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BourneID On April - 10 - 2012

They’ve Got the Best Health Care Tax Payers’ Money Can Buy

For the Justices of the Supreme Court, and the members of the Congress opposed to the Affordable Care Act there is no risk for them if the ACA is knocked down. They will continue to enjoy very fine, very affordable coverage in a tax payer supported program that does as much for them as the ACA hopes to do for most citizens and more. But they have no reason to be personally concerned about throwing health care reform under the bus. They are covered.

Simply put, the ultimate goal of The Affordable Care Act, (a.k.a. Obamacare), is to provide most Americans with the level of care the President, Congress, the Supreme Court and most federal employees have for themselves and their immediate families.

I know about this care from my 30-year experience as an active (now retired) federal civilian employee. The plan is great. But you wouldn’t think so given what the GOP has put forth regarding ACA.

The GOP has so intensely and successfully embedded the notion that the ACA will bankrupt the nation while destroying the quality of our health care that there is widespread popular support for setting Obamacare aside. This obsession with the debt is curious when that same GOP had few problems with two wars, massive tax cuts, an explosion in the size of the government, Medicare D, and a host of supports for big business when their impact on the national debt has been and continues to be far greater than that of the ACA.

The $2 trillion cost of two wars which have reaped very few benefits over 8 years is acceptable, but the $1.76 trillion cost for health care reform over a 10 year period is deemed excessive. Furthermore, that $1.76 trillion cost is offset by explicit savings and new funding sources. In fact, the CBO projections show it reducing the deficit in the mid and long term. No such claims could be made for those two wars.

 

THE FEDERAL EMPLOYEE HEALTH BENEFIT (FEHB) AND HOW IT WORKS

The President, the members of the Supreme Court, the members of the Congress, and most of their staffs and other federal employees count on the FEHB to care for their health needs.

The Office of Personnel Management (OPM) manages the FEHB Plan. It negotiates costs with the insurance companies and health care providers for services to its members. It functions as an insurance exchange much like the one the ACA proposes to establish for those who are not privately insured or insured through an employer.

President Obama said early in his presidency that he wanted all Americans to have the same quality health care that he and Congress access. It’s the same kind of plan the Supreme Court now holds in its hands.

In the federal program the key is choice. Many plans are available from which to choose. They vary throughout the country; costs depend on location. I live in California. My plan offers Blue Cross/Blue Shield (BC/BS); Health Net; Kaiser, et al. I have BC/BS. Within that plan are several providers: Catholic Healthcare West (CHW), Kaiser, Sutter Health, etc.

Every year, from mid-November to early December, the Office of Personnel Management (OPM) offers Open Season during which members make changes in providers, adjust payments, select or jettison various coverage elements, and even change plans entirely without loss of benefit. A member’s plan cannot be cancelled unless personally requested in writing. If that choice is made, coverage is lost; the member may not re-enroll.

 

EXAMPLES OF SERVICES AND COSTS

The costs have always been reasonable and the coverage excellent even for Basic Medical. But for the first time, three years ago, OPM negotiated for Vision and Dental care, the costs of which, like Medical, are borne by members and deducted from current or retirement pay. Vision covers one exam per year with one pair of free glasses. MetLife Dental for a single person such as myself provides annual coverage of $10,000 including the rarely covered implants.

Here are the monthly BC/BS premiums for Basic coverage, reflected in its Service Benefit Plan manual. Fees are deducted from current or retirement pay:

Individual Coverage:
Medical: $121.88
Dental: $48.00
Vision: $24.00
Prescriptions $10.00
Total: $203.88

So, when I had a vision problem here is what two office visits to my general practitioner and one referral visit to an ophthalmologist cost as billed on the same PHYSICIAN STATEMENT:

Total Charges: $682.00
Plan Allowance: $207.00
BC/BS Payment to Medical Providers: $132.00
MY DIRECT PAYMENT TO MEDICAL PROVIDERS: $75.00

The Plan Allowance is the OPM-negotiated cost. Great deal, yes?

