellowship. The cost is about $750,000.00. Please remember that by the time they begin practice most are married and have a child. The starting salary for a family doctor is $143,000.00. The cost of a student loan too support this doctor is about $63,000.00 per year for 20 years. Malpractice insurance today runs $50,000.00 to $250,000.00 depending on the state where you practice. After the doctor pays 35% income tax on $143,000.00 they are $20 grand in the hole before the pay for an office, rent a home, or buy food for the family. Lastly regarding the shortage of the family doctors, the majority of medical students are women. They traditional work 5 or ten years and then retire to raise their children or move to academia.
If we are to spend tax dollars on better and less expensive medical care we have to financially support any qualified student who dreams of becoming a doctor, increase the space in medical schools and academia in teaching hospitals. More doctors with less debt leads to more competition, earlier detection of medical problems and more tax revenue for the government for years to come.
August 7th, 2009 at 11:26 am
The reform that is being touted as a fix to health care is not an option for America, the socialist countries have terrible health care, long waits and a mediocre system overall. If the government wants to meddle in health care then I agree with the previous poster that portability, like your telephone number, tort reform and if the government is worried about insurance for those that have lost their jobs then extend medicaid to people who are collecting unemployment and allow them to pay a portion based on household income. There are many ways to fix the coverage gaps without destroying our free economy. Try to think outside your box. Leave America the Great and our capitalistic society alone. If you don’t like it. Go live elsewhere.
August 7th, 2009 at 11:56 am
So many factors work together to create the negatives (problems) driving a need for ‘reform.’ {I prefer to say improvement.}
The introduction of insurance lessened the cost burden on individuals with coverage, increasing individual buying power and subsequently the demand for services; economics dictates where demand increases, prices do also. As prices creep up, the disparity felt by the uninsured increases. Introduction of no cost care for low-income individuals fosters more increased demand.
Subsidized premiums (by government or employer) and the pricing influence gained thru group policies, particularly a large group, increases the cost to individual disparity for the uninsured.
Our health care industry has flourished with improved methods and means for improved health. We do not want to undermine this great feature of our system. But the absence of access to affordable health insurance is crippling to the uninsured. The cost of social medicine is crippling to our nation’s finances.
To address both of these concerns, we need more access to affordable insurance. How do we get there?
1) Alter the insurance model away from employer based groups. I did not say eliminate them, but foster development of group plans based on other entities. Any association of persons, church, clubs, memberships, community organizations, etc. Allow grouping of smaller employers and self-employed thru associations or chambers of commerce. Do not provide government subsidies to these entities. Let them force competition in the industry.
>This will foster broad access to larger group policies and multiple choices for a group plan for all individuals. If my employer offers the best option fine, if it is my local credit union, NAACP, NRA, ACORN, AARP, church, alumni association, or whatever, I have options each possessing the strength and benefits of group policy status.
2) Require all medical insurance policies to cover all care associated with the physical well being at some level. Do not specify the level; let competition drive this. Do not require coverage for nonessential care – non-essential meaning it does not alter the general health of the individual. Do not force coverage of care not specifically for the direct improvement or preservation of the patient’s physical health. Allow plans to offer add-on coverage for anything they wish, but do not require the group to provide nonessential care coverage, which is cost-shared by all group members. These items should be, pay if you want it, but not if you don’t. Similar to I can buy a car a basic warranty, but if I want the enhanced warranty, I pay for it separately.
3) Set a deadline to phase out government programs; Medicare, Medicaid (as individuals become insured thru other plans, we will not need these any more) and the redirect individual taxes for them to HSAs type funds, which can be used for premiums or coinsurance/copays. Employer contributions (50% share) will encourage employment in some capacity thru a viable employer, and also help assure all income is subject to proper taxation. (Could somewhat reduce the cost of unemployment, food stamps, welfare, etc., which is not a negative.)
4) Lastly, tort reform. Why do we have so much “malpractice” by licensed physicians? If they cannot practice soundly, take away their license. It lowers cost of health associated with unnecessary repeat treatment and preserves life and limb suffering due to these incompetent or negligent practitioners. This measure will likely force a healthier definition of malpractice as well. Limit damages to real costs. Existing worker’s compensation models could be used to establish the quantification of such losses. Eliminate cash settlements for these claims. Too often in the past, when a settlement occurred, it was followed by a spending spree, and then government programs got stuck with the future treatment and unemployment bills.
I am not a guru of all of life’s wisdoms on these matters, but my exposure to health insurance as a group plan administrator, a covered individual, a veteran subject to that system, and a recipient of the welfare system as a youth, I do have exposure to varied perspectives.
If we take the best of where we have been and hone it, we can have an even greater health care system. The rest of the world may not like that, as we already have the best system in the world. Why is that, I would say it is because we have birthed or naturalized into us a yearning for excellence. We favor no obstacle to achieving it. In this our forefathers were ingenious. The ‘pursuit of happiness’ drives us to want the best for ourselves and our fellow man. This inner will has afforded this nation the greatness we enjoy, the innovations that enrich our lives, and the liberties we cannot imagine the absence of. Let us and our leaders not settle for the way of other nations, we were not therein created, but find the resolve and wisdom to craft a better more refined mechanism to ensue our goal, the general welfare of all American citizens. Our forefathers founded the greatest nation on earth, not through the notion of the strength of a government, but the unimaginable strength found in the power of the people, as the preamble notes, “We the people,” not we the leaders. Let’s not lose this power by thinking the government has a strength greater than the people. Leave choice where it belongs, with the people.
August 7th, 2009 at 11:56 am
Carol,
I and many others agree with you on the rising costs (on a constant dollar as a percentage of net income basis over decades, it’s debatable, but nonetheless). It’s the manner in which they are proposing the “reform” that is the problem. Please understand that all on this site that are responding to this are small business owners. I have no backing by anyone but myself. The existing gov options for those not fitting into soc sec or medicare are already out there. Many states offer their own options. I’m just asking us all to please read and research beyond the “evil insurance company” propaganda and look to ourselves for ideas for a real solution.
August 7th, 2009 at 12:06 pm
Highlights of first 500 pages of the 1000 page heath care reform bill:
• Page 22: Mandates audits of all employers that self-insure! (increasing cost of doing business)
• Page 29: Admission: your health care will be rationed!
• Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)
• Page 42: The “Health Choices Commissioner” will decide health benefits for you. You will have no choice. None.
• Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.
• Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.
