Atlasian National Healthcare Bill (Law'd)

[Marokai Backbeat]

I like the intent of this bill, and indeed, universal coverage should be a goal at some point in the future. But the bigger issue is not those who aren't insured (though that is a big problem) but the people losing coverage because it's too expensive despite a middle-class income.

If you provide universal coverage through a government plan, but don't try to control the rate of increase in health care costs (without rationing), then you simply shift the problem to the government. The system cannot, and will not be sustainable if costs are not simultaneously dealt with. I realize that universal coverage helps control costs, but more must be done.

Using my great influence as Midwest Lt. Governor , I urge all Senators to vote nay on this bill unless more is done to control the rising costs.

My proposed tax on health care benefits was actually intended to do just that. I agree we will need to find additional ways to cut costs (currently reading through 5 CBO reports, so I'll be some time), but it is definitely on my list of things to do.

I look forward to hearing misguided congressional mumbo-jumbo.

As for controlling costs, there's only so much you can do. The program itself lowers costs, (I've said this routinely) simply on the virtue of being less profit-based and spending much less in administrative costs. The government is not going to take on all of the costs from the private market (like you somehow believe it will) because the private market creates a ton of costs on their own to make obscene profits and push people off the insurance rolls. (Also, many insurance companies don't like to pay for procedures, so they force you to undergo additional test after additional test, when they're not necessary. This will not happen, at least to the same extent, under a government plan.)

Many other costs can be controlled, but at some point you've got to focus on raising money, plain and simple. As for revenue, if we had, pardon my french, the balls to do it, we would raise taxes. But we have no tax brackets on the books, and no one here wants to do that. One side wants to double-tax the poor to raise revenue, another side wants to tax benefits, but no one wants to do the sensible thing and tax the upper class. If you want us to get serious about controlling costs and raising revenue, talk to your side, Vepres, don't complain to us.

[Purple State]

I like the intent of this bill, and indeed, universal coverage should be a goal at some point in the future. But the bigger issue is not those who aren't insured (though that is a big problem) but the people losing coverage because it's too expensive despite a middle-class income.

If you provide universal coverage through a government plan, but don't try to control the rate of increase in health care costs (without rationing), then you simply shift the problem to the government. The system cannot, and will not be sustainable if costs are not simultaneously dealt with. I realize that universal coverage helps control costs, but more must be done.

Using my great influence as Midwest Lt. Governor , I urge all Senators to vote nay on this bill unless more is done to control the rising costs.

My proposed tax on health care benefits was actually intended to do just that. I agree we will need to find additional ways to cut costs (currently reading through 5 CBO reports, so I'll be some time), but it is definitely on my list of things to do.

I look forward to hearing misguided congressional mumbo-jumbo.

As for controlling costs, there's only so much you can do. The program itself lowers costs, (I've said this routinely) simply on the virtue of being less profit-based and spending much less in administrative costs. The government is not going to take on all of the costs from the private market (like you somehow believe it will) because the private market creates a ton of costs on their own to make obscene profits and push people off the insurance rolls. (Also, many insurance companies don't like to pay for procedures, so they force you to undergo additional test after additional test, when they're not necessary. This will not happen, at least to the same extent, under a government plan.)

Many other costs can be controlled, but at some point you've got to focus on raising money, plain and simple. As for revenue, if we had, pardon my french, the balls to do it, we would raise taxes. But we have no tax brackets on the books, and no one here wants to do that. One side wants to double-tax the poor to raise revenue, another side wants to tax benefits, but no one wants to do the sensible thing and tax the upper class. If you want us to get serious about controlling costs and raising revenue, talk to your side, Vepres, don't complain to us.

Why is taxing benefits misguided? It helps control costs by providing incentives for people to join plans with lower premiums, leading them to shop for the best plan at the lowest price. There are options to tax only the higher priced benefits, of course at the expense of the effectiveness of the tax at lowering costs.

And why is a non-partisan group of health and economic experts weighing in "mumbo-jumbo"? They may not propose ideas that you agree with, but they sure are effective and know more about these things than any of us.

[Marokai Backbeat]

Oh I haven't a problem with a modest tax on some benefits like you proposed, I just wish we could get serious with more potent measures of raising revenue. (Instead of targeting things at the middle class.)

[Purple State]

Oh I haven't a problem with a modest tax on some benefits like you proposed, I just wish we could get serious with more potent measures of raising revenue. (Instead of targeting things at the middle class.)

So propose something. I already geared health benefits taxes to a progressive increase according to income, so further taxing the rich would be a bit much at this point. But I left my amendment open to suggestions, so give me ideas that will raise revenue or reduce costs or both.

[Marokai Backbeat]

Oh I haven't a problem with a modest tax on some benefits like you proposed, I just wish we could get serious with more potent measures of raising revenue. (Instead of targeting things at the middle class.)

