Healthcare reform

[bmags]

Don't want to come in here acting ignorant, but can you guys point me somewhere that will explain what this reform does for average folks like myself?

 

it depends on who you are. Age, income, medical history, etc.

[NorthSideSox72]

Don't want to come in here acting ignorant, but can you guys point me somewhere that will explain what this reform does for average folks like myself?

If anyone gives you any one-line answers to this, ignore them. Its too complicated for that. I'd suggest you try to find a news source that is relatively objective, and read about it. Then find some more, and read some more.

 

[lostfan]

If you're an average healthy young person who gets insurance through your job its not going to change much. If you're not healthy you won't be able to get insurance yet but that's because the new laws won't take effect until 2014 I think. I forget what the income level is but for something like less than 40k a year is exempt from the mandate.

[Balta1701]

Don't want to come in here acting ignorant, but can you guys point me somewhere that will explain what this reform does for average folks like myself?

Without knowing your exact economic situation it's hard to say exactly. There's a number of goodies that do start immediately, the moment the president's ink dries. If you're uninsured currently and you apply for insurance, you can't be turned down because of a pre-existing condition. If you're currently insured and you get sick, the insurance company can't cancel your policy. If you're currently in college, you can now stay on your parent's insurance until you're 26. If you're really sick, lifetime caps on insurance company payouts are eliminated, so you can't run out of coverage just because you (or a family member) gets cancer. There's also a small business health insurance tax credit that starts this year, and a number of other "Goodies" if you qualify for Medicare.

 

Long term, the bill does a couple things. It gets you better treatment by spending money to see if treatments we're doing actually work. It saves you a freaking boatload on your long-term tax bill. Puts at least 10 years more stability onto Medicare, maybe more if the cost controls work better than the CBO thinks. It completely reforms the individual insurance market so that people who aren't employed or who work for small businesses or who start a business don't lose their insurance or can buy it. It mandates that there is a fine if you don't have insurance, but it also offers subsidies if you can't afford it.

[StrangeSox]

Good Morning, Comrades!

[Balta1701]

Good Morning, Comrades!

[southsider2k5]

On the bright side, at least the lawyer will make some money off of this...

 

http://www2.timesdispatch.com/rtd/news/sta...-000603/332103/

 

Virginia will file suit against the federal government charging that the health-care reform legislation is unconstitutional, Virginia Attorney General Ken Cuccinelli's office confirmed last night.

 

Cuccinelli is expected to argue that the bill, with its mandate that requires nearly every American to be insured by 2014, violates the commerce clause of the U.S. Constitution. The attorney general's office will file suit once President Barack Obama signs the bill into law, which could occur early this week.

 

"At no time in our history has the government mandated its citizens buy a good or service," Cuccinelli said in a statement last night.

 

Word of the impending legal action came as the U.S. House debated late into the evening and passed the landmark reform legislation, 219-212.

 

The votes of the House delegation from Virginia mirrored those cast when Obama's health-reform package first came up for a vote in November.

 

Four of Virginia's six Democratic congressmen supported the $940 billion bill: Rep. Robert C. Scott, D-3rd, Rep. Tom Perriello, D-5th, Rep. Gerald E. Connolly, D-11th, and Rep. James P. Moran, D-8th.

 

"It covers all Americans that have no insurance and provides extended benefits to those who already have insurance," said Scott, who has been a steadfast supporter of the president's reform package.

 

"Future generations will look back at the votes we cast today just like today we look back at the votes that were cast on Social Security and Medicare, and those generations will see that we proudly voted for health care for all."

 

Two Democrats -- Rep. Glenn Nye, D-2nd, and Rep. Rick Boucher, D-9th -- were among 34 Democrats to cross party lines and vote against the measure.

 

They joined the commonwealth's five Republican lawmakers: Rep. Eric Cantor, R-7th, Rep. Robert J. Wittman, R-1st, Rep. J. Randy Forbes, R-4th, Rep. Robert W. Goodlatte, R-6th, and Rep. Frank R. Wolfe, R-10th.

