Healthcare Reform Thread

[Drake Tungsten]

I have no clue what your point is now. If you're trying to disprove Elmendorf's verdict on the cost savings of the House plan, you're doing a pretty bad job of it.

[Ramo]

More on cost savings:

By Jacob Goldstein

Health ReformSo House Democrats just released their big health-reform bill. As expected, it includes a new, government-backed health plan — a plan that’s been among the most contentious topics in the health reform debate.

As we were poring over the analysis out today from the CBO (the Congressional scorekeeper whose estimates are key in shaping the debate), we were struck by one estimate in particular:

…total enrollment in the public plan would equal about 11 million or 12 million, counting both individually purchased policies and employer-sponsored enrollees.

That’s about 4% of the current U.S. population, and seems rather small in comparison to how much attention the debate over the public plan has drawn.

Of course, the CBO itself notes that its “estimate is subject to an unusually high degree of uncertainty,” which means that the actual number of people who enroll in a public plan could be significantly higher.

The plan would pay doctors and other practitioners 5% more than Medicare pays. Rates for hospitals and others would be the same as Medicare. And the public plan would negotiate rates for drugs, according to the CBO. The public plan would have premiums on average around 10% lower than private plans, because of factors including the lower rates it would pay to doctors and hospitals, the CBO says.

For more on the bill, including new taxes that would be used to fund insurance subsidies, see this story from the WSJ.

The next big shoe to drop is likely to be the health bill coming out of the Senate Finance Committee, which is expected in the next week or so. It’s unclear whether that bill will include a public plan; it may instead create a system of health co-ops.

http://blogs.wsj.com/health/2009/07/14/cbo-public-health-plan-would-enroll-less-than-5-of-americans/

It should be noted that a significant drop in premiums due to the bargaining leverage of the public plan would force a smaller drop in premiums of private plans. I don't know how large that would be, but I'd be that it would be significant. You can come up with an estimated savings figure if you make a few assumptions (average premium over the relevant years, portion of public funding of the average premium, number of people enrolled in the public plan, effect on the premium on private insurers), but these aren't necessarily trivial amounts we're talking about. And as I was saying, there is the crippling of its ability to piggy-back on Medicare disbursement that should be accounted for if we're talking about an ideal public plan (which Oerdin was).

[Ramo]

I have no clue what your point is now. If you're trying to disprove Elmendorf's verdict on the cost savings of the House plan, you're doing a pretty bad job of it.

Who said I was responding to Elmendorf? He's a good guy, and he should be in public more. I was clearly talking about the public plan, and why anyone who cares about cost savings should get on board with making it stronger (and support other cost control measures). You still haven't explained what has been superseded by events. The only new event is that right wingers got new talking points.

[Drake Tungsten]

I was clearly talking abou the public plan, and why anyone who cares about cost savings should get on board with making it stronger.

The House bill includes a strong public option, yet doesn't reduce costs.

[Ramo]

Yes, we all know that talking point by now.

It's a "strong plan" that exists for 3 out of the 10 years that the CBO actually scored, and operates on a disbursement handicap. Even then, it's not anywhere near as strong as it could be. If Wyden's amendment passes, the public plan would be significantly more effective by allowing anyone into the exchange (and therefore with public plan access), subsidized by the employers.

And no, it reduces costs (almost a logical corollary of operating 10% cheaper than its competition), if not necessarily very much. The more interesting score would be ten years afterward. But that isn't what the CBO does.

[Drake Tungsten]

Elmendorf's statement was temporally open-ended; he doesn't see the House bill (which includes a strong public option) ever reducing healthcare costs for the government. You're grasping at straws...

[Ramo]

Jesus. I'm not referring to the House Bill. I'm referring to a public option. They are not interchangeable. The House Bill includes a variant of the public option (that isn't as strong as it could be), but it also includes other things. Like a broadened safety net that gets 97% of legal residents insured. If you haven't noticed, those things do not come cheap.

There are actual CBO numbers characterizing the efficacy of potential public options. And savings could be pretty sizeable. Like $150 billion/ten years. But yes, let's ignore that and focus on temporally open-ended vagueries.

[Drake Tungsten]

The Mayo Clinic comes out against the House healthcare reform bill...

Although there are some positive provisions in the current House Tri-Committee bill – including insurance for all and payment reform demonstration projects – the proposed legislation misses the opportunity to help create higher-quality, more affordable health care for patients. In fact, it will do the opposite.

In general, the proposals under discussion are not patient focused or results oriented. Lawmakers have failed to use a fundamental lever – a change in Medicare payment policy – to help drive necessary improvements in American health care. Unless legislators create payment systems that pay for good patient results at reasonable costs, the promise of transformation in American health care will wither. The real losers will be the citizens of the United States.

http://healthpolicyblog.mayoclinic.org/2009/07/16/mayo-clinic%E2%80%99s-reaction-to-house-tri-committee-bill/

Obama is a big fan of the Mayo Clinic. Maybe he'll listen to them and veto this POS if it comes to it...

[OzzyKP]

No matter how bad the bill may be, Obama won't veto it.

[Drake Tungsten]

That's why I laughed.

[OneFootInTheGrave]

The real losers are the citizens of the United States.[/q]

http://healthpolicyblog.mayoclinic.org/2009/07/16/mayo-clinic%E2%80%99s-reaction-to-house-tri-committee-bill/

Obama is a big fan of the Mayo Clinic. Maybe he'll listen to them and veto this POS if it comes to it...

QFT

[KrazyHorse]

Spam spam spammy spam

[Drake Tungsten]

That was more insightful than anything Ramo's posted in here in the past week.

[KrazyHorse]

Hell no, can't stop me now

[Ramo]

The Mayo Clinic comes out against the House healthcare reform bill...

Although there are some positive provisions in the current House Tri-Committee bill – including insurance for all and payment reform demonstration projects – the proposed legislation misses the opportunity to help create higher-quality, more affordable health care for patients. In fact, it will do the opposite.

In general, the proposals under discussion are not patient focused or results oriented. Lawmakers have failed to use a fundamental lever – a change in Medicare payment policy – to help drive necessary improvements in American health care. Unless legislators create payment systems that pay for good patient results at reasonable costs, the promise of transformation in American health care will wither. The real losers will be the citizens of the United States.

http://healthpolicyblog.mayoclinic.org/2009/07/16/mayo-clinic%E2%80%99s-reaction-to-house-tri-committee-bill/

Obama is a big fan of the Mayo Clinic. Maybe he'll listen to them and veto this POS if it comes to it...

Waxman (i.e. the House) is on board with the kind of Medicare disbursement reforms (the Orszag/Rockefeller plan) that Mayo was referring to. Sorry to mess up your narrative.