What's in the Healthcare Bill for You?

sthnreb wrote: A good friend of mine is in the hospital here with a severe stroke. While I was in the lobby waiting for them to move him from emergency to and ICU room, I read a sign hanging over the desk. It stated the hospital could not discriminate against anyone for race, religion or whatever. It even included persons without any money. It stated they had to treat them equally regardless. If anyone has a problem with the hospital concering this please contact xxxxxxxxxx. Now, here, who has to have a paid policy health care under the current system? People who do pay also pay for the ones who don't. What's wrong with the way it is? How can someone say there are millions without healthcare when anyone can get healthcare regardless of money, race or religion?

We have basically the same signs. In California they had Prop.187 some do gooder Judge said it was unconstitutional so he over turned it. (against the illegal aliens in California)I am lucky that I have medical insurance from my employer, being as I am disabled due to a work related injury. I really don't think it will affect me and my wife, but the more I read it I see that it's loaded with useless accommodations for each congress person and senator that has a pet project. I am afraid that in the long run it will effect all of us. Look at the bovine excrement stuff I had to go thru to get a new Bi-pap Machine. where as the DME would not replace the broken one with a new one with out a lot of run around. As I said before I think it's time to bend over again. I do not see any of those elected clowns having to worry about how they get their medical care.

sthnreb wrote:A good friend of mine is in the hospital here with a severe stroke. While I was in the lobby waiting for them to move him from emergency to and ICU room, I read a sign hanging over the desk. It stated the hospital could not discriminate against anyone for race, religion or whatever. It even included persons without any money. It stated they had to treat them equally regardless. If anyone has a problem with the hospital concering this please contact xxxxxxxxxx. Now, here, who has to have a paid policy health care under the current system? People who do pay also pay for the ones who don't. What's wrong with the way it is? How can someone say there are millions without healthcare when anyone can get healthcare regardless of money, race or religion?

There is no general federal rule that hospitals must treat everyone regardless of ability to pay. EMTALA requires that hospitals that have emergency departments examine anyone who comes in to see if they need emergency care and transfer them elsewhere only after they have been stabilized. Many states have public hospitals which, as part of the condition of their funding, must treat all patients, and to a large extent that is where patients end up after they have been stabilized if they lack the ability to pay. These tend to be woefully underfunded. Grady Memorial, for example, provides much of the care for indigents in the whole state of Georgia, not just Fulton and DeKalb Counties, and seems to be in a state of constant financial crisis. One reason for this is that such hospitals rely on receipt of a federal subsidy for hospitals that provide a disproportionate share of unreimbursed care, but this is an unpredictable lump sum determined late in the year. This makes it impossible to run a hospital in a businesslike way. A worse flaw, however, is that this system makes emergency departments the central provider of care for a huge part of the population. It results in grotesque inefficiency as it steers people with ordinary medical needs into emergency departments geared to advanced care in life-and-death situations. In addition, many who have serious chronic conditions don't get rational ongoing care, but instead end up repeatedly getting high-tech emergency care only after they have a crisis. Since in the end the public is bearing the cost of this bad form of care, we would be much better off converting to a more rational system in which as many people as possible have ordinary health insurance and can be treated in physician offices and clinics for their non-emergency illnesses. Private charitable hospitals, usually supported by religious foundations, also provide much unreimbursed charitable care, but the current system can cause these to fail. Even non-profits have to match income with expense, and when the burden gets too great, quality suffers and sometimes hospitals close. I do think that some of us who support the bill err when we talk about the millions who don't get health care. They don't get preventive care or routine care because they lack insurance, but there is usually a provider of last resort when the need becomes critical. This is bad policy and bad medicine.

sthnreb wrote:... What's wrong with the way it is? How can someone say there are millions without healthcare when anyone can get healthcare regardless of money, race or religion? ...

Unfortunately, the facts speak for themselves. A blog entry from Scientific American reported a new study published online in the American Journal of Public Health:

http://www.ajph.org/cgi/content/abstrac ... 8.157685v1

So, this is just a reporting of the facts. No politics. The blog title? "Lack of insurance causes more than 44,000 U.S. deaths annually, study says":

https://www.scientificamerican.com/blog ... 2009-09-17

The study essentially finds:

The findings show that uninsured Americans—between the ages of 17 and 64—have a 40 percent higher risk of death than those who have private insurance.