 

Before the vote, Cantor took the floor and denounced the legislation, calling it a "trillion-dollar overhaul" that would raise taxes, increase the national debt and reduce freedom of choice in health-care decisions.

 

"It's the latest part of an agenda that is being forced upon the American people that attempts to seize more control over the economy and our lives," he said.

 

Virginia is the only state to date to pass a law that says its residents cannot be required to purchase health insurance. On Wednesday, Gov. Bob McDonnell is scheduled to sign the legislation, passed by the General Assembly in its recently concluded 2010 session.

 

The health-care reform bill includes a mandate that requires nearly every American to be insured by 2014 or face a fine. The law provides an exemption for low-income people.

 

Cuccinelli's argument is that the mandate included in the reform bill creates a legal conflict between the federal government and Virginia.

 

"We believe the federal law is unconstitutional as it is based on the commerce clause. Simply put, not buying insurance is not engaging in commerce," the attorney general added.

 

"If you are not engaged in commerce, the federal government cannot regulate this inaction. Just being alive is not interstate commerce. If it were, Congress could regulate every aspect of our lives."

 

The debate over reform brought a tidal wave of calls, e-mails, faxes and protesters to local and Washington offices of congressmen in Virginia and across the country.

 

The influx overloaded congressional switchboards, flummoxed congressional staff and frustrated constituents, many of whom said they could not get through to their representatives or were given short shrift when they did.

 

"It was quite overwhelming," said Jessica Barba, press secretary for Perriello, the freshman congressman who has been targeted by Republicans in the midterm elections this fall.

 

She said many of the calls to the office appeared to be from out-of-state groups organized against his support of the bill.

 

"It prevented our constituents from being able to contact us," she said, "and that was quite frustrating."

 

Despite the difficulties of the process, Perriello, who held 21 public meetings on the topic, said he was satisfied with the result.

 

"This bill will help our rural hospitals and clinics keep their doors open, improve health care for over 400,000 local residents, reduce the federal deficit, and provide coverage to 48,000 more individuals in the 5th District alone," he said in a statement.

 

"At the end of the day, this decision for me came down to whether working families would see savings at the kitchen table. They will."

 

 

Contact Jim Nolan at (804) 649-6061 or jnolan@timesdispatch.com .

[NorthSideSox72]

On the bright side, at least the lawyer will make some money off of this...

 

http://www2.timesdispatch.com/rtd/news/sta...-000603/332103/

While I am disgusted by the absurdist over the top messages being spewed by the right on this, I actually agree that mandating people have health insurance is a bad idea.

 

I brought up car insurance as an anaology, just for discussion - but driving is a privilege, not a right.

 

Can anyone else think of a situation where the federal government required the purchase of a product or service from everyone in this way?

 

[Harry Chappas]

While I am disgusted by the absurdist over the top messages being spewed by the right on this, I actually agree that mandating people have health insurance is a bad idea.

 

I brought up car insurance as an anaology, just for discussion - but driving is a privilege, not a right.

 

Can anyone else think of a situation where the federal government required the purchase of a product or service from everyone in this way?

 

Clothing

 

You can do damage upon others and be held responsible for it with your car, not so much with your health.

[Texsox]

While I am disgusted by the absurdist over the top messages being spewed by the right on this, I actually agree that mandating people have health insurance is a bad idea.

 

I brought up car insurance as an anaology, just for discussion - but driving is a privilege, not a right.

 

Can anyone else think of a situation where the federal government required the purchase of a product or service from everyone in this way?

 

Paying for the government itself. Taxes. We are paying for all sorts of goods and services in that way.

[southsider2k5]

Clothing

 

You can do damage upon others and be held responsible for it with your car, not so much with your health.

 

In a big picture sense you can, because now you are paying for everyone's heath.

[Balta1701]

In a big picture sense you can, because now you are paying for everyone's heath.

