Congress clears historic health care bill

  By DAVID ESPO, AP Special Correspondent David Espo, Ap Special Correspondent   – 5 mins ago

WASHINGTON – Summoned to success by President Barack Obama, the Democratic-controlled Congress approved historic legislation Sunday night extending health care to tens of millions of uninsured Americans and cracking down on insurance company abuses, a climactic chapter in the century-long quest for near universal coverage.

"This is what change looks like," Obama said a few moments later in televised remarks that stirred memories of his 2008 campaign promise of "change we can believe in."

Widely viewed as dead two months ago, the Senate-passed bill cleared the House on a 219-212 vote. Republicans were unanimous in opposition, joined by 34 dissident Democrats.

http://news.yahoo.com/s/ap/us_health_care_overhaul;_ylt=Ap.Mf7SzFNBLEhoByPxDmUOs0NUE;_ylu=X3oDMTNuM244ZWI5BGFzc2V0A2FwLzIwMTAwMzIyL3VzX2hlYWx0aF9jYXJlX292ZXJoYXVsBGNjb2RlA21vc3Rwb3B1bGFyBGNwb3MDMQRwb3MDMwRwdANob21lX2Nva2UEc2VjA3luX3RvcF9zdG9yeQRzbGsDZnVsbG5ic3BzdG9y

http://news.bbc.co.uk/2/hi/americas/8579322.stm#id8570000/8579300/8579354
In talkback I commented the following

QuoteI'm mixed on it, on one hand it will "normalize" the coverage offered by health insurance, yet on the other hand, do little to make quality healthcare more affordable to the working poor. Until the profit motive is taken away from healthcare in the US it will always be subpar compared to other western nations.

I think it was a low blow that at the "last minute" he pulled his support for abortion just to gain the few votes he'd need to get this passed.

I'm not happy with it mostly because I've never had health insurance, and now I must have it to help pay so some fast food junky can now get their hearth problems or blood pressure problems fixed on the cheap while I, a somewhat healthy person MUST have health insurance.

I don't mind helping someone in need, but to help people who haven't made the right choices in life just bugs the hell out of me.

I smoked for several years of my life. If I get lung cancer it's my own damn fault and I sure as hell wont expect anyone to pay for me to get treatments.

Quote from: LivingInGrey on March 22, 2010, 10:47:58 AM

I'm not happy with it mostly because I've never had health insurance, and now I must have it to help pay so some fast food junky can now get their hearth problems or blood pressure problems fixed on the cheap while I, a somewhat healthy person MUST have health insurance.

I don't mind helping someone in need, but to help people who haven't made the right choices in life just bugs the hell out of me.

I smoked for several years of my life. If I get lung cancer it's my own damn fault and I sure as hell wont expect anyone to pay for me to get treatments.

I very much applaud this landmark legislation. The fact is, unless you are independently wealthy and able to self insure up to maybe $1 million, the rest of us may pay in either the near term or the future for your healthcare. Everyday, many uninsured are taken into hospitals for accidents and health emergencies without health insurance. The hospitals must care for these people, then "cost shift" the this care onto everyone elses bill. This raises the cost of health insurance for everyone.

Quote from: Kvall on March 23, 2010, 05:46:35 AM
Anyone know if there is much in the bill that is of direct relevance to trans-related care? I'm guessing that there aren't any specific mentions for or against trans HRT or SRS, but maybe there is wording included that will make it easier to get our care covered.

I seriously doubt that this bill will result in trans stuff being covered since they will more than likely pull the old "well, trans stuff is elective" kind of crap. But then again you can always get around that by having your doc word things the right way.

Quote from: juliekins on March 22, 2010, 07:26:21 PM
then "cost shift" the this care onto everyone elses bill. This raises the cost of health insurance for everyone.

Ok, I don't think it's the medical community that is responsible for this. I think it's the "community" that is responsible for this. Generations of people now have grown up thinking "if I can't afford it, someone else will help me". Now, we're getting into a situation where this generation is starting to think "someone else will pay for it" and not even bother to worry about the "if I can't afford it".

