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Direct from Pelosi - the top 14 Provisions that take place IMMEDIATELY

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Phoebe Loosinhouse Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 06:50 AM
Original message
Direct from Pelosi - the top 14 Provisions that take place IMMEDIATELY
http://edlabor.house.gov/documents/111/pdf/publications/AHCAA-Immediately-102909.pdf

TOP 14 PROVISIONS THAT TAKE EFFECT IMMEDIATELY

1. BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE — Reduces the donut hole by $500 and institutes a 50%
discount on brand-name drugs, effective January 1, 2010.

2. IMMEDIATE HELP FOR THE UNINSURED UNTIL EXCHANGE IS AVAILABLE (INTERIM HIGH-RISK POOL) — Creates a
temporary insurance program until the Exchange is available for individuals who have been uninsured for several
months or have been denied a policy because of pre-existing conditions.

3. BANS LIFETIME LIMITS ON COVERAGE—Prohibits health insurance companies from placing lifetime caps on coverage.

4. ENDS RESCISSIONS—Prohibits insurers from nullifying or rescinding a patient’s policy when they file a claim for
benefits, except in the case of fraud.

5. EXTENDS COVERAGE FOR YOUNG PEOPLE UP TO 27TH BIRTHDAY THROUGH PARENTS’ INSURANCE— Requires health
plans to allow young people through age 26 to remain on their parents’ insurance policy, at the parents’ choice.

6. ELIMINATES COST-SHARING FOR PREVENTIVE SERVICES IN MEDICARE—Eliminates co-payments for preventive
services and exempts preventive services from deductibles under the Medicare program.

7. IMPROVES HELP FOR LOW-INCOME MEDICARE BENEFICIARIES—Improves the low-income protection programs in
Medicare to assure more individuals are able to access this vital help.

8. PROVIDES NEW CONSUMER PROTECTIONS IN MEDICARE ADVANTAGE— Prohibits Medicare Advantage plans from
charging enrollees higher cost-sharing for services in their private plan than what is charged in traditional Medicare.

9. IMMEDIATE SUNSHINE ON PRICE GOUGING—Discourages excessive price increases by insurance companies through
review and disclosure of insurance rate increases.

10. CONTINUITY FOR DISPLACED WORKERS—Allows Americans to keep their COBRA coverage until the Exchange is in
place and they can access affordable coverage.

11. CREATES NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM—Creates a long-term care insurance
program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled.

12. HELP FOR EARLY RETIREES—Creates a $10 billon fund to finance a temporary reinsurance program to help offset the
costs of expensive health claims for employers that provide health benefits for retirees age 55-64.

13. COMMUNITY HEALTH CENTERS—Increases funding for Community Health Centers to allow for a doubling of the
number of patients seen by the centers over the next 5 years.

14. INCREASING NUMBER OF PRIMARY CARE DOCTORS — Provides new investment in training programs to increase the
number of primary care doctors, nurses, and public health professionals.

PREPARED BY OFFICE OF SPEAKER PELOSI – OCTOBER 29, 2009

*************************************************************************************************************************

So this is directly from the horse's mouth. There's a lot of good stuff here. I say share it with as many people as possible since the Republicans are trying as hard as they can to prevent us from having any reform at all. I think most will find a direct personal benefit on this list.

The Republicans I saw on TV this morning have their comments boiled down to "it's too long and has a lot of big words". This list could help them out.
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polichick Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 06:51 AM
Response to Original message
1. Some really good stuff - thanks for posting. k&r
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babylonsister Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 06:51 AM
Response to Original message
2. Thank you for this-rec'd. nt
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gademocrat7 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 06:59 AM
Response to Original message
3. K & R
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 07:27 AM
Response to Original message
4. High risk pools are a royal screw job. This is pretending to provide help without actually doing it
I notice that they are just planning to disclose price gouging--not to actually do anything about it. Like Conyer's sternly worded letters to Rove et al.

Nice that employers get benefits for sucky insurance for early retirees. My former employer just dropped my plan.

The community health centers and increasing primary care physicians are both good, and neither require anyone to be forced to buy insurance from private companies.
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Phoebe Loosinhouse Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 08:11 AM
Response to Reply #4
5. Here are some facts about the HRP - I don't agree with you that it's a screw job at all
The interim high risk pool is a lifeline for some desperate people and they will be thrilled to have it. People who have not been able to get insurance for YEARS will have access. This will keep some American families from going bankrupt in the future!

Some facts about it -

you qualify if you are unemployed or are not offered insurance by your employer or you have been denied due to pre-exisiting conditions. Thank God!!

Age factor is capped at 2:1 from lowest premium offered (yes that sucks, but it's lower than the Senate version)
Has to have the same "essential benefits" described in section 222 - this seems to negate your fears of limited coverage
deductable no higher than $1500 for an individual
no annual or lifetime limits
max out of pocket capped at 5K a year for individuals, 10K for families
NO PRE-EXISTING CONDITIONS

My understanding is that this is an interim plan until the National Insurance exchange is established. I also understand that for this plan they anticipate that the providers will be those that are already in place through Medicare although it will be voluntary. They are trying tomake it more attractive than Medicare to the providers by not just paying Medicare + 5%, but they will actually negotiate the rates.

The biggest unknown is actual cost of this plan. There will be subsidies and it's pointless to offer something that is unaffordable. If it's unaffordable for most than all hell will probably break lose. As it should.

You seem to be relentlessly downbeat about everything related to these bills because it is not simply Medicare for all. I agree with you that Medicare for all would have been the best plan. Well, we didn't get it, or we haven't gotten it so far. What we have gotten is a damn sight better than what is the current situation.

I am in a very similar position to you. My Cobra runs out shortly. The plan has an automatic Cobra extension in it. I am GRATEFUL for that. I hope that will now have choices not available to me in the past when the exchange is established. I am GRATEFUL on behalf of the unemployed and people with pre-exisiting conditions who will actually have the opportunity to have healthcare very similiar to the Medicare for all that you tout RIGHT AWAY.

I don't understand people who would willingly throw all this away because it is not exactly what you want.It's a start. Honestly, if Howard Dean says it ok, than that's good enough for me. I don't think he would say that unless he thought that we should grab this opportunity and improve it constantly.



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JimWis Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 01:14 PM
Response to Reply #5
34. I was going to say - I thought I heard a representative say that
pre-existing condition would kick in as soon as the bill was signed also. But I didn't see it on the list. But I guess the info above would address that. You could go into the high risk pool then. Thanks for sharing this information.
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 07:52 PM
Response to Reply #5
57. I'd be just fine with Medicare on a VOLUNTARY buiy-in basis
Why in fucking HELL do we need a whole separate plan for high risk people (AKA disposable human garbage)? Why not just put these people into old, unimproved Medicare? You may have notices that I have long since given up on HR 676 this round.
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truedelphi Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 02:23 AM
Response to Reply #5
94. Neither you or Pelosi seem willing to discuss one of the more odious prospects of this bill
One page two of the twenty seven page summary of this bill and its cost is the fact that there will be One Hundred And Sixty Seven Billion Dollars in Penalties to the Employers and to the average American schmuck. They mention it in passing, as it is simply figures on a page that allow the bean counters to show how the 1.1 trillion the government will pay to subsidize the program will be offset by something else.

Which is US! If any of us for any reason end up delinquent in purchasing the policy they will be forcing on us.

Also in Reading over the bill itself, I don't think that any thing is automatic. For instance if you want to be included in the high risk pool, you have to prove that you have been rejected from the insurance industry in the last six months.

It is 1,900 pages of a lot of hullabaloo, and me thinks we will end up like people in MAssachusetts who could not afford it.

When the cheaper, less complicated, less red tape-sy sort of way to go would have been Single Payer Universal Health Care for all.

