Quantcast
Channel: Health Insurance Headlines on One News Page [United States]
Viewing all 22794 articles
Browse latest View live

Poll: Uninsured sit on the sidelines as sign-up season ends

0
0
WASHINGTON (AP) — Most uninsured Americans are sitting on the sidelines as sign-up season under the federal health law comes to a close, according to a new poll that signals the nation's historic gains in coverage are slowing. — More than 7 in 10 say they have not tried to figure out if they qualify for the two main coverage expansions in the law, Medicaid and subsidized private health insurance. "What this survey does suggest is that it will get harder and harder to continue to make gains in the share of people getting health insurance," said Mollyann Brodie, Kaiser's polling director. President Barack Obama's health care law has driven down the share of uninsured Americans to 9 percent, according to the government. The health law's problems in part reflect entrenched political opposition, but there's also skepticism about whether the coverage is affordable for uninsured people of modest means. The law's other big driver of coverage is a Medicaid expansion aimed at low-income adults with no children living at home. Reported by SeattlePI.com 3 hours ago.

No Title

0
0
Obama's chief health official is heading to South Florida as the deadline to sign up for health insurance nears. Reported by WEAR ABC 3 3 hours ago.

Insurance costs dominate public worries about healthcare, survey finds

0
0
Though President Obama's Affordable Care Act continues to animate political debate in Washington and on the campaign trail, Americans are more concerned with basic healthcare issues such as the cost of their health insurance, a new national poll shows.

The health law ranked eighth among issues... Reported by L.A. Times 5 minutes ago.

An Iowa Voter Forced Ted Cruz To Confront The Human Toll Of Repealing Obamacare

0
0
Republicans have spent nearly six years promising to repeal Obamacare and, for most of that time, they have refused to acknowledge what that would mean for the millions who would lose their health insurance.

On Saturday afternoon in Iowa, for at least a few minutes, one Republican couldn't get away with it.

It happened at a Ted Cruz campaign event in Hubbard, a small town smack in the middle of the state. According to reports in The New York Times, The Washington Post and Politico, Cruz fielded a question from Mike Valde, a Democratic voter who had come to the event with a story to tell and a simple question to ask.

The story was about his brother-in-law, a barber named Mark. As Valde told it, Mark was a small business owner who worked so hard that he didn’t even take paid days off. But Mark was unable to afford health insurance until the Affordable Care Act became law. When it did, Mark bought insurance and then, when he started feeling ill, saw a physician -- who promptly diagnosed him with cancer with no hope for recovery. He died last year.
“He had never been to a doctor for years,” Valde said, reportedly on the verge of tears. “Multiple tumors behind his heart, his liver, his pancreas. And they said, ‘We’re sorry, sir, there’s nothing we can do for you.’"

The room fell silent, according to the Times' account, and then Valde, who later told reporters that he was a Hillary Clinton supporter, posed his question: “Mark never had health care until Obamacare. What are you going to replace it with?”

Cruz offered Valde his condolences before launching into the same basic argument that Republicans always make. “Under Obamacare,” Cruz said, “millions of Americans have lost their jobs. Millions of Americans have lost their doctors, have seen their premiums skyrocket.” He pointed out that Obama had promised families would see average savings of $2500 from health care reform, and joked that he’d gladly encourage anybody who'd actually reaped such savings to vote for Clinton -- a quip that drew laughter from the audience.

Valde, apparently less amused, kept at it. “My question is, what are you going to replace it with?” he said. Cruz responded that he’d get there, but first he wanted to talk some more about the “millions of stories on the other side” -- people who'd had to give up their old plans and, as a result, ended up with higher premiums or co-pays, narrow networks of providers or some combination thereof.

Eventually Cruz suggested that if Valde’s brother-in-law couldn’t afford health insurance premiums previously, it was probably because government regulation had driven up the price -- and that the best solution, at this point, was to wipe the slate clean and build a new health care system, one in which people could purchase coverage across state lines.

It mirrored the answer Cruz had given just two days before, when Fox News host Bret Baier posed a similar question during Thursday's presidential debate in Des Moines. And Cruz's description of Obamacare’s effects hadn’t gotten any less misleading in the interim.

It’s true that President Barack Obama's signature health care law rewrote the rules for how insurance companies sell policies directly to individuals -- requiring that all policies include comprehensive benefits, for example, and prohibiting carriers from charging higher premiums or denying coverage outright to people who pose greater medical risks. And it’s true that, because of those changes, insurers cancelled some existing policies.

But early reports suggesting as many 5 million people lost their old policies appear to have been exaggerated. Subsequent studies estimated that the actual number was less than half of that.
Meanwhile, those people were able to get new coverage through the law’s marketplaces. And the best available research suggests that the majority ended up paying less money, not more, for their policies, while enjoying guarantees of coverage nobody had previously.

Overall, fewer and fewer Americans are reporting difficulty with medical bills and the proportion of Americans without coverage has fallen to historic lows. In Iowa specifically, the proportion of residents without health insurance fell by nearly half from 2013 to 2015, according to Gallup.

