Attention!
The following is yet another creeping Dem/Lefty/"Progressive" agenda item notification.
Noteworthy:
"The S-CHIP program shows the mission creep that inevitably results from entitlement programs. Originally launched as a means to insure poor children, its backers have decided that America simply can’t get enough of a good thing. The advocates of expansion have gone with a hard sell, pushing the notion that the Bush administration and the GOP want to leave children without health care, when in fact the vast new expansion threatens to undermine the health insurance most of them already have."
I can hear the plaintive bleating now:
"Why oh why do you conservatives hate children? Why do you want them to die?"
Typical of the Dem/lib tactic of purporting a program to be for the benefit of the children/poor/disabled/elderly and then bashing their opponents when it's revealed that the stated beneficiary is not really the driving force behind the program.
ReplyDeleteA little known rider in the NC General Appropriations Bill gives $25 million to Erskine Bowles and UNC to fund a cancer center when there are already a couple of similar cancers centers up and running well at NC medical institutes.
Ongoing funding will come from an increased tax on “other tobacco products” which include cigars, pipe tobacco, and smokeless tobacco. The tax will be increased from 3% to 10% effective October 1, 2007. The kicker is that it also mandates a 7% retroactive “floor tax” on retailers current inventory of these products. In other words, if a cigar store owner has boxes of aged cigars he purchased even 5 years ago then he must pay a retroactive tax on these! Vendors were given TWO WEEKS to pay this “retroactive tax.” So if a small business owner has $100,000 in inventory he has to cough up $7000 to the State of NC with two weeks notice. How many small mom-and-pop operations will this put out of business??
JR Cigars in Burlington has approximately 100 million cigars in their warehouse (I used to work there part-time so I know this). If those cigars were valued at even $1 apiece (and they’re worth more than that) then JR’s tax liability is $7 million. Wonder if Erskine had his eyes on JR’s when he thought this one up?
Hmmm…Erskine Bowles…UNC…Cancer Center…Elizabeth Edwards, cancer victim…John Edwards out of a job in a few months…John Edwards looking for a nice position like he had with UNC and Bowles in the Poverty Center…is this all a coincidence?? Time will tell.
Do you think they will have enough votes for an override of Bush's veto, Bubba?
ReplyDeleteJoe Guarino
Bubba:
ReplyDeleteThe expansion would be inefficient but would not "undermine" children's private health coverage. As S-CHIP is expanded, some parents will voluntarily drop private coverage for their children to pick up the free government coverage (that is, if they prefer Medicaid-type coverage to their existing private coverage). On net, the number of covered children will increase.
One way to address the crowd-out inefficiency is to allow more families to "buy into" the SCHIP program. These families would pay the full premiums, sharply reducing the incentive to switch programs. Right now, NC allows families with incomes between 200 and 225 percent of the poverty line to buy into the program for one year.
Insurance is an area with lots of market failures. Just providing subsidies to poor families would not be enough to fix the problem.
"Do you think they will have enough votes for an override of Bush's veto, Bubba?"
ReplyDeleteSome of the Republicans who are foolish enough to support this thing don't think so.
Excerpt:
"...the White House issued a statement Friday saying that "Congress is irresponsibly waiting until just before SCHIP expires on September 30 to pass a final bill they know will be vetoed.
Democrats have known for months that President Bush would veto a bill like the one they intend to send him..."
SCHIP undermines children's health care because it encourages parents to place them into a socialized medicine environment where the quality of care would be inferior.
ReplyDeleteIn addition, this bill would be highly destructive to the Medicare Advantage program, which offers an inexpensive way for seniors to help cover expenses that basic Medicare does not.
Excerpt:
"Schip was supposed to help children from low-income families, but
Democrats are now using the program to expand government control of health care and undermine private insurance.
"To finance its Schip largesse, the House would eviscerate Medicare Advantage, an innovative 2003 program that allows seniors to choose among various private health plans. It's growing rapidly and currently serves some 8.3 million seniors, or about 18% of the eligible population. According to the Centers of Medicare and Medicaid Services, most are the urban poor, seniors in rural areas and minorities."
The current SHIP legislation is nothing more than a welfare program for middle class families.
Bubba:
ReplyDeleteDestructive of Medicare?
So socialized and subsidized medicine in the form of Medicare and Medicaid is okay for seniors but not for children. Seniors, of course, had a lifetime to save up for medical expenses. They've also made a lifetime of health choices. Children don't have any choice or control in the matter.
