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Interested to read Sup. Ct. healthcare decision

Discussion in 'Parents Off Topic' started by virgo39, Jun 28, 2012.

  1. sooz

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    Perhaps it will dilute care, perhaps not. I suspect that those who can afford it will still be able to chose their care. As it stands now, insurance companies already limit care in terms of what doctors can be seen and how long treatment can continue for example. At my age, I have many friends who have been denied coverage because of a preexisting condition. They have no choice but to gamble that nothing will happen to them until Medicare kicks in. Personally, my husband is old enough for Medicare but I am not, so we pay over 1 k per month for insurance which we were able to get sort of as an extension of cobra because he was an officer in the company he retired from. As expensive as it is, I am grateful to have it because I know I would not be able to get other insurance.
    I worry that my granddaughter may not get a job that provides insurance.
    I understand your cynicism re government bureaucracies, however, private industry has not provided solutions that might have curtailed the need for the government stepping in. They chose not to do so.
     
  2. hawkeyegirl

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    Well, it hasn't been pending for the past 50 years.
     
  3. obtainedmist

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  4. Nancy in VA

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    The problems with our health CARE system and our health INSURANCE system (which, by the way, are two completely different things and should not be mixed up) are so severe, and deeply rooted, that I'm afraid the only way to really fix the problem is to throw it all away and start over. Otherwise, incrementalism will be the death of any reasonable, logical solution.

    No one ever pays what it actually costs to get treatment - preventative or reactionary - because rates are set based on what they think they can recoup, what insurance has SAID they will recoup, and a bogey to cover all those costs that are never recouped. If all of that mess were removed and we had some idea what it really cost for some of the care, I think many of us would be surprised.
     
  5. Mish

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    I must think more highly of our country than you do, because I can think of a whole slew of things that our government handles well.

    Lets start with our military, our parks service, the FAA, the CDC, Interstate Highways, the FDIC, the FDA(despite how slow they are), and fun things like Head Start, school lunch program, and last but not least, the Federal Election Commission. That's just off the top of my head.

    And rather then believe that you'll consider the possibility that the government can handle healthcare, I'm sure you'll find some reasons why none of these organizations actually work (the way you want them to work) But, that doesn't necessarily mean they are broken.
     
  6. Mish

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    Seriously, this!

    All we have to do is read the forums to see that people are already being denied basics in care. All anyone has to do is look at those of us working in private companies who have to pay the full cost of their own crappy insurance ($1000 a month) and then have to pay 20% -25% on all supplies to know that the system as it is now is broken. Really, really broken. When I look at a bill and I see lab costs of over $4000 for over a few vials of blood I know that something is wrong.

    Anyone that would imply that the system, as it is now, is fine and dandy is just totally clueless; and to admit the system is broken but then BLOCK every attempt at fixing it, is downright evil.
     
  7. Brensdad

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    Nothing about diabetes is basic, and anyone here that's tried to get a pump or CGMS through Medicaid can probably attest to that. I have very serious and very grave concerns about a bureaucrat deciding what will be the "basic" coverage for a diabetic, especially given the almost universal misunderstanding about type 1 diabetes. Anyone that thinks that bureaucrats won't end up deciding what the "basic" coverage will be, then they are the ones that are clueless. The tax on this bill is cheaper than it is to provide health coverage, and I promise you employers are going to drop coverage left and right.

    As someone that deals with Medicare and Medicaid every single day, I promise you that you will not be pleased with the results.
     
  8. Brensdad

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    http://elections.nytimes.com/2010/results/house

    That ought to give you a pretty big hint about what people think of this bill.
     
  9. Lance

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    Well, that's only the newly crafted "not a tax" tax. There are a few others in the bill also...
    So, what do we get for our little $1.8 trillion gift of healthcare from the government??? Not surprisingly, there was no mention Thursday of the 20 other different taxes hidden in Obamacare, many of which affect families earning less than $250,000 a year.? The new taxes, which conservatively are estimated at around $675 billion
     
  10. hawkeyegirl

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    Yes, if only public opinion could repeal a bill....;)

    People have no clue what is in this bill. When polled on the individual parts, they are overwhelmingly in favor of the vast majority of them. The Republicans have done a much better PR job here than the Democrats, and it shows.

