Nathan Newman wrote:
Consumers Union- "The Bradley plan will without a doubt insure more people...Senator Bradley's plan offers a more meaningful starting point for tackling the problems of the uninsured...The Bradley tax credit is likely to be used by a very large percentage of the eligible population, since it by design would cover the entire premium, and the person applying CANNOT BE TURNED DOWN for coverage."(emphasis added)
Most disabled people don't make enough money to qualify for a tax credit - so this is USELESS to them.
> Marta, I really don't think you recognize how important a reform Bradley is
> suggesting by allowing anyone to buy into the FEHBP, since it gives anyone
> access to group rates without facing discrimination for preexisting conditions -
> a very different situation from most HMOs and private employer-based coverage.
>
The FEHB program is awful for pwds. Justice for All, a disability organization in Washington D.C. has made a particular point of saying we do not want to be pushed into FEHBP. I attended public hearings in Washington DC sponsered by NCD ( a few years back) where employees told of their personal experiences such ashaving to choose between getting a prosthesis or getting a wheelchair because FEHB would not give them both. Amputees often require both so they don't miss work when their stump hurts too much to use the prosthesis. This is just one example. The FEHB program has many tiers - it is not one uniform plan. Congress gets the best coverage and many lower level employees get the least.
What I guess is not getting through in this discussion is that you cannot look at a private health care plan like FEBP and automatically assume it will be adequate for everyone. TANF folks, for example, are NOT going to have issues about wheelchairs, adult diapers, bathbenchs, oxygen, etc. as the disabled population on Medicaid does. Private insurers are notorious for denying these things. Matt Johnson, a quadriplegic in California - one of Kevorkians victims - spent nine months trying to get a wheelchair from his HMO and it arrived the day *after* Kevorkian's visit -- too late to do any good.
I should have made it clearer in my post that there are backdoor ways of cherry picking - that is keeping unwanted populations out of plans - like underwriting practices that ensure the policies do not provide coverage for the things those populations may need. Long term care is a prime example, personal assistance services is long term care. What good is the language *not able to turn one down for health care* if the health care one is offered is not adequate? While some plans are starting to offer long term care coverage, it is as you would expect not standard and therefore an additional cost to be born by the consumer and many consumers cannot afford to pay higher premiums for it. None of the plans that I am aware of offer personal assistance services - which provide an attendant to help one get dressed in the morning, etc., they are medically based services, not socially based services.
Nathan, while you think Bradley's plan may be better - I'm not sure you have understood Jim Westrich's points on efficiency. Money that could be going to provide services under Medicaid will be wasted on capitalist enterprises under Bradley's plan. The insurers are not going to increase their services - we already have seen that when the corporations decide they aren't making as much profit as they deem necessary as with the HMOs, they raise the premiums and cut back on prescription coverage and other items which means people must pay out of their own pockets. Competition will not bring about better higher quality care, it will more likely bring about more mega-mergers, less benefits, less choice and higher premiums.
In addition, under the Bradley scheme, insurers will gain even more political power than they already have. The insurers will continue to bribe congress and politicians to support their capitalist interests over the public's - we have seen this in the battle for a "patient bill of rights" - what passed was a farce of a solution to HMOs.
Admittedly I am not an "expert" but honestly, I just don't see how anyone who understands the dynamics of capitalism cannot see the basic problem with Bradley's scheme. It would be far better to expand and improve Medicare and/or Medicaid to cover all uninsured people who should have coverage as a human right.
Marta