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Here’s How the House’s Health Care Reform Would Help You |
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With successful passage of a historic health care reform bill this weekend, experts are weighing in on the benefits that the bill would bring to working families.
Maggie Mahar, a longtime observer of health care policy, says the progress Congress has made on health care is “astounding” and the House bill would move millions of families to less expensive, more comprehensive health care coverage, protecting them from medical bankruptcy, lifetime coverage caps and other consequences of our current flawed system.
A study by MIT health care economist Jonathan Gruber suggests the changes in the House proposal will lower premiums by hundreds or even thousands of dollars for middle-class families who are looking to buy insurance.
This legislation includes numerous benefits for working families, immediately and in the long term, whether you have insurance now or not:
- It will end the national scandal of medical bankruptcy—the number one cause of personal bankruptcy—by eliminating lifetime caps on insurer payments and limiting annual out-of-pocket costs. Medical bankruptcies affect up to 4,000 families every day in the United States—and 78 percent of them are fully insured.
- It ends abusive insurance company practices, including the denial of coverage based on pre-existing conditions and “rescissions”—the practice of canceling coverage when patients file claims.
- It provides subsidies to help middle-class and lower-income families afford coverage.
- Through an exchange, it offers people a wide range of choices of insurance, including a public health insurance option that competes with private insurers.
- It narrows the “donut hole”—the gap in Medicare coverage for prescription drugs.
- It creates incentives to increase the number of doctors and boosts funding for community health centers.
- It allows young people to be covered by their parents’ insurance up to age 27.
- It creates a new fund to help employers give health coverage to early retirees.
- It provides for efficient, computerized medical records and other tools to streamline medical care and increase quality.
- It cuts costs to the federal government as well as to families, reducing the deficit by more than $100 billion over the next 10 years—thanks, in part, to the existence of a public health insurance option, which lowers costs across the system.
- Ad it’s fairly funded—through employer responsibility and a surtax on the very highest earners, not a tax on middle-class health benefits.
That’s a huge, historic win that will make a real difference in the lives of people of all ages. Here’s a two-page fact sheet that explains more.
Meanwhile:
- President Barack Obama praised the House members who showed courage in taking this critical vote.
- Health Care for America Now (HCAN) and other reform supporters are thanking representatives who voted “Yes.” You can thank your member of Congress here. They showed courage by fighting against insurance companies and for working families—and they need to hear from you to know that they did the right thing.
- And the Senate could begin debate on its own health care legislation next week.
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For a critical alternative view of what this “reform” will mean to working people:
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US House passes health care bill
Democrats agree to broad anti-abortion amendment
By Kate Randall
9 November 2009
The House of Representatives narrowly passed legislation on Saturday to overhaul the US health care system, with the inclusion of an amendment that imposes strict bans on the use of federal funds to finance abortion. The bill must be reconciled with legislation still being finalized in the Senate before it can be signed into law by President Barack Obama.
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The CBO also projects that the bill would lower the federal deficit by $104 billion by 2019. These savings would come mainly through deep cuts to federal programs, particularly to Medicare. The bill also includes a mandate that individuals and families obtain insurance or pay a penalty, guaranteeing that billions of dollars are funneled to the insurance companies in the form of new, cash-paying customers.
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The legislation passed the House in a 220 to 215 vote, only two votes more than needed for a majority, gaining the support of 219 Democrats and only one Republican. Thirty-nine Democrats voted against it.
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The amendment bars payment for abortions for woman who select the public option or who receive a government subsidy to purchase private insurance on the exchange. It would also ban abortions for coverage obtained with assistance from a state’s matching Medicaid funds. To the extent that private employers begin to dump workers into the public option, if it is ultimately established, the Stupak amendment would have the long-term effect of drastically reducing access to abortion for lower-income working-class women.
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Despite the ravings of the ultra-right Republicans, the healthcare restructuring bill is no more a “government takeover” of healthcare than the Wall Street bailout was a takeover of the financial system. The legislation will channel billions of dollars into the pockets of the giant insurers and pharmaceuticals, through a mandate requiring individuals and families to obtain insurance or face a penalty of up to 2.5 percent of income.
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The CBO estimates that the House bill would still leave 18 million people uninsured by 2019, including about 6 million undocumented immigrants. The Senate Finance Committee’s version of legislation, which Obama has broadly endorsed, would leave about 25 million without insurance, according to the CBO.
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(Read the full article by following the link below:)
http://www.wsws.org/articles/2009/nov2009/heal-n09.shtml
Is the House Health Care Bill Better than Nothing?
By Marcia Angell, M.D.
Senior Lecturer, Harvard Medical School
November 8, 2009
Well, the House health reform bill — known to Republicans as the Government Takeover — finally passed after one of Congress’s longer, less enlightening debates. Two stalwarts of the single-payer movement split their votes; John Conyers voted for it; Dennis Kucinich against. Kucinich was right.
Conservative rhetoric notwithstanding, the House bill is not a “government takeover.” I wish it were. Instead, it enshrines and subsidizes the “takeover” by the investor-owned insurance industry that occurred after the failure of the Clinton reform effort in 1994. To be sure, the bill has a few good provisions (expansion of Medicaid, for example), but they are marginal. It also provides for some regulation of the industry (no denial of coverage because of pre-existing conditions, for example), but since it doesn’t regulate premiums, the industry can respond to any regulation that threatens its profits by simply raising its rates. The bill also does very little to curb the perverse incentives that lead doctors to over-treat the well-insured. And quite apart from its content, the bill is so complicated and convoluted that it would take a staggering apparatus to administer it and try to enforce its regulations.
