Late on Friday, the Administration laid out a series of new details on the contraceptive mandate that has caused such controversy over the past several weeks. And it turns out that the White House determined that they could not enforce the mandate on self-insured plans (plans where individuals pay directly to the organization, which then purchases health care from that pool), which represents a large minority of plans at self-endowed colleges. Therefore, nearly 200,000 out of the 1 million Americans on student plans at their colleges and universities will not be eligible for birth control coverage free of charge under the mandate, though their self-insured college could provide it to them if it so chose.
Many religious institutions, including universities, have complained that the rule requires them to provide a health service that conflicts with their beliefs. For instance, Georgetown University excludes birth control coverage from its student plan. And because that policy is not a self-insured plan, the birth control mandate will soon apply.
That came as welcome news to Sandra Fluke, a law student at the university who has been lambasted by conservative media personalities — and celebrated by women’s health advocates and President Obama — for speaking out against her school’s policy.
However, Fluke expressed concern that schools with self-insured plans will still be able to deny their students contraceptive coverage.
“I’m confident that students . . . on campuses across the country are going to make sure their universities know that they need this coverage,” she said.
Sarah Kliff is told that most self-insured university plans have generous benefit packages anyway. But this brings up a larger point about the Affordable Care Act.
There may well be nothing for the Administration to do on the contraceptive mandate under current law with respect to self-insured plans. But that’s true for self-insured plans generally, a large section of the employer market at giant corporations. None of the federal insurance regulations apply to these plans, and no effort was made in the Affordable Care Act to deal with that. In general, states oversee self-insured plans, with varying degrees of aggressiveness.
This is a major weakness in our fragmented health care system, or actually health care systems, all happening on a parallel track without integration. And those systems are constantly shifting. The employer-based system, for example, is withering before our eyes. In 2001 nearly 70% of Americans got their health insurance from an employer. By 2010 that number fell to 53.5%, and if anything the trend is accelerating. This means a larger insurance exchange or larger Medicaid or a larger segment of uninsured Americans, or perhaps a larger percentage of employer plans in the more stable self-insured sector. This fragmenting necessarily makes health care more expensive in America, without better results. It reduces bargaining power over providers, and it creates a nightmare to try and maintain continuity for those who must shift between the systems due to employment loss or changes in an employer’s carrier or eligibility for new programs.
It’s a problem that the ACA didn’t attempt to solve. It tried to keep all these balls up in the air, using exchanges for the nongroup market, strengthening Medicaid and Medicare, and applying a weak employer mandate. The ACA tried to work with the health care system(s) as it (they) exist. But no sane person would come to the United States and say that the health care system(s) deserves to remain untouched.




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Servitude to corporations, governments or religious institutions, enabled under law, is not an American value.
Ask Dred Scott, sacrificed by the “SJC” to protect the institution of slavery!
“The ACA tried to work with the health care system(s) as it (they) exist. But no sane person would come to the United States and say that the health care system(s) deserves to remain untouched.”
Servitude/Slavery where Abolished, after years of protection. To bad we have learned little. Your right no one comes to America to pay a “tax on life,” because you exist? ACA is not Healthcare reform. ACA is corporate protectionism, at life’s expense. The same corporations who do not want to incur cost via HCI, fund the election’s of our elected leaders and pass laws based on questionable constitutional grounds at best, leveraging Americans into corporate servitude, using tax code as gun to head, forcing compliance. This sounds like something the King of England would screw the colonist with. In fact he did. Abolish servitude to health insurance lobby and a tax on life, itself!
The fragmentation is the second greatest problem, after lack of access to health care & insurance.
If I were emperor, I would combine all the various programs into one Medicare single-payer system, supported by progressive Medicare/Social Security tax (with no cap on high earners).
More empty promises. Why am I not surprised.
Yep and state exchanges are not going to provide improvement either. Instead of having 50 different guidelines, there out to be one set of standards. Standardizing forms and codes alone would probably help save money and time.
It currently takes 3% of every working persons salary to cover 47.5 million people with Medicare.
To cover everyone, Medicare payroll tax would have to be closer to 20% (although current Medicare might be more expensive than Medicare-for-all, since the current coverage is mostly for olds, who tend to have more health problems).
