Nan wrote:
The bill that was just passed will not impose mandatory insurance on low income people, but will make it available to them via government subsidies or at no charge, depending on their income. Once people pass a certain earnings income limit, they will have to pay a penalty tax of (the last I heard) about $650 per year if they do not obtain coverage - to help pay everyone back for any care they might use as an uninsured patient at some point. If they don't earn enough, there is no penalty for turning down coverage ( the last I'd read). But, basically, if you are poor, you will have access to medical care as the provider will be able to bill Medicaid/another program for it. As written, nobody will be denied care because they cannot afford care.
I would guess that people who do not live in the USA and are not familiar with the existing system most likely do not realize what a huge, huge step forward this is. This ranks up there with the creation of the old age/social security system.
There is not a comprehensive government program out there before or after the passage of the legislation. There are some federal programs (medicare, primarily) run directly by the feds and they are primarily for the elderly and completely/severely disabled. Each state runs their own low-income programs, which are funded federally but controlled/designed/administered at the state level (Medicaid). It's been, in the past, difficult to find a provider who will accept Medicaid, as the reimbursement rates are so low. When my daughter was an infant I phoned every doctor's office in the phone book (I lived in San Diego, CA) and none would accept a new Medicaid patient - she was quite ill. We ended up using the emergency room at the county hospital on a regular basis because that was the only option available. The bills were staggering. Thankfully, Medicaid covered them. But not all the medications she needed - we went without about half of them. I sold my blood plasma monthly to get her one of those not covered.
The new law, when signed, is designed to create pools of health insurance programs set up primarily by the private sector that, hypothetically, will offer the option to select from a number of again hypothetically affordable plans. A family of four with an income of around $88,000 a year would have enough tax breaks that they would be able to purchase insurance and have the tax breaks cover the cost completely.
If you already have insurance, you may be eligible for the same tax breaks to help pay for it, depending on your income levels.
Pre-existing conditions will no longer be grounds for being denied insurance. Denial of coverage, or discrimination in pricing of coverage, will be illegal.
Lifetime caps on how much your care the insurer will pay will be illegal. That is, you can't get halfway through a cancer treatment and be shown the door because your insurance just ran out. No, it happens every freaking day.
Starting in about 6 months (I believe they think it will take that long) children who are no longer in college (or who never went) will be able to be continued on a parent's policy until either 26 or 27 (I did not see the final language). This would be only if they are not eligible for any insurance through their work (if they were working).
An emergency high risk pool will be set up for people who are in immediate need and who cannot obtain coverage elsewhere, while the rest of the provisions are phased in over a multi-year period.
If you are under 30 and consider yourself extraordinarily lucky, you will be allowed to buy "catastrophic coverage only" policies at a lower cost.
Currently, elderly people on social security income get their medicines paid for up until between the government subsidy and any co-pays granny has to make the total comes up to a couple of thousand dollars. Then the government drops them like a hot rock for the next several thousand dollars of medicines, and THEN it picks them back up (if they're still alive) and buys their meds for them again. This legislation will plug that problem - they call it filling "the donut hole"...
My daughter aged off my policy this year, and is COBRA'ing insurance at about $600 a month. Had this law not been passed, once the COBRA period was over she would have been uninsurable. She has several ongoing conditions that will never go away. Had she not been able to pay the premiums and co-payments and dropped COBRA, she would not have been subsequently eligible for the rather minimal "catastrophic" insurance program that my state runs (it has a very low annual maximum benefit and lifetime benefit). She is doing temp work, so we never know how long she'll be in a particular job or when the next one will come
Hospitals in the past have had to write off bad debt caused by treating people without insurance - more often they padded the cost onto the backs of paying customers (regardless of who paid). My premium costs have doubled in the last several years, with cutbacks in services covered. There have been horror stories of people who have lost everything they've owned. And more horror stories of people who died from lack of ongoing care.
Hopefully, in a bit, that will be horror stories from the bad old days.
To the OP - many jobs do not have "benefits" - that is, they do not supply medical insurance of any variety. Some offer some coverage, but only of a very minimal variety. If you have a pre-existing condition, you had to pray you got a job with good benefits and you had to do anything it took to keep that job - regardless of how awful it was. It's a terrible sword to have hanging over your head every day. If you got laid off, if you got fired.... it can/could all fall apart and you could get to watch the people you love die. Even when there were treatments available, because you couldn't pay for them.
