Sunday, March 21, 2010
Yes he did.
Tuesday, December 22, 2009
Comparison of House and Senate Versions of Health Reform Bill
BusinessWeek.com published this comparison of the House and Senate versions of the health insurance reform bill:
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The Senate Democratic bill (Patient Protection and Affordable Care Act):
WHO'S COVERED: About 94 percent of legal residents under age 65 -- compared with 83 percent now. Government subsidies to help buy coverage start in 2014. Of the remaining 24 million people under age 65 left uninsured, about one-third would be illegal immigrants.
COST: Coverage provisions cost $871 billion over 10 years.
HOW IT'S PAID FOR: Fees on insurance companies, drugmakers, medical device manufacturers. Medicare payroll tax increased to 2.35 percent on income over $200,000 a year for individuals, $250,000 for couples. A 10 percent sales tax on tanning salons, to be paid by the person soaking up the rays. Cuts to Medicare and Medicaid. Forty percent excise tax on insurance companies, keyed to premiums paid on health care plans costing more than $8,500 annually for individuals and $23,000 for families. Fees for employers whose workers receive government subsidies to help them pay premiums. Fines on people who fail to purchase coverage.
REQUIREMENTS FOR INDIVIDUALS: Almost everyone must get coverage through an employer, on their own or through a government plan. Exemptions for economic hardship. Those who are obligated to buy coverage and refuse to do so would pay a fine starting at $95 in 2014 and rising to $750.
REQUIREMENTS FOR EMPLOYERS: Not required to offer coverage, but companies with more than 50 employees would pay a fee of $750 per employee if the government ends up subsidizing employees' coverage.
SUBSIDIES: Tax credits for individuals and families likely making up to 400 percent of the federal poverty level, which computes to $88,200 for a family of four. Tax credits for small employers.
BENEFITS PACKAGE: All plans sold to individuals and small businesses would have to cover basic benefits. The government would set four levels of coverage. The least generous would pay an estimated 60 percent of health care costs per year; the most generous would cover an estimated 90 percent.
INSURANCE INDUSTRY RESTRICTIONS: Starting in 2014: no denial of coverage based on pre-existing conditions. No higher premiums allowed for pre-existing conditions or gender. Limits on higher premiums based on age and family size. Starting upon enactment of legislation: children up to age 26 can stay on parents insurance; no lifetime limits on coverage.
GOVERNMENT-RUN PLAN: In place of a government-run insurance option, the estimated 26 million Americans purchasing coverage through new insurance exchanges would have the option of signing up for national plans overseen by the same office that manages health coverage for federal employees and members of Congress. Those plans would be privately owned, but one of them would have to be operated on a nonprofit basis, as many Blue Cross Blue Shield plans are now.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: Self-employed people, uninsured individuals and small businesses could pick a plan offered through new state-based purchasing pools. Would generally encourage employees to keep work-provided coverage.
DRUGS: Grants 12 years of market protection to high-tech drugs used to combat cancer, Parkinson's and other deadly diseases. Drug companies contribute $80 billion over 10 years with the majority of the money used to limit the prescription coverage gap in Medicare.
CHANGES TO MEDICAID: Income eligibility levels likely to be standardized to 133 percent of poverty -- $29,327 a year for a family of four -- for parents, children and pregnant women. Federal government would pick up the full cost of the expansion during the first three years. States could negotiate with insurers to arrange coverage for people with incomes slightly higher than the cutoff for Medicaid.
LONG-TERM CARE: New voluntary long-term care insurance program would provide a basic benefit designed to help seniors and disabled people avoid going into nursing homes.
ANTITRUST: Maintains the health insurance industry's decades-old antitrust exemption.
ILLEGAL IMMIGRANTS: Would be barred from receiving government subsidies or using their own money to buy coverage offered by private companies in the exchanges.
