Officials: Medicare buy-in on table

[yurbud]

Source: Politico

The group of 10 Democrats working to break an impasse on the government insurance option are considering changes to other parts of the bill, including creating a Medicare buy-in, according to multiple officials familiar with the talks.

The Medicare buy-in could allay the concerns of progressives, who are being pressured to abandon the public option. It would allow people younger than 65 to purchase coverage in the popular government program for the elderly -- and it would be a significant win for Democrats, who have been seeking this change for years.

In short, the negotiations over the public option aren’t just about the public option, officials said Monday.

Read more: http://www.politico.com/livepulse/1209/Officials_Medicare_buyin_on_table.html

---

The article makes this sound like a last minute idea, but Thom Hartmann and others have advocated it all along. This would be a huge turn around in the shitty bill!

[alsame]

1. MSNBC reporting 55 as proposed age of buy in. nt

[mikelgb]

2. damn rec'd before I red this

[Delphinus]

3. That's a start ...

we still need Medicare Part E - E for Everyone!

Cradle to grave ability to be seen by medical professionals.

[DesertFlower]

4. that could be a starting point.

i'm a bit more optimistic now.

[yurbud]

5. that was part of Thom Hartmann's idea! add more people over time

[OKNancy]

6. Isn't that what John Edwards proposed in the campaign?

Lower the age to 55?

[yurbud]

8. I think Kerry mentioned something like that too in 2004

[thesquanderer]

27. As did Gore-LIEBERMAN in 2000

so he should be on board for this one...

[yurbud]

32. ''I don't think it would be a good idea...at least that's what Hadassa's bosses told me...''

the ones that work for the insurance industry.

[Kolesar]

134. Hadassah...worked for two lobbying firms,handling matters for healthcare &pharmaceuticals clients

http://harpers.org/archive/2009/10/hbc-90005996

[wordpix]

181. Joe Blow knows where his bread is buttered, for sure

[KamaAina]

54. Because, as we know, Traitor Joe is a man of principle, who never, ever flip-flops.

:sarcasm:

[SemperEadem]

93. Oooooh!!! ROFL! Backstroke Joe!

[No Elephants]

193. Consistency is not the strong suit of traitors, including Traitor Joe.

Besides, he can always point to the change in the economy as his excuse for changing his mind. Of course, his kissin' cousin Dummya did a lot to give us this economy, but Joe will not mention that.

[karynnj]

155. Kerry mentioned it as a possibility in 2004

along with reinsurance for catastrophic costs, which he got included in the basic Finance bill. (The ONLY place I heard re-insurance spoken of was in the Finance committee and it is an important factor cutting costs. The other option letteing people buy into something like the federal system was the heart of Kerry's 2004 proposal.

Here is a link to column from someone who would know. He was a key doctors for Kerry person.
http://www.facebook.com/l.php?u=http%253A%252F%252Fliberalvaluesblog.com%252F%253Fp%253D11435&h=a9432027667dc4848a312ed87cc30120&ref=nf

[glinda]

10. Hoot! That is me! I would be happy with that so I could drop BCBS and pay bills.

Still everyone that cannot afford it needs help.

[harkadog]

51. This is a buy-in

How do you know what the cost would be?

[tsuki]

61. Less than the $1800 that husband and I would have to pay when

COBRA runs out. Plus it actually covers you.

[harkadog]

64. How do you know that?

There have been no figures reported.

[tsuki]

92. The $1800 figure is from 5 years ago when husband left the business

and went to work for a private concern, so it is probably higher given our age.

These are Medicare costs today. If it is close to $443 & $308, we'll be able to get insurance at less than a private concern would insure us.


What Does Medicare Cost?

Finding the bottom line cost for Medicare isn't simple. The amount you'll spend can vary depending on the type of coverage you have, your income and assets, and many other factors. But to give you a rough idea, here's an outline of Medicare's costs -- both the obvious and hidden costs.

Medicare Part A:

For most people Medicare Part A is free. That's because they -- or their spouses -- were paying Medicare taxes while they worked.

You might have to pay for Medicare Part A if you were self-employed or didn't work during much when you were younger. If you or your spouse paid Medicare taxes for less than 10 years total, you will have to pay a monthly fee for Part A coverage. In 2009, this Medicare premium is up to $443 per month, depending on your work history.


Medicare Part B:

Part B isn't free. You have to pay a monthly Medicare premium, which is usually taken right out of your Social Security check. In 2009, this fee is $96.40 per month for most people.

If you have higher than average personal income (over $85,000) or household income (over $170,000), you must pay a higher monthly Medicare premium. The exact monthly fee will vary depending on your income, ranging from $134.90 to a maximum of $308.30.

Then, you have to pay a yearly Part B deductible. In 2009, the deductible is $135. After you pay $135 yourself, your benefits kick in.

Part B is optional. If you don't want it -- because you have other coverage through an employer, for instance -- you don't have to pay for it. But you have to ask to opt out. Otherwise, the Medicare premium is subtracted from your Social Security check automatically.

There's a penalty for signing up late. If you don't sign up for Part B when you first become eligible, your monthly Medicare premium may be higher than $96.40.

[No Elephants]

196. You seem to be assuming that 55 year olds will be able to buy into Medicare at the same cost as

65 year olds or disabled folk. That may turn out to be so, but I don't think that has been established yet. The cost for non-disabled folk under 65 may be different. (On a risk basis, it should be lower, but I don't see that happening either, given the deficits Medicare runs.)

[defendandprotect]

105. There have been some figures loosely mentioned . . . some proportion of Medicare fee...

In other words, if Medicare is $100 a month --

it might be plus 5 - 10 - 20 % . . .

per month --

whatever, based on age --

for instance, an infant might only be plus 5% ....

Someone over 55 might be 15% . . .

Again -- these were just numbers mentioned -- evidently someone in Administration/Congress

was thinking about it --

[quiller4]

94. What is being discussed is roughly double the current Medicare Part B

rate for retirees or close to $200 monthly. That is about half what we currently pay for more than twice the coverage and 1/3 the deductible. I'm 58 and spouse is 63. A Medicare buy-in sounds great to us.

[glinda]

109. Is that 200 for one person or for two?

[glinda]

108. I don't but my hope is that it is better than the $500/mo now.

[LSK]

121. my parents on Medicare right now get something like $100 taken out of SS for Medicare

I would assume it would be around that.

[harkadog]

152. Medicare is heavily subsidized by tax money.

If they extended that to 55 the cost would be enormous. I wouldn't assume that will happen.

[No Elephants]

201. At this point, Medicare is probably heavily subsidized by China.

[harkadog]

260. Ironic considering they have no health insurance in China.

[wordpix]

180. my 84 y.o. mom pays premiums for AARP insurance, on top of getting Medicare

AARP pays part and Medicare pays part of her bills, and she pays the rest. It's fairly affordable but very messy to keep track of. I pay the bills for her and she recently received a bill that was already paid to a doc by AARP. These things are a nightmare to sort out sometimes.

[glinda]

245. just an example. Shoot, I would pay a thousand up front to have just regular low

rates like my husband does. Seriously.

[damntexdem]

30. Much better than now -- and it would likely be popular enough to pressure Congress to lower the age.

A public option we could believe in.

[yurbud]

31. do you have a link to that story? I couldn't find it.

[alsame]

39. It was reported on MSNBC TV by David Schuster. I haven't seen

it in print yet.

[yurbud]

41. ok, thanks

[McCamy Taylor]

48. This bs. The privates won't insure 55 and up so they stick them on tax payers.

Meanwhile, the privates get premiums from young, healthy people who will be forced to buy insurance. And premiums from 40 to 54 will be sky high.

Thanks for very little, Congress.

This title is misleading.

[laughingliberal]

60. Or it could be somewhat of a better situation for both

It is a number of people healthier than Medicare's current population. 55 to 64 are not as expensive as over 65 and the disabled which is the entire Medicare population, now. Privates who are not having to cover anyone over 54 are going to find it a lot harder to sell the need for outrageous premiums as this would significantly lower their risk.

[No Elephants]

226. The Medicare pool will consist of the oldest in our population, plus the sickest.

That will make it very, very costly. On the other hand, the private insurers pool will consist of the youngest and non-disabled, making private health insurance even more profitable. I can just imagine the propaganda that will be spun from those numbers.

[No Elephants]

202. Excellent point. However, if the insurers love lowering the age to 55, it may pass. That will

at least cover more people than Medicare currently covers. And if our "amazing" federal bureaucracy ever makes this work well, I'm guessing people 18 to 55, chafing under a mandate, will clamor for Medicare for all.

Maybe I'm a dreamer.

[HillGal]

72. I don't think it's that great. Not sure if anyone else is seeing this trend, but it

seems more and more Doctors are dropping Medicare, all I see from this is more and more Doctors dropping Medicare, and forget about Medicaid, I don't know of 1 Doctor within a 10 mile radius who takes that.

[Divine Discontent]

74. my sibling has some trouble finding docs, but there is always one in the county for whatever his

specific need is at the time with his illness. I know it'd be nice not to travel 30 min. to a doctor, but at least he has a doc within an hour he can go to (lives in small county)

[HillGal]

85. I know someone on Medicaid who can't find anyone to treat her, she's disabled but for

some reason she's not eligible for Medicare, so she's stuck with Medicaid and she can't find anyone to treat her for routine illnesses, it's so sad.

