How the Baucus Bill Bilks People Over 50
| Fri Sep. 18, 2009 8:11 AM PDT
The people who stand to get screwed most by Max Baucus's health reform plan are those who aren’t old enough to qualify for Medicare, but are still old enough to be discriminated against by insurance companies.
For several months, the Columbia Journalism Review has been publishing analyses of the Massachusetts health care system, which in many ways serves as a model for the current national health care reform—a canary in the coal mine for the rest of us. The state mandates that all residents have health insurance or face a tax penalty. And while it does provide some regulation of private insurers, it doesn’t outlaw “age rating”—setting different premium rates based on age. This doesn’t apply to most working people who are covered by group plans through their employers, at group rates. But for the self-employed and early retirees—whose numbers are growing since the recession began—the costs can be devastating. CJR cites reporting by Kay Lazar in the Boston Globe, which found:
State law allows insurers to charge older people up to twice as much as younger people for the same coverage. In other states, the disparities can be even greater. One result is that more older people choose less comprehensive plans. Data from the Commonwealth Choice program, which offers state-approved private insurance, show that as enrollees grow older, more choose cheaper and less comprehensive coverage.
The main solution that’s been proposed for this problem is to make it “easier for self-employed people and retirees who are 50 to 64 to be exempted from a stiff tax penalty if they can’t afford insurance.” So rather than force insurance companies to stop discriminating on the basis of age, the state may begin “allowing” 60-year-olds to live without health insurance. So much for the great Massachusetts universal coverage model.
All of the major health reform plans that have been floated in Congress allow age-rating. And the Baucus plan endorses disparities even greater than those in Massachusetts. As the New York Times reports:
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Under Senator Baucus’s plan, insurers would be permitted to charge older people five times more for their health insurance premiums than younger people. That proposal, first circulated in a Finance Committee policy options paper last spring, is a significant departure from the approaches put forth by three House committees and the Senate Health, Education, Labor and Pensions Committee. Those bills would only allow insurers to charge older people twice as much as younger ones….
According to AARP, the lobbying organization for older Americans, the number of uninsured adults between 50 and 64 grew to 7.1 million in 2007, an increase of 36 percent over 2000. Among the main reasons for the increase: higher premiums demanded of older, sicker people seeking coverage in the individual insurance market.
Supporters of the Baucus plan and the other half-measure congressional health reform proposals have made a big deal of the fact that insurers won’t be able to turn people away, or charge them more, because they have pre-existing conditions. In other words, they can’t discriminate against sick people. They also cannot discriminate on the basis of race, ethnicity, gender, and the like—meaning that the only form of discrimination that will remain legal is age discrimination.
This is, of course, another sop to the insurance industry, which worries about the effect on its profit margin if it is forced to insure everyone. As the Times notes:
By allowing insurers to charge so much more for older, often sicker people, “You’re just using age as a proxy for health status,” said Uwe Reinhardt, an economics professor at Princeton University. He estimates that Senator Baucus’s age-rating plan would allow insurers to cover roughly 70 percent of the additional risk they’d take on by being required to accept all comers, regardless of health.
Yesterday I wrote in some detail about how the insurance companies stand to gain from the Baucus bill (their stocks immediately jumped upon release of his proposal, which has no public option):
It doesn’t take Einstein to figure out why the Baucus bill is great for the insurance industry: If there’s no public alternative to compete with private insurance companies, guess where all those people will have to go to buy their government-mandated insurance? As for the touted co-ops and exchanges, all they are ultimately likely to offer is better access to private insurance. And people of limited means will get government subsidies, mostly in the form of tax breaks, to buy private insurance—which means a transfer of funds from the taxpayers to private insurers. We might as well be writing our checks directly to United Healthcare, Wellpoint, and Humana, instead of the the IRS.
Read the rest here.
Comments
Health care debate: Its all over but the shouting.
Submitted by evdebs on Fri Sep. 18, 2009 11:30 AM PDT.
It's great for the cable news cycle . It’s a prominent topic of discussion from cocktail parties to the water cooler at work . Health care reform. Will it pass, or more importantly will it really matter to those in need of it when it does.
