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The Almighty Buck United States

Health Care Reform 2044

It appears that today might be the end of a very long road to health care reform. There's been a lot of debate on the subject really leading back before the election. The mainstream sounds like an echo chamber, so I'm hoping you guys have better insight. Will this bill do what the administration claims to do, or is it as bad for the future of America as Fox says?
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Health Care Reform

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  • by dtmos ( 447842 ) * on Friday March 19, 2010 @08:48AM (#31535010)

    Nothing is as bad for the future of America as Fox says.

    BTW, I've seen thousands of comment trolls, but I think this is the first story submission troll I've seen.

    • by Farmer Tim ( 530755 ) <roundfile&mindless,com> on Friday March 19, 2010 @08:54AM (#31535072) Journal

      We have nothing to fear but Fox itself.

    • by Anonymous Coward on Friday March 19, 2010 @09:00AM (#31535156)

      The truth is, the non-left of the American public (i.e. centrists, libertarians, independents, right, etc) would better trust the government to run healthcare if they actually had a better track record of running other programs. Find any government agency that's tried to do exceptionally well and you'll find that the smaller the scope of their responsibility the better they did. Medicare, Medicaid, Social Security, Postal Service, any regulatory agency - you get the picture. The federal government simply doesn't have a good resume; you can't blame the unbiased peoples for not loving the idea of the government running yet another program.

      • by microcars ( 708223 ) on Friday March 19, 2010 @09:26AM (#31535650) Homepage
        The "truth" is, the same people that want anything the Obama Administration does to fail are the same people that created the Third Largest Government Agency [dhs.gov].
        How has that worked out? And where was their outrage over its creation and its current status of operation?

        Try sending a letter or small package through the USPS, UPS and FedEx and let me know which one was more cost effective.
        Now try building a straw man and knocking him down.
        • by saider ( 177166 ) on Friday March 19, 2010 @10:44AM (#31537398)

          The USPS is in debt up to its eyeballs because electronic documents are causing a drop in volume. FedEx and USPS have adjusted their rates , fleets and staffing to accommodate this drop. The USPS is less nimble because it faces restrictions imposed by the government (what kind of business it can do, what rates it can charge, etc.). If we ran healthcare like this, you can bet it would have the exact same problem.

          Furthermore, various states run insurance companies, but often they are used by private companies to dump their risky products. Since the state then holds the risk, they are supposed to set the rates to a level that can cover it, but the politicians intervene and drop the rates. The result is a company that either has to rely on a taxpayer bailout or failure altogether.

          Here in Florida, they created a property insurance company to be the last resort for people who cannot get property insurance, which is required if you finance your house. The private insurance companies started divesting their risky properties, and the state insurance had to take them. When the state insurance company adjusted the rates to accomodate the risk, the policyowners yelled at their politicians, who in turn forced the company to limit the increases. This has resulted in a company that does not have enough money to cover losses in the event of a Hurricane. You can bet that if we get a major hurricane or two (we've had few since the scheme was concocted) that Florida taxpayers will be on the hook for the payouts.

          Government healthcare would suffer the same problem with premiums becoming a political football that politicians use to get elected.

    • by Jhon ( 241832 ) on Friday March 19, 2010 @09:12AM (#31535362) Homepage Journal

      "Nothing is as bad..."

      Yeah. Keep saying that. When our government starts taking away our liberties (forcing people to buy health care, taking away private property to give to another private party are just two examples), I'd say that's bad for America. When it continues to spend us into either runaway iflation or economic ruin, I'd say that's bad for America. But that's just me.

      Any rational person can see this "budget neutral" bill is a hoax. 10 years of taxes, 6 years of real benefits. WTF? Additional budget trimming based on rasing the capital gains tax with estimates of increases in tax revenue that are NEVER going to materalize (as they never have in the past when estimates like this were used).

      If I STILL wasn't paying a tax to help support the spanish american war [wikipedia.org], I'd think this was a joke.

      • by amplt1337 ( 707922 ) on Friday March 19, 2010 @09:45AM (#31536034) Journal

        (forcing people to buy health care, taking away private property to give to another private party are just two examples)

        I'm not a fan of the bill -- the lack of a public option creates, as you say, a major problem by forcing people to give money to insurance companies that have little incentive not to gouge their captive market. A mandate *is* necessary, though, for insurance-based health reform to work. (That's why single-payer was the way to go...)

        As for the other, that's inevitably always going to happen. Unless the government carries out its necessary functions entirely itself (which wouldn't be a bad thing, but would probably be considered "socialist" or something), there will always be government contractors and the like. But redistributing income is a core part of every government, ever. Taxing the serfs to keep your warriors in meat and mead fits that description just as well as does Social Security, the Space Program, and the local fire department.

        When it continues to spend us into either runaway iflation or economic ruin, I'd say that's bad for America.

        We are nowhere near runaway inflation. In fact, there is a substantial risk of a very bad deflationary spiral at present. (see e.g. graph here [nytimes.com]). Deflation is bad; it means wages decrease, consumer spending drops, and job losses keep mounting. I mean, deflation is wonderful if most of your assets are dollars. If you own anything of value though, like say a gold stockpile, or a house, or if you like jobs, deflation is very very bad. And there is approximately zero chance of Zimbabwe-style inflation in any imaginable non-post-apocalyptic America over the next fifty years.

        • by sean.peters ( 568334 ) on Friday March 19, 2010 @10:40AM (#31537312) Homepage

          I'm not a fan of the bill -- the lack of a public option creates, as you say, a major problem by forcing people to give money to insurance companies that have little incentive not to gouge their captive market. A mandate *is* necessary, though, for insurance-based health reform to work. (That's why single-payer was the way to go...)

