Today we passed a health reform bill put a
down payment on the promise of health care reform is necessary.
Now a health reform bill, health care
reform is just beginning, not the end.
1.
It is better tomorrow than it is needed to make health care affordable, nothing
is different today.Keeps
rising cost of health insurance and health care:
Since 1999, jointly by employers and
employees pay health insurance premiums for family coverage, the average
combined cost of 2009 (PDF) for $ 13,375 at 131 percent is reached. Meanwhile,
the median family income is only 2000 and 2009 (PDF) between increased an
average of 19 percent. Insurance and a typical American family of
four in 2009 for a total cost of $ 15,609 out-of-pocket medical costs figures
for 2008, compared with a 7.4 percent increase, was $ 16,771.
15 issues from 2003 to 2007 by 19 percent,
or 57 million Americans paying medical bills increased the percentage of
Americans with a family.
If current trends continue, annual
health care
costs for employers in the next decade will increase by 166 percent - up to $
28,530 per employee.
An
increasing number of people without insurance are:
Health insurance premiums experts forecast
that 52 million Americans will be uninsured in 2010 have risen so high.
Among the uninsured, 80 percent of working
families (PDF) as well.
People without health insurance get less
attention when they are sick and dying, medical care is likely to be delayed.
Lack of health coverage in the U.S. each year causes 45,000
deaths
In 2006, the U.S. economy because of poor
health and uninsured young age as much as $ 200 billion lost.Keep
shrinking benefit frm health insurance cover:
2004 employees’ health insurance co-payments
and deductibles from 40 percent to have to increase your cash outlay since.
American families spend more of their own money as the monetary value of
employer-based health benefits from 2004 to 2007 (PDF) declined.
Sixty percent of people who filed for
bankruptcy they could not pay the medical bills. Insurance, while 75 percent of
those people were overwhelmed by medical debt.
Many companies they wanted it or not,
workers herded in coverage known as the low premium, high deductible health
insurance plan enrollment "consumer-directed health plans," $ 8
million in 2009 (PDF) rose. That is a 250 percent increase since 2006.
2.
Today we passed a health reform bill put a down payment on the promise of
health care reform is necessary.
Good,
affordable health care in the United States to guarantee access for
everyone fighting has been raging for decades.
3.
Now a health reform bill, health care reform is just beginning, not the end.
Senate
Bill (PDF) on improvements in the health insurance premium subsidy rules constitutes
a good start. But it is a beginning, not an end just that.
Can
afford.
If
the Senate bill is passed in the Senate on immediate reforms can be passed
through reconciliation. These include:
Fixing
the excise tax.
Subsidies
for low-income people improve.
Based
on national rather than state health insurance exchange is made.
Adding
a public health insurance plan option.
Even
though, is not the end of reform. We have comprehensive affordable health care
for everyone is a need to expand coverage.
Hurt
or Heal? Weighing the importance of evidence in medical care and coverage
Let's
face it. We are spoiled. We have dozens of brands to choose from toilet paper.
We want soft or strong? Or extra soft. And we hope to translate these into
consumer attitudes medical care.
Medical
terminology to adjust to the new
mentality has changed. Patients who seek medical care are people, they're consumers. “We 'providers,' not seek medical care from doctors and hospitals. We like TV sets, treatment 'than' do. But even when the manufactured goods we often need help in deciding what we should choose.
mentality has changed. Patients who seek medical care are people, they're consumers. “We 'providers,' not seek medical care from doctors and hospitals. We like TV sets, treatment 'than' do. But even when the manufactured goods we often need help in deciding what we should choose.
We
are unhappy with our choices, but in the refrigerator, if it is not life
threatening. We may have the option to medical treatment. Why then examine the
clinical evidence and change their recommendations for breast cancer screening,
an apolitical group of medical professionals all over the dispute?
Brouhaha
raised by some groups were trying to kill health reform. The new
recommendations when played right into their hands.
