The Healthcare Reform Thread


Everything stays except something about state Medicaid funding cuts :slight_smile:
The 4 dissenters wanted to strike the whole thing. Good to see Roberts get something right for once.


While we are watching Greece, Spain and France collapse the Supreme court just nudged us in their direction. Nice.


forget about healthcare. will somebody PLEASE fix it so that when I click over from NYspeed new posts to thread on here it doesn’t always go to page one. so annoying.


France is collapsing? News to me. And France.


Apparently not, lol.

I don’t mind that it was upheld as a tax. As part of the commerce clause I’d be worried.


Not surprised.


WAKE UP PEOPLE! Must be the z10nists.

I can see the upholding either way, but would have expected commerce clause if they did. This is the same court that ruled a guy growing a medical pot plant for himself in his backyard impacted interstate commerce. But then again, with this law, all they had to do was phrase the mandate as a tax, with a credit for anyone who has health insurance, instead of a fee for NOT having it, and this suit never happens.

I was actually expecting it to get tossed, based on the court’s makeup. In a perfect world, that would pave the way to single payer once we went back to continuing the existing clusterfuck system, but in actuality we would have probably just been stuck with it forever.


You are learning… finally :wink:

---------- Post added at 12:31 PM ---------- Previous post was at 12:14 PM ----------

Market reaction…


This will probably get moved to politisuck but…


yea I simply posted that CNN posted the wrong outcome and they moved that thread lol


Romney 2012. All you idiots that think this bill will reduce the costs are delusional.

Low income mark for Medicaid is getting increased to allow more people to fall under that program and any business over 50 employees must now provide health care. Hoary for all those break even businesses in Buffalo that are barley keeping their doors open.


I agree with Boxxa. The only way to fix healthcare in this country is to bring down the cost of the care itself, not to force every person and company to throw more money at the insurance companies and government.

An MRI in France costs something like $280, in the US, it’s more like $2,000…

Bring the cost of care down, premiums should go down and health insurance becomes more affordable. Then small businesses can increase benefits and people that don’t qualify through employers can have a better shot at affording care and/or insurance.

Then, if that STILL isn’t enough we can look at some other options. Maybe we can give tax breaks to new hospitals and incentives for folks going into Med/PA/Nursing school. More doctors and hospitals would create competition and SHOULD bring down costs as well.


Not looking to argue either way…How do the country achieve this?

Pretty happy about the pre existing condition part however I got pwned by that once when I changed jobs and had to wait a month or two for insurance…mostly my fault since I didn’t get COBRA.


There are many ways we can bring down the costs.

-Stopping the frivilous malpractice suits would help. Malpractice insurance is crazy expensive and it causes doctors to order overkill tests to cover their asses, which insurance companies have to pay for.

-Illegal immigrants in the south are also driving up costs. They get in accidents and run themselves over with lawn mowers and ERs are required to stabilize them.

-Educate the consumer. You do not need to go to the ER for little Jimmy’s belly ache. Urgent Care is WAY CHEAPER for both you and your insurance company and you will be in and out in 1/4 of the time.

-Take care of our patients better in between visits. Diabetics go to the doctor quarterly, but nobody checks on their diet or progress between vists. Then they end up in the ER for eating the wrong stuff. Call and check on them once a week and maybe you’ll get them to stop eating candy bars! We have a program here at Duke called Duke Well. They help people with Duke health insurance between visits. They answer questions for patients and just generally check in with them very often to help them stay healthy between visits. It’s VERY successful and has been getting a lot of funding from leadership. It’s win-win. People stay healthier and as such, Duke saves money by keeping them out the doctors offices.

I am just rattling off random examples here, but there are real things we can do to get people healthier, and for less cost.

I agree with the pre-existing condition stuff. I think it’s terrible what some insurance companies do to people in that regard. Sometimes you just need a little bit of regulation.

A little bit of regulation and reform could go a long way in the health industry.