That's been true in this country for centuries.

[Jenksismyhero]

Since you all read about this stuff more than me, a couple of questions:

 

1) the ~30 million uninsured - who are these people? Are they people like me, late 20's, employed, but in a small firm with no health insurance, waiting to get married so I can sign onto my future wife's plan. Are they poor people, who are already covered under programs like Medicaid? Are they illegals? Are they going to be denied care if they don't have an insurance card in 4 years?

 

2) How does the CBO think we're going to SAVE money when we're adding so many people who, i'm assuming, can't/won't pay much of their share for their new insurance, and who are probably going to essentially be covered by the government? Has the federal government EVER had a cost cutting spending program like this? I'm thinking of you know, the post office, which loses 200 billion a year, or defense, whose spending rarely gets cut, etc. Is there a cap on the use of this? What's going to stop people from abusing the hell out of this system? "I have the sniffles, i'm going to the doctor. Since I have no obligation to pay my own share, I can go whenever I want." Are they not concerned about costs going out of control?

 

3) How does this affect private insurance companies? Do we really believe that they're just going to drop prices for the hell of it? Aren't they going to become more specialized? Offer you a better package (who you can go see, what gets covered, the terms of your policy, etc) for a higher price, knowing that the government option is going to be cheap and force you to go to public (i.e. underfunded/mismanaged) hospitals?

 

I just don't get the goal of this bill. Dems made it out like people die on the streets because they lack insurance. While that may happen, it's no more than the amount of people that die due to any other factor the government could control if it wanted to (dui's for example). The poor are already covered under other programs. I'm all for reforming the industry, I just dunno how adding this many people to the system is going to drive down costs. Makes no sense to me.

 

And does it bother anyone else that the people voting on this bill could not possibly have read the whole thing? Why does the bill need to be 2k pages long?

 

And lastly, watching the coverage last night, I couldn't help but laugh at the way they covered the protests. Yes, there were morons out there that yelled things they shouldn't have yelled. But how were they any different from liberal protests of the past that used violence, destroyed property, AND probably offended a lot of people at the same time. I assume it's because one is the progressive message and the other is not? Is that really valid?

[Balta1701]

2) How does the CBO think we're going to SAVE money when we're adding so many people who, i'm assuming, can't/won't pay much of their share for their new insurance, and who are probably going to essentially be covered by the government? Has the federal government EVER had a cost cutting spending program like this? I'm thinking of you know, the post office, which loses 200 billion a year, or defense, whose spending rarely gets cut, etc. Is there a cap on the use of this? What's going to stop people from abusing the hell out of this system? "I have the sniffles, i'm going to the doctor. Since I have no obligation to pay my own share, I can go whenever I want." Are they not concerned about costs going out of control?

I could respond to all of these, but I'm going to only answer a few of them.

 

First of all...the post office loses $200 billion a year? When did we start mail delivery to Mars?

 

Secondly...there's an infinite number metaphors for how you can save money while adding so many more people. It's all about spending money more efficiently, which this bill does in a number of ways. For example, it's cheaper to have a cavity treated than to wait and wind up having a root canal or a tooth pulled. It's cheaper to get yourself on cholesterol lowering drugs than it is to wait until you've had the heart attack. It's cheaper to use a cheaper treatment if you've done the research to discover whether or not the cheaper treatment works better than the more expensive one.

 

Third...going to the doctor isn't like buying TV's. People typically don't like going to the doctor. People usually hesitate to go to the doctor, and the data suggests, they often hesitate longer than they should for financial reasons. It would actually be, on the whole, cheaper for the country if people went to the doctor when they got the sniffles rather than waiting until they wind up in the ER. Overuse of health care isn't a problem in other countries that cover everyone; in fact, it's quite simply cheaper to do it that way.

