Is health reform exhaustion a pre-existing condition? And if so, will exhaustion be banned after health reform is passed? We can only hope. However, now that it is nearly certain that health care reform will pass, it's time to figure out what it will mean for all of us.
No, not the hype about a government takeover or the road to socialism or this is better than sliced bread. What's really in the legislation for you and when will you get it?
After the passage of the legislation, a few things will happen in the first year:
- Insurers can no longer put lifetime limits on your coverage. If you've never been seriously ill, this won't mean much to you, but in the case you get hit by a bus, it's surprising how quickly a million dollar lifetime limit can mount up. Now you would be covered no matter how seriously ill you get.
- If you are uninsured, you "may" be able to get help within 90 days from one of the state-based "high risk pools". These pools will get federal assistance to offer insurance to people with serious illnesses who have not previously been able to get insurance - I note "may" because some of these pools have long waiting lists already.
Another provision for the uninsured relates to an expansion of Medicaid to adults at or below 133 percent of poverty, a provision that should kick in this year.
- If you have been a dependent on your parents' plan, you can stay on that plan until you turn 26 (rules vary by state but many plans only cover young adults until 23 or 24);
- Within six months of passage, your children cannot be denied insurance because of pre-existing conditions, and by 2014, no one can be denied because of pre-existing conditions;
- The so-called "donut hole" in Medicare prescription drug coverage will be eliminated - at first, reduced by500 and then ultimately closed. (If you're on Medicare you know all about this complicated provision ...)
- Insurers will have to spend a minimum of 80 to 85% of your monthly premium on actual medical services (not advertising, marketing, administrative costs). Why is that important? Because if you have tried to buy insurance as an individual, you may have noticed that, if you can get it, it costs a lot and the deductibles are often huge. Forcing insurers to pay out more for medical services (it's called the "medical loss ratio") is predicted to lower premiums nearly immediately.
- Small businesses with fewer than 25 employees would get tax credits to encourage them to purchase insurance for their employees - it might help you if you work in one of those places.
- Community health centers will get an immediate infusion of money from the government to help take care of people who need care but cannot afford it. Here's where you can find one near you.
What will not happen as a result of health reform, is the collapse of the health care system as we know it, despite Limbaugh's predictions. As with all major legislation, it takes awhile for change to kick in. After the first year, it will take a few years to phase in the remainder of the reform - the health insurance exchanges, the rest of the insurance reforms, changes to Medicaid (expansion of the program to include all poor adults not just women and children). There will be little if any noticeable change in Medicare - the changes that will occur will happen on the provider side, where managed care plans that serve the elderly will have to compete for business and doctors and hospitals will have to work together to figure out how to divide up Medicare payments.
Some of the more controversial elements of reform like the requirement that everyone have insurance, new taxes on Medicare for the wealthy, or taxes on companies that make medical devices, will also be phased in. It will be at least 2014 before everything is in place. It is impossible to predict how the slow pace of reform will affect opinions about health reform. Will people get frustrated if change doesn't happen quickly enough? Will opposition die down if change doesn't alter the positive elements of the health care system? Can hysterical threats of disaster maintain their intensity when there's not much disaster to identify? At the very least, we can get back to the business of trying to stay healthy without constantly hearing about health reform every day. And those of us who work in health care can get back to the business of improving the quality of health care in America.
Rep. Dennis Kucinich will vote YES on health reform. http://www.politico.com/arena/
I mention this only because so many commenters have condemned this reform based on Kucinich's objections. But I think he understands what so many of us believe, that you start where you can and you build on it. If the bill is too weak for you, then there is an opportunity to strengthen it. If you feel the bill is a government takeover, god bless you, but Kucinich's position will mean nothing.
This is where the hoops will be built!
http://www.pbs.org/moyers/journal/03052010/watch3.html
It is the law of unintended consequences.
We need to regain control and begin to prevent passage of "good intentions". Good intentions are not enough!
thanks for the link, and I agree wholeheartedly with you both bills are worthless and will do little to reform this bloated and very corporate system of health care. All window dressing by the democrats. Give us real reform not more corporate welfare.
"health insurance". The providers of insurance have been deemed to be unworthy of having anyone's business because a few do not want their product or have some difficulty with the company.
So either the plan is to eliminate the industry, which has been stated, or help the few at the cost of the many.
Truth: The American Public does not want The Myth that has been passed around as Obama-Care. The Media has Spread Lies because their only objectives are to sell papers, get higher ratings and protect their corporate owners.