ABORTION: The bill tries to maintain a strict separation between taxpayer funds and private premiums that would pay for abortion coverage. No health plan would be required to offer coverage for the procedure. In plans that do cover abortion, beneficiaries would have to pay for it separately, and those funds would have to be kept in a separate account from taxpayer money. Moreover, individual states would be able to prohibit abortion coverage in plans offered through the exchange, after passing specific legislation to that effect. Exceptions would be made for cases of rape, incest and danger to the life of the mother.
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The House bill (Affordable Health Care for America Act):
WHO'S COVERED: About 96 percent of legal residents under age 65 -- compared with 83 percent now. Government subsidies to help buy coverage start in 2013. About one-third of the remaining 18 million people under age 65 left uninsured would be illegal immigrants.
COST: The Congressional Budget Office says the bill's cost of expanding insurance coverage over 10 years is $1.055 trillion. The net cost is $894 billion, factoring in penalties on individuals and employers who don't comply with new requirements. That's under President Barack Obama's $900 billion goal. However, those figures leave out a variety of new costs in the bill, including increased prescription drug coverage for seniors under Medicare, so the measure may be around $1.2 trillion.
HOW IT'S PAID FOR: $460 billion over the next decade from new income taxes on single people making more than $500,000 a year and couples making more than $1 million. The original House bill taxed individuals making $280,000 a year and couples making more than $350,000, but the threshold was increased in response to lawmakers' concerns that the taxes would hit too many people and small businesses.
There are also more than $400 billion in cuts to Medicare and Medicaid; a new $20 billion fee on medical device makers; $13 billion from limiting contributions to flexible spending accounts; sizable penalties paid by individuals and employers who don't obtain coverage; and a mix of other corporate taxes and fees.
REQUIREMENTS FOR INDIVIDUALS: Individuals must have insurance, enforced through a tax penalty of 2.5 percent of income. People can apply for hardship waivers if coverage is unaffordable.
REQUIREMENTS FOR EMPLOYERS: Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payrolls under $500,000 annually are exempt -- a change from the original $250,000 level to accommodate concerns of moderate Democrats -- and the penalty is phased in for companies with payrolls between $500,000 and $750,000.
Small businesses -- those with 10 or fewer workers -- get tax credits to help them provide coverage.
SUBSIDIES: Individuals and families with annual income up to 400 percent of poverty level, or $88,000 for a family of four, would get sliding-scale subsidies to help them buy coverage. The subsidies would begin in 2013.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: Beginning in 2013, through a new Health Insurance Exchange open to individuals and, initially, small employers. It could be expanded to large employers over time. States could opt to operate their own exchanges in place of the national exchange if they follow federal rules.
BENEFITS PACKAGE: A committee would recommend a so-called essential benefits package including preventive services. Out-of-pocket costs would be capped. The new benefit package would be the basic benefit package offered in the exchange.
INSURANCE INDUSTRY RESTRICTIONS: Starting in 2013, no denial of coverage based on pre-existing conditions. No higher premiums allowed for pre-existing conditions or gender. Limits on higher premiums based on age.
GOVERNMENT-RUN PLAN: A new public plan available through the insurance exchanges would be set up and run by the health and human services secretary. Democrats originally designed the plan to pay Medicare rates plus 5 percent to doctors. But the final version -- preferred by moderate lawmakers -- would let the HHS secretary negotiate rates with providers.
CHANGES TO MEDICAID: The federal-state insurance program for the poor would be expanded to cover all individuals under age 65 with incomes up to 150 percent of the federal poverty level, which is $33,075 per year for a family of four. The federal government would pick up the full cost of the expansion in 2013 and 2014; thereafter the federal government would pay 91 percent and states would pay 9 percent.
DRUGS: Grants 12 years of market protection to high-tech drugs used to combat cancer, Parkinson's and other deadly diseases. Phases out the gap in Medicare prescription drug coverage by 2019. Requires the HHS secretary to negotiate drug prices on behalf of Medicare beneficiaries.
