The POS As It Stands Right Now

Now, a look at what we are going to get.

President Barack Obama is preparing a final push for a health care overhaul and is expected to announce a plan on Wednesday to move the ambitious legislation forward without support from opposition Republicans. Last week he announced what he wanted in legislation to bridge differences with bills passed by the House of Representatives and Senate. On Tuesday Obama listed some Republican ideas that he said he was considering. Here is a summary of his proposals and the Republican ideas he is exploring:

EXCHANGES AND GOVERNMENT-RUN INSURANCE OPTION

...state-based insurance exchanges similar to the proposal in the Senate-passed bill...(no) public option...Office of Personnel Management to negotiate with private insurers to provide multi-state health plans on the exchanges.

TAX REVENUES

(No) 5.4 percent surtax on high-income households...(will) raise the Medicare tax on high-income earners to 2.9 percent from 2.35 percent (and) impose a new 2.9 percent Medicare tax on some investment income for high-income people....

...modifies the proposed Senate tax on high-cost insurance plans (which) would kick in on plans costing $10,200 for individuals and $27,500 for family plans (beginning in) 2018 rather than 2013...also provides higher tax thresholds for firms that have higher costs because they employ mostly women or older workers (and) higher thresholds for high-risk professions such as firefighters.

...increases proposed new assessments on brand-name pharmaceuticals to raise $23 billion over 10 years...(starting in) 2011.

...closing a tax loophole on a cellulosic biofuels credit to prevent it from being used for a paper processing byproduct...clarify "economic substance" tax rules on investment transactions and raise penalties on transactions that have no economic purpose except to avoid paying taxes.

AFFORDABILITY

...A family of four earning as much as $88,000 a year would receive federal assistance in paying for healthcare costs.

...close the so-called "doughnut" hole in Medicare prescription drug coverage...by 2020...

REGULATION

...young adults up to the age of 26 (can) stay on a parent's health insurance plan. ...insurers would be barred from dropping people from their health plans. When exchanges begin operation in 2014, insurers would be barred from excluding people for pre-existing conditions and setting annual and lifetime coverage limits. The Department of Health and Human Services would get new authority to help states review annual premium rate increases.

MANDATES

...individuals (are required) purchase health insurance. (No) employer mandate...(modified) fees on those uninsured companies with employees receiving subsidized health policies on the exchange...Small firms with fewer than 50 employees would be exempt...a tax credit is provided to encourage small companies to offer health coverage to workers.

REPUBLICAN IDEAS BEING EXPLORED

...medical professionals be engaged to conduct undercover investigations of healthcare providers to reduce waste and fraud in Medicare and Medicaid.

Increase proposed grants to states for demonstration projects to resolve medical malpractice disputes and curb the need for lawsuits...

Increasing doctor reimbursements for Medicaid patients...

...expand health savings accounts used in conjunction with high-deductible health plans (in) proposed new insurance exchanges...

Add to all this the Senate anti-abortion language, which is less onerous than Stupak, but still ridiculous; allowing insurance companies to charge twice as much for premiums to older consumers; allowing insurers to exclude adults with pre-existing conditions for another 4 years (doing so to children would be barred); and allowing insurers to charge families of 4 with incomes over $88,000 yr. pretty much whatever they like for premiums and out-of-pockets, and you've got a real win-win, eh? So long as you have the same insurance policies as the House and Senate, anyway. And how will they rein in the insurers to make premiums and costs affordable? The President's plan itself tells you:

The House and Senate health insurance bills lower premiums through increased competition, oversight, and new accountability standards set by insurance exchanges.

See there? Increased competition, the lifeblood of the free-market, which is a totally acceptable model for a system meant to save lives, so long as those lives are worth more than the stockholders' shares. The exchanges, which will be state, not national, will take care of it for you. So whether you get a good deal or not depends on the compassion of your state leaders and their intimacy with the regional Chambers of Commerce. Now I know you feel better.