What does the insurance industry get out of it? Tens of millions of new customers, courtesy of the mandate and taxpayer subsidies. And not just any kind of customer, but the youngest, healthiest customers — those least likely to use their insurance. The bill permits insurers to charge twice as much for older people as for younger ones. So older under-65’s will be more likely to go without insurance, even if they have to pay fines. That’s OK with the industry, since these would be among their sickest customers. (Shouldn’t age be considered a pre-existing condition?) Insurers also won’t have to cover those younger people most likely to get sick, because they will tend to use the public option (which is not an “option” at all, but a program projected to cover only 6 million uninsured Americans). So instead of the public option providing competition for the insurance industry, as originally envisioned, it’s been turned into a dumping ground for a small number of people whom private insurers would rather not have to cover anyway.
If a similar bill emerges from the Senate and the reconciliation process, and is ultimately passed, what will happen? First, health costs will continue to skyrocket, even faster than they are now, as taxpayer dollars are pumped into the private sector. The response of payers — government and employers — will be to shrink benefits and increase deductibles and co-payments. Yes, more people will have insurance, but it will cover less and less, and be more expensive to use.
But, you say, the Congressional Budget Office has said the House bill will be a little better than budget-neutral over ten years. That may be, although the assumptions are arguable. Note, though, that the CBO is not concerned with total health costs, only with costs to the government. And it is particularly concerned with Medicare, the biggest contributor to federal deficits. The House bill would take money out of Medicare, and divert it to the private sector and, to some extent, to Medicaid. The remaining costs of the legislation would be paid for by taxes on the wealthy. But although the bill might pay for itself, it does nothing to solve the problem of runaway inflation in the system as a whole. It’s a shell game in which money is moved from one part of our fragmented system to another.
Here is my program for real reform:
Recommendation #1: Drop the Medicare eligibility age from 65 to 55. This should be an expansion of traditional Medicare, not a new program. Gradually, over several years, drop the age decade by decade, until everyone is covered by Medicare. Costs: Obviously, this would increase Medicare costs, but it would help decrease costs to the health system as a whole, because Medicare is so much more efficient (overhead of about 3% vs. 20% for private insurance). And it’s a better program, because it ensures that everyone has access to a uniform package of benefits.
Recommendation #2: Increase Medicare fees for primary care doctors and reduce them for procedure-oriented specialists. Specialists such as cardiologists and gastroenterologists are now excessively rewarded for doing tests and procedures, many of which, in the opinion of experts, are not medically indicated. Not surprisingly, we have too many specialists, and they perform too many tests and procedures. Costs: This would greatly reduce costs to Medicare, and the reform would almost certainly be adopted throughout the wider health system.
Recommendation #3: Medicare should monitor doctors’ practice patterns for evidence of excess, and gradually reduce fees of doctors who habitually order significantly more tests and procedures than the average for the specialty. Costs: Again, this would greatly reduce costs, and probably be widely adopted.
Recommendation #4: Provide generous subsidies to medical students entering primary care, with higher subsidies for those who practice in underserved areas of the country for at least two years. Costs: This initial, rather modest investment in ending our shortage of primary care doctors would have long-term benefits, in terms of both costs and quality of care.
Recommendation #5: Repeal the provision of the Medicare drug benefit that prohibits Medicare from negotiating with drug companies for lower prices. (The House bill calls for this.) That prohibition has been a bonanza for the pharmaceutical industry. For negotiations to be meaningful, there must be a list (formulary) of drugs deemed cost-effective. This is how the Veterans Affairs System obtains some of the lowest drug prices of any insurer in the country. Costs: If Medicare paid the same prices as the Veterans Affairs System, its expenditures on brand-name drugs would be a small fraction of what they are now.
Is the House bill better than nothing? I don’t think so. It simply throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges, and it augments the central role of the investor-owned insurance industry. The danger is that as costs continue to rise and coverage becomes less comprehensive, people will conclude that we’ve tried health reform and it didn’t work. But the real problem will be that we didn’t really try it. I would rather see us do nothing now, and have a better chance of trying again later and then doing it right.
Health care reform will also cut down on outsourching jobs to countries where labor costs are lower due to their health care.
It will also enable millions of seniors to retire, thus opening jobs for desperate unemployed younger families.
Texans are going to a statewide rally Saturday nov 14.
Gene Lantz. http://www.labordallas.org
And if our employers didn’t have to spend so much on HC,
we might see higher wages.
Great article. It will help us by getting people the care they deserve. And the care that people have been receiving in Ohio via the public option! http://cli.gs/23yYaM/
Sea Star : Had Medicare For All been on the table and given serious consideration passed as the final bill going to the White
House for signature, everyone would be covered for health care, we pay a small tax to cover us, and health care benefits would not be a negotiating issue, therefore you could negotiate for higher wages. Look at what happened with CWA, no contract for 8 years, now they come to an agreement with workers now having to pay more for their HC.