HCR Passes

[BarTopDancer]

Originally Posted by scaeagles

Because that's not all it is. If those was the sum total of the bill I doubt there would be nearly as much controversy. It's easy to go in and pick out a list of stuff from a 2700 page bill.

Please pick some stuff you are opposed to and post it for discussion. I'm still curious what in the bill you are opposed to. I know you said up thread you weren't well versed in it, yet you are opposed to it. There must be a reason beyond principal.

[Alex]

Just some thoughts on the Huffington Post 14 items.

Health Insurers cannot deny children health insurance because of pre-existing conditions. A ban on the discrimination in adults will take effect in 2014. - I'm fine with this so long as there is a universal individual mandate with teeth. Don't give any time to anyone who says they support eliminating pre-existing decision eliminations but not mandated coverage. Unfortunately the individual mandate passed and soon to be weakened by the reconciliation bill is not "teeth" in my opinion and if it isn't strengthened could be the fatal flaw that puts the whole thing on the economy crashing track feared by the opposition.

Businesses with fewer than 50 employees will get tax credits covering up to 50% of employee premiums. Fine. Another source I saw said it was 35% of benefit for companies with 25 or fewer but wherever the number is it is somewhat arbitrary and within an order of magnitude of what seems reasonable.

Seniors will get a rebate to fill the so-called "donut hole" in Medicare drug coverage, which severely limits prescription medication coverage expenditures over $2,700. As of next year, 50 percent of the donut hole will be filled. The reconciliation bill will change this but I can't remember specifically how. This however, if doom happens, will be the second door through which it might come. We're mandating demand with only minimal tools for controlling costs in a political environment (an insurance company may be willing to make the unpopular decision to not cover an expensive drug of questionable value but your local congresscritter never will).

The cut-off age for young adults to continue to be covered by their parents' health insurance rises to the age 27. Don't really like this one, at least not without some "means testing" attached. This really does feel like infantilization to me. I understand the idea behind it, but I still don't like it.

Lifetime caps on the amount of insurance an individual can have will be banned. Annual caps will be limited, and banned in 2014. - Fine, but this really will mean "rationing" though not necessarily any different than the rationing now but now it can be blamed on people we vote for which is a much stronger incentive to push off the bad news until it destroys the system. All the sooner if the mandate isn't given some bite.

A temporary high-risk pool will be set up to cover adults with pre-existing conditions. Health care exchanges will eliminate the program in 2014. Fine.

New plans must cover checkups and other preventative care without co-pays. All plans will be affected by 2018. - Fine, but I really need to track down the exact language on this. Once there is a way for something to be completely "free" then the lobbying will begin to get everything defined as preventative care. Chemotherapy for lung cancer will be preventative because it can prevent the need for radiation therapy or something. Manipulable labels are a dangerous thing.

Insurance companies can no longer cut someone when he or she gets sick. - Very good and one of the few major pieces that could have been done as a standalone without the mandate.

Insurers must now reveal how much money is spent on overhead. Irrelevant so long as they are meeting the requirements established for participation in the exchanges. But not a huge deal depending on how the terms are defined. It'll just become the next accounting game on how to redefine things so as to minimize overhead.

Any new plan must now implement an appeals process for coverage determinations and claims. Fine.

This tax will impose a ten percent tax on indoor tanning services. This tax, which replaced the proposed tax on cosmetic surgery, would be effective for services on or after July 1, 2010. - Stupid and reeks of scope creep. Also a foreboding sign of how they'll justify taxing anything just by attaching any kind of "health" consequence to it.

New screening procedures will be implemented to help eliminate health insurance fraud and waste. - Fine in itself. However, overall a relatively unimportant element and also a chimera. If fraud were easy to squeeze from the system it would have been done already.

Medicare payment protections will be extended to small rural hospitals and other health care facilities that have a small number of Medicare patients. No opinion.

Non-profit Blue Cross organizations will be required to maintain a medical loss ratio -- money spent on procedures over money incoming -- of 85 percent or higher to take advantage of IRS tax benefits. Fine, but then I already think we're too liberal on granting tax benefits to non-profits.

Chain restaurants will be required to provide a "nutrient content disclosure statement" alongside their items. Expect to see calories listed both on in-store and drive-through menus of fast-food restaurants sometime soon. Stupid nannyism.

The bill establishes a temporary program for companies that provide early retiree health benefits for those ages 55‐64 in order to help reduce the often-expensive cost of that coverage. No strong opinion.