• Page 65: Taxpayers will subsidize all union retiree and community organizer health plans.
• Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange.
• Page 84: All private healthcare plans must participate in the Healthcare Exchange (i.e., total government control of private plans)
• Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens
• Page 95: The Government will pay ACORN and Americorps to sign up individuals for Government-run Health Care plan.
• Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter.
• Page 124: No company can sue the government for price-fixing. No “judicial review” is permitted against the government monopoly. Put simply, private insurers will be crushed.
• Page 127: The AMA sold doctors out: the government will set wages.
• Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives.
• Page 126: Employers MUST pay healthcare bills for part-time employees AND their families.
• Page 149: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll
• Page 150: Any employer with a payroll of $250K-400K or more, who does not offer the public option, pays a 2 to 6% tax on payroll
• Page 167: Any individual who doesn’t’ have acceptable healthcare (according to the government) will be taxed 2.5% of income.
• Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans will pay for them).
• Page 195: Officers and employees of Government Healthcare Bureaucracy will have access to ALL American financial and personal records.
• Page 203: “The tax imposed under this section shall not be treated as tax.” Yes, it really says that.
• Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected.”
• Page 241: Doctors: no matter what specialty you have, you’ll all be paid the same (thanks, AMA!)
• Page 253: Government sets value of doctors’ time, their professional judgment, etc.
• Page 265: Government mandates and controls productivity for private healthcare industries.
• Page 268: Government regulates rental and purchase of power-driven wheelchairs.
• Page 272: Cancer patients: welcome to the wonderful world of rationing!
• Page 280: Hospitals will be penalized for what the government deems preventable re-admissions.
• Page 298: Doctors: if you treat a patient during an initial admission that results in a readmission, you will be penalized by the government.
• Page 317: Doctors: you are now prohibited for owning and investing in healthcare companies!
• Page 318: Prohibition on hospital expansion. Hospitals cannot expand without government approval.
• Page 321: Hospital expansion hinges on “community” input: in other words, yet another payoff for ACORN.
• Page 335: Government mandates establishment of outcome-based measures: i.e., rationing.
• Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc.
• Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals.
• Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by phone).
• Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens, assisted suicide, euthanasia?
• Page 425: Government will instruct and consult regarding living wills, durable powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of time.
• Page 425: Government provides approved list of end-of-life resources, guiding you in death.
• Page 427: Government mandates program that orders end-of-life treatment; government dictates how your life ends.
• Page 429: Advance Care Planning Consult will be used to dictate treatment as patient’s health deteriorates. This can include an ORDER for end-of-life plans. An ORDER from the GOVERNMENT.
• Page 430: Government will decide what level of treatments you may have at end-of-life.
• Page 469: Community-based Home Medical Services: more payoffs for ACORN.
• Page 472: Payments to Community-based organizations: more payoffs for ACORN.
• Page 489: Government will cover marriage and family therapy. Government intervenes in your marriage.
• Page 494: Government will cover mental health services: defining, creating and rationing those services.
August 7th, 2009 at 12:07 pm
mkh,
i see only a couple of problems with points 1 & 2 but overall and certainly conceptually…Bravo!
August 7th, 2009 at 12:13 pm
Maggy,
Please elaborate the problems, and how you would refine.
August 7th, 2009 at 12:41 pm
I went to a town hall meeting last night with my congressman and he read many parts of the bill that are the source of the kind of disinformation in the post from Scott S. Given that the Scott’s interpretation is not what the bill says for the parts that were read last night I’m inclined to not take his word for the rest of them. And it’s also not true that the bill will mandate coverage of abortions for the children of same sex couples.
My mama always told me that overstatement reduces one’s credibility and here is an example of that in action. Lets improve things and lets debate about those improvements. But let’s base the debate on truth.
August 7th, 2009 at 12:57 pm
We need to offer healthcare through a non-governmental private market with incentives and ease of entry for providers to come into the industry. More providers means more goods and services
and lower costs. Also, consumers must have incentives to maintaining good physical health
and improving their health through this marketplace.
August 7th, 2009 at 1:08 pm
mkh,
Sure thing. I like this: “Alter the insurance model away from employer based groups. I did not say eliminate them, but foster development of group plans based on other entities. ” and definitely this: “Do not provide government subsidies to these entities. Let them force competition in the industry.” I would simply, more clearly define “foster development” making it very, very clear that the citizens should foster this rather than the gov., even if it doesn’t support it financially. I’ve had that communications gap happen with friends several times and have learned to draw the lines clearly. The only thing I don’t like about the “group” thing is that it assumes that current discounts to large groups should continue rather than cafeteria like plans for individuals…but it’s a difference i can live with as an interim step.
“Require all medical insurance policies to cover all care associated with the physical well being at some level.” I get a little nervous with this one. Anytime you mandate what a company can sell you risk putting it in a position that it can’t afford or doesn’t have the structure for. More competition (minnesota has so many mandates, it forces competition out, not in) can make many options available, ie., one insurance company may specialize in, say, catastrophic and elderly care while another could specialize in preventive care and childhood or a larger company could offer them all … These are generalities but I think they fit with the direction you are going.
I really like your phase out of Medicare, etc… idea. Tort reform is necessary. I think bad doctors would tend to go away anyway through word-of-mouth, etc. It’s difficult to determine what it takes to remove a license and i think the existing licensing boards do that.
All-in-all, very thoughtful. We should all get together and write our own to present!
August 7th, 2009 at 1:45 pm
Rod,
We should all be reading the bill ourselves rather than relying on others to do it for us, including your Congressman. If you take out Scott’s political commentary (eg., ACORN comments), I think you’ll find that he’s not very far off on the summaries. I don’t vouch for all of it. The overall impact and the far reaching and controlling effects are very real. Let’s finish reading the bill and talk to those who understand how it will impact them and us. M
August 7th, 2009 at 1:53 pm
What about risk-/use-based premiums? We have two employees undergoing cancer treatment, likely due to smoking, and two out on leave due to injuries, likely attributable to obesity. These folks warrant/pay the same premiums under the “group” policy as those with little/no claims experience. The insurers should provide individual incentives for wellness, prevention, smoking cessation and ultimately, lack of claims submitted. The “one size fits all” model needs to incorporate individual accountability.
August 7th, 2009 at 2:31 pm
Maggie,
I don’t know about your congressman, but mine HAS read the bill and is quite knowledgeable about what it says. Even if you take out the ACORN references there is still a great deal of interpretation, much of directly refutable by what is in the bill.
