December 21st, 2009
01:34 PM ET

Real-life effects of reform getting lost in the noise

By Dr. Sanjay Gupta
CNN Chief Medical Correspondent

Last night I was up late covering the senate vote on health care for CNN. The number of e-mails I was receiving while discussing this on air was staggering. I realized that as much as we talked about cloture and reconciliation, most people who didn’t read the 2,000+ page bill (which is most everyone) really wanted to know what this bill means for them. They didn’t care as much about the compromise that was struck by Sen. Ben Nelson, which would obligate the federal government to pick up the Medicaid tab for his state of Nebraska into perpetuity. They are still not sure if a public option is a good thing or not, and they aren’t sure how the exchange would work for them. In short, there is a collision of politics and health care, and sometime the impact on individuals gets a little lost in the shuffle. (Read the Senate health care legislation)

I want to use this blog as a platform to try and address some of your specific questions and to also throw out some key information that may have flown under the radar. I will start with a number. 2014. This is the year most of the provisions of the bill would kick in under this version of reform. That’s right – four years away. Many people think health care reform in binary terms. One moment there is a vote, and the next moment you have it. Many wish it were that easy. It is true that children may benefit earlier in some areas, but for the vast majority of the more than 40 million uninsured, things aren’t going to change significantly for a few years. And, speaking of the more than 40 million uninsured, this bill won’t impact all of them, but instead roughly 31 million.

So, let’s start here: Based on what you know about this bill, do you think you will be impacted? Has this affected your current plan, if, for example, you are working for a large corporation? What information is still lacking for you?

Click here to see Dr. Gupta answering some of your health care reform questions.

soundoff (416 Responses)
  1. Chuck Meek

    One concern is requiring insurance companies to cover pre-existing conditions (and I have them). If they do, the cost of that coverage will be so high as to still be "unavailable" or they will spread the cost and raise the cost of policies to everyone else. Second issue, what is the status of the Public Option? By the way, whoever agreed to Ben Nelson's demand should be impeached!

    December 21, 2009 at 15:02 | Report abuse | Reply
  2. Pete

    Of course I will be impacted. First, this is a compromise of compromises that will create more problems than solutions. Nobody in Congress even likes this bill as it reads. They are all doing it to say they passed something called "healthcare reform" or to get some special deal for their state.
    Second, when the Federal government intrudes more into the private sector my cost of private healthcare will go up. And then the Democrats will use that as proof that the government needs to enter the market for providing healthcare, which will raise my taxes. They get to create the self-fulfilling prophecy.
    Third, using Medicare as an example, we can see that the government never correctly estimates what a program will cost in the long run. So, once again, my taxes will go up. Show me a federal program that has come in on time and on budget before you offer to spend trillions of our money.
    Fourth, the public opposed passage of the bill in its present form at the present time by 2 to 1. The Democrats willingness to ignore the constituency it was elected to represent ceratainly will affect as long as they are in the majority.
    Fifth, why is it always easier to create new government agencies and depatrments than to simply fix what's wrong in the exisitng ones?

    December 21, 2009 at 15:04 | Report abuse | Reply
  3. kathy bates

    I work for a large corporation. This bill will greatly affect me with the taxation that the bill includes. Also my health care standard will go down hill. I will have more $$'s taken from my paycheck because of the direct tax. My premiums will go up, and I know there is another tax, having to do with my income tax returns, which I am not clear about.

    I know that for any proceedure I want to have done, I will first have to see if it is on the Government list of things I am allowed. Then I will be taxed for that procedure.

    In 4 years I will be 66 years old and retire. Then I will be in big trouble, as I want to be able to go to my doctor anytime I want and be treated for whatever i need to be treated for. The Government will put a stop to this.

    In short, the Bill is a monstrosity. The wrong people are being punished. Specifically doctors and the public. And no one is touching torte reform or the lawyers.

    All this and – – during a recession! What wisdom.

    This is a very sad day for America.

    December 21, 2009 at 15:09 | Report abuse | Reply
  4. Jeff

    Nobody really knows how they will be affected because nobody knows what made the final cut. Isn't that a red flag to anyone?

    Studies that indicate a $2 Trillion dollar cost are troubling.