How does the plan do with hospital related costs? Here is one example. In a cluster of four billings for my 2010 surgery, the surgeon fee, hospital care, in-hospital prescriptions, x-rays, MRI, physical therapy, two weeks in an assisted care facility, and six in-home nurse visits were billed at:

Total Charges: $79,888.00
Plan Allowance: $10,875.00
BC/BS Payment to Medical Providers: $9154.00
MY DIRECT PAYMENT TO MEDICAL PROVIDERS: $1,721.00

The cumulative charges (all billing) for the surgery/hospital/recovery was: $146,095.00. My plan allowance was $22,585.00. BC/BS paid $18,921.00. My out of pocket cost (what I paid directly to the medical providers) was $3,664.00.

 

THE BOTTOM LINE
The Bigger the Pool, the Bigger the Savings

Why was this so affordable? The United States Government is the greatest negotiator in the world. Insurance companies and health providers agree to accept specific maximum limits for their services, which are far less than they bill individual clients. Of course, this is also true of insurance policies in general. Most insurers pay 30 to 38 percent of the “billed” cost of medical care. Think of those medical bills in the same way as smart new car shoppers think of the sticker price on a car- only far more inflated.

The Federal Government gets the best rates because its pool is so large (FEHB plus Medicare plus Medicaid plus Veterans Affairs ). Imagine what National Single Payer (Medicare for All) would do?

This is why so many other developed nations with national health care programs get so much more coverage for so many more people for so much less money.

The SCOTUS, the President, the Congress etc. have an excellent federal health care insurance plan but when it comes to providing such a plan for most of its citizens, it seems that not only are the GOP in Congress, joined by a number of state governments, willing to throw the citizens under the bus, but the SCOTUS’s conservative justices may also be willing to drive the bus that runs over the rest of us.

Sources:
http://phobias.about.com/od/treatment/a/obamaplan.htm
http://www.aarp.org/work/employee-benefits/info-12-2010/benefits_what_does_congress_really_get.html?plckOnPage=2
http://usgovinfo.about.com/od/uscourtsystem/a/scotusretire.htm
https://www.pcip.gov/
http://content.healthaffairs.org/content/25/1/57.long

Acknowledgement: The author appreciates the assistance provided by MurphtheSurf3 in research, editing and the publication process.

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Why GOP Leaders Aren't Worried About Throwing the Affordable Care Act Under the Bus, 10.0 out of 10 based on 1 rating

Written by BourneID

California native; worked for the USGov as a civilian employee in Saudi Arabia, Germany, Morocco, the Philippines, Malaysia.

23 Responses so far.

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  1. BourneID says:

    YOU ARE RIGHT!

    I sent our article to my niece in LA who works as a medical transcriptionist in a hospital and asked her to do a survey of some of the medical and administrative folks (I’m beginning to sound iike you) she works with to find out their thoughts on the President’s plan. She’s also very, very, very pro-Obama.

    Did I read that Kaiser is positive about it? I would assume that if SCOTuS gives it a green light, Kaiser would be a huge beneficiary…less expensive, all-in-one service.

    Nourne

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  2. BourneID says:

    Okay, CL. You’re right. We are on the same side of the aisle and almost in the same neighborhood. I live in Fair Oaks off of Fair Oaks Blvd and Madison.

    I taught in Del Paso Heights in the center of poverty, drugs, sad, sad situations. I loved my students; I loved my colleagues. I taught in the North Sacramento School District which merged with Rio Linda and two other shcools. It’s now Twin Rivers School District with its famous police department (you know, shootouts on the streets).

    Murph helped me put this together. He’s so brilliant it’s scary. We’ve been communicating for a couple of hears on HP; I know that’s a sensitive subject, but I wanted to give you some background.

