Discussion:Obama v. McCain Health Plan vs. 1womanshop

As I see it, Obama will let you keep your current plan, give a 50% credit for (small?) business to buy insurance, and let those with pre-existing conditions join the govt. health plan (and pay the premium). I think I understood that buying coverage is required (I guess that's the reason for the tax credit carrot).

McCain's plan will give $5,000 what? Prebate? Credit? To buy health insurance each year. Anyway, 5k for an American to buy any plan, but employer contributions for health insurance will be taxable going forward.

My question is: what is McCain's plan for a pre-exisisting conidtion? This is what forces a small operator like me to try to get on (at my age) with some big outfit to get in a group plan. I note that most of the lawyers I run into now in small firms or sole props. have a spouse that is employed by a large company, and this is the way they can keep insurance as they get older.

Any comments? Did I understand this correctly?

I was listening to Joe Biden talking this morning about the particulars of both plans. Even though I'm not particularly fond of Biden, he was providing details I'd not heard before. Interestingly, he made this observation about McCain's plan: He said that by taxing employer provided health benefits, employers would be more likely to stop providing health benefits and many more people would be without coverage. I have to assume that he meant the employers would get hit with paying their half of SS and Medicare tax on the taxable benefits, which Biden says average $12,000 per year for a family. He goes on to say that families who lose their employer provided health coverage will then have a $5,000 McCain credit to replace their $12,000 policy. Where will the other $7,000 come from. Anybody else have a different take on this? Is this sound logic? Based on a 12,000 average annual premium being taken into taxable income, that would generate what, about $900 in additional SS and MC tax for an employer to pay? I guess that adds up if you multiply it times 50 employees, or 1000 employees.

And the $5,000 applies to families. For single individuals, the credit is $2,500. I'm still living in sin, so I'm only in line to get $2,500, which isn't enough to cover my entire premium (but it would be a HUGE improvement).

McCain does apparently have a plan for those who cannot get insurance or who have a pre-existing condition. You can read the generalities here: http://www.johnmccain.com/Informing/Issues/19ba2f1c-c03f-4ac2-8cd5-5cf2edb527cf.htm

Based on the last few debates, the current state of our economy, and what we are hearing from the candidates, I can only exhort: God help us all.

How many times have I been to the doctor, only for him to barely look at me, and refill the same prescription? We should be able to choose cheaper practitioners if we so desire.

No politician wants to be that creative.

I was thinking the same thing--that $12,000 sounds a bit on the high side for an average, but I don't suppose I'd be too surprised if it were that high. The premiums for my high-deductible plan went up 25% this year. I can only imagine what the premiums would be if I had the same plan that covered me in the firm. Probably close to $6,000, just for me, and I'm very healthy.

In my understanding, the $5,000 McCain credit isn't intended to pay for a government plan. It is to be paid directly to the private insurance company of your choice. McCain doesn't want the government involved in our health care plans (any more than it already is). So, like you observe, it wouldn't go very far for most of us. But it's more of a break than I'm getting now.

Looking at the bigger picture, I think that no matter which candidate ends up in the White House, the health plan, tax law, economic measures, and energy strategy that emerges from Congress will in the end be an extremely compromised, watered down, and mucked up version of what the President submits.

Obama does not have a government plan. From what he said at the debate, if you cannot get accepted by a private plan (pre-exisiting condition), you could buy into the government health plan. It's not free. A key point to remember is that neither candidate is advocating a Single Payor government system.

I don't know what to think of the 12K amount either, but it's probably not totally out of line, over the total range of workers and age demographics. Those premiums begin to skyrocket after 45 (though I'm not sure how age is used as a factor in the large group plans, with huge numbers of insureds, the overall risk to the insurer goes down).

Yikes :-)

I'm curious how plans are priced on the Mainland. Do the premiums keep going up with the family size?

Before the leasing program I had an individual group plan, however, about 5 to 7 years ago the premiums in that plan were about $1,200 per month for just me.

Don't have community group plans, in Florida that I know about.

Part of the problem is that insurance costs are so high... Part of the reason for that is that insurance companies are all about profit margin, as any good company should be. But it's not their fault, they are being charged a ton by hospitals/doctors. hospitals and doctors are charging more to those who can pay because 1/2 of patients PAY NOTHING. Additionally, lawsuits are flying at us from every direction, most are frivolous, but it's easier to settle and take a small hit than risk a big hit (no caps, un(der) educated juries awarding ridiculous and inappropriate awards.) malpractice premiums are huge. I pay $100k a year in malpractice premiums because joe-six-pack has lung cancer that i can't treat in the ER and two weeks later is very sick because he couldn't get in to see a specialist because he doesn't have insurance. Sue the doctor! get rich! It works...

I see about 50% of my patients FOR FREE. That is, they don't pay. You can only imagine how frustrating that is, although I love medicine and helping people, I have $200k in student loans to pay off. My salary is going down the toilet in a brown slurry of taxes, malpractice insurance, my health insurance, huge student loans etc, etc.

The problem is the health care costs are so high. There are many reasons for this: Doctor's medical malpractice insurance is through the roof, drug companies have patents and monopolies on useful drugs and charge out the wazoo, 1/2 the people don't/can't pay, so the rest of us end up subsidizing them.

Crowding in emergency rooms is a huge problem. People are dying in waiting rooms; wait times in some of the worst emergency rooms are over 12 hours. Adding more non-insured/under-insured to the pool will place further strain on this system, and it will crash.