BTW, all health insurance policies “ration” health care in the same way all insurance policies restrict risk by paying only for “covered losses”. So any provision of a health care bill that defines what is covered is, semantically, “rationing”. So while the bill does not provide unrestricted universal coverage for all medical procedures, necessary and elective, the provisions I’ve seen don’t create any actual rationing in the form of someone deciding who gets what. It’s a stretch – spin – to call what is there rationing.
August 7th, 2009 at 3:05 pm
Oh, Cristobal, it isn’t “one size fits all”. That’s what the actuarial tables are all about. Based on past claims history (probably going back to just after World War II) and statiscal information about the age, gender, marital status and a myriad number of other details the insurance companies use to arrive at a factor for calculating the premium rates to charge. In addtion, these rates are closely monitored and/or approved or denied by the individual state insurance reulatory commissions. The corporate insurance I provide to my employees was less expensive per person when the average age of my employees was under 40 — as the average age increases, the premiums increased. In Pennsylvania, where there is no limit on damages (tort reform please!), the number of extraneous tests conducted to protect the phycisans and hospitals from huge law suits (and expensive malpractice premiums) increases the cost of my comapny’s premiums. These are just a few of the things that can impact the premiums your insurance provider charges your business to insure its employees. Their weight and smoking vs. non-smoking isn’t nearly as much a factor as the average age of all company employees. In fact, our group provider does not even ask for height, weight, smoking or previous medical history when we hire on a new employee – just age and marital status.
Considering the excellent policies and private sector healthcare available on demand in the US, I would never want to have to rely on the public healthcare provided in places like Canada or England, or even our our Veteran’s Administration. Public healthcare puts someone else in charge of my life and I do not wish that on ANY one.
By the way, obesity does not cause accidents and smoking is a disease just like alcoholism and drug dependence. One can’t assume that a few claims cause automatic increases in your company’s health insurance premiums the way an accident can increase auto insurance premiums (unless you have “accident forgiveness” in your policy).
August 7th, 2009 at 3:06 pm
Maggie,
Thanks for your reply.
My vagueness is due to the variances states to state, which would need to be considered. One size might not fit all. One state may choose a particular path while another goes differently. Each state’s citizens should have the ability to be represented in the specifics by individuals they can elect. Doing this at the federal level would dilute the citizen representation too much for such an important and very personal matter.
By foster development, I mean things like make it lawful to form the group and potentially afford the same tax deduction to a profit based business that an employer would receive. For example, if a credit union decided to offer a group health policy to its members: 1) the law should not disqualify that group from forming a group plan, 2) allow the credit union to deduct the same plan expenses that an employer could. If Sam’s Club wanted to do the same, law should not prevent it. The more venues of group coverage I have available, the more versatile and cost friendly the plan will be.
As for the medical coverage remarks, I mostly wanted to convey the absence of further inclusion of types of coverage not specifically necessary for good health. What I would deem elective coverage. Basic preventive and reparatory care regardless of coinsurance or copay should be and in most states already is a part of any group plan. To keep cost of coverage down, the cost sharing (pooling) should be the essentials only. Again, I would leave the specifics to the states to decide, as most state insurance commissioners already are.
Regarding tort reform, I mostly think the definitions applied in too many cases is too liberal, and awards are less designed to remedy the impact to the individual than to generate a revenue stream for attorneys. If so many practitioners were as reckless in care giving as one would think from the scores of lawsuits, licensing would be a flawed process. I believe the key and at least initial tort reform measures should focus on the promoting a remedy to the effected party at as little systemic cost as possible. If an individual suffered $200k in damages, it is shameful our system affords the attorney so much of the individual’s remedy. A judicial cooperative with state licensing board might serve as a good vehicle to investigate and award in such cases. No lawyer needed, just the medical facts. Individual files complaint, facts are reviewed, decision rendered, appeal option preserved, of course.
August 7th, 2009 at 3:25 pm
Rod,
You are correct. a form of rationing occurs in every economic scenario. Because we do not have infinite resouces, choices have to be made. Insurance companies (remember, i am not one of them) must make decisions based on actuarial data and their own resources (funding). We must make choices based on our own information and resources. The differences between private market (where we do see some reform: more competition) and government solutions is that a private market solution is more direct and more direct is better for both consumer and provider (insurance co). We won’t get into how excessive mandates hinder this process, but just look at it conceptually.
There are roughly 12 million people who fall through the cracks. Let’s concentrate on them and leave the rest as is or at most, allow for changes such as mkh’s.
August 7th, 2009 at 3:27 pm
mkh,
well put. It is very difficult to be precise in a blog-type environment. Just wanted to let you know that i think you are on the right track. I think our differences are merely nuance in nature.
August 8th, 2009 at 11:04 am
Mr. President and all participants,
Below is from a friend of mine who has been involved in insurance for many years. They are company benefits planners. They are not an insurance company. I think you’ll find the broad experience and perspective helpful. FYI
There is no one quick and easy answer. We need to get our utilization in check, and that won’t happen if the patient doesn’t have skin in the game and if the provider makes more money for providing more services, rather than quality of care and favorable outcomes.
Health Insurance needs to go back and be what it was originally meant to be – financial protection for unforeseen, financially catastrophic accidents and illnesses. A Dr. office visit shouldn’t be financially catastrophic for most people. The fact that it is points to a societal issue that our population as a whole is overextended and living on the edge financially. Also evidenced by the rampant rate of foreclosures, etc.
If Health Insurance were all high deductible plans covering financially catastrophic events, people would be paying attention to cost of x-rays, office visits and rx, likely curbing some demand and forcing providers to compete. This is starting to happen with HSAs, but the government plan does away with HSAs. Back to smorgasbord health care. All you can consume for the same price…
Health Insurance began being offered as a way around wage freezes during WWII, but the tax code has kept it in the employer arena, since individuals who don’t own business historically haven’t been able to deduct their premium. If the plans are offered at work, the employee does not pay taxes on the premium paid by the employer nor do they pay taxes on their portion, if they use a Section 125 plan. However, since close to 50% of workers now pay very little in income taxes, this tax benefit is less meaningful to the masses then it once was.
Kim, you wondered why you don’t offer car insurance to employees as a benefit. You could if you wanted to – there are group auto and home owner policies – but there are no tax incentives to do so, thus not a lot of demand by employees for you to do this.