Logical consistency would demand that you cheer something that undermines socialized medicine, especially an add-on program like Medicare Advantage.
"Destructive of Medicare?"
ReplyDeleteThat's not what I said.
SCHIP is destructive of Medicare ADVANTAGE.
I don't think you understand what Medicare Advantage actually is.
One thing it is NOT is a "Medicare add-on".
Apparently you do not work in the field with real life seniors who have real life needs that are sometimes met with something besides traditional Medicare, and traditional Medicare Supplements.
"So socialized and subsidized medicine in the form of Medicare and Medicaid is okay for seniors but not for children. Seniors, of course, had a lifetime to save up for medical expenses. They've also made a lifetime of health choices. Children don't have any choice or control in the matter."
Irrelevant.
That sounds like a knee-jerk Paul Krugman soundbyte.
As far as "logical consistency" goes, a good part of my work is advising people of ALL ages and economic status the best way to protect themselves from those who would advocate policy decisions that are poorly considered.
Here's more detail on why the SCHIP bill is poorly conceived.
Excerpt:
CONCLUSION:
On its face, it is difficult to understand why the political left would support this expansion of SCHIP. First, the expansion does not focus on low-income children, but rather extends benefits to those clearly in the middle class and a few in the upper class. Second, the expansion is funded by imposing taxes on the lower class. In short, SCHIP expansion results in the lower class paying for benefits of the middle and upper class—something that the political left should adamantly oppose.
But fairness has never been the primary concern of the political left on health care. The primary concern has been achieving a universal, government-run system. Providing near universal coverage for children, and funding it via cigarette taxes, is a big step toward achieving that goal. 'Children' are an effective propaganda tool. Anyone who opposes providing coverage for children can be attacked as heartless and cruel. Cigarette taxes are one of the few types of taxes that the public will not oppose. Indeed, anyone who opposes cigarette taxes can be attacked as being “pro tobacco.” The thinking of the political left seems to be that if government covers enough children of enough people high up the income ladder, then eventually enough of the public will be supportive of extending such government insurance to everyone. Call it 'socialized medicine on the installment plan.'
Given how poorly universal, government-run health care systems work in many other nations, such a system is not the route the United States should travel. Thus, we should not allow SCHIP to be used as a stepping stone toward such a system. SCHIP should be returned to its original purpose of covering only children in families making no more than 200 percent of the poverty level."
Bubba:
ReplyDeleteThe neutral web-site factcheck.org disputes these claims (see their post on the administration's misrepresentation of the SCHIP bill).
As Medicare Advantage REQUIRES that you already be enrolled in Medicare Part A and B and is considered by Medicare officials to be OPTIONAL coverage, it sure seems to fit the definition of an "add-on" (see the governments own description). Also, as it takes the place of unsubsidized, privately offered Medigap insurance policies, it does have something of a socialist tint about it, no?
There is a logical inconsistency in advocating for subsidized add-on medical insurance for one group (a group that is already enjoys generous insurance through Medicare no less) and denying it to another group that has no choice and no control over their circumstances. If add-on medical insurace is good for seniors, no-frills basic insurance should be good enough for working-class children.
For what it's worth, SCHIP is a largely Republican creation--Orrin Hatch was a primary sponsor. The program is a state-federal partnership with the federal gov't providing half to about 5/6 of the funding depending on the state's own economic resources. The proposed expansion reflects a bipartisan consensus and is supported by many Republican governors. There is a veto-proof majority in the Senate that supports the measure; in the House, support appears to fall below the 2/3 veto-proof majority.
"As Medicare Advantage REQUIRES that you already be enrolled in Medicare Part A and B and is considered by Medicare officials to be OPTIONAL coverage, it sure seems to fit the definition of an "add-on" (see the governments own description)."
ReplyDeleteNope, sorry.
Medicare Advantage supersedes the regular Medicare program when elected by the senior citizen.
Here's what CMS says, page 98:
"Medicare Advantage Plan (Part C)—
A type of Medicare plan offered by a private company that contracts with Medicare to provide
you with all your Medicare Part A and Part B benefits. Also called Part C, Medicare Advantage
Plans are HMOs, PPOs, Private Fee-for-Service Plans, or Medicare Medical Savings Account
Plans.