Let's
face facts. And developed the drug.
Take
for ulcer treatment. For decades, stomach ulcers were thought to be caused
solely by emotional stress. Australia in 1982, Barry Marshall, a
doctor from the stomach lining of patients suffering from ulcer biopsies (small
pieces of tissue) was observed a previously unknown bacterium. His theory the
medical establishment, which humiliated him hit the wall of logic:
alleviated by ulcers, inflammation of the
stomach lining is usually intact, and most patients with ulcers themselves and
found back in a year or two. Patients on a regular basis, seeking psychological
counseling to find employment at"
Facts
and changed the treatment protocol as his theory was widely accepted before it
took a decade.
secretion inhibitors can be cured by a
short regimen. "
That
evidence is looking at what you can achieve. That's why we want from our
medical care is better, more effective treatments.
Unfortunately,
the facts are not always so obvious. In many cases, medical intervention
specialists must weigh the potential positive and negative outcomes. As is the
case with mammography recommendations.
The
importance of early detection so we have been droned on, the new
recommendations that the 'common sense' seems to go against the idea when it is
no wonder people are angry and confused. Any medical intervention can have
negative consequences that we remember. Here I have not seen widely discussed
in the dispute mammographies is a potential negative side effects:
suggests that risk. Mammography saves
women's lives, so that's why it's a trade-off. "
With
such a big threat looming shadow benefit of the intervention is important. But
it does not mammographies for women under 50:
Will not be enough to convince the show.
"
Finally,
get the facts straight on all fronts. Senate health reform bill all insurance
companies cover only the U.S. Preventive Services Task Force recommends that
the mandate is not. This no cost to the patient, the Task Force recommended
preventive care; insurance companies are required to cover:
shall not apply -'' (1) evidence-based
items or services under the influence of "A" or the current
recommendations of the United States Preventive Services Task Force
"B" has a rating of that. "
Recommended
because it is more likely to reveal. Senate health reform bill actually does
the study authors recommended that:
Do not pay a lot of little economic sense. Early
disease treatment costs are much higher. "
The
U.S. Preventive Services Task Force now mammography’s only difference is
usually between 40 and 50 for those women over 50 'highly valuable' are not,
that is.
In
the end, however, we emphasized on NBC's Dr. Nancy Snyder man, you should keep
in mind:
Senator
Harry Reid, the majority leader, the Senate health reform bill has been
introduced. Patient Protection and Affordable Care Act (PDF), HR 3590, the
first 10 years is projected to reduce the federal budget deficit. The
Washington Post reports as follows:
"Democratic leaders nonpartisan
Congressional Budget Office, the Senate bill over the next decade as $
130000000000 federal deficit will cut determined that he was happy. Midnight the
night before Wednesday released shortly launch before the House to come to any
legislation of the Big cost savings represents or Senate this year, but the
measure's effective date, also for 2014, a year back was pushed. "
The
House bill a year ago, in 2013, takes effect. According to the New York Times,
the one-year delay "of legislation is primarily to reduce costs."
So,
start date, other than the final Senate bill my last post ("House health
bill to the Senate should be a model") discussed in the categories against
the House bill is over? Too much as expected.
1.
Health insurance exchange.
The
House bill, unlike the federal government's responsibility, the Senate bill
their own health insurance exchanges in charge of states puts. The Washington
Post explains:
"Senate measure that most people buy
insurance will be required. Within the House earlier this month approved
legislation is similar, and their employers affordable coverage did not provide
the new state-based policies Shop are able to individual coverage markets will
act as the exchanges'. Insurance companies such preexisting conditions by
denying coverage as practices will ban the sweeping new rules to be followed.
"
2.
Public Health Insurance Plan.
Public
option to the states, their health insurance in return for the public plan can
not choose, except the House bill mentioned in the same work. Like the House
bill, the public plan will not be tied to Medicare reimbursement rates.