    I did watch the events at CalExpo. Imagine people arriving at 7am and staying overnight to be able to get the care they need. The idea that people have to rely on “free” to survive is heartbreaking. You have no idea how much I learned by teaching in that environment. What I witnessed in every underdeveloped country I worked in I saw in my own. Each Christmas, the Granite Bay High School seniors gathered up their used clothing and other unwanted things and donated them to our students. It was a Romney-like charity event that made those little millionaire students feel so much better on Christmas day when they got the keys to their new SUVs. Each year the superintendent wrote in his Christmas message how “grateful” our students should be. In my first year, I literally exploded in the faculty meeting…couldn’t believe it. The message, I told my fellow teachers, that we send our students is “second hand is good enough for you.” It is not, it never was, it never will be.

    I’m enjoying POV and spent some just navigating the site since I still don’t know how I got to where I am or why I’m there. I’m still shaky on the VP night, but with time I will soon monopolize the conversation.

    Good to hear from you CL.

    Bourne

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    • choicelady says:

      I got it, Murph -- not a problem.

      Our lives are similar, Bourne, though mine was led for long periods back east.Began working inner city boys and girls clubs and discovered early in my life that my white messianic impulses were neither needed nor desired within Black communities. Best lesson EVER. So from age 19 on, I learned to ask -- what do you need, how can I help and to learn FROM communities what they understood about, yes, that “second hand” life. VERY well said. Grateful, snort. Yeah, right.

      Most of my existence has been around the Black community’s work to get out from under police oppression etc., and then WITH them working for women’s rights and labor rights. I walked many a picket line, made soup for the regulars while filling in for them while they ate, and generally working on new ways of fighting the fight. Once beat Henry Kravis, KKR and RJR/Nabisco and kept a plant open and operating by threatening (and we inteded to DO it) to have an employee buy out. That meant opening the books to the union -- and a settlement quickly followed to avoid that. My happiest moment!

      I taught mostly adults (though I did substitute in high school and grade school in a couple of newly desegregated Southern schools. Very weird experience, I must say. Not bad, just weird.) I loved teaching union folks -- did it for 15 years for Cornell’s Industrial and Labor Relations program. They are the salt of the earth, those marvelous people who get global capitalism way beyond what most Americans will ever understand. GOP contempt for working men and women makes me screeching crazy.

      So yes, we have great similarities, equal lack of tolerance for faux liberal BS, and a desire to see right done. Glad to know you!

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    • MurphTheSurf3 says:

      Bourne, I just noticed that this post is not under a CL response. You probably should leave her a note under one of her comments to say that this very substantive reply was written to her.

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      • BourneID says:

        hey thanks MTS,

        See, I’m consistent -- I screw things up immediately but eventually, as we all hope, I get how it works.

        Bourne

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      • choicelady says:

        Ooops -- inadvertantly hit the ‘thumbs down’ button trying to reply, and replying that yes, I saw Bourne’s response above, thank you.

        I’d NEVER give you a thumbs down’!!!!!!

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  3. AdLib says:

    The GOP has always been the party of, “I got mine, you don’t need yours.” It’s now a cliche and a given to call Repubs hypocrites, in fact, you can pretty much depend on Repubs to be hypocrites on just about every issue.

    As you well describe, Bourne, they are hypocrites on attacking the ACA. Add to that the deficit since the Ryan plan would blow up the “must-cut” deficit through tax cuts and their attack on government having too much power paired with their approving of government forcing women to be vaginally violated if they want to exercise a right Republicans disapprove of.

    Maybe we need a new Constitutional amendment that allows the people to recall elected officials based on a pattern of hypocrisy. That would really put the GOP out of business!

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    • MurphTheSurf3 says:

      Ad Lib….nice link between the Justices on the Right and the GOP culture of “I got mine and to hell with you.” I listened to the Romney Campaigns tele conference today on Women’s Issues and was stunned at how inept the Romney surrogates were- the most obvious points regarding equality of pay, access, and treatment were unknown territory to them. The hypocrisy is real…so is the ignorance….followed by the arrogance. And yet they are support, automatically, by 40 percent of the electorate…frightening.

