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Giuliani health plan echoes failed Bush proposal

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Election 2008
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Posted August 1, 2007 9:23 AM
The Swamp

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Rudolph Giuliani in Rochester, NH on July 31, 2007. AP Photo/Jim Cole.

by Craig Gordon

ROCHESTER, N.H. -Rudy Giuliani leapt into the health care debate yesterday with a plan like one that's already been declared dead-on-arrival on Capitol Hill - a version of a $15,000 tax break for insurance that President George W. Bush floated earlier this year without success.

Giuliani's plan also sidesteps the issue dominating the Democratic debate over health care - how to cover all or nearly all of the 47 million uninsured Americans.

In Giuliani's words, that's up to the marketplace, not a government "nanny state" - and he blasted Democratic proposals to subsidize coverage with tax increases as European-style "socialist" medicine that could bankrupt government.

But he admits it could take years for his plan to help those without insurance and makes no promise that all the uninsured would be helped.

"You have to start bringing the price down before you can figure out how many people you can include. It has to be done incrementally. It can't be done with a magic wand all at once," Giuliani told reporters.

His plan would dramatically restructure the employer-based insurance market that has dominated American health care for years - and sets up a stark contrast with Democrats, who believe government has a role in improving access to insurance.

The main element of his plan is a tax deduction of up to $15,000 for families who use the money to buy insurance in the marketplace instead of getting it through employers, as more than half of Americans do now.

As an incentive, the families could bank in a health-savings account whatever was left over after they bought insurance - say, $3,000 if they bought a $12,000 policy. The idea is that all those dollars would drive prices down, and competition and choices up in the marketplace, Giuliani says.

Competition would push prices so low that even the uninsured could afford it, he said. He also said he would propose tax credits and vouchers to help them buy insurance, but offered no details.

But health-care policy experts yesterday were skeptical of Giuliani's claims, saying it will be hard to entice people to leave employer-based programs and also difficult to push marketplace prices down so much that the uninsured can jump in.

"I don't think it's likely to increase coverage of people to any great extent, and I don't think it's going to get a handle on health care cost inflation in this country," said Alan Cohen, executive director of Boston University's Health Policy Institute.

But politically, analysts say, it is reminiscent of the plan Bush espoused earlier this year in his State of the Union address. He proposed creating a $15,000 deduction for health insurance coverage while eliminating its tax-free status.

Democrats balked at that - and are balking at Giuliani's plan - because they say it would discourage employers from providing insurance and could make even more people uninsured.

While Giuliani's hard-nosed fiscal conservative approach might play well now among Republican primary voters, he might have a tougher sell if he makes it to a head-to-head contest with a Democrat.

"It may resonate with Republicans, but in the general election, Democrats will paint this as status quo, recycling Bush's ideas," said independent political analyst Stuart Rothenberg. "Anytime you can attach the president to anything, it hurts."

For now, that's a risk Giuliani appears willing to take, as he seeks to convince Republicans leery of his moderate social stances that he is conservative enough on the economic and national security fronts to make them comfortable. It allows him to bash Democrats such as Hillary Rodham Clinton and John Edwards for promoting "socialist" policies. Edwards, for example, has proposed eliminating Bush's tax cuts for the wealthiest Americans to subsidize coverage of the uninsured.

Breaking it down

Highlights of Rudy Giuliani's health care plan:

TAX CODE REFORM A tax deduction of up to $15,000 to help families buy insurance in the private marketplace.

HEALTH SAVINGS ACCOUNTS Simplify the rules to make these accounts easier to use. LIABILITY SYSTEM REFORM End frivolous malpractice lawsuits without limiting compensation for real loss.

REWARD STATES Offer block grants to states to encourage medical innovation, reduce health costs and enroll the uninsured.

LOW-COST OPTIONS Citizens should be allowed to purchase coverage through plans in other states, if regulations in their home states limit their insurance options.

STREAMLINE THE FDA PROCESS Bring speed and accountability to evaluation process for new drugs.

WELLNESS INITIATIVES New initiatives to promote healthy lifestyles and wellness programs, including tying a state's Medicaid payments to preventive care and obesity tracking in children.

SOURCE: JOINRUDY2008.COM

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Comments

Rudy echoes more than just the health care....He still thinks that Bushs agenda is the way to go....
Bye!