Instead, the public plan providers negotiate rates must. As the New York Times reports:
"Mr. Reid's bill under the private
insurance companies would compete with a new public insurance plan would
establish. State law by passing a public plan opt-out could."
3.
Insurance company transparency and accountability.
The
Senate bills them truly accountable for keeping will be essential that
insurance plans transparency thus requiring far fewer falls. Bill's brief
summary, according to the health plans to disclose will be required is:
"Patient Protection and Affordable
Care Act, hospitals and medical devices physician ownership as well as nursing
home ownership and other characteristics with information will provide
consumers."
Insurance
companies should be required for the disclosure to see my blog post
"Insurance companies still enough regular will not be read".
4.
Affordability.
Expansion
with the cost of help States while the Senate bill, federal poverty level,
(FPL) of the 133 percent below the with income all non elderly to engage
Americans Medicaid for the eligibility is transmitted. The House bill Medicaid
to 150 percent of Medicaid expands.
Both
bills they will be essential to help cover health insurance to low-income
people (up to 400 percent FPL) to provide assistance.
5.
The employer's responsibility.
The
House bill, unlike the Senate bill, employers "play or pay" its
employees to provide health coverage to the falls is not required. Instead, the
low-income workers can discourage employers from hiring that includes a
provision. The New York Times described as:
"The Senate bill clearly employers
provide health insurance coverage requires. But more than 50 employees, an
employer does not provide coverage and any worker a federal subsidy is eligible
for the employer to pay a penalty to be is typically $ 750 for each of your
employees. "
6.
Financing.
The
House bill, unlike the rich no additional tax, but more than $ 250,000 a year
earned by joint Medicare payroll tax of 0.5 percent increase.
Furthermore,
Senate bill high Premium plans tax on imposes.
7.
Immigrant of the abortion coverage and coverage of the grant.
The
Senate bill, the House bill than abortion coverage no federal funding is there
to ensure that a less rigorous attempts. The Washington Post reports as
follows:
"Reed abortion coverage public
insurance plan has been offered in then federal finance from nutrition private
premium would separate you that of a 'firewall' proposed to establish is the,
or abortion opponents muster with the not pass may be that took a different
approach.
"Some details Wednesday were
available, but Sen. Barbara Boxer (D-Caliph.) on the issue of an agreement to
make working an abortion rights advocate, I could not be happier," said.
Want to keep the from the bill out the abortion, Senator Reid it the right way
had done. '
"National Right to Life Committee,
however, Firewall" totally unacceptable "and called for it to allow
federal funding of abortion" layers contrived definitions and hollow bookkeeping
requirements "used to be."
In
addition, the bill slightly different immigrant treatment. The Washington Post
explains:
"House as subsidies and thus highly
both under the bill would expand who have Medicaid, the federal programs would
prohibit the use, while the Senate bill, through the exchanges to buy insurance
illegal immigrants times."
House,
Senate health bill should be a model for
Two
bills from the House bill that we can be stronger and final Senate bill is more
progressive ways than you can see.
:
Roger Hickey of the Campaign for America's Future and Diane Archer
House "Affordable Health Care for America Act of 2009" (HR 3962)
stated in his letter of support for
Acts that hope. "
The
Senate, the House should follow the example of the key areas are:
1.
Health insurance exchange.
The
House bill small businesses (100 employees or less) and will be open to
individuals who do not have employer coverage that creates a national health
insurance exchange. Over time, more employers to offer insurance to their
employees through the Exchange will be able to. The House bill designed to exchange
an active negotiator. The Senate bill, on the other hand, the possibility for
states to build health insurance rates will drop and the role of a passive
price taker Exchange relegates.
Timothy
Jost explains:
That -. States and insurance companies will
also manage resources to oversee...
Can be an important lever, and refusal to
negotiate with the insurance companies do not do anything to keep up no group
market. "
2.
Public Health Insurance Plan.