I have a lot of things I could say about this. But I think I'm just going to leave it here. I've deleted about 6 paragraphs of stuff I could say and all of them just sound too much like lashing out.

As one of my friends said, 'it sucks, but it's a start.'  There are very good and solid economic and social reason that EVERY OTHER INDUSTRIAL nation has universal coverage.  There are no good reasons we don't.  This effort traces back to 1912, when Theodore (Teddy) Roosevelt tried to do it, as did his cousin Franklin as part of the Social Security Act, then Truman tried to implement it at the end of the Second World War, then Johnson, then Nixon, then Carter, then Clinton.

I will say this, the passage of this, no matter how flawed, no matter how much fixin' it's a gonna take, this victory had made Obama pretty powerful.  He could have sat back and done nothing and still gone down in history for some very good reasons.  But he kept on fighting and fighting for this.  He took on about the most concerted efforts of opposition since the Civil Rights Act of the 60s, pretty much laid his entire presidency on the line, and he won.  He never quit and in an extremity rare move for any President, made good on his central campaign promise.  Even when people don't like what the deal is, they do tend to follow those that do what they say, and can get things done.  And it's going to be a huge energy draining gut punch to those that opposed it.

So now, having listened to the most moronic voices of their most extreme members the GOP is now going to have to run (again) as the party trying to undo what has been done - like they have done with Civil Rights, abortion rights, prayer in school, social security and everything else they have opposed, but been unable to change.  They took hugely bad advice when they stood for universal opposition, when they should have supported at least a few parts of it.  They may well be nothing but a rump party now existing in a few geographic locations, none of which have enough votes to win national elections.

The GOP has been busy conducting a circular firing squad for the last year based on the last election, now they have a new blame game to play, should be fun to watch (from a safe distance).

Quote from: Kvall on March 23, 2010, 05:46:35 AM
Anyone know if there is much in the bill that is of direct relevance to trans-related care? I'm guessing that there aren't any specific mentions for or against trans HRT or SRS, but maybe there is wording included that will make it easier to get our care covered.

I think the key terms here are "medically necessary" and "preexisting condition". How these will play together should be interesting in our case. If you have health insurance in 2014, all preexisting conditions come out of all provider policies. Therefore, if your doctor deems your preexisting condition medically necessary, it must be covered. This, I think plays directly into the AMA resolution No. 122 that was passed more than two years ago stating that trans related surgeries are medically necessary.

And, no, I doubt you'll see anything in any health bill that will specifically state "transexual care". It's all gonna ultimately come down to how it can be defined as being medically necessary by your doctor.


Dawn

My understanding is that if you don't have coverage now, and have a pre-existing condition, then you will be able to be covered within 3 months of the law going into effect. Of course, you will need to pay the policy premiums.

What this means, is that we can now clearly state that we are receiving care for our GID without fear that the insurance companies can turn us away. I understand that we will enter into special pools of policies available to those who are uninsured with pre-existing conditions. Once the broader provisions kick in during 2014, we won't need to be these special pools. Get It?

Julie,

So now, if we are able to buy a supplemental policy from a high risk pool; one to stand along side our existing policy (provided you are fortunate enough to have one. I am), is there going to be a waiting period before actual coverage takes place under the supplemental? Will the providers sell them month to month or will they sell them as a yearly premium option only? And, what are the supplementals going to cost?


Dawn

When people voluntarily share it is called charity. When people are forced to share it is called socialism. This is socialism. I don't believe this is a valid use of anyone's tax dollars. As far as I'm concerned it is all a slippery slope. If tax dollars are going to be used to make sure everyone has access to healthcare, next it will be food, housing, transportation, etc. In fact, a lot of this already does exist. Mass transit is often taxpayer-subsidized and many states have housing projects also paid for by taxpayers.

