Professor Roscoe of UMass Dartmouth sent me a very concise sheet detailing exactly what is in the health care reform bill. I thought I would share it with all of you as well. Here is the list of provisions
Health Care Proposal, March 2010
• Insurers cannot deny coverage or set rates based on:
o pre‐existing conditions
o health status
o gender
o family history or genetic information
• Insurers cannot rescind coverage (drop someone from the plan)
• Cap on annual out‐of‐pocket expenses (co‐pays, deductibles)
• Prohibits co‐pays or deductibles for preventive care
• Prohibits caps on lifetime payouts from insurance
• Extends dependent coverage to age 26
• Expands Medicaid eligibility
• Provides tax credits to poorer people for insurance premiums; credits are based on sliding scale
• Sets up state‐based Insurance Exchanges
o small businesses and individuals who don’t get insurance through an employer or who
don’t qualify for Medicaid/Medicare can shop on the exchange
o would be web‐based with standardized information for each provider
• Changes Medicare billing to focus on quality of outcomes rather than fee‐for‐service
• Tax on high‐cost insurance plans
• Annual fees assessed on health industry (pharmaceutical, medical device, insurance)
• Fines on large companies that don’t offer a health care plan (or offer inadequate plans)
• Fines on individuals who do not have any type of health insurance but can afford to purchase it
Looking over the list, what is it that most people would oppose? Especially if you live in Massachusetts which has already adopted most of the provisions.
Senator Brown must know this bill is very much like the system ...
... we have here in the Commonwealth which his campaign website says he supports;
In Massachusetts, I support the 2006 healthcare law that was successful in expanding coverage, but I also recognize that the state must now turn its attention to controlling costs.
Governor Patrick's administration is already proposed a bill to control costs which I posted about here.
Why won't Senator Brown support a bill that does what he said he supported in Massachusetts.
Call or Fax and ask him. His office phone number is 202-224-4543. If you call outside of office hours, you can leave a message. You can fax his office at 202-228-2646.
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29 comments:
The last person I would trust to send out bulletin points for legislation would be Mr. Roscoe. Unless I read the entire bill myself, which I don't have time to do, I'll take a wait and see attitude. MA state health care reforms caused me to have to change to a more expensive plan AND I had to get another doctor. Thank you politicians. Great job---NOT.
Bill,
Of the items you have listed, who could object. The problem is that you have shown only half the list. The other half contains the taxes to pay for it all.
I watched Pelosi explain to the press how unearned income will be taxed 3.2% to help pay for the program. Unearned income is the rent you pay your landlord .... rent he / she will raise to compensate.
Unearned income is the interest you receive on your savings and the dividends you receive from investments.
Fines for companies : When are people going to realize that corporations do not pay taxes ... you pay taxes. ALL costs are passed down to 'we the people' .
If this health care bill is such a good cost saving program why is it that no one can tell me what it is going to cost ME, the individual taxpayer ? I keep hearing how it will be 'cheaper' ... cheaper than what ? Give me a number so I can judge the cost claims.
It is easy to claim it is revenue neutral when you have the power to impose indirect taxes on people in addition to the cost of the insurance itself.
Bottom Line :
Tell me what it is going to cost ME .........
Greg Lynam
The current health insurance system is bankrupting the nation, states, and citizens. It makes our companies less competitive in the world economy. We can either act to reform it or we can slowly sink under the crushing cost of the system that wildly outstrips inflation in costs and provides health care only to those who can afford it. The numbers of those persons is rapidly shrinking. 1 in 4 Californians has no health insurance Same with Texans. But if they are not dying on the streets, then who is paying for their care. Everybody! I have posted here about what other countries spend for health care versus our own spending. We spend twice as much per capita and get poorer results. Almost every other industrialized nation has found a way to provide universal coverage at a lower cost than in our country. So can we and this reform bill is the first step.
Mr. Lynam, you said corporations DO NOT pay taxes ,we pay taxes....then why do CONSERVATIVES like you ALWAYS advovate for tax breaks or tax subsidies for large corporations.(IE evergreen solar) 65 million dollars of your MONEY.
on the FLIP side...any taxes levied to pay for healthcare will be far less than the EMERGENCY ROOM premium you pay for the uninsured to be seen in the hospital. PLUS the cost savings induced by lower overall premiums.
