Democrats' Health Care bill has been passed - SCOTUS ruling update

[the Interceptor]

So is there any remotely neutral place where I read about the actual content of the US health care reform in a nutshell?

 

[Famine]

So is there any remotely neutral place where I read about the actual content of the US health care reform in a nutshell?

Err... I can provide a potted summary.

The Bill means the having healthcare insurance in the US is now mandatory. If you do not take out private healthcare insurance, you will be fined $800 by the US Government and this constitutes your payment towards public healthcare insurance. So everyone has healthcare insurance.

That's pretty much it as far as I can make out.

 

[Fastas]

Err... I can provide a potted summary.

The Bill means the having healthcare insurance in the US is now mandatory. If you do not take out private healthcare insurance, you will be fined $800 by the US Government and this constitutes your payment towards public healthcare insurance. So everyone has healthcare insurance.

That's pretty much it as far as I can make out.

So it's not a NHS that operates and seemingly works well as a model in most of Europe/the commonwealth?
I don't understand why, as a nation, America rushes to the aid of foreign countries 'in need' and yet , as a population, don't care to much for the health and well being of their own. Surely this would have huge benefits to all both directly and indirectly?

 

[Famine]

So it's not a NHS that operates and seemingly works well as a model in most of Europe/the commonwealth?

No. All that's changed that I can make out is that, in 4 years' time, it'll become illegal to not have healthcare insurance.

This might not be the case, by the way, but it's all I've been able to determine.

I don't understand why, as a nation, America rushes to the aid of foreign countries 'in need' and yet , as a population, don't care to much for the health and well being of their own. Surely this would have huge benefits to all both directly and indirectly?

Americans are encouraged to look after their own health, and judge its value to themselves.

 

[Azuremen]

No. All that's changed that I can make out is that, in 4 years' time, it'll become illegal to not have healthcare insurance.

This might not be the case, by the way, but it's all I've been able to determine.

Americans are encouraged to look after their own health, and judge its value to themselves.

Yes, we are encouraged. And this removes that option from us completely. Just one less choice I can choose to make for my own good, as deemed by the government.

 

[Mark T]

Are US citizens of all ages currently required to have insurance in order to receive healthcare? So would a 5 year old have to be insured by the parent in order to get treatment?

Also does the $1000 + premium just cover one person plus children or is it seperate for each family member.

 

[Famine]

Are US citizens of all ages currently required to have insurance in order to receive healthcare?

No. All citizens (and I think non-citizens too) can receive A&E (ER) treatment. Other than that I believe you only need to have proof of being able to cover your treatment costs - which is either a lot of money or insurance which covers your treatment schedule.

So would a 5 year old have to be insured by the parent in order to get treatment?

Yes - or part of the parent's insurance plan.

Also does the $1000 + premium just cover one person plus children or is it seperate for each family member.

I don't actually know this one - but it's not a compulsory premium (that'd be illegal) nor even a tax (that'd be unconstitutional). It's a fine for not having private healthcare. Insert your own rolleyes emoticon here.

On that front I'd imagine that it works the same as private insurance - the parent has the child on their policy, so the fine includes the child. Which does make me wonder how parents who have private insurance policies which do not cover their child (it might happen...) would be treated by the fining system.

 

[Azuremen]

No. All citizens (and I think non-citizens too) can receive A&E (ER) treatment. Other than that I believe you only need to have proof of being able to cover your treatment costs - which is either a lot of money or insurance which covers your treatment schedule.

This is my understanding of our system. Generally it is just having a proof of insurance card with a recognized company with said hospital, etc. ER treatment is required to anyone in need, regardless of any form of ID what so ever. Thus how illegals tend to be a drain on the system even further...

 

[Famine]

It disturbs me slightly how I understand the American system better than the British one.

I've never quite grasped why NHS doctors are free-at-point-of-use, but if you see an NHS dentist, you have to pay (unless you're already in receipt of state benefits). Nor why £20k worth of chemotherapy is free-at-point-of-use, but you must pay for £15 of amoxycillin...

 

[Azuremen]

It disturbs me slightly how I understand the American system better than the British one.

I've never quite grasped why NHS doctors are free-at-point-of-use, but if you see an NHS dentist, you have to pay (unless you're already in receipt of state benefits). Nor why £20k worth of chemotherapy is free-at-point-of-use, but you must pay for £15 of amoxycillin...

First one is likely they need to maintain that British image of terrible teeth.

That aside, it does show a disconcerting side to, what many seem to claim, "the superior socialist system" - a rather irrational system and set of charges.