And as far as making the thing deficit neutral -eliminate any and all salaries, payments or bonuses to any executives receiving over 25 times the salary of the lowest grade employee! Roll back the highly inflated prices on everything from ER visits to drugs (Some drugs have a 8,200 PERCENT markup.)

But everyone on The Hill from the President on down has been very careful not to talk about how exploitive the Big Insurers are. And how before the programs were even formulated, a price fixing discussion should have been going on.

But <sigh> Like Greg Palast says, we in America get the Best Government that Money can Buy!


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Phoebe Loosinhouse Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 11:30 PM
Response to Reply #94
131. I'm happy to discuss any aspect of the bill
but please don't think I have any particular expertise, I'm trying to slog through it and make sense of it just like everyone else. This piece put out by Pelosi is the best stuff I've heard so far but I am well aware that there is a lot of bad in the bill. I am trying to make a reasoned judgement whether we got enough in this bill to make it worthwhile passing. The good stuff, ok better stuff, like a Hish Risk Pool (and I even object to that terminology) in the short term has value to me because it may save some lives. The way the bill is written, even this sad excuse for a Public Option is doomed to failure. It will NEVER survive on premiums alone. I know that. But is it possible that the entire bill itself is indeed a Trojan Horse and once we move it inside the gates, we can begin tweaking it and making it better?

We are doomed to get a bill that goes nowhere close to really fixing our problems because of the deep systemic corruption of our system. I agree with you and Palast that we have The Best Democracy Money Can Buy. I started the primaries as a Kucinich person if that gives you any insight about me. Probably every third post I have written is about corporate and executive greed and excess. I think this process was doomed from the start by giving the "stakeholders" too much dominance over the process and I agree with you that after all the sturm und drang we ended up with Romney Care!

By the way, where is the 27 page summary? Do you have a link?
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zoff Donating Member (302 posts) Send PM | Profile | Ignore Sat Oct-31-09 09:53 AM
Response to Reply #5
112. I called my congressman ...
... and told his staffer that the option had better be affordable.
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nightrain Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 10:56 AM
Response to Reply #112
119. It's not affordable for middle income people--single person with income greater than 43K will pay
up to 12% of income, ~5K for the premium per year, AND up to 5K in copays and deductibles.

Other industrialized countries pay about $1200/year or thereabouts. Affordable would be $100-150/month. Massive give-away to insurance corporations!

Totally unaffordable for middle income people.

It's a sham.

See thread--

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=103&topic_id=492584&mesg_id=492584

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Merlot Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 08:35 PM
Response to Reply #4
60. High Risk Pool vs uninsured. Hmmmmm, which one is more dangerous?
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Merlot Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 08:35 PM
Response to Reply #4
61. High Risk Pool vs uninsured. Hmmmmm, which one is more dangerous?
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Politicub Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 09:52 PM
Response to Reply #4
68. High risk pools may save millions from bankruptcy
It is by far a better alternative to having no insurance until all pieces of the HC plan are in place.

The healthcare bill is not perfect, but nothing rarely is. But it is very good in some respects, and will change our healthcare system for the better.

And, there will just be more work to be done.
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 11:09 PM
Response to Reply #68
72. HIgh risk pools will drive millions of others into poverty
--stripping their bank accounts before they can even budget anything for regular health care needs. Just put us all into Medicare, dammit!!! What is your problem with that? What a worthless, idiotic use of $5 billion that could just be put into Medicare.
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Politicub Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 11:54 PM
Response to Reply #72
75. You are jumping to conclusions about what I think
And if you would have read my post, I acknowledged that the bill that is before the House isn't perfect, but it is better than nothing. Of course, I'm with the majority of people on DU that want single payer. But while so many on here are falling all over themselves to sacrifice the good for the perfect, this legislation will have a positive impact on millions -- but there will still be a lot of work to do.

I don't get some people on DU. There is no piece of perfect legislation. I don't think there ever will be. Perfection for one person is a travesty for another.

There is nothing to say healthcare legislation will end once and for all with this bill. In fact, I can guarantee you that there will be future legislation about healthcare, but I don't think it will be perfect either.

But for millions, this will be far better than the only option available to them today, which is nothing. Well, there's always bankruptcy.
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 12:39 AM
Response to Reply #75
82. I'm not asking for perfect. I am asking them not to do something that will harm reform
--and put it vastly further out of reach. It is already a huge problem that people who have insurance are seriously delusional. They think that because they have it, they will get care if they are sick. This opinion is worth about as much as their opinion on whether their fire extinguishers are any good, that is to say nothing at all. Most people will never get expensively sick, and it is hard enough to get them to care about the 5% that account for 50% of all health care costs.

The bill proposes to give $900 billion of our tax dollars to the very shitstains that kill 44,000 a year and bankrupt 500,000. The weak limits placed on them push half of all sick people down into a permanent pit while helping the other half. Morally and economically, that utterly sucks. More power for insurance companies means it becomes vastly harder to control them.

Disabled people can get into Medicare early. I'd like to hear one good reason why high risk people should not have the same right. Instead of giving $5 billion to the useless sociopaths who now deny care to the high risk, put it into Medicare, dammit! That proposal is in no way, shape or form single payer.
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WillYourVoteBCounted Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 10:34 PM
Response to Reply #4
69. U R right. my state has a high risk pool, but it isn't cheap
especially since insurance companies consider things like ADHD as being high risk!

I have no insurance but would like to have HEALTH CARE.

Health care not health insurance.

We must be the last industrialized country to look at this.

I guess we are still to selfish.
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Blue State Blues Donating Member (575 posts) Send PM | Profile | Ignore Fri Oct-30-09 08:25 AM
Response to Original message
6. 11 is huge -- I'm surpised not to have heard anything about it until now
11. CREATES NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM—Creates a long-term care insurance
program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled.

This will be more and more important as the population ages. Voluntary, sure, but public -- I'd like to see more specifics on that.

I've seen too many situations where elderly and people in need of long term care end up having to sell everything they own (and put the money into their long-term care) to qualify for Medicare for long-term care. Private long-term care insurance can be iffy at best -- like private health insurance, people who buy it find out about its shortfalls only after they need it.

For 12 I'd rather have voluntary expansion of Medicare, but it's something. And 14 is also critical for reducing costs in the system.
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uponit7771 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 08:56 AM
Response to Reply #6
10. WHOA, you're right! There is no medicare part "C" for and you'd have to buy some off beat insurance
...for long term care.

This is good stuff.
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Phoebe Loosinhouse Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 09:00 AM
Response to Reply #6
11. You're right it is a very big deal.
There is a lot of good stuff in this bill and people are just completely trashing it because it's not Medicare for all or single payer.

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Blue State Blues Donating Member (575 posts) Send PM | Profile | Ignore Fri Oct-30-09 11:24 AM
Response to Reply #11
21. Well, as someone who is trashing the bill because it isn't Single-Payer or Medicare for all ...
Not only is it important to make as much noise as possible right now to potentially improve the bill, it's also important to make noise to ensure that the good parts stay in the bill and don't mysteriously vanish before it lands on POTUS's desk.

Advocating for something better isn't the same as wishing for defeat.
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Phoebe Loosinhouse Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 11:39 AM
Response to Reply #21
27. Not in your case (or mine)
Edited on Fri Oct-30-09 11:40 AM by Phoebe Loosinhouse
But I have seen some advocating for complete and utter defeat of the entire bill. I don't understand why. We'd be set back years, it would hurt both Obama and the Dems and people who are actually concretely helped in many ways both physically and financially by this effort would be tossed on the trash heap.

We are stuck with the cast of characters we have in place right now. The party in power USUALLY loses seats in the midterm elections, so I think it is pointless to think we can get anything hugely better (like single payer or Medicare for All) anytime in the not distant future.

My greatest fear was that it wouldn't do enough quickly enough, but I think it does a lot of good stuff fast so that even Republicans will like it - people, not politicians. They all have uninsured college kids they worry about just like Dems. This helps that. They are running out of their Cobra benefits just like Dems and this helps that. Some of them are htting lifetime limits in their policies just like Dems and this helps that. Some are uninsured and now they get insurance!