[laughingliberal]

125. Much harder to find doctors who take Medicaid. Not sure the situation of the person you know but

Medicare does not pick up until the person has been on disability (SSI) for 2 years. Would like to see that change but not hearing any talk about it.

[No Elephants]

195. You don't have to get SSI before you get Medicare. You have to

be eligible for Social Security Disability or Social Security "Old Age" benefits before you get Medicare.

Eligibity for OASDI is based upon strictly your condition or your age, plus a combo of quarters of employment (during which you and/or your employer paid into the OASDI fund, as opposed to working "under the table"). The application for OASDI disabilty does take a while to process, but should not take two years. (If you are applying for disability, your disability has to last at least six months.)

SSI and Medicaid are based upon disability and financial need. If you meet the legal standards of financial need, you are eligbile for Medicaid , even if you never paid into the OASDI Fund for even a single quarter. (And, you don't have to be eligible for full SSI to get Medicaid.) Contradistinctively, you could be a multi-millionaire and still be eligible for OASDI and Medicare, as long as you worked "above the table" for the required number of calendar quarters.

Because the OASDI application can take time to process, people who meet the legal definition of financial need are eligible to collect SSI while they are waiting for their payments from OASDI to start. But, the two systems are totally independent of each other and you do not have to be on SSI for even a day in order to get OASDI and Medicare.

[defendandprotect]

98. Bush in a number of states wasn't paying the doctors . . .. long waits . ..

The right wing has done everything they possibly could do to destroy Medicare/

Medicaid.

For those who are doing it out of greed, there are enough other patients who don't

really make this a loss for them.

A cute other tactic they use is not calling patients back . . . they want them to come

in so they can charge a fee. No fee for a telephone call!!

[No Elephants]

204. Feds and states are notoriously slow payers, no matter who is President.

It's true whether you are a doctor or hospital waiting for payment from Medicaid or Medicare for an operation or whether you are in construction and waiting for payment for a bridge. On the upside, you DO eventually get paid, although, given California's condition, that may start changing.

[defendandprotect]

96. Now THAT would help a great number of people .... IMO . . . !!!

Clinton was trying to include those 57 and up in Medicare --

but was unable to get it done.

He should have started out with that idea rather than the frou frou that went

on with the Hillary meetings . . .

[winyanstaz]

7. long as they throw out that anti-abortion crap those assholes

are trying to tack on the end of the bill.

[mainer]

29. For this age group, at least, abortion isn't an issue

I've always thought that they should allow Americans to opt-in to Medicare, a decade at a time. But I always assumed it would start with the children first.

[No Elephants]

203. Abortion is not much of an issue over 55, with or without a bill. But the Stupak

Amendment would forbid almost every insurer from covering abortions and almost every medical facilty from providing abortions, even if the patient pays out of her own pocket. Fortunately, the Stupak Amendment seems to be on its last crummy legs, but we'll see.

[defendandprotect]

107. Nelson introduced some new anti-abortion crap today . . .

I've been so rattled by the war thing -- new troops in Afghanistan -- I've kinda

tuned out "news" the last few days --

This is uplifting news if they actually do it !!!

But we also have to fight that anti-abortion crap with the Holy Rollers in Congress . . .

and Catholic Bishops' influence -- it's not a theocracy yet, but they're working on it!!


PS: Also polls show that Catholics by large majorities want government or private insurance

coverage for reproductive health care services -- 73% -- 83% among Latina/Latino

they want pre-post-natal coverage 95%/97%
HIV/AIDS testing -- 86%/92%
CONTRACEPTION -- 63%/67%
Condoms to prevent HIV/AIDS 51%/57%

AND government or private coverage of abortions --

when a pregnancy threatens life of woman -- 84%/87%
when it results from rape or incest - 76%/80%
when it poses long term health risk to woman -- 73%/77%
when fetus has severe abnormal condition -- 66%/71%
AND . . .

ANYTIME A WOMAN AND HER DOCTOR DECIDE APPROPRIATE 50%/53%


In other words, the Catholic Bishops and the Vatican are lobbying in their own interests -

and still ignoring what their own members want --

Catholics continue to ignore the church in regard to birth control --

and just as many Catholic women have abortions as any other women -- !!

RCC can't control it's own members so they are seeking, as usual, to do it by controlling

government and limiting reproductive options!!

[debbierlus]

9. I want to see the proposal. Is it actual Medicare or Privatized Medicare

One of those shit ass policies that you can opt into...The ones administered by private insurance companies.

Holding out for details.

[defendandprotect]

99. I'm really not clear on the "privatized parts" -- I thought it was only for the drug program???

[No Elephants]

206. Politicians seem to love privatized parts, no matter whose they are.

:)

[defendandprotect]

259. Ah . . . thank you for the laugh . . .

too much politics ---

I need a break!

:)

[yurbud]

11. If Dems get some version of this in the final bill that's signed, it will save the whole thing

from being an embarrassing exercise in corporate ass-kissing that looked like the Democrats were trying to flush themselves down the toilet in 2010.

[defendandprotect]

100. Well, starting out with Baucus heading the hearings was pretty much handing it to the

"for profit" medical industry --

[cal04]

12. Senate Dems May Open Up Medicare To Pacify Progressives

http://www.huffingtonpost.com/2009/12/07/senate-dems-may-open-up-m_n_382728.html

Senate Democrats are discussing the idea of expanding Medicare by lowering the age limit for the government-run insurance program, Democratic sources on the Hill tell the Huffington Post.

The proposal would lower the age of eligibility for Medicare by ten years. Those over 55 and under 65 (the current eligibility age) would be allowed to "buy-in" to the system. They would have to pay a premium for the coverage, which would alleviate the cost burden on the federal government, but would then receive the same benefits as other Medicare patients.

Crucial details -- such as what that premium would be and the timing of the implementation -- were not provided due to the sensitivity and ongoing nature of the deliberations. A high-ranking Democratic source off the Hill confirmed that such discussions are taking place.

"On its own, it's a good idea," Sen. Chuck Schumer (D-N.Y.) told reporters Monday afternoon. He added that Democrats are also looking at expanding Medicaid. "We're looking at both ends," he said.

[defendandprotect]

101. Someone suggested . . . progressives TRADING war for Medicare .. . !!??????

[WriteDown]

13. This will only work if they REQUIRE doctors to accept...

Medicare patients.

[katkat]

17. WriteDown

If the government is going to require docs to accept Medicare patients, it can start by setting the reimbursement rates above costs. Presto, problem solved.

[WriteDown]

18. Or it can just bring doctor's salaries down within reason...

Maybe at about 100K a year adjusted for cost of living.

[mainer]

24. 100 K? Are you kidding? No doctor spends 11 years in school for that little.

Some of them graduate from medical school with debts of hundreds of thousands of dollars. They work 60 hours a week. And you want to limit them to 100 K?

Better you should do your own brain surgery. Just call up the plumber and ask him to do it.

[WriteDown]

28. Yes, 100K a year is plenty. And they should do it to heal the sick, not get rich.

That isn't the case though

90% of medical students are going into specialties. Why?

"High debt, low pay: Some experts say the doctor shortage boils down to one basic problem -- health care's payment structure.

"A specialist can earn $500,000 or more a year and work 20 hours a week versus a family doctor who earns on average $120,000 a year and works more than 60 hours a week," said Weiner."


http://money.cnn.com/2009/07/16/news/economy/healthcare_doctors_shortage/index.htm


So yeah, the other 10% are fine by me. Its the 90% that have to be reeled in.

[mainer]

34. So people should all work out of the goodness of their hearts?

Why don't you start by asking teachers and social workers to do it "only for the good of their souls." See how many teachers or social workers will agree with you. Or anyone, for that matter. It's fine to work for the betterment of society, but people have kids to put through college and bills to pay, and to ask them to work long hours "out of the goodness of their hearts" is asking too much.

Medicine is a demanding, sometimes hazardous job During residency, they work 80 hours a week. It requires more education than just about any other profession. (How many years does it take to become a neurosurgeon? Look it up. You can't get board-certified until you're into your thirties.) 100 K is NOT plenty. And I don't know ANY DOCTOR who works only 20 hours a week and earns half a million bucks. That's just crap.

I should know. I left practice years ago for a far less demanding -- and ironically better paying -- career that allowed me to spend more time with my children.

[WriteDown]

37. You know the old saying...

Those who can't get into vet school, than go to med school. Although few people would be as accepting as vets if they demanded 500K a year. Sorry, like in the UK, Canada, Sweden, Japan, etc. It's time to reel doctors salaries WAY in.

[mainer]

40. Canadian doctors earn almost as much as US doctors

And they earn way more than 100K. I don't know why you think that American doctors earn too much.


http://student.pnhp.org/content/what_about_physician_salaries.php

[WriteDown]

43. That's why we should look at the BEST healthcare system in the

world. France

http://www.photius.com/rankings/healthranks.html

I believe MD salaries about about 55K in France, but school is paid for. That would be an excellent plan as well.

[mainer]

49. Only if you could guarantee French work hours (35 hours/week)

And no medical malpractice costs. Only then would such a low salary work.

[WriteDown]

50. I would be amenable to that. nt

[w4rma]

178. Which doesn't lower rates, because that's half the number of hours American doctors work.

Dumb idea to lower salaries of skilled professionals.

[WriteDown]

256. And yet it works for the French....

I guess French doctors are just better.

