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Health Care Reform Bill Simplified
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by Graywalker | August 7, 2009 at 05:31 am
3639 views | 2 Recommendations | 15 comments
You have heard the rumors and political talking point, now for the truth. I am going to review the two major health care bills currently in the House of Representatives.
H.R. 3200 ( a good link to the pdf current version of the bill )
Rumors :
- The Bill makes Private Health Insurance illegal! - False.
- The Bill make the elderly choose their death! - False.
- The Bill will cause Health Care Rationing! - False.
Facts :
- The subsection that people refer to in order to support this false claim is part of the section defining "Grandfathered" coverage (Sec. 102). "Grandfathered" means the coverage will not be subject to the bill's requirements. The Provider can not enroll new people in the Grandfathered Coverage, but they can create new plans that comply with the requirements in the bill and sell those.
- The section that people refer to in order to support this false claim is a whole section on providing counseling for end-of-life counseling (Sec. 1233). The bill will cause Medicare to pay for this counseling every five years, but not more often. The counseling will be totally elective, just like many people now pay for such counseling. It covers Living Wills, Hospice Care, Power of Attorney and what pallative treatments are. Basically, it will pay for a thorough explanation of what the choices are and a question and answer session with a doctor of the patient's choice. It does provide cases where it can be paid for more often than every 5 years also.
- Health Care Rationing already exists, it is just really covert and most people don't realize that it is happening. For a better explanation, please see What Is Health Care Rationing? on about dot com and Denial of Care.
Okay, with that out of the way, what does the bill do? Well, for specifics, look it up on http://thomas.loc.gov, but I will cover some Big stuff.
1. It makes all coverage fit some basic guidelines.
- provides payment for medical items and services
- limits cost-sharing
- no annual or lifetime coverage limit (you probably have one now)
- has a good network of providers
- equivalent to average employer-sponsored plans
- and covers:
- Hospitilization
- Outpatient hospital services, including emergency room
- Phsycian and health professional services
- Medical equipment, supplies, etc.
- Prescriptions
- Rehab
- Mental health and substance abuse services
- Preventative services
- Maternity care
- Well baby and well child health, oral health, vision and hearing services for children under 21
2. Prohibits Pre-Existing Conditions exclusions.
3. Sets up the Health Insurance Exchange. Individuals (not Employers) will be required to purchase their health insurance through the Health Insurance Exchange. Many private health insurance companies will provide Exchange Participating Coverage plans to compete alongside the Public Option. Employers can still purchase directly from the company of their choice, which was my major concern with this HIE. They can also purchase from the HIE. All individuals can obtain coverage through the HIE, unless they are already enrolled in a qualified or other acceptable coverage. The HIE (sec. 202) has a phase-in period where people who are not covered at all and employers with under 10 employees have the first chance to participate in the HIE. In the third year, the commissioner can allow companies with more than 20 employees participate. The HIE will be used to give each Coverage Plan a larger risk pool in order to lower the premiums - similar to the way Employer-offered coverage works now. Effectively, it gives Individuals a plan similar to the Federal Employee Health Coverage Plan that Congress (and Federal Janitors) have access to (and pay for out of their salaries).
4. Sets up a list of consumer protections. Things like your insurance company can't just drop your coverage, they have to pay your claims on time, "Rescission" is made more difficult with an appeals procedure and other items.
5. Imposes a Tax on Individuals without acceptable health care coverage. If you don't have coverage, you will have a 2.5% of your adjusted gross income - not to exceed the applicable national average premium for the year - prorated to the amount of time you spent uninsured. Exemptions are made if you live outside the United States, live in a US possession (not state) or have religious conscience objections. (acceptable coverage is Qualified Health Benefits Plan Coverage, Grandfathered Health Insurance Coverage, Medicare/Medicade, Tricare(etc) or VA coverage plus other recognized coverages)
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Most RecentMost Recommended Comments (15)
at 06:15 on August 7th, 2009
Great summary. Thanks!
Lincoln B
HSA
at 08:16 on August 7th, 2009
I just clicked the GPO link from Thomas... its a PDF version of the most current version of the bill - http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3200ih.txt.pdf
at 14:17 on August 7th, 2009
Yes it's nice article!
Todd DiRoberto
at 14:18 on August 7th, 2009
Yes it's nice article!
Todd DiRoberto
at 06:44 on August 12th, 2009
Nice article, and thanks for the link. I dont understand how they can try and pass something this extensive and sweeping in such a short time frame.
page 29 lines 4-12, "cost sharing" exactly what is cost sharing, the amount the Govt is paying or the co pay, it has limits of 5k for individual and 10k for family.
with hospital rooms running 1k per day not long before benefits run out
at 07:55 on August 12th, 2009
Great Question!