          In fact, per the bill, insurers have to pay out 85% of their revenues in actual medical care, which means it's more or less impossible for them to just charge whatever they want. Yes, a public option would be better, and single-payer would be better still... but this bill is still a huge improvement on the status quo.

      • by raddan ( 519638 ) * on Friday March 19, 2010 @10:07AM (#31536498)

        When our government starts taking away our liberties (forcing people to buy health care, taking away private property to give to another private party are just two examples)

        I'm guessing that you chose those two examples because they are hot-button issues, but the reality of it is: you never had those liberties, but because they never affected you, you thought that you did.

        Eminent Domain [wikipedia.org] predates the founding of this country. It sucks, especially when it affects you (my great-grandfather's farm was largely seized to build a school), but there are many, many cases where there is indeed a greater good served by it. The discussion really shouldn't be "should we have it?" but "when should we have it?" Eliminating it is not practical.

        You already pay for health care, but like so many other things (roads, police, schools, car insurance), you don't see those costs directly. If, for instance, you saw an itemized car insurance bill explaining that most of your insurance money goes to paying out drunk driving accidents, or say, minor scratches on someone's Lexus, you would probably be pissed off (fun story: I bumped a Lexus once with my car-- it cost the insurance $1200, for a SCRATCH-- given that my insurance bill for the year is roughly half that, who do you think pays for it? Hint: you). Now there are many, many reasons why health care costs are going up. Medical practitioners are in short supply, medicine and equipment are very expensive (sometimes for good reasons, sometimes not), but most importantly, because the ratio of healthy people to sick (and by sick, I really mean, people needing care) people is swinging rapidly toward more sick people: baby boomers.

        If you're insured, you're paying for them already. Because I work for a large company, and they have good bargainers, we only pay about $300/mo per single employee. I contribute half of that. But ever try to get insurance yourself on the private market? Good luck affording it!

        Now, it can (and should) be argued that health insurance itself is part of the problem, and I agree. Insurance is supposed to be a hedge against catastrophe. You know, brain cancer. The kind of thing where the expense is so astronomical, that it would ruin you. Instead, we have insurers covering viagra (only actually necessary in very rare cases-- I have a friend with a rare pulmonary disorder, and strangely enough, viagra is an effective treatment for her) and elective surgery, because people don't want to pay for them themselves. This abuse has done nothing to control costs. It's a travesty that an out-of-pocket visit to your general practitioner can cost you a week's wages. I had an X-ray done recently-- it was $1000. We're talking about 19th century technology here, people. So anyway, now it covers the routine stuff, but often not the catastrophic stuff. They'll deny you coverage! WTF!

        But hey, this is what we have. Do we:

        • Dive in and fix the problem?
        • Let everyone get increasingly fucked over

        Keep in mind that while there are millions of people who can't get healthcare at all, due to cost, the CEO of United Healthcare recently received a 1 billion dollar (US) bonus [cnn.com]. That, my friends, is fucked up. This man could personally pay for doctor visits for hundreds of thousands of people.

        As many people here have said, they're trapped in their bad employment situations because they have a sick spouse or child. Imagine having to go to work someplace where they treat you like dirt for years on end because, without them, your loved one dies? That is slavery, plain and simple.

        Personal health is a prerequisite for a healthy economy. If that guy could leave his job for a better one, without worrying that it would end his wife's leukemia treatments, or

        • by DavidTC ( 10147 ) <slas45dxsvadiv.v ... x.com minus city> on Friday March 19, 2010 @01:51PM (#31541062) Homepage

          So anyway, now it covers the routine stuff, but often not the catastrophic stuff. They'll deny you coverage! WTF!

          The real fun is when you have a preexisting condition and hence can't get covered for routine stuff, either.

          I had a congenital heart defect, meaning I needed open heart surgery the first day of my life. I had it. It solved the problem, but, as early open heart surgery can often do, it damaged my heart's natural pacemaker, so now I have an artificial one. (Aka, what everyone calls a 'pacemaker', they actually mean 'artificial pacemaker'. Everyone has a 'pacemaker'.)

          Fair enough. It's about $15000 in expenses every eight years or so, and, frankly, I can cover that out of my pocket. I'm not a moron, I know the batteries die, I know roughly the costs, I can save up.

          But now I can't get insurance for anything else. Forget heart conditions, they won't even bother to attempt to cover me for anything. I call them up, inform them I have a pacemaker, and they politely inform me they will not cover me.

          Private insurance is stupid. They simply don't want to actually provide useful insurance. No, everyone needs to pay into a government catastrophic care fund, and whoever needs it can use it. And we should, of course, continue to help subside the care of the poor.

          Likewise, we should probably subside a little preventative maintenance, also. A free checkup a year or something will reduce problems down the road.

          I'm really having a hard time figure out why we shouldn't provide all care, free, like NHS over in England.

          I can vaguely see the argument that costs will be reduced if some people pay for some of their care, but frankly, costs can be just as reduced if the government pays hospitals and doctors set amounts for specific procedures, obviously resulting in them reducing their costs to increase profit.

          But the entire manner we're going about solving this problem is backwards, solving it with 'insurance'. Sadly, we're so fucked up that solving it backwards is also helping solve it, like a car stuck in the mud. If nothing else, it will cut into insurance company profits, thus making it harder for them to fuck with the next reform.