The other thing I find hilarious about this is the people I know with shitty jobs/no jobs/healthcare issues in the past/live in the south bitching about this because they hate Obama.


dammit, where’s that cartoon when I need it… the one that is like “damn, I can’t afford _______($3 item)” and then a dude goes “Here, since you can’t afford what someone else has, here’s $3 so you can”…then the same item is $6 or something in the next slide…


yeah, exactly. This model that Obama is pushing is simply cost sharing. 1 guy can’t afford the $3, so the next 10 people have to pay 30 cents each to help him out. It’s nice to help people that need it, but it’s unmanageable in the long term, and some people just really don’t deserve it.


I’m not a hippy however making a little less money so more people can lead a healthy life and live longer isn’t the end of the world.

This forced a change of an already broken/fucked up system when nobody was doing anything else about it.

If this fails horribly it will force a change in a different direction.


Health care is a privilege, not a right. Hospitals need to turn people away in the ER who are not insured. Ron Paul touched on this at one of the debates and was booed but I give him credit.

I hate these self entitled ass hats in this country that think just because the middle or upper class gets something, everyone should. I pay health insurance, I want health care when I go. Not waiting behind people who have no insurance and are there with a sore throat that I also pay for with my tax money.


a good read on what exactly happens due to Obamacare. A lot of people get it wrong.

Okay, explained like you’re a five year-old, without oversimplification, and (hopefully) without sounding too biased:
What people call “Obamacare” is actually the Patient Protection and Affordable Care Act. However, people were calling it “Obamacare” before everyone even hammered out what it would be. It’s a term mostly used by people who don’t like the PPaACA, and it’s become popularized in part because PPaACA is a really long and awkward name, even when you turn it into an acronym like that.
Anyway, the PPaACA made a bunch of new rules regarding health care, with the purpose of making health care more affordable for everyone. Opponents of the PPaACA, on the other hand, feel that the rules it makes take away too many freedoms and force people (both individuals and businesses) to do things they shouldn’t have to.

So what does it do? Well, here is everything, in the order of when it goes into effect (because some of it happens later than other parts of it):

Already in effect:

It allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices)
It increases the rebates on drugs people get through Medicare (so drugs cost less)
It establishes a non-profit group, that the government doesn’t directly control, to study different kinds of treatments to see what works better and is the best use of money.
It makes chain restaurants like McDonalds display how many calories are in all of their foods, so people can have an easier time making choices to eat healthy.
It makes a “high-risk pool” for people with pre-existing conditions. Basically, this is a way to slowly ease into getting rid of “pre-existing conditions” altogether. For now, people who already have health issues that would be considered “pre-existing conditions” can still get insurance, but at different rates than people without them.
It renews some old policies, and calls for the appointment of various positions.
It creates a new 10% tax on indoor tanning booths.
It says that health insurance companies can no longer tell customers that they won’t get any more coverage because they have hit a “lifetime limit”. Basically, if someone has paid for life insurance, that company can’t tell that person that he’s used that insurance too much throughout his life so they won’t cover him any more. They can’t do this for lifetime spending, and they’re limited in how much they can do this for yearly spending.
Kids can continue to be covered by their parents’ health insurance until they’re 26.
No more “pre-existing conditions” for kids under the age of 19.
Insurers have less ability to change the amount customers have to pay for their plans.
People in a “Medicare Gap” get a rebate to make up for the extra money they would otherwise have to spend.
Insurers can’t just drop customers once they get sick.
Insurers have to tell customers what they’re spending money on. (Instead of just “administrative fee”, they have to be more specific).
Insurers need to have an appeals process for when they turn down a claim, so customers have some manner of recourse other than a lawsuit when they’re turned down.
New ways to stop fraud are created.
Medicare extends to smaller hospitals.
Medicare patients with chronic illnesses must be monitored more thoroughly.
Reduces the costs for some companies that handle benefits for the elderly.
A new website is made to give people insurance and health information.
A credit program is made that will make it easier for business to invest in new ways to treat illness.
A limit is placed on just how much of a percentage of the money an insurer makes can be profit, to make sure they’re not price-gouging customers.
A limit is placed on what type of insurance accounts can be used to pay for over-the-counter drugs without a prescription. Basically, your insurer isn’t paying for the Aspirin you bought for that hangover.
Employers need to list the benefits they provided to employees on their tax forms.