The Republicans have a big rethink about to happen to them if we can just get out the word about all the GOOD in the bill.
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Blue State Blues Donating Member (575 posts) Send PM | Profile | Ignore Fri Oct-30-09 11:50 AM
Response to Reply #27
29. Agreed ... push for the best we can get now
and resign ourselves to another 10-15 YEARS of fighting for what we should have had 50 years ago.

But hey, we're Democrats, we can walk AND chew gum, we can celebrate small victory while still working for a greater one (but let's hold the celebration until the bill is signed into law and we KNOW what we're getting).

If this were easy, we'd have already done it, right?
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euphoria12leo Donating Member (511 posts) Send PM | Profile | Ignore Fri Oct-30-09 01:57 PM
Response to Reply #29
37. That makes sense.
At least to continue fighting we know what we are up against. I don't know what others expected. I expected some push back (big time) but I never expected the fire breathing, mouth foaming, gun toting, Hitler sign carrying, angry protesters that came out at townhalls. Single Payer would be great but its hard enough getting this much of a PO. What do others suggest we do? Just close up shop and do nothing until we're able to get exactly what we all want. And how would we go about doing that? Try and get rid of Bluedogs. Who else would fly under the radar posing as a real Democrat? Ed suggested just stop and wait for 2010 elections to get the real Democrats. I don't agree with that and I'm suprised he suggested such a thing. Nope, it is now or never.


:think:
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John Q. Citizen Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 03:39 PM
Response to Reply #27
47. I think people just oppose bribing the criminals to quit stealing so much. It
bodes ill down the road.

We look at Canada, and they don't have reams of data to sort through tons of paper work to complete. What happens when you need a subsidy, then you get more income, then you lose income, do you have to refile each time to reflect each new income level?

We look at Canada and they fund their health care through taxes and when people are sick or need to get tested they just make an appointment and go to the doctor. It's easy. It's always on. it's afforadble. There is zero out of pocket. No bill to remember to send in, no stamps to buy.

They don't have a 5000 out of pocket a year potential liability, and they aren't spending a trillion in taxes plus who knows how many billions more in private mandates a decade to subsidies criminal cartels who do nothing and make huge bucks.


So please try to understand why people hate this shit. It's clearly an attempt to resurrect the completely broken and discredited criminal insurance industry and make us pay them to treat us better.

It's far more cumbersome, expensive and will result in higher costs and less health care than just doing the right thing would. We know this. We aren't stupid.

So why the hell should we do what isn't best for us instead of what's best for us? it feels like a scam because it smells like a scam and it makes no sense.

The people who have brought us these wonderful improvements are all on the payroll of the insurance industry. We know that. So it's only natural we would and should be suspicious. By the way, I don't let Howard Dean make my decisions for me.

And I won't base my decision on political party advantage calculations. I'm waiting to see what Kip Sullivan's analysis of the bill is. I actually trust him to tell the truth, the good the bad and the ugly. And I have to say, I haven't felt like most of the people pushing the public option have been telling the truth, not from day one. Dean was on TV not that long ago describing the public option as Medicare like when he knew that what was in the bills was minuscule.

The public option was a classic bait and switch. 31 flavors of smoke and mirrors. But now we should be thrilled? Yeah, we don't know what the high risk pool will cost, but if it's sky high we can take solace in our anger? Thanks a lot.

So why should i believe these people?

We know that the Dems are almost all on the take from the health care industrial complex, so why should we trust them?

We know the insurance industry has squeezed every last penny out of sick and dying people then left them in the streets so why should want to subsidize them?


We know that Nancy Pelosi took out of the bill our back up insurance, the right of states to pass our own single payer system, so why would we have confidence that if things go wrong, we'd have the powere to change things? We won't. We will be stuck up a creek without a paddle.

I'm sorry, I hope you can see why we would be suspicious of Greeks bearing gifts.

I'm also of a mind that the limit has been crossed, the point where we have to say, "no deal."


If that means the whole thing is gone and can't be put back together again, well good. It won't be long until the health insurance companies go under, and we can build a single payer system from scratch. I kind of like Obama's idea on that, starting from scratch, and saying no to this boondoggle will make it that much sooner.

So that's my thinking. I'm thinking lets do this right instead of just doing something to say we did something.

If it's worth doing, it's worth doing right.



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timzi Donating Member (100 posts) Send PM | Profile | Ignore Sat Oct-31-09 07:01 AM
Response to Reply #47
99. Good Post John Q, Just One Question.....
What do you mean by:

"I kind of like Obama's idea on that, starting from scratch, and saying no to this boondoggle will make it that much sooner."

Was that from before he got elected? He has been a drug store indian on this since then.
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John Q. Citizen Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 11:12 AM
Response to Reply #99
125. Obama used to support single payer back when he was running for the
Illinois State legislature.

By the time he ran for President he had changed his position, which is fine.

He now says 'if he were starting from scratch, he thinks a single payer system would be the best way to go.'

He says that since we aren't starting from scratch, that since a lot of people already have private health care policies, that he thinks we need to reform that system and build on it.


So that's what I was referring to. I wish I had proof read that more closely and been a bit more concise.

Here's my corrected phrase.


"I kind of like Obama's idea on that, starting from scratch. Saying no to this boondoggle will make it possible that much sooner."

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nightrain Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 10:59 AM
Response to Reply #47
122. see below....
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JTFrog Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 08:46 AM
Response to Original message
7. K&R!
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TwilightGardener Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 08:53 AM
Response to Original message
8. Good summary, thanks!
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uponit7771 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 08:55 AM
Response to Original message
9. 13. COMMUNITY HEALTH CENTERS & 4. are big IMO,
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vaberella Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 11:33 AM
Response to Reply #9
25. Yup....we have a few in Harlem. A few more would come in handy. n/t
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mkultra Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 09:07 AM
Response to Original message
12. starting to shape up. I would like to see the ban on preexisting conditions
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Ikonoklast Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 09:47 AM
Response to Reply #12
14. It's in there, it's just not going into effect immediately.
Not sure on the timeline for that to be implemented, but along with no lifetime monetary cap on care it will be part of the plan.
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Mimosa Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 06:12 AM
Response to Reply #14
98. Right: let us go without and die before we get help?
Ms. MS here. I'm sick of being screwed over.
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mkultra Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 08:53 AM
Response to Reply #98
106. then stop voting republican.
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Mimosa Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Nov-01-09 08:22 PM
Response to Reply #106
140. I don't. How weird is that reply. n/t
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mkultra Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Nov-01-09 09:35 PM
Response to Reply #140
141. just suprising.
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mkultra Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 08:53 AM
Response to Reply #14
105. good, i was worried about that one.
I'm glad its in.
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Phoebe Loosinhouse Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 10:18 AM
Response to Reply #12
18. It's not really a very detailed or complete summary - could be much better
Edited on Fri Oct-30-09 10:26 AM by Phoebe Loosinhouse
that summary does not address what happens to pre-exisiting conditions although I have a pretty good idea based on a lot of reading of the bill as well as various interpretations and summaries elsewhere.

If you have pre-exisitng conditions and are unemployed/and or uninsured due to pre-existing conditions, you are eligible immediately for the high risk pool which looks like it will borrow a lot of current Medicare structure. So, the uninsured folks are taken care of right away.

Aside from that, it looks like pre-exisiting condition exclusions from regular insurance gets phased out in 2013. I have no idea why the delay since they immediately got rid of rescission (except in cases of actual fraud) and lifetime caps to take effect January 2010. Perhaps they think it is a moot point since they have provided a coverage for anyone who is unable to get insurance due to pre-exisiting conditions? I don't know, I think that part is a bit murky.

