I found a transcript of the speech -
http://www.washingtontimes.com/news/2009/sep/09/text-barack-obamas-speech-joint-session//print/Here are my comments -
"And its why those of us with health insurance are also paying a hidden and growing tax for those without it about $1000 per year that pays for somebody elses emergency room and charitable care."
Is it really 'charitable care' if others are forced to pay for it? I believe the term is called 'cost shifting' - it also may happen when costs are shifted from Medicare/Medicaid to private insurance companies...
Is my premium bill going down $1,000 per year? I've read that much of that $1,000 is due to paying for illegal aliens. Who is going to be paying for the illegal aliens in the future?Are illegal aliens going to disappear? Will their need for healthcare disappear? I've also read this past month that there is money coming from Medicare and used to pay for the uninsured in many states, like California and Florida. Will that money disappear too?
How is care for illegal aliens going to be funded after Obama reforms?Who is going to pay for all this 'charity'?
" And there is agreement in this chamber on about eighty percent of what needs to be done, putting us closer to the goal of reform than we have ever been."
Do 80% of Americans believe we need reform? Do 80% of Americans believe in the reform ideas the House is proposing? Where are these 80%? I didn't see them at the town hall meetings. Does Congress work for the people? Or, for their own self interests?
"Instead of honest debate, we have seen scare tactics. Some have dug into unyielding ideological camps that offer no hope of compromise. Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge. And out of this blizzard of charges and counter-charges, confusion has reigned."
I did my best to read the bills. Confusion no, concern yes.
Institutionalized discrimination, racism, and preference. What happened to treating everyone the same? Giving everyone the same opportunity and responsibility? Where was the debate? Input from citizens? Anyone answer my quesions yet?
Why is there racism, and discrimination built into several parts of this bill, HR 3200?"...Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do. Now is the time to deliver on health care."
I recall many folks in town halls don't want any delivery on health care. What happened to listening to people? If people want reform, why not encourage them to take bold and decisive action within their own states?
Compare this
" First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have."
with
"What this plan will do is to make the insurance you have work better for you. Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. As soon as I sign this bill...They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies because theres no reason we shouldnt be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives."
Who's going to pay for these added services and changes?
It seems to me if Obama doesn't sign 'this law' your insurance WILL truly REMAIN the SAME. WHEN OBAMA CHANGES THE LAW, YOUR INSURANCE WILL CHANGE.Where is Obama's miracle bill written/published? "...Its how everyone in this Congress gets affordable insurance. And its time to give every American the same opportunity that weve given ourselves."
Is the public option the plan Congress has? The doors of eligibility will magically open? Or, maybe everyone in Congress and the White House will transition to the public plan? Since the opportunity is the same, will the coverage be the same? Like Medicare and Rail Road healthcare?
"For those individuals and small businesses who still cannot afford the lower-priced insurance available in the exchange, we will provide tax credits, the size of which will be based on your need."
Where will money come from to compensate for the 'tax credits'? How will this affect the nation's finances?
Will there be a subsidy for those with EXISTING insurance programs they like? Maybe it will help those on MAIN STREET keep their doctor and insurance they already enjoy?
"In the meantime, for those Americans who cant get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill."
Details? Who's paying for this low coverage? Premium coverage at bargain prices?
"...There will be a hardship waiver for those individuals who still cannot afford coverage, and 95% of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements...."
Who's chipping in to cover the cost of the 'hardship waivers'? What exactly are 95% of small businesses be exempt from? Chipping in? Hardship waivers? Who decides what is affordable?"...we plan to set up panels of bureaucrats with the power to kill off senior citizens. Such a charge would be laughable if it werent so cynical and irresponsible. It is a lie, plain and simple."
Why, in HR 3200 are their differences, preferences in reimbursements to providers between Medicare the the public plan? Why is this spelled out in the bill? How will race, ethnic, disparity, and other yet to be determined political preferences influence reimbursement schedules, payments, affordability credits, and premiums? Why would anyone ever set up preference by race or ethnic? If the government creates hugh financial incentives to treat non-Medicare patients, what is the effect on seniors and the disabled.
Is it a case of "It's not that we, the government is against seniors and those on Medicare, we're just FOR all these other people..." ? Here is one example in this section - "SEC. 224. MODERNIZED PAYMENT INITIATIVES AND DELIVERY SYSTEM REFORM."(b) Requirements for Innovative Payments- The Secretary shall design and implement the payment mechanisms and policies under this section in a manner that--
(1) seeks to--
(A) improve health outcomes;
(B) reduce health disparities (including racial, ethnic, and other disparities);
Why would anyone base payment on racial, ethnic, or other disparities? Why isn't everyone treated the same?"There are also those who claim that our reform effort will insure illegal immigrants. This, too, is false the reforms Im proposing would not apply to those who are here illegally."
Why did Democrats block several attempts to add language to HR 3200 to ensure that illegal immigrants would not be included? IIRC, there is language that exempts illegal immigrants from paying taxes due to the public plan. A free ride? (c) Encouraging the Use of High Value Services- To the extent allowed by the benefit standards applied to all Exchange-participating health benefits plans,
the public health insurance option may modify cost sharing and payment rates to encourage the use of services that promote health and value.Who decides what is valuable? Why not add something to check for citizenship or legal status just to be sure that illegal people don't end up on the public plan? An E-Verify for health insurance?
I wonder if the plan available to Congress and the President reimburses based on Medicare/Medicaid services and rates?"Without competition, the price of insurance goes up and the quality goes down. And it makes it easier for insurance companies to treat their customers badly by cherry-picking the healthiest individuals and trying to drop the sickest; by overcharging small businesses who have no leverage; and by jacking up rates."
