WEBVTT - President Obama's Health Care Plan: Soup to Nuts 0:00:00.280 --> 0:00:02.840 Brought to you by the reinvented two thousand twelve camera. 0:00:03.160 --> 0:00:07.520 It's ready. Are you welcome to Stuff you Should Know 0:00:08.119 --> 0:00:16.319 from House Stuff Works dot Com. Hey, and welcome to 0:00:16.320 --> 0:00:19.000 the podcast. I'm Josh Clark. With me, as always is 0:00:19.079 --> 0:00:23.160 Charles W. Chuck Bryant, Doctor. And with Charles W. Chuck 0:00:23.239 --> 0:00:27.040 Bryant is Molly Edmonds of Stuff Mom Never Told You Fame, 0:00:27.440 --> 0:00:30.560 one of our sister podcasts, and Molly has also been 0:00:30.600 --> 0:00:34.640 doing more research into healthcare reform than me, Chuck and 0:00:34.720 --> 0:00:38.400 Ram Emanuel Combine. So we're glad to have you here. Molly. 0:00:38.479 --> 0:00:40.760 I think I could take down but you could. He's 0:00:40.800 --> 0:00:44.200 a bulldog. Yeah, but I've seen you. Have you seen 0:00:44.240 --> 0:00:47.640 her leg wrestle? No, but startling. I've been behind me 0:00:47.960 --> 0:00:50.960 in front of her sights. Sure, I'm not a pleasant day. Yeah, 0:00:51.000 --> 0:00:53.680 I have to chuck it, which is why we're scared 0:00:53.720 --> 0:00:56.480 of Molly. But we're glad she's here, right Maum, I hope, 0:00:56.480 --> 0:00:58.880 So I hope you're glad I'm here. We're also glad 0:00:58.880 --> 0:01:02.600 you're here because, like the Necronomicon podcast, we intend to 0:01:02.640 --> 0:01:04.360 use you as a shield. Just to get that out 0:01:04.400 --> 0:01:08.000 of the way, let's talk about healthcare form. All right. 0:01:08.600 --> 0:01:11.000 I want to also say that we are not going 0:01:11.040 --> 0:01:13.800 to be discussing any of the politics in this one. 0:01:13.880 --> 0:01:18.080 This is part two, you lie. Except for that part. Um, 0:01:18.240 --> 0:01:19.880 We're not going to be discussing any of the politics. 0:01:19.920 --> 0:01:23.760 What we're gonna do is simply present, uh, the proposals 0:01:23.800 --> 0:01:26.600 that are in play right now. And then Part three 0:01:26.680 --> 0:01:30.880 is going to be criticisms, pros cons maybe other ideas 0:01:30.959 --> 0:01:33.840 for fixing the health care system. And then part four 0:01:33.880 --> 0:01:37.399 is what I'm excited about, myths and truths. Yes, yeah, 0:01:37.480 --> 0:01:40.759 we're going to be talking about just outright lies, things 0:01:40.800 --> 0:01:42.680 that are kind of on the fence, and things that 0:01:42.720 --> 0:01:46.400 actually are true but are discussing. Um, so let's talk 0:01:46.400 --> 0:01:50.480 about Obama's proposal. Is it even Obama's proposal? You know, 0:01:50.560 --> 0:01:53.840 Obama has made this a priority in his presidency, but 0:01:54.360 --> 0:01:56.560 big time, but he has not come down from on 0:01:56.720 --> 0:01:59.360 high with a massive plan for us all to reactive. 0:01:59.600 --> 0:02:02.000 You know who did do that? The Clintons. The Clintons did, 0:02:02.080 --> 0:02:05.800 that's right, and Moses Moses. Uh, that was on the 0:02:05.920 --> 0:02:09.399 third tablet right yea, Um there tablet was dropped. Yeah, 0:02:09.400 --> 0:02:13.440 the Clintons actually wrote legislation and we're peddling it around 0:02:13.440 --> 0:02:17.200 Capitol Hill in the nineties and it didn't work. That 0:02:17.200 --> 0:02:21.040 that plan didn't work, So clearly Obama learned from his predecessors, right, right, 0:02:21.080 --> 0:02:23.720 So Obama has laid out eight principles. This is what 0:02:23.760 --> 0:02:25.680 he did early on. I think this has gotten lost 0:02:25.720 --> 0:02:27.239 in all the hubbu but he came out with a 0:02:27.400 --> 0:02:30.399 principles UM and then left it to Congress as five 0:02:30.400 --> 0:02:33.440 companies from Congress to create plans. And then in the 0:02:33.480 --> 0:02:35.640 week we're recording this, he came out and made this 0:02:35.760 --> 0:02:38.400 mega speech that's come up with you know, all this attention. 