And they say we are not/were not a third world country? By what standard..... Maybe finally not on Tuesday, when Obama signs the bill into law.
I hate the damned insurance companies just as much as the next guy. Their greed is augmented by government regulation that prevents newcomers from providing meaningful competition. It is the government mandates, regulation, taxation, corporate greed that has brought us to the point we are at now. Government mandates at all levels impede about 90% of all would be (and qualified) providers from being able to provide medical care. An army medic who routinely saves lives on the battle filed is considered a hero. The same person who provides medical care inside the United States outside of the military is considered a felon. Local hospitals (at least in the states that I know of) are not allowed to be opened because doctors and nurses see a need. They are only allowed to be open if the state government agency decides if there is a need. That means that hospitals providing relatively poor care at an expensive rate will see no competition in the area due to the hospital / population ratio.
Any time the government (at least here in the Police States of America) enters any industry, the result is reduced quality, fewer services, and higher costs When the government has entered the college education system, costs went up. When states started mandating college degrees for certain professions, the college costs went up in that area of professional studies, and the costs of using services from the (college mandated_ profession skyrocketed. A prime example of how the government has driven up costs is the automotive insurance industry. Before automobile insurance was mandatory, the costs of obatining it was pretty low. When it became mandatory, the costs almost doubled. When the states implemented a program where companies notified the state governments when policies were dropped, the costs increased tremendously again. Young people are especially soaked by the insurance companies (regardless of driving record). Now, in addition to having to pay exorbitant rates of insurance in order to drive to work, they will be soaked again for mandatory health insurance. Whenever governments mandate purchases, they create little fiefdoms where a few players get rich off the backs of the working population. Mandatory health insurance is no exception.
I recently was admitted to the emergency room for a spike in blood pressure. I received a 50 cent pill and was charged over $800 for the visit. There were no tests done other than being hooked up to a blood pressure monitor. The medical assistant who took me to the hospital told me what kind of blood pressure medication that I would likely be given. Since she didn't have a degree in medicine, she was not able to write a prescription. Instead of driving directly to the pharmacy and getting what I needed, I had to spend over $800 for a doctor's signature. The local hospital was the only game in town. After a couple of days, the same medical assistant called around town to try to find a primary care physician for me. None would take self pay patients.
What the government of the Police States of America passed last night is NOT universal health care. It is only an insurance mandate. The bad thing about the federal government imposing mandatory health insurance is the fact that it has no constitution authority to do so. The constitution is a contract that gives the federal government its authority to govern provided that it heeds certain limitations and protects certain right of the people. The health insurance mandates violates both the limits imposed by the constitution as well as the rights of the people. If the government wants mandatory insurance, the proper way of implementing it is to first go through the process of amending the constitution before passing a "law" that mandates the insurance.
I volunteer at a center that provides education and therapy services to people with autism. The center just relocated. In the center, we installed smoke and fire detectors to provide notification in case of fire. Our costs for doing this was about $168. The fire marshal came in and inspected the place. He said that the fire detection system we had is not good enough even though this is the system that guards people while they sleep. His mandate was a fire alarm system that not only costs over $5000, but one that would paralyze autistic clients with over stimulation. I am autistic myself, and when this thing goes off the only thing I can do is try to get away from the sound and the lights. Not only did this government mandated system cost us $5000 that we didn't have, it also puts us in danger if there is an actual fire. We had to raise money and go into debt to buy something that was not only not needed but also poses a danger to our clients. This health insurance mandate will do much the same thing.
What is the solution to providing health care at a reasonable cost? The answer is simple; it is freedom. There should be freedom for providers to set up shop. There should be freedom for newcomers to enter the payment, finance, and insurance industry, and there should be freedom for patients to decide upon their own treatments. If I had this freedom, I could have purchased a $15 bottle of medicine without spending the $800 in order to obtain the government mandated prescription. If we have to have socialized medicine, then the single payer (government financed) system is the least evil of choices.
_________________
I am AUTISTIC - Always Unique, Totally Interesting, Straight Talking, Intelligently Conversational.
I am also the author of "Tech Tactics Money Saving Secrets" and "Tech Tactics Publishing and Production Secrets."
21 Mar 2010, 10:50 pm