So basically, the social system is still primarily for Catastrophic health issues, which is relatively easy to get in the US as well. Full coverage is a different story, and is why benefits from employers can become massive incentives to stick with them, which helps employer retain employees while keeping them healthy at the same time. Now unions have ruined that some what (just look at GM) by pushing for too much, though I must say my mother's retirement was nice during my father's deterioration from Amyloidosis, which treatment of I doubt would have been covered under most socialized healthcare systems anyhow.

 

[Fastas]

Yes, we are encouraged. And this removes that option from us completely. Just one less choice I can choose to make for my own good, as deemed by the government.

From what I have picked up, there are some U.S. citizens who are denied healthcare insurance on the grounds that they are too ill(?) or can't afford it(?) how does this affect their 'choices'?

I will state now that I think to allow/provide access to all is more important than what seems like a bourgeois attitude to personal choice.

Please don't think I'm 'bear baiting' here, I really don't know very much about this topic.

 

[Famine]

From what I have picked up, there are some U.S. citizens who are denied healthcare insurance on the grounds that they are too ill(?) or can't afford it(?) how does this affect their 'choices'?

If they can't afford it, they'll be fined $800 by the US government. Not particularly helpful there.

As for being denied because they are too ill... when you get car insurance, your insurers might decide that, because you've crashed twelve times, have 11 points on your licence and are epileptic, you are too much of a risk to insure. Health insurance is pretty much the same - if you become ill, your insurers cover you. If you have a "pre-existing condition", they will charge a higher premium (depending on the condition) - to the point where the premium may be so high that you are uninsurable.

I will state now that I think to allow/provide access to all is more important than what seems like a bourgeois attitude to personal choice.

Everyone is allowed access to emergency care. Everyone - until this morning - was also allowed to choose how much their long-term health mattered to them, right down to the value of $0. Now it's "get insurance or an $800pa fine". Now, I don't know how much US private health insurance costs, but it's not particularly likely you can find a superior public sector product for the same price - and if you do, it's likely to be heavily discounted through taxation (which is taken from the taxpayers).

Which itself calls into question the notion that this will benefit the US economy...

 

[Sam48]

Congress is completely disconnected from the voice of the American people. We screamed, "Don't pass it!", but what did they do?, They passed it anyway!

 

[Fastas]

.......- if you become ill, your insurers cover you. If you have a "pre-existing condition", they will charge a higher premium (depending on the condition) - to the point where the premium may be so high that you are uninsurable.

So does the new law mean that flat rates will be introduced? I find it hard to believe someone would 'choose' to be incredibly ill in order to throw more money at healthcare, with or without a nurse fetish. Maybe I'm not quite grasping the term 'emergency healthcare' correctly. I just see a strange ethical paradox.

Everyone is allowed access to emergency care. Everyone - until this morning - was also allowed to choose how much their long-term health mattered to them, right down to the value of $0. Now it's "get insurance or an $800pa fine". Now, I don't know how much US private health insurance costs, but it's not particularly likely you can find a superior public sector product for the same price - and if you do, it's likely to be heavily discounted through taxation (which is taken from the taxpayers).

Which itself calls into question the notion that this will benefit the US economy...

It would be interesting to see how the personal effect to the 'insurance' would stack up.
As for the economical benefit; there may be an element of political spin in that or it may be interpreted in the same sense as unemployment, i.e. the more people at work the more money goes into the economy.

 

[Joey D]

Congress is completely disconnected from the voice of the American people. We screamed, "Don't pass it!", but what did they do?, They passed it anyway!

The American people have no one to blame but themselves if it is indeed true they don't like it. We voted those politicians into office to make these decisions, we have to live with it. It's how representative government works.

Honestly I'm all for health care reform if it's done properly, but this bill is rather lackluster, or at least from what I understand of it. Even at that I'm still a bit clueless on the whole thing because I'm getting skewed media reports that only paint half the picture.

One thing I will say though is that right, wrong or indifferent, a politician kept a campaign promise and for that I'm shocked.

 

[Sam48]

The American people have no one to blame but themselves if it is indeed true they don't like it. We voted those politicians into office to make these decisions, we have to live with it. It's how representative government works.

Yes we voted them into office, but if the majority of all American people are exclaiming to them not to vote for this bill, then they should listen to us. That's why we call them representatives, because they represent us. So if that representative wants to go against the constituents of the people who put him into office, then he is not in any way representing the people.