 

Health care isn't like a number of other things in the economy. If you get sick, genuinely sick, you can't save yourself money by just putting it off, because it's likely to get worse rather than better. If you get sick, it's likely to wind up impairing your ability to do other things in your life. If you get sick and you can't get treatment, you can't do your job, you can't find a job, you're either in bankruptcy or you're bouncing between ER's that are required to treat you anyway.

[HuskyCaucasian]

3) How does this affect private insurance companies? Do we really believe that they're just going to drop prices for the hell of it? Aren't they going to become more specialized? Offer you a better package (who you can go see, what gets covered, the terms of your policy, etc) for a higher price, knowing that the government option is going to be cheap and force you to go to public (i.e. underfunded/mismanaged) hospitals?

Here's my impression of this. Based simply on the little I've read about the Small Business Health Options Programs ("SHOP Exchanges"), these exchanges will make existing private companies have to be a little more competitive to compete with exchanges... as I believe these exchanges are non-profit.

[Balta1701]

Here's my impression of this. Based simply on the little I've read about the Small Business Health Options Programs ("SHOP Exchanges"), these exchanges will make existing private companies have to be a little more competitive to compete with exchanges... as I believe these exchanges are non-profit.

I'm going to have to correct you here. There's a possibility in the bill for states to set up their own not for profits, but it's not mandated and there's no overarching public plan.

 

Here's how the exchanges work. Right now, if you want to buy insurance on the individual market or as a small business, you have no bargaining power, especially if you're in an "at risk group" of any sort (you've had the flu in the past 10 years, you're over the age of 30, you've bruised an arm before, you're married, you're not married, whatever). Small businesses and the self-employed are massively screwed, as is anyone who loses a job. Thus, the individual insurance market has been the real disaster this bill aims to fix.

 

If you're working for a large company or the government, that company can get better prices by polling all of its employees together. Yes, there's going to be some high-risk people, but there's also going to be enough low-risk people that the insurance company will take them on, and they benefit at the same time from savings due to simply growing larger and having more people in their pool.

 

In the exchanges, basically, you are set up with everyone else in the exchange. Plans are offered inside of the exchanges, and the exchanges are able to work like a larger corporation; when you pool people together, you reduce the risk inside that pool and bring economies of scale in at the same time. So insurance companies sell for-profit plans inside the exchanges but they can't single out and remove certain high-risk groups. It is a huge boon to small business in reality; it gives them a chance to purchase insurance at the type of rates that larger companies would be able to negotiate even if they're small.

[HuskyCaucasian]

So insurance companies sell for-profit plans inside the exchanges but they can't single out and remove certain high-risk groups. It is a huge boon to small business in reality; it gives them a chance to purchase insurance at the type of rates that larger companies would be able to negotiate even if they're small.

ahhhhh ok. That clears it up for me. I was under the impression the exchanges were basically a non-profit insurance company. Thanks!

[bmags]

And does it bother anyone else that the people voting on this bill could not possibly have read the whole thing? Why does the bill need to be 2k pages long?

 

Are you serious? Good god, for one, go look at the bill. It's in like size gazillion font with ridiculous spacing. Many pages have a ffew sentences on it.

 

Second. Yes, everyone read the bill, if not, their staffers read it and briefed them on it. What's more, any policy wonk in the media read it. If there was a : 301.1 clause: all babies must be eaten my zombie marlon brandeau, then yes, it would have been spotted.

 

Bills need to be big. I don't remember people complaining about the size of the NCLB bill.

[Balta1701]

ahhhhh ok. That clears it up for me. I was under the impression the exchanges were basically a non-profit insurance company. Thanks!

We wanted that. That's what the "public option" would have been, but that did not make the final version of the bill. States are allowed to set up not for profit co-ops that are allowed to compete in the exchanges, but that is left to the states to do (they can already do this anyway if they want, most choose not to do so because the insurance companies wind up dumping their sickest patients onto the state co-ops and those co-ops then wind up in the insurance death spiral).

[BigSqwert]

People act as if this bill is the only large bill ever written and that all bills leading up to this one were never more than 3 or 4 pages.