0:02:38.440 --> 0:02:40.400 So now the week we're recording this, Obama has come 0:02:40.440 --> 0:02:42.040 back out with the speech and made it made it 0:02:42.040 --> 0:02:43.639 look like it's a little bit more of his plan, 0:02:43.720 --> 0:02:46.639 tried to wrestle control away from you know, the media spin. 0:02:46.720 --> 0:02:48.400 He's saying what he wants in a plan, what he 0:02:48.440 --> 0:02:51.640 doesn't want, what he's open to compromise about. UM. But 0:02:51.720 --> 0:02:54.280 let's start in campaign mode. He was he's definitely back 0:02:54.280 --> 0:02:57.959 from vacation. Yeah, yeah, So should we talk about his 0:02:58.040 --> 0:03:01.280 A proposals. Let's let's say, I mean, what we're talking 0:03:01.280 --> 0:03:06.320 about A thousand pages pages are so of legislation right now, right, 0:03:06.320 --> 0:03:09.400 we got we got two bills on the table from 0:03:09.400 --> 0:03:11.440 four committees. And when he says there are four committees 0:03:11.440 --> 0:03:14.080 who have come up with bills, one of the bills 0:03:14.160 --> 0:03:16.200 is a try committee bill, so that's where that comes from. 0:03:16.320 --> 0:03:18.960 Three committees came up with one bill um from the 0:03:19.000 --> 0:03:21.720 House HR three two zero zero, and then the Senate 0:03:21.760 --> 0:03:23.320 has a bill. I have to point this out. I'm sorry, 0:03:23.360 --> 0:03:25.560 Molly didn't even look at her notes to writt along 0:03:25.760 --> 0:03:30.440 that bill number. I'm just gonna excuse myself to dream 0:03:30.440 --> 0:03:32.600 about HR three two zero zero. I bet you do. 0:03:32.600 --> 0:03:34.359 At this point she didn't look at her notes again. 0:03:34.960 --> 0:03:37.320 And you know what I have anxiety dreams about is 0:03:37.360 --> 0:03:39.800 the upcoming Senate Finance Committee bills. So by the time 0:03:39.840 --> 0:03:42.400 people hear this, that bill might become might be out. 0:03:42.440 --> 0:03:45.280 It's the trifecta. It's the one everyone's waiting for because 0:03:45.280 --> 0:03:48.720 it's a bipartisan committee. Um being the Senate Finance Committee, 0:03:48.760 --> 0:03:50.120 they have to say how they're going to pay for it, 0:03:50.160 --> 0:03:52.280 which the other bills were not as on the hook for. 0:03:52.920 --> 0:03:56.840 So you know that's the one everyone's waiting on. Beta breath. Yeah. Actually, 0:03:56.880 --> 0:03:59.640 I saw today breaking news was that the chairman of 0:03:59.640 --> 0:04:03.560 that commit. The Democrat Max Bacchus basically said, we're pushing 0:04:03.600 --> 0:04:06.760 through with this very soon, and it doesn't matter if 0:04:06.800 --> 0:04:08.960 I have Republican sport or not. We're gonna push it 0:04:09.000 --> 0:04:11.400 through and we'll have it for a review by the 0:04:11.400 --> 0:04:15.040 twenty one September. So wow, that's the latest word. Yeah, 0:04:15.080 --> 0:04:18.160 I have dreams about Max. Now do you really that's nice? 0:04:18.520 --> 0:04:23.640 So um, anyway, that's a personal note. So Obama says, 0:04:23.880 --> 0:04:25.640 here the here are the eight things that he saw 0:04:25.680 --> 0:04:27.480 that he wanted in the plan. Okay, he wanted to 0:04:27.480 --> 0:04:31.240 assure affordable, quality health coverage for all Americans. You guys 0:04:31.279 --> 0:04:34.000 want to I'll do one, yeah, yeah, I'll go next. 0:04:34.240 --> 0:04:37.000 He wants to remove obstacles to coverage for people with 0:04:37.040 --> 0:04:41.600 pre existing conditions. He wants to invest in prevention and wellness. 0:04:41.920 --> 0:04:44.120 He wants to maintain coverage in the event of job 0:04:44.160 --> 0:04:47.560 loss or change. He wants to kill your grandparents. Oh, 0:04:47.600 --> 0:04:50.839 I'm sorry. Now. He wants to improve quality care and 0:04:50.880 --> 0:04:54.600 patient safety. Right uh? And uh, let's see. He wants 0:04:54.640 --> 0:04:57.640 to guarantee choice of doctors and coverage plans, right yes, 0:04:58.040 --> 0:05:02.360 and safeguard families from bankruptcies related to health expenses. I 0:05:02.360 --> 0:05:04.680 think that's seven. He wants to the final one he 0:05:04.680 --> 0:05:08.280 wants to shrink long term cost increases in healthcare for 0:05:08.440 --> 0:05:14.440 businesses and the government. So those are pretty um broad principles. 