As for the claim that the Affordable Care Act has either destroyed jobs or turned millions of full-time positions into part-time ones, it appears to be just plain wrong. Anecdotal stories of employers capping hours got a lot of attention in 2014 and 2015, but experts have now had time to examine the data and they see no signs of a significant trend towards part-time work. (Also of note: the private sector has created jobs in every month since the Affordable Care Act became law.) Based on conversations with several well-respected economists, the website Politifact recently rated this favorite Republican argument “Pants on Fire.”


Pants on Fire! Ted Cruz claims at GOP debate that Obamacare is 'biggest job-killer' https://t.co/lX1rbhISXt pic.twitter.com/j3Uuo17Qru

— PolitiFact (@PolitiFact) January 29, 2016


Allowing people to buy insurance across state lines, as Cruz proposed, is something conservatives have long favored. It would allow insurers to start acting like credit card companies, relocating to whatever states have the least onerous regulations and selling all policies from them.

Like other efforts to gut existing rules on how insurers operate, it’d allow the industry to sell cheap, skimpy policies that might appeal to some healthy people, but would offer nothing to people need comprehensive coverage. In short, it’s a way of allowing insurers to act like they did before health care reform -- not a way to make sure millions get insurance.

There’s a reason Cruz didn’t have a better answer for Valde, and it’s the same reason Republicans never have a satisfying response to this question.

The Affordable Care Act has its pluses and minuses, with plenty of people legitimately aggrieved about what it’s done or how it’s worked out for them -- and plenty more opposed for philosophical reasons. But any alternative that provides similar (or better) access to health care protection from medical bills is bound to require a similar combination of regulation and government spending. Republicans oppose such measures on principle -- which is why, when they talk about Obamacare, they exaggerate the downsides, ignore the upsides, and pretend they have better alternatives.

While Valde never got a real answer from Cruz, he had a chance to ask another candidate his question later in the evening. He showed up at a rally for Clinton in Cedar Rapids and was called onstage while she was speaking. Clinton noted that millions would lose their insurance if Cruz and the other Republicans have their way. "That’s fine with them," she said. "That’s not fine with me."-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 21 hours ago.

The Deadline for Obamacare Coverage Is Today: Here's What You Need to Know

0
0
The last day to enroll for health insurance on an Obamacare exchange is today. Here's everything you should be aware of if you're still uninsured. Reported by Motley Fool 13 hours ago.

New ez1095 ACA Software From Halfpricesoft.com Allows Customers Unlimited Client Accounts

0
0
Halfpricesoft.com accommodates ez1095 ACA software customers to add an unlmited amount of clients within the single user software at no additional cost. Test drive before purchase at http://www.halfpricesoft.com.

Chicago, IL (PRWEB) January 31, 2016

The brand new ez1095 ACA form software from Halfpricesoft. com was created to satisfy the requirements by the government to file forms 1094 and 1095 starting in 2016. ez1095 software’s graphical interface leads customer’s how to setup the software and how to print the forms correctly without extended computer or accounting backgrounds. Customers can also click form level help links to get more details regarding the software. The latest edition can now support unlimited client accounts on the same machine with no additional charge which makes it a perfect choice for accountants as well as larger businesses.

“The new efile version of ez1095 2015 software for printing ACA forms 1095 and 1094 has just been released by Halfpricesoft.com,” said Dr. Ge, the founder of Halfpricesoft.com.

The IRS has recently approved the efile features of the new ez1095 Affordable Care Act (ACA) software application from Halfpricesoft.com. The new healthcare law requires all employers with 50 or more full-time employees or equivalents to file an annual return in 2016 reporting health insurance they offered employees. The efile version will provide a quicker solution to processing forms 1095 and 1094.

ez1095 software is compatible Windows 10, 8.1, 8, 7, Vista, XP and other Windows systems. Potential customers can download and try this software at no obligation by visiting http://www.halfpricesoft.com/aca-1095/form-1095-software-free-download.asp

Some unique features of this innovative application are:· Print ACA Form 1095-C, 1094-C, 1095-B and 1094-B on white paper for recipients and IRS with inkjet or laser printer.
· PDF print 1095-C and 1095-B recipient copies.
· Efile version available at additional cost.
· Support unlimited companies.
· Support unlimited number of recipients.
· Print unlimited number of 1095 and 1094 forms.
· Data import feature
· Print Form 1095 C: Employer-Provided Health Insurance Offer and Coverage Insurance
· Print Form 1094 C: Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns
· Print Form 1095-B: Health Coverage
· Print Form 1094-B: Transmittal of Health Coverage Information Return

Priced at just $195 for a single user version, ($295 for efile version) this ACA forms filing software saves employers time and money by processing forms, in-house. To learn more about ez1095 ACA software, customers can visit http://www.halfpricesoft.com/aca-1095/aca-1095-software.asp

About halfpricesoft.com
Founded in 2003, Halfpricesoft.com has established itself as a leader in meeting the software needs of small businesses around the world with its payroll software, employee attendance tracking software, check printing software, W2 software, 1099 software and barcode generating software. It continues to grow with its philosophy that small business owners need affordable, user friendly, super simple, and totally risk-free software.

