Health insurance: Employer provided insurance is no gem

While many are aghast that single-payer health insurance or Medicare for All advocated by several Democratic candidates would require you to give up your employer-provided insurance, employer insurance is not the gem many think it is. Health care costs have risen, but employer contributions to health insurance have not.  Employees are paying more and more out of pocket.  However, I still believe consumers want a choice of their providers, whether it be employer-provided or offered by the government or private companies.  The problem is that to make a cost comparison among all three or even to make an informed choice is difficult or impossible. Trump and the GOP's plan to repeal Obamacare would even remove that option, leaving millions with no insurance whatsoever.  As this article points out, the real problem is the rising cost of health care and little is being done to bring down costs. Prescription drug costs are key, but even that which has had bi-partisan support cannot surmount Congressional gridlock.  The choice between unaffordable providers is no choice.  There is currently no competition to force providers to become more efficient or cost-effective.  A government public option and requiring competitive bidding for provider formularies, including Medicaid and Medicare, might at least provide incentives for providers to lower their own administrative costs and accept lower margins if they want to survive.  The Obamacare method of giving you a choice of private plans was supposed to provide a degree of competition, but it was never designed to be the whole plan.  Politics forced the Obama administration to drop the government-regulated, nonprofit public option that would have provided a greater measure of competition.  Private health provider company lobbyists did not want the competition, but now they may be faced with even the elimination of private health insurance that is threatened by some candidates.    In their greed, they may have planted the seeds of their own self-destruction.

Update: Not available to Grand County consumers, yet, but for government employees: https://www.skyhinews.com/news/grand-county-joins-peak-health-alliance/


https://finance.yahoo.com/news/health-care-employer-expensive-america-134313774.html

Sober up, Democrats, or say goodbye to your dreams.

Updated 7/15/19

Sober up, Dems. I'll be putting my money in this presidential race on a  candidate with appeal in the key electoral states Democrats need to win or liberals can say goodbye to their dreams. What is becoming clear is that the Democrat's winning nominee must appeal to both blue-collar midwest and high African American turn out or Donald Trump will get his second term. What is at stake for Democrats and possible swing voters are policies fundamental to Democrats and independents. Should Trump gain a second term, it is bye, bye Roe v Wade as the Supreme Court gets more anti-Rove v Wade justices. A Trump second term would place in control more energy lobbyists and executives sabotaging climate change green goals., White nationalism would continue undermining meaningful protection of civil and minority voters rights. It means a veto pen in the White House sinking health care insurance, any expansion, more sabotage, if not completely ending any federal program like Obamacare. Trump's record is to kill affordable health care for millions of citizens and neither he nor the GOP has any feasible plan for a replacement. Democrats can quibble over totally replacing Obamacare with Medicare for All or making Medicare a public option and in debates lose any chance at either being implemented if they lose the electoral college vote.

The horse race White House winner is not determined by who gets the most popular votes. If we learned anything from 2016, Democrats won that race but they lost because of the electoral college that weights votes by each state in favor of smaller populated states and against mammoth blue New York and California. So far, the start of this presidential election cycle shows some hope for Democrats to win both the popular vote horse race and the electoral college vote. but it is not only early,  it is also marginal and iffy. In any recent popularity polls, Donald Trump has held onto his base of 42 to 44% losing to several leading Democratic contenders, but he has not expanded it, even with his job approval at 45 to 47%. Recent polls of demographic blocks, issues such as health care and immigration, swing states, and relative position of Democratic aspirants for their party's nomination provide a snapshot of where the race stands today, but as we have seen in these days of modern communication. much can happen quickly to change public opinion.

Early in the election cycle Joe Biden has shown the ability to appeal to win both key demographics and flip some states from red to blue, yet some of Democrats barking at his heels in the announced field have tried to take him down. Democrats should be wary of a circular firing squad of candidates attacking fellow aspirants to boost their own chances. Those lines of attacks could be used by the GOP to defeat them in a general election.

From a July 8 Washington Post email : The economy is the only major issue on which a majority of people approves of how Trump is doing. On foreign policy, it’s 40 percent. On taxes — remember, Republicans passed a tax bill in 2017 to try to get good marks here — it’s 42 percent. On health care — a potent issue Democrats championed to help them win back the House of Representatives last year — it’s 38 percent.

Voters would choose Trump over a socialist

Match-ups between Trump and most 2020 candidates are dead even (except for former vice president Joe Biden, who beats Trump by 10 points among registered voters in this poll). But the pendulum swings clearly toward Trump when voters are asked to choose between Trump and a “socialist." Trump is suddenly decisively ahead.

_______________________________________________________________________________

Where the race stands now

In June, some polls show Biden beating Trump is key states Trump carried in 2016, including Wisconsin, Ohio, and Michigan, as well as Florida, North Carolina and Arizona. A major portion of the Democratic party is the African American vote. Their turnout and enthusiasm are key to determining who becomes the Democratic candidate.