    Nobody knows what the cutting back of Medicare payments will have. But I'm sure doctors won't be pleased with it, and may dilute the number of doctors that will accept these patients.

    I guess the senator from Nebraska really wasn't concerned about federally funded abortion afterall.

    With as many as 66% of the population againt this because of bugetary concerns and because it was forced upon us, I would not want to be a senator or house office holder.

    December 21, 2009 at 15:11 | Report abuse | Reply
  5. Duebs

    I am a self-employed consultant with a family of 4 and pay approximately $6k in premiums and another $4k on my deductible per year for my high-deductible plan and HSA. This covers all my health care for my family – we have no co-pays and, once the deductible is met, have no costs at all. The insurance is through Medica (you can delete this sentence if you don't want to show company names).
    I have absolutely no idea how this new legislation will affect me and my family. With competition, I could see my premiums going down and, if they really do fix the medical costs, my out of pocket for health care should decrease as well. On the other hand, somebody has to pay for all this and I'm assuming my tax increases will easily offset any possible savings I might see.
    So, what am I missing here?

    December 21, 2009 at 15:15 | Report abuse | Reply
  6. Melissa H.

    I have read that in the Senate version of the bill there will be a tax on "Cadillac" or high value insurance plans. What types of insurance plans are included in this designation?

    December 21, 2009 at 15:16 | Report abuse | Reply
  7. Shane

    Is this the end of "preexisting conditions"? Are there still lifetime caps? The plan seems to provide more regulation for insurance companies, but none for the healthcare providers, hospitals, and pharmaceutical companies who charge obscene amounts of money for even the most routine services. Over 12% of my 2009 income went to unexpected healthcare expenses (not including insurance premiums). These expenses have converted me from a consumer to a miser... from a charitable contributor to someone who believes charity begins in the home. The outrageous cost of healthcare is a threat to our economic stability. It's irrational that one-sixth of the U.S. economy revolves around healthcare.

    December 21, 2009 at 15:17 | Report abuse | Reply
  8. Charles Thomas

    As I currently have limited coverage under the VA Medical, and no private insurance (who can afford it?), and that I will be 60 this year, I don't think that this is going to benefit nor harm me.
    In 4 years I will be barking at Medicare's door and getting ready to switch over to this marvel of Federal Non insurance.

    At an rate. I will truly be surprised if this benefits anyone, more than any so called Federal Medical Insurance has helped anyone to date.

    December 21, 2009 at 15:18 | Report abuse | Reply

    Dear Dr. Gupta:

    I am very afraid.

    Due to a medical mistake, I must now try to move forward and live with a right coronary artery that was accidentally dissected and fixed with stents that keep going into restenosis (scar tissue build up blockage). At first, I had excellent insurance thru COBRA and my ex-husband's insurance company covered my medical bills 100%. I never missed a premium payment for 3 years and my coverage was changed repeatedly with ever reduced coverage. At the end, Humana Cofinity said I was eligible for conversion but his company changed the entire plan to "no conversion" to get me off the plan. I was left with one unavoidable option which was to buy state run insurance thru BCBSM at a markedly reduced coverage and very increased cost. I now pay $464.63 a month for insurance that only allows 2 visits a year and a 70/30 co-pay and a huge deductible. As a result, I cannot afford to go to the doctor since I am unemployed due to my medical condition. I just got disability and it will not come close to covering my costs. On top of that I was informed the policy will go up $200 a month when I turn 55 next September 2010.

    I told you this long story only to let you know that the Health Care bill will not come in time to help me.

    I cannot afford the insurance I do have and the State of Michigan is not taking any more Medicaid applicants at this time since their system is bankrupt. I have 4 stents and a pacemaker and cannot afford to go to my cardiologist for check ups. It is not fair that I cannot sue the doctor for his mistake and get help with all my medical bills due to tort reform laws in the state. It is also unfair that women of my age are typically dumped by their husbands for a younger woman and usually face medical issues in middle age without the help of a husband. Since Michigan is a no fault state, they did not care about his blatant affair and they will not force my ex does to help me out at all. I am left alone after 32 years with no options. My story is all too common.

    Why is it taking 4 years to enjoy the benefits of this law?