Add 12.4% for SS (and that’s not really enough, since it’s going broke).
Your subjects would be paying a lot of payroll tax.
Organizations with self-insured plans are the most likely to discriminate in employment and promotions based on the individual employee’s health care cost.
There is no American healthcare system and anyone who’s been thru the medical industrial complex, in all it’s numbing complexity and designed as much to avoid accountability as anything else, is well aware. If the patient doesn’t keep everything organized and moving along properly, whatever you need won’t happen. It’s that simple. All of the responsibility devolves onto the patient and that’s just the way the “system,” and every practitioner in it, wants it: Nobody in here but us chickens.
For people of substantial means and politicians with special privileges, of course, life in the parallel universe is probably completely different. Having no first hand experience, I wouldn’t know from personal knowledge, but one does suspect.
Once again we see the Obama dance. There’s a lot of rhetoric for progressive causes, then the regressive forces complain, then quietly Obama caves, then the cave gets little coverage, and finally the Obama pseudo-progressive fan club don’t seem to realize they’ve been betrayed.
The willing suspension of disbelief.
Agree. But there are a lot of people like you and me who are disenfranchised, disallusioned, and disappointed.
As we learned at the time, this was just corporate welfare with the deal cut in a backroom.
I call the legislation the Rube Goldberg Health Insurance “Reform” Act of 2010. It is a monument to the staggering mendacity and incompetence of the Democratic Party. Even a team of GOP saboteurs couldn’t have managed to craft legislation that not one in 100 Americans can understand, aside from the hated mandate.
Social Security is not “going broke.” It has trillions of dollars in IOUs due to it. The fact that politicians don’t want to have to pay that back in a timely manner is why we are having the discussion on Social Security. Furthermore, it’s almost ridiculous to posit how much Social Security is going to have 2 decades down the road when the people that you are expecting to fill it’s coffers in some cases haven’t even been born yet. W
The average cost for for profit health care right now is what? The average cost per person is $7,439. Where do you get 20% from?
According to the Social Security Administration’s projections, the old-age trust fund won’t run dry for another 25 years. If and when that happens, payroll taxes will still cover about 70 percent of benefits due retirees.
You’re correct about the IOU’s. Until the trust fund reserves (the paid back IOU’s) are exhausted in 2036. Thereafter, tax income would be sufficient to pay only about three-quarters of scheduled benefits.
20% was just a math problem. Current payroll tax is about 3% of all workers income to cover 47.5M. So to cover all 313M Americans, that comes too about 20% of all workers income.
Right you are. As I posted above, we currently collect 12.4% of wages (less the Obama 2%) for SS and that’s not enough to pay current rate benefits beyond 2036 – when the trust fund will be zero, i.e. broke.
We should all be so lucky as to have a mandated stream of revenue coming in from employers and taxpayers and trillions of dollars in payouts and still be considered to be “going broke.” LOL
The whole entire “debate” occuring is because the politicians who took money from Burger King employees(all the while bashing them as parasites who don’t pay taxes)that was intended for their retirement, now do not want to pay that money back(nor admit that every single working person has been contributing to this country’s upkeep, including minimum wage people they have insisted don’t have any “skin” in the system.)
This is another one of those talking points I am not going to allow to pass. It needs to be driven home that this is about Congress wanting to renege on paying back a loan.
25 years from now there will be new workers entering the work force that haven’t even been born yet.
Projecting the economy that far out is pretty ridiculous.
You have offered this same comment before on other threads where Medicare for All is proposed.
What others offer in response, including the 25-year solvency of SS, the real actuarial impact of bringing millions and millions of younger healthier people into the risk pool (other than your general remark that costs may be lower – of course they would be way lower), what percentage of income individuals and employers are actually paying for private insurance, proposed funding other than merely raising the payroll tax (which would be wrong, since the plan will cover people whose income doesn’t come from wages), cost savings such as prescription drug price negotiation, the fact that countries which provide universal health care have better outcomes for less cost than the private insurance system, factor into your comment.
Just because a formula you propose produces an answer of 20% doesn’t mean that is the formula that describes the proposal.
They are not IOU’s they are treasury bonds backed by the full faith and credit of the United States Government. Just sayin!
And you are correct about the distinction. I consider IOU to be shorthand slang.