Sure. They SHOULD provide equal healthcare. But the fact is that it simply does not happen. Something must be done. Let's put it in perspective. This places this as one of the top ten causes of death in the US. Per the CDC (at http://www.cdc.gov/nchs/FASTATS/deaths.htm):

Number of deaths for leading causes of death [in 2006]:

• Heart disease: 631,636
• Cancer: 559,888
• Stroke (cerebrovascular diseases): 137,119
• Chronic lower respiratory diseases: 124,583
• Accidents (unintentional injuries): 121,599
• Diabetes: 72,449
• Alzheimer's disease: 72,432
• Influenza and Pneumonia: 56,326
• Nephritis, nephrotic syndrome, and nephrosis: 45,344
• Septicemia: 34,234

rooster wrote:... Certainly a big part of it is frustration with the current state of affairs, which you know I will argue is caused by improper government interference and political fraud of both parties at the federal and state government levels. ...

No disagreement. There is not enough competition for my funds. As a result, the insurance companies can generally do what they want.

rooster wrote:... I don't believe businessmen are any less sinful than politicians. ...

Agreed. People in all stripes of life can be evil. The moment we are more interested in "I" than "you" we loose our way.

rooster wrote:... In the noncompetive environment our government has created for large insurance companies, it becomes difficult for the consumer to get what he wants at a decent price. That is really what we all want – a reasonable insurance policy at a decent price. Then we can address how the people in our society who don’t fend well for themselves can be accomodated. ...

I think we can and should do both at the same time. We must increase competition. However, in so doing this, we need to also make certain the insurnace companies can gain new business to offset the more expensive patients they must now cover. The only way this can work is if we work toward win-win. Both the insured and insurer must get something out of this to make it worth their while.

rooster wrote:... As far as the ad hominem attacks, are you aware of the “Foes List” feature? ...

Yes. However, I prefer to treat such posters as I would small children. (And that's just what I used to do with my kids). I patiently repeat over and over the proper behavior that is expected. It's monotonous. But it helps improve the tone for everyone.

rooster wrote:... Finally, assuming the bill is enacted into law, our next subject should be “unintended consequences”. ...

Yup. I recently saw one potential that worries me.

The Senate law as it is written would penalize a large employer who does not offer insurance. The fine? It would be about $750 per person. That is a WHOLE lot less than most insurance policies which most companies offer to their employees. So, imagine we have this brand spanking new law and companies can now legally ditch insurance for a mere fine of $750 per employee and there is this brand spanking law that forces everyone to buy their insurance. And there would be NOTHING any of the states could do, since this is a federal law.

Talk about potential unintended consequences.

So over 2 pages and nobody has an answer to my question?

I thought this whole thing (The Health Care reform Bill) was about providing affordable health care for everyone. If this bill doesn't do that why are people supporting it? Is it just to say "see I atleast tried to do something"?

akcpapguy wrote:I thought this whole thing (The Health Care reform Bill) was about providing affordable health care for everyone. If this bill doesn't do that why are people supporting it? Is it just to say "see I atleast tried to do something"?

It's because they can't. Probably 99.5% talk about what they hear, not what they know as facts. I've not "heard" of any good in it except for a few states that don't have to pay for it through sweetheart deals to secure votes. This govenment takeover is just a beginning, a get your foot in the door deal.

akcpapguy wrote:So over 2 pages and nobody has an answer to my question?

I thought this whole thing (The Health Care reform Bill) was about providing affordable health care for everyone. If this bill doesn't do that why are people supporting it? Is it just to say "see I atleast tried to do something"?

It's not about providing cheaper healthcare. It's about providing additional healthcare. I don't care if I have to pay more if I will have more access.
IE getting healthcare if I choose to retire early. Getting healthcare when I am laid off for a significant amount of time. Getting healthcare beyond the choices offered by my work without worrying about being rejected. Getting healthcare because my job won't offer it. IE Walmart.

Not everything is about being cheaper.

Pork included in the Health Care Bill.............. ( Bribes to get the votes...)

http://newsbuster.com/Pages/content/the ... -bill.html

http://newsmax.com/InsideCover/healthca ... ode=93F4-1

akcpapguy wrote:So over 2 pages and nobody has an answer to my question?

