Health Care Reform Passes

you got a +1 just for making me laugh

lolfail+1 to his voters and supporters!

I think this just about sums it up.

No this sums it up!

I read that in a prof farnsworth (sp) voice

Well here's my 2 cents, I lost my job about a year ago, haven't been able to find one since, lost my healthcare because of it. Just recently I went to hospital and was diagnosed with either a tumor or cancer. Now with no health insurance that's bad >.>. Before I was really skeptical about this reform, fear and everything about it, cuz of the whole conspiracys of gov't take over etc about it.
But now it looks hopefully that it will work in my favor....

Good watch. Definitely clears the mud between opposing views so there isn't so much confusion.

Just hope it will go into effect before you you get too far...

I'd like to think there is a better way than making a 2,000+ page bill also, what are some of your ideas on this?

I also would like to trade services across state lines, but I don't see how that will happen if we put most of the power of any health reform bill in state governments. What will happen in my opinion is health care in Maine will look very different from health care in Arizona.

Is it really anymore unconstitutional to have people have health care than it is for a person to pay car insurance or taxes? If I'm not mistaken there is nothing in the constitution obliging us to pay either. I'm not taking sides and rather wait for the bill to actually go into effect before I judge.

Everyone says the debt will sky rocket yet no one knows everything about the plan and basing what they heard off of Fox news which I've been watching a bit of and all they have been doing is pure rhetoric with no figures, no statistics and no exact mentions of items in the bill.

I'm not saying its perfect but its a base for something, everyone else says "something could be done" but have anyone given any actual thought to anything? Has anyone was able to think of a budget efficient proposal that could cover at least half of the uninsured? Most Republicans didn't most Democrats didn't and no critic has either but we can all b!tch and moan and say that something else could be done when no one actually have any ideas.

I'm worried about the money we're paying into to, I'm also aware of the very limited amount of doctors and the chance of overbearing them with people.

Section 8 of the constitution says: "The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;"

So it does provide power for government to collect taxes. I don't know where car insurance mandates fall though. I'm not sure if that is a federal thing or a state thing.

I'd also caution the notion that republicans didn't have any ideas or were the party of "no". They did have a few ideas that I kept hearing about. Mainly open borders between states and Tort reform. I actually heard those so much that I wondered if they were the only ideas. I'd love to hear more.

The Congressional Budget Office or CBO -- the non-partisan body that does the number crunching for proposed bills -- has said this bill will either save us money over their 10 year projection or be deficit neutral. Now some people have had problems believing the CBO's estimates, and they have a historical reason for doing so. The CBO only estimates out to 10 years, after that the magic 8 ball becomes too cloudy. There are simply too many variables to take into consideration.

Not the very original document, that has been amended if I'm not mistaken, I'm talking about the very first unamended document.

Sort of like right now, if your in Canada, if you're on welfare or social assistance, your covered with Dental or Medical. I know a few ppl who are jobless atm, and had to rely on this service, and you get all this coverage. I'm at a job that has no health care or medical,I have to pay for my drugs outright..not my choice, company wishes not to pay for it. What can I do? <shrugs>

I'm not going to check the other 27 pages of this thread to see if this had already been posted, but this is more or less my feelings on the subject.

Maybe i'm wrong but aren't we paying 10 years of fees for 6 years of service?

Also when you mention people have hard time believing CBO's estimates for these types of things is correct, they are ususally off by a factor of 6-9. Also when social security and the like was created our estimates were off by 1000%.

And I still stand that Glenn Beck does a pretty good job, he does put forth some interesting things he comes across his readings. But again everyone's going to have a differing opinion.

lolol all you people have no clue. You go back and forth about health care or taxes trying to make points like you going to win a prize. You argue over socialism, communism, capitalism like it really means something. Like what you think and believe really counts.

If you are hungry and any one of these systems puts food on your table, thats the one you will be for. No matter what ideals you hold, your actions will reflect the situation you are in. So if you are sitting pretty you can afford to be naive and arrogant. Lose your job, spend up all your saving, then get sick with cancer and lets see how fast your position with health care changes.

People generally don't care unless they are effect directly. A very selfish and in the long run an unsustainable way of living.

http://www.msnbc.msn.com/id/21134540/vp/35994731#35591774

I just don't see why socialist systems are sooooo scary. Especially when this one doesn't even affect your taxes if you make less than $300k, and you do make less than $300k. So what if people with mre money pay more taxes? They've got the money, right? And if you're middle class, sounds to me like you don't lose out on anything, in fact you get to share the wealth, and it's not often your salary jumps from $60k to $500k, unless the American dream happens to you.