Great points, thanks for pushing back.
The 2010 Social Security Trustees Report states that the future finances of the program depend upon:
A lot more than “people that haven’t been born yet”. But just because it’s hard for some folks to comprehend, doesn’t mean the projections are ridiculous.
The math seems off.
Again, how much does the average person pay as a percentage of their pay for their health coverage now?
My husband’s policy costs us a little under 10% of his income(That’s on top of our Medicare costs)without co pays. So we’re already paying almost 13% for health care coverage. We’re one of the fortunate ones because his company pays for most of the costs for the policy. When I worked for Walmart to get a comparable policy I would have been paying about 25% of my income without co pays(on top of the 3% in Medicare costs).
Additionally, the costs for the system should be split. If an employer chooses not to provide coverage then they should be required to pay into a public pool as a percentage of payroll costs. Let the market decide whether the government or private enterprise is more efficient(and if private enterprises can’t get more efficient then let them “com pete or die.”
Oh I understand it just fine. I just consider it ridiculous. The same people who “never could have predicted” the economic downturn are now omnipotent when it comes to running future projections on birth rates and tax revenue. I’m not buying it.
You’re right. I just came up with a number. Far too many people argue for Med-for-all without realizing there’s a cost to them.
Since you mention other countries and their superior performance, I noticed Greece in the news lately:
You’re right. I just came up with a number. Far too many people argue for Med-for-all without realizing there’s a cost to them.
Ahhhhhh, that explains why you’re so quick to protect another group of people who also are tasked with randomly pulling numbers out of their backside.
Most of us are smart enough to realize that there is not any such thing as free. There is already a “cost” associated with keeping the system as it is. Considering the system as it stands has cost thousands of lives and is responsible for almost half of the bankruptcies in this country I think that it is fairly clear that Medicare is not the only approach that has costs.
Health care that is employer based involves private institutions, whether under the mantle of a religious agenda or for profit agenda determining the details and quality of your health care; even what your doctor may or may not tell you or what he/she may recommend for treatment is in my view insanity. We may not like the government but at least people accountable through elections make the rules and apply them equally to all people.
Single payer is the only practical and humane system. Quality is better and it is cheaper without th 30% profit margin demanded by private insurance
sellout oblabla waits for friday night dump to issue his cowardly policies. the next election will be a choice between two pices of shit, one firm and one runny
Why?
Employers aren’t required to pay into a pool to cover auto insurance costs, or homeowners insurance or anything else.
The only reason employers started in the health care business is the insurance companies got to Congress and convinced them it would be good (e.g. we’ll give you money) if employer contributions to health insurance were a deductable benefit.
30% seems high, not sure where it came from.
Here’s a link for WellPoint.
http://economix.blogs.nytimes.com/2009/09/25/how-much-money-do-insurance-companies-make-a-primer/
Why?
Because businesses benefit via profit from a healthy a productive workforce and I’m tired of having to foot the entire bill for their profitability
As for the Car insurance argument, car insurance is not anywhere near the same thing as health insurance. I can opt out of purchasing a car, I can’t opt out of getting sick or eventually having my body break down as it gets older. It’s part of human nature for the body to deteriorate.
It’s just that IOU is the Republican talking point. If we don’t get the narrative correct we can’t win the messaging war. Not trying to be nitpicking. *g*
Without knowing anything else about the Greek tax structure, what other taxes people pay, what they get for their money, how cost control is implemented for what they get for their money, these numbers don’t say anything to me.
As cwaltz said, no one who has thought about this thinks Medicare for All would be free. The actual dollar cost to the taxpayer can’t be just some number, without the context of an actual proposal that addresses cost controls, cost savings (such as preventive care), and funding approaches.
And of course one of the things we would get for our money with universal health care is that the number of people who go bankrupt, or suffer, or die because they lack access to affordable care and medicine would be reduced to, well, zero, which is, in my opinion, a good and wise use of taxpayer dollars.
Ok, you can opt out of buying a car. How about food? Should employers be required by the government to set aside extra money beyond your salary for food because – as you say – businesses benefit via profit from a healthy and productive workforce and you’re tired of having to foot the entire bill for their profitability? Aren’t you tired of wasting all your money on food while the company is sitting around freely profiting from your good health.
