John Podesta Makes 10 Points
Posted by Pellora in Current Events, Health, Relaxed Politics, US News, US Politics
Change of the magnitude envisioned by health care reformers does not come easily. There have been many frustrations and there will be more. But, as a senior White House staffer with a ringside seat for the slow death of comprehensive care in 1994, I am keenly aware of the real alternative to the bills now before us: millions more Americans without health care and billions more for health care spending as the same challenges President Clinton tried to resolve continue to metastasize unchecked.
So while I have great respect for Governor Dean, and we have worked together to provide the strongest health care reform bill for the American people, I come down on the side of the Senate passing the bill.
1. Largest Expansion Of Coverage Since Medicare’s Creation: Thirty-one million previously uninsured Americans will have insurance.
2. Low/Middle Income Americans Will Not Go Without Coverage: For low-income Americans struggling near the poverty line, the bill represents the largest single expansion of Medicaid since its inception. Combined with subsidies for middle income families, the bill’s provisions will ensure that working class Americans will no longer go without basic health care coverage.
3. Insurance Companies Will Never Be Able to Drop or Deny You Coverage Because You Are Sick: Insurers can no longer deny coverage because of a pre-existing condition. They can’t rescind coverage or impose lifetime or annual limits on care. Significantly, the bill also ends insurer discrimination against women — who currently pay as much as 48% more for coverage than men — and gives them access preventive services with no cost sharing.
4. Lowers Premiums For Families: The Senate bill could lower premiums for the overall population by 8.4%. For the subsidized population, premiums would decrease even more dramatically. According to the CBO, “the amount that subsidized enrollees would pay for non-group coverage would be roughly 56 percent to 59 percent lower, on average than the nongroup premiums charged under current law.”
5. Invests in Keeping People Healthy: The bill creates a Prevention and Public Health Fund to expand and sustain funding for public prevention programs that prevent disease and promote wellness.
6. Insurers Can’t Offer Subprime Health Care: Insurers operating in the individual and small group markets will no longer sell subprime policies that deny coverage when illness strikes and you need it most. Everyone will be offered an essential benefits package of comprehensive benefits.
7. Helps Businesses Afford Coverage: Small employers can take advantage of large risk pools by purchasing coverage through the bill’s state-based exchanges. Employers with no more than 25 employees would receive a tax credit to help them provide coverage to their employees. The bill also establishes a temporary reinsurance program for employers providing coverage to retirees over the age of 55 who are not eligible for Medicare.
8. Improves Medicare: The bill eliminates the waste and fraud in the Medicare system, gets rid of the special subsidy to private insurers participating in Medicare Advantage and extends the life of the Medicare trust fund by 9 years. It also closes the doughnut hole that affected 3.4 seniors enrolled in Medicare Part D in 2008.
9. Reduces The Deficit: Not only would the bill expand coverage to 30 million Americans without adding to the nation debt, it would also reduce the deficit by up to $409 billion over 10 years.
10. Reduces National Health Spending: A CAP-Commonwealth Fund analysis concludes the bill could reduce overall spending by close to $683 billion over 10 years – with the potential to save families $2,500. Even the most conservative government estimates conclude that the bill would reduce national health care expenditures by at least 0.3% by 2019.
I will point out, though, there is one commenter who gives an alternative opinion.
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stateofthedivision Says:#3 Insurers will be able to charge customers with health risk factors 50% more, with the ability to impose annual limits.
#7 CMS Chief Actuary predicts 17 million fewer people will have employer sponsored coverage.
#2 Largest single expansion of Medicaid does not mean access to care. Very few primary care doctors in my community take Medicaid patients into their practice. They get them through ER call, but physicians only have to do follow up care for the ER diagnosis. After one or two visits, the Medicaid patient is back on their own.
Individual mandate. 20% of drivers in my town have no auto liability insurance, despite a state law with huge fines. We have 25-30% uninsured in the region. My guess is we’ll be lucky to cut that in half, given our proximity to Mexico.
December 16th, 2009 at 8:31 pm
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stateofthedivision Says:CMS projects 11.9 million people will lose employer coverage in 2009-2010. Subsidies start in 2014.
I haven’t read the Senate’s version of the health care reform bill. I doubt many of us have. We have only “heard” what others have to say about it.
So I wonder which of the above points is more factual. John Podesta or stateofthedivision?
I’m tired of guessing. I’m tired of listening to the opinions. I’m tired of wondering who has the real facts and who has made up facts. I’m tired of listening to the vitriol from both the repugnants and the Democrats and the Progressives.
