MA: Mideast Health Cost Containment Act of 2014 (Failed)

[Queen Mum Inks.LWC]

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Sponsor: TheRileyKeaton

[Queen Mum Inks.LWC]

Riley, have you done any cost estimates for this?

[Potus]

Riley, have you done any cost estimates for this?

The number you gave me for the original plan was 40B with 11 of it being covered by cutting tax expenditure. I halved the 40B and included the usage taxes and the spending cut. The spending cut saves more than 5 billion dollars.

[Kaine for Senate '18]

Can you give me a more detailed breakdown of what's being changed/what this bill will do, in terms of a practical impact.

[Cassius]

I second what Assemblyman Ben said.

[Potus]

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That's what I wrote when I introduced the legislation. The real, practical effect is a decline in healthcare costs.

[Queen Mum Inks.LWC]

Setting Up the MWA- This agency will essentially serve as our chief healthcare agency. It will make administration of healthcare policies simpler and more cost-effective. It is also worth noting that the agency will not add an unfunded dime to the budget. It is in the bill that they can't operate at a loss.

So where will they be getting their money from?

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What kind of incentives?

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What do you mean by "health goals"?

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What goals?  Are these goals different from the goals in clause 8?

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What goals?  Are these different from clauses 8 and 14?

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Why would we not leave co-pays up to the person's individual insurance company?

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Is the MWA setting the prices?

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This seems arbitrary.

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Direct spending of the whole regional budget?

I would suggest going through and turning this into sections.  The line-by-line format is hard to follow.

It would be easier if you had something like this bill

[Potus]

1. We get to budget it at the start of next budget. This is an effective way of maintaining fiscal sanity. We'll budget the money, when we have the money.

2. The MWA will establish them and then we will appropriate money for them. If the incentives aren't good or effective, we defund them.

3. The MWA defines the health goals. Let's amend it to clear that up.

4. The goals they establish in the Health Risk Management program works exactly the same as the goals from clause 8. We can clarify that if you'd like.

5. Same goals. We'll clarify.

6. We can change it from a co-pay. The purpose of the section is to move those eligible for HRP's to enroll in them. I'd be open to compromise on the specifics of that. However, the mechanisms in that section do provide money for the bill. However, it isn't a main stream of revenue.

7. They're negotiating prices. If you feel the current language is objectionable, we can definitely modify it to the Assembly's liking.

8. Generic drugs are cheaper. The name brands are more expensive without much of a more profound effect. This is a part of the cost containment aspect. We want people to move to generics in order to cut overall medical spending.

9. This is different than a 2% cut to everything, across the board. This spending cut is equivalent to 2% of an across the board cut. Let's say that an across-the-board cut is 5 billion. This section mandates that the Governor cut 5 billion from anywhere in the budget. He could make it across the board if he wants, but I wouldn't recommend it.


I like this format. I'd be interested to know the opinions of the rest of the Assembly on the format of the legislation.

[PPT Spiral]

I actually agree with Inks, a different format could make it look neater.

How long would it take to undergo full implementation of the legislation by your estimate? And I assume that the content in the Employee Wellness Programs isn't very different from real-life counterparts, correct?

[Queen Mum Inks.LWC]

It would be much easier if you used the quote feature when you respond to questions.  When 9 questions were asked, and you just respond without quoting, people have to scroll back and forth to figure out what you're talking about.

1. We get to budget it at the start of next budget. This is an effective way of maintaining fiscal sanity. We'll budget the money, when we have the money.

So what happens if we budget $100 million for the MWA, and they use that money up halfway through the year?

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I understand that, but what kind of incentives?  Incentives is such a broad word.  I have no clue what you have in mind here.

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Do you have a suggested amendment?

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It's terribly hard to follow--similar to your answers.

I still would like to see some budget numbers.  The $40B was a rough underestimate.  The fees and budget cuts all just seem like arbitrary guesses to me.  Do you actually have an idea of if this is revenue neutral?

[Potus]

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It's their responsibility to design a system so that they won't run out of money. We fund the incentive system with the cost estimate of their incentives. They shouldn't run out of money. That's why it's set up like this. If they run out of money, we'll have a conversation about where to head from there.

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This is a sample model, not necessarily what the MWA would enact. Let's say they have an equation to determine the intensity of the health goals. You put in all of the variables based on the current condition of the individual and their goals. The equation spits out the figure $450. If the goals are accomplished, then $450 is deposited in a health savings account. That's just an example, but that's what I have in mind.

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You seem to be more particular about the wording of the legislation than anyone else, so an amendment written by you should address any concerns you may have about the wording.

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Well, since you object to the format, amend the format. That's why amendments exist. To fix legislation.

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The Game Moderator has stopped rating legislation. Literally every piece of legislation that spends money or raises revenue, at this point, is an arbitrary guess. All we have are "rough estimates" and "arbitrary guesses." I am confident that this is enough.

[Queen Mum Inks.LWC]

At this point, I'm inclined to just vote against this, rather than spend my time making fixes to it, since you don't seem very invested in this bill.

There's a difference between rough estimates and arbitrary guesses.  Anybody can do what the GM did; it's all public information.  I went through and made some calculations to get to the $40B.  So far, it just seems like you picked random numbers and threw them into the bill.  I want to know what math you've done to get to the point where at.

[Queen Mum Inks.LWC]

Riley, do you have any amendments to offer, or is there any further debate?

[Queen Mum Inks.LWC]

Seeing no debate in over 48 hours, we will bring this to a final vote.  Members will vote AYE, NAY, or ABSTAIN.  This will be a 48-hour vote.

[Queen Mum Inks.LWC]

NAY

[Kaine for Senate '18]

Nay

[Cassius]

Nay

[MyRescueKittehRocks]

Aye

[Queen Mum Inks.LWC]

Voting is now closed.  The AYEs are 1, and the NAYs are 3, with 1 not voting.  The NAYs have it, and the bill has failed.