House passes landmark health care bill

Nurses Activism

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philadelphia inquirer

posted on sat, nov. 7, 2009

[color=#005266]house narrowly passes landmark health care bill -

david espo

the associated press

washington - in a victory for president barack obama, the democratic-controlled house narrowly passed landmark health care legislation saturday night to expand coverage to tens of millions who lack it and place tough new restrictions on the insurance industry. republican opposition was nearly unanimous.

the 220-215 vote cleared the way for the senate to begin debate on the issue that has come to overshadow all others in congress.

a triumphant speaker nancy pelosi likened the legislation to the passage of social security in 1935 and medicare 30 years later.

"it provides coverage for 96 percent of americans. it offers everyone, regardless of health or income, the peace of mind that comes from knowing they will have access to affordable health care when they need it," said rep. john dingell, the 83-year-old michigan lawmaker who has introduced national health insurance in every congress since succeeding his father in 1955.

in the run-up to a final vote, conservatives from the two political parties joined forces to impose tough new restrictions on abortion coverage in insurance policies to be sold to many individuals and small groups. they prevailed on a roll call of 240-194.

ironically, that only solidified support for the legislation, clearing the way for conservative democrats to vote for it.

the legislation would require most americans to carry insurance and provide federal subsidies to those who otherwise could not afford it. large companies would have to offer coverage to their employees. both consumers and companies would be slapped with penalties if they defied the government's mandates.

insurance industry practices such as denying coverage on the basis of pre-existing medical conditions would be banned, and insurers would no longer be able to charge higher premiums on the basis of gender or medical history. in a further slap, the industry would lose its exemption from federal antitrust restrictions on price gouging, bid rigging and market allocation....

[color=#005266]key details of democrats' health overhaul bill

the house health care bill passed saturday would:

  • require most americans to purchase health insurance or pay a fine.
  • expand health care coverage to 36 million more people over the next decade.
  • require employers with payrolls above $500,000 to provide insurance to their employees or pay a fine.
  • prohibit insurance companies from denying coverage because of pre-existing medical conditions.
  • end premium disparities between men and women.
  • impose a 5.4 percent income tax surcharge on income above $500,000 annually for individuals and above $1 million annually for households.
  • establish a government-run insurance plan to compete with private insurers beginning in 2013.
  • cost $1.2 trillion over 10 years.
  • cut medicare spending by more than $400 billion over 10 years.

hr3962 bill link:

http://www.gpo.gov/fdsys/search/page...ls-111hr3962ih

go to formats text (2713 kb) | pdf (3438 kb) | xml (3499 kb)

People who qualify for Medicaid now don't sign up. Why would they start now?

I love the way some people on this site keep bringing this up like it explains everything. While I'm sure there are some people out there who qualify for Medicaid but haven't enrolled, it is not an answer for most of the uninsured. States have increasingly restrictive qualifications for Medicaid (they've been cutting back on Medicaid funding for years as their budgets have gotten tighter) -- most people think of Medicaid as "healthcare coverage for poor people," but, in my state (the only state about which I can speak first hand, but I understand that many states have similar situations), there is no way you can qualify for Medicaid unless you are 1) a minor, 2) pregnant (you qualify for the duration of the pregnancy only), or 3) have one of a small number (5 or 6) of specific chronic illnesses. If you don't fit into one of those groups, it doesn't matter how poor you are -- you are simply not eligible. Expanding the Medicaid program would make a big difference for a lot of poor people, including the working poor, in my state.

I love the way some people on this site keep bringing this up like it explains everything. While I'm sure there are some people out there who qualify for Medicaid but haven't enrolled, it is not an answer for most of the uninsured. States have increasingly restrictive qualifications for Medicaid (they've been cutting back on Medicaid funding for years as their budgets have gotten tighter) -- most people think of Medicaid as "healthcare coverage for poor people," but, in my state (the only state about which I can speak first hand, but I understand that many states have similar situations), there is no way you can qualify for Medicaid unless you are 1) a minor, 2) pregnant (you qualify for the duration of the pregnancy only), or 3) have one of a small number (5 or 6) of specific chronic illnesses. If you don't fit into one of those groups, it doesn't matter how poor you are -- you are simply not eligible. Expanding the Medicaid program would make a big difference for a lot of poor people, including the working poor, in my state.

So Medicaid doesn't work, there is no money for it, and yet you want to expand it. How will that work? Where will the money come from? Why have states increasingly become restrictive, maybe because there is no money.

Massachusetts just raised it's sales tax. They had to. To pay for their UHC.

So Medicaid doesn't work, there is no money for it, and yet you want to expand it. How will that work? Where will the money come from? Why have states increasingly become restrictive, maybe because there is no money.

