Morning Reads for Tuesday, January 10
Good morning! If you have children at home, I hope for everyone’s sake that they’re back in school today – and that’s one more reason why we need to keep the Albany area in our thoughts, since school there won’t resume until January 17. Power outages are still widespread, and cleanup continues more than a week after fierce storms and a tornado touched down in Albany, and affected residents can find resources here.
- Macon-Bibb County will vote next week to accept a subsidy that will bring nonstop flights to Washington, D.C. to Middle Georgia Regional Airport.
- The AJC’s Cheetah story will undoubtedly be fascinating as it unfolds.
- Atlanta’s Brenda Wood discusses her plans for retirement following an award-winning career in journalism.
- Port Wentworth gets the Savannah area’s first diverging diamond interchange next week.
- The Augusta Commission considers a “ban the box” for city job applications.
- As many as sixteen Jewish community centers in the eastern U.S. received bomb threats yesterday.
- Rex Tillerman’s “theatrical” management style. (The WSJ’s dateline is fantastic.)
- Meanwhile, in the Trump inner circle, the Mercer legacy is complete.
- It’s the end of an X-er are as the Limited closed all its stores.
- You’ve probably seen pictures of the famous “tunnel tree” in California – maybe you’ve even walked through the ancient sequoia. Unfortunately, it was felled by the storm that ravaged northern California over the weekend.
About Author
Teri
Teri Anulewicz is a Democrat who represents House District 42 in the Georgia General Assembly. She previously spent nearly a decade on the Smyrna City Council. A native New Orleanian and quasi-Texan, Teri graduated from Agnes Scott College in 1998. She's been a front page contributor since 2015, and she compiles each Tuesday's Morning Reads.
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Ban the Box? Really? Can you say “Negligent Hiring Lawsuits?” ALL employers have the right to make informed hiring decisions. Period. That includes criminal record checks, credit checks and driving records. And employment histories. How many companies have been intimidated over the years into not giving any derog info on a past employee for fear of that crippling lawsuit? That’s BS. If it’s good enough for US gov’t security clearance investigations, it’s good enough for private-sector Joe’s Widgit Company, too.
2,000 plus days since Obamacare was enacted, and the GOP doesn’t have an alternative. Some in the GOP are proposing Obamacare be repealed now, and the replacement be figured out later. That’s not repeal and replace, but cut and run.
It is so funny to watch you guys whine and cry like my toddler.
For some reason I’m not allowed to attach links to my comments so you can use the Google machine and look up Tom Price’s HR 2300 and the House GOP Better Way plan for healthcare. Those two plans will form TrumpCare. You will have it soon, but read those two plans to see what the beginnings will look like.
I know you won’t read them, but I really don’t care. It’s coming whether you like it our not.
They have to do that, Eiger. They must repeat the lie – “there’s no replacement plan” – over and over. Price and others have a better plan. Had it for years. The.libs.will.never.stop.
“Legislation offered by Rep. Tom Price (R-GA) that would repeal Obamacare and replace it with patient-centered healthcare reform would save taxpayers nearly $2.34 trillion over the next 10 years, according to an independent analysis by a former Congressional Budget Office director.”
http://www.unitedliberty.org/articles/15817-tom-prices-obamacare-replacement-saves-234-trillion-over-10-years
Sure thing. Don’t worry. It will be law soon. I guess we will just have to pass the bill to see what’s in in right.
^^ Good one!
There is also this little nugget from the CBO and Forbes.
“The most important improvement is a universal tax credit, adjusted by age, to every American who chooses to buy individual health insurance: $1,200 for those aged 18 to 35, $2,100 for those between 35 and 50, $3,000 for those over 50 and $900 per child. Dr. Price’s previous bill had tax credits, which were not adjusted by age, but by income. Of course, Obamacare’s tax credits phase out by income, which causes very high effective marginal income tax rates at certain income thresholds.”