Most of the forty seven million people without insurance do not pay any tax or pay very little. A tax deduction will not help them. This whole plan is a rehash of old, failed ideas. Giuliani always seems to be just a step outside this universe. Please "google" Rudy and read about his soap opera career.


Of more concern should be the millions of middle class employees who believe they have good insurance but find out the hard way that insurance companies are nothing more than greedy corporations that will do ANYTHING to avoid paying claims.


Again, this Mr. Guiliani believes he's entitled to be President because he was mayor of NYC on Sept, 11th and ventured down to groung zero. Time magazine named him person of the year (in 2001) and he's considered America's mayor. OK. The man brings nothing to the table (except expired old ideas and scripted talk) and he's the least qualified out of all candidates to be President. He is in it just for himself. It will be fun to watch the all skeletons walking out of his closet and his candidacy destruct.


I was so excited about Mr. Giuliani running -- I really considered him a good alternative to the Democratic frontrunners. I respect him as a person and as a leader, esp. after his leadership shown following 9-11. But this one thing - his health care "plan" just wiped it out for me. This plan is terrible and just cost him my vote. Sorry Rudy, but you should have done much better. Americans are demanding universal care, especially now, 'post-Sicko'. Listen to them!


Giuliani's proposal is no more than putting a band-aid on an advanced stage cancer. It does, however, accomplish two things and meets two Republican goals. It keeps the current, broken, healthcare payment system in place and it provides tax subsidies so people are better able to make payments to insurance companies. These companies will continue to deny care but now they will be getting more tax-underwritten dollars to do it. The marketplace does not provide better care at the best price. With all its problems, a single-payer system would be far better. Nothing could be worse than what we have now.


SiCKO: There are nearly 50 million Americans without health insurance.

The Centers for Disease Control and Prevention actually reported that 54.5 million people were uninsured for at least part of the year. Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, 2006. Centers for Disease Control. http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur200706.pdf
SiCKO: 18,000 Americans will die this year simply because they're uninsured.

According to the Institute of Medicine, "lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States. Although America leads the world in spending on health care, it is the only wealthy, industrialized nation that does not ensure that all citizens have coverage." Insuring America's Health: Principles and Recommendations, Institute of Medicine, January 2004.
http://www.iom.edu/?id=19175
SiCKO: Richard Nixon and John Ehrlichman are heard discussing the concept of a health maintenance organization in Oval Office Recordings.

SiCKO: The American Medical Association distributed a record featuring Ronald Reagan discussing the evils of socialized medicine.

SiCKO: The United States is ranked #37 as a health system by the World Health Organization.

"The U. S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds." "World Health Organization Assesses The World's Health Systems," Press Release, WHO/44, June 21, 2000. http://www.who.int/inf-pr-2000/en/pr2000-44.html


Timothy gets it right. This plan is a Big Business giveaway.

As an added bonus, Rudy's plan encourages less government regulation of Big Pharma (Avandia, anybody?) and gives Wall street another product to sell (Health Savings Accounts).


Hmmm, you know, it's funny, I have never had a problem with any insurance ocmpany paying any bill. Where do you Loons get your nonsense?


rudy fruity carries more baggage than a loaded Greyhound. His plans mean nothing because he will never have an opportunity to enact them.


Well,if little Johnny Murano has never had a problem with health insurance,that's all I need.There is no problem with health insurance in this country.

I wonder how many young people signed up for the military for future schooling benefits and health care.

Now,their over in Iraq fighting Little Johnny's war,and he safe at home petting his kitties.With health insurance.

The party of me me me me,right Little Johnny!


I read a report that for the US to cover all AMericans it would cost about more than all the money taht the Gov brings in and would end up costing taxpayers roughly $510 per month. Now I can see why people who do not work would want that but once again the middle class will have to bare the burden of the uninsured under ANY Universal health care. THe idea is good but it just cost way too much to even consider unless people want to see a huge tax increase. Once again the 85% of us who work and earn our fair share have to cover the 15% who sit back and live of the government. I have an idea. Get rid of Welfare and use that money for the uninsured and give tax breaks to those that actually contribute to society.


With Bush nothing succeeds like failure, so Rudy is going to try it too.