You small group premium was higher than the healthy group next door because your group had high utilization. If healthy people pay the same premium rate as sick people do, then the healthy people drop out of the pool, leaving just the sick. This means that less premium money is going in to the pool to pay higher claims per capita. The result is escalating premium to fund the pool to pay increasing claims with fewer insureds, to the point of collapse.
If you charge healthy and young people less to be in the pool, they have an incentive to buy the insurance ‘just in case’, and then their premium dollars are going in to the pool to help pay claims for the sick. Healthy people subsides the sick; young people subsidize the old.
Older people and sick people cost more to insure because they have more claims. They have the incentive to join the pool, even if the rates are high, because they will likely still pay less in premium then they will utilize in medical claims. Healthy people need to participate, in order to subsidize the sick. So, if your group has a liver transplant, and my group consists of 10 – 20 year old men who never go to the DR., as a sick group, you WANT my group in your pool, to subsidize your claims. If my group pays the same as your group, my employees will drop out, leaving your group on its own for all of its claims…
Socialized medicine will do little to ‘bend the cost curve’ – it will actually add to the inefficiencies of an already inefficient market. Let the free market and business figure out the solution. That is where the innovative people are and if there is a financial incentive for them to solve the problem, they will do it. Government is the last place we should look to introduce ‘efficiency’. Their solution revolves around
rationing of care. If rationing must be done, it should be decided by
the end user, based on costs and efficacies of available treatments. Not
by bureaucrats in WA.
August 10th, 2009 at 1:23 am
There is absolutely nothing in the current plans being considered by the Obama Administration and Congress that could even remotely be consider “socialist”. Frankly, it’s laughable to think otherwise.
The large insurance companies—that have been hammering all other types of businesses—are spending approximately $1.4 million a day to spread fear and misinformation on this.
If private, for-profit “health care” insurance was able to deliver good quality care and a decent price, they would have done so years ago. Their first priority is to maximize profits at the expense of everyone else.
Insurance companies routinely deny coverage, refuse to pay claims, cancel policies when you get sick and use scare tactics to maintain their price-fixing monopolies.
As a small business owner, the voluntary Public Option is critical if I’m going to survive and compete against other, larger companies.
I don’t buy the scare tactics of the big insurance companies and their army of well-paid lobbyists and propagandists. I’m backing the Public Option, with enthusiasm and I urge all other business owners to do the same.
August 10th, 2009 at 1:25 am
Here’s a good article by Steven R. Pearlstein, the business columnist for the Washington Post, on the current debate over health care:
http://www.washingtonpost.com/wp-dyn/content/article/2009/08/06/AR2009080603854.html
August 10th, 2009 at 8:44 am
For the record, I am an Independent, and proud of it as both major political parties have conducted themselves poorly.
Here is how I see the health care debate. The health reform has two ends and they appear to be contradictory. 1) There are some who speak about reducing current health care costs to those who have coverage. 2) There is the debate on how to extend coverage to those who are currently without coverage. Two separate topics and we combine them, making it more difficult to understand the objectives. Unfortunately, by combining them, it becomes impossible to achieve both.
The Democrats have tried to ram through Congress a plan before the American people know what is happening to them. After all, President Obama wanted a bill before the August recess. This frightened the American public….sensing a desire by the Democrats to do something to them behind closed doors. No wonder they are taking this opportunity to express their outrage at this intended power grab.
I would prefer a reasoned debate but am fearful that the liberal element of the Democratic majority has their agenda and after 8 years in the wilderness, they will not let it be taken away from them. They speak of the presidential election providing them with a mandate for change. This is so far from the truth. The election did not give the liberals a mandate. The election results were as much a statement by the public of disgust with the mistakes of the Bush / Republican administration. A vote “against something” should not be recorded as a vote “for something.”
Republicans seem interested in frightening the public with make-believe threats (e.g. death panels) while the President and Democrats offer guarantees that the bill will deliver (without the benefit of first creating the bill). Both camps offer misleading and disingenuous arguments.
As a small business owner, I conduct my business by following my business plan. That plan begins with my vision for my organization and lays out clear goals and objectives. I think Congress would be well served by learning from small business owners. Don’t try to sell us a pig in a poke. Spell out your vision and be clear with us about your goals and objectives. If the vision is inspiring and the goals and objectives are worthy, you will be successful.
August 10th, 2009 at 8:56 am
Steve,
First, please note that my tone is friendly and open. Email and blogs leave out the tone of voice. I just want to let you know that I’m not attacking. Do you truly think that we don’t have good quality care at a “reasonable price”? What is a reasonable price? I have been looking at and researching this since about 1983 and have turned it over many, many times. Steve Pearlstein admitted in the first sentence that he is talking from his ideology. I have talked with many people regarding this and i have to say, seeing it first hand, the people who are speaking out aren’t being pushed by the Republicans with an anti-democrat agenda. These people are speaking out because they don’t trust the government to do a good job and know instinctively that costs will rise, not fall. If you haven’t read my previous comment which included comments from a friend of mine (not an insurance company), please do. It’s based on history and sound logic. Thanks for listening. Maggy
August 10th, 2009 at 12:48 pm
Maggy,
Hopefully my tone is friendly and open too. I’m offended by people—not necessarily you—who scream “SOCIALIST” whenever anyone tries to change the atrocity of the current “health care system”. This isn’t a fair or accurate criticism; it’s simply a scare tactic used to shut down the debate and discredit the legislation before anyone even reads the final version.
Most of the people disrupting these town meetings, shouting down the opposition, hanging congressmen in effigy, and calling in death threats, appear to be badly misinformed. One elderly woman stood up and shouted, “Keep your government hands off of my Medicare!” Then there are those protesters who are just seething with rage because a black man with an African name is our new president—and these rallies give them a chance to vent their anger in a “legitimate” way.
The major plans being considered in Congress are far from what any reasonable person could call “socialist”. It’s laughable. If anything, the major problem with these plans is that they require most of our citizens to hand over even more money to the private insurance companies.
The Public Option—which I and many other business owners consider absolutely essential—is a voluntary alternative to the private, for-profit companies. It will serve those people who can’t or don’t want to, get a policy from the insurance companies. No one will be “forced” to enter it. To say otherwise is deliberately deceptive or ignorant.
As small business owners, we can’t afford to be seen as people who can’t think beyond “Government BAD, Private Business GOOD” in each and every instance. It’s not smart. It’s purely based on ideology and wishful thinking. Both have their place, and are essential, in a good society.
