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House Passes Massive Medical Insurance Bill, 219-212
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.
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
Congrats US citizens! You're on your way to a non-broken health care system!
So the bill does a lot of good things. It stops insurance companies basically doing whatever they like, which was the main problem with the US health system. But it actually rewards those same insurance companies by delivering millions of new customers to them. A competitive public option would have pushed down insurance company margins and made them actually compete for business, instead of retaining their confusopoly. And then there's the issue that women will now be required to purchase abortion coverage separately because the government is forbidden to pay for that procedure. This is basically a regression, since lots of plans will probably stop covering abortion in order to be eligible for government subsidised customers. Overall though, lots more people who were unable to get coverage will now be able to get it. Imperfect as it is, this bill will save lives, and contrary to what Fox will tell you, it will not affect anyone who is currently happy with their insurance.
It was the "right to life" people that threatened to block life-saving medical care for millions.
The propaganda cons are all about things like the tremendous waits and how all the medical practitioners are going to quit because they won't get paid enough.
The real ones are that this bill doesn't do enough to reduce costs, while also fining people for not getting insurance. Many people would also put the lack of a strong single payer program as a big con.
If you can't see the value in jet powered ants you should turn in your nerd card. - Dunbal (464142)
I may be wrong, but from the UK perspective this is not "NHS Lite" socialised healthcare, rather this is the wetware equivalent of compulsory motor insurance, now applied to human beings...
Nice civil liberties you have there citizen, shame if anything happened to them, better buy this here medical insurance, know what I mean?
Sounds like this bill has nothing whatsoever to do with medical treatment per se.
One small step from the RIAA et al doing the same thing.
http://slashdot.org/~GuyFawkes/journal
Here's something funny: if everyone jointly pays for healthcare and everybody gets treated health costs go down. This is because no one puts off going to the doctor because of expense. Cancers are caught sooner, infections are treated before the victim starts coughing up blood. What selfish libertarians like yourself don't realise is that a persons health is mostly unrelated to their choices. No one chooses to get prostate cancer, no one chooses to get bitten by a rabid dog.
patriotism, as in caring for the health of your nation, the welfare of your fellow man, belief in the common good, as opposed to the prophets of blind ultimately self-defeating selfishness: i don't know why that's "patriotism"
morality, as in standing up and saying that i don't believe in a society where a corporation takes care of its stockholders and denies middle class americans health benefits while gouging them with skyrocketing rates
freedom, from disease and sickness, as opposed to the false "freedom" to choose between paying for your broken arm, or depending upon society to pay for your broken arm because you can't afford it (while you rail about your "right" to "choose" to not have health insurance)
if you understand why you can't drive legally without car insurance, you understand why health insurance must be mandated. even the young and healthy break their arms. then, what happens? does the hospital turn them away for not having cash? can you live in a society that does that?
furthermore, what currently happens if they have no health insurance? hospitals have unpaid bills, and remains eternally on the verge of bankruptcy, eternally needing bailouts from the state and feds. in other words: you already pay for it, but now you pay for it in the most common sense way
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
Bullshit. The insurance companies spent about $10 million on ads trying to stop just the latest health care bill. Why? Because it killed their main way of maximizing profits: denial of coverage. We have seen nothing but fear mongering, lies and distortions from the conservatives through this whole process -- what is wrong with you people?
Gentlemen! You can't fight in here, this is the war room!
"The biggest problem is no one has ever given me an answer as to why my money has to go to pay the medical bills of my neighbor who smokes half a pack a day, or my neighbor on the other side who thinks it's funny to drink a case of beer each weekend by themselves."
Because it's a liberal progressive mentality bordering on socialistic/marxist ideals.
What would you do to help your mother/brother/sister/father?
How about your next door neighbor you hang out with?
The guy in the next street, or the next town?
At what point do you draw the line and say that I am going to help these people and not those people?
I think that part of the US problem is more that in general this line is drawn closer to home compared to other people who draw it further out.
