What do you think of Obama's health care plan?

According to a CNN flash poll [PDF], the president killed. Asked, "What was your overall reaction to President Obama's speech tonight -- very positive, somewhat positive, somewhat negative or very negative?" 77% of respondents answered that it was either very or somewhat positive, with the majority -- 56% -- calling their reaction "very positive."

But that isn't the only indication that the president's words had an impact. Where 60% said they thought Obama would move the country in the right direction before the speech, 70% thought so afterward -- a ten-point jump. He had even more success with opinions of his specific plan; 53% supported Obama's healthcare reforms before the speech and 67% favored them afterward.

75% believe that congress will pass most of his proposals and 72% felt the president was clear about what he wanted. Looking through this, there isn't a bad number in this poll. But Joe Wilson is getting a lot of the coverage.

my most noteworthy thing is that Obama chose to not back down on the public option.

Beginning in 2013, the Exchange will give Americans without access to affordable insurance on the job, and small businesses one-stop shopping for insurance where they can easily compare options based on price, benefits, and quality.

This:

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Beginning in 2013, the Exchange will give Americans without access to affordable insurance on the job, and small businesses one-stop shopping for insurance where they can easily compare options based on price, benefits, and quality.

If the mandates take effect before this I see it as a significant burden on people who do not have access to employer-sponsored insurance.

FreeDuck wrote:

This:

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Beginning in 2013, the Exchange will give Americans without access to affordable insurance on the job, and small businesses one-stop shopping for insurance where they can easily compare options based on price, benefits, and quality.

If the mandates take effect before this I see it as a significant burden on people who do not have access to employer-sponsored insurance.

It also gives the Obama administration the breathing room needed to get past the next election.

Mostly responding to the topic headers:

•Implements a number of delivery system reforms that begin to rein in health care costs and align incentives for hospitals, physicians, and others to improve quality. The President’s plan includes proposals that will improve the way care is delivered to emphasize quality over quantity, including: incentives for hospitals to prevent avoidable readmissions, pilots for new "bundled" payments in Medicare, and support for new models of delivering care through medical homes and accountable care organizations that focus on a coordinated approach to care and outcomes.

Robert, if you understand that, I was you would explain it to me.

my most noteworthy thing is that Obama chose to not back down on the public option.

This was very important to me, and after Obama had made the wishy-washy-if-there-isn't-a-public-option statement a month ago, that's when I personally observed things unravel the most. This seemed to bring things back in focus for me.

Other than that, I'm pleased with firm language about pre-existing conditional care and preventative care.

T
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Mostly responding to the topic headers:

•Ends discrimination against people with pre-existing conditions.

•Limits premium discrimination based on gender and age.

•Prevents insurance companies from dropping coverage when people are sick and need it most.

Those are important goals. Keep in mind that they can only be acheived if insurance is mandatory. All the young, healthy and active people not engaged in dangerous activities are going to have to be dragged into the program, whether they like it or not, and they are going to have to pay substantially the same premium as transplant recipients, the old, and the chronically ill. The only other possibility is massive government subsidy.

I appreciate your choice of words roger.

They are "important" goals but why and for whom?

People have been conditioned to regard any and all "discrimination" as undesirable, unfair, and even immoral, but this is foolish. As you rightly point out, if we are to eliminate discrimination in terms of healthcare coverage based on age, gender, and medical history, then we must eliminate discrimination in terms of the cost for that coverage based on the same factors.

But, of course, this is not what Obama and the Democrats would have us believe.

Insurance is based on principles of risk spread and the law of large numbers, but has always distinguished between low risks and very high risks. This why young men under the age of 25 pay much more than the rest of us for car insurance.

While men in this age group are more likely than the rest of us to have accidents, it is not certain that they will and so although they may have to pay more than us for insurance, they remain insurable.

A person (young or old) who is not insured, but has just had an accident is not able to call an insurance agent and obtain coverage for his car that is retroactive to one minute before the accident.

It makes absolutely no sense to insure a known loss, unless the premium the company charges is some percentage higher than the cost of the loss and the expense required to process the claim. Why would anyone buy such "insurance?"

However to mandate that insurance companies cannot reject persons with pre-existing conditions comes close to mandating that they also provide a policy for a house that is on fire.

If, God forbid, you or I have cancer but we have no insurance, how can any health insurance company be expected to provide us with coverage at a cost that is less than the cost of the healthcare for our cancer?

The answer is they cannot, unless

a) They are allowed to charge everyone else a rate that is in no way based on our own health statistics, but geared to offset the cost of care for known cancer patients

b) The intent is to drive them out of business

"A" illustrates the intellectual dishonesty of the argument of the president and most Democrats.

Government mandates insurance companies take risks that are beyond a profitable model and then Government castigates these insurers for increasing their premiums.