House
Bill choice, competition and accountability to ensure the exchange makes
available through a national public health insurance option. Like other private
plans, the public option must survive on their premiums. Public option
administered by the Secretary of Health and Human Services and the providers to
participate in rates will be negotiated.
According
to Timothy Jost:
"House public option that requires
negotiate rates with providers, however, is considerably weakened."
3.
Transparency and accountability to the insurance company.
House
Bill Exchange commissioner insurance companies participating in the trade and
exchange for what they are offering clear information about how (PDF) gives the
power to demand to provide:
The
Senate bill may include some such requirements.
CQ
reports today on November 9 at his article "Insurance companies aim to
expand industry power over federal reporting":
The industry is expected to add new
regulatory costs.
Her
congressional testimony (PDF), the Diane Archer in the private health insurance
market, the lack of information currently available to describe the problem:
"The health insurance market is
broken. A competitive market, insurance companies, cancer, diabetes and heart
disease for people with reasons to deliver the best price-performance health
care, health care will be marketed to users. Their messages 20Marketing are
like automobile companies.
Their wonderful care plan would win a prize.
but in reality that would kill them. "
Do not advertise. Information we need to
know is right.
4.
Affordability.
House
bill to provide health coverage and health care generous affordability credits
and out-of-pocket costs by limiting (PDF) makes it more affordable:
"Health Insurance Exchange through
Sec. 341. Availability. Affordable health coverage to 400% of the federal
poverty income affordability credits to ensure that people with builds. These
credits as individual and family income
The
Senate bill may not be as generous.
Timothy
Jost explains:
Are more generous than the Senate bill
either. "
5.
Responsibility of the employer.
The
House bill requires everyone - individuals, government and employers (PDF) -
all to guarantee access to quality, affordable health care, and share in the
responsibility.
"[With $ 500,000 annual salary]
employers either to provide health insurance to their employees or to help fund
should contribute to affordable health insurance. Coverage, workers, families,
at least 65 percent of premiums to 72.5employer to employees to help cover
expenses contributes 8 percent of their salary to coverage through the exchange.
"
There is also a tax credit program for
low-wage small businesses provide coverage for their employees. "
Senate
bill may impose certain requirements on employers. According to Timothy Jost,
"Senate Finance bill is very weak [employer's] mandate, but the final bill
is likely to include a mandate of some sort."
6.
Financing.
Bill
$ 1 million (couples) or $ 500,000 (individuals) in excess of 5.4 percent
surcharge on taxpayers with adjusted gross income.
The
Senate bill, just like coal miners and firefighters is good for people in
high-risk professions, can provide extensive coverage of the poor by taxing
high-premium plans can enforce health policy.
The
Senate should not follow the field
Stupak
amendment to the House bill through the Senate at the last couple regressive
language on abortion coverage should not be included.
In
an editorial in the Detroit Free Press explains:
"As part of the historic bill passed
and anti-abortion Democrats (U.S. Rep. Dale Kildee, D-Flint) including the
Stupak amendment is credited with bringing it more difficult for poor women to
obtain abortions may exclude abortion coverage from any policy until.
You spend more shfts to theGOP health reform bill
The New York Times reportedyesterday that
State Regulation
of Pelosi has come up with an answer. "
That, in a nutshell House GOP bill to reform our health care
system (PDF) is. Same old, same old. His plan is nothing new. The Republican
answer to every problem is a rehash of:
Industry involved
as much as possible deregulate;
Cost and risk burden
on consumers and taxpayers ("buyer beware"), Put, and
Protect consumers
and businesses injured.
Here the tired formula of the Republican Party in his health
care reform plan how that plays out.
Deregulate industry involved as much as possible
(Insurance companies to sell health insurance across state
lines, allow me to explain why Rick Smith Show listen is not a bad idea.)
Why cheat the laws of the State to understand a problem, it
is important to understand how insurance is handled. State health insurance is
the primary regulators. Rules vary from state to state and even individuals,
small or large group markets are based. Employee Retirement Income Security Act
of 1974, or ERISA, bars states from regulating employer-sponsored health plans.
