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McCain's Health Care Plan - 9/19/2008 6:26:32 PM   
cloudboy


Posts: 7306
Joined: 12/14/2005
Status: offline 		Celticlord posted a pro-McCain link from the Atlantic in another thread. That author liked McCain's healthcare reform package.

Well, just this week Bob Herbert of the NYT wrote this about the McCain Healthcare plan:

Has anyone bothered to notice the radical changes that John McCain and Sarah Palin are planning for the nation�s health insurance system?

These are changes that will set in motion nothing less than the dismantling of the employer-based coverage that protects most American families.

A study coming out Tuesday from scholars at Columbia, Harvard, Purdue and Michigan projects that 20 million Americans who have employment-based health insurance would lose it under the McCain plan.

There is nothing secret about Senator McCain’s far-reaching proposals, but they haven’t gotten much attention because the chatter in this campaign has mostly been about nonsense — lipstick, celebrities and “Drill, baby, drill!”

For starters, the McCain health plan would treat employer-paid health benefits as income that employees would have to pay taxes on.

“It means your employer is going to have to make an estimate on how much the employer is paying for health insurance on your behalf, and you are going to have to pay taxes on that money,” said Sherry Glied, an economist who chairs the Department of Health Policy and Management at Columbia University’s Mailman School of Public Health.

Ms. Glied is one of the four scholars who have just completed an independent joint study of the plan. Their findings are being published on the Web site of the policy journal, Health Affairs.

According to the study: “The McCain plan will force millions of Americans into the weakest segment of the private insurance system — the nongroup market — where cost-sharing is high, covered services are limited and people will lose access to benefits they have now.”

The net effect of the plan, the study said, “almost certainly will be to increase family costs for medical care.”

Under the McCain plan (now the McCain-Palin plan) employees who continue to receive employer-paid health benefits would look at their pay stubs each week or each month and find that additional money had been withheld to cover the taxes on the value of their benefits.

While there might be less money in the paycheck, that would not be anything to worry about, according to Senator McCain. That’s because the government would be offering all taxpayers a refundable tax credit — $2,500 for a single worker and $5,000 per family — to be used “to help pay for your health care.”

You may think this is a good move or a bad one — but it’s a monumental change in the way health coverage would be provided to scores of millions of Americans. Why not more attention?

The whole idea of the McCain plan is to get families out of employer-paid health coverage and into the health insurance marketplace, where naked competition is supposed to take care of all ills. (We’re seeing in the Bear Stearns, Fannie Mae, Freddie Mac, Lehman Brothers and Merrill Lynch fiascos just how well the unfettered marketplace has been working.)

Taxing employer-paid health benefits is the first step in this transition, the equivalent of injecting poison into the system. It’s the beginning of the end.

When younger, healthier workers start seeing additional taxes taken out of their paychecks, some (perhaps many) will opt out of the employer-based plans — either to buy cheaper insurance on their own or to go without coverage.

That will leave employers with a pool of older, less healthy workers to cover. That coverage will necessarily be more expensive, which will encourage more and more employers to give up on the idea of providing coverage at all.

The upshot is that many more Americans — millions more — will find themselves on their own in the bewildering and often treacherous health insurance marketplace. As Senator McCain has said: “I believe the key to real reform is to restore control over our health care system to the patients themselves.”

Yet another radical element of McCain’s plan is his proposal to undermine state health insurance regulations by allowing consumers to buy insurance from sellers anywhere in the country. So a requirement in one state that insurers cover, for example, vaccinations, or annual physicals, or breast examinations, would essentially be meaningless.

In a refrain we’ve heard many times in recent years, Mr. McCain said he is committed to ridding the market of these “needless and costly” insurance regulations.

This entire McCain health insurance transformation is right out of the right-wing Republicans’ ideological playbook: fewer regulations; let the market decide; and send unsophisticated consumers into the crucible alone.

< Message edited by cloudboy -- 9/19/2008 6:27:07 PM >
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RE: McCain's Health Care Plan - 9/19/2008 6:36:18 PM   
cloudboy


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I can't imagine Congress passing this plan. I'm no healthcare expert. All I know is that my family is covered by a good employer-based plan.

It might be short sighted, but I'm not crazy on having our healthcare benefits taxed. The next step, I get some money back in a tax refund --- frankly -- I'm not sure how I would use this to make sure I have proper health coverage.

