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First a nit: they have the section III label in there twice.
I don’t care for the way they’ve organized it. They don’t have it organized according to the goals Pres. Obama set out (cost control, quality improvement, cover more people).
Price/Cost Competition
Exchange (to enable the public to compare & buy insurance)
Public Option (paid for by premiums only, but is it gov’t run or private?)
Government-Defined Basic Package (allows better consumer comparisons)
More money for doctors, nurses, community health centers, etc.
Data gathering on disparities around the country
Quality Competition
More primary care training
(other things are included)
Covering More People
Subsidy Credits for poor- & middle-class
Expand Medicaid
No pre-existing-conditions to exclude people
Personal- & employer-mandates (requiring everyone be covered by law)
Problems & Questions I have
What rules can the Exchange enforce?
Is the Public Option run by gov’t or private insurers?
Can an insurance co. doctor deny coverage or otherwise control care?
Does it tie doctor performance to ‘best practices’?
Aside from the gov’t plan can insurers offer other plans?
Are employer- and individual-mandates wise?
Is the ‘cost disparity’ information going to be available to the public?
Is the ‘quality of care disparity’ information going to be available?
Can more insurers (than at present) compete nationally via the Exchange?
Can consumers switch insurers more quickly & easily than at present?
Is Portability addressed at all?
How much money will go to ‘best practices’ research and information dissemination?
Does it do more to encourage doctors to work for salary (instead of fee for service)?
What’s the cost of expanding Medicaid?
What’s the cost of expanding the Medicare Part D donut?
How much more will it cost for expanding existing programs?
How much money will be available for new doctors, nurses, health ctrs?
While there are good things in the bill I see the mandates and public option as bringing more money into the system and I wonder if the Exchange and having more people insured is really all that’s going to hold down overall (systemic) cost?
Will CBO analysis include systemic cost savings to America as well as expenditure costs?
Political Question
Given President Obama’s request for cost control, quality improvement and insurance for more people, what do these other things he didn’t ask for cost(?) and what percentage of the total bill’s cost is it?
2 Comments
Will CBO analysis include systemic cost savings to America as well as expenditure costs?
Mark, according to Bob Reich, the answer is “no.”
“Memo to the President,” Robert Reich
link is too long to post but the quote is from tpmcafe.talkingpointsmemo.com
Given a bit more time to reflect on the bill it appears they’re
Fixing the Medicare donut for older folk
Using the employer mandate to help working folk
Expanding Medicaid to subsidize more lower-income folk
and
Offering the public option with gov’t defined basic plan for other folk
And then using the individual mandate to push everyone into getting covered one way or another.
Will the Medicaid expansion require more gov’t employees to handle or will it be done by computer software — the Exchange? If software, then will it reduce gov’t employee rolls?
In fact, could the Exchange reduce a lot of need for insurance company employees?
If the bill requires some kind of standardization for paperwork then would that reduce a lot of need for doctor’s office and insurance company employees?
Based on the federal employees system Exchange what can they predict it’s impact will be nationally?
Of the 45-50M uninsured just how many will become covered through the employer-mandate? How many more will become covered through the expanded Medicaid? Does the legislation specify MEN will qualify now for Medicaid?
How many do they expect won’t be covered after the employer mandate and the expansion of Medicaid?
Given that number (whatever it may be) is it justified to have an individual mandate to force them to get insurance?
It would also seem the Medicaid expansion could be easily adjusted to bring down the bill’s cost.