[w4rma]

267. The lack of middle men is why the French system is better. Not doctors' salaries.

Doctors' salaries are competative with American doctors.

[WriteDown]

268. No, they're not...

They are decent and you can live well, but they are not competitive.

[eagertolearn]

123. And no call!

[No Elephants]

216. That is a meaningless figure. You have to relate it to salaries of others in France, cost of living

etc.

I live in Boston, which has one of the highest costs of living in the US. My doc in my health center is an endocrinologist, who works both in his speciality and as what used to be called a "general practitioner." He's as good as any doctor I've seen in Massachusetts General Hospital, one of the most prestigious hospitals in the world. He makes about $165,000, which I find appallingly low.

[WriteDown]

244. No matter how you cut it....

Even with France's many social programs, 55K isn't a huge amount.

[mainer]

258. Your French MD salary of $55,000, it turns out, is not accurate

First: the French government pays 2/3 of physicians' taxes, boosting their take-home pay.

http://www.kevinmd.com/blog/2007/06/physician-salaries-would-french-model.html

Second, French doctors actually make a lot more if they're specialists:

http://santecarolina.blogspot.com/2009/11/how-much-money-do-french-doctors-make.html

And finally general practitioners in actuality have a take-home pay of 73,000 Euros. (over $100,000)
http://www.ncbi.nlm.nih.gov:80/pmc/articles/PMC1266221/

[WriteDown]

263. Your first link proves my point...

55K is the actual figure. I am not against physicians doing well, but French physicians do not become uber-wealthy.

[mainer]

264. But NIH (our official government site) says $100,000 for French GP's

That $55,000 that keeps getting bandied about seems to come from a single Washington Post interview with one French GP who was complaining about his income -- and he said he was making $55,000. That does not appear to be supported by actual numbers.

[WriteDown]

265. It is hard to pin down...

I think that 200K salary and paid for medical school(if you pass) would be very reasonable. You can live well, but not a new Porsche Cayman every year.

[Bread and Circus]

153. There is "no old saying..." as the one you mention and I no of NO doctor...

who ever "applied to vet school" but couldn't get in.

I had a 3.92GPA to get into med school, I'm sure any Vet school would take that.

I'm not sure from which hole you speak.

At any rate primary care physicians make too little for what they do and specialists make too much in certain procedure oriented fields. However the bulk of health care inflation is NOT from doctors.

You sound ill-informed to say the least while it seems emotion drives your argument here, not reason.

[WriteDown]

156. "I no of NO doctor..."

And you got into medical school? :rofl:

I stand by my argument.

[musicblind]

191. Yes because doctors are incapable of typos ...

...

[No Elephants]

211. Doctors never make spelling mistakes. It's part of the Hippocratic Oath.

[WriteDown]

242. Now that is funny...

:)

[No Elephants]

205. Never heard of that supposedly old saying until I saw you post it.

Who says it? People who went to vet school?

Keep posting it, though. Maybe it will finally catch on.

Gotta be honest, though. I don't see it ever becoming the next "The buck stops here." Hey, maybe that will catch on in vet school, too.




:-)

[No Elephants]

214. Maybe plastic surgeons to the stars make $500K a year. Most docs make nowhere near that.

And I doubt any doctor "demands" any figure.

[verges]

52. Teachers and Social Workers are paid Crap!!

I've never ever heard of any one of them doing it for the money! (or nurses for that matter!)

[Flatulo]

78. There's a reason for that...

[BrklynLiberal]

79. Yep. Because historically they have been jobs for women! Same is true of nurses.

[Flatulo]

90. Nurses out my way (Massachusetts) can make over $100K. nt

[WriteDown]

133. That's 1/5 of 500K...

and do nurses get to work 20 hours a week? :shrug:

[mainer]

136. Where do doctors work 20 hours a week?

Not in this universe. Unless they've got a working spouse to support them.

Once a doctor drops to less than full-time practice, his malpractice insurance (which DOESN'T get halved just because you work part-time) makes practicing medicine financially unfeasible.

I know this because my husband dropped to 75% time. But he still had to pay his office staff, rent, and malpractice insurance at 100%. He found out he was barely making any income so he opted to just pull out of medicine entirely.

[WriteDown]

137. From the article...

http://money.cnn.com/2009/07/16/news/economy/healthcare_doctors_shortage/?postversion=2009071610

"A specialist can earn $500,000 or more a year and work 20 hours a week versus a family doctor who earns on average $120,000 a year and works more than 60 hours a week," said Weiner.

This is why 90% of medical students are becoming specialists.

[mainer]

147. No data. No examples. No facts.

That statement is like saying, "an actor can earn twenty million bucks just by working one month a year."

Sure. An actor COULD. But how many actors actually do?

I'm in the medical profession, and I don't know any doctor who works only 20 hours and earns half a million dollars.

Any specialist who's in that much demand would work far, far longer hours.

[WriteDown]

148. Please provide data then. nt

[mainer]

149. physician specialties -- incomes

http://www.cejkasearch.com/compensation/amga_physician_compensation_survey.htm

The most highly compensated specialty (spinal surgeons) is about $600,000. These are almost certainly fulltime physicians.

If it were true that they could earn half a million working just 20 hours, then the average income of a fulltime physician would be a million. And none of these incomes approaches that.

[WriteDown]

150. We know nothing unless we know the hours worked...

They probably average out to about 350-400K though after doing a brief scan. 600K = GEEZ!.

[mainer]

151. I've had spinal surgery. I don't begrudge my surgeon one cent.

He changed my life.

$600,000 annual income for someone who operates around your spinal cord -- and can, with one slip of the knife, turn you quadriplegic -- is well-earned compensation.

re: the physicians' incomes: Where do you EVER see "annual income" statistics that mingle half with fulltime workers?

an "annual income" statistic for any profession is meaningless if it's for part-time workers.

[WriteDown]

154. I've had tons of surgeries. Usually about 2 a year...

but I've avoided the spine so far. My surgeons have been good guys and gals but the 600K figure just wows me. I do know one thing, many of my doctors do not take appointments on Fridays. I asked one why that was. He said that was golf day.

People always talk about the debt that doctors incur at school, but looking at the data you've supplied, its easy to see that if a dr. lives modestly for 2 or 3 years, that debt vanishes quickly. Of course that may mean shopping at Macy's instead of Nordstrom's or eating at a chain restaurant! The horror.

[No Elephants]

223. Hmm. I can recall when comedians claimed Wednesday was golf day for doctors. Funny, I've

had appointments with Mondays, Tuesdays, Wednesdays, Thursdays and Fridays; and surgeons make hospital rounds more than five days a week.

As far as repaying debts, you chose the highest salaries of doctors working a lifetime. That is not who repays student loans. How many years do you figure the docs starting at $135 K a year or even less need to pay back student loans?
Not to mention the other loans they've taken because they have been in school, internship or residency for up to 19 years after high school graduation and have needed money to live on and support wives and kids on?

[WriteDown]

243. You must have different doctors....

Nothing after noon on Friday if you can even get Friday at all for many of my doctors. Its easy to pay back debt if you're living a 75K lifestyle while making 135K.

[mainer]

250. Many doctors work saturdays and sundays, you know

Having been in practice myself, and knowing many doctors now in practice, that "half day" they take off during the week is very often devoted to paperwork. They also go in for hospital rounds over the weekend, and they take night call. And you begrudge them a half day a week, probably the only time they have to catch up on administrative stuff?

[WriteDown]

254. I just visited my buddy in Winston-Salem who's in family practice

Even he only works 4 days a week and he's only been practicing for 3 or 4 years. Its a nice life if you can get it. Of course, his folks paid for all his schooling.

[No Elephants]

Deleted-duplicate post.

[No Elephants]

222. You are being very selective, going for the salaries in the highest columns, which are averages to .

boot.

Look at the starting salary salary column, bearing in mind that the starting salary begins only after the doc has been in training for anywhere from five to fifteen years AFTER college graduation. I see many numbers around the $150K mark. Nothing like the salaries at firms that knowingly sold crap derivatives.

Besides that chart is not about doctors in general or even specialists in general. It is about specialists from some of the largest and most lucrative medical groups in the country.

From the link:

The American Medical Group Association, which has been conducting this survey since 1986, represents the interests of medical groups nationwide, including some of the nation's largest, most prestigious integrated healthcare delivery systems.

AMGA advocates for the multi-specialty group practice model of healthcare delivery and for the patients served by medical groups through innovation, and information sharing, benchmarking, and continuous striving to improve patient care. The members of AMGA deliver healthcare to more than 50 million patients in 40 states, including 15 million capitated lives.

The average AMGA member group has 272 physicians and 13 satellite locations. Headquartered in Alexandria, VA, AMGA is the strategic partner for medical groups providing a comprehensive package of benefits, including political advocacy, educational and networking programs and publications, benchmarking data services, and financial and operations assistance.

[No Elephants]

219. "Can earn" is not the same as "do earn," "most earn" or "many earn."

Americans "can" get paid $200 million a year. That says nothing about what most Americans get paid though. And it is certainly no reason to raise or cut anyone's salary.


Same for "doctors 'can' earn $500K a year. That is a meaningless statement when discussing salaries of docs generally.

[No Elephants]

218. 500 K is a meaningless figure, though. 1/5 of a meangingless figure also means nothing.

[wordpix]

182. no good teacher's making that much

[No Elephants]

217. With working how much overtime, though? Besides, now that med schools are letting women enter,

there is a severe nursing shortage. I know a nurse who has literally made a career of bringing nurses from the Philipines to work in the U.S.

