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Intershame Weblog H.R.3200 |
A Look at the Health Choices Act of 2009
07/22/2009
"Look at the Size of That Thing!"
It seems everybody has an opinion about health care reform; 100 talking heads with 100 different ideas about what this legislation will mean for the country. It was more information clutter than I could handle, so I decided it would be easier to turn off the news and read just the bill for myself. So I did (OK, not all of it, but a lot of it). Here's a look at H.R.3200 - America's Affordable Health Choices Act of 2009...A new independent agency in the executive branch will be created called the Health Choices Administration. This Administration will be run by a Health Choices Commissioner. The Health Choices Commissioner will be bound by the same rules as the current Commissioner of Social Security, Michael J. Astrue.
The Health Choices Administration will have an extremely wide range of responsibilities. The Administration will establish Qualified Health Benefits Plan standards, operate the Health Insurance Exchange and administrate individual affordability credits. Oh, they'll do other things too.
The establishment of Qualified Health Benefits Plan Standards responsibility of the Health Choices Administration is an important section. This section outlines the regulations government will be recommending private plans adhere to if they wish to become a Qualified Health Benefit Plan (more on that in a bit). The government standards will be that a private plan mustnot impose any pre-existing condition exclusion, guarantee availability and renewability of the health insurance coverage the plan provides, comply with rate standards (likely so insurance companies can't jack the rates up on people with pre-existing conditions they are now required to cover), not discriminate against people with mental health or substance abuse problems, ensure decent access to health services and meet medical loss ratio standards.
Medical Loss Ratio "measures the fraction of total premium revenue that health plans devote to clinical services, as distinct from administration and profit". In short, it's how much profit a plan generates. Sounds to me like the government is saying to insurance companies that their days of lining their own pockets are coming to an end.
If a private plan meets the requirements of the Health Choices Administration, they are eligible for inclusion into the Health Insurance Exchange. The Health Insurance Exchange will be a marketplace for insurance plans that will contain all the Qualified Health Benefit Plans and the public option. Any person that doesn't have coverage or any employer that doesn't offer coverage is eligible to purchase insurance through the Health Insurance Exchange.
To further summarize what this bill will do...
The private health insurance industry will become a voluntarily regulated industry. If insurance providers want their plans to be part of the Health Insurance Exchange, they will comply to the regulations. If not, they are free to attempt to compete in the free market against the Health Insurance Exchange. The existence of the public option assures the cost of the plans in the Health Insurance Exchange will be low. This will drive the private sector to either a) self-regulate in order to compete with the Health Insurance Exchange or b) except government regulation and join the Health Insurance Exchange.
The part people are going to have the biggest problem with is the limiting of private profits through medical loss ratio standards. The ill-informed will cry "socialism", but they'll be wrong in doing so. Complaining that a inherently socialist concept like insurance - the collection of funds by many to redistribute to the needy - will somehow be more socialist if the government gets involved is laughable. Sending your premium check to the government or a private company doesn't change the nature of how insurance works - its still socialist in nature. The "public plan" is nothing more than a option from an entity not out for profit; the entity just happens to be the government. If a private plan existed in the free market from a company who took razor thin profits, that plan would be inexpensive and people would flock to it.
I realize this is a very high level overview, so forgive me for being broad. Have you seen the bill though? The thing is huge. There's little chance any one person can digest it and have a complete grasp of all its implications. I guess it's up to the millions of eyes on the Internet.
So dig in.
Comments
- 406 days ago"Sending your premium check to the government or a private company doesn't change the nature of how insurance works - its still socialist in nature. The "public plan" is nothing more than a option from an entity not out for profit; the entity just happens to be the government." So according to your explanation, we should then have grocery stores that everyone can shop at, but wouldn't have to pay anything. Or we should have all our housing paid for, because we all deserve to have houses provided for us. Or why not everyone deserves a car, the government should provide that for us too. And by government, I mean everyone paying ridiculous taxes to provide these amenities. How the hell is health insurance any different than the situations I provided? And how the hell can you see it as not socialist?
- 406 days ago"So according to your explanation, we should then have grocery stores that everyone can shop at, but wouldn't have to pay anything" <BR> No, that is not the point at all. The point is ANY form of insurance is a tiny (or large) pool of socialism. A bunch of people get together and give their money into an entity which then provides care as needed. In the private insurance case, the entity in question is a for-profit company. In the public run health care system the entity is the government. Which situation happens to most closely match YOUR reality is irrelevant. Insurance is still fundamentally a socialist concept.
- 406 days agopapageorgio326 : Thanks for your comment and thanks for the opportunity to clarify. I'm arguing that the system already has the fingerprints of socialism all over it (see the link I provide above) and those who think the government's proposed approach to reform will make the system more socialist don't really understand how the proposed reform works. If the public plan being proposed by the government were mandated and free of charge, I'd appreciate the socialist argument more, but it's not. The public plan will cost a citizen more than just the taxes they contribute - if you want the public plan, you're going to pay a premium just like any private plan right now. Really, by creating a plan of their own the government is using their enormous size to apply the capitalist concept of undercutting prices. It's almost as if the government is stealing Wal-Mart's business play book. I understand there are great differences with how people see this proposed reform and I really do appreciate your input to the debate. I'm sure I'm going to write many other things that people think are insane and if I need to be called out for them, great. Open debate is always better than silence.
- 406 days agoOn grocery stores: What if you paid a flat rate per month to your local grocery co-op and in exchange received regular disbursements of necessary food? I'm sure the ins and out of getting that balanced would take a lot of work and thought, but if such a thing were possible it would feel like a form of socialism. If such a service were widespread enough, your employer might even offer such a benefit as part of your employment package, to increase the value of your job with their company. Just thinking! I just moved to MA last fall, and was at first horrified by learning that health insurance was now mandatory, but the state offered many affordable options for me while I was a contractor. Later on, my girlfriend lost her job, but instead of losing her health insurance, she actually received Better coverage from the Commonwealth Care plan offered to those without work than her employer, Tufts Health Insurance, were able to offer.
- 406 days ago"Complaining that a inherently socialist concept like insurance - the collection of funds by many to redistribute to the needy - will somehow be more socialist if the government gets involved is laughable." This quote is laughable. People associate with private insurance companies on a voluntary basis. Insurance companies do not collect money from everyone in society, regardless of their desire for or choice to utilize the insurance, and steal from or jail those who refuse to pay. But this is how government operates with any public service it offers. To conflate violent coercion with voluntarism is to conflate rape with lovemaking.
- 406 days agovolentaryist: The proposal for reform the government is proposing does not include a health insurance plan that is mandatory or free, the two requirementns you seem to argue against. If a citizen wants to buy into the public plan, that citizen will have to pay a premium just as they would if they choose a private plan therefore the point you make doesn't really apply to this situation. As for my quote, I was speaking of the idea of insurance, not the current insurance industry. I urge you to read the article I linked to in the quote. I also urge you to read the bill itself. My examination of the bill's contents led me to the conclusion that it's far less socialist than I assumed it would be. I appreciate the comment.
- 399 days agoThis is exactly what I needed to help me sort out what is actually part of the bill and what is not! I am so sick of what the media has become, more opinion than fact! Nice job!
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