Frankly, I prefer the experts of the employer to pick a good plan to save me the trouble of figuring out an area (health insurance and health care) in which I have no expertise.

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RE: McCain's Health Care Plan - 9/19/2008 7:31:34 PM   
bipolarber


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Status: offline 		It doesn't matter.

We just added a trillion dollars in probable debt to the national debt.

We're not going to have the money to do anything about health care, or any other program to help the lower and middle classes. Bush has put his last nail in our coffins. We'll be lucky to stay employed, keep a home, and have soup for three nights a week, the way this is going. America: the top 2%... and then everyone else. With a huge, impossible to traverse gulf in between.

The American middle class.... R.I.P.

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RE: McCain's Health Care Plan - 9/19/2008 7:35:46 PM   
celticlord2112


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quote:

These are changes that will set in motion nothing less than the dismantling of the employer-based coverage that protects most American families.

Which is a very good thing, just so you know.


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RE: McCain's Health Care Plan - 9/19/2008 7:40:18 PM   
Vendaval


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Status: offline 		Hello cloudboy,
 
Thank you for the post, the information is timely and important.
 
I do not like this idea at all.  If people have insurance provided by their employer then they are already covered.  Why add more confusion and chaos into an already unstable financial situation for working people and their families?  Lack of regulation and letting the competition of the market decide is a major part of what is going wrong with the banking industry now.  We do not need more of the same.

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RE: McCain's Health Care Plan - 9/19/2008 7:47:16 PM   
celticlord2112


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quote:

ORIGINAL: Vendaval

Hello cloudboy,
 
Thank you for the post, the information is timely and important.
 
I do not like this idea at all.  If people have insurance provided by their employer then they are already covered.  Why add more confusion and chaos into an already unstable financial situation for working people and their families?  Lack of regulation and letting the competition of the market decide is a major part of what is going wrong with the banking industry now.  We do not need more of the same.

Correction:  people just think they are covered.

Change employers....and your chronic condition becomes "pre-existing" (meaning not covered).

Employer finds health plan that costs less....and your doctor is no longer in the network (meaning your visits are not covered).

Employer-based health benefits mean the individual is divorced from the rational decision making process regarding his or her own healthcare.  It's insane, irrational, and wholly illogical.


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RE: McCain's Health Care Plan - 9/19/2008 7:48:36 PM   
Thadius


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Status: offline 		I am just curious how Obama's plan doesn't encourage the same thing?  If an employer knows that their employees can be covered by the government plan, why wouldn't they cut that cost from their overhead?

Just one of those things that seems to be overlooked when comparing the 2 proposals, eh?



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RE: McCain's Health Care Plan - 9/19/2008 8:03:32 PM   
cloudboy


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I'm not knowledgeable of Obama's plan.

The problem with the US is that our priorities are fucked. Too much of our federal money is being pissed away in military spending and servicing the exploding national debt. Its political suicide in our system to rethink or modify entitlement programs.

I really feel our nation is at a crossroads, and it would not surprise me if we take banana-republic-way right down to a generalized lower standard of living for everyone.

The American Standard of living has been falling steadily under Republican rule. Energy costs have exploded. Food Costs have risen dramatically. Education costs are in the stratosphere. Wages have remained stagnant at best. While all this has been going on, Washington has engaged in misdirection, keeping everyone's eyes off the costs of the IRAQ WAR, the exploding budget deficits, and the lack of an effective regulatory culture from federal agencies.

I'm not sure how much more endless war and billions of debt we can feasibly sustain.

The NYT, too, just had an article of how the US Supreme Court is losing its influence in the world as other judicial systems no longer look to it to set a guiding example.

If Obama inherits this pile of shit, he really may not be able to do much more than just stop the damn bleeding. Healthcare reform and improvement might be nothing more than a pipe dream.

And then, in these troubled times, McCain picks a dim-wit for a running mate. Its just mind boggling.

Anyway, I think McCain's health care plan will get about as far as Hillary's did.

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RE: McCain's Health Care Plan - 9/19/2008 8:06:43 PM   
Vendaval


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Status: offline 		I have to disagree with you CL.  Employers do sometimes change plans but the employees do have choices within the parameters of the coverage offered.  And changing or loosing a job always carries the risk of loosing coverage.
 
