The relationship between happiness and income is complicated, and after a point, tenuous. It is true that poor nations become happier as they become middle-class nations. But once the basic necessities have been achieved, future income is lightly connected to well-being. Growing countries are slightly less happy than countries with slower growth rates, according to Carol Graham of the Brookings Institution and Eduardo Lora. The United States is much richer than it was 50 years ago, but this has produced no measurable increase in overall happiness. On the other hand, it has become a much more unequal country, but this inequality doesn’t seem to have reduced national happiness.
On a personal scale, winning the lottery doesn’t seem to produce lasting gains in well-being. People aren’t happiest during the years when they are winning the most promotions. Instead, people are happy in their 20’s, dip in middle age and then, on average, hit peak happiness just after retirement at age 65.
People get slightly happier as they climb the income scale, but this depends on how they experience growth. Does wealth inflame unrealistic expectations? Does it destabilize settled relationships? Or does it flow from a virtuous cycle in which an interesting job produces hard work that in turn leads to more interesting opportunities?
If the relationship between money and well-being is complicated, the correspondence between personal relationships and happiness is not. The daily activities most associated with happiness are sex, socializing after work and having dinner with others. The daily activity most injurious to happiness is commuting. According to one study, joining a group that meets even just once a month produces the same happiness gain as doubling your income. According to another, being married produces a psychic gain equivalent to more than $100,000 a year.
If you want to find a good place to live, just ask people if they trust their neighbors. Levels of social trust vary enormously, but countries with high social trust have happier people, better health, more efficient government, more economic growth, and less fear of crime (regardless of whether actual crime rates are increasing or decreasing).
The overall impression from this research is that economic and professional success exists on the surface of life, and that they emerge out of interpersonal relationships, which are much deeper and more important.
The second impression is that most of us pay attention to the wrong things. Most people vastly overestimate the extent to which more money would improve our lives. Most schools and colleges spend too much time preparing students for careers and not enough preparing them to make social decisions. Most governments release a ton of data on economic trends but not enough on trust and other social conditions. In short, modern societies have developed vast institutions oriented around the things that are easy to count, not around the things that matter most. They have an affinity for material concerns and a primordial fear of moral and social ones.
--David Brooks
Tuesday, March 30, 2010
Thursday, March 25, 2010
GOP: The Party Of Violence And Bigotry
What has been really striking has been the eliminationist rhetoric of the G.O.P., coming not from some radical fringe but from the party’s leaders. John Boehner, the House minority leader, declared that the passage of health reform was “Armageddon.” The Republican National Committee put out a fund-raising appeal that included a picture of Nancy Pelosi, the speaker of the House, surrounded by flames, while the committee’s chairman declared that it was time to put Ms. Pelosi on “the firing line.” And Sarah Palin put out a map literally putting Democratic lawmakers in the cross hairs of a rifle sight. All of this goes far beyond politics as usual. Democrats had a lot of harsh things to say about former President George W. Bush — but you’ll search in vain for anything comparably menacing, anything that even hinted at an appeal to violence, from members of Congress, let alone senior party officials. --Paul Krugman
Unfairly or not, the defining images of opposition to health care reform may end up being those rage-filled partisans with spittle on their lips. Whether the outbursts came from inside Congress — the “baby killer” shout of Rep. Randy Neugebauer, and his colleagues who cheered on hecklers — or outside, where protesters hurled vile names against elected representatives, they are powerful and lasting scenes of a democracy gasping for dignity...Most of these vignettes are isolated incidents — a few crazies going off in a vein-popping binge. But the Republican Party now has taken some of the worst elements of Tea Party anger and incorporated them into its own identity. They are ticked off, red-faced, frothing — and these are the men in suits. --Timothy Egan
In Washington on Saturday, opponents of the health care legislation spit on a black congressman and shouted racial slurs at two others, including John Lewis, one of the great heroes of the civil rights movement. Barney Frank, a Massachusetts Democrat who is chairman of the House Financial Services Committee, was taunted because he is gay.
At some point, we have to decide as a country that we just can’t have this: We can’t allow ourselves to remain silent as foaming-at-the-mouth protesters scream the vilest of epithets at members of Congress — epithets that The Times will not allow me to repeat here.
It is 2010, which means it is way past time for decent Americans to rise up against this kind of garbage, to fight it aggressively wherever it appears. And it is time for every American of good will to hold the Republican Party accountable for its role in tolerating, shielding and encouraging foul, mean-spirited and bigoted behavior in its ranks and among its strongest supporters.
For decades the G.O.P. has been the party of fear, ignorance and divisiveness. All you have to do is look around to see what it has done to the country. The greatest economic inequality since the Gilded Age was followed by a near-total collapse of the overall economy. As a country, we have a monumental mess on our hands and still the Republicans have nothing to offer in the way of a remedy except more tax cuts for the rich.
This is the party of trickle down and weapons of mass destruction, the party of birthers and death-panel lunatics. This is the party that genuflects at the altar of right-wing talk radio, with its insane, nauseating, nonstop commitment to hatred and bigotry....If you’re all fired up about Republican-inspired tales of Democrats planning to send grandma to some death chamber, you’ll never get to the G.O.P.’s war against the right of ordinary workers to organize and negotiate in their own best interests — a war that has diminished living standards for working people for decades.