  • by Bos20k ( 444115 ) on Friday March 19, 2010 @08:52AM (#31535048)

    If you really want to fix healthcare, do tort reform first. Then break up the AMA cartel. Then look at other things that may need to be changed.

    Is there anything that the government runs that really functions correctly/efficiently?

    • by Sircus ( 16869 ) on Friday March 19, 2010 @08:59AM (#31535144) Homepage

      Is there anything that the government runs that really functions correctly/efficiently?

      Is there anything about the proposed act that is government-run? If there is, I'd missed it. It mandates a bunch of things that private insurance companies are required to do, but it doesn't set up a public option (aka government-run health care).

      • Is there anything about the proposed act that is government-run? If there is, I'd missed it.

        That's right, you missed it. Medicare and medicaid (the largest expense our government has today, costing more per-citizen (not per covered citizen) than any healthcare system in the developed world, will be expanded to cover something like 15-20 million additional Americans. Everyone else gets mandated employer insurance. I'm not sure what the un- or self-employed get, but I believe that this is modeled on the Massachusetts option, and here in Mass. we are required to buy our own insurance unless our incomes are below the poverty line. In some of those cases, the government then provides subsidies for a private plan

    • by dorre ( 1731288 ) on Friday March 19, 2010 @09:01AM (#31535190)
      The most important thing is not if the government is able run health as efficiently as possible. The important question is who earns money on what. In case of 100% private health care, everybody (even insurance companies!) earns money when someone is sick. In the case of government run health care the government loses money if people are sick. So they have an incentive to keep people well and only recommend useful medications. I think that's the important incentive here to take into consideration. Do people really want a system where the doctor earns more money if you're more sick and so on?
    • Well, lets see (Score:5, Interesting)

      by SmallFurryCreature ( 593017 ) on Friday March 19, 2010 @09:02AM (#31535192) Journal

      How has private industry done so far with american healthcare? Cost more, gets less. Yup, that is a sign of success.

      Oh and how has private industry been managing the economy?

      It kinda amazes me that people with a healthcare system that is useless in the middle of a global recession all under the management of private industry, then dare to ask whether government can run things.

      Imagine a discussion in North Korea: "Can private industry be expected to handle food production?"

      Answer: "Who knows, but the question is silly when the current system is such an obvious mess".

      Sometimes you got to take a chance. Do anything because when you are nose deep in shit, chances are anything is an improvement.

      Can the government do a better job? It would be hard to imagine how they can screw it up even more.

      • Re:Well, lets see (Score:5, Insightful)

        by osgeek ( 239988 ) on Friday March 19, 2010 @09:40AM (#31535916) Homepage Journal

        Is your premise true? That the US health care system is under the management of private industry?

        I would argue that the health care system we have is a monopoly that is shored up by wiling politicians who at best refuse to take simple steps to promote competition and transparency of costs and who pays what to consumers.

    • by orthancstone ( 665890 ) on Friday March 19, 2010 @09:25AM (#31535634)
      Tort reform is good, but it is only so good. Look at Texas: Doctors in Texas have been helped a lot by tort reform, but consumers are still getting royally fucked by the insurance companies. The solution to HC needs to encompass everyone, and tort reform alone does not do that.
  • by Wonko the Sane ( 25252 ) * on Friday March 19, 2010 @08:52AM (#31535052) Journal

    It is a desperate grab for tax revenue [market-ticker.org] to shore up a faltering budget.

    Real health care reform would either include a single payer system or a rational free-market plan [market-ticker.org]. Nether party is willing to do this, however. I wonder why... [opensecrets.org]

    • by Cimexus ( 1355033 ) on Friday March 19, 2010 @09:25AM (#31535624)

      You know, you're right. And I say this as an Australian living with our wonderful (and I'm not being sarcastic) universal, single-payer health care system here.

      In the past on Slashdot, when the issue of US healthcare reform has come up, you inevitably get all the Canadians/Europeans/Australians/New Zealanders on here going "OMG of course you should reform - your system sucks, and ours works pretty well". It seems like a no-brainer ... why would you not want to move to a system like ours. It's cheaper, more efficient, everyone is covered, health insurance is not tied to your employer, and the health outcomes returned are better. I was one of those people ... it seemed absolutely crazy (as in, literally mind-bendingly insane) that someone would want to oppose moving from the overpriced, inefficient and inequitable system you currently have to a system like most of the rest of the world employs.

      BUT... ...now that I actually ~read~ something about the proposal itself, I see why Americans are debating it so much. It isn't really giving you guys a system like that in CA/EU/AU at all! Rather, it's just modifying the current system somewhat. It isn't really a fresh, new or particularly efficient system. It's tacking something onto what's already there ... giving it a coat of paint if you will, but not really addressing the underlying problems. It's not introducing a single payer system like in most other developed countries. And although I would personally still support it on balance, had I been an American, I would agree that it's not really a straightforward decision and it does have some significant flaws.

      So to non-Americans mystified at the opposition to this, take a read of the actual proposal. It's not a stark choice between "the system they have now" and "a system like in other countries". Rather the proposal is for something kinda inbetween, which runs the risk that it may not work as well as ~either~.

      • by Rakshasa Taisab ( 244699 ) on Friday March 19, 2010 @10:58AM (#31537720) Homepage

        No... Most of us already know that they're getting a half-assed health reform bill since it's been mentioned enough times in the international media.

        We just realize something is better than nothing, and that the US will never get its fingers out of the insurance companies collective asses.

