Step 1: Get any kind of healthcare reform passed. Step 2? - Tilted Forum Project Discussion Community

Willravel · 03-20-2010, 05:32 PM

I'm sure the lion's share of moderates and progressives here are unsatisfied with the healthcare bill that will likely be passed on the coming days. I would have preferred a push for single-payer and then maybe a few concessions to get the necessary blue-dog votes. Instead we got the public option as a starting point and now... we'll see. C'est la vi.

So let's say the likely happens and this bill is passed. A few relatively minor things begin to change, and people recognize these things despite the sky-is-falling rhetoric from the right. What happens next? Undoubtedly, progressives will continue pushing for additional reform, I know I will. But what's the next baby step toward real reform? Should we push for a real public option or should we push for Meicare for all?

I'm honestly not sure and I'd like to get your input.

Derwood · 03-20-2010, 07:16 PM

I like the concept of being able to "buy into" Medicare, but I don't know the details of the specific plans that have been offered up for it

dc_dux · 03-20-2010, 07:20 PM

At some point, I think the next step will be in the direction of a program similar to the FEHB (fed employees can chose from among numerous private providers at varying costs with varying levels of coverage) type program and not a Medicare type.

Where the private insurance companies will still be the providers of service and compete for consumers in a marketplace that is regulated by the government.

Willravel · 03-20-2010, 08:41 PM

Derwood, Representative Weiner from New York laid out the idea of a Medicare buy in here. It's an intriguing idea and Rep. Weiner has been making the rounds building a pretty strong case for it.

DC, so you're saying we're simply headed toward a better regulated free marketplace? Do you think that's the best solution or are you still rooting for something like single-payer or nationalized health?

Derwood · 03-20-2010, 09:07 PM

I'd love UHC/Single Payer, but I don't think it will ever happen here

Willravel · 03-20-2010, 09:13 PM

Maybe not, but I think it makes sense to still fight for it. Remember: Canada didn't get single-payer overnight, it took years and years to get in place. The first step was Saskatchewan subsidizing doctors because of a shortage. The idea spread to Alberta. It took almost 40 years, but things now are a hell of a lot better than they were back in the 1940s for Canadians. If the US takes until 2050 to get healthcare, I'm going to be there to see it.

Wes Mantooth · 03-21-2010, 12:15 AM

Well I think so, its been a pretty big part of their platform for years so it only makes sense that they might continue to push it if they have the numbers to. I do however fear them becoming to dogmatic about the whole thing and losing perspective about what the country really wants/needs. For example lets say people are happy with the balance struck by early reforms and instead of leaving it at that, they keep pushing and pushing for more reforms because they feel they have to or need to as its a big part of the platform.

I think ideally a balance between the two sides is what the country really needs right now. Despite how good/bad single payer may be for the country its something we're going to have to ease into with small steps. People just don't like monkeying with a system that works for them and weather its selfish or not, people are going to look out for their own or their families own best interest before others. Its going to be hard to convince somebody with a good health care plan to change anything because they just can't be sure if what they get will leave them worse off.

dc_dux · 03-21-2010, 06:42 AM

Quote:

Originally Posted by Willravel

...DC, so you're saying we're simply headed toward a better regulated free marketplace? Do you think that's the best solution or are you still rooting for something like single-payer or nationalized health?

I think the insurance industry is too deeply entrenched in the system to ever discard it completely...or at least anytime in the foreseeable future.

End the anti-trust exemption the industry currently enjoys, regulate premiums and levels of coverage and encourage greater competition and consumer choice...is a more pragmatic approach to affordable and accessible health care for all.

ASU2003 · 03-21-2010, 08:27 AM

Quote:

Originally Posted by Wes Mantooth

. Despite how good/bad single payer may be for the country its something we're going to have to ease into with small steps. People just don't like monkeying with a system that works for them and weather its selfish or not, people are going to look out for their own or their families own best interest before others. Its going to be hard to convince somebody with a good health care plan to change anything because they just can't be sure if what they get will leave them worse off.

I've seen my healthcare coverage go downhill in the last 20 years. First it was the $20 office visit payments, then the increasing deductibles, and increasing premiums.

And I have never had to get healthcare insurance as an individual.

I view this as something good for the country. And if it is good for the country, then it is good for me.

ottopilot · 03-21-2010, 11:21 AM

Quote:

Originally Posted by Willravel

I'm sure the lion's share of moderates and progressives here are unsatisfied with the healthcare bill that will likely be passed on the coming days. I would have preferred a push for single-payer and then maybe a few concessions to get the necessary blue-dog votes. Instead we got the public option as a starting point and now... we'll see. C'est la vi.

So let's say the likely happens and this bill is passed. A few relatively minor things begin to change, and people recognize these things despite the sky-is-falling rhetoric from the right. What happens next? Undoubtedly, progressives will continue pushing for additional reform, I know I will. But what's the next baby step toward real reform? Should we push for a real public option or should we push for Meicare for all?

I'm honestly not sure and I'd like to get your input.

Quote:

Step 1: Get any kind of healthcare reform passed. Step 2?

Will, I sincerely believe the sentiment of this statement should make everyone here feel very uneasy. I don't mean in a right-wing "sky is falling" way. An uneasiness like you may experience before jumping head-first from a very tall bridge in to an unfamiliar dark and murky stream. However, all you know is that you want relief and the lure of doing something new seems appealing if not exhilarating. What would be your deciding factors for making the 'jump" (or not)?

Sounds like fairly basic problem solving. Why are you there? What are your motivators? What premise drives any consideration of any solution? Have you validated anything? What defines success in your decision? Do you understand all the factors and variables, cause and effect? Are there acceptable and unacceptable outcomes? What are your contingency plans? How much responsibility are you willing to assume for any measure of risk? What is the overreaching affect of minor, moderate, or complete failure? Who are you responsible to or for? Who benefits or suffers from your commitment to "jump in"? Are you informed?

Since my profession relies heavily on project and compliance management, I generally think about such considerations according to complexities and orders of magnitude. I can't think of many projects more complex, visible, and potentially volatile than this current "Health Care" legislation. So my "uneasiness" comes from the startling absence of the most rudimentary problem solving considerations. Essentially, the gross absence of basic due diligence.

Because we are attempting to solve "something" in a purely political exercise, we've jumped way past clearly understanding exactly what that "something" is, and are now poised to vote in to LAW a massively complex and highly convoluted "corrective measure".

So what the hell is Step 1?

Who can define it (in pragmatic detail, not platitudes)?
What are the presumptions and how are they quantified?
Where and how have cross-impacts, multiple causation, and mitigation strategies been exhaustively studied, mapped, presented, validated, and proposed with success criteria and KPI (key performance indicator) metrics?
Is this really all about "Health Care"?
What is "it" that is being voted in to law today?

I'm very certain our representatives don't understand what they are voting on. But it is clear that "someone" does. The debate always deteriorates back to political gamesmanship rather than the pursuit of altruistic pragmatism.

I live in a state where college basketball a daily hot-button. The NCAA championships are underway and we had 3 teams this year. The rivalries are intense and the trash is talked. The funny thing about the most belligerent voices (for or against) are from those who most likely never attended, had a friend or relative attend, or even stepped foot on campus for "their" team. But they are ready to say anything to anyone, promote lies, push, shove, and fight for "their team". Little has anything to do with the outcome, they most likely have aligned themselves out of tradition and social circles. But they are all experts.

I can't help but see the similarities (the superficiality) in support for sports and political teams. Feeling important by proxy of social movement may provide that exhilaration before the "jump". I've seen very little about identifying and fixing the "problem" from both the media and our leadership. Maybe it's because no one can say in detail which "problems" Step 1 is specifically designed to fix.

Below the text from the "Short Title Table of Contents" from H.R. 3590... originally entitled: "An Act to amend the Internal Revenue Code of 1986 to modify the first-time homebuyers credit in the case of members of the Armed Forces and certain other Federal employees, and for other purposes."

which is now referred to as: TITLE I — "QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMERICANS" or Subtitle A— "Immediate Improvements in Health Care Coverage for All Americans" The bizarre renaming is comical in it's own right, forget any reassurance of competency to the "process". No need to question motivation here.

To the President and Congress:
This is just the Short Title index... Now try getting through the entire document with comprehension and the ability to articulate its full meaning. Now look us all in the eye and tell the nation that you're ready to make an informed, responsible, and conscientious decision. Are you feeling uneasy? If not, you're irresponsible, intellectually stunted, dishonest, and/or simply a political hack.

It looks like most of you here are excited about "jumping in". I hope the water is deep, without debris, and you know how to swim. I hate to consider the alternatives, but I do it anyway.

Quote:

In the Senate of the United States,
December 24, 2009.
Resolved, That the bill from the House of Representatives
(H.R. 3590) entitled

"An Act to amend the Internal Revenue Code of 1986 to modify the first-time homebuyers credit in the case of members of the Armed

Forces and certain other Federal employees, and for other purposes.",

do pass with the following

Sec. 1. Short title; table of contents.