 

[Joey D]

Yes we voted them into office, but if the majority of all American people are exclaiming to them not to vote for this bill, then they should listen to us. That's why we call them representatives, because they represent us. So if that representative wants to go against the constituents of the people who put him into office, then he is not in any way representing the people.

How do you know a majority of America didn't want the bill though? I think I know more people who supported it then didn't, but that isn't any form of scientific fact. You will always have people complaining about something the government is doing and the media will always spin it so it looks like a bigger issue then it actually is.

And this is also why we have elections every few years. If we don't like the job someone's doing we can elect to get them out of office and replace them with someone who we do approve of.

 

[Famine]

So does the new law mean that flat rates will be introduced?

I'm as far from American as you are, so I'm not best-placed to answer.

However, imagine the car insurance industry if no insurer was allowed to refuse anyone cover - and if there was provision for a £500 tax (we're allowed to do that) for people who didn't want private cover.

The first thing that would happen is that the uninsureable would become insureable for a £10k premium. The second is that everyone's private insurance would go up to £499 - they'd only need to offer a slightly cheaper product and most people would snap it up. The third is that you'd still have uninsured drivers, but they'd also be tax evaders. Oh, and the fourth is that you'd need a huge government department called The Department of Car Liability, Insurance, Taxation and Organised Reimbursement In Situ, which would cost billions and have an unfortunate abbreviation.

Of course, the analogy isn't really right - you can simply do without a car and the problem goes away, it's a bit harder to do without yourself - but since the system is so wholly alien to us, it'll have to do.

I find it hard to believe someone would 'choose' to be incredibly ill in order to throw more money at healthcare, with or without a nurse fetish. Maybe I'm not quite grasping the term 'emergency healthcare' correctly. I just see a strange ethical paradox.

I don't quite know what you're getting at. Emergency care is casualty/A&E/ER treatment. Broken bones, heart attacks, overdoses, that sort of thing. The Bill doesn't touch that as far as I know, and nor does health insurance.

It would be interesting to see how the personal effect to the 'insurance' would stack up.
As for the economical benefit; there may be an element of political spin in that or it may be interpreted in the same sense as unemployment, i.e. the more people at work the more money goes into the economy.

In essence, the plan is supposed to reduce the US's deficit - and by charging 30m people $800 apiece, it's easy to be suckered in. That's $24bn straight to the treasury.

The only problem is that, currently, there are 83m people in receipt of US public healthcare programmes - and that accounts for about 50% of the US's $2.3 trillion spent on healthcare per annum, or $1.1tn. 30m more people funnelled into that system is an increase of 36%, which bumps that part of the US's healthcare spending up to $1.5tn. So that's $24bn in and $400bn out. Per annum. Even without getting into the notion that the public healthcare plan will almost certainly have to be subsidised. And that's supposed to reduce the US deficit?

So what we're looking at is no benefit for the uninsurable (they still can't get insured - but it's by huge premiums rather than refusal), detriment for the elective non-payers (they get fined $800 each), detriment to the poor (they also get fined $800 each), detriment to people currently insured (private healthcare can now charge a minimum amount) and detriment to the economy (which now loses $375bn a year more).


It's laudable to say "I want everyone to be as healthy as they can be", but the mechanics and morals behind it are staggeringly complex. No-one's yet got it right, and this particular plan has not got it right by quite an impressive margin.

 

[Fastas]

I'm as far from American as you are, so I'm not best-placed to answer.

💡 No, but us Yorkshire folk could have ago?

......Oh, and the fourth is that you'd need a huge government department called The Department of Car Liability, Insurance, Taxation and Organised Reimbursement In Situ, which would cost billions and have an unfortunate abbreviation.

I wouldn't want to rub that department the wrong way.

I had better go and read up on this, before posting any more. I would be surprised though if it was purely to reduce the deficit and in no way viewed as beneficial to the health and well being of the poorest 10% of the U.S. population.

 

[Famine]

I had better go and read up on this, before posting any more. I would be surprised though if it was purely to reduce the deficit and in no way viewed as beneficial to the health and well being of the poorest 10% of the U.S. population.

It's not just for that, but that's part of how it has been sold.

Bear in mind that the poorest 10% of the population may have their health improved insofar as they now* have insurance - but they're being forced to pay $800 each to get it. If they couldn't afford that before, how are they going to afford it now? And if they still can't afford it, what happens to them - the same as anyone else who doesn't pay a governmental fine (then again, healthcare is free to prisoners)?


*In 2014

 

[Sam48]

How do you know a majority of America didn't want the bill though? I think I know more people who supported it then didn't, but that isn't any form of scientific fact. You will always have people complaining about something the government is doing and the media will always spin it so it looks like a bigger issue then it actually is.