Greg, the aggressively nonpartisan Congressional Budget Office has projected the bill will actually reduce the deficit over the next ten years. So, that means we could either offer a tax CUT or increase services in other areas without a tax increase. Yes, there are taxes in this bill, but they are designed to change behavior in a way that will make the provision of health care more efficient.
Doug,
The nonpartisan Congressional Budget Office only opines on what it is given to opine on. The '10 year' figure is not arbitrary ... it is based on the limits set within the "Byrd Rule".
Senator Byrd's rule limits a bill passed under reconciliation such that it can not increase the nation's deficit for more than 10 years after passage. That is why many such bills have sunset provisions of 10 years, such is the case with G.W. Bush's tax cuts that are now being re-considered.
The Health care bill phases in slowly through 2018 for this very reason ... it collects the tax monies in the early years while delaying more serious cost increases until the later years so as to create a paper 'profit' long enough to satisfy the " Byrd Rule " .
To Anon 10:17
A bill, is a bill, is bill .. and it has to be paid. The cost of emergency room care does not go down because it is being paid out of your other pocket. As we pay for it now, those monies come from your taxes paid ... in this bill it will come from your retirement savings in the form of reduced performance of the stocks / dividends you depend on for retirement. It will come from increased costs for the products you buy so the company can pay the tax .. and it will come from increased local and state taxes to pay for those same goods and for salary increases demanded so employees can pay for those goods .. and taxes.
There is no free ride, everything is interconnected and it all leads directly, or indirectly, to your wallet.
Greg Lynam
Right now we pay twice as much per capita as other countries for health care. And we don't even cover everyone, there are millions of under insured and uninsured citizens. That money is coming, as Greg says, from our pockets, yours and mine. Other nations have devised programs which cover everyone, cost less, and get better outcomes. That is what health care reform is all about. My preference would be to have a single payer system, like Medicare, which would cover everyone and control costs.
You are already suffering losses in your retirement account because our country does not have a universal health care program and control costs.
Companies offer health care coverage to their employees as a benefit and the rising costs are affecting their ability to compete in world markets against companies that do not have that burden because health care is provided by a government program. An auto worker in Windsor, Ontario, Canada has no health care cost to his company. Across the river in Detroit, an auto worker has a health benefit that costs thousands per year to his employer. One of the reasons that GM is in such poor shape is the billions that they are paying for retiree health benefits.
As Greg said, a bill, is a bill, is a bill. We are paying very high bills and not getting everyone covered or getting better health outcomes. If it is all connected to your wallet, then you are paying too much and getting too little for your money. The idea is to reform the system to get lower costs, better health outcomes, AND cover everyone.
Bill,
That company in Ontario pays 14% in basic corporate income tax:
[ http://www.cra-arc.gc.ca/tx/bsnss/tpcs/crprtns/rts-eng.html ]
By contrast that U.S. company in Detroit pays 39.3%; second highest in the world.
[ http://www.taxfoundation.org/publications/show/22917.html ]
When compared to other OECD countries:
24 U.S. states have a combined corporate tax rate higher than top-ranked Japan.
32 states have a combined corporate tax rate higher than third-ranked Germany.
46 states have a combined corporate tax rate higher than fourth-ranked Canada.
All 50 states have a combined corporate tax rate higher than fifth-ranked France.
This is why our jobs go overseas.
We can't just go around the world picking out isolated goodies like at a breakfast buffet. We have to look at the whole picture in each and every case.
Bills, are bills, are bills and they have to be paid by one means or another ; there is no getting around that.
It is non sequitur to say one can add x $millions of people to the health care rolls with no additional cost.
That's like the old joke; " I sell $Dollar bills for 99 cents - but I make up for the loss in volume." :)
Life just doesn't work that way ....
Greg Lynam
Indeed we must compare apples to apples. The countries you listed also have a value added tax (VAT) which has largely supplanted their income tax. Tax rate comparisons are problematic because tax laws are complex and the nomenclature varies from country to country. Ofr example, the VAT is also called the goods and services tax, the consumption tax, and others names.