TITLE I — "QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMERICANS"

Subtitle A— "Immediate Improvements in Health Care Coverage for All Americans"

1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
2 (a) SHORT TITLE.—This Act may be cited as the "Pa3
tient Protection and Affordable Care Act".
4 (b) TABLE OF CONTENTS.—The table of contents of this
5 Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I—QUALITY, AFFORDABLE HEALTH CARE FOR ALL
AMERICANS
Subtitle A—Immediate Improvements in Health Care Coverage for All
Americans
Sec. 1001. Amendments to the Public Health Service Act.
"PART A—INDIVIDUAL AND GROUP MARKET REFORMS
"SUBPART II—IMPROVING COVERAGE
"Sec. 2711. No lifetime or annual limits.
"Sec. 2712. Prohibition on rescissions.
"Sec. 2713. Coverage of preventive health services.
"Sec. 2714. Extension of dependent coverage.
"Sec. 2715. Development and utilization of uniform explanation of coverage
documents and standardized definitions.
"Sec. 2716. Prohibition of discrimination based on salary.
"Sec. 2717. Ensuring the quality of care.
"Sec. 2718. Bringing down the cost of health care coverage.
"Sec. 2719. Appeals process.
Sec. 1002. Health insurance consumer information.
Sec. 1003. Ensuring that consumers get value for their dollars.
Sec. 1004. Effective dates.
Subtitle B—Immediate Actions to Preserve and Expand Coverage
Sec. 1101. Immediate access to insurance for uninsured individuals with a preexisting
condition.
Sec. 1102. Reinsurance for early retirees.
Sec. 1103. Immediate information that allows consumers to identify affordable
coverage options.
Sec. 1104. Administrative simplification.
Sec. 1105. Effective date.
Subtitle C—Quality Health Insurance Coverage for All Americans
PART I—HEALTH INSURANCE MARKET REFORMS
Sec. 1201. Amendment to the Public Health Service Act.
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"SUBPART I—GENERAL REFORM
"Sec. 2704. Prohibition of preexisting condition exclusions or other discrimination
based on health status.
"Sec. 2701. Fair health insurance premiums.
"Sec. 2702. Guaranteed availability of coverage.
"Sec. 2703. Guaranteed renewability of coverage.
"Sec. 2705. Prohibiting discrimination against individual participants and
beneficiaries based on health status.
"Sec. 2706. Non-discrimination in health care.
"Sec. 2707. Comprehensive health insurance coverage.
"Sec. 2708. Prohibition on excessive waiting periods.
PART II—OTHER PROVISIONS
Sec. 1251. Preservation of right to maintain existing coverage.
Sec. 1252. Rating reforms must apply uniformly to all health insurance issuers
and group health plans.
Sec. 1253. Effective dates.
Subtitle D—Available Coverage Choices for All Americans
PART I—ESTABLISHMENT OF QUALIFIED HEALTH PLANS
Sec. 1301. Qualified health plan defined.
Sec. 1302. Essential health benefits requirements.
Sec. 1303. Special rules.
Sec. 1304. Related definitions.
PART II—CONSUMER CHOICES AND INSURANCE COMPETITION THROUGH
HEALTH BENEFIT EXCHANGES
Sec. 1311. Affordable choices of health benefit plans.
Sec. 1312. Consumer choice.
Sec. 1313. Financial integrity.
PART III—STATE FLEXIBILITY RELATING TO EXCHANGES
Sec. 1321. State flexibility in operation and enforcement of Exchanges and related
requirements.
Sec. 1322. Federal program to assist establishment and operation of nonprofit,
member-run health insurance issuers.
Sec. 1323. Community health insurance option.
Sec. 1324. Level playing field.
PART IV—STATE FLEXIBILITY TO ESTABLISH ALTERNATIVE PROGRAMS
Sec. 1331. State flexibility to establish basic health programs for low-income individuals
not eligible for Medicaid.
Sec. 1332. Waiver for State innovation.
Sec. 1333. Provisions relating to offering of plans in more than one State.
PART V—REINSURANCE AND RISK ADJUSTMENT
Sec. 1341. Transitional reinsurance program for individual and small group
markets in each State.
Sec. 1342. Establishment of risk corridors for plans in individual and small
group markets.
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Sec. 1343. Risk adjustment.
Subtitle E—Affordable Coverage Choices for All Americans
PART I—PREMIUM TAX CREDITS AND COST-SHARING REDUCTIONS
SUBPART A—PREMIUM TAX CREDITS AND COST-SHARING REDUCTIONS
Sec. 1401. Refundable tax credit providing premium assistance for coverage
under a qualified health plan.
Sec. 1402. Reduced cost-sharing for individuals enrolling in qualified health
plans.
SUBPART B—ELIGIBILITY DETERMINATIONS
Sec. 1411. Procedures for determining eligibility for Exchange participation, premium
tax credits and reduced cost-sharing, and individual responsibility
exemptions.
Sec. 1412. Advance determination and payment of premium tax credits and costsharing
reductions.
Sec. 1413. Streamlining of procedures for enrollment through an exchange and
State Medicaid, CHIP, and health subsidy programs.
Sec. 1414. Disclosures to carry out eligibility requirements for certain programs.
Sec. 1415. Premium tax credit and cost-sharing reduction payments disregarded
for Federal and Federally-assisted programs.
PART II—SMALL BUSINESS TAX CREDIT
Sec. 1421. Credit for employee health insurance expenses of small businesses.
Subtitle F—Shared Responsibility for Health Care
PART I—INDIVIDUAL RESPONSIBILITY
Sec. 1501. Requirement to maintain minimum essential coverage.
Sec. 1502. Reporting of health insurance coverage.
PART II—EMPLOYER RESPONSIBILITIES
Sec. 1511. Automatic enrollment for employees of large employers.
Sec. 1512. Employer requirement to inform employees of coverage options.
Sec. 1513. Shared responsibility for employers.
Sec. 1514. Reporting of employer health insurance coverage.
Sec. 1515. Offering of Exchange-participating qualified health plans through cafeteria
plans.
Subtitle G—Miscellaneous Provisions
Sec. 1551. Definitions.
Sec. 1552. Transparency in government.
Sec. 1553. Prohibition against discrimination on assisted suicide.
Sec. 1554. Access to therapies.
Sec. 1555. Freedom not to participate in Federal health insurance programs.
Sec. 1556. Equity for certain eligible survivors.
Sec. 1557. Nondiscrimination.
Sec. 1558. Protections for employees.
Sec. 1559. Oversight.
Sec. 1560. Rules of construction.
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Sec. 1561. Health information technology enrollment standards and protocols.
Sec. 1562. Conforming amendments.
Sec. 1563. Sense of the Senate promoting fiscal responsibility.
TITLE II—ROLE OF PUBLIC PROGRAMS
Subtitle A—Improved Access to Medicaid
Sec. 2001. Medicaid coverage for the lowest income populations.
Sec. 2002. Income eligibility for nonelderly determined using modified gross income.
Sec. 2003. Requirement to offer premium assistance for employer-sponsored insurance.
Sec. 2004. Medicaid coverage for former foster care children.
Sec. 2005. Payments to territories.
Sec. 2006. Special adjustment to FMAP determination for certain States recovering
from a major disaster.
Sec. 2007. Medicaid Improvement Fund rescission.
Subtitle B—Enhanced Support for the Children’s Health Insurance Program
Sec. 2101. Additional federal financial participation for CHIP.
Sec. 2102. Technical corrections.
Subtitle C—Medicaid and CHIP Enrollment Simplification
Sec. 2201. Enrollment Simplification and coordination with State Health Insurance
Exchanges.
Sec. 2202. Permitting hospitals to make presumptive eligibility determinations
for all Medicaid eligible populations.
Subtitle D—Improvements to Medicaid Services
Sec. 2301. Coverage for freestanding birth center services.
Sec. 2302. Concurrent care for children.
Sec. 2303. State eligibility option for family planning services.
Sec. 2304. Clarification of definition of medical assistance.
Subtitle E—New Options for States to Provide Long-Term Services and
Supports
Sec. 2401. Community First Choice Option.
Sec. 2402. Removal of barriers to providing home and community-based services.
Sec. 2403. Money Follows the Person Rebalancing Demonstration.
Sec. 2404. Protection for recipients of home and community-based services
against spousal impoverishment.
Sec. 2405. Funding to expand State Aging and Disability Resource Centers.
Sec. 2406. Sense of the Senate regarding long-term care.
Subtitle F—Medicaid Prescription Drug Coverage
Sec. 2501. Prescription drug rebates.
Sec. 2502. Elimination of exclusion of coverage of certain drugs.
Sec. 2503. Providing adequate pharmacy reimbursement.
Subtitle G—Medicaid Disproportionate Share Hospital (DSH) Payments
Sec. 2551. Disproportionate share hospital payments.
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Subtitle H—Improved Coordination for Dual Eligible Beneficiaries
Sec. 2601. 5-year period for demonstration projects.
Sec. 2602. Providing Federal coverage and payment coordination for dual eligible
beneficiaries.
Subtitle I—Improving the Quality of Medicaid for Patients and Providers
Sec. 2701. Adult health quality measures.
Sec. 2702. Payment Adjustment for Health Care-Acquired Conditions.
Sec. 2703. State option to provide health homes for enrollees with chronic conditions.
Sec. 2704. Demonstration project to evaluate integrated care around a hospitalization.
Sec. 2705. Medicaid Global Payment System Demonstration Project.
Sec. 2706. Pediatric Accountable Care Organization Demonstration Project.
Sec. 2707. Medicaid emergency psychiatric demonstration project.
Subtitle J—Improvements to the Medicaid and CHIP Payment and Access
Commission (MACPAC)
Sec. 2801. MACPAC assessment of policies affecting all Medicaid beneficiaries.
Subtitle K—Protections for American Indians and Alaska Natives
Sec. 2901. Special rules relating to Indians.
Sec. 2902. Elimination of sunset for reimbursement for all medicare part B services
furnished by certain indian hospitals and clinics.
Subtitle L—Maternal and Child Health Services
Sec. 2951. Maternal, infant, and early childhood home visiting programs.
Sec. 2952. Support, education, and research for postpartum depression.
Sec. 2953. Personal responsibility education.
Sec. 2954. Restoration of funding for abstinence education.
Sec. 2955. Inclusion of information about the importance of having a health care
power of attorney in transition planning for children aging out
of foster care and independent living programs.
TITLE III—IMPROVING THE QUALITY AND EFFICIENCY OF HEALTH
CARE
Subtitle A—Transforming the Health Care Delivery System
PART I—LINKING PAYMENT TO QUALITY OUTCOMES UNDER THE MEDICARE
PROGRAM
Sec. 3001. Hospital Value-Based purchasing program.
Sec. 3002. Improvements to the physician quality reporting system.
Sec. 3003. Improvements to the physician feedback program.
Sec. 3004. Quality reporting for long-term care hospitals, inpatient rehabilitation
hospitals, and hospice programs.
Sec. 3005. Quality reporting for PPS-exempt cancer hospitals.
Sec. 3006. Plans for a Value-Based purchasing program for skilled nursing facilities
and home health agencies.
Sec. 3007. Value-based payment modifier under the physician fee schedule.
Sec. 3008. Payment adjustment for conditions acquired in hospitals.
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PART II—NATIONAL STRATEGY TO IMPROVE HEALTH CARE QUALITY
Sec. 3011. National strategy.
Sec. 3012. Interagency Working Group on Health Care Quality.
Sec. 3013. Quality measure development.
Sec. 3014. Quality measurement.
Sec. 3015. Data collection; public reporting.
PART III—ENCOURAGING DEVELOPMENT OF NEW PATIENT CARE MODELS
Sec. 3021. Establishment of Center for Medicare and Medicaid Innovation within
CMS.
Sec. 3022. Medicare shared savings program.
Sec. 3023. National pilot program on payment bundling.
Sec. 3024. Independence at home demonstration program.
Sec. 3025. Hospital readmissions reduction program.
Sec. 3026. Community-Based Care Transitions Program.
Sec. 3027. Extension of gainsharing demonstration.
Subtitle B—Improving Medicare for Patients and Providers
PART I—ENSURING BENEFICIARY ACCESS TO PHYSICIAN CARE AND OTHER
SERVICES
Sec. 3101. Increase in the physician payment update.
Sec. 3102. Extension of the work geographic index floor and revisions to the practice
expense geographic adjustment under the Medicare physician
fee schedule.
Sec. 3103. Extension of exceptions process for Medicare therapy caps.
Sec. 3104. Extension of payment for technical component of certain physician pathology
services.
Sec. 3105. Extension of ambulance add-ons.
Sec. 3106. Extension of certain payment rules for long-term care hospital services
and of moratorium on the establishment of certain hospitals and
facilities.
Sec. 3107. Extension of physician fee schedule mental health add-on.
Sec. 3108. Permitting physician assistants to order post-Hospital extended care
services.
Sec. 3109. Exemption of certain pharmacies from accreditation requirements.