John D,
I will do the math for you again;

Premiums per year for two;
$5000
Deductible per year each;
$3000
Co payments per event;
20%

Now, wifey had a in by noon out by three outpatient procedure done in Feb.

Deductible paid out;
$1500
Co payment paid out;
$150 so far, bills still coming in Aug?

Insurance paid out;
$550 or so.

Money paid out by us;
$6650

Benefit received;
$550

What a deal!


".... costing taxpayers roughly $510 per month. "

Vinny,
Per person? Per family?

Where did this number come from?

BTW, with no deductibles/co pays it could be worth it.

Anyone else have any numbers?


This is just an excerpt of what I found.

Go to;
www.phhp.org/publications

***************

Who is Eligible
Every person living in the United States and the U.S. Territories would receive a United States National Health Insurance Card and i.d number once they enroll at the appropriate location. Social Security numbers may not be used when assigning i.d cards. No co-pays or deductibles are permissible under this act.

Benefits/Portability
This program will cover all medically necessary services, including primary care, inpatient care, outpatient care, emergency care, prescription drugs, durable medical equipment, long term care, mental health services, dentistry, eye care, chiropractic, and substance abuse treatment. Patients have their choice of physicians, providers, hospitals, clinics, and practices.
Conversion to a Non-Profit Health Care System
Private health insurers shall be prohibited under this act from selling coverage that duplicates the benefits of the USNHI program. They shall not be prohibited from selling coverage for any additional benefits not covered by this Act; examples include cosmetic surgery, and other medically unnecessary treatments.
Cost Containment Provisions/

Reimbursement
The National USNHI program will annually set reimbursement rates for physicians, health care providers, and negotiate prescription drug prices. The national office will provide an annual lump sum allotment to each existing Medicare region, which will then administer the program. Payment to health care providers include fee for service, and global budgets.
The conversion to a not-for- profit health care system will take place over a 15 year period, through the sale of U.S. treasury bonds; payment will not be made for loss of business profits, but only for real estate, buildings, and equipment.

Funding & Administration
The United States Congress will establish annual funding outlays for the USNHI Program through an annual entitlement. The USNHI program will operate under the auspices of the Dept of Health & Human Services, and be administered in the former Medicare offices. All current expenditures for public health insurance programs such as S-CHIP, Medicaid, and Medicare will be placed into the USNHI program.
A National USNHI Advisory Board will be established, comprised primarily of health care professionals and representatives of health advocacy groups.

Proposed Funding For USNHI Program: $1.86 Trillion Per Year
A payroll tax on all employers of 3.3%. Maintain employee and employer Medicare payroll tax of 1.45%. Implement a variety of mechanisms so that low and middle income families pay a smaller share of their incomes for health care than wealthiest 5% of Americans; i.e, a health income tax on the wealthiest 5% of Americans, a small tax on stock and bond transfers, and closing corporate tax shelters. A repeal of the Bush tax cut of 2001. For more details, see PNHP’s “Financing National Health Insurance.”


John D,

After checking our records I must insert a correction;

Premiums paid out;

$5400


I read a report that for the US to cover all AMericans it would cost about more than all the money taht the Gov brings in and would end up costing taxpayers roughly $510 per month

I read a report? I READ a report? I READ A REPORT?!? Well I read a report that Vinny is a delusional fabricator! Give me your reference and I'll give you mine.


wow, the right wing has gone quiet.


I guess your avalanche of facts and sound reason silenced them.


wow, the right wing has gone quiet.

Posted by: C.Morris | August 1, 2007 9:08 PM

The idea of a universal, federal health care plan is . . .

. . . not constitutional;

. . . bound to lead to a loss of civil rights and liberties;

. . . bound to be more costly than a more closely regulated system with market based incentives and competition to keep costs down; and,

. . . only likely to make the situation worse owing to the inherent ability of large government to corrupt men, waste assets and screw things up, thus making even more government and greater expenditures necessary.

These points have been made over and over, in detail, until we were blue in the face. But you won't listen. You already have your minds made up, and no reasonable argument or series of arguments will change your views. So, why should we bother telling you all this stuff again?

"Power over a man's substance is power over his will."

- Alexander Hamilton

"The one is the common right of humanity, and the other the divine right of kings. It is the same principle in whatever shape it develops itself. It is the same spirit that says, 'You toil and work and earn bread, and I'll eat it.'"