Massachusetts just raised it's sales tax. They had to. To pay for their UHC.

I didn't say I want to expand it -- the proposals to expand it were brought up, you made your pointless, gratuitous comment about people not signing up for Medicaid now, and I commented on the reality of Medicaid in my state and that expanding it would help a lot of people in my state. I want a true, universal single-payer system that covers everyone, paid for by everyone's taxes, but too many members of our Congress are bought and paid for whores of the for-profit healthcare lobby for that to happen anytime soon.

Massachusetts' "healthcare reform" plan isn't working because they didn't go with a public plan, and worked exclusively with the existing private insurance companies, most of which are for-profit. I agree with you (much as it pains me greatly to say such a thing) that we can expect similar results if the US Congress takes the same approach nationally.

I didn't say I want to expand it -- the proposals to expand it were brought up, you made your pointless, gratuitous comment about people not signing up for Medicaid now, and I commented on the reality of Medicaid in my state and that expanding it would help a lot of people in my state. I want a true, universal single-payer system that covers everyone, paid for by everyone's taxes, but too many members of our Congress are bought and paid for whores of the for-profit healthcare lobby for that to happen anytime soon.

Massachusetts' "healthcare reform" plan isn't working because they didn't go with a public plan, and worked exclusively with the existing private insurance companies, most of which are for-profit. I agree with you (much as it pains me greatly to say such a thing) that we can expect similar results if the US Congress takes the same approach nationally.

And that's the crux of the matter. What is being proposed isn't sustainable. So I'm not sure why so many are fighting for a losing system? A system that doesn't work now and won't in the future.

America is not gonna get rid of capitalism or independence any time soon. What we need to do is come up with real solutions. No pre-existing conditions, as long as you pay you get coverage. Let the Americans help each other. Cut some slack, give to charities. When was the last time you can remember that the government has given anyone, other than it's law makers, something for nothing. There has to be taxes involved. That's the nature of government. The government doesn't make any thing to sell. It's a true non-profit entity and there fore has nothing to give it's citizens. It's citizens give to the government and many times they don't get their money's worth.

A local dairy gives 10% of it's profits to charity. Many many big businesses help out.

Our ancestors came to this country with the shirts on their backs. Yes, they stole land that didn't belong to them but they raised barns together, they farmed together and they prospered. Simplalistic story. But I bet you get my drift.

There was a story just recently about one of the Lost Boys of Sudan. He came to this country with nothing. He's a taxpaying citizen today. He didn't even speak the language and he managed to make a go of it.

The clinical manager of my home unit was a Vietnamese boat person. She remembers the voyage. She has a BSN now and a couple of apartment buildings. She's a taxpaying citizen. She probably used some programs to get where she is but she's paid them back.

I honestly really dont care for the people who can afford health care but choose not to get it, I dont think they should be forced into it but then again if they do get hurt they should be expected to pay the large bill for there medical expenses as a result for carlesness this does not mean leave them out to die, As for the people who can not afford it i have no problem helping them, I think it is important to help the less fortunit.

Can someone please educate me on the current plan as to who is going to be paying for it? Is it the tax payers? Buissness owners who make 500k + a year? What is the curent plan as to who they expect to pay for everyone who does not have healthcare who can not afford it? and another question, With this new public healthcare option, Does this mean that current employers have the right to take away the current health care you are on and switch it to the public option? Even if you are contracted to it on your benefits? (wouldn't that be breach of contract)?

There are correlative studies suggesting that our health insurance system is killing as many as 45,000 people a year. What are "feasible" interventions? Currently, health insurance companies make that decision. We can't save everyone but modern medicine is built on the premise that we can manipulate nature and those who can pay receive more, and better manipulation than those who can't.

Our health insurance isn't killing anyone, killing is an active process. I've never seen an autopsy report come back with the cause of death listed as "lack of insurance". The whole point I made in painstaking detail was that over the course of nature, people get sick and die. Lack of insurance has never killed anyone, it just isn't saving as many as some would like.

Your definition of health care is incorrect. It's not the absence of illness, it's the treatment (and possible prevention) of illness. The questions you ask are subjective. As we progress, I think Americans are beginning to understand and accept that health care is a right. The question now becomes, how do we as a people provide this right four ourselves and our fellow citizens?

The only rights any person can have, are the intrinsic ones we were born with. What we can create and do for ourselves. To claim anything beyond that as a right makes the assumption that others owe it to us to serve us. Health care isn't free, someone has to be there putting in the work, and the equipment and supplies are expensive. To claim something is a right, is to claim we're entitled to it free of charge. You can't ask anyone to pay for something their entitled to any more then you can ask them to pay for freedom of religion. So no, as you've stated it...health care can't be a right. Now if you were to say that the ability to purchase health care is a right, well...that's more sensible. But if people have serious or chronic conditions, it only makes more sense that they're going to be paying more in premiums.