Sec. 3110. Part B special enrollment period for disabled TRICARE beneficiaries.
Sec. 3111. Payment for bone density tests.
Sec. 3112. Revision to the Medicare Improvement Fund.
Sec. 3113. Treatment of certain complex diagnostic laboratory tests.
Sec. 3114. Improved access for certified nurse-midwife services.
PART II—RURAL PROTECTIONS
Sec. 3121. Extension of outpatient hold harmless provision.
Sec. 3122. Extension of Medicare reasonable costs payments for certain clinical
diagnostic laboratory tests furnished to hospital patients in certain
rural areas.
Sec. 3123. Extension of the Rural Community Hospital Demonstration Program.
Sec. 3124. Extension of the Medicare-dependent hospital (MDH) program.
Sec. 3125. Temporary improvements to the Medicare inpatient hospital payment
adjustment for low-volume hospitals.
Sec. 3126. Improvements to the demonstration project on community health integration
models in certain rural counties.
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Sec. 3127. MedPAC study on adequacy of Medicare payments for health care providers
serving in rural areas.
Sec. 3128. Technical correction related to critical access hospital services.
Sec. 3129. Extension of and revisions to Medicare rural hospital flexibility program.
PART III—IMPROVING PAYMENT ACCURACY
Sec. 3131. Payment adjustments for home health care.
Sec. 3132. Hospice reform.
Sec. 3133. Improvement to medicare disproportionate share hospital (DSH) payments.
Sec. 3134. Misvalued codes under the physician fee schedule.
Sec. 3135. Modification of equipment utilization factor for advanced imaging
services.
Sec. 3136. Revision of payment for power-driven wheelchairs.
Sec. 3137. Hospital wage index improvement.
Sec. 3138. Treatment of certain cancer hospitals.
Sec. 3139. Payment for biosimilar biological products.
Sec. 3140. Medicare hospice concurrent care demonstration program.
Sec. 3141. Application of budget neutrality on a national basis in the calculation
of the Medicare hospital wage index floor.
Sec. 3142. HHS study on urban Medicare-dependent hospitals.
Sec. 3143. Protecting home health benefits.
Subtitle C—Provisions Relating to Part C
Sec. 3201. Medicare Advantage payment.
Sec. 3202. Benefit protection and simplification.
Sec. 3203. Application of coding intensity adjustment during MA payment transition.
Sec. 3204. Simplification of annual beneficiary election periods.
Sec. 3205. Extension for specialized MA plans for special needs individuals.
Sec. 3206. Extension of reasonable cost contracts.
Sec. 3207. Technical correction to MA private fee-for-service plans.
Sec. 3208. Making senior housing facility demonstration permanent.
Sec. 3209. Authority to deny plan bids.
Sec. 3210. Development of new standards for certain Medigap plans.
Subtitle D—Medicare Part D Improvements for Prescription Drug Plans and
MA–PD Plans
Sec. 3301. Medicare coverage gap discount program.
Sec. 3302. Improvement in determination of Medicare part D low-income benchmark
premium.
Sec. 3303. Voluntary de minimis policy for subsidy eligible individuals under
prescription drug plans and MA–PD plans.
Sec. 3304. Special rule for widows and widowers regarding eligibility for low-income
assistance.
Sec. 3305. Improved information for subsidy eligible individuals reassigned to
prescription drug plans and MA–PD plans.
Sec. 3306. Funding outreach and assistance for low-income programs.
Sec. 3307. Improving formulary requirements for prescription drug plans and
MA–PD plans with respect to certain categories or classes of
drugs.
Sec. 3308. Reducing part D premium subsidy for high-income beneficiaries.
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Sec. 3309. Elimination of cost sharing for certain dual eligible individuals.
Sec. 3310. Reducing wasteful dispensing of outpatient prescription drugs in longterm
care facilities under prescription drug plans and MA–PD
plans.
Sec. 3311. Improved Medicare prescription drug plan and MA–PD plan complaint
system.
Sec. 3312. Uniform exceptions and appeals process for prescription drug plans
and MA–PD plans.
Sec. 3313. Office of the Inspector General studies and reports.
Sec. 3314. Including costs incurred by AIDS drug assistance programs and Indian
Health Service in providing prescription drugs toward the
annual out-of-pocket threshold under part D.
Sec. 3315. Immediate reduction in coverage gap in 2010.
Subtitle E—Ensuring Medicare Sustainability
Sec. 3401. Revision of certain market basket updates and incorporation of productivity
improvements into market basket updates that do not
already incorporate such improvements.
Sec. 3402. Temporary adjustment to the calculation of part B premiums.
Sec. 3403. Independent Medicare Advisory Board.
Subtitle F—Health Care Quality Improvements
Sec. 3501. Health care delivery system research; Quality improvement technical
assistance.
Sec. 3502. Establishing community health teams to support the patient-centered
medical home.
Sec. 3503. Medication management services in treatment of chronic disease.
Sec. 3504. Design and implementation of regionalized systems for emergency care.
Sec. 3505. Trauma care centers and service availability.
Sec. 3506. Program to facilitate shared decisionmaking.
Sec. 3507. Presentation of prescription drug benefit and risk information.
Sec. 3508. Demonstration program to integrate quality improvement and patient
safety training into clinical education of health professionals.
Sec. 3509. Improving women’s health.
Sec. 3510. Patient navigator program.
Sec. 3511. Authorization of appropriations.
Subtitle G—Protecting and Improving Guaranteed Medicare Benefits
Sec. 3601. Protecting and improving guaranteed Medicare benefits.
Sec. 3602. No cuts in guaranteed benefits.
TITLE IV—PREVENTION OF CHRONIC DISEASE AND IMPROVING
PUBLIC HEALTH
Subtitle A—Modernizing Disease Prevention and Public Health Systems
Sec. 4001. National Prevention, Health Promotion and Public Health Council.
Sec. 4002. Prevention and Public Health Fund.
Sec. 4003. Clinical and community preventive services.
Sec. 4004. Education and outreach campaign regarding preventive benefits.
Subtitle B—Increasing Access to Clinical Preventive Services
Sec. 4101. School-based health centers.
Sec. 4102. Oral healthcare prevention activities.
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Sec. 4103. Medicare coverage of annual wellness visit providing a personalized
prevention plan.
Sec. 4104. Removal of barriers to preventive services in Medicare.
Sec. 4105. Evidence-based coverage of preventive services in Medicare.
Sec. 4106. Improving access to preventive services for eligible adults in Medicaid.
Sec. 4107. Coverage of comprehensive tobacco cessation services for pregnant
women in Medicaid.
Sec. 4108. Incentives for prevention of chronic diseases in medicaid.
Subtitle C—Creating Healthier Communities
Sec. 4201. Community transformation grants.
Sec. 4202. Healthy aging, living well; evaluation of community-based prevention
and wellness programs for Medicare beneficiaries.
Sec. 4203. Removing barriers and improving access to wellness for individuals
with disabilities.
Sec. 4204. Immunizations.
Sec. 4205. Nutrition labeling of standard menu items at chain restaurants.
Sec. 4206. Demonstration project concerning individualized wellness plan.
Sec. 4207. Reasonable break time for nursing mothers.
Subtitle D—Support for Prevention and Public Health Innovation
Sec. 4301. Research on optimizing the delivery of public health services.
Sec. 4302. Understanding health disparities: data collection and analysis.
Sec. 4303. CDC and employer-based wellness programs.
Sec. 4304. Epidemiology-Laboratory Capacity Grants.
Sec. 4305. Advancing research and treatment for pain care management.
Sec. 4306. Funding for Childhood Obesity Demonstration Project.
Subtitle E—Miscellaneous Provisions
Sec. 4401. Sense of the Senate concerning CBO scoring.
Sec. 4402. Effectiveness of Federal health and wellness initiatives.
TITLE V—HEALTH CARE WORKFORCE
Subtitle A—Purpose and Definitions
Sec. 5001. Purpose.
Sec. 5002. Definitions.
Subtitle B—Innovations in the Health Care Workforce
Sec. 5101. National health care workforce commission.
Sec. 5102. State health care workforce development grants.
Sec. 5103. Health care workforce assessment.
Subtitle C—Increasing the Supply of the Health Care Workforce
Sec. 5201. Federally supported student loan funds.
Sec. 5202. Nursing student loan program.
Sec. 5203. Health care workforce loan repayment programs.
Sec. 5204. Public health workforce recruitment and retention programs.
Sec. 5205. Allied health workforce recruitment and retention programs.
Sec. 5206. Grants for State and local programs.
Sec. 5207. Funding for National Health Service Corps.
Sec. 5208. Nurse-managed health clinics.
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Sec. 5209. Elimination of cap on commissioned corps.
Sec. 5210. Establishing a Ready Reserve Corps.
Subtitle D—Enhancing Health Care Workforce Education and Training
Sec. 5301. Training in family medicine, general internal medicine, general pediatrics,
and physician assistantship.
Sec. 5302. Training opportunities for direct care workers.
Sec. 5303. Training in general, pediatric, and public health dentistry.
Sec. 5304. Alternative dental health care providers demonstration project.
Sec. 5305. Geriatric education and training; career awards; comprehensive geriatric
education.
Sec. 5306. Mental and behavioral health education and training grants.
Sec. 5307. Cultural competency, prevention, and public health and individuals
with disabilities training.
Sec. 5308. Advanced nursing education grants.
Sec. 5309. Nurse education, practice, and retention grants.
Sec. 5310. Loan repayment and scholarship program.
Sec. 5311. Nurse faculty loan program.
Sec. 5312. Authorization of appropriations for parts B through D of title VIII.
Sec. 5313. Grants to promote the community health workforce.
Sec. 5314. Fellowship training in public health.
Sec. 5315. United States Public Health Sciences Track.
Subtitle E—Supporting the Existing Health Care Workforce
Sec. 5401. Centers of excellence.
Sec. 5402. Health care professionals training for diversity.
Sec. 5403. Interdisciplinary, community-based linkages.
Sec. 5404. Workforce diversity grants.
Sec. 5405. Primary care extension program.
Subtitle F—Strengthening Primary Care and Other Workforce Improvements
Sec. 5501. Expanding access to primary care services and general surgery services.
Sec. 5502. Medicare Federally qualified health center improvements.
Sec. 5503. Distribution of additional residency positions.
Sec. 5504. Counting resident time in nonprovider settings.
Sec. 5505. Rules for counting resident time for didactic and scholarly activities
and other activities.
Sec. 5506. Preservation of resident cap positions from closed hospitals.
Sec. 5507. Demonstration projects To address health professions workforce needs;
extension of family-to-family health information centers.
Sec. 5508. Increasing teaching capacity.
Sec. 5509. Graduate nurse education demonstration.
Subtitle G—Improving Access to Health Care Services
Sec. 5601. Spending for Federally Qualified Health Centers (FQHCs).
Sec. 5602. Negotiated rulemaking for development of methodology and criteria for
designating medically underserved populations and health professions
shortage areas.
Sec. 5603. Reauthorization of the Wakefield Emergency Medical Services for Children
Program.
Sec. 5604. Co-locating primary and specialty care in community-based mental
health settings.
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Sec. 5605. Key National indicators.
Subtitle H—General Provisions
Sec. 5701. Reports.
TITLE VI—TRANSPARENCY AND PROGRAM INTEGRITY
Subtitle A—Physician Ownership and Other Transparency
Sec. 6001. Limitation on Medicare exception to the prohibition on certain physician
referrals for hospitals.
Sec. 6002. Transparency reports and reporting of physician ownership or investment
interests.
Sec. 6003. Disclosure requirements for in-office ancillary services exception to the
prohibition on physician self-referral for certain imaging services.
Sec. 6004. Prescription drug sample transparency.
Sec. 6005. Pharmacy benefit managers transparency requirements.
Subtitle B—Nursing Home Transparency and Improvement
PART I—IMPROVING TRANSPARENCY OF INFORMATION
Sec. 6101. Required disclosure of ownership and additional disclosable parties information.
Sec. 6102. Accountability requirements for skilled nursing facilities and nursing
facilities.
Sec. 6103. Nursing home compare Medicare website.
Sec. 6104. Reporting of expenditures.
Sec. 6105. Standardized complaint form.
Sec. 6106. Ensuring staffing accountability.
