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SmthBluCitrus
05-10-2009, 10:09 PM
AP source: $2 trillion offered in health savings

WASHINGTON (AP) — Top representatives of the health care industry plan to offer $2 trillion in cost reductions over 10 years in a bid to help pass President Barack Obama's health overhaul, a source familiar with the negotiations said Sunday.

Industry officials representing health insurers, hospitals, doctors, drug makers and a major labor union plan to be at White House on Monday to present the offer.

Costs have emerged as the biggest obstacle to Obama's ambitious plan to provide health insurance for everybody. The upfront tab for the federal government from Obama's proposed expansion of health coverage will be due right away while the savings he expects from wringing waste and inefficiency from the health care system will take longer to show up.

A source outside the administration told The Associated Press that the savings would come from slowing projected cost increases by a small percentage each year for 10 years. The result over time would be an estimated $2 trillion in savings on health care costs. The source requested anonymity in order to speak before the public announcement.

In a rare move before the administration has unveiled all the details of its proposal, the industry groups are trying to strike a deal now with Obama officials to help get coverage for all Americans in the hopes they can stave off legislation that would restrict their profitability in future years. Obama has courted industry and provider groups; he invited representatives to a health care summit discussion at the White House. There is a sense among some of the groups that this may be the best opportunity to strike a deal before public opinion turns against them, fueled by anger over costs.

Insurers, for example, want to avoid creation of a government health plan that would directly compete with them to enroll middle-class workers and their families. Drug makers worry that in the future, new medications might have to pass a cost-benefit test before they can win approval. And hospitals and doctors are concerned the government could dictate what they get paid to care for any patient, not only the elderly and the poor.

It's unclear whether the proposed savings will prove decisive in pushing a health care overhaul through Congress this summer, as Democratic leaders have vowed to do. Covering the estimated 50 million uninsured Americans could cost from $1.2 trillion to $1.5 trillion over 10 years. To pay for that, lawmakers would have to identify specific savings in government programs like Medicare, or come up with new revenues.

But the industry offer shows a willingness to help find the money. That's far different from the situation in the 1990s, when insurers and other key groups successfully opposed the Clinton administration's plan to cover all Americans.

"This is intended to get all the groups to share responsibility about bending the cost growth curve downward," said Ron Pollack, president of Families USA, a liberal group that advocates for expanding coverage. Pollack said he was aware of intense negotiation in the last few weeks between the groups and the administration, but not the specifics.

The AP source said the groups include America's Health Insurance Plans, the Pharmaceutical Research and Manufacturers of America, the American Medical Association, the American Hospital Association and the Service Employees International Union.

Google News (AP) (http://www.google.com/hostednews/ap/article/ALeqM5irNxCC9jjmVT9NsYoi39usrvum2gD983JOL01)

I could have posted from HuffPo. But, I figured that would get shot down as just some lib site. AP via Google instead.

Yay! Health care is coming, health care is coming!

SmthBluCitrus
05-10-2009, 10:11 PM
Here's the HuffPo link. (http://www.huffingtonpost.com/2009/05/10/obama-and-industry-groups_n_201366.html)

blenderboy5
05-10-2009, 11:57 PM
My prefered situation, if we must reach the point in this country where health care is a natural right like life, liberty, and property, is one like the auto insurers have.

Everyone has to have it, they can choose the coverage they want and how much they want to pay for, and even the insurers are cheaper. After all, it's a huge benefit for the insurance companies if the most healthy in our society have to get health insurance, because eliminates the adverse selection issue.

cabernetluver
05-11-2009, 12:24 AM
My prefered situation, if we must reach the point in this country where health care is a natural right like life, liberty, and property, is one like the auto insurers have.

Everyone has to have it, they can choose the coverage they want and how much they want to pay for, and even the insurers are cheaper. After all, it's a huge benefit for the insurance companies if the most healthy in our society have to get health insurance, because eliminates the adverse selection issue.

I understand your comment, from your point of view about health care being a right or not, but in a very real way, it is. Poor people get health care from Medicaid. Older people, which I will be in a few years get it from Medicare. People with money or jobs with benefits get it there.

It turns out, the only people who cannot afford it are middle income people who don't have a job with that benefit.

The cost of health insurance is reflective of the cost of health care. Just as Ari is an expert in econ, this is an area that I have equal expertise. I am not saying that I know what the solution to this problem of paying for this type of insurance is, but I do know where all of the burrs under the saddle are to be found.

I will tell you that all of the simple places that blame is placed are at best partially correct, to a small degree, and at worst are just so much posturing.