Contact Information
Halfpricesoft.com 13011 W HWY 42, Ste 101 Prospect, KY 40059 USA
contact(at)halfpricesoft.com
Fax: (866) 909-6448
http://www.halfpricesoft.com/aca-1095/aca-1095-software.asp Reported by PRWeb 13 hours ago.

The 1 Part of Obamacare Insurers Don't Want to Change

0
0
Medicaid expansion is boosting financial results at the nation's biggest health insurance companies. Reported by Motley Fool 12 hours ago.

Fox host shreds Ted Cruz over Obamacare falsehoods: ‘More people have jobs and health insurance’

0
0
Fox News host Chris Wallace cornered Republican presidential candidate Ted Cruz on Sunday about his claim that President Barack Obama’s health care reform law had cost jobs. “The fact checkers say you’re wrong,” Wallace told Cruz. “Since that law went into effect, the u... Reported by Raw Story 9 hours ago.

Donald Trump Promises He'll 'Work Something Out' On Health Care

0
0
Republican front-runner Donald Trump is going to "work something out" on health care after he dismantles Obamacare, he said Sunday. He didn't say what exactly that "something" will be -- but the real estate mogul said he's going to have it under control.

"Nobody knows health care better than Donald Trump," he said on ABC's "This Week with George Stephanopoulos." 

Trump's opponent Sen. Ted Cruz (R-Texas) has been attacking the business mogul for supporting government-run health insurance, comparing it to Obamacare. Trump said Cruz was a "total liar" and that he strongly opposes Obamacare.

As for his own health care plan, Trump has offered broad statements but few details -- similar to his promises to deport all undocumented immigrants through "management."

Stephanopoulos challenged him on how his plan would differ from Obamacare, if both are aimed at making sure everyone is insured and would involve government help. Trump said it was true -- "I want people taken care of," he said, adding that maybe Cruz has "no heart." But Trump said he does not want a single-payer system.

So, Stephanopoulos asked, how would it work?

"We're going to work with our hospitals," Trump replied. "We're going to work with our doctors. We've got to do something. ... We'll work something out. That doesn't mean single-payer."

Trump is leading in Iowa among Republicans with only a day to go before the caucuses, according to a Bloomberg/Des Moines Register/Selzer poll released late Saturday. Twenty-eight percent of those polled said Trump was their first choice, compared to 23 percent who plan to support Cruz.

The HuffPost Pollster average, which aggregates all available polls, shows Trump with an even larger lead in Iowa: 32 percent of the vote versus Cruz's 24 percent.

Note to our readers: Donald Trump is a serial liar, rampant xenophobe, racist, misogynist, birther and bully who has repeatedly pledged to ban all Muslims -- 1.6 billion members of an entire religion -- from entering the U.S.

*Also on HuffPost:*

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 8 hours ago.

Madison Beach Hotel Loses Appeal; Sonic Boom Causes Shakes; New Coffee Truck Opens: Madison's Best

0
0
Madison Beach Hotel Loses Appeal; Sonic Boom Causes Shakes; New Coffee Truck Opens: Madison's Best Patch Madison, CT -- School budget request greatly impacted by skyrocketing health insurance costs/ local resident enters wrestling Hall of Fame for CT and more. Reported by Patch 6 hours ago.

Millions Eligible for Medicaid Go Without It

0
0
Among the 30 million people still without health insurance despite the Affordable Care Act, there is one poorly understood group: as many as six million people who could get near-free care through Medicaid but don’t sign up. Reported by Wall Street Journal 2 hours ago.

Feds Hopeful Hispanics Will Respond As Open Enrollment Come To A Close

0
0
Sunday January 31st is the deadline in most states to buy health insurance through the Affordable Care Act. Federal officials are reaching out to those previously uninsured, with a focus on Hispanics. Reported by NPR 2 days ago.

