The FDL health care team has been covering the health care debate in congress since it began last year. They have put together a fact sheet to help readers sort through the myths and facts of the health care bill:
|1. This is a universal health care bill.
||The bill is neither universal health care nor universal health insurance.
Per the CBO:
|2. Insurance companies hate this bill
||This bill is almost identical to the plan written by AHIP, the insurance company trade association, in 2009. The original Senate Finance Committee bill was authored by a former Wellpoint VP. Since Congress released the first of its health care bills on October 30, 2009, health care stocks have risen 28.35%.|
|3. The bill will significantly bring down insurance premiums for most Americans.
||The bill will not bring down premiums significantly, and certainly not the $2,500/year that the President promised.
Annual premiums in 2016, status quo / with bill:
Small group market, single: $7,800 / $7,800
Small group market, family: $19,3oo / $19,200
Large Group market, single: $7,400 / $7,300
Large group market, family: $21,100 / $21,300
Individual market, single: $5,500 / $5,800*
Individual market, family: $13,100 / $15,200*
|4. The bill will make health care affordable for middle class Americans.
||The bill will impose a financial hardship on middle class Americans who will be forced to buy a product that they can’t afford to use.A family of four making $66,370 will be forced to pay $8,628 per year for insurance. After basic necessities, this leaves them with $8,307 in discretionary income — out of which they would have to cover clothing, credit card and other debt, child care and education costs, in addition to $5,882 in annual out-of-pocket medical expenses for which families will be responsible.|
|5. This plan is similar to the Massachusetts plan, which makes health care affordable.||Many Massachusetts residents forgo health care because they can’t afford it.A 2009 study by the state of Massachusetts found that:
|6. This bill provide health care to 31 million people who are currently uninsured.
||This bill will mandate that millions of people who are currently uninsured must purchase insurance from private companies, or the IRS will collect up to 2% of their annual income in penalties. Some will be assisted with government subsidies.|
|7. You can keep the insurance you have if you like it.||
The excise tax will result in employers switching to plans with higher co-pays and fewer covered services.
Older, less healthy employees with employer-based health care will be forced to pay much more in out-of-pocket expenses than they do now.
|8. The “excise tax” will encourage employers to reduce the scope of health care benefits, and they will pass the savings on to employees in the form of higher wages.||There is insufficient evidence that employers pass savings from reduced benefits on to employees.
|9. This bill employs nearly every cost control idea available to bring down costs.
||This bill does not bring down costs and leaves out nearly every key cost control measure, including:
|10. The bill will require big companies like WalMart to provide insurance for their employees||The bill was written so that most WalMart employees will qualify for subsidies, and taxpayers will pick up a large portion of the cost of their coverage.|
|11. The bill “bends the cost curve” on health care.
||The bill ignored proven ways to cut health care costs and still leaves 24 million people uninsured, all while slightly raising total annual costs by $234 million in 2019. “Bends the cost curve” is a misleading and trivial claim, as the US would still spend far more for care than other advanced countries.
In 2009, health care costs were 17.3% of GDP.
Annual cost of health care in 2019, status quo: $4,670.6 billion (20.8% of GDP)
Annual cost of health care in 2019, Senate bill: $4,693.5 billion (20.9% of GDP)
|12. The bill will provide immediate access to insurance for Americans who are uninsured because of a pre-existing condition.||Access to the “high risk pool” is limited and the pool is underfunded. It will cover few people, and will run out of money in 2011 or 2012Only those who have been uninsured for more than six months will qualify for the high risk pool. Only 0.7% of those without insurance now will get coverage, and the CMS report estimates it will run out of funding by 2011 or 2012.|
|13. The bill prohibits dropping people in individual plans from coverage when they get sick.||The bill does not empower a regulatory body to keep people from being dropped when they’re sick.There are already many states that have laws on the books prohibiting people from being dropped when they’re sick, but without an enforcement mechanism, there is little to hold the insurance companies in check.|
|14. The bill ensures consumers have access to an effective internal and external appeals process to challenge new insurance plan decisions.||The “internal appeals process” is in the hands of the insurance companies themselves, and the “external” one is up to each state.
Ensuring that consumers have access to “internal appeals” simply means the insurance companies have to review their own decisions. And it is the responsibility of each state to provide an “external appeals process,” as there is neither funding nor a regulatory mechanism for enforcement at the federal level.
|15. This bill will stop insurance companies from hiking rates 30%-40% per year.
||This bill does not limit insurance company rate hikes. Private insurers continue to be exempt from anti-trust laws, and are free to raise rates without fear of competition in many areas of the country.|
|16. When the bill passes, people will begin receiving benefits under this bill immediately
||Most provisions in this bill, such as an end to the ban on pre-existing conditions for adults, do not take effect until 2014. Six months from the date of passage, children could not be excluded from coverage due to pre-existing conditions, though insurance companies could charge more to cover them. Children would also be allowed to stay on their parents’ plans until age 26. There will be an elimination of lifetime coverage limits, a high risk pool for those who have been uninsured for more than 6 months, and community health centers will start receiving money.
|17. The bill creates a pathway for single payer.
||Bernie Sanders’ provision in the Senate bill does not start until 2017, and does not cover the Department of Labor, so no, it doesn’t create a pathway for single payer.