*************
edit -

oops! The summary I am referring to is this one which is supposedly the Detailed Summary of the Affordable Healthcare for Americans Act. I actually forget what thread I was in! Anyway, although the link is to Politco it is the actual summary prepared by the 3 Committees of the House that merged their bills into the one presented yesterday.

http://www.politico.com/static/PPM41_hcr_complete_summary.html
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jesus_of_suburbia Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 09:52 PM
Response to Reply #12
129. yep... when that is included, the glass will be half full indeed.
I wanted more, but if they can do all that, it is a huge step in the right direction, and I'll be quite pleased with what the Obama administration accomplished.
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Clio the Leo Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 09:41 AM
Response to Original message
13. Yay! More happy Phoebe!!!! NT
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NYC_SKP Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 10:11 AM
Response to Original message
15. Rec'd. I see a glass half full. And what we had before was an empty glass.
I'm with Alan Grayson on this.

"Good can be made better, and better can be made best."

:patriot:

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vaberella Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 11:30 AM
Response to Reply #15
24. Agreed. Amendments will help and future legislation during the next term.n/t
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NYC_SKP Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 11:52 AM
Response to Reply #24
30. We got our foot in the door and the Republicans are Freaking OUT!
Bet on it!

:toast:
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truedelphi Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 10:45 AM
Original message
Are they allowing amendments? I heard they are NOT allowing any.
Edited on Sat Oct-31-09 10:49 AM by truedelphi
And Obama has been consistently saying this needs to be done now, quickly, and then no one will ever have to do it again. "I plan on being the last Presdient to have to deal with Health Care legislation"

I don't see much hope about making the thing better.
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truedelphi Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 10:45 AM
Response to Reply #24
118. Self deleted dupe. n/t
Edited on Sat Oct-31-09 11:19 AM by truedelphi
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Cha Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 01:21 PM
Response to Reply #15
36. A glass half full emerged out of
ground glass.

I'm with Dean and Grayson:patriot::patriot:
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Truth2Tell Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Nov-01-09 02:59 AM
Response to Reply #36
133. It's too bad
the glass will leak empty through the cracks.

Maybe if the glass had emerged from a functioning democracy rather than ground glass it would have eventually filled up. Doesn't look like we'll get to know this time around.
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timzi Donating Member (100 posts) Send PM | Profile | Ignore Sat Oct-31-09 07:05 AM
Response to Reply #15
100. Just That It Is No Longer A Gless....It Is A Thimble
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rockymountaindem Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 10:17 AM
Response to Original message
16. That's positive. As someone who is about to turn 23 and in grad school
the possibility of staying on my parents' good health insurance plan until I am 27 seems appealing. Hopefully I'll have graduated and be gainfully employed well before then, though :)
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vaberella Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 11:27 AM
Response to Reply #16
23. Good luck...29 and that didn't work out. Ugh, my parents couldn't even hold me until 23.
I was out at 21. And then to extend didn't com into practice for me, until I was 25. And at that time, it was too late. However, I get PO under Pelosi's plan in January 2010.
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derby378 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 10:17 AM
Response to Original message
17. All she has to do is drop the mandate for individual coverage...
...and Pelosi's little list may become more palatable. As it stands, the House bill forces us to become slaves of Big Insurance, and that ain't right.
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BluinTX Donating Member (34 posts) Send PM | Profile | Ignore Fri Oct-30-09 10:33 AM
Response to Reply #17
19. Slaves of Big Insurance?
As I read the bill, the mandate for those without insurance is that they must purchase a policy under the National Exchange, which will include private plans from the for-profit industry AND the Public Option. So no one will be forced to buy anything from a privately owned insurer -- at least not as far as I can tell.
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derby378 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 10:46 AM
Response to Reply #19
20. As for my wife and I, however, we may be stuck
Our insurance plan has been raising premiums and cutting services, pharmaceuticals, coverage, etc. We can't even choose our own doctors anymore - and we're under a PPO system, not one of those wretched HMOs.

Now I do concede that there are some DUers who think there may be a way for us to get into a public option despite the wording of the bill, and I hope they're right, because right now the bill looks like a big Valentine to Big Insurance.
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vaberella Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 11:26 AM
Response to Original message
22. Thanks Phoebe. I love my President and Pelosi!!! Shit...I love this Gov---as long as I exclude...
Edited on Fri Oct-30-09 11:28 AM by vaberella
Repubs, Bluedogs, and Conservadems.

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and-justice-for-all Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 11:34 AM
Response to Original message
26. So that is what a compromise looks like??
I am not terribly impressed; with some fortitude and back bone they should have told them all to kiss their ass, we are doing Medicare for all and if you can not adapt or change, that is not our problem because we should not be listening to the private insurance industry or asking for their permission to do anything.
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Nicholas D Wolfwood Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 01:04 PM
Response to Reply #26
33. List for me the 60 Senators and 218 House members that would vote for your plan.
Until you can do so, you have no business making such a claim.
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Name removed Donating Member (0 posts) Send PM | Profile | Ignore Fri Oct-30-09 03:22 PM
Response to Reply #33
46. Deleted message
Message removed by moderator. Click here to review the message board rules.
 
timzi Donating Member (100 posts) Send PM | Profile | Ignore Sat Oct-31-09 07:13 AM
Response to Reply #26
101. Love The "Universal Health Care Is Pro Life" Banner
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optimator Donating Member (606 posts) Send PM | Profile | Ignore Fri Oct-30-09 11:49 AM
Response to Original message
28. what about mandates and fines
i'm sure those provisions will take effect immediately since the insurance scums wrote most of this bill.
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bornskeptic Donating Member (951 posts) Send PM | Profile | Ignore Sat Oct-31-09 07:51 AM
Response to Reply #28
103. You're wrong, of course.
However, if that's what you choose to believe, feel free. The truth is that the mandates, the exchange, the public option, the ban on pre-existing condition exclusions, and the subsidies, all go into effect at the same time, in 2013.

http://edlabor.house.gov/documents/111/pdf/publications/AHCAA-IMPLEMENTATIONTIMELINE-102909.pdf
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kestrel91316 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 11:59 AM
Response to Original message
31. My nephew is seriously considering medical school. I am gonna urge him
Edited on Fri Oct-30-09 11:59 AM by kestrel91316
to go into primary care. I think he'd be great at it. He's always had a great deal of empathy for other people, and that is SO IMPORTANT in the medical profession.
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NYC_SKP Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 12:59 PM
Response to Original message
32. Kick. Thanks, Phoebe Loosinhouse!
:yourock:
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Hutzpa Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 03:17 PM
Response to Reply #32
45. +1000
:headbang:
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Cha Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 01:17 PM
Response to Original message
35. And, this is what Dean was ADAMANT about last
night when he was talking to Lawrence O'Donnell on KO's.:D

Getting this kicked in before the elections in 2010.
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Divine Discontent Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 02:08 PM
Response to Original message
38. "it's too long and has a lot of big words" - LOVE IT! very funny & very true! eom
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Phoebe Loosinhouse Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 03:04 PM
Response to Original message
39. It's dawning on me that little if any of the stuff on this list is being reported
Particularly the High Risk pool which takes effect immediately.

It's going to be up to us to educate people apparently since the media and all the so-called journalists are either incompetent or dysfunctional and incapable of reporting what is contained in a bill that real people might be interested in that will affect them positively in the very near furture IF their reps have the wit to vote for it.

My disgust meter is going off the charts!
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janx Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 03:07 PM
Response to Original message
40. Does this mean that I might actually have health insurance for
the first time in eight years? :shrug:
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Phoebe Loosinhouse Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 03:11 PM
Response to Reply #40
42. It does if we can get people to get excited about that idea
and not let the Republicans and the media manipulate them out of it.
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Garam_Masala Donating Member (711 posts) Send PM | Profile | Ignore Fri Oct-30-09 06:18 PM
Response to Reply #40
56. Yes! If you can afford the premiums...
I have been reading that public option premiums will be higher
than private insurers!

