Atlasian National Healthcare Bill (Law'd)

[Southern Senator North Carolina Yankee]

Whoa, I miss a lot on Saturdays.

I support Franzl's amendment. There is no reason to outright ban private health insurance plans.

For the public plan idea, the only way it works without pummeling private health insurance companies is by preventing companies that provide employer-based coverage from switching to the public plan. We also need a mechanism that keeps the public plan competitive, but not unreasonably so to the point where private companies can't lower costs enough to compete.

Whats your opinion on my plan, PS?

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I have explained a great deal about in response to Marokai's and Hashmite's questioning. Just look through the last few posts. If you still have questions I will be glad to answer them.

[Marokai Backbeat]

Your ideas are mostly simple and uncontroversial for the most part, Yankee, it's the whole "give people checks and subsidize costs" silliness that bothers me.

Edit: I would also like to state that I'm opposed to allowing people to buy insurance across state lines

[Purple State]

Whoa, I miss a lot on Saturdays.

I support Franzl's amendment. There is no reason to outright ban private health insurance plans.

For the public plan idea, the only way it works without pummeling private health insurance companies is by preventing companies that provide employer-based coverage from switching to the public plan. We also need a mechanism that keeps the public plan competitive, but not unreasonably so to the point where private companies can't lower costs enough to compete.

Is there a reason we should care about that should it happen? There's a reason private insurances costs so much, you know. (Administrative costs being triple or quadruple administrative costs of Medicare, for instance.)

If people choose to turn over to the public plan there's no reason we should just decide to stop them. The only way it will destroy private insurance is if people decide for themselves that it's better. Why are we just arbitrarily deciding to put limits on a public plan?

The government can cost cut in ways that are uncompetitive and just as bad as monopolies or cartels. Corporations that provide employees with health care will look for the cheapest plan, without necessarily considering quality, which means people will not actually be choosing for themselves. Their cheap bosses will be.

Not to mention, Medicaid/care have far lower overhead costs, but still lose money! That is the pitfall of cost-cutting like that. This plan can't be fashioned after Medicaid. It has to be at least able to be profit/loss neutral, if not profitable with a commitment to return profits to investments into innovation. This means higher costs and actual competition.

@NC Yank, I agree with your ideas, but I need to see what it looks like written up as legislation. There are also a few additions I would include per my comments thus far.

[Southern Senator North Carolina Yankee]

Your ideas are mostly simple and uncontroversial for the most part, Yankee, it's the whole "give people checks and subsidize costs" silliness that bothers me.

Edit: I would also like to state that I'm opposed to allowing people to buy insurance across state lines

Well as I said there are two paths mentioned in Clause 4.
1. Gov't Subsidized Health Care based on income. Everyone pays a premium and the Gov't will pay a percentage based on Income paid for by the Taxes I mentioned in there and reducing reimburesments to Hospital(No one will be uninsured).

2. Public plan for Middle and Lower class. Everyone pays a premium to fund the plan the. How much you pay is based on your income. Funding for this plan is the same as option 1.

Overall there would be some kind of Income level cut off thats the same for each plan, like 100,000 or something. Under the Subsidiziation they are just priced out of the sliding scale and have to buy it on there own. Under the Gov't plan they could still purchase the Gov't plan(You know if they are considered to high risk for private insurance or whatever) but the rate would be the same as the going market rate. The Tax cut is for these people only and for those in the sliding scale that have only 50% subsidization or lower.


Why do you oppose allowing the purchase of insurance across state lines? I didn't put that in the plan but its one of many possible changes I had in mind for Clause 1(REgulatory Reform).


Our main goal is to provide every one with access to Quality Health Care, correct? Does the program really matter as much as long as that is taken care off, costs are driven down, and people have a fair shake instead of being shaken down?

[Lief 🗽]

I'm fairly opposed to keeping the current employer-provided health insurance system in place. The entire system is an accident of history, and doesn't really make any sense at all. I'd prefer not to simply to a bandaid over it by throwing around subsidies and tax breaks.

[Purple State]

I'm fairly opposed to keeping the current employer-provided health insurance system in place. The entire system is an accident of history, and doesn't really make any sense at all. I'd prefer not to simply to a bandaid over it by throwing around subsidies and tax breaks.

And what do you propose we do with all the jobs that the plan will destroy? In the middle of a major recession.

[Southern Senator North Carolina Yankee]

Whoa, I miss a lot on Saturdays.

I support Franzl's amendment. There is no reason to outright ban private health insurance plans.

