Monday, September 24, 2007

Hillary's (and Edward"s) unworkable mandate v. Medicare's working coverage

A syllogism:
a) Hillary's (and Edward's) plan can work only with a mandate.
b) A mandate is likely unworkable (see below) and is almost certainly unacceptable to Americans who don't like be told what to do (who like it less than Canadians and Europeans in any case). And, guess what: Hillary herself says she does not forsee any penalty to enforce the necessary mandate -- has so far, as far as I know, only come up with some "Brave New World" speculation about a future in which we may be forced to show proof of health insurance to get a job.
c) Ergo, Hillary's (and Edward's) plan cannot work.

Quoted from:
The Gaping Holes in Massachuesetts' Health Care Plan
Mass Failure
By Dr. STEFFIE WOOLHANDLER
and Dr. DAVID HIMMELSTEIN
http://www.counterpunch.org/woolhandler09212007.html

And 244,000 of Massachusetts uninsured get zero assistance--just a stiff fine if they don't buy coverage. A couple in their late 50s faces a minimum premium of $8,638 annually, for a policy with no drug coverage at all and a $2,000 deductible per person before insurance even kicks in. Such skimpy yet costly coverage is, in many cases, worse than no coverage at all. Illness will still bring crippling medical bills--but the $8,638 annual premium will empty their bank accounts even before the bills start arriving. Little wonder that barely 2 percent of those required to buy such coverage have thus far signed up.

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(Let me try to sort this out.)

Our Dem heroes got licked last time out (1993) because the Republicans could get away with calling PRIVATE based health coverage "socialism".

But this time out our Dem heroes are afraid to propose PUBLIC based Medicare-for-all -- which ironically is the only plan Repubs CANNOT GET AWAY WITH calling "socialism" because everybody knows what Medicare is -- because our Dem heros are now that the "very industry" that (together with Repubs) knocked out private-based universal care the last time will oppose Medicare this time.

(Am I making any sense?)

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Medicare is ready to go now -- no need for years of phasing in.

Medicare is almost too easy to sell to the American public.

Medicare may need to take over from Medicade -- the difference in fee payout can be so exaggerated (as much as 8X lower in N.Y. state) that it defeats LBJs original purpose which was to get care to the poor -- which is where we supposedly came into this movie. (Between Medicade's partial erasure and the 1968 minimum wage -- $9.50/hr adjusted CPI-U -- diving almost in half by the time average income doubled, LBJ must be spinning up a storm.) http://www.nytimes.com/2005/10/17/nyregion/nyregionspecial4/17clinic.html

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Next to last gasp on Medicare-for-all:
Leaving universal coverage in the private hands leaves our industries competing with foreign counterparts who don't have to include -- ever more unaffordable -- employee medical coverage in their price structures.

Last gasp:
It would shore up the funding of Medicare if the great mass of patients -- who pay its regressive taxes -- were not so badly underpaid in these days of deunionized America, low low minimum wage (2009 version will be at least .50/hr short of 1956 minimum wage in equal purchasing power), etc. The rich don't have more livers and teeth to fix so support for doctor's incomes has to come from the incomes of the great majority.

Last gasp on private medical insurance:
If unnecessary paperwork constitutes 30% of private insurance costs (20% on the part of the insurer, 10% on the part of doctors trying to get paid -- and to not get treatment denied -- by dozens of varied insurance plans), that means that (rounded to the nearest 5%) private insurance ADDS 45% to health insurance prices -- 30% down equal 45% up in 8th grade math.

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