A party that promotes ignorance (“Just say no to global warming”) and provides a safe house for bigotry cannot serve the best interests of our country. --Bob Herbert
Unfairly or not, the defining images of opposition to health care reform may end up being those rage-filled partisans with spittle on their lips. Whether the outbursts came from inside Congress — the “baby killer” shout of Rep. Randy Neugebauer, and his colleagues who cheered on hecklers — or outside, where protesters hurled vile names against elected representatives, they are powerful and lasting scenes of a democracy gasping for dignity...Most of these vignettes are isolated incidents — a few crazies going off in a vein-popping binge. But the Republican Party now has taken some of the worst elements of Tea Party anger and incorporated them into its own identity. They are ticked off, red-faced, frothing — and these are the men in suits. --Timothy Egan
In Washington on Saturday, opponents of the health care legislation spit on a black congressman and shouted racial slurs at two others, including John Lewis, one of the great heroes of the civil rights movement. Barney Frank, a Massachusetts Democrat who is chairman of the House Financial Services Committee, was taunted because he is gay.
At some point, we have to decide as a country that we just can’t have this: We can’t allow ourselves to remain silent as foaming-at-the-mouth protesters scream the vilest of epithets at members of Congress — epithets that The Times will not allow me to repeat here.
It is 2010, which means it is way past time for decent Americans to rise up against this kind of garbage, to fight it aggressively wherever it appears. And it is time for every American of good will to hold the Republican Party accountable for its role in tolerating, shielding and encouraging foul, mean-spirited and bigoted behavior in its ranks and among its strongest supporters.
For decades the G.O.P. has been the party of fear, ignorance and divisiveness. All you have to do is look around to see what it has done to the country. The greatest economic inequality since the Gilded Age was followed by a near-total collapse of the overall economy. As a country, we have a monumental mess on our hands and still the Republicans have nothing to offer in the way of a remedy except more tax cuts for the rich.
This is the party of trickle down and weapons of mass destruction, the party of birthers and death-panel lunatics. This is the party that genuflects at the altar of right-wing talk radio, with its insane, nauseating, nonstop commitment to hatred and bigotry....If you’re all fired up about Republican-inspired tales of Democrats planning to send grandma to some death chamber, you’ll never get to the G.O.P.’s war against the right of ordinary workers to organize and negotiate in their own best interests — a war that has diminished living standards for working people for decades.
A party that promotes ignorance (“Just say no to global warming”) and provides a safe house for bigotry cannot serve the best interests of our country. --Bob Herbert
Now that we have an insurance bill, can we move on to healthcare reform?"
Where the bill falls short
-The mandate forcing people without coverage to buy insurance. Coupled with the subsidies for other moderate income working people not eligible for Medicare or Medicaid, the result is a gift worth hundreds of billions of dollars to reward the very insurance industry that created the present crisis through price gouging, care denials, and other abuses.
-Inadequate healthcare cost controls for individuals and families. 1. Insurance premiums will continue to climb. Proponents touted a "robust" public option to keep the insurers "honest," but that proposal was scuttled. After Anthem Blue Cross of California announced 39 percent premium hikes, the administration promised to crack down with a federal rate insurance authority, an idea also dropped from the bill. 2. There is no standard benefits package, only a circumspect reference that benefits should be "comparable to" current employer provided plans. 3. An illusory limit on out-of-pocket medical expenses. But even in the regulated state exchanges, insurers remain in control of what they offer and what will be a covered service. Insurers are likely to design plans to attract healthier customers, and many enrollees will likely find the federal guarantees do not protect them for medical treatments they actually need.
-No meaningful restrictions on claims denials insurers don't want to pay for. Proponents cite a review process on denials, but the "internal review process" remains in the hands of the insurers, and the "external" review will be up to the states, many of which have systems now in place that are dominated by the insurance industry with little enforcement mechanism.
-Significant loopholes in the much touted insurance reforms: 1. Provisions permitting insurers and companies to more than double charges to employees who fail "wellness" programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions. 2. Permitting insurers to sell policies "across state lines", exempting patient protections passed in other states. Insurers will likely set up in the least regulated states in a race to the bottom threatening public protections won by consumers in various states. 3. Allowing insurers to charge three times more based on age plus more for certain conditions, and continue to use marketing techniques to cherry-pick healthier, less costly enrollees. 4. Insurers may continue to rescind policies, drop coverage, for "fraud or intentional misrepresentation" -- the main pretext insurance companies now use.
-Taxing health benefits for the first time. Though modified, the tax on benefits remains, a 40 percent tax on plans whose value exceeds $10,200 for individuals or $27,500 for families. With no real checks on premium hikes, many plans will reach that amount by the start date, 2018, rapidly. The result will be more cost shifting from employers to workers and more people switching to skeletal plans that leave them vulnerable to financial ruin.
-Erosion of women's reproductive rights, with a new executive order from the President enshrining a deal to get the votes of anti-abortion Democrats and a burdensome segregation of funds, that in practice will likely mean few insurers will cover abortion and perhaps other reproductive medical services.
-A windfall for pharmaceutical giants. Through a deal with the White House, the administration blocked provisions to give the government more power to negotiate drug prices and gave the name brand drug makers 12 years of marketing monopoly against competition from generic competition on biologic drugs, including cancer treatments.
Most critically, the bill strengthens the economic and political power of a private insurance-based system based on profit rather than patient need.