An employee can opt out of the insurance and buy their own.  Nothing forces them to use the insurance from the employer. 


_____________________________

"Beware, the woods at night, beware the lunar light.
So in this gray haze we'll be meating again, and on that
great day, I will tease you all the same."
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RE: McCain's Health Care Plan - 9/19/2008 8:07:30 PM   
Hippiekinkster


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quote:

ORIGINAL: Thadius

I am just curious how Obama's plan doesn't encourage the same thing?  If an employer knows that their employees can be covered by the government plan, why wouldn't they cut that cost from their overhead?

Just one of those things that seems to be overlooked when comparing the 2 proposals, eh?


That's the point of single-payer, or at least one of them. By adopting a single-payer system (which is NOT universal healthcare, no matter how often the righties repeat that lie), employers can drop coverage (reduce costs) and become more competetive internationally. Employees might even get a meaningful raise, too!

In essence, this McInsane proposal would increase taxes for 20 million working class Americans. Way to go.

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RE: McCain's Health Care Plan - 9/19/2008 8:24:15 PM   
Thadius


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Status: offline 		To answer my own question, I went looking.

The Obama answer is to give a 50% refundable credit for employee health insurance premiums that are paid by the employer.

Which does one of 2 things.

1. It spends even more money from the treasury.
2. Leaves it up to employers to still opt out to save the cost, which adds more money coming out of the treasury because we are going to cover more folks.

With changes to the current medical savings account laws (like allowing the money to roll over every year) and a tax credit for health insurance, I would be much better off under the McCain proposal.  Even if I wasn't receiving my personal health care for free, it would be a much better solution for covering my slave.



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RE: McCain's Health Care Plan - 9/19/2008 8:39:58 PM   
celticlord2112


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quote:

ORIGINAL: Vendaval

I have to disagree with you CL.  Employers do sometimes change plans but the employees do have choices within the parameters of the coverage offered.  And changing or loosing a job always carries the risk of loosing coverage.
 
An employee can opt out of the insurance and buy their own.  Nothing forces them to use the insurance from the employer. 


Let's take the first bolded sentence first.  How many times does the average person change jobs?  My father, who graduated high school in 1953, worked for at least five employers before he retired.  Other than myself, I've worked for five employers since 1990.

People do not stay at the same job.  Changing jobs (and thus healthcare coverage) is the norm for the American workforce.

As for the second bolded sentence, people paid on a W2 are coerced by the tax code into taking their employer-based coverage.  Only self-employed individuals can fully deduct the cost of their health coverage.  The employed individual is significantly discouraged from shopping for alternate coverage.


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RE: McCain's Health Care Plan - 9/19/2008 11:03:36 PM   
Vendaval


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Status: offline 		CL,
 
Most of my disagreement with you is because of the statement in the quote box below.  I maintain that consumers whether they have insurance covered by their employer or not, have many decisions to make about their health care.
 
Have you had health insurance at all of your jobs?  How many were with the same or different carriers?  How many times have you had to change doctors and not because you wanted to? 

Married people have choices about coverage if they both have employers who provide insurance.  Adding unmentionables creates even more variables. One person may need more dental work, another needs contacts or glasses, one company supplies an HMO the other a PPO. 
 
While attending college I paid for dental insurance at the rate of about $30-$35 per month to cover cleanings every 6 months and X-rays.  I used a credit card to cover eye exams every other year (at a reduced rate through the campus health center) and new glasses when needed.
 
The way taxes are structure means that a person may be discouraged from not taking the employer based insurance but I have worked for places where you could opt out of the coverage and keep more money in your paycheck. 
 
A case in point, I worked for health organization that provided their employees reduced or free services at their locations.  But because their system was crap, they did not protect confidentiality and most of their personnel incompetent buffoons I paid out of pocket expenses to my own doctor.  Sometimes that meant doing without something else I wanted or using a credit card to cover lab expenses.  The quality of care was the deciding factor.


quote:

ORIGINAL: celticlord2112
Employer-based health benefits mean the individual is divorced from the rational decision making process regarding his or her own healthcare.  It's insane, irrational, and wholly illogical.


