Two Health Care Plans Republicans Should Support

Whenever health care reform is talked about, Republicans respond in an almost Pavlov-style manner. Immediately we start talking about the evils of the Canadian and British healthcare systems and about the loss of American freedoms. Some even go a step further and claim as blogger John Vecchione writes in a recent post, that there is no health care crisis and when nations make universal health care a goal it also makes conservative parties unconservative.

Such claims amount to sticking one’s head in the sand and defending a system that really is undefendable. As I have shared in a recent blog posting as well as in the past, the American health care system is broken. That is not some liberal scheme, this is a plain fact. As some conservative bloggers have noted in the past, the current system keeps people tied to jobs they may not want simply to have health insurance benefits. The other problem is that when one loses their job, they also lose their health benefits. People are also faced with rules like pre-exisiting conditions and recission.

Conservatives are not crazy about having a government-run system for many reasons. One big reason is that such systems tend to be unsustainable. For example, Travis Frey noted in a recent blog post that France is faced with a healthcare system that is cracking under the strain on rising costs:

France claims it long ago achieved much of what today’s U.S. health-care overhaul is seeking: It covers everyone, and provides what supporters say is high-quality care. But soaring costs are pushing the system into crisis. The result: As Congress fights over whether America should be more like France, the French government is trying to borrow U.S. tactics.

In recent months, France imposed American-style “co-pays” on patients to try to throttle back prescription-drug costs and forced state hospitals to crack down on expenses. “A hospital doesn’t need to be money-losing to provide good-quality treatment,” President Nicolas Sarkozy thundered in a recent speech to doctors.

And service cuts – such as the closure of a maternity ward near Ms. Cuccarolo’s home – are prompting complaints from patients, doctors and nurses that care is being rationed. That concern echos worries among some Americans that the U.S. changes could lead to rationing.

The French system’s fragile solvency shows how tough it is to provide universal coverage while controlling costs, the professed twin goals of President Barack Obama’s proposed overhaul.

Conservatives rightly point out the problems in health care systems that have a high amount of government control. But the problems is that we stop there. We pretend there is no problem and maybe offer a few sops to change the system.

But the fact is, as more and more people lose their health care or face problems with the insurance that they have, people are looking more and more to Washington to help solve the problem. If Republicans decide to take John Vecchione’s advice, we can expect the public will look towards those who are providing solutions, namely the Democrats. The best way to assure that we have single payer is for Republicans to simply ignore the issue and not care.

But the fact is there are two plans that offer some real change without creating a large new governmental program. If the GOP really cared about offering solutions and not just political one-upsmanship, they could really make a difference.

The first plan is the Healthy Americans Act supported by Democratic Senator Ron Wyden of Oregon and Bill Bennett, the Republican Senator from Utah. Their plan basically is a grand compromise that achieves universal coverage and fulfills the aims of both Democrats and Republicans: it allows for the universal coverage that Democrats want and it also injects market forces into the system, something that Republicans would like to see.

The other option is modifying the model that is used by the nation of Singapore. The plan basically is basically as follows:

Singapore’s system requires individuals to take responsibility for their own health, and for much of their own spending on medical care. As the Health Ministry puts it, “Patients are expected to co-pay part of their medical expenses and to pay more when they demand a higher level of service. At the same time, government subsidies help to keep basic healthcare affordable.”

The reason the system works so well is that it puts decisions in the hands of patients and doctors rather than of government bureaucrats and insurers. The state’s role is to provide a safety net for the few people unable to save enough to pay their way, to subsidize public hospitals, and to fund preventative health campaigns. (emphasis mine)

Medisave, which covers about 85 percent of all Singaporeans, is a component of a mandatory pension program. Employees typically pay 20 percent of their wages into the Central Provident Fund (CPF), while employers pay 13 percent. (Since 1992, the self-employed have also participated.) At the beginning of 2007, CPF had over $1 billion in surpluses.

In Singapore’s system, the primary role of government is to require people to save in order to meet medical expenses they don’t expect.Medisave accounts can be used to pay directly for hospital expenses incurred by an individual or his immediate family. Limits are in place on the extent of Medisave funds that can be used for daily hospital charges, physicians’ fees, and surgical fees. The idea is to cover fully the bills of most patients in state-subsidized wards of public hospitals. Beyond that, individuals dip into their own pockets or use benefits from insurance plans (see more on this below). Medisave can also be used for expensive outpatient treatments such as chemotherapy, renal dialysis, or HIV drugs.