The Latest: Rubio bemoans 'kitchen sink' attacks in Iowa

0
0
DES MOINES, Iowa (AP) — The Latest on the 2016 race for president on the final weekend of campaigning before Monday's leadoff Iowa caucuses (all times local): Rubio supports allowing immigrants in the U.S. illegally to stay with certain provisions, including no criminal background, but not until legislation to curb illegal immigration is enacted. Cruz opposes the federal renewable fuel standard, which requires a minimum amount of petroleum additives such as corn-based ethanol. Beck told the overflow crowd of hundreds that he'd never endorsed anyone for president before, but sees Cruz as a conservative who can be trusted to do what he promises. The Department of Homeland Security says it has received an official request for Secret Service protection from the Sanders campaign. The agency did not provide any additional details on the Vermont senator's request, but it is an initial step for a presidential candidate to get the protection. Vermont Sen. Bernie Sanders is kicking off the final weekend before the first-in-the-nation caucuses with a pitch to his Iowa supporters to make the rest of the nation follow their lead. The self-described democratic socialist says Iowa could be a model for the nation if "ordinary people — working people, middle-class people, seniors, young people — become involved." Cruz was confronted about the stance Saturday by an audience member at a campaign stop in Hubbard, Iowa. Cruz says health insurance is too expensive under the law and told Valde his brother-in-law could have gotten insurance earlier if he could have afforded it "but because of government regulations he couldn't." Valde said after the event that promising to repeal Obama's law is just a campaign slogan and he wanted to hear Cruz's plan for a replacement. The Ohio governor's comments came during a Saturday presidential campaign stop in New Hampshire in response to a voter question about elevated lead levels in Reported by SeattlePI.com 2 days ago.

Iowa Voter Confronts Ted Cruz Over His Enmity Of Obamacare

0
0
Ted Cruz's attempt to hew to his anti-Obamacare talking points Saturday led to an uncomfortable exchange with a voter who said his brother-in-law -- who couldn't afford health insurance for most of his life -- finally gained it under the president's health law but died anyway because he discovered several tumors too late.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 2 days ago.

Sunday night deadline for 2016 health insurance enrollment

0
0
Sunday night deadline for 2016 health insurance enrollment Sunday night is the sign-up deadline for subsidized private health insurance under President Barack Obama's health care law. Reported by WTHR 2 days ago.

Millions Eligible for Medicaid Go Without It

0
0
Among the 30 million people still without health insurance despite the Affordable Care Act, there is one poorly understood group: as many as six million people who could get near-free care through Medicaid but don’t sign up. Reported by Wall Street Journal 9 hours ago.

Pre-existing medical conditions coverage claims top the list of all claims processed under India Network Visitors health insurance program in 2015

0
0
Analysis of India Network Claims data demonstrate that most visitors are getting sick due to one or other pre-existing medical conditions. All members are advised to purchase a plan with pre-existing conditions coverage.

Orlando, FL (PRWEB) January 31, 2016

India Network Foundation has been helping thousands of Asian Indian families in the United States with visitor health insurance for more than two decades. During that time, the Foundation's plans progressively covered typical problems often denied by almost all other insurance companies in the world. In the last five years, India Network Foundation has sponsored plans that include coverage for pre-existing health conditions, accidental death benefits, repatriation benefits and medical evacuation benefits as a part of their health insurance coverage.

Pre-existing coverage varies by plan design and by company that offers. It is important to understand the pre-existing before purchasing any plan. India Network Visitor health insurance plans offers the broadest coverage for pre-existing conditions at affordable premiums. Any good pre-existing condition coverage plans cost more than the plans that offer restricted pre-existing conditions coverage or no pre-existing conditions coverage. All claims are paid either under pre-existing coverage or like new problems and accidents under ACE Premier and Network plans. Both Premier and Network plans cover pre-existing conditions on the same way but the difference is in how they settle the claims. Fixed benefit plans are cheaper to purchase but would leave you with a large hospital bill in case of illness or accident.

A recent analysis of India Network Visitor Health Insurance claims data demonstrated that the insurance plans with pre-existing conditions have been extensively helping visiting parents than the plans without such coverage. In the United States, heart disease was noted on 68% of diabetes related death certificates among citizens 65 years or older. Diabetes is the leading cause of kidney failures in 44 percent of all new cases. On top of all, about 60 to 70 percent of people with diabetes have some form nervous system damage ( http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf).

Dr. KV Rao, India Network said that the diabetic is so common among elderly that many visiting parents think that it is not a pre-existing condition that needs to be taken care of. As such, they tend purchase cheapest plan available in the market. Only those got sick realize how bad their plan was and it is too late to join a good one like India Network Health Insurance.

About India Network Foundation

India Network Foundation, established as a US non-profit organization, has been helping the Asian Indian community in North America with programs and grants to academics from India for more than two decades. India Network Foundation sponsors visitor health insurance to tourists, students, temporary workers (H1 visa holders) and their families.

For more information visit http://www.indianetwork.org

About India Network Health Insurance

India Network Health Insurance is a US based company that administers visitor health insurance to transition residents, tourists, students, temporary workers and their families. Visitor medical plans are offered for all age groups with both fixed coverage, comprehensive coverage and with pre existing condition coverage. India Network Services also offer scheduled benefit plans for US Citizens and Green Card holders under the age of 64.

For more information visit http://www.kvrao.org Reported by PRWeb 1 day ago.

In Praise of Unrealistic Ideas

0
0
The core blockage of American politics today is that nothing in mainstream debate is radical enough to fix what's broken in the economy. Today, the vast majority of Americans are being left far behind a halting economic recovery. The typical American family has not gotten a raise in more than three decades.

The Sanders campaign on the populist left and the Trump campaign on the populist right are both emblematic of the fact that large numbers of Americans have concluded that the system is not serving them, and they want radical change.

