House Approves Health Overhaul, Sending Landmark Bill to Obama

Woo hoo!

Agreed. This is excellent. Not ideal, but a bit first step.

And the people spouting racial slurs to those congressmen are mindless sub-humans.

"To pay for the bill, a 40 percent tax would be levied on high-value health insurance policies of over $10,200 for individuals and $27,500 for families starting in 2018. The Medicare Hospital Insurance Tax would be increased for individuals who earn more than $200,000 and families who earn more than $250,000. There is also a 3.8 percent tax on unearned income, including dividends and interest, for individuals making over $200,000 per year, or couples making over $250,000 a year."

The above is commonly referred to as "Taxing only the Cadillac health plans".

The favorite tactic of congress is to set limits in fixed dollars then sit back and let inflation drive everyone's costs to where even the inexpensive health plans are taxed.

Their actions were inexcusable, but unless I missed something, not related to the health care debate.

The first words I spoke to the wife after I head it passed – “I feel poorer already.”

Haven't heard an racial slurs where do you guys hang out.

So I have insurance from my employer now, there is a downside to everything so what bad will come of this if it passes for me and everyone else that already has health insurance from their employers ?

Ah, my apologies, I'd heard about it as though it were.

Please actually read the bill instead of making assumptions.


"Section 1(f)(3)" refers to the Cost-of-Living Adjustment defined in US Law, which is based on the Consumer Price Index as published by the Department of Labor.

First, it already passed. There are additional changes that may or may not pass, but the basic structure is now there.

Generally speaking, if you already have insurance, there are no direct changes, unless you have one of the so-called "Cadillac plans", which are super-expensive plans that provide little additional benefit compared to their increased cost. Unless you're part of a labor union, you probably don't have one. If you do, though, there is a tax on the cost of the plan over a set amount.

Indirectly, there will probably be a transition period where wait times for services may be longer, as the infrastructure comes to grips with a massive influx of people who suddenly have insurance. It's not as if all 23 million people get coverage at once, though. Only those who have preexisting conditions will be affected now. The rest will become covered in 2013.

I can't think of anything else that might have a more-or-less "soon" negative repercussion.

I am on the side of less “government is better.”

Free market will, in most cases, always outperform and be more cost effective than a government run or controlled environment. Medicare has been around for decades and they still can’t get that right. Medicare fraud is more prevalent now than ever.

The US Postal service is another example. UPS and FedEx are doing OK. Just making a simple decision like “should we drop Saturday service” seems to be a huge task for them. In a profit driven organization it would be a no-brainer.

People keep pointing to the fact that health care costs are going up every year “the government should put a stop to that.” The increase is mainly driven by the fact the population on average is getting older and medical advances have been developed to keep more people living longer. Another layer of bureaucracy will only add to rising costs, unless the “death panels” are real.

To your question – The estimated 10 year cost of this bill is over 900 billion. While taxing those SOB millionaires is always popular the SOB millionaire are usually smart enough to pass the expense on to us hardworking pee-on’s. As well as stated above. With inflation someday we may all be millionaires.

Please show your work. Provide examples.

Also show me at what point the costs of keeping a person alive outweigh the benefit.

Avoiding the snark, though, keeping people healthy should not be a profit-based business. When a company decides that it's simply too expensive to pay for that cancer treatment and decide to drop you, despite the fact that you've been paying premiums for years -- well, that simply shouldn't happen.

Outside, though, the limitation of the egregious excesses that the bill limits, there's almost the exact same free market now that there was before, only now there's a larger market as the government requires people to have health insurance, and subsidizes those who can't afford it. The biggest difference along these lines is that the individual market mostly goes away, as the government effectively created a new category of group coverage: those who don't otherwise have access to group coverage. One would assume that the insurance companies are making money now on the plan you purchase through your employer. If they weren't, they wouldn't offer it; there's no requirement that they do. But they're making an assload off of the individual insurees, as they have no carrot to wave. (See Anthem's 40% increases, despite increasing profits.)

Actually, that brings up a good point. If health care cost increases are driven by increased cost to the insurers, why are the insurers making record profits? It might be explained by the fact that there is very little actual competition in your "free market". Because of the way insurance is segregated, and due to mergers and acquisitions, there is usually only one major player available to each individual.


Heehee. That's a good one.

Congratulations guys. Long time coming, long time needed. It would be nice to see the US lead in universal healthcare in a few years' time.

Oh, why is it that most people who complain about spending tax dollars on healthcare have no problem with the trillions spent on war? Or military defense/offense in general?