I didn't think we'd have homework over the Christmas vacation. This is the question akcpapguy is referring to:

akcpapguy wrote:So I put the question to those of you here who have stated a similar position, not trying to sound challenging, but merely as a question of clarity because I have read both bills and frankly I don't see anything that guarantees the coverage will be affordable.

Just so you understand where I'm coming from, for example if I lost my job tomorrow and OSA (which I have) is considered a pre-existing condition, what is preventing the insurance companies from saying "Sure we will insure you with your pre-existing condition, your monthly premium will be $2,500 a month for an individual policy".

Yes I am aware that there are rebates and such built into the bills, but that is not an answer. How much are the rebates, to whom do they apply, is there a qualifying income, can I drop my work coverage and get private insurance with the rebate if it's cheaper?

The relevant language starts at page 78. It is in the form of amendments to existing law passed several years ago as part of the Health Insurance Portability and Accountability Act (HIPAA), which made it easier to go from one group plan to another without losing coverage for preexisting conditions. This bill replaces that language with stronger provisions that apply to individual policies as well as group policies. New section 2704(a) states:

A group health plan and a health insurance issuer offering group or individual health insurance coverage may not impose any preexisting condition exclusion with respect to such plan or coverage.

The new section that prevents an insurer in the individual market from just increasing the premium to drive away people with preexisting conditions is 2701. This is long, so I'm going to summarize it instead of quoting in full, but it starts at page 80 so anyone can check the fairness of the summary. It establishes a list of factors that can be used in setting rates, and says that no other factors can be used. The factors are (1) whether the policy is for an individual or family, (2) geographic area (what the bill calls "rating areas"), (3) age, but not by more than a 3 to 1 ratio from oldest to youngest, and (4) tobacco use, but not by more than 1.5 to 1.

New section 2705 prohibits limiting eligibility based on health status, medical condition, claim experience, medical history, genetic information, disability, etc.

The rebates are keyed to the federal poverty level, which varies by family size. Basically, the bill extends Medicaid eligibility to families up to 133 percent of the FPL. Premium subsidies are available from 133 to 400 percent limiting the percent of income spent on insurance. The Kaiser Family Foundation, which operates a very informative web site on health care policy, has a calculator at http://healthreform.kff.org/SubsidyCalculator.aspx that can be used to show the amount of subsidy at various incomes and premiums.

Thanks PST, that was a very excellent explanation of the program......sorry for the homework over vacation.

I just knew someone had to have the answer since there were so many who were supporting the bills for the same reasons that my friends were stating. I see now where the rebates will help individuals who are paying for their own coverage. Thank you also for the links to the calculators, I'm sure they have helped more people understand whats going on than myself. What I don't see however is a reference to caps on deductibles in policies, high deductibles alone can be financial killers for people. Anyway, I still believe both bills need some refining before I would get behind either of them 100%.

Thanks again PST!!!

I'm one of those working poor. To rich to be poor and to poor to be rich. If it wasn't for my V.A. benefits I wouldn't have found out that I have sleep apnea or have the machine. This goverment healthcare does work in several other countries so why can't it work here?

Maybe because graft and corruption in this country exceeds that of the other countries? Maybe because our politicians and government officials are cozier w/the financial industry and big business than those of other countries? Maybe because our once great country is fast going to hell in a handbasket?

Second it.

Slinky wrote:Maybe because graft and corruption in this country exceeds that of the other countries? Maybe because our politicians and government officials are cozier w/the financial industry and big business than those of other countries? Maybe because our once great country is fast going to hell in a handbasket?

I agree!

JohnBFisher wrote: Unfortunately, the facts speak for themselves. A blog entry from Scientific American reported a new study published online in the American Journal of Public Health:
http://www.ajph.org/cgi/content/abstrac ... 8.157685v1
So, this is just a reporting of the facts. No politics.

Welllll, maybe.

From the AJPH website, slightly buried:
"The goals of both the online and the print versions of the Journal, published monthly by the American Public Health Association, are

• To publish the best scientific research in the field of public health
• To serve as a forum for diverse viewpoints on major public health issues and policies
• To promote diverse public health practice models
• To increase public and professional understanding of public health problems and their solutions through delivery channels relevant to different audiences and their needs
• To work in concert with the 3 main priorities of the American Public Health Association, namely
  • to develop universal coverage,
  • eliminate health disparities, and
  • rebuild the public health infrastructure.

(Formatting by me, text by them.)

John, I appreciate your research, but you missed the prejudiced boat on this one.