31 Comments - Anonymous - Tuesday, Aug 29, 06 @ 2:10 pm: very interesting. we already know that roskam has contact with karl rove (rove “showed” him around what, a year ago?), but this is right out of rove’s playbook — attack your opponent’s perceived strengths. a little club for growth thrown in, as well! - bored now - Tuesday, Aug 29, 06 @ 2:12 pm: i see i scrubbed my history folder. opps… - Way Northsider - Tuesday, Aug 29, 06 @ 2:34 pm: Given how the govt is paying drug manufacturers way more for certain drugs under Part D than, for example, the Veterans Admin pays, what makes Roskam think his Small Business Plans would result in cost savings? Theoretically, pooling buying power SHOULD drive costs down but that doesn’t happen when the buyers and sellers are in cahoots and don’t negotiate at arms length. The poor “beneficiary” ends up, once again, getting shafted. - Truthful James - Tuesday, Aug 29, 06 @ 2:34 pm: Anon 2:10 I don’t care if Roskam got it from Mephistopheles or Mount Sinai!! Criticize the Plan not the messenger. - bored now - Tuesday, Aug 29, 06 @ 3:01 pm: i was critizing neither the plan, nor the messenger, merely putting it in context. what was the part that perturbed you, it’s association with rove or the club for growth? - Chicagograssroots - Tuesday, Aug 29, 06 @ 3:36 pm: So he’s really going out on a limb — coming down against fraud and abuse. These are harmless reforms that won’t offend anyone except hard core single payer advocates (who weren’t voting for Roskam any way). - NW burbs - Tuesday, Aug 29, 06 @ 3:50 pm: On Point 1, the Republicans have had more than a decade to enact some sort of small business healthcare-coalition plan… They haven’t. What makes anyone thinks Roskam’s going to be different considering we already know he’s a movement conservative receiving help (monetary, mailings, endorsements, etc) from Establishment Republicans and Conservatives??? Please. Point 1 is a good idea and way overdue. I don’t trust the conservatives to actually do it — they haven’t yet and there’s no incentive from their K-Street money-peddling influencers to start now. Point 2 is the same ol, same ol. Republicans claim to cut taxes but in reality they simply shift more cost burdens directly onto individuals. Tax-free HSA’s are a good idea for people who can afford them. (”It’s your money.”) A great many people who don’t have insurance to begin with cannot afford such “add-on” accounts that take more money directly out of your pocket and sequester it away. Besides, HSA’s don’t do much good for catastrophic, but not life-ending, events like major accidents or dire illnesses. Privacy advocates and liberatarians are going to love Point 3. Not. Way too much potential for abuse and extremely little benefit no matter how much spin Roskam and other Kool Aid drinking conservatives put on it. How many times during Bush’s presidency has the VA or another agency “accidentally” made thousands of digital medical records publicly available (or “lost” them). The key to reducing costs isn’t necessarily more efficiencies. While that may help it’s a one-time thing. You get efficient and then you’re done — no more savings to come. The key, rather, is bargaining — using economies of scale and market influence to negotiate better pricing…. which leads me to Point 4. How any Republican can even speak to Medicare reform is beyond me. They’ve loused it up but good in their attempts to serve up little more than a talking point and a taxpayer-funded windfall to the profitable Pharmaceutical industry. Now if only citizens had their own K-Street lobbyists and money-peddling influence… Whether this plan comes from Roskam’s pals Karl Rove, Grover Norquist (Club for Growth) or the Easter Bunny it doesn’t matter. It’s a fiction of Roskam’s imagination to think folks will buy into this after they realize the baloney Republicans have been peddling on this for the past 12 years… Roskam and his supporters reveal themselves to be hypocrites and charletans more and more every day. Take for instance his recent endorsement from the “Free Enterprise Fund PAC.” FEF claims to be for limited government and responsible spending. So why they support someone like Roskam who is for more Red China-funded pork and ill-advised tax giveaways to the filthy rich is beyond me… How do you say “earmarks” in Chinese? - bored now - Tuesday, Aug 29, 06 @ 3:59 pm: grover norquist is not the club for growth… - NW burbs - Tuesday, Aug 29, 06 @ 4:21 pm: Thanks bored. There are so many conservative influence group they do sometimes get confusing. The right-wing influence machine really is “vast”. Not