****If you are enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan, and are not paid for under the Original Medicare Plan.***** "
It's "free market" meets "socialized medicine".
"There is a logical inconsistency in advocating for subsidized add-on medical insurance for one group (a group that is already enjoys generous insurance through Medicare no less) and denying it to another group that has no choice and no control over their circumstances."
This point is irrelevant, seeing as how we now see that Medicare Advantage is NOT an add-on, but what the heck......
You're right.
Let's revoke the entire Medicare program.
That ought to solve the looming funding crisis, right?
"The proposed expansion reflects a bipartisan consensus and is supported by many Republican governors."
So was the pre-war authorization to invade Iraq.
The proposed revision of SCHIP is just an incremental step toward universal health care.
But since it's "for the kids", it can be grandstanded, politicized, and propagandized into a stealth incremental step toward the ultimate goal, universal health care.
Bubba:
ReplyDeleteRead pages 33-34 of your document. You cannot enroll in Medicare Advantage unless you are enrolled in Medicare part A & B. Medicare Advantage is an add-on, but this is invisible to the user. All payments are handled through the Advantage plan with the government's Medicare payments going into the Advantage plan. In other words, you cannot get Medicare Advantage by itself only in conjunction with parts A & B.
Medicare IS universal, socialized health coverage for the elderly. You're already halfway there. Now just take that last step for a population with no choice.
Sorry. you're wrong.
ReplyDeletesee pg 1, and read this from pg.98 again.
"****If you are enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan, and are not paid for under the Original Medicare Plan.***** "
There is no way to interpret those words to make Medicare advantage an "add on".
Pg. 33:
"In many cases, the
premiums or the costs of services (co-pays) can be lower in a
Medicare Advantage Plan than they are in the Original Medicare
Plan or the Original Medicare Plan with a Medigap policy."
This clearly establishes the fact the Medicare Advantage is separate and different from traditional Medicare.
"Medicare Advantage Plans provide all of your Part A (hospital) and
Part B (medical) coverage and must cover medically-necessary
services. They generally offer extra benefits, and many include
Part D drug coverage."
Pg 34:
"You have a chance to switch plans each year between November 15
and December 31. In certain situations, you may be able to switch plans at other times (see page 72). For more information about joining and switching plans, see pages 71–78."
"Switching plans" within an annual election period indicates there are two plans: traditional Medicare and Medicare Advantage.
Medicare Advantage is NOT an add on. Add on programs DO NOT provide Pt A and Pt B.
An add on is a Medicare supplement program.
Next question:
Are you licensed by the state of North Carolina as an agent in health, Medicare Supplement, and Long Term Care insurance?
Regardless, SCHIP takes funds away from Medicare Advantage, which might lead to some of the private companies that provide this form of Medicare to leave the market, thus depriving seniors the choice of this plan.
CMS document, pg 1.
ReplyDeleteFrom the left column, under the heading "Original Medcare Plan":
"Medicare provides this coverage."
Immediately to the right of this column, seperated clearly by the word "OR", is another column, entitled "Medicare Advantage Plans like HMOs and PPOs":
"Private insurance companies approved by Medicare provide this coverage."
I can't make this any clearer for you.
Bubba:
ReplyDeleteThe bill that the House just passed does not call for any changes to the Medicaid Advantage program. Maybe that provision was in an earlier House-initiated version of the bill, but it wasn't in this one (which started in the Senate). For information on the bill that was just passed see the Thomas documentation.
The expansion that was just passed would be financed entirely through a boost in tobacco taxes, as shown in the CBO's analysis.
With respect to Medicaid Advantage, the CMS writes (all emphases mine), "Medicare Advantage Plans are health plan options that are part of the Medicare program. ... To join a Medicare Advantage Plan, you must have Medicare Part A and Part B. You will have to pay your monthly Medicare Part B premium to Medicare. In addition, you might have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits that they offer." I will agree that "add-on" might not be the best description because it is possible to find Medicaid Advantage plans with premiums or (net costs less co-pays and deductibles) that are lower than the Part A premiums (of course, those plans have lots of restrictions). The Advantage plans are certainly optional, and the default is receiving Parts A and B.
So ALL seniors have access to at least two subsidized health insurance options--neither of which is threatened. At the same time, 8.7 million children (just over one out of every nine children) are without ANY insurance at all.
Dave Ribar said:
ReplyDelete"At the same time, 8.7 million children (just over one out of every nine children) are without ANY insurance at all."
