Obama Healthcare?

[XoBLoNDiE85]

What are your guys thoughts about stupid Obabms healthcare crap? I cant believe ppl actually think this can be good...it makes me nervous about Hannahs care!!!!!

[Dodger67]

For those of us not in the know - what are the main problems?

[LisaJoy]

XoBLondie, I don't know what to think. Frankly, I haven't been able to figure out what is actually in the bill (and remember, I have a PhD!).

Dodger -- part of the issue is that the legislation is over 2700 pages long and pretty much no one, including the president & members of Congress, has actually read the whole thing!

I hope it accomplishes the best of intentions -- to make insurance more affordable for people who have to buy it on their own, and to prevent insurance companies from denying coverage to people with pre-existing conditions.

I hope it does this without undermining the health care of the 85% of Americans who have employer or government- provided coverage that they are happy with. I can't help but think back to last summer, when I started having some issues, had an appointment with my urologist within a day, had an MRI the SAME day, and saw a neurosurgeon the next week. I paid a total of $60 in copays. If I had decided to go forward with surgery, it would very likely have happened within two weeks, and it would have been 100% covered. I remember reporting that on this forum and people from Canada and GB expressing shock that anything could happen that fast. But I also realize that if I didn't have good health insurance, it wouldn't have happened at all. My health insurance is provided by my employer, the state of Tennessee. I pay less than $100 a month in premiums. I have no deductible and my co-pays are reasonable ($25 for primary care, $30 for specialists, $20 for physical therapy. My drug co-pays are mostly $5; some are $10.) The network of participating doctors & hospitals is huge, and I don't need a referral to see a specialist. (The excellent health insurance help makes up for the fact that I make about 50% less than people with a comparable level of education in the private sector, or even in states that are richer than Tennessee).

If I did not have employer-provided group insurance, I would not be able to purchase insurance in the current system. IF anyone would write a policy for me, it would likely cost at least half of my income and would exclude everything sb related from coverage. My only choice would be to go without insurance, or to apply for total disability in order to qualify for Medicare or Medicaid. I would not be allowed to work and would have to stay below the poverty level to be allowed to keep the insurance.

One problem with the proposed system is that it would forbid insurers from denying coverage for pre-existing conditions, but as far as I can figure out, it would not place any limits on what they charge. So my guess is that most "uninsurable" people will still be unable to purchase individual policies under the proposed system.

I have issues with the taxation of existing insurance coverage, the so-called "cadillac" policies, which supposedly are only held by corporate fat cats. In reality, virtually everyone who is single and childless and has employer provided insurance will have to pay the tax, regardless of income. Their co-workers with families who have EXACTLY the same coverage, will not be taxed. That's because the rules are written without taking into account the fact that singles pay proportionately higher premiums because they are already subsidizing family policies. To be a fair tax, this tax should have been based on the ratio of insurance premium to income.

Last thing -- the tax payers have to start paying for the system right away, but it will be five years before the system is actually operational. The only reason the system is projected to "save" money over ten years is that it will have only income and no expenditures for the first five years. It is all smoke and mirrors. If the history of Medicare and Medicaid are anything to go by, the costs will be enormously greater and the benefits significantly less than are being projected. My pessimistic side tells me that in ten years, fewer people will have insurance and those that have insurance will have worse coverage than they have now.

Hope I am wrong!

[angel]

In my opnion I am not against this health care because if they discontinue the pre existing condition then it will make it more possible for me to actually get a good job and not have to worry about dying because of it. As things stand now if you make anything over minimum wage you don't qualify for most state help. We have tried to find insurance for me through my husband's employeer and even out of our own pockets.
I was told flat out NO WAY because Spina Bifida is a pre existing condition. I see how it does affect us in the long run and I am all for it.

Angel

[Mustang Sal]

Being a Brit, I actually didn't know that people are refused health insurance in the US because they have a pre-existing condition - that's surely a heck of a lot of people!! I naively assumed that everyone got some kind of cover, because surely they can't let people get ill and just leave them to a life of pain and illness, and ultimately to die? Or does that happen? If so, that's shocking! So in that respect, I can see why Obama wants things to change, but it sounds like a half-baked idea that needs to be shelved until some of the big issues have been sorted out.