For the insurance industry and Pharma it will matter. Just look what Medicare Part D did for their bottom lines. For the rest of US the matter has already been settled in the time honored tradition endemic to the United States. Obama has made his back room deals with Pharma and the insurance industry . (Is he naïve or complicit?) The Baucus bill has been drafted by the lobbyist of the very industry to be brought under scrutiny. The checks have been cashed. The attaches stuffed with hundred dollar bills have been received. Your excess premiums and prescription charges have been hard at work corrupting “your” representative democracy. Want proof? Watch the market. Wellpoint, United Health , Phizer, et al, are reaching for new highs in the face of this imminent “reform”.
All of you progressive Democrats, independents, secular humanists, etc., have been sold out once again. When will we ever learn?
“To turn your back on the corrupt Republican Party and the corrupt Democratic Party---the gold-dust lackeys of the ruling class----counts for something. It counts still more…to join a minority party that has an ideal, that stands for a principle, and fights for a cause.“ Eugene Victor Debs from his 1918 speech at Canton, Ohio for which he was sentenced to 10 years in federal prison in this “the land of the free”.
Oh please, baby boomers
Submitted by Rusty (not verified) on Fri Sep. 18, 2009 1:38 PM PDT.
Oh please, baby boomers don't get enough breaks? Every plan is going to have problems -- I'd prefer single-payer (opening Medicare to all) but it ain't gonna happen. Here's a chance to actually turn health insurance into health insurance (no recision, dumping sick people) and greatly expand coverage and you want to make the good slave to the perfect.
Oh please
Submitted by deniseb (not verified) on Tue Sep. 22, 2009 8:46 PM PDT.
I'm sure you would feel differently if you were the one to be charged 5 times as much.
The State Of "Yes We Can", Minnesota Knows Better !!
Submitted by HSR0601 (not verified) on Sat Sep. 19, 2009 8:44 AM PDT.
1. As regards a make-believe scheme, the source of funding coming from a middle class is utterly against the commitment of Democratic party.
2. No cost-competitive advantage does not clear the grave concern about the unsustainable cost of overall health care program in the long run.
3. Even with some benefit for primary practitioners, the baseless scheme does not come with fundamental payment reform, or a pay for value reimbursement formula. It means that the insurer-friendly scheme is not cleaning up the concerns over a quality issue and $9trillion of deficit over the next decade.
((Here is some of CBO analysis : While the costs of the financial bailouts and economic stimulus bills are staggering, they are only a fraction of the coming costs from Social Security, Medicare, and Medicaid. Over the next decade, the Congressional Budget Office (CBO) projects that each year Medicaid will expand by 7 percent, Medicare by 6 percent, and Social Security by 5 percent. These programs face a 75-year shortfall of $43 trillion--60 times greater than the gross cost of the $700 billion TARP financial bailout)).
4. For Medicare & Medicaid system to survive from the most wasteful structure on earth, enough savings by ways of fundamental changes need to be secured, in return, the savings thereof suffice to meet the goal of well-planned public option.
((Even with far less visits to docs, which average a half or a third of them in any other free states, Americans pay roughly twice as much per person right now)).
5. For the record, prior to nation-wide deployment of reform, The State Of "Yes We Can", Minnesota influenced by Mayo clinic spends "20 percent" less per patient than the national average and 31 percent less than in the highest cost state. It highlights that no substantial tax raise is needed at least for sure.
((The $583 billion of revenue package, and the astronomical savings of public option aside, "20%" of $923.5bn (the combined Medicare and Medicaid cost per year, as of July) represents around $184.7bn per year and 1.847trillion over the next decade, and this patient-centered value alone could be sufficient to meet the goal of public option)).
6. In brief, the long-awaited and most hopeful health care plan is to meet these criterias : Affordability, Quality, and A Check function against runaway premiums thereof.
Clearly enough, due largely to its lower overhead cost, purchasing power and fundamental payment reform, the well-planned public option would be an even better candidate than the fabricated scheme by THE INDUSTRY in these aforementioned regards.
Now is the moment to turn page to contemporary energy and financial upgrades glossed over in 8 years.
Just so you know, criteria
Submitted by Anonymous (not verified) on Mon Sep. 21, 2009 7:11 AM PDT.
Just so you know, criteria IS the plural of criterion. It does not require an 's' to make it plural. So, "the criteria are....." not the 'criterias' are.....
They only care about the industry, not the people.
Submitted by Something Stinks on Mon Sep. 21, 2009 5:38 AM PDT.
The "other" health care bill is crafted by the same type of people. All this money just passes through the people and will go into the coffers of those who have made our heath care system then mess it is with the primary purpose of insuring their obscene profits.