Sec. 6107. GAO study and report on Five-Star Quality Rating System.
PART II—TARGETING ENFORCEMENT
Sec. 6111. Civil money penalties.
Sec. 6112. National independent monitor demonstration project.
Sec. 6113. Notification of facility closure.
Sec. 6114. National demonstration projects on culture change and use of information
technology in nursing homes.
PART III—IMPROVING STAFF TRAINING
Sec. 6121. Dementia and abuse prevention training.
Subtitle C—Nationwide Program for National and State Background Checks on
Direct Patient Access Employees of Long-term Care Facilities and Providers
Sec. 6201. Nationwide program for National and State background checks on direct
patient access employees of long-term care facilities and providers.
Subtitle D—Patient-Centered Outcomes Research
Sec. 6301. Patient-Centered Outcomes Research.
Sec. 6302. Federal coordinating council for comparative effectiveness research.
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Subtitle E—Medicare, Medicaid, and CHIP Program Integrity Provisions
Sec. 6401. Provider screening and other enrollment requirements under Medicare,
Medicaid, and CHIP.
Sec. 6402. Enhanced Medicare and Medicaid program integrity provisions.
Sec. 6403. Elimination of duplication between the Healthcare Integrity and Protection
Data Bank and the National Practitioner Data Bank.
Sec. 6404. Maximum period for submission of Medicare claims reduced to not
more than 12 months.
Sec. 6405. Physicians who order items or services required to be Medicare enrolled
physicians or eligible professionals.
Sec. 6406. Requirement for physicians to provide documentation on referrals to
programs at high risk of waste and abuse.
Sec. 6407. Face to face encounter with patient required before physicians may
certify eligibility for home health services or durable medical
equipment under Medicare.
Sec. 6408. Enhanced penalties.
Sec. 6409. Medicare self-referral disclosure protocol.
Sec. 6410. Adjustments to the Medicare durable medical equipment, prosthetics,
orthotics, and supplies competitive acquisition program.
Sec. 6411. Expansion of the Recovery Audit Contractor (RAC) program.
Subtitle F—Additional Medicaid Program Integrity Provisions
Sec. 6501. Termination of provider participation under Medicaid if terminated
under Medicare or other State plan.
Sec. 6502. Medicaid exclusion from participation relating to certain ownership,
control, and management affiliations.
Sec. 6503. Billing agents, clearinghouses, or other alternate payees required to
register under Medicaid.
Sec. 6504. Requirement to report expanded set of data elements under MMIS to
detect fraud and abuse.
Sec. 6505. Prohibition on payments to institutions or entities located outside of
the United States.
Sec. 6506. Overpayments.
Sec. 6507. Mandatory State use of national correct coding initiative.
Sec. 6508. General effective date.
Subtitle G—Additional Program Integrity Provisions
Sec. 6601. Prohibition on false statements and representations.
Sec. 6602. Clarifying definition.
Sec. 6603. Development of model uniform report form.
Sec. 6604. Applicability of State law to combat fraud and abuse.
Sec. 6605. Enabling the Department of Labor to issue administrative summary
cease and desist orders and summary seizures orders against
plans that are in financially hazardous condition.
Sec. 6606. MEWA plan registration with Department of Labor.
Sec. 6607. Permitting evidentiary privilege and confidential communications.
Subtitle H—Elder Justice Act
Sec. 6701. Short title of subtitle.
Sec. 6702. Definitions.
Sec. 6703. Elder Justice.
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Subtitle I—Sense of the Senate Regarding Medical Malpractice
Sec. 6801. Sense of the Senate regarding medical malpractice.
TITLE VII—IMPROVING ACCESS TO INNOVATIVE MEDICAL
THERAPIES
Subtitle A—Biologics Price Competition and Innovation
Sec. 7001. Short title.
Sec. 7002. Approval pathway for biosimilar biological products.
Sec. 7003. Savings.
Subtitle B—More Affordable Medicines for Children and Underserved
Communities
Sec. 7101. Expanded participation in 340B program.
Sec. 7102. Improvements to 340B program integrity.
Sec. 7103. GAO study to make recommendations on improving the 340B program.
TITLE VIII—CLASS ACT
Sec. 8001. Short title of title.
Sec. 8002. Establishment of national voluntary insurance program for purchasing
community living assistance services and support.
TITLE IX—REVENUE PROVISIONS
Subtitle A—Revenue Offset Provisions
Sec. 9001. Excise tax on high cost employer-sponsored health coverage.
Sec. 9002. Inclusion of cost of employer-sponsored health coverage on W–2.
Sec. 9003. Distributions for medicine qualified only if for prescribed drug or insulin.
Sec. 9004. Increase in additional tax on distributions from HSAs and Archer
MSAs not used for qualified medical expenses.
Sec. 9005. Limitation on health flexible spending arrangements under cafeteria
plans.
Sec. 9006. Expansion of information reporting requirements.
Sec. 9007. Additional requirements for charitable hospitals.
Sec. 9008. Imposition of annual fee on branded prescription pharmaceutical
manufacturers and importers.
Sec. 9009. Imposition of annual fee on medical device manufacturers and importers.
Sec. 9010. Imposition of annual fee on health insurance providers.
Sec. 9011. Study and report of effect on veterans health care.
Sec. 9012. Elimination of deduction for expenses allocable to Medicare Part D
subsidy.
Sec. 9013. Modification of itemized deduction for medical expenses.
Sec. 9014. Limitation on excessive remuneration paid by certain health insurance
providers.
Sec. 9015. Additional hospital insurance tax on high-income taxpayers.
Sec. 9016. Modification of section 833 treatment of certain health organizations.
Sec. 9017. Excise tax on elective cosmetic medical procedures.
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Subtitle B—Other Provisions
Sec. 9021. Exclusion of health benefits provided by Indian tribal governments.
Sec. 9022. Establishment of simple cafeteria plans for small businesses.
Sec. 9023. Qualifying therapeutic discovery project credit.
TITLE X—STRENGTHENING QUALITY, AFFORDABLE HEALTH CARE
FOR ALL AMERICANS
Subtitle A—Provisions Relating to Title I
Sec. 10101. Amendments to subtitle A.
Sec. 10102. Amendments to subtitle B.
Sec. 10103. Amendments to subtitle C.
Sec. 10104. Amendments to subtitle D.
Sec. 10105. Amendments to subtitle E.
Sec. 10106. Amendments to subtitle F.
Sec. 10107. Amendments to subtitle G.
Sec. 10108. Free choice vouchers.
Sec. 10109. Development of standards for financial and administrative transactions.
Subtitle B—Provisions Relating to Title II
PART I—MEDICAID AND CHIP
Sec. 10201. Amendments to the Social Security Act and title II of this Act.
Sec. 10202. Incentives for States to offer home and community-based services as
a long-term care alternative to nursing homes.
Sec. 10203. Extension of funding for CHIP through fiscal year 2015 and other
CHIP-related provisions.
PART II—SUPPORT FOR PREGNANT AND PARENTING TEENS AND WOMEN
Sec. 10211. Definitions.
Sec. 10212. Establishment of pregnancy assistance fund.
Sec. 10213. Permissible uses of Fund.
Sec. 10214. Appropriations.
PART III—INDIAN HEALTH CARE IMPROVEMENT
Sec. 10221. Indian health care improvement.
Subtitle C—Provisions Relating to Title III
Sec. 10301. Plans for a Value-Based purchasing program for ambulatory surgical
centers.
Sec. 10302. Revision to national strategy for quality improvement in health care.
Sec. 10303. Development of outcome measures.
Sec. 10304. Selection of efficiency measures.
Sec. 10305. Data collection; public reporting.
Sec. 10306. Improvements under the Center for Medicare and Medicaid Innovation.
Sec. 10307. Improvements to the Medicare shared savings program.
Sec. 10308. Revisions to national pilot program on payment bundling.
Sec. 10309. Revisions to hospital readmissions reduction program.
Sec. 10310. Repeal of physician payment update.
Sec. 10311. Revisions to extension of ambulance add-ons.
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Sec. 10312. Certain payment rules for long-term care hospital services and moratorium
on the establishment of certain hospitals and facilities.
Sec. 10313. Revisions to the extension for the rural community hospital demonstration
program.
Sec. 10314. Adjustment to low-volume hospital provision.
Sec. 10315. Revisions to home health care provisions.
Sec. 10316. Medicare DSH.
Sec. 10317. Revisions to extension of section 508 hospital provisions.
Sec. 10318. Revisions to transitional extra benefits under Medicare Advantage.
Sec. 10319. Revisions to market basket adjustments.
Sec. 10320. Expansion of the scope of, and additional improvements to, the Independent
Medicare Advisory Board.
Sec. 10321. Revision to community health teams.
Sec. 10322. Quality reporting for psychiatric hospitals.
Sec. 10323. Medicare coverage for individuals exposed to environmental health
hazards.
Sec. 10324. Protections for frontier States.
Sec. 10325. Revision to skilled nursing facility prospective payment system.
Sec. 10326. Pilot testing pay-for-performance programs for certain Medicare providers.
Sec. 10327. Improvements to the physician quality reporting system.
Sec. 10328. Improvement in part D medication therapy management (MTM)
programs.
Sec. 10329. Developing methodology to assess health plan value.
Sec. 10330. Modernizing computer and data systems of the Centers for Medicare
& Medicaid services to support improvements in care delivery.
Sec. 10331. Public reporting of performance information.
Sec. 10332. Availability of medicare data for performance measurement.
Sec. 10333. Community-based collaborative care networks.
Sec. 10334. Minority health.
Sec. 10335. Technical correction to the hospital value-based purchasing program.
Sec. 10336. GAO study and report on Medicare beneficiary access to high-quality
dialysis services.
Subtitle D—Provisions Relating to Title IV
Sec. 10401. Amendments to subtitle A.
Sec. 10402. Amendments to subtitle B.
Sec. 10403. Amendments to subtitle C.
Sec. 10404. Amendments to subtitle D.
Sec. 10405. Amendments to subtitle E.
Sec. 10406. Amendment relating to waiving coinsurance for preventive services.
Sec. 10407. Better diabetes care.
Sec. 10408. Grants for small businesses to provide comprehensive workplace
wellness programs.
Sec. 10409. Cures Acceleration Network.
Sec. 10410. Centers of Excellence for Depression.
Sec. 10411. Programs relating to congenital heart disease.
Sec. 10412. Automated Defibrillation in Adam’s Memory Act.
Sec. 10413. Young women’s breast health awareness and support of young women
diagnosed with breast cancer.
Subtitle E—Provisions Relating to Title V
Sec. 10501. Amendments to the Public Health Service Act, the Social Security
Act, and title V of this Act.
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Sec. 10502. Infrastructure to Expand Access to Care.
Sec. 10503. Community Health Centers and the National Health Service Corps
Fund.
Sec. 10504. Demonstration project to provide access to affordable care.
Subtitle F—Provisions Relating to Title VI
Sec. 10601. Revisions to limitation on medicare exception to the prohibition on
certain physician referrals for hospitals.
Sec. 10602. Clarifications to patient-centered outcomes research.
Sec. 10603. Striking provisions relating to individual provider application fees.
Sec. 10604. Technical correction to section 6405.
Sec. 10605. Certain other providers permitted to conduct face to face encounter
for home health services.
Sec. 10606. Health care fraud enforcement.
Sec. 10607. State demonstration programs to evaluate alternatives to current
medical tort litigation.
Sec. 10608. Extension of medical malpractice coverage to free clinics.
Sec. 10609. Labeling changes.
Subtitle G—Provisions Relating to Title VIII
Sec. 10801. Provisions relating to title VIII.
Subtitle H—Provisions Relating to Title IX
Sec. 10901. Modifications to excise tax on high cost employer-sponsored health
coverage.
Sec. 10902. Inflation adjustment of limitation on health flexible spending arrangements
under cafeteria plans.
Sec. 10903. Modification of limitation on charges by charitable hospitals.
Sec. 10904. Modification of annual fee on medical device manufacturers and importers.
Sec. 10905. Modification of annual fee on health insurance providers.
Sec. 10906. Modifications to additional hospital insurance tax on high-income
taxpayers.
Sec. 10907. Excise tax on indoor tanning services in lieu of elective cosmetic medical
procedures.
Sec. 10908. Exclusion for assistance provided to participants in State student
loan repayment programs for certain health professionals.
Sec. 10909. Expansion of adoption credit and adoption assistance programs.