    I am willing to pay more taxes so that everyone has access to healthcare.
     
    Last edited: Jul 1, 2012
  11. caspi

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    I feel exactly the same way. And believe me, we are far from wealthy. It is the right thing to do, IMO.
     
  12. sooz

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    I agree also. It isn't even so much the Republicans as it is ...

    I am editing this post because I did nt know the the term I used was offensive. I'm old! Please accept my apology. What I had in mind when I made the post was a particular blog that I had read from a specific Tea Party Group that I found disturbing. Thank you to the person who sent me a message regarding my mistake.
     
    Last edited: Jul 1, 2012
  13. Brensdad

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    Thanks for keeping it civil.
     
  14. Brensdad

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    It wasn't a public opinion poll, it was the 2010 election results.

    You're right, people have no idea what's in the bill, including the people that wrote it behind closed doors and "deemed" it passed.

    "We have to pass it to find out what's in it." - Nancy Pelosi

    The issue of paying taxes is this: I don't necessarily mind paying more to cover more people either per se, but giving more money to the federal government is like providing a bottle of vodka to an alcoholic. I do not trust that our money will be used efficiently, and instead it will be use to further corrupt those in power - of either party.
     
  15. swellman

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    So much funny in this thread. I mean, how many Constitutional experts do we have on these boards now?

    As a lifelong Republican, yea I know I've said it probably too many times, I am in support of the SCOTUS.

    I'm not a big fan of paying for other people's healthcare but I think this is a good starting point. Not perfect by any standards but a good start.

    This is not the first federal mandate for insurance - the framers of the constitution, yea the one's that wrote it, made a few mandates for health care in the first few years of our country's existence. So ... constuitutionaly be damned - it's a moot and silly argument at this point because it is, in fact, constitutional.

    I don't think it will really reduce healthcare costs though ... not at first.

    I also think that the claim of "federal oversight" resulting in reduction in care is a red herring.

    In my opinion there really is very little reason to hate the law other than it was from a President you didn't like.
     
  16. Lance

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    Of course people like the stuff that's out there so far. All of the "goodies" were front loaded in the first years. All of the cost was pushed out to the later years. Seriously, I like the current changes. I just don't think they're sustainable. You simply can't add millions of people to the system, eliminate caps, and insure all pre-existing conditions (it's not really insurance at that point) without massive costs that no one seems willing to acknowledge. NOTHING is free.

    This also tosses out laws of supply and demand. Ever have to wait a long time to get an appt with a specialist? Add millions more patients without adding doctors, and guess what the likely result is?

    It isn't about the PR. It's about the actual contents of a bill so huge that nobody read it before passing it. It's about moving forward with eyes wide open. Government central planning doesn't have a great track record. Nor does government have a great record when it comes to being cost effective.
     
  17. swellman

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    Original blog.

    EDIT: I'm sick of the cut and paste problem with this editor ... Jeff?
    _________________________________________________________

    Okay, explained like you?re a five year-old (well, okay, maybe a bit older), without too much oversimplification, and (hopefully) without sounding too biased:


    What people call ?Obamacare? is actually the Patient Protection and Affordable Care Act. However, people were calling it ?Obamacare? before everyone even hammered out what it would be. It?s a term mostly used by people who don?t like the PPACA, and it?s become popularized in part because PPACA is a really long and awkward name, even when you turn it into an acronym like that.


    Anyway, the PPACA made a bunch of new rules regarding health care, with the purpose of making health care more affordable for everyone. Opponents of the PPACA, on the other hand, feel that the rules it makes take away too many freedoms and force people (both individuals and businesses) to do things they shouldn?t have to.


