Debate: US Healthcare Reform!

Netto Azure · Net Battler Joined: 22 Jun 2009 Posts: 58

The Current Status of United States Healthcare Reform (March 25th, 2010)

US President Barack Obama signs the heathcare bill in the East Room of the White House in Washington March 23rd, 2010

Patient Protection and Affordable Care Act (H.R. 3590)

Introduction
“To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.”

Summary: The summary of the bill includes the following elements, among others:

Effective September 21, 2010

All insurers are fully prohibited from discriminating against or charging higher rates for children based on pre-existing conditions
Adults with pre-existing conditions will be eligible to join a temporary high-risk pool, which will be superseded by the health care exchange in 2014
Children and young adults will be permitted to remain on their parents' insurance plan until their 26th birthday
Insurers are prohibited from charging co-pays or deductibles for preventive care and medical screenings on all new insurance plans
Individuals affected by the Medicare Part D coverage gap will receive a $250 rebate, and 50 percent of the gap will be eliminated in 2011
Insurers' abilities to enforce annual spending caps will be restricted, and completely prohibited by 2014
Insurers are prohibited from dropping policy holders when they get sick
Insurers are required to reveal details about administrative and executive expenditures
Insurers are required to implement an appeals process for coverage determination and claims on all new plans
Indoor tanning services are subjected to a 10 percent service tax
Enhanced methods of fraud detection are implemented.
Medicare is expanded to small, rural hospitals and facilities
Non-profit Blue Cross insurers are required to maintain a loss ratio (money spent on procedures over money incoming) of 85 percent or higher to take advantage of IRS tax benefits
Companies which provide early retiree benefits for individuals aged 55-64 are eligible to participate in a temporary program which reduces premium costs
A new website installed by the Secretary of Health and Human Services will provide consumer insurance information for individuals and small businesses in all states
A temporary credit program is established to encourage private investment in new therapies for disease treatment and prevention

Effective by January 1, 2011

Insurers will be required to spend 85% of large group plan premiums (minus certain expenses) on health care or to improve health care quality. The percentage for small group and individual plans is 80% though the Secretary has the ability to adjust that rate for a state if it would destabilize the state market. In both cases states may apply more rigid standards. If insurers spend a lower percent they will be required to rebate back to the customer the difference. Insurers will also be required to report to the U.S. Department of Health and Human Services how they are spending premiums for each plan year including those portions not spent on health care. HHS will then post this information on it's web site though the timing for this seems to be left more open. (Title X, Subtitle A, Sec 10101(f), amending Sec 1001(5), which amends Sec 2718 of the Public Health Service Act)

Effective January 1, 2014

All insurers are fully prohibited from discriminating against or charging higher rates for adult individuals based on pre-existing medical conditions
All insurers are fully prohibited from establishing annual spending caps
Expand Medicaid eligibility; individuals with income up to 133 percent of the poverty line qualify for coverage
Establish health insurance exchanges, and subsidization of insurance premiums for individuals with income up to 400 percent of the poverty line
Offer tax credits to small businesses who have fewer than 25 employees and provide health care benefits for them.
Impose a tax penalty on employers with over fifty employees who do not offer health insurance to their workers.
Impose an annual fine on individuals who do not obtain health insurance; exemptions to fine in cases of financial hardship or religious beliefs.
Creation of a new voluntary long-term care insurance program.
Creation of tax credits for individuals who purchase private insurance policies
Employed individuals who pay more than 9.5 percent of their income on health insurance premiums will be permitted to purchase insurance policies from a state-controlled health insurance option
Pay for new spending, in part, through spending and coverage cuts in Medicare Advantage, slowing the growth of Medicare provider payments, reducing Medicare and Medicaid drug reimbursement rate, cutting other Medicare and Medicaid spending
Revenue increases from a new $2,500 limit on tax-free contributions to flexible spending accounts (FSAs), which allow for payment of health costs
Chain restaurants and food vendors with 20 or more locations are required to display the caloric content of their foods on menus, drive-through menus, and vending machines. Additional information, such as saturated fat, carbohydrate, and sodium content, must also be made available upon request

Effective by 2018

All existing health insurance plans must cover preventative care and checkups without co-payment.
Raising various taxes, and creating a new excise tax for high cost "Cadillac" insurance plans

Status:

US House of Representatives: Affordable Health Care for America Act (H.R. 3962, introduced October 29, 2009, passed on November 7, 2009)

The United States House of Representatives has passed it's version of the bill by a vote of 220 Yay - 215 Nay.