DodgersFan28
05-11-2009, 04:23 AM
A source outside the administration told The Associated Press that the savings would come from slowing projected cost increases by a small percentage each year for 10 years. The result over time would be an estimated $2 trillion in savings on health care costs. The source requested anonymity in order to speak before the public announcement.

So this is an "estimated" savings based on a slowing of a "projected" cost increase each year for well after Obama is guaranteed to be gone from office.

Sorry, not buying it, but I have the popcorn ready to see the propaganda that'll come out from both sides about this.

SmthBluCitrus
05-11-2009, 10:08 AM
Of course it's an "estimate" based on a "projection" -- what else could it be? It's not like you're ordering a pizza where the price they charge you is what is coming out of your pocket; they're talking numbers over the next decade.

Even Pizza Hut can't guarantee their operating costs and price per pizza that far into the future.

blenderboy5
05-11-2009, 10:59 AM
I understand your comment, from your point of view about health care being a right or not, but in a very real way, it is. Poor people get health care from Medicaid. Older people, which I will be in a few years get it from Medicare. People with money or jobs with benefits get it there.

It turns out, the only people who cannot afford it are middle income people who don't have a job with that benefit.

The cost of health insurance is reflective of the cost of health care. Just as Ari is an expert in econ, this is an area that I have equal expertise. I am not saying that I know what the solution to this problem of paying for this type of insurance is, but I do know where all of the burrs under the saddle are to be found.

I will tell you that all of the simple places that blame is placed are at best partially correct, to a small degree, and at worst are just so much posturing.

Admittedly I'm not an expert on health care. But while I don't think health care should be a guaranteed right, there's no doubt that a lack of health care can lead to all kinds of unfortunate events-- bankruptcy, death, poverty, lack of employment, etc.

But do you, as someone who knows more about this, think a car insurance like system would work for the lower middle class too rich for medicaid but not well off enough to get insurance from their job?

poodski
05-11-2009, 11:12 AM
But do you, as someone who knows more about this, think a car insurance like system would work for the lower middle class too rich for medicaid but not well off enough to get insurance from their job?

A ton of people don't get car insurance, so it still wouldn't be perfect.

blenderboy5
05-11-2009, 11:47 AM
A ton of people don't get car insurance, so it still wouldn't be perfect.

True... but a ton of peole break the law because they don't think they need it. Just like some people don't think they'll ever get into an accident, some people believe they'll never get sick or have a medical emergency.

But personal choice, even if it's the choice to violate the law, still exists.

SmthBluCitrus
05-11-2009, 01:20 PM
The letter (pdf) (http://blog.prospect.org/blog/ezraklein/051109%20Letter.pdf):


May 11, 2009
The President
The White House
Washington, D.C. 20500


Dear Mr. President:

We believe that all Americans should have access to affordable, high quality health care services. Thus, we applaud your strong commitment to reforming our nation’s health care system. The times demand and the nation expects that we, as health care leaders, work with you to reform the health
care system.

The annual growth in national health expenditures—including public and private spending—is projected by government actuaries to average 6.2% through the next decade. At that rate, the percent of gross domestic product spent on health care would increase from 17.6% this year to 20.3% in 2018—higher than any other country in the world.

We are determined to work together to provide quality, affordable coverage and access for every American. It is critical, however, that health reform also enhance quality, improve the overall health of the population, and reduce cost growth. We believe that the proper approach to achieve and sustain reduced cost growth is one that will: improve the population's health; continuously improve quality; encourage the advancement of medical treatments, approaches, and science; streamline administration; and encourage efficient care delivery based on evidence and best practice.

To achieve all of these goals, we have joined together in an unprecedented effort, as private sector stakeholders—physicians, hospitals, other health care workers, payors, suppliers, manufacturers, and organized labor—to offer concrete initiatives that will transform the health care system. As restructuring takes hold and the population's health improves over the coming decade, we will do our part to achieve your Administration’s goal of decreasing by 1.5 percentage points the annual health care spending growth rate—saving $2 trillion or more. This represents more than a 20% reduction in the projected rate of growth. We believe this approach can be highly successful and can help the nation to achieve the reform goals we all share.

To respond to this challenge, we are developing consensus proposals to reduce the rate of increase in future health and insurance costs through changes made in all sectors of the health care system. We are committed to taking action in public-private partnership to create a more stable and
sustainable health care system that will achieve billions in savings through:

• Implementing proposals in all sectors of the health care system, focusing on administrative simplification, standardization, and transparency that supports effective markets;

• Reducing over-use and under-use of health care by aligning quality and efficiency incentives among providers across the continuum of care so that physicians, hospitals, and other health care providers are encouraged and enabled to work together towards the highest standards of quality and efficiency;

• Encouraging coordinated care, both in the public and private sectors, and adherence to evidence-based best practices and therapies that reduce hospitalization, manage chronic disease more efficiently and effectively, and implement proven clinical prevention strategies; and,

• Reducing the cost of doing business by addressing cost drivers in each sector and through common sense improvements in care delivery models, health information technology, workforce deployment and development, and regulatory reforms.