      • by Eskarel ( 565631 ) on Friday March 19, 2010 @11:24AM (#31538380)

        I have Australian and American citizenship, I have lived in both countries and experienced both health care systems.

        The US bill is not single payer public health insurance, it would be better for the American people if it was, but the reality of the situation is that such a system cannot pass in the US as things stand. The Republicans are against anything the Democrats do, more than half the Democrats are in the pockets of big corporations and the Libertarians are always up in arms about anything at all which costs them money no matter how large a benefit it might provide society at large. That's not even taking into account the Tea Party and all the crazies that have come out of the woodwork because Dick Cheney proved to the American people that the government was out to get them and made every right wing conspiracy theorist and Militia member seem sane.

        That's not even counting the Americans of all political persuasions who are irate because Obama can't magic more than 11 million jobs out of his ass to fix unemployment. I mean presuming an average salary of 40k a year that'd involve finding 440 billion dollars a year somewhere, but never mind.

        Single payer health insurance cannot pass in that environment it's too radical, too different, too much like the government actually doing something useful with the tax dollars. Never mind the fact that the US pays almost twice as much in terms of percentage of GDP than any other western nation, has poorer health outcomes, and leaves more than 10% of its population uninsured, it just won't pass.

        As such this bill, which is very much imperfect is the best the American people can really hope for. Yes it leaves the insurance companies intact, yes it's full of corruption, pork, and special interest anti-abortion clauses, and yes it will probably mean that individuals who believe that they can cover the couple of grand a night for a hospital bed if they get sick might have to take on some of the burden of minimizing the insurance risk pool to keep down costs.

        On the other hand it will give 30 million Americans insurance, require insurance companies to insure people with preexisting illnesses, and remove the bonds forcing people to keep a job at any cost to keep their insurance when they need it. It would also save the insurance companies from their current death spirals by bringing healthy people back into the risk pool which would in turn reduce over all costs. It would do this while, at least according to projections, actually lowering the deficit.

        This is an ugly bill, and there are things about it which will need to be fixed, sections which are almost unconscionable. It will also require tort reform, medical practice reform, and educational reform to along with it to give it its greatest potential. Despite all that it is miles ahead of the current situation, and the best we can hope for. If Republicans had been more willing to vote yes, or there was more cost to minority filibusters we might have had a better one, with less pork, lower costs, and better results, but that's not the reality of the situation. This bill is the best the American people are likely to get under the current circumstances, and while it doesn't affect me personally I have a lot of family and friends who would be helped out tremendously by its passage.

        • by IICV ( 652597 ) on Friday March 19, 2010 @01:09PM (#31540398)

          That's not even counting the Americans of all political persuasions who are irate because Obama can't magic more than 11 million jobs out of his ass to fix unemployment. I mean presuming an average salary of 40k a year that'd involve finding 440 billion dollars a year somewhere, but never mind.

          Heeeeey... you know, that's about half of what the Iraq War costs per year. Maybe if we hadn't had a complete moron for president twice in a row in the last decade, we could actually magic those jobs out of someone's ass! And instead of spending all that money blowing shit up and killing people in a foreign country, we could spend it improving our goddamn infrastructure so we don't have any more bridge collapses, or building a long, high-speed transcontinental rail line so we have a workforce that can compete with China in the mass transit area, or laying more fiber optic cables so we don't have stone-age Internet access, or hell just sending all those 11 million people to college so we'll actually have an educated workforce (and solve the problems with university funding at the same time!)

          Pity that would all be socialist though, not good and republican like a nice big war.

  • by FlyingBishop ( 1293238 ) on Friday March 19, 2010 @08:53AM (#31535062)

    But then everyone knew that already.

    I expect it will at least mitigate my issues getting health insurance after getting kicked off my parents' plan, so there's that.

    As for the Republicans' complaints, I'm not really clear on what there is in this bill the Republicans didn't argue for. If the left had written the bill, it would dismantle the insurance industry and set up single payer. The only thing it's missing is tort reform, and the fact is that tort reform is a red herring. It accounts for 1-2% of healthcare expenditures, and that sounds about right. There should be a process for handling legitimate malpractice claims, and it's never going to be free.

    • by osgeek ( 239988 ) on Friday March 19, 2010 @09:10AM (#31535320) Homepage Journal

      I don't understand how someone could say that tort reform is a red herring.

      In terms of the direct financial impact of malpractice insurance and litigation costs, tort reform doesn't help more than a few percent or so. But in terms of the hundreds of billions of dollars wasted on unnecessary treatment because doctors are paralyzed to do anything besides order the extra tests and procedures, tort reform would make a HUGE difference.

      Unnecessary treatment should have been dealt with head on, and tort reform is a key part of it since being sued is the excuse that doctors give for ordering all of that and the excuse that insurance companies give for allowing it. In reality, they LOVE it. Doctors get paid extra per procedure, and insurance companies just pass the costs on through premiums, making sure to collect their extra percentages.

      Law suits are like terrorism. They affect the whole system in an extremely disproportionate measure beyond their direct impact due to the way that people change their behavior.