    I have been told I am terminal and will not live long enough to take part of these future benefits.

    In the meantime, I have to spend my last days worried about money and being unable to interface with my doctor the way I really need. In the richest country in the world with the best medical care I can't get real help.

    Mary Pagels

    December 21, 2009 at 15:18 | Report abuse | Reply
  10. Susan

    For me, healthcare reform means that I will finally be able to go to bed at night and not worry about what would happen if I were to lose my employer-sponsored coverage. I would finally be able to buy coverage on the individual market. I have pre-existing conditions, and would not be eligible for insurance to cover my needs on the individual market under our current system. For a long time, I've wanted to go back to school for a doctoral degree, but I have not been able to because I could not risk losing the employr based healthcare coverage. Maybe, if reform passes, I will finally be free to pursue my dreams without risking my life, should I get sick. I lost one good friend because she was in a job that did not offer insurance, and she was not eligible to buy on the individual market. She developed endometrial cancer and died because she did not have insurance and did not have money to pay for a hysterectomy. She ended up on disability, but died before the 2 year eligibility for Medicare. Our current system is just scarey. II pray that reform passes.

    December 21, 2009 at 15:20 | Report abuse | Reply
  11. Polly

    First of all, why does this bill need to be passed before Christmas? Are all these politicians going to be so worried about being re-elected that they don't have time to think clearly about helping those who got them there in the first place? The thing that bothers me most is that mostly insurance companies and lawyers will make millions off this bill. It has been rushed through voting and for the most part been done behind very closed doors. President Obama was elected by telling us that there would no longer be any earmarks to any bills passed once he was elected. He also told us that bills would be written in easy to understand language. I don't for one minute believe in him any longer. I don't see any Republicans and Democrats sitting in a room together discussing what should be included in a health bill. I don't see medical personnel writing a bill. I see only long time politicians stuffing their own pockets with all this nonsense. I am on Medicare as is my 92-year-old father as well as my husband and this will impact us all. I would love to see a bill written in plain old English, understandable by all, getting rid of ridiculous lawsuits, making medicines more affordable, getting rid of malpractice insurance premiums which are ridiculous due to the lawsuits mentioned above and insurance plans that cross the state lines for competition. The insurance companies love this bill as they are going to be megabillionaires and we are going to be megapoor, even a third world country very soon if this bill passes.

    December 21, 2009 at 15:21 | Report abuse | Reply
  12. Norman Causey

    I'm 68 years old. I am not sick or disabled yet. How will the Health Care Reform affect Me ?

    December 21, 2009 at 15:21 | Report abuse | Reply
  13. Becky Caplan

    My daughter just turned 25 and is still a student. She is getting kicked off her father's health insurance plan. We will have to pay $415 per month in COBRA. I heard that tis new plan will cover her until the age of 26. Is this true?

    December 21, 2009 at 15:22 | Report abuse | Reply
  14. Scott G

    I believe a National Health Care Plan is needed. But we need to do it right, not half way. Everyone needs to be on it! From Congress, to Medicare, the Military, to those on Welfare and EVERYONE IN BETWEEN. The time needs to be taken to build a truly good plan and then institute it. A committee of Working people, NON-Medical Insurance people, true business people, and regular medical people should take the best of the plans from all countries and make the national Health Plan for the US. Standards should be set in place to set costs and practices. But that does NOT mean we can not add extended or other coverage’s from an Insurance company.
    Thank you

    December 21, 2009 at 15:23 | Report abuse | Reply
  15. Eileen Leccese

    Yes, Dr. Gupta...I do have a few questions. Hopefully you can help me.

    First of all...I was unaware there was an exchange option. Will this be similar to the Health Connector in Massachusetts? Here some of the insurance companies offer much discounted programs. There are some restrictions....but it really covers those in need very nicely (my daughter is one of them)

    Will the regulations on Health Insurance Companies take effect immediately? (ie. Coverage for those with pre-existing conditions, no limits on coverage...both annually and lifetime, and no rescission of coverage when someone gets really sick)

    And, is there anything in this bill that will control the cost of premiums? Health Insurance Companies at the moment are exempt from the Anti Trust Laws....they can set premiums anyway they would like. I will bet my life (excuse the pun...I have been a diabetic for over 40 years) those premiums will skyrocket immediately. The reason....we had to include all those sick people!!!!!

