Health care bill passed!!!!

The Matrix

Bench Warmer
Jul 25, 2007
2,332
0
#1
Having staked the success of his presidency on the longstanding Democratic dream of universal health care, President Obama finally achieved victory on Sunday night, bringing an end to a yearlong partisan struggle. "This legislation will not fix everything that ails our health care system, but it moves us decisively in the right direction," Obama said shortly after the historic vote. "This is what change looks like." With Democrats chanting the signature line of the Obama presidential campaign - "Yes we can!" - the House voted 219-212 to send a sweeping overhaul of the nation's health care system to be signed into law. "We tonight will make history for our country and progress for the American people," Speaker Nancy Pelosi declared shortly before the vote. "Today we have the opportunity to complete the great unfinished business of our country."
The Democrats passed the bill without a single Republican vote - and with the knowledge that it may well have ended the political careers of some who voted for it at a time when the public remains deeply divided over the entire endeavor. "If we pass this bill, there will be no turning back," warned minority leader John Boehner. "It will be the last straw for the American people." (See 10 health care reform ads.)
Suspense about the outcome continued until the final hours of the debate. Passage appeared to be assured only after Michigan Congressman Bart Stupak announced in the late afternoon that he and a group of antiabortion Democrats, who had pushed for more restrictive language in the original House bill, had been satisfied that the Senate version would not allow the use of federal funds to pay for the procedure. That only came after President Obama promised to sign an executive order reaffirming that the bill would maintain a "consistency with longstanding restrictions on the use of federal funds for abortion." In reality, that executive order was more a symbolic move than an actual concession; the bill's supporters have insisted all along that it does nothing to change the current federal policy, known as the Hyde Amendment, which has been in effect since 1976.
The second bill passed by the House late Sunday will make adjustments to the legislation, such as lowering the impact of an excise tax on high-value insurance plans and stripping out some sweetheart deals like the now infamous cornhusker kickback, using a process known as budget reconciliation. Such changes would be filibuster-proof in the Senate, though that process could still drag on a while if Republicans choose to draw it out with objections and amendments. Even so, it will be an anticlimax to Sunday's historic House vote, which will send the underlying Senate bill to President Obama's desk for signature. (Watch TIME's video "Uninsured Again.")
As the House debated throughout the day, hundreds of protesters from the Tea Party movement rallied on the Capitol lawn, chanting, "Kill the bill." It was a dead-serious message, but on a glorious spring day, when cherry blossoms were just beginning to appear on the trees, the atmosphere felt more like a carnival - especially compared to the day before, when some protesters had hurled racial epithets at a few African-American members of the House. The crowd was stoked by regular appearances that lawmakers made on a balcony overlooking the protesters. "It's interesting how many faces they recognize," said Republican Congressman Steve King of Iowa. Republicans flashed handwritten signs with the word No on them, sending the crowd into rapture.
Democrats also got into the act. Sheila Jackson-Lee, a liberal Democrat from Texas, said she went down among the protesters saying, "God bless America. We're glad you're here." She also flashed two fingers in a mischievous V for victory. The response? "Someone flipped a third finger," she said.
On the other end of Pennsylvania Avenue, the President and his team were waiting and working the phones to make sure the final votes were nailed down. There was also the distraction of March Madness to pass the hours. One aide said of Obama: "He's in the West Wing, getting updates, dropping in on staff, and like the rest of America, examining the rubble of his bracket." At one point during the afternoon, the Commander in Chief ordered his health care czar, Nancy-Ann DeParle, to take a break and go out for a run.
With passage of the legislation, Obama has achieved the signature domestic goal of his presidency, and the most sweeping piece of social legislation since the 1960s Great Society initiatives that saw the passage of Medicare and Medicaid. Universal coverage is a goal that has eluded Presidents going at least as far back as Teddy Roosevelt, and Obama's bill comes as close to that target as anyone has. The bill would provide health coverage to an estimated 32 million additional Americans, meaning 95% of those who are legally in this country would have health insurance, up from 83% today.
The bill also promises to rein in health costs by reorienting the practice of medicine, making it more efficient, with health care providers rewarded on how well they treat their patients, rather than how much care they give them. Whether it actually achieves that latter ambition, however, is far more uncertain. (See more about health care.)
In the early years, most Americans will see only minor changes in the health care system. It will almost immediately end some insurance-company practices, such as denying coverage to children with pre-existing conditions. And dependent children under the age of 26 would be allowed to remain on their parents' policies if they cannot get health insurance elsewhere. Adults with pre-existing conditions would also be able to buy coverage through expanded high-risk pools.
Beginning in 2014, more far-reaching measures will begin to take effect. States would be required to set up new "exchanges," or insurance marketplaces, that would offer a variety of health care plans for small businesses and individuals who do not get coverage from their employers. Government subsidies would be available to those earning up to 400% of poverty. Employers with 50 or more workers who do not offer coverage would be fined, and for the first time, most people would be required to obtain health coverage - either at work, or by purchasing it on their own - or pay a penalty.
All of this would be paid for in two ways: By reducing spending on Medicare by hundreds of billions, and by imposing a set of new taxes, including a 40% levy on certain high-priced insurance policies.
But while the bill is headed toward becoming law, the fighting over it isn't going away anytime soon. Republicans have already issued notice that they plan to campaign in this fall's midterm elections on a pledge to repeal it. There will be constitutional challenges. And in dozens of states, legislatures are considering measures that would attempt to exempt their citizens from some of its provisions, including the requirement that individuals purchase insurance.