This is just another corporate bailout done for the benefit of "us" people.
They don't give a damn about us.
That is why we have money for war, Wall Street, banks and the auto industry but not for health care as it is only for the rest of the civilized world but not for Americans who foolishly vote for Republicans and Democrats.
Now they are talking about bailing out the newspapers. We need them to help sell us some more wars and cheap politicians. They helped Obama, now Obama wants to help them. Who can blame him?
Isn't there a law against that shit?
Oh yeah, what laws?
Something Stinks!
No choice
Submitted by Anonymous max (not verified) on Mon Sep. 21, 2009 5:44 AM PDT.
If NONE isn't a choice then there is No choice. The insurance mandate is simply a plan to force us all to play by the insurance companies rules with the IRS as the chief enforcer. I am self-employed and self-insured. I pay cash for doctor visits and pay for my prescriptions too. That is far cheaper than the $900 a month that insurance companies want for a 57 yo single male.
If this happens I won't play and you can fine me. Open Medicare to all or go home. Pay for it with a national sales tax and be done.
Bravo! I sympathize with all that you have said.
Submitted by evdebs on Mon Sep. 21, 2009 6:24 AM PDT.
However, as a self insured person, the system has been radically stacked against you. For reasons that have never been adequately explained to me, you'll pay twice as much for doctor visits, three times as much for hospital visits, and up to twenty seven times as much for presciption drugs.
“The subjects of every state ought to contribute toward the support of the government in proportion to their respective abilities; that is, in proportion to the revenue which they respectively enjoy under the protection of the state. Adam Smith. Wealth of Nations, 1776
You miss the point. At $900
Submitted by Anonymous (not verified) on Tue Sep. 22, 2009 5:00 PM PDT.
You miss the point. At $900 a month you will pay much more over a lifetime than if you paid cash at point of sale, unless you suffer a catastrophic illness which is what health *insurance* would be for if only the government allowed you to buy that kind of insurance.
Here is your explanation
Submitted by Anonymous (not verified) on Tue Sep. 22, 2009 5:05 PM PDT.
The reason "you'll pay twice as much for doctor visits, three times as much for hospital visits, and up to twenty seven times as much for prescription drugs" is the same reason you cannot buy catastrophic-only insurance in most states: government mandates that dictate what insurance companies must cover.
Hope that clears it up.
Pass the Preparation-H...
Submitted by Gray Dancer (not verified) on Mon Sep. 21, 2009 12:09 PM PDT.
What do you expect? Our country is still ruled by the same elite consortium of criminals that has been strangling the rest of us for the past thirty years (at least). Everything else is window dressing. The two-party political process is total crap, and the chances of coming up with a viable third party are zilch, as are the chances of starting a successful revolution. If there was any place left to emigrate to, I'd be gone.
Protests Against Teabaggers
Submitted by ThePantaloon.com (not verified) on Mon Sep. 21, 2009 12:14 PM PDT.
Adult Screen Actors Guild Protests Republican Teabaggers
A Public Option Plan that works
Submitted by robert diogenes on Mon Sep. 21, 2009 5:34 PM PDT.
GET THE FACTS BEHIND THE NEWS
A Public Option Plan That Works
Should there be a “public option” that competes with private insurance?
Answers might be found in San Francisco, where ambitious health care legislation went into effect early last year. San Francisco and Massachusetts now offer the only near-universal health care programs in the United States.
The early results are in. Today, almost all residents in the city have affordable access to a comprehensive health care delivery system through the Healthy San Francisco program. Covered services include the use of a so-called “medical home” that coordinates care at approved clinics and hospitals within San Francisco, with both public and private facilities. Although not formally insurance, the program is tantamount to a public option of comprehensive health insurance, with the caveat that services are covered only in the city of San Francisco. Enrollees with incomes under 300 percent of the federal poverty level have heavily subsidized access, and those with higher incomes may buy into the public program at rates substantially lower than what they would pay for an individual policy in the private-insurance market.
To pay for this, San Francisco put into effect an employer-health-spending requirement, akin to the “pay or play” employer insurance mandates being considered in Congress. Businesses with 100 or more employees must spend $1.85 an hour toward health care for each employee. Businesses with 20 to 99 employees pay $1.23 an hour, and businesses with 19 or fewer employees are exempt. These are much higher spending levels than mandated in Massachusetts, and more stringent than any of the plans currently under consideration in Congress. Businesses can meet the requirement by paying for private insurance, by paying into medical-reimbursement accounts or by paying into the city’s Healthy San Francisco public option.
