the new health bill?

[nteeman]

I named one thing I liked about the bill. If you have everybody in the insurance pool, healthy and sick, that will pay for those previously denied coverage. BTW, that is how insurance is supposed to work. If you only have old and sick people of course it will be costly. That is what the insurance companies are asking for, as well.


This bill is a first step, it is not perfect. I look at it more as a work in progress.  One of my problems from what I observe people want from healthcare is that many want everything under the sun covered and they pay nothing. Healthcare should be affordable, not free.  For example: If I go for a blood work-up the bill from the lab is $300--after this is adjusted through my insurance plan it becomes $70, of which my insurance pays $56 and I pay $14.(aren't I lucky!) Someone without insurance is billed $300, and that is the amount of loss reported when they don't pay it.  Now if it was $70 for everybody, I believe, more people would pay, the amount of coverage needed could be less and the overall cost to insure would be less.

Neal

[ppearl214]

There has been "flaming" on either side, which is nice..  

honestly, hon... no its not and against site rules (Please see Netiquettes for elaboration).  

Not saying don't have this discussion... just tone it down a wee bit, ok?  Emotions running a little amock on this..... healthy, respectable  debate, fine... letting emotions overtake too much, not good.

Thanks folks.

Phyl

[lori67]

Phyl,

Forgot to mention that I love the new picture too!  And I, for one, am glad that the whip isn't aimed in my direction this time!  See, my halo does stay straight sometimes!   

Lori

[Pooter]

I named one thing I liked about the bill. If you have everybody in the insurance pool, healthy and sick, that will pay for those previously denied coverage. BTW, that is how insurance is supposed to work. If you only have old and sick people of course it will be costly. That is what the insurance companies are asking for, as well.


This bill is a first step, it is not perfect. I look at it more as a work in progress.  One of my problems from what I observe people want from healthcare is that many want everything under the sun covered and they pay nothing. Healthcare should be affordable, not free.  For example: If I go for a blood work-up the bill from the lab is $300--after this is adjusted through my insurance plan it becomes $70, of which my insurance pays $56 and I pay $14.(aren't I lucky!) Someone without insurance is billed $300, and that is the amount of loss reported when they don't pay it.  Now if it was $70 for everybody, I believe, more people would pay, the amount of coverage needed could be less and the overall cost to insure would be less.

Neal

Neal,

I think we're getting somewhere...  In order to not allow pre-existing conditions, you must mandate the coverage.  BUT, the Federal Government doesn't have the authority under our constitution to mandate a certain product or service.  SO, you can either let the Federal Government outlaw the pre-existing condition of being able to get insurance forcing the insurance companies in each state to raise premiums or they outlaw the pre-existing condition and force each state to enact mandated insurance...  But, constitutionally, the Federal Government doesn't have the authority to do both, as they've done.

I agree that it seems ludicrous that someone with insurance is billed at a lower rate than someone without.  But, as you said, that's how insurance is supposed to work.  If you pay your monthly premium (guaranteed money for the insurance company), then you have the privledge of paying a reduced rate for things.  If you do not have healthcare, then you don't get that privelidge.

In my opinion, for a "first step", this is a bad one... Let alone them not having the constitutional authority to madate that everyone buy something.  But, this bill is at odds with itself.  To deny insurance companies the right to exclude based on pre-existing conditions means that premiums will necessarily go up (costs in general).  To get to one of the other "aims" of this bill, lowering premiums, you either have to rob the money from some other program (Medicare Advantage, for instance) or force everyone to buy insurance with no regard to need or want or both..  You can't mandate at the federal level (explained why already), so either you take the money from even more programs OR you allow insurance companies the right to deny over pre-existing conditions.  People can't have it both ways..  Personally, I think the insurance companies told Obama officials that it isn't possible to lower premiums AND extend coverage to pre-existing unless the pool is larger (mandate it for everyone) knowing good and well they couldn't do that at the Federal level.  Just a hunch on my part though.