Make no mistake though, I WILL NOT VOTE FOR ANY REPUGNANT IN 2010 OR 2012. I WILL VOTE. I will do my part in getting more Democratic Representatives and Senators in Congress.
Entries (RSS)
OK off to the
Another one for you to go read.
@ Texas Betsy:
…I may feel differently in an hour. Damn mood swings.
Has it been an hour…?
You’re not quoting me CT.
@ Texas Betsy:
I was quoting your article, M’dear…!
Both sets of numbers are probably “right”. Podesta seems to be using using CBO and CAP numbers. CBO numbers tend to be conservative. CAP does great stuff.
CMS is Center for Medicare and Medicaid Services, which is another part of the gummint. But stateofthedivision doesn’t really say what those numbers are (projection with HCR? without HCR?) And here in ME, you can’t buy are car without proof of insurance. You can’t register a car without current proof of insurance. “given our proximity to Mexico”, ooooh, he’s a Texan!
On his Medicaid point, I saw numbers a few weeks ago that said something like 97% of docs take Medicare, and 85% take Medicaid.
Now this: “CMS Chief Actuary predicts 17 million fewer people will have employer sponsored coverage” and this: “CMS projects 11.9 million people will lose employer coverage in 2009-2010. Subsidies start in 2014″ shows we need to know 17 million over what time frame and under which conditions? If 12 million lose employer coverage in 2 years (for reasons that don’t have anything to do HCR, because the salient parts haven’t started yet), then 17 million would be a reasonable number for 2011 or 2012 (still before 2014).
But the major reason single-payer is not on the table is that big employers and unions like employer based healthcare. It gives them power. Which it does, because the individual market sucks. If the individual market (and small group market) didn’t suck, they would have to find some other way to lure potential employees and dues-paying members. And when it no longer gave them power, they would all happily cede it. To single-payer, even.
Gordon, what happens to those of us who have employer health insurance now? (Mine is the same offered to all city and school district employees.)
Nothing, for quite awhile.
That 11.9 million number is just employers going out of business, or giving up on providing coverage because it’s too expensive – employers in financial trouble. Once the exchange(s) are up a running, more firms will drop out of providing coverage simply because it’s a royal PITA (maybe that’s the 17 million?) and their employees can get coverage (at least) as good as what they can.
For large groups and unions, it will take a lot longer.
Wow. This guy is good.
gordon wrote:
Yep. Political Reality 101.
Back from my meeting. Now to figure out what to
during KO.
And he even asks better questions than Nate Silver (and that ain’t easy).
And he snarks with the best of them.
gordon wrote:
“…So, while it is true that Republicans are following a rejectionist strategy, it’s also true that Democrats are placing a priority on getting the most liberal bill possible, not the most possible votes….”
Huh…? What hasn’t been sacrificed for votes…? What did the Conservatives sacrifice…?
…
…
…
… Well, I’m listening…!
Oh Keerist. From a C&L post:
Does Ed have a bug in the WH? Is that how he knows the President is listening to Rahm and the insurance lobby?
I don’t think we elect the COS and he selects the Prez. I’m pretty sure it works the other way ’round.
Well I guess there is historical precedent. Dick Cheney was COS (in one admin), and ended up telling the Prez what to do (in another admin, when he wasn’t COS). But the only people who would pursue that analogy would be Larry Johnson and his crowd of rabid PUMAs. (Was Ed a PUMA? He seems to have sympathies that way.)
And again, why oh why would the insurance companies be spending millions per day on advertising to kill HCR if Obama was doing just what they told him? Why?
Seriously. I spent years and years (way too many) working with MBAs. MBAs control advertising budgets in every large corporation. Your typical MBA in a job like that is entirely soulless, dishonest and self-serving. Just the type of person who would not do (or spend a penny on) anything that wasn’t in their direct interest. So why are they spending literally millions per day to fight HCR?
@ CTuttle:
We’d have Snowe wrapped up if we’d given her her trigger. We probably could have had Collins, too, if we’d let her have her chance to play heroic dealmaker on national TV.
Meanwhile, answer my question. No joke. Answer it.
@ gordon:
Dood.. They’ve fought tooth and nail since the Sixties(Earlier even…)…! They will continue to fight it until it is as dead as a doornail…! WTF…! As you’re so eloquently pointing out… Why are they still fighting it…? Reflex…? No, they still aren’t satisfied with the largesse…! Uncle… Already…!
