Let's talk about the basic facts about the health care reform bill...

[morningland]

I do not like politics. I am neither a liberal nor a conservative so I don't like arguing about political sides.

I do want to know about this health care bill. So far, I know that it is saying that health insurance companies will be more regulated and people will be forced to purchase health insurance but....

- How are people going to purchase health insurance if they can't afford it now?

- How is this going to affect patient care?

- How will nurses be affected by this?

I want to know any basic information about this bill but I am a nursing student so... as is most likely shocking to all of you... I don't have much time to research it, lol.

Thanks and lets try and keep it friendly folks!

-Joseph

[herring_RN, ASN, BSN]

what the bill does provide

-expansion of government-funded medicaid to cover 16 million additional low income people, though the program remains significantly under funded. this limits access to its enrollees as its reimbursement rates are lower than either medicare or private insurance, with the result some providers find it impossible to participate. though the federal government will provide additional subsidies to states, those expire in 2016, leaving the program a top target to budget cutting governors and legislatures.

-increased funding for community health centers, thanks to an amendment by sen. bernie sanders, that will open their doors to nearly double their current patient volume.

-reducing but not eliminating the infamous "donut hole" gap in prescription drug coverage for which medicare enrollees have to pay the costs fully out of pocket.

-insurance regulations covering members' dependent children until age 26, and new restrictions on limits on annual and lifetime on lifetime insurance coverage, and exclusion of policies for children with pre-existing conditions.

-permission for individual states -- though weakened from the version sponsored by rep. dennis kucinich -- to waive some federal regulations to adopt innovative state programs like an expanded medicare.

all of these reforms could, and should, have been enacted on their own without the poison pills that accompanied them.

where the bill falls short

-the mandate forcing people without coverage to buy insurance. coupled with the subsidies for other moderate income working people not eligible for medicare or medicaid, the result is a gift worth hundreds of billions of dollars to reward the very insurance industry that created the present crisis through price gouging, care denials, and other abuses.

-inadequate healthcare cost controls for individuals and families.

1. insurance premiums will continue to climb. proponents touted a "robust" public option to keep the insurers "honest," but that proposal was scuttled. after anthem blue cross of california announced 39 percent premium hikes, the administration promised to crack down with a federal rate insurance authority, an idea also dropped from the bill.

2. there is no standard benefits package, only a circumspect reference that benefits should be "comparable to" current employer provided plans.

3. an illusory limit on out-of-pocket medical expenses. but even in the regulated state exchanges, insurers remain in control of what they offer and what will be a covered service. insurers are likely to design plans to attract healthier customers, and many enrollees will likely find the federal guarantees do not protect them for medical treatments they actually need.

-no meaningful restrictions on claims denials insurers don't want to pay for. proponents cite a review process on denials, but the "internal review process" remains in the hands of the insurers, and the "external" review will be up to the states, many of which have systems now in place that are dominated by the insurance industry with little enforcement mechanism.

-significant loopholes in the much touted insurance reforms:

1. provisions permitting insurers and companies to more than double charges to employees who fail "wellness" programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions.

2. permitting insurers to sell policies "across state lines", exempting patient protections passed in other states. insurers will likely set up in the least regulated states in a race to the bottom threatening public protections won by consumers in various states.

3. allowing insurers to charge three times more based on age plus more for certain conditions, and continue to use marketing techniques to cherry-pick healthier, less costly enrollees.

4. insurers may continue to rescind policies, drop coverage, for "fraud or intentional misrepresentation" -- the main pretext insurance companies now use.

-taxing health benefits for the first time. though modified, the tax on benefits remains, a 40 percent tax on plans whose value exceeds $10,200 for individuals or $27,500 for families. with no real checks on premium hikes, many plans will reach that amount by the start date, 2018, rapidly. the result will be more cost shifting from employers to workers and more people switching to skeletal plans that leave them vulnerable to financial ruin.

-erosion of women's reproductive rights, with a new executive order from the president enshrining a deal to get the votes of anti-abortion democrats and a burdensome segregation of funds, that in practice will likely mean few insurers will cover abortion and perhaps other reproductive medical services.

-a windfall for pharmaceutical giants. through a deal with the white house, the administration blocked provisions to give the government more power to negotiate drug prices and gave the name brand drug makers 12 years of marketing monopoly against competition from generic competition on biologic drugs, including cancer treatments.

most critically, the bill strengthens the economic and political power of a private insurance-based system based on profit rather than patient need

http://www.californiaprogressreport.com/site/?q=node/7584

[linda2087]

What the bill does provide

Herring, I'm glad you posted that article. It's from a radical left website. It's interesting that they're not too happy with the new laws either.

"The California Progress Report offers an online megaphone to advocates campaigning for economic justice, global sustainability, civil rights and civil liberties, government reform and many other areas"

http://www.californiaprogressreport.com/site/?q=why

[piscesguy]

Only a small percentage of corporations bribe politicians....

:hpygrp:

[linda2087]

:hpygrp:

There are thousands of corporations. Name all the corporations that bribe politicians.