Last time I checked, our Founding Fathers and the Constitution made it clear that this country is to have limited government and that most matters are to be left to the states or the people. Should this slippery slope continue, it will basically become full-fledged communism. It is already fairly close to that anyway because why work at all or try to gain any wealth when you can just pretend your leg is hurt and pop out a couple of kids you know you won't be able to take care of and then get a free roof over your head, spending money, free transportation, free medical care, and in some cases even free cable TV and internet all off of the taxpayers' dole.

Worse this opens the door for more control over the populace. For example, my workplace is filled with obese people some of which are over 400 lbs and more than half over 200 lbs. It is not my job to tell them to exercise or eat right or what to do with their lives. If they can afford to engage in gluttonous behavior and likewise pay the medical bills for it, then that is fine because it is all about freedom of life, liberty, and pursuit of happiness. However, if the government decides that their medical bills are going to be paid for, the same government could then tell them how to eat and how to exercise. In fact, they could even round them up, imprison them, or even send them to the gas chambers. If you want an example of a country that did just that to groups that didn't fit its national socialism model, you can find one within the past 100 years.

It may sound far-fetched but it should be a wake up call. Anytime you need something you have two options: get it yourself or depend on someone else. When you acquire it yourself, you are in control over that aspect of your life. When you need someone else whether it be your family, a charity, or the government then control over that aspect of your life has now shifted away from you to them. An example of this is with government housing. I have seen government apartment buildings that have signs saying "No Firearms Allowed" and the tenants who live there have to sign agreements waiving rights that private apartments cannot or choose not to do such as consent to inspections of their dwellings for any reason at any time without notice. These may seem like small or subtle things but it starts a slippery slope. Someone who chooses between apartments is not likely to choose one that renders them defenseless in their own home and severely violates their privacy. With government, you don't have a choice.

Last but not least I wouldn't get too excited about this new Obamacare because it may well be declared unconstitutional and if not many individual states may opt out anyway. The federal government does not have a Constitutional right to require citizens to buy a product or service from a private company. I have no doubt that Obama's dream is a fully socialist nation where the entire populace lives, works, and spends where and how they are told, where the entire populace is disarmed and defenseless, and where the only education and information available is government-approved.

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Post Merge: March 30, 2010, 02:36:47 AM

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One more comment: I believe that services should be paid for by people who use them. I drive a car and I don't ride the bus yet part of my tax dollars go to subsidize the bus system. However, people who use the bus are not required to pay for part of the gasoline that goes in my car. That is because the government would see them as a have-not and me as a have. Again, proof of socialism. The same with the public school system. I have no children and have no intention of ever having them. I never attended public school either but went to a private one. I may have a neighbor who has six children all in the public school system. Because that person gets so many tax credits due to all of their kids they likely pay little to nothing towards the public education with their tax dollars. Instead, me being single with no children I basically pay a higher tax rate subsidizing my neighbors' excessive childbearing. Again, people who use the services should be those paying for them. In many ways this country is already like a shell of capitalism over communism.

As to this healthcare, it is just like the prior example of driving a car vs. taking the bus. The government will get to decide what is covered and what is not. For instance, they may cover lung cancer treatment despite the patients' 50 years of cigarette smoking yet deny me BA and SRS. Or, me and another patient could have the same disease yet the other patient chooses Western medicine which is covered whereas I choose alternative therapy which is not covered. I don't see how this is not a serious abuse of tax dollars and tyrannical form of government control. When 'they' get to decide all of these different things, the government is clearly not "of the people, by the people, and for the people."

Many people who are obese or smoke etc etc have mental and genetic problems. I hope this gets them help so they don't have to smoke or overeat.

I am all for this and we are not like we were back in 1776 so we have to change. Then people rode horses and didn't have cars etc. Things have changed and our constitution has to change to reflect that fact.

That car you are driving in such an 'individual freedom' way - is being driven on government roads, highways and freeways.   