“According to the Congressional Budget Office (CBO), this creates a disincentive to work that will lead to 2.5 million fewer full-time equivalent jobs once Obamacare is fully implemented. Dr. Price’s previous bill did not impose effective marginal income tax rates as harmful as Obamacare’s, but any phasing out of a benefit will have this effect to a degree. Allowing anyone to claim the same tax credit without fear of being penalized for increasing his working hours is very positive.”
http://www.forbes.com/sites/theapothecary/2015/05/26/prices-empowering-patients-first-act-gets-better-with-age/#26afcaa7ec31
“I believe Price’s system is flawed.” Got it. Thanks.
You still never address the costs of providing healthcare. Only paying for the costs of healthcare. Those are two very different things. Again, Price’s plan addresses both.
It’s mainly becasue I have no desire to try to convince someone who doesn’t want to be convinced. But I’ve now had my Costco hotdog and my snarkyness is fading with the caffeine so I will try. Only for the benefit of the others who may be reading.
I’ll post something at the bottom of the thread in a few minutes.
Just throwing out a concept here. Would it be feasible for Insurers to price their plans based on length of time with the insurer?
The longer you are with an Insurer, the lower the rate. This could provide a consumer incentive to start insurance early and build loyalty. No fair dropping plans and forcing subscribers into higher premiums with less benefits, like the old days. Long time subscribers would get lower premiums even if the insurance co. changed plans with shifting laws or other healthcare reforms.
That is a very innovative and worth looking into idea. But alas, it would be illegal under Obamacare. That is what is wrong with too much government restriction and regulation. It stifles innovation.
Under Tom Price’s plan, insurance companies would be free to test ideas like yours to held build a relationship with the individual that you just don’t get now with health insurance.
Under Obamacare, they are told what to sell and at what price. That stops innovation.
Not sure why they didn’t try this pre-ACA to boost participation. Supplemental policies (ex. Cancer, disability, injury) offered by AFLAC and other companies used this pricing model. Stay with the plan, rate never changes. Of course, these policies provide limited benefits for specific health events, not full insurance.
I look forward to a new thread on Health insurance reform here soon. I have expressed my frustrations with individual coverage pre-ACA to current day in the old PP posts. My letters to Congressional representatives were kindly ignored from both parties.
It’s always been an aggravation of mine that companies offer incentives to get new customers but not to loyal long-term customers.
Yep. State Farm was unwilling to help us after thirty years of being a “good customer” because of a minor, auto damage claim to a parked car. They discovered the driver had a few uncontested, but paid, moving violations – too many “points” on their record. State Farm decided to drop the driver over this, despite no moving accidents ever.
Our family exercised proper revenge by dropping four vehicles from State Farm.
You are right, we shop for better rates every few years since someone else always wants new business.
This is a perfect example of what is wrong with healthcare. If you have employer based health insurance you can’t shop around like you did for your car insurance.
Price’s plan allows you to own your insurance plan and take it with you if you switch jobs or if you just want to shop for a better plan. You can’t do that now becasue your HR rep at the company you work for decides what plans you get to choose from and not you. Soon you will be able to shop health plans like you do for car insurance. And not just the three plans offered on the Ocare exchanges.
“Under Trumpcare you can elect to opt out of employer-provided insurance and buy an individual policy, but you could already do that under Obamacare.” Correct, but Price’s plan allows for a mechanism for the employer to continue to contribute to a portion of an employees health insurance premiums. Now if you opt out of you coverage there is no mechanism for your company to continue to help pay a portion of your premiums.
I’m only on the 3rd section, the first two devoted to repeal, and then this:
“Nothing in this Act shall be construed to provide a mandate for guaranteed issue or community rating in the private insurance market.”
Hm. So insurers don’t have to insure everyone?
Keep reading. The difference between democrats and republican is you like to force things on people with a stick. We like to entice people with a carrot. The carrots are coming.
Also, by not forcing insurers to insure people with costly and unwanted plans you are able to have cafeteria style plans that are much cheaper that people can afford and encourage people to buy those plan with carrots.
Next question.
“So yes, Price’s plan will lead to cheaper costs, but it will do so by allowing insurers to offer less coverage and kicking millions of Americans off of their existing health insurance.” You mean the plans with deductibles and premiums so high that it’s like you are paying out of pocket for everything anyway vs. plans that are more targeted with what they cover and are cheaper? Yep you are right.