As former Labor Secretary Robert Reich wrote after the vote "don't believe anyone who says Obama's healthcare legislation marks a swing of the pendulum back toward the Great Society and the New Deal. Obama's health bill is a very conservative piece of legislation, building on a Republican (a private market approach) rather than a New Deal foundation. The New Deal foundation would have offered Medicare to all Americans or, at the very least, featured a public insurance option."
Unlike Social Security and Medicare which expanded a public safety net, this bill requires people -- in the midst of the mass unemployment and the worse economic downturn since the Great Depression -- to pay thousands of dollars out of pocket to big private companies for a product that may or may not provide health coverage in return.
Too many people will remain uninsured, individual and family healthcare costs will continue to rise largely unabated and private insurers will still be able to deny claims with little recourse for patients. [For example, the penalty for using pre-existing conditions to deny coverage is a puny $100/day, a real bargain for Insurance companies. --Politex]
--Rose Ann DeMoro, executive director of the California Nurses Association/National Nurses Organizing Committee
-The mandate forcing people without coverage to buy insurance. Coupled with the subsidies for other moderate income working people not eligible for Medicare or Medicaid, the result is a gift worth hundreds of billions of dollars to reward the very insurance industry that created the present crisis through price gouging, care denials, and other abuses.
-Inadequate healthcare cost controls for individuals and families. 1. Insurance premiums will continue to climb. Proponents touted a "robust" public option to keep the insurers "honest," but that proposal was scuttled. After Anthem Blue Cross of California announced 39 percent premium hikes, the administration promised to crack down with a federal rate insurance authority, an idea also dropped from the bill. 2. There is no standard benefits package, only a circumspect reference that benefits should be "comparable to" current employer provided plans. 3. An illusory limit on out-of-pocket medical expenses. But even in the regulated state exchanges, insurers remain in control of what they offer and what will be a covered service. Insurers are likely to design plans to attract healthier customers, and many enrollees will likely find the federal guarantees do not protect them for medical treatments they actually need.
-No meaningful restrictions on claims denials insurers don't want to pay for. Proponents cite a review process on denials, but the "internal review process" remains in the hands of the insurers, and the "external" review will be up to the states, many of which have systems now in place that are dominated by the insurance industry with little enforcement mechanism.
-Significant loopholes in the much touted insurance reforms: 1. Provisions permitting insurers and companies to more than double charges to employees who fail "wellness" programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions. 2. Permitting insurers to sell policies "across state lines", exempting patient protections passed in other states. Insurers will likely set up in the least regulated states in a race to the bottom threatening public protections won by consumers in various states. 3. Allowing insurers to charge three times more based on age plus more for certain conditions, and continue to use marketing techniques to cherry-pick healthier, less costly enrollees. 4. Insurers may continue to rescind policies, drop coverage, for "fraud or intentional misrepresentation" -- the main pretext insurance companies now use.
-Taxing health benefits for the first time. Though modified, the tax on benefits remains, a 40 percent tax on plans whose value exceeds $10,200 for individuals or $27,500 for families. With no real checks on premium hikes, many plans will reach that amount by the start date, 2018, rapidly. The result will be more cost shifting from employers to workers and more people switching to skeletal plans that leave them vulnerable to financial ruin.
-Erosion of women's reproductive rights, with a new executive order from the President enshrining a deal to get the votes of anti-abortion Democrats and a burdensome segregation of funds, that in practice will likely mean few insurers will cover abortion and perhaps other reproductive medical services.
-A windfall for pharmaceutical giants. Through a deal with the White House, the administration blocked provisions to give the government more power to negotiate drug prices and gave the name brand drug makers 12 years of marketing monopoly against competition from generic competition on biologic drugs, including cancer treatments.
Most critically, the bill strengthens the economic and political power of a private insurance-based system based on profit rather than patient need.
As former Labor Secretary Robert Reich wrote after the vote "don't believe anyone who says Obama's healthcare legislation marks a swing of the pendulum back toward the Great Society and the New Deal. Obama's health bill is a very conservative piece of legislation, building on a Republican (a private market approach) rather than a New Deal foundation. The New Deal foundation would have offered Medicare to all Americans or, at the very least, featured a public insurance option."
Unlike Social Security and Medicare which expanded a public safety net, this bill requires people -- in the midst of the mass unemployment and the worse economic downturn since the Great Depression -- to pay thousands of dollars out of pocket to big private companies for a product that may or may not provide health coverage in return.
Too many people will remain uninsured, individual and family healthcare costs will continue to rise largely unabated and private insurers will still be able to deny claims with little recourse for patients. [For example, the penalty for using pre-existing conditions to deny coverage is a puny $100/day, a real bargain for Insurance companies. --Politex]
--Rose Ann DeMoro, executive director of the California Nurses Association/National Nurses Organizing Committee