I am Slashdot. Are you Slashdot as well?
Because when you decide you don't want to buy insurance and subsequently get a ruptured appendix (which there is no way of reducing your risk for aside from possibly exposing yourself regularly to cholera and other digestive diseases), you're not about to lay down and die on principle. You're going to demand that the ER save your life, then demand they swallow the tens of thousands of dollars it cost (which gets passed on to everyone else in the end). Imperfectly "socializing" the worst case scenarios has roughly the same net effect as requiring everyone to buy health insurance, except that the status quo meant a reverse lottery where specific unlucky individuals go bankrupt and their hospitals lose money disproportionately. Yeah, it subsidizes the lazy and those with unhealthy habits, but I somehow doubt people are choosing to smoke so as to take greater advantage of their health care. Demanding that the guy with the ruptured appendix or the type I diabetes must die so the guy with the pack a day habit or the type II diabetes isn't "rewarded" is inhuman.
$_ = "wftedskaebjgdpjgidbsmnjgcdwatb"; tr/a-z/oh, turtleneck Phrase Jar!/; print
Not necessarily a bad thing. Similarly, if my house catches on fire, it is a good thing that the city sends a fire truck to put it out. But I don't call that "fire insurance". They are entirely different things.
Now they should try a health care bill.
Which is worse? People taking advantage of the welfare state, or people dying because of inadequate healthcare? You can't have a welfare system with cheaters. They can be prosecuted under fraud legislation. Of course some will slip by and get away with it, but this way is dramatically the lesser of two evils.
The only thing missing are the Tea Partiers calling congressmen niggers and faggots. But forget reality - what are CNN and Fox News saying?
CNN: Rep. Emanuel Cleaver, D-Missouri, released a statement late Saturday saying he too was called the "N" word as he walked to the Capitol for a vote and that he was spat on by one protestor who was arrested by U.S. Capitol Police. Cleaver declined to press charges against the man, the statement said...
Protesters also hurled anti-gay comments at Rep. Barney Frank, D-Massachusetts, who is openly gay, as he left the same health care meeting that Lewis attended in a House office building.
A CNN producer overheard the word "faggot" yelled at Frank several times in the lobby of the Longworth building. Frank said he heard someone yell "homo" at him.
FOX: Republican National Chairman Michael Steele and one of the organizers of Saturday's Tea Party rally strongly condemned the racial slurs that some black lawmakers alleged were yelled at them by some health care protesters as they headed for a procedural vote at Capitol Hill....
But black lawmakers weren't the only targets of the protesters' invective. Rep. Joe Crowley, D-N.Y., alleges some of the demonstrators also castigated Rep. Barney Frank, D-Mass., who is gay.
"I don't even want to repeat it," said Crowley when asked what they said to Frank.
A spokeswoman for the U.S. Capitol Police said she was unaware of any law enforcement inquiry into the incidents.
Oh Fox... will you ever be more than a conservative mouthpiece?
you understand the legal logic behind requiring people to have car insurance before driving, right?
so if you understand why you can't drive legally without car insurance, you understand why health insurance must be mandated. even the young and healthy break their arms. then, what happens? is everyone an upper middle class paragon of financial virtue with $200,000 in the bank for unforeseen health problems?
furthermore, does the hospital turn them away for not having cash? can you live in a society that does that? so what is the "choice" here? there is no choice: you need health insurance
furthermore, what currently happens if they have no health insurance? what happens is hospitals have unpaid bills, and remains eternally on the verge of bankruptcy... eternally needing bailouts from the state and feds
in other words: you already pay for all of the uninsured with your taxes!
but now you pay for it in the most common sense direct way
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
Most of us have health insurance that we purchase through our employers, provided by insanely profitable corporations.
Except for the 35-50 million who don't and can't get health insurance. Never mind that losing your job has meant a double whammy of losing your health insurance too. Happened to me. It also matters for those who can't get coverage because of pre-existing conditions. Has happened to members of my immediate family.