For the public plan idea, the only way it works without pummeling private health insurance companies is by preventing companies that provide employer-based coverage from switching to the public plan. We also need a mechanism that keeps the public plan competitive, but not unreasonably so to the point where private companies can't lower costs enough to compete.

Is there a reason we should care about that should it happen? There's a reason private insurances costs so much, you know. (Administrative costs being triple or quadruple administrative costs of Medicare, for instance.)

If people choose to turn over to the public plan there's no reason we should just decide to stop them. The only way it will destroy private insurance is if people decide for themselves that it's better. Why are we just arbitrarily deciding to put limits on a public plan?

The government can cost cut in ways that are uncompetitive and just as bad as monopolies or cartels. Corporations that provide employees with health care will look for the cheapest plan, without necessarily considering quality, which means people will not actually be choosing for themselves. Their cheap bosses will be.

Not to mention, Medicaid/care have far lower overhead costs, but still lose money! That is the pitfall of cost-cutting like that. This plan can't be fashioned after Medicaid. It has to be at least able to be profit/loss neutral, if not profitable with a commitment to return profits to investments into innovation. This means higher costs and actual competition.

@NC Yank, I agree with your ideas, but I need to see what it looks like written up as legislation. There are also a few additions I would include per my comments thus far.

Well as I told Franzl and ironically he has the same problem is that while I am great at writing outlines and broad proposals, micro sub details just isn't my cup of tea. I could try but writing this up would take hours and it will be long, very long. For now I would prefer to just discuss these ideas, get as many senators onboard as possible and then together with 1 or 2 other Senators I could write up an alternative bill. Plus I want to look and see what has been previously passed on these issues, espeically if I am going to be able to due Clause 1(Regulatory Reform).

[Southern Senator North Carolina Yankee]

I'm fairly opposed to keeping the current employer-provided health insurance system in place. The entire system is an accident of history, and doesn't really make any sense at all. I'd prefer not to simply to a bandaid over it by throwing around subsidies and tax breaks.

If you are referring to my plan, I would appreciate that you acknowledge two things

1. THere is more to my proposal then a Subsidy and a Tax break

2. There are two paths one of which would mean no Subisidization program. We will have to decide which one to persue, though.

I didn't realise the big problem with compromising is opponents do not even notice, care, or read all of your proposals. jeez .

[Fritz]

I want to bring a single payer plan to a vote.  Any amendment that alters this bill such that it is no longer a single payer plan is a complete re-write of my bill, and should be introduced as competing legislation- not as an amendment to this bill.

[Marokai Backbeat]

I still don't know why we should even bother if we're not prepared to have the guts to take this all the way, as I've complained in the stimulus bill. If we're going to make it so only people around a certain income area can get into the program, we're just throwing glitter on Medicaid. There is no reason we can't create a government program that anyone can get into if they choose to, that provides basic care for everyone.

As for opposing buying insurance across state/regional lines, it's because it allows insurance companies to skirt state/regional regulations. There's a reason the boundaries exist as they do today. (Although it's partially to just create health insurance monopolies.) If California, for instance, outlaws excluding people because of "pre-existing conditions" and Utah doesn't, where would you set up shop? The state that forces you to be fair and give insurance to everyone, or the state that allows you to determine who you give care to or not because you don't want to actually spend money? We could get around that by creating a system of national regulations, but those would override "regional rights" or what have you.

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It does matter. A public program costs less because it doesn't spend a huge amount of it's costs on trying to push people off the insurance rolls, a public program gives care to everyone, no matter what, a public program run by the government can also get drugs at a cheaper cost than private insurance companies. The private market relies on covering as little high-risk people as possible (that term along disgusts me) and charging people as much as possible. The drug companies have one of the largest manufacturing costs to profit ratios of any market out there. Allowing that sort of institution to stand unchallenged is not something I'm going to vote for.

Not to mention, Medicaid/care have far lower overhead costs, but still lose money! That is the pitfall of cost-cutting like that. This plan can't be fashioned after Medicaid. It has to be at least able to be profit/loss neutral, if not profitable with a commitment to return profits to investments into innovation. This means higher costs and actual competition.

Then we raise taxes, or institute minimum fees, or something. We don't start purging people or banning certain practices to get into the government program. We're in this position because we have a system that did things for profit the entire time, we don't need to repeat that mistake under a government program.

Also, Medicaid/care runs at a deficit largely because of corporate welfare, lack of responsible financing, and because it pushes off a large portion of the responsibilities onto state and local governments, all of which are far less capable of funding a said program. This is for the greater good, even if we did run at a deficit for awhile until we get the funding situation tampered out properly.