Medishield, the second part of the program, is a national insurance plan that covers the higher cost of especially serious illness or accident, which in Singapore’s system is described as “catastrophic.” Singaporeans can choose Medishield or several private alternatives, some offered by firms listed on the Singaporean stock exchange. Premiums for the insurance plans, including Medishield, can be paid using Medisave accounts.

Medifund, the third part, was established by the government for the roughly 10 percent of Singaporeans who don’t have the means to pay for their medical needs, despite the government’s subsidy of hospital and outpatient costs. The fund was set up in 1993 with $150 million, with the budget surplus providing additional contributions since then. Only interest income, not capital, may be disbursed.

Finally, there’s Eldershield, an addition to the 3M structure that offers private insurance for disability as a result of old age. It pays a monthly cash allowance to those unable to perform three or more basic activities of daily living.

The Singapore plan is not a plan that would please liberals, but it would please those who think government should have a minimal role in providing a safety net and putting the power in the lap of the consumer.

Of course, there are those who will say that any government intervention is an anathema. Such a view is not only cold hearted, but will not help the GOP in the long run. The average American isn’t looking for a womb-to-tomb welfare state, but they do want help. Most Americans might not like the Obama plan, but they still fear losing their health care or getting sick and finding out that their insurance company will not help them.

It’s way past time for Republicans to be truly concerned with health care. Let’s stop sticking our heads in the sand and offer real practical solutions.

Crossposted at the Progressive Republican

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Author: DENNIS SANDERS

  • Leonidas

    The Singapore Plan sounds a lot like the bill offered by Republican Congressman Paul Ryan

  • http://sovereignmind.wordpress.com/ adelinesdad

    Republicans *have* been advocating these plans, but the Democrats have said that it won't happen (http://themoderatevoice.com/36568/psstt-mr-pres…). I especially like the approach of the Wyden-Bennett bill of moving away from employer-based health insurance which I think has been detrimental for a number of reasons, while the Democrats' approach does the opposite by penalizing employers (yes, even small ones: http://sovereignmind.wordpress.com/2009/07/27/w…) for not providing health insurance benefits.

    I share some of your frustration that the message from the Republicans is much more focused on attaching the Democrats' plans than touting these alternatives, but then again when Republicans do bring up these plans they are usually immediately discarded as unrealistic in a congress dominated by Democrats. So you could make the argument that the only way these sorts of plans will get any attention is if the plans put forth by the Democrats are sufficiently derailed. Then the Democrats will be forced to look for more bipartisan approaches since passing nothing is not an option for them politically.

    Personally, I think it would be great if conservatives and moderates could do both at the same time–point out the flaws in the Democrats approach while explaining our own plans. Some try to do that, but usually are ignored since

  • Leonidas

    Yup and what happened when Mackey brought up his ideas….

    Progressives launched a boycott of Whole Foods,

    My what open-minded creatures they are…. *rolls eyes*

  • SteveCan

    Protect medicare, Keep government from getting between me and my doctors, DO some major Tort reform, Ensure that I can keep my current coverage. Let my insurance company sell it's products in all 50 states. Most of all, don't bankrupt the country.

  • DrToast

    You left out a few parts of the Singapore article:
    ______________________

    Tucci warns that it may be hard to replicate Singapore’s system in the United States. After all, Singapore has a small, concentrated population, with a “backdrop of political stability, enabling successive governments [all of the same party] to introduce consistent measures relating to individual responsibility, compulsory savings, and regulatory control of healthcare services and costs.”

    The public healthcare facilities in Singapore have been clustered, since 2002, into two integrated networks, each government-owned and managed as nonprofits: the National Healthcare Group (NHG) on the western side of the city-state, and Singapore Health Services (SingHealth) on the eastern side. Each provides a full range of services, running the public hospitals and specialty centers as private companies.

    The Health Ministry says that these clusters “provide cooperation amongst the institutions within the cluster, foster vertical integration of services, and enhance synergy and economies of scale. The friendly competition between the two clusters spurs them to innovate and improve the quality of care while ensuring that medical costs remain affordable.”
    _________________

  • CStanley

    It's perfectly appropriate to point out the potential pitfalls due to differences between the US and other countries, as Dr. Toast highlights from the article excerpts. If we use another country's system as a model, we have to consider those potential differences and decide if the system will still be workable here, and if so, whether adjustments need to be made.

    It's funny though how we never seem to see the same degree of caution exercised when liberals point toward the European nations whose healthcare systems they'd like to model ours after.

