Friday Music Break: Counting Crows, “A Long December”

Friday Music Break: Bing Crosby, “White Christmas”

The movie is Holiday Inn.  Martha Mears sings with Crosby, although it’s Marjorie Reynolds on screen.  More info on the song here.

Merry Christmas!

Is the Senate Bill Constitutional?

Of course it hinges on how you interpret the commerce clause.  Constitutional Law Prof provides some comments and links.

Pentagon: Private Contractors Too Expensive

From the Washington Post:

The Defense Department estimates it will save an average of $44,000 a year for every contractor it replaces with full-time federal personnel to perform critical defense jobs, according to the House-Senate conference report on the fiscal 2010 defense appropriation bill.

The measure, which passed Congress on Saturday, contains $5 billion to hire replacements for contractors currently performing what have been termed “inherently government functions” both at home and abroad. Those functions include a wide range of activities, from supervising other contractors who provide guard services at forward operating bases, to providing oversight of aid projects overseas.

Stories like this give the lie to the Conservative Doctrine that the private sector can always do things more cheaply and efficiently than the government.  Sometime it can.  And sometimes, it just ain’t true.

Ezra Klein: How Long Can You Go Without Solving Your Problems?

Full article here.

But the basic problem in America is not courage or cowardice, but systems that are no longer suited to the needs of the country. At this point, structural reform of the legislative system should, I think, be the main priority for people left, right, and center who want to see action on the problems facing the country. It’s all well and good to try to get the best outcomes possible given the existing constraints. But if those outcomes aren’t good enough, then at some point you have to turn your attention away from the problems and toward the constraints that are keeping you from solving them.

Klein quotes Friedman’s article on Copenhagen.

Comparing the House & Senate Health Care Bills

From the Associated Press.  CNN has an article about it here.

Senate Bill	House Bill
Who’s Covered
About 94 percent of legal residents under age 65 — compared with 83 percent now. Government subsidies to help buy coverage start in 2014. Of the remaining 24 million people under age 65 left uninsured, about one-third would be illegal immigrants.	About 96 percent of legal residents under age 65 — compared with 83 percent now. Government subsidies to help buy coverage start in 2013. About one-third of the remaining 18 million people under age 65 left uninsured would be illegal immigrants.
Cost
Coverage provisions cost $871 billion over 10 years.	The Congressional Budget Office says the bill’s cost of expanding insurance coverage over 10 years is $1.055 trillion. The net cost is $894 billion, factoring in penalties on individuals and employers who don’t comply with new requirements. That’s under President Barack Obama’s $900 billion goal. However, those figures leave out a variety of new costs in the bill, including increased prescription drug coverage for seniors under Medicare, so the measure may be around $1.2 trillion.
How It’s Paid For
Fees on insurance companies, drugmakers, medical device manufacturers. Medicare payroll tax increased to 2.35 percent on income over $200,000 a year for individuals, $250,000 for couples. A 10 percent sales tax on tanning salons, to be paid by the person soaking up the rays. Cuts to Medicare and Medicaid. Forty percent excise tax on insurance companies, keyed to premiums paid on health care plans costing more than $8,500 annually for individuals and $23,000 for families. Fees for employers whose workers receive government subsidies to help them pay premiums. Fines on people who fail to purchase coverage.	$460 billion over the next decade from new income taxes on single people making more than $500,000 a year and couples making more than $1 million. The original House bill taxed individuals making $280,000 a year and couples making more than $350,000, but the threshold was increased in response to lawmakers’ concerns that the taxes would hit too many people and small businesses.
Requirements for Individuals
Almost everyone must get coverage through an employer, on their own or through a government plan. Exemptions for economic hardship. Those who are obligated to buy coverage and refuse to do so would pay a fine starting at $95 in 2014 and rising to $750.	Individuals must have insurance, enforced through a tax penalty of 2.5 percent of income. People can apply for hardship waivers if coverage is unaffordable.
Requirements for Employers
Not required to offer coverage, but companies with more than 50 employees would pay a fee of $750 per employee if the government ends up subsidizing employees’ coverage.	Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payrolls under $500,000 annually are exempt — a change from the original $250,000 level to accommodate concerns of moderate Democrats — and the penalty is phased in for companies with payrolls between $500,000 and $750,000.Small businesses — those with 10 or fewer workers — get tax credits to help them provide coverage.
Subsidies
Tax credits for individuals and families likely making up to 400 percent of the federal poverty level, which computes to $88,200 for a family of four. Tax credits for small employers.	Individuals and families with annual income up to 400 percent of poverty level, or $88,000 for a family of four, would get sliding-scale subsidies to help them buy coverage. The subsidies would begin in 2013.
Benefits Package
All plans sold to individuals and small businesses would have to cover basic benefits. The government would set four levels of coverage. The least generous would pay an estimated 60 percent of health care costs per year; the most generous would cover an estimated 90 percent.	A committee would recommend a so-called essential benefits package including preventive services. Out-of-pocket costs would be capped. The new benefit package would be the basic benefit package offered in the exchange.
Insurance Industry Restrictions
Starting in 2014: no denial of coverage based on pre-existing conditions. No higher premiums allowed for pre-existing conditions or gender. Limits on higher premiums based on age and family size. Starting upon enactment of legislation: children up to age 26 can stay on parents insurance; no lifetime limits on coverage.	Starting in 2013, no denial of coverage based on pre-existing conditions. No higher premiums allowed for pre-existing conditions or gender. Limits on higher premiums based on age.
Government-Run Plan
In place of a government-run insurance option, the estimated 26 million Americans purchasing coverage through new insurance exchanges would have the option of signing up for national plans overseen by the same office that manages health coverage for federal employees and members of Congress. Those plans would be privately owned, but one of them would have to be operated on a nonprofit basis, as many Blue Cross Blue Shield plans are now.	A new public plan available through the insurance exchanges would be set up and run by the health and human services secretary. Democrats originally designed the plan to pay Medicare rates plus 5 percent to doctors. But the final version — preferred by moderate lawmakers — would let the HHS secretary negotiate rates with providers.
How You Choose Your Health Insurance
Self-employed people, uninsured individuals and small businesses could pick a plan offered through new state-based purchasing pools. Would generally encourage employees to keep work-provided coverage.	Beginning in 2013, through a new Health Insurance Exchange open to individuals and, initially, small employers. It could be expanded to large employers over time. States could opt to operate their own exchanges in place of the national exchange if they follow federal rules.
Drugs
Grants 12 years of market protection to high-tech drugs used to combat cancer, Parkinson’s and other deadly diseases. Drug companies contribute $80 billion over 10 years with the majority of the money used to limit the prescription coverage gap in Medicare.	Grants 12 years of market protection to high-tech drugs used to combat cancer, Parkinson’s and other deadly diseases. Phases out the gap in Medicare prescription drug coverage by 2019. Requires the HHS secretary to negotiate drug prices on behalf of Medicare beneficiaries.
Changes to Medicaid
Income eligibility levels likely to be standardized to 133 percent of poverty — $29,327 a year for a family of four — for parents, children and pregnant women. Federal government would pick up the full cost of the expansion during the first three years. States could negotiate with insurers to arrange coverage for people with incomes slightly higher than the cutoff for Medicaid.	The federal-state insurance program for the poor would be expanded to cover all individuals under age 65 with incomes up to 150 percent of the federal poverty level, which is $33,075 per year for a family of four. The federal government would pick up the full cost of the expansion in 2013 and 2014; thereafter the federal government would pay 91 percent and states would pay 9 percent.
Long-Term Care
New voluntary long-term care insurance program would provide a basic benefit designed to help seniors and disabled people avoid going into nursing homes.	New voluntary long-term care insurance program would provide a basic benefit designed to help seniors and disabled people avoid going into nursing homes.
Antitrust
Maintains the health insurance industry’s decades-old antitrust exemption.	Would strip the health insurance industry of a long-standing exemption from antitrust laws covering market allocation, price-fixing and bid rigging. The bill also would give the Federal Trade Commission authority to look into the health insurance industry at its own initiative.
Illegal Immigrants
Would be barred from receiving government subsidies or using their own money to buy coverage offered by private companies in the exchanges.	Would be barred from receiving government subsidies but permitted to use their own money to buy coverage offered by private companies in the exchange.
Abortion
The bill tries to maintain a strict separation between taxpayer funds and private premiums that would pay for abortion coverage. No health plan would be required to offer coverage for the procedure. In plans that do cover abortion, beneficiaries would have to pay for it separately, and those funds would have to be kept in a separate account from taxpayer money. Moreover, individual states would be able to prohibit abortion coverage in plans offered through the exchange, after passing specific legislation to that effect. Exceptions would be made for cases of rape, incest and danger to the life of the mother.	Private companies in the exchange could not offer plans covering abortion if those plans received federal subsidy money. Most plans in the exchange would be affected, because most consumers in the exchange would be using federal subsidy money to buy coverage. The new government plan could not offer abortion coverage. Insurance companies would be permitted to offer supplemental abortion coverage in separate plans that people could buy with their own money. Use of federal money for abortion coverage would be limited to cases of rape, incest or danger to the woman’s life.