Obama told Dennis Kucinich that the Ohio Representative’s amendment is similar to Bernie Sanders’ provision in the Senate bill, and creates a pathway to single payer. Since the waiver does not start until 2017, and does not cover the Department of Labor, it is nearly impossible to see how it gets around the ERISA laws that stand in the way of any practical state single payer system.
|18 The bill will end medical bankruptcy and provide all Americans with peace of mind.
||Most people with medical bankruptcies already have insurance, and out-of-pocket expenses will continue to be a burden on the middle class.
*Cost of premiums goes up somewhat due to subsidies and mandates of better coverage. CBO assumes that cost of individual policies goes down 7-10%, and that people will buy more generous policies.
- March 11, Letter from Doug Elmendorf to Harry Reid (PDF)
- The AHIP Plan in Context, Igor Volsky; The Max Baucus WellPoint/Liz Fowler Plan, Marcy Wheeler
- CBO Score, 11-30-2009
- “Affordable” Health Care, Marcy Wheeler
- Gruber Doesn’t Reveal That 21% of Massachusetts Residents Can’t Afford Health Care, Marcy Wheeler; Massachusetts Survey (PDF)
- Health Care on the Road to Neo-Feudalism, Marcy Wheeler
- CMS: Excise Tax on Insurance Will Make Your Insurane Coverage Worse and Cause Almost No Reduction in NHE, Jon Walker
- Employer Health Costs Do Not Drive Wage Trends, Lawrence Mishel
- CBO Estimates Show Public Plan With Higher Savings Rate, Congress Daily; Drug Importation Amendment Likely This Week, Politico; Medicare Part D IAF; A Monopoloy on Biologics Will Drain Health Care Resources, Lancet Student
- MaxTax Is a Plan to Use Our Taxes to Reward Wal-Mart for Keeping Its Workers in Poverty, Marcy Wheeler
- Estimated Financial Effects of the “Patient Protection and Affordable Care Act of 2009,” as Proposed by the Senate Majority Leader on November 18, 2009, CMS (PDF)
- Health insurance companies hang onto their antitrust exemption, Protect Consumer Justice.org
- What passage of health care reform would mean for the average American, DC Examiner
- How to get a State Single Payer Opt-Out as Part of Reconciliation, Jon Walker
- Medical bills prompt more than 60 percent of U.S. bankruptcies, CNN.com; The Patient Protection and Affordable Care Act Section‐by‐Section Analysis (PDF)
Essay by Greg Ng
The 1970s in Hollywood were a fertile time. The emergence of the director, as a legitimate artist in his or her own right, shifted focus from the studios, which by the ’60s had grown formulaic and unadventurous in their output, to a new generation of writers and directors, whose concerns and experience were markedly different from the conservative voice of the movie industry at that point.
Due in part to falling profits and the rise of television, a vacuum arose in the industry that opened the door for fresh ideas. Hollywood was redirected and, as a result, American cinema entered a new age – an age when box-office success did not necessarily preclude sophisticated content in a movie, an age when political discourse was not relegated to non-existence or tokenism, or a niche-market. The period between 1969 and the beginning of the 1980s saw American cinema, inspired as it was by international filmmaking (such as the French New Wave), offering critical, ambiguous and highly artful movies.
At its most ambitious, the New Hollywood was a movement intended to cut film free of its evil twin, commerce, by enabling it to fly high through the thin air of art. The filmmakers of the ’70s hoped to overthrow the studio system, or at least render it irrelevant, by democratising filmmaking, putting it in the hands of anyone with talent and determination. (1)
However, as the decade passed, the promise of real change receded; the status quo prevailed. As Peter Biskind puts it, in his book Easy Riders and Raging Bulls: How the Sex ‘N’ Drugs ‘N’ Rock ‘N’ Roll Generation Saved Hollywood,
although the decade of the 70s contains shining monuments to its great directors, the cultural revolution of that decade, like the political revolution of the 60s, ultimately failed. (2)
Robin Wood, in Hollywood: from Vietnam to Reagan, argues that the Vietnam War, among other things, focussed Western society’s dissenting voices, simultaneously discrediting ‘the system’ and emboldening the dissenters. However, like Biskind, Wood acknowledges “this generalized crisis in ideological confidence never issued in revolution. No coherent social/economic program emerged.” (3)
Commercial imperatives once more came to play their part in shaping the output of the industry, as previously fêted directors suffered box office losses and investment money turned to more secure propositions. Thus, a central tenet of political economy – i.e., the inherent censorship of the mass market – prevailed. Ironically, one of the films that stands as a testament to ’70s Hollywood’s freedom and ambition, Sidney Lumet’s Network (1976), depicts precisely this phenomenon.
Network is an example of a hugely successful and critically acclaimed feature film that offers a critique of television, ideology, radical chic and the consequences of American-led post-war capitalism, whilst being funny – no mean feat, and something only barely achieved in the current day by the likes of Michael Moore, et al.
