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Posted Thursday, October 29, 2009 12:15 PM

What You Need to Know About Pelosi's Health-Care Bill

Katie Connolly

House Speaker Nancy Pelosi unveiled her long-awaited health-care bill today. There aren't any real surprises. Most of the newsy provisions have been well known for weeks now. The bill will likely extend coverage to 36 million Americans, and it will prevent insurers from dropping or denying coverage. It also won't add to the deficit, thus satisfying one of the president's primary objectives. The CBO estimates the cost at under $900 billion. Here are a few of the key points you need to know about the bill:

  • The change that will perhaps have the most impact on Americans is the expansion of Medicaid. Under Pelosi's bill, anyone earning up to 150 percent of the poverty line will be eligible for Medicaid. This is an increase on previous iterations─and the Senate bill─which only covered people up to 133 percent of the poverty line.
  • The bill includes a public option but not the so-called robust plan. Hospitals and providers will be able to negotiate their rates with the government insurer.
  • A surtax will be leveled on wealthy Americans─those earning over $500,000 for individuals or $1 million for families─to help offset costs. This differs from the Senate bill which relies on a tax on "Cadillac," or expensive, insurance plans. Medical-devices companies will also be subject to a new tax.
  • The bill removes the health-insurance industry's exemption from antitrust laws, which will no doubt upset insurers.
  • Like her Senate colleagues, Pelosi won't be offering a "doc's fix," that is, she won't offer a long-term solution to a problematic Medicare formula that causes reimbursement rates for physicians treating Medicare patients to decrease.
  • Medicare expenditures will be cut by approximately 1.3 percent, with the pharmaceutical industry bearing the brunt.

The bill currently has no Republican support. Abortion remains a sticking point for some Democrats, like Bart Stupak of Michigan, who want to see the language tightened to prohibit any federal funds being used to fund abortions, meaning that government subsidies can't be put toward plans that cover abortion.

Politico reports that Pelosi has reneged on a deal she made with Anthony Weiner of New York to allow a vote on a single-payer system on the floor. The vote would have failed by a large margin, but its symbolism was important to liberals who feel that they've already compromised enormously in backing a public option over single payer.

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Posted By: ceanf9 (November 6, 2009 at 11:14 PM)

wont add to the deficit? just like obama said he wouldn't raise anybody's taxes.  rriiigghhhtt.  if you honestly believe that, you are delusional, and i suggest you seek professional help.

@james...  health insurance companies operate at a 3-4% profit margin.  hardly the 'parasite' sucking 'vast amounts' of money from the american people that you claim them to be.  you talk big about choice.  how much choice will you have with a government ran plan that will try to shove all americans into the same bureaucrat designed mold?  at least with private insurance, there are many companies to choose from, so if you decide one is wrong for you, there are others available.  that wont be the case when this public option becomes the only option.  there will be no 'market' for health insurance once the public option undercuts all private options and drives them out.  it is amusing to me that you try to claim that ONE government designed plan will give americans CHOICES when it comes to health care.  open your eyes james. you have been brainwashed by pelosi and friends.


Posted By: Davole (October 31, 2009 at 1:26 PM)

James in Atlanta -

You claim that “Health insurance companies are a parasite on the health care system in the USA” - but on a vastly greater scale, democrat politicians, especially Barack Obama, Nancy Pelosi, and Harry Reid are gigantic parasites on all Americans.

I agree with your suggestion that “It is time that we let the market place decide the fate of health insurance companies,” but I disagree with your further comment that “It just makes good business sense to have a strong public option.”

The best way to enable the marketplace to decide the fate of health insurance, and its numerous companies, is the shatter the democrat roadblock which forbids shopping for healthcare insurance policies across state lines. That freedom apparently works to reduce auto insurance, so why shouldn’t it enable cost savings for healthcare?

It is not good business sense to have a strong public option. Such an ineffective but coercing option would be administered by the government, through a multi-layer system of bureaucratic intermediaries which would mandate whatever services would be permitted. The public would have no direct and effective say in deciding whatever services would be provided.