  • CStanley

    Speaking of Republican alternatives for healthcare reform, in addition to the Ryan bill that's been mentioned here, there are three other GOP sponsored bills currently in committee (plus the Wyden-Bennet bipartisan one.)

    The Ryan bill is HR 2520

    The corresponding Senate one sponsored by Sen. Coburn is S. 1099

    Then there's another Senate one sponsored by Sen DeMint, S 1324.

    And finally, sponsored by my Congressional Rep, Tom Price, is HR 3400.

  • vey9

    If the Republicans have all these swell ideas, where were they when they owned the stick? This could have been done many years ago. The problems we are having didn't start when Obama started talking about them.

    Maybe our esteemed Congressmen never shopped in a Walmart where (I think they are banned now) collection cans and posters were routinely up for an store employee's child that needed an operation to live?

  • CStanley

    vey- some of the same GOP Congressmen who have authored these bills started the process of conservative reform during the Bush administration. HSAs were put into the Medicare drug expansion bill (a bad tradeoff as far as I'm concerned- but apparently they had tried to write a separate bill for HSAs and the Dems were going to filibuster it.) Ryan also put forward at least one more HSA centered bill after that- I think it was after the Dems got the majority in '06 though so obviously it didn't go anywhere.

    It's worth noting that the Mackey Whole Foods healthcare plan was made possible by that legislation, so there's a real world example of how it can help fix our problems.

    The GOP leadership certainly should be faulted for not putting more emphasis on conservative based reforms, but as for where these reformers have been when the GOP was in the majority, they were in the trenches, plugging along.

  • RememebrNovember

    The first step in a proactive, take responsibility for your own health action is to PUT DOWN THE DOUBLE WHOPPER!!!!!!!!!!!
    Seriously, we are creating our own problems. Europeans also eat healthier and exercise more.

  • Leonidas

    There were some efforts at healthcare reforms during the time of Republican control. Tow obstacles confronted them.

    The First was the democratic filibuster in the Senate, the Second was a House of Representatives that was less willing to bi-partisan action than the Senate. The GOP failed to pursue bipartisan options strongly enough and failed, the same thing that is hitting the Democrat plans now. Now who is to blame I'm not that sure, as I didn't follow it at the time, but my guess would be House Republicans back then just as it is House Democrats right now. Nancy Pelosi has ressurrected the spirit of Tom “The Hammer” Delay, and that spirit is continuing to hurt and divide the nation.

  • Dr J

    “The Singapore plan is not a plan that would please liberals”

    Why not? It even has a public option.

  • DLS

    “Republicans respond in an almost Pavlov-style manner”

    You discredited yourself by making this and subsequent false statements.

    Republicans repeatedly have freely conceded that the US health care system obviouly has serious problems with it and that reform is desireable, and likely necessary, as the rest of us sane people have said.

    That doesn't mean that the idiotic and destructive behavior of the Democrats this year merits robotic acceptance and perversely enthusiastic support.

    [sigh]

  • DLS

    “'The Singapore plan is not a plan that would please liberals'

    Why not? It even has a public option.”

    Not only that, but Singapore is highly authoritarian and downright paternalistic (or maternalistic). Its Big Brother public service announcements, for example, are already anticipated here, if the PC “wellness” and food and other lifestyle faddists successfully borrow and flourish within the federal government here.

    Of course, Singapore is consistent, and also is strict on morality and harsh toward misconduct (death for drug trafficking, a crime to toss gum on the street or urinate in elevators, etc.), which may be why liberals might not want to be associated with anything Singaporean (or similarly with anything from Malaysia).

  • DLS

    ” the Mackey Whole Foods healthcare plan”

    C. Stanley, already the more agitated lefties are aghast at this and “rethinking” their love of “traitor” Whole Foods as a result. That has already made it into the news these days.

    “BETRAYAL!” Aieeeeeeeeeeeeeee…

    http://www.washingtonpost.com/wp-dyn/content/ar

  • CStanley

    Yes, DLS…I'm aware of the backlash against Mackey. Though I didn't explicitly mention it, what I was getting at is that we had some steps toward conservative reforms, and subsequent example of a responsible employer using those reforms to enable the company to provide healthcare plans for almost all of their employees- but because it's not the kind of reform that the left would like to see it's either ignored (ie, everyone who keeps claiming that the GOP 'did nothing') or it's attacked by the single payer/public option purists.

    And yet the conservatives are the ones who are having knee jerk, ideological responses in this debate? If the Dems had cared about healthcare reform during the GOP majority, they could have worked with the GOP on bipartisan reform. Their response to the majority then though was no different than the response of the GOP to the Dems now.

