I can only support this plan if the following changes are made:
* Also limit premium discrimination based on health status, i.e., pre-existing conditions.
* Replace tax credits for individuals with a sliding-scale, direct assistance to buy health insurance. Tax credits are helpful only to people who make enough money to pay taxes in excess of the credit. Furthermore they only provide that help as much as a year after people have had to buy health insurance.
* The public health insurance option needs to be available immediately to the uninsured, then expanded to be available to everyone. The fastest, best way to implement it is to modify Medicare, not create a new program. Co-ops are not acceptable because they do not control costs.
* If premium discrimination based on health status as above is ended, there is no need for placing people in a high risk pool. The private insurers should be able to cover them at a reasonable cost. High-risk pools have the taint of discrimination and people often can't afford the premiums, the deductibles or other out-of-pocket costs.
* Taxes need to be increased on the wealthiest Americans. If the private insurers are going to continue to take their profits out of the health care system, a portion of that needs to be returned to the system. Alternatives are taxes on all sales of stock or stock in private insurance companies. Another alternative is to limit deductions for the wealthiest Americans. To say "Requires additional cuts if savings are not realized. is meaningless. If the savings don't occur immediately, and they won't, what are you going to cut, benefits? Why not immediately cut profits taken outside the health care system?
* Eliminate Medicare Advantage and other subsidies to the private health insurance companies related to Medicare. They do just fine writing supplemental insurance for Medicare clients.
* Re adjust Medicare payments so that the same reasonable reimbursement is provided to doctors and hospitals across the country.
* Eliminate the mandate for individuals to obtain insurance. If it is available to them at a reasonable price they will take it; we have far more people who want to be insured but can't get it than we have people who don't want it at all. A mandate is meaningless without enforcement and fining people because they can't afford insurance is repugnant. We're supposed to be helping people, not punishing them.
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