    • by jimbolauski ( 882977 ) on Friday March 19, 2010 @09:27AM (#31535678) Journal
      The bill has many problems, one it takes money from medicare in order to appear budget neutral, doctors will no longer get reimbursed very much for medicare because of the budget shortfall and will drop those patients. Two health benefits will not start for 4 years but the taxes will start right away again so it will appear budget neutral for 10 years. Three forcing insurance companies to take people with preexisting conditions means there is no reason to have insurance except for a fine which is much cheaper then paying for insurance. People will wait until they get cancer and then get insurance, since people will not pay into insurance until they are sick insurance companies will have two options one lose money and go out of business or two raise their rates so high to cover their loses either way this is a huge problem and will lead to the demise of insurance companies. Tort reform has other implications not only in lower premiums for doctors but many test procedures would not be needed because the doctor would not be worrying about covering their ass with unnecessary tests. Also HSA accounts which let people put money into accounts to pay for health care tax free will be eliminated, if this bill was really about making health care more affordable a program that gives people a 30%-40% savings in health care costs would not be eliminated. Luckely there are so many things in this bill that are unconstitutional (slaughter rule, forcing people to buy insurance, trumping states regulations, ...) that this will not go into effect until the republicans can get this nightmare repealed.
  • Wrong forum (Score:4, Insightful)

    by Chemisor ( 97276 ) on Friday March 19, 2010 @08:54AM (#31535076)

    Slashdot is packed with the entitlement generation and you're asking if they approve of the government creating another entitlement? Might as well go to Hell and ask the Devil if sinning is bad.

    • by sageres ( 561626 ) on Friday March 19, 2010 @09:18AM (#31535490)

      /agree mod the parent :-)
      obligatory welfare joke:
      A guy walks into the local welfare office, marches straight up to the counter and says, "Hi . . . You know, I just HATE drawing welfare. I'd really rather have a job".

      The social worker behind the counter says, "Your timing is excellent. We just got a job opening from a very wealthy old man who wants a chauffeur/bodyguard for his nymphomaniac daughter. You'll have to drive
      around in his Mercedes, but he'll supply all of your clothes. Because of the long hours, meals will be provided. You'll be expected to escort her on her overseas holiday trips. You'll have a two-bedroom apartment above the garage. The starting salary is $200,000 a year".

      The guy says, "You're bullshitting me!"

      The social worker says, "Yeah, well, you started it."

  • Neither. (Score:5, Insightful)

    by jgreco ( 1542031 ) on Friday March 19, 2010 @08:58AM (#31535134)

    It's nothing like the health care bill we should have had, something to create a health care system comparable to other modern countries. The Democrats have no backbone and kept watering it down and morphing it until it was only vaguely acceptable to just barely enough of them to possibly pass. This sort of thing leads to awful legislation.

    The Republicans, of course, are chanting "wait, wait, this is being rushed," but the facts are that they had years in which they could have pushed through health care reform - years where it was clearly necessary. Despite what they say, your average Republican simply doesn't believe in health care reform, which is why it didn't happen under Clinton and wouldn't happen under Obama if they could figure out a way to delay it. So instead of pushing for a fiscally responsible and conservative health care reform, the Republicans are really pushing for the status quo, without trying to seem like they're doing that.

    Both parties stink. I'm kind of hoping this passes, but then the Republicans come into power. It'll be impractical for them to repeal this, but perhaps they'll be smart enough to tinker with it to make it better. Past history is not encouraging, though.

    • Re:Neither. (Score:5, Informative)

      by commodore64_love ( 1445365 ) on Friday March 19, 2010 @09:27AM (#31535690) Journal

      >>>Republicans had years in which they could have pushed through health care reform

      They did.
      Or have you forgotten the new Prescription Medicine Reform where people can get "free" medicine? Or the Tort Reform to help reduce expenses?

      • Re:Neither. (Score:5, Insightful)

        by je ne sais quoi ( 987177 ) on Friday March 19, 2010 @09:56AM (#31536254)

        Or have you forgotten the new Prescription Medicine Reform where people can get "free" medicine?

        You mean the one that will cost about a trillion dollars that isn't paid for: [slate.com]

        Simply stated, the bill cost a fortune, wasn't paid for, is complicated as hell, and doesn't do all that much--though it does include coverage for end-of life-counseling, or what Grassley now calls "pulling the plug on grandma." In their 2009 report to Congress, the Medicare trustees estimate the 10-year cost of [the republican medicare bill[ as high as $1.2 trillion. That figure--just for prescription-drug coverage that people over 65 still have to pay a lot of money for--dwarfs the $848 billion cost of the Senate bill.

        This is typical of Republican governance, they bitch and moan all the time about fiscal responsibility, but they acted in the most inconceivably fiscally irresponsible way again and again during the decade or so they were in power. Now we the taxpayer and the democrats are at least attempting to clean up after the unmitigated spending spree that was the Bush Administration and Republican Congress (Iraq war, tax cuts for the wealthy, "free" prescriptions drugs) and are getting dinged for not being fiscally responsible? If this is a joke, it's not funny.

  • by jjo ( 62046 ) on Friday March 19, 2010 @09:00AM (#31535158) Homepage

    As you might expect, this bill is heavy on the benefits and light on the necessary pain. There's virtually only one effective cost-control measure, the tax on high-cost health benefits, and that has been pushed off so far in the future that it will be killed before it sees the light of day. The bill recognizes that coverage of pre-existing conditions requires an individual mandate, but then implements it in a half-assed way that won't achieve the objective of forcing healthy people to get coverage. (It also puts a dual drag on job growth by both raising taxes on private investment and directly increasing the cost of employing people. Way to go.)

    I would much prefer a bill that provided funds to the states to let them structure their own solutions to the health-care problem, as Massachusetts has done. But the top-down command-and-control midset in Washington is too strong for that.