Lisa, that is mega quick! MRI the next day?!! There's a minimum 3 week wait here, and that's actually good - it used to be about 4 months at my hospital!! I'm amazed that you can see a specialist without a referral - in most cases, we HAVE to go to a GP first, and if s/he says 'no', that's that. I know of people who are blatantly ill, but because the very basic blood tests or examination done at the GP's surgery show up fine, they don't get to go any further. Some GP's are really loathe to refer people to specialists, because every referral costs the surgery money (it's taken off the budget the NHS allows them to spend).

We have the 18 week rule - from GP referral through to treatment/surgery should be no more than 18 weeks. In most cases though this is breached, and the managers at our NHS hospitals are very skilled in covering that up so they don't lose points when hospitals are graded. We also have a maximum 4 hour wait in A&E, but this is managed by shunting people around different departments, but doesn't actually mean they've been seen. Smoke and mirrors very much exists here too!!

I actually can't get private health insurance because no company will touch me with my pre-existing condition (the only way I could is if I had employer-based insurance, and even though I work for the government - civil service - I don't have any because it's not offered at all), so i'd be stuffed without the NHS, despite its failings (i've recently been told that i'm beyond help surgically, but I don't believe everything has been investigated properly - i'm going to have to pay £250 a pop to see a specialist privately).

I can see why this is such a contentious issue - unfortunately, whatever happens there are going to people who benefit, and people who lose out.

[Mustang Sal]

Ha, how weird - i'm just watching the news and guess what subject they've just hit on? Yep, American healthcare reforms! Spooky!

[bcain]

I am also afraid of what this could do for Sarah's care. I am worried about Sarah not having coverage d/t her preexisting condition. Right now she is covered under my husband's. I believe in NY state you cannot be denied for a prexisting condit. We need to get back to directly paying for services. As a consumer, I never know what the cost is for this or that. I cannot save the insurer nor myself any money except to go with "in network" providers. And I still don't know what the bottom cost is. Fiscal responsibility has to prevail, or we are doomed to ruin and rationing.

And not to mention our nation is economically in bad shape. Lost jobs are still on the rise.

[LisaJoy]

Bcain, if we had to pay directly for services, my last back surgery would have been at least $38,000. Because of the high cost of high technology medicine, paying directly for healthcare is out of reach for most people. Now we could go back to paying directly for preventive care and only carrying insurance for major medical/hospitalization. But that system went away in the first place because people wouldn't/couldn't afford preventive care for conditions such as diabetes, and ended up with more significant and costly hospitalizations. The idea behind insurance for basic & preventive care is that people will be in good health and major medical costs will be reduced.

The problem with this idea is that it presupposes that people behave rationally -- that they will stop doing what harms themselves and do the things that are good for them. The costliest healthcare problems in America are self-inflicted -- the result of obesity and smoking.

Mustang Sal -- the problem of denial of health insurance to people with pre-existing conditions is a serious one. Some of those people can get health insurance but it excludes the pre-existing condition from coverage. Now, one thing to keep in mind is that most people have insurance through their employer or through the government (Medicare, Veterans, Medicaid). Group health insurance policies by law cannot exclude people for pre-existing conditions. Government-funded programs also do not have that exclusion. So it only affects the approximately 15% of the population who have to buy their insurance on the individual market -- which is the most expensive insurance available, even in the best of circumstances.

Also, people who are uninsured do usually have access to some healthcare -- unfortunately, that is mainly in the form of emergency room visits, which are extremely expensive. (By law, hospital emergency departments must treat anyone who walks through their doors.) Most hospitals get money from the states/federal government for providing uncompensated care. They also make up for those expenses by inflating costs for people with insurance. So if you hear a story about people being charged $50 for a tongue depressor in the hospital, it isn't really about the tongue depressor. That is simply a way for the hospitals to try to recoup some of their costs in providing uncompensated care.

It is very complicated -- more complicated than in most European countries because of the size of the population, the extreme diversity, and the high rate of immigration. It is also more complicated because the system has evolved in a highly irrational way -- a blend of charity, market economics, and government intervention, that is very hard to undo & remake without -- as you pointed out -- someone being on the winning side and someone on the losing side.

[Ziggy]

It scares the crud outta me. I've seen socialized healthcare in action in Australia and it's great when you're healthy, but when you're not, it's horrible. My DH's grandma had to wait over a year to be seen by an orthopedist for severe hip pain! She needs a replacement and has to wait again to have it done because it's "elective".