The Trump voters, more likely to be older white males, working class or lower middle class, are sick of the fact that they seem to be losing ground every year. The question of whether they are losing ground to blacks, or immigrants, or Wall Street, or to jobs leaving our shores, gets blended into a blur or undifferentiated anger. The fact that they keep hearing that the economy is in recovery is all the more enraging.

Trump frightens the Republican elite both because he is uninformed and unpredictable, but also because he is in many respects the least conservative of the conservatives. He doesn't hate government and he doesn't have much use for Wall Street and free trade. But the Trump program, to the extent that he has one, doesn't address the deeper causes of working class rage.

The Sanders voters tend to be younger, more driven by hope than by anger, and painfully aware that their generation has gotten the short end of the stick -- costly college loans, too few real jobs with career tracks, unaffordable housing, and a generational fable about how cool it is to live in a world defined by Facebook, Uber, Starbucks and Airbnb, even if incomes are low and unreliable. Maybe you'll invent a killer app, but maybe you won't. Will that be for here or to go?

These problems are not going away -- they are only deepening. And nothing on offer in mainstream politics is likely to fix them.

Radical ideas are outside the mainstream -- until they're not. Then, oddly, they become as American as apple pie. Radicals had to propose early versions of what became Social Security before the idea was taken up by the New Deal in 1935.
Then it became so popular as to be politically untouchable.

Here are three ideas considered fringe that are urgently necessary.

*Medicare for all. *The Affordable Care Act has enrolled millions of formerly uninsured. But the crisis of under-insurance continues. Many who are nominally insured cannot afford the deductibles and co-pays, which keep rising every year.

In addition, in order to get the ACA enacted, the Obama Administration had to basically accept a status quo health system with too much power for insurers and drug companies, and far too much money wasted on middlemen.

Bernie Sanders has proposed a single payer system to replace all existing health insurance programs. His critics make the fair point that Sanders' proposal requires an immense tax increase; that you can't imagine a Congress that would actually vote for it.

Sanders' supporters respond that a single-payer system would be so much more cost effective than the current fragmented mess that the savings would outweigh the tax increases. However, the people who would save on premiums would not necessarily be the ones whose taxes would go up. Employers might get windfall savings while individuals would have tax increase that exceeded their premium savings. Trying to universalize Medicare in a single stroke is probably a bridge too far.

But by raising this issue, Sanders puts into play a topic that has been considered off limits. And there are other paths to universal, single-payer health coverage that have been made more politically possible thanks to Sanders raising the issue.

For instance, we could allow everyone between age 55 and 64 to buy into Medicare. We could keep those premiums low by raising taxes, but only on the highest brackets.

Then we could give every child a Medicare card at birth, good until age 30. We could pay for it by folding all existing children's health programs into Medicare and top it up with a modest tax increase on the wealthiest. Kids are relatively cheap to insure.

This would set in motion political demands to raise the age ceiling, as young people turning 30 would be a ready-made movement for a rolling increase in continued coverage. Before too long, the pressure to add the generation of 30- to 54-year-olds would be irresistible.

*Put money where it's needed. *Here's another one. The Federal Reserve is keeping interest rates relatively low, and thinks itself brave to buy unprecedented qualities of government and mortgage bonds. The Bank of Japan, reaching the limits of cheap money, just announced it would keep interest rates negative. Obviously, cheap money as a cure-all has its limits.

During the 2008-2009 crisis, the Fed was pumping unlimited funds into banks. It still pumps money into the economy mainly via banks -- which then turn around and invest in risk-free Treasury securities rather than making loans that might be risky.

Meanwhile, the low wages, college debt, and outmoded infrastructure function as lead weights on the economy. So why limit the Fed's operations to banks?

The Fed might declare a jubilee on student debt and just buy up all of the outstanding loans and declare them paid off. A companion program could use tax revenues to drastically cut the cost of college tuition going forward.

The Fed could also announce that it was buying infrastructure bonds, so that we could finance a massive public investment program on the scale needed.

Wouldn't this be like creating money? Yes, it would, but that's the whole point. The problem today isn't inflation; it's deflation and depressed purchasing power.

Isn't this an insane, fringe idea? Actually, at different times, the idea of the Fed pumping money directly into a deflated economy has been proposed by Ben Bernanke on the right and John Maynard Keynes on the left.

For a recent discussion of this idea from an unimpeachably mainstream source, I recommend Lord Adair Turner's recent book, Between Debt and the Devil. Lord Turner used to head the British Financial Services Authority, roughly the equivalent of the U.S. Securities and Exchange Commission.

A universal living wage. Just a few years ago, a $15 minimum was considered a preposterously utopian idea. Now it's law in several cities.

See what I mean?

--

Robert Kuttner is co-editor of The American Prospect and professor at Brandeis University's Heller School. His latest book is Debtors' Prison: The Politics of Austerity Versus Possibility.