Monday, March 22, 2010
20 Reasons We're Against Obamacare
1. Does not have a public option. (2)
3. Does not have 55-64 Medicare Buy-In Exchange. (2) (3)
3. Does not have an actual Gvt. Employee Plan For Anyone Under 65. (2) (3)(4)
4. Exempts Insurance Companies From Anti-Trust Laws
5. Will Allow Insurance Companies To Dictate Profit Margins
6. HC Corps Allowed To Keep Present Med-Cost Ratio, With Book Cooking (2)(4)(3)
7. 30+ Million Uninsured Forced To Buy Overpriced/Underregulated Insurance
8. It is unconstitutional that the Gvt. force a citizen to buy private insurance.
9. 20+ Million Uninsured Left Uninsured
10. Insurers Exempt From State Laws Requiring Certain Med Procedures
11. Older People (A Pre-Existing Condition) Will Pay 300%+ More Than Younger
12. The Sick (A Pre-Existing Condition) Will Pay More
13. It Does Not Allow Drug Re-Importation. (2) (3)
14. Cost-shifting Raises The De Facto Cost/Quality Of Health Care For Seniors (2)
15. The money saved by the government will not lower consumer costs. (2) (3)
16. It Does Not Really Control Consumer Costs (see #s 1-15) (2)
17. It Rolls Back Row vs. Wade Re Hyde Ammendment (2)
18. Includes Abstinence-Only Sex Education Plan (2)
19. Specifically Excludes Guns As A Health Threat
20. No bill implemetation until 2014, some parts 2018. (2)
3. Does not have 55-64 Medicare Buy-In Exchange. (2) (3)
3. Does not have an actual Gvt. Employee Plan For Anyone Under 65. (2) (3)(4)
4. Exempts Insurance Companies From Anti-Trust Laws
5. Will Allow Insurance Companies To Dictate Profit Margins
6. HC Corps Allowed To Keep Present Med-Cost Ratio, With Book Cooking (2)(4)(3)
7. 30+ Million Uninsured Forced To Buy Overpriced/Underregulated Insurance
8. It is unconstitutional that the Gvt. force a citizen to buy private insurance.
9. 20+ Million Uninsured Left Uninsured
10. Insurers Exempt From State Laws Requiring Certain Med Procedures
11. Older People (A Pre-Existing Condition) Will Pay 300%+ More Than Younger
12. The Sick (A Pre-Existing Condition) Will Pay More
13. It Does Not Allow Drug Re-Importation. (2) (3)
14. Cost-shifting Raises The De Facto Cost/Quality Of Health Care For Seniors (2)
15. The money saved by the government will not lower consumer costs. (2) (3)
16. It Does Not Really Control Consumer Costs (see #s 1-15) (2)
17. It Rolls Back Row vs. Wade Re Hyde Ammendment (2)
18. Includes Abstinence-Only Sex Education Plan (2)
19. Specifically Excludes Guns As A Health Threat
20. No bill implemetation until 2014, some parts 2018. (2)
Sunday, March 21, 2010
Reconciliation: Proposed Changes in the Final Health Care Bill
To avoid the threat of a filibuster by Senate Republicans, Democratic leaders are planning to pass health care overhaul in a three-step process. The House completed the first two parts on Sunday by passing both the health bill approved in December by the Senate and a separate package of changes in a budget reconciliation measure -- which can be adopted in the Senate by a simple majority. A look at key provisions of the Senate bill and the changes proposed in the reconciliation bill passed by the House Sunday:
read here
read here
Saturday, March 20, 2010
No Saving: Obama's Payoff To The Health Care Industry Will Cost Over 500 Billion
ON Thursday, the Congressional Budget Office reported that, if enacted, the latest health care reform legislation would, over the next 10 years, cost about $950 billion, but because it would raise some revenues and lower some costs, it would also lower federal deficits by $138 billion. In other words, a bill that would set up two new entitlement spending programs — health insurance subsidies and long-term health care benefits — would actually improve the nation’s bottom line.
Could this really be true? How can the budget office give a green light to a bill that commits the federal government to spending nearly $1 trillion more over the next 10 years?
The answer, unfortunately, is that the budget office is required to take written legislation at face value and not second-guess the plausibility of what it is handed. So fantasy in, fantasy out.
In reality, if you strip out all the gimmicks and budgetary games and rework the calculus, a wholly different picture emerges: The health care reform legislation would raise, not lower, federal deficits, by $562 billion....
...The bottom line is that Congress would spend a lot more; steal funds from education, Social Security and long-term care to cover the gap; and promise that future Congresses will make up for it by taxing more and spending less.
The stakes could not be higher. As documented in another recent budget office analysis, the federal deficit is already expected to exceed at least $700 billion every year over the next decade, doubling the national debt to more than $20 trillion. By 2020, the federal deficit — the amount the government must borrow to meet its expenses — is projected to be $1.2 trillion, $900 billion of which represents interest on previous debt.
The health care legislation would only increase this crushing debt. It is a clear indication that Congress does not realize the urgency of putting America’s fiscal house in order.
--NYT Ed
Could this really be true? How can the budget office give a green light to a bill that commits the federal government to spending nearly $1 trillion more over the next 10 years?
The answer, unfortunately, is that the budget office is required to take written legislation at face value and not second-guess the plausibility of what it is handed. So fantasy in, fantasy out.
In reality, if you strip out all the gimmicks and budgetary games and rework the calculus, a wholly different picture emerges: The health care reform legislation would raise, not lower, federal deficits, by $562 billion....
...The bottom line is that Congress would spend a lot more; steal funds from education, Social Security and long-term care to cover the gap; and promise that future Congresses will make up for it by taxing more and spending less.
The stakes could not be higher. As documented in another recent budget office analysis, the federal deficit is already expected to exceed at least $700 billion every year over the next decade, doubling the national debt to more than $20 trillion. By 2020, the federal deficit — the amount the government must borrow to meet its expenses — is projected to be $1.2 trillion, $900 billion of which represents interest on previous debt.