[angel]

As an adult with SB under the way things are now I can't get anything but state insurance. When i made $6.00 per hour i made to much money to be on the state insurance. I had a child to feed so i had to work. For 3 years i couldn't afford to see a doctor nor afford the meds i should have been taking every day for maintnance to keep the UTI's down. The only time i saw a dr was when i was sick enough to go to the ER (by that time kidneys were bleeding) and the bills were huge and of course i couldn't pay them. I now have kidney damage on the left kidney.
My husband who had a stomach ulcer a few years ago can't get health insurance because of that and a heart arrithmia. In this house it is a huge issue. I hope it goes thorough cause millions of people are suffering horribly because of the way things are now. Get it going somehow get the ball rolling then revise things that need to be fixed. When your kids are small they are taken care of so far if you have state insurance in america but they day they turn 21 they are dropped. Not completly but they pay for almost nothing anymore. Most 21 year olds aren't educated enough and are not old enough to have decent insurance. If we don't do something soon the kids that are covered now won't be when they are grown. There is a long term picture to look at as well.

Lisa I don't think people realize without insruance what anything costs. When my son had his surgery the bill came to 10's of thousands of dollars.

Angel

[bcain]

We definately need reform, but I don't know what the answer is. LisaJoy you are right about the costs will probably be so high for those WITH preexisting conditions that they still won't have access. So I still would say no to this proposal, sadly I would. We do need reform, but not this one.

Here it goes...the house just passed the senate's bill, 219 yea to 212 nay. Still more to come....

[XoBLoNDiE85]

Obamas way is not gonna be any BETTER is will be WORSE "they" will decide if you need care or not! And i thought Kaiser was bad oh boy i'm scared!

[bcain]

This is scary! We are all on the ride unfortunately.

[XoBLoNDiE85]

Im freaking out!!! Why did this have to go thru!!!! omg!! scared to death!

[XoBLoNDiE85]

Bcain-You seem to be one that sides with me....now what? I'm so scared!

[bcain]

I think as with most things, we just take it a day at a time. Somethings may be able to be changed or repealed. Repealed unlikely. Lets hope that the politicians who voted for this, get the boot. I believe as many do, that every incumbant (those who have already served) should be voted out. Too much corruption, everyone has to go. Congressmen and senators stand to lose thier seats over this.

Most changes won't occur for four years at least. So it's not really over yet.

[lonibaloney]

All I can say is I have never been offered health insurance for less than 30% of my pay. Which is not an option for me if I want to eat well and pay my rent. Not to mention all the out of pocket expenses for my daughter with SB that insurance companies would never cover. I thought the point of this was so we wouldn't be at the mercy of our insurance companies. I believe there is an awful lot of waste in the medical industry and a huge lack of self care and neglect which is wasting a ton of money and resources. Preventative care and lifestyle choices are so underestimated and the biggest problem in my opinion.

[Dodger67]

Permanent exclusion of pre-existing conditions is illegal in South Africa.
If you join a scheme for the first time they may exclude pre-existing conditions for one year only.
With good planning that will only happen once in your life - when you come off your parents scheme and join one in your own name for the first time. Exclusions are not allowed if you change schemes provided you do not have a period of no insurance inbetween. This makes switching from one insurer to another painless. Insurers may also not load individuals for having specific conditions - the costs have to be shared by all participants. Mosty schemes have tens or hundreds of thousands of members so the cost of adding one more person with a complex and expensive medical condition is minimal.

Without insurance my open heart surgery of 6 years ago woulkd have cost about US$40 000 but because I have a good "hospital plan" it cost less than US$2 000.
A "hospital plan" means that day-to-day expences are not covered - you pay out of pocket for dentists, sore throats, etc. but as soon as you are admitted to a hospital for longer than 24 hours the insurance kicks in. Hospital plans are reasonably affordable on a middle class income but comprehensive private insurance is only for the wealthy. Most large employers have their own group schemes or alternatively pay a substantial part of your private insurance premium. Smaller employers usually also contribute to your private insurance rather than have their own scheme.

[LisaJoy]

I don't think there's any reason to freak out at this point--you're unlikely to see any changes any time soon. As with so many things, we'll just have to wait and see how this evolves.