  • Neither (Score:4, Interesting)

    by damn_registrars ( 1103043 ) <damn.registrars@gmail.com> on Friday March 19, 2010 @09:01AM (#31535174) Homepage Journal
    It won't do anything. This will go down as the 2010 Health Insurance Bailout act. Few Americans who currently don't have insurance will be helped, and few who do will notice one iota of difference. The largest group of people who will see positive change from this is the top executives at our health insurance companies.
  • by Nautical Insanity ( 1190003 ) on Friday March 19, 2010 @09:01AM (#31535180)

    The evidence for the efficiency and quality of government-run healthcare in other countries is indisputable.

    However, too many people have been making money hand over fist in the US to let any system where they would be the cut cost pass. Overall, it's an opportunity for the government to provide what the market cannot. Either affordable healthcare or writing into law corporate profits. I don't trust our congressmen to avoid the latter.

  • by astaines ( 451138 ) on Friday March 19, 2010 @09:06AM (#31535258) Homepage

    From our perspective (I'm a health policy person based in Europe), US health care is staggeringly expensive, very variable, and very unfair. It's the single biggest cause of personal bankruptcy in the States.

    Your health is poor, overall, especially you have poor child health, and relatively poor maternal and infant health.

    A large part of your population have no access to good quality health care, and this imposes large costs on your society.

    Your major companies find high health care costs for staff a major burden, and this sharply reduces the competitiveness of good US employers.

    You have the highest administrative costs for heath care that I know of, now running over 30%, and at current rates of increase, in thirty years you will be spending 100% of your GDP on health services.
    At the top end, there is no better health care anywhere for acute illnesses, but very few people can access this.

    The proposed changes are a start, and only a start. With no public option, there is a real risk that the insurance companies will continue to combine together to rip you off. However, the current proposals will save a lot of money over the next decade, which is why the insurance companies are spending millions buying ads, and influencing politicians to stop the change.

    I hope it passes!

  • by twoallbeefpatties ( 615632 ) on Friday March 19, 2010 @09:06AM (#31535266)
    I do not have anything of actual use to say about this bill, other than common talking points, unsourced blather about what this bill will accomplish, and vague appeals to antiauthoritarianism. But please mod me +5 Insightful like you're doing with everyone else, just to be fair.
  • by cinnamon colbert ( 732724 ) on Friday March 19, 2010 @09:14AM (#31535400) Journal
    As i understand it, the bill has 3 major parts
    1) a whole bunch of programs to evaluate new ideas; basically grants to researchers of one sort or another
    2) regulations to rein in the bad behaviour of insurance companies
    3) provide insurance to 30 million people who now lack it
    lets leave 1 aside and look at 2 and 3
    Do you really think that this bill will stop the insurance companies ? For instance, there is a section (109 in HR3967) that bans lifetime benefit caps. and you can read it yourself, and it looks pretty straightforward. I don't know how the insurance companies will get around it, but htey have, literally, hundreds of millions of dollars to buy armies of lawyers and lobbyiest and politicians to overturn this over the next 5-10 years
    So my conclusion is tthat at best, (2) will have some moderate effect over a few years
    As to 3 - I think what will happen, based on the MA model(I live in MA) is that yes, there will be a lot of people who will get insurance, but we won't have the money to pay for it. So, to save money, we will make this new insurance cheap and not very good (eg, low payments to doctors and hospitals, so only really bad hospitals will take people on this plan), so what will wind up happening is that we will create a permanent underclasss of people who have "insurance' that doesn't really work - it is like poor people who get charged with a capital felony crime; we pretend to provide lawyers, but dont' do anything really effective
    If you look at the down side, it is Huge.
    Obama is instituting a new national policy - health care, a basic fundamental right ina civilized society, is providd by for profit companies, and the FED. Govt requires you to pay these for profit compnies its horrible
    Another way to look at this is Obama's track record, say with the wall street bail out, where he made sure bankers got their million dollar bonuses - with tax dollars that came from your pocket.
    how on earth could anyone trust this guy with a track record like that ??
  • bad (Score:5, Insightful)

    by Beer_Smurf ( 700116 ) on Friday March 19, 2010 @09:14AM (#31535404) Homepage
    Read it for yourself. What I read is a wet dream for the insurance companies and penalizes anyone who is self-reliant.
  • by itlurksbeneath ( 952654 ) on Friday March 19, 2010 @09:16AM (#31535440) Journal

    It amazes me that with the high percentage of negative public opinion on the health care bill that congress is still considering it. This is supposed to be government by the will of the people, right? To me, the will of the people is not being executed here.

    Also, this is apparent in the back door manner in which they are trying to pass the bill by some trick of house/senate rules. This isn't some bill to appropriate a few million dollars for federal park support but a bill involving a trillion dollars of outlay. Given the current administration's massive spending and addition to the national debt with little to show for it, does anybody have any real confidence that this will work?

    Some comments on health care industries making money hand over fist. Everybody seems to be in an outrage with doctors making hundreds of thousands of dollars per year, but nobody bats an eye when some sports star signs a multi-million dollar contract. If you were going to the hospital for open heart surgery, would you want the lowest paid doctor that has no incentive for good performance cutting you open? I'd want the super-star doctor that drives the Porche. If he's good enough to earn that much money, he's got to be worth his salt.

    If they were really serious about health care reform, why didn't they start with the biggest money issue in health care: tort reform. Why? Because Congress is made up with a bunch of lawyers that don't want to see their industry lose out on billions of dollars per year in fees brought about by the misery of other people. People are incensed about million dollar bonuses at financial firms, but nobody shines the light on lawyers that, for the amount of work put in, end up making thousands of dollars per hour in a settlement or ruling. Consider, also, that even though that doctor is making a quarter of a million dollars per year, he's paying 25 or 30 percent of that in malpractice insurance to protect himself from every Tom, Dick and Harry that decides to sue because they didn't follow instructions and ripped their stitches out.

