Healthcare…let’s actually spell it out

So, a lot of people have been lauding (or steaming about) the new Health Care Act.  But I feel like so many people on both sides of the fence couldn’t tell you three ways the Act will change the current landscape of health care, so I thought I’d take some time to highlight a few.  If you’re already fully informed, then kudos to you!  If not, maybe you can now enlighten someone else…

So, here goes nothing…my “top ten” list of things you can now say you actually KNOW about the  health care bill.

  1. First and foremost – if you have a plan, and you are happy with it, you don’t have to do a darned thing.  Nothing has to change for you.
  2. If you don’t have coverage, you will be able to pick it up from an Exchange where you can comparison shop for the plan that is right for you.  Makes me think about those car insurance commercials where you can price everything out before you buy.
  3. You can no longer be denied coverage due to a pre-existing condition.  If anything, to me, this is the biggest game changer.  You hear time and time again about someone who goes to buy insurance because they want to be covered and discover a condition during their exam and are denied.  Not to mention the people that are just looking for coverage to help offset their life-threatening illnesses.  I cannot imagine enduring such an event without insurance…fighting for your life shouldn’t mean you have to put yourself in financial ruin in the process.  Great, I beat cancer, but now I’m homeless.  Not cool.
  4. The one that we’re hearing a lot about (and goes into effect immediately) is that children through the age of 26 are allowed to stay on their parents’ plan.  In the day of high unemployment and reckless behavior that expands in the early 20s…this is a VERY good thing.
  5. The Act requires that everyone get health care.  Here is where opponents of the Act might have some validity.  If you don’t get covered, there will be a whopping fine of $2250.  That’s a lot.  And don’t think you can just go and get any old simpleton policy.  You will be required to have adequate coverage, or there will be a penalty.  What that penalty is, I’m not sure.  Subpart A on p 303 of the Bill (yes, I’ve been reading it) just says “Tax on individuals without acceptable health care coverage.”   I am hoping the resulting affordability that is proposed will be enough to make the majority of Americans okay with getting themselves covered.  While I do believe that everyone should have access to healthcare, I’m not fully okay with making anyone do anything.  It is not up to me to stop another’s reckless behavior.  I think this is the point Republicans are trying to make…but in a much more polarized manner.
  6. Caps annual out of pocket spending to $5,000/individual and $10,000/family.
  7. Expands Medicaid.
  8. Improves Medicare – closes the ‘donut hole’ – this is about $250 that senior citizens are required to pay for the cost of their prescriptions.  Maybe not much to me and you, but that’s a lot of money when you are on a fixed income.
  9. Tax credits for small business to offer insurance to employees (who usually have to buy on the much more expensive, free market).
  10. Raised taxes for individuals making more than $200,000 and families more than $250,000.  Here is where the Republicans are really in an uproar.  The expansion of health care has to be paid for somehow.  And the rich will shoulder the brunt.  If you are a capitalist by nature (which most Republicans are), than this really lights your fire.  I mean, come on, how dare you take an extra $100 out of my hard earned quarter of a million dollars (or more) in earnings and put it towards something other than myself, like social betterment.  I mean, really, social responsibility is totally overrated.  Okay, okay…that was pure sarcasm (if you didn’t pick it up).  I think I’m a Marxist at heart, so I’m all for it.  I don’t mind giving up a piece of myself if it means my fellow man is better for it in the long run.  This same trait has also led to many a domestic arguments as my husband yells at me for wanting to hand out sandwiches and hot chocolate to the homeless in the winter by myself.  It is what it is.  Most people are somewhere in the middle.

So there you have it.  A little list of things from the Bill that you can actually use in discussion.  Note, missing from this list are the lies and scare tactics used to turn people against the reform.  There is/are no: establishing of death panels, federal aid to support abortions, lack of choices in what sort of coverage you have, free health insurance to illegal immigrants, or the end of private insurance forced out by a government plan.

Everyone should take the time to read up on it for themselves, but for now…a little bit of info is better than none.


  1. I actually don’t have a problem with the tax/fine on those who refuse to obtain health care. Part of the problem with people who are uninsured is that they go to the Emergency Room and receive medical treatment and never pay the bill. Ever wonder why ER’s charge $30 for a band-aid and $50 for Tylenol? Most ER’s have millions of $ in unpaid revenue and as a result they jack up the prices to the insured people so that they can recoup some of that. However I do think you the fine should be waived if the person is unemployed.

    1. Hmmmm, I wonder how Cobra extensions will change under the new bill. Never even thought about that factor.

      Agreed HGE on ER…It’s one of the questions I asked below, “What about the costs that are driven up by emergency rooms used as a vehicle as primary care for the uninsured? “