After the first debate, Kamala Harris attacked Biden on not being favorable enough of busing a decades ago as a way to try to paint him as a person not supportive of the Black community. This worked to her advantage and Biden was caught off guard and fumbled the answer. He took a hit in his polls but maintained his lead and support in the African American community.

As of July 13, Biden maintained a 20 point lead among African American voters in spite of Harris' strategy. Biden's 40 years in high profile public office is less a bane and more of a boon when it comes to appealing to the Black community. Not only does he have a record of defending civil rights on many more issues, but he also served as vice president with Barack Obama, America's first African American president, who trusted him explicitly. He is a known quantity which makes Harris' attacks less effective. Biden's track record is a safe one based on years of trust. Harris, African American/Asian, has been under fire for past support of law enforcement issues opposed by African Americans when she was attorney general of California. Her debate strategy of attacking Biden on busing was a breakout moment for her, showing her political acumen and her debate skills that could take on Trump, moving her up the polling ladder.

Trump and the GOP are banking on the white nationalist elements of their base. To solidify that support, they are launching extreme anti-immigrant and anti-minority policies, hyping fears of a large swath of voters, facing a future where whites will be a minority of voters. This month, Trump announced policies and actions to maintain his hate and fear bonafides, including ICE raids, Vice President Pence visited scary looking male migrants crammed into chain linked holding pens being treated badly. Pence did not visit the facilities housing children separated from parents. Trump announced he is planning to remove the ability of asylum seekers to reach US borders. by forcing them to remain in Mexico. He failed in his attempt to get a citizenship question on the 2020 census form as the SupremeCourt ruled against him, but his effort should at least keep his base happy. Trump media is attempting to paint four women Representatives of color who are outspokenly left of the rest of the Democratic caucus, as representative of all Democratic candidates, sending them "back" to where they came from. , The GOP is also attempting to brand all Democrats as being for open borders in spite of a difference among candidates on the issue of criminalization or decriminalization of undocumented migrants. or plans to secure and improve the immigration system. This may work for Trump, but Biden's 40-year history makes that a hard sell as an older white man with a known history and a reservoir of trust as a rational, thoughtful, public servant.

On health care, Biden has carved out the most moderate approach of the top four, whose position was announced July 13 as keeping Obamacare but providing a buy-in to Medicare, while permitting those who like their private, union, or employer-provided insurance to keep it. Advocates of the more extreme version of Medicare for All would do away with private insurance (except for supplementals) and move consumers into a single payer plan. The GOP's obvious strategy is to scare consumers away from any Democratic by charging them as socialists. Polls show that tagging any candidate as a socialist is a very effective strategy, with Trump beating any candidate branded with that term, fair or not. The tag of "socialism" is especially toxic to Democrats in swing states per an Axios poll. Biden's 40-year record makes sticking him with "socialist" a hard sell.

Obamacare was originally designed to have a public option, government-provided insurance plans like Medicare or one offered to federal employees, to provide competition that would force private insurers to become cheaper. Biden's plan for prescription drugs would be to permit Medicare to bargain with drug companies for the best price. Currently, drug companies and Medicare and Medicaid are forbidden by law to bargain, permitting drug companies to continue to gouge consumers with their own price setting. Biden would also allow consumers to get their prescriptions from providers abroad, giving US drug companies competition they do not have now. Both Sanders and Warren would eliminate private and employer insurance for a Medicare for All plan for everyone, a single payer system more like the Canadian model. Harris has supported legislation of both approaches, the public option, and the Sanders/Warren approach..

From a July 8 Washington Post email : The economy is the only major issue on which a majority of people approves of how Trump is doing. On foreign policy, it’s 40 percent. On taxes — remember, Republicans passed a tax bill in 2017 to try to get good marks here — it’s 42 percent. On health care — a potent issue Democrats championed to help them win back the House of Representatives last year — it’s 38 percent.

Voters would choose Trump over a socialist

Match-ups between Trump and most 2020 candidates are dead even (except for former vice president Joe Biden, who beats Trump by 10 points among registered voters in this poll). But the pendulum swings clearly toward Trump when voters are asked to choose between Trump and a “socialist." Trump is suddenly decisively ahead.

 https://www.cnn.com/2019/07/13/politics/joe-biden-leads-with-black-voters-analysis/index.html

https://www.nbcnews.com/politics/meet-the-press/trump-trails-biden-warren-sanders-new-nbc-news-wall-street-n1029646

https://www.axios.com/alexandria-ocasio-cortez-poll-democrats-2020-aeaa3771-f142-4059-b79e-1fed569dfdf9.html

https://thehill.com/policy/healthcare/451263-nixing-private-insurance-divides-medicare-for-all-candidates

https://www.cnbc.com/2019/07/15/biden-unveils-health-care-plan-to-expand-obamacare-hits-medicare-for-all.html

https://www.usatoday.com/story/news/politics/2019/07/15/donald-trump-says-house-democrats-he-insulted-should-apologize/1732314001/?csp=chromepush

POLITICO.COM

Biden invokes Obama to defend his civil rights record

The former vice president delivered a fiery response after Kamala Harris 
attacked his past stance on busing.

