Debate: US Health Care Reform

[Netto Azure]

Well this Summer has shown another stool in the Domestic policy of the Obama Administration, my favorite topic: HealthCare reform

[FONT=&quot]The Current Status of United States Healthcare Reform [/FONT]
[FONT=&quot](July 27, 2009) [/FONT]​

US President Barack Obama says he wants to pass Healthcare reform by the end of 2009.​

[FONT=&quot]America's Affordable Health Choices Act of 2009 (H.R. 3200)[/FONT]
(Yes there's only 1 Act LOL)​

[FONT=&quot]Introduction [/FONT]
[FONT=&quot]"To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes." [/FONT]​

[FONT=&quot]Summary: [/FONT]
The summary of the bill includes the following elements, among others:

1. Establishes a mandate to purchase health insurance for most legal United States residents with an income above poverty level.
2. Prohibits pre-existing condition exclusions.
3. Prohibits premium variances, except for age, geographic area, or family (vs. individual) enrollment.
4. Prohibits cancellation of coverage except for evidence of fraud.
5. Limits annual out-of-pocket expenses to $5,000 for an individual and $10,000 for a family.
6. Outlines a public health insurance option to be established which would operate based on average private insurance pricing.
7. Establishes a Health Insurance Exchange (HIE) within a proposed Health Choices Administration, to provide individuals and employers access to health insurance coverage choices. The HIE would contract with various insurers to offer benefit plans at competitive prices, by establishing a risk-pooling mechanism. This will allow individuals and small companies to band together to bargain for lower rates.
8. Provides a tax credit for low-income individuals and families to help pay insurance premiums.
9. Requires employers with payroll costs over $250,000 that are using the HIE to provide health insurance.
10. Provides for a tax on individuals without health insurance and employers that do not provide the required health insurance.
11. Provides for a tax on individuals with adjusted gross income exceeding $350,000.
12. Reduces Medicare payments to hospitals with excessive re-admissions.
13. Establishes a Center for Comparative Effectiveness Research, which would analyze cost variances for similar treatments across the country.
14. Further expands Medicaid eligibility and scope of covered preventive services, for lower-income individuals and families.
15. Increases Medicaid payments to physicians for primary care.
16. Requires the Secretary of Health and Human Services (HHS) to develop quality measures for the delivery of health care services in the United States.
17. Establishes the Health Benefits Advisory Committee chaired by the Surgeon General.

[FONT=&quot]Ways of funding [/FONT][FONT=&quot]is currently being debated. [/FONT]


[FONT=&quot]Status:[/FONT]

[FONT=&quot]US House of Representatives [/FONT]
[FONT=&quot]Currently, the Healthcare reform effort has stalled in the House Energy and Commerce Committee chaired by Rep. Henry Waxman (D-CA), Vote on the bill might be voted on [/FONT][FONT=&quot]the US House floor before the August Congressional Recess if "Blue Dog House Democrats" agree on it's passage or US House Speaker Nancy Pelosi (D-CA) might [/FONT][FONT=&quot]bypass the deadlocked committee and bring the Bill into a House vote.[/FONT]

[FONT=&quot]Tri Committee: [/FONT]
[FONT=&quot]House Energy and Commerce[/FONT][FONT=&quot]: In consideration/Being Debated [/FONT]
[FONT=&quot]House Ways and Means[/FONT][FONT=&quot] : Bill revised/Passed (23 Yes – 18 No) [/FONT]
[FONT=&quot]House Education and Labor: [/FONT][FONT=&quot]Bill revised/Passed (26 Yes - 22 No) [/FONT]

[FONT=&quot]Referred Committees: [/FONT]
[FONT=&quot]House Oversight and Government Reform[/FONT][FONT=&quot]: In consideration/Being Debated [/FONT]
[FONT=&quot]House Budget[/FONT][FONT=&quot]: In consideration/Being debated [/FONT]

[FONT=&quot]US Senate:[/FONT]
[FONT=&quot]Currently, the Healthcare reform effort has stalled in the US Senate Finance Committee chaired by Sen. Max Baucus (D-MO). US Senate Majority Leader Harry Reid (D-[/FONT][FONT=&quot]NV) has said that the US Senate floor will not be able to vote on the bill before the August Congressional Recess. [/FONT]