The health care legislation would only increase this crushing debt. It is a clear indication that Congress does not realize the urgency of putting America’s fiscal house in order.
--NYT Ed
Thursday, March 18, 2010
A look at the health care overhaul bill
-- Congressional Democrats have released a final version of President Barack Obama's health care overhaul bill in advance of a House vote planned for Sunday. Some of the main features of the legislation, which makes changes to the bill the Senate passed on Christmas Eve:
COST: $940 billion over 10 years, according to the Congressional Budget Office.
HOW MANY COVERED: 32 million uninsured. Major coverage expansion begins in 2014. When fully phased in, 95 percent of eligible Americans would have coverage, compared with 83 percent today.
INSURANCE MANDATE: Almost everyone is required to be insured or else pay a fine. There is an exemption for low-income people. Mandate takes effect in 2014.
INSURANCE MARKET REFORMS: Major consumer safeguards take effect in 2014. Insurers prohibited from denying coverage to people with medical problems or charging them more. Higher premiums for women would be banned. Starting this year, insurers would be forbidden from placing lifetime dollar limits on policies, and from denying coverage to children because of pre-existing medical problems. Parents would be able to keep older kids on their policies up to age 26. A new high-risk pool would offer coverage to uninsured people with medical problems until 2014, when the coverage expansion goes into high gear.
MEDICAID: Expands the federal-state Medicaid insurance program for the poor to cover people with incomes up to 133 percent of the federal poverty level, $29,327 a year for a family of four. Childless adults would be covered for the first time, starting in 2014. The federal government would pay 100 percent of the tab for covering newly eligible individuals through 2016. A special deal that would have given Nebraska 100 percent federal financing for newly eligible Medicaid recipients in perpetuity is eliminated. A different, one-time deal negotiated by Democratic Sen. Mary Landrieu for her state, Louisiana, worth as much as $300 million, remains.
TAXES: Dramatically scales back a Senate-passed tax on high-cost insurance plans that was opposed by House Democrats and labor unions. The tax would be delayed until 2018, and the thresholds at which it is imposed would be $10,200 for individuals and $27,500 for families. To make up for the lost revenue, the bill applies an increased Medicare payroll tax to investment income as well as wages for individuals making more than $200,000, or married couples above $250,000. The tax on investment income would be 3.8 percent.
PRESCRIPTION DRUGS: Gradually closes the "doughnut hole" coverage gap in the Medicare prescription drug benefit that seniors fall into once they have spent $2,830. Seniors who hit the gap this year will receive a $250 rebate. Beginning in 2011, seniors in the gap receive a discount on brand name drugs, initially 50 percent off. When the gap is completely eliminated in 2020, seniors will still be responsible for 25 percent of the cost of their medications until Medicare's catastrophic coverage kicks in.
EMPLOYER RESPONSIBILITY: As in the Senate bill, businesses are not required to offer coverage. Instead, employers are hit with a fee if the government subsidizes their workers' coverage. The $2,000-per-employee fee would be assessed on the company's entire workforce, minus an allowance. Companies with 50 or fewer workers are exempt from the requirement. Part-time workers are included in the calculations, counting two part-timers as one full-time worker.
SUBSIDIES: The proposal provides more generous tax credits for purchasing insurance than the original Senate bill did. The aid is available on a sliding scale for households making up to four times the federal poverty level, $88,200 for a family of four. Premiums for a family of four making $44,000 would be capped at around 6 percent of income.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: Small businesses, the self-employed and the uninsured could pick a plan offered through new state-based purchasing pools called exchanges, opening for business in 2014. The exchanges would offer the same kind of purchasing power that employees of big companies benefit from. People working for medium-to-large firms would not see major changes. But if they lose their jobs or strike out on their own, they may be eligible for subsidized coverage through the exchange.
GOVERNMENT-RUN PLAN: No government-run insurance plan. People purchasing coverage through the new insurance exchanges would have the option of signing up for national plans overseen by the federal office that manages the health plans available to members of Congress. Those plans would be private, but one would have to be nonprofit.
ABORTION: The proposal keeps the abortion provision in the Senate bill. Abortion opponents disagree on whether restrictions on taxpayer funding go far enough. The bill tries to maintain a strict separation between taxpayer dollars and private premiums that would pay for abortion coverage. No health plan would be required to cover abortion. In plans that do cover abortion, policyholders would have to pay for it separately, and that money would have to be kept in a separate account from taxpayer money. States could ban abortion coverage in plans offered through the exchange. Exceptions would be made for cases of rape, incest and danger to the life of the mother.
--Associated Press
COST: $940 billion over 10 years, according to the Congressional Budget Office.
HOW MANY COVERED: 32 million uninsured. Major coverage expansion begins in 2014. When fully phased in, 95 percent of eligible Americans would have coverage, compared with 83 percent today.
INSURANCE MANDATE: Almost everyone is required to be insured or else pay a fine. There is an exemption for low-income people. Mandate takes effect in 2014.
INSURANCE MARKET REFORMS: Major consumer safeguards take effect in 2014. Insurers prohibited from denying coverage to people with medical problems or charging them more. Higher premiums for women would be banned. Starting this year, insurers would be forbidden from placing lifetime dollar limits on policies, and from denying coverage to children because of pre-existing medical problems. Parents would be able to keep older kids on their policies up to age 26. A new high-risk pool would offer coverage to uninsured people with medical problems until 2014, when the coverage expansion goes into high gear.