Thanks for listening as well, Maggy. Best to you and your business!
August 10th, 2009 at 1:01 pm
John,
I appreciate your civil tone and your intelligent, balanced perspective. While I take issue with a couple of your points, you, like Maggy, make them in a reasoned way. Thanks for that.
I don’t trust the big insurance companies. At all. I could cite numerous anecdotes and a surfeit of data to make my case, by time and space limits me here. Some people don’t trust our government to be involved in any way when it comes to medical care—although, through Medicare, the VA and other institutions, they clearly are already.
So, I believe that every American citizen deserves a choice: If you want to stay with a private, for-profit insurance company for your health care coverage, you should be able to do that. (In fact, absolutely none of the proposals being considered recommend an end to that.) And, if you want to choose a Public Option for your health care, you should have that choice as well.
As a business owner, I’m not interested in a private, for-profit “health care” plan, for me, or my employees. If you trust the insurance companies, and you’re confident they’ll approve the treatments you’ll need if you get seriously ill, and that they’ll cover all of your claims without leaving you thousands of dollars in debt, that’s fine.
Allow me to choose a public option as an alternative, and I’ll allow you to stay with your choice. Okay?
August 10th, 2009 at 1:05 pm
I highly recommend this interview with Wendell Potter, the former Vice President for Public Relations for CIGNA, one of the nation’s largest “health” insurance companies.
http://www.pbs.org/moyers/journal/07102009/watch2.html
This is the man who developed propaganda on behalf of his employer and his industry and was the key player in creating a climate of public fear regarding any changes in health care.
Now, Mr. Potter has had a change of heart and he admits what he did was purely propaganda. And it was wrong. You can watch the entire interview with him as he details his tactics and what happened to change his mind:
http://www.pbs.org/moyers/journal/07102009/watch2.html
Enjoy!
August 10th, 2009 at 1:38 pm
Steve,
I just deleted what I was about to send. Sorry. In a nutshell, most of the people i talk with get their info from experience and iyears of observation and study on the topic. I’m not persuaded by big business, at least not since i reached about 35 years of age. The people objecting to gov care are quite informed and smart, just as you are. just for the record: I don’t like big business in general and don’t like big government…they are in bed together (not new news). With a gov option, you will soon see whose recent lobbying activities have been successful. You will see it by who they use to administrate and implement the program. You’ll really hate CIGNA then. Keep gov small and you reduce big business impact on every day lives. Make gov big and you almost ensure that big business will lobby their way in.
Have you looked closely at bringing in more competition, cafeteria-type plans and what I haven’t read in any bill yet, tort reform? Just wondering what you have found on those topics (they are my favorite solutions).
August 10th, 2009 at 2:04 pm
Maggy,
I agree that big corporations have a way of worming themselves in to almost any and all government programs. But that’s not a problem with the programs themselves; that speaks to the reality of our current state of government where most elected officials take legal bribes (a.k.a. “campaign contributions”) from large corporate interests who then, in direct and indirect ways, shape legislation and policy.
It is possible to create good government programs that aren’t corrupted by large corporations. It’s a matter of who is in office, and if they stand up to these interests or not. Arguing that we shouldn’t have any of these programs isn’t a realistic or desirable alternative.
The “free market” is wonderful for so many reasons. I don’t have to restate them all here. But it shouldn’t and can’t do everything, under any circumstances, at all times. That’s why we need both a strong and efficient private and public sector. It’s about making intelligent choices, hopefully, and not ideology.
For decades, the private insurance companies have given us a song and dance about “more competition” and “cafeteria style plans” (interesting and revealing terminology), HSA’s, etc. All of them are designed solely to fool the person who buys them and maximize profits for the industry.
If these companies were so efficient and so caring, they could have done away with this issue decades ago. The ONLY reason we’re even having this debate is because the insurance companies have failed so miserably. They didn’t deliver good quality health care to all citizens at a decent price; they’re not designed to. Their purpose is maximum ROI for shareholders and large executive compensation packages. They don’t exist to actually take care of people.
So, they’ve lost my trust, based on results. As a business person, Maggy, what do you do with companies or individuals who don’t perform and don’t produce results no matter how many chances you give them?
August 10th, 2009 at 3:00 pm
Amen to much of what you said. I just don’t know any other way to reduce “big greed” without reducing the size of gov. It would be so great to have elected people that held an ounce of altruism but i just don’t see how they can hold up. In general, “absolute power corrupts absolutely…”
Actually, I have an HSA and offer it (among other) to my employees. Those that are in it love it. I know that i do. I can go to whatever doctor I want, buy whatever health care items i need (including bandaids) on a pretax basis and if I don’t use the dollars right away, they are tax free for my whole life if I spend them on health care items. If not, i am taxed on it when I withdraw, just like a 401K. I can even invest any excess dollars. (which I have). I offer the other, more traditional plan to employees who aren’t as comfortable with an HSA. It’s more expensive but not bad and they are very happy with it. I’m sorry it hasn’t worked out for you but all in all, considering what the alternatives are (gov or socialized–real definition, not the exploited one), I’ll take the private companies. Nothing in life is free. There is a cost (whether dollars, time, whatever) to everything. Finite resources must be allocated. There’s no other way.
Ok…enough pontification from me. Have a good day everyone!
August 10th, 2009 at 4:53 pm
I suppose you are comfortable being told by a politician that all is safe without reading the fine print regarding how that is being done.
Here’s the fine print:
SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.
(a) Grandfathered Health Insurance Coverage Defined- Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term `grandfathered health insurance coverage’ means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:
(1) LIMITATION ON NEW ENROLLMENT-
(A) IN GENERAL- Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.
(B) DEPENDENT COVERAGE PERMITTED- Subparagraph (A) shall not affect the subsequent enrollment of a dependent of an individual who is covered as of such first day.
(2) LIMITATION ON CHANGES IN TERMS OR CONDITIONS- Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1.
(3) RESTRICTIONS ON PREMIUM INCREASES- The issuer cannot vary the percentage increase in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all enrollees in the same risk group at the same rate, as specified by the Commissioner.
(b) Grace Period for Current Employment-based Health Plans-
(1) GRACE PERIOD-
(A) IN GENERAL- The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.
(B) EXCEPTION FOR LIMITED BENEFITS PLANS- Subparagraph (A) shall not apply to an employment-based health plan in which the coverage consists only of one or more of the following:
(i) Any coverage described in section 3001(a)(1)(B)(ii)(IV) of division B of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5).