    December 21, 2009 at 15:24 | Report abuse | Reply
  16. Susan

    Hello! Thank you so much for your steadfast coverage on this very important issue for our country. Yes, health care impacts our lives in that I am 60 yrs old with no major problems but my husband age 56 and has controlled diabetes with no major problems but we have to pay $1,360 per month with a $5000 deductible.My husband has not worked in two years due to the recession and I work two jobs which totals about $45,000 per year so needless to say $17,000 per year just for insurance means we are barely surviving even though we have no major bills except for our mortgage for 5 more years. BTW our policy is not any "cadillac" for us but it certainly is for those CEOs who are accepting our money each month so they can ride in their Cadillacs!!! Our premiums go up about 25% per year even though we never use it because nothing meets the deductible. So, since early Medicare was taken off the table we were hugely disappointed because we are one step from bankruptcy if we have a serious medical problem. On the contrary, I think this is a huge help to others that is long over due but too late for us and many others in our category. I doubt we will be able to maintain any increases in premiums so we will be unable to pay in 2011 so 2014 is not even on my radar. Again, I hope this snipet helps someone else tell their story as I know we are not the only ones out there in this situation.. susan – virginia

    December 21, 2009 at 15:27 | Report abuse | Reply
  17. JB

    Yes...after having our insurance company "recode" our daughter's medical condition of depression to "conduct disorder"and denial after denial....we remain hopeful as we move forward with health care reform. The US has been through an incredibly dark period in our history and our citizens have suffered. Congratulations to our brave leaders in the House and Senate.

    December 21, 2009 at 15:28 | Report abuse | Reply
  18. John

    Health "reform" is a joke. Only in government can we attack something that is 80% fine and 20% broken with an overhaul or "reform" that isnt needed. Once insurance companies agreed to cover preexisting conditions and not refuse treatment for those already covered, we were as far as we needed to go. Cutting medicare benefits by 500B and bringing in 30M more people to a broke system is not how to "fix" it. Obama, reid and Pelosi have never run anything and only know how to say "tax the rish", its the answer to everything. Sending more men to Afghanistan, well, "tax the rich". Need more money for those not covered, well, tax the rich. Need more money for other social programs or to fund Senator Nelson's raw deal on abortion-caving, well, tax the rich. Someone make a new Obama doll with a button we can push that says "tax the rich" and we can stop watching the news...we already have the answer. If you are successful in America, you are now EVIL, whereas Chavez et al are ok people. Get out, move to Europe or an island before this governement takes everything you have. And if you are a Doctor, well, I hope you like being poor.

    December 21, 2009 at 15:28 | Report abuse | Reply
  19. Antonia

    Yes this bill will impact me.
    The so called Cadillac Tax is going to hit me. Yes, my employer will be taxed but I guarantee you this means that I will pay higher premiums. In the past, we have given up raises to keep our coverage the same or not to pay higher costs on our health care premiums.
    Unfortunately, my salary is not a "Cadillac" salary. I suppose my employer could lay off more people to pay the tax since they are already trying to cut costs. Oh wait, if I get riffed, then I could always sign up for the public option Democrats touted.. oh.. wait.. no I can't. There is no public option.. great. I wonder how that will impact my cancer treatment. Of course, none of this will impact all the funds I paid out to cover my son's Autism and ABA therapy. This is hardly reform- my health coverage will be even worse now that Congress has passed reform.

    December 21, 2009 at 15:28 | Report abuse | Reply
  20. Nick Fargo, ND

    I keep hearing all this stuff about health care and I have to admit I understand a lot of the big ideas but very little about the details. I am currently in medical school and I was curious to know how this bill will affect doctors and the professional side of medicine because I have heard very little of that in this whole debate?

    December 21, 2009 at 15:30 | Report abuse | Reply
  21. BC

    I'm all for equal access to qualty healtcare, but.... I am in middle class working for a large company. I currently am in a Co. sponsored High Deductible health care plan and utilize HSA to soften the medical tax burden. Will the health care bill that gets passed hurt me financially? Any extra money thrown to health care has to come from somewhere, so someone will get hurt.... No matter what.