MEDICAID: Expands the federal-state Medicaid insurance program for the poor to cover people with incomes up to 133 percent of the federal poverty level, $29,327 a year for a family of four. Childless adults would be covered for the first time, starting in 2014. The federal government would pay 100 percent of the tab for covering newly eligible individuals through 2016. A special deal that would have given Nebraska 100 percent federal financing for newly eligible Medicaid recipients in perpetuity is eliminated. A different, one-time deal negotiated by Democratic Sen. Mary Landrieu for her state, Louisiana, worth as much as $300 million, remains.
TAXES: Dramatically scales back a Senate-passed tax on high-cost insurance plans that was opposed by House Democrats and labor unions. The tax would be delayed until 2018, and the thresholds at which it is imposed would be $10,200 for individuals and $27,500 for families. To make up for the lost revenue, the bill applies an increased Medicare payroll tax to investment income as well as wages for individuals making more than $200,000, or married couples above $250,000. The tax on investment income would be 3.8 percent.
PRESCRIPTION DRUGS: Gradually closes the "doughnut hole" coverage gap in the Medicare prescription drug benefit that seniors fall into once they have spent $2,830. Seniors who hit the gap this year will receive a $250 rebate. Beginning in 2011, seniors in the gap receive a discount on brand name drugs, initially 50 percent off. When the gap is completely eliminated in 2020, seniors will still be responsible for 25 percent of the cost of their medications until Medicare's catastrophic coverage kicks in.
EMPLOYER RESPONSIBILITY: As in the Senate bill, businesses are not required to offer coverage. Instead, employers are hit with a fee if the government subsidizes their workers' coverage. The $2,000-per-employee fee would be assessed on the company's entire workforce, minus an allowance. Companies with 50 or fewer workers are exempt from the requirement. Part-time workers are included in the calculations, counting two part-timers as one full-time worker.
SUBSIDIES: The proposal provides more generous tax credits for purchasing insurance than the original Senate bill did. The aid is available on a sliding scale for households making up to four times the federal poverty level, $88,200 for a family of four. Premiums for a family of four making $44,000 would be capped at around 6 percent of income.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: Small businesses, the self-employed and the uninsured could pick a plan offered through new state-based purchasing pools called exchanges, opening for business in 2014. The exchanges would offer the same kind of purchasing power that employees of big companies benefit from. People working for medium-to-large firms would not see major changes. But if they lose their jobs or strike out on their own, they may be eligible for subsidized coverage through the exchange.
GOVERNMENT-RUN PLAN: No government-run insurance plan. People purchasing coverage through the new insurance exchanges would have the option of signing up for national plans overseen by the federal office that manages the health plans available to members of Congress. Those plans would be private, but one would have to be nonprofit.
ABORTION: The proposal keeps the abortion provision in the Senate bill. Abortion opponents disagree on whether restrictions on taxpayer funding go far enough. The bill tries to maintain a strict separation between taxpayer dollars and private premiums that would pay for abortion coverage. No health plan would be required to cover abortion. In plans that do cover abortion, policyholders would have to pay for it separately, and that money would have to be kept in a separate account from taxpayer money. States could ban abortion coverage in plans offered through the exchange. Exceptions would be made for cases of rape, incest and danger to the life of the mother.
--Associated Press
Wednesday, March 17, 2010
Senate Watch: Stand By For Another Major Economic Crisis
If you think health care reform has been an unsatisfying test of the government's ability to deal with our pressing problems, brace yourself for bigger disappointment in its attempt to bridle Wall Street. This is when the true heavies go to work and, as opposed to the medical industry lobby, the moneychangers fear not the wrath of their clients or, as Scripture tells, any higher power.
Certainly not that of the Congress or the president whose powers they have so confidently purchased. That is how we got into this mess. The bankers wrote the rules of the road that allowed them to exceed all reasonable limits when Democrat Bill Clinton was in the White House. And when the crash came, it was the Republican George W. Bush who made their problems go away. Having survived that disaster of their own creation, they are not about to let anyone make them change their ways.
It will definitely take more than the likes of Connecticut's lame-duck Sen. Christopher Dodd, a likely candidate for more lucrative employment in the financial sector that he has served so faithfully. On Monday he made a big show of introducing legislation to rein in Wall Street, having failed to elicit a single Republican vote after months of caving in. He has abandoned his earlier proposal for a truly independent regulatory agency that would challenge the Fed, which got us into this jam. His bill rejects a public audit of the Fed, where he would house what remains of the president's proposed consumer protection agency.
There is only a nod in the direction of a return to the Glass-Steagall Act's separation of investment and banking firms, a regulation that Dodd, along with New York Democrat Charles Schumer, helped kill a decade ago. As The New York Times reported on Oct. 23, 1999: "Dodd, whose state is home to the nation's largest insurance companies, and Schumer, with strong ties to Wall Street, have long sought legislation to repeal the Glass-Steagall Act."