(ii) Excepted benefits (as defined in section 733(c) of the Employee Retirement Income Security Act of 1974), including coverage under a specified disease or illness policy described in paragraph (3)(A) of such section.
(iii) Such other limited benefits as the Commissioner may specify.
In no case shall an employment-based health plan in which the coverage consists only of one or more of the coverage or benefits described in clauses (i) through (iii) be treated as acceptable coverage under this division
(2) TRANSITIONAL TREATMENT AS ACCEPTABLE COVERAGE- During the grace period specified in paragraph (1)(A), an employment-based health plan that is described in such paragraph shall be treated as acceptable coverage under this division.
(c) Limitation on Individual Health Insurance Coverage-
(1) IN GENERAL- Individual health insurance coverage that is not grandfathered health insurance coverage under subsection (a) may only be offered on or after the first day of Y1 as an Exchange-participating health benefits plan.
(2) SEPARATE, EXCEPTED COVERAGE PERMITTED- Excepted benefits (as defined in section 2791(c) of the Public Health Service Act) are not included within the definition of health insurance coverage. Nothing in paragraph (1) shall prevent the offering, other than through the Health Insurance Exchange, of excepted benefits so long as it is offered and priced separately from health insurance coverage.
————————————————————————————————–
Here is what they call protecting your choice!
No new enrollments! Whether this means new “policies” or the actual word used “enrollments” the result is devastating. If the traditional insurance industry term is applied, no existing plan (policy) can add new members except as dependents of existing members. If it means policies, then present employers without policies, will not be able to get one. How does either of these help the uninsured get coverage?
No updating of plan is like saying no oil changes or fill ups for your car. This will prevent inclusion of new coverages or types of care no presently covered. It prevents cost changes to deductibles and copays for inflation purposes. If your deductible is $500 per year now, it must remain the same forever. Any change to the policy in restricted areas as mentioned results in loss of the grandfathered status; which means the policy is unlawful.
In quick summary, you can keep your coverage if you want, but there will be #$@$# to pay if you do.
Just because the fox is going to watch the hen house, no one should be concerned, right?
August 10th, 2009 at 8:27 pm
mkh, why didn’t you provide the text of the entire bill under consideration? Why did you just provide just part of it?
Also, even with the part you provided, I don’t see the reason for fear and panic. What’s the problem, brother?
If you don’t want to enroll in a voluntary Public Health Care Option, I suggest you don’t. Now, leave we the majority alone as we’d like to consider what is offered and not be subject to the non-choice of only private, for-profit insurance. (If they’ll even write you a policy and if they’ll even pay your claims.)
August 10th, 2009 at 10:06 pm
Steve,
Obviously, posting the entire bill would be unnecessary to discuss this one point. As the section title indicates, this is the section that “protects our right to coverage choice.” However, there is a major problem with that, as anyone can read, the section does not protect anything realistic long-term. It is crafted to appear as if protection is there, but as I pointed out in my notes, the title is quite misleading.
If it was as simple as “you do your thing, and I’ll do mine,” we wouldn’t be having this discussion. Fact though is, this bill takes away my choice and forces me to fund yours.
You are either influenced by frustration of trying to buy an individual health care policy, a participant in a small group policy, or just repeating rhetoric. Group health coverage is the most effective and efficient model available, unfortunately at present options for group policies other than through employment are very few and void of the tax advantage employers get for providing coverage. Change these two things, and many of the problems will go away without loss of choice or a costly expansion of government ineffective health care systems. By the way, I have decades of experience with U.S. Goverment health care, and it is very wasteful in nature and ineffective due to the way government works and thinks.
As a favor, here is the link to the whole bill: http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3200
August 11th, 2009 at 1:39 am
I don’t read this text the same way you do, “MHK”. I reject your interpretation. I think that a lot of people are using scare tactics to try and maintain the current system. I don’t see anything in the text you abstracted as some sort of “lack of protection” of private policies.
Actually, my distrust of the insurance companies comes from the experience of friends and family. Insurance companies charge us a ransom for premiums and then cancel policies, refuse treatment and deny claims.
If the insurance companies provided good coverage at a decent price, you and I wouldn’t even be discussing this and Congress wouldn’t be debating it. It’s only because the insurance companies have been so greedy and so deceitful that this is an issue.
The insurance company had decades to do the right thing. And they didn’t. They only had one priority; maximizing profits at the expense of every other type of business.
As a small business owner, I want an alternative to the insurance companies. If you want to pay them, that’s fine. Step aside and let we the majority who won last November get what we voted for. Go trust Cigna; I’m sure they’ll treat you accordingly.
August 11th, 2009 at 8:33 am
Steve,
Two things:
1) Please explain my error in reading the bill text. What have I misread?
2) If your distrust of insurance companies arises from the experiences of your friends and family, what about your personal experience? You are a small business owner; do you offer coverage to your employees? How has that gone? Have your friends and family appealed insurance decisions or consulted the state insurance commissioner regarding the issues they feel are unjust and inconsistent with the policy? It is ironic, but presently I am insured using Cigna as the TPA for our self-funded plan. I have no issues with my coverage or the whole plan.
Yes, I have costs. Yes, there are things not covered by the policy. Yes, copay and deductibles vary based on use of network providers. (Note: 95% of all facilities and providers are in network including the major medical research hospitals)
As a small business owner, what is most hindering to you is the inability to find group coverage. What you may not realize is that insurance companies sell the product companies or individuals want. No one size fits all policy. Group status enhances the bargaining power, and allows more tailoring of the policy. Insurance companies cannot provide a cost effective policy a la carte, but buffet-style (mid or large group) offers better value. If this bill as written passes, the outcome will not be more coverage choices for you, your friends, family or employees, but your customers, suppliers and any company you do business with which does enough business will start passing on the 8% increase in taxes to you. In return, you will get a federal health system subject to the whims of who won in any present or future November.
As for the insurance companies having decades to get things right, you seem to miss the very real aspect of the insurance industry being regulated by the government. Government actually dictates what policies can be written and what insurance companies can do business where. As cost have risen some less user friendly policy models or features have been tried, but the market quickly adapted. How many HMOs still exist? Very few in percentages. Why? It was a faulty means to control costs. It took too much control away from the consumer. PPOs with contracted networks and the choice to still go out of network if desired is the model most prevalent today. Why? It puts choice back to the consumer, and allow choice even if that choice bears consequences. Those consequences also help motivate healthier lifestyles, and individual cost containment measures.