[FONT=&quot]Senate Health, Education, Labor and Pensions (HELP) Committee: Bill revised/Passed (13 Yes – 10 No) [/FONT]
[FONT=&quot]Senate Finance Committee[/FONT][FONT=&quot]: In Consideration/Being Debated[/FONT]

Healthcare around the world​

United States - Private system
Private sector funded, with more than half from private sources. Private health insurance available through employer, government or private schemes.​

15.3% of population (45.7 million people) do not have health insurance.
Federal government is largest healthcare insurer - involved in two main schemes, Medicaid and Medicare, each covering about 13% of population.
Medicaid - joint funded federal-state programme for certain low income and needy groups - eg children, disabled.
Medicare - for people 65 years old and above and some younger disabled people and those with permanent kidney failure undergoing dialysis or transplant.
Most doctors are in private practice and paid through combination of charges, discounted fees paid by private health plans, public programmes, and direct patient fees.
In-patient care is provided in public and private hospitals. Hospitals are paid through a combination of charges, per admission, and capitation.​

UK - Universal, tax-funded system

Public sector funded by taxation and some national insurance contributions.

About 11% have private health insurance. Private GP services very small.
Healthcare free at point of delivery but charges for prescription drugs (except in Wales), ophthalmic services and dental services unless exempt.
Exemptions include children, elderly, and unemployed. About 85% of prescriptions are exempt.
Most walk-in care provided by GP practices but also some walk-in clinics and 24-hour NHS telephone helpline. Free ambulance service and access to accident and emergency. In patient care through GP referral and follow contractual arrangements between health authorities, Primary Care Trusts and the hospital.
Hospitals are semi-autonomous self-governing public trusts.

France - Social insurance system
All legal residents covered by public health insurance funded by compulsory social health insurance contributions from employers and employees with no option to opt out.
Most people have extra private insurance to cover areas that are not eligible for reimbursement by the public health insurance system and many make out of pocket payments to see a doctor.

Patients pay doctor's bills and are reimbursed by sickness insurance funds.
Government regulates contribution rates paid to sickness funds, sets global budgets and salaries for public hospitals.
In-patient care is provided in public and private hospitals (not-for-profit and for-profit). Doctors in public hospitals are salaried whilst those in private hospitals are paid on a fee-for-service basis. Some public hospital doctors are allowed to treat private patients in the hospital. A percentage of the private fee is payable to the hospital.
Most out-patient care is delivered by doctors, dentists and medical auxiliaries working in their own practices.

Singapore - Dual system
Dual system funded by private and public sectors. Public sector provides 80% of hospital care 20% primary care.

Financed by combination of taxes, employee medical benefits, compulsory savings in the form of Medisave, insurance and out-of-pocket payments.
Patients expected to pay part of their medical expenses and to pay more for higher level of service. Government subsidises basic healthcare.
Public sector health services cater for lower income groups who cannot afford private sector charges. In private hospitals and outpatient clinics, patients pay the amount charged by the hospitals and doctors on a fee-for-service basis.

_____________________________________​

Well for me there's a solution for this...Universal Single-Payer Publicly funded-Privately Administered HealthCare similar TO THE REST OF THE INDUSTRIAL WORLD. >.>​

What are the other options...keep everything private? The Obama Private-Public funded campaign plan? So opinions? Socialized Medicine/Harry and Louise arguments again?​

These videos just summarizes what I think. Seriously. =|
https://www.pbs.org/moyers/journal/05222009/watch.html
https://www.pbs.org/moyers/journal/05222009/watch2.html​

_______________________________________​

Update (August 21, 2009): As we do have a US Democratic Congressional Majority and Administration. I will have to draw the line with compromises by having a Medicare-based Public Insurance Option and having any State in the Union keep the right to opt-out of the Federal program in order to institute their own plans.

 

[Yamikarasu]

I'm all for universal health care. A little bit of socialism is a good thing. Really. As it stands, I think the US has some of the best health care in the world, but definitely not one of the better health care systems. Until everyone has insurance, the system is fundamentally flawed, and needs to be fixed.