People don't willy nilly get insurance now... at least not employer provided ones.  There are "enrollment periods".  You can either enroll or deroll into the insurance during that window and that window only (at least in my state).  Only unless there is a qualifying "life event" can you change insurance coverage out of that window (you get married or divorced for example).  There may be some amount of that going on with privately purchased health insurance, but I'd venture to say that it's not a widespread problem overall.

How else does is solve the problems of the current system?

Regards,
Brian

[Jim Scott]

Phyl ~ 

Your concerns are valid and your cautionary words will be heeded, I'm sure.  Frankly, I have no interest in debating anyone.  However, I believe we're all entitled to have an opinion, whether for or against any relevant issue, especially one that will directly impact AN patients.  If someone doesn't happen to share my 'published' opinion, I'm a big boy and can deal with that.  Of course, I hasten to add that my PM box remains open to those who wish to support or assail my point of view and I strongly recommend the PM venue for those who desire to actually debate this or any other serious issue with another member.     

That noted, in the interest of healthy, respectable discussion I'll offer the observation that the law just enacted by congress - accomplished by a process that I consider corrupt and that was embarrassing to watch -  permanently changed the relationship of citizen and government, by design.  From this point on and with more impact as more aspects of the current law are activated, government bureaucrats will control your health care to one extent or another.  With the 'old' health care insurance system, our biggest problem was getting our health insurance company to authorize and/or pay for services we needed.  However, there were avenues of appeal and every state had an insurance commission that could reverse an insurance company's decision and actually order them to pay.  I know, because I successfully used that option in the past.  In addition, if we wanted to forgo buying health insurance (as many under-30, single people do) we always had the option of (gasp!) paying for our medical care by using our own funds, even if we had health insurance.  I seriously considered doing just that (via a second mortgage on my almost-paid-off condo) if my health insurance company had denied coverage for my six-figure AN surgery (plus another $50-60,000. for my FSR).  Like most Americans, I'm of the (old) school that believes you do what you have to do.  Rugged individualism and all that.  However, I'm pleased to report that the insurance company (Blue Cross) paid the bills, as usually happens.  This was why, prior to the passage of the euphemistically-named 'Patient Protection and Affordable Care Act ' or what is popularly called 'ObamaCare', over 80% of those polled said they were satisfied with their health care insurance, and why so many Americans are opposed to the new law.  I don't believe it's all 'political'.  Sure, it's was a very partisan legislative process but the outrage I'm seeing goes beyond party affiliation.  I believe that reaction is based on American's innate understanding that, as the members of the U.S. House of Representatives dragged this near-dead horse (legislation) to a 'victory' (over whom? Republicans never had the votes to stop it) something seismic had occurred and with this new law and all of it's ramifications, something fundamental has radically changed in America - and it isn't good.   

Health care costs will inevitably rise and our taxes will rise with them.  That is a given.  Unemployment will remain high because more 'small' (under 100 workers) employers - the major source of employment for most Americans - will chose to eliminate workers to save having to pay hefty fines for not carrying employee health care insurance or paying out more and more for employee health coverage every year as the system becomes overburdened with millions of people added to the system, some of them with chronic and/or serious illnesses that will require very expensive treatment.  I foresee a 'European-style 'Value Added Tax' (on top of the federal and state income and sales tax) coming soon to America because when a government adopts a European-style 'universal' health care system with all of the problems that carries (the British NHS is notorious for it's deficiencies) multiplied by the sheer volume of people that will be added to the system, sooner or later - very likely sooner - you'll be obligated to adopt the European-style confiscatory taxes to pay for it.   I won't even speculate on the number of doctors who will chose early retirement, the young would-be doctors who will decide to go to law school or get an MBA, instead, both depriving the health care system of the people it needs most because they will realize that having a government bureaucracy dictate their practice of medicine, their income and possibly where they'll work, most will choose not to participate.  I can't blame them.   