Where are the examples? How can insurance companies 'jack up rates' when insurance rates are the business of state insurance departments? Are ALL states lax? Isn't it possible that small businesses have sicker and riskier individuals? Those costing more to insure?
"Insurance executives dont do this because they are bad people. They do it because its profitable."
Why aren't Goldman and other like entities already in the healthcare business? I read that Goldman associated themselves with a company in Texas. Goldman will earn 'fees' and enjoy profit with NO risk. Who's paying for Goldman's profit? Why is Goldman jumping on board this year?
Goldman related health insurance stories -
http://scaredmonkeys.net/index.php?topic=5670.0http://www.realestatechannel.com/us-markets/commercial-real-estate-1/the-blackstone-group-goldman-sachs-credit-suisse-private-equity-investors-insphere-insurance-solutions-philip-j-hildebrand-ing-alex-finkelstein-1052.php"All of this is in service of meeting what this former executive called Wall Streets relentless profit expectations."
"I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects."
Where is the money for the 'affordability credits' coming from? "It would also keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting a vibrant system of private colleges and universities."
I keep hearing about the wonderful Obama administration that come from Yale, Harvard...any from public schools? Just the good ole boys network?"It's worth noting that a strong majority of Americans still favor a public insurance option of the sort Ive proposed tonight."
I watched the coverage of the town halls and would not come to that conclusion."I say that rather than making wild claims about a government takeover of health care, we should work together to address any legitimate concerns you may have."
Who decides what the 'legitimate concerns' are? I saw some Democrats address the concerns of citizens in the town halls. Is 'legitimate concerns' a code meaning ANY and ALL concerns will be ignored or ridiculed? "And I will make sure that no government bureaucrat or insurance company bureaucrat gets between you and the care that you need."
What about hedge funds? Investment banks? Casino bankers?"First, I will not sign a plan that adds one dime to our deficits either now or in the future."
Who is going to be paying for the affordability credits? What is their effect on revenue?"Part of the reason I faced a trillion dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for from the Iraq War to tax breaks for the wealthy. I will not make that same mistake with health care."
Who is paying for the war in Afghanistan? What happens when the wealthy move elsewhere? I have to believe that the 'wealthy' may end up in the unemployement line too.
Any new revenue sources under consideration? Taxing HFT? Dark Pools? Hedge funds? Municipal bond holders?"Right now, too much of the hard-earned savings and tax dollars we spend on health care doesnt make us healthier."
I don't understand this one. Can you give some examples? Lots of people, all over the globe, are healthier because the U.S. has a top notch healthcare system!!! something to be proud of!!! JMHO
"...Medicare is another issue thats been subjected to demagoguery and distortion during the course of this debate."
Here are some sites to help you navigate the Medicare maze -http://www.webmd.com/medicare/how-to-file-a-medicare-appealwww.medicare.govWow...5 levels of Medicare appeals -
http://www.hhs.gov/omha/How to appeal a Medicare refusal to pay -
http://usgovinfo.about.com/cs/healthmedical/a/medicareappeal.htmhttp://www.hapnetwork.org/original-medicare/appeals/medicarehowtohelpmcappeal.htmlhttp://www.medicareappeal.com/Page.asp?Script=12Ways to improve Medicare -
http://www.medicareadvocacy.org/Reform_08_12.23.RecommendationsforRealReform.htmPart D drug coverage -
http://www.medicareadvocacy.org/FAQ_PartD.htm - a gold mine of information...
http://www.medicarerights.org/"The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies subsidies that do everything to pad their profits and nothing to improve your care."
Seniors I know choose these plans because they are like HMOs and may save seniors money - less money from the senior's pocket and more money for food and energy."And we can use some of the savings to fill the gap in coverage that forces too many seniors to pay thousands of dollars a year out of their own pocket for prescription drugs."
Wisconsin has a state drug plan 'SeniorCare' that saves the federal government money. Why not look into state SeniorCare programs for everyone?Compare this
"That is why not a dollar of the Medicare trust fund will be used to pay for this plan." to this -
"Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan." The public plan? Help!!! Confused. Why not lower taxes for those paying payroll taxes for Medicare/Medicaid? "I will protect Medicare." What happens if and when debt brings hyperinflation? Collapse of the currency?"Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan. Much of the rest would be paid for with revenues from the very same drug and insurance companies that stand to benefit from tens of millions of new customers."
What plan? If taxpayers pay $100 to a drug company, and $50 is profit, how much revenue will be returned to pay for the 'plan'? $200? Not getting this..."The middle-class will realize greater security, not higher taxes." Who is going to kick in for those affordability credits? If something is 'self supporting' what happens when many folks enjoy benefits but do not contribute? Is there a financial model of how this will work? Projections? An Excel spread sheet?"Everyone in this room knows what will happen if we do nothing." If we do nothing, I can keep the coverage I have and like. Why not let the STATES can work on addressing the problems of the uninsured, the high risks, and mandatory coverage, based on community interest in solving the problem? Why does one size fit all in the Obama plan? What if different states have different racial, ethnic, and political disparities? Why can't we have diversity?"You see, our predecessors understood that government could not, and should not, solve every problem. They understood that there are instances when the gains in security from government action are not worth the added constraints on our freedom. But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, and the vulnerable can be exploited."
Why haven't the problems with Dark Pools, Hedge Funds, and High Frequency Traders been fixed? Businesses that are to big to fail getting bigger? What is the point in that?
Is government to big to fail?
Is our currency to safe to collapse?
Is our debt so massive, that it will never criple and destroy our nation?
Where are the wise men and women in our nation?Could Obama post on the web his choices for all the new levels of government the 'plan' is creating? Who will fill all these new jobs? 1,000 new CZARS? Maybe some would feel more secure if they knew who was steering the boat through the mine field.jmho