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      • AdLib says:

        Cheers Murph!

        It’s hard to get used to but Romney and the GOP will always be unable to provide sensible and convincing arguments to rebut their prejudices against women…because they support prejudice against women.

        All they can do is clumsily dance around the truth and try to present their weapons aimed at women as “protecting” them from Obama.

        It will never be anything other than awkward and transparent. They hold positions that are anti-women but need the women vote. They won’t change their positions so they instead try the infantile tactic of, “I know you are but what am I?”

        Women are not stupid. You can’t take away their rights and violate them medically through government order then tell them how you believe in their equality.

        This is an inescapable anchor for the GOP and Romney that keeps them down among women and thus the majority of the electorate. It’s kind of intertesting, before all of this I thought it would be the 99% argument that would doom Romney but his need to satisfy the Baggers took him so far against women, there is no full recovery possible.

        He may reduce the gap but never enough to prevail in November. Being that he has cemented himself as a liar and flip-flopper, most women will never believe any assurances he gives to the contrary, that he doesn’t want to destroy Planned Parenthood, won’t restrict women from birth control coverage or will respect a woman’s rights over her own body.

        We may be 7 months out but whatever happens with the economy, Romney is the walking dead when it comes to the women’s vote and losing that by a lot, it’s impossible to win the Presidency.

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    • BourneID says:

      Hi AdLib

      Yes, rather discouraging, isn’t it? I’m left speechless every day as I read and hear the trash talk from that group of infidels (I think this word actually fits). John Boehner and company have consistently demonstrated their inabiity to govern -- a price the country pays for dearly as we continue our descent into the black hole of ignorance.

      Your idea of a Constitutional amendment is very attractive. I would change only one thing -- waste no time on recall but give the people the power to fire on the spot. Somehow we forget they work for us, a fact they forget the moment they’re sworn in. Power is an aphrodisiac -- unfortunately, we’re the most available.

      Bourne

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      • AdLib says:

        Bourne, I do think that the Repubs are paying a price though for their obvious dishonesty and hypocrisy. By all rights, in an economy with high unemployment, ongoing foreclosures and little wage improvement for 99% of Americans, the party holding most of the power should be in the basement.

        Instead, Obama is trouncing Romney in polls at this point, which should be Romney’s and the Repubs strongest period over Obama.

        Polls show greater dissatisfaction with the GOP than Dems and that is a total reversal from the last election in 2010.

        So, as upsetting as it is to see the GOP attacking everyone except the top 1%, consider that many in the 99% are just as upset when we are. Ironically, the most effective campaigning for Obama’s re-election may be conducted by the Republicans.

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        • BourneID says:

          Hi AdLib

          I’m getting the hang of this and really enjoying it.

          I am absolutely delighted with recent polls. I’ve never really relied on them a great deal because I never know who the target group polled is and how the pollsters read the results. But is a measure of trends. The greatest thing about Americans is we never fail to right ourselves. You are right with regard to how the GOP continues shooting itself in the foot. How culd they miss with morons (I can that here, can’t I?) Rep Allen of Florida saying at a town hall meeting that the president wouldn’t debate him and, when asked why, replied, “Because he’s afraid.” Unreal.

          There’s a lot to be said for why we choose the person to support and/or vote for. Much of it is “liking” the person. I think we do factor into our “dossier” the physical things as well as intelligence and other substantive attributes. The entire group of 9 destroyed itself and brought the party down. The TPers who came in fix everything wrong with government are now completely silent, powerless, and learned quickly that governing is a gread deal different than talking about governing. AdLib, I am a registered Republican working for President Obama as I did in 2008. I tell people personally and online that I am ashamed of the behavior of the party, of the complete disrespect members demonstrate daily as they assault President Obama and the Office of the President.