[LittleHurt05]

From what I've read, the bill doesn't appear to contain anything to help doctors w/ malpractice insurance or to enforce malpractice settlement limits. Did I miss it somewhere or is that something that just wasn't dealt with on this bill?

 

 

[bmags]

From what I've read, the bill doesn't appear to contain anything to help doctors w/ malpractice insurance or to enforce malpractice settlement limits. Did I miss it somewhere or is that something that just wasn't dealt with on this bill?

 

It wasn't.

[HuskyCaucasian]

And does it bother anyone else that the people voting on this bill could not possibly have read the whole thing? Why does the bill need to be 2k pages long?

I said this a while ago with regards to another bill. The GOP was raising a stink saying "we never had time to read this. You expect me to vote on a bill I havent read?"

• Those that voted no would STILL have voted no... even IF they had time to read the while thing.
• Most of the concepts and wording have been around for MONTHS! So any argument saying "We didn't have time to read it" is total grand standing B.S. You had time to know and read the basics.

 

Now, are there things in there that people might not have read? Absolutely. Did they REALLY intend on reading word for word the entire bill? Of course not.

Edited March 22, 2010 by Athomeboy_2000

[Jenksismyhero]

I could respond to all of these, but I'm going to only answer a few of them.

 

First of all...the post office loses $200 billion a year? When did we start mail delivery to Mars?

 

Secondly...there's an infinite number metaphors for how you can save money while adding so many more people. It's all about spending money more efficiently, which this bill does in a number of ways. For example, it's cheaper to have a cavity treated than to wait and wind up having a root canal or a tooth pulled. It's cheaper to get yourself on cholesterol lowering drugs than it is to wait until you've had the heart attack. It's cheaper to use a cheaper treatment if you've done the research to discover whether or not the cheaper treatment works better than the more expensive one.

 

Third...going to the doctor isn't like buying TV's. People typically don't like going to the doctor. People usually hesitate to go to the doctor, and the data suggests, they often hesitate longer than they should for financial reasons. It would actually be, on the whole, cheaper for the country if people went to the doctor when they got the sniffles rather than waiting until they wind up in the ER. Overuse of health care isn't a problem in other countries that cover everyone; in fact, it's quite simply cheaper to do it that way.

 

Health care isn't like a number of other things in the economy. If you get sick, genuinely sick, you can't save yourself money by just putting it off, because it's likely to get worse rather than better. If you get sick, it's likely to wind up impairing your ability to do other things in your life. If you get sick and you can't get treatment, you can't do your job, you can't find a job, you're either in bankruptcy or you're bouncing between ER's that are required to treat you anyway.

 

 

Little hyperbole on the 200 billion. My point still remains though, the government rarely, if ever, makes something more cost effective. And I just don't like the CBO's estimates anyway. Bipartisan or not, they're wrong on occasions, and to me this program can't be wrong or we're really screwing ourselves here in the long term. Just like social security or medicare, now that this is signed, we're never going to take it away. That's not an argument against reform, but of this particular reform. That argument, however, has been lost in the sea of political discourse.

 

And to me your other arguments are what bothers me most. Does this bill address the ridiculous amounts of money that it costs to see a doctor? Is it going to cut costs beyond just preventative care? To me it seems like all we've done is do the health care industry a huge favor by giving them an extra 40 million people to take money from (even if the money is from all of us instead of the individual recieving the service).

 

I dunno, in general I just feel like this was a wasted opportunity. OK yay, we all feel good because 40 million more people aren't dying on the streets of various diseases. For most Americans, we've now protected them against evil insurance companies that put caps and exclusions on their policies (both things i'm in favor of). But the per-transaction cost of the health care industry is still the major problem, and they didn't even address it.

 

 

[Brian]

People act as if this bill is the only large bill ever written and that all bills leading up to this one were never more than 3 or 4 pages.

 

Agreed. I remember people talking about W's Patriot Act.