Unless of course if your income is below poverty level.
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ekelly Donating Member (303 posts) Send PM | Profile | Ignore Fri Oct-30-09 11:55 PM
Response to Reply #56
76. Where did you read that?
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nightrain Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 09:55 AM
Response to Reply #40
113. if you can afford it! For a single middle income person--up to 12% of income
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truedelphi Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 10:56 AM
Response to Reply #40
120. It all depends on various factors, including what Congress would define as
Insurance...

For instance, if you feel that you will end up in a high risk pool, due to being non-eligible for normal insurance plans, you must have proof that you have been rejected by the normal insurers.

You also must be uninsured for six months.

But get this - they have capped the damn high risk pool - if too many people use it, and the plan goes above its cost allowances, then:

1) there could be an increase in premiums, even above the set limits
2) there could be a lessening of coverage
or 3) there could be a waiting list.
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depakid Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 03:10 PM
Response to Original message
41. #9 is pathetic
but typical of what one sees in America. Toothless "disclosure" requirements as a substitute for responsible (and effective) regulation.
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Hutzpa Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 03:15 PM
Response to Original message
43. Impressive
This is why I will always stand by the Speaker of the House.

IMPRESSIVE....:bounce: :bounce:


:kick:
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mzmolly Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 03:15 PM
Response to Original message
44. BRAVO! But, lets whine about what isn't in the bill instead. So much more fun!
:sarcasm:
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rhett o rick Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 03:58 PM
Response to Reply #44
48. I want to whine about what is in the bill. Mandates. While most Americans
want a strong public option, which isn't in the bill, I believe most Americans dont want mandated coverage. I dont want mandated coverage. Medicare works fine with out mandated coverage. But the worse thing about mandating that all American must buy health insurance, will be a great weapon for the republicants to attack this bill and get the American people on their side.

The issues listed above are great and I'd be glad to have them (if they get thru the Senate), but I wanted a strong public option. Actually I want single payer, but would've settled for a strong public option. Now I am being asked to settle for less, and after the Senate gets done, probably even less.

Reminds me of a story of a guy that got beat up and kicked in the head multiple times. After it was over, his friend ran over and said, "Aren't you happy? They stopped kicking you in the head?"

The American people want a strong public option and deserve a strong public option and wont be happy with the Democrats when they get less.
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mzmolly Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 05:11 PM
Response to Reply #48
49. Who gets to define "strong" public option? As for the mandates,
Edited on Fri Oct-30-09 05:12 PM by mzmolly
they involve subsidies which help pay for the insurance we're now able to get. We can't open up medicare to all, because of varied reimbursement rates in rural areas, driving Dr.s away from assisting the public as it is. This is a good beginning, and it's only a beginning.

On edit, I too want a single payer system, but I applaud progress.
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rhett o rick Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 05:31 PM
Response to Reply #49
52. I agree it's a beginning. And I admit I havent studied the mandates yet. I am
paranoid about a poison pill.
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mzmolly Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 06:00 PM
Response to Reply #52
53. I don't blame you. But when I heard some define strong public option as
medicare for everyone, and then listened to why that's not currently possible I felt more comfortable with where we were headed.

Peace Rhett O Rick. :hi:
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rhett o rick Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 06:13 PM
Response to Reply #53
55. Peace back, mzmolly.


NGU
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mzmolly Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 06:00 PM
Response to Reply #52
54. Dupe deleted...
Edited on Fri Oct-30-09 06:00 PM by mzmolly
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treestar Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 05:14 PM
Response to Original message
50. Helps explain why it's so long
So many provisions for so many different things.
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livetohike Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 05:25 PM
Response to Original message
51. Copying and sending out to everybody
Thanks for posting this :-).
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SKKY Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 08:11 PM
Response to Original message
58. I see things that offset the high cost of insurance...
...but I don't see much that will reduce the cost of insurance. Let me be honest, as a soon-to-be retired veteran, mine and my families health care is taken care of. But I'm not that short sighted, and natually would be concerned about the population as a whole. I just don't see much that creates an incentive for health insurance providers to cut their costs and reduce premiums.
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truedelphi Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 02:11 AM
Response to Reply #58
93. Why would the Big Insurers allow for something that
Would offset the high cost of insurance?

And why was the only talking point that Obama stuck to this whole summer the one sentence "The Health Care Reform Bill must be deficit neutral"

The Big Insurers, plus Big Pharma plus the Big Medical Interests have driven the pricing of their products sky high. Did you notice that we never really had any Congressional Leader or any speech from the President dsicussing this? It has been about getting this done in one season, rush it through. "We have to do this and do this now." Only on blogs do you find out that some drugs are 8,200 PERCENT higher than their manufacture cost!

At some point two months ago or so, it was being said that the exemption to the Sherman Anti Trust statute that has for so long given the Insurers their hold on us would be negated. But now that negation will not be in the bill. The Insurers are patting themselves on the back that they are still immune to Anti Trust provisions!

And if you read the 27 page summary of the bill, you find on page two that the 1.1 trillion the government will be paying out until 2019 will be offset by One Hundred and Sixty Seven Billion Dollars of Penalties enforced upon average people and employers!

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annabanana Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 08:30 PM
Response to Original message
59. #5 would be an immediate help to me & my family. . . . n/t
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The Wielding Truth Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 08:41 PM
Response to Original message
62. K&R
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alfredo Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 08:55 PM
Response to Original message
63. Looks good now, but what will it be after the Senate gets hold of it.
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Pab Sungenis Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 09:03 PM
Response to Original message
64. And, sadly, none of it will survive the Senate
with people like Lieberman being allowed to be in the drivers' seat.
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chitown606 Donating Member (12 posts) Send PM | Profile | Ignore Fri Oct-30-09 09:08 PM
Response to Original message
65. What about Preexisting Condition
SO the insurance company can still denied on Jan 2010?
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Deep13 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 09:30 PM
Response to Original message
66. marking for future reference
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HughMoran Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 09:36 PM
Response to Original message
67. Holy crap - I could save $1000's if I could keep my Cobra coverage
I went to a small company from a large and insurance is 4x higher!!! Keeping Cobra until these "exchanges" are set up could be a really big deal for me. This would be very helpful and cut down greatly on my heartburn over healthcare.
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truedelphi Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 01:45 AM
Response to Reply #67
85. I am not sure about the Cobra dealings
You might want to look through the first few pages of the Bill itself (COBRA enrollees are mentioned therein) and figure it out.

This bill is one thousand and nineteen pages long, so every possible situation is considered three ways from Sunday. For instance, to be considered eligible for the High Risk pool I think you have to have been excluded from any insurer wanting you over the last six months. And not be eligible for MediCare.

But on the bright side, there is a table of contents section and there are mentions of COBRA early on.

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truedelphi Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 02:02 AM
Response to Reply #67
89. Here are URLs for the bill -- Summary and full 1900 pages)
http://www.scribd.com/doc/21849473/CBO-House-Health-Care
27 page summary

http://docs.house.gov/rules/health/111_ahcaa.pdf
That's the link to the version released Thursday. Have at it! COBRA mentioned early on.
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HughMoran Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 09:17 AM
Response to Reply #89
107. Thanks, I need to look into this
...though I think I should wait until it's signed. If it's signed after the 1st of the year, I'll be forced to go onto the new extremely expensive coverage :(
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HughMoran Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 09:38 AM
Response to Reply #89
109. Crap - I probably can't get an extention
Edited on Sat Oct-31-09 09:42 AM by HughMoran
1 SEC. 113. EXTENSION OF COBRA CONTINUATION COVERAGE.
3 (a) EXTENSION OF CURRENT PERIODS OF CONTINUATION COVERAGE.—
5 (1) IN GENERAL.—In the case of any individual
6 who is, under a COBRA continuation coverage pro-
7 vision, covered under COBRA continuation coverage
8 on or after the date of the enactment of this Act,
9 the required period of any such coverage which has
10 not subsequently terminated under the terms of such
11 provision for any reason other than the expiration of
12 a period of a specified number of months shall, not-
13 withstanding such provision and subject to sub-
14 section (b), extend to the earlier of the date on
15 which such individual becomes eligible for acceptable
16 coverage or the date on which such individual be-
17 comes eligible for health insurance coverage through
18 the Health Insurance Exchange (or a State-based
19 Health Insurance Exchange operating in a State or
20 group of States).