Your entire thought process is flawed. It is all about insurance coverage and covering high healthcare costs. You never address why providing healthcare (not insurance) is expensive and how to drive those costs down. Price’s plan does that.
“To be fair, I’ve addressed a number of issues with far more specificity than you have.” Sure, you have tried. I can continue to point to you HR 2300, but I just don’t feel like it.
We will continue to disagree on what works and what doesn’t. We will never reconcile those differences. The democrats had their chance to address healthcare and it failed. Now the republicans will have theirs.
You will never convince me that more mandates and more government intervention will solve the problems we face with regards to healthcare and health insurance. Just like I will never convince you that an orthopedic surgeon turned Congressman may know what he is talking about when he talks about providing healthcare and the costs of providing that healthcare.
I don’t need to convince you that you are wrong. You will get to see that you are wrong will the bill becomes law.
The Feds should not give Macon a 4.7 million dollar annual subsidy for flights to Washington or flights anywhere. It’s another waste of taxpayer money.
Congrats to that team from the Palmetto State last night (or, early this morning, depending on your time zone) whose quarterback shredded the defense of the famed Crimson Tide.
“We are going to have an unbelievable, perhaps record-setting turnout for the inauguration, and there will be plenty of movie and entertainment stars. All the dress shops are sold out in Washington. It’s hard to find a great dress for this inauguration.” – Trump
Lucky for Giuliani he bought early.
I’m hoping Port Wentworth has traffic cams up and running… going to be a busy DWI catching point at the new DDI.
Saw some of the Sessions confirmation hearing. So far, he is doing a good job. Dems want to talk about abortion, racism, deportations and gays while Sessions talks about crime and enforcing the law.
Sessions said repeatedly that he will enforce the law but let the Dems continue their silliness. Sessions will be confirmed by the full senate with some Dems voting for confirmation.
When discussing healthcare there are two very different angles that have to be addressed. First and what I would say is the most important are the cost drivers to actually providing healthcare. The second angle would be that of how to pay for health insurance. I’ll address the second one first though just to be complicated and because that is what you have been focusing on.
The Empowering Patients First Act makes it so that it is finically feasible for everyone to afford a health insurance package that fits their own personal needs. It does this with a combination of tax credits including refundable tax credits and advance able refundable tax credits. As well as promoting personal savings for healthcare use with HSAs.
Sec. 101. Refundable Tax Credit for Health Insurance Coverage
_ Provides for refundable, age adjusted tax credits with amounts tied to average insurance on individual market adjusted for inflation.1
o $1,200 for those between 18 to 35 years of age
o $2,100 for those between 35 and 50 years of age
o $3,000 for those who are 50 years and older
o $900 per child up to age 18
_ Tax credits would be available to those who purchase health insurance through the individual market. Upon purchase, individuals would have the option of receiving an advanceable, refundable credit.
_ Defines qualified health insurance (in order to qualify for a tax credit) as any insurance that
constitutes medical care (i.e., major medical, qualified coverage in the state of purchase) but does not solely include excepted benefits as defined in section 9832(c) of the Internal Revenue Code (IRC), such as wrap around, vision-only or disease specific plans.
_ The credit is not available to those receiving federal or other benefits including:
_ Medicare, Medicaid, SCHIP, TRICARE, VA benefits, FEHBP, or individuals in employer subsidized
group plans
_ Prohibits an individual who is not a citizen or lawful permanent resident from receiving a credit.
_ Provision to make sure it is only one benefit and there is no extra payout, double benefit rule.
Sec. 111. Refundable Tax Credit for Health Savings Account Contributions
_ Incentivizes the use of HSAs with a one-time $1000 tax credit
Sec. 112. Allowing HSA Rollover to Child or Parent of Account Holder
_ Allows an account holder’s HSA to rollover not only to a surviving spouse, but also to a child, parent,or grandparent
Sec. 113. Maximum Contribution Limit to HSA Coordinated with Retirement Savings Account
Limitation
_ Increases the allowable HSA contribution to be equal to the maximum IRA contribution level
HR 2300 also addresses insurance costs by making it easier to pool together so that individuals have greater purchasing power.