Willravel · 03-21-2010, 11:55 AM

Quote:

Originally Posted by Wes Mantooth

Well I think so, its been a pretty big part of their platform for years so it only makes sense that they might continue to push it if they have the numbers to. I do however fear them becoming to dogmatic about the whole thing and losing perspective about what the country really wants/needs. For example lets say people are happy with the balance struck by early reforms and instead of leaving it at that, they keep pushing and pushing for more reforms because they feel they have to or need to as its a big part of the platform.

I think ideally a balance between the two sides is what the country really needs right now. Despite how good/bad single payer may be for the country its something we're going to have to ease into with small steps. People just don't like monkeying with a system that works for them and weather its selfish or not, people are going to look out for their own or their families own best interest before others. Its going to be hard to convince somebody with a good health care plan to change anything because they just can't be sure if what they get will leave them worse off.

I'm not sure the country knows what it wants right now. Part of us wants capitalistic anarchism, part of us wants the status quo, part of us wants the public option and part of us wants something more European (me!).

The question of what we need is our point of contention. I feel the case has been made for single-payer being the best option should only the facts be considered, but that's just my opinion. Still, when I authored this threat, my thought was simply: the current healthcare bill probably isn't what supporters of reform wanted, so where are we going to push next?

Wes Mantooth · 03-21-2010, 12:03 PM

Quote:

Originally Posted by ASU2003

I've seen my healthcare coverage go downhill in the last 20 years. First it was the $20 office visit payments, then the increasing deductibles, and increasing premiums.

And I have never had to get healthcare insurance as an individual.

I view this as something good for the country. And if it is good for the country, then it is good for me.

Sure, I'm not particularly happy with my coverage or health care in this country in general it needs to be fixed in my opinion. However I do know a lot of people that like the coverage they have and don't feel like they want anyone doing anything to change it. They don't want to see it backfire and leave them with worse coverage then they had before (amongst other issues), its a perfectly normal concern when facing change.

Just because something may benefit the country it doesn't mean it always benefits the individual and lets face it at the end of the day most people are going to look out for number 1. It is what it is I guess.

EDIT: Snuck in on me there Will. I agree I don't think the country really knows what it wants either. I think unfortunately the Dems have dropped the ball here, I don't think they offer enough reform for supporters and offer too much to those opposed. In the end it may not please either side and they may find themselves having to start from scratch to push for more reform or be left out in the cold. I wouldn't be surprised if perhaps the next Democrat President pushes for proper single payer or a more European style system especially if this new bill is effective and proves to be popular.

Willravel · 03-21-2010, 12:27 PM

Quote:

Originally Posted by ottopilot

Will, I sincerely believe the sentiment of this statement should make everyone here feel very uneasy. I don't mean in a right-wing "sky is falling" way. An uneasiness like you may experience before jumping head-first from a very tall bridge in to an unfamiliar dark and murky stream. However, all you know is that you want relief and the lure of doing something new seems appealing if not exhilarating. What would be your deciding factors for making the 'jump" (or not)?

Data, pure and dispassionate data. This is a fall others have made before us and jumping off this particular ledge has without exception been fruitful, certainly more fruitful than the ledge we're falling off now. This isn't about hope or ideology, this is about success rates. Single-payer and even nationalized health systems in industrialized countries are higher in quality and lower in cost than private systems like the one people in the US under 65 have. This has been established countless times across dozens of threads here on TFP.

ottopilot · 03-21-2010, 01:36 PM

Quote:

Originally Posted by Willravel

Data, pure and dispassionate data. This is a fall others have made before us and jumping off this particular ledge has without exception been fruitful, certainly more fruitful than the ledge we're falling off now. This isn't about hope or ideology, this is about success rates. Single-payer and even nationalized health systems in industrialized countries are higher in quality and lower in cost than private systems like the one people in the US under 65 have. This has been established countless times across dozens of threads here on TFP.

Oh that heartless logic! Let's not let problem solving get in the way of solving problems. It's heartless to imagine that we stoop to using problem solving techniques, honest accounting principles, and responsibility to actually solve anything. It's all about the team and how it feels.

Show me the official statement of "the problem" regarding health care. If there is one, then I want to see how they broke each issue down, analyzed, defined solutions with success criteria, and how to execute the specific measures. If I've missed that anywhere, then I'll reverse my opinion.