Obama's plan attempts to correct some of the underlying issues such as frivolous malpractice suits, IT infrastructure (eg. Google health records, etc.), Focus on preventative medicine/medical errors, and as Crow suggested (hey Crow, long time...) increased use of mid-level providers and telemedicine (eg. www.teladoc.com) for non-emergent/urgent problems. He wants to decrease premiums and eliminate exorbitant costs of pre-conditions by pooling Americans into a huge collective that insurance companies can compete for. According to his plan you can also keep your current employer based health insurance with no changes. It's a very well conceived plan from a public health standpoint, actually. McCain's plan on healthcare, by comparison, is a block of swiss cheese.

Can Obama make it work? Who knows... Hope, Change, blah blah blah.

This is only one issue, but it's a big one. I don't like his redistribution of wealth... My salary is getting pummled by the month as it is! CA just cut my salary by about 10% for medi-cal patients. It's getting harder for us in the medical field to not be cynical, especially at the front lines (ER, primary care.) That's why more physicians are going into lucrative specialties like radiology and anesthesiology were they can make double or triple my salary with barely any patient contact. I can't even afford a house where I live! (okay, I refuse to accrue more debt, I'm a saver, I could get a loan... or could I?) ...Anyway, you get the point.

The problems we are currently facing are fascinating and troubling. It will be exciting to see the direction the future takes.

I hope everyone is happy and healthy in these interesting times.

The best thing about Obama's health plan is that it would allow "uninsurable" patients to buy into the government health plan. This alone makes this very friendly to small business, even small medical practices (if there are any left!). Many people hit 50 today, and live on a hope and a prayer that they can make it to 65 and Medicare. Hence, you get your unmanaged hypertension and diabetes, kidney failure, and all the rest of it. Most unnecessary if they had regular care.

There has already been a massive redistribution of wealth due to policies that were put in place in America starting in the 1980's. It's been upward, and into the hands of a small group of people. This was sold under the theory that this wealth would trickle down (cough).

The per capita standard of living among working adults since the '70s has declined. However, they don't use this measure. They use household income. The slight of hand is that a majority of households had one wage earner up to the 70s, and now it's almost universally two wage earners. So, it takes two wage earners to achieve the same standard of living that one used to earn. If the policies of favoring the rich are not working, democracies should get rid of those policies.

Obama's plan, as I understand it, will raise taxes on those making more than $250,000.00 per year, and lower taxes for the middle class. I feel so sorry for these people making over 250, because I just can't imagine how they are making it at present. lol.

We need to get the American people to realize that their health is no better than the health of the uninsured guy fixing their sandwich at a restaurant. By the way, Climb, as you may know, a certain Party is bent on destroying Medicare. Though I don't think they've put much thought as to what they'll do to pay for care when they do. Maybe they don't plan on getting old.

How many illegal aliens are using the system? (Hey we can go broke trying to help the whole world.)

Now why is that?

You see, those of us can pay are paying for those of us who can't.

I laugh at all the candidates' statements, because, of the amount of bias in the collection of medical information and bias in the dissemination of that information.

If you want universal health care then: 1. do away with health insurance; 2. conscript the medical profession; 3. everybody get in line.

Also, Dale, you can end up in a position where no amount of money will buy you health insurance. No one will sell it to you at any cost.

I personally think it is extremely shortsigted to say: well, I'm ok today, and I can afford it today, and I am insurable today, therefore all is well. For today...

It's even more shortsigted to think that 45 million people can run around without health insurance and that there will be no effect on the other more fortunate ones who have it. We have been spoiled by the efficacy of antibiotics and other medications. Just wait until a strain of untreatable TB gets started (very possible if not probable), or one of your family members comes down with hepatitis from a sick uninusred restaurant worker (it's already happened and is happening). There is no "protective coating", gated community, or body prophylactic that will make you immune to the fact that so many people are uninsured.

Maybe I am not understanding something correctly, but leaving people (including myself lol) to use this in a responsible way is going to cause another mortgage mess type of situation.

No money, no problem, it's free, already.

I am sure you don't want the links to such things.

By the way your 45 million is off by say 2 to 3 billion people. Worldwide you know....must not forget everyone, if we are going to do this.

The single payor system could save money, but it must be true single payor: i.e. it must also be administered by the single payor. Even a lot of corporations and businesses are beginning to see this cost savings possibility.

By the way, as I'm sure you know, it's not free if all else fails. That's another myth. All the ER has to do is stabilize you, and get you out the door with the semblance of a pulse. They are not going to do elective surgery, even if such surgery will eventualy save your life. Also, the ER is not designed to treat a chronic illness. Most people die as an end result of a chronic illness of some kind. Most of it treatable with regular basic care. The cost to stabilize is not free either, it's distributed elsewhere.... or they close the ER.

http://www.youtube.com/watch?v=bLJxmJZXgNI

Dale, for 10 years I did medical collections for 14 hospitals. I also helped qualify patients for benefits for hospitals on a contract basis. The real truth is that most hospitals have no earthly idea how they arrive at their bills. By the way, I got out of collections because the 14 hosptials got reduced to 2 major corps., and they started selling their debt. In other words, you had to buy the debt in order to have the privilege to collect it, or give then what was called a guranteed collect.

There should be a law that says the charge for any service/supply in a hospital must be posted, just like Wendy's or Burger King. One thing to keep in mind though, the hospital does have to spread it's labor cost over the items it "sells". In other words, an aspirin might not be $5 if they could show labor separately like the mechanic does.