I believe the real point of contention for many Americans is the unpleasant reality that with this new 'health care' law in place, the price of being an American citizen is now having to carry medical insurance or pay a hefty fine for opting out....pick one.  Yes, you can still pay for health care with your own funds - for now - but you'll also pay for health 'insurance' (or pay a fine/tax) whether you want to or not.  This kind of government coercion (enforced by the feared IRS) is unprecedented in the United States of America and doesn't sit well with a majority of Americans.  I cannot see how that reality, despite all the justifications, is anything but an infringement of personal freedom that millions of Americans are going to oppose and oppose vigorously.  However, even if the voting control in the congress changes parties with the upcoming elections, I fear that this law will irrevocably change the U.S. health care system and, more importantly, change the citizens relationship with his/her government from a people who determine whats in their best interest when it comes to their health care to a citizenry that now has to depend on what largess a government bureaucracy in charge of their health care decides to extend to them, based on arcane rules and regulations as well as the availability of scarce medical personnel and overburdened facilities.  This harsh reality, along with the onerous taxes and restrictions this new law will require as millions of people are added to the U.S. health care system are all prescriptions for problems and the usual unintended consequences this kind of feel-good legislation brings.  This is a sea-change moment in America and frankly, I'm not optimistic about the future of U.S. health care.  I believe that we've given up something vital (choice) and are seeing a redistribution of both wealth and, more importantly, health care in our country.  Not 'access', as some politicians like to pretend.  Access to health care has always been available and many have taken advantage of it in the past as I pointed out in an earlier book, er, post. 

I believe that with incremental steps, including tort reform and allowing insurance companies to sell across state lines (with some level of federal regulation) would be a good beginning.  However, that ship has left the dock and we're now in the very early stages of seeing what congress has wrought with the passage of 'ObamaCare'.  I think there will be rough seas ahead.  Of course I'm not clairvoyant and I could be wrong.  Just in case, I'll try to remain healthy and, to keep the marine metaphor in play, I'll wear a life jacket.     

Jim       

[yardtick]

This is an interested Canadian political junkie here.  Some very good reading and debating.  I'm wondering if anyone has heard or read what Jessie Venture take is on this new health bill.  I love a good old sh*t disturber 

Has any watch Food Inc?  Now that's some food for thought!

Great picture Phyl, can you put some butter on the popcorn when you pass it my way 

Anne Marie

PS Neal, I  also betting on CPP (Canadian Pension Plan) to be there in about 10 yrs when I'm retired, officially.  The cup is always half full.

[leapyrtwins]

Lori  -

I think this is a Forum first.  Phyl hasn't had to crack the whip at you - or me - this entire thread 

Jan

[sgerrard]

Mmpph...Fed Ex...errgh...45 cents...maaww...New Zeal...ruahff...pre-existing...umph...free market....mwbm....Brad Pitt!

Ah. Found the magic words to make Phyl stop stuffing my mouth with popcorn.   

I will side with Neal, and hope that, among other things, the small start on funding more preventative care will make a dent in the overall cost of health care. Not needing so much of it in the first place sounds like a great way to reduce the cost and be healthier at the same time. It will be interesting to see what happens.

Steve

[4cm in Pacific Northwest]

Popcorn tastes really really good with melted butter and a sprinkling of nutritional yeast flakes (full of B12- great for nerve rejuvenation)… The butter not as healthy as the nutritional yeast flakes though… some like it with salt… others with cayenne pepper.

I’ll be sure to call my broker   about Orville Redenbacher stocks… with all those kernels popping… the supply and demand is sure to make it a good investment now.

Oh and those looking for a great charitable donation to make for a tax shelter…. That is an easy one… the acronym starts with an “a” and ends with an “a”.  

