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Wednesday, December 23, 2009

Is it worth it, or should we trash it?

The Senate version of the healthcare bill will add 10 million Americans to Medicaid eligibility. Peanuts? Maybe not for those 10 million people.

According to an MIT analysis, a family at the 36th percentile buying insurance through the exchange will see an annual premium drop from the $12,042 needed today in the open market to $1966 – from over $1000 per month to $163 per month or less for over one-third of the American people. That family's out-of-pocket annual maximum will drop from $12,600 under current law to $4200, and its total exposure to healthcare costs in a year will drop from 68% of annual income to 17%. Meaningless?

A family making virtually the same as the median national income – meaning the same as or better than 50% of the population, of course -- will see a premium drop of about 70%, from over $12000 to $3600, and the out-of-pocket maximum cut in half. Think about that: half the population will pay $300 or less per month for premiums compared to $1000 per month.

For two-thirds of the population, monthly premiums will drop by 30% or more (i.e., from $1000 per month to $700 for families at the 67th income percentile). Even people at the 74th percentile buying through the exchange -- solidly middle class -- will see a significant annual cost reduction.

That's a lot of people getting helped, especially a lot of low income people. That's not even counting the people who lose their jobs, people with young adults aged 26 or younger (who can now remain covered under their parents plan) who haven't been able to find a job in this market, or, of course, people threatened with inability to get insurance at all, broadly-stated exclusion riders or refusal to cover a major claim due to a pre-existing condition.

I'm sorry, but in my book Democrats opposing the bill because they are giving priority to making sure insurance companies don't get another cent, and in the process completely disregarding the enormous benefit for the kind of people we claim to care about, are throwing a bona fide hissy fit. That doesn't mean giving up the fight to add a Federal public option and make other changes – including my favorite for massively reducing national healthcare costs, a national, automatic, absolutely universal Federal catastrophic coverage plan that will once and for all take profit-making entirely out of covering people with the worst illnesses or injuries. But this needs to get done. It's time to circle the wagons, and start firing outside instead of at each other.

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