0:05:13.560 --> 0:05:16.320 I think you'd be hard pressed to find someone who 0:05:16.320 --> 0:05:19.640 would disagree with these principles just it's got and theory. 0:05:20.440 --> 0:05:22.559 But then the Congress had the hard job of making 0:05:22.600 --> 0:05:26.560 them into bills. So we have that thousand pages of 0:05:26.680 --> 0:05:29.039 legislation as it stands right now, not including the Senate 0:05:29.040 --> 0:05:36.280 Finance committment, without the Senate Finance correct in Brail, which 0:05:36.360 --> 0:05:39.599 was she taught herself, had translated and then read in. 0:05:41.240 --> 0:05:44.400 So so let's talk about how Congress did take these 0:05:44.440 --> 0:05:47.679 eight principles and turn them into healthcare. As you were saying, um, 0:05:47.760 --> 0:05:50.240 let's start with individuals. One of the big things is 0:05:50.279 --> 0:05:53.800 that everyone, Both of both of the proposals that are 0:05:53.800 --> 0:05:57.560 out right now say that everyone has to have health insurance. Yeah, 0:05:57.560 --> 0:06:00.160 it's an individual mandate, and you know it's it's sort 0:06:00.160 --> 0:06:01.960 of borrowing an idea from car insurance. If we've all 0:06:02.000 --> 0:06:04.800 got to carry car insurance, then you know, what's what's 0:06:04.800 --> 0:06:07.000 health insurance in addition to that? Right, So if you 0:06:07.480 --> 0:06:11.000 don't have health insurance. You don't have to stormtroopers aren't 0:06:11.000 --> 0:06:12.880 going to come to your house and beat your kids 0:06:12.880 --> 0:06:15.440 in front of you. But the tax man, well right, yeah, 0:06:15.560 --> 0:06:18.920 because I think the Senate bill says you pay seven 0:06:19.400 --> 0:06:23.240 fifty dollars a year in tax penalties for not having insurance. 0:06:23.600 --> 0:06:26.240 And then the house plan is I think up to 0:06:26.360 --> 0:06:31.919 two point five percent of your adjusted income. Yeah, but 0:06:32.120 --> 0:06:36.240 no more than the lowest price plan. Right, Like, they're 0:06:36.240 --> 0:06:37.839 not going to charge you more than you would have 0:06:37.880 --> 0:06:39.600 to pay your health insurance, right, I mean, if you 0:06:39.640 --> 0:06:42.560 if you can pay the premium and taxes, essentially you 0:06:42.560 --> 0:06:44.440 could just pay the premium. Well that's the way I 0:06:44.480 --> 0:06:46.440 took it is we're going to get some money, so 0:06:46.480 --> 0:06:48.320 you might as well, hint, hint, to go spending on 0:06:48.360 --> 0:06:51.560 healthcare ether than funding the I R S. Right, But 0:06:51.600 --> 0:06:54.159 now most people already have health insurance. The majority people 0:06:54.200 --> 0:06:56.760 get it from their employers, and so that's pretty easy 0:06:56.800 --> 0:06:59.400 to to meet that requirement, right, But we don't want 0:06:59.400 --> 0:07:02.640 the employer to just chicken out, So employers have a 0:07:02.680 --> 0:07:05.320 mandate as well, exactly. So now we have to mandates 0:07:05.360 --> 0:07:09.080 employer and individual. And I heard actually the Senate Finance 0:07:09.200 --> 0:07:12.200 is not going to have an employee an employer mandate, 0:07:12.240 --> 0:07:14.040 and that's why businesses are probably gonna be a little 0:07:14.040 --> 0:07:16.480 more favorable that I said. You know, that's one of 0:07:16.520 --> 0:07:18.600 the theories that that's what killed Clinton's bills. You know, 0:07:18.600 --> 0:07:21.680 it's a job killer, right, So um, but that that 0:07:21.720 --> 0:07:24.000 sounds kind of political. So let's just back off and 0:07:24.000 --> 0:07:27.120 say you're an employer, you're in an individual, You've got 0:07:27.120 --> 0:07:31.400 this mandate. What if you can't afford it? Well, there's subsidies. Yes, Well, 0:07:31.440 --> 0:07:33.600 not only subsidies. I mean, if you are going to 0:07:33.640 --> 0:07:36.040 mandate that everybody has to have health insurance, you have 0:07:36.120 --> 0:07:40.440 to make exemptions for certain people. Um, but you also 0:07:40.520 --> 0:07:44.640 we already have Medicaid Medicare, so that covers automatically a 0:07:44.680 --> 0:07:48.640 certain percentage of Americans. But they're also expanding Medicaid, right, 0:07:48.840 --> 0:07:52.640 I think two power Yeah, that is