As far as getting a “layman’s terms” explanation I think the answers are coming at me like popcorn does when one forgets to place the lid on the kettle…

I think I will make it my mission to make sure that people who need prosthetics can have this covered on insurance (public private or otherwise)… which would include baha implants.  (But I will also push the biomedical engineers to try and come up with a baha that can be worn under a safety helmet… be it for a bicycle, skiing, mountaineering, Harley or construction helmet…   What can I say I love Jan's brain and I want it protected.   )

I just know that a few of my ANA buddies might get right back to work if they could improve their hearing and perform better in the work place where hearing challenges them… But it is hard to fund that Baha without a job and insurance. It can be a vicious cycle for one too many.  I just hope that those folks who are in between a rock and a hard spot get a break, understanding, and compassion from those who are more fortunate.

I think it is sooh wrong that an insurance company will not cover someone because they have/had an acoustic neuroma (ie preexisting condition)… in fact it is rather   .

There are many sides to the debate I see…

I guess I just want all my fellow AN’er to have access to good medical care and appliances (Baha’s, eye weights etc) like anyone else… withOUT discrimination.  It is so important, in support group meetings, that we do not have a sense of division between the haves and the have-nots. I just feel I want to provide support and help point my fellow AN’ers on a path that helps them get the best care they can- be it Botox for synkenisis or a hearing prosthetic to return to their livelihoods -as best they can.  The more I can be educated and informed- the more I can pass on information to help them find avenues for funding.

I have decided to make sure there is a balanced mix of oil, kernels and hot air. I know that if you put in too many kernels the lid will just pop off all on its own with hot fluffy stuff flying every which where… but without hot air there is not popcorn.

I am going to reiterate the original question to my respected and cherished forumites

Is there a good (internet) link somewhere that explains this in LAYMAN's terms?

 I am asking this no differently than when I asked, 2 + years ago, for a neuromuscular facial retraining therapist the Pacific Northwest- and you all pitched in to help me find information. Now we have a great therapist here when 2 years ago we didn’t have anyone. Many of us: patients, therapists, and an doctor networked together to get something set up as we indentified a need… and the ANA was instrumental in providing a network of sharing resources of information.

We all need to work together to get the education about Acoustic Neuroma's out there and the obstacle we patients face (both individually and as a group.) Yes there is going to be some polarized views but we MUST help each other gather information so we can help each other out- be it the single mom with two kids, the elderly person who can’t hear their grandchild’s small voice … or the famous barista who can’t hear if it was a caramel latte or a gingerbread latte that the lady just ordered. (BTW saw his face is on every SB door I enter in the PNW - on their “now hiring” posters)

I realize now that college kids CAN get coverage under their parents and no one is stuck between the tough financial decision of choosing between a college education or a tumor surgery. (This seems a good things to me)… No child with an acoustic neuroma will be denied treatment of an acoustic neuroma due to no insurance (and yes we have had kids with these in their teens not just us middle aged foggies)…  I sat next to a very dear mom, at the Chicago symposium, who was so worried about what her daughter would do if there was ever re-growth and she would not be on their insurance plan once she reached her 20’s… Now they have time, less stress and less worry….

EG
So let us say a bright kid (acoustic neuroma surgery survivor) does graduate from college, gets a starting job at age 27 but the insurance benefit packet says “sorry you had an acoustic neuroma (pre –existing condition) we will NOT insure you for treatment”?  This 27 year old has massive student loan payment and also has to pay for cyber knife to treat the tumor re-growth out-of-pocket.

Please put your differences aside and let us do what we can, as a collective, to make sure that AN patients are NOT discriminated from for good care and coverage (public or private). Help people who come to us for guidance by pointing them to links etc as they not only figure out their best treatment option but how they are going to finance it when they think they cannot. (I know many people helped "the Captain" find funds for topomax for her headaches etc)


I have definitely eaten way too much popcorn… maybe I should start stringing it with cranberries for the tree… (In March?     )

Scotty, Pearly Whites and Steve (our artist-in-residence poet) - I STILL love you.  

