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CyGuy

November 13, 2009 4:35 PM

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Since it managed to get a GOP vote and is thus the only of the bills so far voted on in this proces to do so, I say the Senate should just pass the House bill as is and send it on to the President. Then any further attempts to tweak it can be done as technical corrections bills or through the Budget Reconciliation process.

This would of course require getting 60 votes for cloture for the Senate to vote on the House bill, but any Dem that can't vote for a bill that a Republican has already voted for should be booted out of the caucus.

5 replies

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pecan 3.14159265

November 13, 2009 4:35 PM

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@CyGuy: Cao voted for the bill only after the House got all the votes it needed. What he did was publicly voice his opinion while not actually affecting the vote much at all. It was going to pass with or without his vote, and IMO, he did it for the votes in his district, like any savvy politician would.

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Al Swearengen

November 13, 2009 4:35 PM

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Lieberman has already said he would filibuster any public option. So, unless they put some extra pressure (we will take away your committees) he is not going to back it. I don't see this getting past a filibuster.

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agb2000

November 13, 2009 4:35 PM

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The Congress shall have Power To [...] provide for the [...] general Welfare of the United States

- US Constitution, Article 1

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aikimann

November 13, 2009 4:35 PM

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@agb2000: Someone said it better than I:

Madison said: \"With respect to the words 'general welfare,' I have always regarded them as qualified by the detail of power 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 not contemplated by its creators.\" Madison argued that there would be no purpose whatsoever for the enumeration of the particular powers if the general welfare clause was to be broadly interpreted. The Constitution granted authority to the federal government to do only 20 things, each to be carried out for the benefit of the general welfare of all the people. This understanding of the Constitution, as described by the Father of the Constitution, has been lost in this century.

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agb2000

November 13, 2009 4:35 PM

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@agb2000: Oops, I meant that as I reply to hopson77 below.

","

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hopson77

November 13, 2009 4:35 PM

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The powers afforded the federal government are specifically enumerated, and this isn't even close to one of them.

20 replies

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Persistence - Long viv revolisyon an konsomatè yo!

November 13, 2009 4:36 PM

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@hopson77: You kind of sound like a \"Tenther\".

[en.wikipedia.org]

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hopson77

November 13, 2009 4:36 PM

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Never heard that term before today.

What's so wrong with asking that a government stay within its bounds and scope of power?

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hi

November 13, 2009 4:36 PM

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@hopson77: You're a bad American if you question what your masters are doing.

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EllisDees

November 13, 2009 4:36 PM

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@hopson77:
You are absolutely correct. The federal government has no business whatsoever being involved in healthcare. It's a state matter, and only the utterly twisted interpretation of the constitution by the Supreme Court makes it possible. Only they could find that something that is neither interstate nor commerce could be regulated under the interstate commerce clause.

[en.wikipedia.org]

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November 13, 2009 4:36 PM

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@EllisDees: The government *IS NOT* involved in healthcare in this case.

They are involved in healthcare *insurance*.

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hi

November 13, 2009 4:36 PM

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@bravohotel01: And healthcare *insurance has nothing to do with healthcare... lol

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ARP

November 13, 2009 4:36 PM

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@hopson77: I'm interested in your views on the following:

1) Interstates
2) Federal funding of Public Schools
3) Federal Funding of Fire Departments, Policy, etc.
4) The EPA
5) The FDA
6) Any sort of consumer protection agency
7) National Parks, National Monuments, National Forests
8) Social Security
9) Medicare
10) FAA
11) FTC

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hopson77

November 13, 2009 4:36 PM

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And I yours. Show me somewhere in the Constitution and/or one of its 27 amendments that justifies the existence of those programs/agencies. I do grant you that some of them are more justified than others, but I'm curious to see what you find.

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ARP

November 13, 2009 4:36 PM

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@hopson77: I'm not a strict constructionist or a SCINO (Strict Contstuctionist In Name Only) like Scalia or Thomas, so I have an expansive view of the ICC and general welfare clauses (as well as believing in a right to privacy). So, I believe these agencies are appropriate.

What I'm probing here is that I find that many people and judges (like Scalia) are loose or strict contstructionists depending on if they agree with the particular goal of the agency, legislation, etc. In your case, I commend that you don't believe any of these agencies should exist and we should be left to the market, our own devices, and the states. I disagree, but I respect you standing by your principles.

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hopson77

November 13, 2009 4:36 PM

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The Constitution specifically spelled out the powers of federal government, and you may find that list here: [en.wikipedia.org]

Nowhere in that list is anything close to authorizing Congress to pass a bill of this manner. The \"general welfare\" clause argument is being perverted to justify this albatross of a bill.

I wish I could say that I find funny the notion that someone who actually reads and understands the documents upon which this country and its government were founded and asks that we stay within that scope is an \"anti-government whacko\" or whatever derogatory comment was tossed in my direction. Instead, it's a reflection of a society in desperate need of maturity and appreciation for those that have gone before them.

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Mary Marsala with Fries

November 13, 2009 4:36 PM

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@hopson77: Wait a minute...not dying unnecessarily, having healthy babies and children, and being healthy enough to live a productive live isn't general welfare?

Well holy crap then, I just can't imagine what is.

Big corporate profits, you say?

Ah.

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hopson77

November 13, 2009 4:36 PM

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@Mary Marsala with Fries:

As I said in earlier comments here, the general welfare clause is being perverted to justify this bill. As for big corporate profits, the health care industry runs roughly a 3% profit, much less than most other industries.

If one would actually like to solve the problem that is our health care system, one might seek to enact tort reform and interstate competition. Yet, you won't find much of that in the thousand plus page bill that passed the House. Instead, you will find language on fining people who choose not to carry insurance and creating criminal penalties for the same.

Tell me, why are there handcuffs in a health care bill?

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November 13, 2009 4:35 PM

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True, but most of the things the federal government does aren't within its official rights. In fact the government was criticized for its inaction w/r/t Katrina, for example, instead of being praised for it. People expect the government to do things which it's not allowed to do, and the leviathan is happy to comply.

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DreamTheEndless: Death's little brother

November 13, 2009 4:35 PM

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@hopson77: Wow - until this post, I was operating under the assumption that posters on The Consumerist were well reasoned folks... Now I find out that there's a bunch of anti-government wackos hiding among you? Great...
Luckily it seems that there are enough rational people living in the real world here to try to bring those people back to reality.
-------------------------------
On to the question at hand - I would love to see a clause in there about portability of these plans. I'm a technology worker who spends my time working 7-9 months on a contract somewhere (as an employee of the contracting company, not corp to corp,) and then 1 to 3 months not working looking for my next contract. I would love a clause that said something along the lines that if I come into a job as a member of an insurance plan, the new employer would have to pay contributions to that plan similar to the contributions that they offer on other plans. It could even be legislated as a temporary thing. As law, they could pay contributions on plans not included in the list of plans they offer for up to 1 year. That way, short term employees could still be covered with a continuous health insurance plan but new permanent employees could keep their existing coverage until the next open enrollment period...

What do you folks think?

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hi

November 13, 2009 4:36 PM

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@DreamTheEndless: Death's little brother: I think you're delusional to not know that the states have power over the federal government. The States gave the federal government it's power. That is not some anti-government wacko thought it's the facts. I'm not anti-government. I'm pro non-criminal government and government who doesn't abuse it's powers and try power grabs for their own criminal agendas. If you beleive they have the right to maditory healthcare then you beleive it ok to enslave the people of the usa... because thats what it does. not only that but just wait till they start telling people they will have manditory shots and checkups.. just wait till they tell you that you have to put this drug in your body without any choice.. and see how free you feel.

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Al Swearengen

November 13, 2009 4:35 PM

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Good luck with that. Ever since the Supreme Court has allowed the Congress to regulate essentially anything under the interstate commerce clause, they are going to be able to regulate health care. And if you say \"but each state has its own insurance plan, its not interstate commerce\" that argument will fail, because supreme court cases have held even doing something yourself and not letting it get into the stream of commerce has an effect on interstate commerce and so it can be regulated. The main case on this was a farmer growing stuff for his own consumption and never sold it just used it himself - the court held his activities could be regulated because even though he's not putting his stuff into the stream of commerce, his not putting stuff into the stream of commerce effects the stream of commerce, and so can be regulated. So, good luck arguing the Congress cannot pass and enforce this bill.

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Trai_Dep

November 13, 2009 4:35 PM

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@hopson77: So long as we're going the Strict Constructionalist route, I'll leave it to you to explain why some of my friends why they count as 2/3 a person, and to your Mom why she's no longer allowed to vote.
PS: Check out Article I of the Constitution. I know it's a loooong document, but crikey, it's Article I.

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November 13, 2009 4:35 PM

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Someone didn't read his constitutional amendments.

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November 13, 2009 4:35 PM

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I guess you don't know why that was thing was a good thing.

See, the south wanted slaves counted for enumerating Representatives but did not give them votes.

So they would have completely packed the House of Reps and Slavery would have lasted even longer.

And, as someone else pointed out, it was removed when slavery was removed. They also pointed out that you did yourself no favors by giving a slanted view of the subject.

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Tasunke

November 13, 2009 4:35 PM

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@Trai_Dep: And both of those were later amended out. -.-
The 2/3 is wrong, it was 3/5: [en.wikipedia.org]
And was removed by the the 13th ( [en.wikipedia.org] ) and 14th amendments
( [en.wikipedia.org] ).
For women's sufferage, see the 19th amendment ( [en.wikipedia.org] ).

You have a star, so I assume you've made some insightful comments in the past. However, this one, from my perspective at least, seems to be blatantly ignorant. Or maybe I'm missing whatever point you're trying to make. ;)

If not, then please try and make sure you have your facts straight before you make such inflammatory comments in the future, so as not to embarrass yourself. ;)

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bohemian

November 13, 2009 4:35 PM

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@hopson77: This is such a stupid argument. The interstate system isn't specifically documented either. The current private for profit system was a fluke that happened during WWII and was never planned out. It is an utter failure. We need to join the rest of the civilized world and quit holding people's lives at the mercy of greed.

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November 13, 2009 4:35 PM

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@bohemian: Ah, you must have listened to the same NPR story as me.

Rationing and wage freeze = try to attract employees with fringe benefits.

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November 13, 2009 4:35 PM

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@hopson77:
I would agree with you, but the Supreme Court has essentially allowed Congress to pass anything it wants via the Commerce Clause. I think this is something that is absolutely outside of what Congress SHOULD be doing, but the sad fact is that it's pretty unlikely that a court would strike this down. The bulk of this bill is comprised of items that should be squarely within the province of the states, not the Feds.

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ChemicallyInert

November 13, 2009 4:35 PM

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@Esquire99: Yeah, well the states gave up their rights when they started clamoring for that sweet, sweet, income tax money.

(Not that I'm one of those loons who thinks that the income tax is unconstitutional. Or even one of those people who thinks every dollar of tax money is eeeeebil.)

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November 13, 2009 4:35 PM

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@ChemicallyInert: You mean the money that is set aside as a line item for the states that the states must send to the Federal government who can then hold it? You mean the money that it is the right of the state to have?

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bohemian

November 13, 2009 4:35 PM

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@Esquire99: Shoving things back on the states is a great idea if you live somewhere like Minnesota that actually provides services for their residents. People in states like South Dakota would lose out. Our state government can't figure out how to tie its shoes let alone ever implement anything resembling health insurance.

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Trai_Dep

November 13, 2009 4:36 PM

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@bohemian, lannister80: You guys listen to the Planet Money Podcast, right? If you liked the NPR stories, you'll Econogeek-out out on theirs. They also have a great blog, btw.

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November 13, 2009 4:35 PM

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@bohemian:
Well, I guess the people in SD would either demand change or move to another state. That's the great thing with powerful states, if you don't like things in your state you can move to another state. When the Feds start running things you're pretty much screwed.

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November 13, 2009 4:35 PM

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@Esquire99: My company moved from VA to DC, which means, even though we kept the same health insurance plans and rates, they weren't really the same, something changed between states (DC being treated as a state in this instance). Our cards didn't work anymore, but our HR department didn't tell anyone and only sent new cards to half of us. So some people got screwed because by the time they got their new cards and had their doctors send in the claims, the insurance companies denied the claims as being submitted too late. Luckily the CEO reimbursed all those affected with his own money, but I don't see too many CEOs being that generous. Anyway, had there been a national plan instead of a state plan, this mess wouldn't have happened, and people wouldn't have stressed. (Also if we had a halfway competent HR department it wouldn't have happened wither, but good luck finding one of those.)

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November 13, 2009 4:35 PM

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@cordeliapotter: \"competent HR department\"...I'm afraid that being an HR department and being competent are mutually exclusive.

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RecordStoreToughGuy_starcommandseries.com

November 13, 2009 4:35 PM

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@Toof_75_75: You can't spell \"Who cares?\" without HR!

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November 13, 2009 4:35 PM

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@cordeliapotter: A halfway-competent HR department, you say? I’ve been looking for one of those, because I have never worked at a company with one. My wife once worked in HR, and neither of us could understand how her co-workers so frequently screwed up everyday paperwork.

Sorry about the off-topic rant—I'm gone.

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November 13, 2009 4:35 PM

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@Esquire99: normally, i would agree with you that this power is reserved for the states. unfortunately, the feds already control healthcare & have disallowed state programs to exist via recent changes to SCHIP under the reauthorization. here in CT, we had an awesome state healthcare program - HUSKY - that used to cover anyone who wanted to join. low income bought in free or at a reduced premium. middle & high income earners could still participate, but were required to pay higher premiums to subsidize coverage for those at the bottom. changes to SCHIP mandated that federal money (collected from the states) couldn't be used for programs like this that could cover anybody.

so, it came down to power of the purse - do you give up all your federal dollars to provide healthcare to anybody that wants it, or do you buckle & eliminate your state-run healthcare for anyone that wants it?

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chaoss13

November 13, 2009 4:35 PM

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@mac-phisto: HUSKY is alive and well. Due to crazy finances, and even crazier new insurance (or lack thereof) coverages and premiums, I had to move my fiancee and kids onto it. Much to my surprise, we qualified for the free program.

I dislike using any state or federal funded assistances. But as many of us are learning right now, pride is nothing when you need to keep your family safe and healthy.

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November 13, 2009 4:35 PM

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@chaoss13: i'm having trouble finding the information to support my argument, so i'm going to digress here. i know there was a substantial change to the program, but i can't seem to find the information on that change.