    December 21, 2009 at 15:31 | Report abuse | Reply
  22. Kristin Guttormsen

    Since I am morally opposed to insurance in any form, and this bill appears to mandate it, I am strongly opposed. In fact, the mandating (with penalties) of anything is largely objectionable to me.

    There seems to be certain privacy concerns raised by it (issues of identification, records, etc).

    The issue became prominent largely due to the costs of health care, not specifically the cost of insurance (which is merely a symptom). The bill appears to do very little to regulate or reduce those costs, and may increase insurance costs significantly by regulating certain aspects (removal of pre-existing condition clauses and such).

    The inclusion of anything which in any way supports or endorses illegal immigration or non-english speaking accommodation is unacceptable to me and there are some grey areas there.

    December 21, 2009 at 15:33 | Report abuse | Reply
  23. Gardiner Cross

    This will impact me and my family in important, immediate ways. And I already have health insurance–one of those "Cadillac Plans" that you've heard about in the press.

    I'm currently a government employee, considering going back out into the private sector in a few years. Right now, I would have to be an idiot to do it–my wife is self employed, but has a "pre existing condition" which would make her virtually uninsurable under the current system. Likewise, one of my children is healthy, but falls into a diagnostic category that would preclude obtaining insurance.

    Simply eliminating the pre existing condition exclusions would open a world of professional opportunities for us that do not currently exist. I would have been an enthusiastic supporter of early Medicare, even more enthusiastic about a public option.

    But the political realities are that it only takes a few senators to derail progress, and dropping these features was the price for getting anything done. So I will hold my nose, and support the current bill.

    And if you plan on running against Joe Liberman or Ben Nelson, send me an email. I have a check waiting for you. These people are beneath contemptl

    December 21, 2009 at 15:36 | Report abuse | Reply
  24. Soenke

    Dear Sanjay
    Jacking up Prescription drug costs by combining 2 generic Drugs
    Actos ( there is a generic version ) and Metformin. By combining the drug
    into 1 pill they charge about 600 US $ towards the insurance for 3 month while seperate ( 2 pills ) it would cost 12.99 US $ for the metformin and about 125 US $ for the generic Actos for 3 month. I would call this modern robbery.

    December 21, 2009 at 15:39 | Report abuse | Reply
  25. RD

    I work for a privately owned firm of approx 500 workers, Im not familiar with the details of the new plan, nor am I sure how, if at all, i will be affected by the new plan. I do know that we were just made aware that our current provider has already increased our rates for 2010. Now Im not certain what percentage of an increase our company has received, but I do know that my exposure will double. This seems absolutely ridiculous to me, and Im wondering if its a sign of insurance companies gearing up for unceratin changes, or my company reducing their participation based on economic conditions.
    My guess is both, but its a shame the brunt of it falls on the worker.

    December 21, 2009 at 15:46 | Report abuse | Reply
  26. Jim Concato

    Dr. Gupta,
    As a healthcare admninistrator I have no agenda except that whatever is best for the patient. I am in favor of the "public option" because I think that the Insurance Companies (with profit motives) need to have checks and balances on their medical decision making. Reform is necessary and I am glad that prevention and the establishment of preventive heatlh organizations is part of this bill. Too often the American People only hear the negative part of the reform and not the positive aspects of the reforms. For example, over time, I believe that the increase in healthcare accessibility, prevention, and patient education will reduce costs and premiums for all patients.
    Also, it is important to keep in mind that the HIPAA legislation first passed congress in 1996 and has evolved into the HIPAA act that is followed today.
    The business of healthcare is needlessly complicated and I think additional reform is crucial however, this historic reform can be the foundation to future and necessary change in the delivery of healthcare.
    Lets hear about some of the positive parts of this reform.
    Thank you,
    Jim Concato

    December 21, 2009 at 15:46 | Report abuse | Reply
  27. Mike De Luz

    Hi, Dr. Gupta:

    I receive my health care via the VA, so I don't believe that I will personally be affected, unless the level of financial support to the Veterans Administration is altered.

    Do you anticipate that a well-run, well-funded nonprofit insurance plan, open to anyone to join, will help lower costs by competing effectively vs. the private insurers? I have friends and former students who could benefit from a plan like that.