[Flatulo]

257. Well, that was kind of my point. The need for a profession tends

to correlate with the salary, with the exceptions of corporate hoodlums who rig the game.

[katkat]

120. teachers are not paid crap

Where I live they are paid well and can retire after twenty years on nearly full salary and benefits. Plus I'm sure most of us would like three months vacation a year.

[wordpix]

183. geesh, where do you live? I'm moving there

[musicblind]

192. Yeah where do you live? My cousin is a teacher and she has to work full time as a waitress

just to make a living as a single woman. My mom is a retired teacher (after 30 plus years of teaching) and our family has recently talked to a bankruptcy lawyer...

[No Elephants]

221. Hard to believe. I taught for only 1 year or so myself, but I know a lot

a lot of public school teachers and junior college professors. The latter may have had 20 class hours a week, but they worked many more hours than that, doing such things as grading papers, preparing for classes, student conferences, attending department and faculty meetings, etc. Public school teachers had all that, plus more class hours, study halls to supervise, etc.

And I don't know a single public school or community college teacher who retired with almost full salary after only 20 years. They work from college grad to normal retirement age.

They do get good retirement benefits, if they stay long enough, and their health care coverage is usually relatively good, but that is about it. And they get those benefits precisely bc the pay is so low. And all of the teachers I know have taught either in NJ, just outside Manhattan, or in the Boston area, two of the highest cost of living areas in the country. Some had Ph.D's or Ed.D's too. And some unionized.

[No Elephants]

210. Actually, many teachers and social workers do work for little more than the good of their souls and

a doc once told me of getting a meal as payment during the Depression. (I don't share WriteDown's apparent resentment of doctors in the least, but I just thought I'd mention those things.)

[JDPriestly]

59. Doctors delay earning money in order to attend medical school.

They earn relatively little during their residencies. And, unless their parents were very rich, when they finally emerge into the real world, they face a crippling debt burden. Don't worry, your doctor really cares about you and his or her patients. But sometimes they want to have a family or do something besides work and pay off their debts.

One reason doctors end up wealthy is that they mostly work long hours.

Also, doctors in many communities are now having to deal with collecting bills from uninsured patients. All those people going into bankruptcy due to medical costs -- to the medical profession, that's a paycut.

[WriteDown]

159. Not exactly,...

See post 154. Debt is gone in 2-3 years.

[mainer]

160. How do you pay down a $200,000 debt in two years?

Earning $150,000 (internist's salary, pre-tax) a year?

Unless you live on air alone.

[WriteDown]

185. Check the stats he posted for specialists....

Starting salaries for many positions are over 200K a year. Of course, you have to cut down on those 200$ rounds of golf, and you might have to skip having lunch at the new hot sushi places. You may even have to eat at a Chili's now and then. Its almost too horrible to think about.

[JDPriestly]

190. Specialists have even bigger debts.

There are a couple of young doctors in my family. It costs more than $250,000 to get through some medical schools. And it takes years to pay it off because doctors live while they pay it off. No, doctors are not impoverished. They do well. But then, they should. I have no quarrel with that having lived with someone who was going through college, then medical school -- eight years -- and then who did three years of residency. All that while medical students have very little social life, very little down-time. If someone with the enough intelligence and talent to graduate from medical school ran their own business and worked at that pace for 8 years, they would probably be earning a lot more than doctors do.

The doctors in my family are wonderful kids who love their patients more than just about anything. Before these kids went to medical school, I had no idea how much a person sacrifices to become a doctor or how devoted they have to be to their profession to do it. I have utmost respect for physicians.

A lot of doctors specialize because they are genuinely interested in particular scientific or medical challenges.

[WriteDown]

239. 250K debt...

Making 200K starting salary and living a 100K lifestyle has you paying that off in less than 3 years. We should follow France's model. Free med school, but 55K for doctors. Let people who actually love people instead of the beamer and the trophy wife pursue the profession. Probably why France has the best healthcare in the world.

For a counter example. My sister went to vet school. NYU and then UPenn. Has about 200K of debt. She does decent because she's an oncologist, but nowhere near what a doctor in her same field would make.

[mainer]

248. You forget taxes

a 200K salary (and that's not starting salary -- that's probably after several years), once it goes through federal and state taxes, is probably down to $120,000. So to pay off a $200,000 debt in two years you'd have to live on .... um, what, exactly?

[WriteDown]

249. Same thing someone who makes 50K a year lives on....

It can be done.

[mainer]

251. Stick to the subject. Paying off a $250,000 debt in two years.

You said it can be done. How?

Your statement about "someone who makes $50,000 a year faces the same problems" doesn't apply, unless THEY are facing a $250,000 educational debt as well.

[WriteDown]

252. By living like someone who makes 50-75K a year....

Its not that tough.

[mainer]

253. Again, $120,000 take-home pay. $250,000 in debt.

You'd have to live on $10,000 a year to pay off that $250,000 debt in two years.

You certainly can't do it while living "a $50,000 lifestyle."

[WriteDown]

255. If you're taking home 120K....

and living on 50K..... I can see why dr's complan so much now.

[Flatulo]

262. I don't even know how to respond to such an ill-conceived idea. nt

[JDPriestly]

199. Just thought you might like to know.

I just finished a telephone conversation with one of the young doctors in my (extended) family. She had just come home after a 15-hour day. Trust me. Doctors earn their salaries. Compare a doctor's salary with the salary of the CEOs of any of the larger corporations in the country. Compare them to any trader with Goldman Sachs. Doctors deserve every penny they get.

[WriteDown]

240. Family physicians and specialists are two different animals...

90% of med students are going into specialties due to the short hours and high pay. I have several doctors in the family. The one that most springs to mind is my cousin who is married to another doctor. Both specialists. When they're not at their ski house, they're generally vacationing in the Napa Valley or somewhere tropical.

Like I said, France pays for school and pays 55K per year AND has the best system in the world. Wonder why that is.

[No Elephants]

224. Starting salaries for many positions were also well under that figure, too, though. Again, very

selective.

BTW, where do you think those doctors were eating through college, med school, internship and the residencies necessary to qualify as specialists? Unless they had rich and very generous families, they were probably lucky if they could afford ramen noodles, let alone Chilis.

[WriteDown]

241. Not many.

Most starting salaries are quite high IF you live modestly for a few years. Residencies are paid poorly, but they can still live.

[No Elephants]

198. 2 to 3 years from what, though?

K-12 = 13 years
College 4 years
Medical School 4 years
Internship 1 year
Surgical residency 5 years.

That's 27 years of school total, with a full decade of that coming after college graduation. All that while earning nothing or next to nothing and, from third or fourth year of medical school until the end of residency, working killer hours, even though a slip of a scalpel or a missed symptom could kill someone's kid or parent. All while your debt and interest piles up.

[Jackpine Radical]

63. Docs are like lawyers.

It's 95% of them that give the rest a bad name.

[defendandprotect]

110. Wow ... I agree . . . and the longer this mindset goes on the worse the health care . . .

We have tons of doctors now who can add their profits quite well --

but have no clue as to health care --

[No Elephants]

208. You could make the same joke about any group, from priests to posters to teachers to

well, you get the point.

IMO, lawyer bashing should be left to Republicans. Since they started, they've had more time to be really good at it.

[Jackpine Radical]

237. OK, OK. It was a cheap shot.

Actually I work with criminal defense lawyers every day.

[Flatulo]

77. No one in their right mind is going to spend 12 years studying

so that they can make less money than their plumber.

[TankLV]

88. tell it to 80% of the Architects!!!

[Flatulo]

82. My doctor works at least 80 hours per week for about what a

senior level engineer (me) makes, even though he studied three times longer.

He tells me all the time that if he had to do it all over again he would never enter the medical profession.

And I absolutely CRINGE when people say that doctors should serve for the good of their fellow man. What a crock of pure bullshit. That is not very different from slavery in my book.

[12string]

113. 100K a year is plenty

What planet are you from?Since you said call the plumber,here you go.A union plumber does a four year apprenticeship.School twice a week after work and 8000 hours OJT to become a journeyman.If that plumber was to work 60 hours a week he would make in excess of 100K a year and earn every penny of it.Keep in mind that the plumber got paid for those 8000 hours of OJT.He didn't go 10s or 100s of thousands into debt to learn his craft as a doctor must.At an average of 120K a year for a general practitioner working 60 hours a week,it would require dedication to healing as it sure isn't worth the money.No wonder so many choose specialty fields.I might also add that when the time comes that you need a specialist,you just may be glad one is available.

[katkat]

119. WriteDown

You seem to think the Medicare reimbursement goes 100% to the doctor's salary. Who do you think pays the doctor's nurse's salary and benefits and receptionist and office rent and for the medical equipment?

Right now a doctor is lucky to break even seeing a Medicare patient.

And, oh yes, the mega cost of getting through medical school, and the interest on those loans while they're paid off.

[WriteDown]

130. Please link to stats where doctors are "lucky" to break even. nt

And how long does it take to pay of those loans earning 300K a year? :eyes:

http://money.cnn.com/2009/07/16/news/economy/healthcare_doctors_shortage/?postversion=2009071610

[No Elephants]

209. Odd. You seem to have more problem with doc compensation than you do with AIG compensation.

[earcandle]

57. or fly you own airplane then reduce pilot's fees !

