Real reasons to question the Obama plan

Okay, we've seen the crazies talk about health care.

But what about people who have read the bills and actually know something about health care?

Here's Marcy Wheeler questioning what kind of health insurance will get sold to the uninsured:

How would you feel about this insurance plan: a $500 deductible; a 50% co-pay, and a maximum of $4,200 out-of-pocket cost. Using a highly simplified model from the CBO, this plan has an actuarial value of about 66%. The premium for an individual would be $3,290 plus the administrative costs, which range from 7% to 30%. The high end is for individual and small firm policies, so let’s say 25%, for total premiums of at least $4,112.50.

Under this plan, if you had medical costs of $8,725, or more, you would get back more than you paid in, that is, your premiums plus your co-pay plus your deductible would equal your costs. If you had $5,000 in expenses, maybe the cost of falling and breaking an arm (you'd be amazed how hard it is to find the cost for a medical procedure), you’d be out your premium and $2,750, a total of $6,862.50 that year. That is going to be a real problem for someone making $35,000 per year.

I’d call that a pretty good definition of junk insurance. 

And here's Trudy Lieberman:

By now, it should be obvious to everyone that the Massachusetts model was the president’s health reform endgame all along...

...recent Census Bureau statistics show that, in 2008, some 352,000 Massachusetts residents did not have coverage, even though the law requires that they do. That’s about 5.5 percent of the state’s population; up from the 2.6 percent who were uninsured in the years after reform took effect....

...It’s no secret that Massachusetts’ lack of cost controls, deliberately avoided when reform passed, threatens to undo the law. Ultimately, if the state has no way of paying for subsidies to cover insurance premiums, the law is doomed. Same goes for national reform. Most cost control measures under consideration by Congress and the president are weak or predicated on squeezing savings out of the existing health care order—savings that may or may not materialize.

Massachusetts has now crafted a plan to reduce medical spending by at least $50 billion over the next decade, mostly by scrapping fee-for-service payments to providers in favor of global payments that provide a set amount to cover the cost of care for patients. Aside from sounding like the HMO’s capitation payments of old, draft proposals would give providers five whole years to shift to the new payment methods. What happens in the meantime? The state is looking at interim options, like a set fee for certain procedures.