LONG-TERM CARE: New voluntary long-term care insurance program would provide a basic benefit designed to help seniors and disabled people avoid going into nursing homes.
ANTITRUST: Would strip the health insurance industry of a long-standing exemption from antitrust laws covering market allocation, price-fixing and bid rigging. The bill also would give the Federal Trade Commission authority to look into the health insurance industry at its own initiative.
ILLEGAL IMMIGRANTS: Would be barred from receiving government subsidies but permitted to use their own money to buy coverage offered by private companies in the exchange.
ABORTION: Private companies in the exchange could not offer plans covering abortion if those plans received federal subsidy money. Most plans in the exchange would be affected, because most consumers in the exchange would be using federal subsidy money to buy coverage. The new government plan could not offer abortion coverage. Insurance companies would be permitted to offer supplemental abortion coverage in separate plans that people could buy with their own money. Use of federal money for abortion coverage would be limited to cases of rape, incest or danger to the woman's life.
Fix The Senate Health Care Bill
Fix The Senate Health Care Bill
For those of you following the continued drama surrounding the health care reform bill(s) floating around Washington, here's a summary of progress to date. In order for this bill to become law, both houses of Congress (the Senate and the House of Representatives) put forward their own preferred versions of the bill. Once each house of congress passes its individual version of the bill, the two versions will be sent to a committee comprised of members of both houses, from both Democratic and Republican backgrounds. This committee will determine which parts of the proposed bills to include in the final bill, and which parts to discard. In other words, the committee will compose the final bill.
Currently the House of Representatives has put forward a version of the health reform bill that aggressively tackles issues such as the U.S.'s lack of public insurance options, and the fact that insurance companies are currently exempt from the usual anti-trust laws by which other industries must abide. The Senate, after much debate and a spoiled filibuster, is in the final throes of putting forward its own, significantly less progressive, version of their bill.
Below are five main ways that the Senate version of the health reform bill differs from the House version.
Five Critical Flaws in the Senate Health Care Bill
The Senate bill would:
#1—Deny Americans the choice of a public option. In contrast, the House bill contains a national public option, the key to real competition, greater choice, and lower costs.1
#2—Leave insurance unaffordable for some lower income and working people. Both bills require virtually all Americans to buy insurance. But even with the subsidies provided, some families could have to pay up to 20% of their income on health care expenses.2
#3—Impose dangerous restrictions on women's reproductive health care. Unfortunately, both bills do this and the House provision is worse. Both versions would be a dangerous step and neither should be in the final bill.3
#4—Tax American workers' health coverage to pay for reform. The Senate would pay for part of reform by taxing the hard-won benefits packages of some working Americans. The House, on the other hand, pays for reform with a small surcharge on only the wealthiest Americans—a far better approach.4
#5—Allow insurance companies to remain exempt from anti-trust laws. Under current law, insurance companies are actually exempt from laws designed to prevent monopolies and price-gouging. The House bill would fix this, but the Senate bill leaves it in place.5
Of course, these aren't the only problems with the bill. Most glaringly, both the Senate and House bill would leave millions uninsured,6 a far cry from the vision of universal coverage so many of us have fought for. That remains a long-term goal.
But these five things need to be fixed immediately—and we need to spread the word to make sure House and Senate leadership and the White House get the message we're counting on them to craft a final bill with these key fixes...