To acknowledge that there are problems is not dispassionate. I believe there are problems with a variety of factors related to "health care" costs. However, I want them detailed and documented. If government is not up to accountability, how can I be assured of their competency or sincerity.

Who is it that "fell" before us? Most likely more political tools who sold us all another one-size-fits-all, chicken-in-every-pot, pie-in-the-sky solution full of villains, victims and saints. Success rates for what? What are you measuring in these comparisons? The debate is plenty here and everywhere, but aren't you at least curious about what exactly is wrong? What is right about it? Do you believe we shouldn't attempt to fix the bad things first rather than encumber everyone with this giant albatross? There are far more unknowns in this legislation (for me) to accept it as a responsible solution.

If you want to get rid of a fly, dynamite is generally considered overkill... unless you just like blowin' stuff up. Perhaps this is more about blowin' stuff up.

aceventura3 · 03-21-2010, 01:36 PM

At best I think health insurance companies will be regulated and controlled like utility companies. The most likely scenario is that they begin a long slow death, while more and more people go on public plans, eventually leading to single payer. It would be more efficient just to go to a single payer system, but that is where this will lead. Our health care system will eventually run like the post-office.

rahl · 03-21-2010, 01:39 PM

Quote:

Originally Posted by aceventura3

Our health care system will eventually run like the post-office.

So you believe it will run cheaply and quite efficiently?

RogueGypsy · 03-21-2010, 01:45 PM

I'm still confused over why we have to destroy and rebuild a system that only 10% of the population needs, half of which don't care. I thought this was a democracy, doesn't that mean majority?

That aside, I believe reform is needed. Just not in the form of a 2000 page bill being shoved down our throats. How many people do you think have actually read or understand the bill and of them how many are voting on it?

Personally I don't care if it's a creature of the left or the right, it's political bullshit. No one is discussing what the bill actually says, just ranting about the right hating Oblahblah, or the left being so entrenched up his ass they can't see through the shit. This bill will affect every industry, business and individual in the country and these assholes are trying to shove it down our throats without the common courtesy of a clear and concise explanation of what it entails. If it were the all glorious solution they claim it to be, why can't they explain it? Surely if it's as great as they claim everyone would be on board and it would pass with no resistance.

I'm just sayin'. Whenever something has to happen 'right now' or I'm getting the 'hard sell'. My bullshit flag raises immediately and this bill sent it flying high.

I think everyone needs to put down the political blinders, back away slowly and take a deep breath. Forget who proposed what and why, read the document in it's entirety and develop an informed opinion based on what we've read.

As far as socialized medicine goes, like communism, it looks great on paper, but it just doesn't work. To model our system on the failing systems already out there is idiotic. We have a chance to truly reform medical care in a meaningful and significant way. To throw that away based on politics is treasonous. Some think it's just hype that socialized medicine is a failure, but all you have to do is look at the numbers; they're bankrupt or heading that way fast. It's been world headlines since before this debate began. Those who can afford too, come here for treatment instead of using their own systems. Those who can't are stuck in months, sometimes years long waiting lists. How exactly is this better than what we have?

Why do we have to cater to the lowest common denominator? Why can't we strive to achieve what the rest of the world only dreams of?

I say we write some serious tort reform, freeze insurance premiums for 10 years and send everyone in favor of socialized medicine to live in a country with a socialized system for 10 years. When they come back we vote. Really what's 10 years compared to the rest of your life and your children's lives and their children's lives? There is no substitute for real world experience. Further more, if it's good enough for the masses, then it is absolutely good enough for public servants. It should be mandatory for all government employees if it is for us. WTF is up with the double standard?

blktour · 03-21-2010, 02:14 PM

Quote:

Originally Posted by RogueGypsy

I'm still confused over why we have to destroy and rebuild a system that only 10% of the population needs, half of which don't care. I thought this was a democracy, doesn't that mean majority?

That aside, I believe reform is needed. Just not in the form of a 2000 page bill being shoved down our throats. How many people do you think have actually read or understand the bill and of them how many are voting on it?

Personally I don't care if it's a creature of the left or the right, it's political bullshit. No one is discussing what the bill actually says, just ranting about the right hating Oblahblah, or the left being so entrenched up his ass they can't see through the shit. This bill will affect every industry, business and individual in the country and these assholes are trying to shove it down our throats without the common courtesy of a clear and concise explanation of what it entails. If it were the all glorious solution they claim it to be, why can't they explain it? Surely if it's as great as they claim everyone would be on board and it would pass with no resistance.

I'm just sayin'. Whenever something has to happen 'right now' or I'm getting the 'hard sell'. My bullshit flag raises immediately and this bill sent it flying high.

I think everyone needs to put down the political blinders, back away slowly and take a deep breath. Forget who proposed what and why, read the document in it's entirety and develop an informed opinion based on what we've read.

As far as socialized medicine goes, like communism, it looks great on paper, but it just doesn't work. To model our system on the failing systems already out there is idiotic. We have a chance to truly reform medical care in a meaningful and significant way. To throw that away based on politics is treasonous. Some think it's just hype that socialized medicine is a failure, but all you have to do is look at the numbers; they're bankrupt or heading that way fast. It's been world headlines since before this debate began. Those who can afford too, come here for treatment instead of using their own systems. Those who can't are stuck in months, sometimes years long waiting lists. How exactly is this better than what we have?

Why do we have to cater to the lowest common denominator? Why can't we strive to achieve what the rest of the world only dreams of?

I say we write some serious tort reform, freeze insurance premiums for 10 years and send everyone in favor of socialized medicine to live in a country with a socialized system for 10 years. When they come back we vote. Really what's 10 years compared to the rest of your life and your children's lives and their children's lives? There is no substitute for real world experience. Further more, if it's good enough for the masses, then it is absolutely good enough for public servants. It should be mandatory for all government employees if it is for us. WTF is up with the double standard?

Actually we are a Republic. It is different from a Democracy.

I believe that this health care "reform" is a reform. it will reform how the government takes control. In the sense that this is a big hijack of our freedoms to choose what the heck we want.

A big power grab is all it is.

as for the comment of the USPS running smoothly, I swear I read some article last year about it running on a deficit.

The government was established to protect our freedoms, if they are not doing that, then they should butt out of it.

dc_dux · 03-21-2010, 02:19 PM

Quote:

Originally Posted by blktour

Actually we are a Republic. It is different from a Democracy.

I believe that this health care "reform" is a reform. it will reform how the government takes control. In the sense that this is a big hijack of our freedoms to choose what the heck we want.

A big power grab is all it is.

How is it a power grab or hijacking your freedoms if you are currently among the nearly 200 million with employer-based insurance? By giving you the freedom NOT to have pre-existing conditions excluding or the freedom NOT to go bankrupt as a result of a medical crisis AND the freedom to have free preventive care?

Exactly how is the government taking control of your choices?

A comprehensive approach was needed. not only to address the 30+ million currently uninsured, but address the deficiencies and the existing restrictions for those with insurance and to address the rising costs.

ottopilot · 03-21-2010, 02:32 PM

Quote:

Originally Posted by dc_dux

A comprehensive approach was needed. not only to address the 30+ million currently uninsured, but address the deficiencies and the existing restrictions for those with insurance and to address the rising costs.

Whew... if that's all, well then... that's d i f f e r e n t.

comprehensive - Including all or everything; "comprehensive coverage"; Broadly or completely covering; including a large proportion of something
comprehensively - in an all-inclusive manner
comprehensiveness - completeness over a broad scope

dc_dux · 03-21-2010, 02:34 PM

Quote:

Originally Posted by ottopilot

Whew... if that's all, well then... that's d i f f e r e n t.

comprehensive - Including all or everything; "comprehensive coverage"; Broadly or completely covering; including a large proportion of something
comprehensively - in an all-inclusive manner
comprehensiveness - completeness over a broad scope

So whats your specific complaint?

ottopilot · 03-21-2010, 02:42 PM

Quote:

Originally Posted by dc_dux

So whats your specific complaint?

No complaint... I got your back buddy! You can't argue with cold hard talking points.

dc_dux · 03-21-2010, 02:44 PM

Quote:

Originally Posted by ottopilot

No complaint... I got your back buddy! You can't argue with cold hard talking points.

Oh, the talking points wont go away.

I expect the "government take-over" and "road to socialism" rhetoric and all the rest to continue. It has a greater political purpose.

Ignorance is bliss, particularly if one is guided by rigid extremists ideologues with an agenda.

ottopilot · 03-21-2010, 02:46 PM

Quote:

Originally Posted by dc_dux

Oh, the talking points wont go away.

I expect the "government take-over" and "road to socialism" rhetoric and all the rest to continue.

Ignorance is bliss.

You must be very happy.

So are you saying there is no power grab or are you justifying it?

dc_dux · 03-21-2010, 02:51 PM

Quote:

Originally Posted by ottopilot

You must be very happy.

So are you saying there is no power grab or are you justifying it?

Its not a great bill, but IMO, it is a very good bill and long (nearly 100 years) overdue. I dont expect it to "fix" the health care system overnight, but as taking important steps in the right direction.

And no, I dont see a power grab. I see the majority in Congress using the system as it always has.

ottopilot · 03-21-2010, 03:00 PM

Quote:

Originally Posted by dc_dux

Its not a great bill, but IMO, it is a very good bill and long (nearly 100 years) overdue. I dont expect it to "fix" the health care system overnight, but as taking important steps in the right direction.

That's a very interesting response. So it's not very good, but it's nearly 100 years overdue... in what respect (overdue)?

rahl · 03-21-2010, 03:02 PM

Quote:

Originally Posted by ottopilot

That's a very interesting response. So it's not very good, but it's nearly 100 years overdue... in what respect (overdue)?

The fact that we are the only modern industrialised nation that doesn't have some form of national healthcare. The fact that our current system is statistically worse than others of said nations in terms of quality of care, affordability of care and life expectancy.

dc_dux · 03-21-2010, 03:04 PM

Quote:

Originally Posted by ottopilot

That's a very interesting response. So it's not very good, but it's nearly 100 years overdue... in what respect (overdue)?

Nope...its very good for those 30+ million uninsured who will have access to affordable health care and for those 200 million who will have protections against discriminatory practices and financial insecurity....and other benefits to all, including such things as a significant investment in health care technology to help contain future costs.