the current Senate 0:07:52.680 --> 0:07:55.680 plan would be a hundred about the federal power level, 0:07:55.760 --> 0:07:58.160 and the House would do a hundred of the federal 0:07:58.400 --> 0:08:00.480 powery level. Right. And they're also planning on kind of 0:08:00.520 --> 0:08:03.360 cleaning house in those two systems, right and making them 0:08:03.360 --> 0:08:08.360 more efficient and cheaper. Yes, hopefully. Yeah, Well we'll get 0:08:08.360 --> 0:08:09.760 to that when we start talking about how this is 0:08:09.760 --> 0:08:12.760 going to be paid for? UM. But let's talk about 0:08:12.760 --> 0:08:18.000 subsidies for individuals. UM. Let's say that, Oh, I don't know, 0:08:18.400 --> 0:08:22.920 I make three hundred and fifty percent income above the 0:08:22.920 --> 0:08:26.760 federal poverty level. Right, Well, I know they're to dream. 0:08:27.640 --> 0:08:32.439 Will will I be eligible for subsidies? Yes? Yes, Okay, 0:08:32.520 --> 0:08:35.040 So I think it goes from Uh, let's say if 0:08:35.080 --> 0:08:38.360 we're going with a hundred and fifty percent above poverty level. Uh. 0:08:39.000 --> 0:08:42.920 From that to poverty level you're covered by medicaid. From 0:08:42.960 --> 0:08:47.800 a hundred up to what is it? Uh, you're eligible 0:08:47.840 --> 0:08:50.600 for subsidies on a sliding scale only. Right. What they 0:08:50.640 --> 0:08:52.560 do is, obviously, if you make a little bit more money, 0:08:52.559 --> 0:08:55.560 if you're closer to that level of the federal poverty level, 0:08:55.600 --> 0:08:58.360 you will pay a greater amount of the premium than 0:08:58.440 --> 0:09:00.960 if you were just making a hundred five of the 0:09:00.960 --> 0:09:04.079 federal pobby level. So in the House Committee, for example, 0:09:04.240 --> 0:09:06.760 you get your subsidy, but you will pay Let's say 0:09:06.800 --> 0:09:08.920 you were at three fifty, You're gonna people still paying 0:09:09.880 --> 0:09:13.040 your income toward the thing, and but then you also 0:09:13.080 --> 0:09:17.440 get a subsidy to cover the rest of the premium. 0:09:17.520 --> 0:09:18.960 Kind Of like when I go to my shrink and 0:09:19.000 --> 0:09:21.880 I say, dude, I make a year and he doesn't 0:09:21.920 --> 0:09:25.440 charge me as much as the physician. It comesn't after me. Yeah, 0:09:25.520 --> 0:09:27.680 that's actually a really good point, Chuck, that there's a 0:09:27.720 --> 0:09:30.720 lot of um, a lot of key points in these 0:09:30.760 --> 0:09:35.720 proposals are already in effect in some ways either um 0:09:35.920 --> 0:09:39.400 de facto like your your shrink charging you on a 0:09:39.480 --> 0:09:43.960 sliding scale, or you know, um mandates about everyone having 0:09:43.960 --> 0:09:47.319 to have insurance like that the Massachusetts experiment. Right, So 0:09:47.360 --> 0:09:49.640 this is kind of taking a lot of maybe good 0:09:49.679 --> 0:09:53.160 ideas and putting them together, a good ideas being a 0:09:53.280 --> 0:09:56.120 very political way to put it. Right, what's the Massachusetts 0:09:56.160 --> 0:09:59.480 experiment where everyone has to have insurance? I don't think 0:09:59.520 --> 0:10:02.160 I knew that? Yeah, wow, Yes, And you know, that's 0:10:02.160 --> 0:10:03.839 probably a good thing for you guys to discuss in 0:10:03.880 --> 0:10:06.920 the next podcast, because I mean, is the Massachusetts a 0:10:06.920 --> 0:10:12.520 success in terms of its health insurance? So, um, where 0:10:12.559 --> 0:10:14.880 is everybody going to get this insurance? There's an insurance 0:10:14.920 --> 0:10:17.199 marketplace that's being set up, right, Yeah, this is sort 0:10:17.200 --> 0:10:19.840 of the new big thing. Um. So the insurance marketplace 0:10:19.920 --> 0:10:23.480 is sort of this attempt to have the general public 0:10:23.520 --> 0:10:26.360 get their insurance the same way that Congress people do, right, 0:10:26.440 --> 0:10:29.840 because essentially, when you become elected to Congress, you are 0:10:29.880 --> 0:10:32.960 presented with five plans. Are not not five, that's not 0:10:33.040 --> 0:10:35.120 I mean it's not a specific number. But basically you're 0:10:35.160 --> 0:10:37.400 offered all these