Good health care, like good educational policies, like transportation and other infrastructure projects are simply good industrial policy, and it's high time we enacted some sort of industrial policy before we lose all our industrial base

I'm not sure what you mean by our Constitution needing to change with the times. You mentioned transportation evolving from horses to cars. That simply means that there has been an evolution in technology. I don't see how the principles of liberty need to be changed with technology except to keep an even closer watch on them if necessary. Again, this comes down to freedom vs. security. Our Constitution places a far greater emphasis on freedom than security.

Freedom basically means you have the individual right to pursue life, liberty, and happiness but that there are no guarantees. You could be doing everything right but still get run over by a car, shot, robbed, or faced with survival problems due to lack of food, healthcare, housing, etc. That means that a society that places an emphasis on freedom will focus on having just the right laws and regulations in place to punish people who violate other people's freedom or infringe on their survival habits. That still doesn't mean that anything is guaranteed to all individuals.

Security basically means you are guaranteed the types of things mentioned above: guaranteed safety and survival. That means taking laws and regulations to ensure fair and equal opportunity much farther to basically laws and regulations forcing people to share, cooperate, work together, give up individuality, etc. Taken to the extreme you have a forced safety and forced healthy society where everyone who is able is required to work, required to share their wealth and services with everyone else, do as they are told, and the haves are required to take care of the have-nots.

That is really what this particular healthcare reform bill is about. I am for healthcare reform that reduces costs by having laws and regulations to improve the fairness in the free market (such as anti-trust laws) and prevent abusive practices (unethical contracts). I am not for healthcare reform that requires one set of people to pay for another set's issues. Just like with public school tax, it doesn't make sense to me that the more kids a person has the less tax they pay (part of which goes to schools their kids attend) whereas the person who has no kids pays higher tax including school tax that they will never use. It all comes down to forcing one person to pay for another person's needs.

I'd rather live in a free society where nothing is guaranteed than a nanny state where everything is provided for you but you must do what you are told. This is really what all of this stuff is about. Again, a slippery slope toward communism.

Quote from: LivingInGrey on March 22, 2010, 10:47:58 AM


I smoked for several years of my life. If I get lung cancer it's my own damn fault and I sure as hell wont expect anyone to pay for me to get treatments.

The thing is under the current system if you get lung cancer and don't have insurance then the cost gets passed onto all of us who do have insurance.  It's like being allowed to drive a car with no insurance.  It's just not fair to the rest of us in the system.

This setup actually makes people MORE accountable for their healthcare while allowing for better service and access.

My main gripe is that I want a single payer government run system with a private option for those that can afford it.  I don't believe that people's healthcare should be left up to profit margins and people trying to turn a quick buck.  IMO that diminshes the value of life in the country.

When you have so many people who have their lives ruined by an unavoidable and suprising health crisis, the system is broke.

I would prefer the French, Canadian, or English models, even with their flaws to having to worry about money when the most important thing is your life.

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Post Merge: March 31, 2010, 02:52:47 AM

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Quote from: Britney_413 on March 31, 2010, 02:14:59 AM

I'd rather live in a free society where nothing is guaranteed than a nanny state where everything is provided for you but you must do what you are told. This is really what all of this stuff is about. Again, a slippery slope toward communism.

I'd rather live in a communist state than a completely free anarchy.  People are vile and vicious monsters who if allowed to would make you die a thousand deaths just to charge you for it.  Pure capitalism is a vile system that exploits and destroys everyone but the elites.

I believe that the purpose of government is to protect people's rights and allow them an honest chance at happiness.  That's what this country was founded upon.  But we've fallen a long ways from that.  Our government and media is run by large faceless corporations that are accountable to no one, and who manipulate and control our lives to degrees which make the notion of freedom completely idyllic.  We're being strip mined every single day of our lives.  That's what America is.  It's a lie designed to keep the populace fat and complacent while the elites harvest our output for their own gain.