You assert that a public option will inevitably “lower health care costs and be able to provide higher quality health care.” That naive argument is validly contradicted  by the almost bankrupt government programs of Medicare and Medicaid. Politicians, usually democrats, love to low-ball expected costs to implement such programs. Then they pathetically try to change the topic when the actual costs are significant multiples of the original projection. And years later, when the costs have really skyrocketed, they resort to several poor excuses, one of them being that the bill was just too important to fail, that there was no time to adequately read and debate it, and that it had to be approved immediately.  

Again, you naively believe that the government scheme “will be run to cover administrative costs and not for profit and greed.” It’s surprising that democrat sympathizers don’t realize that such a scheme would lavishly pay back the vast conglomerate of obamabo(ugh)t supporters, especially those lab-coat provided supposed medical workers who were commissioned to appear for a recent televised photo-op.    

Although, in your words, “ The system will also provide good paying and secure employment for many Americans who are out of work,” it will also result in a probable mass exodus of competent doctors, especially skilled surgeons, who will choose to market their services more productively elsewhere. So, expect “the system” to be one fraught with ridiculous wait-periods for both critical and elective surgeries.

It is absurd to read your statement ” I would be glad to purchase insurance from a public administered plan and even feel it my patriotic duty do so” - great shades of Sloppy Joe Biden!

It used to be considered patriotic for Americans to have the FREEDOM to exercise a right to choose how to live!  

You stated that you are “very un-happy with the health insurance I have.” The Constitution does not guarantee you a right to happiness - rather, it guarantees you a right to the PURSUIT of happiness.

With regard to your own health insurance plan, why don’t you DEMAND that the partisan democrat scheme implement the option for Americans to shop across state lines for healthcare policies, thereby lowering the costs and expanding the quality of coverage for all plans?

You object to your insurance plan which stipulates where medical procedures will be provided.

Won’t a government run plan also dictate that kind of restriction, probably in addition to deciding for you who your doctor will be, how often you will be allowed to see him or her, the maximum time for any visit, the only kinds of treatment which will be permitted, and the wait-periods for visits and treatment, along with the probable introduction of user fees somewhere in the future?

Then, if you object to your lack of treatment options, to whom will you turn for arbitration - some anonymous panel of so-called experts who reside in a distant state, and who are not even obliged to respond to your complaints?

Have you ever wondered why Nancy Pelosi’s scheme amounts to 1990 pages of sometimes  incomprehensible legalese which the majority of Americans cannot comprehend?

Note - this is a trial-lawyer’s ticket to Nirvana, and the democrats purposely steer clear of including the cost saving tort reform provision which opponents of the scheme propose as a significant cost saving measure.

Rest assured - somewhere in all the devious loop-holes of this Power-Grab Scheme which democrats are determined to foist on all Americans, except for themselves (they will still retain their gold-plated medical insurance plans), there will probably be a means for disgruntled taxpayers to (as you say) “die quickly.”  

You commiserate that “All most (did you mean almost?) every other developed country has a lower infant mortality rate and have longer life spans and suffer less from preventable health disorders. Yes, there is some truth to that allegation, mainly for the following 4 reasons. Some countries measure infant mortality rates differently. A lot of illegal immigrants purposely sneak into the US to give birth to their undernourished and in poor health offspring. Whereas most other developed countries have somewhat more homogenous populations, the US is much more diverse, and includes greater percentages of immigrants from poor undeveloped nations in which healthcare is almost non-existent. Lastly, the US is probably the country with the greatest percentage of obese and morbidly obese persons in the world.

In your blindfolded rampant democrat zeal, you pathetically attempt to deride the GOP and attribute to them the false statement - No we can't!

Their proposal is Yes we Can - provided that non-deceptive, intelligent, affordable, and constitutional provisions are proposed and implemented.

Yes, Olympia Snowe has finally made the right decision to reflect the wishes of her constituents by opposing the democrat administration's demand for a government-run scheme.

Although Americans (and many ACORN sponsored illegal immigrants and democrats cast multiple ballots) naively voted for Barack Obama’s phantom concept of unspecified change, many of them have finally become so offended by his radical, devious, unpatriotic, and unconstitutional policies that true change is being demanded. And it all starts with defeating that massive Government Power-Grab Enslaving Scheme!


Posted By: James In Atlanta (October 31, 2009 at 3:38 AM)

First do not confuse health care industry with health insurance industry!  Health care industry is health care providers and the companies they work for to provide services to take care of sick and injured Americans.