So, either the company stops offering me insurance or we somehow determine that the coverage is too expensive and therefor not "acceptable" (not likely).

Edit: if it is signed after the 1st of the year and I do NOT enroll during open enrollment (Jan 1st), then I would not be eligible for open enrollment until the next Jan 1st, in which case my COBRA would be extended until then (it is set to expire in August.)
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Hekate Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 10:39 PM
Response to Original message
70. Rec and Hallelujah. These are a big deal.
Thank you so much for posting this.

Hekate

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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 11:06 PM
Response to Original message
71. Odd that none of the pompom waving posts mention MANDATES, no?
And disabuse yourself of the notion that you will get a subsidy that will make insurance affordable.

http://www.cbo.gov/doc.cfm?index=10642&zzz=39653

...exchange subsidies would be automatically adjusted to avoid the estimated increase in the deficit for that year. ... estimates of the deficit impact for the proposal, the failsafe provisions would require a reduction in exchange subsidies averaging about 15 percent during the years 2015 through 2018.
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dflprincess Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 11:51 PM
Response to Reply #71
74. Or question that it only "starts" to close the donut hole?
There's no reason that can't be slammed shut immediately.
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truedelphi Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 02:04 AM
Response to Reply #74
91. According to the OP and its full sentences,
Donut hole is closed in 2010.

However, you must have a reason for how that fact is not really the case.

If you can spot me to a link, I'd be grateful.

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dflprincess Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 09:23 PM
Response to Reply #91
127. You need to read the OP again, this is what it says about the donut hole
Edited on Sat Oct-31-09 09:25 PM by dflprincess
which says:

1. BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE — Reduces the donut hole by $500 and institutes a 50% discount on brand-name drugs, effective January 1, 2010.


It only cuts the donut hole by $500 as of 1/1/2010. Currently the amount someone pays when they fall in the hole is several thousand dollars.

There was a Congressman (forgot the name) on Stephanie Miller's show Friday morning who talked about this and said the hole would be entirely closed in 10 years. All the while the Congress person as well as Stephanie oohed and aahed like this was the best news they'd ever heard.

As for a link, hear you go:


http://news.yahoo.com/s/cq/20091023/pl_cq_politics/politics3230095

The gap in Medicare's Part D prescription drug benefit leaves many seniors responsible for out-of-pocket costs for their prescriptions, costs many say they can't afford.

Pelosi said the legislation she is negotiating with members of her caucus will give Medicare recipients who fall into the coverage gap an immediate 50 percent discount on brand-name prescriptions and shrink out-of-pocket costs by $500. The doughnut hole would be completely phased out by 2019, she said.

The Part D plan currently covers up to $2,700 per year in prescription drug payments, then stops. Coverage does not resume until a recipient's prescription drug costs reach $6,100 annually. That leaves recipients with a potential $3,400 expense.
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truedelphi Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 01:47 AM
Response to Reply #71
86. And no one is mentioning what the Government's
Own Accounting People are mentioning - that the 1.1 Trillion bucks the government will spend on this through 2019 will be subsidized with One Hundred and Sixty Seven Billion Dollars of Penalties coming from employers and normal Americans who just cannot afford it.
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truedelphi Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 11:01 AM
Response to Reply #71
124. Oh and here's an important thing
Edited on Sat Oct-31-09 11:02 AM by truedelphi
This offers insurance only somewhat.

For instance - take the high risk pool,please (As in "Take my wife, please)

How does Congress even define Insurance...

For instance, if you feel that you will end up in a high risk pool, due to being non-eligible for normal insurance plans, you must have proof that you have been rejected by the normal insurers.

You also must be uninsured for six months.

But get this - they have capped the damn high risk pool - if too many people use it, and the plan goes above its cost allowances, then:

1) there could be an increase in premiums, even above the set limits
2) there could be a lessening of coverage
or 3) there could be a waiting list.

So just how "insured" will those on the waiting list be? And how "insured" will you be when you face a "lessening" of coverage? Or when your premiums are unaffordable.

But there are considerations that Congress has built in should you feel that the premiums are not affordable. They are called PENALTIES! The Budget Office is relying on One Hundred And Sixty Seven Billion Dollars to come from penalized consumers to help offset the government's 1.1 Trillion dollar expenditures between 2013 - 2019.



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DUlover2909 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 11:23 PM
Response to Original message
73. K&R
:kick: :dem: :dem:
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Aragorn Donating Member (784 posts) Send PM | Profile | Ignore Fri Oct-30-09 11:56 PM
Response to Original message
77. no, it's not much good
Edited on Fri Oct-30-09 11:56 PM by Aragorn
SOME of these things will help Medicare patients - but they are already on a public, single-payer plan. I just retired after 26 years of medicine, almost exclusively with uninsured, Medicare, or Medicaid. I hope that gives some perspective, even credibility.

The exceptions to the above:
2) "Permits" these people to purchase insurance. No financial aid.
3) This IS potentially good for people who have very expensive illnesses, but would it be enforceable on existing contracts? That would be unconstitutional. As it stands now these folks typically are on Medicaid, at the least,when they hit their limit. Now they stay on private insurance? Well, that is good for everyone but the very sick person.
4) More or less the same outcome, for the same reasons.
5) So, is this cheaper for anyone, is the question. I happen to have looked into this again just yesterday, and it's not for my family anyway. If the cost is the same, parents could pay for their kids' insurance or keep them on their own policy. No financial advantage either way. BFD.
9) "Discourages"? BFD. Shop around people. Unless you are sick already. Good luck with that. (see #2)
10) Oh thank you for letting me continue to pay 4-5 times what I paid when I was employed. How about some help finding a JOB!
11) This appears to be another part of the bill which would shift cost back onto the patients. (see #2, 3, and 4 above)
12) Helps employers (corporations) and encourages increased national unemployment.
13) No cost help, but worse care at already over-worked CCCs. BTW the ones I worked with were horrible, and often functioned simply as a funnel to some regional inpatient (hospital) system, at increased expense to the patients.
14) Even if doctors in training could be persuaded to do this, against all trends of the past many years, and you got a 100% increase in graduating medical students to do it, this is 4 years away at a minimum. Hardly an "immediate" effect.

If this bill is passed as described it is a total sham. But you can always get a second opinion until you find someone who says what you want to hear.
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chadmak09 Donating Member (91 posts) Send PM | Profile | Ignore Sat Oct-31-09 12:34 AM
Response to Reply #77
80. Aragorn, you are RIGHT ON!
This bill is a total scam.
They are throwing crumbs at us while handing the insuance comapies a full meal.

and many DU'ers are eating the crumbs up and saying "these crumbs taste good, maybe this is just the start and we will get to eat one day".
Meanwhile, Big insurance is helping themselves to seconds and even get dessert.

The insurance mandate tilts the scale too far in the negative.
The negative outweighs the positive.

So I hope this bill fails unfortunatly.

WIthout a STRONG public option that all americans can join and afford, then a mandate is just a scam.

Either remove the mandate or offer real competition.

Because as this bill stands, the public option will not be self-sufficient.

If only dirt-poor and un-insurable people can join the public option, then it will just eat up tax dollars.
Regular healthy americans must be able to join or the risk will not be spread equally and the money will not even out.

Then the money must be pulled from other programs or taxes will be raised on americans (who 90% of cant join the option they are having to now pay for).

The public option will fail, many people will stop voting democratic because of the lie of "change" that was not fullfilled.
Republicans will get re-elected and have a failed public option to point out and claim universal healthcare cant work because the public "option" didn't work.

