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House Passes Massive Medical Insurance Bill, 219-212 2424

Posted by timothy
from the house-of-representin'-in-effect dept.
The votes are in: yesterday evening, after a last-minute compromise over abortion payments, the US House of Representatives narrowly passed a bill effecting major changes in American medical finance. From the BBC's coverage: "The president is expected to sign the House-passed Senate bill as early as Tuesday, after which it will be officially enacted into law. However, it will contain some very unpopular measures that Democratic senators have agreed to amend. The Senate will be able to make the required changes in a separate bill using a procedure known as reconciliation, which allows budget provisions to be approved with 51 votes - rather than the 60 needed to overcome blocking tactics." No Republican voted in favor of the bill; 34 Democrats voted against. As law, the system set forth would extend insurance coverage to an estimated 32 million Americans, impose new taxes on high-income earners as well as provide some tax breaks and subsidies for others, and considerably toughen the regulatory regime under which insurance companies operate. The anticipated insurance regime phases in (starting with children, and expanding to adults in 2014) a requirement that insurance providers accept those with preexisting conditions, and creates a system of fines, expected to be administered by the IRS, for those who fail or refuse to obtain health insurance.
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House Passes Massive Medical Insurance Bill, 219-212

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  • by alen (225700) on Monday March 22, 2010 @08:15AM (#31565424)

    you are always going to pay for it. about time that we stopped the system of some people getting "insurance" only when they get sick

    • by insufflate10mg (1711356) on Monday March 22, 2010 @08:46AM (#31565772)
      The next generation will read about the status quo before yesterday and will be appalled; they will be proud that the US took steps towards regulating the out-of-control private insurance companies. The Republicans will not repeal this legislation because once the people of the US find out what this bill entails they will defend it like they do Medicare and Social Security.
      • Not until 2014 (Score:5, Interesting)

        by elrous0 (869638) * on Monday March 22, 2010 @09:32AM (#31566640)
        The biggest problem I see with this bill is that it doesn't take effect until 2014. That gives Republicans/Insurance plenty of time to repeal it long before anyone gets to see *any* benefit from it. By 2014 we could well have already had a year of complete Republican rule (White House and Congress), and you know if they retook the White House and Congress, repealing this would be number 1 on their agenda.
        • Re:Not until 2014 (Score:5, Informative)

          by portnoy (16520) on Monday March 22, 2010 @10:00AM (#31567284) Homepage

          But there are provisions that will take place immediately -- things like making sure that young children can't be denied from a new plan due to a pre-existing condition, prohibit dropping people from a plan when they get sick, letting dependents stay on their parents' policies until the age of 26, adding tax credits to small businesses to allow for coverage purchase. It would be pretty easy for Democrats to spin taking those things away as a bad thing.

  • Hoorah! (Score:5, Insightful)

    by Anonymous Coward on Monday March 22, 2010 @08:15AM (#31565430)
    Congrats US citizens! You're on your way to a non-broken health care system!
    • Re:Hoorah! (Score:4, Insightful)

      by SimonTheSoundMan (1012395) on Monday March 22, 2010 @08:21AM (#31565484) Homepage

      I agree. It should be a day to celebrate in America.

    • Re:Hoorah! (Score:4, Insightful)

      by damn_registrars (1103043) <damn.registrars@gmail.com> on Monday March 22, 2010 @08:26AM (#31565540) Homepage Journal

      Congrats US citizens! You're on your way to a non-broken health care system!

      We could only be so lucky. This bill by and large doesn't change anything. Most of us have health insurance that we purchase through our employers, provided by insanely profitable corporations. And for almost none of us will that change.

      Unfortunately our government doesn't do change this year.

      • by sjbe (173966) on Monday March 22, 2010 @08:50AM (#31565828)

        Most of us have health insurance that we purchase through our employers, provided by insanely profitable corporations.

        Except for the 35-50 million who don't and can't get health insurance. Never mind that losing your job has meant a double whammy of losing your health insurance too. Happened to me. It also matters for those who can't get coverage because of pre-existing conditions. Has happened to members of my immediate family.

        Does this bill cure everything? Of course not. But it does change things for a lot of people, hopefully for the better. If you have been lucky not to be affected by the broken parts of the US healthcare system, consider yourself lucky.

        • by Runaway1956 (1322357) on Monday March 22, 2010 @09:21AM (#31566392) Homepage Journal

          Ditto here, my freind. But, there are millions of Republicans lined up, waiting their turn to call us both "LOSERS!"

          I remember when that Cobra (or, Corba?) thing was passed, making it possible to keep your health insurance between jobs. Big joke. My insurance was costly while I was employed. When I was laid off, the price quadrupled. Jesus H. Christ! It looked good, when it was being tossed around by the politicians. In reality, it was just another cruel way for the rich bastards to let me know they had really stuck it to me!

      • Re:Hoorah! (Score:5, Insightful)

        by DavidShor (928926) <supergeek717.gmail@com> on Monday March 22, 2010 @08:52AM (#31565854) Homepage
        Removal of life-time spending caps, ban on discrimation for people with pre-existing conditions, hundreds of billions of dollars worth of subsidies paid for by taxes on the rich, and strict limits on the profitability of Insurance companies (85% of premiums must go to actual care, not administrative fees).

        .

        Also, over the next decade, the exchanges will get larger and larger. The exchanges are the market place where insurance companies will place bids on standardized plans(The idea is that by pooling everyone together and creating standards, we can avoid the market inefficiencies that currently plague the individual market). It's originally only open to small businesses and the poor, but the it ramps up to the rest of the population in a fairly quick time-frame. That, combined with the excise tax which effectively phases out the tax exemption of health-care, puts us on a path away from employer provided health insurance.

        You can argue whether that's positive or negative, but that it indisputably moves us away from the employer-based model with very profitable insurance companies.

    • Re:Hoorah! (Score:5, Insightful)

      by Above (100351) on Monday March 22, 2010 @10:07AM (#31567462)

      You clearly don't understand our politicians ability to screw something like this up.

      [Waits to see if this gets modded funny or insightful.] *sigh*

  • Pro / cons (Score:4, Interesting)

    by MistrX (1566617) on Monday March 22, 2010 @08:17AM (#31565442)

    Not being a USA citizen, I can't think of any reason why this bill is controversial.
    What exactly are the pro's and cons?

    • by Cornwallis (1188489) on Monday March 22, 2010 @08:20AM (#31565472)

      The pros are the government gets to tell us even moreso what to do while extorting even more in the form of taxes.

      The cons are the government gets to tell us even moreso what to do while extorting even more in the form of taxes.

    • by Mr Thinly Sliced (73041) on Monday March 22, 2010 @08:24AM (#31565522) Homepage Journal

      From the U.S. population point of view - there are very few people that seem to be against reform.

      This bill in particular has basically been a power play between the two big parties if I understand correctly.

      It didn't really pan out brilliantly for either side - the Republicans get egg on their face because the other side got their bill through anyway, whilst the Democrats didn't really get the thing they wanted because they watered down their original bill to try and get Republican support.

      The lead up to why this silly thing got pushed through can basically be summarised as follows (stolen from Digg - it's a great summation):

      Democrats: "We need health care reform"
      Republicans: "Liberal fascists! Give us a majority and we'll do it better"
      Democrats: "Done, you have majority of both houses"

      12 years later, health care is irrefutably worse in every respect for every single person in the United States

      Democrats: "We need health care reform"
      Republicans: "Liberal fascists! Americans are tired of partisan politics!"
      Democrats: "OK, let's compromise"
      Republicans: "OK, get rid of half your ideas"
      Democrats: "Done"
      Republicans: "Too liberal, get rid of half your ideas"
      Democrats: "Done"
      Republicans: "Too liberal, get rid of half your ideas"
      Democrats: "Done"
      Republicans: "Too liberal, get rid of half your ideas"
      Democrats: "Done"
      Republicans: "Too liberal, get rid of half your ideas"
      Democrats: "Done. Time to end debate"
      Republicans: "Too liberal, we need more debate, we will filibuster to prevent you from voting"
      Democrats: "OK, we'll vote--sorry guys, debate is ended. It's time to vote on the bill"
      Republicans: "Too liberal, we vote no"
      Democrats: "OK, it passed anyway--sorry guys."

      One month later

      Republicans: "Wait--wait, OK, we have less of a minority now so we can filibuster forever."
      Democrats: "Sorry, the bill already passed, we need it to pass the House now"
      Republicans: "But we have enough to filibuster"
      Democrats: "Sorry, the bill already passed, we need it to pass the House now"
      Republicans: "Liberal fascists! You haven't listened to our ideas! You've shut us out of this whole process!"
      Democrats: "Sorry, show us your proposal"
      Republicans: "Smaller government"
      Democrats: "That's not very specific"
      Republicans: "OK, here's our detailed proposal--It's our common-sense ideas we spent 12 years not enacting"
      Democrats: "OK, we'll add a bunch more of your ideas"
      Republicans: "Liberal fascists! You included all these back-room deals"
      Democrats: "OK, we'll get rid of the back-room deals"
      Republicans: "Liberal fascists! You're using obscure procedural tricks to eliminate the back-room deals!"
      Democrats: "No, we're using reconciliation, which both parties have used dozens of times for much larger bills"
      Republicans: "Liberal fascists! You're pressuring Congressmen to vote for your bill! Scandal!"
      Democrats: "It's called 'whipping', it's been done since 1789"
      Republicans: "Liberal fascists! Can't you see the American people don't want this?"
      Democrats: "This bill is mildly unpopular (40-50%), doing nothing (your proposal) is extraordinarily unpopular (4-6%)"
      Republicans: "We need to start over! We need to start over!"
      Democrats: "We should really consider voting--"
      Republicans: "Liberal fascists! Start over! Clean slate! Common-sense! America!"
      Democrats: "OK, suit yourselves, here it comes"

      • Re:Pro / cons (Score:5, Informative)

        by Anonymous Coward on Monday March 22, 2010 @08:30AM (#31565580)

        This truly is the best and most accurate description of the actual process I've seen.

        • by copponex (13876) on Monday March 22, 2010 @08:47AM (#31565788) Homepage

          The only thing missing are the Tea Partiers calling congressmen niggers and faggots. But forget reality - what are CNN and Fox News saying?

          CNN: Rep. Emanuel Cleaver, D-Missouri, released a statement late Saturday saying he too was called the "N" word as he walked to the Capitol for a vote and that he was spat on by one protestor who was arrested by U.S. Capitol Police. Cleaver declined to press charges against the man, the statement said...

          Protesters also hurled anti-gay comments at Rep. Barney Frank, D-Massachusetts, who is openly gay, as he left the same health care meeting that Lewis attended in a House office building.

          A CNN producer overheard the word "faggot" yelled at Frank several times in the lobby of the Longworth building. Frank said he heard someone yell "homo" at him.

          FOX: Republican National Chairman Michael Steele and one of the organizers of Saturday's Tea Party rally strongly condemned the racial slurs that some black lawmakers alleged were yelled at them by some health care protesters as they headed for a procedural vote at Capitol Hill....

          But black lawmakers weren't the only targets of the protesters' invective. Rep. Joe Crowley, D-N.Y., alleges some of the demonstrators also castigated Rep. Barney Frank, D-Mass., who is gay.

          "I don't even want to repeat it," said Crowley when asked what they said to Frank.

          A spokeswoman for the U.S. Capitol Police said she was unaware of any law enforcement inquiry into the incidents.

          Oh Fox... will you ever be more than a conservative mouthpiece?

        • Re:Pro / cons (Score:5, Informative)

          by Anonymous Coward on Monday March 22, 2010 @10:16AM (#31567682)

          No HERE is a better summary:

          Everyone wants better health care, and everyone wants a law, or series of laws, which in some way addresses the problem.

          The dispute comes down to two opposing perspectives on how to fix it.

          The Republican conservatives believe that no taxpayer money should be funding abortions. They also think that the principle reason that healthcare doesn't work in this country is because the cost of health care is too high. They believe this is due to too many people trying to get a "free pass" by not having insurance. It's also due, they think, to a serious problem with "impulse" lawsuits which force doctors to buy an incredibly high amount of malpractice insurance. The Republicans also think that there are way too many procedures, both surgical (angioplasty vs. TPA for heart problems) and diagnostic (too often a large, extremely expensive test is conducted for no good reason). Finally, the Republicans think there is no such thing as a single bill that will fix this. What is required is a gradual, step-by-step series of bills, to be written and implemented over a series of years, to ease us into a new era of health care.

          The liberal Democrats believe that health care costs too much because insurance companies are massive, bloated corporations who are jacking up the price of their premiums so they can squeeze money out of everybody, and work WAY too hard at getting OUT of paying for claims (such as, "you had cancer before you signed up with us, so you'll have to pay for your own treatment" or "you can't go to this emergency room to treat your heart attack, since we won't cover your visit there. You'll have to go across town instead, and hope you can make it there without dropping dead. Are you feeling lucky today?"). For the Democrats, the government needs to get involved in such a way that reminds HMOs that they are in some cases quite literally selling life, as opposed to soap flakes or cheeseburgers. They also don't care much about abortion, and fear that if we don't pass a single bill now, we'll be relying on future sessions of Congress to take up the issue with the same attention, focus and passion that it's getting now. History shows that Congress has not always been able to do this.

          The trouble is, BOTH sides make some VERY good points about what's wrong with health care in this country. What makes Americans like me VERY angry, is that the politicians can't see past their own party lines, which is wrong because we didn't elect them to serve their PARTIES. We elected them to serve the PEOPLE.

      • Re:Pro / cons (Score:5, Insightful)

        by characterZer0 (138196) on Monday March 22, 2010 @08:52AM (#31565844)

        From the U.S. population point of view - there are very few people that seem to be against reform.

        Almost everybody thinks reform is needed. Almost nobody thinks that Congress is competent enough to make good reforms.

      • Re:Pro / cons (Score:5, Insightful)

        by commodore64_love (1445365) on Monday March 22, 2010 @09:08AM (#31566112) Journal

        >>>"the Republicans get egg on their face because the other side got their bill through anyway, whilst the Democrats didn't really get the thing they wanted because they watered down their original bill to try and get [Bluedog Democratic] support."
        .

        Fixed. The Democrats didn't need Republican support (as was demonstrated by the vote). The problem was a lot of Democrats are actually conservatives, and they were against the "One Payer" goal set by Obama. They were also against funding the killing of human fetuses.

        The bill was watered down to make those conservative Democrats happy.

    • Re:Pro / cons (Score:5, Insightful)

      by NeoSkandranon (515696) on Monday March 22, 2010 @08:26AM (#31565536)

      The propaganda cons are all about things like the tremendous waits and how all the medical practitioners are going to quit because they won't get paid enough.

      The real ones are that this bill doesn't do enough to reduce costs, while also fining people for not getting insurance. Many people would also put the lack of a strong single payer program as a big con.

  • by Travoltus (110240) on Monday March 22, 2010 @08:19AM (#31565462) Journal

    It's a 4 page bill that basically proposes to extend Medicare benefits to everyone from age 0 to age 64 with a simple 'buy-in.' You buy in at cost and you're covered.

    That means no Cigna Corporation sitting around denying you a liver transplant - which cost at least one girl her life.

    Spread the word. This bill got 50 sponsors in 2 days.
    http://www.opencongress.org/bill/111-h4789/show [opencongress.org]
    http://www.open.salon.com/blog/brinna_nanda/2010/03/10/a_public_option_we_can_all_love_hr_4789 [salon.com]

  • Mixed feelings (Score:5, Insightful)

    by Ma8thew (861741) on Monday March 22, 2010 @08:22AM (#31565492)
    So the bill does a lot of good things. It stops insurance companies basically doing whatever they like, which was the main problem with the US health system. But it actually rewards those same insurance companies by delivering millions of new customers to them. A competitive public option would have pushed down insurance company margins and made them actually compete for business, instead of retaining their confusopoly [wikipedia.org]. And then there's the issue that women will now be required to purchase abortion coverage separately because the government is forbidden to pay for that procedure. This is basically a regression, since lots of plans will probably stop covering abortion in order to be eligible for government subsidised customers. Overall though, lots more people who were unable to get coverage will now be able to get it. Imperfect as it is, this bill will save lives, and contrary to what Fox will tell you, it will not affect anyone who is currently happy with their insurance.
  • Ironic (Score:4, Insightful)

    by Burpmaster (598437) on Monday March 22, 2010 @08:22AM (#31565494)

    It was the "right to life" people that threatened to block life-saving medical care for millions.

  • by OzPeter (195038) on Monday March 22, 2010 @08:28AM (#31565552)
    Not really a total troll here, but I have heard that people like Rush Limbaugh have stated that they would leave the US if this bill was passed. Not that he will be missed by me, but are there people who are now seriously considering emigrating because they believe the government has failed them? I know that there have been a lot of trash talk from right leaning people along the lines of "if you don't like it here then leave", but I am curious to know what will happen now that the boot is on the other foot. Maybe it could be a good poll?
  • by GuyFawkes (729054) on Monday March 22, 2010 @08:31AM (#31565596) Homepage Journal

    I may be wrong, but from the UK perspective this is not "NHS Lite" socialised healthcare, rather this is the wetware equivalent of compulsory motor insurance, now applied to human beings...

    Nice civil liberties you have there citizen, shame if anything happened to them, better buy this here medical insurance, know what I mean?

    Sounds like this bill has nothing whatsoever to do with medical treatment per se.

    One small step from the RIAA et al doing the same thing.

  • patriotism, as in caring for the health of your nation, the welfare of your fellow man, belief in the common good, as opposed to the prophets of blind ultimately self-defeating selfishness: i don't know why that's "patriotism"

    morality, as in standing up and saying that i don't believe in a society where a corporation takes care of its stockholders and denies middle class americans health benefits while gouging them with skyrocketing rates

    freedom, from disease and sickness, as opposed to the false "freedom" to choose between paying for your broken arm, or depending upon society to pay for your broken arm because you can't afford it (while you rail about your "right" to "choose" to not have health insurance)

    if you understand why you can't drive legally without car insurance, you understand why health insurance must be mandated. even the young and healthy break their arms. then, what happens? does the hospital turn them away for not having cash? can you live in a society that does that?

    furthermore, what currently happens if they have no health insurance? hospitals have unpaid bills, and remains eternally on the verge of bankruptcy, eternally needing bailouts from the state and feds. in other words: you already pay for it, but now you pay for it in the most common sense way

  • yay insurance (Score:5, Insightful)

    by Bobtree (105901) on Monday March 22, 2010 @08:40AM (#31565700)

    Now they should try a health care bill.

  • by Danathar (267989) on Monday March 22, 2010 @08:51AM (#31565836) Journal

    Cool. Government mandating that people buy PRIVATE health insurance (never been done...and no car insurance is not the same as you don't have to buy a car and many people don't own one). Private health insurance stock is going to skyrocket! Profit!

    I predict a good chance it will be knocked down by the Supremes since the court is Majority conservative. Their justification will be the one I put above.

  • by Opportunist (166417) on Monday March 22, 2010 @08:53AM (#31565862)

    Here's how we do it: 23% of your paycheck is ripped from you. For that you get: As many sick days (with pay) as you have to get (of course they come check on you if you're sick too long), full accident and sickness insurance, including medication (albeit with a small fee, around 5 bucks, per prescription), hospital of your choice if you need one, pretty much all checkups your doc deems sensible, any life saving (or ability-saving) operation, hospital stay as long as you need to (iirc with a nominal per-day fee of a few bucks, unless you either absolutely HAVE to stay there or are needy, which also eliminates all other fees you'd have to pay) and a few other nifty things.

    On the downside, you get the doc that happens to be available, you get crammed into a room with 12 other people, the food is pretty much ... well, let's say it doesn't instantly kill you and no TV, internet or other perks. You can of course invest in a private "additional" insurance that covers these expenses, or you pay for them directly when you need/want them.

    I don't know about you, but somehow I like that system. Yes, it's anything but cheap (hey, it costs me a fourth of my income), but it means that I get any operation, any medication and any treatment I could possibly require to stay healthy (or return to that state as well as medically possible). I'd say it's worth it.

  • by DiniZuli (621956) on Monday March 22, 2010 @08:54AM (#31565886) Homepage
    The text of the bill:
    http://www.opencongress.org/senate_health_care_bill [opencongress.org]

    The economy of the bill:
    http://cboblog.cbo.gov/?p=508 [cbo.gov]

    Congrats from Europe :)
  • by fluffernutter (1411889) on Monday March 22, 2010 @09:09AM (#31566142)
    I'm confused about this bill... Some honest questions:

    1) What is in it to stop the premiums going up as the money from subsidies comes in? In other words, will the basic laws of supply and demand in a free market not still apply? This bill does not seem to limit the dynamics of the free market.
    2) What will stop the insurance companies from making their own rules that slowly erode the value of coverage by limiting the treatments that they pay for?
    3) How will someone who is poor be ensured the same treatments as someone who is wealthy?

    From what I have been reading, these have been the biggest issues with US health care, does the bill do anything about this? Making sure 'everyone has something' seems to be a drop in the bucket to me; or am I missing something?

    Please don't label me a troll for these questions.. I think they are important questions.

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