It is just not great or perfect. Little in life is perfect....and the legislative process is even less so.

And overdue for the same reasons.

Now how is that a power grab or hijacking individual freedoms?

ottopilot · 03-21-2010, 03:06 PM

Quote:

Originally Posted by rahl

The fact that we are the only modern industrialised nation that doesn't have some form of national healthcare. The fact that our current system is statistically worse than others of said nations in terms of quality of care, affordability of care and life expectancy.

Oh really? Thanks dc_dux for your clarification.

---------- Post added at 07:06 PM ---------- Previous post was at 07:05 PM ----------

Quote:

Originally Posted by dc_dux

Nope...its very good for those 30+ million uninsured who will have access to affordable health care and to those 200 million who will have protections against discriminatory practices and financial insecurity....and other benefits to all, including such things as a significant investment in health care technology to help contain future costs.

It is just not great or perfect. Little in life is perfect.

And overdue for the same reasons.

Now is that a power grab or hijacking your freedoms?

Thanks REAL dc... just curious. it may not be a hijack but it is a form of power grab... I'd like to discuss this later (respectfully), but must attend to a dirty diaper and other family duties (doody).

rahl · 03-21-2010, 03:08 PM

Quote:

Originally Posted by ottopilot

Oh really? Thanks dc_dux for your clarification.

---------- Post added at 07:06 PM ---------- Previous post was at 07:05 PM ----------

Thanks REAL dc... just curious.

I thought this was a discussion board...my bad

dc_dux · 03-21-2010, 03:12 PM

Quote:

Originally Posted by rahl

I thought this was a discussion board...my bad

I think its fly paper.

Those opposed throwing out everything bogus argument - government take-over, unconstitutional, power grab, hijacking individual freedoms - and hoping something sticks.

Willravel · 03-21-2010, 03:14 PM

Quote:

Originally Posted by ottopilot

Oh that heartless logic! Let's not let problem solving get in the way of solving problems. It's heartless to imagine that we stoop to using problem solving techniques, honest accounting principles, and responsibility to actually solve anything. It's all about the team and how it feels.

Quote:

Originally Posted by ottopilot

Show me the official statement of "the problem" regarding health care. If there is one, then I want to see how they broke each issue down, analyzed, defined solutions with success criteria, and how to execute the specific measures. If I've missed that anywhere, then I'll reverse my opinion.

Expense to quality ratio is the main problem. I doubt anyone not on the healthcare industry's payroll would disagree. The United States does not enjoy as beneficial a ratio of expense to quality as all of our Western industrialized peers. Countries with GDP smaller than California enjoy higher quality care than anywhere in the US, and yet we by far pay the most money on average in the entire world for care.

Quote:

Originally Posted by ottopilot

To acknowledge that there are problems is not dispassionate. I believe there are problems with a variety of factors related to "health care" costs. However, I want them detailed and documented. If government is not up to accountability, how can I be assured of their competency or sincerity.

What accountability do you require? What of Medicare is so hidden?

Quote:

Originally Posted by ottopilot

Who is it that "fell" before us? Most likely more political tools who sold us all another one-size-fits-all, chicken-in-every-pot, pie-in-the-sky solution full of villains, victims and saints. Success rates for what? What are you measuring in these comparisons? The debate is plenty here and everywhere, but aren't you at least curious about what exactly is wrong? What is right about it? Do you believe we shouldn't attempt to fix the bad things first rather than encumber everyone with this giant albatross? There are far more unknowns in this legislation (for me) to accept it as a responsible solution.

It might be faster to list countries that have not yet jumped into universal-style healthcare. Just in Europe alone, there's Austria, Andorra, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, the Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Monaco, the Netherlands, Norway, Poland, Portugal, Romania, Russia, San Marino, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Ukraine and the United Kingdom.

What's wrong is much, but mainly it's a for profit system which benefits from covering the healthy and is hindered by covering the unhealthy. The unhealthy, which could be either of us at a moment's notice, are not served by the market option, thus another option is necessary for a free society's stability in part depends on wealth. Our peers don't have this problem.

RogueGypsy · 03-21-2010, 04:12 PM

Quote:

Originally Posted by Willravel

Expense to quality ratio is the main problem. I doubt anyone not on the healthcare industry's payroll would disagree. The United States does not enjoy as beneficial a ratio of expense to quality as all of our Western industrialized peers. Countries with GDP smaller than California enjoy higher quality care than anywhere in the US, and yet we by far pay the most money on average in the entire world for care.

If this is the main problem, then why tear down the whole system? Why not just give Medicare a public option. The insurance companies would have to compete or go under.
It's also a lot easier to administer a few million than 300 million. So yeah, it is probably better in countries with a smaller GDP than California. So why not do this on a state level with interstate cooperation?

What accountability do you require? What of Medicare is so hidden?

It might be faster to list countries that have not yet jumped into universal-style healthcare. Just in Europe alone, there's Austria, Andorra, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, the Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Monaco, the Netherlands, Norway, Poland, Portugal, Romania, Russia, San Marino, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Ukraine and the United Kingdom.

What's wrong is much, but mainly it's a for profit system which benefits from covering the healthy and is hindered by covering the unhealthy. The unhealthy, which could be either of us at a moment's notice, are not served by the market option, thus another option is necessary for a free society's stability in part depends on wealth. Our peers don't have this problem.

I can't speak for everyone, but if I spend 10 years in school, I expect to get paid. SO it's not the system but the insurers that need to be addressed. Unfortunately, this bill will kill the doctors as well.

The majority of insurance issues that have arisen in the past 20 years are due to frivolous law suits. Every time an insurer gets whacked with a multi-million dollar law suit, it gets tougher for the rest of us. Tort reform could address this easily.

This bill is just insane. And it bears repeating, the government does NOTHING efficiently. If it did, our taxes would remain steady or decrease, but they don't. Now this bill suggests we entrust our health and lives to the same people who bankrupted a whore house? Dude, really??

Everyone seems to want the same thing. Good, affordable health care. There is absolutely nothing in history showing that over blow bureaucracy can achieve anything good or affordable. These idiots pay a thousand dollars for a hammer. What do think it's gonna cost to get a medical procedure done? Nothing? Bullshit.

If you want better preventative medicine: Clamp down on the FDA and all the bullshit they allow into our foods. Open public exercise centers. Educate our children about diet and nutrition -not a one week class in elementary school- but a real course. Bring physical education back into schools-whoever that idiot is should be kicked in the nuts-. Adopt a more Eastern philosophy toward medicine. Put down the Twinky and eat a carrot.

This can all be solved with minimal government intervention. Which is how it should be. The government isn't daycare for the inept and lazy.

Willravel · 03-21-2010, 05:43 PM

Quote:

Originally Posted by RogueGypsy

This can all be solved with minimal government intervention. Which is how it should be. The government isn't daycare for the inept and lazy.

I welcome you to study up on what single-payer is before we continue.

Charlatan · 03-21-2010, 05:46 PM

The level of disinformation that is floating around the US is just... overwhelming.

I am astounded at the extent to which Republican politicians and supporters are willing to go.

I am also astounded that the Democrats can't get sound counter-argument going.

rahl · 03-21-2010, 05:50 PM

Quote:

Originally Posted by Charlatan

The level of disinformation that is floating around the US is just... overwhelming.

I am astounded at the extent to which Republican politicians and supporters are willing to go.

I am also astounded that the Democrats can't get sound counter-argument going.

unfortunately it's not so simple. I myself was very much against this bill when I first heard about it because I am in the insurance industry and I also didn't really know what was in it. Having read most of it and seen the data surrounding it I have made a complete 180 to now supporting it.

Most people however don't want to do the work in order to judge the bill on the facts.

ASU2003 · 03-21-2010, 07:46 PM

Quote:

Originally Posted by rahl

unfortunately it's not so simple. I myself was very much against this bill when I first heard about it because I am in the insurance industry and I also didn't really know what was in it. Having read most of it and seen the data surrounding it I have made a complete 180 to now supporting it.

Most people however don't want to do the work in order to judge the bill on the facts.

Honestly, it's the media that is supposed to give us the facts, not the opinions of people. Why aren't they interviewing the people at the CBO? Why aren't the journalists telling us what is in the bill and how it will effect different people in differing situations?

It will probably make the insurance companies jobs easier now, since they can't try and find loopholes to deny payment. It will be interesting how that industry changes now. I'm still not sure what it will look like in 10 years.

And sometimes it is cheaper to treat someone like me for $2000 when I was poor, and then I was able to get a job and have been able to pay it back and a lot more in taxes over the past 6 years. So, they have done step 1 and passed it, but now step 2 is to get people to think that a basic level of health care is a right like in the vast majority of developed countries.

But, the Democrats and the White House really didn't do enough planning and screwed up how they handled it and communicated this to the public. I hope they learned a lot from this.

rahl · 03-21-2010, 08:13 PM

I don't think the democrats screwed up how they communicated it, they just always give people more credit than they deserve. They seem to underestimate the propoganda machine that is the republican party and faux news. When people hear something over and over and over again they tend to believe it.

Willravel · 03-21-2010, 09:54 PM

Quote:

Originally Posted by ASU2003

But, the Democrats and the White House really didn't do enough planning and screwed up how they handled it and communicated this to the public. I hope they learned a lot from this.

This assumes the Democrats, on the whole, wanted reform passed. Don't forget, there are just as many Democrats on the healthcare industry's payroll as Republicans.

