Thanks for rec’cing guys! What you need to know is here.

The first infusion of our tax dollars is slated TO BE SET ASIDE in the Reform Bills in order to reimburse PRIVATE INSURERS for medical claims of RETIREES covered under their group plans! Why? Why would the FED pay medical claims FOR the private insurance companies? Isn’t this a Bailout?

$10,000,000,000 or Ten Billion Dollars 90 days after the Bill is enacted.

Within 90 days after enactment, H.R. 3200 would create a temporary reinsurance program, with funding not to exceed $10 billion, to assist participating employment-based plans with the cost of providing health benefits to eligible retirees who are 55 and older and their dependents.

The Secretary would reimburse the plan for 80% of the portion of a claim above $15,000 and below $90,000 (adjusted annually for inflation).

Amounts paid to the plan would be used to lower costs directly to participants in the form of premiums, co-payments, and other out-of-pocket costs, but could be not used to reduce the costs of an employer maintaining the plan.
Page 7, paragraph 2

If you don’t believe me, you go here to read it for yourself.

Read the Congressional Analysis here:

Do you have any objections to what seems like this Insurance Industry Bailout? I do.

My objection is that the $10,000,000,000 will flow from the FED to the INSURERS. The insurers, at the very least, will gain the $$$$ interest earned on the float. And the justification for this is a very narrow need: Retired Employees lucky enough to retire WITH health insurance benefits? Any guesses, dear readers, who these fortunate retirees are?


1. Even if every dime the FED pays directly to the INSURER is passed on to these fortunate retired employees, which the insurers will be trusted to do, how is this justified?

2. How many days can the INSURER hold the funds before passing it on to an individual retiree?

3. Will they mail the retiree a check?

4. What recourse will the retiree have if the insurer performs poorly, leaving the retiree in the grasps of medical bill collectors until the insurer performs?

5. Who are these fortunate retirees? Federal/State retirees? Golden Parachute retirees? Union retirees? Is this why the unions are backing the Bill as is?

They certainly aren’t the burger flippers, construction workers, employees of small businesses, and/or the majority of Americans!

Who and/or what prompted the inclusion of this language in the House Bills?

No mention is mentioned of either ERISA or the Pension Benefit Guaranty Corporation, both charged with taking care of retirees IF their pension plan is at risk or becomes insolvent. Why are these not mentioned in the above section of Reform legislation?

ERISA was enacted to protect the interests of employee benefit plan participants and their beneficiaries by requiring the disclosure to them of financial and other information concerning the plan; by establishing standards of conduct for plan fiduciaries; and by providing for appropriate remedies and access to the federal courts.

The Pension Benefit Guaranty Corporation (or PBGC) is an independent agency of the United States government that was created by the Employee Retirement Income Security Act of 1974 (ERISA) to encourage the continuation and maintenance of voluntary private defined benefit pension plans, provide timely and uninterrupted payment of pension benefits, and keep pension insurance premiums at the lowest level necessary to carry out its operations.

So many questions. Do you have questions? Please drop in comments, K? Thanks.

If this Bill language remains in the final Bill, won’t this narrow group of fortunate retirees be the only group in America receiving FREE, 100% Federally subsidized health care insurance and care.

But maybe I am wrong. This seems like a huge Private Insurance Industry Bailout, or a bailout for some very fortunate retirees.

My problem with this is that, under the above clause, it seems as though the FED is planning on paying for medical claims that the insurer is usually obligated to pay, under the terms of employment-based, or group policy, to pay, otherwise the specific payment range wouldnt’ be mentioned. And/or some very lucky retirees won’t have to pay a dime for health care. Either way, WHAT?!

Am I wrong in this analysis? If so, please help me understand how/where? And if I am totally wrong:

Analysis: The employer pays the employment plan premiums. An employee retires with enrollment in the plan intact. If the retired employee has a major health event, he/she may have to pay up to $15K out-of-pocket depending on the plans rules.

The FED under this section of the legislation, will pay the 80% of the bills for a health event that are over $15K up to $90K or a possible total of $60K, paid to the insurer, who can then reimburse the employee for what?

The $15K possible out-of-pocket? maybe some premium charges if the employer requires a contribution? But certainly, if I am reading this correctly, the insurance company is being subsidized by the FED for medical costs paid for. Do you see this differently? If so, please jump in and help us understand, K?

No where in the reform discussion is anyone talking about subsidizing insurance companies to help them pay for some fortunate retirees (the most expensive group) health care costs. Wouldn’t that be a form of Bailout?

And, again, what employees these days leave a company at age 55 WITH their health insurance in tact for them and their family? Federal/State? Golden Parachute?

I’ll tell you what this example reminds me of.

In IRS Code there is or was a clause that allows for the deduction of an "institutionalized cousin". The class laughed when this was brought up. The instructor explained that laws are written by people, and that, more than likely, someone charged with writing code at that time was peeved that he/she couldn’t deduct the "institutionalized cousin" they had inherited.