Most people do not realize that insurers are not able to raise their prices without State approval. If insurance premiums rise, it is because the companies have made a compelling case to Government that an increase is necessary.

This is the cynical and disingenuous Kabuki dance in which Obama and the Democrats want to engage: Just about regulate the profit out of insurance and then cast the insurance companies as out of control bad guys.

Because of extreme regulation, insurance profit margins are very very thin. It is absolutely foolish to invest in any publicly traded insurance company that is subject to regulations.

Government controls insurance prices and mandates terms of coverage. Does anyone really think that the profitability of insurance companies is a major concern of Government regulators? Reluctant assent to increased premium is given only when regulators fear that an insurance market in their state will disappear.

Most Democrats and some Republicans prefer that Government pay for the losses of their citizens. In this way they can artificially keep costs down for the voters and punt the real financial implications to ensuing generations.

The state funded and run property insurance company in Florida is a perfect example. If you live in Florida, there is a much greater chance that your house will be damaged by a hurricane than if you live in Ohio, and yet Floridians want to pay the same premiums as folks in Ohio. Insurance companies can only spread the risk so far. Catastrophes that cost insurance companies billions of dollars happen regularly in Florida. They do not in Ohio. People in Florida should pay more for homeowners insurance than people in Ohio.

For political reasons, the state of Florida has established a state funded insurance pool to cover those citizens who do not want to, or cannot pay their fair premium.

What a great idea!

The state can do so because it doesn't demand profit, and it doesn't incur those ridiculous costs of executive shindigs in Boca Raton. Right? (Sound familiar as regards the "Public Option" for health insurance?)

Problem is that in subsidizing insurance for an enormous number of Floridian properties, the state's "insurance company" is one major hurricane away from total insolvency. The math of economics is not suspended because Government is involved.

So what will happen if a category 5 hurricane hits Florida? The state run "insurance company" will go bust and be unable to pay claims. What will they do then? Well, what they plan on doing is levying "assessments." Assessments against:

1) The insurance companies that do business in FL but never saw a dime of the premiums paid by the state's insureds
2) Out of state property owners - Snowbirds who have vacation residences in FL but don't vote there.
3) The citizens of Florida who have paid premiums to private insurance companies.

None of these assessments will be enough and so the ultimate bail-out source will be the federal Government.

There is a reason why Florida and other coastal states are pushing for a Federal Catastrophe Insurance fund --- subsidized by the citizens of Ohio, Michigan, Kentucky, Nevada, Arizona, etc etc etc.

Obama's health insurance plan is to drive private insurance companies out of business, and get the pesky constraints of economics out of way of pleasing voters, but just like the Florida Catastrophe Fund will, eventually, have to pay the piper, so will a Federal Health Insurance option.

BTW - what insurance company is able to cancel coverage once one of their policyholders becomes ill? This is a straw man.


•Caps out-of pocket expenses so people don’t go broke when they get sick.

Another fine goal. Again, it's going to be paid for by premiums from the lowest risk part of the population, and I am already hearing grumbles about having to support Medicare. Somebody is going to have to pay for it.

There is a tried and true principle known as "Having Skin in The Game." If you personally bear some measure of a risk you are more likely to mitigate that risk. The Obama plan will have those who do mitigate their risks by exercising, eating healthy and not smoking, paying for their fellow citizens who cannot be bothered.

Of course, this inherent inequity can be resolved by not requiring the fit to subsidize the unfit: Let the Government pick up the extra cost. Of course there is no way this can possibly happen without increasing the deficit.

•Eliminates extra charges for preventive care like mammograms, flu shots and diabetes tests to improve health and save money.

Good idea. I never had such a problem when I had company sponsored health care, but someone must have run into it. Oddly, one of the ways we are going to pay for the whole shebang is to reduce "unnecessary" diagnostic tests. I have concerns about who is going to decide what is necessary. Personally, I vote for my doctor's opinion. I selected him for a number of reasons, and his professional judgement is one of those reasons.

Another straw man Most private health insurance plans pay for preventive care, and the notion that preventive healthcare will save money over the long run sound logical but has not been proven.

Remember when HMOs came on the scene? Their marketing reps would always try to sell you on the fact that you could always visit your HMO doctor whenever you had an ache or the sniffles, because they knew that preventive care would save them money in the long run. What actually happened though? Whenever a virus hit town and you wanted to see your HMO doctor because of your sniffles, you were told that he or she was not seeing patients with minor symptoms and to call back if they got worse. Obviously the model didn't work.

Expensive superfluous tests will be brought under control when there is medical malpractice tort reform, and not before. The alternative is to have a bureaucrat decide what tests are valid = personal disasters.

Enough for tonight.