too much difference between those ATR and CFG if ya ask me. Let me rephrase and add a bit more color to the commentary… “Whether this plan comes from Roskam’s pals Karl Rove, Grover Norquist, the Club for Growth, the Free Enterprise Fund, a little green leprechaun or the Easter Bunny it doesn’t matter.” - Anonymous - Tuesday, Aug 29, 06 @ 4:30 pm: Point 1 is NOT a great idea. The savings are not from pooling together - they are from avoiding the impact of state laws mandating certain minimum coverages. Under Roskam’s plan, employers save money by offering less coverage to their employees than plans regulated by states would allow. - Greg - Tuesday, Aug 29, 06 @ 4:35 pm: Bored, Leave him alone he’s on a roll… Actually, the President has pushed association health plans for six years, but we’ve haven’t been able to get much out of the US Senate, the place where good ideas go to die. As far as HSA’s being for the rich goes, the evidence suggests that a good many HSA’s participants earn less than $50K a year and a substantial portion (rougly 20% in 2005, I recall) make well under $50K. HSA’s are designed for catastrophic events — that’s what high deductible insurance is for. If you have a chronic condition they can be unwise because chronic conditions makes it harder to save funds for retirement. Maybe he meant that — again he was on a roll. Then diatribe I’m beginning to hear about HSA’s increasing what comes out of our pockets is the latest after the “healthy” and “wealthy” criticisms were proven wrong. Sure, they take money out of your pre-tax income and out of your pocket for deductibles. But, the third party payee employer benefits have been taking more. Those gold plated plans are a major reason why wage growth has flattened in some areas of the economy. Health care is a benefit that is paid in lieu of take home dollars. Because you don’t see it, doesn’t mean you don’t pay for it. A great example of that is that it takes 17.7 weeks on average to see a specialist in Canada where a coronary by pass is considered elective. You see they don’t “pay” in terms of dollars out their pockets. They pay in time waiting to see someone and move life saving operations into the elective category. It might be a different kind of cost, but it’s a high cost nonetheless. Roskam has put together a quality, responsible program very much in the mainstream of what the center-right has been pushing. I wish more would talk about these issues. Greg Blankenship Illinois Policy Institute - HANKSTER - Tuesday, Aug 29, 06 @ 4:57 pm: A nice example of a healthcare industry giveaway. This ‘plan’ does not even come close to addressing the issue that healthcare prices keep on rising as they bring in record profits. It is interesting that Roskam now says he supports negotiating for lower healthcare prices but he has not spoken out against the provision prohibiting medicare from negotiating for lower drug prices. - Middle Majority - Tuesday, Aug 29, 06 @ 5:00 pm: These are all reasonable “next step” reforms worthy of debate and discussion, if not enactment. Unfortunately, they do not do anything to resolve the real philosophical debate which is between “healthcare is a right and everyone should have access to the same quality of care regardless of means” and “healthcare is one of many personal responsibilities that each individual has the right to prioritize for themselves”. In the past our country favored the latter and the popular choice was to pool risk through health insurance, but even those who had no insurance were rarely bankrupted by medical costs because medical capabilities were not what they are today. The adoption of health insurance as a popular employment benefit since WWII has had the unfortunate effect of separating most of the public from the evolving issues, technologies, and costs of modern healthcare. Our current system and most reforms now attempt to awkwardly straddle these two philosophies of healthcare with neither side being content or well-served. The insurance pool does not work well if people only join when they know they have a need, but the high cost of the technological marvel that is modern medicine is beyond most citizens’ ability to self-insure. I do not believe the public is anywhere near a consensus opinion on healthcare philosophy. Reforms are only stopgaps, but they also serve to keep the public discussion active. - Dan Vock - Tuesday, Aug 29, 06 @ 5:04 pm: As far as other incumbents or candidates using the same template, I think they’ve been using this template for years. This is very consistent with the emphasis of the Bush Administration