Does this bill cure everything? Of course not. But it does change things for a lot of people, hopefully for the better. If you have been lucky not to be affected by the broken parts of the US healthcare system, consider yourself lucky.
Almost everybody thinks reform is needed. Almost nobody thinks that Congress is competent enough to make good reforms.
Go green: turn off your refrigerator.
You're funny. Have you seen how much those companies have contributed in bribes?
But with the mandate for coverage of pre-existing conditions, I don't see how there is a contingent aspect of this anymore. It is like selling "fire insurance" coverage for houses that are already on fire. That is not really "insurance".
You forgot the important qualifier. "a form of risk management PRIMARILY used to hedge against the risk of a contingent loss". Insurance can be to hedge against gains, it can be to share risk, it can be to shift risk to another party. It's not so simple as a single sentence quoted from wikipedia. You cannot cover pre-existing conditions unless you force everyone to have coverage, otherwise the smart play is to buy insurance only after you get sick which destroys the financial structure of insurance (no premiums being paid in).
The Democrats ran on the platform of healthcare reforms. And they won! By a sizeable margin! This is what we call a mandate.
Legally required car insurance is insurance for other people/property you injure/damage.
You are not required to insure your car against theft, you are not required to insure your car against the damage done to it when you crash it.
Health insurance is not for other people that you might harm in some way, it is for yourself. And hence is nothing like mandatory car insurance.
>>>"the Republicans get egg on their face because the other side got their bill through anyway, whilst the Democrats didn't really get the thing they wanted because they watered down their original bill to try and get [Bluedog Democratic] support."
.
Fixed. The Democrats didn't need Republican support (as was demonstrated by the vote). The problem was a lot of Democrats are actually conservatives, and they were against the "One Payer" goal set by Obama. They were also against funding the killing of human fetuses.
The bill was watered down to make those conservative Democrats happy.
"I disapprove of what you say, but I will defend to the death your right to say it." - historian Evelyn Beatrice Hall
It actually is, in many ways. Every infection is a potential health hazard for others.
"It's such a fine line between stupid and clever" -- David St. Hubbins, Spinal Tap
Actually, it does say that. I'll quote it for you:
"The 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."
See that "Preview" button?
The problem with applying the "free market" model to health care is that this is not, in practice, how the American people treat it. When your kid is seriously injured or has a high fever, you don't expect to be turned away from an emergency room because you couldn't pass a credit check. As the GP said, it's more like auto liability insurance, where you pay for it one way or another (which is why most states have mandated auto insurance for drivers). Whether someone has insurance or not, they're going to find a way to get treatment if they're ill or injured. It's just a question of whether you let them see a regular physician or force them to go to the (more expensive) emergency room.
To truly turn health care into a free market, you would have to create a system that is much more callous than almost anyone would be willing to tolerate. But, I guess if you're a free market thinker, every problem looks like a nail.
SJW: Someone who has run out of real oppression, and has to fake it.
Or the CIA. Or the air force. Or the public education system. Or funding nuclear power plants. Or the FDA, FCC, CDC, OSHA, EPA, FBI, NSA, and believe me, I could go on.
The founding fathers believed only landowning white men should have rights. The world is quite a different place. We have germ theory, evolutionary theory, cars, planes, electricity, running water, and a toilet that is more than a hole in the ground. And women and non-whites and non-landowners can vote.
The real genius of the Constitution is that they gave us the power to change it. So, right after you get all of the above in the Constitution, you're welcome to start bitching. Otherwise, it's just empty rhetorical fluff that stops rational discussion.
One thing many of the founding fathers had was an affinity for a "natural" aristocracy, in other words, smart people; and a hatred of the aristocracy of birthright, in other words, wealthy people. In fact, some of them believed in awarding good education through competition and paying for it with public funds, passed laws ending entails and primogeniture, and here's a couple quotes that will really blow your mind:
"Taxes should be proportioned to what may be annually spared by the individual." -Thomas Jefferson to James Madison, 1784.
