Source: Medpage Today
Union leaders have recently endorsed the current version of the federal healthcare reform legislation bill following a deal with the White House concerning the tax on high-cost insurance plans, possibly indicating a real breakthrough in negotiations on a final bill.
Union leaders had said they couldn’t support the Senate bill because it taxes high-cost, so-called Cadillac insurance plans, which are common among union members.
In many cases, unions negotiated high-benefits plans with employers in lieu of pay raises, so taxing the Cadillac plans would be unfair, labor leaders said. Even though insurance companies would pay the tax, the unions believe the cost would be passed on to workers.
But officials from major unions, including the AFL-CIO, National Education Association, and Service Employees International Union, announced Thursday they reached a deal with the president under which they could accept a tax.
The unions and the White House agreed on a higher threshold for what defines a Cadillac plan: $8,900 instead of $8,500 for an individual and $24,000 rather than $23,000 for a family of four. The tax rate remains 40% but it would hit fewer people.
The average health insurance policy in 2009 cost $13,375, according to the Kaiser Family Foundation.
INSURANCE FOR YOUR INSURANCE?
For starters, experts say diet and stress are the number-one causes of heart disease, which is a leading cause of death in America. Since there could be a component in this new package or following versions that rewards those who pass certain healthy standards tests, it’s probably would be a good idea to start thinking about preventive measures, like taking supplements, such as HCC drops, which is a homeopathic option for losing weight. The HCC drops diet plan is one of many organic approaches to lowering obesity levels, which is a serious issue not just for adult Americans, but their children as well. And, because they come in drops, they pack lightly and are convenient for travel anywhere.
Dental and vision care would also be excluded in determining the total cost of the plan. In addition, plans that contain a high proportion of women and elderly will receive special treatment so they are not automatically taxed more just because they include larger numbers of people expected to have higher healthcare costs.
The deal also shields unions that secured their insurance plans through collective bargaining with an eight-year grace period during which their plans would be exempt from the tax. Critics of the deal characterized the long transition period as a “special deal” for labor unions.
The compromise earned the White House and Democrats in Congress the important endorsement of the powerful labor unions. It comes with a price, however: $60 billion over 10 years.
That is the difference between the revenue the original plan would have brought in compared with the new plan. Originally, the excise tax was expected to raise $150 billion over 10 years, but now it will likely raise $90 billion, AFL-CIO President Richard Trumka told reporters during a press call.
But President Obama never viewed the excise tax as a revenue-builder, said a senior administration official. The tax will still accomplish the goal of slowing future healthcare spending by offering a disincentive for companies to offer Cadillac plans, the official told reporters.
The House bill doesn’t contain the excise tax. Its main revenue-builder is a surtax on individuals earning more than $500,000 and couples earning more than $1 million.
“Everyone agrees we’ve taken a big step forward to moving this to conclusion,” White House Communications Director Dan Pfeiffer told reporters on Thursday evening.
Still, a few sticking points remain as House and Senate leaders negotiate the final package, including how the “insurance exchanges” will be structured.
The exchanges are meant to act as a central marketplace where consumers can buy insurance plans. The House version would create a single, national exchange, while the Senate would establish separate exchanges in each state.
The President visited House leaders during their annual “issues conference” on Thursday evening to give a speech that stressed the importance of passing healthcare reform. According to an aide who was present in the closed-door question-and-answer session following the speech, the excise tax was not discussed.
The president did, however, express his support for a single, national health insurance exchange, the aide said.
During the speech itself, Obama talked about the tragedy in Haiti and domestic job creation as well as healthcare legislation.
The final reform bill is expected to be sent to the Congressional Budget Office on Friday or Saturday. House leaders have vowed to make the package available for review for 72 hours before it takes a vote.
The House bill was passed in November. The Senate passed its version on Christmas Eve.
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My take: I’ve got my reasons for thinking real healthcare reform is still light years away, given the pace at which the issue has evolved over the last decade. I’ve traveled all over the world and lived in the UK, where there has been a state-wide system for healthcare for all for decades. And, while it may not always be the best of the healthcare available, average citizens don’t have to worry if they break their leg in a car accident or fall down a mountain hiking in the English countryside.
But traveling or not, my approach to healthcare is healthy living first. That means I do whatever I can to take ownership of my health by watching my diet and exercising. Heart attacks are deadly and did you know that women are high at risk for having one? If you are over 50 and haven’t exercised in a while but are going to start, ask your doctor about an exercise stress systems analysis. Between that and an electronic health record system you could do a great deal to help decrease your risks.
There are lots of options for exercise out there and not all of them are right for everyone. Some of my friends are heavily committed to the Alexander Techique for stress. What is that, you ask? The Alexander Technique is a long-established kind of breathing and posturing practice that is said to help reduce stress while realigning your spine and addressing stiff joints and other common health issues.
Meditation is one of my favorite ways to distress and take control of health. I don’t always find time for it during my crazy week, but when I can’t sit for 10 or 15 minutes and listen quietly for that balanced spot in my head, I use a shortcut: long baths or just a few minutes sitting quietly with candles burning. My favorites right now are the Scentsy wickless candles. These Scentsy scented candles smell so good and are easy to use.
Even doctors get stressed. And, those that do may want to offer a low-key approach to decorating their offices and making their environments more “homey.” They could try the old school wooden signs that tend to ease and comfort patients. These are kind of like the old fashioned lake house sign you’d see at those fabulous lake getaways in the Catskills for example, only customized with their name or common sayings relating to doctor patient relationships. Think of them as bar signs personalized for the waiting room or exam room, but with light-hearted jokes or slogans that are designed to help everyone do more of what experts say also lowers stress levels: laugh.
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