The health insurance industry is a group of companies that take money from American citizens and promise to take care of them when they get sick or injured. In reality they extort money and often refuse to pay for sick and injured people health care they cover to increase profit margins.

It is time that We the People of the United States in order to form a more perfect union and to provide for the common good establish a strong public option. A single payer system would be better but a strong public option is better than what we have now or the ridiculous bill that the magnificent six, a bi-partisan group came out with a bill that was obviously written by the health insurance lobby.

Health insurance companies do not provide health care; health care workers and the companies they work for provide health care and they do not care who pays them for services rendered.

Health insurance companies restrict choice of patient right to choose; choose out side the plan and they do not pay.  Health insurance companies often will not pay for practices and procedures deemed necessary by the patient’s doctor leaving it up to the patient to pay for necessary drugs or procedures out of their own funds.

Health insurance companies are a parasite on the health care system in the USA and remove vast amounts of money for lavish office furnishings and give large bonuses to employees who find new ways to say no or limit coverage of the people they insure.

It is time that we let the market place decide the fate of health insurance companies.  It just makes good business sense to have a strong public option that will insure those who can not afford insurance limiting costs by cutting out the middle man and allow people who can afford insurance participate in the program too if they choose to do so.

A system to provide health care ran by the people for the people and not for profit and greed is long over due. In the long run it will lower health care costs and be able to provide higher quality health care since the organization will be run to cover administrative costs and not for profit and greed.  The system will also provide good paying and secure employment for many Americans who are out of work.

Health insurance companies make vast amounts of profits at the expense of sick and injured Americans by saying no or refusing to pay health care providers for services rendered. More often than not the patient/sick or injured persons insurance "runs out" or the bills are not paid in full and the American has to go bankrupt and may end up loosing everything. This is immoral.  

I would be glad to purchase insurance from a public administered plan and even feel it my patriotic duty do so.  

I am very un-happy with the health insurance I have. I pay over ten thousand dollars per year in premiums and deductibles for me and my wife. Once the 5,000.00 deductable is meet then they cover 80/20 leaving us to pick up the remaining 20%. I have to pay full price for drugs and it limits my choice of doctor and other health care providers, the drugs they prescribe and the procedures they deem necessary for our health care. Our insurance company goes to the extreme of dictating where any procedures must be carried out and if the doctor on the plan does not work for the place where the procedure is allowed then one has to start from square one.  This may takes weeks or months of research to have something taken care of like a colonoscopy to remove bleeding polyps or a breast lump biopsy.

It would be nice to take my insurance card to the doctor of my choosing and he provide the health care he deems necessary in a timely manner without the fear of being dropped from the plan or being priced out of it by ever increasing premiums and deductibles because the doctor did his job and found something wrong and is taking care of it.

Do not allow the insurance lobby and the fear and scare adds in the media block change.  It is time all Americans have affordable quality health care with out the fear of going bankrupt or hoping that they die quickly or before their health insurance runs out or they are dropped when the policy is up for renewal.

Health insurance companies extort vast sums of money from sick and injured American citizens.  We enjoy the most expensive health care system in the world but rank 37th in quality of health care provided.  All most every other developed country has a lower infant mortality rate and have longer life spans and suffer less from preventable health disorders.

We need to remove the middle man from the equation and let them insure something else besides sick and injured Americans. Obviously they can not to the job effectively and efficiently and they do not want to change.  Sounds like the GOP.  No we can't!  The industry will fix it self without government intervention!

I only hope the democrats have the guts to get the job done.  In some cases this may mean biting the hand that feeds since a lot of them took campaign money from the health insurance industry.

We the people have the power of the vote and if this congress does not get the job done then it is our duty as American citizens to vote the incumbent out of office and replace them with someone who can follow the wished of the people who voted them in office.  Ms. Snowe did the right thing and followed the wishes of her constituents once.  We need more like her to do the right thing.

Call, write, fax, email your congressman and senator often and tell them your feelings on health care and other important issues. Do not allow industry lobbies to dictate legislation.  We voted for change by electing President Obama and he needs our support to make change happen for us all! Change will not happen over night and the GOP is in lockstep with industry lobbies to prevent, slow or limit change on important issues.

James In Atlanta