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arcticJKL

November 13, 2009 4:35 PM

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hopson: Yes and if it passes the Senate we need to sue to stop implementation.

Jerry: FAA, covered, CDC unconstitutional. Our representative government is limited, it may not violate the constitution.

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November 13, 2009 4:35 PM

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But neither are a lot of things (roads, the FAA, the CDC, etc.). Does that mean we should wipe out anything not specifically mentioned in the constitution? There may be some people who feel that way, but we have decided, through our represenantive forme of government, that this would be a bad idea.

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Meggeler

November 13, 2009 4:35 PM

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@hopson77:
Wow - you think the Federal Government as currently comprised cares about enumeration? They are on a systematic course to destroy the constitution.

","

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cf27

November 13, 2009 4:35 PM

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That mandate's quite a mandate -- if you don't do it and don't pay the fine for not doing it, hello prison!

13 replies

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nova3930

November 13, 2009 4:35 PM

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Oh yes, our great and wonderful US House of Representatives have passed a bill, that for the first time in the history of the US, requires an individual to buy a good or service whether they want it or not, simply as a consequence of their existence.

If this were to ever get through the senate, you're alternative to buying insurance is to put a bullet in your brain...

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November 13, 2009 4:35 PM

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@fs2k2isfun: What about those who've had health insurance (through one carrier or another), and then gets diagnosed with an expensive disease to treat?

They've been paying into the \"insurance\" system their entire lives, so the companies should have managed their risk accordingly. If for some other reason, (e.g. person loses their job), is it right then for another insurance company to turn around and deny coverage? From a business standpoint, it's not helpful from a bottom line - this is why the bill is mandating universal coverage.

That way, risks can predicted with reasonable accuracy and rates be adjusted accordingly. Unfortunately, employment and health are too entertwined - and just because you lose one oughtn't mean you'd lose the other.

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SacraBos

November 13, 2009 4:35 PM

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@nova3930: That's the biggest reason I question the Constitutionality of this bill.

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November 13, 2009 4:35 PM

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@cf27: You all are forgetting that little clause in the Constitution about not being able to jail you for a debt. That's right, unless the debt itself is a criminal sentence (i.e. you were found guilty of a crime and sentenced to pay $1000), you cannot be imprisoned for a debt.

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Verucalise (Est.February2008)

November 13, 2009 4:35 PM

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@Ursus Maritimus: Maybe so, but they can attack your property and garnish your wages- making your life a living hell.

Please correct me if I'm wrong, but lets say you make $60k a year. You don't carry insurance on yourself and your employer doesn't offer it. That's $1500 a year penalty and most likely, would be just taken out of your tax return if you received one, right? Or you would just owe the government during tax season?

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November 13, 2009 4:35 PM

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@Verucalise(countingcalories): It's 2.5% of AGI, not simple gross, so it'd be almost certainly less than that for 60k a year, especially if you have family.

Ideally, the system would mean that purchasing through the insurance exchange is cheaper than the fine. I don't offhand know my AGI from last year, but I think that the fine would be only marginally larger than what I pay for insurance through my employer.

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November 13, 2009 4:35 PM

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@cf27: No. The IRS sends your debt to collectors.

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November 13, 2009 4:35 PM

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@cf27: Well, at least prisoners get great medical care.

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Verucalise (Est.February2008)

November 13, 2009 4:35 PM

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@Laura Northrup: Ha, I love you Laura... if you didn't say it, I was gonna ;)

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Bhockzer

November 13, 2009 4:35 PM

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@Laura Northrup: Yeah, that explains the ridiculous infection rate of prisoners who have visited in-prison medical centers. Not that I'm saying they don't deserve what they're getting, I'm just saying it's not like they're in a 4-star resort.

It's really more like a 2-star motel with a 1000% increase in the threat of rape.

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catastrophegirl chooses not to fly

November 13, 2009 4:35 PM

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@Laura Northrup: well that wouldn't work out for the people who need it most - low income people wouldn't be able to use not paying the fine or getting coverage to get into prison to get medical care
[i had a homeless guy break into my car in front of a cop once so he could get INTO prison]

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lmarconi

November 13, 2009 4:35 PM

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@catastrophegirl: I support health care reform, but I'm wondering how low income you have to be to be exempt and whether it's adjusted for the area you live in. Seriously, if you're making $30,000 a year in a major city like NYC and not getting health insurance from your employer, you should not have to choose between going broke or going to prison.

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arcticJKL

November 13, 2009 4:35 PM

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@lmarconi: There is the move out of NY option.

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November 13, 2009 4:35 PM

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@arcticJKL: If I am correct, there are quite a few people who haven't paid the fine in MA and have yet to be jailed, I saw an article on this recently and would have to dig it up.

I can't see the gov't jailing those who refuse to buy health insurance, wouldn't make the best of headlines.

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Bhockzer

November 13, 2009 4:35 PM

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@metsarethe...: They won't jail them, they'll levy huge fines against those who don't participate.

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hi

November 13, 2009 4:36 PM

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@Bhockzer: Wrong. If you don't pay the fines you will sent to prison. it will make criminals out of people who choose not to have healthcare insurance (yes some people like me don't want it).

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Mr_Human

November 13, 2009 4:35 PM

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@rctcJKL: Tht's stpd

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coren

November 13, 2009 4:35 PM

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@cf27: Well get enough traffic fines and there's jail involved too. The way it was explained to me it's done (the fine) via taxes which would make it tax evasion anyway. But I don't know about that.

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November 13, 2009 4:35 PM

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@coren:
That's also my understanding. The \"fine\" is a (I think) 2.5% income tax penalty. Thus, if you don't pay it the IRS and its immense power (including criminal enforcement) is after you.

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bohemian

November 13, 2009 4:35 PM

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@cf27: Ironically, if I was in that situation and unable to pay that fine it would likely be because all of my money is going to over inflated medical bills.

","","

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November 13, 2009 4:35 PM

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What a train wreck. That \"the world is ending in 2012\" theory is becoming all the more real every day.

\"Insurance mandate: Uninsured Americans will pay a penalty; low-income people exempt.\"

The above doesn't affect me, but F off government. Get out of our business.

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tape

November 13, 2009 4:35 PM

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@ZeGoggles: this is ripped straight from the program passed in Massachusetts 3-ish years ago. The biggest proponents of the plan were health insurance providers, and our governor who was in their pocket. The biggest dissenting voices were, well, every human being I know.

The program sucks. The federal program will suck.

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bohemian

November 13, 2009 4:35 PM

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@tape: The mandate is the one thing in health reform I don't agree with. What I want to know is what happened to all the detailed insurance company rules that were in the first Senate bill.

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chrylis

November 13, 2009 4:35 PM

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@bohemian: If you're going to put in provisions forbidding taking into account existing medical conditions, you have to make buying insurance mandatory. Otherwise, people wait until they're pregnant or get cancer to go buy \"insurance\".

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November 13, 2009 4:35 PM

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@bohemian: I agree 100% , you can place someone especially at a lower wage level to make choices that they didn't have to make before like if paying for something they can't afford . A couple thousand dollars is alot of food , a month or two of rent , gas , car repairs so you can at least get to A job .

Someone has skipped health insurance for a while is usually doing it to manage a budget without putting themsleves in a position to take food stamps , welfare or even borrow money from family or a bank .

And this is where the government really gets in your businesss . And since the government loves paper work there will be records & documentation that someone else will be able to take or subpeona one day .

I've gone through many periods in my life where I couldn't afford health insurance . The very cost they're trying to save with MANDATED insurance will come right back in the way of increased food stamps , welfare , credit problems , bankruptcies etc . If I couldn't maintain a car I'd would be done . Even an 8 dollar an hour job requires or prefers those with a car .

With mandated insurance you are forcing people into a public funded system .

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BWoodle

November 13, 2009 4:36 PM

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@u1itn0w2day: If you are at an income level that you have to choose between food, rent, and health insurance, then you meet the requirements for 100% subsidized insurance.

Thus, you don't have to choose between food and health insurance. Sounds like reform to me.

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Bhockzer

November 13, 2009 4:35 PM

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@u1itn0w2day: And what's so bad about a public funded option? Our elected officials have been on one for decades. They seem to be happy with the results.

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November 13, 2009 4:35 PM

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@Bhockzer: Do you really think that OUR health care will be the same as THEIR health care? There's a reason why so many of the big guy in Washington send their kids to private school instead of the \"public funded option\".

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November 13, 2009 4:36 PM

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@Toffeecake: I found it deeply IRONIC that the GOP was running scare ads telling seniors that the government will take away their medicare.

Medicare is wildly popular. Time for all Americans to get access to it.

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November 13, 2009 4:35 PM

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@tape: Hopefully if it's enough of a trainwreck, it can get repealed.

","

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November 13, 2009 4:35 PM

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Out of college I had an office job that required me to get a health insurance license, and I'm still confused by many of the options available to me (though I'm lucky enough to have generous insurance options available to me through my employer).

I'm not going to take a political stand on this thread, I just wish people who \"don't want this coming out of my paycheck\" realized how much they're already paying for people with no or insufficient insurance.

6 replies

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morlo

November 13, 2009 4:35 PM

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@HesNoKennedy: Most people with no or insufficient insurance don't go to doctors. Look at MA, which faced a physician shortage once it implemented its insurance mandate.

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East_Coast_Midwesterner

November 13, 2009 4:36 PM

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I live in MA and there is no issue getting to see a doctor.

And \"Most people with no or insufficient insurance don't go to doctors. \" Really? You beleive that? I would agree that they will not get any preventative care, but they go to the hospital when a crisis strikes.

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November 13, 2009 4:35 PM

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@morlo: You're right, they have to wait until a problem gets bad enough to warrant a trip to the emergency room at Cook County General, which costs, at a minimum, thousands more than routine checkups.

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B

November 13, 2009 4:35 PM

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@morlo: Actually no, this isn't true. They go to the Emergency room, where the hospitals by law can't refuse care. They then skip out on the bill, and the hospital passes the costs on to their other customers.

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November 13, 2009 4:35 PM

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@B: Actually, EMTALA states that it's only illegal to turn someone away when they present with an emergency. Most don't because one legal battle will eat any benefit you got from turning them away.

In many cases, people who use the ER as a clinic wait until they are so sick that they can't work before they show up. They don't show up with a cough - they show up with pneumonia and stay for a week or two.

You are correct in that for many true EMTALA cases, they skip, and the hospital has to make it up somewhere else - namely medicare/medicaid and private insurance.

Hospitals want cash paying customers more than either Medicare/Medicaid or privately insured. They're like unicorns, though. Most public hospitals have huge groups of people that their sole job is working EMTALA cases and finding any way they can to be paid for services rendered.

The big problem in all of this is that non-citizens will still qualify to be treated under EMTALA, but have no access to the public option, so the hospitals will still be left holding the bag for them. Depending on the geography, that can be a considerable amount of people.

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Tetrine

November 13, 2009 4:35 PM

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@HesNoKennedy: Consumer Reports prescription for change site says the cost for a family to cover expenses incurred by the uninsured is $1000/yr.

People don't seem to get that. It's not propaganda, it's a damned reality that the insured are paying for the uninsured -- they ARE getting care and WE are paying for it.

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November 13, 2009 4:35 PM

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It is also a \"damned reality\" that this boondoggle costs more than $1000 a year.

Surely we could come up with something better than this?

The fact that this is done in the \"Interstate Commerce Clause\" and yet does not include reforms like buying insurance over state lines tells you how bad it is.

","","","

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That's Consumer007 to you

November 13, 2009 4:35 PM

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Good to see Repugnicans didn't succeed in their quest to make sure we all died quickly after getting sick.

2 replies

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November 13, 2009 4:35 PM

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@Areyouagoodlittleconsumer: Um, I maybe wrong, but wasn't that a Democratic quest?

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psm321

November 13, 2009 4:35 PM

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@Thomas Palmer: It's pretty much 95% of congress :)

","","","","

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CarbonFiberFootprint

November 13, 2009 4:35 PM

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Another sad day in our nation's history. The willingness of people to vote their rights away is astounding. This incarnation reads as if it were written in the boardroom of an Insurance company.

5 replies

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Bhockzer

November 13, 2009 4:35 PM

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@CarbonFiberFootprint: Voting rights away...you mean like the Patriot Act which basically stripped you of your constitutional rights to privacy (wire-tapping) and unlawful search & seizure. If that's what you mean, I can totally see how that's the same as providing health care to every man, woman, and child in the United States.

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November 13, 2009 4:35 PM

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@Bhockzer: Nice!

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November 13, 2009 4:35 PM

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@Bhockzer: It's the same in that it will give the government a right, and a reason, to tell every man, woman, and child what they should be doing with their own bodies. You can bet that once the government is paying for your health care, there will come plenty of penalties for making \"unhealthy choices\".

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ARP

November 13, 2009 4:36 PM

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@Toffeecake: That's true. Unlike now, where a large corporation with zero accountability does that, especially choices like going to a doctor when you're sick (oops, that's a pre-existing condition now).

Also, aren't the republicans big into telling people what they can do with their bodies and legislating their own personal morality?

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hi

November 13, 2009 4:36 PM

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@ARP: This isn't a dem/rep matter. It's a constitutional matter. Don't let them fool you with their divide and conquer tactics. Look into your rights as an american and stand up for them before they are taken away.

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BrazDane

November 13, 2009 4:36 PM

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@Toffeecake: Sure, and right now it is MUCH better that we have private insurance companies deciding who lives and dies based on their greed for profit, right?

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November 13, 2009 4:35 PM

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@CarbonFiberFootprint: The people didn't vote them away, the informed voted just got overwhelmed by the people who voted Democrat because they had a black Presidential candidate and all Republicans are George Bush.

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JulesNoctambule

November 13, 2009 4:35 PM

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@CarbonFiberFootprint: Best laugh I've had all day -- thanks!

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November 13, 2009 4:35 PM

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I hope that the Senate actually uses some sense and refuses to pass a bill. This had gotten ridiculous. $1 Trillion dollars. More costs imposed on businesses that are already firing people and not hiring. Huge govt. bureaucracy that has already proven to be incapable of running things now in charge of health care. Corporations are now no longer permitted to choose who they do business with (the no pre-existing denial provision). Hopefully Ben Nelson and some of the other Moderate Senators will filibuster any bill that even resembles the House bill.

