DHM ~
Your concerns regarding how the new 'health care' bill will affect you are completely valid and are shared by millions of Americans.
Steve's comments regarding the short term effect of the new law ('ObamaCare') being somewhat negligible were accurate and quite helpful . I'll try to add to his explanation. Initially, those currently without health care insurance will be mandated to purchase it (or pay a fine). However, government subsidies will pay for the bulk of the coverage for the currently uninsured. One way that will happen is by expanding Medicaid eligibility -- with income limits up to nearly $30,000 for a family of four. The other way is by the government subsidizing private coverage through the new 'insurance exchanges'. Families with incomes between $30,000 and $88,000 a year should be eligible for those subsidies. For those who have their health care insurance through a relatively 'big' employer, nothing will change, although your annual cost will probably rise, soon. Those who work for a small business are likely to see their employer drop their health care coverage, making the employee eligible for some kind of government subsidy that will allow them to purchase health care insurance through the newly-created 'health care exchanges' that are formed as a result of this new law. Younger people, like my son (age 30, single, with employer-supplied health care insurance) will likely see their health care premiums substantially rise. Beginning this year, people with pre-existing health conditions who have been denied coverage and have been uninsured for six months will be eligible for government-subsidized coverage through a national 'high-risk' insurance 'pool' program. The pool serves as a temporary fix until the insurance exchanges are up and running. By 2014, insurers may no longer charge individuals and small businesses higher premiums or deny coverage on the basis of pre-existing conditions. 'ObamaCare' contains several Medicare enhancements, i.e. beginning in 2011, preventive services tests and treatments will be covered in full, instead of in part, as is now the case. However, the legislation also slashes subsidies to private health plans that serve seniors -- so-called "Medicare Advantage" plans which is a minus for millions of Medicare recipients.
What has to be mentioned is that when politicians use the term 'government subsidized' they really mean: the government takes your money (via taxes or fines) to pay for health care insurance for someone else. The only money the 'government' has is what it receives in taxes on American citizens. Based on previous large-scale government programs (Medicare, Social Security) the cost of this health care 'reform' will undoubtedly range far beyond the original (rosy) estimate of almost one trillion dollars over ten years or 100 billion per year, making it, in the Washington, D.C. idiom: unsustainable. I believe that 'rationing' of medical care/procedures will be inevitable and that folks in my general age bracket will get the short end of that deal. I hope I'm wrong. In addition, there are many unintended consequences in this 'reform'. It's not unreasonable to assume that many doctors will likely chose to retire early and young people will not want to take on the years of schooling, intense training and the huge financial burden of becoming a physician when you'll be basically working for the government with bureaucrats telling you who'll you'll treat, how you'll treat them and how much you'll be paid. Those who believe that Washington politicians can effectively form a gigantic bureaucracy that can add tens of millions of people into the health care system with no loss of quality or availability of treatment and actually save money doing so, are going to be sorely disappointed with this 'reform'.
I also believe that once 'private' insurance companies are legally mandated to accept those with pre-existing illnesses they'll cease to operate because the element of calculated risk ('underwriting') will have been obliterated and the insurance company can no longer make a profit. The government will then be 'forced' to 'step in' and offer what is usually referred to as 'single-payer' health insurance. The 'single payer' now being the federal government. I do not believe this will be good for AN patients or almost anyone. I also fail to see how the federal government can force American citizens to purchase health insurance against their will. I believe that we should all have some form of health insurance and the indigent have long been covered under state Medicaid programs, but for our government to force, by law, punishable by fines enforced by the dreaded IRS (up to $2,2050. or 2% of your income, whichever is greater) a free citizen of the U.S. to purchase health insurance seems to be overreaching and sets a dangerous precedent. I'm certain this issue will be heard by the U.S. Supreme Court because it is a valid constitutional question and affects everyone in the country, but with the court's decision regarding 'eminent domain' (Kelo v. City of New London - 2005) I'm far from sanguine about this provision of the new national health care bill being struck down as unconstitutional, although I think it should be. If congress has that kind of power to force otherwise free American citizens to buy something they don't want, what else can they mandate? The usual comparison to states mandating that you have auto insurance is invalid. Driving is a privilege...no one has to drive a car if they don't chose to do so. This law offers no 'opt-out' clause. I simply don't believe that health care is a 'right', as this bill's supporters claim but I know that in America, anyone can walk into most hospitals and receive medical care. There are people on the hospital's staff to help those uninsured to procure some sort of payment for their care, usually Medicare. Illegal aliens in the U.S. have been receiving free health care for years, often at the expense of the hospitals they use and the local taxpayers, but that's another issue. Right now, illegal aliens are not specifically 'covered' by this government scheme but I suspect that it is just a matter of time until they are, depending on the mid-term election results.
I don't believe the taxpayers of America can afford this health care debacle, which the president and the congressional leaders had to push over the legislative 'finish line' like Bernie Lomax's corpse in the movie 'Weekend at Bernies' (1989), except that was a movie comedy - this is real life...and I'm not laughing.
I know it wasn't limited but I trust my commentary was polite and somewhat informative.
Jim