    Some lawyers are a blight on society, but unfortunately, their buddies are crawling all over Washington as lobbyists or in Congress/DoJ/White House/etc. The more I think about it, the more I agree with what Get Out of Our House [goooh.org] is doing.

  • by CaroKann ( 795685 ) on Friday March 19, 2010 @09:18AM (#31535504)
    The healthcare bill is so huge and complex that it is difficult to have any intelligent debate over it. People mostly make simple, sound bite sized remarks. Very few people seem to understand the bill. I don't understand it myself.

    That said, the conventional wisdom states that the bill will be extremely expensive, on the scale of Social Security or Medicare. While I agree the current health care system leaves a lot to be desired, I think the timing is terrible. Our financial house is not in order and the economy seems to be in the middle of a long term case of fatigue. In short, I don't think we can afford it. I'm worried it could be the straw, or bale, that breaks the camel's back.
  • by cervo ( 626632 ) on Friday March 19, 2010 @09:21AM (#31535544) Journal
    The reality is that the government doesn't seem to get anything done. I recall Arlen Spector saying that the patriot act was flaws, but he would vote for it as is and fix it later... Well as you can see, no one has really changed it to fix it. In 1992/1993 when Bill Clinton tried to make health care, no one agreed with him and he couldn't pass the bill. The republicans that later got in control of congress failed to make another health care bill. I think it will be similar with this bill. The republicans are calling to scrap the bill and start over, or why the hurry. But pretty much they (and the democrats who vote no) will forget about it.

    Still a lot of provisions I don't like. For example if you get cancer you are screwed with a 5 million per year benefits cap. But then again my insurance at work has a 5 million dollar lifetime cap, so I am even more screwed. People like my brother who didn't go to college and work at hourly jobs without benefits need this bill. He doesn't make enough money to afford health insurance, and the company does not provide it. So there's really nothing he can do. If he gets poison ivy, even real bad, he has to sit at home and suffer rather than visiting a doctor to get a prescription for a cortico steroid that could cure it. That's not right.....

    Also an awful lot of personal bankruptcies are due to medical bills. There was a time when I graduated college and I was unemployed for almost a year before finding a job. If I got into a traffic accident or I broke my foot jogging, I would have been in deep trouble. Sometimes surgeries go into the hundred thousands or even millions.... I don't have that kind of money. Even now, if I got cancer and went over that 5 million lifetime cap on my company's insurance, I'd have to somehow borrow massive amounts of money that I would never pay back, or just die... Any system that doesn't value human life over all else is broken....

    This bill pretty much sucks. The more provisions I see of it, the more I hate it. Also the parties are busy taking pot shots about things like abortion funding instead of fixing the bill. I don't really care about abortion funding. Most Americans don't give a damn either except for a few religious right nuts. I just want a bill that gives me some security that if I lose my job and get sick, I'm not going to have to declare bankruptcy or suffer with my illness until it gets better or I die......

    Considering the Trillions we spend on wars, I think one trillion for health insurance is worth it. It is an investment in the american people... And unfortunately if this shitty bill doesn't pass, the same thing that happened in 1992-1993 will happen again, people will scream it is the other party's fault, and then it will go away..... But it's a shitty Bill for sure. It is overly complicated, probably on purpose so that no one can read/understand the whole thing before voting on it. I'm sure there are lots of special interest payments in here......

    It also does nothing to address the over charging on medical supplies. Ie the $500 paperclip. Not only that but when you don't have insurance all the rates are way higher than the rates negotiated with insurance companies. So not only is it harder to pay, it is even more expensive without insurance. Because those companies have people to say $500 for a paperclip, you're full of shit, we'll give you $1 and the hospital will be like okay, we still make $.95. And the people doing the billing try to double/triple charge me all the time. The insurance company and hospital billing often fight for 6 or 7 months before they get the entire bill properly worked out........ The hospital will bill twice, the insurance company will see two bills and reject all the bills, etc... Then you have to act as mediator to teach the hospital how to code the bill....And the insurance company to be ready for a payment....it wastes a long time.... By yourself you don't have a chance.... The rates are crazy too. I was well over $1,0
  • no reform. (Score:5, Informative)

    by roman_mir ( 125474 ) on Friday March 19, 2010 @09:29AM (#31535732) Homepage Journal

    This is not a 'health care reform'.

    This is not even an 'insurance reform'.

    What is going to pass is a few regulations that are supposedly going to make it not possible for an insurance company to drop coverage, to do rescission and a few more items. - This is good.

    Here is what you are not going to get:

    1. No optional public insurance against private insurance, the prices will not go down. Worse than that, what is happening is private insurance is raising prices to offset any of the new changes that will be coming with this 'reform'. Does not look good.

    2. You probably are going to get a mandate, which is unfortunate given that you will have no public option. You will be forced to buy into expensive private insurance, there will be no choice or it looks like you will get some sort of a fine. Does not look good.

    3. No cheaper drugs imported from other countries. The bill was introduced earlier this fall, but Obama actually killed it very very personally because he signed a deal with the manufacturers to do this: no competition from cheaper imported drugs AND the patents are to be extended from 5 years to something like 12 years. Does not look good.

    4. Looks like US is one of the backwards countries that will try to limit women's access to health care they need. You going to get the 'reform' that will prevent any private insurance coverage for women that includes abortion. This is no joke, even for those who have coverage today, looks like they will actually lose it with this 'reform'. Does not look good.