    December 21, 2009 at 15:53 | Report abuse | Reply
  28. Pat Heethuis

    Yes. I believe I will be greatly impacted by the results of this bill.

    No doubt, legislation will be passed making it impossible for businesses to continue covering their employees and/or retirees. The fact that my employer continues to cover me the same way they originally agreed to, with only deductible changes in my prescriptions, has help immensely in retirement.

    This whole bill fills me with a sense of dread as to what will happen to our medical industry in the future.

    December 21, 2009 at 15:53 | Report abuse | Reply
  29. Jacqueline Curtis

    First, we need to know who gets what. We have no idea what this bill covers and does not cover. I'm in a full-time job with full healthcare benefits, but plan to go on Medicare in 5 years. Until that time, how will my employee healthcare benefits be impacted? What will be provided by Medicare in 5 years?

    December 21, 2009 at 15:53 | Report abuse | Reply
  30. Danna

    Sure, healthcare reform will touch me, it will raise my taxes, and lower the quality of care I can get. I am a SAHM. My husband works for a non-profit heathcare cooperative in the pacific northwest. It is the WORST insurance and worst healthcare we've ever had. His company is consulting with the Obama team on how to do "healthcare right". This is the only health system that only allows me to get a pap every 3 years, even though my mother had cervical and endemetrial cancer. When a mass was found in my breast after a mammogram they want me to "wait 6 months and reimage it". When my children had H1N1 and are both under 4 years old, they told me not to bring them in until they had 105 degree temp. When I tried to schedule a pap it took 3 months to get an appointment.

    Please just let me have regular health insurance again! It was cheaper, it was better and I had more choice.

    December 21, 2009 at 15:53 | Report abuse | Reply
  31. Sherry Galloway

    I have insurance but pay more because of asthma will bill make it cheaper? Also is there anything in bill to help bring more docs to my area, even with insurance hard to get dr appt. Will it do anything to help shorten wait at emergency room? From where I stand it looks like insurance "reform" not health care reform. Congress says Big Oil is bad, Fat Cat Bankers are bad, and now Insurance companies are bad. Maybe its all the stupid laws and regulations that make it bad. I am still concerned that I will not be better off and may be worse off.

    December 21, 2009 at 15:55 | Report abuse | Reply
  32. Dr. Terry Belden

    This isn't about healthcare, it's more about politics and government control. Here the politicians are in such a hurry to get this passed and it doesn't even go into affect until 2014, and still not everyone will be covered. Nice work politicians!

    December 21, 2009 at 15:55 | Report abuse | Reply
  33. G. Moore

    At age 61 I don't expect any help in paying my $614 per month premium. Unfortunately the job market in my area means there are no available jobs with employer-paid health benefits . I'm lucky to still have a job in spite of a big reduction in pay. The best thing for me would be the ability to deduct my premiums from my income, rather than subjecting them to the 7.5 % rule. The only way I'm going to have decent coverage before I turn 65 is to get elected to Congress!

    December 21, 2009 at 15:55 | Report abuse | Reply
  34. Jim Camp

    Reform will assure that my pre-existing condition will not stop me from obtaining insurance. Hence I will not be trapped with my current carrier which has me and my wife locked into $4,000.00 per month with no ability to get competitive quotes.

    December 21, 2009 at 15:57 | Report abuse | Reply
  35. Emil Posavac

    Medicare-covered patients will find a harder time starting with a new physician. My wife and I moved twice (2005 and 2007) following grandchildren. (Twice is enough.) Both times - once in an economically declining area and once in an economically growing area - we had difficulty finding physicians who would accept Medicare. Granted, we sought university-affiliated medical practices. And we did get in, but only after being repeatedly declined an appointment on the basis of Medicare coverage-"Dr. X is not accepting new Medicare patients at this time."

    I am telling friends and family members who are planning to move that they may have a problem finding new physicians. A friend of mine with considerable experience teaching statistical process control at hospitals in the US, Canada, and Europe is being sure that he gets his knee replaced before the new coverage is in effect because he expects to be denied care under Obama-care.