If you feel the corporate income tax is too high and should be lowered, do you also feel that the personal income tax is too low and should be raised. By your argument, we pay the corporate tax anyway. The government has to have revenue otherwise how can we buy freedom bombs to drop on Third World countries.
Greg,
Ever here of an EFFECTIVE TAX RATE?
That is the percentage corporations actually PAY. It is NOT 39% as you have stated.
If a company is paying 39%...AFTER Deductions that equals EASILY to 22% or lower.
Second....Businesses LEAVE this country because WAGES here cut into there PROFITS
IRELAND has a corporate tax rate of 11%...(according to John McCain'08)
I dont see many toys being made there...maybe im shopping at the wrong stores
New York Times today has a nice summary of the bill, including a description of how the House's proposed reconciliation package alters the original Senate bill:
http://www.nytimes.com/interactive/2010/03/19/us/politics/20100319-health-care-reconciliation.html#tab=16
There goes Doug again, telling us how paying more taxes will save us money. If it weren't for his twisted logic when it comes to presenting things to the public, I would actually vote for him for school board. His 10:51 post is just another reason that I can't bring myself to do it.
To Anon 3:09
It is not taxes that drive companies away ... it is not wages ... it is not regulation or mandates .. it is the aggregate of all these together that makes the business climate toxic.
Its nice to look around and see someone with higher taxes and say " Lets raise ours to match " ... then see someone who pays higher wages and say " Lets raise our to match " but you reach a point where your employer has no profit. If he is not making a profit he doesn't need you.
You only have to look around you to see that these policies have already had this effect. If we want to entice manufacturing back home, how does poisoning the business atmosphere further that goal ?
I looked at the link Doug gave, Referencing Taxes :
1 -Drug makers would pay $2.5 billion in 2011:
$3 billion from 2012 to 2016:
$3.5 billion in 2017:
$4.2 billion in 2018:
$2.8 billion in 2019 and thereafter
2 - Medical device manufacturers would pay 2.9 percent excise tax on devices sold (excluding eyeglasses, contact lenses, and hearing aids.
3 - MEDICARE PAYROLL TAX: Would impose an additional 3.8 percent tax on capital gains, dividends, interest and other “unearned income.”
Sounds great until you come to realize that the cost of all your medications will rise in step and then a little more due to the added costs involved.
Sounds good until you understand that your diabetes metering devices will cost more in order to pay for the tax. So will oxygen devices and all the assistive devices people rely on.
Sound good to me until I realize that rich people are not the only ones who have capital gains, earn interest or collect dividends. Most of us have all those things when we sell a home or investment property, own stocks for our retirement or collect dividends to live off of in later years.
Nothing is for nothing, everything has a cost ... but you can't even tell me what the cost is; can you ?
Then there is the real cost :
The whole point is not to get people insurance, the point is to get quality health care. Already in MA doctors are refusing, or delaying, patients because Medicare / Medicaid pays to little to run a practice on. It is tolerable when there is a mix of patients that pay varying amounts, some with govt insurance and some with higher paying private insurance but if too many are only paying the government's rate there will be less or no care. Doctors are just like you and me, they work for a living and if they can't make a living they do something else.
I want to know what the true cost of this program will be to ME. Does anybody know ??
... anybody ?
Greg Lynam
PS
Ireland is : In terms of GDP per capita, Ireland is ranked as one of the wealthiest countries in the OECD
A study by The Economist found Ireland to have the best quality of life in the world
... high economic growth led many to call the country the Celtic Tiger.[7] One of the keys to this economic growth was a lower than average level of corporation tax, currently at 12.5% standard rate and 10% for certain manufacturing companies.
Pass health care reform NOW! We can make changes later. How many years have we been talking about this! The millions of uninsured don't have a voice. They don't go to town hall meetings, they don't have a car, they are living on the edge, health care to them is extra when food and rent are due, but when they get into an accident and go to the ER, we pay!
Let's fix this system NOW!
Mr. Lynam,
A person gets into business because there is a DEMAND for his supply.
Supply side economics DOES nothing.
since 1979-2010 the top tax bracket has been cut in half. 71% to 35%...all on a promise that prosperity trickles down.
NOW we are told high wages is a job killer and will lead to lay-offs. Those tax breaks were supposed to be reinvested in wages and business expansion,NOT enhancing a profit margin.