That's what legally made possible the too-big-to-fail mergers of insurance giants like Travelers and AIG with banking companies. As Peter Eavis pointed out in Monday's Wall Street Journal, Dodd's current bill "still flunks the AIG test," in that "if the Senate bill became law, it looks like the government could still find itself making the sort of payments it made to AIG counterparties." And that's before the lobbyists go to work. --Robert Scheer
"I'm sure by the time all the banking lobbyists are done the Senate bill will become one of the key primary sources for students 100 years from now on how broken the Senate of the early 21st Century was. But in terms of lobbying there seems to be nothing that needs to move. Which should worry us all." --Mike Konczal
[Dood's new bill] reads like the chairman and his Senate colleagues couldn't make up their minds about who or what caused the financial crisis or who could be trusted to fix the system. They've come up with a set of jury-rigged patches designed to placate as many interest groups as possible while preserving the existing regulatory apparatus and prerogatives.... There are so many political accommodations involving carve-outs and size limits and overlapping responsibilities that it creates exactly the kind of complexity, the opportunities for regulatory arbitrage and the lack of accountability that got us into this mess in the first place --Steve Pearlstein
Certainly not that of the Congress or the president whose powers they have so confidently purchased. That is how we got into this mess. The bankers wrote the rules of the road that allowed them to exceed all reasonable limits when Democrat Bill Clinton was in the White House. And when the crash came, it was the Republican George W. Bush who made their problems go away. Having survived that disaster of their own creation, they are not about to let anyone make them change their ways.
It will definitely take more than the likes of Connecticut's lame-duck Sen. Christopher Dodd, a likely candidate for more lucrative employment in the financial sector that he has served so faithfully. On Monday he made a big show of introducing legislation to rein in Wall Street, having failed to elicit a single Republican vote after months of caving in. He has abandoned his earlier proposal for a truly independent regulatory agency that would challenge the Fed, which got us into this jam. His bill rejects a public audit of the Fed, where he would house what remains of the president's proposed consumer protection agency.
There is only a nod in the direction of a return to the Glass-Steagall Act's separation of investment and banking firms, a regulation that Dodd, along with New York Democrat Charles Schumer, helped kill a decade ago. As The New York Times reported on Oct. 23, 1999: "Dodd, whose state is home to the nation's largest insurance companies, and Schumer, with strong ties to Wall Street, have long sought legislation to repeal the Glass-Steagall Act."
That's what legally made possible the too-big-to-fail mergers of insurance giants like Travelers and AIG with banking companies. As Peter Eavis pointed out in Monday's Wall Street Journal, Dodd's current bill "still flunks the AIG test," in that "if the Senate bill became law, it looks like the government could still find itself making the sort of payments it made to AIG counterparties." And that's before the lobbyists go to work. --Robert Scheer
"I'm sure by the time all the banking lobbyists are done the Senate bill will become one of the key primary sources for students 100 years from now on how broken the Senate of the early 21st Century was. But in terms of lobbying there seems to be nothing that needs to move. Which should worry us all." --Mike Konczal
[Dood's new bill] reads like the chairman and his Senate colleagues couldn't make up their minds about who or what caused the financial crisis or who could be trusted to fix the system. They've come up with a set of jury-rigged patches designed to placate as many interest groups as possible while preserving the existing regulatory apparatus and prerogatives.... There are so many political accommodations involving carve-outs and size limits and overlapping responsibilities that it creates exactly the kind of complexity, the opportunities for regulatory arbitrage and the lack of accountability that got us into this mess in the first place --Steve Pearlstein
Friday, March 12, 2010
Three Myths About Health Care Reform
First...is the claim that President Obama is proposing a government takeover of one-sixth of the economy, the share of G.D.P. currently spent on health.
Well, if having the government regulate and subsidize health insurance is a “takeover,” that takeover happened long ago. Medicare, Medicaid, and other government programs already pay for almost half of American health care, while private insurance pays for barely more than a third (the rest is mostly out-of-pocket expenses). And the great bulk of that private insurance is provided via employee plans, which are both subsidized with tax exemptions and tightly regulated.
The only part of health care in which there isn’t already a lot of federal intervention is the market in which individuals who can’t get employment-based coverage buy their own insurance. And that market, in case you hadn’t noticed, is a disaster — no coverage for people with pre-existing medical conditions, coverage dropped when you get sick, and huge premium increases in the middle of an economic crisis. It’s this sector, plus the plight of Americans with no insurance at all, that reform aims to fix. What’s wrong with that?
The second myth is that the proposed reform does nothing to control costs. To support this claim, critics point to reports by the Medicare actuary, who predicts that total national health spending would be slightly higher in 2019 with reform than without it.
Even if this prediction were correct, it points to a pretty good bargain. The actuary’s assessment of the Senate bill, for example, finds that it would raise total health care spending by less than 1 percent, while extending coverage to 34 million Americans who would otherwise be uninsured. That’s a large expansion in coverage at an essentially trivial cost.
And it gets better as we go further into the future: the Congressional Budget Office has just concluded, in a new report, that the arithmetic of reform will look better in its second decade than it did in its first. Furthermore, there’s good reason to believe that all such estimates are too pessimistic....
Which brings me to the third myth: that health reform is fiscally irresponsible. How can people say this given Congressional Budget Office predictions — which, as I’ve already argued, are probably too pessimistic — that reform would actually reduce the deficit? Critics argue that we should ignore what’s actually in the legislation; when cost control actually starts to bite on Medicare, they insist, Congress will back down.