  • DLS

    “If the Dems had cared about healthcare reform during the GOP majority, they could have worked with the GOP on bipartisan reform.”

    In the same stubbornly and singular Obstructionism, Only manner in which they approached Social Security reform?

    (And, the Dems “own” Social Security and Medicare politically, and had the best chance ever to profit had they made any meaningful reform of Social Security at that time as an alternative to the GOP's.)

    Saying “We should reform Medicare first” as one of several bogus arguments against Social Security reform doesn't count! Had the GOP switched to Medicare reform, the Dems would have opposed that.

  • vey9

    I have no problem with Mackey's plan for his employees, but the rest of his ideas do nothing to solve the underlying problems. In fact, they would make things worse.

    Let's just choose one of his proposals that seems to be fond of being proposed in TMV as well:
    “Repeal all state laws which prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live. Health insurance should be portable.”

    The common argument is that this would encourage competition and it would . . . for a short time and the downsides are huge.

    First, I will assume that Mr. MacKey is proposing deregulation rather than reregulation by a Federal agency. Do you know why insurance companies became regulated in the first place? It was because of abuse. Not enough reserves is the major reason insurance companies are barred from many states.

    In fact, if you look at the recent large bank failures, you will see a roadmap of where deregulation leads if the insurance companies were likewise deregulated. How did those banks get “too big to fail?” Once upon a time there were laws that actually prohibited banks from crossing state lines (this was in my adult life time, so that is why I know). They were repealled and any bank could do business anywhere it liked.

    Did this result in more competition? Actually I have seen a cottage industry set up to start a bank, run it for a few years and then sell it to a Big Bank, take the profit and start another bank. So what has happened is that around here, we have either huge banks or small startups. They all pay about the same interest and they charge about the same amount in fees.

    But the one thing that the banks did and that the insurance companies will do is not keep enough capital in reserve.

    Also, advocating for this shows a real lack of understanding when it comes to procedure pricing. I can understand that, because the pricing is a secret. Let me explain because I have yet to read any of this elsewhere:

    Let's say according to the hospital, a certain x-ray costs $1,000 I'll call this the fantasy price.
    And let's say the hospital knows the real cost is $200. This allows for depreciation, space costs, pay, the whole shootin' match plus maybe 10% gravy to pay for the next expansion.

    Okay. Here is a list of who pays what:
    Uninsured no haggling: $1,000
    Uninsured with haggling: $500 (yes, it is routine to slash a bill in half and this really makes the patient happy since they think they got a really good deal)
    Company A: $400
    Company B: $250
    Medicare: $200

    These prices are all secret and the hospital won't tell you what they are getting even if you ask.

    Why the disparity in prices? Well, company “A” only has 100,000 signed up in their plan and company “B” has a million. This means that B can negotiate harder, “We can guarantee you 30,000 patients next year if you sign up with us.” Whereas maybe A can only guarantee 500.

    When someone that has insurance gets their bill from the insurance company, the insurance company typically quotes the fantasy hospital price, then what they paid (which may, or may not be true — to keep things secret) and the patient feels great because he thinks he is getting a good deal, so the co-pay doesn't sting as badly.

    Now, because the bigger company can negotiate a better price than the smaller one, they can offer cheaper policies, which means they can negotiate even harder. Nobody buys from Company A because they are much more expensive and either they go out or they are bought out.

    How does this increase competition? So now we have the danger of too little capitalization, the formation of insurance companies that if they fail will stick the providers with a huge bill (and believe me, the AMA and hospital lobby would never allow that), with a reduction in competition and absolutely no change in the prices of things which keep going up over the moon.

    Sounds like a good idea to me!

  • DLS

    “In fact, if you look at the recent large bank failures, you will see a roadmap of where deregulation leads if the insurance companies were likewise deregulated.”

    Misapprehension of deregulation is misplaced, even if occasionally we see cases of failure (due in large part to misconduct, which has never been desired with, and which doesn't follow normally with, typical deregulation).

    The more pertinent, if smaller typical kind of issue we would see with cross-state insurance is that were there problems (with billing, with delay or refusal to pay claims, etc.), one's own state insurance commissioner would have no authority do anything in the case of a company wholly located outside the state. (“A Delaware Corporation”)

  • vey9

    “(due in large part to misconduct, which has never been desired with, and which doesn't follow normally with, typical deregulation).”

    Disagree. The insurance industry is part of the “financial sector” as are the banks.
    The “misconduct” of which you speak was legalized and once it was legalized, 40-1 (where the law had previously required at least 3-1) ratios of capitalization followed.