- Abraham Lincoln

"No man's life, liberty or fortune is safe while our legislature is in session."

- Benjamin Franklin

"[A] government big enough to give you everything you want is also big enough to take away everything you have."

- Benjamin Franklin, Barry Goldwater & Gerald R. Ford (each in their own day.)


John D, you are right.
Insurance companies have no problems helping out families with medical problems, or injuries. They don't have departments with the sole purpose of denying claims, or telling doctors what they can & can't do, even over the advice of doctors.
Families never have problems with claims being denied over "technicalities".
& yes, all this competition in the healthcare industry has driven prices down to the point where even the poor in this country can afford the best healthcare.

By the way, universal, socialist healthcare has been a failure in every country that has it, including Japan, Australia, England, Germany, Canada, etc.

Once again, conservatives hit another grand slam in their argument.


C. Morris--I need to know what your insurance might be. My premiums are $10,000 a year for two, and my primary is medicare. My out of pocket medical expenses,excluding my wife, last year was almost $20.000. And I am in pretty good health for a septegenarian.


C. Morris--I need to know what your insurance might be. My premiums are $10,000 a year for two, and my primary is medicare. My out of pocket medical expenses,excluding my wife, last year was almost $20.000. And I am in pretty good health for a septegenarian.


Wow, imagine that, folks have to pay something towards health care!!!! Hmmm, housing costs money. Food costs money. Cars costs money. Clothes cost money. Furniture costs money. Vacations cost money. Toys cost money. But, yet, health care shouldn't?

And for all these folks who ocmplain about coverage denied, etc. I've never experienced it. My sister did have to fight with her insurance company through her ex-employer, but they eventually took care of it.
Some insurance companies are good, some are bad.
A good friend of mine's wife had most of her colon removed about five years ago, no problems with insurance coverage.
Folks, the system isn't great, I don't think anyone would say that. Every system has problems, whether it's Japan, Canada, England, wherever. Fact is, socialized medicine has proven to not be the cure-all. Also, using countries who's populations are a fraction of ours, is not a good comparison, but I also know Americans who live and work in Canada in which a spouse still works for a U.S. firm and she crosses the border every day to get to that U.S. company. Why? Better health care here than in Canada.


coach,

You can only pass out so much personal info here, buddy!

To keep it generalized;
Mine is a private Blue Cross of (State) for $2400 per year.
My wife's is employer privided, but her share is $3000 per year.
We are under 60 and in good health.

John W,
Nicely put together, but somehow universal health care just doesn't add up to a totalitarian state.

Of course those that support it have made up their minds, just as the opponents have made up theirs. This is not a new idea. We have all been thinking about it, collectively, for 50 years.

Let's try some real democracy in America for a change; let the people vote directly on it. (Yeah, I know, that's unconstitutional too.)


THe report I am referring to is a study done by the State of Wisconisn. All you have to do is google it. They said that the total cost of Health insurance is more than the entire Rev the gov brings in and it would cost $510 per month per taxpayer to pay for Universal Health Care. W/Out huge tax increases UNiversal Healthcare is not going to happen no matter what Politician lies to you.


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"Nicely put together, but somehow universal health care just doesn't add up to a totalitarian state."

********

Posted by: C.Morris | August 2, 2007 10:55 AM

When the government gets to have a say in regulating and monitoring your bodily functions, and then keeps all the data in a commonly shared database, there is little left of one's life for the individual to control. And then, when a doctor tells you to do something or to stop doing something, his or her word carries the weight of government.

So, no, universal health care is not the equivalent to a totalitarian state. But it sure makes a totalitarian state a lot easier to implement a short distance down the road. Never forget that encroacments on liberty are always taken in baby steps, and never by leaps and bounds. The fact that a program might start with benign intentions doesn't mean that it can't turn into the instrumentality of tyrrany in the wrong hands.

Might I remind you that the Nazis rose to power in Germany precisely because decades of (non-marxist) socialist collectivization made it possible? Now go read F.A. Hayek's book, "The Road to Serfdom." He explains, rather convincingly, how implementation of socialist measures leads to some form of authoritarian or totalitarian State.

So, I must ask: What do you people have against FREEDOM?