One of the problems I have with health insurance corporations is that they do not exist to provide insurance, but rather to make money and continue existing. The only way we can change this is to either get rid of them entirely or give them strict rules to follow. I'm not sure how well the government is capable of doing this, but I think Obama is an alright guy and I don't think he's out to screw us over.

The US is the only wealthy, industrialized nation without universal health care. I think that should mean something in the current debate.

It's sad that people hear the word "socialism" and think "OH MY GOD COMMUNISTS!" :/

 

[.little monster]

I am all for a US Health Care reform. We have the most expensive health care system in the world. Millions of Americans have no health insurances. And about a million people die in America alone because they cant afford treatment they need. Health care is so expensive here, that prices will continue to rise and the U.S. will eventually bankrupt itself. Anyone who says it is bad, anyone who thinks what we have no are complete idiots, and everyone knows that. Except those said idiots anyways.

Also, anyone who goes "OMFG COMMUNIST" when hearing "socialism" is an idiot as well. :|

 

[Legobricks]

Require individuals to have health insurance.

The only thing I argue is that the insurance should be optional.

 

[.Seth]

"If you guys can't even run Cash for Clunkers, what in the hell makes you think you'll be able to run a federal healthcare plan?"
That just about sums up what I think on the subject.

 

[Esper]

In Consideration/Being Debated, Or: How HMOs Pay Elected Officials To Drag Their Feet And Keep Good Bills From Becoming Law.

I'd like to say I'd be happy to see any version of the health care bill pass, but I'm afraid American government is too business friendly for real universal health care. I wish it weren't so, but when it's a question of when effective universal health care will become available I'm not holding my breath.

 

[Camisado]

I'm not all that good with US politics (or my own, for that matter, and I'm a government employee), but as a UK resident with a "free" National Health Service, paid for by small deductions each month from my wages, I have to say, this sort of system works fantastically =< my godmother had life saving treatment to her heart on the NHS last year, and I've had free physiotherapy treatment for my bad back from which I've just been discharged. I couldn't have afforded a chiropractor. =(

I'm really baffled by a nation as strong as the US not having that sort of healthcare system. All our NHS hospitals and general practitioners are free for our use, as well as a good proportion of medication, and there is always the private healthcare option if you really want it it.

 

[Ivysaur]

I think the same way as Camisado- here, in Spain, we got an Universal Health Care system during a fascist dictatorship, and it's as fine as ever, so I seriously can't understand how the most developed Western country still has millions of people dying each year because they just can't afford going to the doctor's.

I'm afraid that the system that will be set up will be a cheap version forced by Insurance Companies and the Republicans in an attempt to damage Obama's image, but even the cheapest Universal health Care system will be an absolute improvement from what they have right now. Seriously, 40 million people have to pay to go to the hospital? Spain pays free health care for just as many people- and we spend about 9 times less than the US in oursystem. And there are little complaints, as far as I know.

 

[Cherrim]

Cue another non-American coming in to express disbelief at the fact that the US can even function without "proper" health care.

Canada's yet another with a socialized health care system. I honestly just can't imagine it any other way. It is SO nice to be able to walk right into a medi clinic over something small like a cold. I don't have to worry about insurance, or wait only until I "need" care. I just can't even fathom that some people can't seek treatment because they can't afford it... or I can't imagine that someone could be sick, know it, and not be able to go to the hospital for fear of being bankrupt afterwards. (Hospital stays are expensive. D:)

The only argument against social health care that I can even begin to entertain is the wait times. I know Canadian wait times for some things like scans, diagnostics or even surgeries can be pretty icky, depending what you need. No one I know personally has ever had an issue with this, though. The longest I've waited for a test was... a month, maybe? Not too long in the grand scheme of things, definitely. Otherwise I've never had problems.

I'm definitely one of the people who makes good use of the health care system. There's almost always something wrong with me, haha. If it weren't for our universal health care, my family would probably be pretty broke. Either that or I would definitely have not been able to afford most (any?) of the treatments I've had in the past. I guess maybe I'd have insurance but I assume that only goes so far? Honestly, I'm not entirely sure how insurance works down there--here, my parents' medical coverage from work usually just goes towards prescriptions and the like because the basics are all covered from the start.