Climate Change and Hacked E-mails: A Good Overview of What Really Happened

Public Option vs. Single-Payer

FactCheck.org looks at the differences between the public option and single-payer.

The so-called “public option” has taken several forms in several different health care bills this year in Congress. All of the proposals, however, would create a federal health care plan, something like Medicare, but for persons under age 65. Individuals and small businesses would be able to buy such a plan just as they would purchase a health care plan from a private insurance company.

* * *

The public option is drastically different from a single-payer health care system. Under a single-payer system, everyone in the country would have health coverage provided by the government, and private insurance largely would cease to exist. Like Medicare, the government would act as the insurer; doctors and hospitals would operate privately, receiving payments from public funds under such a nationalized health insurance system. (The group Physicians for a National Health Program provides details on how it believes such a system would operate in the U.S.)

Friday Music Break: Band Aid, “Do They Know It’s Christmas?”

Privacy Rights in Oklahoma

Regarding the Oklahoma abortion law (read about it here), and whether it violates women’s privacy, state senator Todd Lamb says, “Nothing in the Individual Abortion Form shall contain the name, address or information specifically identifying any patient . . . Nobody’s identity will be made known.”  Therefore, the law does not invade anyone’s privacy.

Lamb helped draft the legislation.

Here’s the problem with Lamb’s argument: there’s a lot more to privacy than your name.  The Individual Abortion Form collects a great deal of information.  Many of the questions are invasive.  Very few of them (if any) are medically relevant.  And all the answers will made available in an online database where the curious can potentially use the information to identify or misidentify someone in the community.  Lamb claims that since the patient’s name isn’t recorded or shared, there is no violation of privacy.  He is saying that your right to privacy ends with your name.  But if a peeping tom peers through your window to take photographs of you in your home, he violates your privacy even if he does not know your name.  In the same way, if a woman is required to volunteer information that will later be posted online, information she would not otherwise give up, because doctor’s don’t need it to perform the abortion, her privacy has been violated.

You can view the legislation here (PDF).  Go to page 8 to find the Individual Abortion Form.

Ostensibly, the goal of the legislation is to reduce the number of unwanted pregnancies and abortions in Oklahoma.  There are other ways to accomplish this goal, ways that do not involve an invasion of privacy.