_____________________________

"Beware, the woods at night, beware the lunar light.
So in this gray haze we'll be meating again, and on that
great day, I will tease you all the same."
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RE: McCain's Health Care Plan - 9/19/2008 11:38:45 PM   
NuevaVida


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quote:

ORIGINAL: Vendaval

Have you had health insurance at all of your jobs?  How many were with the same or different carriers?  How many times have you had to change doctors and not because you wanted to? 


Hi Vendaval,

I have had 5 jobs in the last 10 years, and I have never had to change doctors.  I have maintained the same coverage throughout, as it has always been offered.  In fact, at two of those jobs, I am the one who set up the employee benefits plan, and I did so with the employees in mind, providing as many options as possible for them at the lowest rate possible.  At all of these jobs, I never had to pay out of pocket for the premium, except when married, as my husband was on my plan.

Nor was I ever denied care for a pre-existing condition, when changing employers.

Now I am on COBRA at a whopping $540/month!  I shopped for individual coverage outside of the plan and the lowest I could find (without having to pay a ridiculous deductible first) was close to $300.  And guess what?  Healthy me was denied coverage because my BMI is too high and I have a history of depression. 

I can't wait to start my next job so I can have affordable healthcare again, and keep my current doctor.  Personally I think it is ridiculous to be taxed on my healthcare as though it is income.  The whole idea behind tax exempt premiums was to help the working middle class get the care they  need.  That's why "Section 125" plans exist (the additional medical savings plan that many employers offer) - so people can save their money while covering medical care that their insurance did not cover.

I am in opposition to taxing healthcare as I believe it is going to deter people from getting the care they need.  Like you, I disagree with CL's comments.

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RE: McCain's Health Care Plan - 9/20/2008 12:34:04 AM   
Vendaval


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Status: offline 		Hello Nueva Vida,

Yes, when someone is laid off the cost of COBRA compared to the rate of Unemployment Insurance usually does not work in the real world.  Factor in mortgage or rent, utilities, car payments and/or insurance, groceries and household items and you will most likely have to drop COBRA.
 
The bullshit with pre-existing conditions is very frustrating and consumers definately need better options that what is available now.
 
Best of luck with your new job and being able to keep your doctor.


quote:

ORIGINAL: NuevaVida
Now I am on COBRA at a whopping $540/month!  I shopped for individual coverage outside of the plan and the lowest I could find (without having to pay a ridiculous deductible first) was close to $300.  And guess what?  Healthy me was denied coverage because my BMI is too high and I have a history of depression. 


_____________________________

"Beware, the woods at night, beware the lunar light.
So in this gray haze we'll be meating again, and on that
great day, I will tease you all the same."
"WOLF MOON", OCTOBER RUST, TYPE O NEGATIVE


http://KinkMeet.co.uk

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RE: McCain's Health Care Plan - 9/20/2008 3:59:20 AM   
hoodie


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quote:

ORIGINAL: Vendaval

Hello Nueva Vida,

Yes, when someone is laid off the cost of COBRA compared to the rate of Unemployment Insurance usually does not work in the real world.  Factor in mortgage or rent, utilities, car payments and/or insurance, groceries and household items and you will most likely have to drop COBRA.
 
The bullshit with pre-existing conditions is very frustrating and consumers definately need better options that what is available now.
 
Best of luck with your new job and being able to keep your doctor.


quote:

ORIGINAL: NuevaVida
Now I am on COBRA at a whopping $540/month!  I shopped for individual coverage outside of the plan and the lowest I could find (without having to pay a ridiculous deductible first) was close to $300.  And guess what?  Healthy me was denied coverage because my BMI is too high and I have a history of depression. 



The system is broken, no doubt about it.  However, I've yet to hear either one of these jokers even broach how to change several inconsistencies.

It amuses me that insurance will pay for treatments a life long smoker needs, ie. when they develop lung cancer, or COPD, or the like.  But they won't pay for the methods for a smoker to quit. 

I've encountered several people who are diabetic due to obesity. Their insurance will pay for all the diabetic testing strips, etc. but won't pay for a dietician to help in getting their weight under control.

Far too often, our insurance companies are reactive to our health, and not proactive.  I'm a state government employee, and I have some of the best healthcare around.  However, I also am the last female on my mother's side of the family who hasn't been touched by cervical cancer in some way, shape or form.  Imagine my horror when my doctor wanted to do 2 PAP's a year and the insurance denied saying, and I quote, "the costs outweigh the benefit of this second test"

So I think more preventative measures must be covered under insurance plans.  If more people are quitting smoking, there's less lung cancer treatments they need to shell out for.  If more people are eating right, there's less diabetic treatments.  We have some of the best technology around, and it's also the most expensive. 