This Subsidy to Pay the Medical Costs of an Employee Plan Retiree, more than likely, represents one of the submissions by a lobbyist or a lawmaker asked to help out a friend or a company. No matter how it got into the legislation, it is too specific for me to understand why this belongs in this initial Reform Bill. It doesn’t fit the language of the rest of the Bill. It stands out.

It is the largest amount of Money Set aside, $10B, and the first to be dispersed (90 days after enactment to private industry.

Once again, private industry is bailed out while people are left to suffer.

That could be used to help the millions of people in desperate need of health care as demonstrated by the 3rd-World-looking free events offered this summer and swarmed by suffering people denied health care otherwise.

A lot of teeth can be fixed for $10 Billion dollars!

I have written 5-6 diaries enumerating the problems I find with the the legislation coming out of the house. The documents are clearly referenced, although the large analysis won’t let me edit and republish so I can’t correct it. Very embarrassing, btw..

But, please, I am just being redundant. Here are my analyses again.

And, yeah, there is some snark in the diaries. When people are suffering, I feel sad and upset. And the 60+ hours I have spent this week hoping to help others know what the freak we are talking about was worth it to me. I have done my part. If no one wants to dig into the details, then we deserve what ever we get, sadly.

However, many have offered great insights and additional analyses of areas of the Bill the diaries didn’t address. If you truly are interested in KNOWING THE HEALTH REFORM BILL, I highly recommend scrolling through the comments as well.

It is truly my hope that, by working together, we can bridle our talents and continue to work together to get to know the details of the Public Option.

I specifically want to thank marleycat, who spent the better part of yesterday reading the House Bill and sharing other important sections not included in the diary. And a big thanks to ArthurPoet who has cheered me on and offered very helpful insights. Also "Thank You" to neroden, SarahLee, Ministry of Truth, Kovie for the Mike Taibbi article link, and to GN1927

As it stands, the PUBLIC OPTION SUCKS eggs, in my opinion, until and unless someone responds and explains where my analysis is wrong. The insurers will receive a huge WINDFALL, as witnessed by Wall Streets rallies every time the Public Option is dissed by Congress, and the suffering Middle Class will have to choose between food or premiums, and the poor will continue to hope for Free Health Fairs.

Compromise is often the villain of true reform. This isn’t what I voted for last November. btw, I am not a conservative troll (been accused several times). I am a screaming liberal who cannot abide to see so many suffer needlessly, just so Corporaticians on the Hill can BE enriched by the corporations they now seem to serve and protect. I hoped for better than this!

AND PLEASE, EVERYONE, don’t let any Bill pass that dismantles the States’ ability to protect your insurance issues. If the Republicans have their way (and probably some Democrats, too), we could end up with as little protection from insurer abuse as we now enjoy from the Credit Card companies.

Please do so! Until then be informed. Read this:

It’s a Congressional Review overview of the four bills passed in the house committees.

and these DAILY DOSE diaries on specific items and instructions to help you discover your costs IF a Reform Bill similar to the House Bills passes:

DAILY DOSE: Will $14K or $19K a Year Bankrupt You?$14K-or-$19K-a-Year-Bankrupt-You-

DAILY DOSE: 39% of Your Net Income Mandate Sucks!!


DAILY DOSE: Changes Insurers Will Make, OH MY!,-OH-MY!

And this,-Please-Rec

Be informed, or be hoodwinked. It’s a choice.

Until and unless I am asked or invited to do so, I am moving on to another aspect of the Health Care discussion. Specifically, the negative impacts on our health resulting from industry and the governments refusal to properly enforce safety measures to protect our health and the lack of payment for preventative care and natural, alternatives to treatment.

Lastly, if you haven’t already, Elizabeth Warren clearly demonstrates why we are all feeling so financially overwhelmed and why, under our present health care insurance system, we can’t afford it. She begins her presentation at about 6:20.

This is a must see:

The Coming Collapse of the Middle Class

CLINTON ADVOCATED for MEDICARE for the 55-65 age group in 1999. It’s not like this hasn’t been considered before

In his new budget request, President Clinton will again ask Congress to open Medicare to people 55 to 64 years old, Administration officials said today.

Though the proposal died in Congress last year, Mr. Clinton will resubmit it, in part because he is concerned about the erosion of private insurance coverage among people 55 to 64, the officials said. Medicare now covers people who are 65 and older or who are disabled.

The number of people without health insurance rose by 4 percent in 1997, to 43.4 million, the Census Bureau said. The number of uninsured people age 55 to 64 rose more sharply, by 7 percent, to 3.2 million….

Senator Daniel Patrick Moynihan, Democrat of New York, introduced a bill to carry out Mr. Clinton’s proposal to expand Medicare last year. Under that proposal, people ages 55 to 64 could have bought Medicare coverage by paying premiums of $300 to $400 a month. People 62 to 64 who chose this option would also have had to pay surcharges on their premiums after they reached the standard eligibility age of 65.

The Administration says the proposal is needed because commercial insurance is often unavailable or unaffordable for people age 55 to 64.

Thanks, masslib, for this Clinton article reference!