Obama's Health Care Overhaul: Your Opinions

[Jet]

Opening the thread starting with the following report. But please feel free to comment on anything regarding Obama's health care plan.


Nearly 4M to pay health insurance penalty by 2016

By STEPHEN OHLEMACHER – 58 mins ago

WASHINGTON – Nearly 4 million Americans — the vast majority of them middle class — will have to pay the new penalty for not getting health insurance when President Barack Obama's health care overhaul law kicks in, according to congressional estimates released Thursday.

The penalties will average a little more than $1,000 apiece in 2016, the Congressional Budget Office said in a report.

Most of the people paying the fine will be middle class. Obama pledged in 2008 not to raise taxes on individuals making less than $200,000 a year and couples making less than $250,000. Republicans have criticized the penalties, even though the idea for a mandate was originally proposed by the GOP in the 1990s and is part of the Massachusetts health care plan signed into law in 2006 by then Gov. Mitt Romney, a Republican. Attorneys general in more than a dozen states are working to challenge the mandate in federal court as unconstitutional.

"The individual mandate tax will fall hardest on Americans who can least afford to pay it, many of whom were promised subsidies by the Democrats and who the president has promised would not pay higher taxes," said Rep. Dave Camp of Michigan, the top Republican on the tax-writing House Ways and Means Committee.
Democrats argue the mandate and the penalties are a necessary part of a massive overhaul designed to expand coverage to millions who now lack it. They point out that getting young, healthy Americans in the insurance pool will reduce costs for others.

Americans who don't get qualified health insurance will be required to pay penalties starting in 2014, unless they are exempt because of low income, religious beliefs, or because they are members of American Indian tribes. The penalties will be fully phased in by 2016.

About 21 million nonelderly residents will be uninsured in 2016, according to projections by the CBO and the Joint Committee on Taxation. Most of those people will be exempt from the penalties.
Under the new law, the penalties will be phased in starting in 2014. By 2016, those who must get insurance but don't will be fined $695 or 2.5 percent of their household income, whichever is greater. After 2016, the penalties will be increased by annual cost-of-living adjustments. People will not be required to get coverage if the cheapest plan available costs more than 8 percent of their income.

The penalties will be collected by the Internal Revenue Service through tax returns. However, the IRS will not have the authority to bring criminal charges or file liens against those who don't pay.
About 3 million of those required to pay fines in 2016 will have incomes below $59,000 for individuals and $120,000 for families of four, according to the CBO projections. The other 900,000 people who must pay the fine will have higher incomes.

The government will collect about $4 billion a year in fines from 2017 through 2019, according to the report.

[MsDemeanor]

I don't feel that Obama's plan goes far enough or acts fast enough. Single payer is my preference. If we have to continue to feed the insurance cartel, there at least needs to be a Medicare For All buy-in option; this could easily be made available within the next year. And I fail to understand why so many of the policy changes aren't slated to take effect for months or years. Why is it so hard to say "starting May 1st, you cannot cancel or refuse someone for a pre-existing condition"? What about that requires months or years to enact? Oh, yeah, it's like credit card reform, where we had to give the banks lots of time to jack up rates, cancel folks, rewrite policies, and just all around fuck over as many people as possible.

As for the three million people who elect to pay the non-enforceable penalty instead of getting taxpayer-subsidized insurance? *shrug, whatever*

[Apocalipstic]

Yeah, I think we should have a single payer system. The healthcare changes fall WAY short of what I think they should be, but I understand the heavily charged political situation we are in.

I do think the media is trying to freak people out...as usual.

[key]

The penalties will be collected by the Internal Revenue Service through tax returns. However, the IRS will not have the authority to bring criminal charges or file liens against those who don't pay.

About 3 million of those required to pay fines in 2016 will have incomes below $59,000 for individuals and $120,000 for families of four, (key: many of these will qualify for MAJOR subsidizes, so why avoid having health care?) according to the CBO projections. The other 900,000 people who must pay the fine will have higher incomes.

If you want to know exactly what your premiums (and subsidizes would be, click below)

http://healthreform.kff.org/SubsidyCalculator.aspx

IF you want an easy to understand detailed explanation of the plan click here

http://healthreform.kff.org/

I agree much of the media is designed to keep people afraid very very afraid (especially of the big bad Government - heaven forbid that the people wake up to the fact the WE ARE the government).