[XoBLoNDiE85]

Yea we do have a least 4 years till it will even begin I guess but man it sucks! The republicans will be going after this so that makes me feel a little bit betteR =)

[Barb]

I have been waiting to weigh in on this because I honestly don't know how I feel about it. At first I was like Laura, freaking out. I have been doing some research on it though and found some interesting things.

Positives:


can't be denied based on pre-existing conditions
kids can be covered up to age 26 on parents
no lifetime caps
seniors will no longer have the 'doughnut hole'-my mom falls into this every year and it gets really expensive especially for those on fixed income

Negatives:


Taxing people who don't get insurance-may possibly be un-Constitutional and 12 states (including CO) already planning to take to Supreme Court
5 years til anything happens and we start paying now
No limits on what can be charged for premiums on pre-existing yet we are required by law to have it.

This boat has so many holes in it. It is also likely that when the Senate gets it back from Obama they will filibuster it and eventually send it back to the House starting the cycle again.

It is also very likely that Obama won't be in office next term and this whole thing will be re-written again by the Republicans that take over control. Think that won't happen? MA never thought a republican would sit in Kennedy's seat either but Obamacare is making all sorts of things happen. :2aa:

[lonibaloney]

By the way, in MA, they already steal your tax refund if you don't have health insurance and you can afford it. In my case they stole mine because my husband didn't have it and we filed jointly. .Bas%#@ds!

[stephsteph]

I have Medicare and Tricare. These are both government plans already. I'm scared that we'll have fewer choices on which doctors and facilities we can use.

[Barb]

Interesting video clip on CNN

http://www.youtube.com/watch?v=v0wc7btrpgc

[LisaJoy]

Barb, that was really interesting. Thanks for posting.

Regarding whether there are limits on what premiums insurers can charge for pre-existing conditions -- I'm confused because the accounts I've read are conflicting. Some say there are no limits. Some say they can't charge more than for a healthy person. Some say they can't charge more but they can force those people into extremely high deductible policies (i.e., tens of thousands of dollars in deductibles for the pre-existing condition).

In other reports, I've read that the rule is immediate for children -- that is, starting now, they can't deny coverage for children with pre-existing conditions. But other reports say that won't go into effect for a year.

This all just underscores the fact that nobody knows what is actually in this new law.

[Barb]

Lisa-the more I research it the more confuzzled I get. I have puzzled and puzzled til my puzzler hurts over this. :33a:

I have read everything from liberal Dem views to conservative Republicans and I think you are absolutely right. The one thing I think we can all agree is that this monstrous 2000 page bill is confusing the heck out of everyone.

Here are my more educated concerns after further research.

This thing is law. It is unlikely that anything the Senate does will affect the main parts of the law. It is likely that even if the Supreme Court hears the states lawsuits it will be be upheld as Constitutional because it is carefully framed within interstate trade laws and tax laws.

I think the coverage of adults to age 26 on parents insurance is interesting and gets them through college years BUT in the case of developmental disabilities I think the law should cover them as long as they are deemed dependents (and I don't know that it doesn't, I can't find any clear answer on that). That concerns me too. WHY is it so hard to get clear answers on this? Like the link above I am afraid that the reason no one can understand it and there is so much confusion is on purpose. Why is it being rushed and hushed??? Sure, it is online. Not many average Americans have the time or where with all to read all 2000 pages. I know I don't.

I worry about overburdening barely surviving specialists with more patients. There are so few neurosurgeons out there, what happens if our wait to get into them is now ridiculously longer than it already is? What about all the people now privy to free screenings. That will certainly backlog our access to needed machines for important tests. I know to some people that may seem selfish but they have no idea the uphill battles we already fight. It just seems like it is adding more people in line in front of us.

What happens when the systems become so overly burdened that there is not time or funding for new research? The right we all have to bicker over Xaio and fetal surgery may now be moot if there is no new research happening.

And in my opinion, our government needs to get smaller not bigger.

I heard an interesting theory today that the reason this is being pushed so quick is so that the average American gets used to it by next election and the dems will run on the platform that 'people don't want the republicans to take away all their great new benefits'.

Of course, all of this is what ifs so it will remain to be seen the impact on us. I have friends on both sides ardently discussing this and I will continue to post what I find thought provoking. At least we are all paying attention to it now.