The bill was supported by 219 Democrats and one Republican - Joseph Cao from New Orleans. Opposed were 176 Republicans and 39 Democrats.

Now the Senate bill has been deemed the basis for the Health-care reform effort. Voting has occurred March 22, 2010 with 219 Yay - 212 Nay.

All Republicans voted against the bill with 41 Democrats.

A third vote on the Reconciliation Act was voted 219 Yay - 207 Nay

US House of Representatives
(1st Vote): Bill Passed (220 Yay - 215 Nay)
(2nd Vote): Bill Passed (219 Yay - 212 Nay)
(3rd vote): Bill Passed (219 Yay - 207 Nay)

Tri Committee:
House Energy and Commerce: Bill revised/Passed (31 Yes - 28 No)
House Ways and Means : Bill revised/Passed (23 Yes – 18 No)
House Education and Labor:Bill revised/Passed (26 Yes - 22 No)

US Senate: The Patient Protection and Affordable Care Act (H.R. 3590) is a bill passed by the United States Senate at 7:05am on December 24, 2009.

On December 21, the Senate voted to end the Republican filibuster and vote on their version of health care reform, by 60 to 40.

On Christmas Eve of 2009, the Senate arrived at 7am Eastern Time, the first time the Senate had met on Christmas Eve since 1895, and passed the bill to be compromised by both houses of Congress by a vote of 60-39, with only Jim Bunning (R-KY) failing to vote.

As the basis for the reform effort, amendments proposed by the House were passed through Reconciliation with minor changes, 57 Yay -43 Nay.

US Senate
(1st Vote): Bill Passed (60 Yay - 39 Nay)
(2nd Vote): Bill Passed (57 Yay - 43 Nay)

Senate Health, Education, Labor and Pensions (HELP) Committee: Bill revised/Passed (13 Yes – 10 No)
Senate Finance Committee: Bill revised/Passed (14 Yes - 9 No)

Healthcare around the world

Sai-kun · Posted: Fri Jul 24, 2009 12:24 pm Post subject:

Some woman in the early stages of breast cancer got her breasts removed because she was afraid that when it health care got reformed she wouldn't be able to be treated.

Neutral

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Saito-kun · Posted: Fri Jul 24, 2009 12:51 pm Post subject:

Oh great.

I can't even escape politics here.

Netto Azure · Net Battler Joined: 22 Jun 2009 Posts: 58

Saito-kun · Posted: Fri Jul 24, 2009 2:11 pm Post subject:

Politics are the opposite of life. Rolling Eyes

I'll just look the other way while you all have a blast with them.

HeatShadow · Posted: Fri Jul 24, 2009 6:02 pm Post subject:

All I want to say is that I find it ironic that the vast majority of critics seem to forget that Obama's reform plan is based heavily around giving health care to people who don't already have it, not changing what's already there. That woman who had her breasts removed? She probably already had health care, so she panicked over nothing. If she didn't, any health care, even a slow government-run one, is better than nothing.
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Sai-kun · Posted: Fri Jul 24, 2009 10:51 pm Post subject:

Netto Azure · Net Battler Joined: 22 Jun 2009 Posts: 58

Saito-kun · Posted: Sat Jul 25, 2009 12:59 pm Post subject:

We didn't need to bail anyone out, or at least none of the corporations. We should have let those companies crash. Neutral

Such a large and unpayable debt is worse than all the jobs that would have been lost. Many jobs are being lost anyway, and those resources would have been put to better use some other way.

Oops! I wasn't supposed to be paying attention, was I?