I did, USPS and Medicare are a good example of a gov-o-fuck.

As far as creating monopolies the government is helping to do that by prohibiting insurers from sell across state lines decreasing competition a raising costs. I’ll let you Google.

I’m glad the insurance companies are finally becoming more efficient and making a profit. I would go for a money grab if I was in their shoes and had mounting concerns over looming new laws aimed at putting me out of business.

I wouldn't want to be paying $20 to send a letter or a package costing a couple of ounces to UPS or FedEx if the USPS wasn't around.

Okay, I ignored your examples.


Yeah, it's too bad that the government took over that market. The competition between all those companies looking to insure the elderly and disabled really kept the prices down. Huh? What? No one was competing for those plans? You don't say! Oh, nevermind. Government is bad. Let's repeal Medicare and let those folks find their own insurance on the common market again.


This may actually be a reasonable example.

It may work out to $20 a letter if the USPS doesn’t quit losing money. If you pay it up front or through taxes $20 is still $20.

Are you sure you’re not “Comic book guy,” It sounds like I’m watching the Simpsons.

Yep, you can never drop an entitlement program. That’s why it better be damned good and well thought out before you create one. But that’s not my point. Medicare is run poorly and is full of waste and fraud (again, you Google it’s all over the news). If the government can’t get that right, for decades, what makes them think that if they throw Medicare away the next, more expensive, program will be any better?

I don't think you can argue with these figures...

http://news.bbc.co.uk/1/hi/health/8201711.stm

The NHS here in the UK is a real bargain compared to the system you currently have in the US.

I think this is a real mile stone for your country, you should all be very proud that steps are being taken to take care of the most needy in your society.

Cheers

Cris.

One more point on this. By design, the law eases into the tax payer slowly so that the answer to the immediate question: "How does this impact me now?" is "Not much." Most USA’ers only look to the now. As the laws finally become effective the insurance companies will raise rates more and more as they are mandated more and more. They are not going to eat the costs of these new laws. While I’m not against all these mandates they will raise rates and soon.

An example to this is the recent explosion of credit card interest rates since the banks were spanked by the government with new credit card laws.

In my personal experience. All the uninsured poor I knew over the years had fine medical care.

I however do see issues with the uninsured lower middle class that IMO needed addressing.

I hope this does all work out for the best.

Being someone who doesn't like being in debit. This makes me nervous. I think if most worker-bees had to write a check to the government instead of having a payroll deduction taken , a lot more people would be asking where the hell it all goes.

In addition to Bitt's reply, perhaps this article could help?

In broad brush strokes, the U.S. plan is most similar to the plan that's currently in place in Switzerland. In the Swiss plan, there's something of a basic coverage plan that's state mandated, with identical prices from every insurance vendor. They then compete to offer you extras on top of that. If hospitalized, do you want a private room versus a shared room? Pay a little more now, get better service later.

To my mind, there are two big unknowns in the U.S. plan:

- Will insurance premiums go up, due to the new requirements imposed by the government, people voluntarily dropping their coverage, and/or insurance companies cooking their books to justify premium increases? The whole financial balance of the system depends on mandatory insurance, yet the mandatory bit doesn't kick in for several years. It's interesting to ponder how insurance companies may try to game the system, and how the system might respond.

- Will the new plan pass constitutional muster? Lawsuits are already being planned to challenge the legality of various aspects of the new system.

I'm also curious the extent to which this will play out politically for the balance of power in Congress. My guess is that there will be a shift toward Republicans, but that the Democrats will retain their majorities. And, while I'm curious about politics, I'm curious if the Republicans will play the same "sky is falling" card for every Democratic initiative over the next year, and whether that will continue to work for them.

Let's see. I'm overweight, sarcastic, have a ponytail, frequently unshaven, and worked at a comic shop. So, no, I'm not sure. (At least I'm not balding.)


Yeah, it is. So is private insurance, though. (Admittedly, not as much so.) But let's take that as read, for the sake of argument.

Medicare provides health provider payments for services rendered. This health care bill (as far as providing health care to people) does no such thing. All it does is create a group for existing health care companies to compete for that is comprised of those who aren't members of another eligible group. All of the sections about the government providing a health care plan of its own were stripped.

This is actually creating a new market, and giving people bargaining power. I'm not really sure how anyone can be opposed to that.

While not the goal of most USA'ers we are some lard asses. That sure doesn't help costs.

http://www.cnn.com/video/#/video/bestoftv/2010/03/17/behar.donna.simpson.intv.cnn?iref=allsearch

So Medicare is good when you have personal experience with it, but it's bad when not confronted with the ramifications of it not being there.