The stock market BOOm of the 80s was not due to higher DEMAND, but to lower taxation of the corporations.
Higher DEMAND is real economic growth. If disposable income remains the same as a generation ago, how do you expect economic growth.
Disposable income needs to increase in order for ANY business to grow,no matter how LOW your taxes are. I will not expand my business or hire more people if DEMAND for my service or product does not increase.
To Anon 2:28
You said : I will not expand my business or hire more people if DEMAND for my service or product does not increase.
Yes, you are exactly right ......
You also said : A person gets into business because there is a DEMAND for his supply ...
No .. you got into business because you thought you could make a greater return on your money and efforts [ profit ] than by doing something else with both.
Like the old marketing 101 example; If I employ 5 people making 100 hamburgers a hour at 20 cents each and selling them at 60 cents ; how much more profit can I make by raising the price to $1.20, thereby reducing demand and halving my labor costs ? Demand influences price in relation to your costs.
Taxes do raise money but their chief effect is to influence behavior. If I want to reduce energy consumption and increase the use of renewable energy generation and create jobs in the process I will raise taxes on your electric bill [ Renewal Energy tax ] and lower the effective taxes on Wind Generators by offering tax credits [ Net Metering ]to encourage their construction. This will cause a new industry to be born and more jobs to be created.
The flip side is that Power suppliers are in business to sell the electricity they generate. If they sell less [ demand falls ] the price rises, just like the hamburgers above.
If the return on your time and investment falls to a level below what you can get by doing something else .. then you do that something else. This goes for you and me, doctors and auto-makers and everyone and everything else.
You can take your money and buy a corporate bond, say Comcast Ser B [ CCW ] and get a 7% return. You would have to feel certain that your money and efforts would return substantially more than that before you would invest in flipping hamburgers and hire those workers above. The tax codes can incentivise or disincentivise you to do one or the other ..... or neither.
So the question becomes ; : What behaviors are we trying to encourage, or discourage by raising taxation on a specific industry ? ... or specific people ?
Greg Lynam
To Lynam:
I also said : A person gets into business because there is a DEMAND for his supply ...
you said : No .. you got into business because you thought you could make a greater return on your money and efforts [ profit ] than by doing something else with both.
I disagree and here is why,
I got into business because there is a demand for my product.
Very simple, a VCR manufacturer is either out of business today or had to convert his business to the market demand of DVD players.
Demand for a new technology forced his company to change.
Also another example is the HUMMER. Due to higher demand for fuel efficient vehicles the HUMMER is all but out of the marketplace.
Greg,
The taxes imposed within this bill is far less than the premiums you pay out due to higher emergency room visits by the uninsured. So yes your tax bill will be higher, but the imposed "tax" within your insurance bill should be less.
With premium moving in an upward direction at a clip of 30-40%(wellpoint california) while your taxes for this bill will be in the ball park of 3-4% the tax will be far less than the insurance inflation CPI-(M)
We know, as history tells us. Your republican party will do NOTHING to mitigate the current situation. Start over has been the mantra for 100 years.
Your republican party idea of health care reform was MEDICARE(D)
which was not funded, had a gaping loophole that has cost our seniors MILLIONS and gave no bid contracts to pharmaceutical giants.
Start over? In your terms means put it off until the republican party gains control and never STEPS up to address the situation. History is our best teacher.
As Ms. Palin would say, thanks but no thanks.
I am an independant and when health care was reformed in MA, I got hosed. I will give odds at three to one on any bets that when the national health care reform is signed, I will not be better off than I was before. In fact, I will also take bets that I will be worse off but you'll have to give me odds on that one. Any takers?
To Anon 11:41
You said : I got into business because there is a demand for my product.
Unless you are independently wealthy and operate a charity that just isn’t so. If you got into business it is because you felt you could make more money at it than working somewhere else.
Demand is a subjective thing. There is a ‘market’ for just about anything and if the cost structure is low enough you can make a living. ‘Demand’ for a product is what drives your cost of manufacturing down and your profit up hopefully, but not always, while reducing the final sale price. You can see this at work in the flat panel display industry right now.