    So what does it do? Well, here is everything, in the order of when it goes into effect (because some of it happens later than other parts of it):
    (Note: Page numbers listed in citations are the page numbers within the actual document, not the page numbers of the PDF file)


    Already in effect:

    • It allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices) ( Citation: An entire section of the bill, called Title VII, is devoted to this, starting on page 747 )
    • It increases the rebates on drugs people get through Medicare (so drugs cost less) ( Citation: Page 216, sec. 2501 )
    • It establishes a non-profit group, that the government doesn?t directly control, PCORI, to study different kinds of treatments to see what works better and is the best use of money. ( Citation: Page 665, sec. 1181)
    • It makes chain restaurants like McDonalds display how many calories are in all of their foods, so people can have an easier time making choices to eat healthy. ( Citation: Page 499, sec. 4205 )
    • It makes a ?high-risk pool? for people with pre-existing conditions. Basically, this is a way to slowly ease into getting rid of ?pre-existing conditions? altogether. For now, people who already have health issues that would be considered ?pre-existing conditions? can still get insurance, but at different rates than people without them. ( Citation: Page 30, sec. 1101, Page 45, sec. 2704, and Page 46, sec. 2702 )
    • It forbids insurance companies from discriminating based on a disability, or because they were the victim of domestic abuse in the past (yes, insurers really did deny coverage for that) ( Citation: Page 47, sec. 2705 )
    • It renews some old policies, and calls for the appointment of various positions.
    • It creates a new 10% tax on indoor tanning booths. ( Citation: Page 923, sec. 5000B )
    • It says that health insurance companies can no longer tell customers that they won?t get any more coverage because they have hit a ?lifetime limit?. Basically, if someone has paid for health insurance, that company can?t tell that person that he?s used that insurance too much throughout his life so they won?t cover him any more. They can?t do this for lifetime spending, and they?re limited in how much they can do this for yearly spending. ( Citation: Page 14, sec. 2711 )
    • Kids can continue to be covered by their parents? health insurance until they?re 26. ( Citation: Page 15, sec. 2714 )
    • No more ?pre-existing conditions? for kids under the age of 19. ( Citation: Page 45, sec. 2704 and Page 57, sec. 1255 )
    • Insurers have less ability to change the amount customers have to pay for their plans. ( Citation: Page 47, sec. 2794 )
    • People in a ?Medicare Gap? get a rebate to make up for the extra money they would otherwise have to spend. ( Citation: Page 379, sec. 3301 )
    • Insurers can?t just drop customers once they get sick. ( Citation: Page 14, sec. 2712 )
    • Insurers have to tell customers what they?re spending money on. (Instead of just ?administrative fee?, they have to be more specific).
    • Insurers need to have an appeals process for when they turn down a claim, so customers have some manner of recourse other than a lawsuit when they?re turned down. ( Citation: Page 42, sec. 2719 )
    • Anti-fraud funding is increased and new ways to stop fraud are created. ( Citation: Page 699, sec. 6402 )
    • Medicare extends to smaller hospitals. ( Citation: Starting on page 344, the entire section ?Part II? seems to deal with this )
    • Medicare patients with chronic illnesses must be monitored more thoroughly.
    • Reduces the costs for some companies that handle benefits for the elderly. ( Citation: Page 492, sec. 4202)
    • A new website is made to give people insurance and health information. (I think this is it:http://www.healthcare.gov/ ). ( Citation: Page 36, sec. 1103 )
    • A credit program is made that will make it easier for business to invest in new ways to treat illness by paying half the cost of the investment. (Note ? this program was temporary. It already ended) ( Citation: Page 830, sec. 9023 )
    • A limit is placed on just how much of a percentage of the money an insurer makes can be profit, to make sure they?re not price-gouging customers. ( Citation: Page 22, sec. 1101 )
    • A limit is placed on what type of insurance accounts can be used to pay for over-the-counter drugs without a prescription. Basically, your insurer isn?t paying for the Aspirin you bought for that hangover. ( Citation: Page 800, sec. 9003 )
    • Employers need to list the benefits they provided to employees on their tax forms. ( Citation: Page 800, sec. 9002 )
    • Any new health plans must provide preventative care (mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge. ( Citation: Page 14, sec. 2713 )
    1/1/2013

    • If you make over $200,000 a year, your taxes go up a tiny bit (0.9%). Edit: To address those who take issue with the word ?tiny?, a change of 0.9% is relatively tiny. Any look at how taxes have fluctuated over the years will reveal that a change of less than one percent is miniscule, especially when we?re talking about people in the top 5% of earners. ( Citation: Page 818, sec. 9015 )
    1/1/2014
    This is when a lot of the really big changes happen.

