Health care reform

[maat55]

True, but there are lots of different ways to go about fixing things so there is plenty of disagreement about what should be done and how to do it.

Good generic answer Steve, how about giving us your opinion on lowering costs.

[Snodog]

We could always do healthcare the Dwight Schrute way. I'll grant you his views would be controversial but think of the money we'd save.

[disneysteve]

Good generic answer Steve, how about giving us your opinion on lowering costs.

I have in a number of other threads. Since this thread is specifically about the bill just passed, I didn't think it was the right spot for it.

[cptacek]

The measure will require most Americans to have health insurance coverage

except for Muslims, Amish, Christian Scientists, Congressional staffers, ILLEGAL ALIENS who will still get free care at your local hospital, etc...

would add 16 million people to the Medicaid rolls

which is paid for by the states (except we all will pay for Nebraska's) and will take ~$522 Billion away from Medicare and ~$52 Billion from Social Security

and and would subsidize private coverage for low- and middle-income people.

Yes. Thank you all for covering my health care for me. My farmer husband and I can pretty much take our income down to nothing in taxes due to depreciation, etc., so to everyone making over ~$55,000, I thank you

It will regulate private insurers more closely, banning practices such as denial of care for pre-existing conditions.

It is already the law (i.e., before this law was signed today) that insurers must cover pre-existing conditions after 1 year. I think that was part of the HIPPA regulations.

The law will cost the government about $938 billion over 10 years, according to the nonpartisan Congressional Budget Office, which has also estimated that it will reduce the federal deficit by $138 billion over a decade.

This $938 Billion number and $138 Billion number are bogus.
We will pay 10 years of taxes for 6 years of "benefits."
The $138 Billion includes the "savings" of $522 Billion of Medicare cuts and $52 Billion in Social Security cuts, as well as assuming that the Doctor Fix won't be passed again, which is $371 billion. They aren't counting the Doc Fix in this bill to keep the bill under $1 Trillion. But they already have another bill under consideration to pass the Doc Fix which means they are going to spend that money anyway. They are putting a surcharge on investment income over $200,000 a year (single) or $250,000 (MFJ) of 3.8%. If you have too "expensive" of health insurance, you will have to pay an additional tax, unless you are a member of a union.

[disneysteve]

It is already the law (i.e., before this law was signed today) that insurers must cover pre-existing conditions after 1 year.

What good is covering them after 1 year? What are people supposed to do in the meantime? If your insurer won't cover your pre-existing diabetes, how do you pay for your meds, your insulin, your syringes, your blood sugar testing supplies?

How many tens of thousands of people have been stuck in lousy dead-end jobs because they can't afford to change to something better and have a gap in their coverage that would trigger the pre-existing clause?

[cptacek]

~deleted~

Sorry. That may have been offensive to you all. While I am plenty hacked off, I don't want to offend anyone.

[cptacek]

What good is covering them after 1 year? What are people supposed to do in the meantime? If your insurer won't cover your pre-existing diabetes, how do you pay for your meds, your insulin, your syringes, your blood sugar testing supplies?

Pay for it yourself for a year.

[disneysteve]

Pay for it yourself for a year.

With what? Gold unicorn poop? My patients have enough trouble affording their med copays when they are covered by insurance. Take away the insurance and they haven't got a chance.

[cptacek]

So you think that when someone has diabetes, a disease that has known costs associated with it, the insurance companies should accept that known cost on the first day of coverage? That isn't insurance, that is a prepayment plan.

[cptacek]

And you've said yourself that your patients have money for beer and cigarettes. To me, that sounds like they are choosing wants and needs, and insurance doesn't make their "needs" list.

[markusk]

So you think that when someone has diabetes, a disease that has known costs associated with it, the insurance companies should accept that known cost on the first day of coverage? That isn't insurance, that is a prepayment plan.

I don't know if anyone knows this but pre-existing conditions include things like pregnancy. In otherwords, if you get pregnant while uninsured, most insurance companies will not allow you to sign up for their insurance after the fact (because they known the cost associated with it). If you say that you are not pregnant and get insurance, and later the insurance company finds out you lied, then you owe them money.

If, as a nation, we think denying insurance based on pre-existing conditions is wrong, then we need a law that says you can't deny insurance based on preexisting conditions. But then the only way an insurance company can make a profit/break even/ stay in business is by having a large pool of relatively healthy people in the health plan -- to spread the cost. As my neurosurgeon friend on mine said recently, "This is not rocket science. The more healthy people in the health plan, the cost will be lower for everyone."

I am sure you've heard of Anthem Blue Cross in California's plan to raise premiums 30-35% in a month or two, affecting most small business and self-employed plans affecting about 600,000 to 700,000 people. Their justification is that with so many people losing their jobs (and hence their health insurance) the pool of "the really sick people" or those with a preexisting condition is greater (they stay because they can't afford to leave), so Anthem Blue's cost is going up -- they don't have enough healthy people to spread the cost. Unfortunately this will most likely cause the remaining healthy people on the plan to drop their health insurance since it is too costly AND they are healthy anyway. As commentators have pointed out, this, in turn, will force Anthem Blue to raise premiums again... This is already happening in California.

[dannin]

I love these projections about how much this plan will cost. When have the projections ever been remotely close !? There was a website that I saw once that gave some good examples of the projections for government programs and then the actual numbers. It was laughable.

I also find it interesting that 2010 is going to be the first year that Social Security brings in less money than it pays out. This, the same year another massive entitlement program is signed into law.

[Radiance]

I don't know, Radiance. I don't know how the government will check your religion. Don't you think it pretty unfair that some Americans can get around this mandate and others are stuck with it, because of their religion? What happened to Equal Protection Under the Law?

It would be Equal Protection since any religion should do, a person's set of believes is her/his religion, whether it has a name or not. But that is a story for another post, in another forum.

In any case I just heard in the radio that there are a lot of lawsuits already statarted in the basis that forcing people to buy insurance is not constitutional.

I want health insurance, but as long as I have the freedom to chose my coverage...I have no idea if I can afford the coverage I want, as of last month it wa $150, how much will it be? Has anyone say?

[MonkeyMama]

I am sure you've heard of Anthem Blue Cross in California's plan to raise premiums 30-35% in a month or two, affecting most small business and self-employed plans affecting about 600,000 to 700,000 people. Their justification is that with so many people losing their jobs (and hence their health insurance) the pool of "the really sick people" or those with a preexisting condition is greater (they stay because they can't afford to leave), so Anthem Blue's cost is going up -- they don't have enough healthy people to spread the cost. Unfortunately this will most likely cause the remaining healthy people on the plan to drop their health insurance since it is too costly AND they are healthy anyway. As commentators have pointed out, this, in turn, will force Anthem Blue to raise premiums again... This is already happening in California.

I don't see why this is *news.* All the insurers have been raising premiums 20-40% every year for the last few years. Our insurance went up 40% about 3 years ago. I think 30% last year.

Anyway, something obviously has to give, but I am not sure if this Health Bill will lower our premiums at all (and am not convinced it won't raise them more rapidly). Will see...

I really don't mind paying for good health care, but don't see how we can afford it, indefinitely. Not when it has gone up at least 25% every year for the last decade. This year our health insurance cost as much as our mortgage. It cost less than $100/year when I graduated college in 1999, for better coverage really.

[cptacek]

It would be Equal Protection since any religion should do, a person's set of believes is her/his religion, whether it has a name or not. But that is a story for another post, in another forum.

I have read that this provision is already enacted in Massachusetts' health care plan, and if you are Christian or Jewish, you are not eligible for this exception. I don't know how it will be enacted at the Federal level.