A peek inside the Health Care Bill

Discussion in 'Economics' started by the1, Nov 11, 2009.

  1. the1


    The health bill that House Speaker Nancy Pelosi is bringing to a vote (H.R. 3962) is 1,990 pages. Here are some of the details you need to know.

    What the government will require you to do:

    • Sec. 202 (p. 91-92) of the bill requires you to enroll in a "qualified plan." If you get your insurance at work, your employer will have a "grace period" to switch you to a "qualified plan," meaning a plan designed by the Secretary of Health and Human Services. If you buy your own insurance, there's no grace period. You'll have to enroll in a qualified plan as soon as any term in your contract changes, such as the co-pay, deductible or benefit.

    • Sec. 224 (p. 118) provides that 18 months after the bill becomes law, the Secretary of Health and Human Services will decide what a "qualified plan" covers and how much you'll be legally required to pay for it. That's like a banker telling you to sign the loan agreement now, then filling in the interest rate and repayment terms 18 months later.

    On Nov. 2, the Congressional Budget Office estimated what the plans will likely cost. An individual earning $44,000 before taxes who purchases his own insurance will have to pay a $5,300 premium and an estimated $2,000 in out-of-pocket expenses, for a total of $7,300 a year, which is 17% of his pre-tax income. A family earning $102,100 a year before taxes will have to pay a $15,000 premium plus an estimated $5,300 out-of-pocket, for a $20,300 total, or 20% of its pre-tax income. Individuals and families earning less than these amounts will be eligible for subsidies paid directly to their insurer.

    • Sec. 303 (pp. 167-168) makes it clear that, although the "qualified plan" is not yet designed, it will be of the "one size fits all" variety. The bill claims to offer choice—basic, enhanced and premium levels—but the benefits are the same. Only the co-pays and deductibles differ. You will have to enroll in the same plan, whether the government is paying for it or you and your employer are footing the bill.

    • Sec. 59b (pp. 297-299) says that when you file your taxes, you must include proof that you are in a qualified plan. If not, you will be fined thousands of dollars. Illegal immigrants are exempt from this requirement.

    • Sec. 412 (p. 272) says that employers must provide a "qualified plan" for their employees and pay 72.5% of the cost, and a smaller share of family coverage, or incur an 8% payroll tax. Small businesses, with payrolls from $500,000 to $750,000, are fined less.

    Eviscerating Medicare:

    In addition to reducing future Medicare funding by an estimated $500 billion, the bill fundamentally changes how Medicare pays doctors and hospitals, permitting the government to dictate treatment decisions.

    • Sec. 1302 (pp. 672-692) moves Medicare from a fee-for-service payment system, in which patients choose which doctors to see and doctors are paid for each service they provide, toward what's called a "medical home."

    The medical home is this decade's version of HMO-restrictions on care. A primary-care provider manages access to costly specialists and diagnostic tests for a flat monthly fee. The bill specifies that patients may have to settle for a nurse practitioner rather than a physician as the primary-care provider. Medical homes begin with demonstration projects, but the HHS secretary is authorized to "disseminate this approach rapidly on a national basis."

    A December 2008 Congressional Budget Office report noted that "medical homes" were likely to resemble the unpopular gatekeepers of 20 years ago if cost control was a priority.

    • Sec. 1114 (pp. 391-393) replaces physicians with physician assistants in overseeing care for hospice patients.

    • Secs. 1158-1160 (pp. 499-520) initiates programs to reduce payments for patient care to what it costs in the lowest cost regions of the country. This will reduce payments for care (and by implication the standard of care) for hospital patients in higher cost areas such as New York and Florida.

    • Sec. 1161 (pp. 520-545) cuts payments to Medicare Advantage plans (used by 20% of seniors). Advantage plans have warned this will result in reductions in optional benefits such as vision and dental care.

    • Sec. 1402 (p. 756) says that the results of comparative effectiveness research conducted by the government will be delivered to doctors electronically to guide their use of "medical items and services."

    Questionable Priorities:

    While the bill will slash Medicare funding, it will also direct billions of dollars to numerous inner-city social work and diversity programs with vague standards of accountability.

    • Sec. 399V (p. 1422) provides for grants to community "entities" with no required qualifications except having "documented community activity and experience with community healthcare workers" to "educate, guide, and provide experiential learning opportunities" aimed at drug abuse, poor nutrition, smoking and obesity. "Each community health worker program receiving funds under the grant will provide services in the cultural context most appropriate for the individual served by the program."