(Ewe ah Steve I think you have the makings for another great poem… what rhymes with “popcorn”?… What rhymes with “health care”? Gee those are toughies… HMMM ... maybe you may need to dig out DR Seuss for some help. Dr Seuss no doubt would have some great rhymes and illustrations for this topic.  This one came close to the topic
http://www.amazon.com/Youre-Only-Once-Obsolete-Children/dp/0394551907 )

Daisy Head Maize  

P.S Pssst Scotty... "Layman's terms" (Nevertheless since you entered my life my vocab has gone up tenfold  )

[Pooter]

Speaking of BAHAs etc, anyone have information about how the provision in this bill creating a tax on "medical devices" will do to the price of BAHA, Transear, etc?  Just curious.

DMH, I know of no layman explanation of the law yet because we weren't told what was in it prior to the final vote. We were told that it would have to pass and THEN we could see what was in it (said Pelosi).  Now that it's law, expect someone to put an explanation out within a few months or so I would expect. If I find one, I'll share.

Regards,
Brian

[grega]

G'mornin DHM, et al,

In answer to your question ("Is there a good (internet) link somewhere that explains this in LAYMAN's terms?"), .... yes, probably many, with google help.  But a suggestion for your search:  If you get websites from those on one side of the popcorn bowl (e.g. Steve and Neal), look also at websites from those on the other side (e.g. Brian and Jim) ..... and vice versa.  Hopefully, you'll get a good idea of pros and cons .... or close thereto. 

In other words, don't listen to those who tell you what to think .... listen to those who suggest how to think.  Or not ... if you're mind is already made up.  But you just might learn a bit more than you realized .... from the more than 2,000 pages (ugh!) that were not read before the vote.

And run fast from those who demand that they're opinion is not open to your opposite opinion.  But that's just my opinion, with a mouthfull of light-butter-popcorn.

Have a great weekend.
Greg

[leapyrtwins]

Yeast flakes on popcorn   

[lori67]

That's what I said, Jan!     Just butter and salt for me, thanks.

[lawmama]

Great debate and I love that a lot of different opinions have been shared, yet the discussion has remained very civil.  Nice to see.   

For law nerds like me, this is a really interesting subject.  I would bet the farm that the Supreme Court will be hearing this case before it is all over, but what they do with it is anybody's guess.  Generally, the Supreme Court gives great deference to things the Congress does under the Commerce Clause, however they have never gone quite this far before.  I believe the key difference is that you can be subject to the penalty (tax?  Whatever) without ever having done anything.  This is a step removed from anything the government has done before.  Congress will probably be arguing that by NOT buying insurance, an individual person is having an effect on the entire insurance market, thus Congress has power to require them to buy under the Commerce Clause.  Still, I can't think of another example where a citizen is taxed or even required to purchase something without taking any action to be subject to that tax (work, buy something, apply for a license, etc).  I just think this is inherently different. 

It could really go either way, but I honestly believe the Supreme Court should find the Bill unconstitutional.  I don't think the framers ever intended to give the government this much power.  It's dangerous and I don't like the slippery slope it takes us down.  I think there are a lot of other measures they could have taken before going this far.  In my opinion, I believe they are trying to "ease" us into a true single-payer system.  Boil the frog, so to speak.  That's why I don't like it.

Lyn

[sgerrard]

Boil the frog? 

This is a link to an ABC News article from last week, titled "What Does it Mean For You?" It is just a description of some of the provisions that go into effect this year and on into 2014. It does not attempt to analyze the impact or consequences of any of them, so it is reasonably light on strong rhetoric either way.

http://abcnews.go.com/Politics/HealthCare/health-care-bill-obama-sign-bill-tuesday/story?id=10169801

I still the think the Supremes will not find it unconstitutional, or if they do, only in a way that requires rewording or revision, not striking it down completely. If they do, there are a lot of lawyers who could use that precedent to undo a lot of other measures related to federal taxation, opening Pandora's Box.

I wonder if Pandora's Box is filled with boiled frogs...

Steve