I dunno, I just wish I understood how if every country has some sort of plan, the US took until 2010 to catch up. @_@ I find it kinda weird how, looking in from the outside anyways, it seems like so many people are 100% for or 100% against. It's really, really, really not that bad, honestly! I'm tired of seeing my system represented poorly, is all.

Welcome to the NEW WORLD ORDER embrace it people....

Slate Q&A on the bill and what it means. (Slate has a reputation for being non-partisan.)

------------------

Say I have a pre-existing condition. Can I get affordable insurance now?
Wait three months. The requirement that insurance companies take any and all comers—known as "guaranteed issue"—doesn't kick in until Jan. 1, 2014. But the Patient Protection and Affordable Care Act allocates $5 billion for the establishment of "high risk pools" within 90 days across the country. These group insurance plans will provide coverage only for people with pre-existing conditions who can't find insurance through normal avenues. By law, they must take all eligible applicants and can't charge more than the standard rates.

The bill costs nearly $1 trillion in the first 10 years. How exactly does it reduce the deficit?
First, it slows spending on Medicare and Medicaid by reducing the rates those programs pay for services such as hospital visits. (It also reduces the amounts paid out through the Medicare Advantage program.) Second, it introduces new taxes, including a 0.9 percent Medicare payroll tax hike for workers who make more than $200,000 a year (and couples who make more than $250,000 a year) and a 3.8 percent tax on unearned income for the same tax brackets. Both taxes will take effect in 2013. Lastly, the so-called "Cadillac" tax on relatively high-end employer-sponsored insurance plans will target individual plans that cost more than $10,200 every year and family plans that cost more than $27,500. (The "Cadillac" tax won't roll out until 2018.) The Congressional Budget Office estimates that, together, these measures will decrease spending and increase revenue enough to reduce the deficit by $143 billion over the first 10 years and more than $1 trillion in the second decade.

There's a fine for not having insurance. How does the government know whether you have insurance or not?
Through the tax system. The legislation doesn't explicitly say how the individual mandate for health insurance will be enforced, but taxpayers will probably be required to prove that they own insurance when filing their taxes each year. (If you get insurance through your employer, they'll help take care of it. If you're self-employed, your insurer will probably send you a document to submit with your other tax forms.) If a taxpayer doesn't have insurance, the IRS will notify him of his nonenrollment and show him how to sign up through their state's insurance exchange. If he still refuses to enroll, the IRS will levy a fine that shows up on his tax forms. The fee starts small in 2014—$95 or 1 percent of income—but edges up incrementally until 2016, when uninsured individuals will have to pay $695 a year, with a family maximum of $2,085 or 2.5 percent of household income. (Jaerik note: the bulk of the bill's costs is providing subsidies to have the government pay for the insurance of those making up to 400% of the poverty level -- about $43k/year.)

What if I have federally subsidized insurance and need an abortion? Who pays for it?
You do. The compromise struck between the House and the Senate says that federal funds cannot be used to pay for abortions. So if the federal government fully subsidizes your plan, you have to pay out of pocket for abortions—except in cases of rape or incest. (This is the same arrangement for women covered by Medicaid.) Even if the government only partly subsidizes your insurance, you still have to pay for the portion of the insurance that covers abortion. Here's how it works: You write two separate checks to your insurance company every month—one to cover possible abortions, one for all other treatments and services. The federal government then contributes a third stream of money, which cannot be used to pay for abortions. Insurers that offer abortion coverage are required to keep those three pots of money separate. So any time someone gets an abortion, it's paid for from the account devoted exclusively to abortion coverage. (Pro-life advocates who claim that the health care bill subsidizes abortion argue that even if you keep the pots of money separate, the government is still contributing to plans that allow abortion.)

The Virginia attorney general has promised to file a lawsuit against the federal government claiming that it can't compel Virginians to buy health insurance. His supporters say health care reform violates the 10th Amendment. Does it?
Probably not. The 10th Amendment states that "[t]he powers not delegated to the United States by the Constitution, nor prohibited by it to the states, are reserved to the states respectively, or to the people." The federal government, however, can claim two Constitutional justifications for mandating health care. One is the right to regulate interstate commerce, which includes any business that operates across state lines. (Even if not all health insurance companies operate in more than one state, Congress can still regulate them as long as that regulation is part of a comprehensive interstate scheme, according to the Supreme Court.) Congress also has the Constitutional right to tax. Just as Congress taxes polluting companies for imposing a burden on other people, it could tax Americans who don't buy health insurance for doing the same. As if to emphasize the point, the fine for not buying insurance is levied by the IRS. (Jaerik note: they're also forgetting the Supremacy Clause of the Constitution, which trumps state legislation, and would be hard to argue against.)

