The U.S. Health Care Debate

[Strike For The South]

Then I aplogize an he's wrong

[Evil_Maniac From Mars]

Isn't quite alot of this money directed in political ways ? or is that discounted...

I've never heard charity as referring to political parties.

I would hardly call giving Israel money charity (or at least no more than giving Hamas money is charity)

The State of Israel is not giving to charity, giving to things like Israeli hospitals is (and should be).

Is this money adjusted for different wealth between countries ?

This is an American-only statistic for now.

Amount of millionaires and billionaires ?

It is adjusted as a percentage.

Also im sure alot of religious donations go towards keeping churches going and recruiting new members...

Sure, and Churches give a lot of money to the poor as well. You're also forgetting that the Christian left is as big as the Christian right, if not as vocal.

Long story short, the right gives significantly more than the left, in America, based on percentages.

[Don Corleone]

Almost as if according to the Pelosi/Hoyer/Reid/Emmanuel playbook, the healthcare debate in the Org has dropped to the same silent levels elsewhere in society (last post was 6 weeks ago?) What better time to launch the final version of the bill and schedule a rush vote on it?

So, despite promises of posting the material 72 hours prior to a scheduled vote online, Nancy Pelosi finally authorized web publication of HR 3962 (the so-called Affordable Health Care for America Act) in the middle of the night last night.

Due to dissmenination from the staffs of various House members committees, certain information is already known. For example checking in the bill, you can see that all Americans will now be required to belong to a "qualified plan" or contribute 2.5% of their salary to a mandated federal health insurance program. Failure to do so will incur tax liabilities for all uncovered members, and if the IRS determines it to be willful (at their discretion, with no burden of evidence), the offender(s) can be fined $250,000 and jailed for up to 5 years.

http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3962:

Despite being over 1990 pages (8.5" x 11" or A4) when printed out, and only having been released to the public late last night, the vote is tentatively scheduled for later today.

Rumored (and undenied) provisions include: -coverage for elective abortions by all qualified plans; -linguistic & cultural sensitivity counselers at border stations across the southwest. Note: I have NOT had time to investegate these claims, but they come from Lou Dobbs, not Glenn Beck. (At least, Lou Dobbs is my source on them, I have no earthly idea what kind of hay Glenn Beck or Rush are making with this).

This is exactly what I feared.

“H.R. 3962 provides that an individual (or a husband and wife in the case of a joint return) who does not, at any time during the taxable year, maintain acceptable health insurance coverage for himself or herself and each of his or her qualifying children is subject to an additional tax.” [page 1]

- - - - - - - - - -

“If the government determines that the taxpayer’s unpaid tax liability results from willful behavior, the following penalties could apply…” [page 2]

- - - - - - - - - -


“Criminal penalties

Prosecution is authorized under the Code for a variety of offenses. Depending on the level of the noncompliance, the following penalties could apply to an individual:

• Section 7203 – misdemeanor willful failure to pay is punishable by a fine of up to $25,000 and/or imprisonment of up to one year.

• Section 7201 – felony willful evasion is punishable by a fine of up to $250,000 and/or imprisonment of up to five years.” [page 3]

[Strike For The South]

Oh dear. What an abortion of legislation.

[Louis VI the Fat]

Oh dear. What an abortion of legislation.

I would comment on that, but I was taught Americans prefer I don't by my linguistic & cultural sensitivity counseller.

[drone]

Well, after last week it's clear that they need to rush to get this passed before the midterm elections next year.

Pelosi is such a tool...

[KukriKhan]

Oh dear. What an abortion of legislation.

Open yer wallet, Strike. They're gonna get some cash out of you (and your 18-25 brothers), one way or another.

Fix this when you get elected, OK?

[Don Corleone]

So, the bill passed, 220-215. One Republican, John Cao, a freshman from a Democratic district in New Orleans crossed the line to vote for it, 39 Democrats risked Nancy's wrath by voting against it. Their political lives are now not worth a plug nickle, as MoveOn.Org is already actively seeking primary challengers to unseat them.

