House Passes Massive Medical Insurance Bill, 219-212 2424
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.
Re:health insurance is like auto insurance now (Score:1, Informative)
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
Well that is exactly what this system is. You pay a fine until you get sick, and then when sick you go to the insurance company. They have to accept you due to not denying any with preexisting conditions.
Re:Pro / cons (Score:5, Informative)
This truly is the best and most accurate description of the actual process I've seen.
Re:Pro / cons (Score:2, Informative)
What exactly are the pro's and cons?
Pros
Cons
Medicare's operating costs: 2 to 3% (Score:5, Informative)
Typical private insurer: 15 to 30%
Of course, if you define "efficiency" by the ratio of things they decline to cover, sure, they're way more efficient.
Comment removed (Score:5, Informative)
Re:Hoorah! (Score:3, Informative)
MOST –adjective,superl.
1. in the greatest quantity, amount, measure, degree, or number.
2. in the majority of instances.
Re:Pro / cons (Score:5, Informative)
It's those two things that make the mandatory bit necessary. Note that all universal health care is mandatory; if you satisfy the rules for "must pay", then you pay. There are subsideis for the poor in this bill, probably not big enough (inadequate subsidies for the poor, a Republican idea to discourage poorness), but they are there. It would have been better to get rid of the health insurance companies altogether (look at the countries that did that, no loss of quality, but it's cheaper), but the Republicans were not that interested in cutting costs (nor were many of the conservative Democrats).
Beware, lawmakers: November is coming. (Score:2, Informative)
November. Remember? The time when so-called representatives find out what happens to them, under our style of non-violent revolution, when they subvert the will of the people they’re elected by.
I can’t wait. This should be fun.
It is surprising to me (Score:2, Informative)
That intelligent people such as slashdotters have no knowledge of the United States Constitution. Nowhere in the constitution does it guarantee the citizens healthcare.
Re:health insurance is like auto insurance now (Score:3, Informative)
The fine is going to be cheaper. A quick google for "health insurance fine" shows predictions around <$1000 or 2.5% of your income (if you make $50K a year that's only $1250). And it looks like finding [smartmoney.com] a policy cheaper than that will be hard (I'm not sure if I trust those numbers as the advertised (i.e. artificially-low-to-catch-your-attention) prices for insurance are closer to $60-$100 per year). In any case the Massachusetts law that it this bill modeled after is designed so the fine will always be less than the cheapest premium [mass.gov].
The Bill and the Economy (Score:4, Informative)
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
Re:Hurry up and wait (Score:4, Informative)
The apocalypse comes when the Chinese decide not to loan us any more money.
Re:health insurance is like auto insurance now (Score:4, Informative)
You kidding?
The insurance industry LOVES this bill, because it means they'll get 35 million more customers during 2011. (Either signed-up directly, or paid via the government mandate.) Insurance stocks have already gone up, and they'll likely skyrocket this week.
Which reminds me. The Congress had been throwing-out the number "50 million uninsured" all during 2009. Now they are saying this bill will cover 35 million uninsured americans. So where does that leave the other 15 million? Are those the non-citizen intruders/foreigners who don't qualify under the bill?
Re:Pro / cons (Score:5, Informative)
1) There are several hundred billions of dollars that provide subsidies to people too poor to afford health-care, with an explicit rule that a family can not be forced to spend more then a certain % of their income on care (I believe it's 15%, but I don't remember the exact number).
2)The poorest of the poor already receive health care for free in the form of Medicaid, and that Medicaid is being expanded to cover 50% more people
3)People who pay the fine *gets something* for it. They still have the right to receive emergency care for free. Not only that, but they have the ability to purchase insurance if they ever get sick without paying an enormous bankrupcy-causing penalty for having a pre-existing condition.
"And that will - and this is the intent of the "insurance" crooks that drew up the bill - create a market for "Never Pay" cover, i.e. schemes that appear to meet the absolute minimum requirement, but which have such egregious exclusions and excess contributions that you'll never use them. In effect, free money for the insurers."
This is also not true. While there are different types of insurance with different levels of generosity, by law, at least 85% of premiums must be paid out in the form of health-care for any given plan, so "free money" for the insurance company is effectively outlawed..
How many people have read the bill? (Score:3, Informative)
Re:health insurance is like auto insurance now (Score:5, Informative)
I recently lived off of food stamps and eat nothing but organic frozen/canned/fresh vegetables, and the occasional choice cut of meat, exactly how I ate/eat without assistance. I rarely spent half of the money given for food.
The health insurance given to me was in a higher league than what I use to pay $410/mo for from Blue Cross Blue Shield. I was able to get some dental fillings done, get my eyes checked, not pay outrageous amounts for random things they did not cover.