and the House GOP. The reason why the small health plans aren’t law is because they keep getting filibustered in the Senate. Dick Durbin’s one of their most vocal opponents. - (618) Democrat - Tuesday, Aug 29, 06 @ 5:13 pm: If you want to do somthing about healthcare start out by raising the minimum wage so people could afford to pay their portion of a health care plan. If it were up to Republicans like Roskam no one would be making more than$5.15 an hour. Small business can’t afford health care for their employees no matter how many tax incentives you give them. Even if they could afford it the first year, the following year the incetive would remain the same and healthcare cost would go up and the small business would drop the coverage. This is a joke. Another reason to vote Democrat if you are a wage earner. - NW burbs - Tuesday, Aug 29, 06 @ 5:53 pm: Greg, If you think this is a “center-right” plan that shows just how far to the right you are…. This is, sadly, a quite conservative plan which leaves people who work for a living behind. - Bridget Dooley - Tuesday, Aug 29, 06 @ 6:11 pm: Interesting how the statement is made that if someone has a health savings account they are “insured”. - Radio Shack - Tuesday, Aug 29, 06 @ 6:31 pm: that’s right. Health Savings Accounts are only offered in conjunction with HDHP insurance. Therefore, HSA purchasers are most certainly “insured”. - NW burbs - Tuesday, Aug 29, 06 @ 7:23 pm: Bridget, That’s what I meant by this being a “quite conservative plan”. It is the essence of any given conservative policy: You’re On You’re Own (YOYO). Every failed conservative policy is a YOYO policy. In Iraq, we’re essentially on our own (Britain has a relatively small contingent soldiers in the safest parts of the country). Bush and FEMA’s reaction to Katrina for days was, ‘Hey Gulf Coast, You’re On Your Own’. Same for the failed social security destruction plan — that one was purely a YOYO policy. Roskam still buys into and promotes the failed conservative YOYO philosophy. Most Americans have had enough of it. - SAT - Tuesday, Aug 29, 06 @ 8:31 pm: It is very interesting that many people like to talk about things they know very little about! Step 1. I run my own small business and work in the healthcare field…and offer health insurance to my employees. The Small Business Health Plans is a good idea and arguing that it should’ve been done years ago is just stupid…perhaps we should look at who’s been blocking it? If I could take my employees and pool them with other small businesses we would be negotiating for medical and pharmacy plans with 100,000 lives and not 15. This would allow us access to more competitive rates and protect us from outrageous annual premium increases. In effect, it would get us on close to equal footing in purchasing healthcare coverage like large employers. And please, don’t talk to me about single payer, government run healthcare. Do you really want to pay all those taxes to have poor quality, rationed healthcare that’s only goal is cost containment. Picture receiveing your healthcare from the Department of Motor Vehicles…ouch! Step 2. Expand HSAs…I am not a big proponent of HSAs in their present form. I do support their creation and continued evolution. By the way, most of our insurance plans our becoming high deductible plans. Can you say convergence? HSAs do need to be expanded…people need to be allowed to invest more so they can build more cushion over time. Greg Blakenship is right…high deductible plans are catastophic plans…the way insurance used to be. After you hit your deductible, the HSA becomes a regular insurance plan that pays at 80/20, 90/10 or 100% of needed care. In fact, HSAs are most popular with small businesses, because the premiums are lower, therefore they can afford to offer these plans to their employees. Most businesses take some of the premium savings and contribute to the employee’s HSA to get them started (in the range of $500 to $2,500). Most large employers are taking a wait and see attitude on HSAs and high deductible plans, because the business and health outcomes data on these plans is lacking…which is why I am not a complete convert, yet. Step 3. Information technology. Hello! Is anyone paying attention to the healthcare world out there? It’s just a little out of synch with your normal world. Name another industry that keeps all of their records in paper files? That describes the high tech world of your doctor’s office. Is it surprising to anyone that the most technologically advanced part of the doctor’s practice is the billing process…hmmm…wonder why that