The Secretary of Health and Human Services will set up a new Web site to make it easy for Americans in any state to seek out affordable health insurance options The site will also include helpful information for small businesses. Meaningless feel good measure. If you feel this is an important element first please explain without doing any new research in what ways the current federal and state information provided on health insurance options is inadequate.

A two‐year temporary credit (up to a maximum of $1 billion) is in the bill to encourage investment in new therapies for the prevention and treatment of diseases. Nice, but meaningless from the point of view of health care reform.

[Ghoulish Delight]

This is obviously a biased, heavily edited video. However something tells me it did not take the producers of this video much effort to find material.

http://www.youtube.com/watch?v=pilG7...ayer_embedded#

[JWBear]

But GC... Don't you know that Huffington Post is Teh Liberal EVIL. They're just going to lie to get you to support it! They don't want you to know about the death panels and secret granny death squads. The government wants to take control of the country, and we can't allow that!! Who do they think they are? Who told the government they could run things?! And don't forget, they are coming to take away your guns and money and put you in a re-education camp!

[BarTopDancer]

Well I have no grandparents so obviously granny-death squad it doesn't effect me and I don't care.

I see one of those things will help a friend of mine who is against this. He owns a small business with less than 50 employees.

And I suspect that blogger has already been arrested by the Secret Service.

[innerSpaceman]

Yay, I'm glad my employers will get a tax credit for my coverage. That's the only benefit I will remotely see from this - and yet I STILL support on behalf of the people I have compassion for. And because I see nothing more socialist in it than, as has been pointed out, schools, roads, fire and police, national weather service and the list could go on and on.

I wish I could live long enough through good health to see some real reform, but I have no illusions that much more will be done in my lifetime.

And I don't know if this counts to break the record (imo, it does not), but it was pointed out to me that - as evidence Congress is hopeless broken - no major legislation has been passed in the last 40 years.

[Morrigoon]

There's one aspect of the bill that I know is intended to help people, but I don't think should have been put it - the no co-pays bit. Copays for many insurance plans are modest enough that they function less to reduce the insurance company's burden on that visit, than they do to discourage gratuitous visitation by overprotective parents and hypochondriacs.

A good compromise would have been setting limits on copays but still allowing them. A modest $10 or $20 copay would make office visits accessible to pretty much everyone but discourage people from visiting every time they get a headache.

I'd also like to see pharmacists empowered to do more. Perhaps release certain medications to a near-OTC situation where a pharmacist can clear a patient to receive it without having to wait for a doctor's visit. Medication for UTI and bladder infections, for example.

Oh a side note, it occurred to me to wonder about this: For those folks who have gotten a "prescription" for certain "herbal" remedies... would the prescription coverage now be required to cover people's access to pot? How odd would THAT be!

[BarTopDancer]

Originally Posted by Morrigoon

I'd also like to see pharmacists empowered to do more. Perhaps release certain medications to a near-OTC situation where a pharmacist can clear a patient to receive it without having to wait for a doctor's visit. Medication for UTI and bladder infections, for example.

Problem with this is it will lead people to self diagnose more than they already are. What if that UTI or bladder infection is really an STD. Instead of being treated for the STD they are treating for the bladder infection while the STD gets worse.

[Morrigoon]

Originally Posted by BarTopDancer

Problem with this is it will lead people to self diagnose more than they already are. What if that UTI or bladder infection is really an STD. Instead of being treated for the STD they are treating for the bladder infection while the STD gets worse.

But how often do people allow a bladder infection to worsen because they can't get to a doctor?

[BarTopDancer]

Originally Posted by Morrigoon

But how often do people allow a bladder infection to worsen because they can't get to a doctor?

Now they can.

I get what your original point was, and some things like allergy medication should be available OTC or nearly OTC. Things that require antibiotics or that have symptoms similar to something more serious should not. Antibiotics are already over-prescribed and should be more controlled (by doctors, not the government), not less (dispensed by a pharmacist after being given a random list of symptoms).

The over-prescribing of antibiotics is personal to me thanks to all the antibiotic resistant strains out there now. I am seriously allergic to anything that ends in 'cillin or is derived from a 'cillin antibiotic - as in if they were to administer penicillin they would have to do it in the hospital because the reaction would be life threatening. There isn't much I can take and if things become resistant to zythromax I'm pretty much SoL.