Wednesday, September 16, 2009

Compromise is not always a good thing

The much anticipated Senate “Gang of Six” bill was put forth today by Montana Senator Max Baucus. Follow the Link to the PDF . I took most of the day to read it and I must say I am not happy. This is not the plan we were promised during the election. If this is what passes for reform than we are pretty much boned.
There is no public option in the bill, there is a provision for cooperatives but no public option. We were promised in writing.
“Specifically, the Obama plan will: (1) establish a new public
insurance program, available to Americans who neither qualify for Medicaid or SCHIP
nor have access to insurance through their employers, as well as to small businesses that
want to offer insurance to their employees; “ from the Obama plan PDF page2
There is a tax placed on the reciprocation of drugs.
The Chairman‘s Mark would increase the rebate for non-innovator, multiple source drugs to 13 percent of AMP. Page 53
The Chairman‘s Mark would impose a fee on any person that manufactures or imports prescription drugs for sale in the United States. Page 217
What we were promised during the campaign.
Drug reimportation. The second-fastest growing type of health expenses is
prescription drugs.46 Pharmaceutical companies should profit when their research
and development results in a groundbreaking new drug. But some companies are
exploiting Americans by dramatically overcharging U.S. consumers. These
companies are selling the exact same drugs in Europe and Canada but charging
Americans a 67 percent premium.47 Obama will allow Americans to buy their
medicines from other developed countries if the drugs are safe and prices are
lower outside the U.S. from page 10.
Looks like the drug dealers made a pretty good compromise. Protectionist policies continue and now they will have a captive audience.
The worst part of the bill in my opinion.
Beginning in 2013, all U.S. citizens and legal residents would be required to purchase coverage …. “ page 31
The mandate with a fine. $750 per year. For the poor, 100 to 300% of the poverty level. However, the maximum penalty amount a family above 300 percent of FPL would pay is $3,800.
The mandate was supposed to come later and only after lower premiums failed to get everyone to purchase coverage. The trigger was supposed to be for the mandate not the public option.
The details are still sorely lacking but the general tenor of the bill is full of loopholes and grandfathering. The fees tend to kick in in 2010 and any benefits tend to begin in 2013.
Hospitals that have physician ownership and a provider agreement in operation on November 1, 2009 and that met other specified requirements would be exempt from this self-referral ban. Page 177 for example.
And the big one Pre existing conditions. This for many the point of reform. What we were promised :
“Guaranteed eligibility. No American will be turned away FROM ANY
INSURANCE PLAN because of illness or pre-existing conditions. “
What we get under Baucus:
Within a year of enactment, any uninsured individual who has been denied health care coverage due to a pre-existing condition can enroll in a high-risk pool. Page 5
If you have cancer or other progressive type disease you might be dead in 6 months or bankrupt.
The rules for the small group market would be the same as those for the individual market, except that they would be phased in over a period of up to five years beginning January 1, 2013, as determined by each state with approval from the Secretary. Page 6 so the pre existing thing may not go away until 2018?
The ambiguities in the bill are going to lead to more government takeover nonsense but I am not going to be specific as the lunatic fringe on the right doesn’t need my help.
We are being sold out to the corporate masters in this bill. Will The President make good on his promises? We await his response. Bear in mind that the Missouri compromise preserved slavery for 40 odd years.

No comments: