What the Health Care Bill Means to You

[William Haskins]

http://www.washingtonpost.com/wp-srv/special/politics/what-health-bill-means-for-you/?hpid=topnews

for the fun of it, i entered a single parent with 3 kids, making 40k a year with no insurance.

http://i457.photobucket.com/albums/qq291/whaskins/HCR.jpg?t=1269282367

[veinglory]

Apparently what it means to me is nothing at all.

[robeiae]

I have to pay more in taxes. Shocking.

[William Haskins]

note to all the kids out there finishing up college... in addition to your student loan payments and rent and food and transportation, you will be saddled with a 2 or 300 dollar a month insurance bill (no subsidies for you) and you'll be fined if you don't buy it.

(based on 1 single person without insurance entering the work force at 30k a year)

[rugcat]

Try entering the same single parent making 24K -- a job that would pay about about $11 an hour.

[Magdalen]

First I stamp my foot,
then slam my right fist into the flat
of my left hand all the while,
muttering Fuck!



Magdalen
beaten by a carrot stick

[William Haskins]

Try entering the same single parent making 24K -- a job that would pay about about $11 an hour.

yep. that parent pays $75 or so a month and rob pays the other $225.

[robeiae]

I should get to choose their doctor and which treatments they receive.

[rugcat]

yep. that parent pays $75 or so a month and rob pays the other $225.The only problem with that is... wait, I don't have a problem. Except that rob should also be paying for me.

[Perks]

According to this, is doesn't change my situation at all.

My sister will have to buy health insurance or face a fine. I'm torn, because the compulsory aspect feels intrusive, but she really needs health insurance. She's never made it a priority and has always spent her money on other things. Her health and well-being have suffered greatly for it and she's complained regularly about not being able to afford to see a doctor.

$117 a month is a pretty good deal, but I'll be interested to know, if this ever happens, what sort of coverage will be available to her.

ETA - But there's an awful lot of fineprint about tax credits and maximum out-of-pocket and blah, blah, blah...

[Don]

Come on, now, admit it.

Who's in sticker shock after visiting that site, but doesn't want to say anything because they supported the bill?

Fess up, we know you're out there. :D

[MacAllister]

Huh. If I was married, I wouldn't be eligible for the tax penalty, all other information being exactly the same.

But since I'm NOT married, I get penalized.

[AndiB]

Yikes! I will receive tax credits to help afford my premiums and ensure I do not spend more than $8,312.50 on premiums PLUS my out of pocket deductibles and copayments will be capped at 30% (in addition to the more than $8,000 a year we're already paying just to have insurance). YIKES! That's a LOT of money in addition to any taxes that might go up along the way.

Oh yeah, failure to comply will mean a penalty of 2.5% of my household income AND if we get raises or increased income of $701 or more we will not receive any subsidies at all. We'll just be required to pay whatever they ask.

ETA It's cheaper to pay the penalties and out of pocket for health care. I wonder if they are going to do something really slimy like restrict access to health care for those who do not buy the mandatory insurance down the road.

[shawkins]

No change for me on either coverage or taxes.

[backslashbaby]

I pay just over $1000 a month now for premiums alone. Single, no kids. Talk about sticker shock.

Yeah, I supported the bill (a better bill would have been better, clearly).

ETA: 20% copay on nearly everything, and I still have a deductible so casts, etc. weren't even covered yet. You don't want to know my presciption bill...

[Williebee]

It doesn't look to change my situation.

But my daughter is going to have to get health insurance.

[William Haskins]

ETA It's cheaper to pay the penalties and out of pocket for health care. I wonder if they are going to do something really slimy like restrict access to health care for those who do not buy the mandatory insurance down the road.

the cheapest way is to refuse to pay the penalties and go to jail... there you will get free health care (paid for by rob).

[backslashbaby]

I don't mean to be rude, but when y'all say no insurance, are you talking not even catastrophic coverage?

Like, if this hypothetical person got a disease or got hit by a bus, they'd have no coverage to pay for it right now?

Because $1k is a ton to pay before anything even happens, but it's still much less than what I've seen happen to folks without any nets in place.

[shadowwalker]

I'm not unhappy about being required to carry insurance - I'm required to carry auto insurance and homeowner's insurance, so what's the difference? But this also means I'll be able to afford health insurance. Which means the next time I end up in the emergency room because of heart problems, the bill won't be added to the general hospital costs because I don't have the money to pay for it (so other people won't end up with higher costs to cover that). It also means that maybe I can get the heart surgery I need so there won't be any more trips to the emergency room. Lastly, it means I may actually live long enough to get published.

Yeah, I'm pretty happy about it.

[Opty]

note to all the kids out there finishing up college... in addition to your student loan payments and rent and food and transportation, you will be saddled with a 2 or 300 dollar a month insurance bill (no subsidies for you) and you'll be fined if you don't buy it.

(based on 1 single person without insurance entering the work force at 30k a year)

Not to step too much on your doom and gloom scenario but where are you getting your "2 or 300 dollar a month" figure?

National average for health insurance premiums for a single person in the situation you described is roughly $160/month. I pay around that amount, too, which includes dental coverage.

You're also forgetting the fact that kids will now be able to stay on their parents insurance until age 26. Not to mention the fact that many companies out there already offer health insurance for employees which, if these college kids do sign up for, will cost them about half of what the national average is (at my former company, it worked out to about $90 month for a single person).

Your example doesn't really fit reality.

[Al Ross]

Yea mandatory health care, one more way to shackle people to the chains.
Penalizing those that do not get a health care, great way of criminalizing the poor people.

[robeiae]

What if their parents don't have insurance?

Oh, wait...the kids can turn them in and get a reward!

[Shadow_Ferret]

I will see no change, although my medicare payroll taxes will go up .9% and I will have to pay 3.8% tax on investment income, whatever that is.

[Perks]

It's hard to know what to think about this. I know right off that I hate its complexity, because I'm immediately suspicious of it.

At this point, it looks like my family - if everything remains as it is - won't feel any difference. (Why don't I believe that?)

My sister will be forced to get health insurance, but she's a textbook case of what much of the clamor is about. She ekes out a living, takes horrible care of herself, avoids the doctor because she can't afford it, then goes to the emergency room when she gets intolerably sick or injured, resulting in an enormous bill that she never pays.

And then I hear that someone like Mac incurs a penalty because she's not married.

This is a mess.

[AndiB]

I don't mean to be rude, but when y'all say no insurance, are you talking not even catastrophic coverage?

Like, if this hypothetical person got a disease or got hit by a bus, they'd have no coverage to pay for it right now?

Because $1k is a ton to pay before anything even happens, but it's still much less than what I've seen happen to folks without any nets in place.

My husband's company is going over to a high deductible/health savings plan on April 15th (anyone notice the irony there) to cut their expenses. They've also laid off 2/3 of their employees and closed two offices over the past year moving most operations to India.

We've been shopping around for alternatives. We think it's nuts to spend $400 a month plus invest $200 a month for something that leaves us struggling to pay (out of pocket) for monthly prescriptions and periodic doctor's visits.

Incidentally, the price estimate I got from the link above is more than double the estimates I've been getting from companies like Blue Cross/Blue Shield which were about the same amount we would be paying for coverage through husband's work with a $35 copay for office visits and name brand prescriptions ($15 for generics) and $1,500 deductible for hospital etc.

I'm also curious to know about the subsidies. My understanding is that people are supposed to start buying now but the subsidies won't kick in until 2014. Am I misreading that?

[CheekyWench]

I don't mean to be rude, but when y'all say no insurance, are you talking not even catastrophic coverage?

Like, if this hypothetical person got a disease or got hit by a bus, they'd have no coverage to pay for it right now?

Because $1k is a ton to pay before anything even happens, but it's still much less than what I've seen happen to folks without any nets in place.

The Hill Burton Act (http://www.hrsa.gov/hillburton/default.htm) is still in place. I've used it before when my daughter was born and my portion was around 7 grand. (with insurance.) My husband, who didn't have insurance at the time also ate a $1200 burrito (food poisoning) and we couldn't afford it. We proved how poor we were and the hospitals filed Hill-Burton and wrote it off.

[William Haskins]

Not to step too much on your doom and gloom scenario but where are you getting your "2 or 300 dollar a month" figure?

National average for health insurance premiums for a single person in the situation you described is roughly $160/month. I pay around that amount, too, which includes dental coverage.

You're also forgetting the fact that kids will now be able to stay on their parents insurance until age 26. Not to mention the fact that many companies out there already offer health insurance for employees which, if these college kids do sign up for, will cost them about half of what the national average is (at my former company, it worked out to about $90 month for a single person).

Your example doesn't really fit reality.

i entered a single person making 30k with no insurance. it says the program will "ensure that you do not spend more than $2414 to $2850 on premiums."

then i took those numbers and i punched them in a calculator and divided by 12 (the number of months in a year). the magic screen came back with the numbers 201 to 237.

[backslashbaby]

The Hill Burton Act (http://www.hrsa.gov/hillburton/default.htm) is still in place. I've used it before when my daughter was born and my portion was around 7 grand. (with insurance.) My husband, who didn't have insurance at the time also ate a $1200 burrito (food poisoning) and we couldn't afford it. We proved how poor we were and the hospitals filed Hill-Burton and wrote it off.

That's just for hospitals and might be lower income than the folks I'm thinking of (I'm not sure). This wasn't an emergency-type situation. Cancer. They were well off and 'healthy'. The wife didn't work.

One of my mom's at-home cancer prescriptions was $1000 a month. She had insurance through her work before she got sick, thank God. Of course, they tried to fire her because the premiums would go up...

[robeiae]

It's hard to know what to think about this. I know right off that I hate its complexity, because I'm immediately suspicious of it.

At this point, it looks like my family - if everything remains as it is - won't feel any difference. (Why don't I believe that?)

My sister will be forced to get health insurance, but she's a textbook case of what much of the clamor is about. She ekes out a living, takes horrible care of herself, avoids the doctor because she can't afford it, then goes to the emergency room when she gets intolerably sick or injured, resulting in an enormous bill that she never pays.

And then I hear that someone like Mac incurs a penalty because she's not married.

This is a mess.
This is for you, Perks:

http://www.realclearpolitics.com/articles/2010/03/22/obama__pelosis_agenda_of_spreading_dependency_1048 65.html

[Opty]

Okay, so you were intentionally inflating the number when you put "to 300 dollars," I can only assume for dramatic effect.

Also, your entire argument ignores the fact that there are currently private insurance programs out there that cost substantially less (like mine).

[brokenfingers]

Hmmmm, it's hard to tell right now if it's better or not. I pay a little over $900 a month for crappy insurance right now (I'm in a high-risk occupation) so I'm curious how this will all pan out.

As it stands, I'll be paying less with this new plan, but I guess we'll see.

But I definitely like the idea of Rob paying for me.

[CheekyWench]

That's just for hospitals and might be lower income than the folks I'm thinking of (I'm not sure). This wasn't an emergency-type situation. Cancer. They were well off and 'healthy'. The wife didn't work.

One of my mom's at-home cancer prescriptions was $1000 a month. She had insurance through her work before she got sick, thank God. Of course, they tried to fire her because the premiums would go up...


Oh, I see.
Well, I don't know what to tell ya. My FIL's wife died of brain cancer. They didn't have insurance. They went bankrupt and he lost everything including his wife.

[backslashbaby]

Oh, I see.
Well, I don't know what to tell ya. My FIL's wife died of brain cancer. They didn't have insurance. They went bankrupt and he lost everything including his wife.

:( Exactly.

[robeiae]

(I'm in a high-risk occupation)
Inflatable sex-doll manufacturing is high-risk?

[Opty]

This is for you, Perks:

http://www.realclearpolitics.com/articles/2010/03/22/obama__pelosis_agenda_of_spreading_dependency_1048 65.html

Linking to an opinion article by George Will (because that's all his pieces really are. He stopped being a credible, legitimate journalist at least 30 years ago) can be considered about as credible as if I'd linked to one by Keith Olbermann.

[Don]

Inflatable sex-doll manufacturing is high-risk?
Only if you work in quality control.

[robeiae]

Linking to an opinion article by George Will (because that's all his pieces really are. He stopped being a credible, legitimate journalist at least 30 years ago) can be considered about as credible as if I'd linked to one by Keith Olbermann.
Quiet. I'm trying to instill fear.

(you've been away for too long)

[brokenfingers]

Inflatable sex-doll manufacturing is high-risk?The occasional explosions are often lethal. Or debilitating, at least. Especially if you're a Tester.

[Jamesaritchie]

It means those who work hard and actually pay their own way will now have to work even harder to support even more people who don't pay their own way.

But it's a long, long, long way from being the law of the land at this stage. Anyone who's counting on this health care bill to pay their way is in for a very long wait, and it's in no way certain that it will ever be actual law a the state level. Thank God.

[Celia Cyanide]

It means those who work hard and actually pay their own way will now have to work even harder to support even more people who don't pay their own way.

I don't know, I pretty much work the same ammount of "hard" no matter how much I'm paying in taxes.

[Don]

This is for you, Perks:

http://www.realclearpolitics.com/articles/2010/03/22/obama__pelosis_agenda_of_spreading_dependency_1048 65.html
You sure you wanna pimp that? 'Cause George is soundin' kinda libertarian there, you know. ;)

[Opty]

Quiet. I'm trying to instill fear.

(you've been away for too long)

But you have such better fear-mongers to link to like Beck, Limbaugh, Coulter, Malkin, Steele, even Armstrong Williams.

I expect better from you next time, Rob.

[backslashbaby]

Brokenfingers pays a ton for crap because of a high-risk profession. I pay a ton for crap because I am statistically predisposed to certain ugly conditions and I'm a 1099 worker.

My actual health costs aren't anywhere near what I pay in.

[Perks]

Quiet. I'm trying to instill fear.

(you've been away for too long)Don't mess with me, bub.

[Inkblot]

One trip to the emergency room is all you'd need to get over the sticker shock of a couple hundred a month for insurance. One of my college age children broke a finger and had to go to the E.R. -- cost more than $5,000. Fortunately, insurance paid for it.

[Magdalen]

You sure you wanna pimp that? 'Cause George is soundin' kinda libertarian there, you know. ;)

From the link:
"As America's teetering tower of unkeepable promises grows, so does the weight of government, in taxes and mandates that limit investments and discourage job creation. America's dynamism, and hence upward social mobility, will slow, as the economy becomes what the party of government wants it to be -- increasingly dependent on government-created demand."

It's almost as if Washington is playing "Jenga" while the rest of us are playing "Operation" (with burnt-out lightbulbs)

[backslashbaby]

I don't know, I pretty much work the same ammount of "hard" no matter how much I'm paying in taxes.

Yeah, let's take a self-employed roofer and compare him to someone like JA. I'm sure we'd all agree with the insurance disparity in cases like that /sarcasm

[Don]

From the link:
"As America's teetering tower of unkeepable promises grows, so does the weight of government, in taxes and mandates that limit investments and discourage job creation. America's dynamism, and hence upward social mobility, will slow, as the economy becomes what the party of government wants it to be -- increasingly dependent on government-created demand."

It's almost as if Washington is playing "Jenga" while the rest of us are playing "Operation" (with burnt-out lightbulbs)
Except for the pot/kettle crap, it's pretty good. He forgets the growth in government his own party managed under GWB.

The Party of Government is the Republicrats. I've yet to see any proof to the contrary.

[William Haskins]

Okay, so you were intentionally inflating the number when you put "to 300 dollars," I can only assume for dramatic effect.

Also, your entire argument ignores the fact that there are currently private insurance programs out there that cost substantially less (like mine).

yes. please be aware all, that i said "up to 300" when it was only 237.
other than that, opty, i'm not ignoring shit.

i'm expressing data as generated in the app linked in the OP.

[rugcat]

It won't affect me at all. I have insurance through work, and it won't be all that long before I qualify for Medicare.

But if I was ever successful enough as a writer to quit work (very unlikely, though not impossible) I will now have the option to quite work -- something not previously possible, since pre existing conditions have basically made me ineligible for private insurance. Even with insurance my average yearly costs have been running at 5 K or so -- and that's without anything major happening. Without insurance, 25-30 K.

[CheekyWench]

One trip to the emergency room is all you'd need to get over the sticker shock of a couple hundred a month for insurance. One of my college age children broke a finger and had to go to the E.R. -- cost more than $5,000. Fortunately, insurance paid for it.

See also my above post about the $1,200 burrito. That was an ER visit when DH had no insurance. $1,200 bucks for a bucket to ralph in and a shot in the ass of phenagren.

[Williebee]

That's a NICE bucket you got there Cheeky!

[Perks]

See also my above post about the $1,200 burrito. That was an ER visit when DH had no insurance. $1,200 bucks for a bucket to ralph in and a shot in the ass of phenagren.
I dunno, I might pay $1200 not to have to clean puke out of the carpet. Especially burrito puke. Did he have a margarita, too? In that case, it's the deal of the century.

[Lyra Jean]

I'll receive tax credits that will ensure that I do not pay more $2142 to $2737 on premiums. My maximum out-of-pocket costs for deductibles and co-payments would be capped at 27% of the total cost.

I am required to have health insurance. My penalty would be $695 up to $2,085 a year or 2.5% of household income.

I'm married without insurance. My husband has insurance through work and we have a combined income of about $35,000 I think.

[CheekyWench]

That's a NICE bucket you got there Cheeky!

it was SO Nice. :D

I dunno, I might pay $1200 not to have to clean puke out of the carpet. Especially burrito puke. Did he have a margarita, too? In that case, it's the deal of the century.

No, he didn't! Actually, tack on another 16 bucks to that because we went to see Pirates of the Caribbean when he got sick... what a date that was.

[billythrilly7th]

I have great AETNA group insurance through work. I pay about $80 a month.

I really hope Obama didn't fuck that up.

I make around 60k a year.

I hope the health care bill means nothing to me except the anger on principle that people like Rob and my sister have to pay higher taxes to pay for other people to get insurance.

I do like the part about people being forced to buy insurance though. I think.

Who knows?!!!! It's too complicated to understand and I don't think anyone really has a clue of it's impact!!!!!!!!

Thank you.

[backslashbaby]

it was SO Nice. :D



No, he didn't! Actually, tack on another 16 bucks to that because we went to see Pirates of the Caribbean when he got sick... what a date that was.

:D Sue the burrito people!

I had a British friend say, "I see why you Yanks sue each other so much!" when she heard what medical things cost here. :D

[CheekyWench]

:D Sue the burrito people!

I had a British friend say, "I see why you Yanks sue each other so much!" when she heard what medical things cost here. :D

It's true!

[mscelina]

:D Sue the burrito people!

I had a British friend say, "I see why you Yanks sue each other so much!" when she heard what medical things cost here. :D

Yes, and one other thing the Health Insurance Bill Means To You is that those costs will remain unchanged. The only difference is that now it won't be just the medical care industry, pharmeceutical companies and insurance conglomerates charging those exhorbitant prices--tap in some extra money to the IRS bucket, too. After all, they are now the final arbiters of health insurance in this country.

Yep. Only in America would health decisions be regulated by the tax collectors.

[William Haskins]

another interactive model...

http://www.nytimes.com/interactive/2010/03/21/us/health-care-reform.html

and a chart:

http://www.latimes.com/features/health/la-na-healthcare-passage22-2010mar22-g,0,7818440.graphic

and a timeline:

http://www.washingtonpost.com/wp-dyn/content/article/2010/03/21/AR2010032103485.html

[backslashbaby]

Yes, and one other thing the Health Insurance Bill Means To You is that those costs will remain unchanged. The only difference is that now it won't be just the medical care industry, pharmeceutical companies and insurance conglomerates charging those exhorbitant prices--tap in some extra money to the IRS bucket, too. After all, they are now the final arbiters of health insurance in this country.

Yep. Only in America would health decisions be regulated by the tax collectors.

It totally should have addressed medical costs more. Totally. But my biggest expense is the premiums. I simply can't keep up with them. And my trips to the doc are flat-rate, check my scripts stuff and blood work.

How much good $$ is poured into premiums that really cover the uninsured or line the pockets of the top dogs in the industry? It has to be a huge amount. And we don't pay for that equally at all.

[AndiB]

:D Sue the burrito people!

I had a British friend say, "I see why you Yanks sue each other so much!" when she heard what medical things cost here. :D

I maintain that the high cost of health care in this company is the direct result of sue happy people. Before I decided to freelance I worked in a law firm that specialized in pharmaceutical defense. We defended against these massive class action lawsuits against drug companies.

The costs involved in defending against malpractice, the sheer volume of people jumping on the lawsuit bandwagon, and raw tonnage of paperwork, court filings, and legal and medical expertise involved in trying and defending these cases is astronomical. We're talking hundreds of millions of dollars per class action case just in the defense (this isn't counting any awards that are made and paid out).

Don't forget the number of unnecessary tests that are ordered by physicians in a CYA effort to avoid being named in a lawsuit for that one in million shot that the headaches are symptoms of a brain tumor and not the direct result of inflamed sinuses during allergy season. It's astonishing the links and extra tests that are ordered just so doctors can avoid becoming the target of someone going for a lottery windfall by lawsuit.

The Republicans weren't ignoring a huge problem by seeking tort reform. They were addressing a huge issue that is added on to the cost of every insurance policy that is sold in the country.

[SPMiller]

Recently, I told a non-American friend that American politics can be explained in large part as a clean divide between two opposed factions: "white people who don't want taxes to go up" and "everyone else". If reading that makes you upset, stop, think, and read it again.

[billythrilly7th]

another interactive model...

http://www.nytimes.com/interactive/2010/03/21/us/health-care-reform.html

If you are refused coverage because of your health, you can get insurance from a new high-risk pool.

The pool will be established within six months and will operate until 2014, when insurance companies can no longer refuse applicants with pre-existing health problems. Annual out-of-pocket medical costs will be capped at $5,950 for individuals and $11,900 for families.

What does that mean? What is a "new high-risk pool?"

Is that through companies like blue cross or a government run plan called whatever..."GOVPLAN ORANGE."???

"Hi...I had cancer and can't get insurance..I want to buy insurance from the new high risk pool."

Who is that person calling?

[billythrilly7th]

Recently, I told a non-American friend that American politics can be explained in large part as a clean divide between two opposed factions: "white people who don't want taxes to go up" and "everyone else". If reading that makes you upset, stop, think, and read it again.

I've read it four times..what's supposed to happen after you get upset after the initial reading and then read it a few more times?

[SPMiller]

Are you white, and do you want your taxes to not go up?

Just wondering.

[Lyra Jean]

Can I have Rob pay for my insurance too? :)

[billythrilly7th]

Are you white, and do you want your taxes to not go up?

Just wondering.

I am white and I do not want my or other people's taxes to go up.

Wow.

You proved your point.

You are a political demographic genius.

The United States can be divided into two political groups.

White people who don't want their taxes to go up and everyone else.

Got that everyone?

And it was so simple all these years.

:rolleyes:

[SPMiller]

Thanks, billy. You never disappoint.

[tjwriter]

I don't think anyone wants their taxes to go up. But that doesn't mean some of us don't recognize that if we want the government to fund all these things so we don't think about them ourselves, that taxes will have to go up to pay for that.

So yeah, I pasty-fucking white (except for that 1/16 of me that is Cherokee) and I know that taxes will have to go up. Your post implies something very hateful.

[SPMiller]

Hateful? Lol.

[billythrilly7th]

Thanks, billy. You never disappoint.

No problem.

And THANK YOU. Because, I'll copy and paste and email your analysis of United States political demographics to my friends of other ethnicities who don't want their taxes to go up as well and we'll all have a good laugh at your expense if you don't mind.

A deep, hearty laugh.

Thanks, SP!

:)

[Robert Toy]

Recently, I told a non-American friend that American politics can be explained in large part as a clean divide between two opposed factions: "white people who don't want taxes to go up" and "everyone else". If reading that makes you upset, stop, think, and read it again.
It's nice to know that "everyone else" wants increased taxes.

ETA: one of the non-white "everyone elses"

[Don]

Recently, I told a non-American friend that American politics can be explained in large part as a clean divide between two opposed factions: "white people who don't want taxes to go up" and "everyone else". If reading that makes you upset, stop, think, and read it again.
That is one of the most racist things I've ever heard.

The color of one's skin has nothing to do with one's knowledge of economics, government and bureaucracy.

You weren't far off though. American politics can be explained in large part as a clean divide between two opposed factions: "hard-working people of all races who want to keep what they earn" and "everyone else".

[backslashbaby]

What does that mean? What is a "new high-risk pool?"

Is that through companies like blue cross or a government run plan called whatever..."GOVPLAN ORANGE."???

"Hi...I had cancer and can't get insurance..I want to buy insurance from the new high risk pool."

Who is that person calling?

I'm interested in how they are going to do the pools. As it stands now (and states differ on this) I am in no pool because I'm a 1099 employee. I have ZERO bargaining power with the insurance industry as an individual, so my costs are blasphemous.

If I try to pay the docs straight-out, the cost is higher than what insurance would pay because I have no bargaining power with the docs, either.

If I try to shop around for new insurance, I won't get it, because I have a pre-existing condition.

If I give up insurance, medical costs will bankrupt me.

So the pools are supposed to at least group people together so they have some collective power. It's better than what we're doing now.

[shadowwalker]

I'm just always amazed (and I really shouldn't be) that "Them That Has" are always so worried what it will cost them if "Them That Hasn't" gets it. It might actually mean what - you miss the morning Starbuck's? Once a week you don't go to a restaurant for lunch? Have to skip a manicure once a month?

Much better to keep the status quo - so hospital costs will keep going up (because the uninsured will wait until later in their illness to go to the emergency room and that cost will be passed on to those with insurance), and those without insurance will take more time off work because they have no preventive care (thus increasing the costs of producing the goods that everyone will have to pay more for), and die younger (which at least gets rid of the surplus population).

Yeah. Much better to leave things as they were.

[robeiae]

I don't think this bill fixes jackshit. It won't improve healthcare. It won't lower costs. And, ultimately, it won't make anyone happy.

That said, my answer to the OP remains exactly the same: what this bill means to me is that I'll pay more in taxes.

And that said, I have no intention of missing my morning Starbucks. I'll just have less to give to the Red Cross, the next time there's a major disaster.

[Don]

...which means that charitable donations go down, and now we have another "crisis" on our hands that only the gunvernment can solve. Groovy how that works out for the power freaks, isn't it?

[Gregg]

But is the Bill even constitutional? There are several new taxes in it- mostly payroll/medicare taxes I think.

But Article I, Section 7 says:

"All bills for raising revenue shall originate in the House of Representatives; but the Senate may propose or concur with amendments as on other Bills."

Didn't this bill originate in the Senate?

[Sheryl Nantus]

Recently, I told a non-American friend that American politics can be explained in large part as a clean divide between two opposed factions: "white people who don't want taxes to go up" and "everyone else". If reading that makes you upset, stop, think, and read it again.

just when I think there's a hope in hell that I might understand you Americans...

...

...

nope.

:D

[emandem]

Haven't had a chance to read the whole thread, but what does this mean to me as a doctor owning my own practice?? ALONG with the projected 21% cut in medicare payments projected to happen later this year--?

It means I have to lay off a couple of people b/c I can't afford to pay all their insurance and I have to markedly shorten my time spent in the patients' rooms in order to keep the bills paid...

[William Haskins]

I have to markedly shorten my time spent in the patients' rooms in order to keep the bills paid...

if you're like most doctors, that will cut it down to what... 10 seconds from 25?

[Perks]

I've read it four times..what's supposed to happen after you get upset after the initial reading and then read it a few more times?That he tricked you into being upset a bunch of times, silly.

[billythrilly7th]

That he tricked you into being upset a bunch of times, silly.

lol

I knew I'd feel the same after reading it a few more times, but I relish in being upset. What you call hell..I call home.

:)

[Bird of Prey]

LOL!! Yup, this bill spells disaster. There goes the sky: falling, falling, falling, falling:

. . . .Daniel Reed, a Republican representative from New York, predicted that with Social Security, Americans would come to feel “the lash of the dictator.” Sen. Daniel Hastings (R.-Del.) declared that Social Security would “end the progress of a great country.”

John Taber, another Republican representative from New York, went further and said of Social Security: “Never in the history of the world has any measure been brought here so insidiously designed as to prevent business recovery, to enslave workers.”

In hindsight, it seems a bit ridiculous, doesn’t it? Social Security passed, and the republic survived.

Similar, ferocious hyperbole was unleashed on the proposal for Medicare. President Kennedy and later President Johnson pushed for a government health program for the elderly, but conservatives bitterly denounced the proposal as socialism, as a plan for bureaucrats to make medical decisions, as a means to ration health care.

The American Medical Association was vehement, with Dr. Donovan Ward, the head of the AMA in 1965, declaring that “a deterioration in the quality of care is inescapable.” The president of the Association of American Physicians and Surgeons went further and suggested that for doctors to cooperate with Medicare would be “complicity in evil.”

The Wall Street Journal warned darkly in editorials in 1965 that Medicare amounted to “politicking with a nation’s health.” It quoted a British surgeon as saying that in Britain, government health care was “crumbling to utter ruin” and suggested that the U.S. might go in the same direction. . . .

http://www.projo.com/opinion/contributors/content/CT_kristof24_11-24-09_SPGHCBF_v8.3f8c3be.html

[veinglory]

A bunch more people get health insurance.

Good. Health care is like law enforcement and education--everyone really should have a basic amount even if they are stupid enough not to want it. Whether they pay for it through tax or mandatory payment seems trivial to me.

[blacbird]

In the interest of actual information (which, I realize, is probably futile here):

http://www.msnbc.msn.com/id/34609984/ns/health-health_care/?GT1=43001

caw

[blacbird]

Meanwhile, amidst all the crisis over health care and totalitarianism, a potentially bad scary volcanic event has commenced in Iceland:

http://www.msnbc.msn.com/id/35988484/ns/technology_and_science-science/?gt1=43001

In 1783-84 Iceland experienced the largest volcanic event in recorded world history, judged on the basis of volume of material erupted. As the story points out, this event had a severe impact on northern hemisphere climate for the next year and more. This is worth paying attention to.

I'm waiting for Rush Limbaugh to blame it on Obama. Or maybe Pat Robertson to blame it on homosexuality.

caw

[billythrilly7th]

In the interest of actual information (which, I realize, is probably futile here):

http://www.msnbc.msn.com/id/34609984/ns/health-health_care/?GT1=43001

caw


This is no time for actual information. What is wrong with you?!

Get ahold of yourself.

http://www.funnyordie.com/videos/fd70f76148/calm-down-get-a-hold-of-yourself-from-airplanefan

[billythrilly7th]

http://www.msnbc.msn.com/id/35988484/ns/technology_and_science-science/?gt1=43001

In 1783-84 Iceland experienced the largest volcanic event in recorded world history, judged on the basis of volume of material erupted. As the story points out, this event had a severe impact on northern hemisphere climate for the next year and more. This is worth paying attention to.

Nah. We'll be fine. Volcano eruptions like that only affected people who lived before electricity was invented. Like the Krakatoa'ins.

Natural disasters are very handleable in these modern times. I live in NYC and volcano or not, I look forward to a nice summer.

[William Haskins]

actually, there's been quite a bit of info; still it's not a complete day without a condescending post from the bird.

[billythrilly7th]

actually, there's been quite a bit of info; still it's not a complete day without a condescending post from the bird.

http://www.inquisitr.com/wp-content/mark-the-bird-fidrych.jpg

[Magdalen]

Uh uh billy, not that bird -- he's flown

http://mlb.mlb.com/news/article.jsp?ymd=20090416&content_id=4295722&vkey=news_mlb&fext=.jsp&c_id=mlb

[Ol' Fashioned Girl]

Hasn't anyone figured out yet that this whole debacle is the result of lobbyists from the insurance companies and health care providers? If you follow the dollar, those big bills from the ERs, hospitals and specialists don't get paid for catastrophic illnesses in those with no coverage. If we require everyone to have insurance, the providers get paid by the insurance companies, who have deals with the providers to charge them 'special rates' and the insurance companies get paid by everyone. That's the Law of Large Numbers at work, folks.

And, like the lady who thought Uncle Barry was going to 'pay her mortgage and fill her gas tank', a lot of folks who don't have coverage seem to be laboring under the impression that the passage of this bill means they'll get free medical insurance.

This has only just begun to get ugly.

[History_Chick]

It says that my coverage won't change and won't hike up my taxes. BULL FUCKING SHIT.

First, my employer may drop what we have now. Secondly the idea that money is going to magically fly outta my ass so I don't have to pay for the poor who aren't covered means someone is smoking some strong crack.

My taxes will rise. I'm part of the middle class. I'm single. I'm screwed.

[billythrilly7th]

It says that my coverage won't change and won't hike up my taxes. BULL FUCKING SHIT.

First, my employer may drop what we have now. Secondly the idea that money is going to magically fly outta my ass so I don't have to pay for the poor who aren't covered means someone is smoking some strong crack.

My taxes will rise. I'm part of the middle class. I'm single. I'm screwed.

I may want to date you.

[backslashbaby]

It says that my coverage won't change and won't hike up my taxes. BULL FUCKING SHIT.

First, my employer may drop what we have now. Secondly the idea that money is going to magically fly outta my ass so I don't have to pay for the poor who aren't covered means someone is smoking some strong crack.

My taxes will rise. I'm part of the middle class. I'm single. I'm screwed.

Cheer up... maybe you'll get really sick and others' latte money can go to you! Then you'd be making out like a bandit instead of so very screwed.

*cough*

[History_Chick]

OR

Since Obama is so busy stroking himself over this new victory and isn't too worried about this small little problem called UNEMPLOYMENT.... I may lose my job next year to budget cuts. So I'll just become a leech. I paid into the fucking system about time I started sucking it dry too.

[backslashbaby]

I just hate how anyone who can't afford the ridiculous prices of insurance, etc. are painted as leeches, folks who hate hard work, etc.

A lot of this debate boils down to whether you are self-employed or Union, blue collar or white, own a small business or are chained to a cubicle. Folks don't understand that we aren't talking about people who don't work. They have programs already.

And folks who get sick? Well, that would never be you (in general), would it? They should pay exponientally more than they cost.

[Don]

OR

Since Obama is so busy stroking himself over this new victory and isn't too worried about this small little problem called UNEMPLOYMENT.... I may lose my job next year to budget cuts. So I'll just become a leech. I paid into the fucking system about time I started sucking it dry too.
Might as well shrug now, while there's still a chance to get some back.

[Bird of Prey]

It says that my coverage won't change and won't hike up my taxes. BULL FUCKING SHIT.

First, my employer may drop what we have now. Secondly the idea that money is going to magically fly outta my ass so I don't have to pay for the poor who aren't covered means someone is smoking some strong crack.

My taxes will rise. I'm part of the middle class. I'm single. I'm screwed.

Not at all.

What I don't think is completely understood is that everybody pays for the uninsured NOW. The hospitals don't want to lose money, but they legally have to treat the uninsured, thus the uninsureds' clinic of choice is the emergency room. Why?? Once again, because the uninsured can't be denied there. And short of letting the uninsured writhe in pain on the sidewalk until they meet an untimely end as the fortunate insured hop over them like so much dog doo, the hospitals must treat. Who pays?? Each and every person with any asset at all that needs that hospital pays through the nose for the uninsured in big fat fees, bankruptcies, etc.

This health insurance bill is just a step in an inevitable outcome, which is universal coverage and ultimately direct health care coverage from the government. We can't afford much else. . . .

[Medievalist]

note to all the kids out there finishing up college... in addition to your student loan payments and rent and food and transportation, you will be saddled with a 2 or 300 dollar a month insurance bill (no subsidies for you) and you'll be fined if you don't buy it.

(based on 1 single person without insurance entering the work force at 30k a year)

I note however that there's a provision that kicks in next year to stay on parents' insurance, up to age 26.

[robeiae]

A bunch more people get health insurance.

Good. Health care is like law enforcement and education--everyone really should have a basic amount even if they are stupid enough not to want it. Whether they pay for it through tax or mandatory payment seems trivial to me.
Well--again--healthcare and health insurance are two different things. People--who are now forced to carry health insurance--will not necessarily avail themselves of healthcare.

[shadowwalker]

I just hate how anyone who can't afford the ridiculous prices of insurance, etc. are painted as leeches, folks who hate hard work, etc.

I've put in a total of 40 years in the work place, and most of that was not in a cozy office. But I'm called a leech and lazy and a sponge because I can't afford health insurance without this. I'm also going to bankrupt the next ten generations because I dare to think I should be able to purchase insurance without selling my house to do it.

People who say that crap haven't a clue. I just hope they never find themselves in the same position. Oh wait - they won't have to now...

[Don]

Well--again--healthcare and health insurance are two different things. People--who are now forced to carry health insurance--will not necessarily avail themselves of healthcare.
We can take care of that. Everybody gets an appointment for a physical on their birthday. If they don't show, OnStartm disables their GovernmentMotors car, SmartGridtm locks them in their house, and the IRS train paddy wagon is dispatched to carry them to their processing center Doctor's office.

It's for the common good, after all. We can't have undesirables spreading diseases, can we?

[Silver King]

One trip to the emergency room is all you'd need to get over the sticker shock of a couple hundred a month for insurance. One of my college age children broke a finger and had to go to the E.R. -- cost more than $5,000. Fortunately, insurance paid for it.
My youngest boy broke his arm last year, a clean break that did not require surgery, and the total bill was in excess of fifteen grand, including doctor visits.

I paid all of the bills, and still came out well ahead of what it would have cost to insure my family for a year.

When the dust settles with this health care bill, I'm confident (or rather foolishly hopeful), that I'll be able to finally afford decent health insurance for my family.

[Magdalen]

Doesn't $15,000 seem like an awful lot for a broken arm? No hospital stay, right? Sounds like you paid an arm & a leg for that arm!

[William Haskins]

i'm sure a broken arm will be $9.99 now.

and two bits for a colonoscopy...

[Death Wizard]

i'm sure a broken arm will be $9.99 now.

and two bits for a colonoscopy...

The one I'm having in two weeks will cost me $430. But the laxative-laden day before ... ahhh ... now that will be priceless.

[William Haskins]

have fun with it and eat from the rainbow for the week preceding.

[Death Wizard]

At least I'll get a lot of reading done.

[Ol' Fashioned Girl]

You ever had a colonoscopy before? You ain't gonna have time to read between trips. ;)

[Ol' Fashioned Girl]

My youngest boy broke his arm last year, a clean break that did not require surgery, and the total bill was in excess of fifteen grand, including doctor visits.

I paid all of the bills, and still came out well ahead of what it would have cost to insure my family for a year.

When the dust settles with this health care bill, I'm confident (or rather foolishly hopeful), that I'll be able to finally afford decent health insurance for my family.



And that's the most obscene thing about this farce: there's still no control on what doctors and/or hospitals charge or what tests they'll run just because 1) they can get it paid for and 2) if they don't and they miss something, hooooooboy! Here comes the lawsuit!

It's not just the insurance premiums that are obscene... it's what's being charged for a broken arm and an office visit and a bottle of the latest drug and the lawyer to chase the ambulance before, during, and after. There's no tort reform to help limit frivolous lawsuits. And in all the thousands of words in this forsaken mess, was there anything to say the insurance companies are limited in the premiums they'll charge in four years when the rest of it hits the fan and our political 'leaders' are focused on the next great humanitarian crisis?

[Death Wizard]

You ever had a colonoscopy before? You ain't gonna have time to read between trips. ;)


There's no between about it!

[Silver King]

Doesn't $15,000 seem like an awful lot for a broken arm? No hospital stay, right? Sounds like you paid an arm & a leg for that arm!
No hospital stay to speak of, except for the six hours we spent there from the time we walked in until he left with a temporary cast and a couple of x-ray images to share with whichever doctor we hired to treat the arm.

When it came to paying for medical services, the conversation typically sounded like this:

"Insurance provider, please."

"I don't have insurance."

"Then how do you expect to pay for services?"

"Cash."

A long, incredulous pause.

"Cash, you say?"

"Yes. Or I can give you a check."

"We don't accept checks, sorry."

"Good, then cash it is."

Another long, incredulous pause.

"Sir, I'm sorry, but we can't accept cash payments over one thousand dollars..."

I reached over the counter, broke both of her arms and said I hoped for her sake that the doctor had a two-for-one special going on that week.

Not really, but I wanted to...

[blacbird]

healthcare and health insurance are two different things.

A logical fallacy gleefully promulgated by the political right, simplistic thinking in full flower. They are not identical things, to be true, but they are far from unrelated.

caw

[blacbird]

Following on the anecdote Silver King just posted:

Three years ago I had an emergency appendectomy. Upon admission to the hospital, of course, I had to fill out forms (around midnight, and I wasn't in a real good frame of mind, having been in significant pain for about four days). One question on the form was "Are you worried about paying for the expenses?"

I answered, "Yes."

Which right quicklike brought an administrative nurse[person to my bed to ask, "Why?"

I remember looking her in the eye, and replying, "Isn't everybody?"

You'd have thought she swallowed a pigeon. The lack of recognition of reality in these situations is truly amazing.

The procedure, which was routine, and included only a two-night hospital stay, cost in excess of $10,000. I paid out of pocket right around half of that, which was the deductible on my private insurance, which costs me in excess of $800 per month. Do the math. God help me if there had been any complications.

caw

[MattW]

And that's the most obscene thing about this farce: there's still no control on what doctors and/or hospitals charge or what tests they'll run

It's not just the insurance premiums that are obscene... it's what's being charged for a broken arm and an office visit and a bottle of the latest drug and the lawyer to chase the ambulance before, during, and after. There's no tort reform to help limit frivolous lawsuits.
That sounds like a really big problem. We should have Congress look into that or something...

:rant:

[shadowwalker]

The last time I went to the emergency room (other than for my heart problem) was due to a growth on my instep, which had become so painful I couldn't walk on it. Scenario:

Man in white garb comes in: What's the problem?

Me: I have a lump on my foot. (Shows him lump)

Man in white garb: Wow, that's a big lump. (He leaves)

2nd man in white garb and extra equipment hanging around his neck enters: What's the problem?

Me: I have a lump on my foot. (Shows him lump)

2nd man: Wow, that's really a big lump! (He leaves)

3rd man in white garb, with tag designating him as a doctor, comes in: What's the problem?

Me: I have a lump on my foot. (Shows him lump)

3rd man: That's huge! Does it hurt?

Me: If I press on it.

3rd man proceeds to jab his thumb down on lump. I scream. Nurse comes in, hands doctor chart, whispers: No insurance.

3rd man: Well, we don't treat foot problems in the emergency room. You'll have to make an appointment with Podiatry in the morning.

I went home, put my foot up for 3 days until the lump went down.

Bill: Almost $1200.

Yeah. Love the medical profession.

[Celia Cyanide]

First, my employer may drop what we have now. Secondly the idea that money is going to magically fly outta my ass so I don't have to pay for the poor who aren't covered means someone is smoking some strong crack.

Hey, look on the bright side! If your employer drops what you have, you won't have all that all that money taken out for the insurance company any more!

[MattW]

Nothing will change for me. Even if my wife stays home to care for our daughter, nothing changes.

My coverage gets no cheaper, copays are still what they were, I will pay outrageous amounts for minor tests, and, unless every med student was granted a license to practice by this bill, healthcare is no more accessible than it was on Friday.

[Liosse de Velishaf]

Following on the anecdote Silver King just posted:

Three years ago I had an emergency appendectomy. Upon admission to the hospital, of course, I had to fill out forms (around midnight, and I wasn't in a real good frame of mind, having been in significant pain for about four days). One question on the form was "Are you worried about paying for the expenses?"

I answered, "Yes."

Which right quicklike brought an administrative nurse[person to my bed to ask, "Why?"

I remember looking her in the eye, and replying, "Isn't everybody?"

You'd have thought she swallowed a pigeon. The lack of recognition of reality in these situations is truly amazing.

The procedure, which was routine, and included only a two-night hospital stay, cost in excess of $10,000. I paid out of pocket right around half of that, which was the deductible on my private insurance, which costs me in excess of $800 per month. Do the math. God help me if there had been any complications.

caw



Three years ago, I had a non-emergency appendectomy. In fact, the doctors said they almost couldn't believe I had appendicitis. I stayed overnight one or two nights I believe, and at home for a week. (Shockingly, the hospital food was very good.) My IV got a little loose, and a few hours later when the nurse finally agreed to fix it, I had practically scratched through my wrist. This cost around $13,600. That's a year of my college tuition. (Thank the Goddess I had insurance.) Of course, that does not compare to $15,000 for a broken arm, which is just ridiculous. Gotta love American healthcare.

Will this bill change it? I don't know. I don't hold out much hope, though.

[Bartholomew]

No hospital stay to speak of, except for the six hours we spent there from the time we walked in until he left with a temporary cast and a couple of x-ray images to share with whichever doctor we hired to treat the arm.

When it came to paying for medical services, the conversation typically sounded like this:

"Insurance provider, please."

"I don't have insurance."

"Then how do you expect to pay for services?"

"Cash."

A long, incredulous pause.

"Cash, you say?"

"Yes. Or I can give you a check."

"We don't accept checks, sorry."

"Good, then cash it is."

Another long, incredulous pause.

"Sir, I'm sorry, but we can't accept cash payments over one thousand dollars..."

I reached over the counter, broke both of her arms and said I hoped for her sake that the doctor had a two-for-one special going on that week.

Not really, but I wanted to...

If that happens again, tell her our fiat currency reads:

http://rj55.com/dollar/dollar-legal-tender-photo-10.jpg


Then demand to speak with her boss.

[GeorgeK]

The last time I went to the emergency room (other than for my heart problem) was due to a growth on my instep, which had become so painful I couldn't walk on it. ...
I went home, put my foot up for 3 days until the lump went down.

Bill: Almost $1200.

Yeah. Love the medical profession.

If you know you have a heart problem, then surely you have an internist or Family doctor and cardiologist, so why not call them? Seeing your primary care is far cheaper than the ER.

Oh, I think I know why. You probably did call and were told that they were already overbooked and couldn't see you until 3 weeks and if you couldn't wait that long, then you should go to the ER. That's what's happened since the early to mid 90's when for reasons I still don't understand some agency told the residencies to cut down the number of slots, because someone thought there were too many physicians and they were predicting a glut of doctors. They failed to consider the rising population.

So what was it? I'm guessing gouty tofus or bunion.

[thethinker42]

The last time I went to the emergency room (other than for my heart problem) was due to a growth on my instep, which had become so painful I couldn't walk on it. Scenario:


At least you got to see a doctor.

I spent 3 hours in the emergency room last night, and never actually saw one. In fact, I never got past the triage desk.

Apparently having severe pain in the kidney area (if you've ever had a kidney infection, you KNOW what I'm talking about.) that rates an "8" on the "how much pain?" scale isn't worthy of a doctor's time. I was sent home with antibiotics (that part made sense, at least), and absolutely nothing for the pain except a flippant "just take some Tylenol." I said, "I mean, aren't they concerned about what's causing this kind of pain?" Evidently not.

Military hospital. Surprise surprise. (In all fairness, their day crew was excellent when I visited the same ER 3 weeks ago. The night shift doesn't seem to give a shit.)

[Diana Hignutt]

It's for the common good, after all. We can't have undesirables spreading diseases, can we?

Gosh, that sounds like the soon to be crime biological assault (sneezing or coughing in public), which clearly is not in the public good, and most be stopped at all costs. It's for the fucking children, after all.

[Lyra Jean]

I'm just always amazed (and I really shouldn't be) that "Them That Has" are always so worried what it will cost them if "Them That Hasn't" gets it. It might actually mean what - you miss the morning Starbuck's? Once a week you don't go to a restaurant for lunch? Have to skip a manicure once a month?

Much better to keep the status quo - so hospital costs will keep going up (because the uninsured will wait until later in their illness to go to the emergency room and that cost will be passed on to those with insurance), and those without insurance will take more time off work because they have no preventive care (thus increasing the costs of producing the goods that everyone will have to pay more for), and die younger (which at least gets rid of the surplus population).

Yeah. Much better to leave things as they were.

I'm considered a Have because I make just enough money to not get government help. I'm barely keeping my bills paid forget starbucks everyday. I don't have insurance because I'm part time at work and they don't offer insurance to part timers and well forget single payer. I'm lucky to get my car insurance and car payment paid every month. So yeah, I'm worried.

[Magdalen]

This health care bill is making me sick.
I think I need to see a Doc.
I don't have a Doc,
Doh!
Maybe I'll be feeling better in 4 years when that there new-fangled X-change becomes available.

[emandem]

To those who commented upthread about the $15,000 for a broken arm...just a few comments here:

You do realize the significance of this bill? Just to give you a scenario: (I am going to use meaningless numbers here, but this is how it works)...

You are a doctor. It costs your practice say... $5,000 to do a surgery. If you are KIND enough to take medicare/medicaid and government-insured patients, you enter into contract with medicare to accept whatever they will pay for said surgery, e.g. $4,000. Therefore, you lose $1,000 each time you do the surgery. BUT, you DO have some private insurance patients, and when you enter into the same contract with THEM, most of them will pay $6,000 or $7,000.

Ah, you say, at last a little money to cover my effort and pay my malpractice fees!! Then, lo and behold, you discover one insurance company that will pay $15,000. And if you only charge $6,000 or $7,000 that's all they'll pay. So, you bump your charge up to $15,000, so you can actually do the same surgery for a number of other medicaid patients and still come up with positive balance. Now, your private insured patients are paying for the government-paid ones, and you are obligated (on paper) to charge everyone the same (even though you never collect full charge).

NOW, if someone walks into your office with NO insurance, if you TRY to be kind and only charge them $4,000, guess what? YOU will be in trouble with the government for favoritism. You HAVE to charge everyone the same. Believe me, docs don't get paid $15,000 for each of those surgeries. They get whatever the insurance company and the government chooses to give them which sometimes barely covers the cost.

Oh, and just to add: Yes, they are talking 21% cuts in medicare payments currently...

[robeiae]

A logical fallacy gleefully promulgated by the political right, simplistic thinking in full flower. They are not identical things, to be true, but they are far from unrelated.

caw
Logical fallacy?

Regardless, I didn't say or imply that they were unrelated. Of course they are related.

But you can't say that having health insurance means--as a matter of course--that you will receive healthcare.

And you can't say--not if you're honest, imo--that "fixing" health insurance fixes healthcare.

That's the real simplistic thinking, here: when the goal is to make healthcare more affordable (meaning lowering costs), that goal can be achieved by increasing costs, but hiding them more effectively.

[tjwriter]

To those who commented upthread about the $15,000 for a broken arm...just a few comments here:

You do realize the significance of this bill? Just to give you a scenario: (I am going to use meaningless numbers here, but this is how it works)...

You are a doctor. It costs your practice say... $5,000 to do a surgery. If you are KIND enough to take medicare/medicaid and government-insured patients, you enter into contract with medicare to accept whatever they will pay for said surgery, e.g. $4,000. Therefore, you lose $1,000 each time you do the surgery. BUT, you DO have some private insurance patients, and when you enter into the same contract with THEM, most of them will pay $6,000 or $7,000.

Ah, you say, at last a little money to cover my effort and pay my malpractice fees!! Then, lo and behold, you discover one insurance company that will pay $15,000. And if you only charge $6,000 or $7,000 that's all they'll pay. So, you bump your charge up to $15,000, so you can actually do the same surgery for a number of other medicaid patients and still come up with positive balance. Now, your private insured patients are paying for the government-paid ones, and you are obligated (on paper) to charge everyone the same (even though you never collect full charge).

NOW, if someone walks into your office with NO insurance, if you TRY to be kind and only charge them $4,000, guess what? YOU will be in trouble with the government for favoritism. You HAVE to charge everyone the same. Believe me, docs don't get paid $15,000 for each of those surgeries. They get whatever the insurance company and the government chooses to give them which sometimes barely covers the cost.

Oh, and just to add: Yes, they are talking 21% cuts in medicare payments currently...

You've got quite a bit of it, there. Hospitals and doctors, without charging an arm and a leg, can't even cover overhead with the amount they get paid when they take on Medicare patients. The amount the government gives them as reimbursement is not enough.

Many of the doctor blogs I follow mentioned that when the government put through a 21% cut to reimbursement in February they would no longer be able to accept Medicare patients because the loss would be too great. Then the cut was postponed to March and now, I believe to October. If the cut passes though, there will be fewer doctors available to those with government insurance. If we are adding people to government health insurance, what good does it do when there are no doctors that will take them?

And Walgreens will no longer be taking Medicare for prescriptions.

The government is screwing the people it is supposed to be helping out of being able to get that help. How in the hell are they going to help the rest of us?

[shadowwalker]

If you know you have a heart problem, then surely you have an internist or Family doctor and cardiologist, so why not call them? Seeing your primary care is far cheaper than the ER...
So what was it? I'm guessing gouty tofus or bunion.

Actually, I don't go to a doctor for my heart problem because I don't have insurance - and because the last doctor I did see after an ER trip said that I could have some kind of implant but without insurance I'd have to wait until I had a heart attack, which would make it an emergency - unless, of course, it killed me first. Honest to God, that's exactly what he told me.

Anyway, the thing on my foot was some kind of fatty deposit that was resting on a nerve - so apparently keeping it elevated made it move somewhere else and dissolve.

[backslashbaby]

I don't think people realize that you can't get 'treated' an an ER unless it's an emergency. I guess if you come in for a sinus infection, they can give you antibiotics; why not? So if your situation is easy and not chronic you are OK [and my premiums go way up; Silver King's cash payment goes way up].

But if you have something that isn't an emergency and requires tests, etc, you won't get help. You have to be poor enough to get help covering those expenses, not middle class.

I had abdominal pain, too, and the ER couldn't help. I'm sure their pokes and prods ensured them that it wasn't apendicitis or a huge emergency, so that part is cool. But they had no clue what did cause it. I got a shot of Demoral because I was crying too loudly ["Give that girl a sedative!"] and my boyfriend drove my sleepy ass home.

Obviously, if someone had had cancer that caused that episode, the ER wasn't going to be of much help.

[AndiB]

You've got quite a bit of it, there. Hospitals and doctors, without charging an arm and a leg, can't even cover overhead with the amount they get paid when they take on Medicare patients. The amount the government gives them as reimbursement is not enough.

Many of the doctor blogs I follow mentioned that when the government put through a 21% cut to reimbursement in February they would no longer be able to accept Medicare patients because the loss would be too great. Then the cut was postponed to March and now, I believe to October. If the cut passes though, there will be fewer doctors available to those with government insurance. If we are adding people to government health insurance, what good does it do when there are no doctors that will take them?

And Walgreens will no longer be taking Medicare for prescriptions.

The government is screwing the people it is supposed to be helping out of being able to get that help. How in the hell are they going to help the rest of us?

They want a single payer health care system. On Sunday, they paved the way.

[Robert Toy]

I'm watching the president speak at the HC bill signing...why does he keep saying "you will be able to buy insurance...", I thought it was free?

[backslashbaby]

I'm watching the president speak at the HC bill signing...why does he keep saying "you will be able to buy insurance...", I thought it was free?

Did you really? Having all of the uninsured pay something for coverage is kind of key in the theories behind this working.

Maybe my sarco-meter is broken :)

[Don Allen]

I've read this thread and understand completely the cynicism because the issues are so complex and have been so under explained it's literally impossible to grasp the value of this law unless you work in the industry and deal with case by case scenarios of what this law is trying to address. I've taken a good deal of criticism for supporting this effort acknowledging along the way that it is an imperfect bill and will need to be strengthened.

My motivation for support has nothing to do with politics and everything to do with my experience as a health insurance agent (as I've said in the past)

One of the saddest days in my life was explaining to a couple in their late fifties that the health insurance I sold them denied their coverage for a life threatening cancer do to a pre-exising condition though they were only a few months shy of the incontestable period. What's worse was that the denial was based upon on a policy omission rather than an actual condition. (hence the reason agents carry e&o insurance themselves)
Anyway's, the lady got really sick went to the emergency room in her town and was stabilized and transferred to Cook County hospital where she eventually died.

These folks were of simple means and the woman probably would have died regardless of her insurance situation, BUT,,, the fucking stress that they went through, and I went through fighting for their cause I'm sure hastened her demise and probably knocked a year off my life. One example repeated thousands a time per day around the country. God bless you from the bottom of my heart if you never experience such a thing..

My prayer is that this law will minimize if not eradicate these kinds of family dilemmas
Because losing your life in this nation because you can't afford a doctor in this day in age is criminal.

[Celia Cyanide]

I am white and I do not want my or other people's taxes to go up.

Why do you care if my taxes go up?

[William Haskins]

two questions:



has pelosi gone mad with power, and
what the fuck is ron wood doing there?

http://d.yimg.com/a/p/rids/20100322/i/r3234687515.jpg?x=400&y=295&q=85&sig=xE4s9zHsfnBZlq3uXalL7w--

[robeiae]

Why do you care if my taxes go up?

He's a compassionate conservative?

[William Haskins]

you'll have lower quality garbage for him to pilfer through?

[DeleyanLee]

Y'know what health care insurance legislation I'd like to see pass?

Make it mandatory, but I think it should be sold like auto insurance.

Let some company come in, as Geico or SafeAuto has done for car insurance, and offer a reasonable rate and see what that does to the health insurance power houses' prices. Something the average Joe has a prayer to afford and you get what you pay for. But, of course, that won't happen.

The one thing that really irks me about what passed is the idea that I can be fined if I don't have health insurance. That really sucks. If it's so important that every American has health insurance, it should just be something we get and pay for through taxes like we do sending our kids to public school. Yeah, taxes would go up, but they're going to anyway.

[sassandgroove]

we need to end the tie between employment and health insurance. sure I have it now through work but I had no choice in my policy. I'd rather beable to shop around, like Deleyanlee said, and choose my coverage.

[robeiae]

we need to end the tie between employment and health insurance.
Yep.

But try that and the health insurance companies would go apeshit, to say the least.

[tjwriter]

Several states have filed suit that mandating coverage is a unconstitutional.

This mess is going to get really interesting.

I have coverage, really good coverage, but I pay for it and one of the main reasons is that I have small kids and they are especially prone to situations that could cost quite a bit. My husband and I rarely use it. I am now because I'm pregnant, but otherwise, not a lot.

[jana13k]

Can someone please explain to me why everyone ALSO assumes that if you don't want your taxes to increase, that you're somehow rich and can afford Starbucks everyday? In the past year, we've seen decreases in salaries, increases in insurance premiums and decreases in company covered benefits. Meanwhile, every one of my credit cards has doubled my interest rates (even though I have NEVER made a late payment) in order to pay for irresponsible people who refuse to pay their bills. The cost of utilities, gas, etc. creeps up constantly. I work a fulltime job, have novels under contract and STILL had to take a part-time job in order to NOT be a deadbeat and stop paying my bills.

So pardon me if I don't want to spend one more dime in taxes on someone who's NOT putting in the 7-day workweeks at 14+ a day that I am.

And without tort reform, this is pouring liquid into a bottomless hole. It's a complete waste of everyone's time. But since most of our lawmakers made money on those bullshit lawsuits, then why in the world would they want that to change?

[Sheryl Nantus]

The one thing that really irks me about what passed is the idea that I can be fined if I don't have health insurance. That really sucks. If it's so important that every American has health insurance, it should just be something we get and pay for through taxes like we do sending our kids to public school. Yeah, taxes would go up, but they're going to anyway.

that's what sort of confuses me - if I could *pay* for the health insurance now, I probably would.

and, as far as I know, the "subsidies" won't cover the entire amount - so the uninsured person will still have to go into debt somehow, taking money from their budget, to buy the mandatory insurance. And let's not forget that there's going to be HUGE government departments created for the sole purpose of tracking and issuing checks for these subsidies to those who qualify.

2.5% of your income/$695 for the fine is a lot.

I'm waiting to see the first poor person dragged into court for not buying insurance. As I said, seems to me that if you can't afford it NOW, a subsidy won't make that much of a difference. And do we really need to overload the legal system with more "criminals" being charged for not buying insurance?

at least, that's how it looks to me. But I've been unable to make head or tails out of the entire debate.

:Shrug:

[William Haskins]

people who can't afford insurance will become walking organ farms for those with it.

you can pick out a kidney the way you'd pick out your lobster in a fancy restaurant.

[shadowwalker]

Can someone please explain to me why everyone ALSO assumes that if you don't want your taxes to increase, that you're somehow rich and can afford Starbucks everyday?

My response was to the myriad of comments here and elsewhere about leeches and deadbeats and lazy people getting free rides, yada yada yada. Those assumptions are just as ridiculous as saying that only the wealthy don't want their taxes going up. I also pay taxes, and I don't like them going up either. But that's no reason to continue to deny people the ability to buy health insurance. There are a lot of other places we could cut taxes, after all.

This health insurance thing is not new - it's been "not dealt with" through many administrations, Democrat and Republican. Is it perfect? No. Is it a step in the right direction? Yes. Want someone to blame? Look at all the politicians over the decades who kowtowed to special interest groups and refused to deal with it.

[sassandgroove]

But that's no reason to continue to deny people the ability to buy health insurance.how does this bill fix that though? the reason I can't just go out and but it myself is that it is prohibitively expenseive, and I can't get a policy that fits my needs. I have to get it through work or not at all. Now not only that but I HAVE TO BUY IT OR I'M A CRIMINAL. Forgive me but I don't see how this helps, AT ALL.

[Don Allen]

how does this bill fix that though? the reason I can't just go out and but it myself is that it is prohibitively expenseive, and I can't get a policy that fits my needs. I have to get it through work or not at all. Now not only that but I HAVE TO BUY IT OR I'M A CRIMINAL. Forgive me but I don't see how this helps, AT ALL.


All you need to know is "pre-exsisting conditions" That alone makes the bill a winner.

[William Haskins]

All you need to know is "pre-exsisting conditions" That alone makes the bill a winner.

yep. just go to any healthcare provider or hospital and say, "pre-existing conditions" and a path to their best doctors and equipment will open as if the red sea had just been parted.

[jana13k]

how does this bill fix that though? the reason I can't just go out and but it myself is that it is prohibitively expenseive, and I can't get a policy that fits my needs. I have to get it through work or not at all. Now not only that but I HAVE TO BUY IT OR I'M A CRIMINAL. Forgive me but I don't see how this helps, AT ALL.
I'll tell you how it helps - see, healthy people HAVE to pay for the insurance too or the only people interested will be sick people, and no insurance policy could sustain with only sick people on the dole. So, essentially, in being required to pay for insurance you are being TAXED to pay for others.

Property tax, vehicle registration, use tax, volume tax, even highway tolls. If you're being charged money to own something or merely exist, then it's a tax.

Has anyone ever taken a year of their life and added up every single tax they pay and see what percentage that is of their total income? I have, and it's frightening.

Keep squeezing and there will no longer be a middle class. There will only be haves and have nots. And then where will we be?

[shadowwalker]

how does this bill fix that though? the reason I can't just go out and but it myself is that it is prohibitively expenseive, and I can't get a policy that fits my needs. I have to get it through work or not at all. Now not only that but I HAVE TO BUY IT OR I'M A CRIMINAL. Forgive me but I don't see how this helps, AT ALL.

It fixes "prohibitively expensive" by offering subsidies and tax credits for those whose income qualifies them. You have to get it through work - consider yourself lucky your employer offers insurance. As to having to buy it - I've said this before, but will say it again - you have to buy auto insurance, too, or face heavy fines. And since you have health insurance through your employer, how is that a problem for you?

[Roger J Carlson]

All you need to know is "pre-exsisting conditions" That alone makes the bill a winner.So if a bill protected people with pre-existing condition, but it made insurance too expense to purchase, that would be okay? Or if the bill cost trillions of dollars to implement and bankrupts our country, as long as it covers pre-existing conditions, it's a winner?

I'm not saying that's the case, necessarily, with this bill, but there is obviously more to know about it than just "pre-existing conditions".

[William Haskins]

I've said this before, but will say it again - you have to buy auto insurance, too, or face heavy fines.

you can say it until you're blue in the face; that doesn't make it so.

[Celia Cyanide]

I'll tell you how it helps - see, healthy people HAVE to pay for the insurance too or the only people interested will be sick people, and no insurance policy could sustain with only sick people on the dole. So, essentially, in being required to pay for insurance you are being TAXED to pay for others.

I don't really agree that only sick people would be interested in health insurance.

Has anyone ever taken a year of their life and added up every single tax they pay and see what percentage that is of their total income? I have, and it's frightening.

I haven't. Never really cared enough to.

[Jamesaritchie]

All you need to know is "pre-exsisting conditions" That alone makes the bill a winner.

Oh, I forgot that part. It means that I now have to work four times as hard as I thought to pay for people who waited to get health insurance until after they were sick.

Damn, I always thought "insurance" meant "you pay us premiums now, and we'll pay your bills should you get sick in the future."

Now I learn it means "go ahead and wait until you get sick, you worthless bum, and we'll still pay all your bills, even though you never paid a single premium in the past."

[Celia Cyanide]

Oh, I forgot that part. It means that I now have to work four times as hard as I thought to pay for people who waited to get health insurance until after they were sick.

Why does this mean you have to work harder AT ALL? Seriously?

[shadowwalker]

I'll tell you how it helps - see, healthy people HAVE to pay for the insurance too or the only people interested will be sick people, and no insurance policy could sustain with only sick people on the dole. So, essentially, in being required to pay for insurance you are being TAXED to pay for others.

Property tax, vehicle registration, use tax, volume tax, even highway tolls. If you're being charged money to own something or merely exist, then it's a tax.

We pay into insurance to spread the costs. Even before this bill, if you had insurance, you were being "taxed" to pay for others. Just the same way we pay highway taxes to build and maintain roads. You want to pay full cost of the road in front of your house? Or divide the cost of the road you take to work with only your co-workers? I don't think so.

What people don't seem to recognize is the savings across the board when the cost for caring for the uninsured is not handed off to everyone else, when workers aren't losing work because of illnesses that could've been prevented had they had insurance, of all the social costs of having people unable to access medical care simply because they don't have insurance to pay for it. It's very short-sighted to look only at the costs of this bill without looking at the savings as well.

[tjwriter]

As to having to buy it - I've said this before, but will say it again - you have to buy auto insurance, too, or face heavy fines.

You don't HAVE to buy auto insurance. Only if you want to drive. And there are people that locate themselves in areas so that they can meet all of their needs and never drive. They don't carry auto insurance.

If you're not a homeowner, you don't HAVE to carry homeowner's insurance.

So that's wrong.

[AndiB]

It fixes "prohibitively expensive" by offering subsidies and tax credits for those whose income qualifies them. You have to get it through work - consider yourself lucky your employer offers insurance. As to having to buy it - I've said this before, but will say it again - you have to buy auto insurance, too, or face heavy fines. And since you have health insurance through your employer, how is that a problem for you?

You do not HAVE to buy auto insurance. I know plenty of people who do not have cars or auto insurance. They use mass transit, ride bikes, or take taxis. You have a CHOICE as to whether or not you buy car insurance. You can CHOOSE not to drive.

Also, the requirement to purchase auto insurance is a state requirement not a federal one.

[shadowwalker]

Now I learn it means "go ahead and wait until you get sick, you worthless bum, and we'll still pay all your bills, even though you never paid a single premium in the past."

Yeah, I'm a worthless bum because I didn't know I had health problems until I found myself in the ER - and of course, since I couldn't afford insurance before that, why the heck should I be allowed to get it now?

[Celia Cyanide]

You do not HAVE to buy auto insurance. I know plenty of people who do not have cars or auto insurance. They use mass transit, ride bikes, or take taxis. You have a CHOICE as to whether or not you buy car insurance. You can CHOOSE not to drive.

I don't exactly disagree with you here. I have chosen not to drive. I don't even have a license. Yet, you can't really choose to opt out of what health insurance is for, which is your health and your life.

[shadowwalker]

Well, if you live in a city where there is mass transit, then no, you don't have to buy insurance. If you live in a rural area, then you need a vehicle and that means you need insurance.

So no - it's not wrong. It's a matter of recognizing that there are people who live under different circumstances than you do. Or are we all supposed to move to a city so we don't have to buy insurance?

[Gretad08]

Damn, I always thought "insurance" meant "you pay us premiums now, and we'll pay your bills should you get sick in the future."



If only that were true. My Dad had cancer. As of 12-01-2009 his FMLA 3 month leave expired so he was forced to retire, which meant that he lost his insurance. At this point he was still in the hospital getting ready to come home with very very expensive hospice treatment. He's paid premiums his entire adult life, but when it was time for his end of life treatment, they cut him off within 3 months.

Anyway, there are a lot of unfair things about health insurance and I realize my example is entirely anecdotal, but I still fail to see how this bill will fix this kind of problem.

[William Haskins]

Well, if you live in a city where there is mass transit, then no, you don't have to buy insurance. If you live in a rural area, then you need a vehicle and that means you need insurance.

So no - it's not wrong. It's a matter of recognizing that there are people who live under different circumstances than you do. Or are we all supposed to move to a city so we don't have to buy insurance?

this (above) is not this:

I've said this before, but will say it again - you have to buy auto insurance, too, or face heavy fines.

and it is wrong.

wrong.

it's wrong.

wrong.

[Robert Toy]

btw, I would consider myself a failure if I had to have my son/daughter still living in my house at 26 years old.

[robeiae]

I don't exactly disagree with you here. I have chosen not to drive. I don't even have a license. Yet, you can't really choose to opt out of what health insurance is for, which is your health and your life.
Which, of course, begs the question: when will the government require everyone to buy life insurance? After all, we're all gonna die. And that costs money.

And on the flippantly ridiculous side, would a pre-existing conditions view mandate that life insurance could be purchased for those that have already died, at the same cost basis for those currently living? After all, if my mom dies without life insurance and I can't afford the costs for burial and the like, it would ease my burden if I could go ahead and buy a policy on her, then get the money for those expenses...

[Gretad08]

I don't exactly disagree with you here. I have chosen not to drive. I don't even have a license. Yet, you can't really choose to opt out of what health insurance is for, which is your health and your life.

Why can't you choose to opt out of your own health insurance? (not being snarky here) What about people who choose not to seek medical treatment under any circumstances, or the ones who only go when things are dire and pay out of pocket? Why can't they just keep doing what they're doing?

Maybe we could add something to the bill: You can opt out of the coverage, you have to sign waivers, but if you seek emergency treatment you'll still be seen. You will then spend however long it takes paying back the treatment to the government once you're better. If you die, it will be taken out of your estate. If you have no estate, we write it off. If you don't pay for your treatment you go to jail where you'll be forced to do something productive for the government in whatever field you have expertise.

[billythrilly7th]

I don't exactly disagree with you here. I have chosen not to drive. I don't even have a license.

We here in NYC do sleep better knowing that you aren't on the road.

Thank you.

[William Haskins]

buy the right congressman, and sure -- why not?

http://www.house.gov/apps/list/speech/mi01_stupak/morenews/20100319faagrant.html

[AndiB]

I don't exactly disagree with you here. I have chosen not to drive. I don't even have a license. Yet, you can't really choose to opt out of what health insurance is for, which is your health and your life.

Which was exactly the point I was making. You can choose the other. With this bill you have no CHOICE. Oddly enough this bill was pushed through by the party that has traditionally been pro-choice and argued for keeping the government off our bodies (a platform I firmly agree with BTW). It just seems completely hypocritical to me...aside from the other many problems I have with this bill.

[Roger J Carlson]

I don't exactly disagree with you here. I have chosen not to drive. I don't even have a license. Yet, you can't really choose to opt out of what health insurance is for, which is your health and your life.I can't opt out of eating either. Must I join a federally mandated program to provide me food, too? Or can I simply be allowed to take care of it myself?

[sassandgroove]

It fixes "prohibitively expensive" by offering subsidies and tax credits for those whose income qualifies them. You have to get it through work - consider yourself lucky your employer offers insurance. As to having to buy it - I've said this before, but will say it again - you have to buy auto insurance, too, or face heavy fines. And since you have health insurance through your employer, how is that a problem for you?
How does it fix prohibitively exepensive? I don't see that. Point it to me will you?

I already explained why getting insurance through an employer AS THE ONLY OPTION TO ME is a problem in the post you are answering. I DON'T HAVE A CHOICE. That's the problem. It's my crappy option or my husbands crappier one. That's it. No shopping around. Making it mandated isn't going to change that. COmpetition would change that. Making it so individuals could afford to buy what coverage they want from the company they want. That would be a fix.

If they want to tax me and mandate insurance I'd rather it just be a NHS rather than this stupid BS of having to buy it or be fined.

[William Haskins]

hey, if it's good enough for the authors of the bill...

oh, wait...

http://www.cbsnews.com/stories/2010/03/23/opinion/main6324480.shtml

[DeleyanLee]

Just made me wonder--what about those religions that don't do the modern medical treatment thing?

[Sheryl Nantus]

btw, I would consider myself a failure if I had to have my son/daughter still living in my house at 26 years old.

I would hope, and I have no idea if it's there or not, that there'd be a provision that you have to *prove* that you're a student at a recognized college/university/school to qualify for this option.

Otherwise I see a lot of ticked-off companies having to expand their coverage for the noodnik sitting on the couch, playing video games all day. Or they'll just jack the premiums for mom and dad, passing it onto them.

btw, seems to me that 26 yrs. would be enough to get a Master's Degree. Seems a bit excessive to me.

[Magdalen]

Why can't you choose to opt out of your own health insurance? (not being snarky here) What about people who choose not to seek medical treatment under any circumstances, or the ones who only go when things are dire and pay out of pocket? Why can't they just keep doing what they're doing?

Maybe we could add something to the bill: You can opt out of the coverage, you have to sign waivers, but if you seek emergency treatment you'll still be seen. (snip)


Yes, sign me up for that. I don't want any shots except the kind I suck out of my lover's navel. I will happily waive my "right" to any type of medical care due to my religion and/or personal philosophy.

[sassandgroove]

If only that were true. My Dad had cancer. As of 12-01-2009 his FMLA 3 month leave expired so he was forced to retire, which meant that he lost his insurance.BOLD MINE.
Shadowwalker are you listening?this further explains my point.
WHICH IS WHY WE SHOULD BE ABLE TO BUY IT ON OUR OWN AND NOT HAVE THE ONLY OPTION BE THROUGH WORK. MAKE IT SO THERE IS COMPETITION AND LET ME BUY MY OWN!
At this point he was still in the hospital getting ready to come home with very very expensive hospice treatment. He's paid premiums his entire adult life, but when it was time for his end of life treatment, they cut him off within 3 months.

Anyway, there are a lot of unfair things about health insurance and I realize my example is entirely anecdotal, but I still fail to see how this bill will fix this kind of problem.I don't see it either.

[William Haskins]

Just made me wonder--what about those religions that don't do the modern medical treatment thing?

exempt, along with some native americans.

[Celia Cyanide]

Which was exactly the point I was making. You can choose the other. With this bill you have no CHOICE.

I know you have no choice but to buy health insurance. But you have no choice but to deal with your health, either. If you don't want to buy car insurance, you don't have to buy a car.

[Celia Cyanide]

Why can't you choose to opt out of your own health insurance? (not being snarky here) What about people who choose not to seek medical treatment under any circumstances, or the ones who only go when things are dire and pay out of pocket? Why can't they just keep doing what they're doing?

I didn't say you can't opt out of health insurance. I said you can't opt out of your health. Many of those people who only go when things are dire do not always pay out of pocket.

[rugcat]

Keep squeezing and there will no longer be a middle class. There will only be haves and have nots. And then where will we be?Actually, the US has one of the lowest tax burdens of any developed country. The idea that wee are being taxed out of existence is a bit of hyperbole.

http://moneycentral.msn.com/content/taxes/p148855.asp

[AndiB]

I know you have no choice but to buy health insurance. But you have no choice but to deal with your health, either. If you don't want to buy car insurance, you don't have to buy a car.

He have insurance through my husband's work. I've been shopping around recently because his company is downsizing their benefits and one of the casualties is the good health insurance package we had. We were planning to buy in April.

It's not that I'm opposed to having health care or opposed to having health insurance. I'm very much opposed to being required by law to buy it when I can't choose not to if I don't want to or if my husband loses his job and we need to rearrange finances temporarily. I resent the choice being taken away.

[DeleyanLee]

exempt, along with some native americans.

For some, this might be a compelling argument to change religions. Cheaper than moving to another country.

[Roger J Carlson]

Actually, the US has one of the lowest tax burdens of any developed country. The idea that wee are being taxed out of existence is a bit of hyperbole.

http://moneycentral.msn.com/content/taxes/p148855.aspPerhaps the reason we have one of the lowest tax burdens is that we've managed to avoid, until Sunday, many of the socialist programs (like universal healthcare) that the rest of the developed world has saddled itself with.

[Celia Cyanide]

It's not that I'm opposed to having health care or opposed to having health insurance. I'm very much opposed to being required by law to buy it when I can't choose not to if I don't want to or if my husband loses his job and we need to rearrange finances temporarily. I resent the choice being taken away.

Yes, but see, I don't really care. I don't care about my right not have health insurance. It's not important to me. I don't have a choice which insurance company I get now, so it doesn't bother me that the choice to have nothing is being taken away.

[Roger J Carlson]

I didn't say you can't opt out of health insurance. I said you can't opt out of your health. Many of those people who only go when things are dire do not always pay out of pocket.Having health insurance is not the same as maintaining your health. People have done it for centuries without health insurance.

[Celia Cyanide]

Having health insurance is not the same as maintaining your health. People have done it for centuries without health insurance.

They didn't live as long back then, though.

[sassandgroove]

Why can't you choose to opt out of your own health insurance? (not being snarky here) What about people who choose not to seek medical treatment under any circumstances, or the ones who only go when things are dire and pay out of pocket? Why can't they just keep doing what they're doing?

Maybe we could add something to the bill: You can opt out of the coverage, you have to sign waivers, but if you seek emergency treatment you'll still be seen. You will then spend however long it takes paying back the treatment to the government once you're better. If you die, it will be taken out of your estate. If you have no estate, we write it off. If you don't pay for your treatment you go to jail where you'll be forced to do something productive for the government in whatever field you have expertise.

Just made me wonder--what about those religions that don't do the modern medical treatment thing?

I didn't say you can't opt out of health insurance. I said you can't opt out of your health. Many of those people who only go when things are dire do not always pay out of pocket.
But there are people who don't want treatment. Are we to force them to get it? It may seem folly to me to watch a person deteriorate because they refuse treatement, but it should be their right to do so.

[Celia Cyanide]

But there are people who don't want treatment. Are we to force them to get it? It may seem folly to me to watch a person deteriorate because they refuse treatement, but it should be their right to do so.

Having health insurance does not mean you have to go to a doctor. Ever.

[William Haskins]

no, it means that if you're a healthy 20-something, you may well just get to pay thousands into a program you'll never use.

[Celia Cyanide]

no, it means that if you're a healthy 20-something, you may well just get to pay thousands into a program you'll never use.

You mean like when I pay taxes for education, but never want kids?

[William Haskins]

false analogy.

this isn't a tax. a tax is levied by the government for distribution for the common good.

what's happening here is a deal between the government and private industry to force citizens to buy a product.

[Robert Toy]

a tax levied by the government for distribution for the common good.
near future plan

[jana13k]

Actually, the US has one of the lowest tax burdens of any developed country. The idea that wee are being taxed out of existence is a bit of hyperbole.

http://moneycentral.msn.com/content/taxes/p148855.asp
Ah, but other countries STARTED with that tax burden. If you start with a low tax burden and people structure their lives to their available income, THEN you consistently increase the tax burden, that's when things fall into disarray.

And while our federal tax level may seem low to other countries, that's not taking into consideration all the other forms of taxation that add up to a significant portion of our income.

Also, this country enjoys a higher standard of living than many countries with high taxes, and I prefer it stay that way. The fact that people in other countries pay more in taxes doesn't convince me one bit to want to pay more myself, ESPECIALLY when the country does nothing to incentivize people to actually work.

[rugcat]

false analogy.

this isn't a tax. a tax is levied by the government for distribution for the common good.

what's happening here is a deal between the government and private industry to force citizens to buy a product.I'm curious william.

Were you in favor of a public option, where citizens would be forced to pay for a government run insurance option?

Would you be in favor of increased taxes to fund healthcare?

[rugcat]

Also, this country enjoys a higher standard of living than many countries with high taxes, and I prefer it stay that way. And a lower standard of living than others. I'm just pointing out that the oft repeated mantra that our taxes are unconscionably high in this country isn't really accurate, compared to other places.

[jana13k]

And a lower standard of living than others. I'm just pointing out that the oft repeated mantra that our taxes are unconscionably high in this country isn't really accurate, compared to other places.
But I'm just pointing out that I don't live in other places, don't want to live in other places and so your argument is mute. I don't really care what any other country taxes or does with the money. I ONLY care about this one because that's the one I live in.

I am a degreed accountant with over 20 years of tax prep experience. Trust me when I say there are HUGE inequities in our current system of taxation, and until they're repaired, I have no interest in paying for more services I will never use.

Like another poster, I also paid a crapload of property tax and never have had and never wanted kids. Same thing.

[William Haskins]

I'm curious william.

Were you in favor of a public option, where citizens would be forced to pay for a government run insurance option?

Would you be in favor of increased taxes to fund healthcare?

i am not in favor of the public option as it has been engineered thus far. i would, however, be amenable to a single-payer system whose costs were fairly (not regressively, but fairly) shared...

[sassandgroove]

I should n't post when I am not calm.

[Don Allen]

yep. just go to any healthcare provider or hospital and say, "pre-existing conditions" and a path to their best doctors and equipment will open as if the red sea had just been parted.

No that's not what I said.

But chew on this william. A good percentage of small businesses including those who are self employed are currently denied coverage, excluded from coverage, or rated beyond their means.. Hence "pre existing conditions" In the business this is a buzz phrase for "You ain't getting coverage". This bill will give a lot of working people not just BUMS a chance to get health care for needed conditions and illnesses that wouldn't be covered otherwise.

Your a smart guy and I'm not patronizing you here, I'm serious. I know the package isn't perfect and I know it will be costly, but you know that currently part of the healthcare industry costs are inflated to cover freebies or people without insurance. This plan actually takes that into consideration and should end up lower costs across the board. At least according to the CBO... Will happen, how the fuck should I know, but something needed to be passed, and regardless of what the Right has been saying they know it too.

[Don Allen]

So if a bill protected people with pre-existing condition, but it made insurance too expense to purchase, that would be okay? Or if the bill cost trillions of dollars to implement and bankrupts our country, as long as it covers pre-existing conditions, it's a winner?

I'm not saying that's the case, necessarily, with this bill, but there is obviously more to know about it than just "pre-existing conditions".


The mandates in this bill actually account for the morbidity of pre-existing conditions being a provision of all insurance policies. Which is why Obama reluctantly agreed to mandate all people must buy coverage. It's the only real way to guarantee a profitable scenario for the insurance industry. Otherwise insurance companies would get out of the business. Which really wasn't his goal.

[William Haskins]

i've never played the "bum" card, don. don't paint me that way.

i have as much, if not more, empathy for impoverished people without health insurance than most of the scumbags who are being lionized in congress.

i shouldn't have made light of your comment, but it was something of an oversimplification of what this law does for those with pre-existing conditions.

[AndiB]

Yes, but see, I don't really care. I don't care about my right not have health insurance. It's not important to me. I don't have a choice which insurance company I get now, so it doesn't bother me that the choice to have nothing is being taken away.

So, it's OK if they take rights away just so long as it's not a right that's important to you? That's a slippery slope. Don't you think?

[sassandgroove]

Having health insurance does not mean you have to go to a doctor. Ever.
so then why shoudl the have to have it?

[Don Allen]

Oh, I forgot that part. It means that I now have to work four times as hard as I thought to pay for people who waited to get health insurance until after they were sick.

Damn, I always thought "insurance" meant "you pay us premiums now, and we'll pay your bills should you get sick in the future."

Now I learn it means "go ahead and wait until you get sick, you worthless bum, and we'll still pay all your bills, even though you never paid a single premium in the past."

Get this under you hat bud.. There are some hard working S.O.B's who couldn't buy an insurance policy for any sum of money. High blood pressure "Fuck you, no coverage" Diabetes "Fuck you, pay me double" "High Album Count" (spelling don't look right) Same deal. Oh I'm sorry, do you work with hazardous materials, we must rate you accordingly,,... This is not about some slob on the street corner I don't know why people can't get that through their heads....

[sassandgroove]

So, it's OK if they take rights away just so long as it's not a right that's important to you? That's a slippery slope. Don't you think?
exactly. it's the apathy that's dangerous.

[Don Allen]

i've never played the "bum" card, don. don't paint me that way.

i have as much, if not more, empathy for impoverished people without health insurance than most of the scumbags who are being lionized in congress.

i shouldn't have made light of your comment, but it was something of an oversimplification of what this law does for those with pre-existing conditions.

Understood and appreciated, but this doesn't mean we're going to start swapping spit in the shower...

[Celia Cyanide]

So, it's OK if they take rights away just so long as it's not a right that's important to you? That's a slippery slope. Don't you think?

No. It's just something that I don't feel strongly about.

[Celia Cyanide]

exactly. it's the apathy that's dangerous.

Give me a break. I am not obligated to care about every issue that you do. I have issues that are important to me. This is not one of them, and that is the way I feel.

[Celia Cyanide]

so then why shoudl the have to have it?

That wasn't your question. You were talking about forcing people to get treatment, which isn't what is happening here.

[sassandgroove]

my point was - everyone is compelled to get insurance now or be fined. but there are people - for religion or apathy- who don't want to go to the doctor, ever, and won't even when they are really sick- so I am asking why they should have to have INSURANCE. Yes, as you stated, having insurance doesn't mean you have to go to the doctor- but then you don't need insurance.

And I don't understand why you don't care about your rights. that's how they get taken away.

[William Haskins]

Understood and appreciated, but this doesn't mean we're going to start swapping spit in the shower...

your loss...

[Celia Cyanide]

And I don't understand why you don't care about your rights. that's how they get taken away.

Again, give me a break. Because I don't care that it is mandatory that people buy health insurance, I suddenly don't care about my rights altogether?

No, I don't give a flying fuck about losing my right to be uninsured. Obviously you do. However, for me, it's not a right that has ever been wanted or needed, so, no, I don't care.

[jana13k]

my point was - everyone is compelled to get insurance now or be fined. but there are people - for religion or apathy- who don't want to go to the doctor, ever, and won't even when they are really sick- so I am asking why they should have to have INSURANCE. Yes, as you stated, having insurance doesn't mean you have to go to the doctor- but then you don't need insurance.

And I don't understand why you don't care about your rights. that's how they get taken away.
While I agree (sorta) in principle, how are you going to guarantee that they don't go to the doctor. If they're passed out in a car wreck and taken to the emergency room, is there some sort of tattoo that identifies them as not to be serviced? When those religious zealots get a real disease and change their mind about wanting care, do we get to backbill them for all the premiums everyone else paid? If doctors have no right to deny care, and those religiously opposed get a "get out of jail free card" then what's to stop a bunch of people from claiming religion as their reason for not paying in?

[Celia Cyanide]

While I agree (sorta) in principle, how are you going to guarantee that they don't go to the doctor. If they're passed out in a car wreck and taken to the emergency room, is there some sort of tattoo that identifies them as not to be serviced? When those religious zealots get a real disease and change their mind about wanting care, do we get to backbill them for all the premiums everyone else paid? If doctors have no right to deny care, and those religiously opposed get a "get out of jail free card" then what's to stop a bunch of people from claiming religion as their reason for not paying in?

Yes, and that is kind of my issue, too. There are some people who don't believe in medical treatment, but when it comes down to a life or death situation for you or your child, I think those beliefs are tested, and I think people are fairly likely to change their minds at that point. And yes, we all pay for it, which is the way it is already when someone without health insurance goes to the ER. Even if doctors were allowed to deny someone care because they couldn't pay, many of them would not, anyway.

[backslashbaby]

Get this under you hat bud.. There are some hard working S.O.B's who couldn't buy an insurance policy for any sum of money. High blood pressure "Fuck you, no coverage" Diabetes "Fuck you, pay me double" "High Album Count" (spelling don't look right) Same deal. Oh I'm sorry, do you work with hazardous materials, we must rate you accordingly,,... This is not about some slob on the street corner I don't know why people can't get that through their heads....

And business owners who can't afford to offer policies to employees. Large businesses who hire folks in India because the cost of providing benefits in America is prohibitive.

I wish the companies involved hadn't screwed everyone except their stockholders over so badly; I wish my neighbors had bought their healthy selves insurance instead of the extra minivan and widescreen.

But the mess that was made was screaming for government to step in, unfortunately.

[MattW]

But the mess that was made was screaming for government to step in, unfortunately.
The mess partially created by government intervention last time.

See sig.

[Don]

Perhaps the reason we have one of the lowest tax burdens is that we've managed to avoid, until Sunday, many of the socialist programs (like universal healthcare) that the rest of the developed world has saddled itself with.
And guess what? This huge new cut out of the private free markets into government-mandated spending won't be counted by FedGov when they talk about our "tax burden," either.

Because it's not a tax. I guess mandatory expenditures are only taxes when you pay the gunvernment, and not their corporate asshole buddies. :rolleyes:

Call it what you will, we all just got a massive tax increase, but this time the corporations managed to cut out the middleman.

[backslashbaby]

The mess partially created by government intervention last time.

See sig.

I don't know which ones you are thinking of.

I think the state setup is bizarre and limited competition, but I've never researched who did it. Either the State or Fed, I guess, so it's gov't either way.

But if insurance can cross state lines, it needs consistent regulations. None of this stuff that entices cruise ships to register in Liberia ;)

I can't think of more regulation that was bad, offhand. Badly enforced, of course. We're kinda idiots, I think ;) Yes, your sig.

[Bird of Prey]

Oh my. Listen, please. I'm serious. This bill is going to free the average American - yes, free you, each and every one of you - and move the economy in the right direction.

Right now, reasonable - i.e. family/pre-existing problems/a spouse unemployed/complicated pregnancy - health insurance ties every corporate wage earner to corporate duty . . .until Medicare if he/she wants to protect his/her family.

This is an extremely unhealthy state of affairs, particularly when it comes to our otherwise entrepreneurial spirits stuck churning out ideas and patents for the likes of IBM and Boeing because they don't dare lose their health insurance because they've got a kid with a health problem. We can't afford a corporate stranglehold anymore. We've got plenty of people with great ideas that could set a brand new path if it wasn't for the complication of loving their families so much - or trying to survive themselves - that they're stuck with corporate oblivion when it comes to health insurance. Otherwise, it's Cobra until it's used up and then. . . .bankruptcy. Now that's a bleak future that nobody relishes, hence the Willy Loman sacrifices ala the last thirty or more years.

This bill will free the average American: free the average American to make choices regarding his/her independence: his/her ideas, start-up company or companies, manufacturing - AT HOME, no less: you name it. This bill allows a person to pursue his/her goal regardless of family health and the concern that otherwise enslaved a person to a corporation and its corporate benefits.

This is a brand new world, ladies and gents, and I'm all for it and then some. We will experience far more freedom, not less freedom. And the reasons are profoundly broad and philosophical and far-reaching. This is not a bill to be feared. This is a bill that allows you as an independent entity contributing ideas and cherishing dreams to move confidently forward. . . .

[Don]

Well, for starters, the sainted Teddy Kennedy wrote the legislation that tied health insurance to the employer, creating the cries we hear today for portability of health care.

I think it was the same act that gave HMOs decided regulatory advantages over other forms of organizing healthcare and insurance, and essentially destroying any ability to innovate in those areas.

Then a bunch of states started dictating what policies must contain. For example, I can't buy a policy that doesn't include drug treatment, psychiatric care, or pregnancy coverage. Hello, I'm a dude. Srsly. Look in my pants if you don't believe me. Pregnancy coverage?

So there's plenty of blame to go around, and it doesn't all belong on the insurance companies, big pharma, hospitals, or doctors.

[Don]

Somebody's been listening to Nancy Pelosi. :D

Note, as I explained in the post above, that it was Saint Teddy the K that wrote legislation that made us corporate slaves in the first place.

So why didn't they simply unbundle the employers from the coverage if they wanted that to be? That's a far cry from what they actually did.

[backslashbaby]

Well, for starters, the sainted Teddy Kennedy wrote the legislation that tied health insurance to the employer, creating the cries we hear today for portability of health care.

I think it was the same act that gave HMOs decided regulatory advantages over other forms of organizing healthcare and insurance, and essentially destroying any ability to innovate in those areas.

Then a bunch of states started dictating what policies must contain. For example, I can't buy a policy that doesn't include drug treatment, psychiatric care, or pregnancy coverage. Hello, I'm a dude. Srsly. Look in my pants if you don't believe me. Pregnancy coverage?

So there's plenty of blame to go around, and it doesn't all belong on the insurance companies, big pharma, hospitals, or doctors.

Ah! Good stuff. I have wondered how the hell the existing companies found such a monopoly. I didn't know the earlier history of how we did this.

We need to do more to foster competition and a variety of policies and price levels, always. Particularly if folks have to buy it.

I disagree that this can be done without any regulation, but I think it's hugely important.

[Bird of Prey]

Well, for starters, the sainted Teddy Kennedy wrote the legislation that tied health insurance to the employer, creating the cries we hear today for portability of health care.

I think it was the same act that gave HMOs decided regulatory advantages over other forms of organizing healthcare and insurance, and essentially destroying any ability to innovate in those areas.

Then a bunch of states started dictating what policies must contain. For example, I can't buy a policy that doesn't include drug treatment, psychiatric care, or pregnancy coverage. Hello, I'm a dude. Srsly. Look in my pants if you don't believe me. Pregnancy coverage?

So there's plenty of blame to go around, and it doesn't all belong on the insurance companies, big pharma, hospitals, or doctors.

Who is to blame is irrelevant. We're moving forward, licensing independent people to be independent, and freeing corporate lackeys that aren't appreciated to make their own destiny, knowing that they have the power to take care of their families regardless of their path. I'm all for it. It's a new dawn. . . .

[jana13k]

Who is to blame is irrelevant. We're moving forward, licensing independent people to be independent, and freeing corporate lackeys that aren't appreciated to make their own destiny, knowing that they have the power to take care of their families regardless of their path. I'm all for it. It's a new dawn. . . .
That's an idealistic viewpoint, and while as an artist, I would love to quit my day-job and pursue only writing with the knowledge that I could still have decent medical coverage, here's the reality - all that time I won't be "chained" to a desk in corporate America, I can instead spend sitting in one of the two clinics in the entire city that will agree to take the government insurance which will likely want doctors to take $2.50 for an office visit. Do you know how many private practices do NOT accept Medicare/Medicaid for that reason - AND the complicated billing system that makes them crazy?

So are we also going to tell people who spent 10+ years and a half million in education that they're not "allowed" to make more money? Because then we'll have to follow all our doctors to the other countries they'll move to.

[William Haskins]

Who is to blame is irrelevant. We're moving forward, licensing independent people to be independent, and freeing corporate lackeys that aren't appreciated to make their own destiny, knowing that they have the power to take care of their families regardless of their path. I'm all for it. It's a new dawn. . . .

yeah it's a new dawn... a whole new generation of corporatists has manifested from thin air.

[Bird of Prey]

yeah it's a new dawn... a whole new generation of corporatists has manifested from thin air.

OMG. What a crock.

The fact is, many have the luxury of a corporate copay as long as they sell their souls to a long commute, an eight to six paper pushing extravaganza, bullshit meetings, shitty bosses and deferred dreams until their reincarnation. . . all for love of family or the drug that keeps them alive.

Sorry, those days are over. . . .

[William Haskins]

Sorry, those days are over. . . .

be patient... we have time.

let us watch the costs of coverage, of care, of medication.

if it goes down, i will eat crow.
if it doesn't, then you will have been a cheerleader for a huge (and ever-growing) giveaway to big business.

[Bird of Prey]

be patient... we have time.

let us watch the costs of coverage, of care, of medication.

if it goes down, i will eat crow.
if it doesn't, then you will have been a cheerleader for a huge (and ever-growing) giveaway to big business.

I won't insist on crow. That's not the point. Besides, I like you too much.

I'm very patient, and I'm very confident, William. This will be the best thing that ever happened to us as independent artists and inventors, entrepreneurs and engineers, individuals and familes. . . .

[William Haskins]

well, though it's counter to my nature, i'm something of a pessimist on this.

[Magdalen]

well, though it's counter to my nature, i'm something of a pessimist on this.

LOL.

Out of respect (deep and abiding) I've refrained from using smilies.

[Don]

I won't insist on crow. That's not the point. Besides, I like you too much.

I'm very patient, and I'm very confident, William. This will be the best thing that ever happened to us as independent artists and inventors, entrepreneurs and engineers, individuals and familes. . . .
Better than fire?
Better than socialization of the species?
Better than farming?
Better than language?
Better than math?
Better than the Magna Carta?
Better than 1776?
Better than the 13th Amendment?
Better than The New Deal?
Better than Camelot?
Better than The Great Society?

I can hardly wait. :rolleyes:

[Bird of Prey]

Better than fire?
Better than socialization of the species?
Better than farming?
Better than language?
Better than math?
Better than the Magna Carta?
Better than 1776?
Better than the 13th Amendment?
Better than The New Deal?
Better than Camelot?
Better than The Great Society?

I can hardly wait. :rolleyes:

Better than Charlie Daniels and Itzhak Perlman rolled into one. . . .

[sassandgroove]

idealistic post BOP- explain to me howall of that is going to happen.

[Slushie]

No insurance. Single. $18k.
Beginning in 2014, you will receive tax credits to help afford insurance premiums in the new exchanges as well as assistance with deductibles and co-payments. According to your income and family size, the tax credits will ensure you do not spend more than $720 to $1134 on premiums. Your maximum out-of-pocket costs for deductibles and co-payments would be capped at 15% of the total cost.
---
You are required to have health insurance. If you don't, you will pay a tax penalty of $695 per year up to a maximum of three times that amount ($2,085) per family or 2.5 percent of household income.
18,000x0.025=450

If I'm still single and making 18k/yr four years from now, this health insurance bill is the least of my problems. :(

But, at least now I get to sneak into the rich people's potty when my chronic diarrhea strikes! I wonder what it looks like in there?



http://i295.photobucket.com/albums/mm134/TRUACURAIMPORT/money.gif
Oh. I see.



Interesting:
http://www.aolnews.com/healthcare/article/opinion-eighteen-myths-about-the-health-reform-bill-debunked/19406480

Myth 18: The bill will end medical bankruptcy and provide all Americans with peace of mind.