If there's a will to make it happen then there's a way. Every developed nation on the planet finds a way, except ours.

Yes, they do. In the whole "Tax the rich, save to the poor" sense. And we're not every other developed nation in the world. If it's really so great over there, why not relocate? Why try to change this country? Why can't we have one country in the world where the individual can live their own lives without being forced to take on the burdens of the misfortunes of everyone around them?

Taxes are taken out of your paycheck each pay period to pay for Medicare for seniors. While there are some who are undoubtedly upset and being "forced" to pay for it, I think the vast majority of people realize that Medicare is a good program (not perfect) that helps every American 65 or older.

I pity seniors only for the fact that they grew up brainwashed by the government's social programs. In another shining example of the government stepping in and taking over what should be individual responsibility, they've convinced generations not to worry about retirement, because once they hit that golden age they can suckle on that golden teat for the rest of their days. And lets face it, SS and Medicare are a joke. It encouraged them to not worry about providing for their own retirements, and is doing a half assed job of providing for our elders. The days of self reliance are long since past.

We pay taxes, and we benefit from them, there is no country in the world worth living in that doesn't have a tax system for the public good.

I can guarantee you that you and I have extremely different views on the definition of "public good".

No one is stopping you from investing in google.

Surprisingly enough, I wasn't giving stock tips. I was pointing out how worthless my SS benefits are. The money I pay into the system now is essentially going down the drain as far as I'm concerned.

Specializes in Critical care, tele, Medical-Surgical.
People who qualify for Medicaid now don't sign up. Why would they start now?

What is your source?

Our health insurance isn't killing anyone, killing is an active process. I've never seen an autopsy report come back with the cause of death listed as "lack of insurance". The whole point I made in painstaking detail was that over the course of nature, people get sick and die. Lack of insurance has never killed anyone, it just isn't saving as many as some would like.

The only rights any person can have, are the intrinsic ones we were born with. What we can create and do for ourselves. To claim anything beyond that as a right makes the assumption that others owe it to us to serve us. Health care isn't free, someone has to be there putting in the work, and the equipment and supplies are expensive. To claim something is a right, is to claim we're entitled to it free of charge. You can't ask anyone to pay for something their entitled to any more then you can ask them to pay for freedom of religion. So no, as you've stated it...health care can't be a right. Now if you were to say that the ability to purchase health care is a right, well...that's more sensible. But if people have serious or chronic conditions, it only makes more sense that they're going to be paying more in premiums.

Yes, they do. In the whole "Tax the rich, save to the poor" sense. And we're not every other developed nation in the world. If it's really so great over there, why not relocate? Why try to change this country? Why can't we have one country in the world where the individual can live their own lives without being forced to take on the burdens of the misfortunes of everyone around them?

I pity seniors only for the fact that they grew up brainwashed by the government's social programs. In another shining example of the government stepping in and taking over what should be individual responsibility, they've convinced generations not to worry about retirement, because once they hit that golden age they can suckle on that golden teat for the rest of their days. And lets face it, SS and Medicare are a joke. It encouraged them to not worry about providing for their own retirements, and is doing a half assed job of providing for our elders. The days of self reliance are long since past.

I can guarantee you that you and I have extremely different views on the definition of "public good".

Surprisingly enough, I wasn't giving stock tips. I was pointing out how worthless my SS benefits are. The money I pay into the system now is essentially going down the drain as far as I'm concerned.

One of the shining reasons so many countries have admired the USA, ( until recently) was because we are free. Because we bucked the trends and formed a free country. We didn't follow the Piped Piper we struck out on our own. Took a risk and it paid off. We did out way. We didnt/don't need anyone to tell us how to run this country. But it seems some think we should follow others and run this country into the ground.

What is your source?

My next door neighbor.

Specializes in LTC.
Our health insurance isn't killing anyone, killing is an active process. I've never seen an autopsy report come back with the cause of death listed as "lack of insurance". The whole point I made in painstaking detail was that over the course of nature, people get sick and die. Lack of insurance has never killed anyone, it just isn't saving as many as some would like.

It's correlative, I thought I made that clear. By denying a person services that would provide them a reasonable chance or survival and thereafter a decent quality of life, it correlates to killing them.