          I have a friend on HP (I know, sensitive, but I’ve met some great people there) who is from Australia and is completely engaged in this election and our politics. He comments frequently about those who denigrate the Office of the President -- the disrespect for the man, for the office. I tell him I appreciate his views; we need to know how others see us. This great, great country, always first to respond wherever the need but treating but treating our own citizens like garbage.

          We’ll be back in November and it will be a glorious holiday season for all of us. Now if we could just do something about the messy, ineffective news and print media, we may even bring intelligence back. What a treat that would be.

          Thanks for your comment. I would ask, may I invite my Australian friend to visit the planet and join if he’s interested? He would broaden the perspective.

          Bourne

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          • AdLib says:

            Bourne, that is a very cool story and well done! You handled the situation smartly and effectively, very pleased that people in the community are properly informed about business owners who display such prejudice openly. They are free to be prejudiced, when we are informed, we are free to patronize only those who aren’t.

            As you demonstrated, it’s not just the minority students who have to be enlightened to the fact that not everybody is as prejudiced as some they’ve been exposed to but the racism of stereotyping by those who aren’t minorities needs to be recognized as well.

            As the saying goes, “Just because you’re paranoid, it doesn’t mean there aren’t people out to get you.”

            The fears and suspicions of AAs are unfortunately validated on a regular basis. Whether seeing the daily racism slung at Obama, the white woman who clutches her purse when black teens approach or as you describe, store owners who assume some kids are more likely thieves than not because of their skin color.

            Before Obama, I used to think that racism was dying. Then I spent a lot of time in The South and was surprised to find that racism was alive and going strong.

            I was never swayed to believe we were in a post-racial society just because Obama was elected but I was proud of this nation that a majority of Americans had transcended race and instead judged this man by the content of his character.

            We will get there and I think that the racism we’re seeing so openly expressed are the gasps of a dying mentality. I’m not saying prejudice will ever be wiped out but I do think that the virulent hatred of others because of the color of their skin, mostly resides in older white people who are dying off in greater numbers than those who are joining their ranks.

            It may take decades but if we can finally surmount the racist/wealthy minority coalition that has been deteriorating our democracy, as white people lose majority status, the GOP will either swing back towards a rational and broadly acceptable party or the Dems will become the only majority party and the GOP is relegated to cult status.

            It does require a bit more enlightenment for indie voters who still see the GOP as a reasonable alternative to the Dems, I hope that the growing extremism of the GOP helps accelerate that realization for them.

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          • AdLib says:

            Bourne, glad you’re getting the hang of the site and enjoying it!

            Please feel free to invite your Australian friend to The Planet. Our site is open to all and it’s our goal to have the greatest diversity of opinions and discussions possible (as long as everyone is shown respect whether they do or don’t share one’s opinion).

            As for HP, it’s not a sensitive issue at all. There are many folks here who are critical of HP but it’s never a reflection on the folks who blog over there since many here also blog there.

            I too am not reverent of polls but like you, look at them as indicators of trends and so far, the trend is for Obama’s re-election and a rejection of the greedy GOP policies.

            Your being a registered Republican who supports Obama is very meaningful and impactful. As you describe, the GOP has become an extremist party that doesn’t reflect the values anymore of its heritage.

            Lincoln was a Republican as was Eisenhower and neither would be welcome in the GOP of today. Even Reagan, who I did not like, would be seen as failing the current litmus test.

            Republicans used to support universal health care, tax increases to balance the budget and bipartisanship. Those days are gone and as the GOP is solidifying itself as the party of the 1%, they don’t seem likely to return.

            As for the disrespect shown to President Obama, it is a sad reflection on how some feel completely comfortable in expressing lightly cloaked racism publicly. In the future, people will look back on this period with shame, at how impotent the MSM and others were at calling out and confronting the racism freely displayed by the RW towards Obama.

            And Obama will look even more distinguished and powerful for not being moved from his goals by the hatred and prejudice constantly spewed at him.

            We are pretty fortunate to have had this man to elect as President at this time in our history and with his re-election and a Dem Congress, he may be able to be even more of a transformative President than he has been.

