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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.

97 of 2,424 comments (clear)

  1. health insurance is like auto insurance now by alen · · Score: 4, Insightful

    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

    1. Re:health insurance is like auto insurance now by osgeek · · Score: 5, Insightful

      Right, it's a question of which is cheaper; the fine or the insurance.

    2. Re:health insurance is like auto insurance now by i_ate_god · · Score: 5, Insightful

      You get your kraft dinner and a shack paid for, you don't get a nice meal and a house with a large screen tv and high speed internet and fancy clothes paid for.

      --
      I'm god, but it's a bit of a drag really...
    3. Re:health insurance is like auto insurance now by houghi · · Score: 5, Informative

      I live in Belgium, where we have health insurance and auto insurance and bicycles and none of the problems you imply. My parents live in Spain and also none f those issues. My sister in Germany? No problems there.

      --
      Don't fight for your country, if your country does not fight for you.
    4. Re:health insurance is like auto insurance now by DavidShor · · Score: 5, Insightful

      That's actually how it worked pre-bill, the poorest people qualified for Medicaid, and so the only way for a lot of people after they got sick was to get health-care was to stop working. Now you'll be able to buy subsidized insurance (or pay the fine), get health-care, and still be able to keep your job and make money. The subsidy's decrease smoothly enough with income so that the marginal return to money is almost always positive. So it would never make economic sense to make less money in order to make it back in health-care benefits. Seems like a big improvement...

    5. Re:health insurance is like auto insurance now by mikerz · · Score: 5, Insightful

      How do you figure? Some of these regulations mirror the auto insurance industry regulations. The logical outcome of forcing restrictions on companies, and who they must do business with is simply that their operating costs go up, and they charge more (right now, insurance makes 2-3% profit margin while pharmaceuticals make huge excesses of money off of lifestyle drugs).

      Anyway, this reform bill has everything to do with politicians wanting more control over the system and nothing to do with actually lowering prices. Government is a legalized mob, practically by definition -- it's just that we as a people are willing to listen to it. If you are suggesting those who put this bill into play did so for any kind of altruistic reason -- consider the context of their political ambitions (no one goes into politics to help people, they go into politics to control people).

    6. Re:health insurance is like auto insurance now by iapetus · · Score: 4, Funny

      Yes, but you're all communists living under oppressive regimes that stifle individual creativity and deny people the impetus and ability to make the use of their God-given talents, instead encouraging laziness and crime.

      --
      ++ Say to Elrond "Hello.".
      Elrond says "No.". Elrond gives you some lunch.
    7. Re:health insurance is like auto insurance now by insufflate10mg · · Score: 4, Insightful

      The next generation will read about the status quo before yesterday and will be appalled; they will be proud that the US took steps towards regulating the out-of-control private insurance companies. The Republicans will not repeal this legislation because once the people of the US find out what this bill entails they will defend it like they do Medicare and Social Security.

    8. Re:health insurance is like auto insurance now by Anonymous Coward · · Score: 5, Informative

      I recently lived off of food stamps and eat nothing but organic frozen/canned/fresh vegetables, and the occasional choice cut of meat, exactly how I ate/eat without assistance. I rarely spent half of the money given for food.

      The health insurance given to me was in a higher league than what I use to pay $410/mo for from Blue Cross Blue Shield. I was able to get some dental fillings done, get my eyes checked, not pay outrageous amounts for random things they did not cover.

    9. Re:health insurance is like auto insurance now by DJRumpy · · Score: 4, Informative

      You haven't done much homework if you think you'll be paying that much living paycheck to paycheck. The bill would fine someone who can afford coverage but refuses to. Folks who can't afford it will get subsidies to defray the costs. Typically people who can't afford insurance just create catastrophic care costs because they wait too long and then show up at their local emergency room, so even the managed care option for those where the government fronts the bill should be a little more manageable.

      This will also prevent folks from gaming the health care system and making those of us that do pay for insurance cover their costs like folks used to with welfare. I'm also pleased about the pre-existing condition clauses which, being in IT, always makes me nervous considering how easy it is to lose your job to India these days. At least there will now be options to get insurance when you are unemployed.

    10. Re:health insurance is like auto insurance now by atchijov · · Score: 5, Informative

      this is not true. take a look at this http://www.washingtonpost.com/wp-srv/special/politics/votes/house/finalhealthcare/?nav=rss_email/components If you sort by amount of contributions, you will see that health care industry spread its $$$ almost evenly between Dem and Rep. Also, you will see that amount of contributions from healthcare industry does not really correlate with Yes/No vote on HCR.

    11. Re:health insurance is like auto insurance now by Wonko+the+Sane · · Score: 5, Informative

      The insurance industry has been fighting AGAINST ANY CHANGE by throwing money to every/any one except to the Democrats

      BULLSHIT
      Are you paid to spread this disinformation or are you just a useful idiot?

    12. Re:health insurance is like auto insurance now by timeOday · · Score: 5, Insightful
      In other words, the system worked perfectly. Your life wasn't thrown into utter turmoil, you didn't have to short-sale your home or default on your mortgage, your family didn't go hungry, and you found a job before these limited-term unemployment benefits (that you've always paid into when you were working) expired.

      And you're whining about it.

    13. Re:health insurance is like auto insurance now by Hatta · · Score: 5, Insightful

      That's exactly why we needed a public option. If your costs go up, blame the Republicans who killed it.

      --
      Give me Classic Slashdot or give me death!
    14. Re:health insurance is like auto insurance now by SteveFoerster · · Score: 5, Insightful

      If i understand the US-founders correctly they had a country in mind where everybody is equal and even the poorest have right to a respectable life in America.