[TankLV]

87. Cry me a fucking river - ARCHITECTS spend just as much time in school, and we're lucky to see FIFTY

thousand -and that's AFTER about 10 - 20 years in the field - and our education costs JUST AS MUCH and we're ALSO responsible to the life and safety of EVERYONE!!!

Don't make me laugh at these precious doctors' salaries...

[Flatulo]

89. Maybe you're getting screwed?

From Wiki...

United States
According to the 2008–09 Occupation Outlook Handbook published by the US Department of Labor, the median salary of architects was $76,750. <4>

Intern architects typically earn between $24,000 and $34,000 depending on experience prior to licensure. Architects that have completed the internship period can expect an average starting salary of between $51,709 and $64,519. For 10 years' experience, the base compensation level increases significantly to an average range of $62,608–79,919; that range reaches $72,678–96,928 for architects with 15 years' experience.

Senior architects and partners typically have earnings that exceed $100,000 annually. It is not unusual for an officer or equity partner to earn a base salary of $235,000, with a bonus of $200,000. Due to the major stake in ownership that equity partners may have, they can earn incomes approaching, and occasionally surpassing, seven figures. <5>

[grahamhgreen]

116. Maybe architects aren't gaming the system

[No Elephants]

235. But four years of pre med and four years of med school are only the beginning of a doctor's training

Next comes a year of internship and up to ten years of residency. While architects do have to do a lot of schooling and training, it is not as much as medical specialists. http://education-portal.com/education_needed_to_become_an_architect.html

Besides, posts on this thread about wildly high medical specialists' compensation are not based on realtiy. One set is pulled from nowhere and the other set from the highest end of a graph showing compensation in the largest and most lucrative medical groups. That is more like comparing the income of the most highly paid partners in a large and highly successful architectural firm with the income of a starting architect.

[berni_mccoy]

62. You'll need to completely reform medical malpractice insurance to get their salaries anywhere near

100k as well as provide free Medical School to anyone qualified enough to go.

[Sanity Claws]

67. Doctor salaries ARE NOT the problem

The problem is the money taken by the insurance companies, for which we get nothing.

[defendandprotect]

102. I agree . . . however, there is another side to this which is that we have

created so much disease that it's hard to tell whether there's more traffic going

into fast food places, or traffic going in for medical care!!

Much of it is a lack of preventive medical care --

And another part of it is that the money keeps corrupting our medical practice --

We're now up to doctors being wined and dined by pharma companies and rewarded when

they prescribe their drugs. Rather than a simple antibiotic which might cost $15, doctors

are prescribing drugs that cost 8-10X that much.

The corruption in medical practice is DEEP --

But we're not going to get to actually reforming what's wrong with our medical system

until we get the privatized interests OUT.

Illness is now a way of life in America --

Patients are hooked into constant visits to doctors as long as there is a prescription involved.

It's all BS.


PS: Just want to add that the chemical crap they're passing off as medicine is creating huge

side effects, which require more medicines which create more side effects.

If anyone wants to check out what others who are taking the same medications they are may be

experiencing -- http://www.askapatient.com

Just put the name of the drug you're taking --

[WriteDown]

131. No, its definitely PART of the problem....

but there can be many parts with varying severity.

[mainer]

26. most doctors already do

It's Medicaid patients that have a hard time finding doctors, because the compensation isn't worth the money the doctors spend on paperwork.

[twitomy]

86. Thats it exactly.

I heard this from two of my doctors. One said if they had to stay in business soley on medicare reimbursments, it would not be for too long. And to the brainiac who said we should REQUIRE doctors to take medicare patients, good luck finding one when they are all out of business.

[WriteDown]

132. Once again...

Please link to stats on this. ]

Looks like if you are an efficient hospital, you do just fine.

http://voices.washingtonpost.com/ezra-klein/2009/07/does_medicare_pay_below_cost_w.html

[twitomy]

157. I dont need stats...

I heard it first hand from my doctor(s). One of my doctors is actually quitting, she has had enough of the bullshit. I have a brother who is in hosipital admin, medicare reimbursements suck according to him as well. His hospital serves a predominatly older population.

Another local hospital is in bankruptcy: The local Dem congressmen mentions crappy medicare reimbursements in a letter:

http://timryan.house.gov/index.php?option=com_content&task=view&id=325

Some more:

http://www.endocrinetoday.com/view.aspx?rid=50940

http://www.medicalnewstoday.com/articles/152553.php

There is plenty more one can find on the net once ones head is out of the sand.

Medicare for all without drastic change in reimbursements would be a disaster.

[WriteDown]

158. I just heard from an AIG exec that his salary doesn't even cover...

his cost of living. I don't understand why no one will help him. Bwahahahahahaha! :rofl:


You're right. Things like stats and facts are just too much to ask for. You'll notice, that I actually provided a link that discussed medicare reimbursement.

[twitomy]

179. What does AIG exec pay have to do with Medicare reimbursments?

Trying to change the topic doesnt work with me.

Reimbursments suck = Doctors quit the business. I know this first hand. You can use your tainted statitics as toilet paper if you wish, I choose to deal with the real world.

BTW, if you as a third party are willing to dictate to someone how much money a person can make, be prepared to accept some other third party to tell you how much YOU can make.

And I really love this resentment of those who make more than you. Often I hear, "they dont deserve it, or havent earned it, etc, etc," I wonder if these same whiners would refuse the gift a winning powerball ticket.

[WriteDown]

186. You said you heard from YOUR doctor..

and didn't need stats. Why do you need stats on AIG execs then? If you don't pay CEO's enough, then they quit. :rofl:

[twitomy]

231. I dont need any stats from AIG execs.

Where did I ask for stats about AIG execs?
:crazy:

[No Elephants]

220. You just heard from an AIG exec? LOLOL. You have personal conversations

with folks in every conceivable situation and job--and at just the right moment, too. Golly, I am in such awe of your social network and time managment skils and amazed that you find time to post so regularly. Kudos.


But, what does the cost of living your friend, the AIG exec, has chosen for himself have to do with a fair income for docs?

[twitomy]

233. Yeah I cant follow this train of logic either...

But I guess that is par for the course with this poster:crazy:

[WriteDown]

238. It was a joke...

Thus the rofl smilies. I swear, some people's sarcasm meters are defective.

It was based on his/her initial statement of "I dont need stats...I heard it first hand from my doctor(s)"

[twitomy]

266. Well I dont get the joke...

My doctor says her practice would have to shut down as they simply couldnt stay in business versus a greedy AIG exec. The humor is lost on me...

[No Elephants]

207. They could also raise Medicare payments in areas where they are insufficient

(which is not all areas of the country) and/or make the payments to doctors and hospitals more prompt.

The population 55 and over accounts for a lot of the population who see doctors most. If Medicare is the only game in town, doctors are going to have to deal with it or go into obstretics or pediatrics.

[AllyCat]

14. Seriously, what would be the problem with letting everyone do this?

If the idea of a "buy in" is to keep the cost off the federal gov't, then just let us all do it. And, then, like others have said, require docs to accept it.

[harmonicon]

25. the "problem" is that it would drive insurance companies out of business.

Our oh-so-wonderful congressional representatives are bought-and-paid-for by by those companies and see their real job in congress as keeping the profits rolling in for their donors/sponsors.

[earcandle]

58. its a dumb economy

[BrklynLiberal]

81. That sounds like an excellent idea to me..

[harmonicon]

83. me too

actually, it wouldn't drive the private insurers out of business, it would just be some good old-fashioned trust busting. I've lived in the UK going on 3 years now, and there are private insurance companies here, but they exist to give people special perks: private hospitals with private rooms, more personal treatment from doctors (doctors who establish private practices to treat only these patients), etc.

I'm sure that those things would exist in the US if we had a first-world healthcare system, just as we have both public and private schools.

[yurbud]

97. they should not just be driven out of business but their execs should be tried for murder for profit

and if Tim McVeigh deserved to be executed, so do they.

[defendandprotect]

103. Same corruption which effects every other part of our government . . ..

[coyote]

15. Oh please...this will never happen.

If there is not profit involved for the private health insurance companies, then this will never see the light of day.

[hootinholler]

22. Actually it removes risk from the insurance pool

Shifting the cost of care to the government, which is why it may just work. Now I would agree with you if they set it at birth.

-Hoot

[coyote]

236. so basically it is profitable for the privates....

Who wants those old costly non-profitable patients when we can dump them into medicare and let goverment eat the cost. Perfect for setting up the goverment plan to fail. Private insurance can then come back to use and say "we told you so, the goverment plan was too expensive and failed."

It´s brilliant.

God bless profit.

[defendandprotect]

104. sigh . . . crossed fingers . . . but think you're probably correct . . .

[LiberalAndProud]

114. Well okay then ... It must be quitting time,

Call your Senator and tell him to come on home.

[No Elephants]

228. But, this is profitable for private health insurance companies. The government will be

covering the oldest, the disabled and the poorest (medicaid) parts of the population. Those tend to be the expensive patients. The health insurers would have to deal with only the least expensive patients. And, while they will not be able to deny coverage to folks with pre-existing conditions, they probably will be able to charge them more. And the really bad pre-existing ocnditions tend to be disabling and/or impoverishing,anyway, which means government will be covering them anyway.

Medicare's already huge deficit will increase even more rapidly, while insurers make more profits.