  • CStanley

    vey, I wasn't endorsing the entirety of Mackey's proposal- I was pointing out though, that he shows a real world example of how the prior legislation already enacted by conservatives has allowed his company to provide insurance for nearly all of its workers.

  • vey9

    “a real world example of how the prior legislation already enacted by conservatives has allowed his company to provide insurance for nearly all of its workers.”

    His WSJ opinion piece was the first I heard about it.I keep hearing Repubs going on and on about HSA as if they didn't exist. I do know this, with the way prices are going, $2500 per year is chump change. The emergency rooms here charge $900 to say hello. More than that is extra.

  • DOUGLASFIELD

    ~ WHO LET $ATAN THROUGH THE BACK DOOR OF OUR U.$ CONGRE$$ ~

    THIS OLD WORLD ORDER OF ABUSE AND NEGLECT OF OUR POORER AMERICANS NEEDS ENLIGHTENED POLITICAL MINDS AND HEARTS TO VIEW GOD DIFFERENTLY THEN $$$… NO MATTER WHAT THEIR POLITICAL PARTY AFFILIATION ???

    WHEN WILL OUR WEALTHY ELITE AMERICANS ABATE THEIR ASSAULT ON POORER AMERICANS WITH THEIR MONETARY CONTROL OF OUR IVORY TOWER U.S. CONGRESSIONAL LEADERS OF THE NEW WORLD ORDER ???

    THERE ARE NOT MANY MORE DISTRACTIONS LEFT WHICH ARE AVAILABLE FOR OUR WEALTHY ELITE AMERICANS TO HIDE BEHIND IN NOT TAKING PROPER CARE OF ALL OUR AMERICANS IN A HUMANE FASHION !!!

    RALPH NADER ATTEMPTED TO EDUCATE AMERICAN VOTERS ABOUT U.S. CORPORATE POWER IN AMERICA AND HOW THEY CONTROL OUR CONGRESSIONAL PEOPLE THROUGH THEIR POCKET BOOK (POLITICAL DONATIONS). WITHOUT THE DOUGH $$$ THESE U.S. CONGRESSIONAL LEADERS OF THE FREE WORLD DO NOT GET RE~ELECTED TO CONGRESS.
    TO STAY IN POLITICAL OFFICE IN AMERICA,ONE HAS TO BARTER YOUR VOTES IN CONGRESS AND REPRESENT POWER INTERESTS IN RETURN FOR THE BUCK$.

    POORER AMERICANS HAVE NEVER HAD THE $$$ LOBBY TO INFLUENCE THIS CORRUPT POLITICAL CONCEPT (of horse trading political votes for political contributions) TO ACHIEVE PROPER HEALTH ~CARE OR LEGAL REPRESENTATION FOR ALL OUR MIDDLE ~ CLASS AND WORKING POOR AMERICANS.

    AMERICAN IVORY TOWER U.S.CONGRESSIONAL LEADERS OF THE FREE WORLD HAVE PASSED FEDERAL LEGISLATION IN WASHINGTON DC TO SPEND 50 BILLION AMERICAN TAX $$$ ON THE INTERNATIONAL FIGHT AGAINST AIDS OVER THE NEXT FIVE YEARS WHILE THEIR OWN AMERICAN CITIZENS ARE BEING TOLD BY THIS SAME U.S.CONGRESS THAT NATIONAL HEALTH CARE AND PROPER LEGAL REPRESENTATION FOR MIDDLE CLASS AND WORKING POOR CITIZENS IS UNAFFORDABLE.

    *** WEALTHY ELITE AMERICANS (WHO ARE ONLY 1% OF OUR USA POPULATION) SADLY ALSO CONTROL HOW OUR U.S.CONGRESS SPENDS THEIR BUDGET TRILLION$ AND HAVE OBVIOUSLY FOUND MORE WORTHY INTERNATIONAL CITIZENS THEN OUR OWN DESPERATE AND NEEDY POOR TO ASSIST !!!

    ~Poorer Americans Nationwide only get 400 million $$$ per year for legal representation allocated them by CONGRESS~

    Middle Class and Working Poor Americans are unable to afford proper legal representation in their Civil, Criminal and Family Courts of law all across America causing tremendous hardships nationwide,but these great minds and callous hearts in our American Congress have found others Worldwide more needy then their own citizens who are being falsely incarcerated,wrongfuly executed,losing their homes or apartments,losing child custody or visitation with their children etc…

    Not being afforded proper legal representation by our U.S. Congress has created a total breakdown of the American judicial system for our poorer Americans because the our U.S. Courts punish all of us little people if we are not assisted with proprer legal counsel.it is a known fact that our average Middle Class and Working Poor Americans without proper legal representation in all of our American Courts of law lose their legal cases to the better financed who are able to afford lawyers.