      Then I think you partially misunderstand them. They had in mind a country where everyone is free, not equal. There's a difference. The idea is that freedom allows people to reach their own potential and to pursue happiness in their own way, not that it guarantees three hots and a cot, and free healthcare, and the "right" to broadband, and so forth and so on.

      So no, universal health care is not what they had in mind. They were rightfully skeptical of government in a way that we, to our detriment, have forgotten.

      --
      Space game using normal deck of cards: http://BattleCards.org
    15. Re:health insurance is like auto insurance now by Mashdar · · Score: 5, Insightful

      Yeah. While we're at it, lets abolish fire departments and police stations. It's not fair that I'm being forced to help some dude down the street when his house is on fire or some old lady when she gets robbed and shoved and breaks her hip.

      Seriously... All government services are meant for the betterment of society, and picking and choosing which ones you use is the tragedy of the commons at work. It is in everyone's best interest to maintain a healthy and productive workforce.

    16. Re:health insurance is like auto insurance now by twistedsymphony · · Score: 4, Insightful

      The immigration system is even more screwed up than the insurance system. As someone who personally knows a few "illegals" (not for any lack of want) I can tell you that the way this country handles immigration is just as messed up and backward as any other major federal policy.

      Take my friend, lets call him Tom.. He was born in Japan, both his parents were Japanese, When he was 3 his mother married an American soldier and he was adopted by his step father and moved to the US with a permanent visa. When he was 17 he moved back to Japan for 10 years, during that time he met a Japanese woman and got married. he Moved back to the US at age 27 and was told that he needed to renew his visa since the information on his paperwork was still from when he was 3. Around this time he and his wife applied to become citizens. Since his wife didn't have a permanent visa she was only able to stay in the country a few months at a time before going back to Japan. She always left early to avoid any issues with her "overstaying her welcome" in the eyes of the department of immigration. Unfortunately the new visa they issued him had an expiration date and even though he submitted to have it renewed Immigration never approved the paperwork.

      His Visa has since expired and he hasn't been issued a new one, the best advice the local Immigration office can give him is to "lay low until it's all worked out"... that is a direct quote, He's technically been "illegal" for 5 years now. They also refuse to let his wife back into the country because "she has too many contacts" and as such is "at risk of becoming an illegal". It's now been 12 years since they applied for citizen ship, they've spend THOUSANDS on legal fees trying to get the paperwork pushed though the system and they're pretty much followed every rule in the book save for Tom not leaving the country when his Visa expired, but then he still followed the advice of the local Immigration office.

      He speaks English better than most natural born American citizens I know. He's incredibly smart (was accepted to MIT but decided to go to school in Japan, which is why he went back). He's also an extremely well matured and hospitable guy. He would give you the shirt off his back if he thought you needed it. Now consider that some schmuck from another country can enter illegally, not speak a word of english, not have any worthwhile qualities to themselves, and not even make any attempt to play by the book can sneak into the country, pop out a child and get a free pass to citizenship....

      How messed up is that?

      My Friend "Tom" isn't the only one in this situation either, it boggles my mind how nearly impossible it is to legally obtain a greencard in this country unless you decide to just pop out a kid on American sol.

    17. Re:health insurance is like auto insurance now by ffreeloader · · Score: 4, Interesting

      Ummmm.... Have you ever dealt with a hospital's debt collection system? Going to a hospital and getting treated without insurance for something major will drive you into bankruptcy by the time the hospital is done with you. They will take you to court, then garnishee enough of your wages so that you can't pay for food and shelter, thus forcing you into bankruptcy which is a major negative.

      I've had hospitals come after me when I wasn't even the one responsible for the bill. Once a hospital came after me for a niece's bill. It took months of fighting with them to get them to back off.

      Another time an employer who was self-insured rather than pay for Workman's Comp sent me to a hospital for testing in a labor dispute over retraining after I became ill due to working conditions and had to change occupations. The employer went bankrupt two years later and never paid the hospital bill. The hospital came after me 5 years later and I finally had to hire a lawyer to stop them from collecting not only the original bill, but interest, fees, and penalties that more than doubled the bill. Even that didn't stop them. They came after me again 2 years later with an even larger bill and I had to go through all the same shit all over again.

      This horseshit that anyone can just go to the hospital and get treated for free is ridiculous. If you don't pay there are major consequences in your life and hospitals will make sure you pay those consequences.

      --
      "while democracy seeks equality in liberty, socialism seeks equality in restraint and servitude." de Tocqueville
    18. Re:health insurance is like auto insurance now by cpt+kangarooski · · Score: 5, Insightful

      I would also add, no matter how poor you are, you don't have a right to your neighbors' money.

      Well, there is, of course, a pragmatic argument to be made. People understand that it's wise to have a fire department to keep fires from spreading, growing out of control, and burning down entire towns as used to happen. A modest investment protects against possible catastrophic loss, which is even better than merely being compensated after the fact for such a loss.

      Think of the cost of providing a decent minimum standard of living for your countrymen as being a way to protect against violent revolution. The US came close to this in the 1930's, and if we had not had the New Deal, we very well might have one that would be far worse for wealthy people than anything FDR did.

      So if those neighbors would like to keep most of their money, a modest investment is not such a bad idea. Given that there's usually a whole lot more poor people than rich people, and given that a large enough group of people have a perfect right to reorganize their government and society as they see fit, but that contentment doesn't cost a lot (no one wants strawberries and cream here, just honest work, a decent living wage, a reasonable standard of living, including access to health care when needed, particularly preventative care), it's not a bad idea at all.