(Also, this is going to save us money in the long-run. I agree we don't need to operate them precisely the same, but a government program lowers both care and management costs, which will save businesses and individuals thousands of dollars. Of course, subsidies and tax rebates don't do this, and could actually cost more.)

With that, I need to take a shower!



Jesus Christ, people, five replies while I'm writing one? Cool your jets!

I'm fairly opposed to keeping the current employer-provided health insurance system in place. The entire system is an accident of history, and doesn't really make any sense at all. I'd prefer not to simply to a bandaid over it by throwing around subsidies and tax breaks.

And what do you propose we do with all the jobs that the plan will destroy? In the middle of a major recession.

What jobs, the insurance market? I didn't here these objections from you when we banned payday loan lending!

Any jobs that will be lost in the insurance market, which by the way we are not banning under a two-tiered system, will be more than overcompensated for by the much lower costs of a government healthcare plan. Businesses will no longer be forced to provide ballooning healthcare benefits to their employees and individuals won't be going bankrupt. (Or the thousands that die each year because of a lack of insurance, they'll now, you know, be able to work.)

[Lief 🗽]

I'm fairly opposed to keeping the current employer-provided health insurance system in place. The entire system is an accident of history, and doesn't really make any sense at all. I'd prefer not to simply to a bandaid over it by throwing around subsidies and tax breaks.

And what do you propose we do with all the jobs that the plan will destroy? In the middle of a major recession.

http://www.thenation.com/blogs/thebeat/396919?rel=hp_picks

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I don't know that this plan would destroy that very man jobs. Sure, private insurance plans would no doubt need to cut back (and I am fine with section f being removed), but private insurance companies still exist and are profitable in many countries with public insurance plans. At the same time, the government would no doubt need to hire many people to run the new program. Finally, by removing the burden of providing health insurance to employees, we would be helping out many struggling businesses, from small businesses right up to large corporations like the auto makers, which would in the long run save jobs and prevent wage cuts.

Also, if this bill does not pass and I still believe that it can, I would not sign on to any bill that did not include a robust public option available to all Atlasians, especially if it includes a mandate to buy insurance, as that would essentially amount to a health insurance company bailout.

[Southern Senator North Carolina Yankee]

Marokai


1. I already said I would be willing to allow everyone in the public option in clause 4 even Bill Gates if the said Bill Gates can't get private insurance cause he is "Too high-risk". But I think Bill Gates should pay for all of his bill, don't you?   

2. I intended to nationalise all Regulatory standards in Clauses 1 and 2 of my plan anyway. Regional Rights never came into my mind. Don't make broad based assumptions based on party labels

3. If you want the plan to make a profit, as I previously said, charge premiums and have the amount people pay go down the as you descend the income levels eventually the poorest would pay nothing. And you recoup the cost of the reduced pricing for the poor by taxing Tobacco, Alcohol, etc and reducing reimbursements to Hospitals.

4. Has medicaid insolvency even been addressed in Atlasia other then temporary fixes?

I want to bring a single payer plan to a vote.  Any amendment that alters this bill such that it is no longer a single payer plan is a complete re-write of my bill, and should be introduced as competing legislation- not as an amendment to this bill.

In my opinion this bill is unamendable. I had every intention of offering a separate altenative and not as an amendment.

[Southern Senator North Carolina Yankee]

I'm fairly opposed to keeping the current employer-provided health insurance system in place. The entire system is an accident of history, and doesn't really make any sense at all. I'd prefer not to simply to a bandaid over it by throwing around subsidies and tax breaks.

And what do you propose we do with all the jobs that the plan will destroy? In the middle of a major recession.

http://www.thenation.com/blogs/thebeat/396919?rel=hp_picks

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I don't know that this plan would destroy that very man jobs. Sure, private insurance plans would no doubt need to cut back (and I am fine with section f being removed), but private insurance companies still exist and are profitable in many countries with public insurance plans. At the same time, the government would no doubt need to hire many people to run the new program. Finally, by removing the burden of providing health insurance to employees, we would be helping out many struggling businesses, from small businesses right up to large corporations like the auto makers, which would in the long run save jobs and prevent wage cuts.

Also, if this bill does not pass and I still believe that it can, I would not sign on to any bill that did not include a robust public option available to all Atlasians, especially if it includes a mandate to buy insurance, as that would essentially amount to a health insurance company bailout.

