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Politics : President Barack Obama -- Ignore unavailable to you. Want to Upgrade?

To: Bread Upon The Water who wrote (60867)	8/16/2009 12:58:03 PM
From: Little Joe	Read Replies (2) \| Respond to of 149317

The fact that Health Care is involved accounts for some, but by no means all, of the intensity of the argument. I really think we are seeing a seachange in politics. My view is that you can start anywhere on the curve. You could say the problems began with Eisenhower, Reagan, Clinton, Bush or where ever. But lets start with Bush II, where I think things hit critical mass. People began to feel more manipulate, lied to, and cheated than I can ever remember. I believe Obama played to these concerns more than any other candidate and the hope that he would bring change in these areas is what cause the middle to vote for him. I think the middle wanted honesty, trasparency, fiscally conservative policies. In short they wanted a government they could trust. However, almost upon taking power the Dems began to make it clear they intended to conduct business as usual. Tax cheats were nominated and in some cases appointed. Nothing was done to Charles Rangel or Chris Dodd. Bills began to be rushed through in the dark of night without even reading them. We had more earmarks than ever. Bigger deficits, etc. The left loved it, Republicans predictably opposed it and the center was becoming uneasy. The Dems appeared to be the Reps on steoroids. Deficits began to soar. True, some but not al of Bush's economic people were removed to be replaced by equally dishonest and incompetent econmic advisors many of whom were major contributors to the problem. The unrest in the center was growing. People were realizing that Obama had no intention of changing the culture of corruption or reining in spending. Against this background he tries another time to rush a bill through congress, and people rebelled. The public was right as it turned out. Many congressman who claimed to support the bill had not read it. It was, I believe, deliberately obscure and the rationale for the bill changed from cutting costs to evil insurance companies as soon as the CBO announced that it was going to cost a lot. Of course the real source of the evil insurance companies attack was that it polled well. I don't know about you, but when the purpose of a bill is to save money today and the next day it is to reign evil insurance companies without any changes in the bill at all, I think something is to quote the whitehouse "fishy". Obama continued to pressure passage of the bill without any idea of how we will pay for it. This is the most inept handling of legislation that I have seen in my lifetime. The message that people, except for yellow dog dems, got was: We support this bill, but we haven't read it, and we have no idea where we are getting the 1.4 Trillion to pay for it, and those people who are opposed to it are all Nazi, KKK, bigots. (Not too smart when most Americans oppose the bill), oh and by the way there is really no plan, even though we would have passed one in July, if we could have gotten away with it. Oh and by the way all of this occuring against a background of the worst economy since the depression. In bad economic times people don't give the government as much slack as when times are good. Too be sure much of the mistrust people have is caused by previous administrations, but he did nothing to separate himself from those policies. Coupled with all that went before it is there any wonder that people are angry.

To: Bread Upon The Water who wrote (60867)	8/16/2009 10:58:26 PM
From: ChinuSFO	Read Replies (1) \| Respond to of 149317

Yes, we can pay for health care reform - here's how Alain Enthoven Sunday, August 16, 2009 Sen. Dianne Feinstein said last month: "I'm ready for people to come and say, 'Look, here's our plan to cover 46 million uninsured people, and here's how we pay for it: A, B, C, D. That has to happen.' " I'm here, and I'm saying it. This plan is based on the principle of an informed, cost-conscious individual choice of health plan from among competing alternatives meeting common standards. (See links.sfgate.com/ZHWC to review the proposal.) All of these ideas already exist in some form. Here is the A, B, C, D of health care reform: A. Create a health insurance exchange: The federal government should create a system to offer standard benefit health insurance packages and impartial information about them so individuals could choose what best fits their needs. The system, or exchange, would make it easy to compare the plans. Employers would contribute fixed dollar amounts not to exceed the price of the lowest-priced plan in each market. Employees would choose their own plan. All insured employed people would be eligible to participate, regardless of pre-existing conditions, and would be able to keep the plan even if they changed jobs. The exchange would collect money from plans who enrolled the healthiest to compensate those enrolling people with health problems, so no plan would have an incentive to avoid enrolling the sick. Two forces would make this exchange work: People would save money by choosing wisely, and health plans would be motivated to keep costs down to attract customers. The model: California's CalPERS, an exchange that serves employees of more than 1,000 public agencies. In Holland, the exchange is online. B. Tax employer-paid health benefits: But only the excess over the low-price plan, the one offering the standard benefits for the fewest bucks. The fact that employees today can take advantage of unlimited tax benefits on health plans costs the federal government more than $260 billion per year. This tax benefit is a powerful incentive for people to choose more-costly plans, and most of the money goes to upper-income people. Why should taxpayers have to subsidize your choice of a more expensive plan? The cap would save billions of dollars that could be used to subsidize health insurance for low-income people. The subsidies could be used only to buy health insurance through the exchange (See A). C. Convert Medicare to a similar model: Create an insurance exchange for government-paid health care and offer beneficiaries a voucher. Help them choose among the competing subsidized plans. The exchanges would follow rules similar to the employer-funded plan exchange described in A. Retirees would be rewarded for choosing plans that cost less than Medicare's fee-for-service plan. Medicare is wastefully subdivided into Hospital Insurance (Part A), Physician Insurance (Part B) and Drug Insurance (Part D). Reorganize Medicare into comprehensive care insurance, just like insurance that serves non-Medicare people. The savings would allow Congress to slow the growth in government contributions to Medicare. The model: Extend Health, a California company that serves dozens of America's largest companies. Each company contributes fixed amounts toward retiree Medicare Supplemental Insurance and contracts with Extend Health to assist seniors and enroll them in the plan of their choice. D. End employer-based health care: Once health expenditures have slowed to the nationwide rate of income growth, phase in subsidies for everyone at the cost of the lowest-priced plan in their market. As this happens, health insurance would no longer be connected to jobs. Government would pay for health insurance for all with a broad-based tax on consumption, like the value added tax in Europe. With A, B, C and D, the United States could achieve a health care system with built-in incentives to improve value for money and to satisfy patients. Alain Enthoven is professor emeritus of public and private management at the Stanford Graduate School of Business and a senior fellow in the Kaiser Permanente Institute of Health Policy. He is also on the board of Extend Health and project director of the Committee on Economic Development report cited. Contact us at forum@sfchronicle.com. sfgate.com This article appeared on page E - 5 of the San Francisco Chronicle