The only rights any person can have, are the intrinsic ones we were born with. What we can create and do for ourselves. To claim anything beyond that as a right makes the assumption that others owe it to us to serve us. Health care isn't free, someone has to be there putting in the work, and the equipment and supplies are expensive. To claim something is a right, is to claim we're entitled to it free of charge. You can't ask anyone to pay for something their entitled to any more then you can ask them to pay for freedom of religion. So no, as you've stated it...health care can't be a right. Now if you were to say that the ability to purchase health care is a right, well...that's more sensible. But if people have serious or chronic conditions, it only makes more sense that they're going to be paying more in premiums.

Rights are entitlements derived from law or morality. You make an excellent point however, regarding how those rights should be fulfilled. For example, by law I have the right to purchase a firearm, and as a society we have decided that the way I should fulfill this right is to pay for it directly. In regards to health care, we are currently in a debate regarding the best way to offer it.

Yes, they do. In the whole "Tax the rich, save to the poor" sense. And we're not every other developed nation in the world. If it's really so great over there, why not relocate? Why try to change this country? Why can't we have one country in the world where the individual can live their own lives without being forced to take on the burdens of the misfortunes of everyone around them?

In other words, you are suggesting that if I don't like it, I can move. This is a weak argument. For example, my neighbors occassional play music very loud late at night, I don't like it. My options are to accept it, move, or try to get them to stop so I can get sleep. Each and every one of those options is acceptable.

There are many of us who don't like the way our health care system is set-up, some undoubtedly have moved, others have accepted it and still others are advocating to change it in a way that they think will best serve everyone.

I pity seniors only for the fact that they grew up brainwashed by the government's social programs. In another shining example of the government stepping in and taking over what should be individual responsibility, they've convinced generations not to worry about retirement, because once they hit that golden age they can suckle on that golden teat for the rest of their days. And lets face it, SS and Medicare are a joke. It encouraged them to not worry about providing for their own retirements, and is doing a half assed job of providing for our elders. The days of self reliance are long since past.

Nonsense. Seniors (and indeed most Americans) are self-reliant, motivated individuals. The argument that social programs encourage people to be dead-beats is a figment of your imagination and adds to the idea that those who utilize these programs are lazy.

Let's be clear about Medicare. It's in the whole and it has problems. But it runs with efficiency and has the highest user satisfaction among health insurance methods in the United States.

Americans don't want everything given to them on a silver platter, but many of us want to improve the framework of equal opportunity, and it's hard to deny it's not in need of improvement.

Specializes in PICU, NICU, L&D, Public Health, Hospice.

I am happy to discuss much needed reform to our healthcare system, especially reform in the way that we pay for it (insurance reform). I am not interested in arguing about each and every tiny detail or question or nuance of health insurance, or care delivery, etc with someone who is angry with our government and is itchin for a fight. I find that being irritable and obstructionist doesn't work well for me at work and it doesn't work well for me in life. I am an optimist by nature. While I can see that our current system is not sustainable financially, delivers subpar outcomes, and leaves too many people without adequate access...I believe that we can do better. We have the ability to examine other successful healthcare practices in other countries, to listen to many, many ideas, and come up with a distinctly American plan. I support that.

Reminisce, I have not read the new house bill. I have heard that the payment for this is spread out over individual taxes, business taxes, and premiums. I have heard that the wealthiest 1% have an additional expectation in supporting this, but that is just Hannity talking to me - I cannot give you a source. In terms of current employers and insurance benefits. What I understand is this....if you have insurance ABC, you will be able to keep that insurance if you continue to make the payments. If your employer decides not to provide access to health insurance they will have some sort of additonal fee, or something, which helps to defer cost for the public option which their employees will likely become a part of. Like I said, I haven't seen it yet, only heard about the parts that Rush and Sean don't like.

In other words, you are suggesting that if I don't like it, I can move. This is a weak argument. For example, my neighbors occassional play music very loud late at night, I don't like it. My options are to accept it, move, or try to get them to stop so I can get sleep. Each and every one of those options is acceptable.

I was making the point there if thats what you believe, there are plenty of places that cater to that belief. America is the only country left that those of us who disagree have. So, rather than try to take that away, why not agree to disagree and have your system across the pond and let us keep ours here?

Nonsense. Seniors (and indeed most Americans) are self-reliant, motivated individuals. The argument that social programs encourage people to be dead-beats is a figment of your imagination and adds to the idea that those who utilize these programs are lazy.

I never said they were lazy, you're putting words in my mouth. I said the government assumed the role that should have been an individual responsibility. As you work, you should be contributing towards your retirement to make sure you have a nest egg to live off of. The government decided they could best see to the well being of our elders, and convinced them of that. They're not lazy in the least, they've been paying into a system their entire lives with the promise that they would be able to live off it when they retire. They just had the misfortune of trusting the government with something so important to their individual lives.

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