@ CTuttle:
Ok, so it’s not “shoveling money to the insurance companies”. Because obviously they think they are better off with the status quo than with the current bill. So they have calculated that they will take a hit. A big hit, based on what they are spending to fight it.
Big Pharma has agreed to a $80 billion hit (and they have much, much more money to fight this than the insurance companies do).
The last (and much the biggest) villain is the providers – doctors (well, specialists) and hospitals. And, according to Gawande (who should know, since he’s a specialist, as well as a wonk) half the Senate bill is devoted to finding out how we can get them under control.
So all of the villains lose to some extent or another.
So what’s not to like?
@ gordon:
Gordon… It’s the bureaucracy… As Sanders had pointed out on the floor of the Senate…
“…A 900 bed Hospital has 900 hundred billing specialists…!”
@ CTuttle:
And how does that support “kill the bill”?
Thank you Gordon –
I have been wondering about your take on all of this. And thank you CT for goading Gordon until he spilled the beans! 
I want the bill done. I think it is generally good. I am disappointed in some parts. I am not for being made to spend my money to greedy awful evil insurance company jerks.
I want to boycott that part 
I have a question though – Gordon you said ***And again, why oh why would the insurance companies be spending millions per day on advertising to kill HCR if Obama was doing just what they told him? Why? ***
I want to know why that is so… I don’t watch teevee, I listen to radio and I don’t hear many ads. However, it has been pointed out by radio guy Ed (who is generally well read enough to say what is going on… but there are days when I can’t listen to him – days when that red head is bezerk! ) Anyway – if it is true, why are the stock values of The Big Insurance Cos going up? if it is assumed that they are taking a *big hit* ?????
The two don’t mesh, in my opinion.
@ gordon:
I’ll reiterate.. Strip the mandate and I’m fine…! Otherwise, you’ve no cost containment whatsoever… In fact, by allowing interstate movement of HMO’s you further weaken existing State regulations (In most States that’s bad…!)…! Think of the flight of credit card issuers to N. Dak. and Del. to evade St. regulation…!
Another question – aren’t there parts of the Senate bill, and I guess the House bill too for that matter, that is designed to ** get rid of the waste and fraud of the providers ** ?
“Don’t let the perfect be the enemy of the good”
It’s not even good…!
Sure ain’t perfect!
Does this tell us where the insurance companies come down? I think they’re looking for a 99% capitulation instead of whatever percentage the current bills offer them. Insurance Stocks Soar With Joe Lieberman’s Statements
The Unions. Two of them, at least. Major unions line up against Senate health bill
Aren’t these the kinds of things that conference can figure out?
Of course, the final bill must be voted on again, and there is the next filibuster to deal with then.
@ Texas Betsy:
That’s what I was asking Gordon at #20 – why stocks going up AND insurance companies doing negative advertising cause of the hit they are going to take.
Can it really be both?
@ Pellora:
If you, or Ed, or anyone else, has private knowledge about why or when stock values go up or down, please contact me. Privately. Before it goes up or down. I do have a semblance of an IRA, with full control over its investments.[*]
@ CTuttle:
No mandate, you get nothing. No bill at all.
Again, mandate + subsidies is the closest you will get to increased taxes + single-payer. At least until you’re eligible for Medicare and can join the Tea Party (motto: “Gummint hands off my Medicare!”). No mandate and it doesn’t even pass the House.
And yet again, if there’s no cost containment, why are they fighting it? ‘Cause your excess costs are their pure profit. Nope, they’re betting that there’s a lower profit margin if it passes. And they are betting very publicly, at a huge cost. So why are you taking their side?
Oh, you’re taking your cues from that wet place, aren’t you? You know, the place that killed Carolyn Kennedy so we could have Kristen Gillibrand? How has that worked out? Seems like “noun and a verb and 9/11″ Guiliani is outpolling her. Significantly. Wow, what a victory for movement progressivism.
Got some reference for “HMOs”? I don’t know exactly what’s in the Senate plan (nobody does, it hasn’t been released), but there have been 2 Dem proposals to counter the R “sell crappy insurance across state lines” proposals. One requires that the states enter into agreement with each other (so presumably a high regulation state would not allow buying into a plan from Alabama or Texas), and the other requires meeting federal standards, not state.