 

[TRIFORCE89]

The only argument against social health care that I can even begin to entertain is the wait times. I know Canadian wait times for some things like scans, diagnostics or even surgeries can be pretty icky, depending what you need. No one I know personally has ever had an issue with this, though. The longest I've waited for a test was... a month, maybe? Not too long in the grand scheme of things, definitely. Otherwise I've never had problems.

I haven't had to experience it, but I don't mind the waits too much either. I look at like this...

In the States there aren't wait times because so few people can afford the procedures and tests they need. Here, everyone has the opportunity. So, naturally there'd be a bit of wait. It's not like say...if your arm got cut off you're going to be waiting six months or something (which the American media keeps implying). They get to you sort of in order of need. That would be a big one. Years ago my brother split his face open. It's not like we showed up at the hospital and they said "come back later". XD They worked on him right away.

I think another part of our wait problem is that we're short on doctors. My uncle's brother is a doctor. While hiring everywhere, the most openings are in the more northern and rural areas. Nobody wants to work there lol We also don't pay as much as they do in the US (which has nothing to do with our health care system. You get paid a lot more in America for everything. If my dad held the same position in the States that he has now, I'd be typing this from a yacht). As a result they end up working in the states. I believe my relative is now in New England.

I've been seeing American commercials recently saying stuff like "Do you want the government running your health care system?" Well, you know what? They don't run it here in Canada. All the doctors run their own private practices just like in America. The difference is just how we pay them. There are also some things that you still need insurance for (not everything is covered. Unnecessary cosmetic surgery say. I've had some vaccinations before they made it under the plan. Meds).

As long as there's a profit in keeping you sick and having you pay for unnecessary medication, surgery, and tests you're going to stay a sick nation.

 

[Cherrim]

In the States there aren't wait times because so few people can afford the procedures and tests they need. Here, everyone has the opportunity. So, naturally there'd be a bit of wait. It's not like say...if your arm got cut off you're going to be waiting six months or something (which the American media keeps implying). They get to you sort of in order of need. That would be a big one. Years ago my brother split his face open. It's not like we showed up at the hospital and they said "come back later". XD They worked on him right away.

Well, emergency rooms in Canada use the same triage system as everywhere else. (Or at least, a triage system.) For emergencies and dire medical needs, of course those who really need treatment are fast-tracked. It's the same thing in the states. Even if you're paying money and you end up in the emergency room, if you go in bleeding to death from a gaping wound, they're gonna treat you before the person who came in complaining about a stomach ache in the middle of the night. 8|;;

It's mostly just basic tests or diagnostics that can take a while. Like iirc if you book an MRI it may very well not happen the same-month. Specialist appointments are another one... even once you get a referral, it can take a few months to get in with an appointment to a pain clinic or rehab centre, depending what it's for. :( Frustrating, definitely, but not life-threatening.

 

[TRIFORCE89]

Well, emergency rooms in Canada use the same triage system as everywhere else. (Or at least, a triage system.) For emergencies and dire medical needs, of course those who really need treatment are fast-tracked. It's the same thing in the states. Even if you're paying money and you end up in the emergency room, if you go in bleeding to death from a gaping wound, they're gonna treat you before the person who came in complaining about a stomach ache in the middle of the night. 8|;;

It's mostly just basic tests or diagnostics that can take a while. Like iirc if you book an MRI it may very well not happen the same-month. Specialist appointments are another one... even once you get a referral, it can take a few months to get in with an appointment to a pain clinic or rehab centre, depending what it's for. :( Frustrating, definitely, but not life-threatening.

I know. I was commenting more on advertisements I've been seeing and the annoying talking heads on TV. I swear I've seen them talk random "Canadians" (supposedly) who say they had to go to the States because if they waited a week for their life-altering surgery they would have died. @___@

 

[Netto Azure]

"If you guys can't even run Cash for Clunkers, what in the hell makes you think you'll be able to run a federal healthcare plan?"
That just about sums up what I think on the subject.

Now where did that come from?

Cash for Clunkers has been hailed as one of the great successes of the stimulus (More appropriately, stabilization) package.