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            • BourneID says:

              Hi again, AL

              There is something about this man, this President, that touches the soul (at least of those who still have one). He repreents the best example of “grace under file.” I often wondered if his caution at the beginning of his administration came from that place outside the circle that we keep people who are “different.” Here is the first black president -- probably the most emotional day I’ve experienced -- entrusted with the Oval office and then quickly criticized for not moving forward fast enough. You know, it doesn’t take a PhD in psychology to understand the human condition. I have thought often of how he must have felt the first night, when finally alone with his thoughts, of the enormity of what had just happened in his life. The most powerful country in the world is now in his care but despite that achievement, he still had to overcome that little voice tht reminded him that he’s a black man. In a response that Murph made on HP to a poster who insulted the President, he said the problem is that some people still wonder why that black guy in the White HOuse isn’t wearing a white uniform. I think that’s spot on.

              He will be extremely effective in his next 4 because this time we are electing him because we know what he can do, what he’s been up against, and it will be, not a mandate as the press loves to say, but a vote of confidence in his ability to make the right decisions. Last election was mind-numbing because we actually elected a black president. This is my view from the bridge and I may have it all wrong.

              Fifty percent of my 6th graders were black…all feisty, ready to take anyone down, sensitive to their color, aware of some people’s prejudice. I told them everyday that they have a right to everything the country is and then I showed them what that looked like. In Nov and Dec I took 4 students every Sat and Sun to shop, lunch, tour the university -- show them what it’s like on my side of town. i had 4 girls one Saturday, 2 black, 2 Hmong, 1 Mexican. We walked into a music store and the manager signaled one of his male employees who came and stood by us, watching the girls. I went to the Manager, introduced myself as their teacher, told him why they with me and what our plan and that I would NEVER again enter his store and make certain every teacher in my district knew the name and location of his store and would also inform the superintendent so he could include it in his next newsletter. And then I said, “Shame on you” and we left.

              You must have guessed by now I love conversation.

              Bourne.

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  4. Bravo surf. I’m so glad you mentioned the FEDERAL EMPLOYEE HEALTH BENEFIT (FEHB). That’s what the exchanges will look like in most states including a non profit insurance plan of some kind. For the most part Obama delivered what he promised the same type of plan government has. People now forget the whole public option was mostly a post election plan.

    CL and I argued when we had the Dean and Hamsher ‘kill the bill’ people that they wanted to kill the bill because they had no skin in the game. The same goes for GOP politicians like you said. The most ridiculous part is they have skin in the game and don’t know it. Their future premiums will go down with the ACA too because they won’t be paying for as many uninsured going to the ER who can’t pay their astronomical medical bill. We will all feel the pain when the country goes bankrupt without the ACA and it’s prescriptions to change Medicare.

    But of course all that could be moot based on one or two men’s decisions who already have excellent healthcare coverage and we could be headed for a bigger healthcare disaster.

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  5. choicelady says:

    Bourne -- very interesting assessment of the existing federal plan. I gather we live in the same area and you get SUTTER which was dropped from MY Blue Shield as too expensive. I have UCDavis which is fine if rather impersonal. Oh,well…

    Today the ACA is actually better for lower income folks I think -- lower deductibles, lower out of pocket than you’re paying. The premium (borrowed directly I think from CA single payer) is on a sliding scale of 1-9% depending on income from 134% to 400% of the Federal Poverty Level.

    That’s an amazing subsidy very different from “Romneycare” that gave a flat premium subsidy and danged what it cost you as you got older, lived in the wrong place, etc. If the government gave you a credit of $200 but you had the marked incivility to be older and female and your premium was over $900 -- well, toots, YOU have to make up the $700. And in exchange for the GREAT subsidy you ALSO had a $5000 deductible and an additional $10,000 out of pocket if you got sick. That’s an additional $15K per person per year. In MA too many people are using this as catastrophic care because they cannot dip into the deductible, they do not have the money.

