U.S. House's Health Care Reform Bill

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The American and Canadian systems seem to suffer with two extremes-the American with its lack of universality and the outrageous fact that those who most need health care cant get insurance to cover them and the Canadian with its lack of choice and rationing of services.

I am proud of how Australia has navigated a middle path through these two extremes in how it structures its health care. America needs to have a healthy public system in direct competitioon with a viable vital group of private insurers.

Other Australian members rightly point out the downward pressure that a good universal public health insurance scheme places on private insurers making them offer good, relevant and competitive products. But I need to add that there are some important forces that the privately insured allow others to bring to bear on the public sysytem. My being able to have my arthritic hip replaced a week after diagnosis as a private patient allows the uninsured to bring moral pressure to bear on the politicians in charge of our public system by asking why other people need to wait years to have a hip replacement with its associated pain suffering and disability.

The private sector is also more responsive and adaptable to technological innovation and improvement. In recent years many new techniques have been introduced first to private patients but the skills and knowledge quickly spreads to doctors in the public system as doctors can bring pressure to bear in the public system to introduce improvements that they have already seen benefit their patients.

Hence the privately insured patient has alot to thank Medicare for in Australia in offering a rational alternative to buying the private insurance products, but also the uninsured can thank those who do insure for creating higher expectations of and greater choice in the health system in general.

Trust me I'm a doctor...

Peter
 
Sorry, in case it wasn't already clear, participation is moreless compulsory for Americans who choose the public option. Those who choose private insurance aren't affected.
 
but...

But if there is the ability to opt out due to fianncial hardship surely that means the poorest (especially the "working poor") will choose to not be covered to save money thus defeating the aim of universal coverage?
 
Well, it's not a matter of choice for America's poorest. You can't get blood out of a stone, so it's very probable these "affordability credits" will be close to 100% of the premium amounts for people living under or just above the poverty line. The credits extend (regressively) for those making up to $43,000/year, or $88,000 for a family of four.
 
i really hope we do get it. The uninformed have never written checks i would think. The parents both had health insurance with "capped coverage" from Dad's retirement. His cancer and her heart disease, reached the cap quickly. Many people who have insurance do not realize there a limits to the "max" coverage. When the "Companies" will no longer insure, for less than a kings ransom. The naysayers may well embrace the public option. "I have health insurance and i am very happy with it", has probably been blessed with good health. Do not think for a minute if you have a catastrophic illness, that hospital adm. is uninterested in your personal assets.
 
Tax increases on the "mega-wealthy"

equals higher cost for the products and services they provide. We ALL will have to pay for this, not just the "mega-wealthy".
 
Why isnt this bigger news?

Where are all the bleeding heart liberals? Where are the right wingers who see this as a covert threat to the right to bear arms? I thought this would have stimulated alot more debate. I watch the New York Times site and very little on there either. I thought the private insurance companies would be telling horror stories about socialised medicine by now. I thought the left wingers would be parading uninsured families in front of the press. I thought members here would be excited and or horrified at the changes proposed.

Is Obama such a clever politician that he can get this through without all of the controversy?
 
Why isnt this bigger news?

Where are all the bleeding heart liberals? Where are the right wingers who see this as a covert threat to the right to bear arms? I thought this would have stimulated alot more debate. I watch the New York Times site and very little on there either. I thought the private insurance companies would be telling horror stories about socialised medicine by now. I thought the left wingers would be parading uninsured families in front of the press. I thought memebers here would be excited and or horrified at the changes proposed.

Is Obama such a clever politician that he can get this through without all of the controversy?
 
Is Obama such a clever politician that he can get this throu

Methinks things, times and the econmy here are so bad and the lack of hope abounds so much that tradtinal reisitance to change has faded.

I was shocked to here car manufacturers here commending the governmnt on its more stringet emissions and efficieny (mileage) standards. The things one will do to get millions!
 
Read the bill. It is a disaster, just like the cap and tax bill. The price of everything will go up to cover the cost, in addition to taxing the hell out of small business owners.

As for actual healthcare, see what you may be in for..

 
The din of impending doom is getting very tired.

Yes. There are problems with other healthcare systems in other countries. It's pretty short-sighted to automatically assume ours will have to be identical to theirs or that we're not smart enough to come up with a program that works for our needs.
 