plans that tell you exactly how much 0:10:37.400 --> 0:10:40.120 it's going to cost and what benefits are provided. And 0:10:40.160 --> 0:10:43.559 it's very easy to use. Yeah, I think plain language 0:10:43.600 --> 0:10:46.280 is one of the provisions in at least the House 0:10:46.320 --> 0:10:50.240 Bill Transparency Plan language. Yeah, like you have to say 0:10:50.360 --> 0:10:53.600 this is what's covered, and this is what's not covered, 0:10:53.640 --> 0:10:56.120 and this is what you get for what you pay for. Right. Like, 0:10:56.760 --> 0:10:59.360 plain language is a really big part of this. So 0:10:59.400 --> 0:11:02.040 if you're trying to fulfill your individual mandate, you will 0:11:02.200 --> 0:11:03.800 look at all these plans and say, well, I want 0:11:03.800 --> 0:11:05.600 this one because I know it costs this much and 0:11:05.640 --> 0:11:07.640 I know that this, this, and this and is covered. 0:11:08.200 --> 0:11:11.040 And in both of these bills, every plan that's in 0:11:11.080 --> 0:11:15.200 that marketplace will will have a certain set of minimum 0:11:15.240 --> 0:11:18.960 benefits that it wills that have to be in there, 0:11:19.360 --> 0:11:21.760 and then there will be plans that are better than 0:11:21.800 --> 0:11:24.240 that in terms of maybe you want you know, spaw 0:11:24.320 --> 0:11:26.120 days covered or something like that you can pay to 0:11:26.120 --> 0:11:28.720 get that extra. But let's say you just want to 0:11:28.720 --> 0:11:31.720 be able to go get you know, a mammogram under 0:11:31.720 --> 0:11:34.080 your health insurance plan. That's probably closer to what's going 0:11:34.120 --> 0:11:36.200 to be considered an essential benefit that has to be 0:11:36.240 --> 0:11:38.040 in the plan, right and it gets will get into 0:11:38.040 --> 0:11:40.120 this obviously latter two. But that's getting a little political 0:11:40.120 --> 0:11:42.200 as well, with what can be covered and what's not right. Right, 0:11:42.480 --> 0:11:45.760 But let's just for the time being called the minimum benefits, 0:11:45.800 --> 0:11:50.559 because what we're what these proposals give the government license 0:11:50.679 --> 0:11:54.000 to do, is to define what these minimum standards of 0:11:54.080 --> 0:11:57.840 health insurance are, and eventually all health insurance plans, if 0:11:57.840 --> 0:12:00.240 you are have an existing one, it will I have 0:12:00.240 --> 0:12:03.439 about five years to meet these requirements as well, right, 0:12:03.440 --> 0:12:05.720 but it won't change it first. Right now, they have 0:12:05.760 --> 0:12:08.920 about a five year window grandfathered in for several years. Right. 0:12:09.120 --> 0:12:12.920 And you staid in your article how healthcare reform works that, um, 0:12:13.240 --> 0:12:17.040 these basic requirements will keep the marketplace from becoming like 0:12:17.080 --> 0:12:21.000 a dumping ground for shoddy policies, right right, You know, 0:12:21.160 --> 0:12:23.560 we don't want anyone in the marketplace who already maybe 0:12:23.559 --> 0:12:25.960 doesn't have a job or can't afford regular insurance to 0:12:26.040 --> 0:12:30.920 just be stuck with sort of um crappy coverage. I mean, 0:12:31.520 --> 0:12:33.520 the whole point of this plan, whether you have insurance 0:12:33.600 --> 0:12:35.600 or you don't have insurance. And Obama's point of view 0:12:35.640 --> 0:12:39.480 is to strength and health insurance for everyone. Right, So obviously, 0:12:39.559 --> 0:12:41.400 if you don't have a plan already, you're gonna want 0:12:41.440 --> 0:12:43.640 sort of that basic care. But you also want to 0:12:43.640 --> 0:12:45.520 make sure that the people who already have insurance are 0:12:45.520 --> 0:12:47.599 being protected in the same way, right, right, right? Do 0:12:47.640 --> 0:12:50.320 you know what insurance everyone should have? What motion picture 0:12:50.320 --> 0:12:53.640 health and welfare? Is it good? It's like it's better 0:12:53.640 --> 0:12:56.839 than the army. Did you get Spada? You get massage, 0:12:57.080 --> 0:13:00.480 spa days, you get like Manny Petties paid for it. Actually, 0:13:00.480 --> 0:13:02.800 because this is the first I've ever