Further, it really bothers me that the Federal govt. is forcing companies to cover all of their employees. That seems to be something that they should be doing, not the Feds. Of course the only reason Congress gets away with this is the fact that the Supreme Court has basically blown the doors off the Commerce Clause and will allow the Feds to do whatever they please.

11 replies

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November 13, 2009 4:36 PM

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This is a great day for America. The majority of Americans elected Obama based on, in part, his promise to overhaul healthcare. It is a shame that so many uneducated people have been tricked by the far right and corporate fascist interest into opposing this bill.

If the Republicans want to be stubborn and filibuster this in the Senate, they just need to push it through the budget reconciliation process. In either case, the uninformed and unenlightened few will not be allowed to hold up progress for everyone.

Keep pushing them Obama.

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November 13, 2009 4:35 PM

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@Esquire99: Obvious AstroTurfer is obvious.

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November 13, 2009 4:35 PM

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It's hard to be against the bill and not come off like as a jerk who doesn't care if the poor suffer and die.

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bohemian

November 13, 2009 4:35 PM

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@Esquire99: A trillion dollars, so that is like one day in Iraq war spending.

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November 13, 2009 4:35 PM

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@bohemian:
Probably. But please don't assume that because I'm against health care reform that I'm for the war. That would be an erroneous assumption.

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November 13, 2009 4:35 PM

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@bohemian: @Esquire99:

I posted this on the 2nd page, but it's relevant to this discussion, so I'll repost here.

[costofwar.com]

Site run by the National Priorities Project.

Dunno about its accuracy, but it shows the total cost of the Iraq war to date is (as of right now) just under $700 billion since 2001. They're saying the combined cost of both the Iraq and Afghanistan wars to date (since 2001) is just under a trillion.

If these numbers are accurate, 8 years of 2 simultaneous wars have cost less than this healthcare bill's final tally. There are things I both agree and disagree with regarding this bill. Just throwing that out there.

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Trai_Dep

November 13, 2009 4:35 PM

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@WraithSama: Yeah, you gotta be careful about sourcing problems. Your Pentagon cite doesn't cover replacement costs of materiál, nor the breathtakingly expensive health care and disability of veterans. A more realistic figure is closer to $3 Billion. And those numbers didn't count the last year (plus however many years forward) of equipment and personnel.
Versus $100B/year (and of that, you're not counting cost savings or money that'd be spend anyway - think emergency room uninsured).

It's not IF we're going to pay, we are. It's HOW we'll pay, and how rationally, humanely and economically we do so.

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November 13, 2009 4:35 PM

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@Esquire99: Well it was a government program that developed this thing called arpanet - under budget and on time. I heard it turned out well.

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ohnoes

November 13, 2009 4:35 PM

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@Esquire99: Your opposition to preventing insurance companies from denying coverage for pre-existing conditions (which are often used frivolously) renders the rest of your post equivalent to the dialogue for an adult in a Peanuts cartoon.

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November 13, 2009 4:35 PM

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@ohnoes:
Tell me how this following is fair.

Bob has a disease that costs $10,000 per month to treat
Bob goes to XYZ Insurance company to get coverage
XYZ would normally say, \"Well, since you can't pay a $10,001 per month premium, there is absolutely no way this will be profitable. In fact, it will cost us a ton of money to insurance this person. Thus, we will deny them coverage.
But now, Congress has said they have to provide coverage. Thus, XYZ is forced to enter into a contract that they know will provide them absolutely no benefit and will actually cost them a ton of money.

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kmw2

November 13, 2009 4:35 PM

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@Esquire99: I don't think you understand how insurance works. See, Bob isn't expected to cover the whole cost himself - the 100 people with no significant health problems that only cost the company $200 a year for a physical and an antibiotic prescription once a decade are making sure the company's got plenty of profits, despite Bob's expensive disease.

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redkamel

November 13, 2009 4:35 PM

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@Esquire99: you forgot to continue your metaphor....(also I don't know any disease that cost 10000 dollars a month to treat anymore....unless you have mad AIDS)

\"Bob gets no insurance. So he sits at home, sick. Then one day he gets really sick and has to go the hospital. It costs the hospital 1,000,000 dollars to treat him. Bob can't pay, in fact, he ends up dying before his time since he didn't have his disease controlled. The hospital is out 1,000,000 dollars. But the insurance company wasn't out any money! Phew! Of course, if Bob had been able to buy insurance/covered back before he was sick, maybe his disease wouldn't cost 10,000 dollars a month to treat.\"

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ohnoes

November 13, 2009 4:35 PM

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@Esquire99: How is it fair to let Bob die because a company won't make a profit off of his good health?

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November 13, 2009 4:35 PM

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@ohnoes:
It's not even that the insurance company won't make a *profit*, they will be losing a ton of money on Bob. Why should the cost of his care be the responsibility of someone else? There are charities and other programs Bob can seek out for assistance; forcing a corporation to pay his bills isn't right. Insurance is about managing risk, not about finding someone to pay your regular expected bills because you can't afford to. It sucks to be Bob, but that doesn't mean XYZ should have to essentially act as his welfare agent.

When they take on a patient with no pre-existing conditions, they are taking on a risk. They manage that risk by collecting premiums. The hope is that collectively they will pay out less than they take in. When they take on patients who they KNOW will cost a ton of money, that's not taking on risk, but taking on a known cost that will not come close to breaking even.

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Tetrine

November 13, 2009 4:35 PM

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@Esquire99: The whole principle of the insurance business is that a LOT of people pay to have insurance and thus cover the expenses the company incurs when a FEW people need care greater than their premiums/employer's share pays in.

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November 13, 2009 4:35 PM

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@Tetrine:
Yes, that's effectively what I said.

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Mr_Human

November 13, 2009 4:35 PM

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@Esquire99: \"Why should the cost of his care be the responsibility of someone else? \" That's the whole point of insurance, you moron. It's a -- oh, shit -- a collective.

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November 13, 2009 4:35 PM

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@Mr_Human:
The original point of insurance was to manage risk, not to cover routine expenses. You pay a little bit in and if something severe happens, you're covered. The point isn't for someone who already knows he has a truckload of expensive problems to go and find a company willing to pay his $10k per month expenses in exchange for a $500/month premium.

The fact of the matter is people simply don't want to have to pay (directly) for their health care. They expect insurance to pay for everything and it's a travesty if they have to pay anything out of pocket. Instead of paying for routine costs out of pocket and having an insurance plan to cover the unknown, people expect their insurance company to take a small premium in exchange for paying ALL of their bills. W

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November 13, 2009 4:35 PM

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@Esquire99: People don't want to pay directly for their health . And that's half the problem . You have entire generation or two that simply pulled out an insurance card or payed a deductable for general non emergency office visits .

I have frequently saved money even if I have to pay for an office visit or two out of pocket . The premiums for the plans for paid or lower cost office visit can exceed the cost of a couple of out of pocket visits .

But as with the health insurance plan user you have an entire industry that has become accustomed to being paid by an insurance plan or third party which can raise the cost and increase their profit at the corporate level especially . Even the third party or suppliers realize that an insurance plan will be paying for their product wether it's an mri machine or drugs .

There are alot of problems involving cost but my whole thing with this bill is that only addresses or assumes that controling the insurance end of the industry is the answer . It's saying insurance is the only way to get health care ,the only way the only solution .

And then passing this 2,000 page bill on a Saturday Night??? wtf

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Trai_Dep

November 13, 2009 4:35 PM

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@u1itn0w2day: So, you'll take the plunge for us and reject your company's insurance to let us know how splendidly market forces will compel you to drive your medical costs down when you're your own provider?
Send us a postcard in three or five years, okay?

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November 13, 2009 4:35 PM

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@Trai_Dep: All I want is a policy for catastrophic hospitalizing events and bill racking tests & supplies. That's the only thing insurance should be there for. If the patient wants free office visits and very low deductables they should pay or expect to pay more. I don't want to pay extra for someone who has to make a 150$ visit to the office for the sniffles and be told rest,fluids and take these OTC meds.

I'd love to be my own provider AND NOT have to pay alot in INSURANCE premiums for routine/ordinary/non emergency health care. A truely free market would drive down cost but so much of the medical/health care industry have become hooked to INSURANCE like a junkie on crack that true alternatives are not only hard to come by but hard to accept .

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November 13, 2009 4:36 PM

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@u1itn0w2day: You are espousing hilariously awful ideas. If insurance is limited to catastrophic medical events and specifically excluded from routine preventive care, huge numbers of people will not get routine preventive care, resulting in vastly more catastrophic medical events, driving total medical expenditures through the roof. Come on, this is obvious. And what problem are you addressing to begin with? Routine office visits are not creating the cost problem.

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November 13, 2009 4:36 PM

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@GuidedByLemons: The problem here is that too many only believe what a doctor says even though you can get the same exact thing from a nurse , emt , trainer or a PA . You don't need a full fledged office visit for a doctor to tell you to exercise regularly or rest when you have a cold .

\" preventive \" health care is rather loosely used term when it comes to the health care industry . \" preventive \" health care as far as the current insurance based health industry is concerned more than likely an expensive test with expensive technology manufactured for profit by the supplier .

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November 13, 2009 4:36 PM

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@u1itn0w2day: Colonoscopies are expensive; let's wait until people get late-stage colon cancer and then their catastrophic medical coverage can pick up the tab for their slow, painful death. Blood lipid panels are expensive; people should wait to seek care until they need bypass surgery. Strep cultures are expensive; it'll be so much better when we wait and treat people for severe complications from rheumatic fever instead.

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November 13, 2009 4:36 PM

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@GuidedByLemons: I know people who got later stage colon cancer which manifested itself with physical symptoms and got an operation with no complications and/or remission . Even if discovered earlier the treatment would've been almost the exact same . I know individuals who are wiped out for 3-5 days for 1 conlonoscopy -what : loose a week of your life and much more income for a 'routine' test ? And that's just one test & trip to the doctors . The people who need continuous monitoring fine then : Ok the dollars for them . But is such financial and physically disabilitating 'routine' testing really worth it ?

The only reason many get routine tests is the doctor recommends it . And alot of doctors recommend tests to cover their butts to keep their insurance company happy with profits . Insurance seems to be self perpetuating in the health care industry .

And as far a lipid tests for bypass surgery . Again heart trouble manifests itself with physical symptoms long before you are going to the doctor for lipid tests . A lipid test should be for conformation on a hard to diagnose problem . The problem with many tests is that they are considered THE only tool by doctors when in fact they are one of many .

Too many patients and doctors assume they should be using Cadillac medical care on everything .

Alot of problems come from a lack of physical education and favorable lifestyle . That's where a couple sessions with a trainer could educate you and give as much information and even many of the same test results as one trip to the doctor . I'm not saying a trainer is a substitute for a doctor but they and others can do many of the same things doctors do including dispensing information .

Doctors and patients should be able to use physical symptoms much more than they are doing . Patients need to be able to realize what a fit body feels like . A doctor should know what a fit body LOOKS like in person and not off a chart . If there are reasons for the doctors to use tools such as a lipid test or colonoscopy then OK reimbursement for those test .

\"routine\" testing in itself is almost hit and miss dart throwing science in that it's like lets see what we can find this time . But where is THE PREVENTION: the things YOU can do in YOUR daily life to prevent those things . Better yet since it's paid for what is the medical industry doing to prevent rather than discover/reveal medical conditions .

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thisistobehelpful

November 13, 2009 4:36 PM

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@u1itn0w2day: Yeah I'm sorry, I got charged several hundred dollars to tell a doctor what I had and what to give me, sans testing of any sort I just needed his John Hancock to get the right script. Don't even try to throw that \"oh they just test for everything\" crap as an excuse for what it costs now.

And no you can't just go see an EMT or nurse for everything. They can't write prescriptions and it's about a grand to show up at the ERs around me.

You completely skipped over the fact that insurance companies have bidding wars with providers and then no-insurance patients get robbed to make up the difference. I hope you get cancer and lose your job in whatever order it is that makes you wake up.

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November 13, 2009 4:36 PM

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@thisistobehelpful: The steep billing of non insured patients is actually a good example of costs out of control . And it's out of control because the health CARE industry choose to make the health INSURANCE industry their preferred form of compensation . There are a crap load of cost problems but everyone is ASSuming INSURANCE is where to fix it and regulate it .

And if the INSURANCE industry wasn't reimbursing the health care industry alot of these 'tests' would only be used as a last resort for non emergency care . Many tests are A tool and not the only tool .

You're right a nurse or emt can't do everything but unless you have a really chronic or catastrophic condition why pay 150-200$ for a doc visit when you can pay a clinic or Walmart 50-75$ . They'll refer you anyway if out of their skill level/jurisdiction .

It's already going on with eye care. Most of these eye glass stores are staffed with opticians as compared to an opthomologists . Something needs a second opinion or eye doc you'll get referred . More of the health care industry needs to go like that . And by the way glasses/eye care usually is one of the least insured segments of the health care industry and also one of the cheapest . The eye glass/eye care industry also has ALOT of competition with-in the industry .

WHAT?-minimal insurance reimbursements , true competition and one of the cheapest parts of health CARE ? uh-oh , can't have that now can we ?

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November 13, 2009 4:36 PM

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@u1itn0w2day: Man, I really need to move to your planet, where failing to catch \"colon\" \"cancer\" early doesn't drastically reduce \"survival\" rates and you can judge someone's HDL level by observing how fit their \"body\" \"looks\".

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November 13, 2009 4:35 PM

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@Mr_Human:
Oh, and I'm glad you were able to keep the debate civil and intelligent and not resort to name calling :)

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Eyebrows McGee (now with more baby!)

November 13, 2009 4:35 PM

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@Esquire99: \"Huge govt. bureaucracy that has already proven to be incapable of running things now in charge of health care.\"

So you agree we need to shut down the military?

Or you have a problem with the not-tax-supported post office and its ability to deliver your emo poems from your door to your grandma's door in Kansas in three days? (To borrow from Jon Stewart)

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November 13, 2009 4:35 PM

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@Eyebrows McGee (now with more baby!):
The post office is horribly run and is currently operating at a $2bil deficit.

The military is run well from a discipline and getting things done perspective, but has so many holes through which money leaks it's almost funny.

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kmw2

November 13, 2009 4:35 PM

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@Esquire99: The post office is also a private company.

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November 13, 2009 4:35 PM

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@Esquire99:
Actually, the post office has posted a profitable or break-even year 13 of the last 14 years, and hasn't needed taxpayer money to support it in well over 4 decades.