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truedelphi Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 01:56 AM
Response to Reply #77
87. Plus the government's own Accounting People estimate the government will offset
Edited on Sat Oct-31-09 01:57 AM by truedelphi
Its 1.1 trillion dollar expenditure through 2019 by the One Hundred and Sixty Seven Billion Bucks in PENALTIES that will be issued against those Americans who cannot afford the insurance.
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annabanana Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 09:44 AM
Response to Reply #77
110. re #5
If you had two kids who just "aged off" the family plan, and you had the choice of getting new plans for each of them, or putting them back on the family plan (which costs the same no matter how many kids you have)... how is this "no different"?
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joeycola Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 09:59 AM
Response to Reply #77
114. I think there is going to much anger when folks discover the limitations
put into this bill.
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Phoebe Loosinhouse Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 01:48 PM
Response to Reply #77
126. You're cavalier and dismissive of some important things
2)"Permits" these people to purchase insurance. No financial aid.
"These people" as you call them are people who have gone without insurance because they are unemployed or employed with no access through their insurer or have been DENIED healthcare due to pre-exisiting conditions. Trust me when I tell you that people with chronic or acute conditions who have been without coverage and most likely facing severe financial stress due to their lack of coverage will be extremely happy to be "permitted" to have coverage that is capped with a deductible no higher than $1500 for an individual, no annual or lifetime limits and a MAX out of pocket 5k for an individual, 10K for a family. Tell "those people" no, it's not much good. PLus how do you know whether financial aid is offered or not?


3) This IS potentially good for people who have very expensive illnesses, but would it be enforceable on existing contracts? That would be unconstitutional. As it stands now these folks typically are on Medicaid, at the least,when they hit their limit. Now they stay on private insurance? Well, that is good for everyone but the very sick person..
You think banning lifetime limits on coverage is "potentially good"?! See, when people hit their limits, they usually quickly go bust and bankrupt and that is the reason they go on Medicaid - their illness has driven them into poverty. Why is keeping their private insurance "good for everyone but the very sick person"? That sentence just makes no sense to me and seems completely nonsensical. Also nice to have your legal insight that this must be unconstitutional. Forgive me if I take the legal minds in the House over yours.

4) More or less the same outcome, for the same reasons.
This one is about rescission, the cancellation of coverage. I guess when you say "same outcomes, same reasons" that you are relating it to your comments about lifetime limits and those comments seems just as irrelevant/unaware in this context as that context. I guess I would have to agree that it is "potentially good" for people not to have their policies canceled arbitrarily and often retroactively after expensive treatment has already been approved and taken place. I guess you think this is unconstitutional too.

5) So, is this cheaper for anyone, is the question. I happen to have looked into this again just yesterday, and it's not for my family anyway. If the cost is the same, parents could pay for their kids' insurance or keep them on their own policy. No financial advantage either way. BFD.
This allows young adults to say ontheir parents' policy up to age 27 and it's BFD to you. Well whoopdie doo for you. What if that child had an expensive pre-existing condition? (Thankfully, that won't be as great a factor in the future due to the #2 you are willing to blow off) You can bet there are thousands dealing with this very issue right now. In a larger family it's a very big deal. If you had 3 kids right now that were 21, 22, and 23 I would bet a million bucks that keeping them on the existing family policy which would insure 1 kid or 10 for the same price, is going to be cheaper than buying three individual policies. But, it didn't save you money, so who cares, right?

I've had my say about your say. I think your say is a BFD. Just my opinion.








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dflprincess Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 09:35 PM
Response to Reply #126
128. The deductibles (aka "cost-sharing" in the bill) are not capped at $1,500
the annual cap, at least for the first year is $5K for a single and $10K for a family. This is in addtion to the up to 11% of income going to premiums as well as any costs not covered by insurance that also do not count toward the deductible (for example, adult dental and vision).

Both premiums and out of pocket amounts may increase every year. Out of pockets this high will still keep some people from being able to access care and there will still be people who wind up using credit cards to cover medical expenses. We will still have the "honor" of having a system that is so "uniquely American" that it is the only one that drives people into debt and keeps them from having affordable access to care.


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Phoebe Loosinhouse Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 10:57 PM
Response to Reply #128
130. The deductible and the cost sharing are 2 different things
This is cut and pasted directly from page 23 of the bill itself.

(A) the annual deductible for such benefits
may not be higher than $1,500 for an indi-
vidual or such higher amount for a family as
determined by the Secretary;
(B) there may not be annual or lifetime
limits; and
(C) the maximum cost-sharing with respect
to an individual (or family) for a year shall not
exceed $5,000 for an individual (or $10,000 for
a family).
**************************************************

Aside from that, I don't disagree that this bill doesn't go anywhere near as far as it really needed to and that basically, when all is said and done our system will still be the most expensive with the least access and affordability of the countries we are always comparing ourselves to. It will still be our "uniquely American" system, only somewhat less crappy due to things like elimination of prior conditions, rescissions, life-time caps, etc.

I honestly don't know what to think at this point. Many will see some very tangible benefits but the system overall will still suck.
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dflprincess Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Nov-01-09 01:13 PM
Response to Reply #130
136. And on page 9 it says:
"cost-sharing is defined as including "deductibles, copays, coinsurance and similar charges but does not include premiums, balance billing amounts for non-network providers or spending for non-covered services."

On page 122 deductibles, copays and coinsurance are all listed again as cost-sharing items.

There appears to be some contradictions here. I wonder if any members of Congress will catch them? My money is on "No".
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berni_mccoy Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-30-09 11:59 PM
Response to Original message
78. Thank you for posting this.
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angee_is_mad Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 12:02 AM
Response to Original message
79. keep kicking and
thanks for posting.
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nightrain Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 12:38 AM
Response to Original message
81. have you checked out the costs for a middle-income person or family of this bill??
Totally unaffordable! For one person making more than 43K, up to 12% of income--that's at least 5K. Then, copays/deductibles/cost-sharing up to 5K a year.

This is a good deal for a single person??!! Gets worse for more people!

Remember, affordable means $100 or so a month--that's what other industrialized countries do.

This bill is a windfall to the insurance corporations with some carrots to make it look as if something decent is happening. But, it's not happening--this is piddly health INSURANCE reform, not health CARE provision.
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 02:07 AM
Response to Reply #81
92. Or at least no more than $150/month.
The Netherlands, with mandated private insurance, has a regulated charge of 100 euros/month.
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Odin2005 Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 01:32 AM
Response to Original message
83. K&R
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patrice Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 01:37 AM
Response to Original message
84. marking for reference
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Dangerously Amused Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 01:59 AM
Response to Original message
88. Thanks; will forward accordingly!
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snot Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 02:02 AM
Response to Original message
90. Is anyone counting
the value of the billions of manhours already wasted by millions of people just trying to negotiate what's covered and what's not, and how, in an already overly complex system?

I don't see this as helping that particular aspect of the problem.
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Major Hogwash Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 03:36 AM
Response to Original message
95. So, where do we sign up for the death panels?
I plan to sign up early and beat the rush from the far right.

LoL
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LynneSin Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 05:03 AM
Response to Original message
96. My nephew is campaigning hard for this - he is 19 and no insurance
He just go over swine flu. Thankfully the family doc took him in with his sister (also with the flu)
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 08:40 AM
Response to Reply #96
104. So, pull the usefel parts out and pass them separately
There is no need to poison a good idea like extending young adult coverage until 26 with utter crap like mandated private insurance.
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barbtries Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 05:27 AM
Response to Original message
97. i'd be able to get my son covered
for another year. he's already gone without insurance for a year. just turned 26, in college. going to law school next year.

now i'd like to see some real money put into higher education in this country. heh.
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zoff Donating Member (302 posts) Send PM | Profile | Ignore Sat Oct-31-09 07:30 AM
Response to Original message
102. Public LTC ... wow! and funding for CHC's .. awesome!
LTC is what makes some seniors lose homes they've worked all their lives to pay for. There are laws that can help avoid this, but paying for the care is still a problem. Medicaid LTC is an unpalatable choice for those who know what goes on in non-private nursing homes. I will let you guys know when the LTC segment of the industry comments on this provision.