What would it take to repeal health care reform?
Realistically, a Republican majority in the House and Senate, plus a Republican president. Even if the GOP won back a majority in the House and Senate in 2010, President Obama could still veto any legislation that would repeal any part of health care reform. Republicans would then need a two-thirds majority in both chambers to override his veto, and there are not enough seats up for reelection for them to do so.

If the Republicans control the House, Senate, and presidency in 2012, they will still need 60 votes in the Senate to overhaul the bill in its entirety. They could, however, cut off funding for it through the budget reconciliation process, which only requires a 51-vote majority. But they wouldn't be able to tamper with any part of the legislation that doesn't affect the budget, such as the ban on discrimination against pre-existing conditions.

Actually the job/insurance relationship began during WWII because the government regulated what employers could pay their employees during the war effort, they began to offer benefits such as health insurance as a way to reward employees. The rest of your post seems pretty spot on with a "Deregulate and the market will fix it" attitude.

Don't know why you have a problem with old people getting powerchairs ...

The car insurance laws -- do you know if that is enforced from a state level or a federal level?

Excellent information Jaerik, thanks for posting it.

Wow, stupidity really knows no bounds does it?

It's not that I don't WANT health insurance, but that I can't afford it! Now I have to pay $695 more because I can't afford it? How am I gonna get $60/month more? I mean if health Ins was $20/month I wouldn't play FFXI anymore and be covered!

The majority of the cost of the bill is for the government to help cover 90-100% the cost of private insurance for anyone making up to 400% of the poverty level. ($43000 for an individual or $88000 for a family.) Beyond that level, the amount the government covers fades out, up to $200k/year income.

The intent seems to be to only penalize those who can both afford insurance, and choose not to buy it. Your mileage may vary as to what you believe the intent actually is, but that's the text of the bill that was approved.

Similarly, businesses that choose to give health insurance to their employees will get tax credits to help offset the cost. Larger businesses who elect not to give their employees insurance will be penalized.

"20 million" isn't the going rate for a malpractice settlement or prosecuting victory, but I do agree with you -- to what extent, I'm not sure -- that malpractice reformations deserve some attention. However, I don't think that you necessarily have to cap reimbursements, as they are only a part of the problem.

To give some background, malpractice cases are meant to include the element of negligence; however, many patients are injured in the health care system not by negligence. Even patients that are injured by negligence rarely receive compensation because -- contrary to popular belief -- most do not sue. And, out of those that do, many do not win their cases. Therefore, only a small percentage actually receive compensation. Moreover, how much they receive is generally in the hands of a jury made up of average citizens, not scientists who could weigh the medical evidence or economists who could assign economic valuations. They are normal citizens. Thus, it is to little surprise that we occasionally learn of a multimillion-dollar jury award that seems out of proportion to the patient's injury through the news media. What the media leaves out most of the time is how those rewards are usually substantially reduced in subsequent court proceedings.

However, the issue of malpractice -- or rather, the more important issue I feel -- is that it contributes to a cyclical behavior of defensive medicine, erring on the side of caution by ordering extra tests and procedures, often unnecessarily -- but driving up health care costs nonetheless.

That said, we witnessed the free market at work earlier in the decade. In the early 2000s, the steep decline in the stock market caused insurers to lose a great deal of money in their investment portfolios, and they raised premiums. They contended that the increases were needed to cover higher administrative costs, higher average payouts for malpractice claims, and extremely large, high-end outlier awards.

But regardless of the underlying cause, malpractice premium increases are likely to be built into provider's fees, in which case they contribute to the overall costs of health care. Some experts believe that malpractice insurance rates cannot be controlled without fundamental tort reform that reins in the amount of malpractice awards. Newer approaches to dealing with medical injuries include "health courts" (see http://cgood.org/healthcare-events-62.html), which could more effectively provide compensation, deterrence, and corrective justice or establishing a highly structured system to determine the size of malpractice awards akin to the workers' compensation system to eliminate the current near-lottery system of jury decisions.

For those that are too lazy to click the points are these:

• 3 to 4% of patients suffer an adverse event, of which 1/3rd or 1/4th are due to negligence;
  

• Only 2 to 5% of patients injured by negligence ever file a claim;
  

• Of the total claims filed, about 50% have merit, while a little less than 50% do not;
  

• 24% of cases without merit nevertheless result in compensation.