According to About.com Cost Sharing is anything the customer/patient has to pay out of pocket. So, Deductibles, Co-Pays and such are Cost Sharing. The most startling to many people is the Annual Coverage Limits and Lifetime Coverage Limits that they probably don't know they have.
Some policies have out-of-pocket limits and annual coverage limits. So, once you hit $5000 out of pocket, they cover everything... up to the point you hit $30,000 in total costs for that year, then it is ALL out of pocket because you've hit your annual limit. (numbers are guesstimations, check your specific policy for actual numbers)
So, the Bill limits your out of pocket to $5000/$10,000 for Basic Coverage (I'm sure there will be wildly varying options out there too). It also eliminates annual and lifetime coverage maximums. So, once you hit that out of pocket limit - everything is covered no matter how much it gets to be. (This link is a good article on cost sharing.)
I know that is a good and ethical policy in theory, but I am not sure on how realistic that is. Cost Sharing is one way of keeping insurance premiums down and affordable. When the companies have to take on all that risk, what will that make them to do their premiums? So, it is not all that many people who will ever actually reach those limits, but some will. Some will greatly exceed it. How will the companies be able to mitigate the risk? Lowering their multi-million dollar CEO salaries would be helpful, but they are more likely to raise premiums for everyone.
at 12:10 on August 12th, 2009
Graywalker, although I appreciate your trust of the government. Dont you have to ask yourself why do they have to pass this 1.3 trillion bill so quickly??? They couldnt even manage the cars for clunkers program, why do you think they could manage this program? We have given them education, social security, and medicare. I am sure you would agree those programs are completely mismanaged, abused, and in short order will be out of money according to the government. Ninety percent of Americans have insurance coverage and are relatively happy with it. I know some dont but the 47 million number they keep spewing is not accurate and includes illegal aliens and those making above 75k who could afford it but choose not too. I dont want the government telling me I have to have coverage or they will fine me 2500.00 per year. Obama claims this will save money but the non-partisan CBO says that is not true it will cost us more money. Obama clearly stated in 2003 as a Illinois State Senator he was a proponent of a single payer health care system (government control, no private insurance). He also stated it again at a meeting with the AFLCIO in 2007. Both of these events were recorded. Damn recordings always come back and bite you in the butt. Again in 2003 he clearly stated it wouldnt be immediate and may take 10-15 years but a single payer system is the goal. England rations health care due to the UHS system they are on again single payer. Breast cancer death rates are 400% higher than the U.S. Prostate cancer death rates 600% higher, but yet this is a good thing? Obama and the rest of the congress will not put there family on it, why then would you want too?? Respectfully submitted.
at 15:06 on August 12th, 2009
Who said I trusted the Government? Just because I am telling people what, exactly, the bill says instead of making up all kinds of distorted lies about it, I automatically trust the government? No.
Of course, the Cash for Clunkers was Wildly Successful, so much so it went back for a second round of funding. So, where is the failure there?
Blind trust in corporations is appalling to me though. Right now you are paying through the nose for Health Coverage and trusting that they will be there if (or when) you really need it. But Many, Many, Many stories prove that, No, they won't be there - because once you get sick, you are no longer profitable for them.
And, also, Single Payer has NOTHING to do with H.R. 3200. Single Payer is H.R. 676, again, NOT H.R. 3200. There is nothing anywhere close to Single Payer in H.R. 3200.
Also, do you have a link to those supposed recordings? If they are out there and readily available, then where are they?? All I can find are snippits cut and pieced together without much of the surrounding dialogue and then different people talking about single payer.
So, you say, the Public Option is a 'slippery slope' to Single Payer? Then don't get the public option. Apparently, according to you, only about 10% of Americans want or need it anyway, so what is the problem?
Again, Nothing about Single Payer is in H.R. 3200. Nothing. Zero. Nadda.
Besides, check out the charts on - http://www.nationmaster.com/cat/hea-health - The UK (not England any more) has a lower overall rate of death from cancer. In Heart Disease, Germany, Denmark, Canada and 9 other countries fare better than the U.S. The United States is #47 in life expectancy - below Canada, the UK, Germany, Spain, Israel and Japan. And, although harder to navigate, the World Health Organization stats back it up. So, as with everything else, your stats are out of context.
Check out http://www.politifact.com/truth-o-meter/ I am a moderate. I want Health Coverage Reform, I want to preserve the right to keep and bear arms, I want term limits on congress to oust career politicians to the curb, I want mandatory car insurance overturned, I'd like to get illegal immigrants out of the country, but have a legal way back in for them - I'm not a rabid hater, I want Credit Card reform, I want welfare reform to get lazy jerks off my back. But most of all, I want Truth in debate and Facts instead of lies - from either side. But right now, I wouldn't trust anything a Republican, especially Fox News and Limbaugh, says without some serious backup and research.
at 11:40 on August 15th, 2009
Listen all cash for clunkers did was move money from the taxpayers to the car dealerships. What's so good about that? How did that 3 billion help the economy? It just means that your and my taxes will go up even more to cover the trillions we are spending, not to mention the burden for our grandchildren. And about comparing our health care to other countries as stated by the World Health Organization...I read an article by a doctor, which I can not put my fingers right at the moment, stating that other countries do not tally their numbers in the same format that the U.S. does. He compared Japan with the US and showed how it appeared that Japanese men lived longer than American men but when he equalized the data Asian-American men lived longer than Japanese men. Also, he claimed our death rates contain a larger number of murder victims, soldiers, etc which other countries do not include. I too have seen statistics which show the cancer death rate is higher in England than in the US. I am also wary of propaganda on both sides. I do know anything, except for executing wars, that the government has ever run efficiently or effectively. How could anyone trust the government? Politicians promise the sun, the moon and the stars to get elected even if it will be the demise of our country. Atlas is close to shrugging! I suggest looking at the info at the Cato Institute.
at 06:57 on August 18th, 2009
So, basically, you are saying that helping corporations employ people is a bad thing?
(More cars bought = more cars built = more jobs maintained/created + More cars removed from road = more scrap metal = cheaper metals for building cars/steel/etc = increased production)
And it seems your solution is to ignore, twist or deny the facts and "lets start some more wars" because we do that pretty good??
Ayn Rand was a supporter of the Individual, Morals, Integrity, Justice and Against the Status Quo. In the times she wrote those books, I would have been a conservative. These days, the "conservative" movement has gone so far away from those ideals that it isn't even funny. They are the masses, not the individual, they do not adhere to the morals they pay lip service to, they will sink to any despicable depths to achieve their goals and they fight to keep the status quo. They stand for "Their" rights, but tread all over anyone else's rights. Its repulsive.
Its like no matter how many times your masters whip, beat, cut and deprive you, you still fawn at their feet begging for more of the same because it makes you feel safe. I don't care how much money or 'power' someone has - they can not tread on me and evade the repercussions. Health Insurance - among many corporations - have been treading on the middle class for decades, their top people reaping the benefits and keeping the 'masses' down and thankful for the pittance of crumbs from their tables. Suffering under the yoke of any tyranny - government or corporation or individual - is unacceptable.
at 09:27 on August 18th, 2009
For how "unsuccessful" the Cash for Clunkers program was read :
GM Is Latest Automaker Boosting Production Due To 'Cash For Clunkers'
at 09:31 on August 18th, 2009
For just how "unsuccessful" the Cash for Clunkers program was, read :
GM Is Latest Automaker Boosting Production Due To 'Cash For Clunkers'
(Doah! dual posting... log-in was acting funny... well, not-funny actually... )
at 18:18 on August 17th, 2009
Graywalker, thanks for the reply. Here is a link at an AFLCIO meeting where Obama clearly states he is a proponent of a single payor system. http://www.youtube.com/watch?v=fpAyan1fXCE&feature=related
But yet here he denies he is a proponent of such a system.
http://www.youtube.com/watch?v=bd-F8Z6sSpA
Which Obama do you believe?? Those are my questions. The initial goal of HR 3200 may not be a Single Payor System. However, socialists, liberals, or progressives always move towards incrementalism instead of getting the entire slice of the pie.
at 15:43 on August 12th, 2009
A more specific link for Politifact.com - on Health
The CBO includes the "Medicare Fix" bill that they are trying to get truly 'fixed' - as in getting rid of it, which - if the "Pay-as-you-go" bill gets passed (already approved by the House) - then there will be an extra $5 billion left over.... if not, then there will be a $239 Billion deficit. (all figures over a ten year period)
On the Myth of Government Run Health Care
Government won't kill Granny!
H.R. 3200 does NOT outlaw private insurance.
... and there are more... and some Falsehoods from Obama on there too.
at 18:28 on August 17th, 2009
Graywalker,
one more for you. Although I'll admit it is clips, it is still interesting. Coming from all sides including Barney Frank.