[katkat]

16. that would be great

and it would address the serious problem of older workers not getting hired because the potential employer's insurance rates would skyrocket. Of course, that's only one aspect of age discrimination in employment, but anything is better than nothing.

[valerief]

19. It's a start. When buy-in age is 1 day old, we're talking healthcare reform!!!! nt

[eomer]

20. As long as there is a universal mandate and other insurance reform then this is a good thing.

You've got to have a universal mandate and you've also got to have rules that will keep private insurers from refusing coverage or benefits, or raising rates for sick people. Otherwise it would end up as a dumping ground for sick people; the private insurers would rake in profits on people who were well and then dump them on this new Medicare if and when they get sick.

[rateyes]

21. Can a person, with this option, choose the Medicare buy in as an

option against what their employer provides now?

[amandabeech]

23. A Medicare buy-in could be prohibitively expensive.

Here's the last comment on the Politico article:

"Great idea but do you know the cost? The CBO estimated that an unsubsidized cost of someone under 65 entering Medicare would be $865 per month. So nothing is free here."

The government picks up a huge subsidy for those over 65, so that their monthly payment is something between $100 and $200, IIRC. I doubt that Congress would be interested in subsidizing older workers to that tune, or any tune for that matter.

I'll be 55 next year, and that is more than 1/4 of my take home pay as things stand now, and I live in a high-cost area.

Most seniors get a Medicare supplement plan, too. My Mom has one through her former employer, and it really shaved the costs down on my late father's last 12 years. I don't know what those would cost for a somewhat younger co-hort.

[mainer]

38. You need younger enrollees to make this affordable

55+ year old patients have a lot of medical problems, and would indeed be expensive for the system.

The only way to make the public option affordable is to bring in lots of young, healthy enrollees who pay premiums but don't suck up too many resources. While it's nice to start adding Americans to the Medicare-eligible rolls, they should start with children and gradually increase the age of eligibility.

[amandabeech]

42. Yes, the program needs the younger people in order for it to be affordable

to the greatest number.

Unfortunately, I don't see that happening.

[BrklynLiberal]

75. Remove the upper income limit on FICA deductions...

That would more than cover the cost..even if everyone went to Medicare/Medicaid

[Doremus]

65. I call bullshit on those numbers.

My DH and I are 50-somethings and we buy our insurance at cost from his union hall from a private insurer. Cost is $1000/mo. for the both of us.

Medicare has a HUGE pool, much bigger than our (national) union. Why the cost would be higher makes no sense at all.

[karynnj]

161. If that is more than 1/4 of your income, you will be eligible for subsidies on ANY plan

as I think you will be under the limit. (I'm not 100% sure of the individual threshold.)

[seafan]

33. Sam Stein was on this earlier. Following this closely.

Link

[Lydia Leftcoast]

35. Adding younger people could help alleviate the Medicare balance of payments

On average, people in their late 50s are a lot healthier than those in their 80s, so they'd be paying in like an 80-year-old but wouldn't require as many services.

(I know I'm a lot healthier than my mother was at my age.)

[Gman]

36. It's awfully nasty to watch sausage being made

but the final product is usually pretty tasty.

[No Elephants]

225. We don't know what this sausage will be like when it is finally made, though..

And a lot of sausage that comes out of Washington, D.C. is not at all tasty.

[BlueIdaho]

44. 25 and 45

Young people should be eligible until the age of 25 and everyone should be eligible at age 45.

[JDPriestly]

45. If the bill will also prohibit discrimination based on medical histories

by insurance companies, this would work well.

[musicblind]

194. I thought it did?

oh dear, does it not? That's bad for me then :( I was born with severe hearing impairment and some related health problems and insurance (outside of the much much cheaper 400 dollar a month cobra I'm able to get since my mom works as a teacher) is very expensive for me. I age out of the cobra in the next year and was hoping this reform would help me :(

[JDPriestly]

200. I think the bill is supposed to prohibit discrimination based on pre-existing

conditions, but who knows what the bill will look like after all the changes being made now.

[No Elephants]

229. I thought the bill prohibited insurers from denying coverage, BUT allowed them to charge higher

premiums to those with pre-existing conditions?

[supernova]

46. I like it and more

55 to start... but they need to make it so that every few years the elibibility age lowers. So that ok it's 55 now, and in say 5 years, it's lowered to 50. In another five years, it's lowered to 45, and so on.

I'll be 50 in three years, btw. (Wow, never thought I'd type that. x( )

[loyalkydem]

47. I'll beleive it

when I see it.

[galileoreloaded]

53. Excellent way to disenfranchise folks....K&R!!!!

man, if you are gay AND 30 you really gotta feel good about all this equality goin' round.

Wait......

[TheCML]

55. Great!

In 30 years my partner will be eligible! Now if we can just keep this chronic illness in control until then. What a joke.

[Penguin31]

56. MEDICAID EXPANSION ALSO ON THE TABLE

The bigger deal seems to be flying under the radar

From the article: http://news.yahoo.com/s/ap/20091207/ap_on_bi_ge/us_health_care_overhaul

The key sentence: Under the potential trade-off with party moderates, near-retirees beginning at age 55 or 60 who lack affordable insurance would be permitted to purchase coverage under Medicare, which generally provides medical care beginning at 65. Medicaid, the federal-state health care program for the poor, would be open to all comers under 300 percent of poverty, or slightly over $66,000 for a family of four.

Full table, based on current poverty guidelines. Income under this number at this family size means you get Medicaid:

Family of:
1: $32490
2: $43710
3: $54930
4: $66150
5: $77370
6: $88590
7: $99810
8: $111030

Honestly, making Medicare opt-in at 55 and dramatically raising the Medicare eligibility does more for the health care situation than watered down "public option" baloney ever could, as it had existed, ever could.

[Jackpine Radical]

66. Wow, that's amazing, it would be the answer to a lot of prayers.

It would be very helpful, though, if they were to increase medicaid payments to a reasonable level. Or, rather, even them out more equitably across the board. In my field, Medicaid pays about 1/4 the full rate, and the paperwork requirements are Godawful; I dropped my provider number years ago & have never regretted it. I would rather (and do) provide pro bono care rather than deal with the Guardians of the Exchequer who spend their lives acting out the fear that someone, somewhere will get a mental health service they don't deserve.

[grahamhgreen]

117. Those figures are far too low - we need to be able to dump big insurance.

[harun]

68. I think this is meant to completely scare the shit out of Blue Dogs and Pukes so

as they cave on the Public Option.

As others have said I'll believe an expanded age on Medicare when I see it. It would be HUGE HUGE HUGE if they did that.

[Politicub]

69. Please please please let this be so... and pass - as long as it isn't tilted towards 55+

It would be a significant step on the road to single payer.

On edit - as long as it is for everyone

[glitch]

70. That would be an incredible rescue from the abyss. Sorry to say I'll believe it when I see it. nt

[still_one]

71. If only were really true /nt

[FVZA_Colonel]

73. It isn't perfect, but it is a start.

If something like this could pass, it could create popular momentum to continue moving the minimum age downwards, as time goes by.

[No Elephants]

227. Or, it could have the opposite effect.

With Medicare covering ONLY the disabled and those over 55, it will be the most expensive program. With private insurance covering only the non-disabled, non-poor (the really poor being in a public program, like Medicaid) and the youngest, private insurance will be even more profitable than it is now. That is a lot of red meat for Teabaggers and Republicans running for office.

[BrklynLiberal]

76. Great. Hope it happens and expands to inlcude everyone. Remove upper income limit from FICA

and it will all be paid for...

[SandWalker1984]

80. Before you start dancing - Keith O & Rachel both say plan would only be for 3 to 4 million

Yet again, the Democrats in Congress are getting our hopes up for real reform only to dash them upon the (corporate) rocks.

Keith and Rachel both said the buy in, as currently being discussed, would only be an option for about 3-4 million who don't have access to group plans.

It sounds good, but reality is no more people would be covered than in the watered down, thinned down, next to nothing pitiful excuse for a public option.

Insurance corporations will still rule, still not have competition, still be able to charge whatever they want and pay out only if they feel like it.

Sigh.

:argh:

[nightrain]

84. depending on cost and improvements to Medicare, this could be a very good thing...

it's aout time...

[Odin2005]

91. HOLY SHIT!

:wow:

[defendandprotect]

95. THAT would be a redeeming measure . . . !!!

[shimmergal]

106. On this argument about

"doctors won't take it" (Medicare.) I haven't seen any evidence of that where I live. In fact they seem quite set up to handle Medicare patients, and with good reason. Medicare recipients are the most reliable repeat customers. The average person who's say, 21 thru 40-something doesn't need to see a doctor very often, and if anything's put in their way (like high co-pays or lack of insurance) they'll be even less motivated to go. OTOH, the over-65's usually have one or more chronic conditions which need to be monitored with regular physician appts. I wonder about all those rumored "Doctors who refuse to take Medicare patients". Where are their patients coming from? Are they getting paid under the table for those patients they do have, so they can afford to just have a few?

Perhaps it's a little different in small towns, which are notoriously under-served medically. But at least in cities, competition is such that, if many doctors refuse to take Medicare, they're limiting their own customer base more than anyone else.

Seems like this would be even more true with a buy-in for 55-65 year olds. It could be a plus for everyone involved. Even the insurance companies...though they may not see it that way. But certainly if there's a mandate, that disallows (theoretically) covering "pre-existing conditions" but does allow rating by age, there'll be huge pressure to lower the age for Medicare coverage regardless.