Like Robert Kuttner on Facebook.-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 22 hours ago.

The Trouble with Bernie Sanders's Revolution

0
0
AP Photo/Evan Vucci

Bailey Baker, of Fort Dodge, Iowa, center, cheers as Democratic presidential candidate Senator Bernie Sanders speaks during a campaign rally at the University of Iowa, on Saturday, January 30, 2016, in Iowa City, Iowa. 

We'll know Monday night whether Bernie Sanders has taken the first step toward the revolution he has promised, but we can already say that his campaign has achieved stunning success, more than almost anyone thought was possible. Now that the voting is beginning and Democratic voters have to make their choice, we should take a good hard look at what Sanders wants to do and how he wants to do it. Whatever the results of the Iowa Caucuses, he's a serious candidate, and his candidacy should be engaged on serious terms.

If there's one word that Sanders uses more than any other when describing what he wants to do (other than "billionaires"), it would have to be "revolution." He uses it in two different ways, both to describe the movement for change he wants to lead in the campaign, and the substantive change that movement will produce. So his revolution will both overthrow the old order and replace it with something new.

Even if Sanders began this race by trying to make a point, he's now trying to win. So it's worth taking the goals of his revolution, like single-payer health insurance, free college tuition, and a $15 an hour minimum wage, and asking what the process will be between him being elected and those goals being achieved.

By now, Sanders has been asked the logical question—This is pretty ambitious stuff, how are you going to pass it through Congress?—many times. The answer he gives is always some version of Because this is going to be a revolution. In other words, his candidacy will so mobilize the American people that Congress will be forced to acquiesce to the public's desire to see his agenda enacted.

But let's get more specific than Sanders does. If his revolution is to succeed, it must do so through one of two paths:

1. It elects so many Democrats that the party regains control of both the House and the Senate, and those Democrats support Sanders' policy agenda with enough unanimity to overcome any opposition; or

2. It so demonstrates the public demand for Sanders' agenda that even congressional Republicans go along with it.

Start with number 1. Let's imagine Sanders is the Democratic nominee. What would it take for his coattails to deliver both houses back to Democratic control? Taking the Senate first, at the moment a Democratic takeover looks difficult, but possible. The Republicans have a 54-46 advantage, and they are defending 24 seats this year, while Democrats are defending only 10 (the imbalance is because the senators elected in the Republican sweep of 2010 are up for reelection). That looks great for Democrats, were it not for the fact that most of those seats are not competitive at all. No matter how revolutionary the Democratic candidate is, Republicans are still going to hold on in places like Idaho and Oklahoma. Most of the experts who follow these races obsessively (see here or here) rate only nine or ten of these races as even remotely competitive.

But it's certainly possible that Democrats could sweep most of them and take back the Senate. What is not possible is for Democrats to win so many that they'd have the 60-seat margin necessary to overcome Republican filibusters. And there would be filibusters of all the items on President Sanders's agenda. So on the Senate side, the revolution would seem to require both a Democratic sweep and a willingness of the Democrats to destroy the filibuster. Might they do that? Sure. Will they? Probably not.

But that's not the biggest problem. The biggest problem is the House, where redistricting and a more efficient geographic allocation of voters (there's an explanation of that here) have left Republicans with a structural advantage that will make it particularly hard in the near future for Democrats to take back control. The overwhelming majority of seats in the House are not at all competitive, with one party or the other all but guaranteed to win the seat no matter who the party nominates for president. As election analysts Charlie Cook and David Wasserman recently noted, "Today, the Cook Polit­ic­al Re­port counts just 33 seats out of 435 as com­pet­it­ive, in­clud­ing 27 held by Re­pub­lic­ans and six held by Demo­crats. That means that even if Demo­crats swept every single com­pet­it­ive seat, they would still fall three seats short of a ma­jor­ity."

That doesn't mean it's completely impossible for Bernie Sanders to win such a dramatic victory that he pulls in a Democratic House behind him, just that it's very, very unlikely. And if it did happen, many of those newly elected Democrats would be from conservative districts. He'd have to not only hold their votes, but hold them on intensely controversial reforms. It might be worth remembering how hard it was for Barack Obama to keep Democrats together on things like the Affordable Care Act, which Sanders argues was a change that didn't go nearly far enough.

That brings us to the second possibility for Sanders's revolution, which he hints at without going into detail: that public support for his agenda will be so overwhelming that congressional Republicans, fearing for their political careers and helpless in the face of political reality, will have no choice but to get behind it.

There's a reason Sanders doesn't get too specific about the idea that Republicans will vote for things like single-payer health care: it's absurd. No one who is even vaguely familiar with today's Republican Party—a party that has grown more conservative with each passing year, and which has come to view any compromise with Democrats as a betrayal, no matter the substance of the issue in question—could think there are any circumstances short of an alien invasion that would make them support a Democratic president (and maybe not even then).