is. On-line, real-time claim processing, but let’s not harness the efficiency or effectiveness of technology when it comes to your health and they type of care you receive. Oh please, don’t tell me about the risk of your information being on-line. I’ll let you in on a secret, your information is already on-line in every other phase of your life, and there is nothing you can do to stop it. Should there be protections in place sure…will it ever be 100% foolproof no. There is already legislation in place…HIPPA…that over reaction to privacy concerns in healthcare that have already cost the healthcare system billions! The real issue in health care is value. How can we determine who is providing the best care/outcome for the money we are paying. You can’t get here without electronic data. So how can we speed the process to convert a cottage industry to electronic applications…we can’t do it without one of the largest purchasers of healthcare, the government, supporting standards for electronic data. Step 4. Medicare. A huge issue, which actually starts with what did the goverment do with all the money…they spent it. So until we figure out how to fix this mega problem, why not start with something that should be done…plug the leaks! $54 billion a day is wasted…that’s unbelievable. Why wouldn’t you want to stop this? It’s achievable, it’s doable and why would anyone be against stopping the waste and fraud with our money? For you single payer fans out there, do you think we’ll repeat the same mistakes we made in both Medicare and Medicaid? If we have this much waste, fraud and abuse in these programs, run by our government, how much do you think we’ll have in a plan delivered to 300 million people? We need a rational plan for government assistance for our poor and our elderly, but I am not sure either side of the aisle has the courage to fix what is badly broken until we have no choice. Sad we’re in this predicament and doubly sad that we can point to both Democrats and Republicans on this one. - Mr. Luxury Yacht - Tuesday, Aug 29, 06 @ 8:48 pm: But it’s pronounced “Throat Wobbler Mangrove.” I LOVE this from above: “Roskam has put together a quality, responsible program very much in the mainstream of what the center-right has been pushing. I wish more would talk about these issues. Greg Blankenship Illinois Policy Institute” Fox + Henhouse = Republican “Healthcare Plans” As said above, Point 1 is WAY overdue but hey, where has the Gingrich/Hastert-led House been for the past 12 years? Proof positive that the R’s are out of ideas is that they’re stealing old ones from Dr. Howard Dean, MD (look it up, Mr. B). Point 2 - Say, how did those private Social Security accounts work out? HSAs are no substitute for catastrophic insurance. Unless you work on/for Wall Street of course. Then it’s yet another juicy pool of poor/elderly/working people’s money to play with. As noted, Point 3 is “Health Information, sponsored by Gen. Poindexter et. al., who brings you library spying, illegal wiretaps and, well, the Nixon Administration.” Point 4: The expanse of hubris needed for a party to suggest the need for Medicare reform, after pushing through “No Big Pharma Group Left Behind” is…continental. And speaking of continents, Greg boy, the options available as alternatives to these thin, silly, discredited or outright hysterical ideas are not limited to the way things are done north of the border. “Illinois Policy Institute”? Try “Illinois Tired Wouldn’t-Know-An-Idea-If-It-Walked-Up-And-Smacked-’Em Mean Old White Guys Business Shills Institute” This is why the Grand Old Pasties club is gone to get its head handed to it in the fall. Rove is out of ideas and you guys have no relief pitchers. The RNC(C) should start saving its money for 2010 instead of spending it in IL-06, ‘cuz that’s the next chance y’all are gonna git. - anon - Tuesday, Aug 29, 06 @ 10:13 pm: when you say repubs should save their money, are you referring to the presidential election? thats in 2008… - Angie - Tuesday, Aug 29, 06 @ 11:29 pm: Whoever was worried about medical privacy ought to know that your medical info is already all over the place, although HIPAA does apply to covered entities, so employees who have access to your info are supposed to keep their mouths shut. I worked in medical claims for a bit, and the company was dragging in people whose last job was as a bartender in a bar as well as some really creepy characters who were doing that door-to-door sales thing, and then they were turning them loose with Protected Health Information, but they were all trained in HIPAA compliance to keep the info in the