    The other part of it, the cost of it, that's a moot point. It was calculated that if Medicare was provided as a buy in for anyone at all, at cost (at cost - means whatever it costs, but no money is made for profit), or if there was a public option, then the reform could even save money. The way it is going to happen with no public negotiations with hospitals, no public negotiations with drug manufacturers, no import of cheaper drugs, no generics because the patents will be extended, well, I don't know if this will be cost neutral. It does not matter really, if US just cut its WAR cost, it's defense contractors costs they could probably fund the entire reform in health insurance and there would be enough money for the public education reform. Of-course that's not going to happen.

    Anyway, Pelosi and Obama and the rest of them are lying sacks of shit. They do not want to take a vote on the public option, they will not take a vote on Grayson's proposal to just allow anyone to buy into Medicare at cost. This is not a health reform, this is just a little chunk of 'change' you were promised. Take it and be happy, cause you are not going to get anything better at all.

  • universal healthcare is a form of investment in your society that pays dividends

    if you don't pay for it overtly, you pay for the lack of universal healthcare in terms of easily preventable heart conditions complicating into more expensive conditions, breadwinners out of work because they can't treat their diabetes leading to their children to become street criminals, mumps and whooping cough outbreaks because vaccination is too complicated for the poor, people out sick more often because of inadequate healthcare, personal bankruptcies leading to losses at financial institutions due to sudden and expensive healthcare, etc.

    in other words, you pay for healthcare, one way or another, no matter what your policy is

    its just that universal healthcare is the CHEAPEST way to pay for it. but since the cost is overt and in your face, you reject it. but this simply means you don't understand the roundabout MORE EXPENSIVE and hidden ways you pay for it if you DON'T have universal healthcare

    in other words, libertarian and tea bagger rejection of universal healthcare is based on a lack of ability to understand that life is complicated. what happens if you DON'T pay for healthcare as a society? people who get sick just disappear off the face of the earth? they are all paragons of personal financial virtue and never need aid? you yourself never need a helping hand? think about reality, then form an opinion

    there are PLENTY of areas of life that should NEVER be public, and should always be private, for a number of reasons. capitalism, in fact, is the most useful engine for the creation of wealth ever invented by man. the point is, for SOME sectors of life, not all, making some thing run by the government actually is the CHEAPEST AND MOST EFFICIENT way for that sector to function

    in other words, simplistic, fundamentalist adherence to the idea of free markets does NOT answer all questions in life, JUST AS TRUE as a simplistic, fundamentalist adherence to communist ideas does not work. but socialism, as understood by the rest of the first world, is simple the concept that SOME, not ALL, sectors of life require the government to run it for MAXIMUM FINANCIAL EFFICIENCY

    a society with a capitalist engine, with socialist safety nets grafted on, is SUPERIOR and MORE EFFICIENT than a purely capitalist society. this really is the objective financially solid truth, not an opinion. lose your utopianism please: in life, simplistic absolutist philosophies, such as a fanatic devotion to individual reliance, DOES NOT WORK IN ALL FORMS. you are part of a society. as such, you contribute financially to it so that SOME functions in your life. by doing that some functions in your life are simply handled MORE CHEAPLY than if you handled them yourself. life is complicated, and requires a moderation between competing needs. understand this about the world, and drop your extremist ideologies

    there is such a concept as the common good. there is such a concept as personal reliance. both are paragons of virtue that, in the real world, exist in tension in how they work. the idea is to find a BALANCE between the two ideals, not to simplemindedly adhere to one or the other polar extreme

    teabaggers and libertarians: in SOME avenues of life, not all, the government is good, and works for you. you reject it at the price of your own impoverishment. that's the simple obvious truth

  • The whole insurance industry for healthcare is based on a flawed premise that normal care need insurance.

    Here's the car analogy... if our cars were done like healthcare:
      1. Gas would cost 10$/gal at the pump for cash/credit.
      2. You would pay 25$ for every time you fueled up and your car insurance company would actually pay them 3.75$/gal for the gas
      3. You would pay 150$/month for this "wonderfully cheaper gas"
      4. Ohh... and if you need roadside assistance you have to pay for the first 5 fully before the insurance company starts picking up the tab.

    So let's go back to why health insurance is flawed. Normal healthy individuals may make 3 (annual plus 2 cold/flu) trips to the doctor in a year. I pay 218$ per month for insurance through my employer (not counting the portion they pay). This means that I am effectively paying 872$ per trip to my doctor... ok... lets let that sink in... even if you count a nurse, doctor and receptionist out front splitting it and them only seeing 3 patients per hour (rough cases might take that long) we are still talking they would be making 1.74 MILLION DOLLARS PER YEAR EACH! Now if you have any friends that are medical professionals I bet you know that there are VERY few that are making that much per year... especially receptionists :)

    Now the argument is that "well this money helps balance out all the catastrophic claims"... fine then why are we using insurance for non-catastrophic claims? I have home owners insurance in case a tornado takes my house out but I don't run my water-softener salt or home improvement projects through the insurance company.

    Why when it comes to health insurance do we loose the common sense that the more people that touch the money the more we have to pay for the same service.

    Leave insurance for catastrophic claims and lets get rid of the day-to-day shenanigans. This should quell a lot of the issues in the industry and make it so that people could pay for what they need instead of padding peoples pockets for day-to-day necessities.

I've finally learned what "upward compatible" means. It means we get to keep all our old mistakes. -- Dennie van Tassel