    Lawyers For Poor Americans is now actively in the hunt for International Countries and Leaders Worldwide to help raise 5 Billion Dollar$ for our slighted poorer Americans who have had their own American Congress turn their backs on their desperate needs in not affording them proper legal representation.

    Troy Davis and Mumia Abu – Jamal are 2 perfect examples of American citizens who never had proper legal representation afforded them by our U.S. Congressional Leaders Of The Free World in their initial criminal trials in (Georgia and Pennsylvania) who might very well have to pay the ultimate price of possibly being completely innocent and falsely executed in the near future.
    These two poor Americans are perfect examples of the tens of thousands of legal cases nationwide that never were afforded proper legal representation or proper defense investigations at their initial trials.
    We the public really have no idea if these men TROY DAVIS AND MUMIA ABU~JAMAL are even innocent or guilty until they both are given fair legal representation at their new future trials.

    Improper murder trials and needless health related deaths take place in third world countries all the time,but why should average Middle~Class and Working Poor Americans
    in the Wealthiest Country Of The World also be treated as if they are living a Third World Life Style ???

    This is the first of many www International pleas by Lawyers For Poor Americans for other leaders and countries to help raise the needed monie$ to correct these blatant injustices that have been inflicted on poorer Americans for the last few decades.

    Lawyers For Poor Americans has many other written articles that can be viewed with any www search engine by our name or our telephone number.

    Lawyers For Poor Americans is a www lobby group of volunteers that sing out about the decades old neglect,abuse and injustices being inflicted on our poorer Americans that have become Crimes Against Humanity issues for the International World Court to investigate.

    [email protected]

    (424-247-2013)

  • DLS

    “The insurance industry is part of the 'financial sector' as are the banks.”

    Aside from the distinction between the insurers and others lumped into a broad “financial sector” category, and between nominal “insurance” and health care (of which the HMOs acquired by many insurers at least were honest about their purpose), again, misconduct which makes news headlines, and similar actions that don't, have never been “caused” by and normally do not accompany in anywhere like the degree which would make the words synonymous, deregulation.

  • CStanley

    vey, perhaps you should actually look at the proposed legislation, which seeks to expand the funding possibilities for HSAs (also, your comment seems to indicate that an HSA is used as a sole funding mechanism for healthcare costs- it's not. They're generally used in combination with high deductible health insurance plans.)

    The reason you hear Republicans 'going on and on' about this issue is because the Dems ideas of health insurance reform will wipe out HSAs/HDHPs, and that is moving in the opposite direction that conservatives believe is necessary for real cost control without centralized, top down rationing. The HSA/HDHP model makes healthcare consumers more accountable for their own healthcare spending, and can be subsidized for low income earning individuals as necessary.

  • vey9

    If expanded HSA's are on the bill, then why complain about the bill?
    But, I wonder how much impact they would have on retail workers. Over half of the retail workers don't “qualify” for any type of insurance, catastrophic or otherwise.

    The reason they don't qualify is because they aren't given enough hours. It's not that they don't want the hours, the stores won't give the hours to them. The way WalMart shows high coverage numbers is by hiring people that already have insurance from another source.

    This is how you get people working “3 jobs” and no benefits.

    In this case, they wouldn't qualify for the HSA money either unless they put in 100% of the money and since the retail jobs pay so poorly, that is unlikely.

    MacKey contributes $1,800 of the $2,500 per year, but only to full-time employees. He admits that he, too plays the hours game with some of his employees, so I wonder if he isn't playing with the numbers the way WalMart does, too.

    BTW, I don't understand why the Repubs keep saying that they can't buy insurance from other states. There are lot's of insurance companies that sell health insurance in lots of states. All they have to do is get a license in the state they want to do business in.

    As I said before lack of capitalization is the number one reason companies are turned down. You don't want undercapitalized insurance companies just like you don't want undercapitalized banks. Unless You think the whole TARP thing was a swell idea that we ought to do every 10 years or so when the next bubble bursts.