And this is also why we have elections every few years. If we don't like the job someone's doing we can elect to get them out of office and replace them with someone who we do approve of.

The Gallup Polls show 56% of Americans are against the bill, 25% think the bill is good for the economy, and 19% are undecided. (you can google these poles if you like).

Regarding the mid term elections, I believe the 2010 mid term elections will let in a flood of republicans (like in 1994).

 

[Northstar]

The Gallup Polls show 56% of Americans are against the bill, 25% think the bill is good for the economy, and 19% are undecided. (you can google these poles if you like).

Regarding the mid term elections, I believe the 2010 mid term elections will let in a flood of republicans (like in 1994).

Can you provide a link to this poll?

The only one I could find is this one that shows it's pretty much dead even(especially since it's only a sampling and there is always a margin of error when they do these polls).

 

[Joey D]

The Gallup Polls show 56% of Americans are against the bill, 25% think the bill is good for the economy, and 19% are undecided. (you can google these poles if you like).

Regarding the mid term elections, I believe the 2010 mid term elections will let in a flood of republicans (like in 1994).

It's still just an opinion poll and it's hard to tell how accurate it actually is. There is always a bias in polling whether it be from the people they ask, the questions they ask, or the person asking the questions. Always take that sort of stuff with a grain of salt and a disclaimer.

Just for an example this Gallup Poll from 19 March 2010 said they interviewed 1,009 people. The population of the US is 307,000,000 citizens..that's just .0003% of the US population they polled.

And I would hate to see a flood of Republicans, the country does not need that right now.

 

[Sam48]

And I would hate to see a flood of Republicans, the country does not need that right now.

The country needs something to balance this mayhem out. I'd rather have a flood of conservatives instead anyway.

 

[Joey D]

The country needs something to balance this mayhem out. I'd rather have a flood of conservatives instead anyway.

True conservatives maybe, but the currently Republican party is full of half wits and idiots. And really you'll see no balance if Republicans take more seats in Congress, it'll just be a bunch of old white guys in a pissing match over ideologies that don't matter while the rest of the country continues to get hosed.

 

[Omnis]

People are going to get laid off like woah with this new 26-year-old age extension for children on their parents' employer's plans.

My uncle says the city is going to have to let go a lot of people especially since the city pays for 78% of expenses for those covered, including their families. But, of course, they won't let go of anybody, and therefore we'll have at least another $20mil (if we're lucky) every year that needs to be paid somehow.

 

[Sam48]

True conservatives maybe, but the currently Republican party is full of half wits and idiots. And really you'll see no balance if Republicans take more seats in Congress, it'll just be a bunch of old white guys in a pissing match over ideologies that don't matter while the rest of the country continues to get hosed.

That's what I fear might happen during the mid term elections. We'll just get a bunch of midway republicans idiots. Conservatives seem to be the only people who have even a clue about how to get this country back on track.

 

[Joey D]

That's what I fear might happen during the mid term elections. We'll just get a bunch of midway republicans idiots. Conservatives seem to be the only people who have even a clue about how to get this country back on track.

I'm not so sure about that. Many conservatives have socially backwards ideals which aren't good for this country. I fully agree with being fiscally conservative for the most part but socially we need to be progressive.

You are still going to end up with a pissing contest however it works out though and nothing will get done then, well large quantities of money will be squandered but that's about it.

 

[Duke]

The American people have no one to blame but themselves if it is indeed true they don't like it. We voted those politicians into office to make these decisions, we have to live with it. It's how representative government works.

Except that you don't wind your representative up at the beginning of a 4-year term and then leave him/her on autopilot for that entire time. There is supposed to be feedback and in this case, all the feedback I've heard is that this bill sucks and NOBODY except Obama, Pelosi, and a bunch of insurance lobbyists wants it. Yet it got passed anyway. The narrowness of the margin should say something.

 

[Joey D]

Except that you don't wind your representative up at the beginning of a 4-year term and then leave him/her on autopilot for that entire time. There is supposed to be feedback and in this case, all the feedback I've heard is that this bill sucks and NOBODY except Obama, Pelosi, and a bunch of insurance lobbyists wants it. Yet it got passed anyway. The narrowness of the margin should say something.

But that is what you do, do you really think any Congress person cares if you don't like something they support? No not at all. All politicians are disconnected with the people now it seems and I don't care what party they represent.

This is why I think protesting is a huge waste of time and energy.

And of course insurance companies want this, it's a huge pay off to them (indirectly).