HeatShadow · Posted: Sat Jul 25, 2009 1:22 pm Post subject:

Dark Roll · Posted: Wed Jul 29, 2009 9:06 pm Post subject:

Netto Azure · Net Battler Joined: 22 Jun 2009 Posts: 58

Netto Azure · Net Battler Joined: 22 Jun 2009 Posts: 58

Update (August 21, 2009): As we do have a US Democratic Congressional Majority and Administration. I will have to draw the line with compromises by having a Medicare-based Public Insurance Option and having any State in the Union keep the right to opt-out of the Federal program in order to institute their own plans.

Also I have updated the first post to better summarize the current bills in Congress.

I am more than willing to debate the details of the current bills, I am not dropping my support for HR 676, but given the current political climate, I must accept this current proposal as anything is better than the status quo.

Ozone · Posted: Fri Aug 21, 2009 9:11 am Post subject:

maybe, I'll be kicked off, but...
Here in Italy, healt-care is managed by the state, healt insurances don't exist here, and all the cures performed by public hospitals (there are privates too) are totally free of charges: you pay them with taxes as citizen, so that everybody has the right to stay in good healt, without differences of sex, religion or race.
So, yes, I agree to Obama's policy to put sanity under the USA competence.
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Netto Azure · Net Battler Joined: 22 Jun 2009 Posts: 58

Netto Azure · Net Battler Joined: 22 Jun 2009 Posts: 58

According to a White House report, US President Obama has called for a speech to a Joint Session of the United States Congress on Wednesday, September 9th 2009 on the topic of Healthcare. He is expected to drop the controversial "Public Option" provision. Some White House officials have told NPR that the President has given up on the possibility of a Bi-partisan bill and will go through with the Democratic Majorities in the US Congress and hopes to get the support of the Senators from Maine, Susan Collins and Olympia Snowe.

US President Obama to give major health speech

Mr Obama will be "more prescriptive" in his speech, an aide said

Goddra2 · chip otaku Joined: 17 May 2006 Posts: 111

...Of all the places to pick up politics, I was not expecting this one.

To Ozone:

You bring up a valid example. But, here are just a few points to help flesh out the topic.

First, while the Italy's system may work for Italians (I don't know enough about it to give it a solid critique), Italy has a population of about 58 million. The United States, by comparison, has a population of about 300 million -- abstractly, this isn't much of a difference, but on a scale of people, it's much greater, almost exponentially.

Second, the U.S. government happens to be in crushing, back-breaking debt. I don't care WHO is blamed (that's not why we're here, now, is it?), but it nonetheless IS.

Third, which is really more of a second-point-five, the government's resources are ALSO limited.

Moving on.

Now then, there are a good several hundred thousand people in need of health care (not counting those who lack it because, hey, they don't want it). If the government is really going to put all the people without a plan on the gov't (I'm getting tired of typing it out) plan, then the government is going to be responsible for them. All of them.

Enter point 2.5/3. The government will have to spread its already thin resources across the several hundred thousand aforementioned. And that's just for your average bumbs, scrapes, skinned knees, and compound fractures. How about the maternity ward? How about letting people go?

That's where a lot of socialized health care leads: Granny on the gov't plan has terminal cancer; the gov't has to decide whether to keep paying tax dollars (because, let's face it, that's where pretty much ALL gov't money comes from) to keep her alive, or to let her die and move on to someone with a better chance of survival. In addition, Betsy Markey, democratic congresswoman in Colorado’s 4th Congressional district, mentioned on August 27 that Medicare benefits were going to have to be cut. There are going to be some people who are going to have to give up some things. Meaning, the American gov't can barely afford to run the health providers it already has. And in a state-run system, the gov't decides who gets the new, state-of-the-art treatment. Chances are it's
not going to be Granny.

It being slow isn't the problem (unless it's a ten-month wait for the maternity ward).
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Netto Azure · Net Battler Joined: 22 Jun 2009 Posts: 58

Sorry for getting a bit partisan here. ^^" But the American constituency should really find out how things work...

Netto Azure · Net Battler Joined: 22 Jun 2009 Posts: 58

Ok, the US Democrats have just secured the 60 Votes needed to pass it from the US Senate.

There's still the conference bill but we're close to passing this.

Unknown Neo · Posted: Sat Dec 19, 2009 8:48 pm Post subject:

Well, that good news. Maybe we can get something done for once.