Yea nothing like saying no to and all possible compromises. Why do I even bother?

I wonder how many of those jobs would be created under my plan as well. I assume many of them are in Hospital Staffing(doctors, nurses etc) and employees of Pharma companies. Any plan we pass yours, or mine will subsidize expansion in big Pharma. I see no reason if you feel you can regulated big Pharma to operate in an acceptable way, why you can't do the same with the insurance companies. After all you aren't planning to Nationalise big Pharma are you? So you must be planning to regulate them.

[Purple State]

I want to bring a single payer plan to a vote.  Any amendment that alters this bill such that it is no longer a single payer plan is a complete re-write of my bill, and should be introduced as competing legislation- not as an amendment to this bill.

A re-write that seeks to accomplish the same goals and relates to the same topic really should not have to be done through competing legislation. The nature of compromise is to allow legislation, initially introduced, to change drastically from the initial form. Just look at the Mideast legislation passed by the Senate when DWTL introduced it way back when.

If this body chooses to amend your bill, that is appropriate enough. It is a democratic body.

Not to mention, Medicaid/care have far lower overhead costs, but still lose money! That is the pitfall of cost-cutting like that. This plan can't be fashioned after Medicaid. It has to be at least able to be profit/loss neutral, if not profitable with a commitment to return profits to investments into innovation. This means higher costs and actual competition.

Then we raise taxes, or institute minimum fees, or something. We don't start purging people or banning certain practices to get into the government program. We're in this position because we have a system that did things for profit the entire time, we don't need to repeat that mistake under a government program.

Also, Medicaid/care runs at a deficit largely because of corporate welfare, lack of responsible financing, and because it pushes off a large portion of the responsibilities onto state and local governments, all of which are far less capable of funding a said program. This is for the greater good, even if we did run at a deficit for awhile until we get the funding situation tampered out properly.

(Also, this is going to save us money in the long-run. I agree we don't need to operate them precisely the same, but a government program lowers both care and management costs, which will save businesses and individuals thousands of dollars. Of course, subsidies and tax rebates don't do this, and could actually cost more.)

Whoa, what purges and bans are you talking about? I am saying massive corporations that provide health insurance to their employees should not be able to participate in the public plan. That could and likely would result in wholesale shifts to different health care systems, against the will of the individuals involved. I thought you were all about choice. Where do the workers get to choose in this equation?

Nor am I saying that the government should do this for profit. But we certainly can't institute uncompetitive practices with the intention of running it at a loss. How is that anything close to competition?

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And what do you propose we do with all the jobs that the plan will destroy? In the middle of a major recession.
[/quote]

What jobs, the insurance market? I didn't here these objections from you when we banned payday loan lending!

Any jobs that will be lost in the insurance market, which by the way we are not banning under a two-tiered system, will be more than overcompensated for by the much lower costs of a government healthcare plan. Businesses will no longer be forced to provide ballooning healthcare benefits to their employees and individuals won't be going bankrupt. (Or the thousands that die each year because of a lack of insurance, they'll now, you know, be able to work.)
[/quote]

You are eliminating countless jobs in the health insurance industry. Payday loans are harmful to people and deceptively so. Most people are happy with their private insurance plans, so why should we simply eliminate them?

I have no problem with a competitive public plan in the mix, but to say that a significant number of jobs won't be lost by allowing these companies to provide "nonessential" services is incorrect. We can mix things up and make these companies compete, we can break up cartels, but we can't outlaw entire sectors.

Instead, adding competition to the mix will most likely result in competitive pricing from current insurance companies, reducing costs and resulting in exactly what you stated in your second paragraph there.

@Lief: I have no problem with including a public plan and I am happy to see you are willing to remove clause f. While it may create a chunk of jobs in new government agencies, it would destroy just as many. In addition, while it may inject money into the economy, you also further expand the government's expenditures in Medicaid. The fact is, Medicaid siphons far too much money from government already. Adding such a large number of people to the plan would exponentially increase the amount lost, likely equalling anything injected into the economy. Essentially, doing this is at best a neutral situation that steepens our debt, at worst (as could very well be as the group conducting that study was a union, not exactly the most objective of sources) a losing initiative.

[Southern Senator North Carolina Yankee]

I want to bring a single payer plan to a vote.  Any amendment that alters this bill such that it is no longer a single payer plan is a complete re-write of my bill, and should be introduced as competing legislation- not as an amendment to this bill.