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Sources:
1. "Comparing the House and the Senate Health Care Proposals: Public Plan," The New York Times, December 19, 2009
"The House Bill and the Senate Bill," The Now! Blog, December 21, 2009
"Why We Need a Public Health-Care Plan," The Wall Street Journal, June 24, 2009
"Why a public health insurance option is key to saving costs," Economic Policy Institute, June 25, 2009
2. "Assessment of Affordability Provisions in the Exchange in House (H.R. 3962) and Senate (H.R. 3590) Health Reform Bills," Health Care for America Now
"Finishing Reform Right: Fixing affordability before the President signs a health care bill," The Now! Blog, December 22, 2009
"Comparing the House and the Senate Health Care Proposals: Individual Mandate," The New York Times, December 19, 2009
"The House Bill and the Senate Bill," The Now! Blog, December 21, 2009
"Senate health bill is launch pad," Jacob Hacker, December 22, 2009
3. "Comparing the House and the Senate Health Care Proposals: Abortion," The New York Times, December 19, 2009
4. "Comparing the House and the Senate Health Care Proposals: Paying for the Proposals," The New York Times, December 19, 2009
5. "Comparing the House and the Senate Health Care Proposals: Insurance Regulations," The New York Times, December 19, 2009
6. "H.R. 3962, Affordable Health Care for America Act," Congressional Budget Office, November 20, 2009
"Patient Protection and Affordable Care Act," Congressional Budget Office, November 18, 2009
"REPORT: How the Senate Bill Compares to Other Reform Legislation," Think Progress, November 19, 2009
Wednesday, December 16, 2009
Scary New Health Care Tax = Small Tax on Cosmetic Surgery
For example, perhaps Cousin Sally was just diagnosed with leukiemia. But Sally is widowed and works two part time jobs to keep her kids in shoes and food, and neither of her low-wage jobs provides her with health insurance. On the other side of the tracks, Banker Joan has traded her youthful years to become a wealthy businesswoman, and wants to finally enjoy her single retirement. So she would like to get nice, natural looking facelift and peruse the single life in her golden years. The Question: Is it wrong for Congress to suggest that a small tax on Joan's fully elective, cosmetic procedure is in order to help Sally afford to get medical insurance, which will help Sally work longer, and ensure that she is around and healthy enough to take care of her kids for as long as medically possible?
It's a question of priorities. Every special interest group in our nation has political action committee (PAC), and guess whose PAC is spending lots of money to tell you that this kind of taxing priority is wrong, wrong, wrong? If you guessed the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery (if you've misplaced your thesaurus, "aesthetic" translates as "pretty") then you are a winner! These are the doctors who are being paid (and have a personal financial stake) in telling you that Congress is trying to raise health care taxes - they just don't happen to mention that the tax is relatively small for each individual, and is only applied to non-medically required, purely aesthetic, elective cosmetic procedures.
These are the kinds of priorities that Congress is currently debating with a health insurance reform bill. What they are NOT debating is a "government takeover" of health care (remember, this is insurance reform, not doctor/patient reform; no matter what version of the bill passes, you will be able to keep your own doctor and your current insurance if you can afford and prefer it).
And since we're on the topic of priorities, let's discuss this proposed "cosmetic tax." What are the doctors who specialize in cosmetic procedures claiming is wrong with such a tax? Why, they say it is discriminatory. So apparently they're under the impression that people who can afford to pay out of pocket to have purely cosmetic procedures are some kind of protected class in our society...while apparently impoverished parents and children who suffer and die due to lack of insurance should be just swept aside as a national "oops, my bad."
Look, as a former policy specialist and an aging woman myself, do I think that this tax is likely to be primarily paid by women? Of course. Women are by far the largest consumers of elective cosmetic procedures (although men are gaining on us). But the key word here is "elective." If you really don't want to pay tax on a cosmetic procedure, don't get the procedure, or get it elsewhere (although you'll probably just end up paying for another nation's taxes if you do so). If you want the procedure enough to pay tax on it... well then you can probably afford your health insurance anyway. Consider yourself fortunate to be financially (and medically) stable in a time when millions of your fellow Americans are not.