[LisaJoy]

I have friends all over the spectrum, too -- some who think it's the greatest thing since sliced bread and others who think it's doomsday. And everything in between.

Just this morning in my American history class, I showed a video that quoted used the quote from the 1830s & 40s -- "That government is best which governs least." It was the motto of a publication that was one of the mouthpieces of the DEMOCRATIC Party, no less! And was quoted by Henry David Thoreau in his essay "On Civil Disobedience."

I think your point on developmentally disabled adults is well-taken.

This is one of those things that we are going to have to wait and see how it unfolds.

[bcain]

Yes, Yes I'm with you on smaller government. I know, I don't have much I can do with a little one in tow, but I'll definately vote out every existing politician. I'm hopeful that there will be some good choices for supporting smaller government. My husband and myself regularly call and/or email the congressman/ senators office to say our part. I hope they're listening.

[Jill]

I'm always surprised that American's don't want to change their health care stuff! TBH, I don't understand it at all. The copay, pre-existing, insurance policy, denial stuff is all foreign in Canada and I like it that way. :D

FWIW, I didn't have to wait at all for an MRI when I was pregnant with Kingsley to find out more about where his lesion was. I've been to emerg a couple times, never paid a dime and didn't have to fill out so much as my name on any paperwork. His surgeries have both been done the day they needed to be done with the neuro we wanted. All of his therapy and treatment and visits from PT, nurses, etc. are free for everyone who needs them. We even get $ to buy his catheters. Any devices for walking will be covered for the most part as well, from what I'm told. I am thankful every day for the healthcare that we have here in Canada. :)

[ainemc]

It is very very difficult to get a MRI on the NHS. People wait years to have one done and even in emergency cases you have to wait weeks. When Caitlin was in hospital the baby beside us was having seizures and they booked her in for an emergency MRI and still had to wait 12weeks for it.
I wont get an MRI for Caitlin although I would like one to see exactly were her level is but they are only done when they really need to find out something.
I think the healthcare in Canada sounds great! Unforunately my experiences with the NHS aren't very good, and i hope the same kind of service doesn't happen in America!

[Dodger67]

The government medical system in South Africa owns a total of 4 (yes FOUR!) MRI machines - SA has a total population of about 45 million (not counting illegal immigrants who may number up to 2 million according to some estimates).
One machine for every ~12 million people.

The private sector has 50 (FIFTY). About 7 million South Africans have medical insurance.

[Mustang Sal]

It is very very difficult to get a MRI on the NHS. People wait years to have one done and even in emergency cases you have to wait weeks. When Caitlin was in hospital the baby beside us was having seizures and they booked her in for an emergency MRI and still had to wait 12weeks for it.
I wont get an MRI for Caitlin although I would like one to see exactly were her level is but they are only done when they really need to find out something.
I think the healthcare in Canada sounds great! Unforunately my experiences with the NHS aren't very good, and i hope the same kind of service doesn't happen in America!


12 weeks for an emergency MRI!! Perhaps it's different in NI, but my experiences in England aren't quite that bad. Yes for routine outpatient scans you do have to wait, sometimes several weeks, but in emergency scenarios they should be done pretty quickly. I was admitted to hospital on bed rest before my last surgery, the main reason being that inpatients get things like scans arranged as a priority, so my consultant decided that's what he wanted to happen. It's probably this that causes the waiting times to be somewhat long for outpatients, because inpatients always come first (i've had several long waits in radiology departments despite being given a scheduled time, because emergency cases from the wards kept coming).

I know i've not exactly sung the praises of the NHS in the past but one thing I do like about it that it treats everyone the same, whether you've got a million in the bank or don't even have a roof over your head. The reason I like this is because I don't believe a person's financial status should determine whether they get health care or not - I think basic healthcare should be available to all who need it, regardless of wealth, race, religion, and all that jazz. It's not perfect, but nothing is!

[Gymp]

I think basic healthcare should be available to all who need it, regardless of wealth, race, religion, and all that jazz. It's not perfect, but nothing is!

That's exactly how I feel.

Our Health Care System (Canadian) is far from perfect but it's there for all of us.Basic blanket coverage for,young,old,poor or wealthy and if you want more you can get that too through private insurance and if your employer offers group insurance you have that as well.

Gymp