    ACA exempts dozens of things including colonscopies ($1800-3000 per test) from your deductible. People can use Obamacare, where they could NOT use Romneycare, to stay well or catch things very early such as pre-cancerous polyps that get removed and prevent harm.

    The one thing I think does resonate with SCOTUS is the issue of health care as our obligation to one another. It is the only thing we are MANDATED to provide -- we will not allow hospitals to dump you by the side of the road if you’re uninsured. BUT when you cannot or will not pay -- WE have to. The forced payment via increased premiums or taxes that we all pay for uncompensated care is astronomical. Unless we want the Ron Paul audience’s “let him die” standard for America, the government can ask that people take personal responsibility NOT to be burdens on society.

    What amuses and amazes me is those who think “you can always go to the ER” is perfectly fine where “I’d never take charity” they boast. Well, dumping your health care costs on us IS taking charity, is living off us, is dodging your obligations, IS a form of “welfare fraud”. The son of a friend got into a fight and broke his jaw -- went to Kaiser that fixed him, no question, and set up a payment plan. And he skipped. He only had to pay $200 per month -- but he preferred to bar hop rather than pay his bill. He drank that much up in a week. But it’s “unfair” to expect him to pay. Uh-huh. Right.

    So I think the justices -- at least some of them -- got it. The intolerable burden of the uninsured passing their costs onto us is something even Roberts, Kennedy, and EVEN Alito alluded to or said outright. I’m hoping they realize that THEIR great health care might not survive if we don’t get people to accept their own weight in this health care debate. For alleviating that societal burden the government has every right to require that we accept our own responsibilities for our own health care coverage.

    But -- we shall see what the Great Minds of todays’ SCOTUS believe is the bottom line for government and the rest of us. But if they overturn the mandate they have JUST unleashed the era of absolute irresponsibilitiy, and for even most of these lightweight minds, that might just be too much.

    Thank you for wading the waters of federal health programs for federal employees. I have a much better sense of it all thanks to you! But I AM peeved you get Sutter and I don’t! Rats!

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    • Hi CL. Spot on 100% true as usual. The GOP hypocrisy on healthcare rises to a new lever.

      But if they overturn the mandate they have JUST unleashed the era of absolute irresponsibility…

      No truer words have been said.

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    • BourneID says:

      Good mornign CL

      I assumed that we live in the same area as your mentioned in one of your posts that you’re a lobbyist. That pretty much puts in the Sacramento area.

      SUTTER is not my provider; Catholic Healthcare West (CHW), the Mercy hospitals and clinics. All of the figures I used in the article are are taken directly from the Physician Statements and billings I’ve received for hospital care. I quoted the specific costs related to TOTAL CHARGES, PLAN ALLOWANCE, YOUR COST (which I refer to as My Cost.

      Your information is quite interesting in that it appears BC/BS negotiates costs individually with each care provider. OPM is very good at negotiating, as is the entire US Government. It pays its bills. When I moved from the federal investigative side of the aisle to budget, I learned a great deal about the procurement process since it was my responsibility to fund contracts…but that’s another subject.

      I’m not sure we’re on the same side of the aisle on some issues. There are many irresponsible people out there -- some in my family who haven’t yet learned to take responsibility for their actions and lives; disappointing but seems to fit the description of your friend’s son. My issue with the loss of the ACA is with the people who were employed, who had and helped pay for their own health insurance; lost there jobs and have literally been “thrown under the bus.” They don’t deserve that and Congress and SCOTUS who now decides hold the health of an entire nation in their increasingly incapable hands disturbs me. This was not in the report, but during my extensive research, I came upon informaiton about the retirement benefits of the Justices of the Supreme Court that knocked my socks off. The Justices, if they have served a full 10 years, at retirement will receive, for the remainder of their lives, the equivalent of their full annual pay. At this moment, the Chief Justice is paid $223,000 per annum and the other 8 are paid $213,000 per annum -- this they will receive for the remainder of their lives in addition to their health care benfits. I can’t imagine a “worthier” recipient than Justice Thomas.