Congradulations to all the American-Iranians here.:mexi-wave::mexi-wave::mexi-wave::mexi-wave::cheers::cheers::cheers::westi::westi::westi::westi::aylar::aylar::hug::hug::dance3::dance3::dance3::dance3::dance3::dance3:
 

tajrish

Elite Member
Oct 18, 2002
3,037
197
57
San Diego, California
#2
The consequences of this bill is to be seen. some elements in the new reform are clearly progressive and humane, yet there are several passages in the bill that could potentially be disastrous for the economy and the businesses.

I am a liberal so I welcome the idea of the universal healthcare, but the way this thing is pieced together have me definitely worried for the future. Let's give it some time and see how the whole thing will unfold.
 
Oct 18, 2002
8,727
0
#5
hehe, actually this makes sense now Americans can eat as much as they like and if they get sick uncle sam pays. hehe
 

The Matrix

Bench Warmer
Jul 25, 2007
2,332
0
#6
The consequences of this bill is to be seen. some elements in the new reform are clearly progressive and humane, yet there are several passages in the bill that could potentially be disastrous for the economy and the businesses.

I am a liberal so I welcome the idea of the universal healthcare, but the way this thing is pieced together have me definitely worried for the future. Let's give it some time and see how the whole thing will unfold.
dont be negative, hopefully it will turn out fine :).
 
Oct 16, 2002
39,533
1,513
DarvAze DoolAb
www.iransportspress.com
#7
Regardless of the positives of government sponsored health-care, one unavoidable consequence is the dumbing down of the heath-care workers including doctors and nurses.

I witness the incompetence and the lack of motivation of Canadian doctors quite often. They simply don't care, because their institution or hospital doesn't care because the money is coming in no matter what they do.
 

Khorus

National Team Player
Oct 25, 2002
5,193
0
CA
#9
It is difficult to tell what will happen, and probably not a lot immediately. I haven't read enough about it to know all the detail, but a few significant items will not even take effect until 2014. Here is a brief summary in plain english that I found:

  • Six months after enactment, insurance companies could no longer denying children coverage based on a preexisting condition.
  • Starting in 2014, insurance companies cannot deny coverage to anyone with preexisting conditions.
  • Insurance companies must allow children to stay on their parent's insurance plans through age 26.
  • In 2014, everyone must purchase health insurance or face a $695 annual fine. There are some exceptions for low-income people.
  • The uninsured and self-employed would be able to purchase insurance through state-based exchanges with subsidies available to individuals and families with income between the 133 percent and 400 percent of poverty level.
  • Separate exchanges would be created for small businesses to purchase coverage -- effective 2014.
  • Funding available to states to establish exchanges within one year of enactment and until January 1, 2015.
What is missing is the gov't organization that was to oversea the insurance companies rate increases, which was one of the critical components to me.

There is also no provision for governing the prices the drug companies can charge, so they actually stand to benefit from this bill because more people will be insured, so more drugs will be purchased, and gov't foots the bill without having a say about drug prices.

They have also excluded illegal immigrants from being eligible for Medicaid, or even from buying insurance thorugh government exchanges. I am not sure how I feel about this one from a personal stand point, but it must have been a concession made to the republicans, although I don't think a single republican voted for this bill, so I don't know.

Somewhat significant in terms of paying for the cost of providing health care to more people are the following items, so it seems the wealthy will be subsidizing some of the cost. But they are also cutting $500 billion from medicare, so the elderly will have to pay a little more too.

  • Medicare Payroll tax on investment income -- Starting in 2012, the Medicare Payroll Tax will be expanded to include unearned income. That will be a 3.8 percent tax on investment income for families making more than $250,000 per year ($200,000 for individuals).
  • Excise Tax -- Beginning in 2018, insurance companies will pay a 40 percent excise tax on so-called "Cadillac" high-end insurance plans worth over $27,500 for families ($10,200 for individuals). Dental and vision plans are exempt and will not be counted in the total cost of a family's plan.
  • Tanning Tax -- 10 percent excise tax on indoor tanning services.
All in all, I think this is a step in the right direction, because for too long the insurance companies, and particularly the business men and bureaucrats with only money on their minds have been affecting people's health care, and it had to stop. It will take time as we find the holes or flaws in the current plan and iron out a few things, but I think with proper management, this is ultimately for the better (big if on the proper management). While I don't adhere to socialist concepts, I think healthcare is one where I would make an exception, and especially in the US where as I stated, the wrong people have been making health decisions for everybody.
 