Lumet’s direction and Paddy Chayefsky’s script lambaste the ills of the modern world (couched within the fast-paced soliloquies delivered by the stellar cast of Peter Finch, Faye Dunaway, Robert Duvall and William Holden) and are oft times prescient, predicting the rise of ‘reality television’, and the subsequent decline of both production and social values.
One of the central themes of Network – the decay of society and of love, concurrent with a plunge in standards and morality of the audience, which represents the world (in keeping with the mindset of both the film and its characters) – proves salutary in explaining what happened to Hollywood after the ’70s. Just as the collapse of the old studio system in the ’60s was precipitated by a change in demography and values, so too has a drift toward social conservatism and the continuing project of marketising everything affected our age.
When Howard Beale (Peter Finch), the ageing news anchor for Union Broadcasting System, is fired due to poor ratings, he announces to his friend and network executive Max Schumacher (William Holden) that he intends to “blow my brains out, right on the air, right in the middle of the 7 o’clock news” (4).
Schumacher replies, “You’ll get a hell of a rating. I’ll guarantee you that. 50 share, easy.” He facetiously begins to run with the idea: “We could make a series out of it. ‘Suicide of the Week.’ Oh, hell, why limit ourselves: ‘Execution of the week.’” [Read more...]
by digbyJim VanDehei was on Mitchell this morning talking about his new article which evidently reports that Obama is going to twist arms today to make sure health care reform passes before Christmas. Mitchell asked him if (as Chuck Todd absurdly posited) Lieberman actually pulled back from the brink and decided not to blow up the Democratic party or if he is sitting pretty because he actually got exactly what he wanted:
VanDeHei I don’t think there’s any question that he got what he wanted. He’s been able to kill, or help kill, the public option and now he’s single handedly killed this Medicare expansion for people over the age of 55.
And so now what the president is doing is calling in Democrats in the Senate and saying “listen this is the last chance we have to get health care reform and if I fail, like Clinton failed, we’re talking about generations before another Democratic president with this big of a majority can actually tackle health care reform”. His case is going to be that if we don’t do this in the next two weeks it’s never going to be done.
The big question is, will that message pacify liberals? Liberal Democrats on the hill are saying “listen we wanted a single payer system or at least we wanted the public option or at least we wanted the medicare buy-in. Now we’re getting squat on that end so what are we actually getting?”
Obama will say, you’re actually getting a lot. You’re getting coverage for everybody. You’re getting insurance reform. And he’s going to have to convince them that that is sufficient.
That doesn’t make sense and if Obama is able to persuade liberals with that incoherent line of reasoning then he really is good and they really are stupid.
If this is the only chance for reform in generations, wouldn’t it have made more sense to fight for a truly comprehensive bill that actually solved the problem? If you’ve only got one bite of the apple every couple of decades, it seems remarkably foolish not to really go for broke. To end up with a bill like this as your once in a generation liberal accomplishment is about as inspiring as a Bobby Jindal speech.
And Obama can say that you’re getting a lot, but also saying that it “covers everyone,” as if there’s a big new benefit is a big stretch. Nothing will have changed on that count except changing the law to force people to buy private insurance if they don’t get it from their employer. I guess you can call that progressive, but that doesn’t make it so. In fact, mandating that all people pay money to a private interest isn’t even conservative, free market or otherwise. It’s some kind of weird corporatism that’s very hard to square with the common good philosophy that Democrats supposedly espouse.
Nobody’s “getting covered” here. After all, people are already “free” to buy private insurance and one must assume they have reasons for not doing it already. Whether those reasons are good or bad won’t make a difference when they are suddenly forced to write big checks to Aetna or Blue Cross that they previously had decided they couldn’t or didn’t want to write. Indeed, it actually looks like the worst caricature of liberals: taking people’s money against their will, saying it’s for their own good. — and doing it without even the cover that FDR wisely insisted upon with social security, by having it withdrawn from paychecks. People don’t miss the money as much when they never see it.
And as for the idea that insurance reforms are a huge progressive victory that can only be accomplished once in a generation, well that’s a pretty sad comment on our country — and progressivism.
What this huge electoral mandate and congressional majority have gotten us, then, is basically a deal with the insurance industry to accept 30 million coerced customers in exchange for ending their practice of failing to cover their customers when they get sick — unless they go beyond a “reasonable cap,” of course. (And profits go up!) If that’s the best we can expect of progressivism for the next generation then I’m afraid we are in deep trouble.
*I realize that the subsidies and the medicaid expansion are meaningful. But they are also going to be subject to ongoing funding battles in an age of deficit hysteria. I don’t hold out much hope for any improvement on that count. Indeed, I fully expect they will be assailed as welfare and eliminated as soon as Republicans gain power. They have learned from their mistakes — don’t let any liberal “entitlement programs ” become entrenched. That’s why a big comprehensive program would have been better. It’s much harder to disassemble.
Update: I think it’s really cool being lectured to by Obama about not getting everything you want. I would imagine that Joe Liberman laughed and laughed and laughed at that one.