Sec. 202. Pool Reform for Individual Membership Expansion
_ Establishes Independent Health Pools (IHPs) in order to reform and expand enrollment in health
insurance coverage in the individual and small group markets.
_ Amends the Public Health Service Act to allow individuals to pool together to provide for health
insurance coverage through IHPs.
_ An individual may enroll for health insurance coverage (including coverage for dependents of such individual) or an employer may enroll employees for health insurance coverage (including coverage for dependents of such employees) offered by a health insurance issuer through the IHP.
_ IHPs are formed as legal nonprofit entities that:
o Have been formed and maintained in good faith for a purpose that includes the formation a risk
pool in order to offer health insurance coverage to its members.
o Do not condition membership in the IHP on any health status-related factor relating to an
individual (including an employee of an employer or a dependent of an employee).
o Do not make health insurance coverage offered through the IHP available other than in
connection with a member of the IHP.
o Are not health insurance issuers, and do not receive any consideration directly or indirectly from
any health insurance issuer in connection with the enrollment of any individuals, or employees
of employers, in any health insurance coverage (except for consideration received in direct
conjunction with services offered through the IHP).
Sec. 211-216. Small Business Health Fairness Act
_ Association Health Plans (AHPs) allow small business owners to band together across state lines
through their membership in a bona fide trade or professional association to purchase health coverage for their families and employees at a lower cost. Increases small businesses’ bargaining power, volume discounts and administrative efficiencies while giving them freedom from state-mandated benefit packages.
_ Requires solvency standards to protect patients’ rights and ensure benefits are paid.
o Requires AHPs to have an indemnified back-up plan to prevent unpaid claims in event of plan
termination.
o Requires AHPs to undergo independent actuarial certification for financial soundness on a
quarterly basis.
o Requires AHPs to maintain surplus reserves of $2 million above normal claims reserves
It increases competition across state lines so that insurance companies have to compete nationally and can’t chop the country into smaller monopolies.
Sec. 301. Cooperative Governing of Individual Health Insurance Coverage
_ Increases access to individual health coverage by allowing insurers licensed to sell policies in one
state to offer them to residents of any other state.
_ Allows consumers to shop for health insurance across state lines, just like other insurance products –online, by mail, by phone, or in consultation with an insurance agent.
The whole idea is not to tell people what they must have and what the insurance companies must sell it for. The idea is to free up the market so that insurance companies truly have to compete. You do this by allowing people to own their own insurance so that insurance companies are looking to do business with an individual and not a HR representative. You allow companies to sell a greater variety of products so that people can pick and choose what works best for their family and their finances.
Now, you have to address the cost drivers to providing healthcare. This is my biggest gripe with liberals. They say, “healthcare cost too much so let’s figure out a way too have to government pay for it.” Instead you should say why does healthcare cost so much and what is driving that cost. The Empowering Patients First Act asks those questions and addresses them. I know you won’t like this next part, but bear with me.
Defensive medicine is the largest cost driver of providing healthcare. No doctor likes to be sued or wants to be sued so they all do more than what is needed. This costs money. I will stop here and tell you that I used to be of the belief that capping noneconomic damages in lawsuits would solve this. It hasn’t and won’t stop the practice of defensive medicine and to be honest you never will stop all defensive medicine. But you can try to stop most of it and Tom Price’s bill does that by allowing specialist societies to formulate a standard of care for procedures that can be held up in a court of law as a defense. It also allows for the creation of administrative health care tribunals that will make recommendations on liability and compensation.
Sec. 401. Change in Burden of Proof Based on Compliance with Clinical Guidelines
_ The Secretary of Health and Human Services shall enter into a contract with a qualified physician
consensus-building organization, such as the Physician Consortium for Performance Improvement
(PCPI), in concert and agreement with medical specialty societies, to develop clinical guidelines for
the evaluation and/or treatment of medical conditions.
o The PCPI (convened by the AMA and comprised of over 100 medical specialty societies, state
medical societies, AHRQ, CMS, and others) works on quality of care and patient safety through
the development, testing, and maintenance of evidence-based clinical performance measures
and resources for physicians.