Oct 18, 2002
6,139
0
Los Angeles, CA USA
#10
Regardless of the positives of government sponsored health-care, one unavoidable consequence is the dumbing down of the heath-care workers including doctors and nurses.

I witness the incompetence and the lack of motivation of Canadian doctors quite often. They simply don't care, because their institution or hospital doesn't care because the money is coming in no matter what they do.
Thats why you need a two tier system. People tend to ignore that most government run systems have two tiers that work well. Law has both government run attorneys (public defenders) and private attorneys. Education has both public schools and state colleges, while having private schools and private colleges. You can call the police, or if you have a lot of money hire private security. All these two tier systems work. A healthcare system with two tiers would both ensure everyone has baseline healthcare while top doctors and facilities still have motivation...
 

Khorus

National Team Player
Oct 25, 2002
5,193
0
CA
#11
Farbod, the 2 tier system has the distinct flaw of shifting quality in the direction of money, and with health it is something I would want to avoid. It is like Iran back in the 1970s. Anybody who had money would go to the best doctors, and those who didn't would get stuck with second rate doctors. A 2-tier health system can only work if there is enough regulation on or incentives for the doctors to ensure adequate health care for everybody.
 
Oct 18, 2002
6,139
0
Los Angeles, CA USA
#12
Farbod, the 2 tier system has the distinct flaw of shifting quality in the direction of money, and with health it is something I would want to avoid. It is like Iran back in the 1970s. Anybody who had money would go to the best doctors, and those who didn't would get stuck with second rate doctors. A 2-tier health system can only work if there is enough regulation on or incentives for the doctors to ensure adequate health care for everybody.
2nd rate doctors are better than no doctors. Plus if you keep only one tier, not only will all doctors lose the motivation to hone their craft, it will drive many people out of the industry.

2 Tiers (1 private and 1 public) mitigates the problems that either a single private tier or a single public tier has inherently. Its not perfect, but its BY FAR the best system. And yes, Khorus-jan, I am a big proponent of regulation.

The best system for anything is:

Regulatory Ceiling, Socialist Floor, and a strong capitalist center...
 

tajrish

Elite Member
Oct 18, 2002
3,037
197
57
San Diego, California
#13
can u plz elaborate on these passages? I have heard similar statement several times, but no example was given ...
There are few that are worth mentioning:

Firstly, the tort reform is not included and those states that had a cap on the the medical malpractice can no longer practice it. As you might know, many claim that frivolous lawsuits drive up health care costs and require doctors to practice “defensive medicine” that’s costly and wasteful. Proponents of the reform say that the cost of defensive medicine practices due to frivolous lawsuits are minimum and is not the main driver of the rising healthcare costs. That needs to be seen.

Secondly, we have just added 50 million uninsured to the system but failed to add additional doctors and medical staff to provide medical services to these people. Now, that is not going to be solved any time soon. Your average wait time to see a doctor will increase by 10 days, according to some estimates.

The third problem is that most opponents of the bill claim that the savings stipulated in this bill are fictitious and the actual health reform will cost the taxpayers a lot of money. Their argument is mainly the fact that addition of 15% more patients to a system financed by the Government will automatically mean higher taxes. That argument makes a lot of sense to me. I don't see how the Government will keep the insurance costs the same for those middle-income families. Obama's claimed savings on the medicare and medicaid don't make sense to me and most others.

These are some of my immediate concerns. There are some other issues such as the lack of focus on health rather than healthcare, which is completely omitted from this bill, that concerns me the most. Let's see how this thing will unfold. I am certainly hoping that my assumptions are wrong.
 
Oct 16, 2002
39,533
1,513
DarvAze DoolAb
www.iransportspress.com
#14
The Canadian situation is uglier than many would like to believe.

Here, I pay a hefty 42% income tax of which the government claims 30% is for health-care costs.

If I earned $100K/year, that would be $30,000/year for health-care costs. I don't have the option of opting out of this scam. I don't even have the option of paying the damn money but expect better health-care for additional money! I'm stuck with an incompetent, slow and downright dangerous group of health-care workers who couldn't give a fuck if I died in their emergency waiting room.

For $30,000/year, I could get top notch care in the poorest countries on Earth.

I realize my tax is covering the costs for some other unprivileged people as well, but I would only feel happy about that if I had the luxury of getting somewhat decent service myself.
 

