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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.
Congrats US citizens! You're on your way to a non-broken health care system!
Right, it's a question of which is cheaper; the fine or the insurance.
Why are you letting these clowns ruin our country?
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"
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)
This truly is the best and most accurate description of the actual process I've seen.
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.
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?
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...
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.
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.
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...
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).
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.
The Democrats ran on the platform of healthcare reforms. And they won! By a sizeable margin! This is what we call a mandate.
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..
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.
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.
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!
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.
BULLSHIT
Are you paid to spread this disinformation or are you just a useful idiot?
"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.
And you're whining about it.
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!
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
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?
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.
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.
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.
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.
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
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?
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.
No sig for you!!
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.