People flocked to exchange their cars. @~@

(But meh, the fuel standards for the rebates were a bit low IMO, but meh.)

In Consideration/Being Debated, Or: How HMOs Pay Elected Officials To Drag Their Feet And Keep Good Bills From Becoming Law.

I'd like to say I'd be happy to see any version of the health care bill pass, but I'm afraid American government is too business friendly for real universal health care. I wish it weren't so, but when it's a question of when effective universal health care will become available I'm not holding my breath.

Ok, Healthcare, this mostly boils down to people being all anti-government and such, as for the Insurance HMO thing. DEAR GAWD GET READY FOR THE AUGUST "FLOOD THE AIRWAVES" WITH PICTURES OF PEOPLE PILING UP DEAD ON THE STREETS OF CANADA TO AUSTRALIA. @~@

I'm exaggerating, but that's the feel that you get from the stuff that comes out of the critics.

And I truly agree, this coverage bill has been contorted and compromised so much that the costs GO UP instead of DOWN. TT^TT

But meh, I'll take anything by this point....

 

[.Seth]

Now where did that come from?

Cash for Clunkers has been hailed as one of the great successes of the stimulus (More appropriately, stabilization) package.

People flocked to exchange their cars. @~@

(But meh, the fuel standards for the rebates were a bit low IMO, but meh.)

Well, they said it was going to last several months, but it only lasted like two weeks, and it might only run for another week.
They're OUT of money for it already.

Basically, what I mean by that, is that they can't estimate very well, and that is not good in a healthcare budget especially, which could lead to more and more unnecessary spending and money being "lost" somewhere, and could eventually drive the US bankrupt before everything recovers.
It's like my mom said:
"I think that healthcare could use a little reform, but not this much."

 

[Netto Azure]

Well, they said it was going to last several months, but it only lasted like two weeks, and it might only run for another week.
They're OUT of money for it already.

Basically, what I mean by that, is that they can't estimate very well, and that is not good in a healthcare budget especially, which could lead to more and more unnecessary spending and money being "lost" somewhere, and could eventually drive the US bankrupt before everything recovers.
It's like my mom said:
"I think that healthcare could use a little reform, but not this much."

Sorry for the off topicness. XD
(I would make another thread, but I don't want to be called as someone flooding OC with political debates ;~; )

Well, ever since when did tax-rebates become bad to our capitalist system? They ran out of money because NOBODY really expected people to actually take advantage of the program as much, seriously, it's more of a win-win really. The government got money out to support the auto-industry, we're saving gas and help the environment.

As for your Mom's comment, you do know that under the current system, insurance companies and employers can arbitrarily cancel your policy or jack up your rates so high that you cant pay it to "Hold down costs" or more appropriately "jack up the profits."

And the thing is, costs are spiraling out of control as we have a quantity and reactive based system than a preventive one.

 

[.little monster]

Well, emergency rooms in Canada use the same triage system as everywhere else. (Or at least, a triage system.) For emergencies and dire medical needs, of course those who really need treatment are fast-tracked. It's the same thing in the states. Even if you're paying money and you end up in the emergency room, if you go in bleeding to death from a gaping wound, they're gonna treat you before the person who came in complaining about a stomach ache in the middle of the night. 8|;;

It's mostly just basic tests or diagnostics that can take a while. Like iirc if you book an MRI it may very well not happen the same-month. Specialist appointments are another one... even once you get a referral, it can take a few months to get in with an appointment to a pain clinic or rehab centre, depending what it's for. :( Frustrating, definitely, but not life-threatening.

I thought I would just say this:

I broke my arm so badly that I needed 3 surgeries on it to fix it (ironically my mom filed for bankruptcy 3 months later.) Three people came in after me, while I was waiting. Each with minor things..fevers, flu, things like that. They all went before me, because they had insurance. :/

 

[Aurafire]

Ugh, I don't have the patience to write a huge response, so I'll just keep it short.