I suspect the latter, which would allow Kaiser-Permanente to sell across all state lines, which would be a very good thing. But, if you’re in a high regulation state (like I am, and you are), the former is not so bad, either. Your argument (which is correct) is against the Republican alternative (buy nationally, but regulate state by state). And the R’s are not controlling this, they are just delaying it.
gordon wrote:
See linkie at Betsy #25 which actually leads to a WSJ story The WSJ is behind a pay wall for the whole story though. Betsy’s linkie seems to summarize (it’s a puddle piece… )
CTuttle wrote:
Then why are they fighting it??
No “uncle” this time. It’s good, or it’s bad. If it’s bad, WHY ARE THEY FIGHTING IT?
@ gordon:
…Oh, you’re taking your cues from that wet place, aren’t you? You know, the place that killed Carolyn Kennedy so we could have Kristen Gillibrand?…
Where did that come from…? I glean some from FDL, but, by no means do I ‘take my cues’ from ‘em…!!! There’s a whole lot more out there that I utilize… Do you ever read my cites… On occasion, I’ll cite FDL…!
Dr. Howard Dean is (right now anyway) on Montel Williams radio show. I’m sure this is delayed air though.
I am virtually
on an orchid speaker circuit conference call. 
I’m ignoring the healthcare fight
gordon wrote:
They’re still not happy…!
What part of that did you not understand when I first said it…???
@ gnome de plume:
Orchid conference calls? Wow…ain’t technology wonderful??
For anyone who’s interested, the Colts are losing to the Jaguars with 8 minutes left in the game. They’re only down by 4 points, and 8 minutes is an eternity in Peyton’s world.
@ Pellora:
No it doesn’t.
I worked for a Fortune 500 company who consistently got “buy” ratings from all of the investment analysts, when anybody who actually worked there could have told you it was “sell”. Then I made a good bit of cash money off the dot com boom (I did unix and sockets as well as almost anyone), but I knew as well as anyone in the business that it was 99% a crock of shit. (Alas, an ex spent all that cash before it all went bust, which I predicted, and then she spent a bunch more after that that we didn’t have.)
If the stock market was not subject to idiocy, we would never have a crash. Really.
Stock market analysts regard the “public option” (or some really vague analogue, like buy-into-Medicare-at-55) as the scent of doom. They’re kind of like a certain dinosaur in their incomparable olfactory discernment.
Gnome there’s no healthcare in the upstairs thread.
@ madmommy:
We get sun, but not enough in one day to really melt the snow/ice. And it refreezes at night. I’d *almost* prefer just plain cold no melted conditions. *almost* except it’s too damn cold that way. 
I still haven’t driven my Saturn coupe – using parents’ VUE, while Kidlet3 uses our VUE (it’s really his car anyway… I took the one with the better gas mileage 
so though I pay for gas for both right now, down the way a bit, I win!
Forgot about the game
I’m trying to work, which has been a bit difficult while driving my parents around to various and sundry stuff. The main roads are dry (well, depends, if it melts there is water on the road, which by middle of night is icy) mostly dry. All the residential streets, except for the highly traveled ones are still one of these – packed icy snow, slush in various depths, two tracks down to pavement on an otherwise snowy packed icy roadway, clear with melt water that might be frozen. And if someone is so fortunate to get stuck on a street, by the time they get themselves out or get help getting out, they have more often than not completely destroyed an otherwise passable street.
Okay – I guess I can go back to topic. Which I posted, so I have no one to blame but myself
Howard Dean is really pissed that the insurance company “regulation” (my word) was stripped in the Senate. He hopes that such plus competition to rein in cost of premiums gets added in conference with House bill, but if not, he wants to “kill the bill” and start over. He’s pretty firm on this it seems.
MM… You cursed the Jags…! 35-31 Colts with 5 and change left….!
@ gordon:
I wondered about that. Stocks and trading is all gambling anyway, and being born and raised in a gambling state, well, I don’t cotton to it at all and can smell it from a long way away.
I’m wondering if it is an attempt to *game* the … system… for lack of a different word. You know, like the dot com shit. Play the game, act serious, get people to go for your faint, and wham! $$$ for some and not for others.
Some serious stoopids around – idjits into ultimate idiocy! Or as my grandma used to say
A Fool and His Money are Soon Parted!
I peeked – the new post isn’t my coloring book pages just re-named. I’m not going to more *current events* because I’m
of the news. Though the fact of the subject of the new post is a good thing, I don’t much care right now and don’t want to read about the *who* who hid shit. 
new new new non=political post 2 flights up the stairs.