So propose something. I already geared health benefits taxes to a progressive increase according to income, so further taxing the rich would be a bit much at this point. But I left my amendment open to suggestions, so give me ideas that will raise revenue or reduce costs or both.

I'll propose more serious revenue raising in another bill, as I believe I've said repeatedly. If we're going to raise taxes, I want a set of tax brackets on the books.

Also, if you think many rich or upper-class individuals are going to take part in this plan..

[Purple State]

Oh I haven't a problem with a modest tax on some benefits like you proposed, I just wish we could get serious with more potent measures of raising revenue. (Instead of targeting things at the middle class.)

So propose something. I already geared health benefits taxes to a progressive increase according to income, so further taxing the rich would be a bit much at this point. But I left my amendment open to suggestions, so give me ideas that will raise revenue or reduce costs or both.

I'll propose more serious revenue raising in another bill, as I believe I've said repeatedly. If we're going to raise taxes, I want a set of tax brackets on the books.

Also, if you think many rich or upper-class individuals are going to take part in this plan..

It's not for this plan. It is all health benefits. Combined with a mandate...

And I will not be voting for a bill that doesn't include all facets of the proposal. Passing a plan without effective revenue clauses is a mistake.

[Marokai Backbeat]

Oh I haven't a problem with a modest tax on some benefits like you proposed, I just wish we could get serious with more potent measures of raising revenue. (Instead of targeting things at the middle class.)

So propose something. I already geared health benefits taxes to a progressive increase according to income, so further taxing the rich would be a bit much at this point. But I left my amendment open to suggestions, so give me ideas that will raise revenue or reduce costs or both.

I'll propose more serious revenue raising in another bill, as I believe I've said repeatedly. If we're going to raise taxes, I want a set of tax brackets on the books.

Also, if you think many rich or upper-class individuals are going to take part in this plan..

It's not for this plan. It is all health benefits. Combined with a mandate...

And I will not be voting for a bill that doesn't include all facets of the proposal. Passing a plan without effective revenue clauses is a mistake.

Obviously I agree we need to do this right and fund it properly, I just don't want the Senate to have two major fights over revenue raising and lose sight of the real issue here, which is healthcare. With sin taxes, coupled with a taxing of healthcare benefits, and phasing out Medicare and Medicaid in favor of this new program, revenue will not be a problem for awhile.

[Purple State]

Oh I haven't a problem with a modest tax on some benefits like you proposed, I just wish we could get serious with more potent measures of raising revenue. (Instead of targeting things at the middle class.)

So propose something. I already geared health benefits taxes to a progressive increase according to income, so further taxing the rich would be a bit much at this point. But I left my amendment open to suggestions, so give me ideas that will raise revenue or reduce costs or both.

I'll propose more serious revenue raising in another bill, as I believe I've said repeatedly. If we're going to raise taxes, I want a set of tax brackets on the books.

Also, if you think many rich or upper-class individuals are going to take part in this plan..

It's not for this plan. It is all health benefits. Combined with a mandate...

And I will not be voting for a bill that doesn't include all facets of the proposal. Passing a plan without effective revenue clauses is a mistake.

Obviously I agree we need to do this right and fund it properly, I just don't want the Senate to have two major fights over revenue raising and lose sight of the real issue here, which is healthcare. With sin taxes, coupled with a taxing of healthcare benefits, and phasing out Medicare and Medicaid in favor of this new program, revenue will not be a problem for awhile.

Health care is a zero-sum game. We either pass a whole package, including systemic reform, cost reductions and revenue, or nothing at all, in my opinion. The individual pieces are crap. It is the total package that counts.

[Vepres]

Oh I haven't a problem with a modest tax on some benefits like you proposed, I just wish we could get serious with more potent measures of raising revenue. (Instead of targeting things at the middle class.)

So propose something. I already geared health benefits taxes to a progressive increase according to income, so further taxing the rich would be a bit much at this point. But I left my amendment open to suggestions, so give me ideas that will raise revenue or reduce costs or both.

I'll propose more serious revenue raising in another bill, as I believe I've said repeatedly. If we're going to raise taxes, I want a set of tax brackets on the books.

Also, if you think many rich or upper-class individuals are going to take part in this plan..

It's not for this plan. It is all health benefits. Combined with a mandate...

And I will not be voting for a bill that doesn't include all facets of the proposal. Passing a plan without effective revenue clauses is a mistake.

Obviously I agree we need to do this right and fund it properly, I just don't want the Senate to have two major fights over revenue raising and lose sight of the real issue here, which is healthcare. With sin taxes, coupled with a taxing of healthcare benefits, and phasing out Medicare and Medicaid in favor of this new program, revenue will not be a problem for awhile.

Health care is a zero-sum game. We either pass a whole package, including systemic reform, cost reductions and revenue, or nothing at all, in my opinion. The individual pieces are crap. It is the total package that counts.