I'm sure some of Sanders' more enthusiastic fans will say that in looking at his idea of a revolution this way, I'm either shilling for Hillary Clinton or I'm some kind of apologist for the the prevailing corporate-dominated order. I doubt I could convince them otherwise, though I will say that I've been extremely critical of Clinton on any number of issues for years, and I've been a strong supporter of single-payer health care for just as long. But whatever you think about Clinton or about the substance of Sanders's ideas, the challenge of passing Sanders's agenda remains the same.

One can also say, "Well Hillary Clinton doesn't have much of a plan for how she'll get anything passed through Congress either." And that would be true—she faces the same congressional problem, and Republicans will fight her more modest program with just as much energy and venom as they would Sanders's. I have little doubt that if Clinton becomes president, much of what she's now advocating will fall by the wayside, not because she isn't sincere about it but because she won't find a way to pass it. That's a problem that she needs to address for Democratic voters, but it doesn't change Sanders's responsibility to address the practical difficulty his program presents.

Eight years ago, Barack Obama was elected on a campaign notable for its lofty rhetoric about hope and change. But his actual policy agenda was, if not modest, then certainly firmly in the mainstream. Among other things, he wanted to end the war in Iraq, use government spending to alleviate the misery of the Great Recession, and pass market-based health care reform. None of these were radical ideas. But he had to fight like hell to pass them, in the face of a Republican Party that sincerely believed he was trying to destroy America with his socialist schemes.

Unlike Obama, Bernie Sanders is advocating radical change. Which means his revolution would face obstacles even greater than Obama did. It's a long way from here to there. Reported by The American Prospect 15 hours ago.

The False Lure of Sanders’s Single-Payer Plan

0
0
(Photo: AP/Evan Vucci)

Democratic presidential candidate Senator Bernie Sanders speaks during a campaign rally in Cedar Rapids, Iowa, on January 30.

Wouldn’t it be great if we could just go to the doctor and not pay any bills? After all, isn’t that what they do in other countries, and don’t those countries have lower health-care costs than the United States does? And aren’t private insurance companies the only reason we don’t have that kind of system?

This is the appeal of Bernie Sanders’s single-payer health plan. Free health care, with none of the frustrating paperwork of today’s insurance, and with taxes that cost less than insurance premiums—what could be better than that? Of course, the single payer in Sanders’s plan is the federal government, which implies concentrating payment and therefore power over health care in Washington. But, at least in this area, many Democrats don’t seem worried about that prospect.

Sanders doesn’t just call for incremental steps toward single-payer. He’s proposing to shift all of health care to federal taxes in one fell swoop. That’s one reason for the enormous, sudden increase in taxes the plan would require—$1.38 trillion on top of existing federal spending, according to Sanders’ own estimates. As Harold Pollack has pointed out, that $1.38 trillion is just about equal to total federal income and estate tax collections in 2014—in other words, the plan would require doubling that revenue. Sanders insists that he’s shown how he would pay for it through a 6.2 increase in payroll taxes (which he calls an “income-based premium paid by employers,” though the cost will fall on employees); a 2.2 percent increase in income taxes on everyone; higher estate taxes; taxing capital gains and interest as ordinary income; limiting tax deductions for the rich; and higher income-tax rates on the upper brackets (which, combined with other increased taxes he’s also calling for, would bring the top marginal federal rate to 77 percent, as Dylan Matthews shows at Vox).

But Sanders’s estimate of the needed increase in taxation, despite its whopping size, is too low. The plan would actually cost another $1.1 trillion a year, according to an analysis by Kenneth Thorpe, a health-care economist at Emory University, who has long experience working with single-payer proponents. In 2006, the Vermont legislature hired Thorpe to cost out a single-payer proposal, and in 2014 progressive legislators in Vermont hired him again. So this is not an estimate from an economist generally opposed to universal health care or to single-payer. Thorpe’s estimates indicate that workers would have to pay an additional 20 percent of compensation to pay for Sanders’s plan.

At Vox, Matthews has probed both Thorpe and the Sanders campaign on some of the specific areas where their numbers diverge. Here’s one stunning detail: When the Sanders campaign released its plan, it estimated $324 billion in annual savings on prescription drugs—until Thorpe noted that the United States spent only $305 billion for that purpose in 2014. (If Trump can expect Mexico to pay for a wall on the border, I suppose Sanders can expect drug companies to pay consumers instead of the other way around.) When Matthews pointed out that it was impossible to save $324 billion out of $305 billion, the Sanders camp cut their savings estimate to $241 billion, while conveniently increasing other projected savings to make up the difference. But $241 billion in drug savings are still implausible, and as the entire episode indicates, the Sanders campaign is simply pulling numbers out of the air.

The Sanders’s plan also makes implausible assumptions about health-care spending by the states. While eliminating the Medicaid program, Sanders counts on states to continue spending what they now spend on Medicaid, even though the Supreme Court has ruled that the federal government cannot require the states to spend money on a program—especially one that no longer exists.