Contrary to popular belief, most Americans actually like the health insurance they have now and don't want the government in control of healthcare. They also don't like the trillion dollar plus price tag that comes with it, which will send us only deeper into debt. Seriously, we've already spent a trillion dollars on a stimulus package that really didn't stimulate anything, and now we want to spend even MORE money? If Obama thinks he can pay for all this spending without raising taxes on middle-class America, then he is sorely mistaken. (By the way? He already broke his promise of not raising taxes on anyone making less than $250,000 by adding a new $33 billion dollar cigarette tax, and the carbon cap-and-trade bill raises the taxes of all Americans)

So comments like "Well we have universal healthcare, why doesn't America?" and "Omg, how does America survive without universal healthcare!" are essetially short-sighted and ignore the fact that the majority of Americans simply do not want this to happen. The polls don't lie, and they show that Obama is quickly losing support. I'll say it again, Americans want healthcare reform. What they don't want is a pitifully put together and hastily rushed 1,000 page nightmare of government madness being slammed through Congress as fast as possible without their opinions being heard.

If Obama would just slow it the hell down and allow for a somewhat bi-partisan bill with compromise and debate, this whole debacle would be going much more smoothly.

 

[lx_theo]

Where do you get this info that most Americans don't want health care reform?

 

[Aurafire]

Where do you get this info that most Americans don't want health care reform?

https://online.wsj.com/article/SB10001424052970204313604574330442429438938.html

All the major polling data, not just the Rasmussen Repots, indicate that there is more opposition for Obama's plan then there is support.

 

[Netto Azure]

https://online.wsj.com/article/SB10001424052970204313604574330442429438938.html

All the major polling data, not just the Rasmussen Repots, indicate that there is more opposition for Obama's plan then there is support.

And yet that poll essentially shows a partisan split on the issue. ;D

And how are supposed to have an intelligent debate when we have the other side muzzled by the mainstream media, and all of these tea-baggers and birthers disrupting debates? XD

https://www.msnbc.msn.com/id/21134540/vp/32323732#32323732

Seriously, we need to hear all sides, not just the "Centrists and right-wingers"

https://www.pbs.org/moyers/journal/05222009/watch.html
https://www.pbs.org/moyers/journal/05222009/watch2.html

White House advises Democrats on protests

Protesters gather in front of a clinic in Denver, Colo., on Thursday where House Speaker Nancy Pelosi spoke about health care.​

WASHINGTON - Top White House officials counseled Democratic senators Thursday on coping with disruptions at public events on health care this summer, officials said, and promised the party and allies would respond with twice the force if any individual lawmaker is criticized in television advertising. These officials also told skittish senators that fresh polling suggests an emphasis on issues such as barring insurers from denying coverage on the basis of pre-existing medical conditions is a political winner, able to increase support among independents, women, seniors and rural voters.
The officials spoke on condition of anonymity, saying they were not authorized to discuss details of the closed-door session that took place hours before lawmakers headed to their home states for a monthlong vacation.

'Destructive efforts'
Pushing back, Democrats have accused Republicans of sanctioning mob tactics, and Senate Majority Leader Harry Reid D-Nev., accused protesters of trying to sabotage the democratic process.

The Republican Party says it's not behind the protests, but Reid scoffed at the notion that the protesters reflect grass-roots sentiment. He held up a piece of artificial turf during a session with reporters.
"These are nothing more than destructive efforts to interrupt a debate that we should have, and are having," Reid said Thursday. "They are doing this because they don't have any better ideas. They have no interest in letting the negotiators, even though few in number, negotiate. It's really simple: they're taking their cues from talk show hosts, Internet rumor-mongerers ... and insurance rackets."

Republicans answered back.

"All the polls show there is serious concern, if not outright opposition, to the president's health care plan," said Antonia Ferrier, spokeswoman for House Republican Leader John Boehner of Ohio. "Democrats are ginning up this cynical shell game."

Also Thursday, the AFL-CIO announced plans to mobilize labor activists to attend town hall meetings in 50 congressional districts this month to counter the conservative protesters.White House aides David Axelrod and Jim Messina traveled to the Capitol for their presentation to Democratic senators. Senators saw videos of disruptions at events held by House members, and were told to organize their events more carefully as well as work with labor unions and other friendly groups to generate enthusiasm.

Oh dear goodness, has this turned into mob rule? @~@
​