And by the way, politicians that accept bribes should be jailed. This is why it is stupid for people to trust the government.

You liberals sure hate corporations, yet you get a paycheck from a corporation, drive a car made by a corporation, eat food made by a corporation, wear clothing made by a corporation, use a computer made by a corporation, use internet supplied by a corporation, live in a house made by a corporation, see movies made by a corporation, use cell phones made by a corporation, watch TV made by a corporation, fly on planes made by a corporation, stay at hotels made by a corporation, etc.

The USA way of life is capitalism, not socialism.

By the way, MSNBC is a corporation.

[elkpark]

There are thousands of corporations. Name the corporations that bribe politicians.

And by the way, politicians that accept bribes should be jailed. This is why it is stupid for people to trust the government.

When corporations do it, it's not called "bribery," it's called "political contributions." And the conservatives on the Supreme Court just ruled that it's an infringement of corporations' "constitutional right" to free speech to set any limits on how much money they can spend on political campaigns -- so we're not only not outlawing it, the SCOTUS is encouraging it.

[linda2087]

When corporations do it, it's not called "bribery," it's called "political contributions." And the conservatives on the Supreme Court just ruled that it's an infringement of corporations' "constitutional right" to free speech to set any limits on how much money they can spend on political campaigns -- so we're not only not outlawing it, the SCOTUS is encouraging it.

I believe that ALL politicians who give or accept bribes should be jailed. Do you agree?

[charlestonsailing]

It isn't on the topic of the thread but if a union can collect contributions from its members and donate to a campaign why can't a corporation do so from its shareholders??

I think the SCotUS got it right.

[jmeng]

I think it's a noble idea that everyone gets covered. In terms of money, I don't think it will make any difference for us nurses. hosp reinbursments (sorry for the spelling) from the government may go down, however, since almost everyone is covered by insurance, the hospital gets their money back somehow...now every little thing in the hosp costs so much, like IV fluid for 1000 dollars and so on...because they wanted to cover for the loss from the uninsured patients...

Additionally, since there will be more patients, there will be plenty of jobs for nurses and doctors and nps...lots of overtime. There will also be plenty of opportunities for nurses to advance their career in different fields...one initiative in the bill is to make health care electronical...it means that those nurses with informatics will have more and more jobs...no more hosp closings...so more and more jobs for nurses...i think there will be huge nursing shortage, and those incentives like sign up bonuses will return.

and there is an increase in funding in the home health care...good for those visiting nurses...So overall, i think it's a very good idea....

And another thing, for those who wants to go back to school, they made a law also for taking out loans...no more private bank loans, but from the government only with low interest rates...that is meant for the medical students who gets out with a mortgage before graduating...if it's good for them, good for us who wants to become NPs...

So i am positive!!!! Its about time that everyone gets covered...

[Toquay]

Maybe over time due to people opting for more government health care options over the higher priced Insurance companies, we will all become government employees and at 20yrs of work we get to retire with full benefits. I can dream can't I? With the hits my 401K took I will prolly have to work til the day I die. I envy my firefighter neighbor who retired at age 45 OMG!!

Toq

[piscesguy]

There are thousands of corporations. Name all the corporations that bribe politicians.

And by the way, politicians that accept bribes should be jailed. This is why it is stupid for people to trust the government.

You liberals sure hate corporations, yet you get a paycheck from a corporation, drive a car made by a corporation, eat food made by a corporation, wear clothing made by a corporation, use a computer made by a corporation, use internet supplied by a corporation, live in a house made by a corporation, see movies made by a corporation, use cell phones made by a corporation, watch TV made by a corporation, fly on planes made by a corporation, stay at hotels made by a corporation, etc.

The USA way of life is capitalism, not socialism.

By the way, MSNBC is a corporation.

Pu-lease! Name them yourself! You're the one that made the claim. I's jess laughin'

[tewdles, RN]

What I do not understand is what statements like..."you liberals sure hate corporations"...actually add to the conversation.

In what way does a statement like that encourage meaningful debate or help people to listen to the legitimate concerns of those who disagree with them?

[Sunnysidegirl]

No, our cars are more important than our health? huh? Who doesn't drive cars? Most people drive cars, come on.

Not only that, but there are going to be people that aren't going to buy the insurance just as they don't buy car insurance.

I can't believe people that don't want this health care in place. Sure details need worked out, but come on, think about

people that need health care. You have health care, but what if you didn't and you needed it ???

The selfishness needs to Stop!

Thanks for your post I am so tired of the negativity! If we could only switch from whats in it for me to whats in it for ALL of us the world would be alot better off. Change is always a bit scary but when I look at some of the provisions in the health care bill(excepting those with pre-existing conditions is one) I see more good than harm.So yes if I made over $250,000 would I care to give a little in the form of taxes to help fix our healthcare nightmare YES! and I presently have great insurance.Health care should see past a persons wallet size,and social status.It should be a right not a privilage.And yes I agree it is not perfect yet.Obama is not god nor can he do it alone so I wish people would stop attacking him and other democrats.