workplace and not going any farther. Still, it creeped me out seeing some of the characters who had access to health info. I think there ought to be some type of professional certification required, or at least some college education, much like with claims analysts in the insurance industry, where at least a college degree is preferred. Small businesses need a ton of help. Help them out as much as possible, because they employ the most people in America. Large corporations can afford the best plans (last one I worked for gave us health, dental, and vision for a whopping $57.00 a month out of our own paychecks, great plan), but small ones cannot negotiate the best deals. Whatever helps individuals and small businesses have many more options is a winner. Blago’s plan seems to be to push for health insurance for all kids. I can just see many many more out-of-wedlock births than there already are when EVERY last kid has access to health insurance through some government-sponsored plan! - Angie - Tuesday, Aug 29, 06 @ 11:51 pm: Forgot to add: For good reading material from a libertarian perspective, hit the website for the Cato Institute and read the piece “Kids Just Pawns in Governor’s Big Government Scheme” by Michael F. Cannon. Interesting critique. - Snidely Whiplash - Wednesday, Aug 30, 06 @ 7:32 am: Savings plans can only be afforded by people who likely already have medical insurance; nice shot of cash for rich bankers, though. Small employers pool together to shop lower rates? They’ll just raise rates across the board, causing more large employers to either drop coverage or force more contributions from their employees. This is one of those “big money” area where the little guy never wins out. - Still Anon - Wednesday, Aug 30, 06 @ 8:52 am: So how does Roskam’s plan square with his concern for health care in the General Assembly all these years? Is the fact that it’s a national crisis an epiphany for him? - Still Anon - Wednesday, Aug 30, 06 @ 8:53 am: PS - re the brothers Roskam: Since when do the docs care whether it’s affordable for mere mortals? - VanillaMan - Wednesday, Aug 30, 06 @ 9:09 am: It’s time to admit that the ‘universal health care’ like a planned economy, a bureaucratic system in which everybody’s role is spelled out in advance and there are few incentives for innovation and productivity. It’s no surprise that it hasn’t worked in any country, and that the United State’s health care system is considered the world’s best by other countries. A universal health care system resembles the communist economy than a market economy. But still the Democrats push the idea. They have been pushing it since 1948. Like most all New Deal programs, universal health care is obsolete. Had the US adopted it when first proposed, our health care system would be still be falling apart, as is Canada’s. This week, 60% of Canadians polled said their health care system does not provide timely or effective care, they are tired of waiting for needed surgeries, and are concerned over the escalading costs. This is what we similarly find in other western European countries like Germany, Britain, and France. So, why do the Democrats push this stupid idea? Because it is an easy political sell. We have a generation or two of seniors and near-seniors raised on socialism and believing in it. Now that they are retiring, they want their gravy train. They are greedy. What Roskam is proposing is an alternative. It takes into consideration the many facets of “health care” - which is not a system, by the way, and divies it up into proper perspectives. He then addresses each issue thoroughly. Rich is right in that Republicans need to do something to counter the Democrat’s obsolete New Deal solution, and this is Roskam’s. Truthfully, there is NO health care “system”. Anyone claiming that one exists is wrongly identifying and merely simplifying many complex markets. This simple minded approach is an easy sell to voters, but will cause far more damage to our current system. Voters believing that they can get what they need, choose the doctors they want, get cutting edge health benefits, get the best pharmaceuticals, and get this whenever they want have never experienced the realities of the health care system in Europe and Canada. After 50 years, their system STILL don’t work. If you believe we can make it work, you are needing mental health care. - Radio Shack - Wednesday, Aug 30, 06 @ 9:43 am: Since this still seems to be an issue, I’d like to explain clearly that Health Savings Accounts are offered in conjunction (and only in conjunction) with high deductible (HDHP) health