      You might say that this sounds ugly, and if the problem is left to fester, it can be. But that's the reality of the situation. Ignoring it for whatever reason -- the 'let them eat cake' approach -- has predictably bad outcomes.

      --
      -- 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.
    19. Re:health insurance is like auto insurance now by commodore64_love · · Score: 5, Insightful

      Rather than guessing why don't we just ASK James Madison, the man who authored the Constitution? He knows better than anybody what he meant when he scribed the words on the page:

      "With respect to the words "general welfare," I have always regarded them as qualified by the detail of powers connected with them. To take them in a literal and unlimited sense would be a metamorphosis of the Constitution into a character, which there is a host of proofs, was not contemplated by its creators."

      "I cannot undertake to lay my finger on that article of the Constitution which granted a right to Congress of expending, on objects of benevolence, the money of their constituents...." James Madison as he vetoed a bill.

      "There is nothing more natural than to begin with a general statement and then qualify it with specifics. [In other words read the WHOLE sentence, not just the first clause.] If Congress can do whatever in their discretion can be done by money, and will promote the General Welfare, the Government is no longer a limited one, possessing enumerated powers, but an indefinite one." James Madison.

      And if you still have doubt, just read the Constitution itself:

      "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." "The Tenth Amendment is the foundation of the Constitution." Thomas Jefferson

      --
      "I disapprove of what you say, but I will defend to the death your right to say it." - historian Evelyn Beatrice Hall
    20. Re:health insurance is like auto insurance now by cayenne8 · · Score: 4, Insightful
      Trouble is...the Federal govt. really doesn't have the constitutional power to mandate that every citizen purchase insurance or anything else really. The state attys and others are already lining up to challenge this aspect of the bill based on 10th amendment and other considerations.

      I have a feeling this will go all the way to SCOTUS and likely be thrown out, maybe this will be a good thing after all, as that the feds have been running roughshod over the 10th amendment for a long time now.

      I mean, they had to pass an amendment to let the feds tax income, which should there be any LESS requirement for them to force a citizen to buy something or pay a fine?

      --
      Light travels faster than sound. This is why some people appear bright until you hear them speak.........
    21. Re:health insurance is like auto insurance now by kainewynd2 · · Score: 4, Informative

      Gun laws are illegal for starters but hey, why let a little thing like that prevent the government from centralizing and wresting power from the hands of the people. I for one find a nation where the government has no need to fear the people very scary indeed.

      No offense, but what the hell are you talking about?

      As some others pointed out already: it is not illegal to own a gun. You have to go through an established process to get them because GUNS ARE DANGEROUS.

      That said, why don't you just go buy a .22 rifle? There are pretty much no restrictions, no background check or anything else in place (in NY, at least)? Hell, I know someone who is on anti-depressants who walked in and walked out with a .22 rifle.

      But that isn't what you want, is it? You want a 3.06, an automatic/semi-automatic assault rifle, or a high-powered handgun.

      Everyone always forgets the first part of the second amendment:
      A well regulated militia being necessary to the security of a free State, the right of the People to keep and bear arms shall not be infringed.

      I'm not aware of the legal precedent since its inception, but to me, that statement means that I should be happy to have the privilege to purchase arms given that I'm not part of a "well regulated militia."

      If I were doing the interpretation here, I'd say that if you want to own weapons, you should join the National Guard, but that's just me.

      --
      I just don't get... eh, ugh... never mind. This post wasn't worth the research I put into it.
    22. Re:health insurance is like auto insurance now by DJRumpy · · Score: 4, Insightful

      They know what's in the bill. The points have been debated endlessly for over a year with many congressmen and women putting their job on the line for it. To claim they don't know what's in it due to the number of pages is ridiculous. I can read a 2000 page novel in a weekend and give you a very detailed outline of what's in it. It also wasn't a very good 'closed door' meeting if every deal made in the meeting is published in the bill now is it? Considering we all knew what was discussed the same day also makes that argument a little silly. The political buzzards were circling within minutes, and folks in the room were actively tweeting about the discussions going on like the various deals being discussed. Any detail discussed behind closed doors is in black and white, and you can bet that any opponents of the bill will go over every letter of the bill with a fine tooth comb. There is no hiding what's in it.

      I find these claims about the number of pages rather stupid not to put too fine a point on it. One of the primary reasons lawyers thrive is due to ambiguity in law. "Thou shall not kill". Kill what? Only people? What about animals? What if there are religious rights in involved? Have we thought about the children? Have we though about the chickens? Law is messy, and needs very complex verbiage to define what's what.

      I would rather have very specific terminology in a bill this complex, rather than some ambiguous concept that will be abused as was not intended in the original bill.

    23. Re:health insurance is like auto insurance now by NeutronCowboy · · Score: 4, Informative

      What's with people calling others liars so quickly? Every time someone does that and I look into it, it turns out that whoever yelled liar the loudest was the one most full of shit.

      Here's how it actually breaks down, starting with the Washington Post:
      * top three contributions are to democrats, with roughly $10.5M between them
      * next five contributions are to republicans, with roughly $14M between them.
      After that, it's a pretty even distribution.

      Opensecrets shows something similar:
      * 2010: 58% to democrats
      * 2008: 54% to democrats
      * for the next time that the health industry spent less than roughly 60% on republicans, you have to look back to.... 1994.