[Oerdin]

111. What a red herring.

So they sell the public option down the river, give greedy insurance companies hundreds of billions in subsidies, legally force people to buy over priced insurance company insurance, and all we get in return maybe... possibly... someone 60 years old might be able to buy into medicare (which is free for everyone over 65 as it is)? How the hell does that help me? I'm not in my 60's. I'm in my early 30's with a wife & kid plus insurance costs which are killing me.

[stopbush]

112. 112 responses in this thread so far and not a single "Dump Obama in 2012" post.

I'm disappointed. What's happened to "The New DU?"

:sarcasm:

[grahamhgreen]

118. I HOPE he will come out as a strong supporter of Medicare for all!

[yurbud]

126. because it's about the policy not the person. You want us to set up shrines like Bush/Palin bots?

[stopbush]

127. What I want is:

1. a bit of perspective, and

2. an ability to see things strategically

[yurbud]

129. that is precisely what the Democrats are NOT doing by putting the DLC in the drivers seat

Here's a good strategy: get 90% of corporate America behind you by spanking and neutering the 10% that are screwing the rest of businesses as well as average Americans. Then you could please both progressives and the corporate whores. Instead, the Democrats are going whole whore on everything, which, while winning them corporate love, is alienating their activist base.

[stopbush]

135. Sorry, but you seem to be lost in an imaginary world of your own creation.

Are the Ds going whole whore on health reform? Last I heard, the public option debate was getting stronger and louder and the option itself was getting better and better.

Last I heard the health insurance industry is going to lose its monopoly exempt status.

Last I heard Obama announced a strategy and a timeline to get us OUT of Afghanistan.

Last I heard the banks are lining up to pay back the TARP $ they borrowed.

Last I heard monthly job losses had dropped from 700,000 a month to 11,000.

Here's a good strategy: check the news on a daily basis and read what's actually happening 11 months into the Obama administration, rather than carping about what might happen if your worst nightmares come true.

[No Elephants]

232. You are right about the general point. Many things are better.

On a couple of specifics, though, just for the sake of accuracy:

The health insurance exemption from monopoly laws is unchanged. There has been discussion on both sides of that issue and we currently have no idea what the final outcome will be.

We will never get all the TARP money back. I believe we had little choice at the time, though, and loss of some TARP money is preferable to worldwide economic collapse, which I think was the alternative.

And a number of things tnat you left off your list have not improved much, as far as I can tell.

But, this thread is about health coverage as it is making its way through Congress. Why are you trying to make it about the Obama administration?

[stopbush]

246. I was responding to post #129. That post was not limited to the health care debate.

Savvy?

[No Elephants]

234. If you want a bit of perspective and an ability to see things strategically, maybe Santa will bring

them to you. Meanwhile, here's my perspective on your post.

This thread is about a specific issue in a health care reform, as it makes its way through Congress. It is not about something that Obama did that seems like what Bush did or that otherwise seems undesirable. Hence, it should not be any surprise that no one posted "Dump Obama in 2012" on this thread. Duh.

"Thinking strategically" does not consist only of the way you think strategically (or imagine that you do).

On most, if not all, message boards, there are varying opinions. Deal with it by rebutting the views you don't like, not by trying to silence them. Or, start your own board, where only posts that reflect your views will be allowed.

I don't mind posters who disagree with me. I don't even mind posters who idolize Obama unconditionally, even though some sound quite childish. But posts on a thread solely to try to silence or "chill" expression by other posters got old before Inauguration Day. And posts implying that people are deficient in some way because their views are not identical to yours got old before Al Gore invented the internet.

[Iowa]

188. Here comes the pom-pom squad. But look at the positive side...

We had an entire 112 posts without having to endure a single wide-eyed, grinning, naive, Pollyannaish, cheer-leading, hero-worshiping, la-la-land, groupie. It was a refreshing interlude, but all good things must eventually end.

[stopbush]

247. Hmmm? A groupie? Geez, Elmer, if that's what you're calling lifelong Dems

who have been voting the straight-D ticket since 1972, then I guess I'm a groupie.

You say that like it's a bad thing. I'll wear it like a badge of honor.

[grahamhgreen]

115. Finally! Call em all. This is real reform.

[onlyadream]

122. God, I hope so. nt

[MissMillie]

124. I applaud the effort in this

but still have concerns that until we back away from a "fee for service" type of health insurance system, rising health care costs will not be arrested.

I do think that making private insurers compete for customers w/ a Medicare-like system is a good thing.

Does anybody know how many people will be left uninsured or under-insured under this type of plan?

[denverbill]

128. I strongly support this. This is VASTLY better than a 'public option'. n/t

[TomCADem]

138. Liberal Senators Press for Expansion of Medicare

Source: NY Times

WASHINGTON — In return for concessions on their proposal for a new government-run health insurance plan, liberal Democratic senators pushed Monday for expansion of Medicare and Medicaid and more stringent federal regulation of the insurance industry.

Liberal and centrist Democrats are trying to work out a deal on the proposal for a public option, which has become the most divisive issue in the debate over President Obama’s effort to offer affordable health insurance to all Americans.

Under a possible compromise, the federal Office of Personnel Management would negotiate with insurance companies to offer national health plans to individuals, families and small businesses. The personnel office has decades of experience arranging health benefits for federal employees, including members of Congress.

One of the changes being pushed by the liberals would lower the age of eligibility for Medicare to 55, from 65. Another would expand Medicaid to cover people with incomes up to 150 percent of the poverty level (up to $33,075 for a family of four). The Senate bill, as it now stands, would expand Medicaid to cover people up to 133 percent of the poverty level ($29,327 for a family of four).

Read more: http://www.nytimes.com/2009/12/08/health/policy/08health.html

[NeoConsSuck]

139. Senate Democrats eye alternatives to public option

Source: CNN.COM

Washington (CNN) -- Liberal and moderate Senate Democrats said Monday they may be nearing agreement on a package of alternatives to a government-run public health insurance option in the chamber's sweeping health care bill.

Emerging from a meeting, the negotiating senators said the ideas under discussion would replace the controversial public option in a compromise intended to win the support of the chamber's entire Democratic caucus. Senate Republicans unanimously oppose the health care bill so far. The bill requires support from all 60 members of the Democratic caucus to pass.

<snip>

According to an aide to one of the senators involved in the talks, one provision under discussion would have private insurers seek approval from the government's Office of Personnel Management to provide coverage for people in state insurance exchanges being created by the bill.

By participating in the exchanges, the private insurers would limit their profits, just as they do by taking part in the federal workers' plan, according to the senator's aide. The fee-for-service plans for federal workers can earn private insurers a service charge of up to 1 percent, with the average charge being about 0.75 percent.


Read more: http://www.cnn.com/2009/POLITICS/12/07/health.care.senate/index.html

---

Talk about a watered down piece of shit. This is health care reform? You can thank the Blue Dogs for this.

[waterscalm]

140. RIP public option. To the graveyard along with single payer.

[Javaman]

142. These senators wouldn't be raising this issue of they thought

there was a real chance of a real public option surviving this latest round of bullshit in the senate.

We are all about to be pushed under the bus.

I'm waiting for the blackmail to begin to get what ever the hell watered down bill to be passed.

What we will get is a good fucking over. a massive gift to health insurers, high prices to the consumer and nothing to be enacted for at least 4 years, during which time it will be further watered down till it resembles nothing more that thin soup.

Yet, all the moron dems will hip hip hooray over this bullshit, Obama will take credit for "powerful leadership", the repukes will feign the bitch and moan and like aways, we the people will get the colossal clusterfuck with more forms to fill out, teeny tiny fine print that will make living a liability thus exempting us from any healthcare.

I said it before and I will say it again, our government has devolved into a retarded kabuki show of epic proportions.

[waterscalm]

141. Obama Silent On Public Option In Speech To Senators...........

http://www.huffingtonpost.com/2009/12/06/obama-silent-on-public-op_n_381847.html


Obama Silent On Public Option In Speech To Senators
digg Share this on Facebook Huffpost - Obama Silent On Public Option In Speech To Senators stumble reddit del.ico.us RSS


First Posted: 12- 6-09 03:23 PM | Updated: 12- 6-09 09:57 PM



..........Lieberman was beaming as he left the room and happy to re-point it out when HuffPost asked him what Obama had said about the public health insurance option, perhaps the most contentious issue still facing Democrats as they negotiate their way toward a final health care reform bill.

"Well, it was interesting to me -- of course everybody hears with their own ears -- that he didn't say anything about the public option," said Lieberman. "In other words, when he outlined how far we've come on the bill, he talked about the cost-containment provisions; he talked about the insurance market reforms; and he talked about enabling 30 million more people to get insurance. He said these are historic accomplishments, the most significant social legislation, or whatever you call it, in decades, so don't lose it."......................

Obama's reluctance to stand up for the public option has been a source of contention between Reid, who is pushing for it, and Obama. Reid has asked five progressive senators and five conservatives to work out a compromise on the public option. The group will meet again Sunday afternoon, though without guidance from the president.

White House spokesman Bill Burton also mentioned insurance reform and affordability in his statement about the meeting, but neglected to mention the public option. "The president thanked members of the Senate for their hard work so far and encouraged them to continue forward on this historic opportunity to provide stability and security for those who have insurance, affordable coverage for those who don't and bring down the cost of health care for families, small businesses and the government," he said.
Story continues below

Sen. Tom Harkin (D-Iowa) said that Obama is working with Lieberman behind the scenes and that his failure to mention the public option doesn't meant the president doesn't support it.