Anyway, now that the bill has passed the House and is headed to the Senate, it seems this threat is one step closer to being relevant. This will be a victory for Dems, but they may choose to rest on their laurels instead of tempting fate with a second major push. It's hard to say.

roachboy · 03-22-2010, 04:06 AM

i have to say that i have found these threads too depressing to post in because of the litany of cookie-cutter memes that are everywhere in both from the right. my basic response is similar to charlatans, to marvel at the lengths to which the right is willing to go in mobilizing its demographic on the basis of fear and disinformation and projection.

so we have an economic transition engendered enabled and concealed by 30 years of neoliberalism the realities behind which are now coming home to roost not because they haven't been present but because monetarist bubble-manufacturing is not able to create the illusion of happy valley endless expansion...in this context there is a perfectly reasonable move, to extend health care access to the 30 plus million uninsured. this is an ethical problem that's being addressed AND a political problems and i cannot for the life of me figure out how the communications apparatus of the administration managed to find a way to not frame this debate so that the right noise machine could be made to say "we think the uninsured are extraneous people who should die"---because that is in effect the argument they're making---but instead you get all this chicken little horseshit about "the amurican way" blah blah blah.

it'd be funny if i didn't live here.
this is what collapse of empire looks like, sports fans. a running away from reality.

i'm glad the bill passed but i don't like the bill particularly. it should have gone further. there are alot of reasons why it is as it is. some folk have wondered what the administration was thinking in terms of issue framing from the start. i did. but it's good it passed---better than nothing and certainly an improvement over the social barbarism that's obtained so far, which conservatives are trying to defend as "the amurican way"..

but this "debate" insofar as the right is concerned in particular is about as depressing a thing as i can remember.

03-20-2010, 05:32 PM	#1 (permalink)
Willravel ... a sort of licensed troubleshooter.	Step 1: Get any kind of healthcare reform passed. Step 2? I'm sure the lion's share of moderates and progressives here are unsatisfied with the healthcare bill that will likely be passed on the coming days. I would have preferred a push for single-payer and then maybe a few concessions to get the necessary blue-dog votes. Instead we got the public option as a starting point and now... we'll see. C'est la vi. So let's say the likely happens and this bill is passed. A few relatively minor things begin to change, and people recognize these things despite the sky-is-falling rhetoric from the right. What happens next? Undoubtedly, progressives will continue pushing for additional reform, I know I will. But what's the next baby step toward real reform? Should we push for a real public option or should we push for Meicare for all? I'm honestly not sure and I'd like to get your input.

03-20-2010, 07:16 PM	#2 (permalink)
Derwood Who You Crappin? Location: Everywhere and Nowhere	I like the concept of being able to "buy into" Medicare, but I don't know the details of the specific plans that have been offered up for it __________________ "You can't shoot a country until it becomes a democracy." - Willravel

03-20-2010, 07:20 PM	#3 (permalink)
dc_dux Location: Washington DC	At some point, I think the next step will be in the direction of a program similar to the FEHB (fed employees can chose from among numerous private providers at varying costs with varying levels of coverage) type program and not a Medicare type. Where the private insurance companies will still be the providers of service and compete for consumers in a marketplace that is regulated by the government. __________________ "The perfect is the enemy of the good." ~ Voltaire

03-20-2010, 09:07 PM	#5 (permalink)
Derwood Who You Crappin? Location: Everywhere and Nowhere	I'd love UHC/Single Payer, but I don't think it will ever happen here __________________ "You can't shoot a country until it becomes a democracy." - Willravel

03-21-2010, 12:15 AM	#7 (permalink)
Wes Mantooth Junkie Location: Tennessee	Well I think so, its been a pretty big part of their platform for years so it only makes sense that they might continue to push it if they have the numbers to. I do however fear them becoming to dogmatic about the whole thing and losing perspective about what the country really wants/needs. For example lets say people are happy with the balance struck by early reforms and instead of leaving it at that, they keep pushing and pushing for more reforms because they feel they have to or need to as its a big part of the platform. I think ideally a balance between the two sides is what the country really needs right now. Despite how good/bad single payer may be for the country its something we're going to have to ease into with small steps. People just don't like monkeying with a system that works for them and weather its selfish or not, people are going to look out for their own or their families own best interest before others. Its going to be hard to convince somebody with a good health care plan to change anything because they just can't be sure if what they get will leave them worse off. __________________ “My god I must have missed it...its hell down here!”

03-20-2010, 08:41 PM	#4 (permalink)
Willravel ... a sort of licensed troubleshooter.	Derwood, Representative Weiner from New York laid out the idea of a Medicare buy in here. It's an intriguing idea and Rep. Weiner has been making the rounds building a pretty strong case for it. DC, so you're saying we're simply headed toward a better regulated free marketplace? Do you think that's the best solution or are you still rooting for something like single-payer or nationalized health?

03-20-2010, 09:13 PM	#6 (permalink)
Willravel ... a sort of licensed troubleshooter.	Maybe not, but I think it makes sense to still fight for it. Remember: Canada didn't get single-payer overnight, it took years and years to get in place. The first step was Saskatchewan subsidizing doctors because of a shortage. The idea spread to Alberta. It took almost 40 years, but things now are a hell of a lot better than they were back in the 1940s for Canadians. If the US takes until 2050 to get healthcare, I'm going to be there to see it.

03-21-2010, 01:36 PM	#15 (permalink)
aceventura3 Junkie Location: Ventura County	At best I think health insurance companies will be regulated and controlled like utility companies. The most likely scenario is that they begin a long slow death, while more and more people go on public plans, eventually leading to single payer. It would be more efficient just to go to a single payer system, but that is where this will lead. Our health care system will eventually run like the post-office. __________________ "Democracy is two wolves and a sheep voting on lunch." "It is useless for the sheep to pass resolutions on vegetarianism while the wolf is of a different opinion." "If you live among wolves you have to act like one." "A lady screams at the mouse but smiles at the wolf. A gentleman is a wolf who sends flowers."

03-21-2010, 01:45 PM	#17 (permalink)
RogueGypsy Insane Location: The Great NorthWet	I'm still confused over why we have to destroy and rebuild a system that only 10% of the population needs, half of which don't care. I thought this was a democracy, doesn't that mean majority? That aside, I believe reform is needed. Just not in the form of a 2000 page bill being shoved down our throats. How many people do you think have actually read or understand the bill and of them how many are voting on it? Personally I don't care if it's a creature of the left or the right, it's political bullshit. No one is discussing what the bill actually says, just ranting about the right hating Oblahblah, or the left being so entrenched up his ass they can't see through the shit. This bill will affect every industry, business and individual in the country and these assholes are trying to shove it down our throats without the common courtesy of a clear and concise explanation of what it entails. If it were the all glorious solution they claim it to be, why can't they explain it? Surely if it's as great as they claim everyone would be on board and it would pass with no resistance. I'm just sayin'. Whenever something has to happen 'right now' or I'm getting the 'hard sell'. My bullshit flag raises immediately and this bill sent it flying high. I think everyone needs to put down the political blinders, back away slowly and take a deep breath. Forget who proposed what and why, read the document in it's entirety and develop an informed opinion based on what we've read. As far as socialized medicine goes, like communism, it looks great on paper, but it just doesn't work. To model our system on the failing systems already out there is idiotic. We have a chance to truly reform medical care in a meaningful and significant way. To throw that away based on politics is treasonous. Some think it's just hype that socialized medicine is a failure, but all you have to do is look at the numbers; they're bankrupt or heading that way fast. It's been world headlines since before this debate began. Those who can afford too, come here for treatment instead of using their own systems. Those who can't are stuck in months, sometimes years long waiting lists. How exactly is this better than what we have? Why do we have to cater to the lowest common denominator? Why can't we strive to achieve what the rest of the world only dreams of? I say we write some serious tort reform, freeze insurance premiums for 10 years and send everyone in favor of socialized medicine to live in a country with a socialized system for 10 years. When they come back we vote. Really what's 10 years compared to the rest of your life and your children's lives and their children's lives? There is no substitute for real world experience. Further more, if it's good enough for the masses, then it is absolutely good enough for public servants. It should be mandatory for all government employees if it is for us. WTF is up with the double standard? __________________ Methods, application and intensity of application vary by the individual. All legal wavers must be signed before 'treatment' begins. Self 'Medicating' is not recommend. However, if necessary, it is best to have an 'assistant' or 'soft landing zone' nearby. Any and all legal issues resulting from improperly applied techniques should be forwarded to: Dewy, Cheatum & Howe, Intercourse, PA 17534. Attn: Anonymous.

03-21-2010, 05:46 PM	#35 (permalink)
Charlatan Getting it. Super Moderator Location: Lion City	The level of disinformation that is floating around the US is just... overwhelming. I am astounded at the extent to which Republican politicians and supporters are willing to go. I am also astounded that the Democrats can't get sound counter-argument going. __________________ "My hands are on fire. Hands are on fire. Ain't got no more time for all you charlatans and liars." - Old Man Luedecke

03-21-2010, 08:13 PM	#38 (permalink)
rahl Junkie Location: Ohio	I don't think the democrats screwed up how they communicated it, they just always give people more credit than they deserve. They seem to underestimate the propoganda machine that is the republican party and faux news. When people hear something over and over and over again they tend to believe it. __________________ "Your life is Yours alone...Rise up and live it"

03-22-2010, 04:06 AM	#40 (permalink)
roachboy Super Moderator Location: essex ma	i have to say that i have found these threads too depressing to post in because of the litany of cookie-cutter memes that are everywhere in both from the right. my basic response is similar to charlatans, to marvel at the lengths to which the right is willing to go in mobilizing its demographic on the basis of fear and disinformation and projection. so we have an economic transition engendered enabled and concealed by 30 years of neoliberalism the realities behind which are now coming home to roost not because they haven't been present but because monetarist bubble-manufacturing is not able to create the illusion of happy valley endless expansion...in this context there is a perfectly reasonable move, to extend health care access to the 30 plus million uninsured. this is an ethical problem that's being addressed AND a political problems and i cannot for the life of me figure out how the communications apparatus of the administration managed to find a way to not frame this debate so that the right noise machine could be made to say "we think the uninsured are extraneous people who should die"---because that is in effect the argument they're making---but instead you get all this chicken little horseshit about "the amurican way" blah blah blah. it'd be funny if i didn't live here. this is what collapse of empire looks like, sports fans. a running away from reality. i'm glad the bill passed but i don't like the bill particularly. it should have gone further. there are alot of reasons why it is as it is. some folk have wondered what the administration was thinking in terms of issue framing from the start. i did. but it's good it passed---better than nothing and certainly an improvement over the social barbarism that's obtained so far, which conservatives are trying to defend as "the amurican way".. but this "debate" insofar as the right is concerned in particular is about as depressing a thing as i can remember. __________________ a gramophone its corrugated trumpet silver handle spinning dog. such faithfulness it hear it make you sick. -kamau brathwaite