Another means of silently lessening the inequality of property is to exempt all from taxation below a certain point, and to tax the higher portions of property in geometrical progression as they rise." -Thomas Jefferson to James Madison, 1785.
Oh no! One of our founders was a socialist marxist pinko commie fascist! Run for your lives, I mean, money!
The Democrats ran after 8 years of a very unpopular administration with a major economic collapse against an opponent who was over 100 years old with a veep whose main qualification was that she could see Russia from her house. Healthcare reform isn't what got the Dems into power.
Slow down, cowboy! It has been 4 hours since you last posted. You must wait another few hours.
selfish libertarians
You, sir, are too kind. Compliments such as this truly lighten a dark day.
Learn about Photography Basics.
I'm with ya, dude. I've spent a long time analyzing the health care industry, just for my own personal edification.
Health care definitely needs reform. As a small business owner myself, I can see how hard it is to get insurance sometimes, even if you're healthy and willing to pay. Our current health care system is designed with the 1950s in mind - people working for large corporations, getting their health care from a group pool. It can be a nightmare for individuals and small business owners.
However, the new system incentivizes everything backwards. It is now optimal for healthy people to go without health insurance, perhaps with just catastrophic coverage, and then sign up when they get sick. Everyone else in your pool will pay for your illness, so people who have traditional insurance will end up paying more. While the current system supports the corporate employee at the expense of the small business owner, the new system reverses the exploitation.
Some notes:
1) About half of all the health care money in the US comes from the government, so the notion about socialized medicine is already half-true. If they opened up Medicare to everyone (paying in at cost so that it doesn't bankrupt the government) that could be an effective replacement for a single-payer system that doesn't destroy the advantages of our current health care system. Or it would, except I think a lot of hospitals are about to start dropping Medicare coverage entirely due to the cuts in the current bill. Medicare reform is desperately needed - it incentivizes doctors in paradoxical ways that are deleterious to patient care.
2) Tort reform is necessary. John Edwards suing doctors because kids randomly get born with Cerebal Palsy does not make doctors better. It makes doctors quit the OB/GYN business, and hurts the general public. The Democrats are a party of lawyers, and the lawyers were the conspicuous winners from this bill. Malpractice insurance makes up a huge part of the cost of health care these days.
3) Medicare Part D needs to be able to negotiate with drug companies for reduced prices. The VA does, which is one of the reasons they can stay afloat on a restricted budget. VA reform is necessary though, too - their computer systems are a babylonian nightmare.
4) The way billing works in hospitals is more or less fraudulent. It works by inflating prices by 4x, offering a 75% discount to insurance companies (who essentially pay the original price), thus screwing over people that don't have insurance in order to cover losses from people that don't pay. You also can't tell how much something is going to cost before you pay for it, if you don't have insurance. When you remove the free market that far from a payer, it's no mistake that the billing system is so messed up.
Ever been to an auto mechanic? They have a list of prices up on the wall - this much for an oil change, this much per hour for labor. We need a rule for hospitals for the same.
You do realize that if insurance companies do not discriminate against pre-existing conditions, they cannot possibly stay in business. If everyone waits until they are sick to even buy insurance, there will not be an insurance fund from which to draw to cover costs. The entire idea of *insurance* requires that pre-existing conditions not be covered. Imagine if you could get auto-insurance after getting into a wreck, or flood insurance *after* the flood occurs. Nobody would bother buying insurance, and as a result, insurance could not exist. Sure, the bill imposes fines to prevent people from remaining uninsured, but for many people those fines are cheaper than actually getting insurance.
so what is the "choice" here? there is no choice: you need health insurance
Before yesterday, you could choose to live "off the grid". You could grab some stuff, head out for the mountains, build a shack, and provide for yourself. While you were still technically supposed to file taxes, etc., no one really cared if you didn't apply for the tax credits and social programs you'd almost certainly be eligible for.
Today is different. As of now, you are officially a tax cheating criminal if you choose to wander off alone. You can bet the government will be interested that you're not filing returns that certify that you owe money for being uninsured.
The world is changed this morning, and I awake to applause. This is not the country I grew up to love and swore to protect.
Dewey, what part of this looks like authorities should be involved?
Did you read my post? In your selfish system people don't get things checked out until they end up in the emergency room and then the government pays anyway, because no civilised nation lets hospitals turn away people in critical condition. Ill health is punishment enough for bad life choices. Getting lung cancer from smoking will often still kill you. Getting leukaemia and then going bankrupt from medical bills? The illness is awful, and the bankruptcy is a fucking travesty.
A high earning physician told me his tax load will increase by $100,000 per year when this bill is fully implemented. That has a nice populist sound to it--tax the rich, give it to the poor. But the people who won't see that money will be master carpenters and their assistants, automobile factory workers, boat builders, waiters and bus boys, and all those businesses that he would have spent the money on. Also, the money won't be invested into the stock market. Instead, it will go to a new bulked up government bureaucracy which will then redistribute some fraction of it to this new policy purpose.
So you're saying that we should not try to improve health care in the US, if it involves taxing wealthy people more, since it would interfere with trickle down economic policies?
I hate to break it to you, friend, but we've had ill-conceived forms of this since Reagan (and long before, in fact), and it never works unless the tax rate is absurdly high (and it isn't now, and won't be even after the bill takes effect). Even then it's somewhat dubious.
Personally, though, my complaint with the bill is not that it goes too far, but that it doesn't go too far enough. We need a single payer system.
-- This and all my posts are in the public domain. I am a lawyer. I am not your lawyer, and this is not legal advice.
You do realize that if insurance companies do not discriminate against pre-existing conditions, they cannot possibly stay in business.
I'm not disagreeing with your logic, but wanted to point out that by so over-reaching in their denial claims the insurance industry brought this upon themselves. Had they been more reasonable and less greedy, it would not have been far less of an issue.
If brevity is the soul of wit, then how does one explain Twitter?
and when you broke your arm off the grid, and wandered in bleeding to the emergency room 50 miles away, you gratefully accepted the aid of a society you rejected
i do weep for american society too. that so many people are so blindly selfish and irresponsible that they think aggressively defying what is obviously just common sense fiscal policy is somehow being patriotic or american
just admit you have no interest in american society, and leave social policy to those who actually care about american society
after all you are the one championing going off grid!
don't you see the simple logical fallacy in your attitude?:
"i am declaring myself apart from american society in the name of american society!"
pfffffffft
logic fail
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
... Sure, the bill imposes fines to prevent people from remaining uninsured, but for many people those fines are cheaper than actually getting insurance.
I see this talking point a lot. It sounds like a strong point on casual hearing, it's bottom-line simplicity and all that, but it ignores a very important fact.
Even people who are reluctant to pay for a health plan are not actually opposed to having it! Except for small number of odd (or quite wealthy) individuals, they actually would very much like to have health coverage, just in case. When faced with the prospect of paying a fine, and getting nothing in return, and paying somewhat more and getting a valuable benefit - health coverage - people are very likely to go for the coverage. (Remember also that people on the low end of the economic ladder get assistance.)
When framed properly as a decision theory problem, the rational choice is very likely to be buying the insurance even if more money is spent.
NB. It is also easy to adjust the fine as experience dictates with routine legislation, and all such major legislation is modified after the fact. The apparent belief that mid-course adjustment will not occur is profoundly unrealistic.
Starships were meant to fly, Hands up and touch the sky - Nicky Minaj
So you think you'll wait until your sick to buy insurance. Ok.
If you get a chrnoic illness that requires ongoing treatment, having set aside the money you would've spent on premiums to cover the initial treatments before you can process the purchase of insurance, then I suppose you win. Hope it doesn't happen before you've had time to set aside enough money. For anything serious it's going to take many years of savings on premiums even if you don't spend any of that sweet money you're planning to pocket.
On the other hand, if you get an acute illness, you lose. You'll pay for the treatment on your own because you'll be treated before your coverage becomes effective. Sure, the insurance company can't deny you coverage, but do you really think they're going to pay bills you'd already received? Better think twice.
You're worse off still if you get in an accident. A few years ago I went to the ER because a bicycle had run over me. (After dark, bike had no lights and was on the sidewalk. And I think the cyclist was drunk.) Because I was insured, I paid the hospital $100. If I were uninsured, I wouldn't have had a chance to buy coverage for the emergency treatment I received. Instead, I would've been handed a hospital bill for over $10,000.
Also, insurance covers this thing called "preventative care". It's one of the most effective ways to reduce your odds of getting severely sick. Since your plan is to avoid paying for insurance until you need it, I assume you won't want to erode those savings by getting the preventative care that the insurance would otherwise be covering for you. You might want to consider that while you might pay something like $20 to see your doctor, that isn't what you'll pay to see him if you're uninsured.
If you do eschew preventative care, the odds increase that sooner or later you will get sick enough to (1) be unnecessarily miserable, and (2) have some nasty bills to cover while you scramble to find last-minute coverage.
This still sounding like a good gamble to you?
For reference, on average, Health Insurance companies are running about a 3.5% profit margin.
And LoTR lost money. As did all the Spiderman movies. I spent a lot of time in my middle paralegal years working on litigation in opposition to Insurance Companies, and I simply do not find anything they say as the least bit credible. Bitter and/or cynical? Sure, but, believe me, it was well earned.
If brevity is the soul of wit, then how does one explain Twitter?
1) 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.
Insurers have new regulations. First, 85% of revenue must go towards providing care, which caps administrative costs (and profit) at 15%. This isn't a huge difference from the current system; most insurers keep similar margins, and grow revenue through volume. It sounds crazy, but insurers actually depend on doctors and hospitals doing too many tests and procedures.
Second, health insurers are no longer protected from anti-monopoly laws. This should actually help, because currently most regions are locked into 1 or 2 insurance choices.
2) What will stop the insurance companies from making their own rules that slowly erode the value of coverage by limiting the treatments that they pay for?
The bill has pretty specific requirements for what plans can be eligible for assistance and/or tax credits. I.E. You can't start a health insurance company that just hands out band-aids. Additionally, there will be expanded eligibility for Medicare and insurance exchange programs; competing for customers will keep insurers from cutting too much.
3) How will someone who is poor be ensured the same treatments as someone who is wealthy?
That doesn't even happen in Canada--the wealthy can always turn to medical tourism if they want special treatment. The poor will still get inferior care, but inferior is better than non-existent or bankrupt.
So tell me - why has every other first world nation been able to implement universal coverage? Why have so many of those nations consistently beaten the US in virtually every measure of health care efficacy? Why have so many of those nations consistently beaten the US when it comes to quality of life, child mortality rates, and lifespan?
If reforming healthcare is such a bad, awful, wrong thing to do that will ultimately wind up in some kind of small-business apocalypse, why has virtually every other nation on Earth who's tried it wound up in a pretty enviable spot, health-care wise?
Or, put another way, why do you think Americans are incapable of doing something virtually every other major nation has managed to do?
I keep on hearing people say this will be bad, yet I keep on seeing examples in the real world of it working pretty well - so all I can figure is that you guys seem to think we're just not as good as everyone else since you think it'll cause such huge problems for us.
Since I can't tell them apart, I treat all ACs as the same person.
Before yesterday, you could choose to live "off the grid". You could grab some stuff, head out for the mountains, build a shack, and provide for yourself.
Whose mountain land would you be building that shack on? Scavenging and/or farming on? fishing/hunting on?