A re-write that seeks to accomplish the same goals and relates to the same topic really should not have to be done through competing legislation. The nature of compromise is to allow legislation, initially introduced, to change drastically from the initial form. Just look at the Mideast legislation passed by the Senate when DWTL introduced it way back when.

If this body chooses to amend your bill, that is appropriate enough. It is a democratic body.

Not to mention, Medicaid/care have far lower overhead costs, but still lose money! That is the pitfall of cost-cutting like that. This plan can't be fashioned after Medicaid. It has to be at least able to be profit/loss neutral, if not profitable with a commitment to return profits to investments into innovation. This means higher costs and actual competition.

Then we raise taxes, or institute minimum fees, or something. We don't start purging people or banning certain practices to get into the government program. We're in this position because we have a system that did things for profit the entire time, we don't need to repeat that mistake under a government program.

Also, Medicaid/care runs at a deficit largely because of corporate welfare, lack of responsible financing, and because it pushes off a large portion of the responsibilities onto state and local governments, all of which are far less capable of funding a said program. This is for the greater good, even if we did run at a deficit for awhile until we get the funding situation tampered out properly.

(Also, this is going to save us money in the long-run. I agree we don't need to operate them precisely the same, but a government program lowers both care and management costs, which will save businesses and individuals thousands of dollars. Of course, subsidies and tax rebates don't do this, and could actually cost more.)

Whoa, what purges and bans are you talking about? I am saying massive corporations that provide health insurance to their employees should not be able to participate in the public plan. That could and likely would result in wholesale shifts to different health care systems, against the will of the individuals involved. I thought you were all about choice. Where do the workers get to choose in this equation?

Nor am I saying that the government should do this for profit. But we certainly can't institute uncompetitive practices with the intention of running it at a loss. How is that anything close to competition?

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And what do you propose we do with all the jobs that the plan will destroy? In the middle of a major recession.

What jobs, the insurance market? I didn't here these objections from you when we banned payday loan lending!

Any jobs that will be lost in the insurance market, which by the way we are not banning under a two-tiered system, will be more than overcompensated for by the much lower costs of a government healthcare plan. Businesses will no longer be forced to provide ballooning healthcare benefits to their employees and individuals won't be going bankrupt. (Or the thousands that die each year because of a lack of insurance, they'll now, you know, be able to work.)
[/quote]

You are eliminating countless jobs in the health insurance industry. Payday loans are harmful to people and deceptively so. Most people are happy with their private insurance plans, so why should we simply eliminate them?

I have no problem with a competitive public plan in the mix, but to say that a significant number of jobs won't be lost by allowing these companies to provide "nonessential" services is incorrect. We can mix things up and make these companies compete, we can break up cartels, but we can't outlaw entire sectors.

Instead, adding competition to the mix will most likely result in competitive pricing from current insurance companies, reducing costs and resulting in exactly what you stated in your second paragraph there.

@Lief: I have no problem with including a public plan and I am happy to see you are willing to remove clause f. While it may create a chunk of jobs in new government agencies, it would destroy just as many. In addition, while it may inject money into the economy, you also further expand the government's expenditures in Medicaid. The fact is, Medicaid siphons far too much money from government already. Adding such a large number of people to the plan would exponentially increase the amount lost, likely equalling anything injected into the economy. Essentially, doing this is at best a neutral situation that steepens our debt, at worst (as could very well be as the group conducting that study was a union, not exactly the most objective of sources) a losing initiative.
[/quote]

I was hoping someone would bring that up. People are already making broad based assumptions about me I didn't want to add being Anti-Union to the mix.

[Marokai Backbeat]

Not to mention, Medicaid/care have far lower overhead costs, but still lose money! That is the pitfall of cost-cutting like that. This plan can't be fashioned after Medicaid. It has to be at least able to be profit/loss neutral, if not profitable with a commitment to return profits to investments into innovation. This means higher costs and actual competition.

Then we raise taxes, or institute minimum fees, or something. We don't start purging people or banning certain practices to get into the government program. We're in this position because we have a system that did things for profit the entire time, we don't need to repeat that mistake under a government program.

Also, Medicaid/care runs at a deficit largely because of corporate welfare, lack of responsible financing, and because it pushes off a large portion of the responsibilities onto state and local governments, all of which are far less capable of funding a said program. This is for the greater good, even if we did run at a deficit for awhile until we get the funding situation tampered out properly.

(Also, this is going to save us money in the long-run. I agree we don't need to operate them precisely the same, but a government program lowers both care and management costs, which will save businesses and individuals thousands of dollars. Of course, subsidies and tax rebates don't do this, and could actually cost more.)