Last minute changes:

-Conservative Democrats, led by Rep. Stupack inserted a clause into the rules committe that blocked the language that would have required insurance companies (public options or private plans) to provide coverage for elective abortion. The language on this ammendment was included in the final bill, as was a reinstatement of the "conscience clause", a law that prevents facilities from requiring doctors and nurses from performing elective abortions if it runs against their morals. Democratic House leaders are vowing to have Stupack's ammendment stripped from the final bill in the reconciliaiton bill with the Senate, or by line-item veto in the White House, returning a requirement to fund all elective abortions and removing the legal protections for the "conscience clause".

-An ammendment which would have blocked the ability for undocumented workers to participate in the healthcare exchange was removed in order to secure the bill's support by the Hispanic Caucus. Undocumented workers will now be allowed to participate in the government sponsored health care exchanges (the House bill did not have a public option, but the senate one does).

-Nancy Pelosi took a victory lap by introducing a bill and seeing it passed, on a 219-216 vote, that required Republican House members to wear a button depicting a castrated elephant, with the words "We LOST" under it, for the remainder of the 111th Congress (through January, 2011). It will now be a Class A misdemeanor, punishable by a $50K fine and 90 days in jail for a member of the House Republican Caucus to come to the House floor without the button prominately displayed on a lapel.

(Just kidding on that last one).

Seriously, whether you're for Nancy's bill (I'm not talking about actual Health Care Reform) or against it, I'm curious what any of the rest of you have heard about the final version.

Or does anybody even know?

[jabarto]

Can anyone tell me if it's true that insurance is now mandated but nothing has been done to cap premiums? Every source I've read today gives me teh impression that the bill is just a giant handout to the reigning corporate oligarchy.

[Don Corleone]

Can anyone tell me if it's true that insurance is now mandated but nothing has been done to cap premiums? Every source I've read today gives me teh impression that the bill is just a giant handout to the reigning corporate oligarchy.

Yes and no...

Insurance companies got kicked in the goonies....

-They're not allowed to deny coverage for any pre-existing conditions.

-They're not allowed to drop coverage for people while in the midst of being treated for a chronic illness, even if they stop paying their premiums.

-They're now required to charge the same premium to anyone, regardless of their health status.

-Their anti-trust exemptions have been revoked, which means they're not longer allowed to negotiate fixed pricing targets with hospitals and doctors, who are now free to charge whatever they want.

-They are now subject to regular congressional sub-committee review panels.

But, no price caps on premiums were introduced. They just have to charge everyone the same rate. If they had done as you suggest, forcing mandatory premium maximums onto them, in light of all the coverage requirements I listed above, no health insurance company could have survived.

Just out of curiosity, do you know how insurance actually works?

[jabarto]

Yes and no...

Insurance companies got kicked in the goonies....

-They're not allowed to deny coverage for any pre-existing conditions.

-They're not allowed to drop coverage for people while in the midst of being treated for a chronic illness, even if they stop paying their premiums.

-They're now required to charge the same premium to anyone, regardless of their health status.

-Their anti-trust exemptions have been revoked, which means they're not longer allowed to negotiate fixed pricing targets with hospitals and doctors, who are now free to charge whatever they want.

-They are now subject to regular congressional sub-committee review panels.

But, no price caps on premiums were introduced. They just have to charge everyone the same rate. If they had done as you suggest, forcing mandatory premium maximums onto them, in light of all the coverage requirements I listed above, no health insurance company could have survived.

Just out of curiosity, do you know how insurance actually works?

I misspoke, I didn't mean literal caps, more like controls. You know, something to keep the prices reasonable so that the bill isn't just a blank check to the insurance industries.

[Don Corleone]

The bill that just passed the House is anything but a blank check to the insurance companies.

Seriously, do you understand how insurance (of any form) works? Insurance companies collect premiums from a large pool of insured, on the assumption that the majority of them will have no claims, or that their claims will be less than their total in premiums.

SCANDALOUS!!! SCOURGE THOSE CAPITALIST PIGS!!!!

Wait... how about the minority that I didn't mention above? Well, for them, their health (or for that matter, liability) bills might come to 3x, 5x, 10x, maybe more than what they paid in premiums.

People pay (and grumble, granted) health care premiums not because they expect to come out even on the deal, they do it because "what if...". If my costs incurred exceed my means to pay, I'm covered.

If you force the insurance companies to take a haircut on premiums, and simultaneously force them to up their coverage on everyone, you don't have an insurance scheme, you have a wealth transfer.

I'm no apologist for the insurance industry. They've done a lot of malevolent things to gain what I would say is a well-deserved nasty reputation. But don't kid yourself into thinking that money comes out of thin air. An insurance company isn't a cookie jar. If you try to force it to be one, it will simply divest of its health care holdings, and you and I will be paying the health care costs for an Orange County divorcee who believes she needs a 4th reconstructive nose job and breast implants.

If you really want to "reform" health care, you need another oversight committe looking at not-for-profit hosptials that turn 28% profit numbers and doctors that order 3 MRI's to make the loan payment on their sailboat.

And putting an end to WhoCanISue.Com, a website dedicated to helping people who don't even have a case sue anybody, anywhere, any time with no downside risk, wouldn't hurt either. Lemur likes to point to the actual legal cost of lawsuits (most of which get settled btw, specifically to keep the legal costs down) and say "It's not that bad, let the ambulance chasers have their fun", but it goes well beyond that. Doctors and hospitals, who need no encouragement on the matter, end up ordering many more diagnostic tests then even they deem sane, just to keep the slathering lawyers at bay.

[jabarto]

The bill that just passed the House is anything but a blank check to the insurance companies.

Seriously, do you understand how insurance (of any form) works? Insurance companies collect premiums from a large pool of insured, on the assumption that the majority of them will have no claims, or that their claims will be less than their total in premiums.

SCANDALOUS!!! SCOURGE THOSE CAPITALIST PIGS!!!!

Wait... how about the minority that I didn't mention above? Well, for them, their health (or for that matter, liability) bills might come to 3x, 5x, 10x, maybe more than what they paid in premiums.

People pay (and grumble, granted) health care premiums not because they expect to come out even on the deal, they do it because "what if...". If my costs incurred exceed my means to pay, I'm covered.

If you force the insurance companies to take a haircut on premiums, and simultaneously force them to up their coverage on everyone, you don't have an insurance scheme, you have a wealth transfer.

I'm no apologist for the insurance industry. They've done a lot of malevolent things to gain what I would say is a well-deserved nasty reputation. But don't kid yourself into thinking that money comes out of thin air. An insurance company isn't a cookie jar. If you try to force it to be one, it will simply divest of its health care holdings, and you and I will be paying the health care costs for an Orange County divorcee who believes she needs a 4th reconstructive nose job and breast implants.

If you really want to "reform" health care, you need another oversight committe looking at not-for-profit hosptials that turn 28% profit numbers and doctors that order 3 MRI's to make the loan payment on their sailboat.

And putting an end to WhoCanISue.Com, a website dedicated to helping people who don't even have a case sue anybody, anywhere, any time with no downside risk, wouldn't hurt either. Lemur likes to point to the actual legal cost of lawsuits (most of which get settled btw, specifically to keep the legal costs down) and say "It's not that bad, let the ambulance chasers have their fun", but it goes well beyond that. Doctors and hospitals, who need no encouragement on the matter, end up ordering many more diagnostic tests then even they deem sane, just to keep the slathering lawyers at bay.

You're blowing this all out of proportion.

All I did was ask if the clause that mandated you to own health insurance made it in to the final bill (I honestly didn't know) and if so, was anything done to control costs. Because if not, than the insurances companies can charge whatever they want and if you can't pay it you get fined, hence the "blank check" analogy.

[Don Corleone]

By the way, I'm not opposed to the core of the bill that got passed. On the surface, the bill sounds a lot like the Corleone plan I unveiled 2 months ago (require coverage of everyone, subsidize those that cannot afford it). Requiring universal coverage is the one thing that you can do to make certain insurance companies can keep up with all the other demands, and also is the best way to provide coverage for all Americans.

I'm just disgusted with a 1992 page bill getting released 24 hours before its voted on so that a dozens of other items, that have nothing to do with "reforming health care costs" can get rolled into it.

[CountArach]

-Conservative Democrats, led by Rep. Stupack inserted a clause into the rules committe that blocked the language that would have required insurance companies (public options or private plans) to provide coverage for elective abortion. The language on this ammendment was included in the final bill, as was a reinstatement of the "conscience clause", a law that prevents facilities from requiring doctors and nurses from performing elective abortions if it runs against their morals. Democratic House leaders are vowing to have Stupack's ammendment stripped from the final bill in the reconciliaiton bill with the Senate, or by line-item veto in the White House, returning a requirement to fund all elective abortions and removing the legal protections for the "conscience clause".

It should be noted that this was already law since the 1960s (From memory...) and that the vote simply reaffirmed the existing law.

[Crazed Rabbit]

Good God, we're getting in the with a pipe.

Jail time for those who don't but the insurance Pelosi deems necessary! Huge debt incurred. Taxes raised. A great deal of government control of insurance of the practice of medicine. Mandates and idiotic rules destined to raise rates. No ability to buy interstate insurance. Individual insurance still taxed. And the best possible result is a slightly higher percentage of people with insurance.

This isn't about healthcare; it's about control.

CR

[jabarto]

Good God, we're getting in the with a pipe.

Jail time for those who don't but the insurance Pelosi deems necessary! Huge debt incurred. Taxes raised. A great deal of government control of insurance of the practice of medicine. Mandates and idiotic rules destined to raise rates. No ability to buy interstate insurance. Individual insurance still taxed. And the best possible result is a slightly higher percentage of people with insurance.

This isn't about healthcare; it's about control.

CR

You know that the interstate insurance thing is there for a reason, right? If it were an option, the companies would all relocate to the state that allows them to shaft consumers the most.

Also, what exactly is the problem with government control of medicine? It works in every othe rcountry that's tried it.

Not that I'm not disputing most of the rest of what you said , mind you...

[Louis VI the Fat]

-Nancy Pelosi took a victory lap by introducing a bill and seeing it passed, on a 219-216 vote, that required Republican House members to wear a button depicting a castrated elephant, with the words "We LOST" under it, for the remainder of the 111th Congress (through January, 2011). It will now be a Class A misdemeanor, punishable by a $50K fine and 90 days in jail for a member of the House Republican Caucus to come to the House floor without the button prominately displayed on a lapel.

(Just kidding on that last one).

Oh Don! We knew you were just kidding on this one - we all know the bill was passed 220-215, not 219-216.

[Don Corleone]

So, I'm not exactly sure what Democrats were trying to do in terms of limiting health care costs in this bill, as they seemed to go the other way, every time.

One of the biggest reasons health care in America is so expensive is because the decision makers either don't know the true cost (the patients) or have a vested interest in running the cost up (doctors & hospitals). Industry experts (from industry and academia), have hailed high deductible plans with savings accounts as one of the single best and most innovative ways to curb spiraling health care costs..... give the patient a little skin in the game before they sign up for a series of expensive diagnostics even the doctor admits they don't really need.

But the bill passed last night completely guts the health care savings accounts (capping them at $2500 and removing the ability to use them to pay for medication), which will steer people away from high deductible plans and move them back to traditional PPO/HMO plans.

Stranger yet, no lobbying constituency asked for this. This was a bone the Democrats tossed to themselves, unless that was the price the AMA secretly expressed in private for support of the bill (as they benefit from patients moving back to "let somebody else pay" models).

For a group that claims they want to control health care costs, it's hard to see their sincerity based on items like this...

[Don Corleone]

Other provisions instruct federal officials to “give priority” to construction of Indian health clinics in Minnesota, Nevada and New Mexico; provide scholarships for training veterinarians, among others; and require health plans to pay a fee — perhaps $2 a year for each subscriber — to finance research comparing the effectiveness of different treatments.

I can see the clinics on Indian reservations, probably long overdue (though the procedural purist in me who loathes omnibus bills would argue it should be a seperate bill), the mandated industry-funded effectivity studies I could see other way...

But veterinary scholarships?????

[Banquo's Ghost]

But veterinary scholarships?????

Our Lizard Overlords require priority.

[Beskar]

Hurray! 56% more of America can now afford Healthcare, it isn't privileged to just 40% of the population anymore.

Also, I link this - http://news.bbc.co.uk/1/hi/world/americas/8247534.stm

This is disgusting, anyone who rejected Healthcare reform should not be allowed to get Healthcare or be charged outlandish prices. Seriously, anyone who is against reform don't even value the lives of people, and are barbarians. I am so glad I has the NHS, and to those in the America who scoffed at it, I rather have it than yours and I am laughing at the bank while I am not dying of some illness which was wiped out in the United Kingdom back in the 1940's which is still rampant in America today.

[Evil_Maniac From Mars]

This costs a trillion dollars. Not even the government can afford it anymore.

[Crazed Rabbit]

You know that the interstate insurance thing is there for a reason, right? If it were an option, the companies would all relocate to the state that allows them to shaft consumers the most.

Also, what exactly is the problem with government control of medicine? It works in every othe rcountry that's tried it.

Not that I'm not disputing most of the rest of what you said , mind you...

'Shaft' the consumers? I want to buy insurance from a company in a state with few mandates because it will be cheaper.

And Beskar, calm down for crying out loud. It's not helping people by requiring them under the law to have insurance and throwing them in jail if they don't.

CR

[Strike For The South]

Aren't Indian reservations there own countries? I guess you run back to daddy when things get to tough.

What are the chances this passes in the senate?

At this point I almost wish they would raise taxes at least to put an end to the guise of something for nothing.

[Seamus Fermanagh]

This costs a trillion dollars. Not even the government can afford it anymore.

No, it costs a trillion dollars PLUS, and the estimate is being provided by the good ole U.S.G., and they've never had an issue with underestimating....

The cost will exceed two trillion if this version is enacted.


However, politics being what it is, the Senate version will not be quite as sweeping. The conference Bill will be somewhere in between, but trending toward the Senate version a bit (this process is pretty normal).


Jab'

Insurance companies don't actually have to relocate. They merely have to be given the opportunity to compete for business in a given state within the guidelines of that state's regulations. That is exactly what happens with property, car, and life insurance at the current time.


Beskar:

Relax, the USA will follow down the path laid out by Britain. It will be slower and a bit more haltingly at first -- after all we've 280+ millions and 3000+ mile distances involved, PLUS, we have to figure out how to pay for the 20-30 millions from Mexico who will use our system as well -- but we'll be where you are soon enough.

[jabarto]

Jab'

Insurance companies don't actually have to relocate. They merely have to be given the opportunity to compete for business in a given state within the guidelines of that state's regulations. That is exactly what happens with property, car, and life insurance at the current time.

I think you misunderstand. I wasn't saying that the legislation requires them to move, I'm saying they would *choose* to move to the state that allows them the greatest amount of power. The same thing happened with the credit card companies moving to Delaware.

[Strike For The South]

to figure out how to pay for the 20-30 millions from Mexico who will use our system as well -- but we'll be where you are soon enough.

TU MENTIRA

[Beskar]

For the record, I am releaxed. Though, if I wasn't after all this time, I would need seriously mental health check.

[Lemur]

Relax, the USA will follow down the path laid out by Britain. It will be slower and a bit more haltingly at first -- after all we've 280+ millions and 3000+ mile distances involved, PLUS, we have to figure out how to pay for the 20-30 millions from Mexico who will use our system as well -- but we'll be where you are soon enough.

I don't understand this line of reasoning. At its most radical, the Dem proposal would put maybe five million people into a government sponsored insurance exchange. The much-dreaded "public option." And yet somehow this means we're going to become like Great Britain, where every medical professional is an employee of the state, where a truly socialist system of healthcare is entrenched?

I don't mean to say slippery slope, but man, that is a very friction-free incline you're standing on. The proposals, as they stand, are disappointingly modest, especially if we want to carve real cost efficiencies from the half-rabbit half-antelope system we currently have.

I really, truly wish the Repubs had been more involved in crafting the bill, rather than screaming "Socialism!" from the gallery. If both parties would just work together in good faith ... ah, who am I kidding?