    • No more ?pre-existing conditions?. At all. People will be charged the same regardless of their medical history. ( Citation: Page 45, sec. 2704, Page 46, sec. 2701, and Page 57, sec. 1255 )
    • If you can afford insurance but do not get it, you will be charged a fee. This is the ?mandate? that people are talking about. Basically, it?s a trade-off for the ?pre-existing conditions? bit, saying that since insurers now have to cover you regardless of what you have, you can?t just wait to buy insurance until you get sick. Otherwise no one would buy insurance until they needed it. You can opt not to get insurance, but you?ll have to pay the fee instead, unless of course you?re not buying insurance because you just can?t afford it. (Note: On 6/28/12, the Supreme Court ruled that this is Constitutional, as long as it?s considered a tax on the uninsured and not a penalty for not buying insurance? nitpicking about wording, mostly, but the long and short of it is, it looks like this is accepted by the courts) ( Citation: Page 145, sec. 5000A, and here is the actual court ruling for those who wish to read it. )
    Question: What determines whether or not I can afford the mandate? Will I be forced to pay for insurance I can?t afford?


    Answer: There are all kinds of checks in place to keep you from getting screwed. Kaiser actually has a webpage with a pretty good rundown on it, if you?re worried about it. You can see it here.


    Okay, have we got that settled? Okay, moving on?

    • Small businesses get some tax credits for two years. (It looks like this is specifically for businesses with 25 or fewer employees) ( Citation: Page 138, sec. 1421 )
    • Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty.
    • Insurers now can?t do annual spending caps. Their customers can get as much health care in a given year as they need. ( Citation: Page 14, sec. 2711 )
    • Limits how high of an annual deductible insurers can charge customers. ( Citation: Page 62, sec. 1302 )
    • Cut some Medicare spending
    • Place a $2500 limit on tax-free spending on FSAs (accounts for medical spending). Basically, people using these accounts now have to pay taxes on any money over $2500 they put into them. ( Citation: Page 801, sec. 9005 )
    • Establish health insurance exchanges and rebates for the lower and middle-class, basically making it so they have an easier time getting affordable medical coverage.
    • Congress and Congressional staff will only be offered the same insurance offered to people in the insurance exchanges, rather than Federal Insurance. Basically, we won?t be footing their health care bills any more than any other American citizen. ( Citation: Page 81, sec. 1312 )
    • A new tax on pharmaceutical companies.
    • A new tax on the purchase of medical devices.
    • A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more they?ll get taxed.
    • The amount you can deduct from your taxes for medical expenses increases.
    1/1/2015

    • Doctors? pay will be determined by the quality of their care, not how many people they treat. Edit: a_real_MD addresses questions regarding this one in far more detail and with far more expertise than I can offer in this post. If you?re looking for a more in-depth explanation of this one (as many of you are), I highly recommend you give his post a read.
    1/1/2017

    • If any state can come up with their own plan, one which gives citizens the same level of care at the same price as the PPACA, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the PPACA. So if they can get the same results without, say, the mandate, they can be allowed to do so. Vermont, for example, has expressed a desire to just go straight to single-payer (in simple terms, everyone is covered, and medical expenses are paid by taxpayers). ( Citation: Page 98, sec. 1332 )
    2018

    • All health care plans must now cover preventative care (not just the new ones).
    • A new tax on ?Cadillac? health care plans (more expensive plans for rich people who want fancier coverage).
    2020

    • The elimination of the ?Medicare gap?
    .
    Aaaaand that?s it right there.


    The biggest thing opponents of the bill have against it is the mandate. They claim that it forces people to buy insurance, and forcing people to buy something is unconstitutional. Personally, I take the opposite view, as it?s not telling people to buy a specific thing, just to have a specific type of thing, just like a part of the money we pay in taxes pays for the police and firemen who protect us, this would have us paying to ensure doctors can treat us for illness and injury.


    Plus, as previously mentioned, it?s necessary if you?re doing away with ?pre-existing conditions? because otherwise no one would get insurance until they needed to use it, which defeats the purpose of insurance.