Whoa, what purges and bans are you talking about? I am saying massive corporations that provide health insurance to their employees should not be able to participate in the public plan. That could and likely would result in wholesale shifts to different health care systems, against the will of the individuals involved. I thought you were all about choice. Where do the workers get to choose in this equation?

Nor am I saying that the government should do this for profit. But we certainly can't institute uncompetitive practices with the intention of running it at a loss. How is that anything close to competition?

Well, yourself and NCY were talking about charging people for the program, as I understood, and even talking about income requirements. That sort of thing is absolutely worthless as a solution and, as I said, just throws glitter on Medicaid.

I'm saying we should get rid of the practice of employers providing healthcare altogether, as Lief has said as well. The process is absolutely archaic and forces a huge burden onto businesses, and is one of the chief reasons why our automakers are bogged down in huge costs. I do support a choice, but employer healthcare is a great burden on our economy and on job creation. If we're going to keep it, I see no reason, however, why that burden should be relieved by the government plan. If people don't want it, they can get their healthcare elsewhere.

Also, many countries, including (I believe) Canada, do not have dental or eye care under their national healthcare programs, and many two-tiered countries are built the same way. This program doesn't have to have these things. I'll talk about this lower, but moving onto what you said about operating at a loss, I'm not, under any circumstances, saying we should operate this at a loss. But we shouldn't be afraid of potentially running it at a deficit for some of the initial years, as we set up the funding apparatus and get the entire program into place. We can't have the attitude that we must never run the program at a deficit because it is, at times necessary. At some point you have to temporarily suspend your concerns for the greater good.

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And what do you propose we do with all the jobs that the plan will destroy? In the middle of a major recession.
[/quote]

What jobs, the insurance market? I didn't here these objections from you when we banned payday loan lending!

Any jobs that will be lost in the insurance market, which by the way we are not banning under a two-tiered system, will be more than overcompensated for by the much lower costs of a government healthcare plan. Businesses will no longer be forced to provide ballooning healthcare benefits to their employees and individuals won't be going bankrupt. (Or the thousands that die each year because of a lack of insurance, they'll now, you know, be able to work.)
[/quote]

You are eliminating countless jobs in the health insurance industry. Payday loans are harmful to people and deceptively so. Most people are happy with their private insurance plans, so why should we simply eliminate them?

I have no problem with a competitive public plan in the mix, but to say that a significant number of jobs won't be lost by allowing these companies to provide "nonessential" services is incorrect. We can mix things up and make these companies compete, we can break up cartels, but we can't outlaw entire sectors.

Instead, adding competition to the mix will most likely result in competitive pricing from current insurance companies, reducing costs and resulting in exactly what you stated in your second paragraph there.[/quote]

First of all, while it's technically true that most Americans are happy with their healthcare, Americans routinely give stupid self-centered answers to polls like that. In the same polls, you can find that a majority of Americans support a government healthcare program, are worried about costs, and are unhappy with the quality of the care. These sort of "there are problems but not with me" answers to polls are ridiculously common, and you can see that sort of thing in other polls and even election results. (Examples: The education system is awful, but my kid is doing fine. Parents need to do a better job, but I'm a great parent. Congress always has low approval ratings, but I'll re-elect my congressman, etc.)

With that out of the way, I would just like to state that I'm not trying to defend outlawing private health insurance, as always our philosophy towards governing here at the JCP is aim high to compromise in the middle I think Fritz's bill is, at the core, superb, but I do support striking the outlawing of private health insurance from the bill and modifying the scope of the care provided.

I do concur that introducing a robust public program would drive competition and would lower prices, however, do keep in mind that any plans that fall short of doing just that likely will not reach that conclusion. (Such as the government writing a few thousand dollars in a check or subsidizing absurd costs instead of running a program themselves.)

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Did someone send you to conservative camp when I wasn't looking? Let me spell this out in bulletins.

• Private insurance will not be banned under a two-tiered system, it will simply force the system to reform and adapt to a new market. No serious job losses will go un-compensated for elsewhere.
• Drug insurance can still be purchased, covering prescription drug costs, as is done in many countries, including Canada. Further supplement insurance programs can be purchased, as already exist for Medicare for instance, providing additional dental, vision, and other services.
• New jobs will be created, in the public sector to run the newly established program and to carry out the care, and in the private sector because of the burden of huge healthcare costs being lifted from big and small businesses alike. This will more than compensate for the fact that some jobs, not all jobs, will be lost from the private insurance market.