Re:health insurance is like auto insurance now (Score:3, Informative)
I think the other 15 million are the freaking ILLEGAL ALIENS who are gumming up the works. They all need to return to their home countries, and get jobs and insurance there.
Re:Brilliant Plan (Score:4, Informative)
The fines are around $700, if I read that correctly.
That sounds like more than health insurance would normally cost. I pay $600 for my international travel health insurance, per year (this covers me almost completely-- excluding more expensive dental work-- while I live and work in the US, and while I travel elsewhere.)
Re:health insurance is like auto insurance now (Score:5, Informative)
You haven't done much homework if you think you'll be paying that much living paycheck to paycheck. The bill would fine someone who can afford coverage but refuses to. Folks who can't afford it will get subsidies to defray the costs. Typically people who can't afford insurance just create catastrophic care costs because they wait too long and then show up at their local emergency room, so even the managed care option for those where the government fronts the bill should be a little more manageable.
This will also prevent folks from gaming the health care system and making those of us that do pay for insurance cover their costs like folks used to with welfare. I'm also pleased about the pre-existing condition clauses which, being in IT, always makes me nervous considering how easy it is to lose your job to India these days. At least there will now be options to get insurance when you are unemployed.
Here is a nice rundown of the big points (Score:4, Informative)
Found this. Decent quick summary of what's in the final bill going to the presidents desk: http://www.cbsnews.com/8301-503544_162-20000846-503544.html [cbsnews.com]
I'm fairly sure a brain is not required either ... (Score:1, Informative)
that's why the Republicans, especially the Tea Party nutters, are still allowed to roam free.
Whoever is against a universal health care is the real fascist here. The Constitution is more than 200 years old, from a time when something like health care was unthinkable and usually the equivalent to a bottle of whiskey and a blunt hammer.
Being conservative is a good thing at times. But sometimes you need to accept that times change and that not everyone is running around with a colt on his hip anymore and doing justice by simply shooting the opponent.
I know that you Americans have trouble to see that social != communism (or whatever you think communism is).
"God's own country" - my ass! Did any of the die-hard christians over there ever read the bible (and understood it)? Then no one would even think a split second about universal health care anymore and simply do it because that's the core of all the stuff in that ancient book. I'm no christian at all but that's pretty much the only good thing in this book: taking care for each other, without looking at the bank account every time.
Damn you cheap bastards! One day it'll bite your butt to be so selfish.
Re:health insurance is like auto insurance now (Score:5, Informative)
Re:Hoorah! (Score:1, Informative)
Re:health insurance is like auto insurance now (Score:5, Informative)
BULLSHIT [opensecrets.org]
Are you paid to spread this disinformation or are you just a useful idiot?
Re:Pro / cons (Score:1, Informative)
Couple of corrections:
First, health care is in no way worse than it was 12 years ago.
Second, all of the concessions made to get health care passed were made to entice Democrats. No concessions were made to Republicans, and no Republicans voted for any version of the bill.
Third, Republicans have had detailed proposals on the table, all of which addresses specific problems with specific solutions, since before the first Democratic bill was ever conceived. You're right that they failed to enact any of these when they had power, and for that they deserve scorn. But supporting the democratic bill on those grounds is a bit like shooting yourself in the head because your mother served meatloaf for dinner even though she had steak in the fridge.
Fourth, the backroom deals were not eliminated, they are still there along with a bunch of new ones.
Fifth, this is the first ever use of reconciliation for something that isn't reconciliation. And there has never been anything bigger than this, let alone anything bigger than this passed by reconciliation.
Sixth, support for this bill is under 40%. That is not "mildly unpopular".
Seventh, our proposal is not "doing nothing". If anything, the democratic proposal would be more accurately described as "doing nothing" on the grounds that while it does do a ton of stuff, none of it addresses any of the things that are wrong with health care in the US today - with the possible exception of the individual mandate, which is unconstitutional.
Imagine that there's a garbage can on fire in your back yard. A couple hundred firefighters respond. They evacuate your neighbors from their homes, dig trenches around the garbage can and bulldoze your home to prevent the fire from spreading, but nobody throws any water on the fire. This is a little bit like what this bill does. You couldn't exactly accuse the firefighters of "doing nothing", but it would surely be absurd to accuse the homeowner, standing helplessly by watching this happen while imploring the firefighters to please just throw water on the fire and leave my house standing, of advocating "doing nothing".
Re:It is surprising to me (Score:5, Informative)
"We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare..."
Does not guaranteed healthcare promote the "general welfare" of American citizens?
Re:Pro / cons (Score:3, Informative)
Almost everybody thinks reform is needed. Almost nobody thinks that Congress is competent enough to make good reforms.