> Methinks things, times and the econmy here are so bad and the lack of hope abounds so much that tradtinal reisitance to change has faded. <

It's more that we now recognize we can no longer afford the cost of doing nothing. The same thing is true for global warming and cap-and-trade.

We must have a public option for healthcare, if for no other reason than to exert downward pressure on costs and pricing of our private insurance system. Without this pressure, health care costs would eventually bankrupt us.

The other reason this is happening now is because most people realize it's never going to happen with Republican leadership in Congress. From 1994-2006 they had 12 years to address these problems, and they spent their time doing nothing except giving corporations everything they ever wanted, giving tax breaks to people who didn't need them, and trying to prove Bill Clinton had an extramarital affair. Just as our national debt quadrupled in just eight years under Ronald Reagan's "leadership", and in just eight years the U.S. went from being the world's largest creditor to the world's largest debtor -- a title we still hold today, 12 years of Republican control of Congress did more to damage our economic stability and gut our middle class than 40+ years of Democratic "tax and spend liberalism" did.
 
When we first saw the paragraph Tuesday, just after the 1,018-page document was released, we thought we surely must be misreading it. So we sought help from the House Ways and Means Committee.

It turns out we were right: The provision would indeed outlaw individual private coverage. Under the Orwellian header of “Protecting The Choice To Keep Current Coverage,” the “Limitation On New Enrollment” section of the bill clearly states:

“Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day” of the year the legislation becomes law.

So we can all keep our coverage, just as promised — with, of course, exceptions: Those who currently have private individual coverage won’t be able to change it. Nor will those who leave a company to work for themselves be free to buy individual plans from private carriers.

http://www.ibdeditorials.com/IBDArticles.aspx?id=332548165656854
 
Wilkinservice, We have Medicare in the USA for the elderly and Medicaid for Kids.. The battle is really for the Middle class that cannot obtain coverage, it's either not offered by their small employer or they are self employed. I have worked with people that would be retired Except for the fact they are not old enough for Medicare. They have a pre-existing condition, that requires care and high dollar rx medicine. If this reform would pass, i think an incredible amount of people will retire early, change jobs, work part time. An employee that is gasping for the employers healthcare coverage or cannot pass a physical at a new employer, is an indentured servant...
 
"It turns out we were right: The provision would indeed outlaw individual private coverage. Under the Orwellian header of “Protecting The Choice To Keep Current Coverage,” the “Limitation On New Enrollment” section of the bill clearly states:

“Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day” of the year the legislation becomes law."

What a joke....another left wingnut twisted interpretation...but that's what we've come to expect from republicans.

State facts, then debate and discuss them....not hype and horseshit. It's insulting.
 
I dont understand...

Will the individual be able to insure against the cost of services by hospitals and doctors that do not accept payment at the current medicare/medicaid levels? I know there are some doctors who do not see medicaid/medicare patients and surely some hospitals that also do not admit patients with that level of cover only.
 
It is illegal for Hospitals to decline care to medicaid or medicare recipients or indigent cases in an emergency, there are doctors that do not participate in care/caid in their pvt offices. In large urban area's there are OB/GYN's that prefer Medicaid and have their offices geared toward billing medicaid.There are many things patients do not understand about coverage and what is paid. Most if not all insurance companies follow the Medicare guidelines for reimbursement for adult care based on DRG's (Diagnosis related groupings). It's a big can of worms, and most have the same odor.
 
For what it is worth...

I think it is important that any US resident under any new scheme can interact with the health providers at three levels. Firstly if they chose to do nothing about health insurance they have "public" insurance by default however this can be made discouragingly expensive if they earn above a certain income. Secondly if they choose to insure privately (whether this be by a personal policy or via an employer scheme is relatively immaterial except that by making employer schemes tax effective it can be a way to ensure a strong incentive to insure privately) they then are covered for a large proportion of costs, at least as much as the public scheme covers. Thirdly they can interact with the health providers as purchasers paying the cost of services in the service of their choice as a cash transaction. I believe that it is important that there always be some absolute cash value attributed to health care. This is very imporatant in making the health providers accountable. This is I believe one of the major shortcomings in socialised medical schemes (for example the National Health in Great Britain). I believe that doctors and hospitals need to relate their care back to a cash value to be able to justify their decisions in a fiscal fashion.
 

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