These and other reforms will make our health care system stronger and more sustainable. However, there are many important factors driving health care costs that are beyond the control of the delivery system alone. Billions in savings can be achieved through a large-scale national effort of health promotion and disease prevention to reduce the prevalence of chronic disease and poor health status, which leads to unnecessary sickness and higher health costs. Reform should include a specific focus on obesity prevention commensurate with the scale of the problem. These initiatives
are crucial to transform health care in America and to achieve our goal of reducing the rate of growth in health costs.

We, as stakeholder representatives, are committed to doing our part to make reform a reality in order to make the system more affordable and effective for patients and purchasers. We stand ready to work with you to accomplish this goal.

Sincerely,

Stephen J. Ubl
President and CEO
Advanced Medical Technology Association

J. James Rohack, MD
President-elect
American Medical Association

Karen Ignagni
President and CEO
America’s Health Insurance Plans

Billy Tauzin
President and CEO
Pharmaceutical Research and Manufacturers of America

Rich Umbdenstock
President and CEO
American Hospital Association

Dennis Rivera
Chair, SEIU Healthcare
Service Employees International Union

ari1013
05-11-2009, 03:34 PM
So this is an "estimated" savings based on a slowing of a "projected" cost increase each year for well after Obama is guaranteed to be gone from office.

Sorry, not buying it, but I have the popcorn ready to see the propaganda that'll come out from both sides about this.
That's how it works. Everyone was jumping on the CBO projection which showed that huge increase in spending and now this is an estimate of how much that increase can be curbed.

This brings the CBO estimate back in line with the White House estimate.

It still means insanely high deficit spending for the next decade, but as evidenced by this move, there are plenty of ways to cut waste without cutting key programs.

cabernetluver
05-11-2009, 10:38 PM
BB, I am not sure what you mean by a system along the lines of auto insurance, but here is some information to put this conversation on a more factual basis.

The rate of inflation in the cost of medical care, as a rule of thumb, has been double the rate of inflation of the CPI.

Given that as a starting point, and given the size (2.4 trillion in 2008) I don't find anything out of bounds when the statement was that they would save 2 trillion over 10 years in projected cost increases.

lakersrock
05-12-2009, 01:59 AM
Admittedly I'm not an expert on health care. But while I don't think health care should be a guaranteed right, there's no doubt that a lack of health care can lead to all kinds of unfortunate events-- bankruptcy, death, poverty, lack of employment, etc.

But do you, as someone who knows more about this, think a car insurance like system would work for the lower middle class too rich for medicaid but not well off enough to get insurance from their job?

Go work at Wal-Mart. They have benefits. I agree with whichever person said everyone has it. There really arn't too many full time jobs that don't offer some sort of health care package. Then you add in the rich who can afford it and the ones who can't with medicaid and you're pretty good in terms of overall coverage. I think charging us multiple trillions for something that really doesn't need to be nationalized (in a sense) is freaking stupid.

DodgersFan28
05-12-2009, 06:57 AM
I don't find anything out of bounds when the statement was that they would save 2 trillion over 10 years in projected cost increases.

But do you notice how lacking in actual substance that statement is? I want to know how exactly these projected cost increases would be "slowed".

cabernetluver
05-12-2009, 09:55 AM
Go work at Wal-Mart. They have benefits. I agree with whichever person said everyone has it. There really arn't too many full time jobs that don't offer some sort of health care package. Then you add in the rich who can afford it and the ones who can't with medicaid and you're pretty good in terms of overall coverage. I think charging us multiple trillions for something that really doesn't need to be nationalized (in a sense) is freaking stupid.

You are missing some information that I will be glad to give you. I am sure having read many of your comments that you will not be surprised that 38% of the work force is now employed by small business. What you may not know is that less than 2/3 of those companies offer health insurance to their employees (The Henry J. Kaiser Family Foundation. The Uninsured: A Primer, Key Facts About Americans without Health Insurance. January 2006. ttp://www.kff.org/uninsured/). 266,000 companies dropped health insurance benefits from 2000-2005, with 90% of those having less than 25 employees.

A third of all firms did not offer health insurance in 2007 (The Henry J. Kaiser Family Foundation. Employee Health Benefits: 2008 Annual Survey. September 2008. http://www.kff.org/insurance/7672/index.cfm).

You want more information? Or do you just want to express your opinion based on your opinion?

cabernetluver
05-12-2009, 10:16 AM
But do you notice how lacking in actual substance that statement is? I want to know how exactly these projected cost increases would be "slowed".