Provided. Therefore, state law, at least 50 employees generally sold to
individuals and small groups with policies sold to small employers implement
policies.
In general, state laws are more extensive than federal law.
In almost all states, for example, in the small group health insurance
companies for the same coverage can vary premiums among small employer groups,
limits on the amount by which the offer. Also, in many states, insurers are
required to cover certain conditions or providers.
GOP plan proposed state health insurance insurance companies
will be allowed to circumvent the rules.
That's why virtually unfettered discretion in their practice
allows insurance companies. This piece further and guarantee access to health
insurance market, in particular, like Maine,
Massachusetts, New
Jersey, New York,
and in states like Vermont,
premiums, limit coverage exclusions, and / or has limited mandate which
benefits would eviscerate the viability of the most comprehensive consumer
security market.
And it is not a new idea. Republicans have proposed this
time and time again. For example, they repeatedly Health Care Choice Act (HR
4460) and health insurance policies across state lines, circumventing state
regulations and consumer protection will be allowed to sell the Small Business
Health Fairness Act (HR 241), introduced have.
Small Business Health Fairness Act of small businesses band
together and buy insurance exempt from most state insurance regulations and
consumer protections that allow the Association for Healthcare Plans (AHPs),
will be created. : Drum Major Institute for Public Policy (PDF) of the
will soar, and
unable to cope with the increased costs to their employees leave companies at
risk of becoming uninsured. For this reason, the Congressional Budget Office
estimates that the AHP legislation, if enacted, four out of five small
employers would result in higher premiums for. "
Even the National Small Business Association (NSBA) AHPs
against. Back in 2005, Todd McCracken, NSBA president, said:
Businesses need a
better solution’s not the answer. "
: In 2004, the National Governors Association writing that
they have also come out against these types of schemes
Would raise 'would
undermine existing financial oversight and consumer protection measures. "
Such "pick-your-regulatory" provisions during his
2008 presidential campaign of John McCain's health reform proposals were
central. (See my blog post "deregulate, baby, deregulate: McCain's health
reform plan")
("Too late, too little health insurance industry,
health care reform has revealed a new plan." See my blog post)
("Buyer bewares") costs and risks placing the
burden on consumers and taxpayers
The "Health Insurance: A Primer," As (PDF)
Congressional Research Service Bernadette Fernandez says:
This is why
individuals are considered risk pool, the entire pool of individuals for
serious medical experiences or something catastrophic financial loss that is
less likely. "
Expensive high-risk pool premiums to people with a portion
of the state subsidy offer a choice of private insurance plans. Inevitable
result of high-risk pools good, affordable health care access to the medically
uninsurable myriad of problems that have plagued. In a study published in
Health Affairs found that most state high-risk pool:
Failed to health
problems. "
Yet none of these shortcomings will be addressed by the GOP
bill.
They can not afford it nor the House Republican bill that
help people pay for coverage. The bill any tax credits, subsidies, guarantees
of profits or out of the pocket does not provide maximum protection.
As the Washington Post reports today:
"Republican
health care debate, the long-awaited entry into the ranks of the uninsured
would be hard to dent the congressional budget analysts concluded that the
assessment made last night.
easure ",
according to an analysis by the nonpartisan Congressional Budget Office,
through 2019 at a cost of $ 60 billion would cover only 3 million additional
people. It is now more than a decade would leave 52 million Americans
uninsured."
Protect consumers and businesses injured
To reduce overall health care costs of the bill, the
Republican plan to improve their health is one of the mainstays: "tort
reform." Bill doctors, hospitals, and patient lawsuits against
manufacturers of drugs and medical devices impose new restrictions. The
insurance companies can set their premiums have no restrictions.
Therefore, the savings in medical malpractice premiums on
total health care spending may have only a small effect.
Other contributing factors (PDF) decline in investment
income of insurance companies and insurance companies are among the least
competition.
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