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Health Care

Health Care. 4/17/2012. Learning Objectives. Accurately describe the social, economic, and political dimension of major problems and dilemmas facing contemporary American society

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Health Care

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  1. Health Care 4/17/2012

  2. Learning Objectives • Accurately describe the social, economic, and political dimension of major problems and dilemmas facing contemporary American society • Use knowledge and analyses of social problems to evaluate public policy, and to suggest policy alternatives, with special reference to questions of social justice, the common good, and public and individual responsibility.

  3. Opportunities to discuss course content • Today-11-2 • Wednesday 10-2

  4. Readings Required • Health and Welfare (Chapter 5 pp 97-115) Dye • American Dilemmas Handbook pp. 27-38 Optional • Health Care: Problems of Physical and Mental Illness (Chapter 10) Kendall

  5. Health Care

  6. The Problems of the System • Access • Cost • Quality

  7. Problem 3: Cost • Outpacing Inflation • Why

  8. Cost- Labor • 5.5 People per patient (the old days) • Jobs that require skill and education • Recession Proof

  9. Cost- Malpractice • Actually not the suits themselves • Defensive medicine • High Insurance- just in case

  10. Cost- Greedy people • We want to get our benefits back • We do not realize the actual costs • A “Tragedy of the Commons”

  11. Cost- An Older Population • Our last years of life consume much of our health care dollar • We are living longer and there are more of us • More Care means more $

  12. Cost and Prescription Drugs • Average cost is $2400 • 9 in 10 Seniors use a drug • Direct to Consumer Ads

  13. The Solution Patient Protection and Affordable Care Act

  14. What is it • A law that will get health insurance to roughly 30 million Americans • Not a single payer system

  15. What it looks like

  16. How will it Work: Expanding Federal Programs • Getting those eligible on programs they are eligible for • Expanding Medicare Eligibility • Expanding COBRA health insurance • Expanding SCHIP Program

  17. How will it Work: Making Changes to Private Insurance • Cannot Deny for Pre-Existing Conditions • Cannot remove people who use up their coverage • The Slackers mandate • Subsidies to purchase insurance

  18. How will it Work: Individual Mandates • People will be required to have health insurance • Just as we are required to have auto insurance • Up to 2.5% of income by 2016

  19. What if I have Insurance? • In theory it should not change • Your employer, however, can just cut you off

  20. When does it start • Mandates begin in 2014 • Costs should be lowered over time as people have insurance

  21. How can we afford this • 1 Trillion over first 10 years • Tax on Tans • Higher Medicare taxes on wealthy and Medicare cuts on providers • Taxes on High-end insurance • Fees on Health Care Industry

  22. Upwards of 20 million mayRemain Uninsured • Illegal Immigrants and non-citizens (10 million) • People who do not sign up for eligible programs. • People who pay the penalty (mostly younger and single Americans.

  23. Keeping the law

  24. Democratic Strategy • Draw a line on health care and do not let the Republicans cross it • Use institutional advantages to delay change • Focus on the popular parts of the law • Re-Cast the GOP into the Party of No (Part II)

  25. Democratic Advantage 1: Laws are Difficult to Repeal • They come in with political support and they retain that support • Minor changes and fixes only serve to strengthen the existing law! • Prohibition lasted for 13 years

  26. Democratic Advantage 2: Marketing Popular Initiatives

  27. Democratic Advantage 3: Divided Government • Use Senate Majority to control the Agenda • Filibuster when necessary • The Presidential Veto as a last resort

  28. Democratic Advantage 4: No new taxes in 2011 or 2012 • FSA limits in 2013 • Medicare tax increase by 0.9% and 3.8% tax on investments income for high-wage earners in 2013 • Individual mandate in 2014 • Cadillac Tax in 2018

  29. Democratic Advantage 5: Debt and Deficits

  30. The Republican Strategy Repeal the bill through other means

  31. Republican Strategy • A straight-up repeal was unsuccessful • Continue to push the issue through other political avenues • Force this as a campaign issue in 2012

  32. Republican Advantage 1: Consensus in the Party • The Republicans are unified in the support for repeal. • Try to exploit Democratic cleavages between those who want to keep the existing law, and those who may want to strengthen it. • Try to switch Democrats to their side

  33. GOP Advantage 2 Public Opinion

  34. Republican Advantage 3: The Individual Mandate • This is key to the success of the bill • And one of the least popular portions • Expect Heavy Resistance if the GOP tries • Which is exactly what the GOP wants

  35. A Court Ruling in 2012

  36. On Repeal Probably For Repeal Probably Against Repeal Ruth Bader-Ginsburg Stephen Breyer Sonia Sotomayor Elena Kagan • Antonin Scalia • Clarence Thomas • Samuel Alito

  37. On the Fence Chief Justice Roberts Justice Anthony Kennedy

  38. This Makes the Legal Challenge a 2012 Campaign Issue

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