Conclusion: The Democrats must never assume that Republican Propaganda is too outrageous to be believed. The Democrats Must Tell the American Public what is actually in Health Care Insurance Reform and then Americans will like the bill.
Lie: Obama should have concentrated on Jobs instead of Health Care.
Truth: The Stimulus bill was a Jobs Bill.
Conclusion: The Democrats should have called the Stimulus Bill, "The Jobs Bill". The Democrats Must Spread the word that President Obama did concentrate on Jobs First.
Lie: The Democrats are trying to take over Health Care and 1/6th of the American economy.
Truth: The Democrats want to reign in the Insurance Industry which is now in control of Health Care.
Conclusion: The Health Care Reform effort should have been called "Health Car Insurance Reform". Democrats Must Tell Americans that Reforming Insurance does not mean government controlling 1/6th of the American economy.
Karl Rove said that Democrats would have to think that Americans are Stupid to believe that they would fall for Lies, but the American Public does not have to be Stupid to be mislead by a Republican Party and a Media both intent with passing around false information.
FreddieVee
t will be "not for profit" healthcare. Your right wing slogans are becoming increasingly boring and tiring.
Dr.Macia Angell of Hrvard University speakes frankly about so-called health care "reform" with Bill Moyers:
http://www.pbs.org/moyers/journal/03052010/watch3.html
Good night.
THIS IS CORPORATE WELFARE--not people welfare.
Ms.Bergthold must not know what it's like to be sick and be at the tender mercy of and insurance cartel that ruins your life and leaves you bankrupt.
Obamabots don't care as long as "Dems win" .
If they wanted real reform--they would not stand in the way of states rights of single payer. ERISA--gone.
This bill nor story is not worth sh*t.
The one issue I have now and the past and forever is the unwillingness of anyone in the know to tackle costs. Yes, cost. Why should a doctor charge $350 for an office visit, no counting charges for any procedure he/she might actually perform during the office visit. Why is an MRI or other scan, that's be paid for over and over again, $1,000 or more. Why is saline solution over $100 a bag?
Don't hand me the crappola about covering the uninsured. If that were true WHY are so many uninsured unable to access healthcare and if they do face medical bankruptcy. Why are hospital so quick to sue patients who had no say in how their bills were run up.
Medical care is the ONLY commodity whhere we the consumer have no negotiating rights. It should be illegal.
How can anyone say with certainty how much something is going to cost one, five or even ten years down the road? The CBO scoring has to take Congress at its word for some things; what if all those savings in costs attributed to eliminating "fraud, waste and abuse" are never realized? By then it's too late. What's the time gap between when taxes are increased to fund health care reform and when it actually starts?
"I often help friends and family negotiate medical bills. It's surprising how much you can accomplish by asking the kinds of questions you are asking."
The problem is that with a third-party payer most people never know what anything costs. If you take things that are not typically covered by health care plans (like LASIK), their prices have actually come down over time. Not so with things that are "covered". And why do the Democrats and Republicans still insist that the main way for people to buy health insurance is through an employer? If individuals are given the same or better tax incentives that businesses get then we could get them out of the loop. But no one wants to do that...
Pass this bill, and then lets pass a public option or medicare buy in for those under 65 years of age.
Also next year, cancel the deal with big pharma, and start negotiating drug prices, or importing drugs from Canada.
Consider 85% are happy with their insurance Some 280 million, spending about $2.5 trillion, or around $8,900 each. we are going to take that to some 95%. 313 million at a cost of $3.7 trillion. Cost now $11,800 each!
Does this look like a cost reduction to you??
1. employers -- They don't want the employment/benefits contract broken which keeps workers indentured and excuses employers from raising REAL wages.
.They won't give up their PROFITEERING off health care delivery.
Here's the stock chart of Wellpoint, the profiteering parent of Anthem/Blue Cross that wants to raise INDIVIDUAL subscriber rates 39% this year after already raising them 18% last year.
http://finance.yahoo.com/q/bc?s=WLP&t=my&l=on&z=m&q=l&c=
For the corporate, for-profit system served by our government, this 'reform' is a billion dollar give-away to the medical cartel (for-profit doctors and hospitals, Big Pharma, insurance, nursing homes and medical supply/device companies.)
Wingnuts? Well the "wingnuts" are on both sides of the political spectrum.
Perhaps the only ones wedded to this bill are the Progressives, and they will be the death knell of the country.
And no Progressive does not mean what you think!