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Linda Bergthold

Linda Bergthold

Posted: November 25, 2010 10:00 AM

Every year at Thanksgiving, my husband requires all of us to tell what we are thankful for. The kids sigh and groan, but in the end, it's usually a sweet exercise. This year I will wonk out everyone by recounting the five things I'm thankful for related to health reform (they will most definitely sigh and groan... )

1. I'm thankful that I can get preventive care now at no co-pay as part of my Medicare benefits. That includes flu and pneumonia shots, mammograms (ugh I hate getting them, but I know I need to), colonoscopies (which I hate even more, particularly the preparation), but also all kinds of screening for things that affect older people like glaucoma, diabetes, etc.

2. I'm thankful that my family members who are not yet 26, but have been uninsured, can now get coverage under their parents' plans. I am really thankful that my hairdresser's son, who has had cancer, can continue his treatments. Otherwise he would be uninsurable.

3. I'm thankful that my family is healthy, but that if they were not, they would still get the care they need. My family members are insured, but that doesn't mean they will always get the right care at the right time. Health reform has alerted all of us to the importance of improving quality of care, and most importantly the Affordable Care Act has funded many good projects to help doctors and hospitals improve the quality of what they do.

4. I'm thankful that my nieces and nephews, and ultimately my grandkids, will have guaranteed maternity and newborn care when they decide it's the right time to have children. Not all insurance plans have covered maternity care in the past, but now it's part of Essential Benefits in the Affordable Care Act.

5. I'm thankful that the many people who don't have insurance coverage will be finally able to get good affordable coverage -- at least by 2014. And for people who do have coverage, I am thankful that insurance companies will have to spend at least 80 percent of our premium dollars on actual medical care, starting next year!

That's a lot to be thankful for. I couldn't have said this last year when we were still wrangling over health reform. What I am most thankful for is that our country finally had the courage to try to solve a problem that had been put off for 50 years. Yes, it was an ugly debate at times, and we didn't all get what we wanted. But we tackled it, and we will continue to work on it for many years to come.

 
Every year at Thanksgiving, my husband requires all of us to tell what we are thankful for. The kids sigh and groan, but in the end, it's usually a sweet exercise. This year I will wonk out everyone...
Every year at Thanksgiving, my husband requires all of us to tell what we are thankful for. The kids sigh and groan, but in the end, it's usually a sweet exercise. This year I will wonk out everyone...
 
 
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05:56 PM on 12/03/2010
While this law mandates coverage, mandates more benefits and mandates 80% of premiums spent on medical care - the only direction premiums are going to go is up. While it is a noble goal of getting more people covered, I am a bit surprised by your naïveté regarding "good AFFORDABLE coverage". This law has done nothing to reduce the cost of health care DELIVERY. You can hate the health insurance companies all you want but the fact of the matter is that Premium = Expected Claims (which become actual) + Expenses + Profit (All divided by the number insured). Claims drive approximately 75% of your premium costs, expenses about 21% and profit 4%. If you were going to reduce the cost of premium which of those 3 would you focus on. Even if you eliminate all the profit in the formula - you will save , on average, 4%. We have non-profit insurance companies (e.g. BCBS) - did everyone flock to them with their business? If profit was such a factor, the non-profits would have driven out the for-profit companies. Did you see BCBS scrambling in MA to have their rate increases approved? Health care DELIVERY is what is driving up premiums (or another way to say it , driving up healthcare costs). The mandates may make you feel all warm and fuzzy during this Thanksgiving holiday but reality is that what this law will do is set us up for significant premium increases. For that, I am NOT thankful.
07:51 AM on 11/27/2010
Nothing was changed structurally to accommodate the mandates of the healthcare reform as it is currently written, and it will eventually cripple the system for all.
What people are envisioning is the ability to obtain the level of healthcare that is currently provided. What you'll see by 2014 is a decrease in healthcare providers and services, the healthcare system unable to sustain the number of users, inability to fulfill the unfunded mandates and a greater waiting time for the service you desire/require.
04:55 PM on 11/26/2010
Before Health Care Reform was passed, I was one of millions of Americans who could not afford to purchase insurance.