"Well, he didn't mention either abortion or the public option," said Harkin, a strong backer of the public option and a chairman of the health committee. "He just laid out in very stark terms for us what the future would be if we didn't pass . I think he's right. I think it would be devastating. Not just for us as a party, I think for the hope that people have that we're going to actually make these changes. To fail at this would just again be another one of those things where people say, 'See, Washington doesn't work. Washington can't get anything done. We gave the Democrats all that power and nothing happens.' And it would be depressing to people. We want to be more hopeful, we want to give people hope. So I thought his message on that was right on target."

......................

UPDATE: The consensus emerging from this evening's meeting between liberal and conservative Democratic senators on the public option is that little progress was made, but that talks will continue. Much of the discussion focused on a proposal involving responsibility for the Office of Personnel Management that the Huffington Post reported on Saturday. The most notable development may have been that, according to a Democratic staffer, Lieberman sent staff to attend. Lieberman himself has not been involved in public option negotiations since he has ruled out any variety of one. But earlier Sunday he said he hadn't yet formed an opinion on the OPM plan and wouldn't support it if it relied on government money. It's difficult to see how the proposal is anything of a substitute for a public option and, indeed, Sen. Olympia Snowe (R-Maine) said earlier Sunday that it was being considered on its own right, no longer looked at as an alternative to the public option. But things are fluid in the Senate.

[Javaman]

143. Here comes the bus, grab onto something, they are going to push! nt

[Doctor_J]

144. The Repukes won't let this happen

expansion of Medicare would destroy their electoral prospects for next fall. Therefore it won't happen. If they could pass a cure for cancer between now and November it wouldn't happen.

[Winterblues]

145. Republicans have been clamoring lately how valuable Medicare is and how it can't be cut.

Republicans are boxing themselves in. I have heard none of them say they don't like Medicare. If they think it is a good program it is hard to say it shouldn't be expanded..

[Bette Noir]

146. I emailed both my senators as soon as I heard this.

If we could buy in to Medicare, my husband could retire in two years, instead of twelve.

[laughingliberal]

162. Medicare Buy-In Proposal Could Begin In 2010

Source: http://www.huffingtonpost.com/2009/12/08/medicare-buy-in-proposal_n_384591.html

There is "growing enthusiasm" for a proposal that would make Medicare coverage available to more consumers as early as next year, a Democratic source with knowledge of health care negotiations tells the Huffington Post.

Throughout the day, Senate Democrats have been feeling out a supplemental compromise to the public option that would allow consumers between the ages of 55 and 64 to buy into Medicare. The sticking point, at least for progressives, has been how quickly such coverage will be made available.

Now, it appears, negotiators are making headway to ensure that the expansion would take place at a far quicker pace than any proposed public option. According to the well-placed source, Democrats are rallying behind a proposal that would allow a portion of the 55-64 year old age group to buy in to the Medicare system as early as 2010. By contrast, a public plan for insurance coverage would not come into being until 2014.

This would be a major breakthrough in the context of negotiations. Former DNC Chairman Howard Dean, who was responsible for pushing the buy-in proposal among Senate Democrats this past week, told Think Progress that he backed the idea, but only if it was available from day one. A Democratic aide on the Hill confirmed that discussions about a start date for such a Medicare buy-in proposal were, indeed, taking place. Though the Hill source cautioned that discussions are fluid.

Read more: http://www.huffingtonpost.com/2009/12/08/medicare-buy-in-proposal_n_384591.html

---

I'm inclined to believe this is a good thing due to Dean's support of it.

Sorry about the source. Could not find it on any mainstream media as yet.

[MNDemNY]

163. This would be a real "foot in the door"

I would like to see it combined with some sort of trigger that would lower the age limit even further if the Industry does not behave and "reform " itself.

[laughingliberal]

164. That would be a good use of a trigger

One that might actually get pulled if the cartels don't play nice. It's already there, no need to create a new system, just open the doors to larger groups. I like it.

[MNDemNY]

166. This would be reform.

[elocs]

165. Well, expanding Medicare is a big step if they could pair it with expanding Medicaid

for the lower income. If you combine that with eliminating pre-existing conditions and the ability to just drop people, that is something also. Public option would be great but if we can get something good I'm not for an all or nothing attitude.

[laughingliberal]

169. The progressives are in there still fighting for the expansion of Medicaid

Conrad (D)ickhead ND is whining but has not indicated it is a deal breaker for him. Still whining about Medicare reimbursement rates in his state. For God's sake, raise their rates and be done with it!

[BlueIdaho]

176. And the young... Birth to say... 25. nt.

[Oregone]

167. This might equate to a real improvement in the system

[doc03]

168. How do you put more people on an already

bankrupt program? How are they paid for? I am 61 years old I don't see Medicare as any great savior. If I couldn't get health coverage any other way I would settle for it as a last resort.

[laughingliberal]

170. You're right. Let's abolish Medicare and make everyone buy private insurance

:sarcasm:

[doc03]

171. The question is how are you going to fix it by

screwing it up even worse?

[w4rma]

172. … nt

[twitomy]

174. I'm with you. Medicare is in trouble as it is...

Amazing how some people ignore this obvious problem and make dumbass retorts instead. "Damn the consequences, full steam ahead!"

[laughingliberal]

213. I happen to believe the 'problems' with Medicare are grossly

exaggerated and, mostly, by those who are in favor of abolishing 'entitlements.' 'Some people' have wanted to get rid of Medicare since its inception. It's not likely to be going anywhere.

[madrchsod]

175. my parents had medicare with a supplemental

never denied any treatment and never paid a dime for any treatment. they went to the doctor or clinic showed them the card and that was it. the biggest problem they had was the cost of drugs.


i can`t wait till i have medicare in two more years.

[laughingliberal]

215. In my 25 years as an RN, I found Medicare to be the absolutely easiest

pay source to work with. They had their sticking points but not nearly the pitfalls we had with the private insurance cartels.

[laughingliberal]

212. I don't believe this is screwing it up even worse. That is, obviously, your assumption but I

don't agree with your starting premise that it's screwed up to begin with. I believe this has been grossly overblown mostly by those who wish there was no Medicare. Feel free to disagree but I'm not likely to buy into this argument.

[quiller4]

177. I'm 58 and I do see Medicare as a "great savior" . The program isn't

bankrupt and simply eliminating the lid for FICA and Medicare taxes (which has not even risen sufficiently to keep up with inflation) would take care of solvency. I'd be happy to drop the private insurance for which we pay close to $800 monthly with a $3500 deductible and 75/25 slip thereafter to enter Medicare. I handled Medicare claims for both of my parents and for one aged aunt. All of my docs accept assignment. Even if my premium rose, entering Medicare would yield a very significant savings for me and most others I know who are over 55 and buy their own private insurance.

[wordpix]

184. my mom has Medicare but also pays insurance premiums. Medicare doesn't pay for all

the medical expenses. Definitely helps, though.

BTW, her AARP health ins. premiums are $166/mo. She gets good coverage with that and Medicare at age 84.

[SandWalker1984]

173. How is offering Medicare to 2 or 3 million going to hold down insurance costs?

Both Keith and Rachel were talking about the Medicare option last night on their shows and it, as currently being discussed, is going to be very limited -- you have to be without insurance or option for insurance from your employer. It would cover maybe 2 or 3 million more people.

So how is that going to provide competition for the private insurance corporations WHEN BOTH THE HOUSE AND SENATE VERSIONS MANDATE INSURANCE COVERAGE. Without a public option or plan, you have no choice but to buy insurance from the very blood sucking corporations that have ruined the system now.

Where is the regulations on what insurance corporations can charge?

These predatory corporations, since 2002 have raised the average premiums by 87% and their profits have soared 428% but we are supposed to cheer for this corporate giveaway bill for the insurance ccmpanies?


Folks, the Medicare provision is a sliver of change, not real change.

I didn't vote for slivers.

[Penguin31]

187. As someone still a couple of decades from 55...

While any improvement is welcome, it still won't do be a bit of good to *me*. Lowering the Medicare age to 55 will help quite a few people, and that's great. But what about those of us who won't be 55 for another couple of decades? You want us to just die quickly? For someone like me this little nugget is a nice start but *it's not enough*.

[No Elephants]

197. Maybe something like this will cause younger people to be more active politically?

That is the only hope, and I am not even sure being politically active works anymore, either.

The Mayor of Boston spends many of his New Year's Eves at a senior citizens party. I suspect that may be because seniors are pretty consistent about voting.

[Zavulon]

189. About fucking time.

I've wanted this from the start. I also agree with your "shitty bill" assessment of the current bill.

[No Elephants]

230. The pundits claim that the pushback from the Left forced revival of the public option. If so,

thank heaven for the Left and pray that it never shuts up, instead of demanding that it be grateful for whatever crumbs politicians throw us. In fact, all of us should all be emailing and calling as often as we can.

We should be demanding single payer, though. Either that, or socialized medicine (no, those two are not the same). The more threads like this I read, and the more I think about it, those are the only two things that will work.

If the politicians want to give us a goldfish instead of pony, let that be on them. But asking for a goldfish when you want a pony and don't think much of goldfish is just silly.

[and-justice-for-all]

261. Well that does not do me and my own any fucking good...nt