  • TheMagicalSkyFather

    Feingold, Kucinich, Paul, Sanders I know there are more republicans like this as well I just cant think of them for the life of me right now and Spector was one of them but I am not as sure now that he flipped. Anyways these are good mean, agree or disagree with them they are fighting the good fight and doing it lawfully and with great honor. I think Gregg is a pretty good man as well from what I have read and seen.

    They vote their values, and they have giant bouncing balls of steal for some of the things they have resisted. Sadly many more though are pretty slimy in either party but that in my opinion is what happens when money enters politics. The day I began to hate Rush was the day I realized that he was throwing the primary for Bush. I was a McCain voter, but then he sullied by making all that I liked about him look like a political calculation.

  • CStanley

    If expanded HSA's are on the bill, then why complain about the bill?

    They're not in the Dems' bills (in fact most of those will explicitly phase out HSAs through other policies that they'll put in place (the exchanges.)

    They're in the GOP bills that are languishing in committee.

    As for Mackey, I'll have to go back and reread his op-ed but I'm pretty sure he's covering most of his part timers too.

    And what that dentist is doing doesn't make a whole lot of sense under current tax laws. The money would go a lot farther for them if he'd buy the health insurance for them because it's tax exempt on the employer side. Maybe what he's saying though is that he'll either buy the policy or give them the cash portion (which would be after taxes) if they prefer.

  • TheMagicalSkyFather

    I would go for the Singapore plan, I do not think it will be offered though. An intelligent Republican party would have solved this issue at some point over the last 30 years but they decided to ignore it. Now the price for the nation is a Democratic plan which has always been the Republicans worst nightmare. I have doubts that they will like the outcome. If they joined negotiations as a party and swallowed a public plan or even strong co-ops they would get a good deal of free market reforms in return. We are responsible not only for our actions but the likely result of those actions.

    If they really think this is headed off a cliff and they do not try to strike a deal they are just as responsible for the outcome in my opinion as the Democrats that actually believe in it. The believers are expected to muck stuff up every now and again, that is why this country fears them in all their forms but to step in and make a deal that fixes the problem bolsters the image of your party to those on the outside and if it goes south it still a Democratic bill. The populace knows what party is in control, if they join the process and make deals they get to start down the path of not looking like the crazy obstructionist party which is problematic image wise.

    If things go badly with health care though and Republicans stayed out of it completely people will still want to know why they didn't try to do a damn thing as the country went down in flames. The problem is that it has been so publicly offered for them to join the process so many times that anyone paying attention knows that they refuse to get involved, is that in their constituents best interests? They chose to squeal and kick over co-ops and they will have to realize that they are not the party in power anymore, but they still need to do their jobs.

    It looks like we will have a Dem only bill though which will shift the debate in this country for the next half century to expanding coverage or taking coverage away and that is why they fear the electoral consequences as they will at most have to shift to being maintainers and waste eliminators which would mean an entire change of identity for the party. They may just find themselves in the same situation they did after the new deal.

  • Dr J

    Dennis, there seems to be a typo in your post. It reads: “France is faced with a healthcare system that is cracking under the strain on rising costs.”

    France, as we all know, is in Europe, where health care is better than ours at half the cost. Everyone loves the system, and the government prevents cost increases through its single-payer negotiating power. Or, if that fails, by drowning them in Bordeaux.

    You surely must have meant Florida, where greedy capitalists prey on frail citizens while Governor Sarkozy tries to accumulate enough Bordeaux to drown them.

  • Don Quijote

    The GOP leadership certainly should be faulted for not putting more emphasis on conservative based reforms, but as for where these reformers have been when the GOP was in the majority, they were in the trenches, plugging along.

    As I remember the years from 2000 to 2006, the Repugs had the house, the senate and the presidency, they had no problems giving tax cuts to their supporters, starting wars against defenseless countries and passing any other legislative agenda they wanted to. The Hammer made sure that all Repugs followed the party line and damn near every bill they passed got 90 plus percent support from the Repug Caucus. The repugs did not pass any health-care bill because they didn't want to and couldn't give a damn how many death could have been prevented.

    The Repugs had six years in power and they didn't do a damn thing about health-care.

  • Don Quijote

    France, as we all know, is in Europe, where health care is better than ours at half the cost. Everyone loves the system, and the government prevents cost increases through its single-payer negotiating power. Or, if that fails, by drowning them in Bordeaux.

    At least in France they don't have 100,000 people dying every year due to a lack of health-care.

    France, Japan and Australia rated best and the United States worst in new rankings focusing on preventable deaths due to treatable conditions in 19 leading industrialized nations, researchers said on Tuesday.