[MsMerrick]

Single Payer, thats ta way to go. Create law, prohibiting Insurance Companies, being for Profit, go back to when they were non profit, thats another way to go, and actually my preference. I could live with all the rest of teh HC Bill,if that was done.d

[Apocalipstic]

Great point M! Health care should not be for profit. There should be no Health Care "Industry".

[Linus]

I personally would prefer, being Canadian and all, single payer for the necessity stuff (e.g., general physician, non-cosmetic surgery, accident, emergency, long term, etc). Anything beyond that: insurance.

[MsDemeanor]

Other than cosmetic surgery, what is not "necessity stuff"?

[Jet]

Report: Health overhaul will increase nation's tab

By RICARDO ALONSO-ZALDIVAR, Associated Press Writer – 23 mins ago


WASHINGTON – President Barack Obama's health care overhaul law will increase the nation's health care tab instead of bringing costs down, government economic forecasters concluded Thursday in a sobering assessment of the sweeping legislation.

A report by economic experts at the Health and Human Services Department said the health care remake will achieve Obama's aim of expanding health insurance — adding 34 million Americans to the coverage rolls.
But the analysis also found that the law falls short of the president's twin goal of controlling runaway costs, raising projected spending by about 1 percent over 10 years. That increase could get bigger, however, since the report also warned that Medicare cuts in the law may be unrealistic and unsustainable, forcing lawmakers to roll them back.

The mixed verdict for Obama's signature issue is the first comprehensive look by neutral experts. In particular, the warnings about Medicare could become a major political liability for Democratic lawmakers in the midterm elections. The report projected that Medicare cuts could drive about 15 percent of hospitals and other institutional providers into the red, "possibly jeopardizing access" to care for seniors.

The report from Medicare's Office of the Actuary carried a disclaimer saying it does not represent the official position of the Obama administration. White House officials have repeatedly complained that such analyses have been too pessimistic and lowball the law's potential to achieve savings.

The report acknowledged that some of the cost-control measures in the bill — Medicare cuts, a tax on high-cost insurance and a commission to seek ongoing Medicare savings — could help reduce the rate of cost increases beyond 2020. But it held out little hope for progress in the first decade.

"During 2010-2019, however, these effects would be outweighed by the increased costs associated with the expansions of health insurance coverage," wrote Richard S. Foster, Medicare's chief actuary. "Also, the longer-term viability of the Medicare ... reductions is doubtful." Foster's office is responsible for long-range costs estimates.

Republicans said the findings validate their concerns about Obama's 10-year, nearly $1 trillion plan to remake the nation's health care system.
"A trillion dollars gets spent, and it's no surprise — health care costs are going to go up," said Rep. Dave Camp, R-Mich., a leading Republican on health care issues. Camp added that he's concerned the Medicare cuts will undermine care for seniors.
In a statement, HHS Secretary Kathleen Sebelius sought to highlight some positive findings for seniors. For example, the report concluded that Medicare monthly premiums would be lower than otherwise expected, due to the spending reductions.

"The Affordable Care Act will improve the health care system for all Americans and we will continue our work to quickly and carefully implement the new law," the statement said. Passed by a divided Congress after a year of bitter partisan debate, the law would create new health insurance markets for individuals and small businesses. Starting in 2014, most Americans would be required to carry health insurance except in cases of financial hardship. Tax credits would help many middle-class households pay their premiums, while Medicaid would pick up more low-income people. Insurers would be required to accept all applicants, regardless of their health.

A separate Congressional Budget Office analysis, also released Thursday, estimated that 4 million households would be hit with tax penalties under the law for failing to get insurance.

The U.S. spends $2.5 trillion a year on health care, far more per person than any other developed nation, and for results that aren't clearly better when compared to more frugal countries. At the outset of the health care debate last year, Obama held out the hope that by bending the cost curve down, the U.S. could cover all its citizens for about what the nation would spend absent any reforms. The report found that the president's law missed the mark, although not by much. The overhaul will increase national health care spending by $311 billion from 2010-2019, or nine-tenths of 1 percent. To put that in perspective, total health care spending during the decade is estimated to surpass $35 trillion.

Administration officials argue the increase is a bargain price for guaranteeing coverage to 95 percent of Americans. They also point out that the law will decrease the federal deficit by $143 billion over the 10-year period, even if overall health care spending rises.

