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ObamaCare
Выжимки из последней речи Обамы, описывающие его план здравоохранения. В речи полно всяческого булшита (может, напишу отдельный пост про него), однако он мне менее интересен, чем б-м четкое описание плана Обамы.
1. If you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have.
2. It will be against the law for insurance companies to drop your coverage when you get sick /.../ They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses /.../ And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies.
3. For those individuals and small businesses who still cannot afford the lower-priced insurance available in the exchange, we will provide tax credits, the size of which will be based on your need.
4. In the meantime, for those Americans who can't get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill.
5. Individuals will be required to carry basic health insurance – just as most states require you to carry auto insurance. Likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers. There will be a hardship waiver for those individuals who still cannot afford coverage, and 95% of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements.
6. There are also those who claim that our reform effort will insure illegal immigrants. This, too, is false – the reforms I'm proposing would not apply to those who are here illegally.
7. And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.
8. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear – it would only be an option for those who don't have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up.
9. I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects.
10. I will not sign a plan that adds one dime to our deficits – either now or in the future. Period. And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize.
11. Not a dollar of the Medicare trust fund will be used to pay for this plan.
12. Much of the rest would be paid for with revenues from the very same drug and insurance companies that stand to benefit from tens of millions of new customers. This reform will charge insurance companies a fee for their most expensive policies.
13. Add it all up, and the plan I'm proposing will cost around $900 billion over ten years. /.../
14. Creating a new insurance exchange – a marketplace where individuals and
small businesses will be able to shop for health insurance at
competitive prices./.../As one big group, these customers will have greater leverage to bargain
with the insurance companies for better prices and quality coverage.
Я сомневался, включать ли это последнее в список конкретных предложений, т.к. механизм exchange не описан и совершенно непонятен - каким образом можно сочетать individuals shop for insurance и one big group?
1. If you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have.
2. It will be against the law for insurance companies to drop your coverage when you get sick /.../ They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses /.../ And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies.
3. For those individuals and small businesses who still cannot afford the lower-priced insurance available in the exchange, we will provide tax credits, the size of which will be based on your need.
4. In the meantime, for those Americans who can't get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill.
5. Individuals will be required to carry basic health insurance – just as most states require you to carry auto insurance. Likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers. There will be a hardship waiver for those individuals who still cannot afford coverage, and 95% of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements.
6. There are also those who claim that our reform effort will insure illegal immigrants. This, too, is false – the reforms I'm proposing would not apply to those who are here illegally.
7. And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.
8. But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear – it would only be an option for those who don't have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up.
9. I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects.
10. I will not sign a plan that adds one dime to our deficits – either now or in the future. Period. And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize.
11. Not a dollar of the Medicare trust fund will be used to pay for this plan.
12. Much of the rest would be paid for with revenues from the very same drug and insurance companies that stand to benefit from tens of millions of new customers. This reform will charge insurance companies a fee for their most expensive policies.
13. Add it all up, and the plan I'm proposing will cost around $900 billion over ten years. /.../
14. Creating a new insurance exchange – a marketplace where individuals and
small businesses will be able to shop for health insurance at
competitive prices./.../As one big group, these customers will have greater leverage to bargain
with the insurance companies for better prices and quality coverage.
Я сомневался, включать ли это последнее в список конкретных предложений, т.к. механизм exchange не описан и совершенно непонятен - каким образом можно сочетать individuals shop for insurance и one big group?
no subject
а) Из п. 2 и п. 9 очевидным образом следует, что страховые компании должны будут повысить премии -- или разориться.
б) Каким образом он собирается выполнить пп. 3 и 4 -- и п. 10 одновременно?
в) Если публике дадут возможность покупать медстраховку на свободном рынке (бирже), то у меня нет сомнений, что там очень скоро появятся affordable предложения от разного рода мошенников -- как у нас на рынке ОСАГО.
no subject
б) очень просто - одна из черепашек врет. Т.е. деньги будут выделяться, натурально, из бюджета, но будут проведены так, что прямой связи между дефицитом и этими деньгами не будет. Можно, например, сказать, что деньги произошли от сокращения программ на X, a дефицит - от увеличения программ Y, которое необходимо из-за сокращения программ X. В общем, там не дураки сидят, найдут способ.
в) это будет не рынок, а exchange - доступ на который будет контролироваться. Разумеется, мошенничество будет quantum satis - как полно его в Медикере, но, думаю, не в той форме, как на российском рынке.