My CHC experience has been positive. The wait may a bit longer as more people avail of their services but doubling the staff will remedy this situation. CHC's are great options for the uninsured if you need preventative and non-emergency room care. I hope this provision allows CHC's to offer more affordable care. Overall, CHC funding is a good thing.
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demodonkey Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Nov-01-09 03:26 AM
Response to Reply #102
134. Yes but $50 - $75 per day benefits won't help that much. LTC costs here RIGHT NOW are over $200/day.

And rising. It is at least a small recognition that we have a growing problem with Long Term Care, though.

And "healthcare" without FULL long term care is pretty much worthless when you become disabled. And it is very, very easy to become disabled and need long term care. One head injury or sudden stroke and you can be done for.

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zoff Donating Member (302 posts) Send PM | Profile | Ignore Sun Nov-01-09 08:00 PM
Response to Reply #134
139. Link please.
If it only pays that then you are correct. LTC is upwards of $250 a day. Home Health Care is cheaper.
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annabanana Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 09:35 AM
Response to Original message
108. We should all have this list committed to memory. . . n/t
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Jakes Progress Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 09:52 AM
Response to Original message
111. This may be all we can hope for.
But it's not any good. Most of the points listed are cop outs. They "allow" you to save for you old age needs. They "allow" you to pay huge amounts of money for insurance when you've lost a job. This is an embarrassing list. And it is a list prepared as a press release for a congress person. It hides more than it shows.

We may have to settle for this, but there is no way you can call this a victory. We got beaten. Badly.

The insurance companies and pharma and neocons played us and the administration like a cheap whistle. Any of the good that is in those paltry 14 items could have been a tiny bill passed by Congress at any time. To scrape this together and call it victory is delusional.

You can complain that I'm just trashing the bill because I'm too idealistic or because I hate the president (both are wrong) but I would have to retort that you are praising it because you are gullible and love the idea of a perfect president (both of which are also wrong). Actually, I don't see why this is a cause for celebration. We started with the hope of getting something nearly as good as what other countries have. We got worse.

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nightrain Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 10:02 AM
Response to Reply #111
115. yep. Folks, read the details, not the promotional material. It SUCKS.
and for middle income people is entirely unaffordable.
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Jakes Progress Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 10:08 AM
Response to Reply #115
116. For people, unaffordable and unsustainable.
For corporations, a tax powered windfall.

This tiny list is the few things that corporations allowed in so that Democrats could vote for it and progressives would draw fire for blocking. None of these will cost the insurance companies anything, and many will be additional streams of income for their bloated coffers.
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chadmak09 Donating Member (91 posts) Send PM | Profile | Ignore Sat Oct-31-09 10:39 AM
Response to Reply #111
117. I agree with all of that except................
The part where you said the insurance industry played all os and the ADMINISTRATION.

They didn't play the administration. The administration simply never fought for what is right.

They gave the insurance companys a golden mandate.

This IS NOT HEALTH REFORM. ITS SIMPLY INSURANCE REFORM THAT BENEFITS THE INSURANCE COMPANIES MORE THAN US.

thats why I have to take the stance of calling my representatives and asking that they vote against this bill.

We need real reform and this is not it BY FAR.
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nightrain Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 10:57 AM
Response to Reply #117
121. yes, it's a sham.
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Jakes Progress Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-31-09 11:00 AM
Response to Reply #117
123. I agree except
I think the administration thought it was going to get something. I think they made their deal with Pharma and then were encouraged to deal with the republicans. I agree that they didn't fight, but I think they were simply naive enough to think that the people they were dealing with would keep their word or operate in good faith.

You either have to believe that the administration is a nasty, corporate tool or is simply not up to the job. Maybe, I'm just a dreamer, but I lean towards the latter.

My biggest gripe is people who call this a victory. With that attitude there is zero chance of trying to get real reform in the next 50 years. I think Obama ought to tell Congress he will veto a bill this weak and introduce his own. That would be him doing his job.

If this bill passes and is signed, we need to stop jumping up and down and celebrating. We need to begin fixing all the things wrong even before the next congress. We need to face up the fact that we lost, that the corporations won. If we treat this as a victory, we are damning the next two generations to corporate rationed health care.
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demodonkey Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Nov-01-09 01:25 AM
Response to Original message
132. Just MAKE SURE that the KUCINICH AMENDMENT gets added back in......
Edited on Sun Nov-01-09 01:26 AM by demodonkey

Canada's system started in ONE Province. It worked and soon and spread nationwide. That's the best bet for single-payer here in the US, too.

DK's Amendment will allow individual states to proceed forward with their own SINGLE-PAYER systems. With his amendment stripped, insurance companies will use ERISA to sue the states that pass single payer.

If we are ever to have a single-payer system nationwide it will probably come after states start adopting single-payer one-by-one -- IF THEY ARE ALLOWED TO.

Please call one or more of these House leaders (especially Hoyer & Pelosi) and ask them to put the Kucinich Amendment back into the Manager's Amendment of the bill (the final version they are bringing to the floor):

Speaker Nancy Pelosi: Washington, DC, office (202) 225-4965; San Francisco office (415) 556-4862

Majority Leader Steny Hoyer: Washington, DC, office (202) 225-4131; Greenbelt office (301) 474-0119; Waldorf office (301) 843-1577

Rep. Henry Waxman: Washington, DC, office (202) 225-3976; Los Angeles office (323) 651-1040

Rep. Charles Rangel: Washington, DC, office (202) 225-4365; New York office (212) 663-3900

Rep. George Miller: Washington, DC, office (202) 225-2095; Concord office (925) 602-1880; Richmond office (510) 262-6500; Vallejo office (707) 645-1888
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Phoebe Loosinhouse Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Nov-01-09 06:28 AM
Response to Reply #132
135. Agreed!
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WinkyDink Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Nov-01-09 02:08 PM
Response to Original message
137. I'm interested in #12, being an early retiree!
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newspeak Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Nov-01-09 02:27 PM
Response to Original message
138. the donut hole reduction helps my in-laws
Edited on Sun Nov-01-09 02:46 PM by newspeak
we only have the donut because of *'s big pharma give away. I was against FORCING people as CAPTIVE CONSUMERS to auto insurance without having an alternative. California attempted to pass a proposition where everyone was minimally insured and the private insurance companies covered the rest. It was so that the working poor could still afford transportation. I consider driving a privilege, not a right, unlike health. The insurance companies spent millions to defeat that proposition. Ya know, they're just so concerned about our well being over their own pocket book.

Now, I may have the government FORCING my family to buy private insurance without a CHOICE for public option. It looks like to me, they've just stolen Romney's pro-corporate insurance schtick. I am not a rah-rah-rah corporate free-market cheerleader. As a matter of fact, I don't really believe that now days there's much of a FREE market. It's a controlled pricing market, where the corporations control the price--and if any small entity steps out of line, they usually pay the price.

So, I am not jumping up and down with joy for the prospect of being forced to buy a piece of shite from the health corps so they can make even more obscene money while giving us a shitty policy that we may never use because the deduction will probably be too high for the policy we could afford.

We'll see the final bill--but I bet after the Senate gets done with it--it will be more crappy-screwing us even more while giving the insurance corps even more power. They couldn't take the easy way of medicare for all--no, they had to pacify their greed buddies, wall street and the insurance industry over us.
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Zoeisright Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Nov-01-09 11:51 PM
Response to Original message
142. Really, really good stuff.
This is a great start.
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Mimosa Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Nov-02-09 01:12 AM
Response to Original message
143. Good stuff! If only it goes through and soon. n/t
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