    If the U.S. health care system performed as well as those of those top three countries, there would be 101,000 fewer deaths in the United States per year, according to researchers writing in the journal Health Affairs.

    Researchers Ellen Nolte and Martin McKee of the London School of Hygiene and Tropical Medicine tracked deaths that they deemed could have been prevented by access to timely and effective health care, and ranked nations on how they did.

  • CStanley

    There are obviously problems in France's healthcare system which can, and have, resulted in deaths too though, DQ.

    Remember this story?

  • http://polimom.com Polimom

    MagicalSF said: An intelligent Republican party would have solved this issue at some point over the last 30 years but they decided to ignore it. Now the price for the nation is a Democratic plan which has always been the Republicans worst nightmare. I have doubts that they will like the outcome.

    There's some truth to this.

    Most everyone, I think, understands that the health care system in the US is not… umm… working optimally. If the Republicans had seriously taken up health care reform during the first 6 Bush years, there'd have been at least an opportunity for bipartisan reform, because the Dems are highly invested in this rolling catastrophe.

    OTOH, it might have gone immediately into the screaming bowels of Partisan Hell, as happened to immigration reform.

    I do think it's fair to say, though, that the Republicans frittered some very important opportunities.

  • Don Quijote

    There are obviously problems in France's healthcare system which can, and have, resulted in deaths too though, DQ.

    What ever problems they have, they don't have 18,000 people dying every year due to lack of health insurance.

    Remember this one? Heat waves are potential humanitarian disasters no matter where they happen.

  • Don Quijote

    If the Republicans had seriously taken up health care reform during the first 6 Bush years,

    They would be Democrats.

  • CStanley

    Heat waves are potential humanitarian disasters no matter where they happen.

    Of course- but the magnitude of that episode in France was startling, and was much worse than in neighboring countries that had similar weather conditions, and everyone- including the French govt- recognized that there were problems with their healthcare system that contributed.

  • CStanley

    Yet the Democrats who were in Congress at that time refused to participate in (and threatened to block) any of the GOP reform efforts because they weren't the 'correct' kinds of reforms for liberals.

  • Leonidas

    Feingold, Kucinich, Paul, Sanders I know there are more republicans like this as well I just cant think of them for the life of me right now and Spector was one of them but I am not as sure now that he flipped. Anyways these are good mean, agree or disagree with them they are fighting the good fight and doing it lawfully and with great honor. I think Gregg is a pretty good man as well from what I have read and seen.

    Feingold and Sanders, yes honorable men; Paul is well and maybe Kucinich as well maybe but both have spats of being bats**t crazy and so are hard to hold up as rolemodels, although I certainly admit to liking some of Paul's ideas.

    If you want to look at honorable Republicans I'd put forth John McCain, Jeff Flake, Tom Coburn, Jim DeMint as examples. You might not agree with their position on issues but there character is honorable.

  • montanaduse

    Learn more about the impact of Obamacare on the medical sales industry by visiting http://www.gorillamedicalsales.com/blog

  • groupbenefitsnyc

    Health care Insurance was the very important factor for our everday's life we did'nt know when we are going to be sick or in emergency so they need to do more things to convince people to have that kind of benefits …

  • DLS

    “The way WalMart shows high coverage numbers is by hiring people that already have insurance from another source.”

    Do you believe that Washington is above this?

    I suppose I need to repeat something here.

    In addition to simply taking $500 B from Medicare, cramming down provider payments that already are known to be deficient often, and threatening to get providers and pharmaceutical companies to Do More (as Pelosi has said) in the future — don't you realize Medicare cost-shifts to private providers now?

    http://www.cms.hhs.gov/Manuals/IOM/itemdetail.a

    http://www.cms.hhs.gov/MEDICARESECONDPAYERANDYOU/

    No wonder they want to keep the private providers now (to cost-shift as part of “reducing costs” they don't spend a lot of time telling you about) while continuing the effort toward eventual replacement.

    (And in case you finally are led to guess, yes, Washington already has flirted with extending the period during which others pay for medical care first.)

    That is aside from keeping the lawsuit gravy train rolling strongly (which could be aided by “reform” measures that include mandatory malpractice insurance with ratcheting-upward liability minima), and to avoid the public rejection of 100% federal takeover now, as reasons for remaining partially private.

    The lawsuit gravy train's health may not be neglected currently, either. In addition to the sinister nature of defining standards or “appropriateness” of care insofar as future rationing and denial is concerned, what about this, which was attempted in regards to Medicare Secondary Payer (at least)?

    http://www.american.com/archive/2009/august/tri