But this isn’t an argument against Obamacare, it’s a declaration that we can’t control Medicare costs no matter what. And it also flies in the face of history: contrary to legend, past efforts to limit Medicare spending have in fact “stuck,” rather than being withdrawn in the face of political pressure....
more from Krugman
Well, if having the government regulate and subsidize health insurance is a “takeover,” that takeover happened long ago. Medicare, Medicaid, and other government programs already pay for almost half of American health care, while private insurance pays for barely more than a third (the rest is mostly out-of-pocket expenses). And the great bulk of that private insurance is provided via employee plans, which are both subsidized with tax exemptions and tightly regulated.
The only part of health care in which there isn’t already a lot of federal intervention is the market in which individuals who can’t get employment-based coverage buy their own insurance. And that market, in case you hadn’t noticed, is a disaster — no coverage for people with pre-existing medical conditions, coverage dropped when you get sick, and huge premium increases in the middle of an economic crisis. It’s this sector, plus the plight of Americans with no insurance at all, that reform aims to fix. What’s wrong with that?
The second myth is that the proposed reform does nothing to control costs. To support this claim, critics point to reports by the Medicare actuary, who predicts that total national health spending would be slightly higher in 2019 with reform than without it.
Even if this prediction were correct, it points to a pretty good bargain. The actuary’s assessment of the Senate bill, for example, finds that it would raise total health care spending by less than 1 percent, while extending coverage to 34 million Americans who would otherwise be uninsured. That’s a large expansion in coverage at an essentially trivial cost.
And it gets better as we go further into the future: the Congressional Budget Office has just concluded, in a new report, that the arithmetic of reform will look better in its second decade than it did in its first. Furthermore, there’s good reason to believe that all such estimates are too pessimistic....
Which brings me to the third myth: that health reform is fiscally irresponsible. How can people say this given Congressional Budget Office predictions — which, as I’ve already argued, are probably too pessimistic — that reform would actually reduce the deficit? Critics argue that we should ignore what’s actually in the legislation; when cost control actually starts to bite on Medicare, they insist, Congress will back down.
But this isn’t an argument against Obamacare, it’s a declaration that we can’t control Medicare costs no matter what. And it also flies in the face of history: contrary to legend, past efforts to limit Medicare spending have in fact “stuck,” rather than being withdrawn in the face of political pressure....
more from Krugman
Sunday, March 7, 2010
Obama Ticks Off Arab World With Toothless Attempt To Stop Israeli Expansion
The president didn’t say all the right words in his [Cairo] speech. He created an obstacle for himself by demanding that Israel stop expanding settlements when it was not going to do so — even though it should — and when that wasn’t the most important condition to Arabs.
Now Obama seems ineffectual, as Israel pushes ahead on 600 more new homes in East Jerusalem, where the Palestinians want their capital, despite the White House protest in November about 900 other houses that Israel plans to put up there.
I asked Prince Saud if he thinks America has less influence over Israel than it used to.
“You’re asking me about something that has tickled our imagination,” he replied. “If the settlements are illegitimate, the least you would expect is that the aid the United States gives to Israel would cut that part that is going to build settlements. Israel is getting away without implementing the Geneva Convention as an occupying authority. Now if it were somewhere else, in Burma or somewhere like that, hell would be raised.”...
“There are no troops arrayed on the border of Israel waiting for the moment to say, ‘Attack Israel,’ ” the prince said. “Nobody is going to fight them and threaten their peace. But they didn’t accept that. So it makes one wonder, what does Israel want?”
If anyone deserves to be paranoid, of course, it’s Israel. But Israel can’t be paranoid because paranoia is the mistaken perception that people are out to get you.
Asked about the possibility that Israel could attack Iran with its new drones, Prince Saud said dryly: “Talk about changing lifestyle. I think this would change lifestyles at once, forcibly.”
Hillary Clinton was in the region recently, warning that Iran was “moving toward a military dictatorship” and could trigger a nuclear arms race.
“God help us if we see countries with atomic weapons in the Middle East,” said Prince Saud. “The way to resolve this is through the United Nations.” Good luck.
more Maureen Dowd
Now Obama seems ineffectual, as Israel pushes ahead on 600 more new homes in East Jerusalem, where the Palestinians want their capital, despite the White House protest in November about 900 other houses that Israel plans to put up there.
I asked Prince Saud if he thinks America has less influence over Israel than it used to.
“You’re asking me about something that has tickled our imagination,” he replied. “If the settlements are illegitimate, the least you would expect is that the aid the United States gives to Israel would cut that part that is going to build settlements. Israel is getting away without implementing the Geneva Convention as an occupying authority. Now if it were somewhere else, in Burma or somewhere like that, hell would be raised.”...
“There are no troops arrayed on the border of Israel waiting for the moment to say, ‘Attack Israel,’ ” the prince said. “Nobody is going to fight them and threaten their peace. But they didn’t accept that. So it makes one wonder, what does Israel want?”
If anyone deserves to be paranoid, of course, it’s Israel. But Israel can’t be paranoid because paranoia is the mistaken perception that people are out to get you.
Asked about the possibility that Israel could attack Iran with its new drones, Prince Saud said dryly: “Talk about changing lifestyle. I think this would change lifestyles at once, forcibly.”
Hillary Clinton was in the region recently, warning that Iran was “moving toward a military dictatorship” and could trigger a nuclear arms race.
“God help us if we see countries with atomic weapons in the Middle East,” said Prince Saud. “The way to resolve this is through the United Nations.” Good luck.
more Maureen Dowd
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