Every individual and small business needs access to the group buying power at work for them, but like yourself, not every business is large enough to qualify alone. If present laws were changes to permit and better even, encourage the creation of alternative groups such as community organizations or chambers of commerce, etc., you would find more insurance policy options at less cost.
Of course, employment based plans are also highly influenced by the employer, who is buying on behalf of their employees. Some employers are more or less interested in the value of the plan. Some buy a ‘cheap’ policy, just to say they have one. Others shop frugally to get the maximum value in return for their employees. This is not a flaw in insurance companies. By opening the door for competing groups by non-employment based associations, individuals will have more choices for where to seek a policy. Present laws already provide protections against pre-existing conditions, etc. when changing policies, so no harm in dropping one for the better choice.
To make that work, we just need to allow these type associations the ability to form a group policy, and give them the same tax advantage for doing so that employers get.
By the way, I did not lose last November. Regardless of how one may have voted, we are still Americans living in the greatest nation on earth. The flag still flies reminding us of our history and the freedoms we enjoy and treasure. To lose would require the loss of those things more precious than the name or party of a single or group of politicians.
August 11th, 2009 at 9:19 am
I don’t know who you are mkh, but well done! Logical, reasonable, forward-looking. Rather than depending on the altruistic nature of another human or entity, you are approaching this from a personal responsibility stand point. Shop for insurance, call or write when you think something isn’t right and nothing in life is free.
Keep up the polite, logical arguments!
August 12th, 2009 at 11:06 am
One of the reasons I work where I do it the quality of the benefits program we offer to employees, and those that I choose to participate it/take advantage of. My biggest concern is the discussion that Congress and the President (and his family of course) will continue with the coverage they currently have…that they will be exempt from the fine program that is being designed for the rest of us. If the designed program is so much better than what we all have now then why are they exempt?
You keep yours, let me keep mine.
August 12th, 2009 at 1:16 pm
I for one will trust in myself and in the private insurance companies.
I’ve worked hard (gaining experience, training, continued education, etc.) all my adult life to improve my marketability as an employee. This hard work and personal effort enables me to seek employment with companies who provide the quality “benefits” I want for myself and my family. I have also made the choice to pay for those benefits, typically “buying-up”. I spent my earnings on health and dental insurances instead of the daily latte’s, the big screen TV’s, or the new cars every 3-5 years. For me it boils down to a matter of personal choice – a matter of hard work – a matter of accepting personal responsibility for both my financial and my physical well-being – a matter of making sound decisions.
During this time, my family has experienced it’s share of medical issues. A major back surgery, a total knee replacement, and most recently a heart attack, not to mention all miscellaneous medical and dental expenses that come with birthing and raising three children. We are talking hundreds of thousands of dollars in expenses. If it were not for my employee benefits and the private insurance carriers (forget the HMO’s and HSA’s) we would have been financially devastated and probably living off public assistance. Instead, we are all still working, contributing, members of society.
I understand that sometimes, “I can’t afford it” is a real issue – but I feel that all too often it is overused and overstated. Personal choice is the core of the issue in all things. The choice to simply work, the choice to improve ones place/marketability in the employment arena, the choice to participate in employer sponsored plans, the choice to “buy-up” instead of buying the latest cell phone/package, or the granite counter tops and the stainless steel appliances. Unfortunately in today’s society there is an entitlement attitude. Too many of us want it all, while wanting others to pay for it.
And I agree with the question: If, as history shows, government is unable to effectively and efficiently run a program (i.e. Social Security, Veterans Health Care, Medicare, etc.) why should we believe that this new program will be different (better)?
Fool me once shame on you, fool me twice, shame on me.
August 12th, 2009 at 1:38 pm
djc – Couldn’t have been said better…bravo!
August 12th, 2009 at 2:25 pm
What has the government ever done that gave us better service and lower cost? This health care plan will mean more cost to small business and less choices for all Americans. We do not need the government playing GOD.
We need tort reform. We need portablity of insurance. We need doctors to advertise what there prices are. We need to shop around for the best value in a doctor just like any other purchase.
Government controlled health care is not the solution
August 12th, 2009 at 2:53 pm
Except, Brett, absolutely NONE of the plans under consideration in any of the congressional committees call for anything even resembling “government controlled health care.”
That accusation is a scare tactic pushed by the insurance industry and their paid lobbyists. It is completely untruthful. The plans under consideration will improve things considerably for small business. I can’t wait!
August 12th, 2009 at 3:11 pm
Steve,
What is this section for if not government controls?
http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3200
Subtitle E–Governance
SEC. 141. HEALTH CHOICES ADMINISTRATION; HEALTH CHOICES COMMISSIONER.
(a) In General- There is hereby established, as an independent agency in the executive branch of the Government, a Health Choices Administration (in this division referred to as the `Administration’).
(b) Commissioner-
(1) IN GENERAL- The Administration shall be headed by a Health Choices Commissioner (in this division referred to as the `Commissioner’) who shall be appointed by the President, by and with the advice and consent of the Senate.
(2) COMPENSATION; ETC- The provisions of paragraphs (2), (5), and (7) of subsection (a) (relating to compensation, terms, general powers, rulemaking, and delegation) of section 702 of the Social Security Act (42 U.S.C. 902) shall apply to the Commissioner and the Administration in the same manner as such provisions apply to the Commissioner of Social Security and the Social Security Administration.
SEC. 142. DUTIES AND AUTHORITY OF COMMISSIONER.
(a) Duties- The Commissioner is responsible for carrying out the following functions under this division:
(1) QUALIFIED PLAN STANDARDS- The establishment of qualified health benefits plan standards under this title, including the enforcement of such standards in coordination with State insurance regulators and the Secretaries of Labor and the Treasury.
(2) HEALTH INSURANCE EXCHANGE- The establishment and operation of a Health Insurance Exchange under subtitle A of title II.
(3) INDIVIDUAL AFFORDABILITY CREDITS- The administration of individual affordability credits under subtitle C of title II, including determination of eligibility for such credits.
(4) ADDITIONAL FUNCTIONS- Such additional functions as may be specified in this division.
(b) Promoting Accountability-
(1) IN GENERAL- The Commissioner shall undertake activities in accordance with this subtitle to promote accountability of QHBP offering entities in meeting Federal health insurance requirements, regardless of whether such accountability is with respect to qualified health benefits plans offered through the Health Insurance Exchange or outside of such Exchange.