I'm not sure why you're being so obtuse about this, you're usually far more reasonable. The private insurance market will not go anywhere under a public option. It will simply contract (somewhat), reform, and adapt to a new market system. We have more than 45 million people with no health insurance, thousands of people die each year because of a lack of insurance coverage, and millions more who are under-insured. If you admit that much of the jobs will be compensated for, at least in some fashion, that's fine, but you need to remember why we're doing this. Ballooning costs on individuals and millions of people vulnerable.

I'm working on some changes as we speak. Some of them were a bit of a bitter pill for me to swallow, but I think it's a reasonable snipping of the original bill.

[Marokai Backbeat]

I propose the following amendment: (Please give a shot, Fritz )

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I think I've ceded plenty of ground here, any further compromise better have a good reason.

[Franzl]

It's a plan I'll probably end up accepting...my only hope is that the public plan doesn't unfairly eliminate competition with private sector so far that it eliminates alternatives.

[Fritz]

I wish you people would specify what is being changed in an amendment.  Since you didn't, I will:

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[Fritz]

My objections are the changes to section 1b.  I believe the health care benefits under this Act must cover ALL medically necessary services, not just "most basic". 
1b point 5: Prescription drugs will only be covered if they are required due to life-threatening illness or injury?  Sorry, but a lot of people need prescription drugs for conditions that are not life-threatening.  My Parkinson's disease is not going to kill me anytime soon, and I would not die without my drugs- but I still need them, they are medically necessary.
I would rather not remove dentistry, but if we have to remove that to pass this, so be it.
Substance abuse treatment: face it, most people who need this don't get it because they cannot afford it, and their insurances won't cover it even if they have insurance.
Why should we say that vision care is medically necessary, and hearing care is not?

The other changes to my bill I can live with, but some of the changes to section 1b described above are unacceptable.

[Hash]

I oppose the removal of 1b, clauses 11 and 14. Optimally, I wouldn't remove 10, but I can live it.

[Fritz]

If Marokai will make some changes to 1b back, I might be willing to accept it as friendly.

[Southern Senator North Carolina Yankee]

I would oppose the amendment for the same reasons as Fritz stated pertaining to 1 b and what is covered.


Also I still don't like the way this is funded. I would prefer that we raise taxes to make sure this program isn't leching off the general fund. I would suggest tax high priced insurance policies such as thoughs that cost over $17,000 a year. I wasn't even aware that they had insurance that expensive but appearently they do in NY and other areas, some of them are over $25,000 a year. By taxing these plans we will discourage them from being used while at the same time provide new revenue. I agree with using the sin taxes that have already been mentioned on Tobacco, Alcohol, and Marijuana. But I think that should be made more specific and deal with any conflicts like programs already being funded by those taxes. Plus nothing is mentioned about the subsidation of hospitals to operate at a deficit. If everyone will have insurance these should either be reduced or eliminated with that revenue being put towards funding whatever program we adopt.

Next there is no mention of any previous laws in this bill that I am sure have been passed in preceding senates dealing with Health Care. These bills need to either be repealled our modified in the language of this bill to fit the program.

I am uncomfortable with getting rid of Medicaid and Medicare.

I am uncomfortable with Subsidising Bill Gate's Health Care. If he wants to get into plan, then fine, but he should pay the going rate.

Next this is more of a bandaide approach then mine, Marokai. The reason is, it does nothing about encouraging comparison shopping or competition as far as I can tell. It does nothing about junk lawsuits which involve another form of insurance. Lawsuit Liabililty Insurance premiums for which are soaring due the soaring amounts paid out to defend doctors against lawsuits. All I see this plan doing is taking several Million into a program, subisidising all there costs and not doing a thing on these above issues. It also doesn't properly fund a program of this scale. The problem in Atlasia is we no longer due budgets, but that doesn't mean we shouldn't take cost into consideration. This program would probably cost about 250 Billion or more a year an most of that will fall to the General fund leading to substantial tax increases on all Atlasians not just to subsidize the care for the poor, but also people as rich as Warren Buffet or Bill Gates.

Lastly if the amendment to the underlying legislation passes, there will still be a large number of uninsured people. Ironically my Market based plan covers everyone while this amendment to the underlying bill would create a boondoggle of a program that is essentially underfunded according to the language of the bill and yet millions would go without coverage remaining a burden to health care system at large and the only think that is Insured about this is that prices will continue to spiral upward.

Let me state a few facts.