We can stop arguing about it now and sit back and see who is right. Do you want a concrete example of the free market? Look at veterinary medicine. Drugs, diagnostics and procedures are a small fraction of the price of the same thing for humans. And no cute comments about sanitary conditions, etc. That doesn't apply to drugs and x rays. The primary difference is that the consumer pays for his own vet bills, while someone else pays for his health bills. When someone else pays, there is no incentive to be a smart consumer. This is the root of the problem that nobody wants to talk about. Of course prices are high in America! They can be, and nobody really cares because someone else is paying. It only matters if you're outside of the corrupt system. Get rid of that, and you'd have market competitive prices. This "solution" is simply to make sure everyone is part of the corrupt system -- it doesn't deal with the root cause of the corruption.

Go to an optometrist: if you have insurance, an exam is $250 (someone else is paying), if you don't it's $80 (what the market will bear).

I will make some predictions:

1. This will be a far worse intrusion into liberty than even the Patriot Act. You will see many, many more bills like the absurd New York salt ban bill. All in the name of "public health" and "lower healthcare costs". Now that the government is paying, like any good parent, they now have the right to tell you how to live healthily.

2. McDonalds will become a target and be forced to change their practices, despite the fact that they make a product that people like and want, and nobody is forced to buy it. No matter! The government can't be asked to pay for all of the downstream consequences of this unhealthy food. McDonalds is the new Phillip Morris, poor bastards.

3. Speaking of Phillip Morris, you will see an all-out offensive to completely ban tobacco products.

4. Etc. more of the same. Welcome to the Therapeutic State. You now have your government daddy who will happily force everyone to live healthily.

5. There will be practical considerations, too, like government specifications on exactly which tests and treatments doctors can prescribe. The doctor will not have the authority to make the right decision. This has already happened with the equally absurd war on drugs, with many doctors being scared to prescribe effective levels of pain medications due to federal government oversight.

I'm done. Let's see what happens. Those who refuse to learn from history...

Jim

I didn't say Medicare was good. I've never used Medicare but know those who have and they have gotten more out of it than I ever expected. I just think it could be run better. Maybe even run better by a private company.

If outsourcing sending people into space is good enough for NASA I’m sure an insurance company could do a good job with Medicare. After all it’s not rocket science (sorry had to do that).

Yes, the smaller insurance companies can't compete against the big boys now, so, clearly, giving them a bigger market to be washed away in would help.

As point of comparison, when I was a kid, there were dozens of five-and-dimes and hardware stores around town. Then Home Depot, Lowes, and Wal-Mart moved in and they're all gone. It's certainly not because Home Depot and Lowes are cheaper now. I'm sure I never had to pay 43¢ (or the equivalent in '80s cents) for a screw. And Wal-Mart keeps their prices down by exploiting everyone they come in contact with. Yay for the free market!

I certainly know that when my wife started having stroke-like symptoms a few weekends ago that had I not had insurance I would certainly have been doing some comparison shopping before heading out to an emergency room.

There are certainly cases to be made for excess in the insurance system, and other aspects of the bill speak to at least some of those issues. And while I'd certainly appreciate lower healthcare costs, it remains not my primary concern.


And if you can't afford that $80, then I guess it's just too bad about that glaucoma that you didn't know you had. Fifteen years down the road, your optic nerve stop functioning, and you know you should have chosen to skip a few meals that month. Or we could make sure that everyone can see the doctor. But that doesn't jibe with your free-market ideals.


The only additional people government will be paying for are the people who can't afford insurance. Which they're doing now with Medicaid, except usually only as emergencies, not as preventative care. And they've made no such mandates in the last 45 years. So I don't see this happening.


If they're selling poison under the guise of food, then they should change. Other than trans-fat shortenings and maybe HFCS, I don't think that's the case. Regardless, I call your prediction. Won't happen.


Gee. Darn. More poison. Still, won't happen.


How, exactly? Hard to refute a prediction that doesn't predict anything.


Because God knows that they are free to prescribe drugs and tests without restriction now. Again, though, why do you think that the government is going to tell insurance companies what products they're allowed to sell? You still seem to be under the impression that the government will be reimbursing healthcare providers, when this bill will likely decrease that practice, as some people are moved from Medicare to the public group plans, which, again, are private insurance.

On the other hand, assume that the 32 million uninsured (or whatever the number is) were just put directly on Medicare, and the doctors were told that they couldn't prescribe some set of tests and treatments. How, exactly, would that be worse than those people not having any reasonable access to health care at all?