There has been great demand for this plan. Thus far, around 45,000 adults have enrolled, compared to an estimated 60,000 who were previously uninsured. Among covered businesses, roughly 20 percent have chosen to use the city’s public option for at least some of their employees. But interestingly, in a recent survey of the city’s businesses, very few (less than 5 percent) of the employers who chose the public option are thinking about dropping existing (private market) insurance coverage. The public option has been used largely to cover previously uninsured workers and to supplement private-coverage options.
Through our experience working on health-care-reform efforts in California and Washington (one of us worked for President George W. Bush’s Council of Economic Advisers), we have seen how concern over employer costs can be a sticking point in the health care debate, even in the absence of persuasive evidence that increased costs would seriously harm businesses. San Francisco’s example should put some of those fears to rest. Many businesses there had to raise their health spending substantially to meet the new requirements, but so far the plan has not hurt jobs.
As of December 2008, there was no indication that San Francisco’s employment grew more slowly after the enactment of the employer-spending requirement than did employment in surrounding areas in San Mateo and Alameda counties. If anything, employment trends were slightly better in San Francisco. This is true whether you consider overall employment or employment in sectors most affected by the employer mandate, like retail businesses and restaurants.
So how have employers adjusted to the higher costs, if not by cutting jobs? More than 25 percent of restaurants, for example, have instituted a “surcharge” — about 4 percent of the bill for most establishments — to pay for the additional costs. Local service businesses can add this surcharge (or raise prices) without risking their competitive position, since their competitors will be required to take similar measures. Furthermore, some of the costs may be passed on to employees in the form of smaller pay raises, which could help ward off the possibility of job losses. Over the longer term, if more widespread coverage allows people to choose jobs based on their skills and not out of fear of losing health insurance from one specific employer, increased productivity will help pay for some of the costs of the mandate.
The San Francisco experiment has demonstrated that requiring a shared-responsibility model — in which employers pay to help achieve universal coverage — has not led to the kind of job losses many fear. The public option has also passed the market test, while not crowding out private options. The positive changes in San Francisco provide a glimpse of what the future might look like if Washington passes substantial health reform this year.
William H. Dow, who was a senior economist for President George W. Bush’s Council of Economic Advisers.
This seems rather fair really
Submitted by Ed Coughlin (not verified) on Tue Sep. 22, 2009 4:06 PM PDT.
I fail to see the reason for moral outrage here. Old people are more likely to be sick, thus they cost more to insure. To pretend that is not the case would only raise the rates on everyone since lowering their rate to the average rate would in turn raise the average rate.
This is the worst possible thing to happen because, while they pay more costs, older people make significantly more money as they are in the prime of their careers. The 50+ set, on average, makes more then twice as much as workers in their 20s and are far less likely to have significant child expenses as their children leave home.
Additionally someone who is 60 has had a rather long life already and it is not nearly as vital that they be given help when it comes to health as someone who is 25. If someone who is 25 dies they had the rest of their life ahead of them, if someone dies at 63 they only really had a few good years anyway before something else went wrong, heartless as that sounds.
Finally age rating is already enshrined in auto insurance, to the benefit of older people. Teenagers and young adults pay vastly higher rates even with clean records, often twice as much or more then married adults 30 and over. Higher medical premiums are somewhat offset by paying less for auto insurance, less for child care and other expenses, and making more. Plus, they are more likely to take out care from the system so it only makes sense they put more in.
It seems rather backwards the way our country works now where we devote most of our resources to those who make the worst use of them. We spend trillions on those 65+ who do very little to advance any important cause and contribute very little to society as a whole and then we refuse to provide even basic services to childless 20 year olds. If anything support should start high and decrease with age instead of the other way around. We should be giving everyone under 65 free health care first instead of last.
Care provided and marginal utility of the individual should be linked, instead they go in opposite directions with the most useful individuals with the most time ahead of them get the least while those who have almost no time left and no utility to society get the most
This is almost certainly because old people vote more since they have nothing else to do, young people are too busy working hard to pay 12% of their income to make sure old people can get free money and medical care while they sit at home watching the price is right.
And they wonder
Submitted by Denise (not verified) on Tue Sep. 22, 2009 8:49 PM PDT.
why the old folks aren't getting behind the "plan"...