But there is no doubt, one thing that does factor into the costs of healthcare, malpractice suits and insurance.  Doctors, a few years ago, were leaving Pennsylvania in droves because the premiums for malpractice insurance were upwards of a million dollars a year.  We are in a litigious society, and any little thing goes wrong, we sue.  Get the Trial lawyers out of the picture, there's a big improvement right there. 

We had a woman a few years ago, who was told, in utero, that her baby would be born with Down's syndrome.  While still pregnant, she sued the doctor, stating that the information was withheld from her, leaving her no "time to decide whether to abort or not".  She lost the case, but the fact that the doctor was sued is still a permanent mark.  His malpractice premiums went up, which in turn meant the price of every service he offers also went up. 

I'll be happy when politicians look at the reality of this issue.  While it's sad that alot of people don't have coverage, getting them covered isn't going to make healthcare more affordable.  There needs to be numerous reforms.

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RE: McCain's Health Care Plan - 9/20/2008 4:54:30 AM   
thishereboi


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quote:

ORIGINAL: Vendaval

I have to disagree with you CL.  Employers do sometimes change plans but the employees do have choices within the parameters of the coverage offered.  And changing or loosing a job always carries the risk of loosing coverage.
 
An employee can opt out of the insurance and buy their own.  Nothing forces them to use the insurance from the employer. 



When our company switched insurance companies, we had NO choices in the matter. One day I had a great doctor and dentist, the next I was out looking for someone on "the list".

Now it is true that I could have opted out and bought my own, but there was no way I could afford that, and I doubt many others can either.

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RE: McCain's Health Care Plan - 9/20/2008 6:19:24 AM   
cloudboy


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quote:

Now it is true that I could have opted out and bought my own, but there was no way I could afford that, and I doubt many others can either.


What does "opt out," mean? Does that mean the employer would pay you a higher salary or the same salary without healthcare benefits?

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RE: McCain's Health Care Plan - 9/20/2008 8:51:39 AM   
celticlord2112


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quote:

ORIGINAL: cloudboy

quote:

Now it is true that I could have opted out and bought my own, but there was no way I could afford that, and I doubt many others can either.


What does "opt out," mean? Does that mean the employer would pay you a higher salary or the same salary without healthcare benefits?

SOME companies will allow you to forego the company health plan and receive the putative cost of that healthcare plan on your paycheck. I venture to say most companies, however, would not pad the paycheck of an employee wishing to opt out of the company health plan.

In either case, where there is a company healthcare plan in place, an employee who chooses to purchase his or her own health plan does so with "after tax" dollars. W2 employees who purchase their own health insurance cannot deduct the cost of that insurance from their taxes. The company health plan, however, is a business expense to the company (tax deduction) and is not taxable income to the employee. As a consequence, employees have a decided economic incentive to go with the company health plan.

In the article referenced in the OP, much was made about people being transitioned into the "non-group" portion of the health insurance market, which is currently the weakest (smallest) segment of that market. The assertion was that this is a bad thing. I disagree. Strengthening the non-group market segment is in fact bringing market forces directly to bear on healthcare costs, forces which are noticeable by their absence in the current system. Group healthcare plans are, in essence, people paying for someone else's healthcare coverage. They distort costs and purchasing decisions because people do not get sick as a group, but singly, nor do they visit the doctor en masse. Group healthcare coverage is a severe market distortion, and an economically bad idea that needs to go away. Individuals and households need to purchase their own healthcare coverage directly, need to make the purchasing decisions directly, and need to be able to change healthcare providers easily. Individual enablement will force healthcare costs to align with individual incomes--an alignment which does not exist today.

When the vast majority of people cannot afford healthcare on their own, that alone is conclusive proof that the prices attached to healthcare are irrational and ultimately unsustainable. The crutch that is propping up healthcare pricing in this country is the employer-subsidized group health plan. McCain wants to yank that crutch away; that is an extremely good idea.

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RE: McCain's Health Care Plan - 9/20/2008 9:01:50 AM   
popeye1250


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Status: offline 		Abadabba's healthcare plan would give coverage to Illegal Aliens.

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