tag:blogger.com,1999:blog-5877221018800830362.post538898721779786388..comments2024-02-22T01:35:03.164-05:00Comments on Cure Strategy (formerly, Serious Medicine Strategy): Repeal vs. Reform, UpdateJames P. Pinkertonhttp://www.blogger.com/profile/06914344842339708576noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-5877221018800830362.post-75679716896314934012010-03-29T03:47:26.395-04:002010-03-29T03:47:26.395-04:00I think we are overlooking the $2,000 some odd pre...I think we are overlooking the $2,000 some odd premium that because the insurance is mandatory will be required of everyone. My first 35 years (I am now 59)were spent living in New York City. I am sure in all that time I have touched down in every corner of the City of New York. I will say unequivocally that in my judgement there will be nothing but defaults at that price point. People have enough problems with credit card debt and layoffs and believe it or not although I was born shortly after WWll, I am telling you that that $2,000 plus is still a million dollars for countless New Yorkers. Add that to what all of us know is going to be the level and quality of care that in and off itself will be difficult to arrange for low payers. We have to all get together and tune this bill up.Anonymoushttps://www.blogger.com/profile/02264524142416451513noreply@blogger.comtag:blogger.com,1999:blog-5877221018800830362.post-19528929118518978052010-03-28T09:46:39.285-04:002010-03-28T09:46:39.285-04:00I guess we have a horse race. But one way or anot...I guess we have a horse race. But one way or another Healthcare has to be fixed. Hopefully before summer camp closes and the winter of our discontent begins.Peter913https://www.blogger.com/profile/01805602464724466047noreply@blogger.comtag:blogger.com,1999:blog-5877221018800830362.post-46770189566562205322010-03-28T00:35:47.287-04:002010-03-28T00:35:47.287-04:00So I’m wondering what happens if the individual pu...So I’m wondering what happens if the individual purchase mandate is struck down as unconstitutional. It would then be up to the court to decide whether the remaining provisions of the act stand. (See http://www.theattackdemocrat.com/2010/03/health-reform-and-severability.html.) If the court decided to save the rest of the act, would it not then be politically possible to reform the reform to simplify it so that:<br /><br />1) Everyone gets medical treatment even if they CAN'T pay for it (often the case already, except the failure to make this rule of thumb into a law or AMA policy or some other policy led to the legislative debacle that will have resulted in the unconstitutional provision – the difference would be an explicit federal reimbursement to patients, the most impoverished of whom would be eligible for mandatory credit from providers pending federal reimbursement)<br /><br />2) People who CAN pay for medical treatment and/or insurance get personal tax deductions for treatment and/or insurance<br /><br />3) A repeal of the employer deduction causes people to shop for their own insurance and/or pre-paid treatment and/or treatment on demand, resulting in price pressure on suppliers and putting people back in charge of their own medical decisions by creating genuine direct customer-provider markets for medical care and insurance<br /><br />#1-3 could happen, assuming the court doesn’t throw out universal coverage along with the individual mandate – couldn’t it?<br /><br />I don’t know – just wondering here how reforming the reform might move us to a system that is better than both the status quo and the status quo ante-HCR.<br /><br />Another potential constitutional problem came to mind while pondering this: Doesn’t universal coverage convert Medicare into a pernicious form of age discrimination? Until now, there's been a rational basis for a minimum age for federal health care, i.e. Medicare (we can’t afford to cover everyone so we need an arbitrary cut-off so we can afford to cover older people). Now the government has decided we can afford universal coverage. If federal law gives everyone access to health care, why should some people get one form of health care (under the new bill) and others get different health care (under Medicare)?<br /><br />Just because someone happens to fall on one side or the other of an arbitrary age threshold? Thanks to reform, there is a much weaker case for a rational basis, a compelling state interest, or whatever the proper equal protection test is for such obvious age discrimination. Couldn’t the ultimate result be means testing that applies to a unified system of federal medical assistance for those in need whether or not one happens to be a Medicare beneficiary? And wouldn’t a genuine market for medicine plus generous assistance to those who couldn’t otherwise afford to participate in the genuine market subsidize serious medicine instead of starve it? Granted, people who were led by the government to believe that their Medicare taxes were a form of health insurance for their old age would have a legitimate beef against means testing of “their” benefits – but perhaps a 50-year phase-out of non-means tested Medicare would pass constitutional scrutiny. Again, just wondering.Paul Wilkinsonhttp://paulwilkinson.comnoreply@blogger.comtag:blogger.com,1999:blog-5877221018800830362.post-12582622815171894842010-03-27T21:23:00.333-04:002010-03-27T21:23:00.333-04:00It is most apparent that the Congress voted in the...It is most apparent that the Congress voted in the majority for the Bill and the President has or will sign it into the law. That in and of itself makes a total repeal most unlikely. There are a few acceptable and desired points displayed and a reform at some later date would retain the passages that are universally desired and forwarding to a revamped fiscally fair law that takes into consideration insured and medical practitioners. I think the Democrats failed to look at repercussions of shortchanging the doctors versus all the faith they had in a self serving AARP and the AMA representing a small portion of doctors in the USA. The other very shrewd and business oriented medical men and women who we need in a desperate way are not going to take a dime on the dollar. The very individuals that the Democrats declared as their raison d're are going to end up waiting to the point of getting fired or running around different states in order to find inexpensive care.Anonymoushttps://www.blogger.com/profile/02264524142416451513noreply@blogger.comtag:blogger.com,1999:blog-5877221018800830362.post-37086857868400793602010-03-27T21:19:31.337-04:002010-03-27T21:19:31.337-04:00Jim, I totally disagree. The single reason the bus...Jim, I totally disagree. The single reason the businesses would waht reform instead of repeal is that the bill incentivizes the businesses to be bad stewards of their employees' health, by making it cheaper for them to pay fines for no health care options than it would be to pay for their employees' health care. This is not by accident. This is the first lever Obama et al are using to make a public option make sense. This alone makes me want to rip the bill from the House's hands, throw it in the mud, and stomp on it. Cadillac plans? Why should it be an offense to offer your employees more expensive health care? HOw can it be right to tax certain higher priced prosthetics? If you read these things with a jaundiced eye, you see how much of a money and power grab this is, more so than any other purpose. This stuff needs to be flushed and for Congress to start over, with real boundaries, objectves and goals. If you go to my blog, http://gregburtononpolitics.blogspot.com, you'll se a treatise on what I believe should happen wih healthcare.Anonymoushttps://www.blogger.com/profile/06224995708640734283noreply@blogger.com