(2) COMPLIANCE EXAMINATION AND AUDITS-
(A) IN GENERAL- The commissioner shall, in coordination with States, conduct audits of qualified health benefits plan compliance with Federal requirements. Such audits may include random compliance audits and targeted audits in response to complaints or other suspected non-compliance.
(B) RECOUPMENT OF COSTS IN CONNECTION WITH EXAMINATION AND AUDITS- The Commissioner is authorized to recoup from qualified health benefits plans reimbursement for the costs of such examinations and audit of such QHBP offering entities.
(c) Data Collection- The Commissioner shall collect data for purposes of carrying out the Commissioner’s duties, including for purposes of promoting quality and value, protecting consumers, and addressing disparities in health and health care and may share such data with the Secretary of Health and Human Services.
(d) Sanctions Authority-
(1) IN GENERAL- In the case that the Commissioner determines that a QHBP offering entity violates a requirement of this title, the Commissioner may, in coordination with State insurance regulators and the Secretary of Labor, provide, in addition to any other remedies authorized by law, for any of the remedies described in paragraph (2).
(2) REMEDIES- The remedies described in this paragraph, with respect to a qualified health benefits plan offered by a QHBP offering entity, are–
(A) civil money penalties of not more than the amount that would be applicable under similar circumstances for similar violations under section 1857(g) of the Social Security Act;
(B) suspension of enrollment of individuals under such plan after the date the Commissioner notifies the entity of a determination under paragraph (1) and until the Commissioner is satisfied that the basis for such determination has been corrected and is not likely to recur;
(C) in the case of an Exchange-participating health benefits plan, suspension of payment to the entity under the Health Insurance Exchange for individuals enrolled in such plan after the date the Commissioner notifies the entity of a determination under paragraph (1) and until the Secretary is satisfied that the basis for such determination has been corrected and is not likely to recur; or
(D) working with State insurance regulators to terminate plans for repeated failure by the offering entity to meet the requirements of this title.
(e) Standard Definitions of Insurance and Medical Terms- The Commissioner shall provide for the development of standards for the definitions of terms used in health insurance coverage, including insurance-related terms.
(f) Efficiency in Administration- The Commissioner shall issue regulations for the effective and efficient administration of the Health Insurance Exchange and affordability credits under subtitle C, including, with respect to the determination of eligibility for affordability credits, the use of personnel who are employed in accordance with the requirements of title 5, United States Code, to carry out the duties of the Commissioner or, in the case of sections 208 and 241(b)(2), the use of State personnel who are employed in accordance with standards prescribed by the Office of Personnel Management pursuant to section 208 of the Intergovernmental Personnel Act of 1970 (42 U.S.C. 4728).
SEC. 143. CONSULTATION AND COORDINATION.
(a) Consultation- In carrying out the Commissioner’s duties under this division, the Commissioner, as appropriate, shall consult with at least with the following:
(1) The National Association of Insurance Commissioners, State attorneys general, and State insurance regulators, including concerning the standards for insured qualified health benefits plans under this title and enforcement of such standards.
(2) Appropriate State agencies, specifically concerning the administration of individual affordability credits under subtitle C of title II and the offering of Exchange-participating health benefits plans, to Medicaid eligible individuals under subtitle A of such title.
(3) Other appropriate Federal agencies.
(4) Indian tribes and tribal organizations.
(5) The National Association of Insurance Commissioners for purposes of using model guidelines established by such association for purposes of subtitles B and D.
(b) Coordination-
(1) IN GENERAL- In carrying out the functions of the Commissioner, including with respect to the enforcement of the provisions of this division, the Commissioner shall work in coordination with existing Federal and State entities to the maximum extent feasible consistent with this division and in a manner that prevents conflicts of interest in duties and ensures effective enforcement.
(2) UNIFORM STANDARDS- The Commissioner, in coordination with such entities, shall seek to achieve uniform standards that adequately protect consumers in a manner that does not unreasonably affect employers and insurers.
SEC. 144. HEALTH INSURANCE OMBUDSMAN.
(a) In General- The Commissioner shall appoint within the Health Choices Administration a Qualified Health Benefits Plan Ombudsman who shall have expertise and experience in the fields of health care and education of (and assistance to) individuals.
(b) Duties- The Qualified Health Benefits Plan Ombudsman shall, in a linguistically appropriate manner–
(1) receive complaints, grievances, and requests for information submitted by individuals;
(2) provide assistance with respect to complaints, grievances, and requests referred to in paragraph (1), including–
(A) helping individuals determine the relevant information needed to seek an appeal of a decision or determination;
(B) assistance to such individuals with any problems arising from disenrollment from such a plan;
(C) assistance to such individuals in choosing a qualified health benefits plan in which to enroll; and
(D) assistance to such individuals in presenting information under subtitle C (relating to affordability credits); and
(3) submit annual reports to Congress and the Commissioner that describe the activities of the Ombudsman and that include such recommendations for improvement in the administration of this division as the Ombudsman determines appropriate. The Ombudsman shall not serve as an advocate for any increases in payments or new coverage of services, but may identify issues and problems in payment or coverage policies.
August 12th, 2009 at 3:14 pm
typo on link, sorry
http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3200:
August 14th, 2009 at 11:46 am
This is a test.
August 14th, 2009 at 12:34 pm
This is a test of the emergency e-mail system.
July 22nd, 2010 at 2:14 pm
It’s amazing we have an oil field in North and South Dakota going into Canada that is so large we would be self sufficient for gas for the next 2,041 yrs, (Bakken Formation, look it up). We would love to get rid of our dependency on others for oil. The Government has known about this for 4 yrs and still has not produced any measurable oil but, we can ramrod through a Health care plan in less than 4 months that, the way it is set up, most everyone does not want and, the ones that do, don’t realize how much this is going to cost every LEGAL American. November we must make a stand and vote these people out. Stand up America for our rights.
October 2nd, 2010 at 2:42 am
The Association of Mortgage Investors said securities trustees should conduct an investigation “in the wake of reports about serious irregularities in the processing of legal affidavits by the nation’s largest mortgage servicers” when foreclosing on homes.Mortgage-bond trustees should probe whether loan servicers are doing their jobs “properly” and “audit and review the resulting losses to hold servicers accountable for negligence in maintaining the assets of trusts,” the Washington-based trade group said today in an e-mailed statement.