Agreed. You cannot sustain health care insurance that is rising many times faster than inflation. You have to get it at or close to inflation, or you're just asking for a budget crisis down the road.

Marokai, I know your plan will slow the rate, but I feel it is not enough. While we shouldn't remove the profit aspect of health care we need a way to prevent redundant tests and procedures from occurring. Computerizing the system would help tremendously, as doctors could easily share information with each other.

[Marokai Backbeat]

Agreed. You cannot sustain health care insurance that is rising many times faster than inflation. You have to get it at or close to inflation, or you're just asking for a budget crisis down the road.

Marokai, I know your plan will slow the rate, but I feel it is not enough. While we shouldn't remove the profit aspect of health care we need a way to prevent redundant tests and procedures from occurring. Computerizing the system would help tremendously, as doctors could easily share information with each other.

Well I feel you haven't a clue what you're talking about and don't really know what you want. You want to reduce costs, but you want to leave a market in place that gouges prices and spends huge amounts of money each year on trying to find ways to not help people. You can't have both unless you institute a bunch of different subsidies and regulations that creates a patchwork system that still would be insufficient, but you may as well institute a public option.

You operate from the viewpoint of the costs as they currently stand, in the insurance market. What we know is that government programs spend only a fraction of administrative costs that private insurance companies do, what we do know is that every other country in the world that has a national health care program spend less than we do per-capita, and are still just as healthy, if not more so than us. The public health care program would also provide an incentive for the private market to cut costs. (And indeed, some studies show that private hospitals and insurance companies can cut costs

I'm tired of wasting time reading the same "OMG, THE COST" posts from you and others. In the most recent budget, we're going to spend $453 billion on Medicare and $290 billion on Medicaid. We spent an additional $30 billion on SCHIP earlier this year. These (rough) expenditures, coupled with a plan to raise sin taxes and tax all healthcare benefits, would raise a considerable chunk of revenue, and added with a modest tax increase to the top income tax bracket (brackets that don't exist, mind you) we can have more than enough money to fund such a program.

You keep repeating the same lines. In the past, you've done the same thing over and over again, and I'm tired of being expected of defending plans against such baseless and tired talking points. You've repeated several inaccuracies or talking points around these forums, even among questions or substantive response. Claiming that unions were the downfall of the auto-companies, despite my response comparing unionized and non-unionized plants, awhile ago (and still, as far as I know) you claimed that the GOP thought that they had a "lock" on the youth vote in 2004. Absurdity and I asked you for clarification: twice. If you have something to add, go do your homework first. There are a ton of different public health care program proposals that have been brought up over the years and the consensus is clear.

Study of a proposal brought up in 2007 that would provide coverage for all Americans, saved billions.

Public health care plans can save hundreds of billions more than private healthcare programs.

Preliminary study of one of the public option plans, yeah, shocker, saves billions.

I could go on. Plenty of people, even conservatives, can admit that public health care saves hundreds of billions of dollars. In addition to various revenue raising proposals we're bringing up here, I think we'll manage.

[Countess Anya of the North Parish]

also Japan had free health care during the war. And they are doing great. They are not in a huge mess like we are.

[Southern Senator North Carolina Yankee]

Aye ftr on the previous Amendment

[MasterJedi]

I hereby open up a vote on this amendment. Please vote Aye, Nay or Abstain.

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[Hash]

aye

[Bacon King]

Not following the specifics of this thread very closely, but regarding the Vepres/Marokai thing: by its nature, for-profit insurance is more expensive than any sort of not-for-profit government insurance. If they're in the business to make money of course they're going to charge more, so they can make more money. It's simple economic common sense. Transition to a national healthcare program will inherently reduce healthcare costs by removing the profit-driving element from the cost of people's insurance.

Also, everyone, please remember to be civil. I don't want to have to get out my Vice Presidential Gavel of Justice^TM.

But anyway, I look forward to this bill's eventual pasage

[Marokai Backbeat]

Aye on the amendment, I suppose.

And I'm glad we have your support mister VP.

[Fritz]

Aye to the amendment.

[Southern Senator North Carolina Yankee]

Aye

[afleitch]

Aye!

[tmthforu94]

Aye

[Purple State]

Can someone tell me what exactly this amendment does and what its impact will be?

[MasterJedi]

Aye

With 7 Ayes, 0 Nays and 0 Abstentions this amendment has passed.

[Purple State]

Abstain

I would still like to know what we just did.

[Purple State]

(Not that I'm worried about this, but...) I ask that a final vote not be brought tomorrow on this or the stimulus, as I won't be able to vote on it. I also think this definitely has a lot of work to go before it is truly viable for passage.

[Purple State]

Can we see a current version of the bill? Just so I refer to things correctly in the amendment I plan to introduce.