Indeed, but if there comes a time when an industry that affects 99% of a countries population refuses to reform voluntarily, then the government of the people must step in. After all, this country was formed "...to promote the general welfare" of it's citizenry.
The one thing that I find highly entertaining, yet sad, is that 95% of those claiming this bill is Unconstitutional don't realize that A) it's not; and B) there is already established case law that supports the goals of this bill. I don't agreed with all the provisions - but something HAD to be done, and now it has.
Here's the rates and how they went up by year. (Score:5, Informative)
The $6400 is just an average I saw somewhere. I can't find that article; however, here's a breakdown on employer provided plan costs [usatoday.com]. Your employer pays $4824 for just you, or $13375 for a family plan. Since individuals buying health insurance don't have as good a bargaining position, I would expect the premiums to be much higher, and $6400 sounds about right. Note the $13375 figure for the family plan, which is what most people will be buying.
Re:health insurance is like auto insurance now (Score:4, Informative)
The EU *is* member state's governments apart from the democratic European parliament. The members of the "undemocratic" European Commission (essentially executive branch) that anti-EU scaremongerers harp on about are actually nominated by national governments, while the Council of the EU (another legislative branch) *is* member state governments (in the sense that for e.g. agriculture policy, the members are the member state government ministers for agriculture). Additionally there is the European Council that kind of sets the overall direction of the EU - this is the heads of government of the EU. The Euroskeptics want to have their cake and eat it, as they want member states to remain in control of the EU, yet criticise the very institutions that allow that as being undemocratic.
There are plenty of flaws with the EU, but some of these are precisely because it remains beholden to the member state governments.
EU "law" mostly consists of "directives" that national governments implement as they see fit (they only have to satisfy the aim of the directive). Now some governments (e.g. UK) use these as an opportunity to implement over-the-top national law and blame it on Europe. Certain other governments (e.g. Ireland) don't even succeed in implementing all the directives (or ignore enforcement of national law), which shows that EU law isn't some dire threat. Of course in the instance of Ireland, it also shows how EU law isn't a bad thing (the laws concerned are things like "don't pump raw sewage onto your beaches"). Of course Ireland (and other states) do run the risk of fines, but I think Greece has been the only country fined to date (again afaik for something dumb like allowing refuse dumps to be sited where they pollute ground water).
There have also been plenty of cases of the EU criticising and acting against national restrictions on people's freedoms, again for example in the case of the UK (but also other countries restricting people's ability to live/work in other member states, or having broken legal remedies for their own citizens, or not doing anything about infringing on rights of minorities).
Some of the "freedoms" people in certain member states want are the freedom to act as they see fit including infringing on the freedoms of others, and indeed to some extent they can get away with this and merely object to even being criticised for their actions.
Re:Not until 2014 (Score:5, Informative)
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.
Re:Pro / cons (Score:3, Informative)
12 or so were against it because it didn't overturn "Roe V Wade" and some of the money may find it's way to abortion clinics.
Others were against thing bill because it didn't go too far as it didn't include a "single payer" option.
As for the rest.. well i'm not sure what they were thinking...
Comment removed (Score:3, Informative)
Re:health insurance is like auto insurance now (Score:2, Informative)
When I was on unemployment I got $550 a week.
I call bullshit on that. Over at Salary.com, they have the unemployment details for every state in the union, and I was not able to find one that pays more than $400/week. So...bullshit on you sir.
Give me your poor, your naive, your idiots (Score:1, Informative)
And I'll give you the bill that was just passed. Today marks the death of liberty and freedom. Welcome to just being another country folks! YAY leftist douchbags!
Re:health insurance is like auto insurance now (Score:2, Informative)
Take a drive through a section 8 subsidized apartment complex. They are pretty nice apartments (unless the tenants trash them) and you'll see a lot of nice cars.
I used to date a woman living in a section 8 complex. It seemed that a lot of the people living there were scamming the system.
Re:Pro / cons (Score:5, Informative)
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:Not gonna happen (Score:4, Informative)
You pay $6400/year for insurance? Damn, either you're getting ripped off, or you have some chronic condition.
Most people who pay for their insurance get a group rate and are covered under a company health plan. You should check to see how much you cost to your company. I'm guessing it's a lot more than you think it is (and makes your comment look rather stupid).
And, for the record, I have previously worked in the health insurance industry, so I know exactly how much people pay.
I checked, insurance is more expensive (Score:3, Informative)
That sounds like more than health insurance would normally cost
Specifically, a 30yo. male non-smoker living in Austin, Texas with Blue Cross/Blue Shield:
(All plans include prescription coverage but no dental. And are the no frills hook-em-with-low-cost-then-upsell-them-with-addons plans.)