So, older Americans should pay more just because we're older?
Submitted by Anonymous (not verified) on Wed Sep. 23, 2009 9:08 AM PDT.
I am wondering what you REALLY think should happen to older people. You say someone who's 60 has had a pretty long life already. So does that mean that that person should just suffer physically, lose his/her home and any assets accumulated, and just die if they can't afford to pay outrageously multiplied health insurance premiums? I suspect that you are not among the 50+ year old crowd. Otherwise you might feel differently. And not all of us, yes I am 60 this year, are in our peak earning years. Even a cursory reading of the employment news would tell you that it is the 50+ folks who are being pushed out of jobs and never manage to replace their previous earnings. You can find them at Home Depot and McDonalds or your grocery store deli, or pretty much anywhere paying minimum wage as they struggle to survive after ageism has left them underemployed.
And, not all 50+ people are unhealthy. So, should they pay greatly multiplied rates just because they might become ill at some point before they do the right thing and die? Or should we solve the problem by killing everyone at 50 or 60 or whenever they are diagnosed with a catastrophic and expensive disease? Some children are born with these things. Some folks in their 20's and 30's also get very ill through no fault of their own. Should we do some sort of genetic profiling in an attempt to make sure they, too, are charged greatly multiplied premiums?
Personally, I think the solution is to end insurance companies and have national health care for all. All the money now employing all those folks who work so hard to make sure that they don't compensate for anything that actually happens to a human who pays premiums will be out of work; they can staff the national plan, or if they're over say 50, they can just commit suicide and get out of the way for the younger ones who find them unworthy of life--after all, they, too, have had a pretty long life, haven't the?
My husband is 51 and has
Submitted by Anonymous (not verified) on Wed Sep. 23, 2009 1:41 PM PDT.
My husband is 51 and has paid for health insurance through his employer for 32yrs but has only been to the Dr. 5 times in those 32yrs. I think he has paid enough. And I am sure there are hundreds of thousands just like him.
Maybe the right answer is...
Submitted by GarySeven on Tue Sep. 22, 2009 5:02 PM PDT.
...when you get to a certain age, donate all your stuff to charity, sell your place/your car, and just become a ward of the state. If you fall below 'normal' income levels, you're eligible for all sorts of freebies, right? Plus, if you're flat broke, no job, no savings, just plain nothing, they can either let you die in the street( bad for the image), or they can figure out how to take care of you medically. Of course, if enough people followed THIS plan, then the insurance companies and hospitals and so forth would go broke, and the people operating them would retire back to whatever countries they're from, and then we could open up a hospital that had up front pricing and all that, and people could resume working normal jobs etc. Seriously, though, insurance has been shown to be a somewhat dishonest business, people with no money don't pay premiums, right, so lucrative business model 'goes away' and is replaced by cash-on-the-barrelhead-care, physicians working directly with and getting paid by the public. Cut out the middleman, cut out the fancy billing, cut out the stock dividends, and make sure that healthcare dollars actually go to healthcare professionals that are helping the public stay healthy, recover from injuries, or in some cases, make it through next week. But, intermediaries pulling down 6-figure salaries, and deciding who gets the operation, and who doesn't? Forget THAT!
You may think it's foolish, but I dumped my health plan, and I haven't looked back since. Employer contributions? Well, another way to read that is that these insurance companies have worked on your boss, and maybe even on your union, and decided that they'll just help themselves to your paycheck before you ever get it in the first place, you'll never miss the money, right? And they never miss an opportunity to buy a new boat, either. Good riddance.
Klaatu marachas necktie
Much like auto insurance,
Submitted by Anonymous (not verified) on Wed Sep. 23, 2009 4:43 AM PDT.
Much like auto insurance, most of us never actually have any claims.
There is a reason it's called insurance. I pay thousands of dollars for years and years.
My parents paid thousands of dollars for years and years. Insuring there will be coverage for when I actually need it.
If insurance companies are allowed to change the rules whenever they see fit, I am not insured.
People over fifty have undoubtedly paid into an insurance pool for at least 30 years.
Unfortunately greed overcomes logic and reason.
Baucus is a fake Democrat
Submitted by Grover Syck (not verified) on Fri Sep. 25, 2009 4:53 PM PDT.
Baucus is starting to look lkie a closet Elephant. Snow is closer to the democrat than Baucus is.
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