    These programs will "enhance the capacity of individuals to utilize health services and health related social services under Federal, State and local programs by assisting individuals in establishing eligibility . . . and in receiving services and other benefits" including transportation and translation services.

    • Sec. 222 (p. 617) provides reimbursement for culturally and linguistically appropriate services. This program will train health-care workers to inform Medicare beneficiaries of their "right" to have an interpreter at all times and with no co-pays for language services.

    • Secs. 2521 and 2533 (pp. 1379 and 1437) establishes racial and ethnic preferences in awarding grants for training nurses and creating secondary-school health science programs. For example, grants for nursing schools should "give preference to programs that provide for improving the diversity of new nurse graduates to reflect changes in the demographics of the patient population." And secondary-school grants should go to schools "graduating students from disadvantaged backgrounds including racial and ethnic minorities."

    • Sec. 305 (p. 189) Provides for automatic Medicaid enrollment of newborns who do not otherwise have insurance.

    For the text of the bill with page numbers, see www.defendyourhealthcare.us.

  2. Are these premiums for the public option plan? They are extremely high. These amounts cannot be right.

    Private insurance now is cheaper than these prices. My family, which includes 3 people, pays only about $2,000 per year for insurance with Humana with a $7,500 deductible here in Georgia. I am self employed and my wife is a stay at home mom.
  3. the1


    It sounds like this is the public plan. If you make less than 44k you get subsidized. If you make more you will have to purchase it yourself. Self-employed people are going to get stung the worst. This bill will provide health care for people who don't have it now but will make it harder for people to get who DO have it now. Our broken health care system is going to look like a finely tuned machine once this bill passes.

  4. Can somebody that is for this plan come forth and explain to us how expendable income reduction to the tune of 20% per household is a good thing?

    How are we going to buy food, clothes for the kids, pay electric bills, pay mortgage and save for retirement after income tax, state tax, property tax and health care tax?

    My effective tax rate is already 50% Add another 20% and i`m fucked...as are many.

    Seriously, I need a liberal Dem to tell me how this is a good thing.
  5. Reaction to health care bill by a die-hard Obama supporter.

    “... This rigid, intrusive and grotesquely expensive bill is a nightmare. Holy Hygeia, why can't my fellow Democrats see that the creation of another huge, inefficient federal bureaucracy would slow and disrupt the delivery of basic healthcare and subject us all to a labyrinthine mass of incompetent, unaccountable petty dictators? Massively expanding the number of healthcare consumers without making due provision for the production of more healthcare providers means that we're hurtling toward a staggering logjam of de facto rationing. Steel yourself for the deafening screams from the careerist professional class of limousine liberals when they get stranded for hours in the jammed, jostling anterooms of doctors' offices. They'll probably try to hire Caribbean nannies as ringers to do the waiting for them. A second issue souring me on this bill is its failure to include the most common-sense clause to increase competition and drive down prices: portability of health insurance across state lines. What covert business interests is the Democratic leadership protecting by stopping consumers from shopping for policies nationwide? Finally, no healthcare bill is worth the paper it's printed on when the authors ostentatiously exempt themselves from its rules. The solipsistic members of Congress want us peons to be ground up in the communal machine, while they themselves gambol on in the flowering meadow of their own lavish federal health plan. Hypocrites! “ Camille Paglia
  6. OF COURSE THEY CAN.... because Obamacare is NOT primarily about medical care... it's about Libtard power and control over the citizenry...

    The "health care" business is the MISDIRECT.... you know, like a magician's trick.
  7. As an allied health care professional, I'm sure that the passage of such nonsense will hasten my retirement.

    Right now medicare rations health care by nearly endless documentation for the provider.

    Time spent documenting is time not spent on the patient and eventually affects earnings as well.

    Eventually , especially if they cut back on reimbursement it will reach the "why bother any more point"

    Can anyone say Health care shortage?
  8. kashking


    If anybody supports this bill, please tell me how this will bring down the cost of medical care?

    The issue in not about insurance when it comes to cost, it is about the cost of the underlying medical procedures.
  9. ron2368


    I dont think cost of procedures is the problem, medicare controls these and allows 2 to 4% per year cost increases. The problem is frequency or utilization which is exponential. The only way to stop that is rationing which is exactly what the medicare MD gatekeepers will be for.
  10. It makes sense that it is so expensive. A good portion of it is probably to pay for the unemployed/underemployed getting free insurance.
    #10     Nov 12, 2009