Eight months later, I am still one of millions of Americans who cannot afford to purchase insurance.
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Linda Bergthold
Health policy consultant
05:45 PM on 11/26/2010
If health reform survives as passed, you will get some help to afford health insurance, but unfortunately not until 2014. A few things have happened right away, but the subsidies and the cost controls have to be phased in over a period of time.
11:25 PM on 11/26/2010
Oh, so I just to wait until 2014. I hope I don't get sick for the next 3 years.
04:51 PM on 11/26/2010
You know who is even more thankful for Health Care Reform?

The insurance companies and their CEOs.
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Damiano Iocovozzi MSN NP
10:41 AM on 11/26/2010
I'm grateful, too, that one can purchase health insurance with a pre-existing condition. It's a start. However, carriers will charge what they like, even if it means paying more than one grosses per month for the opportunity. The fee-for-service plan needs to be completely scrapped, as it incentivizes providers to sell goods & services that are considered medically futile. The single payer system has no incentives to commit waste, fraud & abuse as there is no money to be earned. In fact, the USA pays about 30% per dollar spent on medical futility per annum which is about 1.2 trillion USD, estimated by the medical long-term care literature. 1.2 trillion USD could give every person on the planet basic, free health services. Health insurers wrote this piece of law so they would be insured of remaining in the driver's seat. As long as the US citizen is mandated to buy from them, they are insured long term profits, make tons of money off the float which the insured pay per month & deny services. The US still pays the most, yet trails Turkey (#37) in health care rankings for women & child health outcomes. The US places almost last in other outcomes in developed nations. Until health care is considered a basic human civil right, the US will get it wrong as it lives in its own artificial reality of health care as privilege. Visit my web page http://www.soonerorlaterbook.com
02:14 AM on 11/26/2010
Legitimate question here. Can anybody point me to data on what countries produce the most new drugs and medical techniques? Thanks in advance if anybody has info.
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Gary Shapiro
10:53 PM on 11/25/2010
Will your kids and grandkids be thankful for the incredible increase to federal spending and the deficit this deceptive legislation caused? Although Pelosi and the White House web site still say it cut the deficit, the CBO, after the House vote said it made scoring mistakes (over $100 billion) and didn't include over 50 unfunded mandates.

This was a sad moment in our hsitory as many politicial "leaders" from the President (deceiving with "facts" about $50k diabetic amputations) to Republicans (death panels) to Democrats (the cost and purpose and hiding the bill -Pelosi saying you will learn about it after the vote)), never had a discussion of what problem was being solved, the facts and the options. Oh and what about cutting $350 b from medicare by an unidentified panel...and did we forget to reform malpractice?

Not our finest moment.
10:48 PM on 11/25/2010
The health insurance industry is also very thankful for this bill. Instead of reducing their power and profit, the bill that Barky signed increased it. I personally am thankful that my premiums have risen umpteen percent the last four months. I can't think of a better place to send my money than to health care insurers. I know they care, and I know they will reward me amply. Thanks Barack. You did a GREEEEEAAAAAAT job, Man!
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parlimentMike
Don't settle for less evil, demand good
07:25 AM on 11/26/2010
It can't be reform if the folks who screwed it up get even bigger. It also isn't patriotic what's in that act either. The Defense Department is starting to have a hollow ring too.
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10:02 PM on 11/25/2010
This Thanksgiving I'm thankful for my excellent immune system, health, and safe lifestyle because I'm not buying Obamabare anytime soon.
09:04 PM on 11/25/2010
I am thankful all these new mandated reforms on the health insurance industry only caused my premiums to go up by 20% in 2011. By health reform, you mean making the health insurance companies pass on the expenses imposed by the government on to me. Thanks Democrats. Less money for me to pay my student loans off.
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10:04 PM on 11/25/2010
Bergthold never mentions things like that which you describe.
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Linda Bergthold
Health policy consultant
10:58 PM on 11/25/2010
Health reform has not yet been implemented yet. So you can't quite blame it for these increases in costs. Health care costs were already going up, and if insurance companies decide to try to pass any future costs on to us now, this is not the fault of reform. It's the fault of the greed of the insurance industry.
11:57 PM on 11/25/2010
So, no co pay on preventive care is completely free? That isn't an expense? Widening the base of coverage without covering the costs? Is that what you think happens? Child Please.
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lolablev
08:57 PM on 11/25/2010
Thank you - YES, much to be thankful for - it's a start, it will get better if we all push for it - if we piss and gripe we get what we put into it - a hard battle democracy.
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10:07 PM on 11/25/2010
A "hard battle democracy" appears to be in store for us regardless of the attitude with which we approach it.
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samtee
Shankapotomus.
06:24 PM on 11/25/2010
She must not have read it.
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Beatriz09
05:40 PM on 11/25/2010
Well said, I couldn't agree more!
 