      Notice something there? Right - it correlates wonderfully with whoever controls the House and Senate.

      In other words, the health care industry gives to whoever is in power, with the percentage distribution correlating nicely with the distribution of party affiliation.

      So just for emphasis, I'll state it again: the single biggest indicator for how much contributions a party gets is how many seats that party holds. No shit, Sherlock. And just because it pisses me off, I'll repeat this point as well: whoever yells liar the loudest is generally the biggest liar.

      --
      Those who can, do. Those who can't, sue.
    24. Re:health insurance is like auto insurance now by superdave80 · · Score: 4, Insightful
      The real problem I have with this 'you must buy health insurance or else' clause, is the fact that I now have to pay money for the right to be a citizen of this country.

      This has never existed before. All previous taxes/fees/mandated insurance were based on you doing/earning something first:

      Income taxes: Only if you earn money

      Auto insurance: Only if you drive a car

      Property taxes: Only if you own property

      Now, however, the second you become an adult in this country you have to pony up money to the government or insurance company, or else you will be fined.

    25. Re:health insurance is like auto insurance now by ultranova · · Score: 4, Insightful

      they will defend it like they do Medicare and Social Security.

      Yes and like the Bernie Madoff ponzi scheme, they are doomed to collapse as the number of recipients exceed the number of new entrants to the pyramid. I certainly won't defend either of these programs.

      Social Security and Medicare are not ponzi schemes any more than, say, road maintenance is. A ponzi scheme collapses because everyone expects to get out of it more money than they paid into it and there is no productive activity being done with the money (if there is, it's a normal and legitimate investment firm). A social scurity program is simply a state-run (and often tax-funded) insurance program, where the average participant ends up putting in as much or more money than withdrawing.

      --

      Forget magic. Any technology distinguishable from divine power is insufficiently advanced.

    26. Re:health insurance is like auto insurance now by aztektum · · Score: 5, Insightful

      What a myopic view. Fine, keep all the money you earn, every penny. But please be moving to your own private island and stop using my public services. Get off my internet, it was invented by the Government in case you've forgotten. I can only imagine what the corporation created internet would look like. AOL but worse? Where you can only say, read and discuss what they choose so as not to offend and push away customers?

      Stop driving on my interstates, again taxes at work.

      No more postal services for you. Shit almost every business in existence these days has been the benefit of tax dollars, or rebates/credits. So fuck you and stop buying our products.

      You are no longer allowed to participate. Have fun with that.

      --
      :: aztek ::
      No sig for you!!
    27. Re:health insurance is like auto insurance now by binary+paladin · · Score: 4, Insightful

      Indeed.

      Republicans are only fiscal conservatives when they aren't in power.

      Democrats only give a shit about the "working class" when they aren't in power.

    28. Re:health insurance is like auto insurance now by steltho · · Score: 4, Informative

      The real problem I have with this 'you must buy health insurance or else' clause, is the fact that I now have to pay money for the right to be a citizen of this country.

      This has never existed before. All previous taxes/fees/mandated insurance were based on you doing/earning something first:

      Income taxes: Only if you earn money

      Auto insurance: Only if you drive a car

      Property taxes: Only if you own property

      Health Insurance: Only if you earn money

      There, fixed that for you. The health insurance mandate does not apply to people with low income. You will only have to pay money if your income is high enough.

    29. Re:health insurance is like auto insurance now by mea37 · · Score: 5, Informative

      Interesting, except one thing.

      If you don't make enough money that you have to pay income taxes, you're exempt from the fine. Even then the fine is capped based on your income level.

      In other words, the argument of "only if you earn money" argument that you applied to income tax, applies to this fine as well. The idea that you are liable for this fine "the second you become an adult" is incorrect.

  2. Hoorah! by Anonymous Coward · · Score: 5, Insightful

    Congrats US citizens! You're on your way to a non-broken health care system!

    1. Re:Hoorah! by SimonTheSoundMan · · Score: 4, Insightful

      I agree. It should be a day to celebrate in America.

    2. Re:Hoorah! by damn_registrars · · Score: 4, Insightful

      Congrats US citizens! You're on your way to a non-broken health care system!

      We could only be so lucky. This bill by and large doesn't change anything. Most of us have health insurance that we purchase through our employers, provided by insanely profitable corporations. And for almost none of us will that change.

      Unfortunately our government doesn't do change this year.

      --
      Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
    3. Re:Hoorah! by DavidShor · · Score: 5, Insightful
      Removal of life-time spending caps, ban on discrimation for people with pre-existing conditions, hundreds of billions of dollars worth of subsidies paid for by taxes on the rich, and strict limits on the profitability of Insurance companies (85% of premiums must go to actual care, not administrative fees).

      .

      Also, over the next decade, the exchanges will get larger and larger. The exchanges are the market place where insurance companies will place bids on standardized plans(The idea is that by pooling everyone together and creating standards, we can avoid the market inefficiencies that currently plague the individual market). It's originally only open to small businesses and the poor, but the it ramps up to the rest of the population in a fairly quick time-frame. That, combined with the excise tax which effectively phases out the tax exemption of health-care, puts us on a path away from employer provided health insurance.

      You can argue whether that's positive or negative, but that it indisputably moves us away from the employer-based model with very profitable insurance companies.

    4. Re:Hoorah! by Above · · Score: 4, Insightful

      You clearly don't understand our politicians ability to screw something like this up.

      [Waits to see if this gets modded funny or insightful.] *sigh*

  3. Pro / cons by MistrX · · Score: 4, Interesting

    Not being a USA citizen, I can't think of any reason why this bill is controversial.
    What exactly are the pro's and cons?

    1. Re:Pro / cons by Cornwallis · · Score: 4, Funny

      The pros are the government gets to tell us even moreso what to do while extorting even more in the form of taxes.

      The cons are the government gets to tell us even moreso what to do while extorting even more in the form of taxes.

    2. Re:Pro / cons by Mr+Thinly+Sliced · · Score: 5, Funny

      From the U.S. population point of view - there are very few people that seem to be against reform.

      This bill in particular has basically been a power play between the two big parties if I understand correctly.

      It didn't really pan out brilliantly for either side - 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 Republican support.

      The lead up to why this silly thing got pushed through can basically be summarised as follows (stolen from Digg - it's a great summation):

      Democrats: "We need health care reform"
      Republicans: "Liberal fascists! Give us a majority and we'll do it better"
      Democrats: "Done, you have majority of both houses"

      12 years later, health care is irrefutably worse in every respect for every single person in the United States

      Democrats: "We need health care reform"
      Republicans: "Liberal fascists! Americans are tired of partisan politics!"
      Democrats: "OK, let's compromise"
      Republicans: "OK, get rid of half your ideas"
      Democrats: "Done"
      Republicans: "Too liberal, get rid of half your ideas"
      Democrats: "Done"
      Republicans: "Too liberal, get rid of half your ideas"
      Democrats: "Done"
      Republicans: "Too liberal, get rid of half your ideas"
      Democrats: "Done"
      Republicans: "Too liberal, get rid of half your ideas"
      Democrats: "Done. Time to end debate"
      Republicans: "Too liberal, we need more debate, we will filibuster to prevent you from voting"
      Democrats: "OK, we'll vote--sorry guys, debate is ended. It's time to vote on the bill"
      Republicans: "Too liberal, we vote no"
      Democrats: "OK, it passed anyway--sorry guys."

      One month later

      Republicans: "Wait--wait, OK, we have less of a minority now so we can filibuster forever."
      Democrats: "Sorry, the bill already passed, we need it to pass the House now"
      Republicans: "But we have enough to filibuster"
      Democrats: "Sorry, the bill already passed, we need it to pass the House now"
      Republicans: "Liberal fascists! You haven't listened to our ideas! You've shut us out of this whole process!"
      Democrats: "Sorry, show us your proposal"
      Republicans: "Smaller government"
      Democrats: "That's not very specific"
      Republicans: "OK, here's our detailed proposal--It's our common-sense ideas we spent 12 years not enacting"
      Democrats: "OK, we'll add a bunch more of your ideas"
      Republicans: "Liberal fascists! You included all these back-room deals"
      Democrats: "OK, we'll get rid of the back-room deals"
      Republicans: "Liberal fascists! You're using obscure procedural tricks to eliminate the back-room deals!"
      Democrats: "No, we're using reconciliation, which both parties have used dozens of times for much larger bills"
      Republicans: "Liberal fascists! You're pressuring Congressmen to vote for your bill! Scandal!"
      Democrats: "It's called 'whipping', it's been done since 1789"
      Republicans: "Liberal fascists! Can't you see the American people don't want this?"
      Democrats: "This bill is mildly unpopular (40-50%), doing nothing (your proposal) is extraordinarily unpopular (4-6%)"
      Republicans: "We need to start over! We need to start over!"
      Democrats: "We should really consider voting--"
      Republicans: "Liberal fascists! Start over! Clean slate! Common-sense! America!"
      Democrats: "OK, suit yourselves, here it comes"

    3. Re:Pro / cons by NeoSkandranon · · Score: 5, Insightful

      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)
    4. Re:Pro / cons by Anonymous Coward · · Score: 5, Informative

      This truly is the best and most accurate description of the actual process I've seen.

    5. Re:Pro / cons by dr2chase · · Score: 4, Informative
      Pros
      • No more yanking health insurance when you get sic.
      • No more denying health insurance because you were sick once upon a time.

      It's those two things that make the mandatory bit necessary. Note that all universal health care is mandatory; if you satisfy the rules for "must pay", then you pay. There are subsideis for the poor in this bill, probably not big enough (inadequate subsidies for the poor, a Republican idea to discourage poorness), but they are there. It would have been better to get rid of the health insurance companies altogether (look at the countries that did that, no loss of quality, but it's cheaper), but the Republicans were not that interested in cutting costs (nor were many of the conservative Democrats).

    6. Re:Pro / cons by characterZer0 · · Score: 4, Insightful

      From the U.S. population point of view - there are very few people that seem to be against reform.

      Almost everybody thinks reform is needed. Almost nobody thinks that Congress is competent enough to make good reforms.

      --
      Go green: turn off your refrigerator.
    7. Re:Pro / cons by DavidShor · · Score: 5, Informative
      Come on, it's intellectually dis-honest to not point out that

      1) There are several hundred billions of dollars that provide subsidies to people too poor to afford health-care, with an explicit rule that a family can not be forced to spend more then a certain % of their income on care (I believe it's 15%, but I don't remember the exact number).

      2)The poorest of the poor already receive health care for free in the form of Medicaid, and that Medicaid is being expanded to cover 50% more people

      3)People who pay the fine *gets something* for it. They still have the right to receive emergency care for free. Not only that, but they have the ability to purchase insurance if they ever get sick without paying an enormous bankrupcy-causing penalty for having a pre-existing condition.

      "And that will - and this is the intent of the "insurance" crooks that drew up the bill - create a market for "Never Pay" cover, i.e. schemes that appear to meet the absolute minimum requirement, but which have such egregious exclusions and excess contributions that you'll never use them. In effect, free money for the insurers."

      This is also not true. While there are different types of insurance with different levels of generosity, by law, at least 85% of premiums must be paid out in the form of health-care for any given plan, so "free money" for the insurance company is effectively outlawed..

    8. Re:Pro / cons by commodore64_love · · Score: 4, Insightful

      >>>"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
    9. Re:Pro / cons by Anonymous Coward · · Score: 5, Informative

      No HERE is a better summary:

      Everyone wants better health care, and everyone wants a law, or series of laws, which in some way addresses the problem.

      The dispute comes down to two opposing perspectives on how to fix it.

      The Republican conservatives believe that no taxpayer money should be funding abortions. They also think that the principle reason that healthcare doesn't work in this country is because the cost of health care is too high. They believe this is due to too many people trying to get a "free pass" by not having insurance. It's also due, they think, to a serious problem with "impulse" lawsuits which force doctors to buy an incredibly high amount of malpractice insurance. The Republicans also think that there are way too many procedures, both surgical (angioplasty vs. TPA for heart problems) and diagnostic (too often a large, extremely expensive test is conducted for no good reason). Finally, the Republicans think there is no such thing as a single bill that will fix this. What is required is a gradual, step-by-step series of bills, to be written and implemented over a series of years, to ease us into a new era of health care.

      The liberal Democrats believe that health care costs too much because insurance companies are massive, bloated corporations who are jacking up the price of their premiums so they can squeeze money out of everybody, and work WAY too hard at getting OUT of paying for claims (such as, "you had cancer before you signed up with us, so you'll have to pay for your own treatment" or "you can't go to this emergency room to treat your heart attack, since we won't cover your visit there. You'll have to go across town instead, and hope you can make it there without dropping dead. Are you feeling lucky today?"). For the Democrats, the government needs to get involved in such a way that reminds HMOs that they are in some cases quite literally selling life, as opposed to soap flakes or cheeseburgers. They also don't care much about abortion, and fear that if we don't pass a single bill now, we'll be relying on future sessions of Congress to take up the issue with the same attention, focus and passion that it's getting now. History shows that Congress has not always been able to do this.

      The trouble is, BOTH sides make some VERY good points about what's wrong with health care in this country. What makes Americans like me VERY angry, is that the politicians can't see past their own party lines, which is wrong because we didn't elect them to serve their PARTIES. We elected them to serve the PEOPLE.

  4. H.R. 4789 introduced by Congressman Alan Grayson by Travoltus · · Score: 4, Interesting

    It's a 4 page bill that basically proposes to extend Medicare benefits to everyone from age 0 to age 64 with a simple 'buy-in.' You buy in at cost and you're covered.

    That means no Cigna Corporation sitting around denying you a liver transplant - which cost at least one girl her life.

    Spread the word. This bill got 50 sponsors in 2 days.
    http://www.opencongress.org/bill/111-h4789/show
    http://www.open.salon.com/blog/brinna_nanda/2010/03/10/a_public_option_we_can_all_love_hr_4789

    --
    --- Grow a pair, liberals... stop letting the Republicans bully you!
  5. Mixed feelings by Ma8thew · · Score: 4, Insightful

    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.

  6. Ironic by Burpmaster · · Score: 4, Insightful

    It was the "right to life" people that threatened to block life-saving medical care for millions.

  7. Unintended consequences? by OzPeter · · Score: 4, Interesting

    Not really a total troll here, but I have heard that people like Rush Limbaugh have stated that they would leave the US if this bill was passed. Not that he will be missed by me, but are there people who are now seriously considering emigrating because they believe the government has failed them? I know that there have been a lot of trash talk from right leaning people along the lines of "if you don't like it here then leave", but I am curious to know what will happen now that the boot is on the other foot. Maybe it could be a good poll?

    --
    I am Slashdot. Are you Slashdot as well?
  8. Not citizens, just cars, ode to Detroit. by GuyFawkes · · Score: 4, Insightful

    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
  9. Re:So the government is forcing me to buy somethin by Ma8thew · · Score: 5, Insightful

    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.

  10. patriotism and morality and freedom won by circletimessquare · · Score: 4, Insightful

    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
  11. Re:Not reform, capitulation. by je+ne+sais+quoi · · Score: 5, Insightful

    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!
  12. Re:So the government is forcing me to buy somethin by OzPeter · · Score: 5, Insightful

    "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?
  13. Re:So the government is forcing me to buy somethin by ShadowRangerRIT · · Score: 5, Insightful

    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
  14. Re:Stop calling it 'insurance' (or update Wikipedi by Palestrina · · Score: 5, Insightful

    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.

  15. Medicare's operating costs: 2 to 3% by Nicolas+MONNET · · Score: 4, Informative

    Typical private insurer: 15 to 30%

    Of course, if you define "efficiency" by the ratio of things they decline to cover, sure, they're way more efficient.

  16. yay insurance by Bobtree · · Score: 5, Insightful

    Now they should try a health care bill.

  17. Re:Really? by Ma8thew · · Score: 5, Insightful

    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.

  18. The only thing missing... by copponex · · Score: 4, Insightful

    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?

  19. what happens if you drive without car insurance? by circletimessquare · · Score: 4, Insightful

    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
  20. Yes it does change things by sjbe · · Score: 5, Insightful

    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.

    1. Re:Yes it does change things by Runaway1956 · · Score: 4, Insightful

      Ditto here, my freind. But, there are millions of Republicans lined up, waiting their turn to call us both "LOSERS!"

      I remember when that Cobra (or, Corba?) thing was passed, making it possible to keep your health insurance between jobs. Big joke. My insurance was costly while I was employed. When I was laid off, the price quadrupled. Jesus H. Christ! It looked good, when it was being tossed around by the politicians. In reality, it was just another cruel way for the rich bastards to let me know they had really stuck it to me!

      --
      "Windows is like the faint smell of piss in a subway: it's there, and there's nothing you can do about it." - Charlie Br
  21. Re:Brilliant Plan by Wonko+the+Sane · · Score: 4, Insightful

    All you have to do is make damn sure that you don't bail out the insurance companies when they go bankrupt.

    You're funny. Have you seen how much those companies have contributed in bribes?

  22. The Bill and the Economy by DiniZuli · · Score: 4, Informative

    The text of the bill:
    http://www.opencongress.org/senate_health_care_bill

    The economy of the bill:
    http://cboblog.cbo.gov/?p=508

    Congrats from Europe :)

  23. It's not that simple by sjbe · · Score: 4, Insightful

    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).

  24. Re:Beware, lawmakers: November is coming. by Ma8thew · · Score: 5, Insightful

    The Democrats ran on the platform of healthcare reforms. And they won! By a sizeable margin! This is what we call a mandate.

  25. Re:what happens if you drive without car insurance by nedlohs · · Score: 4, Insightful

    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.

  26. Non-American: questions by fluffernutter · · Score: 5, Interesting

    I'm confused about this bill... Some honest questions:

    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.
    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?
    3) How will someone who is poor be ensured the same treatments as someone who is wealthy?

    From what I have been reading, these have been the biggest issues with US health care, does the bill do anything about this? Making sure 'everyone has something' seems to be a drop in the bucket to me; or am I missing something?

    Please don't label me a troll for these questions.. I think they are important questions.

    --
    Laws are rules for the court, but merely a bottom bar to hit for life. Think beyond laws in your actions always.
    1. Re:Non-American: questions by fullfactorial · · Score: 4, Insightful

      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.

  27. Re:what happens if you drive without car insurance by dunkelfalke · · Score: 4, Insightful

    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
  28. Re:It is surprising to me by Orgasmatron · · Score: 4, Insightful

    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?
  29. Re:Health insurance is a tax now by elrous0 · · Score: 5, Insightful

    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.
  30. Re:It is surprising to me by copponex · · Score: 5, Insightful

    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!

  31. Re:Beware, lawmakers: November is coming. by Cro+Magnon · · Score: 4, Insightful

    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.
  32. Re:So the government is forcing me to buy somethin by lwsimon · · Score: 4, Insightful

    selfish libertarians

    You, sir, are too kind. Compliments such as this truly lighten a dark day.

    --
    Learn about Photography Basics.
  33. Not until 2014 by elrous0 · · Score: 4, Interesting

    The biggest problem I see with this bill is that it doesn't take effect until 2014. That gives Republicans/Insurance plenty of time to repeal it long before anyone gets to see *any* benefit from it. By 2014 we could well have already had a year of complete Republican rule (White House and Congress), and you know if they retook the White House and Congress, repealing this would be number 1 on their agenda.

    --
    SJW: Someone who has run out of real oppression, and has to fake it.
    1. Re:Not until 2014 by portnoy · · Score: 5, Informative

      But there are provisions that will take place immediately -- things like making sure that young children can't be denied from a new plan due to a pre-existing condition, prohibit dropping people from a plan when they get sick, letting dependents stay on their parents' policies until the age of 26, adding tax credits to small businesses to allow for coverage purchase. It would be pretty easy for Democrats to spin taking those things away as a bad thing.

  34. Re:Health insurance is a tax now by ShakaUVM · · Score: 4, Insightful

    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.

  35. Re:It is surprising to me by EzInKy · · Score: 5, Informative

    "We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare..."

    Does not guaranteed healthcare promote the "general welfare" of American citizens?

    --
    Time is what keeps everything from happening all at once.
  36. Here's the rates and how they went up by year. by Chemisor · · Score: 4, Informative

    The $6400 is just an average I saw somewhere. I can't find that article; however, here's a breakdown on employer provided plan costs. Your employer pays $4824 for just you, or $13375 for a family plan. Since individuals buying health insurance don't have as good a bargaining position, I would expect the premiums to be much higher, and $6400 sounds about right. Note the $13375 figure for the family plan, which is what most people will be buying.

  37. Re:Not gonna happen by brian0918 · · Score: 4, Insightful

    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.

  38. Re:what happens if you drive without car insurance by Just+Some+Guy · · Score: 5, Insightful

    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?
  39. Re:So the government is forcing me to buy somethin by Ma8thew · · Score: 4, Insightful

    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.

  40. Re:Not gonna happen by Fnkmaster · · Score: 4, Interesting

    In the state of New York, I had to purchase health insurance for my mother at one point in time. She was 52 years old, and based solely on that fact, I had to pay about $9000 a year for Blue Cross/Blue Shield coverage for her. That was back in the early '90s.

    Just looked up the current rates. As of mid-2009, the Direct Pay HMO rates are $1110 per month and the Direct Pay POS plan rates are $1400 per month. That is in the range of $13,000 to $17,000 per year, for an individual plan, if you live in New York City.

    A family plan is $3500-$4500 per month.

    Think this is crazy? See here. Individual health insurance plans have increased by an insane amount in the last 10-15 years. The cheapest, crappiest HMO plan where you have limited doctor choice, etc. is $750-$800 a month, more than $9,000 per year. And if you go with the cheapest possible option, you know it will suck.

    So basically, you don't know what you are talking about.

  41. Re:Health insurance is a tax now by cpt+kangarooski · · Score: 4, Insightful

    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.
  42. Re:Not gonna happen by Shadow+Wrought · · Score: 4, Insightful

    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?
  43. Re:what happens if you drive without car insurance by circletimessquare · · Score: 5, Insightful

    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
  44. Re:Not gonna happen by careysub · · Score: 5, Insightful

    ... 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
  45. Re:Not gonna happen by mea37 · · Score: 5, Insightful

    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?

  46. Re:Not gonna happen by Shadow+Wrought · · Score: 4, Insightful

    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?
  47. Re:Health insurance is a tax now by Captain+Splendid · · Score: 4, Interesting

    You're right - Nature IS callous - everybody dies.

    I used to be just like you. Survival of the fittest, I'll fight whatever or whomever to pass my genes on. Dog eat dog...

    And, while most of that is still very relevant today, it's fucking 2010. We have the means, we have the technology to at least start thinking differently.

    Even as a liberal pussy, I will completely back up the assertion that socialism is at least some form of theft.

    But we don't live in caves anymore, or shit ourselves when lightning strikes. Maybe there's some other things we should look a doing differently too.

    --
    Linux, you magnificent bastard, I read the fucking manual!
  48. Re:Health insurance is a tax now by thesandtiger · · Score: 4, Insightful

    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.
  49. Re:what happens if you drive without car insurance by Zzesers92 · · Score: 4, Insightful

    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?

  50. Re:Health insurance is a tax now by fahrbot-bot · · Score: 4, Informative

    2) Tort reform is necessary. ...

    That won't really accomplish much. Even the quickest search reveals that the cost of medical malpractice is less than 2% - a rounding error compared to total costs.:

    • Q. But critics of the current system say that 10 to 15 percent of medical costs are due to medical malpractice.
    • A. That's wildly exaggerated. According to the actuarial consulting firm Towers Perrin, medical malpractice tort costs were $30.4 billion in 2007, the last year for which data are available. We have a more than a $2 trillion health care system. That puts litigation costs and malpractice insurance at 1 to 1.5 percent of total medical costs. That's a rounding error. Liability isn't even the tail on the cost dog. It's the hair on the end of the tail.

    (Tort Reform) "It's really just a distraction," said Tom Baker, a professor at the University of Pennsylvania Law School and author of "The Medical Malpractice Myth." "If you were to eliminate medical malpractice liability, even forgetting the negative consequences that would have for safety, accountability, and responsiveness, maybe we'd be talking about 1.5 percent of health care costs. So we're not talking about real money. It's small relative to the out-of-control cost of health care."

    Annual jury awards and legal settlements involving doctors amounts to "a drop in the bucket" in a country that spends $2.3 trillion annually on health care, Amitabh Chandra, another Harvard University economist, recently told Bloomberg News. Chandra estimated the cost of jury awards at about $12 per person in the U.S., or about $3.6 billion. Insurer WellPoint Inc. has also said that liability awards are not what's driving premiums.

    --
    It must have been something you assimilated. . . .
  51. Re:How many people have read the bill? by Anpheus · · Score: 4, Informative

    I always think it's disingenuous for people to say our bills are X pages long. If you open up the PDF, then copy and paste the text only (no formatting) into your favorite document editor at the default font size, and remove the extra line breaks, you'll see that for every "normal" 1 page you can get 3-4 pages of a bill from Congress. Try it.

    So, realistically the bill is still novel-like long, and yeah it'd be great if the bills were shorter but they do have to deal with complex issues. But it's not actually 2000 pages of dense text, like the Republicans try to make it out to be (by bringing reams of paper to press conferences and saying, "Look at how big this thing is! It's enormous! We haven't read it because we're going to vote no anyway, but hoo-eey, this is a big bill don't you think?"

  52. Re:Health insurance is a tax now by mcgrew · · Score: 4, Informative

    there are also huge tax increases on higher income groups, and the effects will be felt by all Americans.

    That is a fallacy that relies on the "trickle down" theory of economics. Wealth isn't created by the wealthy, it's created by the worker; wealth isn't created by the head of the construction company, it's created by the carpenter. McDonald's stockholders don't create McDonald's wealth, the fry cook does. The constructed house and the hamburger are the wealth.

    Cutting taxes on the rich doesn't help the economy, and raising taxes on the rich doesn't hurt it unless you raise them to insane levels. Cutting taxes (and other costs) for the poor and middle class does help the economy, because they're going to spend that money, putting it right back in the economy. Tax the poor and everyone suffers; less money to buy those houses and hamburgers, as well as more crime.

    And I would posit that the person paying capital gains tax instead of income tax should be paying higher taxes than those truly earning their money, as opposed to gambling on the stock market. When Reagan cut that tax in the '80s it was a boon to the rich, but the orgy of leveraged takeovers hurt the average taxpayer badly.

    The companies that exceed 50 employees on the full time payroll will be forced to pay a fine per employee for lack of health insurance coverage. Will this cause millions of small to medium businesses to budget for health insurance, if they don't already have it?

    If they don't, they have a bad business model. And they should already be insuring their workers. If they can't afford to pay their employees a living wage, they can't afford employees already; they are simply parasites on the system, bringing down competetitors who do treat their employees as human beings instaed of treating them as property.