Get Health Care Up In This Bitch

While the amazing, four-day Democratic commercial goes on, I thought this would be a good time to revisit a topic that has dropped off the grid since the spring. Remember health care? Seemed to be a big topic a few months ago, but not so much now. Now we’re clearly more concerned with who’s a bigger celebrity and how many houses Old School owns.

But 45 million Americans do not have health care and 25 million more are underinsured. McCain and Obama have very different ideas on reforming health care. I’m going to break their shit down and you’re going to read it. That’s how we do.

McCain’s plan is a piece of shit created in jackass land. It does NOTHING to address the problem of uninsured Americans. NOTHING. Did I make that point strong enough? I used capital letters. That is some serious shit.

Johnny’s plan is more of the same crap that already got us into this mess. It’s all about “market forces and individually purchased insurance.” Sweet. Up until now we haven't tried "market forces and individually purchased insurance." It's so fresh!

Old School’s plan mainly focuses on….taxes. What a big surprise.

Currently, workers do not pay taxes on health insurance premiums paid by their employers. The McCain plan would eliminate this tax exclusion and use the revenue generated — projected to be $3.6 trillion over 10 years — to pay for refundable tax credits for Americans obtaining private insurance ($2,500 for individuals, $5,000 for families). Uninsured Americans could use their credits to help buy insurance coverage on the individual market, and workers with employer-sponsored insurance could use theirs to offset the cost of paying taxes on their employers’ premium contributions or to purchase coverage on their own.

Oooooo. That sounds fucking awesome. Unless, of course, you are like the millions of Americans who can’t get insurance due to your medical history, or one of the millions of Americans who have claims denied and are dropped because they had the gall to have surgery. But don’t worry about that, because McCain will solve the problems of spiraling costs with “deregulation.”

Oh, fuck yes. Please, more deregulation. It has worked out so very well in every other market over the past ten years, especially energy and housing. Old School’s plan would allow insurers to sell across state lines and people would be able to buy policies from companies in any state. Wow, that should not make even the slightest difference.

McCain also believes by making insurance more “visible,” people will seek out lower cost insurance plans. Johnny thinks if workers can see how much their employers are paying, they would go for the cheaper insurance.

Since Americans would receive a fixed credit, the expectation is that they would seek out lower-cost, less comprehensive insurance plans, fostering competition among insurers.

Yeah, good luck with that. In the end, McCain’s plan doesn’t do shit for people who can’t afford insurance. Most uninsured people would remain uninsured and the fixed tax credit would lead to a gap in affordability as health care spending increases. And the number of Americans paying higher taxes for employer insurance would go up, too. McCain’s plan would force many people to purchase higher deductible, less comprehensive insurance. Oh, and if we got rid of the tax benefits of employer sponsored insurance, some businesses would stop insuring workers. How great does that sound?

But don’t fret, because McCain has proposed a “guaranteed access plan.”

The federal government would work with states to create insurance alternatives for those unable to afford coverage on the individual market. The plan builds on the experiences of the 34 states that operate high-risk pools for residents who are deemed to be medically uninsurable.

Oh, good. The castaways. Only, McCain’s plan has no way to pay for this part. It’s quite simply, bullshit. His interstate insurance market plan would actually weaken some states regulated protections. Oh, and those “34 states” plans already have high costs and limited benefits.

McCain basically is offering very little. It’s more of the same, which is unacceptable considering the situation we currently find ourselves in. If McCain is elected, expect our health care situation to get a lot worse.

Now, Obama at least seems to be trying, though he is also a bit deluded. Barack wants to spend money. Lots and lots of money. His plan includes an employer mandate, insurance regulation and a combination of public and private insurance.

Under Obama, employers will have to offer employees insurance or pay a tax. Smaller business would not have to pay a tax.

The Obama plan would also create two new options for obtaining health insurance: a new government health plan and a national health insurance exchange that would offer a choice of private insurance options. Both would be open to persons without access to group health insurance or other public insurance, as well as to small businesses that wanted to purchase coverage for their workers. Income-related subsidies would be provided to help lower-income persons afford coverage.

Best of all, insurers would not be able to deny coverage or charge more for preexisting conditions. His new "insurance exchange" would provide a pooling system, which would increase the purchasing power of individuals. Obama believes by pooling people together, it will cut administrative expenses and increase competition. Good luck with that.

And the attempts to cut costs don’t end there. While McCain has proposed little to nothing to drop health care costs, Obama’s plan is much more thoughtful and nuanced.

Other cost-control measures include accelerated adoption of electronic medical records, promoting disease management and better coordination of long-term care, paying providers on the basis of performance and outcomes, strengthening prevention, permitting the federal government to negotiate prescription-drug prices for Medicare patients, cutting excessive payments to private health plans contracting with Medicare, and establishing an institute for comparative-effectiveness research to generate information about effective treatments.

A big criticism of Obama’s plan is that it does not mandate insurance for adults, just children. That means it would not cover all uninsured people, but Obama has stated he may move forward with mandates if his plan does not result in universal health care.

The big problem is the money. The cost control plans are not certain to work and he needs to come up with $50 to $65 billion. He says he will pay for it by ending tax cuts to families making over $250,000 a year, but that will not cover the whole enchilada. He expects to save a lot of money with his cost cutting measures explained above. If they don’t work, it’s going to cost more. And you can pretty much guarantee there will be problems. But we’re spending $15 billion a month in Iraq, so if you are okay with paying for the war but don’t want to pay for universal health insurance, then you are a major douchebag.

Obama’s plan is way better than McCain’s, but it’s got a lot of problems. The only guy who had a decent health care plan was Kucinich. Until you take the profit out of health care, nothing’s going to work. Ever. So, don't get too excited either way, because we are a long way off from something decent.

UPDATE: One of the architects of McCain's healthcare plan uttered this gem today...

Mr. Goodman, who helped craft Sen. John McCain’s health care policy, said anyone with access to an emergency room effectively has insurance, albeit the government acts as the payer of last resort. (Hospital emergency rooms by law cannot turn away a patient in need of immediate care.)

“So I have a solution. And it will cost not one thin dime,” Mr. Goodman said. “The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American – even illegal aliens – as uninsured. Instead, the bureau should categorize people according to the likely source of payment should they need care. “So, there you have it. Voila! Problem solved.”



FearTheReaper also is a blogging idiot. Read more of his tripe on his blog, Stop All Monsters.

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