      If you choose to open the links, you’ll find supporting documents for the position I take on the ACA. One of particular interest, and unknown to me and many others, I discovered quite by accident while researching the Blue Cross/Blue Shield manual related specfically to the federal employee plan. It was a very small paragraph at the top of a page re PCIP, the Pre-existing Condition Insurance Plan administered by the US Government. It is avaialable in only 20 states -- don’t know why. I found it online, made a link, and included it, There are many people who cannot acquire health insurance because of pre-existing conditions.

      We see healthcare and government and define them in terms of rillions of dollars; the paralyzed Congress can speak of nothing else. But within those trillions of dollars are the sums paid to thousands of businesses that provide goods and servies, from weapons s;ystems to paper clips. And no, I’m not a pollyanna or apologist. I just have a serious problems with how we’re removing classifying people who need help, whether food or healthcare, as burdens. I taught school in Del Paso Heights. I think you know what that is.

      Thanks CL for reading the article.

      Talk to you VP.

      Bourne

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      • choicelady says:

        Bourne -- I don’t think we’re in disagreement at all. I am in agony over people who’ve lost employer-backed care, and I know via several of our friends here and those to whom I’ve sent to the High Risk Pool that ACA is a lifeline for so many people! Yes -- only 20 states have the PCIP, and one of the ironies is that it is MUCH more expensive (at least here in CA) than the High Risk Pool per se. You can get to either plan via http://www.healthcare.gov. The federal plan -- a PUBLIC OPTION tah dah -- is simply wonderful and about 40% of the cost of the PCIP with much lower deductibles and copays.

        My focus on my friend’s son is actually an “argument directed at SCOTUS” and not my beef (though I am peeved at the kid who is now a grown adult, thank you.) He had the money -- he elected not to pay. That is not uncommon, but it is NOT the issue for the majority of Americans. They want health care coverage but CANNOT pay or simply cannot get covered through private plans.

        I have not yet found anything to dislike about ACA. What is coming is fantastic, affordable, accessible, accountable, and inclusive. The one gaping hole is coverage for families with undocumented members, and that partly is aided by the huge expansion of community clinics that “will not ask, so for Pete’s sake don’t tell.” I fear it won’t help those needing major medical intervention, but this nation will HAVE to get over itself on immigration before we can be a truly just society.

        I hope the venality of some of the conservatives -- looking after their own tax issues -- will move them to rational agreement that ACA and the mandate need to stay. We are already paying for uncompensated care but through the most expensive and inefficient means of doing so after high charges are raked up. It is vastly more credible to stingy people’s concerns that we do it up front before charges are rung up for the uninsured.

        But if they pick the Ron Paul “let ‘em die” health care “program”, this nation won’t be worth a bucket of warm spit. You might have seen that Cal Expo hosted a free medical clinic a couple of weeks ago, and had I known enough in advance, I’d have been adamant that they had to pass out “healthcare.gov” and “healthyfamilies.ca.gov”
        links to every single person to get them enrolled in what’s already on the table.

        I do know Del Paso. My office is in the general vicinity out Auburn near Winding Way in what I think it the Arden Arcade area (never have been entirely sure where the hell I am!) Glad to “meet” you and know you’re part of this effort! Glad as well you’re “on the Planet”!

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    • MurphTheSurf3 says:

      Choice….as always you weigh in with a great data base and vast experience. I am going to read this through another time or two to get a better grasp on it.

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      • BourneID says:

        Hope your continuing work on this in view of the headlines that Supreme Court justices may have “misunderstood” the healthcare bill. Timely subject that needs to be kept full view.

        Check google.

        Bourne

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        • MurphTheSurf3 says:

          I think you are having a good time in “the conversation” re. your article!

          AND, you have a great reference to which you can send folks when they want to know more!

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