You’ll die a lot faster without food than you will without health care.
Maybe employers should pay their employees for their work and let employees use that money to buy things they need and want, rather than having the government mandate what it wants.
I think the 30% is not the profit margin, but the medical loss ratio (percent of money not spent on health care). For Medicare this is about 3%.
The Not-Healthcare Bill tried to reduce this to 15 or 20% but the insurance companies then started looking for ways around it.
I’m already paying for food for one out of every seven of us and YES I think corporate taxes ought to pay for it too. Or they could go with option B and pay their people enough that they don’t need food stamps.
Edit: Tried to reduce the money not spent on health care from 30% to 15 or 20%
Spare me.
Corporate America likes to think they are special. They aren’t. If they benefit from this country’s school systems, roads, security, or a whole host of other programs, they, like the rest of us, belong helping to pay for it.
I’m tired of the parasites putting their hands out and asking the rest of us to pay for things that improve their bottom line.
> rather than having the government mandate what it wants
Alan, not everyone is a selfish prick. “The government” doesn’t “want” anything. “The government” is us, “the people.” (Theoretically.) We decide how we want to all live together. And if you don’t like it, sport, I suggest that you “go rogue” and move somewhere more to your liking, such as Saudi Arabia. Otherwise, you’re going to be stuck living how we all collectively decide to live. And we’re in the process of deciding that health care should be a human right and not a profit center. Yes, even after listening to your depraved Randian bullshit.
I hear Somalia is a libertarian paradise. You don’t have to worry about the government at all there.
Yes the 30% is a consistent figure for premiums not spent on health care. You can break it down however you like as to how the for profit companies spend it. It does include hefty shareholder dividends and CEO salaries etc. The pharmaceuticals are the biggest profiteers.
Single payer countries such as Canada it is around 15%. For profits by definition must harvest profit above costs. Single payer non-profits do not.
But we must accept that we live in a country where profits for private business are the highest priority for government.
Have you read anything from Physicians for a National Health Program? You might want to rummage around, find some of the studies they’ve done providing documentation that Single Payer would save money.
Just a suggestion…
http://www.pnhp.org/
But we must accept that we live in a country where profits for private business are the highest priority for government.
They sure want us to accept it. I’ll be damned if I will though. I’ll keep tossing the buggers out if I have to.
So the parasites ask others to pay for things, us non-parasites require others to pay.
:-) Hmm, cwaltz first used IOU’s @ #13. Not sure (s)he’d be happy about it being called a Republican talking point.
> I hear Somalia is a libertarian paradise. You don’t have to
> worry about the government at all there.
Excellent thought. Alan should find it most agreeable there with his fellow Randrogues. And he’s of such fine character that he’ll not even ask us to pay for his one-way ticket to paradise.
As I say I am not trying to nitpick but that’s what the people who are sure SS is broke say. Worthless IOU’s. It’s not the way to win the message war.
Fun Fact for Alan the Parasite: If we do nothing, by 2036, payments at the current rate will be able to cover 77% of the program’s scheduled benefits and administrative costs for the foreseeable future. Minor adjustments can bring it back to 100 percent or even more (recommended).
Yes every word you say is true. The “Affordable Health Care Act of 2009″ does not leave us with much health care, and what we get still takes up huge resources of our money and our time.
I know that many wome4n in their thirties and forties have fibroids lining their uterus. in a sane system, such tumors would be removed through embolisation. But Kaiser Permanaente, In Calif. makes you wait up to three months to take a one day course in whether the procedure is right for you. It is scheduled at only ONE of the many KP centers in the San Francisco area. In my case, I would have had to travel five hours to get to the campus where it was presented.
Only after completion of this full-day-spent-in-a-seminar, does a person get the right to have the procedure. This means many women have their insurance dropped (if they are fired or their employer no longer covers them) before they get to have the procedure. My COBRA ran out before I could have it done. All this helps Kaiser Permanente avoid hiring on enough radiologists to do the job for this population of women.
Thank you for posting this link. And thank you for taking on Alan.
“All this helps Kaiser Permanente avoid hiring on enough radiologists to do the job for this population of women.”
What is the tax status of K.P.?
With the exception of you calling me names on several occasions, I agree with you. In fact, I beat you to it, see my post at #15: