Health-care reform is making a difference

[babylonsister]

(edited for copyright purposes-proud patriot Moderator Democratic Underground)

I know this will disappoint a whole lot of people-sorry about that.

http://www.philly.com/inquirer/opinion/20100923_Health-care_reform_is_making_a_difference.html

Health-care reform is making a difference

By Michael R. McGarvey


It's high time for people who know something to speak up. Six months ago today, Congress passed and President Obama signed the Affordable Care Act, the most ambitious and far-reaching reform of the health-care system in 45 years. In the months since that historic accomplishment, the public has been subjected to a relentless barrage of know-nothing, self-interested negativism from politicians and interest groups funded by the insurance industry, and the polls show voters are taking it seriously.

In the run-up to the reform vote, House Minority Leader John Boehner repeatedly crowed that the U.S. health-care system is "the best in the world." That is simply false. On every measure used to assess the effectiveness of health-care systems, the United States is outranked by more than 30 other nations. The first step to improvement is to recognize the problems.

I am a physician, and I spent 16 years of my career in and around the health-insurance industry, and I think the health-reform law is a huge step in the right direction.

Let's consider what the law has already accomplished: Roughly four million Medicare beneficiaries who have hit the "doughnut hole" in their drug coverage are getting $250 rebates this year, along with a 50 percent discount on prescription drugs; a temporary reinsurance program was established to protect early retirees; and a temporary high-risk insurance pool was created to help Americans who are uninsured because of preexisting conditions.

Beginning today, a number of key provisions go into effect: No health plan will be able to continue the practice of dropping a person who gets sick; lifetime caps on coverage will be prohibited; annual coverage limits in many plans will be tightly restricted; most health-insurance plans will be prohibited from denying coverage to children with preexisting conditions; young people up to their 26th birthday will be able to remain on their parents' insurance policies; and new plans will be required to cover preventive services without imposing co-payments or deductibles.

(snip)

[Exilednight]

1. Can you find something with facts, and not opinion?

This is nothing but a generic op-ed piece of stuff everyone already knows, but just because something is implemented, doesn't mean that it's doing what it's designed to do. Let's see what the ACTUAL results are in about six months to a year.

[tabatha]

2. Actually, not..

There are lots of people who don't know this stuff. And to hear a physician instead of a politician talk, is important.

[niceypoo]

7. Before the bill passed, the US was 37th internationally in health care

A realistic goal would be to put the US in, say, the top 20 within five years, no? This bill will actually make the US lose ground against other countries because the premium and deductible gouging is so hardcore that it eviscerates out any good this bill might do. Personally I am much worse off since the bill passed. I cant afford to go to a doctor at all anymore and I have insurance through my employer so nothing in the bill will help me one bit, and no I dont want a 'pony.'
'

[truedelphi]

13. Sorry about your situation and I totally agree.

The price gouging that occurred for 48 months prior to the signing of the bill, and which the Press Democrat said circa May 2010 would continue on into 2011, is a catastrophe for most households.

It may be wonderful that should some person be lucky enough to afford health care, now there are some provisions that may help that person as a consumer.

But most people cannot afford it.

And waiting until 2014 for the "exchange" for high risk people - that provision also demands that you be without ANY insurance for a full six months before you get to enter that pool of insured.

Of course, I am not sure that after yesterday any of this now matters to me- they are rounding up progressives in Chicago and Minneapolis, so will I even be on the streets in 2014?

[BzaDem]

24. The bill actually will help you, whether you acknowledge it or not.

Preventive care will be free. No deductible, no cost-sharing, nothing.

For other types of care, if your employer plan doesn't meet stringent standards, you can get a plan on the exchange and get subsidies if your income qualifies.

And if you were to ever lose your job, the bill would help you tremendously.

[niceypoo]

40. The exchange doesnt start for five years

[woo me with science]

3. "Having" health insurance

is not the same as being able to afford to use it. People are still being priced out of health care by exorbitant premiums and outrageous deductibles.

This horrible legislation does nothing to address the core problem of spiraling costs. It only mandates that people buy a product they cannot afford to use.

[LWolf]

10. +1,000

[BzaDem]

25. "It only mandates that people buy a product they cannot afford to use."

That's some first class bullshit right there.

It doesn't ONLY mandate people buy a product. It provides massive subsidies to help them afford that product. It also mandates the product be of certain quality, limiting deductibles/cost-sharing and insurance company profit, mandating free preventive care, and mandating a long list of benefits.

Nice try though. :hi:

[woo me with science]

32. You attempt to claim

that the problem of skyrocketing costs is being addressed with this legislation?

You are entitled to your own opinions. You are not entitled to your own facts. Even the Obama administration agrees that costs for health insurance are continuing to rise. They ran on cutting costs.

Denial of the problem is offensive to people who are actually living the problem. This sort of condescension toward what people are actually experiencing will kill Democrats at the ballot box.

[BzaDem]

34. They ran on bending the cost curve down.

That means reducing the RATE of cost increases. And yes, the bill will help with that, when it actually takes effect in 2014. The bill also makes it more affordable with subsidies.

[woo me with science]

35. No they didn't. They claimed repeatedly that actual costs would decrease

and provide relief to families struggling to afford healthcare.

I was in the audience and heard such promises with my own ears, and they are in the public record in the health care discussions. We were told repeatedly during the campaign that reform would lower the costs of health care, and that the average American would experience those decreases in cost directly.

I'll link below for you just a sampling of examples. It took me less than two minutes to find these clips the other day. I am certain that if I spent more time looking, I could fill an entire page with similar examples, because we all heard it repeatedly during the campaign.

The "reduction of increase" spin is just that. It's spin and revisionist history, because they ignored the warnings and predictions of many that this would happen.


http://www.youtube.com/watch?v=lUd-slJc-GY

http://www.youtube.com/watch?v=qxl9eExU5VA

http://www.youtube.com/watch?v=N_yt9GT-Mas&p=7948374513EA6FF2&playnext=1&index=12

http://www.youtube.com/watch?v=gdj5bEXZ_0E

[area51]

30. +1

Each day, 273 people die due to lack of health care in the U.S.; that's 100,000 deaths per year.

We need single-payer health care, not a welfare bailout for the serial-killer insurance agencies.

We don't need the GingrichCare of mandated, unregulated, for-profit insurance that is still too expensive, only pays parts of medical bills, denies claims, bankrupts and kills people. Republinazi '93 plan:

"Subtitle F: Universal Coverage - Requires each citizen or lawful permanent resident to be covered under a qualified health plan or equivalent health care program by January 1, 2005."

"We will never have real reform until people's health stops being treated as a financial opportunity for corporations."

[niceypoo]

4. Its making a difference in my life...

...since it passed I have been price gouged so severely by my insurer that I cant even afford to visit a doctor any longer.

[cornermouse]

5. What HCR did for me.

1. More than doubled my insurance payments.
2. Will force me to drop my vision and dental insurance riders.
3. Makes it impossible for me to see a doctor because the money I would have spent to cover my co-pay is now going to pay for the increase in insurance premiums so that I don't get fined or worse.

We sure are lucky no one considered single payer or expanded medicare as an option because if they had, people would have been happy enough that the republicans and teabaggers couldn't have used healthcare as one of their key issues.

[niceypoo]

8. Remember, we couldn't pass a robust bill because there was a midterm coming up?

...because a good bill would come back to bite us? This is a pattern with Democrats. Too scared to pass anything meaningful because, 'an election is coming up and it could be use against us'. When the election comes, the Democrats get their asses handed to them because they they were too scared to pass anything meaningful.

[Exilednight]

9. Bingo! The big D circular train of ilogic. n/t

[Zavulon]

14. Applause, applause.

Not for your situation, mind you, but for pointing out that the bill we got sucks.

I'm sorry your situation sucks as much as the bill. Not that I expect this to help, but my situation is actually worse. All I have to do is wait until 2014 before I get to enrich insurance companies at gunpoint and bask in all of these glorious benefits.

[eridani]

18. What it might do for me

If I give up my doctor, the government will give my former employer money. Big whoop.

[Name removed]

26. Deleted message

Message removed by moderator. Click here to review the message board rules.

[woo me with science]

33. Your experience is very, very common.

Thank you for posting this.

[OhioBlue]

41. How are you gonna get fined or worse?

and your premiums doubled???? holy crap - is this insurance through an employer or self-pay? Have you looked into any other options? I know in Ohio - we can get in through the Farm Bureau or our local chamber. My insurance went up too - tho it is through an employer and they pick up 80%. I dropped the dental or vision which is 100% out of pocket several years ago.

[Honeycombe8]

6. Unfortunately, none of those provisions affect most Americans.

Also unfortunate, with all the new things ins. cos. will be required to cover, I don't see the provision that caps the premiums that the ins. cos. will be allowed to charge us all for all those new things being covered.

Most people get ins. through their employers. None of those provisions apply to those people (incl. me).

Oh, except one thing: My employer is now required to put on my W-2 the amount they pay for my health insurance. I think we all know that is because we're about to be taxed on that "benefit."

And I guess the cost of the ins. will go up, because of the ins. cos. having to cover all those other things outside of group policies. They'll raise rates across the board. Without a cap on raising the premiums, well, I think we're screwed.

The problem I have with being taxed on my health ins. coverage provided by my employer is that...I have absolutely no say-so in anything about that coverage. I don't choose the ins. company, or the benefits being provided. It is given to me...this is it. I can't even leave it and get my own through a group exchange. I am stuck with what someone else is giving me. And I will be taxed on it.

Health care is not a free market commodity. The new HCR bill doesn't take that into account. Just the opposite...it seems to enshrine the concept that it is a free market commodity, like towels at Target.

[freebrew]

12. K&R

Oh, except one thing: My employer is now required to put on my W-2 the amount they pay for my health insurance. I think we all know that is because we're about to be taxed on that "benefit."

After being fired and having to pay much $$$ for COBRA coverage, I found that individuals have to pay taxes on insurance premiums. They are NOT deductable. If you work for a corp that provides insurance coverage, the premiums are held out as pre-tax income.
So, how is this fair? My taxes after losing my job were higher than when I was working.

How did this country get so damned f*cked up?

[Safetykitten]

11. The biggest difference? A future nightmare to come.

[kentuck]

15. K & R

Good report.

[golfguru]

16. Yes! HCR bill is making a big difference for me

like 30% hike in monthly premiums for 2011 over current year.
The average hike has been 9% over last 10 years.

[eridani]

17. If it was making a real difference, no one would have to announce it

Obama and the Dems KNEW that insurance companies would jack up their rates the way they always have in the past, but blame it on HCR this time. They knew that Repukes would lie about it and call it communism and every other nasty snarl word under the sun. They effing well SHOULD have known that the only practical way to counter this would have been to frontload the plan with benefits for a significant number of people who could not be ignored this year—really big facts on the ground to counter the inevitable and totally predictable really big lies. They seem to have belatedly caught on to this, because not a single representative who voted for it is running on that vote (with a couple of exceptions in the case of safe seats.

In contrast, an initiative on the fall ballot in WA State to put an income tax on individuals earning more than $200K ($400K for couples) was crafted intelligently. To help the lowest income people, the thing to do would have been to cut our very high sales taxes. Unfortunately, many surveys have shown that the low income people who would benefit most from a taxation plan that included a graduated income tax are the very people who are the most strongly opposed to any income tax. Furthermore, the political problem with a sales tax reduction would have been that not a single one of the beneficiaries would have noticed it. Take a bottle of Suave conditioner on sale for $1.29. A 9.8% sales tax would result in a total price of $1.42. A 5.8% sales tax would result in a total price of $1.36. Big whoop. In other words, this is a price difference that no one would notice or care about. Sure these pinpricks add up over time to result in one of the most regressive state tax schemes in the country, but low income people certainly don’t have the time to save up a year’s worth of sales slips and calculate their total tax and compare it to their incomes.

The taxes that the initiative if passed will reduce are state property taxes and the Business and Occupation tax, which is probably the single most idiotic way ever invented to tax businesses—on their gross, not their net incomes. 80% of businesses will have that tax eliminated. You’d better believe that THAT will be noticeable. Also, property tax bills are paid once or twice a year, and a 20% cut in a big lump sum is also quite noticeable. These cuts don’t benefit lower income people nearly as much, but they are sure the hell much harder to ignore.

The analogy to HCR is clear, I hope. Sure, some people are benefiting now, but they are nowhere near as noticeable as the outrageous premium increases that have been inflicted on large numbers of people. Following is a list of the mostly invisible people who have benefited

• Sick rich people. Only 2000 out of 4 million have bothered to sign up for the high risk pool. Yes, Virginia, 10-20% less outrageously expensive is STILL outrageously expensive.
• 23-26 year olds whose parents can afford to insure them. A larger group, to be sure, but plenty of people in that age group are left out. Still, there are enough to help downgrade HCR from disaster to mere liability, which is a helpful political effect of this provision.
• Children with pre-existing conditions. This s a very small group, as kids are the healthiest demographic of all—the vast majority are never going to be seriously sick. Not to mention which, insurance companies are now refusing to issue child-only policies to get around the antidiscrimination mandate.
• The people on Medicaid whose situations will not deteriorate because states are getting chunks of change that will keep their health care budgets from crashing. But they aren’t going to notice anything because they aren’t the ones who get the money—state governments are.

Now, assuming that Democrats in Congress had been as politically savvy as the authors of Initiative 1098, and that we were not going to end up with single payer this time around, what might they have done instead? The simplest possible thing to have done would have been to expand Medicare, either by dropping the eligibility age to 60 or 55, or by taking a smaller slice of older people and adding a slice of the youngest adults. The administrative apparatus is already in place—no waiting until 2014. Lieberman was actually for this before he was against it. Charge 4% of income for voluntary enrollment, and tell the teabag whackjobs to STFU and just not enroll if they don’t want to. This would have created a huge group of beneficiaries that would have been absolutely impossible to ignore. Enrolling older people only would have the political advantage of directing major benefits to a demographic slice that has seen its unemployment rate go up by more than 300%, and which tends to supply much more reliable voters in off-year elections. This would have been by far the smartest thing to do if we couldn’t get single payer. So why didn’t they?

[Milo_Bloom]

19. Yep, it is increasing costs and leaving children w/o insurance.

[babylonsister]

20. One Question: Are Any Of You Doctors? Can Any Of You See

The Big Picture?

I am recently divorced and have no insurance with a pre-existing condition that was cancer. I am lucky enough to have my health at the moment at the age of 54, working a dinky p/t job.

I am not a doctor, but I'm in the same boat many of you are.

So sorry you think this sucks. Would all of you have preferred the way things were prior to at least this attempt? Really??

I was happy to 'meet' people in Obama's chat the other day who begged to differ and are enjoying some benefits that were sorely needed.

Maybe you will be one of those people soon.

I don't know what to say otherwise. This thread is owned solely by those who think this hcr sucks. That's too bad, because until the law is changed after Obama is out of office, you're stuck with it due to veto power. But I guess you can go vote with the rethugs who think it sucks, too.

[cornermouse]

23. The doctor's main focus is

finding out what ails you and helping you get better. The money side is not their main focus, its a sideline. And that's one of the other flaws in your argument that I wasn't drawing attention to.

If Congress had done things right and tried to pass single payer/universal healthcare or medicare expansion, the republicans and teabaggers could not now be using it against them. Do I think they need to scrap it and start over? Yes. Where was it written that some should, in effect, "lose" their access to health care so that others could get maybe/maybe not get health care? Wasn't the idea to allow everyone access to health care rather than make it a trade at best? There's no way you can improve a bill this bad that caters so exclusively to the insurance industry.

[babylonsister]

27. Guess what? We don't have single payer; we have to work

with what we have. And the doc in the OP seems to think it's not as bad as you do. He's the professional; I take it from your response you're not.

It's like you want to continue fighting the primaries; for now, it's a done deal. I'm hoping the House progressives might introduce legislation down the road to introduce universal, but we need to focus on what is positive in this hcr, like the good doc did in the OP.

[cornermouse]

28. I'm not the one who is stuck back in the primaries.

I'm talking reality of a whole lot of people in this country are discovering right now. If you want to ignore that, then prepare to be surprised when those people cast votes. I am sure the doc cares about his patients, but his salary exempts him from facing the personal budget devastation the rest of us are looking at.

Its been fascinating to listen to insurance companies lay the blame for their new found wealth and income at the feet of HCR; talk about backstabbing. Even so, Congress, whether republican or democratic, is not going to introduce anything that might threaten the big bucks for campaigns that they get from the insurance companies. Don't waste your time looking for "improvements because the insurance companies are going to be using their new found wealth, aka the extra money that I'm paying them, to get rid of anything they regard as an inconvenience that was left in the bill. In fact, I believe they've already started. I keep hearing rumblings in the news that someone's found studies indicating diagnostic mammmograms aren't all that helpful. Since that only affects women, I suspect that's high on the list of things to get rid of. It wouldn't surprise me to find out someone's working on a study that indicates diagnostic colonoscopies are inadequate and inaccurate right now.

[woo me with science]

31. +100000 nt

[mbee]

39. In my opinion the real problem is that most of the healthcare plans

are in the hands of the employer. This keeps the average person from being able to demand any type of competitive system. The companies just tell the same story to the employer every year such as they've utilized the system too much or some other lie and then up the premiums with usually no questions asked other than tweeking the plan a little to pay higher co-pays or bigger deductibles while charging higher and higher premiums. The bottom line is that if it was in your own hands it would be like if you had received an automobile insurance premium that was up 30 or 40% what is the first thing you would do? Bingo - change plans, but we can't do that because of the way the system is set up.

[mbee]

38. It is great that some things are now better such as doing away

with pre-existing conditions, covering young people under 26, etc., but the fact remains that they could have easily extended Medicare to persons 55 and older and those new premiums would have helped the system. Many young people are working part time jobs and if they are over 26 they can't necessarily afford to buy a private plan. The fact remains that the current system is still a big mess and I just don't see how the things that were put in place will open the doors to get the complete job done. Also, frankly I've never understood why someone who buys Medicare also has to have a second health plan. We the people aren't very smart when we let big business and the political elite get away with this.

[KakistocracyHater]

21. it's 2014 already? Man I just lost a whole lotta time, sheesh

*

[patsimae]

22. I agree...however

There needs to be further action to put some kind of cost control/cap on premiums and deductibles.

We will benefit from the new legislation in January when we are able to enroll our 23 year old son on my husband's plan. As it stands now, we are paying 112.00 a month for his coverage which has a 2500.00 deductible and a 2 year rider on covering his preexisting condition. So it is basically catastrophic coverage. We have paid out a couple thousand already covering his broken wrist and some medical issues he has had. Feel fortunate that we can afford all this, and feel for all those who would struggle if they were in our situation.

[Vinca]

29. Catastrophic coverage unless the catastrophe involves his pre-existing condition.

There are way too many "ifs" associated with the bill. For example, IF I was wealthy I could afford the pre-existing condition pool. Everyone should be covered and it should be paid for out of the common funds, end of story.

[woo me with science]

36. Not to mention that $112 dollars is on the extremely low end of what people are facing.

That is to add your son to an existing plan. Many people on individual plans are paying half a grand to a grand per month, with deductibles at that level or even higher. And costs continue to spiral higher.

It is a crisis, and the outright denial by some of what others are experiencing is not the way to win an election.

[mbee]

37. All these facts while a good start don't even begin to address

the problem and that is we need to fix a broken system. We need to be able to buy healthcare just like we buy our auto and homeowner's insurance. I feel the USA Mantra is - Insure Cars not Humans! We need affordable plans that anyone can buy and it is possible, but the greed of huge profits has to be regulated! My son is 28 working two part-time jobs and he won't be covered so again the rest of us are discriminated against!