"The utter vulgarity of the herd of men comes out in their preference for the sort of life a cow leads."

- Aristotle


John W.

The freedom to throw yourself on the mercy of the bankruptcy court? Today's 'justice' is no longer tempered with any mercy.

That's where we are all headed with the current system, unless we can just take the pain and die at home w/o treatment.



Might I remind you that the Nazis rose to power in Germany precisely because decades of (non-marxist) socialist collectivization made it possible? Now go read F.A. Hayek's book, "The Road to Serfdom." He explains, rather convincingly, how implementation of socialist measures leads to some form of authoritarian or totalitarian State.

So, I must ask: What do you people have against FREEDOM?

"The utter vulgarity of the herd of men comes out in their preference for the sort of life a cow leads."

- Aristotle


Posted by: John W. | August 2, 2007 4:34 PM

John W,
What was that you were saying about how crazy it is to call political partys in America "Nazi's" the other day?


John E:

I searched the threads in which I have recently participated, and I then searched my own collection of messages (because I regularly write them out in a word processor first, but not always).

I found nothing in any of my writings to indicate that I believed it was "crazy" to call a political party Nazi.

Are you sure you haven't inadvertently confused me with John D. this time?

I have often associated collectivism and non-Marxist socialism with the roots of the Nazi and Fascist movements.

But, if I am wrong, I would greatly appreciate if you could show me where I ever wrote such a thing - as you suggest - so that I may clarify my position.

Could you do that for me?


Anonymous:

It very nice to know that someone thinks the merits of socialized medicine are not all once sided, and that those who oppose socialized medicine have valid points. So said Auntie Pinko.

However, what no one has ever responded to is the undisputable point that a federal universal health care plan, socialized or not, is unconstitutional because it is beyond the powers of Congress. Can you dip into your little bag and come up with a response to that one?


This Republican administration is hands down the closest thing this country has ever had to a Nazi regime.

*****
Posted by: John E | July 19, 2007 3:26 PM

That's a little over the top, don't you think? Duh'bya never put 120,000 innocent American citizens behind barbed wire fences, did he? Well, then, maybe he doesn't qualify as "hands down the closest thing this country has ever had to a Nazi regime."

Posted by: John W. | July 19, 2007 4:36 PM


John E:

Thanks for the reply, but it doesn't bear out your claim. I didn't say that it is crazy to call political parties Nazis. In the cited instance, you were making an unfavorable comparison, claiming "This Republican administration is hands down the closest thing this country has ever had to a Nazi regime." (Emphasis added.)

In my reply, I didn't disputed that someone might be unfavorably compared to the Nazis; I just didn't think that Duh'bya's administration qualified as the closest. That is why I gave the example of Duh'bya having never "put 120,000 innocent American citizens behind barbed wire fences . . ." That wasn't a reference to the Nazi's. The Nazis brutally imprisoned and killed millions; and not just tens or hundreds of thousands. The number 120,000 was, itself, a reference to the number of innocent Japanese-American citizens Franklin D. Roosevelt had interned – as an example of how much more repressive other administrations in this country have been (insofar as Nazi's tended to be repressive in the extreme). You see, I was making my own comparison. That's all.

I'm glad I could clarify this for you.


John W,
Bush is a partisan political criminal and you voted for him.

You Repubs better put on your thinking caps when it comes to who you're going to "lockstep" behind this time around.


John E:

Please stop telling me how you think I ought to vote. You have enough trouble on your side of the aisle.

For instance, the Democ-rat majority in Congress just approved of the extensive wiretapping power President Bush has been seeking for a long time. It's essentially the same power that he asserted in making his blanket authorization for warrantless searches.

Well, let me clue you. The FISA law was of questionable constitutionality before. President Bush violated the Constitution and the FISA laws by authorizing a blanket disregard for them. The President has no power to suspend operation of the Constitution.

Bush should be going to jail, if for no other reason, because his blanket authorization violated the criminal portions of FISA.

But, instead, of investigating him and sending him to jail, YOUR Democ-rat Congress just told him to go on doing the same illegall, unconstitutional crap. So, go right ahead, be proud of those idiots for whom you root for in your party.

But don't tell me I back Nazis. In light of this turn of events, you simply have no place to speak.


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