Revisiting the public option Obamacare debate of 2009

From a blog posting and column written during the debate of including the public option in the proposals for what became Obamacare.  

October 12, 2009

My August  2019 updated comments in support of a public option:

What the private health care system needs is more competition from government options and non-profits who are not profit and stockholder driven. In addition, all purveyors of public options, including Medicare and Medicaid as constituted now, should be able to negotiate formularies with drug companies. Consumers need to have affordable choices of both public, private and union and employer-provided plans that are not junk and covering pre-existing conditions. How we get there are several ways. Competition is the basic driver of prices. Unaffordable comprehensive policies are no choice. If you can't afford them, a choice of 0 is meaningless.
If you are given no choice but only able to have of a government program, that, too, is depriving consumers of choice. On that basis, I support the public option instead of the Canadian system. Price, taxes, and government costs v benefits are important, but politically "choice" is the more sellable approach. That one plan or another would deprive consumers of choice or insurance they like now that may be better than a public option may be effective lines for those who support the Sanders type plan, but in the long run, consumer choice is a more positive sales point for a public option approach, though it might not be the cheapest in terms of government spending or consumer out of pocket expenses.

October 12, 2009 comments continued:

Last week the Congressional Budget Office gave the Democrats' health care reform legislation an early Christmas present. They put a price tag on the Baucus plan that makes Democrats look like fiscal conservatives and Republicans as penny wise pound foolish. It also gives room to add the public option that polls show 60-65 percent of the electorate want and leaves the congressional Republicans with egg on their faces.

The CBO calculated the Baucus plan would cost $829 billion over the next ten years, $71 billion under the maximum amount of $900 billion the President had set. Furthermore, it reduces the federal debt by $81 billion. The Congressional Republicans, advocating for the continuation of the status quo, are still supporting the “do nothing” option which would be $81 billion more expensive than the Baucus plan.

Of course, what you pay for is what you get. The Baucus plan would leave at least 18 million uncovered, relying on the emergency room for health care, with a 41 percent greater risk of dying prematurely, and leaving the uninsured in danger of adding to the staggering bankruptcy figures.

Baucus also left out the public option. His is the economy model with gas fuel efficiencies when a significant majority of voters still want a hybrid with a choice of a public option.

However, there is wiggle room for both the public option and for more extensive coverage to be added in later on the Senate floor and or in conference committee. There is even a financial incentive to do so. The beauty of the CBO estimate is that there is enough cost slack to allow more of the uninsured to get access to affordable health insurance, to include a public option, and still make the case that the Democrats are more fiscally responsible than the Republicans.

The CBO had “scored” the cost of the public option in the House version as being $10 billion cheaper over 10 years than a version without a public option, because the competition would force down the high private insurer's administrative costs.

Aside from stonewalling, one Republican strategy has been to offer sound-good “alternatives” that look more like the cardboard substitute for a shiny toy the chubby-faced kid in the Ally Bank commercial called “a piece of junk.” Adding insult to injury, there is not even a CBO price tag attached, so an apples to apples comparison of plans cannot be made. Republicans have offered tweaks worthy of adopting, but they ignore their limits as panceas. The oligopoly of private insurers, protected from anti-trust action, makes a farce of the “alternative” to promote competition by allowing cross state insurance purchases. Thirty-five states have already adopted tort reform that caps jury awards with no evidence of impact on health care costs. The other panacea: Let's change human behavior — if you go on a diet and stop smoking, you will get a break on your insurance costs.

This year, 71 percent of doctors, the most adamant group opposing socialized medicine over the past 100 years, are supporting either the Obama plan or the Canadian system. That is the ultimate credible attestation that the summer fear campaign Republicans launched to scare us has no merit. Overwhelmingly, most docs do not believe that reform would be a socialistic government takeover of the medical system, or would get between you and your physician.

The Republicans are still fear-mongering that seniors would lose $500 billion in Medicare benefits. Full disclosure: I am one of the 20 percent of Medicare recipients on the useless Advantage program, targeted for cuts. My Medicare benefits will not be cut. There is a difference between administrative costs and benefit cuts. Wise up, seniors.

The result: Congressional Republicans look like they are stonewalling, heartless grinches, not caring if people die without insurance. They have postured themselves as protectors of the insurance industry and as anti-consumer. They want to deny consumers a choice of a public option. They want consumers and taxpayers to keep on paying private insurers for their premiums that are rising four times faster than care delivery cost and to continue paying for excessive charges for their high salaries and commissions.

Unlike Democrats, they have not even bothered to put consumer protections from insurer abuse into any legislation whatsoever, giving only lip service to some vague future legislation that would outlaw insurer's coverage denial for pre existing conditions or dropping coverage for the sick, and arbitrarily denying claims.

No wonder moderate Republicans outside Congress — New York Mayor Bloomberg, former Republican standard bearer Bob Dole, former Sen. Bill Frist, California Gov. Arnold Schwarzenegger and others — have looked at the polls and are urging moderates to get on board with reform. They must have realized that their party's tactics may not be the best political face they could put forward in the 2010 midterms.