In your first example, the VCR was a classic example of improving the return on investment. There was no demand for DVD players that didn’t yet exist; they evolved because VCR’s were difficult and expensive to manufacture and offered poor video quality. A greater profit could be realized by switching to this ‘new’ technology. It had the added advantage of improving the ease of manufacture and profit for the content providers as well. The ‘demand’ was created to improve ROI.
The Hummer still is in ‘demand’ ... just that the volume is not sufficient to support the return on investment GM needs to meet. That volume was reduced by the high cost of fuel, whether caused by market forces or taxes doesn’t matter . In other words it can make more profit ‘doing something else’.
Anything that reduces the return from monies invested to below what could be garnered by investing elsewhere causes the money to flow in the direction of greatest returns. It doesn’t matter if that is caused by excessive wage costs, healthcare costs, taxation or market forces. No matter what law you pass or tax you impose money will flow to maximize profit. The problem today is that money, and the jobs that go with it, can flow anywhere on the globe; it is not restricted to the US anymore.
Bottom Line : The only reason for operating a business [ and by definition placing capital at risk ] is to make a profit .. anything that reduces that profit causes the money to flow elsewhere, and any jobs along with it.
Greg Lynam
To Greg,
The money and flow to profitability you speak of is accurate for corporations but not always for small business. Believe it or not, there are some of us out here who create business plans with a primary goal and objective of attaining a certain quality of life.
Many people trade extra profitability to spend more time with their family or eliminate a commute. Some simply want to carry on tradition and will do so as long as they make enough to live on. Fishermen and family farmers come to mind. Small businesses are still what makes this country great.
I believe your tax arguments hold true for these types of businesses as well as large corporations though.
Thank You Dems for a real reform bill of a broken system.
Bob Corker for president in 2012.
To Anon 9:57
You said : many people trade extra profitability to spend more time with their family or eliminate a commute
I am one of those 'people' you speak of for I did just that and still do.
The implications of taxation and mandates are very important to small business because, by definition, small business operates in markets where there is little 'demand' to provide the 'pricing power' needed to absorb additional costs without lay offs or closings.
I know I used a manufacturer as an example, but yes ... it holds especially true for small retail business as well.
Your point is only realized by someone who is, or has been, self-employed so it is no mystery that most others argue for more and more benefits.
I fear that after its too late they will come to understand that when you own a cow you can drink milk every day, but the first day you enjoy steak is the last day you eat at all :)
Greg Lynam
Greg said:If you got into business it is because you felt you could make more money at it than working somewhere else
Greg, I got into business because I can make money. I can make money because there is a demand for my product and/or service.
There isn't a market for VCRs, because there isn't a demand for it.
The more disposable income consumers have,the more demand there is in the marketplace.
This will cause businesses to hire more staff and expand manufacturing to keep pace with the demand.
Supply is not the problem in this country, it is demand. Consumer demand is the driving force of this economy and if consumers are purchasing only basic items, the economy will remain stagnant.
The mobility of the 1980s stockmarket was primarily due to an increase in profit...but the profit did not come from demand, it came from tax reduction.
Real economic growth is an increase in consumer confidence and demand.
Here is the real world: I am a small business person that owns a business in MA - no mean feat these days - and that business has been sucessfull. I pay for health insurance for my measly 2 employees - have been doing so for 18 years. It is expensive but my people and I are happy. Mass Health gets passed. We are promised more coverage for more people. This we are told will somehow drive down costs. How is that I wondered back then? More coverage, better coverage, more people and cost less? People won't have to use the emergency room when they get simple illnesses if they have insurance.....yadayadayada
Sound familiar?
Well, my rates have just gone up 16% thank you very much. All this talk means absolutely nothing when all it means is that it will cost me still more money for absolutely nothing gained. Guess what? I am now looking for a less expensive (read - worse) plan so that I can continue to do business and make some sort of profit. Although at the rate this country is going I would probably be better off getting out and joing the hoards for a handout of my own.
Pathetic.
Great...another medicaid!
Your premiums went up 16%? what would the increase have been if reform had not occured? 20%, 30%?
Im not arguing but that piece of the puzzle is unknown.
I'm sorry 10:47 - MassHealth was sold on the idea it would reduce health care costs. It has done no such thing for me, rather just the opposite.
The current Obamacare plan has been sold on the same premise and will provide the same, if not worse results.
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