And I even didn't know yet that maternity care was part of the Essential Benefits, whereas I thought knowing this law rather well ... . I'm certain that by 2016, a vast majority of the American people will strongly support this law. That will be too late for Obama to get some political benefits from it, which makes it only more amazing that this president really had the guts to get it done.
 
 
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04:58 PM on 11/25/2010
I am far to the right, but also worked for many years in healthcare administration. I actually support what some might consider some very radical options, like a govt run primary care system, similar to what I use with the VA.

However, this bill was not done well. Harry Reid did it without being bothered with any real knowledge. It was also passed with less than the 60 votes required, huh? Dictators normally do things like that! Very concerning.

As I understand it, this is really a huge tax bill, with very little real healthcare in it. It also cuts doctors' incomes in huge ways. Shortly we will have far fewer doctors because they will move to less socialist countries. Where will our healthcare be then?
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Beatriz09
05:43 PM on 11/25/2010
1. Dictators rule by using the votes of the minority. This bill passed with a 60 vote SUPERMAJORITY. So you may not like it, but is was clearly a VERY democratic vote.
 
2. Cutting doctors incomes: link?
 
3. Hugh tax bill: link?
 
4. Most of the Western developed democracies go much further in "socializing" health care than this bill does. So WHICH Western country would those doctors actually flee to, you think?
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05:53 PM on 11/25/2010
They passed it with fewer than 60 votes. Called it reconcillation.
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05:56 PM on 11/25/2010
Many have already left. Many of our most successful people have already left. They see the handwriting on the wall!
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Pamela Grundy
Freelance writer & blogger.
07:19 PM on 11/25/2010
How can you say that you actually favor a government run healthcare program similar to the VA (which would basically be single payer, which is in fact socialized medicine and therefore a form of socialism), and in the very next breath say that this program is all about taxes and and slam it as 'socialist' because (you claim) it cuts physician pay?

There's nothing socialist about this health care legislation. Nothing. Nada. Zip. By contrast, the program you say you favor really IS socialist.

This program, the Affordable Care Act, supports private insurance corporations by requiring people to buy private insurance. Private insurance is a business, it's not socialism. It's not run by the government.The Affordable Care Act subsidizes private insurance, so it's a give away to insurance companies--it may be corporate welfare but it's sure not socialism.

What you're saying here is really just a longer version of that nonsensical rant, "Get your government hands off my Medicare!" I don't think you know what socialism is at all, you just know it's supposed to be bad.

We need a little socialism in the U.S right now. We need single payer, like yesterday. We need to quit stealing money from sick people and running costs off the charts so CEOs and stockholders can get richer and richer. If health care really focused on health and care instead of profit we wouldn't be in this mess at all. You can thank St. Ron for that, not socialism.
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07:37 PM on 11/25/2010
I was talking single-payer for a very basic level of primary care. We must use extreme care to not remove all incentive from the system OR we're gonna have: 1) no new drugs, 2) techniques, or even 3) doctors - they are already leaving in droves or deciding not to even enter medicine. And I mean leaving the country!

If we lose 1,2,& 3, I promise you will not like your "healthcare".

I support reform, but have ZERO confidence that Comrade Reid even knew what was going on, much less got it right.
04:30 PM on 11/25/2010
Public option is a reform. This is a fraud and leaves us at the mercy of the criminal health insurance profit industry.
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Beatriz09
05:47 PM on 11/25/2010
A lot of things a public option only would obtain after years (by competing with private sector policies) are now MANDATED by law. So this bill is certainly not a fraud. I want a public option too, and as soon as possible single payer, but I don't see how you could deny the fact that this HCR law brings us closer to what we wanted to obtain with a PO or single payer than the situation as it was, before passing this law.
 
Again, I personally think that health insurance should NOT be the business of private sector companies. But if you know that for 50 years it was impossible to do anything about this problem, I think you really have to say that this bill is finally a first step in the right direction.