America could do with a healthy dose of communism.  Say what you will about the tenets of communism, but those communist movements of the 20s and 30s were instrumental in giving us things like equal rights for men and women, child labor laws, social security, workers rights and protections, and strong antitrust laws.

If you're making less than 1 million dollars a year and want to live in a completely free America, it's because you watch too many Westerns.

I do have to say as someone who lives in the UK that i really don't understand why so many people in America seem so frightened by this.

The only downsides that I can see with a publicly funded healthcare system is that you tend to become the target of loads of silly government targets for health initiatives, some of which become pretty difficult to avoid because of course the government is now holding the purse strings. The other one is that your ignorant neighbour now often feels that he or she has the right to veto your sex change, despite the fact that they smoke and drink to excess, on the basis that they assume that their taxes are being "wasted" on your surgery.

As I actually chose to pay privately such people really do get very blunt and short shrift indeed from me! To say nothing of tempting me to point out the difference between self inflicted smokers complaints and a condition that one is born with...

But yes overall I do think that having some sort of publicly funded comprehensive healthcare system is an essential part of any civilised nation and I wonder why it is that it has taken this long for America to have one.

Quote from: Britney_413 on March 30, 2010, 02:26:02 AM

Last time I checked, our Founding Fathers and the Constitution made it clear that this country is to have limited government and that most matters are to be left to the states or the people. Should this slippery slope continue, it will basically become full-fledged communism. It is already fairly close to that anyway because why work at all or try to gain any wealth when you can just pretend your leg is hurt and pop out a couple of kids you know you won't be able to take care of and then get a free roof over your head, spending money, free transportation, free medical care, and in some cases even free cable TV and internet all off of the taxpayers' dole.

If you think America is currently anything close to a communist country, even with this policy for healthcare--you really should travel more.  We're one of the only industrialized societies without single payer government run healthcare.  Our public transit system is an embarrassment compared to those in Europe and Japan.  Our electrical grid is outmoded, outdated, and our reliance on big oil is not helping us out much either.  Frankly if I could get citzenship in it, I'd rather live in Sweden.  They may not live to the excesses that our rich do, but society overall has a higher quality of life.

Quote
Worse this opens the door for more control over the populace. For example, my workplace is filled with obese people some of which are over 400 lbs and more than half over 200 lbs. It is not my job to tell them to exercise or eat right or what to do with their lives. If they can afford to engage in gluttonous behavior and likewise pay the medical bills for it, then that is fine because it is all about freedom of life, liberty, and pursuit of happiness. However, if the government decides that their medical bills are going to be paid for, the same government could then tell them how to eat and how to exercise. In fact, they could even round them up, imprison them, or even send them to the gas chambers. If you want an example of a country that did just that to groups that didn't fit its national socialism model, you can find one within the past 100 years.

England has socialized medicine right now.  How come they are rounding up people there and doing all of the things you are worried about?  Is it because the english are just better than Americans at not torturing and killing people, or is it because your comparison to Nazi germany while capturing the socialism element, completely tosses out the racial element which led to those atrocities.  Hitler's Germany wasn't bad for being liberal.  It was bad because he wanted to eliminate large swaths of people from the earth because he believed he had the religious backing to do so.  If anything Nazi germany is a stern warning about the role propoganda and religion can brainwash a society to do evil as a reaction to societal struggles.  I'd be more worried about the concentration camps that the anti-LGBTQ groups on the right have.  All of these conservatives who are supposed to be about people's rights, and limited government intervention, when it comes to their faith, they have no problems trying to pass laws that take rights away from us.

Libertarianism, at it's root, you often find, is really just a desire for the majority to destroy the minority.  Which is NOT what this country was founded upon.

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Last but not least I wouldn't get too excited about this new Obamacare because it may well be declared unconstitutional and if not many individual states may opt out anyway.

It won't be declared unconstitutional.  Just like social security and medicare aren't unconstitutional.  Just like your car insurance isn't unconstitutional.  The precedent for this has already been set in the courts.  And while I wouldn't put it past the current supreme court to completely change precedent to rule for a political point, it's still extremely unlikely.