So if a family making $80,000 a year with a nice house in a nice neighborhood in GSO with 2 SUV's, cable internet, TV in every room, 3 cell phones, and a gym membership should be able to force ME to pay for their kid's snotty nose??
'With respect to Medicaid Advantage, the CMS writes (all emphases mine), "Medicare Advantage Plans are health plan options that are part of the Medicare program. ... To join a Medicare Advantage Plan, you must have Medicare Part A and Part B. You will have to pay your monthly Medicare Part B premium to Medicare."
ReplyDeleteOnce again, irrelevant.
Traditional Medicare and Medicare Advantage are two distinct programs paid from two distinct choices offered under the Medicare umbrella.
Seniors generally must choose one or the other.
"Option" refers only to the choice of plan under Medicare.
As far as the bill being reconciled to eliminate the defunding of Medicare Advantage, that would only remove one reason to oppose this bill.
There are plenty of others that would more than merit a veto by the President.
Jaycee lists but one of those.
IBD summarizes things nicely:
ReplyDelete"Add it all up, and SCHIP's costs will be much, much higher than the $60 billion forecast — just as happened with Medicare.'
"This is a very bad, very cynical bill, disguised as an effort to help children. If it becomes law, spending will soar and we will have taken another foolish step down the road to a poorly run, expensive and inefficient nationalized health care system.
President Bush would be right to veto it.'
So when was the last time a major entitlement program or revision came in at "projections"?
We have only to look at the Part D real numbers to to see the most recent example of the folly of "projections".
Bubba:
ReplyDeleteJaycee's post also doesn't refer to the legislation that was passed by Congress. Your choices of what's "relevant" (non-existent cuts to the Medicaid Advantage program, a bill before the NC legislature) are very strange.
Again, you support universal, socialized medicine for one group--the elderly--but not for another. You even use the escalating cost of the program you support to argue against the one that you don't. Again, very strange.
Sorry, I did not see Jaycee's second post. As factcheck.com has reported, "nothing in either the House or Senate bill would force coverage for families earning $83,000 a year. That's already possible under current law, but no state sets its cut-off that high for a family of four and the bill contains no requirement for any such increase."
ReplyDeleteUnder NC's SCHIP plan, regular SCHIP coverage only extends up to 200 percent of the poverty line (about $41000 for a family of four). Short-term SCHIP coverage that requires the family to pay the full cost of premiums is available up to 225 percent of the poverty line.
So Jaycee's second post seems to be as far off base as his first. His tax dollars will not be going to support SCHIP insurance for any Greensboro families making $80K a year (with or without the other luxuries that he describes).
In fact, unless Jaycee is a smoker, he won't have to pay ANY additional tax dollars for the SCHIP program.
"That's already possible under current law, but no state sets its cut-off that high for a family of four and the bill contains no requirement for any such increase."
ReplyDeleteIf I am not mistaken, I believe this bill mandates that the states conform.
By the way, do you have a link to a copy of the original bill where the red lining of the Medicare Advantage cutback is shown?
How about a link to a reputable source that provides the same information?
i can't seem to find your version verified anywhere.
As far as jaycee not having to pay, that statement expires in 2012, according to Robert Novak.
"The program's $35 billion expansion is supposed to be financed by a 61-cent increase in cigarette taxes, but financing is scheduled to abruptly fall 72 percent halfway through 2012. With private insurance probably no longer available, Congress would then have no choice but to provide additional funding."
Bubba:
ReplyDeleteIn this thread, I previously linked to "Thomas," which is the legislation documentation system of the Library of Congress. The text of the bill is available there. The cost information that I provided comes from the Congressional Budget Office and comes from an analysis that they did using static scoring (they are the basis of the $35 billion figure that everyone uses).
The Medicaid Advantage provision that you were discussing was in a more expensive House-initiated plan that is no longer on the table. The conference bill that was just passed was closer to the Senate plan, which is smaller in scope and funds everything through a tobacco tax increase.
SCHIP, like Medicaid, is a state-federal partnership. There are some mandated elements and some optional elements in the current and proposed systems. There is also federal oversight in both systems. There is nothing in the current or proposed law that requires states to enroll children from families up to $83,200. States now have and would have an option to request coverage up to that point, but this is and would be subject to federal approval. In any case, most states would have to put up half of their own money to extend coverage (poor states like Mississippi would put up less than half the funds).