Fact: Most people with medical bankruptcies already have insurance, and out-of-pocket expenses will continue to be a burden on the middle class.

* In 2009, 1.5 million Americans declared bankruptcy.
* Of those, 62 percent were medically related.
* Three-quarters of those had health insurance.
* The Obama bill leaves 24 million without insurance.
* The maximum yearly out-of-pocket limit for a family will be $11,900 on top of premiums.
* A family with serious medical problems that last for a few years could easily be financially crushed by medical costs.

Real health care reform is needed. But this bill falls short of that on many levels.

I want my fucking rainbow, dammit!

[blacbird]

* The Obama bill leaves 24 million without insurance.

As opposed to the 45-50 million who don't have it now? If this is an example of the level of criticism of the bill, I'm more in favor of it now than ever.

caw

[SPMiller]

Yeah, it's funny. I was essentially opposed to the bill at first--and I have the posting record on AW to prove it--but after the persistent refusal of conservative lawmakers (mostly but not entirely GOP) to budge on any of the few good ideas the Democrats came to the table with, I realized this was the best we could possibly get. I'm not happy at all, though.

[AndiB]

Yeah, it's funny. I was essentially opposed to the bill at first--and I have the posting record on AW to prove it--but after the persistent refusal of conservative lawmakers (mostly but not entirely GOP) to budge on any of the few good ideas the Democrats came to the table with, I realized this was the best we could possibly get. I'm not happy at all, though.

How about the steadfast refusal of all democrats on this to take any suggestions from republicans that might actually LOWER the COST of health care rather than simply subsidizing the fees for some of the people?

Seriously, there is nothing in there that is going to actually lower the cost of health care. There are only subsidies that will have to come from somewhere. When you look at the fact that our government is BROKE it doesn't matter how creatively they are working the numbers they will run out of money to pay for this unless they take DRASTIC action to reduce the costs of health care in this country.

I'm all for health care reform. This bill sucks though. It's not reform. It's a brave new entitlement.

[backslashbaby]

How about the steadfast refusal of all democrats on this to take any suggestions from republicans that might actually LOWER the COST of health care rather than simply subsidizing the fees for some of the people?

Seriously, there is nothing in there that is going to actually lower the cost of health care. There are only subsidies that will have to come from somewhere. When you look at the fact that our government is BROKE it doesn't matter how creatively they are working the numbers they will run out of money to pay for this unless they take DRASTIC action to reduce the costs of health care in this country.

I'm all for health care reform. This bill sucks though. It's not reform. It's a brave new entitlement.

Which suggestions? How do they work?



There has been a lot of talk in this thread about how some healthcare costs will be lowered. There is more in the actual bill.

I'm not thrilled with the bill. But it does do many things that make sense, imho.

[AndiB]

Which suggestions? How do they work?



There has been a lot of talk in this thread about how some healthcare costs will be lowered. There is more in the actual bill.

I'm not thrilled with the bill. But it does do many things that make sense, imho.

1) Tort reform is the biggest of the big. If the bill doesn't call for comprehensive tort reform then doctor's will continue to order expensive and unnecessary tests in order to cover their rears from all potential possibilities. Right now they test for rare complications for the simplest of things in order to avoid potential lawsuits.

Windfall awards, expensive litigation, and countless attorneys jumping on the class action bandwagon keeps doctors living in fear of career ending and financially crippling lawsuits.

2) Negative outcome insurance is another way. It's a low cost insurance that people MAY purchase before surgery that would cover medical expenses caused due to complications or negative outcomes as a result of the surgeries or treatments being performed. This will allow the cost of malpractice insurance to be reduced (which will greatly lower the costs involved for medical practitioners at all levels - which is ultimately passed on to patients).

3) Open access for all to health insurance. This will open the doors for competition and choice. Competition on the free market will drive the prices down as companies try to gain an edge over one another.

4) Encourage healthy lifestyles by making exercise equipment, nutrition consultations, and smoking cessation tools tax deductible. Healthier people in general require less costly health care.

[backslashbaby]

1) Tort reform is the biggest of the big. If the bill doesn't call for comprehensive tort reform then doctor's will continue to order expensive and unnecessary tests in order to cover their rears from all potential possibilities. Right now they test for rare complications for the simplest of things in order to avoid potential lawsuits.

Windfall awards, expensive litigation, and countless attorneys jumping on the class action bandwagon keeps doctors living in fear of career ending and financially crippling lawsuits.

2) Negative outcome insurance is another way. It's a low cost insurance that people MAY purchase before surgery that would cover medical expenses caused due to complications or negative outcomes as a result of the surgeries or treatments being performed. This will allow the cost of malpractice insurance to be reduced (which will greatly lower the costs involved for medical practitioners at all levels - which is ultimately passed on to patients).

3) Open access for all to health insurance. This will open the doors for competition and choice. Competition on the free market will drive the prices down as companies try to gain an edge over one another.

4) Encourage healthy lifestyles by making exercise equipment, nutrition consultations, and smoking cessation tools tax deductible. Healthier people in general require less costly health care.

1- I agree that we need to look into some sort of tort reform. I don't like the Republican's ideas on it, but the way other countries do it seems reasonable (Germany, was it?)

2- Lots of emphasis on bad outcomes here, but sure. Sometimes things do go wrong due to nobody's fault, so coverage for that sounds good. It's another thing to buy, though.

3- Explain what this entails.

4- Encourage? Hmmm, if the gov't isn't telling me what to do. Your examples are cool, and they sound great.

So, these things sound great, depending on how they are done. Current legislation doesn't restrict any of them, but if we should add them, that sounds good to me.

I don't believe that tort reform will change healthcare costs nearly as much as some say, but it's worth looking into.

The bill does include other suggestions taken from Republicans. "Taken from" because they refused to work on this bill.

[AndiB]

3- Explain what this entails.



I know I said I was going to go work on happy things but I got sucked back in. LOL. I'm going to have to work at some point today (sigh...darn those dastardly bills that keep coming).

To answer this what I'm talking about goes down to simple economics: supply and demand. Most states have a very limited number of health insurance companies that operate within the state. Less competition means these companies have a sort of monopoly in the states. It's the same problem I have with the electric company, water company, etc. (though I can understand with them because there's only so much infrastructure to service the area the same does not quite hold true when it comes to health insurance).

If you allow all health insurance companies to operate in every state there would be more competition and they would have to operate on a more competitive level across the board. Make sense?

One more thing I'd like to see is transparency in charges. We pay cash for my son who isn't covered on insurance due to his pre-existing condition. When we go in for office visits we can never get a price on the visit before we go in. On one visit we asked one question that added $55 to the office visit because it was unrelated to the reason we initially scheduled the appointment.

But the doctor's office said that is a government requirement that all charges must be related or separate. There is even a requirement (according to son's pediatrician) that if we go in for one reason and something unrelated is discovered (like a sports physical that discovers a breathing problem or kidney problem) then we must either be charged for two visits or schedule a second visit to come back and discuss the problem. It's stuff like this that is utterly insane and the direct result of existing government interference in health care due to their involvement in Medicaid/Medicare. Attempts to prevent fraud have made it impossible for doctors to actually treat people.

[backslashbaby]

I know I said I was going to go work on happy things but I got sucked back in. LOL. I'm going to have to work at some point today (sigh...darn those dastardly bills that keep coming).

To answer this what I'm talking about goes down to simple economics: supply and demand. Most states have a very limited number of health insurance companies that operate within the state. Less competition means these companies have a sort of monopoly in the states. It's the same problem I have with the electric company, water company, etc. (though I can understand with them because there's only so much infrastructure to service the area the same does not quite hold true when it comes to health insurance).

If you allow all health insurance companies to operate in every state there would be more competition and they would have to operate on a more competitive level across the board. Make sense?

One more thing I'd like to see is transparency in charges. We pay cash for my son who isn't covered on insurance due to his pre-existing condition. When we go in for office visits we can never get a price on the visit before we go in. On one visit we asked one question that added $55 to the office visit because it was unrelated to the reason we initially scheduled the appointment.

But the doctor's office said that is a government requirement that all charges must be related or separate. There is even a requirement (according to son's pediatrician) that if we go in for one reason and something unrelated is discovered (like a sports physical that discovers a breathing problem or kidney problem) then we must either be charged for two visits or schedule a second visit to come back and discuss the problem. It's stuff like this that is utterly insane and the direct result of existing government interference in health care due to their involvement in Medicaid/Medicare. Attempts to prevent fraud have made it impossible for doctors to actually treat people.

Oh, yeah, that's good stuff. I'm for encouraging competition entirely, while smacking down practices that rip folks off in a standardized way.

All of this coding and billing stuff is crazy, too. The new technology in this bill should help with not having to repeat things (info and the actual tests) and being standardized. But standardization needs to be reasonable and not cause crazy charges, yes.

It is a hard balancing act.

And then folks hear of the technology parts and write that the gov't will control your bank account. So it's crazy hard to work out.

[AndiB]

I don't believe that tort reform will change healthcare costs nearly as much as some say, but it's worth looking into.


Oh yeah, meant to address this before. In my former life I worked in a law firm that specialized in pharmaceutical malpractice and class action defense. Just to defend these cases costs multiple hundreds of millions of dollars (if not billions) per case. That's before any awards or settlements are made. I think that will have a much bigger impact than people who don't have experience in this field can imagine.

And the negative outcome insurance is something extra you'd have to buy but you'd only need to buy it when it's needed rather than having to pay month after month like you do with health insurance.

If you're getting the tax credits or deductions to match your health insurance outlay every month you're much better off than you are now (for the next four years anyway if this health care bill passes). You have incentive to make the purchase, the taxes of the people making the purchases are affected and not those of everyone else, and you aren't penalized if you choose not to.

[backslashbaby]

Oh yeah, meant to address this before. In my former life I worked in a law firm that specialized in pharmaceutical malpractice and class action defense. Just to defend these cases costs multiple hundreds of millions of dollars (if not billions) per case. That's before any awards or settlements are made. I think that will have a much bigger impact than people who don't have experience in this field can imagine.

And the negative outcome insurance is something extra you'd have to buy but you'd only need to buy it when it's needed rather than having to pay month after month like you do with health insurance.

If you're getting the tax credits or deductions to match your health insurance outlay every month you're much better off than you are now (for the next four years anyway if this health care bill passes). You have incentive to make the purchase, the taxes of the people making the purchases are affected and not those of everyone else, and you aren't penalized if you choose not to.

Unfortunately, I think health care is one of those things where the risks and benefits need to be shared to a great extent, like education or infrastructure. On other things, I think a more direct tax incentive situation works great.

[jana13k]

I know I said I was going to go work on happy things but I got sucked back in. LOL. I'm going to have to work at some point today (sigh...darn those dastardly bills that keep coming).

To answer this what I'm talking about goes down to simple economics: supply and demand. Most states have a very limited number of health insurance companies that operate within the state. Less competition means these companies have a sort of monopoly in the states. It's the same problem I have with the electric company, water company, etc. (though I can understand with them because there's only so much infrastructure to service the area the same does not quite hold true when it comes to health insurance).

If you allow all health insurance companies to operate in every state there would be more competition and they would have to operate on a more competitive level across the board. Make sense?

One more thing I'd like to see is transparency in charges. We pay cash for my son who isn't covered on insurance due to his pre-existing condition. When we go in for office visits we can never get a price on the visit before we go in. On one visit we asked one question that added $55 to the office visit because it was unrelated to the reason we initially scheduled the appointment.

But the doctor's office said that is a government requirement that all charges must be related or separate. There is even a requirement (according to son's pediatrician) that if we go in for one reason and something unrelated is discovered (like a sports physical that discovers a breathing problem or kidney problem) then we must either be charged for two visits or schedule a second visit to come back and discuss the problem. It's stuff like this that is utterly insane and the direct result of existing government interference in health care due to their involvement in Medicaid/Medicare. Attempts to prevent fraud have made it impossible for doctors to actually treat people.
Another point, many national organizations (like writer's organizations) would love to offer insurance to members but would have to negotiate contract in every single state, under that states restrictions and with the insurance companies located there. It's cost prohibitive for most organizations to even attempt the research and administrative cost of doing so, so they simply don't offer it at all. If insurance sales were opened across state lines, the organizations COULD offer policies to members and still take advantage of the large group rates.

[Don Allen]

1) Tort reform is the biggest of the big. If the bill doesn't call for comprehensive tort reform then doctor's will continue to order expensive and unnecessary tests in order to cover their rears from all potential possibilities. Right now they test for rare complications for the simplest of things in order to avoid potential lawsuits.

Windfall awards, expensive litigation, and countless attorneys jumping on the class action bandwagon keeps doctors living in fear of career ending and financially crippling lawsuits.

2) Negative outcome insurance is another way. It's a low cost insurance that people MAY purchase before surgery that would cover medical expenses caused due to complications or negative outcomes as a result of the surgeries or treatments being performed. This will allow the cost of malpractice insurance to be reduced (which will greatly lower the costs involved for medical practitioners at all levels - which is ultimately passed on to patients).

3) Open access for all to health insurance. This will open the doors for competition and choice. Competition on the free market will drive the prices down as companies try to gain an edge over one another.

4) Encourage healthy lifestyles by making exercise equipment, nutrition consultations, and smoking cessation tools tax deductible. Healthier people in general require less costly health care.

1. Tort reform will NEVER pass. For two reasons, first it would be struck down by the supreme court as a first amendment infringement, second trial lawyers are both republican and democrats, need i say more. The best you could do here would be capping jury awards, but that would end up being a state issue not a federally mandated one .

2. Negative outcome Insurance??? Other than Lloyds of London, try to find a carrier... If you do, you the underwriting will be done on an individual basis and cost more than the botched procedure itself. Again, a better solution would be a monetary cap.

3. We have this now and prices have doubled every 3 years for the last 30 years, I don't understand what you're talking about.

4. This was the original premise of HMO's that turned to shit after they realized they could exclude, rate or deny coverage to those who didn't do exactly as they were told. Case in point, a patient with asthma was told by an HMO that their benefits would be reduced by 50% if they did not lose a certain amount of weight and adhere to a strict regimen of steroids prescribed by the HMO provider. The problem: The steroids prevented the patient from losing the weight, hence the HMO determined that the patient was in violation of the policy terms and benefits for anything related to asthma were reduced by 50% .. True story....