heard of spot date, 0:13:02.880 --> 0:13:05.920 I think there's a sushi clause. You know, in Germany, 0:13:06.280 --> 0:13:12.959 spots are included universal health care. That's wonderful. Um, small businesses, 0:13:13.400 --> 0:13:15.840 you were saying that that businesses are going to have 0:13:15.880 --> 0:13:19.040 a mandate to provide health insurance. Uh, they're also going 0:13:19.080 --> 0:13:22.520 to be allowed to, um, go to this insurance marketplace 0:13:22.559 --> 0:13:25.280 to select as well. Right, employers are going to be 0:13:25.640 --> 0:13:28.720 subject to a payer play requirement where if you don't 0:13:29.559 --> 0:13:31.800 provide health insurance for your employees. You're gonna have to 0:13:31.840 --> 0:13:34.320 pay into a fund for all your employees who don't 0:13:34.320 --> 0:13:37.520 have health insurance. Now, this would probably be a job 0:13:37.600 --> 0:13:39.720 killer if it were to be applied to small businesses. 0:13:39.720 --> 0:13:42.160 So small businesses will be exempt from this requirement, right. 0:13:42.200 --> 0:13:45.640 I think Obama said small businesses in the US will 0:13:45.640 --> 0:13:49.360 be exempted his recent speech, right, So, um, and and 0:13:49.480 --> 0:13:52.199 the Senate and the House to find small businesses differently 0:13:52.200 --> 0:13:54.400 in their current plan. They might look at how many 0:13:54.400 --> 0:13:56.800 employees you have. They might look at your you know, 0:13:57.160 --> 0:13:59.000 income per year. I think if you make more than 0:13:59.040 --> 0:14:02.200 two dollars a year, you wouldn't be considered a small 0:14:02.200 --> 0:14:05.360 business under this exemption. Um. But you know, that's that's 0:14:05.360 --> 0:14:07.080 probably gonna be one of the things that's ironed out 0:14:07.520 --> 0:14:10.679 and re examine pretty closely in the reconciliation of these 0:14:10.720 --> 0:14:14.360 two bills. But um, they would also be eligible to 0:14:14.480 --> 0:14:18.840 enter this marketplace and provide insurance to their employees with 0:14:18.880 --> 0:14:22.680 the help of subsidies. Okay, And like people, those employers 0:14:22.720 --> 0:14:25.400 that decide I'm not doing this, they are going to 0:14:25.440 --> 0:14:28.440 have to pay, and that money will be contributed to 0:14:28.480 --> 0:14:32.360 the insurance marketplace, right right, So either way, it's provide, 0:14:32.560 --> 0:14:36.280 like you said, pay your play. Um. So in this marketplace, 0:14:36.360 --> 0:14:39.320 let's all pretend that we're in there right now. Okay, closure, closure, 0:14:39.640 --> 0:14:42.280 This is nice. Do you see all these little logos, 0:14:42.320 --> 0:14:45.360 like there's Etna's logo, there's Snoopy, say hi to Snoopy. 0:14:46.120 --> 0:14:48.240 Um do you see this one? What is that? Like 0:14:48.280 --> 0:14:51.960 a screaming eagle with a bandaged head with the us 0:14:52.040 --> 0:14:55.520 of a that is new or it would be if 0:14:55.560 --> 0:14:58.800 this thing gets past. That's the public option, right, yes, 0:14:58.840 --> 0:15:01.600 the public option has in one of the more controversial 0:15:01.640 --> 0:15:07.040 parts of all these bills. Correct, yes, okay, so it's controversial. 0:15:07.320 --> 0:15:09.320 What's what's what does it entail? What's going on here? 0:15:09.520 --> 0:15:12.200 So the point of having this marketplace is one way 0:15:12.240 --> 0:15:15.000 that Obama thinks we can keep our insurance companies honest 0:15:15.160 --> 0:15:18.920 and competitive, because if you're competing against people, then you 0:15:18.960 --> 0:15:23.040 will provide good service for good value. Makes sense? Makes sense? Now, 0:15:23.080 --> 0:15:25.240 Obama thinks that one way to ensure that this happens 0:15:25.280 --> 0:15:28.640 is to also introduce this public health insurance option. Um. 0:15:28.760 --> 0:15:31.400 So that it's a government run option that will have 0:15:32.000 --> 0:15:35.320 lower rates probably. Um Now, obviously right there, you're going 0:15:35.400 --> 0:15:37.920 to have some contention about what the rate should be 0:15:37.920 --> 0:15:40.960 because kind of private ensure compete with UM. You know, 0:15:41.080 --> 0:15:44.920 a public ensure will have sort of the government um 0:15:45.360 --> 0:15:48.520 stamp of approval that might make it impervious to any 0:15:48.560 --> 0:15:52.560 sort of attack or disaster. UM. But the thinking is 0:15:52.560 --> 0:15:54.800 is that, you know, similar to the way we provide 0:15:54.840 --> 0:15:57.400 Medicare and Medicaid for certain people, that we would have 0:15:57.440 --> 0:16:01.200 this option for people to UM get health insurance at 0:16:01.200 --> 0:16:04.760 a pretty pretty affordable cost set by the government. But 0:16:04.800 --> 0:16:07.160 we don't know what cost that would be yet, So 0:16:07.160 --> 0:16:09.640 you really can't get into an argument about whether insurers 0:16:09.640 --> 0:16:12.600 could compete. Are the financials not really set on this yet. No, 0:16:12.800 --> 0:16:14.520 And you know, if you've been following the news, this 0:16:14.560 --> 0:16:16.840 is probably the thing you see that, oh it's been dropped. 0:16:16.840 --> 0:16:18.480 Oh it hasn't been dropped. We might have a co 0:16:18.600 --> 0:16:21.920 op instead. UM. It's really something to watch. That was 0:16:21.960 --> 0:16:24.080 something that in the speech Obama said he was willing 0:16:24.120 --> 0:16:27.560 to negotiate on, so it's still to come. He has 0:16:27.600 --> 0:16:31.160 said so far though, that it wouldn't be just another Medicare. 0:16:31.200 --> 0:16:34.240 We wouldn't just have Medicare rates which are about lower 0:16:34.760 --> 0:16:37.720 than most insurance rates, because that isn't fair to private insurers. 0:16:37.720 --> 0:16:41.080 It would have to be UM similar to private insurance likely, 0:16:41.120 --> 0:16:44.479 and it would also UM have to fund itself through premiums. 0:16:44.520 --> 0:16:47.120 It would be self sustaining because I mean, if you've 0:16:47.120 --> 0:16:50.560 got federal or injections of federal cash, you're not really 0:16:50.600 --> 0:16:53.480 competing with anything, right, Yeah, And I think Obama said 0:16:53.480 --> 0:16:55.520 that he wouldn't back anything to added to the deficit. 0:16:55.640 --> 0:17:00.400 Is that correct? So that's the public option. Everybody back 0:17:00.440 --> 0:17:03.040 away slowly. Well, you know one thing that might be 0:17:03.080 --> 0:17:05.960 interesting to talk about is we always hear Obamas saying 0:17:06.000 --> 0:17:08.200 that if you like your health insurance, you can keep it, 0:17:08.480 --> 0:17:10.760 right right, If you like your health insurance, you can 0:17:10.840 --> 0:17:14.600 keep it. The thing is it is Clinton saying no, 0:17:15.520 --> 0:17:17.560 if you like your health insurance, you can keep it 0:17:17.680 --> 0:17:20.280 there much better. But the thing is, let's think about 0:17:20.280 --> 0:17:23.200 the people who don't like their health insurance and might 0:17:23.240 --> 0:17:25.600 be thinking, oh, man, a public option sounds pretty good. 0:17:25.680 --> 0:17:28.240 That's an excellent point because you never hear that mentioned. Um, 0:17:28.280 --> 0:17:31.159 you know, you can't really opt out of your employer 0:17:31.320 --> 0:17:33.879 based health insurance because you don't like it and just 0:17:33.880 --> 0:17:37.040 get into a cheaper public option. You can't. Why not? 0:17:37.760 --> 0:17:41.160 Because because you have the option through work so you're 0:17:41.160 --> 0:17:44.360 immediately discounted. Because yes, but if right now the insurance 0:17:44.359 --> 0:17:47.800 marketplace will only be open to those people who don't 0:17:47.800 --> 0:17:50.440 have insurance through their employer at first, but I mean, 0:17:50.480 --> 0:17:53.560 I don't if we're still five years away from a marketplace. 0:17:53.600 --> 0:17:55.359 I think we'd be at least five years after that 0:17:55.680 --> 0:17:58.680 away from allowing everyone in. So right now, you have 0:17:58.760 --> 0:18:01.280 to stick with your employer based health insurance unless your 0:18:01.280 --> 0:18:03.639 employer drops. You know, that's something that people are saying. 