Any health plans sold after this date must provide preventative care (mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge.


If you make over $200,000 a year, your taxes go up a tiny bit (0.9%)


This is when a lot of the really big changes happen.
No more “pre-existing conditions”. At all. People will be charged the same regardless of their medical history.
If you can afford insurance but do not get it, you will be charged a fee. This is the “mandate” that people are talking about. Basically, it’s a trade-off for the “pre-existing conditions” bit, saying that since insurers now have to cover you regardless of what you have, you can’t just wait to buy insurance until you get sick. Otherwise no one would buy insurance until they needed it. You can opt not to get insurance, but you’ll have to pay the fee instead, unless of course you’re not buying insurance because you just can’t afford it.
Insurer’s now can’t do annual spending caps. Their customers can get as much health care in a given year as they need.
Make it so more poor people can get Medicare by making the low-income cut-off higher.
Small businesses get some tax credits for two years.
Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty.
Limits how high of an annual deductible insurers can charge customers.
Cut some Medicare spending
Place a $2500 limit on tax-free spending on FSAs (accounts for medical spending). Basically, people using these accounts now have to pay taxes on any money over $2500 they put into them.
Establish health insurance exchanges and rebates for the lower-class, basically making it so poor people can get some medical coverage.
Congress and Congressional staff will only be offered the same insurance offered to people in the insurance exchanges, rather than Federal Insurance. Basically, we won’t be footing their health care bills any more than any other American citizen.
A new tax on pharmaceutical companies.
A new tax on the purchase of medical devices.
A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more they’ll get taxed.
The amount you can deduct from your taxes for medical expenses increases.


Doctors’ pay will be determined by the quality of their care, not how many people they treat.


If any state can come up with their own plan, one which gives citizens the same level of care at the same price as the PPaACA, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the PPaACA. So if they can get the same results without, say, the mandate, they can be allowed to do so. Vermont, for example, has expressed a desire to just go straight to single-payer (in simple terms, everyone is covered, and medical expenses are paid by taxpayers).


All health care plans must now cover preventative care (not just the new ones).
A new tax on “Cadillac” health care plans (more expensive plans for rich people who want fancier coverage).


The elimination of the “Medicare gap”
Aaaaand that’s it right there.
The biggest thing opponents of the bill have against it is the mandate. They claim that it forces people to buy insurance, and forcing people to buy something is unconstitutional. Personally, I take the opposite view, as it’s not telling people to buy a specific thing, just to have a specific type of thing, just like a part of the money we pay in taxes pays for the police and firemen who protect us, this would have us paying to ensure doctors can treat us for illness and injury.
Plus, as previously mentioned, it’s necessary if you’re doing away with “pre-existing conditions” because otherwise no one would get insurance until they needed to use it, which defeats the purpose of insurance.
Whew! Hope that answers the question!
Edits: Fixing typos.
Edit 2: Wow… people have a lot of questions. I’m afraid I can’t get to them now (got to go to work), but I’ll try to later.
Edit 3: Okay, I’m at work, so I can’t go really in-depth for some of the more complex questions just now, but I’ll try and address the simpler ones. Also, a few I’m seeing repeatedly:
For those looking for a source… well, here is the text of the bill, all 974 pages of it (as it sits currently after being amended multiple times). I can’t point out page numbers just now, but they’re there if you want them.
The website that was to be established, I think, is
A lot of people are concerned about the 1/1/2015 bit that says that doctors’ pay will be tied to quality, not quantity. Because so many people want to know more about this, I’ve sought out what I believe to be the pertinent sections (From Page 307, section 3007). It looks like this part alters a part of another bill, the Social Security Act, passed a long while ago. That bill already regulates how doctors’ pay is determined. The PPaACA just changes the criteria. Judging by how professionals are writing about it, it looks like this is just referring to Medicaid and Medicare. Basically, this is changing how much the government pays to doctors and medical groups, in situations where they are already responsible for pay.