insurance. So to respond to Bridget Dooley’s concerns about HSA purchasers being considered “insured”–they are. Next, all this class-envy rhetoric from Snidley Whiplash about HSA’s for the wealthy only. A typical line of argument, though not very compelling. What happens with an HSA is that rather than pay for defined benefits–e.g. 1 checkup each year, 1 specialist visit, 1 pair of glasses, 1 dental hygiene appointment, etc. employeers contribute money to your HSA. For small medical costs, you pay most/all of the cost, until your deductible is reached. That’s what your HSA money is for. After you reach your deductible, you are covered 80, 90, or 100% on all medical expenses. NOW, before you go crazy, let me finish explaining. “Paying for things” with your HSA DOES NOT mean that your cost of healthcare is increasing…therefore only the rich can afford this, blah, blah, blah. What it means is that rather than your company paying the insurance company, who pays your healthcare provider, the company pays you, and you pay the doctor. This SAVES money by eliminating the middlemen and reducing administrative overhead. YOUR COST OF HEALTHCARE IS NOT INCREASING (its often getting better), YOU ARE JUST PAYING WITH YOUR EMPLOYEER’S MONEY, what they used to send the check for. Either way, this is where the market is going, so people can get on board or not; it’s happening. - Angie - Wednesday, Aug 30, 06 @ 10:58 pm: There are folks trying to push to expand the same tax credits that EMPLOYERS get for insurance so that individuals can be in control of their own insurance. Maybe not everyone wants a High Deductible Health Plan tied to an HSA, but the option should be there for those who do (more choices in a free society, what’s wrong with that?). People switch jobs, move across state lines and have to get new coverage, decide to start a small business or run a very low overhead self-employment gig (freelance writers, teachers who collect adjunct appointments running from college to college to teach, while getting NO benefits), or their employer just has a really crappy plan. Why can’t more people have more choices? Don’t want one? Don’t buy one then! That’s what I hate about this only-for-the-healthy-and-wealthy stuff. Look, don’t buy it if you don’t want it, OK? I’m lovin’ the idea of YOU in charge of your own health insurance instead of being at the mercy of whatever lousy plan your jerk employer might currently offer. Hate your job but just barely have decent coverage? Great. Now you feel luckier than most, but still miserable. Is that any way to live? Open up some competition, folks. Open it up and let the people make their preferred choices. That is what everyone misses with all of the rhetoric. It is about two ideas: free market ideas versus socialism. Let the people who want more openess and freedom of choices be free already! By the way, do you think a large part of the cause behind uninsured kids on the rise is due to these women who just knock out illegitimate kids because some cad thought they were hot enough to sleep with and use to help spread their seed, but not good enough to officially commit to? Yep, I’ll bet it’s a ton of single and never-even-tried-being-married moms creating all of those kids that are now in need of health insurance. And guess what? Your tax dollars are gonna prop them up instead of the Baby Daddy, who probably skipped out on the mom before she even got his last name to chase for child support. - Angie - Wednesday, Aug 30, 06 @ 11:57 pm: Just to add, in reference to Radio Shack’s excellent bit of clarification, premiums for High Deductible Insurance Plans can be very affordable when you consider that employer-sponsored plans are already costing employees more as employers shift more of the burden of cost onto the employee. I got a quote that was under $100, and my last employer’s insurance cost me about $70 a month. For $20 more coming from me, heck, I could just save the difference by working closer to home and saving on gas. They’re worth looking into, especially if you want more control and don’t want to be job locked into a company just because fewer employers are providing employer-sponsored benefits. A little under $100 is not bad at all if you’ve been asked to contribute $70-$80 a month to cover your premiums through work, and on top of it, there’s still a deductible, plus co-pays, plus denials if you just have to, for whatever reason, go out-of-network. You’re being asked to jump through hoops and pay a lot as it is. Just decouple it from employers for those who want that. Sorry, comments for this post are now closed.