Quote
The federal government does not have a Constitutional right to require citizens to buy a product or service from a private company.

But it does have an obligation to allow for the pursuit of happiness, and the current system is a harm on a majority of people's ability to pursue happiness within this country.  You can't live the life you want to live, when it costs you hundreds of dollars just to diagnose the flu.

Quote
I have no doubt that Obama's dream is a fully socialist nation where the entire populace lives, works, and spends where and how they are told, where the entire populace is disarmed and defenseless, and where the only education and information available is government-approved.

I wish this was true.  Obama would be my fave president ever if he was indeed like this.  But if you compare his agenda to the rest of the world, you'll see that Obama is very much a Right-Centrist.  Liberalism in America is a complete joke to the rest of the world and when you call Obama a socialist, it's a complete and utter farce.  I mean this healthcare bill is basically the same one that Mitt Romney came up with for Massachusetts, and it's similar to the republican counter-proposal for Hilary-Care back in the 90s.  It's very much a republican type of bill, whether they supported it right now or not.

The bill does not socialize medicine in any real way.  It is in fact the largest privatization of medicine in the industrialized world.  So I don't know what you're on about, calling him a socialist. 

Quote
One more comment: I believe that services should be paid for by people who use them. I drive a car and I don't ride the bus yet part of my tax dollars go to subsidize the bus system. However, people who use the bus are not required to pay for part of the gasoline that goes in my car. That is because the government would see them as a have-not and me as a have. Again, proof of socialism. The same with the public school system. I have no children and have no intention of ever having them. I never attended public school either but went to a private one. I may have a neighbor who has six children all in the public school system. Because that person gets so many tax credits due to all of their kids they likely pay little to nothing towards the public education with their tax dollars. Instead, me being single with no children I basically pay a higher tax rate subsidizing my neighbors' excessive childbearing. Again, people who use the services should be those paying for them. In many ways this country is already like a shell of capitalism over communism.

This is a very selfish and shortsighted way to look at these issues.  A working public transit system helps to ease congestation on the roads, which allows you to drive your car a little more freely, it also allows for transit in cities that might be too big to have a car.  You can't really work with a car in New York unless you want to pay huge prices to park your car.  It just works better in a big city to have a functioning public transit system.

As far as the schools, if you don't want a public school system then I suppose you have no problem with illiterate criminilized youth roving the streets while you're at work and their parents are at work.  Public education also pays long term dividends in terms of a better working democracy.  DEmocracy doesn't work when everyone is too dumb to know what they are voting on.  Democracy relies on an informed alert populace.  Taking away public education encourages authoritarianism from the elites who can afford an education.

Quote
As to this healthcare, it is just like the prior example of driving a car vs. taking the bus. The government will get to decide what is covered and what is not. For instance, they may cover lung cancer treatment despite the patients' 50 years of cigarette smoking yet deny me BA and SRS. Or, me and another patient could have the same disease yet the other patient chooses Western medicine which is covered whereas I choose alternative therapy which is not covered. I don't see how this is not a serious abuse of tax dollars and tyrannical form of government control. When 'they' get to decide all of these different things, the government is clearly not "of the people, by the people, and for the people."

Obamacare doesn't do this though.  There's no government run single payer system that the government is running here.  It just sets a few regulations in order to encourage the insurance companies to offer better service and selection to the customers, while being less exploitative. 

You can still buy whatever insurance you want to buy.  THe only thing is with this bill that you have to have some kind of insurance, because the strain on the taxpayer is too great if we are forced to cover for people who don't have insurance.

Your answer might be that if people don't have insurance then they should be denied treatment, but I think most of us don't want to be stacking bodies in the village square if we can help it.  Plus better overall wellness of the populace gained by being able to access a healthcare system helps stamp epidemics, and keeps many diseases that used to ravage societies from really going.