The report's most sober assessments concerned Medicare.
In addition to flagging the cuts to hospitals, nursing homes and other providers as potentially unsustainable, it projected that reductions in payments to private Medicare Advantage plans would trigger an exodus from the popular program. Enrollment would plummet by about 50 percent, as the plans reduce extra benefits that they currently offer. Seniors leaving the private plans would still have health insurance under traditional Medicare, but many might face higher out-of-pocket costs.

In another flashing yellow light, the report warned that a new voluntary long-term care insurance program created under the law faces "a very serious risk" of insolvency.

[Linus]

Originally Posted by MsDemeanor

Other than cosmetic surgery, what is not "necessity stuff"?

Varies from province to province. One of the specific ones is trans surgery/support. Right now, only Ontario and B.C. provide this as part of their health care. Some provinces include dental, some chiropratic, etc.



After reading the last news article that Jet posted, I wonder if anyone considered the aging baby boomers who will, in the near future, have the biggest affect on the health care system. With people living longer and the boomers being such a large segment of society now and many at or entering an age where additional medical services may be needed, health care becomes critical. Having it like this doesn't bode well in the long run.

[Miss Scarlett]

Both Houses of Congress are owned by big business. The fact that this got through at all is amazing to me. It's a start. Hopefully Congress won't screw it up too much in the future.

The arguments and backlash are reminiscent of the carrying on when the Civil Rights bills were being passed. Medicare too.

Hopefully when America realizes that this is not the apocalypse after all they will stop all the whining, wailing and gnashing...well, I can dream can't I?

[key]

At the very least "Medicare Advantage" should be required to change its name. It is a private insurance company, it is NOT Medicare. I have no problem with this private insurance company losing customers. And while we are at it AARP should be abolished too, as it is just a front group for private insurance. I want all private insurance companies to lose all of their customers and get everyone on a not for profit system.

The reform process is not over people. Check out Alan Grayson's proposal to allow anyone to buy into Medicare at cost. I would even be agreeable for anyone under 65 to buy into Medicare at cost plus 5% or something to help cover costs for others.

http://www.huffingtonpost.com/2010/0..._n_492831.html

[Apocalipstic]

President Obama is actually a Baby Boomer, as are most members of Congress, I am sure some thought was given to the cost?

If we were not at war, we would have plenty of money for this.

If we were not so anti-immigration, we would have plenty of money to pay for this.

I think it is important to provide health care for all of us, The US is only as strong as the weakest among us, and right now, that is pretty darn weak.

Maybe I know more people without insurance? Performers, artists, musicians, food and beverage workers, stage managers, directors, av people.....on and on....I am fine with paying higher taxes if the money goes to helping this situation.

[Linus]

For those wondering, you can now figure out how many chickens you'll need on hand to pay for various health care procedures: http://lowdenplan.com/

I figure I might need 4,000 chickens but since I'm vegetarian/vegan I wonder if I can pay with Seitan Spicy Wings.

[casey35]

I may not have the right for this opinion but this is mine. I personally dont think that we the tax payers should have to pay for others insurance. If you dont have insurance which i dont then it should be your responsablity to get some.

[Linus]

Originally Posted by casey35

I may not have the right for this opinion but this is mine. I personally dont think that we the tax payers should have to pay for others insurance. If you dont have insurance which i dont then it should be your responsablity to get some.

So what happens when you get hurt in an accident (fell off a ladder say because your foot slipped), have no job and have been out of work for 9+ months and insurance costs $600 a month (as it does in parts of NYC)? Why is it wrong to be compassionate and caring for one another, even if we are strangers to each other?

[Luv]

Ive been turned down for insurance because of pre-exhistiing problems I have had..if I am able to get insurance it will cost me 1/2 of my monthly paycheck.

My generation has been called " Generation Jones " ( http://en.wikipedia.org/wiki/Generation_Jones ) . As I look at life now days,,Id say yea..we are. Here we are approaching middle age or are middle aged and have no health insurance. I hope they get this thing figured out.

[casey35]

I do understand the need of insurance and for those who are declined from insurance. But the government needs to back out of our personal life. I do not believe that the government should tell me what i can do and what i cant. For me to hear from our leaders it unamerican to not vote for the health care pisses me off. I have served my country and I for one believe it still america and we have choices what we want and what we dont.

[theoddz]

Originally Posted by casey35

I do understand the need of insurance and for those who are declined from insurance. But the government needs to back out of our personal life. I do not believe that the government should tell me what i can do and what i cant. For me to hear from our leaders it unamerican to not vote for the health care pisses me off. I have served my country and I for one believe it still america and we have choices what we want and what we dont.