Why does the Sanders plan cost so much? Among other reasons, the plan calls for eliminating all patient cost-sharing. I’m not a fan of high co-pays and deductibles, but eliminating them altogether will increase health spending more than Sanders acknowledges. His plan also includes no limits on the scope of coverage. “Bernie’s plan,” the campaign says, “will cover the entire continuum of health care, from inpatient to outpatient care; preventive to emergency care; primary care to specialty care, including long-term and palliative care; vision, hearing and oral healthcare; mental health and substance abuse services; as well as prescription medications, medical equipment, supplies, diagnostics and treatments.” This is an extraordinary list; long-term care alone is spectacularly expensive. Although Sanders refers to his plan as “Medicare for all,” it is far bigger than Medicare, which has never eliminated cost-sharing or covered all these services.

Let’s leave aside whether even a Democratic Congress could pass tax increases of the magnitude Sanders’s plan would require. There’s also a question of priorities: Should Democrats—should anyone—support devoting so much federal revenue to health care? The country has a lot of other needs. Transferring all private health spending to the federal treasury is not necessarily the best use of federal tax capacity. Sanders’s health plan is so costly it would make it impossible to do much else.

It’s not just private insurers that would stand in the way of this plan. Thorpe estimates that 70 percent of people with private insurance would end up paying more than they do today.

But what about other countries that Sanders often cites? Don’t those examples show that a system of national health insurance is cheaper and better than one with private insurance?

Here’s where I agree with that argument: If we could wind back the clock to the 1940s, when health care was just 4 percent of GDP and private insurance was just beginning to develop, we might well be able to design a national insurance program—as Harry Truman proposed—that would have kept down the growth of costs. But we can’t wind back the clock. In the mid-to-late 20th century, a very different system developed with the rise of both private, employer-based insurance and the adoption of public programs that accommodated the interests of physicians and hospitals.

This is a story I’ve told in two books—The Social Transformation of American Medicine (1983) and Remedy and Reaction (revised edition, 2013). The financing arrangements that emerged in the United States had two complementary effects: They created incentives for high-cost specialized care and protected much of the public from the full, direct cost of that system. As a result, starting from 4 percent of GDP, health care grew to 17.5 percent, far more than in any other country. That level of costs is reflected in investments in medical technology, the physical infrastructure of hospitals and other facilities, the patterns of medical training and specialization, and the size and structure of the health-care labor force. Adopting a government insurance plan won't undo a system that's been built up over decades, though it would certainly alter its future evolution.

While having the federal government take over all private health expenditures (and state and local government spending too, unless Sanders can also appoint new justices to the Supreme Court), the Sanders plan attempts to squeeze per capita health expenditures down to Canadian levels. The plan doesn’t explain how it is going to bring this about, and Thorpe’s analysis says it won’t. But if the federal government did impose sufficient controls, the results would be to bankrupt many institutions that are counting on future streams of revenue to cover debt payments, meet payroll, and satisfy other obligations. 

The Affordable Care Act does not try to roll back spending levels to the share of GDP that health care represented decades ago. It has the limited, uninspiring, but ultimately more sensible goal of “bending the cost curve”—slowing the rate of growth of health-care costs, which has actually happened in the years since the law’s passage.

The ACA is far more in keeping with the lesson to be drawn from the history of health policy in other countries. Most countries have built on their existing institutions as they have pursued universal coverage and sought to control costs. The governments that instituted unified national insurance systems generally did so before private insurance had developed on a large scale. Many countries that had multiple insurance funds have maintained them; rather than centralizing all payment, they have created regulatory and negotiating arrangements that keep costs in check. This is the direction we can and should take.

In the wake of the adoption of the ACA—if it isn’t repealed by Republicans—the United States could adopt additional reforms to improve coverage and control costs, including measures opening Medicare to wider enrollment. One possibility is to provide a basis for 55-to-64-year-olds to buy into Medicare. The idea of a Medicare buy-in was supported by Bill Clinton in the late 1990s and by Al Gore in the 2000 election campaign. It is even more practical now as a result of the ACA’s individual mandate, which reduces the likelihood of adverse selection (higher enrollment by those with high medical costs). A Medicare buy-in came up late in the 2009 Senate debate about the ACA as an alternative version of the “public option,” but it died as a result of Joe Lieberman’s objections and worries among other Democrats about its impact on the financial stability of hospitals in their states—a concern that would have to be dealt with in any effort to revive the idea.

I mention a Medicare buy-in for people in the decade before full Medicare eligibility only to illustrate the kind of incremental measure that is both practical and consistent with the aspirations of many progressives. It would be difficult to enact, but it wouldn’t require a Sanderista revolution and heroic assumptions about Americans’ support for increased taxation.

Sanders’s single-payer plan is not a practical or carefully thought-out proposal. It’s a symbolic gesture, representative of the kind of socialism he supports. The question that Democratic primary voters will have to answer is whether they want their party to go into a general election with a gesture of this kind. Reported by The American Prospect 15 hours ago.
Viewing all 22794 articles
Browse latest View live




Latest Images