Americans are by and large a compassionate, caring group of people. If 9/11 taught us nothing else, it taught us that when the shit really hits the fan, we as a nation want to be one community that cares for its own. So I really believe that once we learn who is truly in the business of trying to buy our votes - either with money, or with hyperbolic emotional half-truths and scare tactics, then we as a nation will do the right thing for our communities and our country. So keep an eye out, and remember to always ask the question: Who stands to benefit from this commercial, or that speech, or the other emotion-laded, fist-pounding diatribe? And once you find out who that beneficiary is, ask yourself whether they're really concerned with the best interests of you and your family, or simply with their own pocketbooks. Then you'll have an educated base from which you can confidently decide your own priorities.
Friday, October 16, 2009
Why We Should Support Reform NOW
The President's Plan for Health Reform“It will provide more security and stability to those who have health insurance. It will provide insurance to those who don’t. And it will lower the cost of health care for our families, our businesses, and our government." – PRESIDENT BARACK OBAMA | ||
If You Have Health Insurance, the President's Plan:
| If You Don’t Have Insurance, the President's Plan:
| For All Americans, the President's Plan:
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Wednesday, October 7, 2009
Medical Debt #1 Cause of Bankruptcy In the U.S.
Are you concerned about the state of the U.S. economy? If you are, then consider the findings of a recent article in the American Journal of Medicine (among multiple other sources), which reports that medical debt is the #1 cause of bankruptcy in the U.S.
If you are like most Americans, you live one medical disaster away from poverty. What's worse, many of those who have unwillingly found themselves sunk in such debt had health insurance. The Washington Post points out that of those who were forced into bankruptcy by medical debt, nearly 80% had some health insurance coverage at the time of their illness, yet still reported an average medical debt of nearly $18,000. Meanwhile, Americans who did not have health insurance carried an average medical debt of over $26,000. What does all of this mean? As the health insurance system in the U.S. currently stands, you are more likely to fall to bankruptcy for medical debt than for any other reason - even IF you have health insurance!
Isn't it time we demanded more for our money?
Watch CBS News Videos Online
According to CBS News:
Health and Human Services Secretary Kathleen Sebelius pointed out on The Early Show Friday that many Americans who have health insurance have inadequate protection, and increasing out-of-pocket expenses are "crushing families and businesses."
"That’s why President Obama is so focused on health reform this year," she said, "lowering costs for those who have coverage already so that we can keep the coverage we have, keep the doctors we have, but also to provide some coverage and some payment for the millions of Americans -- close to 50 million -- who have no insurance coverage at all."
Thursday, October 1, 2009
A Public Option Story: How "Socialized Medicine" Is Already Saving Lives In America
Critics of health care reform seem eternally focused on the potential for problems, but rarely do we take the time to consider the possibility of the "best case scenario" where the public option is concerned. But we needn't tax our imaginations to see what a successful health policy would look like. Surprisingly, it seems that a successful public option already exists in America... for people with one specific diagnosis.
Jennifer Nix is the author of the article "I Love My Socialist Kidney," a first-hand look at how a government-sponsored "public option" for patients with end-stage renal disease has been saving lives for decades right here in the U.S... and how it saved hers.
The day after this country elected Barack Obama its 44th president, a doctor told me I'd inherited from my father a rare form of cystic kidney disease and that I was already in renal failure. Beyond the devastation I felt on hearing this news, and despite having health insurance, my greatest fear in those first, foggy days was one that haunts millions of Americans. I was more terrified of being dropped or denied treatment by my insurer over some minuscule technicality than I was of facing the disease.... A few weeks into my ordeal, however, I learned that my diagnosis qualified me for a little-known existing "public option," or government health insurance plan. The same program had saved my father's life, but I was frankly surprised to learn it still existed despite numerous legislative changes through the decades. Today, almost a year after my diagnosis and amid the disheartening acrimony and willful misinformation pervading our healthcare debate, I can bear witness to what constitutes "socialized medicine" in the United States....