1. I keep hearing about the need to cover those who can't afford it as reason to support this bill. My proposal does the same thing, it just doens't subsidize people as rich as Bill Gates like this bill does. I would love to know what is wrong with my proposal that makes it glitter on Medicaid, please explain this unfounded charge.

2. Lets remember that not all the 47 million uninsured are poor. 20 Million make more then $70,000 a year. 7 million are college students who have been forced off there parents plan. There are simple solutions two the both of these.


Also I want to know why there is a problem with charging people premiums? The biggest problem that is driving up costs is irresponsibility on the part of the people. They don't take care of themselves when they are health and they don't comparison shop when they are sick. This is the biggest driver of raising costs. Charging people premiums would require people to take responsibility for there own health care. Again the premiums would have little or no impact on the poor. We can't create a sense of a free ride hear, people are going to have to sacrifice to get this and I see no reason why these so called Progressives are adocating to subsidize the rich on the back of the Middle class while not even guarrenteeing all the poor are covered first. And this will lead to substantial Income tax increase if it is reliant on the General fund. These will not be born primary by the rich but substanitally on the backs of the middle class.

There is a fundamental disagreement here. Our health care is the best in the world. If we have a problem, it is a problem of access. Once people have access we have the best doctors, the best equiptment, the best procedures, the best regulations and protections, and the best technology. We shouldn't scrap a system that is a Mansion on the inside. All we need to do is to get people through the front door. This bill tears the mansion down and replaces it with  a shed. Those pushing this bill prefer to throw the baby out with the bath water, and refuse to acknowledge the areas in which we are superior to any other country in terms of health care.

I would remind all Senators that if this bill fails we will still get a Health Care reform through. Though a certain group of people might whine and complain, and few may threaten to take there toys and leave, in the end cooler heads will prevail, a consensus will be reached, and Atlasians will get the reform they need and the not the reform we may each prefer due to partisanship. No Senator who has severe misgivings about this bill should feel pressured into voting for this because, nothing will get done. WE WILL GET THIS DONE. If not through this bill then through a common sense, realistic, and bipartisan compromise that expands access, decreases costs, preserves our level of quality, encourages competition, discourages junk lawsuits and preserves choice while at the same time ensuring everyone has some kind of coverage. I would encourage all Senators to defeat both the amendment and the underlying bill.

[Marokai Backbeat]

NCY, stop whining, all you want to do is take the credit. Any issues you have with the bill that haven't been included yet, such as regulations or opening up the private market, are minor and could be easily written up and included.

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Oh, wah. Then go find them.

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Why? With the Atlasian National Health Care Program they become completely useless. That seriously makes no sense.

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To pretend that any wealthy person would enroll themselves into a basic government healthcare program is not just silly, it's completely ignorant. Wealthy individuals have no reason to sign themselves into a government program that only covers basic procedure and basic care.

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Sometimes when I'm talking to you, I think you're one of my favorite Senators because you're always so interested in the debate. Other times I wonder how someone made it out of junior high. We're talking about the health of individuals, poor or otherwise, who can't afford any premiums at all. All your asking is for the government to get into the same business as the private market, which is making a business out of people's lives.

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It scraps nothing, does rid of nothing, eliminates nothing, pushes aside nothing. It creats a separate, very basic program, that provides "free" care for all those who need it. Private health insurance will still exist.

Shitloads of other countries have the same basic two-tiered system of what I'm proposing, some of them even go further, and those countries still have a very active and profitable insurance industry. This bill leaves private insurance to continue to exist. It still leaves the room for supplemental insurance programs (such as what exist today to accommodate Medicare users), it leaves the room for dental insurance, vision care insurance, drug insurance.. the list goes on. This bill creates a limited program for basic care, and allows people to get out of it and buy something more lucrative if they so desire it.

Your proposal is to charge people, make an income requirement (so people are still forced to buy into the insurance industry), give people a few thousand dollars in a check, or subsidize huge costs. You live in a fantasy land where simple solutions will solve the problems we're having, that the insurance industry will cut costs themselves, and that if we just open up the private market all our ills will magically solve themselves.

I, on the other hand, am looking across the world at dozens of successful examples, and none of their private markets collapsed. If you want to propose something to deal with the regulation of the private market, I'm all for that, go ahead. But there's nothing wrong with the program that's been proposed, so cease the histrionics.

[Franzl]

I don't see why a certain contribution can't be justified.....why can't somebody be expected to pay....let's say, 5-10% of his income in exchange for membership in the national healthcare system. Obviously it would remain free for people with no income.