0:18:04.000 --> 0:18:06.560 You know, if there's some cheap plan and employers figure 0:18:06.560 --> 0:18:08.600 it's cheaper just to pay the fee than to cover 0:18:08.640 --> 0:18:13.000 their employees, that could happen. But um, the thinking is 0:18:13.000 --> 0:18:15.679 is that if if everyone has to know sort of 0:18:15.720 --> 0:18:18.720 what their insurance cost versus what it costs in the marketplace, 0:18:19.040 --> 0:18:22.480 then that competitive spirit might keep insurance fair and honest. 0:18:22.760 --> 0:18:25.160 This canna get really tricky, so well, let's talk about 0:18:25.240 --> 0:18:28.000 Let's talk some more about how insurance companies are going 0:18:28.040 --> 0:18:32.240 to be effected. Just in addition to this possible competition 0:18:32.400 --> 0:18:36.600 from a public option, there are some mandates in this legislation, 0:18:37.240 --> 0:18:41.320 for example, that says you can't discriminate based on pre 0:18:41.400 --> 0:18:45.439 existing conditions any longer. Obama likes to use that. Um. 0:18:45.560 --> 0:18:48.480 The example of that woman who's denied that what wasn't 0:18:48.520 --> 0:18:51.200 she was going to have a mastectomy, and then they 0:18:51.200 --> 0:18:53.800 found out she didn't declare a case of acne from 0:18:53.800 --> 0:18:56.560 her childhood, and thus they postponed the treatment on her 0:18:56.560 --> 0:18:59.840 breast cancer grow right and and under under this proposal, 0:19:00.080 --> 0:19:02.840 there's no more pre existing condition to niles and right 0:19:03.000 --> 0:19:04.560 or and it, and it doesn't cost you more. You 0:19:04.600 --> 0:19:06.440 can't be charged a higher premium because you have a 0:19:06.480 --> 0:19:09.679 pre existing because they're gonna do with that completely for 0:19:09.800 --> 0:19:12.080 people who have insurance and for people who are trying 0:19:12.080 --> 0:19:14.560 to get insurance, like that's going man under this plan. 0:19:14.720 --> 0:19:16.639 So if you smoke tin packs of cigarettes today and 0:19:16.680 --> 0:19:19.040 you walk in there with an oxygen tank, they have 0:19:19.119 --> 0:19:22.760 to cover you, Yeah, for the same amount of money. Yeah, 0:19:22.880 --> 0:19:27.119 as far as I know about the country, that's awesome. UM. 0:19:27.440 --> 0:19:30.840 There's also a mandate that, um, there can no longer 0:19:30.920 --> 0:19:35.239 be caps on spending my insurance companies. And actually not 0:19:35.320 --> 0:19:39.639 only that, the the the it's back on the consumer. 0:19:39.800 --> 0:19:42.840 There's now a cap on how much a consumer can 0:19:42.880 --> 0:19:46.920 pay out a pocket every year for their own healthcare. 0:19:47.040 --> 0:19:49.760 Right because a lot of bankruptcies are driven by medical costs. 0:19:50.240 --> 0:19:52.560 We're thinking that you know, if if there's if you 0:19:52.640 --> 0:19:55.439 can't go broke because you're sick, then we will decrease 0:19:55.440 --> 0:19:59.159 the number of bankruptcies. Damage right, the damage we might 0:19:59.160 --> 0:20:01.880 be doing to our economy that way interesting definitely. Um 0:20:01.920 --> 0:20:05.560 there then, so that's insurance companies. That's also again we're 0:20:05.600 --> 0:20:07.920 just kind of hitting the high points here. We're talking about, 0:20:08.000 --> 0:20:10.760 as Molly said, sixteen hundred pages of legislation as the 0:20:10.840 --> 0:20:15.400 stands now. UM, So let's talk about UM Medicaid and Medicare. 0:20:15.480 --> 0:20:19.800 Chuck mentioned this earlier about UM kind of cutting waste 0:20:19.800 --> 0:20:23.520 in the Medicaid and Medicare system. Uh, and that actually, 0:20:23.640 --> 0:20:25.640 let's talk about how much is this going to cost? 0:20:25.720 --> 0:20:29.320 The OMB suggests it's going to be about a trillion 0:20:29.359 --> 0:20:32.720 dollars over ten years for these these proposals for Obama's plan. 0:20:33.280 --> 0:20:35.960 Obama is saying that two thirds of this can be 0:20:36.080 --> 0:20:39.000 paid for right off the bat, just by cutting waste 0:20:39.720 --> 0:20:43.479 with Medicare and Medicaid. What is he talking about, Well, 0:20:43.520 --> 0:20:47.160 there's an estimate that about of the services that are 0:20:47.560 --> 0:20:50.760 performed medically in this country are unnecessary. And that's overall, 0:20:50.800 --> 0:20:55.399