By the 1960s, dialysis and transplantation were established as effective treatments for kidney failure, which could allow ESRD patients to live full and productive lives. With no funding for long-term, chronic dialysis, however, hospital committees decided who would live and die. These committees looked at age, complicating health concerns, psychological well-being and a patient's "social worth," but because the wealthy could afford to pay for their treatments outright, they were the most often treated, resulting in a class-driven mortality rate. The government "death panels" decried in the hyperbolic rhetoric of today's right-wing anti-healthcare reform fanatics may be imaginary, but in the 1960s and early '70s there really were death panels for ESRD patients....
Without the government stepping in to remedy a situation that the market and private business willfully ignored, both my father and I would most likely have died within a year of our diagnoses. I believe every American citizen deserves the same kind of health security. Even before I got sick, my father's story was the reason I became an activist myself during the Bush years, as I saw people's faith in government dwindling. It's why I fought so hard to get Obama elected, and why I'll be gravely disappointed if he gives in on the public option....Click HERE to read the entire article.
The author makes a strong point about the idea of "death panels," as the ultra neo-conservative rhetoric has labeled them. Although the myth of Social Security "death panels" in President O'bama's plan is patently false, the idea behind them is perhaps more based in reality than we would care to admit to ourselves.
Today, the specter of a "death panel" lingers over American families who receive a chronic or terminal medical diagnosis. For those who have health insurance, the stress of waiting and wondering whether their insurance will cover the high costs of treatment - or continue to cover them at all - has become in itself a part of the illness which much be treated. The same can be said for the millions of Americans who are lost somewhere in the (usually multi-year) process of applying for disability. In these situations, an insurance executive or an administrative law judge will literally make decisions of life and death - decisions which would be left in the hands of the patients and their own physicians if a public option for health insurance were available to these same patients.
So rather than pouring our national energy into figuring out ways that a policy of providing health insurance for everyone could go wrong, perhaps we have reached a point where we need to admit to ourselves that failing to provide such coverage has already cost us too much in terms of our economy, our national standing, and - most importantly - the lives of our own loved ones. Our lack of universal health coverage has already gone far wrong. It is up to us as citizens of "the world's wealthiest nation" to refuse to allow such a monumental failure of policy to continue. What we can do, as the moral and just society we want ourselves to be, we must do. What we can do to save one life, we can do to save many. We have seen the devastation caused by the lack of such a policy, and we can see how a successful policy can be run. Now it is up to us as Americans to make it work for everyone.
Monday, September 28, 2009
Health Care Reform = Insurance Reform; The Difference Between Public/Private, and Profit/Non-Profit
How Can the Public Own An Insurance Organization?
Labels: insurance companies, public option
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References and Sources
- A Public Option Success Story
- American Journal of Medicine On Health Care and Bankruptcy
- Business Week compares Senate and House versions of bill
- CHIP - Children's Health Insurance Program
- Contact Representative Anh "Joseph" Cao
- Contact Senator David Vitter
- Declaration of Independence
- Facts About Louisiana's Uninsured
- Graph Showing Louisiana's Health Index Compared to Other States
- How States Compare On Health Care
- http://moveon.org
- LA Representative Anh "Joseph" Cao - historic vote
- LA Representative Anh "Joseph" Cao - party lines are no match for him
- LA Senator David Vitter - Prostitution Scandal
- LA Senator David Vitter - Top Campaign Contributers
- LA Senator Landrieu Hopes To End CHIP
- LA Senator Landrieu Supports Reform At Last Minute
- Louisiana Clinics and Hospitals
- Louisiana Ranks Last In Health Care
- Louisianans Most Likely to Lose Insurance
- Medical debt = #1 Cause of Bankruptcy
- Move On
- Non-Profit Insurers Haven't Made Much Difference
- Organize America - Support Reform Now
- Pelican Briefs
- Scary New "Health" Tax = Tax On Purely Cosmetic Procedures
- Still no Equal Rights Amendment?
- U.S. Census Bureau's Facts on Voting
- Video Challenge
- Video Challenge Results - vote for your favorite!
- What Insurance Reform Means for Louisiana