Am I wrong in thinking that your feel that these savings (offered by private industry, not the government) are things you are cynical about?

I agree that it is just a pledge from groups that represent hospitals, doctors, drug makers, insurers and others. If it is just the beginning.

It can be fleshed out in a lot of incremental steps, if they all work at it. It can also be hot air, but, at a minimum, this is the first time that the industries different components are saying that something can be done without starting off by pointing fingers at each other as to who is the root cause of the expensed, but instead are saying that they all are.

poodski
05-12-2009, 10:44 AM
Am I wrong in thinking that your feel that these savings (offered by private industry, not the government) are things you are cynical about?

I agree that it is just a pledge from groups that represent hospitals, doctors, drug makers, insurers and others. If it is just the beginning.

It can be fleshed out in a lot of incremental steps, if they all work at it. It can also be hot air, but, at a minimum, this is the first time that the industries different components are saying that something can be done without starting off by pointing fingers at each other as to who is the root cause of the expensed, but instead are saying that they all are.

Why wouldnt they all work at it? If we have national health care that health care has to come from someone meaning more work for them.

Its not really the health care people being nice by "cutting 2 trillion in costs" its them lowering the percentages which in turn brings more work which in turn means more profit. Their profit percentage may not be as high but their overall profit will be higher.

Plus its only for ten years, so after ten years guess whats likely to happen?

I just dont get why we dont have a tax credit for health care. We have a credit for damn near everything else (Education, Child Care) why not just have another one. You get X dollars per dependent. It allows some freedom, while also making it easily affordable.

cabernetluver
05-12-2009, 10:55 AM
Why wouldnt they all work at it? If we have national health care that health care has to come from someone meaning more work for them.

Its not really the health care people being nice by "cutting 2 trillion in costs" its them lowering the percentages which in turn brings more work which in turn means more profit. Their profit percentage may not be as high but their overall profit will be higher.

Plus its only for ten years, so after ten years guess whats likely to happen?

I just dont get why we dont have a tax credit for health care. We have a credit for damn near everything else (Education, Child Care) why not just have another one. You get X dollars per dependent. It allows some freedom, while also making it easily affordable.

The problem is more complex than that. Starbucks said in 2005 that they spent more money on health insurance than they did on coffee beans.

It is a systemic problem that requires a systemic approach. If the system is out of control then your tax credit idea will just feed an out of control system.

I am not blaming any segment as the standout problem, but instead I am blaming the entire system. We spend as a nation more money per capita on health care than any other nation, but we are not getting results.

This is one of those problems that reminds me of the trusts that Teddy Roosevelt broke. Some problems need to have that kind of approach to make them work.

lakersrock
05-12-2009, 02:02 PM
You are missing some information that I will be glad to give you. I am sure having read many of your comments that you will not be surprised that 38% of the work force is now employed by small business. What you may not know is that less than 2/3 of those companies offer health insurance to their employees (The Henry J. Kaiser Family Foundation. The Uninsured: A Primer, Key Facts About Americans without Health Insurance. January 2006. ttp://www.kff.org/uninsured/). 266,000 companies dropped health insurance benefits from 2000-2005, with 90% of those having less than 25 employees.

A third of all firms did not offer health insurance in 2007 (The Henry J. Kaiser Family Foundation. Employee Health Benefits: 2008 Annual Survey. September 2008. http://www.kff.org/insurance/7672/index.cfm).

You want more information? Or do you just want to express your opinion based on your opinion?

...and most of those have a spouse and might have insurance through them. Do you have a stat for that? My mom's health insurance from her employer is crazy high, so she's on my dad's. People can get health coverage if they want to. It's just most would rather say oh darn, there is absolutely no way I can get it...help me government. I work at a terrible job that makes $7 an hour and I have full health benefits. People can get them if they want to. I'm about as poor as they come and I can afford it.

cabernetluver
05-12-2009, 02:09 PM
...and most of those have a spouse and might have insurance through them. Do you have a stat for that? My mom's health insurance from her employer is crazy high, so she's on my dad's. People can get health coverage if they want to. It's just most would rather say oh darn, there is absolutely no way I can get it...help me government. I work at a terrible job that makes $7 an hour and I have full health benefits. People can get them if they want to. I'm about as poor as they come and I can afford it.

I can't have a conversation with you when I quote statements from respected organizations and you don't. I am sorry that you have a terrible job, but, what does that have to do with the facts that I quoted from the studies of non profit, non political health foundations?

Neither you nor I hold any standing when compared to these well respected groups. You are entitled to your opinion, but the overwhelming body of evidence is not on the side you are taking.