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coren

November 13, 2009 4:35 PM

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@Esquire99: Isn't a large part of that debt health care related?

","","","","

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trmentry

November 13, 2009 4:35 PM

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They should try reforms that don't cost us, the taxpayers, more money in a black hole money pit of another entitlement program.

o reforms so that docs dont' have to pay HUGE premiums for malpractice

o allow insurance companies to sell over state lines, open up interstate trade, something congress is supposed to do.

o make insurance what it's for. catastrophic events. do you really ask what it costs if someone else is paying? Why not? You ask what other things cost, why not this? Forcing Docs/Hospitals to compete would bring costs down. Think Lasik, you can call any Lasik Doc and they will QUOTE you the cost of the procedure. Call you PCP and ask what it costs to get blood drawn for a test... they have no clue. this brings us to:

o everyone gets a flex savings type account to 'save' pre-tax money for doc visits, etc. but this one isn't use or loose, it rolls over year to year so it's a true savings account type thing.

I love the idea of 'no pre-existing conditions'. However the 'tax' to pay if I don't' carry insurance is CHEAPER than for the insurance itself. And if I get cancer or some such, I can't be denied when I go in to get insurance to have someone else pay for it.

12 replies

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November 13, 2009 4:35 PM

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@trmentry: \"Call your PCP and ask what it costs to get blood drawn for a test... they have no clue\"

If you want to know how much a blood test (or any other procedure) costs, call and ask to speak to the office manager at your doctor's office. They can tell you how much procedures will be billed for, and the amount you pay will be the difference between that and how much your insurer is contracted to pay. Or in your case, the full amount if you don't have insurance. Even still, you can ask for a discount if you are paying in cash.

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bohemian

November 13, 2009 4:35 PM

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@trmentry: Nice parrot of every right wing blog. Sigh.

You are missing a huge portion of health care spending. Chronic conditions. These costs huge sums of money per year to treat people and the costs are far more than anyone could pay out of pocket themselves. This is why we need everyone in the same big risk pool.

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trmentry

November 13, 2009 4:35 PM

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Sure... put me in the pool. It will be vastly cheaper for me to opt-out of my employer plan. And pay the 'tax' for not having insurance... then going to get a plan when I need it.

There is no intensive to NOT do something like this.

All I was trying to say is TRY to do things that don't cost us all more money that we can't afford. Just b/c you want something for free doesn't make it a good idea. And saying we all in the same risk group doesn't make sense to me, since I won't be paying for a policy anyway, and just paying my little tax to not have a plan until I need it.

Great idea.

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LadyTL

November 13, 2009 4:35 PM

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@trmentry: so you believe wanting to be healthy if you are sick is not something we should get but \"entitlement\" if we can't pay for all of it ourselves?

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November 13, 2009 4:35 PM

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@LadyTL:
Hell yes it's an entitlement. Believing that you have a right to have someone else take care of your problems because you can't take care of them yourself is certainly entitlement.

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trmentry

November 13, 2009 4:35 PM

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I'm not saying that there isn't things that could be done to fix things and to help people. But bilking more and more people for a minority isn't the answer. There are things that can be done that don't cost money to the taxpayers.

All I would like to see is that happen first. Sure if that doesn't work, we can try other things.

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November 13, 2009 4:35 PM

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@jamar0303: And the cheapest per-megabyte Internet access in the world!

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November 13, 2009 4:35 PM

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reforms so that docs dont' have to pay HUGE premiums for malpractice

Texas passed major tort reform legislation in 2003. Their premiums have skyrocketed as much as anybody else's. Try again.

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November 13, 2009 4:35 PM

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@trmentry: \"o everyone gets a flex savings type account to 'save' pre-tax money for doc visits, etc. but this one isn't use or loose, it rolls over year to year so it's a true savings account type thing.\"

With all the other pointless garbage in this bill, it would have been nice to see the flex account rules relaxed; mainly what you said... getting rid of the \"use it or lose it\" clause.

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catastrophegirl chooses not to fly

November 13, 2009 4:35 PM

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@ZeGoggles: yeah, my flex account is hard to use in advance since it gets deposits out of each paycheck - and the last one of the year is right before christmas. so i'm saving a dental bill i paid out of pocket to send in at the end of the year so i can clean out every penny.

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November 13, 2009 4:35 PM

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@trmentry:
You have many reasonable, and likely effective, ideas. Unfortunately, no one will every pay any attention to them and will instead claim that you're ridiculous for suggesting that we actually try to control costs. Clearly the best way is a $1 trillion entitlement program setup to simply pay the inflated costs.

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morlo

November 13, 2009 4:35 PM

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@trmentry: Yeah, those ideas don't make anybody money. In fact they do the opposite! Congress is not interested.

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November 13, 2009 4:35 PM

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@morlo:
It's more that those options don't create govt. programs that the various members of Congress can take credit for passing. Plus, they don't give any tangible benefits to the populous, so they think their representative isn't doing anything for them. Plus, there's the money issue.

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November 13, 2009 4:35 PM

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I am not loving this requirement for insurance or fee. I see the intention behind it, but I feel there's too much that can go wrong with this, even something as simple as it going into effect before a reasonable public option is introduced.

Introduce a reasonable public option - then why do we need insurance at all? base it on the NHS idea (but fix what is broken there), and then there is nothing to fine people for.

7 replies

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thisistobehelpful

November 13, 2009 4:36 PM

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@subtlefrog: Yeah really. And what's their basis for low wage? Federal poverty wage? So if you're a family of 8 and make less than $26k annually you're fine. Oh no wait, now it's going to be better! If you're a single person you have until the $26k mark. Yeah that doesn't work where I live.

If something like this passes, I'm going to refuse to pay the fine that I will probably incur being unable to pay another premium. The entire point of a public option is to not have a premium to an insurance company because THOSE are the first thing screws up our chances at getting medical treatment without destroying our financial futures.

This country just sucks at being a first world nation. If I get cancer, I'm having a family dump my dead or dying body on the whitehouse lawn. TAKE THE HINT CONGRESS AND TAKE CARE OF YOUR CONSTITUENTS NOT YOUR LOBBYISTS. Jerks...

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ARP

November 13, 2009 4:36 PM

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@subtlefrog: My big worry is that the mandate will stay, but the public option will turn into a \"trigger\" that can be easily manipulated so that its actually never triggered. So, we'll be required to buy overpriced insurance but without the cost control measures the public option was intended to create.

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ChemicallyInert

November 13, 2009 4:35 PM

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@subtlefrog: Exactly, eliminate protective markets and set up safeguards against medical cartels, and we'd be set with a public option (which ends monopolization). Either that or go full NHS, which is not a goddamn death-sentence already. All I know is that what we have now sucks- and what we'll soon have will suck just as bad if not worse. Design by committee is the absolute dumbest way to do anything this complex. Save it for designing constitutions and getting fat on jelly doughnuts while you gossip at work.

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bohemian

November 13, 2009 4:35 PM

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@ChemicallyInert: I would be all for an NHS style system. The private system already has all of the faults and then some that get brought up about the UK system.

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ktetch

November 13, 2009 4:35 PM

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@bohemian: There *IS* a private system in the UK as well (companies such as BUPA exist)

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morlo

November 13, 2009 4:35 PM

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@subtlefrog: There won't be a public option. There are hundreds of billions of dollars at play which is simply enough to buy any government made by man. Even if God sent a Messiah to effect the public option, the health care industry would raise a mercenary army to crucify Him and His followers easily.

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ChemicallyInert

November 13, 2009 4:35 PM

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@morlo: OMG it's so clear! The insurance industry is Gog and Magog! :P

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ohnoes

November 13, 2009 4:35 PM

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@morlo: You get a heart for the metaphor.

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ChemicallyInert

November 13, 2009 4:35 PM

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Economically this makes no sense. The only health care system that works is going to be one kind of extreme or another. Either we create a universal health care system (Which would be MUCH better than what WILL get passed. The tea-baggers effectively settled on the worst of two evils by attempting to scuttle the process and refusing to be a part of the process.) or we institute a solution that controls for adverse selection without enforcing a mandate (i.e. a hybrid system).

It's a clusterfuck, and the paranoia and general ignorance of a large number of people isn't helping. Objections and constructive criticism welcome, insanity- not so much.

3 replies

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bohemian

November 13, 2009 4:35 PM

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@ChemicallyInert: If we can pass something that includes a public option it puts us closer to a national health insurance program. I think anyone should have the choice to join the public option if their employer coverage stinks.

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LadyTL

November 13, 2009 4:35 PM

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@ChemicallyInert: There is no such thing as a health care system that works economically. Not if it actually covers everyone even just for emergency services.

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ChemicallyInert

November 13, 2009 4:35 PM

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@LadyTL: That depends on what you mean by \"work\" admittedly. I frankly don't give a damn whether or not someone else makes a profit (the neoliberals here can call it Randist self-interest if they prefer) All I care about is that it actually provides good health care to the vast majority of the population.

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Thaddeus

November 13, 2009 4:35 PM

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This is how I think most Americans feels about it: \"I like the part where sick people who need help get it. Everything else, including how we make it happen, I hate.\"

2 replies

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November 13, 2009 4:35 PM

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@Thaddeus: That's because there's not a person in the world who wouldn't like something for nothing.

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November 13, 2009 4:35 PM

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@Darklighter: But isn't that what the government is pretending to offer? I've heard plenty of uninformed people refer to this as \"free health care\".

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November 13, 2009 4:36 PM

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@Toffeecake: I've also heard uninformed people refer to this as an evil socialist plan to destroy the country. What's your point?

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pahncrd

November 13, 2009 4:35 PM

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It seems that it is perfectly acceptable for the oligarchical corporate structure to absolutely control every aspect of our lives, however, the concept of giving the working class a tiny amount of leverage against their corporate masters is anathema. I'll never understand people that despise every possible bit of government regulation of big business, yet at the same time push all sorts of individual loss of freedoms (4th amendment violations such as dui checkpoints, prohibition, habeus corpus et cetera...). All the while they tolerate absolute control from a corporate standpoint. Personally, it makes sense to play the government against the oligarchy to keep them both at bay and afraid.

3 replies

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bohemian

November 13, 2009 4:35 PM

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@pahncrd: Your right. The problem is too many people don't think this whole thing through. Someone tells them the government is bad and they just run with it.

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November 13, 2009 4:35 PM

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@bohemian:
Unfortunately a lot of people who haven't thought this through are Representative who voted \"Yes\" on Saturday night. Why did they vote yes? Because they a) are democrats and Barry O. told them to, b) someone promised to vote for a bill they want to pass if they vote for this, c) fear of political fall-out.

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ARP

November 13, 2009 4:36 PM

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@Esquire99: As opposed to the Republicans who skipped out on a Patriot Act vote to attend the Teaparties and talk about how healthcare reform is worse that the threat of terrorism. They did it entirely on love of country and principle, not to score cheap political points with the most vocal of their potential supporters.

And I'm sure that Republicans, who have a long history of voting lockstep, all do it because they want to, not because party leaders pressure them. Also, I'm sure that since the Health Insurance lobby donates more heavily to Republicans, it has nothing to do with it.

If you're going to apply Real Politic to a situation, apply it to both sides.

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ChemicallyInert

November 13, 2009 4:36 PM

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@ARP: \"Realpolitik\". Sorry, I don't mean to patronize but I could not let that error stand!

Smiles! :)

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BrazDane

November 13, 2009 4:36 PM

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@Esquire99: Right, and now let's hear the real reason why most Republicans voted against it: 600+ million $ spent on lobbying by big insurance and pharmaceutical companies. To me, most Republicans seem to be businesspeople with absolutely no morals or ethics - it's the mighty dollar that rules and votes are for sale if the relevant industry spends enough money!

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November 13, 2009 4:35 PM

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@pahncrd:
You realize there are people in the middle, right? Not everyone despises \"every possible bit of government regulation\" and not all of us push the loss of individual freedoms. Some of us feel that there is a certain level of government regulation that is tolerable and necessary, but that certain things (like a govt. takeover of health care) cross the line. Not everything is Liberal or Conservative, Red or Blue, Republican or Democrat. Some of us like certain Democrat principals and certain Republican principals.

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Eldritch

November 13, 2009 4:35 PM

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The Mass. plan was a giant mistake. Why can't we take what Canada or England already has and just copy it for our country?

Am I just missing something? Why do we have to make everything three billion times more complicated than it has to be?

12 replies

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ARP

November 13, 2009 4:36 PM

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@Eldritch: There is a multi-billion dollar industry who wants to protect every penny and are spending in excess of $1M per day to lobby congress. That's what you're missing.

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theothered

November 13, 2009 4:35 PM

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I myself would prefer a single-payer system but we are generally pleased with the results here in Massachusetts, so please don't misrepresent the health plan results.

60% of residents and 70% of physicians support it. 97% of Mass residents are covered and the cost to taxpayers has been a 1.7% increase to the state budget. There was a brief shortage of Primary Care physicians as more people came into the system but that has been offset by decreased reliance on Emergency Room visits for basic care. All indications are that the initial ramp-up costs have slowed and real savings will be accomplished longterm as preventative and wellness care begin to work their way through the system.

It is not a perfect solution but as a model for national coverage, it is a vast improvement over the existing system.

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ChemicallyInert

November 13, 2009 4:35 PM

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@Eldritch: Methinks campaign finance reform and disemvoweling corporations in congress might put an end to a lot of the asshattery.

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November 13, 2009 4:35 PM

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@ChemicallyInert: Bst By? Wlmrt?

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AngryK9

November 13, 2009 4:35 PM

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@Eldritch: Because it's not about making life better for Americans. It's all about setting up loopholes to allow someone to line their pockets.

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BrazDane

November 13, 2009 4:36 PM

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jayphat

November 13, 2009 4:35 PM

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@Eldritch: You may want to look at the ginormous wait times in Canada. Or the fact that once, you are born in England, you are saddled with 25K right from the start in public medical debt.

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jayphat

November 13, 2009 4:35 PM

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@jayphat: I think people are mistaking my wait times. I'm not refering to the E.R. visit. I will be the first to tell you that sucks. About 6 years ago I was involved in a wreck where I THOUGHT my arm was broken(it wasn't thank god). I had insurance. The guy next to me was involved in a wreck as well. His arm was probably broken. I know for damn sure his knee was screwed up, as it shouldn't have been that low on his leg. His insurance was questionable. After a 2 hour wait for me, and a 7 hour wait for him, they call me first. I make them take him.

My point in terms of wait times was general procedures. MRI's and the such. I have a friend who lives in Sarnia, who thought it was perfectly fine that he was knocked unconcious playing football, and that waiting SEVEN months for an MRI was perfectly healthy.

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littlemisslondon

November 13, 2009 4:35 PM

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@jayphat: I live in Canada and I have never, ever, ever had to wait as long for anything as I did when I lived in the US.

Need an appointment with my GP? How about tomorrow? Need an appointment with my OB/GYN for a post-birth checkup? How about next week? Need to be seen by a doctor in a rammed ER with chest pain for my husband? How about 10 minutes? Need a swine flu vaccine because I have a baby? How about a free shot at the local city clinic, in and out in an hour despite the huge lineup?

Oh, yeah, and all of this is 100% free. I already pay for it through my taxes, which aren't inordinately high.

Granted, I live in a big city, and access to services is better here. But that's the case anywhere.

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kyle4

November 13, 2009 4:36 PM

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@littlemisslondon: You can't be from Canada, or if you do you're from a small town. The wait time in the Emerg in a town with a pop of 80,000 was nearly ten hours. My parents are both in the medical field and were enraged by the portrayal of our health care system in Sicko. My check-ups? Book them 3 months in advance. Family members have died of cancer that has been missed because of this wait.

Also, our taxes are ridiculous, it's not 100% free. They take like 8% of my dad's paycheck costing him nearly 8-10 grand a year in losses that he doesn't get back. That's one person. On top of that we pay 13% tax for everything we buy.

Lastly, our population is only 32 million, the States is over 300 million. The transition must be quite difficult.

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ktetch

November 13, 2009 4:35 PM

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@jayphat: I'm from the UK. I've been living in the US for 7 years. I've done a lot of hospital visits in both the US and UK. Emergency wait times have been longer in an empty US hospital, than in a busy UK one. My youngest daughter got some counter-cleaner in her eyes (tuck her hands on a counter we were cleaning, then rubbed her eyes) took 5 hours to get through the ER. In the UK, she'd have been in and out within an hour (unless there'd been a major incident) - I've seen the triage code requirements.

Thing is, the UK's NHS hospitals knows they a) have accountability to their trust, which is accountable to the government. and b) have competition in the form of private healthcare.

A box of wetwipes doesn't cost $12 either (taken from a Tennent Healthcare bill for my son's birth)

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bohemian

November 13, 2009 4:35 PM

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@jayphat: LOL. Please. Those claims are so 2006.

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Trai_Dep

November 13, 2009 4:35 PM

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@bohemian: Isn't it adorable when people who've clearly never left the Continental US have such assured positions on the relative benefits of the global health care system?
It makes me want to put out warm cookies and milk for them.

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LadyTL

November 13, 2009 4:35 PM

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@jayphat: Are the wait times for long term illness or for emergency rooms because the Americans have horrendous emergency room priorities which are heavily biased twards the rich with the poor getting the short end of the stick. As for the debt is that any better than our country's national debt?

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Megleris

November 13, 2009 4:35 PM

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I'm amazed at what i'm seeing here. We need 'insurance reforms' to limit malpractice - Why?!?! If you personally injure me there isn't such a limit. If i got you professionally there shouldn't be, either. That, and the few states that HAVE passed this HAVEN'T had a decrease in insurance.

The military get some of the best care 'round, medicare has the highest approval rates of any insurance, the public option is WAY more effecient (medicare vs medicare advantage, medicare is 13x more effecient). I REALLY disagree with there being a mandatory insurance requirement WITHOUT there being an accompanying public option.

8 replies

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November 13, 2009 4:36 PM

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Did you not see 60 Minutes last week where the exposed Medicare fraud? One person made $20 MILLION dollars per year by submitting fraudulent claims to Medicare. This was just one person. Just because their admin rate is low does not mean they are efficient. It means they are simply paying claims without any oversight. The same thing would happen on a public plan. You don't hear about fraud in private plans nearly as often as you do in Medicare/Medicaid.

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BWoodle

November 13, 2009 4:36 PM

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@John Gage: And he's in jail now, right? What's the problem?

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Eldritch

November 13, 2009 4:35 PM

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@Megleris: I thought the military was having problems with their medical stuff? Wasn't there a big scandal a year or two ago about how badly the hospitals run and how long the waits are for people to get treatments?

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November 13, 2009 4:36 PM

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@Eldritch: if you read into the bullshit behind the walter reed scandal, it was because the hospital was privatized under a plan that was rejected by the army b/c they found they could do it better for less money: [www.washingtonpost.com]

so, in reality, the problem here isn't gov't-run - it's gov't-contracted.

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bohemian

November 13, 2009 4:35 PM

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@Eldritch: Under funding of the VA was chronic under Bush. It took exposing this to finally get the funding needed. Most VA clinics can get same day or the next day appointments if they are needed.

The problems brought to light were at Walter Reed. A large portion of the problem was blamed on 3rd party contractors that were supposed to be maintaining that building and didn't.

Having seen the care and how things are handled at some of the better VA hospitals I would rather go there than some of the for profit private providers. 3 month waits for an appointment and doctors insisting on $900 CT scans because you need a hay fever med in spring? Yea private health care is Soooo good.

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utensil42

November 13, 2009 4:35 PM

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@Eldritch: The military health care system is totally separate from the VA.

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November 13, 2009 4:35 PM

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@Megleris:
We don't need insurance reforms to limit malpractice, we need Tort Reform to limit malpractice suits. If you're going to attack a theory, at least get the terms right. Something like tort reform isn't going to lower rates overnight. More than likely, it's just going to stop rates from rising so rapidly. Tort reform will also limit suits against drug and medical device companies, which should keep the costs of drugs down and the costs of medical equipment down.

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Vzylexy

November 13, 2009 4:35 PM

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Tort reform is just a band-aid, at most it'll save under $10Billion/year(I don't remember the exact figure). Big deal.

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November 13, 2009 4:35 PM

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@Vzylexy:
Yes, god forbid we implement anything that would only save $10bil per year.

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Trai_Dep

November 13, 2009 4:35 PM

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@Esquire99: By \"saving\", VZ is referring to malpracticing doctors being able to cheerfully give the finger to maimed patients knowing they'll only face a pittance in punishment or mitigation.
He's NOT referring to savings for the health care system: Texas has the most draconian \"tort reform\" (their lobbyists are best in the nation!), and both their median and deltas are among the country's highest.

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FDCPAGuy

November 13, 2009 4:35 PM

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@Vzylexy:
[ Citation needed ] :P

Why do people focus on something saying it will only save X as if to imply it isn't worth it. I'd say $10 B/yr is a start. Who wouldn't like to save $32 for every man, woman and child in the US?

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Vzylexy

November 13, 2009 4:35 PM

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@FDCPAGuy:
[www.cbo.gov] ( PDF warning)

It would actually save $5bil/year. But like I said, it's simply a band-aid, it doesn't address any actual issues with health care in this country. Besides the CBO report admits that it's not entirely clear if tort reform is the right thing to do.

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AngryK9

November 13, 2009 4:35 PM

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Health care needs reform, there's no doubt. But I do not believe that this bill is the reform that is needed.

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morningface

November 13, 2009 4:35 PM

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I'm actually really angry about the 'not including plans that cover abortion' thing. It's a medical procedure! Get with the program! And stop hating women for having the final say over what happens to their bodies!

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November 13, 2009 4:35 PM

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A simple question is: Name one thing the government does well.

Maybe the post office, and that's even losing tons of money. I can't think of anything else.

2100 pages. It's going to suck.

15 replies

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November 13, 2009 4:36 PM

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@lawnmowerdeth: Taxing! They tax real well. They manage to fool most people into thinking they didn't just pass the largest tax increase in history. The politicos are celebrating now they can rest easy knowing that in spite of passing a large tax increase, they won't feel the pain. They also know how to spend money they don't even have. They are great at taxing with most people not knowing (or caring) that inflating the money supply is eating them alive. The government is great at lying about what they're doing. They will deny when asked a straight question and that will be the end of it. The government is excellent at destroying a massive economy and then blaming its denizens for it. The government has many talents and is great at so many things. The problem is that what they are good at is not what I want them to be good at.

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ARP

November 13, 2009 4:36 PM

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@lawnmowerdeth: When a government agency is well funded, has a reasonable mandate, and has sufficient authority over its operations, they do very well.

You're buying into the trick that Regean pulled with the EPA and lots of other agencies:
1) Underfund them
2) Give them confusing/contradictory priorities
3) Require more red tape or put somone incompetent in charge.
4) Give them more responsibility, but less authority to act upon it.
5) State that the EPA is a failure and that another approach is needed.
6) Repeat.

Putting people in charge of government who hate the government is self-fufilling prophecy.

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theothered

November 13, 2009 4:35 PM

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@lawnmowerdeth:

National Defense
National Highway System
Social Security
Medicare
Environmental Protection
The Federal Court System
FDA

This is just a few. Please tell me which of these we would be better off turning over to private industry as a for-profit business?

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November 13, 2009 4:35 PM

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@lawnmowerdeth:

They don't run the Post Office. It does not receive any Government funding.

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bohemian

November 13, 2009 4:35 PM

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@lawnmowerdeth:The previous Senate bill was over 1000 pages. I read the entire thing. It was double spaced and the bulk of the space was terms clarifying what certain things meant. It isn't that horrible unless reading is too hard for you.

The VA does a better job that our screwed up private health care where I live.

Our post office has very nice people that run it. They just upgraded everything and changed the city to city route so our mail gets where it is going faster.

Our fire department rocks. I could go on all day about some of the things they have to put up with but always do a great job.

Most interaction with government agencies are far better than dealing with Comcast or Best Buy.

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Davezter

November 13, 2009 4:35 PM

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@lawnmowerdeth:

Of course the Post Office is losing money -- we're in the middle of the biggest recession in US History! God, name a company that isn't laying off employees and losing money right now... oh wait, the Insurance Companies!

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redkamel

November 13, 2009 4:35 PM

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@lawnmowerdeth:
1. The post office: I have only had good experiences with them. UPS is bad.
2. The DMVs, in my area, have 1 hour wait on weekdays and friendly staff that just give you the papers you need. I always felt the rep was more of a joke than a real thing.
3. The nut and bolts/day to day of the military seems to work well most of the time
4. The highway system
5. Public parks, when funded
6. This isn't federal, but our local EMS, fire, and police dept are well funded with fast response times
7. my student loans/FAFSA work way better and with lower rates than my private loans

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November 13, 2009 4:35 PM

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@lawnmowerdeth: I'm impressed that you can determine whether or not a document will be worthwhile or not by its length. Can you offer me your length-based reviews on the following documents?

The Holy Bible
The Complete Works of William Shakespeare
Where The Wild Things Are
The Lord of the Rings
Harry Potter
Atlas Shrugged

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hi

November 13, 2009 4:36 PM

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@Darklighter: Those are all fiction.

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November 13, 2009 4:35 PM

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@Darklighter: None of those were written by politicians.

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November 13, 2009 4:36 PM

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@lawnmowerdeth: I'm sorry, I couldn't hear you over the sound of goalposts moving.

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ktetch

November 13, 2009 4:35 PM

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@Darklighter: Never read Where the Wild Things are, but i've read the rest. Shakespeare has good imagery, good storytelling, and is generally interested.

The rest are turgid trash.
The bible contradicts itself so much it's not funny.
The lord of the rings - 3 books about walking (even the trees walked!)
Harry Potter - poorly written, the Literary version of a McDonnalds hamburger
Atlas Shrugged - where to start? It's basically Bulverism, and trumpeted as some philosophical treatise. If you need 60 pages to make a speech in a book, you've lost your point.

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November 13, 2009 4:35 PM

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@lawnmowerdeth:
Aside from losing a ton of money, have you actually been inside a post office lately? Every time I've had the displeasure of having to visit one I'm greeted by slow, uncaring, rude employees who believe their job is to collect a paycheck, not to actually do any work.

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November 13, 2009 4:36 PM

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@Esquire99: The U.S. Postal system should be considered a modern marvel.
I once mailed a letter in the morning, and it was delivered 150 miles away in the afternoon of the same day. All for around 29 cents.

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Trai_Dep

November 13, 2009 4:35 PM

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@Esquire99: Maybe it's your attitude? I generally find you get as good as you give, including the post office.

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Siegeman

November 13, 2009 4:35 PM

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@Esquire99: You know, it's strange... Every time I go to a post office I'm greeted by nice, friendly people who always help me get the lowest rate for the shipping service I need. Every time I deal with UPS or FedEx they treat me like a criminal and a liar that they want nothing to do with.

I wonder if one's perception of our Government is based completley off of the operations of the local post office...

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FormerlyAnonymous

November 13, 2009 4:35 PM

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@Siegeman: I think it's more likely that one's experience with the local post office, and other government agencies, is based entirely off of one's perception of government.

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November 13, 2009 4:35 PM

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\"We are from the government and here to help you\"

Bastards had a special session on a Saturday just to pass this bag o' crap. Where is the real leadership in this country? I say kick the bums out!

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GC

November 13, 2009 4:35 PM

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I'm so glad that I live in Canada. The utter insanity in the above comments is incredibly sad. It's still shocking how in the 21st friggin' century that you have people hollering about 'state's rights' and about how trying to help those who need help the most is somehow against the American constitution.

I truly hope that the dying protests against health care reform are the death throes of the GOP and conservatism in America.

16 replies

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shepd

November 13, 2009 4:36 PM

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@GC: I can tell you for a fact that not all Canadians agree with you. As someone living beside the hospital with the highest death rate in Canada (In the 10th largest city in Canada, no less!), I'd feel safer if I could pay for my healthcare.

And the debacle that is Ontario's (and other provinces) handling of the H1N1 vaccine makes the US' slow, controlled rollout look like a panacea. $2,300 for a shot if you want to pay, here (Ask Medcan). Sports players get special recognition. Lineups so long people parking at 8 am getting parking tickets at 6 pm (The spots didn't allow 6-9pm parking). Ridiculous.

Don't even get me started on how stupid it is that to keep yourself in even halfway decent shape, you need to live in a city for YEARS to get a real doctor due to excessive shortages, and you are pretty much going to have to pay medical insurance anyways (Albeit less than they do in the US), lest you end up with bad eyesight, teeth, need regular medicine, or even just have some sort of chronic pain eased by physio.

And entire provinces of nurses/doctors/paramedics going on strike? Good grief! But it's pretty regular occurrence in Canada, especially out west.

No thanks, Canada isn't a bastion saint of medicare. Now, some places in Europe, that's where socialized medicine is actually working. And for less money, too.

Now, before you say I'm insane, here's the deal: Canada's way of doing health care sucks. The US way is better. The European way seems to be even better than that. In that order, right now I'd rather have the US system here, but, quite honestly, I'd go for the European way of doing things anyday.

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kyle4

November 13, 2009 4:36 PM

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@shepd: Unfortunately most times the Paramedics don't want to go on strike but are forced to because they're in the same union as the garbage men. Do you consider EMS an essential service like Firefighters or Policemen, because according to Ontario they're not.

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bohemian

November 13, 2009 4:35 PM

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@GC: The nutbags have come out of the woodwork. There are quite a few use ID's that you don't see in other threads. My guess is Free Republic put a link to this post on their forum, thus the chowderheaded states rights nonsense.

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trmentry

November 13, 2009 4:35 PM

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What does that mean? chowderheaded states rights?

I'm not following what you meant by that.

Are you saying that we shouldn't be a collection of free and independent states in a union for a common good? That is after all what we are. A collection of states, united for a common defense, etc. However over time, it has been corrupted to an extreme. The US Constitution is a LIMIT on the power the Federal Gov't can do. It wasn't a document to have free reign like the current way of thinking and lump things all into the commerce clause or general welfare clause like the courts have allowed.

The States were to retain their rights to govern themselves basically. Thus the 10th Amendment. As far as I know, it's still in affect.

The whole thing that it's a \"living document\" is bs. It's a limit on power, pure and simple.

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November 13, 2009 4:35 PM

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@trmentry: So the US is basically the EU on a different level? Let's break up the federal government and see how well the states survive on their own, then if that's all it's supposed to be.

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parkj238

November 13, 2009 4:35 PM

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Exactly, lets break up the states and see how well the Red States do without the tax income generated from the Blue states.

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jayphat

November 13, 2009 4:35 PM

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@parkj238: You do know that \"red states\" are running more in the black than \"blue states\" right? Texas has little to no debt, California is out of control.

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Trai_Dep

November 13, 2009 4:35 PM

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@GC: Well, you have to understand that many of the wingnuttier of the commentators went to primary & secondary school in the US, rather than Canada. Some schools here test better than they teach, particularly critical reasoning. Please make all due allowances with your nation's usual understanding and compassion. :)

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November 13, 2009 4:35 PM

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@GC: YES, THIS. I'm hoping for the chance to move north of the border someday. That or Japan (also has a healthcare system that won't leave people dying like what America has now, not to mention anime and all that other fun stuff).

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Trai_Dep

November 13, 2009 4:35 PM

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@jamar0303: You skipped over the best part of the Japanese health care system: they rarely give more than a raised eyebrow over tentacle porn mishaps.

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catastrophegirl chooses not to fly

November 13, 2009 4:35 PM

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@jamar0303: i'm wary of japan. i work for a pharmaceutical company and one of the medications we make is only available in japan based on your postal code. basically, if you don't live in the right place, you can't get your medication.
i have no idea why but it seems a little unfair

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November 13, 2009 4:35 PM

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@catastrophegirl: By POSTAL CODE? I understand if you can't tell me what the medicine in question is but if you could give me an example of a few postal codes where it is available and a few where it isn't it would go a long way towards understanding why (Maybe there are separate pharma contracts for each region and people elsewhere are getting an equivalent made by some other company?). I don't think they'd be so callous as to deny medication by location without good cause.

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shepd

November 13, 2009 4:36 PM

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Canada has a similar system. Each province decides what medication is free and what isn't. The ones that are free are extremely limited in selection. Therefore, in Canada, your postal code will easily determine whether or not you get your treatment for free (Although, the actual availability of the drugs is Canadawide, AFAIK, but the costs of some of them mean they are effectively not available, especially certain new cancer fighting drugs)

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catastrophegirl chooses not to fly

November 13, 2009 4:36 PM

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@jamar0303: there isn't an equivalent to this medication really. and i don't know more about which postal codes, i'm not in that end of the business, i do united states customer support. i found out about that in the process of trying to help a patient who was moving to japan.

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November 13, 2009 4:35 PM

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@GC:
We should send those who want socialized health care to live with you. I'm sure as a Canadian you don't really understand the US Constitution, so I'll just leave that comment alone.

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LadyTL

November 13, 2009 4:35 PM

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@Esquire99: Actually since canadians are taught american history in high school they probably understand the US constitution better tha you do.

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November 13, 2009 4:35 PM

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@LadyTL: Speaking as a Canadian, I do understand the U.S. Constitution but the political differences between our nations are staggering. Living in the U.S. now gives me a whole different perspective on things.

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Trai_Dep

November 13, 2009 4:35 PM

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@Esquire99: So I take it you'll give up using highways, being that they're \"unconstitutional\" and all...

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FDCPAGuy

November 13, 2009 4:35 PM

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@GC:
We aren't against helping people we're against being forced to pay to help people. I'd rather see health care reform being a combination of modernization and tort reform. I feel that if you pass meaningful tort reform costs to providers would drop causing costs to insurance companies to drop then (hopefully) followed by a drop in coverage costs to the consumer. Then if the gov't wants to go about funding health care for the poor/underprivileged then it will at least cost less. Plus, in your great nation your government isn't going to fine you or possibly jail you if you refuse to get health insurance or pay their fine. I wish you'd keep your generalizations about conservatives north of the border eh.

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November 13, 2009 4:35 PM

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@FDCPAGuy: i'm for tort reform, but not without universal coverage, salary caps & some sort of citizen control of licensing boards to ensure that bad doctors lose their rights to practice.

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November 13, 2009 4:35 PM

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@FDCPAGuy: also, important to note that we tried the tort reform thing once before with HMOs & what did that buy us? less expensive medicine? no, cheaper care at a higher price.

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trmentry

November 13, 2009 4:35 PM

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@GC:

Do you know the history of what the UNITED States means? The People formed the States who were all independent before the Revolutionary War. Then the States formed the UNION. The US Constitution was a limit put on the FEDERAL Gov't. The States for the most part would still be their own entity. But that has been twisted over time to where the FED forces crap on the States.

The way things are heading, what is the point to still having State and Local Gov't? I'm truly afraid of that. Central Gov't is a bad idea.

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November 13, 2009 4:35 PM

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@trmntry:
H's Cndn. Tht's why ddn't bthr tryng t xpln th cnstttn, tc. Y'r bttr ff xplnng t t yr dg.

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Nicole

November 13, 2009 4:35 PM

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@Esquire99: Because, what, Canadians are inherently stupid? What makes you think this person wouldn't understand the Constitution because they're not American? Could you be any more condescending?

","

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November 13, 2009 4:35 PM

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You forgot what it doesn't cover. From The Nation:
\"None of the bills emerging from the House and Senate require insurers to cover all the elements of a standard gynecological \"well visit,\" leaving essential care such as pelvic exams, domestic violence screening, counseling about sexually transmitted diseases, and, perhaps most startlingly, the provision of birth control off the list of basic benefits all insurers must cover. \"
Not to mention the Stupak amendment, which has poisoned the bill for progressive supporters. And the passed bill was so bipartisan it got one whole Republican vote.

8 replies

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Trai_Dep

November 13, 2009 4:35 PM

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@MsFeasance: The way I look at it, they went for what's possible the first round. Husband, stew and bottle your rage. Then pull it out once this gets passed to change it for the better. The Perfect being an enemy of the Good, here.
Like FDR noted to Progressives of yore: I agree with your position, but you have to MAKE me agree with you.

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ARP

November 13, 2009 4:36 PM

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@Trai_Dep: Yes, I'm not thrilled with this bill either. However, I view it very similar to they gay marriage debate. I would rather get civil unions now and work our way to civil marriage later, than an all or nothing. That being said, I think there are many who think this will be our only shot for quite some time and are trying to cram everything into it.

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atashida

November 13, 2009 4:35 PM

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I'm currently in the Japanese public health care system (I'm American), and it DOESN'T cover pelvic exams and routine care.

HOWEVER, when you do go in for those things, the cost is low. Like $30-40. Not the $200 it'd be if I went in without insurance in America. And if you go in with a problem, your payment is going to be $5 or less.

It's not perfect, in a perfect world yearly exams would be covered, but I'm pretty happy.

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November 13, 2009 4:35 PM

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@atashida: One assumes that this is not a priority for the natives as only dirty gaijin carry STDs. Pristine Japanese plumbing therefore never needs examining.

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h3llc4t, breaker of office dress codes

November 13, 2009 4:35 PM

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@atashida: If you utilize facilities like Planned Parenthood the cost is comparable to what you have in Japan (depending on your income, of course). I used to be able to get my birth control injection for around $40 through them; with my health insurance I now pay around $100.

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jayphat

November 13, 2009 4:35 PM

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@MsFeasance:
Can someone tell me how the Constitution provides a womens right to abortion as a \"right to privacy\" under the 14th amendment, yet myself, my employer, and my insurance company enter into an insurance contract, choosing what does and doesn't get covered, and suddenly that's everyone's god damn business?

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Nicole

November 13, 2009 4:35 PM

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@jayphat: Abortion is not birth control. Neither is a pelvic exam. No one here has said ANYTHING about abortion.

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jayphat

November 13, 2009 4:35 PM

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@Nicole: Did you read that link in the first comment?

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redkamel

November 13, 2009 4:35 PM

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@Nicole: RTFC?

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November 13, 2009 4:35 PM

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@jayphat:
Good Question. The Constitution doesn't actually include a right to privacy. Unfortunately, the Supreme Court made one up and consistently upheld its existence. I do think there SHOULD be a right to privacy in the Constitution, however, but that's something Congress needs to add via Amendment. That will NEVER happen, so we're stuck with the made-up right. Are we \"Better off\" because this right \"exists?\" Absolutely. Does that justify the judicial branch pulling that right out of thin air? No.

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Rectilinear Propagation

November 13, 2009 4:35 PM

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@Esquire99:
Do we not have any rights other than the ones the government chooses to give us?

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jayphat

November 13, 2009 4:35 PM

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@Rectilinear Propagation: You have EVERY right. The government does not have the ability to give OR take away rights. Now, that does not mean that healthcare is a right, as someone has to actually PROVIDE it for you.

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November 13, 2009 4:35 PM

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@Rectilinear Propagation:

That is not the way it works in the US, although you would think that from the way our government acts.

We the People have the rights, endowed by our Creator. Some of them are abridged as explained in the Constitution.

","

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matt1978

November 13, 2009 4:35 PM

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@Esquire99: It's always going to be easy for people without experience to speak on these matters. It'll always be easy until it's you with the condition - what would you do then esquire? Just shuffle off into the sunset? Put your significant other on the ice floe to oblivion, with the final send-off of, \"Sorry babe, you were putting Cigna in the red\"?

4 replies

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chrylis

November 13, 2009 4:35 PM

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@matt1978: Buy insurance before you get sick instead of waiting until you get the diagnosis? (I might support limited portability measures, but if I don't buy auto insurance until after I hit somebody, it shouldn't cover me.)

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November 13, 2009 4:35 PM

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@Tetrine: In a for profit insurance based system that figure might be correct .

And that's the whole problem . Everybody is looking at this from the stand point of ONE way of paying for health care . Not only is the bill focusing on ONE method of payment because that's what this is a health care method of payment bill it fails to address the COSTS and true alternative solutions to cost .

If anyone CHOOSES to use insurance to pay for their medical needs they have to have to understand in a for profit insurance based system that risk will spread out and if the for profit insurance companies want to throw in the cost of the uninsured into the premiums so be it . You box yourself in with a single method of payment - insurance : extensive insurance at that . One of the many problems with this plan is that it does not provide alternatives for paying OR controlling costs . As long as a third party is paying for it the costs will be out of control .

I want to see ideas explored like paid medical school or subsidized equipment purchases . The medical cost should be driven down to the point where insurance should be for catastrophic hospitalizing events . And not a 150$ trip to the doctor for the sniffles .

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November 13, 2009 4:36 PM

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@u1itn0w2day: Agree with you on the costs issue. I don't understand why Congress has completed ignored the actual problem - high cost of medical care - in favor of wading into the insurance system muck. There are many facets to the health care issue, and coverage is far from the only solution.

Did anyone hear the two podcasts from This American Life on the issue of health care costs? Eye opening and disturbing when you consider how much is being left out of the whole health care debate.

[www.thisamericanlife.org]
[www.thisamericanlife.org]

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November 13, 2009 4:36 PM

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@windycity: The last link with the title \" Someone Else's Money \" sums it all up .

And yes there are too many facets to health COST issue . This bill or debate isn't about better care it's about up front cheaper care . But we'll still pay for it in the back end .

They need to study cost issues including schooling , technology ( too much or not enough ) or find out wether there is just plain old price gouging .

This is a health INSURANCE debate . It's almost like paying a bill before you see the invoice . Too many involved in the whole debate have become hooked on an insurance based reimbursement health care delivery system that getting rid of it or changing will very difficult .

And what do junkies do ? -they lie , cheat , manipulate and steal . Better watch your wallet and qualty of life for which this is supposed to improve

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November 13, 2009 4:35 PM

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@matt1978:
I wouldn't expect the government to force a private company to take me on as a \"customer\" and to simply pay my bills for me.

","

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November 13, 2009 4:35 PM

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@Esquire99: It's not $1 trillion, but even if it was, that's spread over 10 years. That's $100 billion a year. You're telling me there's no way to find $100 billion dollars anywhere? Hell, we just passed a defense bill for fiscal year 2010 alone that's well over $600 billion. No one bats an eye at that.

2 replies

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November 13, 2009 4:35 PM

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@Tightlines:
It's actually $1.055 Trillion (as of last night). And they already know where they are going to find the $100bil/year, they're going to impose a 5% surtax on the wealthy. When that proves not to be enough, they'll raise everyone's taxes. Ridiculous.

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jayphat

November 13, 2009 4:35 PM

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@Tightlines: No no, it's $1.2 trillion by 2019. This doesn't start paying out until 2013, but starts collecting immeadiately. It's more like 1.2 trillion over SIX years.

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chobee143

November 13, 2009 4:35 PM

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Let me get this straigh:
1. we're going to pass a health care plan
2. written by a committee whose head says he doesn't understand it,
3. passed by a Congress that hasn't read it but exempts themselves from it,
4. signed by a president that also hasn't read it, and who smokes,
5. with funding administered by a treasury chief who didn't pay his taxes,
6. overseen by a surgeon general who is obese, and
7. financed by a country that's nearly broke.

What possibly could go wrong?

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November 13, 2009 4:35 PM

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The pre-existing conditions clause is a bad idea. Consider this scenario: I am a young (early 20s) guy who has no health problems. I choose not to get insurance as I could take the money I would pay in premiums each month, say $100, and put them in a savings account and if I did need to see a doctor pay it out of there. I haven't been to a doctor for illness in years.

Suddenly, I become sick with a horrible disease and can no longer afford to pay out of pocket. Insurance companies are now forced to pay for my expensive care since they can't deny me insurance. It's like buying car insurance after you total your car.

I agree that some cases of claims being denied are preposterous, but there has to be a better way of managing insurance exclusions. I understand the scenario above is the impetus for the fines (if one chooses to not buy insurance), but I think there are major ethical and constitutional issues with mandating insurance coverage.

I believe in an America where one has freedom and is not mandated to buy anything. Its a shame the 200 page GOP alternative plan did not get a better look as it had great potential to reduce costs.

10 replies

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East_Coast_Midwesterner

November 13, 2009 4:36 PM

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Hence all are insured. It is cute you think premiums are 100 bucks a month

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Bhockzer

November 13, 2009 4:35 PM

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@fs2k2isfun: Yeah, that GOP alternative cost more in the long term and covered fewer people. How is that even remotely better?

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bohemian

November 13, 2009 4:35 PM

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@fs2k2isfun: This is why what we really need is federal single payer insurance. But since so many companies fought that idea we are in the compromise stage and compromise sucks.

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November 13, 2009 4:35 PM

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@bohemian: Hear hear.

Whining about how the bill will force poor, put-upon insurance companies to rake in slightly less money managing larger risk pools is repugnant: Nobody in a developed nation should ever go without needed medical care, period. Single-payer is the best way to get there, but it's politically impossible in this country. This bill is a whole hell of a lot kinder to the insurance companies, and consequently kind of half-asses the job of providing everybody with medical care.

Bottom line, I believe in the free market to exactly the extent that it makes the world a better place. I view adequate medical care as a much more fundamental right than the right to unrestrained profit-seeking.

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November 13, 2009 4:35 PM

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@GuidedByLemons:
The issue of forcing insurance companies to take on people knowing they will be a huge drain is only part of the issue. Higher taxes to pay for it, costs imposed on employers who are already having trouble keeping their employees, govt. competing with private companies, the fact the bill does nothing to actually REDUCE the cost of care, etc. are also major problems. Moreover, it's also another $1 trillion on top of our currently enormous deficit.

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November 13, 2009 4:35 PM

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@Esquire99: If this bill wiped out every medical insurance company and replaced them with a federal single-payer system I would be all for it. IMO higher taxes for near-universal health care is money well spent, and providing competition is exactly the part about the public option I like best. Again, I support the principles of a free market only as far as they make the world better. I will gladly sacrifice the sanctity of private sector health insurance if it leads in the direction of universal health care.

Moving on: The price tag is in no conceivable way \"on top of our currently enormous deficit\": it is more than offset with taxes and cuts/savings. And if you think the bill doesn't reduce the cost of care relative to the status quo you might want to take that up with the CBO, who have put a whole lot more thought into it.

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jayphat

November 13, 2009 4:35 PM

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@GuidedByLemons: Really? You're ready for the federal government to step in and say what you can and cannot eat, what medication you will and will not be able to have, hell even wether or not you can use a ladder? Because that' what happens with a single payer system. Do some research on England's system.

Single payer is a monopoly by the government with the option to control EVERY aspect of your life in the name of controling costs.

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November 13, 2009 4:36 PM

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@jayphat: Where are you getting this stuff? I have done research on the UK's health system, which does not control even a little bit what people can and cannot eat--everybody's care is provided, period, regardless of what they eat or how many ladders they climb--and perhaps more importantly is absolutely not a single-payer health insurance system. The government directly provides medical care, not insurance.

While I don't think the UK's system is terrible, what I'm advocating is quite different: something like Canada's system, with a private health care industry paid through universal government health insurance.

I always get a kick out of it when people go into histrionics about government bureaucrats controlling what medications and treatments you have access to. Presumably you prefer that your access be controlled only by private bureaucrats with a vested profit interest in denying you anything they can get away with.

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November 13, 2009 4:36 PM

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@JohnQPublic: Actually it's not. You see, I am am in favor of Health Care reform but AGAINST this bill. The costs are too high, it's being rushed through way too fast considering its size and scope and if the House vote showed anything, it showed this is a deeply divisive issue.

I support more regulation of the insurance companies, I support the banning of prescription drug advertising and I support making insurance more affordable. But you know what? All of this can be done WITHOUT a government run health plan.

I think this is the kind of issue that needs to go direct to the people. Let's have a national referendum on health care and let every voter cast a yes or a no on this massive bill and see where the votes line up. I can just about guarantee you it wouldn't pass.

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lmarconi

November 13, 2009 4:35 PM

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@bohemian: Just wanted to say thanks for saying everything I wanted to say in the comments for this article.
I don't necessarily think that all conservatives are Glenn Beck shouting about communism, but I do think states rights are too outdated to be intelligently mentioned. I'm a history student and I think Constitution is an amazingly intelligent and simplistic document, but I don't expect a document written 250 years ago when we were a lot smaller country with a lot less problems to still be entirely applicable today. It's kind of like how I ignore that part in the Bible about beating your wife, but choose to listen to the part about loving your neighbor.
Also, I'd like to point out that I know very few people with an unstable employment situation who are against health care reform. As a grad student graduating this year and jumping into the (less than stellar) job market, it's enough to worry about finding a job at all, let alone one that offers health insurance (or one that pays well enough to allow me to buy it on the current market.)I lived in the UK for a few years and liked the NHS, I'm excited about the prospect of a system that will afford me with more options.
In the interest of full disclosure Esquire99, do you have stable employment and get your insurance through your employer? Does no one in your immediate family have a serious health problem? If so, hey, I don't blame you for disliking the bill - the current problems in the system may not affect you.
However, if we only looked for solutions to problems that affected us, I think we'd be in a pretty sad place.

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LadyTL

November 13, 2009 4:35 PM

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@fs2k2isfun: You know you can actually still buy car insurance after you total your car. You can't always buy health insurance if you get sick even if its just a cold or an allergic reactions in some cases.

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November 13, 2009 4:36 PM

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@LadyTL: But you'll have a hard time buying insurance for your already totaled car that will then fix it, though you certainly can buy it for the new one.

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WillB

November 13, 2009 4:35 PM

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@fs2k2isfun: \"I believe in an America where one has freedom and is not mandated to buy anything. Its a shame the 200 page GOP alternative plan did not get a better look as it had great potential to reduce costs.\"

Ahahahaha you're what is wrong with this country, starting with the fact that the GOP plan would've resulted in spending money on covering less people than currently covered.

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utensil42

November 13, 2009 4:35 PM

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@fs2k2isfun: @Esquire99: The bill states that an individual cannot be denied coverage based on a pre-existing condition. No where does it say that an insurer must cover said pre-existing condition.

So, if I have asthma, I can now get insurance that will cover the emergency appendectomy I end up having 10 years from now but still won't be covering my asthma.

Your argument is now moot. Try again.

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November 13, 2009 4:35 PM

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@utensil42:
I would like to see that clarified somewhere. If that's the case, and they would NEVER have to pay a cent towards that pre-existing condition, I would gladly concede my point. My understanding of the current \"pre-existing condition\" law is that insurance companies that take on a customer with a pre-existing condition can only refuse to cover that condition for something like 1 year. After that, they have to pay bills associated with the pre-existing condition. If that's the case in the new bill, it's still a huge problem. Either way, that doesn't resolve the many other issues I have with the bill.

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bohemian

November 13, 2009 4:35 PM

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I still hold out hope that someone has a stealth single payer option that they will pull out and pass at the last second.

3 replies

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Duke_Newcombe sez íViva la Revolucion de Chihuahua!

November 13, 2009 4:36 PM

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@bohemian: This.

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Trai_Dep

November 13, 2009 4:35 PM

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@bohemian: I think, once they're out in a limited fashion and prove to be more reliable and cheaper than the for-profit alternatives, there'll be a lot of pressure to make them more widely available.
Keep in mind that much of what goes into employer health insurance could be going into our paychecks instead, if we get cost controls down. Most people, given a choice between an additional 4% raise or seeing that money going to Aetna might like the former option more.

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ARP

November 13, 2009 4:36 PM

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@Trai_Dep: That's where the communication breaks down. Opponents have successfully convinced people that their taxes will go up if we get single-payer/UHC. That's true. However, they don't realize that the their net paychecks will likely go up because they don't have to pay health insurance premiums anymore.

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November 13, 2009 4:35 PM

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Sounds like a real win-win for the government. Saying you don't make the low income cut, you either pay one of their \"localized not for profit (bullshit) co-ops\" or pay the Insane Revenue Stealers. Either way, someone's getting money out of your pocket. How the hell does this help the middle class?

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November 13, 2009 4:35 PM

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@Havoc737903:
It doesn't help the middle class. It helps less than 15% of the population and will ultimately end up costing the middle class in the form of more taxes (amongst other things).

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November 13, 2009 4:35 PM

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[costofwar.com]

Site run by the National Priorities Project.

Dunno about its accuracy, but it shows the total cost of the Iraq war to date is (as of right now) just under 700 billion since 2001. They're saying the combined cost of both the Iraq and Afghanistan wars to date (since 2001) is just under a trillion.

If these numbers are accurate, 8 years of 2 simultaneous wars have cost less than this healthcare bill will. There are both things I agree and disagree with regarding this bill. Just throwing that out there.

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Trai_Dep

November 13, 2009 4:35 PM

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@WraithSama: Again, they're not incorporating projected costs, which are staggering.

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November 13, 2009 4:35 PM

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Really? REALLY?? Let me vent a moment. My wonderful husband works a blue collar job. I'm disabled and still fighting for the SSD rights I paid into for 42 years. That would be going on 4 years now. Hubby makes just under $50k a year. It's just the 2 of us. He has pretty decent insurance through his employer. I see my Drs at least twice a month. That's 3 Dr visits at $25 each. Providing I don't need to see them for anything extra like the flu. We PRAY that doesn't happen. There's a $10k yearly cap on that. We usually meet that by April or May.

I take 8 different medications. The copays alone are $280 per month. THE COPAYS! There is NO cap on that expense.

Since our only child is 22 and out of the home and we don't own a home because his job requires frequent transfers we have little tax write offs. Medical won't qualify either. We ARE the middle class hard working people this bill is meant to help. And we are FAR from alone. In fact, while your circumstances may differ greatly...ours are in fact much closer to the majority of middle america. PLEASE THINK OF THE GREATER GOOD FOR THE MAJORITY! We've busted our asses for the upper classes for decades while they used every tax loophole they could create. It's time they gave something back to those who put them there. And I believe that's most of us here.

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sgtcody

November 13, 2009 4:36 PM

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@Shugardrawers: \"PLEASE THINK OF THE GREATER GOOD FOR THE MAJORITY!\"
Wha? This is not a principle on which our country was founded. The US was created based on individual freedom and self reliance. If you want to work for \"the greater good of the majority\" you would be quite happy in Cuba or North Korea. I would rather enjoy my freedom and be responsible for my own welfare (and that of my family).

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November 13, 2009 4:36 PM

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@sgtcody: I hope you remember that self-reliance in the unfortunate event you're ever faced with a severe medical crisis.

Unless you were fortunate enough to amass an extraordinary sum of money, it doesn't take much to wipe out your life's savings in a hurry.

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FDCPAGuy

November 13, 2009 4:35 PM

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@Shugardrawers:
Unfortunately the money you paid into the system for 42 years is long gone and with the passage of this bill all that will be happening is the money will now come from your 22 yr old son and who knows maybe his children. I understand the system is far from fair or just but I believe that when you do win your battle for SSD benefits you will get back pay for the 4 yrs you've been fighting for it. It's a shame we've all been fleeced into believing that the money we pay into the SS system will be there for us upon retirement. I know mine won't be there for me which is why I've taken matters into my own hands. I blame the politicians for using the SS system as fund they can dip into.

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Trai_Dep

November 13, 2009 4:35 PM

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@FDCPAGuy: Or, y'know, they can fix a \"broken\" SS simply by removing the ceiling that stops contributions after a certain, high salary level is reached. That one fix - and there are many others - would have SS securely in the black.

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Digigage

November 13, 2009 4:35 PM

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\"People receiving federal subsidies for insurance may not enroll in a plan that includes coverage of abortions.\"

Could someone explain why this is in there? It just seems to stick out like a sore thumb.

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November 13, 2009 4:36 PM

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@Digigage: Because, as usual, Republicans whined, whined, and then whined some.

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November 13, 2009 4:35 PM

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@Digigage: Because uteruses are not part of the body, silly.

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November 13, 2009 4:35 PM

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@Digigage: there was a lot of debate over this issue

[www.huffingtonpost.com]

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November 13, 2009 4:35 PM

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@Digigage: Because legislators tend to be old, white, Christian men.

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Trai_Dep

November 13, 2009 4:35 PM

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@Digigage: Because Republicans, largely, think sexually active women are... Is \"filthy whores\" to strong of a term?
(Someone clearly needs to explain that it takes two to Tango, but that's a topic for another conversation)

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Rectilinear Propagation

November 13, 2009 4:35 PM

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@Trai_Dep: Why should they care what the Republicans want when they made it clear that they weren't going to vote for it anyway?

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November 13, 2009 4:35 PM

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@Digigage: It was a significant sticking point in getting the bill passed.

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November 13, 2009 4:35 PM

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so..is it a good thing or what?

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brandonwinkle

November 13, 2009 4:35 PM

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You can get instant quality full coverage medical insurance for entire family at the best price from [bit.ly]

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lifeinlouisa

November 13, 2009 4:35 PM

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This might be silly to ask considering whats written here already, but does this mean that, Walmart for example, will be forced to provide \"good\" health care to their employees?

And also how much low income does it take for you to be low income?

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Hakib

November 13, 2009 4:35 PM

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Wow, the people commenting on this article seem to be, how should I put this... of a different social agenda than the majority of consumerist readers?

Most of us are here to fight for individualism and protection against corporate America. A fight that is paralleled in the health insurance debate.

Most of us believe that the government has a role to play in protection of the consumer, and corporations can choose to play nice and reap the rewards of good customer service (Zappos) or pretend that customer service has no connection to sales (Comcast - though in their case, they may be right).

My point is, all this hyperbole about \"government takeover\" is missing the point.

We shouldn't be asking \"when has the government done anything right?\"...

We should be asking \"Is heath care a right?\"

In the year of 2009, I believe that, yes, basic health care should be the RIGHT of citizens of a 21st century culture. No sick person should have to worry about how theyre going to afford to get better.

And the fact of the matter is, most of you who are so opposed to this reform, have never had to fight against insurance companies to pay for necessary services. Most of you have jobs with insurance, and don't feel the pain of the uninsured, or underinsured, who get paranoid at the first sign of a cold, and stress about how to pay for medicine for a simple UTI infection.

There are a lot of things wrong with this bill (yes, I've read it...double spaced, size 18 font, lots of \"title\" and \"definition\" lines...its easy to read). For example, the individual mandate is most likely unconstitutional. But this bill also gets a lot of things RIGHT.

For example, there IS tort reform in this bill!! Yes! TORT REFORM! RABBLE RABBLE! Its in the bill already! So are all the tax credits that the GOP pretends they want. And guess what? All of this is going to actually REDUCE the deficit by 100 billion $$ in 10 years (according to the CBO). This is being paid for by taxing the uber-rich (not by taxing businesses - so you won't see increased consumer prices) and by getting rid of the horrible Bush-era Medicare Advantage programs (Medicare = 100$, dental = 10$, Medicare + dental = 400$??? Math don't work)

I know this is a long comment but really folks... step back and take a look at the rest of the world, and at our national history. If this imperfect bill does not pass, health reform will be put on the back burner for another 10-15 years, at which point we will really start seeing the advantage that other countries have over us, by having a healthier populous. Im sure that changes will need to be made in the future, but you need to crawl before you can walk, and the current system ain't goin nowhere. Forget your party affiliation, read the bill as if it were being proposed for another country, and see if you could imagine it working that way.

Peace. (drop drumsticks on ground)

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November 13, 2009 4:35 PM

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I'm one of the people who will benefit from this if it passes. I was born with a condition that's common in my family, and has killed several relatives in their late 20s and early 30s. With constant medical care in the form of three daily medications and monthly checkups, my condition can be managed so that I'll probably have a normal lifespan. Without such health care, though, I'll almost certainly be dead by 35. As you might expect, it has obviously been impossible for me to get health insurance. No company will take me with a pre-existing condition like that.

Like many other people, I lost my job around the beginning of this year. Despite my best efforts I haven't been able to find anything else in my field, so by now I'm beginning to run out of money. I've done away with everything but the bare essentials (and yes, smartasses, that includes internet access -- I'm leeching it from a neighbor). Still, pretty soon I won't be able to afford my medication or doctor visits. Food and shelter are more immediate needs, and my money will all be going to secure those two things.

In other words, without either this bill or a turnaround in the economy, I'll be dead in a year or two tops.

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Duke_Newcombe sez íViva la Revolucion de Chihuahua!

November 13, 2009 4:36 PM

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@Micromegas: And that how thing are on the ground, all you \"they're destoying my FREEEEDOMZ\" folks. Being free to get sick and die isn't \"freedom\".

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ARP

November 13, 2009 4:36 PM

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@Duke_Newcombe sees what you did there...: Yes, in their mind, that's exactly what it is. The freedom to either go bankrupt, die, or just work 150 hours a week to pay your medical bills and die early.

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chobee143

November 13, 2009 4:35 PM

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Let me get this straight:

1. we're going to pass a health care plan
2. written by a committee whose head says he doesn't understand it,
3. passed by a Congress that hasn't read it but exempts themselves from it,
4. signed by a president that also hasn't read it, and who smokes,
5. with funding administered by a treasury chief who didn't pay his taxes,
6. overseen by a surgeon general who is obese, and
7. financed by a country that's nearly broke.

What possibly could go wrong?

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Al Swearengen

November 13, 2009 4:35 PM

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Is there a cap on how much a person can pay for their insurance? The Baucus Senate bill allows health care costs to be up to 20% of your income. When I saw that, I immediately suspected the insurance companies would raise my rates to 20% of my income. Currently I pay about 4.5% towards a barely there individual health insurance plan through Blue Cross. I don't know about you, but if I pay 20% of my income to health insurance I will be bankrupted, which wouldn't help any because all my debt is student loans which can't be discharged.

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November 13, 2009 4:35 PM

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\"I'm lucky enough to have generous insurance options available to me through my employer\"

You're not lucky at all. If you lose your job, you could find it impossible to get coverage. Health care, in an age where few people work for the same company for more than a few years, let alone a lifetime, should not be tied to employment.

I have paid for Kaiser HMO myself since my 20s. Now I'm in my 40s, and I'm in -- no need to beg to be elt in.

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mamaduck

November 13, 2009 4:35 PM

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It's sad to think that our elected representation will not legislate as the constitution allows. Control over health care was never given to congress. Health care reform should only include those items which are under their authority, such as protecting the public. If they must be involved in health care it should only be to protect those without insurance from being discriminated against. I received lab services for which my insurance company paid in full $110. If uninsured, I would have been billed for $551. Since when is it right to charge uninsured people 5 times what insurance companies pay???

Legislation to require even pricing (with cash up-front discounts allowed), and which requires every patient be given (in advance) a price list of all services from which to choose what they are willing to pay for, would go far to correct the problems in health care. If I enter a hospital, I should choose if I want to pay $15 for a Tylenol, or pay to have strange doctors drop in constantly so they can bill me. In a free-market system, these things would already have come about, but our government already has enough control over the medical system to prevent free-market forces from functioning as they should. How sad.

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3puttblues

November 13, 2009 4:35 PM

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Hey I've got an unique idea that all of the masterminds in Washington haven't thought of. Instead of us giving you more money to oversee programs you aren't qualified to run and will clearly will be bankrupted in the next 10 years (at most) why don't you look at all of the waste and fraud that is already going on in the programs you currently have and use that money to fund your little medical program?
And YES Washington we do and should have a say in how our money is spent and/or wasted by career politicians that could care less about the people they are supposed to represent. I'm not stupid enough to believe that the only answer out of our mess is to give more to the very source that got us into this mess...HELLO!!
I'm sure you know the definition of insanity: Continue to do the same thing and expect different results. However I am smart enough to know that next year when elections come up there will be many of you so-called caring politicians will have the opportunity to become lobbyists for the very system you created because you won't have your jobs after the American public votes your sorry butts out.
Senate it is up to you to have the ethics, fortitude and love of country to not allow this bill to go through as it will be the straw that breaks the camel's back...folks paying for this (well really there isn't a realistic way to do it) will damage us beyond repair.

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November 13, 2009 4:36 PM

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so, can I hope this will get rid of some of the fat people?

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JF

November 13, 2009 4:36 PM

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Let's do the math:

Coverage out of your own pocket can easily cost $10,000 a year.

So, take the 2.5% fine of gross income and figure out how much you can make before the fine cost more than the insurance.

This means that anyone earning under $400,000 a year is now stupid for buying insurance ahead of time instead of just paying the insurance fine since according to this bill you cannot be turned down for preexisting conditions.....

No insurance company is going to survive under these conditions.

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November 13, 2009 4:36 PM

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@Esquire99: Ben Nelson is not a moderate Democrat. AquaNet McGoo is an ex-insurance executive and massive toolbag who will do anything to get re-elected.

And as usual, your opinion is informed only by your terrible knee disorder and your hilarious misconception of the term \"free market.\"

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GlobalVillageIdiots

November 13, 2009 4:36 PM

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Oh Joy!

During the debate, when the interests of insurance companies would have been effectively challenged, that challenge was turned back. The \"robust public option\" which would have offered a modicum of competition to a monopolistic industry was whittled down from an initial potential enrollment of 129 million Americans to 6 million. An amendment which would have protected the rights of states to pursue single-payer health care was stripped from the bill at the request of the Administration. Looking ahead, we cringe at the prospect of even greater favors for insurance companies.

[www.huffingtonpost.com]

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BeerManMike is Bayonetta's personal defender:

November 13, 2009 4:36 PM

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@ohnoes: Bob will die because there will be no XYZ insurance anymore and the govt. run health care does not \"care\" about bob or the lines are too long.

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November 13, 2009 4:36 PM

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I think that instead of a mandate. Make it legal for hospitals and doctors to refuse coverage or to make it legal for health care providers to garnish wages. \"Poor\" people without coverage are, generally, the ones driving up health care costs. If the feel sick, off the emergency room. Addicted to Heroin? Lets go get a battery of tests to find out why your chest hurts....

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EllisDees

November 13, 2009 4:36 PM

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Ahh, the worst of all worlds. Thanks, Mr. Government!

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BeerManMike is Bayonetta's personal defender:

November 13, 2009 4:36 PM

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@[DFX] Deimos: Yes, it has nothing to do with him being black and minorities seeing the (D) next to his name and thinking about all that \"free money\". Nope. That din't play a part in it at all.

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November 13, 2009 4:36 PM

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I see the morality of abortion is being paraded again. Why can't a medical procedure be covered by a federal insurance program? So do the poverty-stricken families who can't afford contraceptives or education on birth control have to resort to coat hangers again?

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ARP

November 13, 2009 4:36 PM

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@Moosenogger: It's complicated, but here's the logic. Republicans and Conservatives want you to be born no matter what the mother or parents want.

After that, you're completely on your own. They don't care if you starve, get a diseases, get an education, etc. Any suffering during your life is your own fault and you're just lazy, even when you're 3 months old.

Now when you want to die, you can do so, as long as its not due to ending life support, removing feeding tubes, etc. They'll force you to keep it, but will make you pay for it.

Got it?

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November 13, 2009 4:36 PM

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\"me the tax payer\", \"why do I have to pay?\", \"me, me, me, me, me\" this is what I am hearing. First of all you aren't paying $300 a month extra on someone else's health care, most of you aren't paying anything out of your taxes.. by this I use tax day.. how many of you get money BACK after doing your taxes.. quite a lot of you I'm betting.. and some of you get ALL of it back.. Most of the people I know in my life up to the $16per hr range.. haven't \"actually\" paid taxes in years or if they have it's preeety dang small.. Like $16 a month small for taxes (in my figures I'm not talking about what comes out of each check.. simply because when april comes around... thats not what you have ended up paying because you got it back). Now out of that money that you paid in taxes how much of it do you think ACTUALLY goes to someone ELSE'S healthcare.. Now if you look at the math presented in the media.. it gets ridiculous.. but if you look at it.. it then becomes clear that its not true.. because it doesn't make any SENSE MSNBC quotes it at $200 per week per person averaging at 11,000 in taxes at end of year figures per person!

go ahead get the calculator and follow along
304,059,724 people in america
-39,100,000 people that are poor
which leaves 264,959,724 people who are supposedly paying 11,000 in medical taxes alone at end of year (already sounding improbable?)
so now we multiply (i'm making everyone even here)

and we come up with
$2,914,556,964,000 thats 2 TRILLION dollars
(does this even smack of correct anymore?)

and we supposedly spend about $2 trillion for health care .. so.. we broke even!! no one owes anything.. we have covered it just fine!!! we don't need health care reform!! *ahem* as you can see just by watching the news.. that's not true... if it were true that you ARE paying someone else's healthcare like that.. the bills would be PAID.. and they're not.. when you look at all the numbers thrown around it becomes obviously ridiculous.

So what is the reality? I'm guessing the reality is probably far closer to a couple of bucks every year (maybe even a couple hundred.... but not thousands) what does that work out to? a tiny fraction of the penny in your pocket (so not even the whole penny) just went to help pay for Joe's broken leg

So first i ask, why are you so adamant about not helping someone? Because that's what your question is really saying \"why do I have to help?\" Do you know who you are helping? Are you totally comfortable walking up to a complete stranger who say.. has pneumonia and saying to their face \"hey I'm sorry that you are sick.. and that its actually treatable and you could recover fully.. but i just don't want to help, send my condolences to your family for your loss\"

What do you think would actually happen if we took no tax dollars for health care AND refused treatment to all uninsured.. Really think about it. Where do you think our death rate would be at now? How many people would die from simple things? Are you really ready to send all those people to their graves.. and realize one day.. that might be you that no one cared about and let die.

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November 13, 2009 4:36 PM

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Someone has to pay the bill for the recent spending!

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November 13, 2009 4:36 PM

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@East_Coast_Midwesterner: You miss my point. I don't believe anyone has the obligation to be insured. If I choose to forgo insurance and I end up developing a costly condition, so be it. I expect to then pay for my care (or suffer by not being able to afford care), even if it then bankrupts me, rather than mooch off others. Granted, I could have avoided such a situation by buying insurance in the first place, but one should have the freedom to choose.

With regards to the $100/month, I was only using it as an example. I know real premiums tend to be significantly more.

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November 13, 2009 4:36 PM

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It won't actually affect me in any way, shape, or form. I intend not to follow any of these things anyhow.

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Rubleaux

November 13, 2009 4:36 PM

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Most people with negative views about the health care bill either have medical coverage or are healthy and don't want it. There are portions of the bill that controversial, but overall, it's a good effort. I would prefer to see all americans with access to care, rather than to see lines of people wrapped around buildings waiting hours for care generously donated by medical professionals. Remember that your name could be next to receive a pink slip. Should that happen, your coverage would probably be cut too. One of those people waiting in line for hours for care could be you!

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3puttblues

November 13, 2009 4:36 PM

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what's you bet on what year we are going to have to bail out the Health Care Industry?

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thebaron

November 13, 2009 4:36 PM

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Health care insurance reform is one thing GC, but allowing the government to take over an industry is entirely another thing. The Constitution is the rules that limit our federal government and should stay that way. The states can do what they want unless they are limited by their founding documents. It ain't about not helping people, but ensuring that they don't rule over us with an iron fist over what we do and eat.

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January 19, 2010 2:36 PM

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I just received an anonymous email asking me to \"pre-register\" with all my personal info for the new health plan. Wow! I can be first in line maybe...

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January 19, 2010 4:46 PM

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How can we all fight and argue over the healthcare bill for months when the congress has not even decided what that bill will be? We don't even know if we will all face the government \"Death Panel\", or if we have to be satisfied with the Blue Cross version.

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