SCHIP is administered by the CMMS (the same agency that administers Medicare). All of the state plans are available there--in this thread, I've previously linked to NC's plan fact-sheet. You are welcome to look through the state plans and see how much variety there is. State control was a major selling point of the initial legislation. This feature is still there, which is one of the reasons why Republicans like Charles Grassley supported it. If you read through the legislation, you will see that almost all of the provisions describe options, special grants, and incentives.
Novack's assertion does not match with the CBO scoring of the bill, which indicates that tobacco taxes will fund the extra costs through 2017. Let's suppose, however, that Novack has spotted something that the CBO hasn't. What would prevent the Congress from just extending the tobacco tax at that point?
For the record, could you indicate which of my sources are non-reputable? My sources in this thread have been:
- factcheck.com
- The Library of Congress
- The Congressional Budget Office
- The Centers for Medicare & Medicaid Services (US DHHS)
Never mind....I found a credible source for the information needed.
ReplyDeleteSo you dispute the funding analysis provided by Heritage here?
Key point:
"In just five years, Congress will need over 9million new smokers. Reauthorizing the program for 2013 to 2017 would require almost 22.4 million new smokers by the end of that period.5 (See Chart 4.)"
Gee, WHERE will we ever get those new smokers?
Let me put my marketing cap on for a second and think about which market to target to get those kind of numbers......but first, let me consult the guys at RJR and Altria.
They've got LOTS of experience with this problem.
Bubba:
ReplyDeleteThe Heritage Foundation is not an impartial source. They, like the American Enterprise Institute, the CATO Institute, the Employment Policy Institute, the Hudson Institute, etc., all slant conservative. They would not convince a skeptical, neutral observer without careful examination of their figures and assumptions.
Similarly, reports from the Economic Policy Institute or Resources for the Future would slant liberal and would not be convincing without careful consideration.
Most of the researchers at these institutes are very good (I personally know many of them, enjoy talking and interacting with them, and especially enjoy reading their work), but they usually are assembling evidence to support a pre-determined outcome, especially in their on-line reports. In an academic (peer-reviewed) work I would only include these sources as evidence of what one side or the other is claiming but not as objective evidence.
So just citing a Heritage report is not especially credible. Even if we give them the benefit of the doubt (didn't we just concede the same point with respect to the Novack column, who in turn appeared to be relying on an unnamed Heritage report--wow, it all goes around), Congress has provided for a substantial amount of funding for this expansion and could easily adjust the funding if the projections for either spending or revenues don't work out. Congress is essentially using the same procedures for this bill (zero-based or pay-go budgeting) that it used in the late 1990s when we eliminated the deficit. That is, it is matching a spending increase with either an offsetting decrease or a revenue source. It is also relying on the same source for its figures, the CBO. After six years, this is a refreshing change in fiscal practice (more like a return to sanity) and stands in sharp contrast to Bush's war-related proposals which have all omitted plans for generating the necessary funding.
The CBO has prepared a neutral analysis. Will its forecasts five years out be accurate to the dollar? If they were, it would be a first for economic and policy forecasting.
Time and again you've mischaracterized the legislation--despite being given links to the actual text of the legislation. First it was cutting Medicaid Advantage (though this legislation wasn't). Then it was requiring states to provide coverage to families with incomes up to $80,000. Now you're grasping at arguments that you would never apply to a program that you support. I mean, really Bubba, look at your arguments. Besides showing your support for socialized medicine for one group but not for lower middle-class children, you're now criticizing the legislation for not raising taxes enough, as if adequate funding would change your mind.
"Time and again you've mischaracterized the legislation--despite being given links to the actual text of the legislation. First it was cutting Medicaid Advantage (though this legislation wasn't). Then it was requiring states to provide coverage to families with incomes up to $80,000. Now you're grasping at arguments that you would never apply to a program that you support. I mean, really Bubba, look at your arguments. Besides showing your support for socialized medicine for one group but not for lower middle-class children, you're now criticizing the legislation for not raising taxes enough, as if adequate funding would change your mind."
ReplyDeleteBlah blah, woof woof.
Anything else?
Be sure to let me know when you've got the agenda blinders off, Dave.
Perhaps then we can talk about the facts as they actually are on the issues, rather than your preconceived and undefendable opinions, and your mischaracterizations of others' opinions when you can't refute the information.