_ Secretarial review and approval: The Secretary shall issue, by regulation, after notice and opportunity for public comment, clinical guidelines endorsed by medical specialty societies.
o Limitation: The Secretary may not make a rule that includes guidelines other than those
approved and submitted by physician specialty organizations.
_ Clinical guidelines shall be publicly available.
_ Clinical guidelines shall be updated regularly, at least every two years.
_ Clinical guidelines provide for a safe harbor if a defendant adhered to the appropriate clinical
guidelines, a defendant will not be held liable unless clear and convincing evidence establishes
liability otherwise.
_ Clinical guidelines may be used by a defendant as an affirmative defense in a lawsuit relating to
medical treatment.
_ Clinical guidelines may, by a preponderance of the evidence, demonstrate that the treatment provided was consistent with those guidelines. This safe harbor will apply in federal courts and in any state action, if such claim concerns items or services with respect to which payment is made under Medicare, Medicaid, SCHIP, or for which the claimant receives a federal tax benefit.
Sec. 402. State Grants to Create Administrative Health Care Tribunals
_ Secretary may award grants to States for the development and implementation of administrative
health care tribunals.
_ Each case must first be reviewed by a panel of experts made up of 3-5 members (at least half
physicians or health care professionals), selected by a state agency responsible for health.
_ The panel will make a recommendation about liability and compensation. The parties may then
choose to settle or proceed to the tribunal. The panel cannot recommend a finding of negligence from the mere fact that a treatment or procedure was unsuccessful or failed to bring the best result. Each tribunal must be presided over by a special judge with health care expertise, selected by the state. The opinion of the expert panel may be admitted before the tribunal. This judge will have the authority, granted by the state, to make binding rulings on standards of care, causation, compensation, and related issues.
_ The legal standard for the tribunal will be gross negligence. No preliminary finding by the panel that the defendant breached the standard of care as set forth under the practice guidelines shall constitute negligence per se or conclusive evidence of liability.
_ In any health care lawsuit in which the attorney for a party claims a financial stake in the outcome by virtue of a contingent fee, the court may restrict the payment of a claimant’s damage recovery to such attorney, and to redirect such damages to the claimant based upon the interests of justice and principles of equity.
_ Prevents a physician’s apology from being used as evidence against a physician showing liability.
_ Provides for proportional damages. Each party shall be liable only for the amount of damages
allocated to such party in direct proportion to such party’s percentage of responsibility.
_ If either party is dissatisfied with the tribunal’s decision, that party may appeal the decision to a state court, to preserve a trial by jury. Any determinations made by the panel and the tribunal will be admissible in state court.
o At that point, any party filing an action in state court must forfeit any compensation awarded by
the health care tribunal.
o No state may preclude any party from obtaining legal representation
I apologize for the length and doubt anyone will actually read all of this, but here you go. There are other cost drivers to healthcare that this bill doesn’t address for a number of reasons. The cost of prescription drugs being one of those things. But that is for another post. I’m tired of writing.
I appreciate you reading it and do enjoy a good debate. You are right that we fundamentally disagree on what will drive down costs. I deal with this daily as well so I’ve seen how the ACA has harmed providers. This is more than a political battle to me. It’s personal.
By the way, if you are having trouble with the FDA you should ask Tom Price’s office for help. As the other thread shows he’s willing to help people fight the FDA. Don’t tell anyone that you asked for his help. They may accuse you of asking for special treatment and say you are a crook.
Why would Macon/Bibb County not accept the $4,700,000 federal grant to allow air service to DC? Do they have any skin in the game? Notice that this isn’t even called a subsidy any more, simply a grant. Free money! In particular for the airline who can profit whether they actually haul anyone or not. While not a significant portion of the federal budget it still rankles that this program still chugs along.
It’s as if this whole thing is lifted from several different South Park episodes.