Re:Medicare's operating costs: 2 to 3% (Score:3, Informative)
Medicare paid for the birth of my son. They were polite and efficient, and also personable.
When my wife (then girlfriend) got pregnant, she didn't have the maternity option on her health insurance. Medicaid said that they would pay for it, but that the hospital / OB would have to submit everything to the other insurance company to get denied first. Any slow-downs or inefficiencies in the process were strictly related to Anthem BC/BS having to deny everything medically that happened to my wife from the day she got pregnant.
20 months later, when the hospital tried to bill us for something else related to the birth, we got a personal call from our Medicare case worker - she already knew about it. She said "Now, you guys know, they only have one year to send you bills, so you're not responsible for that. Fax me a copy of it, and I'll sort it out with the hospital. They should know better."
Anecdote is the singular of data, but my experience with Medicare has been extremely positive.
Re:Pro / cons (Score:3, Informative)
60 votes are required to end debate when a senator or senators choose to deny the Senate the opportunity to vote for a bill. Sometimes there's a legitimate reason for doing so, if issues remain for discussion in the "deliberative" legislative body. Other times it's a procedural trick to prevent the passage of a bill a senator (or senators) simply don't like.
Tragically, the Senate seems to have an informal agreement not to require Senators to actually be debating in order to prevent a vote. Someone threatens to filibuster, and the proponents of the bill cave and don't even attempt to call for an end to debate so that a vote can be taken.
Re:Pro / cons (Score:4, Informative)
>> The republicans (as well as 30+ democrats) are against this bill because it is a pile of shit
I'm sure that some, or even most republicans are against the bill because they really believe that it is not going to be good for Americans. However many are just voting no to toe the party line, and to bring down the democrats. The democrat side shows that some people have legitimate problems with the bill and will vote against it and their own party for that reason, but there is no way that every single republican thinks the bill is a huge failure and wouldn't vote for it if parties didn't exist. If there's one thing conservatives are good at, it's presenting a unified front. The problem is that they are not acting in the best interests of the country with their political bickering.
>> Batman. I am diabetic. I have lived without insurance. I always paid my doctor bills and prescription costs.
Good for you that you had the money. Lots of people don't through no fault of their own.
Re:So the government is forcing me to buy somethin (Score:3, Informative)
If someone feels a religious obligation to feed, clothe and house those in need. That's great. I don't oppose that at all.
Why can't you get it through your head that it's fine to use your resources to do this but wrong to to break into your neighbor's house, take his food and clothing and give it to some third party?
Don't try to hide the behind the government. If you support forcible wealth distribution then morally you're still the one holding the gun.
child mortality rates (Score:2, Informative)
This is something everyone loves to clobber the US with, but it is a case of "statistics" - as in "lies, damn lies, and statistics".
Before comparing the mortality rates of different countries, it is helpful to know just what the numbers actually represent. For example, in the US, an infant born at 28 weeks (two months premature) who then dies soon after birth is counted as an infant mortality. This is not the case in countries with "better" child mortality rates.
As to the bill itself, it might make some folks feel good, but it does not address the cturcural problems with the healthcare industry. I understand it will take 4 years before it really kicks in - for good or bad, but:
1> many docors have stated their intent to cease practicing under the new law for economic reasons
2> medical school takes 8 years and considerable money (and generally massive debt)
3> We already have a shortage of doctors (and nurses as well)
That is an example of a stuctural problem.
Re:Not gonna happen (Score:4, Informative)
Exactly. That's why this law says you must buy insurance. If you're within 150% of the federal poverty line you can opt into Medicaid or take a subsidy to buy private insurance, but you can't shift your risks onto the insured.
It's not surprising that this bill is 2000 pages long. Most provisions have unintended consequences that have to be addressed by other provisions, and so on. No denial for pre-existing conditions means a mandate to buy insurance. That means expanding Medicaid and providing subsidies for hardship cases.
The big problem with the Senate version of the bill is that it stops here. The House bill attempted to shield consumers who would be forced to buy insurance in states where one or two companies hold a monopoly on insurance. The Senate bill stripped that out.
Re:Unintended consequences? (Score:1, Informative)
Re:health insurance is like auto insurance now (Score:4, Informative)
Gun laws are illegal for starters but hey, why let a little thing like that prevent the government from centralizing and wresting power from the hands of the people. I for one find a nation where the government has no need to fear the people very scary indeed.
No offense, but what the hell are you talking about?
As some others pointed out already: it is not illegal to own a gun. You have to go through an established process to get them because GUNS ARE DANGEROUS.
That said, why don't you just go buy a .22 rifle? There are pretty much no restrictions, no background check or anything else in place (in NY, at least)? Hell, I know someone who is on anti-depressants who walked in and walked out with a .22 rifle.
But that isn't what you want, is it? You want a 3.06, an automatic/semi-automatic assault rifle, or a high-powered handgun.
Everyone always forgets the first part of the second amendment:
A well regulated militia being necessary to the security of a free State, the right of the People to keep and bear arms shall not be infringed.
I'm not aware of the legal precedent since its inception, but to me, that statement means that I should be happy to have the privilege to purchase arms given that I'm not part of a "well regulated militia."
If I were doing the interpretation here, I'd say that if you want to own weapons, you should join the National Guard, but that's just me.
Re:Yes it does change things (Score:2, Informative)
Re:health insurance is like auto insurance now (Score:4, Informative)
Re:health insurance is like auto insurance now (Score:3, Informative)
> That's actually how it worked pre-bill,
> the poorest people qualified for Medicaid
And that depends entirely on where you happen to live.
If you live in a state like Massachusetts, which several years ago enacted many of the same reforms contained in this bill -- coverage mandate, subsidies, and guaranteed issue -- you might indeed qualify for Medicaid.
If you live in Texas, it doesn't matter how poor you are. If you're an adult and you're a) not pregnant and b) not so disabled you eat your food through an abdominal tube, you can't get Medicaid. There isn't a box to tick on the integrated application form where you may apply for it, because average adults -- working or not -- do not qualify, ever, for any reason.
The expansion in states like Texas will be slow in coming and relatively miserly, meaning that even if you qualify under the newly-expanded eligibility, chances are greater than 50/50 that you'll still be left with nothing, depending entirely on where you live.
By the way -- please don't give me that "so move to another state!" crap. There are all kinds of reasons why someone can't simply pack their shit and move, such as, in my case, children who live with an ex-spouse that I'd like to continue seeing on a regular basis.
Re:Mixed feelings (Score:3, Informative)
Actually, under the current system they are turned away if their condition isn't dire. Otherwise, they get treated and billed an exorbitant amount. Usually they are unable to pay, so in most cases the hospital has to eat the cost, but they'll try to defray it by raising the rates that they're charging the insurance companies, which gets passed on to the rest of us.
The Kennedy Legacy (Score:3, Informative)
It's funny so many are complaining how HMOs are one of the biggest problems, then pass this health care bill with nods to Edward Kennedy, crusader of health care for the people.
They forget it's Kennedy who championed the creation of HMOs in the first place.
Yes, HMOs, a Democrat creation.
Will they do better this time?
Re:Non-American: questions (Score:3, Informative)
Since no one has attempted to give you a legitimate answer, here we go:
1) Insurance companies are mandated to spend 85% of the premiums they receive on medical care. So they can raise premiums, but they will also have to raise the amount of money they spend out. For this reason, free market principles should ensure that insurance premiums are tied quite closely to medical costs since a company with inflated premiums can always be undercut by one with premiums closer to the cost of care.
2) Once again, free market principles, why would I buy an insurance policy that doesn't cover my insurance needs? And since the law prevents insurers from canceling your coverage if you become sick, I imagine that means they cannot drop your coverage to exclude your illness either.
3) Ensuring equal coverage for everyone was never a principle concept behind health insurance reform. Ensuring that everyone has access to health care was. There's a difference between flying your private jet to New York to see the best doctors in the world and being able to afford to take your child to the local clinic when she has a fever.
Your three questions are interesting and important, but I don't think they qualify as the biggest issues with US health care today.
In my mind, among the biggest issues in US health care are:
1) millions of Americans currently have no access to health care other than going to the emergency room (which tends to be a very expensive way to treat people).
2) employer-provided health insurance is beginning to show cracks as premiums rise and the recession continues. Small businesses are starting to cut coverage or drop it altogether. And people who lose their jobs are faced with paying the full cost of insurance or having no coverage.
3) individuals and people with pre-existing conditions do not have affordable options for health insurance for themselves and their families.
this legislation addresses these problems at least in part.
1) all people will be required to have health insurance. which means more healthy people in the system. it also means that people who are just beginning to get sick will (hopefully) be able to seek treatment before their conditions become emergencies. not only does that mean a healthier more productive populace, but it also should lower medical costs and ease crowding at emergency rooms.
2) small businesses will be able to shop for health insurance through the exchanges which will pool their risk pools together so they can get similar kinds of deals that huge businesses have for their employees. also, standardization of plans should prevent insurance companies from playing games to confuse buyers, allowing apples-to-apples comparisons between insurers.
3) like small businesses, individuals will be able to shop for health insurance through the exchanges. also, while federal law prohibited employers from denying insurance coverage because of pre-existing conditions, that law did not apply to individuals until now.
2 & 3 are tightly bound together. if a stable individual market for insurance comes to be because of this bill, it will remove a huge pressure from small-businesses and . Entrepreneurs can quit their jobs to start the next Google or Facebook knowing that they and their family are still covered. And small businesses (under 50 employees) will be able to hire employees, pay them a decent salary and let them use their earnings to pay for their own insurance plan (rather than quietly taxing their earnings and sending that money to the insurer).
healthcare in this country is a very complex entity with many interwoven aspects. It's hard to look into the future and see what will work and what wont. but one thing was clear was that the way health insurance was being run was not sustainable.
there's another aspect of this bill that is often overlooked. If the insurance companies find a way to worm around the intent of the law, then Congress will most likely find a way to stop it. Insurers know tha
Re:health insurance is like auto insurance now (Score:5, Informative)
What's with people calling others liars so quickly? Every time someone does that and I look into it, it turns out that whoever yelled liar the loudest was the one most full of shit.
Here's how it actually breaks down, starting with the Washington Post:
* top three contributions are to democrats, with roughly $10.5M between them
* next five contributions are to republicans, with roughly $14M between them.
After that, it's a pretty even distribution.
Opensecrets shows something similar:
* 2010: 58% to democrats
* 2008: 54% to democrats
* for the next time that the health industry spent less than roughly 60% on republicans, you have to look back to.... 1994.
Notice something there? Right - it correlates wonderfully with whoever controls the House and Senate.
In other words, the health care industry gives to whoever is in power, with the percentage distribution correlating nicely with the distribution of party affiliation.
So just for emphasis, I'll state it again: the single biggest indicator for how much contributions a party gets is how many seats that party holds. No shit, Sherlock. And just because it pisses me off, I'll repeat this point as well: whoever yells liar the loudest is generally the biggest liar.
Re:health insurance is like auto insurance now (Score:2, Informative)
Re:what happens if you drive without car insurance (Score:2, Informative)
Naw. If you're off the grid and not earning any money, you don't owe the penalty. There is a minimum income to require it, and it's pretty high.
I'm pretty sure they would (Score:3, Informative)
if the oh so friendly Republicans and some rather conservative Democrats would have agreed to it. The initial suggestion included a public insurance but got shot down.
Re:health insurance is like auto insurance now (Score:3, Informative)
Income taxes: Only if you earn money
Now, however, the second you become an adult in this country you have to pony up money to the government or insurance company, or else you will be fined.
If you had to pay income taxes even if you earned no money, but the government actually paid it for you in that case, would that be okay?
That's basically what's happening here. You have to have insurance, but you only pay for it if you make money.
Re:Health insurance is a tax now (Score:5, Informative)
That won't really accomplish much. Even the quickest search reveals that the cost of medical malpractice is less than 2% - a rounding error compared to total costs.:
Re:what happens if you drive without car insurance (Score:2, Informative)
Re:health insurance is like auto insurance now (Score:4, Informative)
The real problem I have with this 'you must buy health insurance or else' clause, is the fact that I now have to pay money for the right to be a citizen of this country.
This has never existed before. All previous taxes/fees/mandated insurance were based on you doing/earning something first:
Income taxes: Only if you earn money
Auto insurance: Only if you drive a car
Property taxes: Only if you own property
Health Insurance: Only if you earn money
There, fixed that for you. The health insurance mandate does not apply to people with low income. You will only have to pay money if your income is high enough.
Re:health insurance is like auto insurance now (Score:5, Informative)
Interesting, except one thing.
If you don't make enough money that you have to pay income taxes, you're exempt from the fine. Even then the fine is capped based on your income level.
In other words, the argument of "only if you earn money" argument that you applied to income tax, applies to this fine as well. The idea that you are liable for this fine "the second you become an adult" is incorrect.
Re:How many people have read the bill? (Score:5, Informative)
I always think it's disingenuous for people to say our bills are X pages long. If you open up the PDF, then copy and paste the text only (no formatting) into your favorite document editor at the default font size, and remove the extra line breaks, you'll see that for every "normal" 1 page you can get 3-4 pages of a bill from Congress. Try it.
So, realistically the bill is still novel-like long, and yeah it'd be great if the bills were shorter but they do have to deal with complex issues. But it's not actually 2000 pages of dense text, like the Republicans try to make it out to be (by bringing reams of paper to press conferences and saying, "Look at how big this thing is! It's enormous! We haven't read it because we're going to vote no anyway, but hoo-eey, this is a big bill don't you think?"
Re:Not gonna happen (Score:3, Informative)
THIS IS WHY WE NEED SINGLE PAYER!
Americans consistently poll between 60-70% to want SINGLE PAYER. Single payer strips out PROFIT from medicine. IT DOES NOT INTERFERE WITH MEDICINE; it simply mediates the funding of the people to the actual providers.
I appreciate some of the positive things from this health care bill, but am wary that it did not address the most highly demanded request of the people. The lawmakers played it to keep their funders in play and ignored what the people really want.
If we went single payer, even most conservatives would come to appreciate the awesome savings as compared to our current system with or without the new legislature.
US = ~$6400/person (but has people denied/screwed)
Canada = ~$3600/person -- all covered, no insurance trickery.
And before you quote the misinformation about Canadian healthcare, I request you talk to a Canadian. I took it upon myself to talk to over 40 Canadians and of the 40, only one had any qualm about healthcare at all. The rest were purely satisfied.
Ask 40 Americans and you'll find many that have been screwed, many upset, and many that don't even have healthcare.
Docotors and Nurses want Single Payer. The people want Single Payer. Even Obama wanted it until he was elected.
Free markets are great. I will always enjoy the concept of the free market on many things that I interact with in life. Healthcare is *not* something that should be in the market for PROFIT. The only money that I want to pay between me and the healthcare is the small cost of administering the funding transfer. Shame on those who would attempt to profit from my unavoidable needs.
Re:Health insurance is a tax now (Score:5, Informative)
there are also huge tax increases on higher income groups, and the effects will be felt by all Americans.
That is a fallacy that relies on the "trickle down" theory of economics. Wealth isn't created by the wealthy, it's created by the worker; wealth isn't created by the head of the construction company, it's created by the carpenter. McDonald's stockholders don't create McDonald's wealth, the fry cook does. The constructed house and the hamburger are the wealth.
Cutting taxes on the rich doesn't help the economy, and raising taxes on the rich doesn't hurt it unless you raise them to insane levels. Cutting taxes (and other costs) for the poor and middle class does help the economy, because they're going to spend that money, putting it right back in the economy. Tax the poor and everyone suffers; less money to buy those houses and hamburgers, as well as more crime.
And I would posit that the person paying capital gains tax instead of income tax should be paying higher taxes than those truly earning their money, as opposed to gambling on the stock market. When Reagan cut that tax in the '80s it was a boon to the rich, but the orgy of leveraged takeovers hurt the average taxpayer badly.
The companies that exceed 50 employees on the full time payroll will be forced to pay a fine per employee for lack of health insurance coverage. Will this cause millions of small to medium businesses to budget for health insurance, if they don't already have it?
If they don't, they have a bad business model. And they should already be insuring their workers. If they can't afford to pay their employees a living wage, they can't afford employees already; they are simply parasites on the system, bringing down competetitors who do treat their employees as human beings instaed of treating them as property.
Re:health insurance is like auto insurance now (Score:3, Informative)
Thank you for the correction, I didn't notice that. But yes, as you stated, it still does not include the health care insurance companies and if you look at the numbers for each category in the health care industry the professionals make up better than 50% of the donations with the next largest contributor in the health care category being the pharmaceuticals at about 20% then hospitals at about 14%.
Actually you can see this even in the health care numbers from the original post. Look at the individual categories and note how the swings in % Democrat and % Republican moves with the current controlling party.
A lot of that historical data that makes the Republicans look so bad may have a lot to do with the control they've had in the past 8 to 10 years. And while the grand parent post is wrong to say these corporations have not been throwing cash at Democrats it is definitely correct that for the recent decade they have thrown significantly more at the Republicans, and again, perhaps only because they have been in power.
Re:Not gonna happen (Score:3, Informative)
So, you're telling me I'm dishonest because I'm honestly reporting the way health insurance works in New York State, the third most populous state in the union. And while it's probably among the worst of states in this regard (I don't claim detailed knowledge of health insurance premiums in all 50 states), it's hardly the only state with such issues.
I can speak from personal experience to the fact that New Jersey and Massachusetts aren't far behind (my company got comparison quotes between Horizon Blue Cross in NJ and Empire Blue Cross in NY for a small business plan when we were relocating from NYC, and while we saved a bit, it was only about 15% less in New Jersey for a comparable plan - about $420 per employee per month vs. $500 per employee per month) - that was 2 years ago. And in Massachusetts (the other state I've lived in over the last 10 years) health insurance prices were significantly lower than New York back around 2000, but increasing even faster and had done quite a bit of catching up as of a few years ago (not sure where they are now).
Since I offered no attribution or analysis of the causes for state by state differences in insurance premiums in my post, to call me dishonest or ignorant is just purely made-up shit. Congratulations on the false dichotomy you've set up. You fail.
Re:Health insurance is a tax now (Score:3, Informative)
The taxes assessed on individuals by this bill are as follows:
-A 3.8% excise tax on the investment income of families earning over $250,000
-A tax of 5.4% on any adjusted gross income over $1,000,000 (see 551)
That's it. Assuming that your high-earning physician friend is not in the indoor tanning salon business, that $100k is 3.8% of his investment income --dividends, rents received, etc. That means he is earning $2.6 billion per year on his investments, which is impressive. Either that, or his AGI is $1.8 billion per year, also impressive.
Yet another option is that he is misinformed.
Re:Yes it does change things (Score:3, Informative)
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.
It's COBRA (consolidated omnibus budget reconciliation act of 1986), and you are wrong. The price didn't quadruple, you are just now responsible for all of the premium. Prior to losing your job your employer was fitting 3/4 of the bill, and you kicked in the rest. COBRA benefits allow you to continue your coverage as long as you pay all of the premium. Which is still a deal, especially if you have ongoing medical needs when you lose your job. See here [dol.gov] for details.
Re:health insurance is like auto insurance now (Score:3, Informative)
If that's the case your machine must be infected with something. Nathan's Economic Edge is a financial blog, not a malware site.
Re:Non-American: questions (Score:3, Informative)
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.
To understand the answers, you need to understand the true purpose of the bill.
The Democrats want to completely socialize health care: they call it "single payer", i.e. the US Government is the only entity to pay for health care. The Democrats knew they couldn't get there immediately, but rather needed to pretend to do something else.
http://www.cnsnews.com/news/print/49788 [cnsnews.com]
This bill is over 2700 pages long, and I haven't read it. So, I'm relying on various news sources for this analysis. But as I understand it, here is how the bill works:
Each American is required to buy health insurance. Anyone who cannot afford it can apply to the government for help. But those who don't buy insurance, can simply pay a "fine" to the government. This fine will cost less than the insurance would have cost.
This bill also requires insurance companies to accept anyone, and pay for their care, regardless of pre-existing conditions.
http://www.cnn.com/2009/POLITICS/12/21/health.care.faqs/index.html [cnn.com]
So, in short: I could cancel all my insurance, and pay a fine to the government, and no insurance company gets any of that money. Then one day I could discover that I had cancer, buy insurance, and that insurance company would be compelled to accept me as a patient and pay for my cancer treatment. Or, one day I could get in a car crash, then buy the insurance and get treated.
Because the above would completely destroy the actuarial basis of insurance, all the companies currently providing health insurance would be forced by cold hard economic reality to stop selling insurance. If they didn't stop on their own, they would go out of business, and close down.
The end game is that the US government would announce that due to the entirely unexpected and unforeseeable wave of insurance companies closing down, the US government would start offering insurance. That, or else it would buy the remaining insurance companies the way the government bought failing car manufacturers.
And there you go: single-payer. The US government would provide all "insurance" (really, it wouldn't look anything like insurance at that point, but the name would be kept for sentimental reasons).
Also, the bill as written saves a tiny bit of money: over ten years, it saves (IIRC) about 160 billion dollars. However, the bill as written includes drastic cuts to Medicare to help pay for it; and the bill does not include the "Doc Fix", so it assumes that bad cuts to doctor pay will be allowed to stand. Also, this bill includes the provision that the broad increases in taxes go into effect immediately, but the benefits don't start to get paid out for four years. I do not expect the cuts to Medicare to be allowed to stand; I expect to see another bill to increase taxes in order to put back everything that was cut. In short, I am expecting the actual costs of this bill to be far in excess of what was promised.
http://www.cato-at-liberty.org/2010/03/04/health-cost-projections-to-2019-the-doc-fix-trick-again/ [cato-at-liberty.org]
I view this bill as a complete disaster. Either everything I have read about it is wrong, or else all the cheerful and happy postings I have read here on Slashdot are uninformed.
steveha
Re:Health insurance is a tax now (Score:4, Informative)
Exactly. I live in Australia. These are my choices here:
1. Do not take out health insurance. Pay about 1% more tax as a penalty. Get free healthcare when I get sick of a standard ranging from ok to excellent. If I am in hospital for an extended period of time, share a room with a number of other patients and put up with less than 'premium' services.
2. Take out health insurance (for around A$70-100/month, i.e. about US$60-90 on current exchange rates). Get premium healthcare when I get sick, including (usually) my choice of doctor and hospital. Get a private room and premium services if I have to stay in hospital for an extended period of time.
Either way the government subsidises many useful medications and I can see a GP within a few hours during business hours, or go to a hospital and wait a few hours at casualty after hours. Regardless of my insurance status, a visit to a doctor costs between around $20 and $50, with the difference being borne by the state.
Amazingly, despite this horrifying crypto-communist arrangement Australia has not gone bankrupt, nor have my rights and freedoms been taken from me.