I totally get your point here, Casey, about not wanting government intrusion into our personal lives....for most things. Thing is, when we have uninsured Americans, we all pay the costs. When I say we ALL pay, we do, especially those of us who are (lucky enough) to have a job and bring home a paycheck these days. Let me explain.

People who don't have health coverage can't usually get in to see private doctors, where a simple office visit usually costs about $125, if you pay out of pocket and you don't have any xrays, tests or procedures done, because those are extra. These people can't the afford the $125 and they usually don't even bother trying to get in to a private doctor because they are denied even an appointment when they call, being told that "Dr. Soandsuch doesn't accept uninsured patients".

When you are sick and/or injured, you must get medical attention, and that's non-negotiable, because you must live. If you can't go to a private doctor, the only alternative is the Emergency Room, because they can't turn you down. At a minimum, they have to stabilize and treat you and, if they are a community-funded facility, then they MUST, by law, take a certain percentage of medically indigent patients. People know this, so this is the route most of them take. Oh, and by the time these folks come in to the ER, they usually have much MUCH more complicated scenarios going on than if they'd just sought treatment for when the problem first started. People who are uninsured though typically put off seeking medical attention until the last cryin' second, because they know they can't afford it and they're scared to death of not just the medical problem, but the expense associated with care.

Care at an Emergency Department is the most expensive care you can get, anywhere, but when you don't have any choice, that's where you go, whether you can "afford" it or not. In the past, there were programs that provided monetary offset or sliding scale reduced costs to people who couldn't afford to pay, or even programs that picked up the entire costs of services to medically indigents. In today's economy, however, those have gradually dwindled down to next to nothing, or nil. Someone has to pay those costs, or the (community funded, especially) hospitals would go under. This is happening more and more, and I beg you to show me one community funded facility now that isn't operating in the red. They can only do this for so long before they disappear and there is no facility whatsoever, for the folks who have no money and no insurance. The entire community loses. Now, in my lifetime, it's been pretty well accepted that some of these community funded facilities have been of the research oriented type and they have had some of the best equipment and facilities of any hospital in any community. In other words, if you were really, really sick, or banged up in an accident, that's where you wanted to go for the most aggressive treatment or care. These places depend on tax dollars for the greater source of their operating budgets. As their expense goes up, so does the demand for our tax dollars to fund them.

Now, that said, I ask you. Wouldn't you rather spend a few less tax dollars to help buy some of these uninsured Americans some level of basic health care?? If they had health insurance, they wouldn't always be clogging up ERs and charging the most expensive level of care to the taxpayers. They would be going to primary care doctors who charge FAR less for office visits than a trip to the ER would ever cost. These folks would have access to routine preventive care so that more complicated medical issues can be, hopefully, averted. I say, let the big insurance industry bear the burden of the costs of most of the care, in the form of negotiated costs, and take the huge burden of the costs of ER visits for non-emergent care off of the shoulders of the taxpayers.

I'm so sick and tired of hearing so many people who DO have health coverage, or are in a position to pay for their care, grumble about why they should have to bear the costs of paying for people who don't have coverage or are not lucky enough to be in the same position of being able to afford and pay for their care. It's the exact same thing as saying "I've got mine, so fuck you.". That doesn't work in a (civilized) society.

We really ARE all interconnected, in society, whether or not we want to admit it or not. Someone's got to pay these huge costs and it's, ultimately, going to fall on the guy whom it's always fallen on.....the taxpayer. The only question that's left to answer is how it's going to be paid. I, as a single filer (I am not legally married), pay approximately 28% of my salary in federal taxes. Of the amount I have left, after that's taken out, I pay about $160 per month for the premium of my health care coverage/insurance. I would rather pay, say, 29 or 30% in federal taxes.....or it may even be a bit less, if we had a single payer system, similar to the VA (#1 Ranking, consistently, in Patient Satisfaction, nationally), to cover EVERY American. Just by sheer volume alone, the cost of medical services and pharmaceuticals would be beaten down....way, waaaaaay down.

~Theo~

[MsMerrick]

Originally Posted by casey35

I do understand the need of insurance and for those who are declined from insurance. But the government needs to back out of our personal life. I do not believe that the government should tell me what i can do and what i cant. For me to hear from our leaders it unamerican to not vote for the health care pisses me off. I have served my country and I for one believe it still america and we have choices what we want and what we dont.

Personally I would rather the Government than the Insurance Companies. You don't get any choices with them