    Whew! Hope that answers the question!
     
  18. Mish

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    do you REALLY think that millions more people are going to be hammering down the door to your pedi-endo?

    And if that's the case...I'll happily wait for our next appointment so that 10 more kids GET to see the pedi-endo. or 20. or 50. or 100.

    This is not a law that's going to be about what's most cost effective. It's a law that's going to be about what's right for everyone in this society.
     
  19. Sarah Maddie's Mom

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    It's ironic that posters with expensive chronic health conditions and with children with expensive chronic health conditions are so tentatively, condescendingly agreeing that they don't mind "paying" for other people's health care...:rolleyes: That's how your insurance has worked all these years - healthy people paying in to balance your needs.
     
  20. sheeboo

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    The effects of the new taxes will not be felt by the majority of Americans, and will still be far less costly than being uninsured.

    Quotes from the article you linked to, with some important bits left out:
    Not surprisingly, there was no mention Thursday of the 20 other different taxes hidden in Obamacare, many of which affect families earning less than $250,000 a year. The new taxes, which conservatively are estimated at around $675 billion (I?ll give 10 to 1 they will cost more) over the next decade, include:

    A 2.3% excise tax on U.S. sales of medical devices that?s already devastating the medical supply industry and its workforce. "not including everyday items such as eyeglasses, contact lenses and hearing aids"--I wonder how they'll code insulin pumps and CGMs?

    The levy is a $20 billion blow to an industry that employs roughly 400,000. (By the way, with this little gem, here are a few fun facts to enjoy and ponder, especially if your looking for work: Michigan-based Stryker Corp., blames the tax for 1,000 layoffs; Indiana-based Zimmer Corp., which cites the tax in laying off 450 and taking a $50 million charge against earnings; Indiana-based Cook Medical Inc., which has scrubbed plans to open a U.S. factory; Minnesota-based Medtronic Inc., which expects an annual charge against earnings of $175 million, and Boston Scientific Corp., which has opted to open plants in tax-friendlier Ireland and China to help offset a $100 million charge against earnings.)

    A 40% excise tax on so-called Cadillac, or higher cost, health insurance plans (Elitism is frowned upon under Obamacare ? wonder what the unions think of this one? Oh, wait ? that?s right ? big unions got a deferral!)

    A 3.8% surtax on investment income from capital gains and dividends that applies to single filers earning more than $200,000 and married couples filing jointly earning more than $250,000.

    A $50,000 excise tax on charitable hospitals that fail to meet new ?community health assessment needs,? ?financial assistance? and other rules set by the Health and Human Services Dept.And this is bad, how?

    A $24 billion tax on the paper industry to control a pollutant known as black liquor.Shudder. This is just awful!

    A $2.3 billion-a-year tax on drug companies (After all, they?re big and deserve it just because, don?t they?)

    A 10% excise tax on indoor tanning salons. (No big deal. It?s always been cheaper to go the beach anyway.)

    An $87 billion hike in Medicare payroll taxes for employees, as well as the self-employed (And we all know how greedy those capitalist-loving self-employed are!) for individuals earning more than $200,000/year; couples more than $250,000

    A hike in the threshold for writing off medical expenses to 10% of adjusted gross income from 7.5%.It is already 10%

    A new cap on flexible spending accounts of $2,500 a year, (Because after all, we need more tax revenue, not savings!) This is a CAP, not a tax, but go on.....

    Elimination of the tax deduction for employer-provided prescription drug coverage for Medicare recipients.Um, people with Medicare are retired, they don't have an employer. What this part of the act does, is close the "donut hole" so Medicare recipients will no longer have to pay for drugs out of pocket!

    An income surtax of 1% of adjusted gross income, rising to 2.5% by 2016, on individuals who refuse to go along with Obamacare by buying a policy not OK?d by the government.They could buy insurance instead, of course.

    A $2,000 tax charged to employers with 50 or more workers for every full-time worker not offered health coverage. Employers are allowed to deduct the first 30 employees.

    A $60 billion tax on health insurers. (Hmm ? wonder where they?ll recoup the costs on this one?)​
    Not with caps on allowable charges.
     

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