Khorus

National Team Player
Oct 25, 2002
5,193
0
CA
#15
2nd rate doctors are better than no doctors. Plus if you keep only one tier, not only will all doctors lose the motivation to hone their craft, it will drive many people out of the industry.
I see what you mean, but people are still liable to go to better doctors, so they will still want to excell more based on volume and less on per procedure fees.

2 Tiers (1 private and 1 public) mitigates the problems that either a single private tier or a single public tier has inherently. Its not perfect, but its BY FAR the best system.
You might need to be more specific about what you mean here, although our current system is 2-tier anyway, if you consider medicaid one of the tiers. And the new bill will allow for government exchanges and subsidies which tentamounts to the same thing as your analogy of public defenders vs. private ones.

Bottom line, I think this can be successful, if the insurance companies can be held a little more accountable. Our problem currently is not the doctors, but the administrators in health insurance companies and the drug manufacturers. So, this bill is only the first step. We have a long way to go.

You added this later:

The best system for anything is:

Regulatory Ceiling, Socialist Floor, and a strong capitalist center...
...and I agree completely with your last statement.
 

ardy

Legionnaire
Nov 25, 2004
6,575
0
San Diego Armando Maradona, CA
#16
This is nothing but a very minor reform and as tajrish and others pointed out its economic consequences are remain to be seen.

Obama and Emanuel really fucked up in selling the idea of public-option to Americans. They just didn't advertise for it the right way as GOP countered them very well. But again a lot of people say if Emanuel wasn't the COS the whole thing would have died anyway. A very slim victory for the Obama administration.
 
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Kian Pars

Elite Member
Dec 9, 2005
2,558
362
#17
Congrats , Now Americans can attack fast food giants more than before and not worried about the hefty Medical bills . OOH finger lickin good ;)



Is this the way you think universal health care works? then we should see more fat people in europe than in US, because this kind of "health care for all" is existing there for decades now. I lived in Germany for years and I saw far less fat people than here in US.
 
Oct 18, 2002
6,139
0
Los Angeles, CA USA
#18
I see what you mean, but people are still liable to go to better doctors, so they will still want to excell more based on volume and less on per procedure fees.



You might need to be more specific about what you mean here, although our current system is 2-tier anyway, if you consider medicaid one of the tiers. And the new bill will allow for government exchanges and subsidies which tentamounts to the same thing as your analogy of public defenders vs. private ones.

Bottom line, I think this can be successful, if the insurance companies can be held a little more accountable. Our problem currently is not the doctors, but the administrators in health insurance companies and the drug manufacturers. So, this bill is only the first step. We have a long way to go.

You added this later:



...and I agree completely with your last statement.
I could go on for hours about this subject but let me basically summarize my views this way. I believe that capitalism is good when the goals of the industry match the desires of the consumers. The goal of insurers is to make as much money as possible by not paying for care. The market will not fix that. It will only make it worse for everyone, doctors included.

I have no problem with medicare and medicaid. Most doctors I talk to (except doctors that perform ONLY elective procedures) love these systems because they always get paid and the paperwork is easier than with insurance companies, hence less overhead and waste. Im all for expanding these to cover everyone, not just super poor or old people. I think that this bill went a long way in regulating insurance companies.

The only way to balance the motivations of capitalism and the general welfare of socialism is to balance the two and to create an integration of them. They are not mutually exclusive, and anyone who says so needs a kick in the balls. Ayn Rand can kiss my ass, she was a near sighted buffoon.
 
Oct 18, 2002
6,139
0
Los Angeles, CA USA
#19
From David Frum, Bush's speech writer:

No illusions please: This bill will not be repealed. Even if Republicans scored a 1994 style landslide in November, how many votes could we muster to re-open the “doughnut hole” and charge seniors more for prescription drugs? How many votes to re-allow insurers to rescind policies when they discover a pre-existing condition? How many votes to banish 25 year olds from their parents’ insurance coverage? And even if the votes were there – would President Obama sign such a repeal?
 

Khorus

National Team Player
Oct 25, 2002
5,193
0
CA
#20
I could go on for hours about this subject but let me basically summarize my views this way. I believe that capitalism is good when the goals of the industry match the desires of the consumers. The goal of insurers is to make as much money as possible by not paying for care. The market will not fix that. It will only make it worse for everyone, doctors included.

I have no problem with medicare and medicaid. Most doctors I talk to (except doctors that perform ONLY elective procedures) love these systems because they always get paid and the paperwork is easier than with insurance companies, hence less overhead and waste. Im all for expanding these to cover everyone, not just super poor or old people. I think that this bill went a long way in regulating insurance companies.

The only way to balance the motivations of capitalism and the general welfare of socialism is to balance the two and to create an integration of them. They are not mutually exclusive, and anyone who says so needs a kick in the balls. Ayn Rand can kiss my ass, she was a near sighted buffoon.
I guess my balls are safe then for now. :D