  2. K,
    Well Kaiser Permanente did get special treatment from my knowledge as well as few choice others that were represented. I would like to be optimistic about this bill, I really am trying. It just seems so hard for me to fathom based largely on those that have done it. Massachussetts which is where we took a large part of this from, it takes an average of 42 days to see your PCP & if they can’t get in, they are still utilizing emergency rooms. Not mention Massachussetts has nearly the highest rates for insurance & overall cost for care in our country.
    In Canada the list for major medical approved services list is near 800,000. That is frightening to me, these non-elected boards are just as terrifying as they will have the say in how our money is spent. I grew up in WI & have a lot of friends that are from Canada, the elderly there are most every time denied coverage for services such as organ transplants if they are over 65. Now you could say the same I guess for the stories heard about services denied by the big insurance companies, however at least right now those insurers are looked at with fine tooth comb & have to answer to the state, federal & insurance boards for compliance.
    Who in the end will stand up if Big Government proves to be just as bad? There is going to be some ignorance on both sides, I wish they all were as eloquent as yourself, however they are not. I am guilty of said arrogance & it is usually met with disdain. So I try to now see all sides but I can’t agree with this in it’s entirety. This in the end will only be deemed constitutional because it will be looked at by the government as a tax vs a mandated requirement to purchase a product from a private seller. This is sort of underhanded & skirts the law, so what is next? I hope you are right & more like you can help keep the balance.
    Take Care,
    Clinton H

    1. That’s REALLY disheartening to hear – about the elderly getting denied coverage over a certain age. I hope that provisions in the new Act allow every case to be taken on an individual basis. There are some that could handle a transplant at that age, but many couldn’t…as the immune system has to be completely shut down to minimize rejection. That’s a really rough road to travel after a certain age…although, I don’t think 65 should be the cut-off! Gonna have to go do some reading on this!

  3. I will admit 1st & foremost & I am a conservative & feel this bill is the end of freedom in this country. However let
    me just say that I really enjoyed your post, it was very well written & informative. Can I really trust that the 83% that have insurance & are happy with that coverage are not going to notice any change? Not for a second, this bill while it as you stated has some good in it, it blatantly leaves out what I consider the most important part of why it was created, to control costs! I work in the health care industry, the out of control costs are largely due to defensive medicine, going in for headache & ending up with a CAT scan to avoid a law suit. Why did they intentionally leave out tort reform? Simple lobbyists & special interest groups is why, same reason why Kaiser Permanente & several other larger insurers struck eleventh hour deals, making them exempt from certain taxation. Is this fair? In Texas in 2003 we enacted expansive tort reform & have since enjoyed some of the lowest costs for health care & insurance in the country. Doctors have moved entire practices here at an unheard of rate. Guess what, this federal bill now will repeal this tort reform & set our progress back to zero. While this bill as you stated has some good in it, it certainly can’t outweigh the bad. There was zero reason for not going about this step by step & with bi-partisan support. This was the largest bill in the history of our country with zero bi-partisan approval & yet bi-partisan disapproval that passed, albeit through reconciliation. It is being shoved down our throats with no regard to the sovereignty of the states or any regard to the constitutionality of the government forcing an individual to purchase a product from a private seller, this is pure fascism. Being kind-hearted & doing right by your society is far from Marxist. Now encouraging & expecting your government to take care of all your needs & wants, this may be. But I don’t think that is what you want, you just like the sound of all the goodies that come with it. This bill is without question going to kill jobs & also raise costs. Doctors who already pass those losses they take from medicare/medicaid on to the privately insured/uninsured are now getting an additional 30+million forced on them at a loss. I am sure that will work. Sorry for the long rant, I appreciate intelligence from anyone & you are obviously intelligent, & I know we will disagree here, but again thanks for the post. Please see my post on a Trillion.
    Take Care,
    Clinton H

    1. Clinton,
      Thanks for your post. First and foremost, no need to apologize for the rant. Rant on my friend. Even in the end, if we agree to disagree, healthy dialogue and exchange is the foundation of sharing knowledge. How can any of us claim to be informed if we’re not exposed to all sides of an argument? I think you bring up a VERY good point. And that is tort reform. I’ve always thought that tort reform and medical liability, while they definitely need to be addressed, are only a fraction of the the costs that drive up health care. And I think there has to be some sort of line drawn in the sand. There’s a huge difference between defensive medicine and wasteful medicine in my mind. Ordering a few additional blood tests is defensive. A CAT scan for a headache at first look at a patient is wasteful. But I definitely get your point. I wholeheartedly agree with you that tort reform should be addressed. But does that mean that the millions that are walking around with no coverage and without ability to seek care should suffer in the meantime? What about the costs that are driven up by emergency rooms used as a vehicle as primary care for the uninsured?

      And I get the departure from Obama’s embrace of post-partisan politics. But I don’t think he can shoulder the blame alone. Is it right to simply oppose the bill – one that expands the rights of Americans to include the pursuit of simple, healthy living – without offering viable options? Some will say that it’s not that they didn’t want expanded health care, but rather that they didn’t want health care in this way. But this sounds like a vicious cycle of an excuse to put any reform on the backburner. Where does it end? My only concern with not one Republican voting for the Bill is “politics as usual” game playing. I do think it was a political move to create fodder for feast of mid-term elections in November. I have to admit, the reward for the risk will be an interesting one to see played out. I don’t believe this health care will be as damning as they have predicted to be. And that, my friend, could be the devil in the details coming back to rear it’s ugly head.

      But, back to health care…I’m back to agreeing with you that this is not the most inclusive Bill possible. But, we deviate in that I am okay with making it better for a larger group of people. And as far as special interest groups…they are an ugly reality in politics. So, how do we address them? Is it a pick and choose game? That may sound too all-encompassing, but it’s true. I think some credit should be given to the Administration for being able to shun the lobbyists representing the large insurance companies, no?

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