    December 21, 2009 at 15:58 | Report abuse | Reply
  36. David Bowering


    Yes this bill will "hurt me". I do not have health insurance as it is to costly. I do have coverage for my 2 children. It makes me very mad that I will now be fined by the fed as I currently am in Ma. for not having coverage while they will not offer lower cost coverage. Will you please tell me if you think I can pay $11,000 or more for coverage?

    I make $75,000
    take out taxes approx $23,000 fed & state
    child support $19,000
    alimony $16,500
    college for my older daughter approx. $5,000

    that gives me a little over $11,000 to live on & pay all my living expenses. Yet I will be fined every year I do not pay my total remaining income for health coverage. Would my medical cover food?

    Thank you,

    David Bowering

    December 21, 2009 at 16:04 | Report abuse | Reply
  37. JRW

    Yes, it will. It will cost me more in taxes (personally and business), resulting in layofss, smaller pay raises and cust in other benefits for employees. So I ask you – is it better to have more uninsured employees, or less insured ones? I know what their answer will be...

    December 21, 2009 at 16:11 | Report abuse | Reply
  38. independent

    1. Why doesn't the media focus lawmakers and ask, "WHAT IS AFFORDABLE?" What will a family pay? What will a single person pay? We need specifics. Break out the charts and do a two hr show.

    2. (Very important) How will this bill deal with job transitions?
    What if someone has a high paying job and goes unemployed? Or, unemployed to a high paying job? Will people have to constantly switch plans when their income changes??? This will be a nightmare. Please cover this.

    3. How is this administration dealing with prevention of medical privacy violators? Everyone is talking about the greatness of electronic medical records but nothing about the potential dangers to privacy. What will be the penalty for violators? If hackers can hack a big biz company certainly they will be able to do the same to a small medical office or hospital. That's the problem with politicians...they never work on preventing problems only try and take care of things when they are broken

    December 21, 2009 at 16:14 | Report abuse | Reply
  39. Gina McFarland

    I have pre existing conditions and just lost cobra and now have to wait 3 more years for any insurance company to touch me. I also broke my foot yesterday and the orthopedic surgeon will not se me even though I can pay cash. This is not the reform that we need.

    December 21, 2009 at 16:17 | Report abuse | Reply
  40. Jim Robellard

    Dr Gupta
    I am on COBRA for my wife(55) and I(58) until end of August 2010. We have not shopped for health insurance yet pending resolution and clarity(?) on health reform. Both of us likely have pre-existing conditions, I from thus far succussful prostrate surgery last year and my wife from a childhood(1962) open heart surgery and her pending cervical biopsy tomorrow. While pre-existing conditions seems to be prohibited as disqualifiers, what will our options be? Will it be cost competitive with the COBRA policy(BC/BS) at $761 a month or more costly than the IL high-risk pool we would most likely have fallen in prior to this legislation($17,000/yr). I heard that they are allowed to charge upto 3X the normal(?) amount if you have a pre-exisiting condition such as if you are on blood pressure or cholesterol medicine which we both are. When should we look into our options as I suspect that the insurance companies will take awhile to ramp up and as you point out, some things won't take effect until 2014. Is that true of the pre-existing condition deal? Seems to me like the bill will require us to have insurance and be very expensive. I'm fine with $750-$1000/month but not $1500-2000/month. Exactly where will we end up?

    December 21, 2009 at 16:19 | Report abuse | Reply
  41. Lee Perez

    The so called "Health Reform Bill" is nothing but a windfall for the insurance industry. It is very obvious that their lobby in Washington is alive and well. Shame on the senators who had to be bribed in order to give their vote. This "Health Reform Bill" is nothing but a handout to those senators and their whims, and not for the good of all people of this great nation. It is a very sad day in our nation that these representatives of the people are only thinking of their pocketbooks and their own agendas, and not for the good of all of us who voted for them in the first place. We will remember when it is time to vote for them again!

    December 21, 2009 at 16:20 | Report abuse | Reply
  42. Earl

    The government can no longer afford health care so they are passing on the cost of the 38 million uninsured americans to those individuals that can afford it. Make no mistake individuals will be paying a lot more in health care insurance and getting a lot less. The government is ignoring the majority for the minority. They should be focusing on jobs.

    December 21, 2009 at 16:21 | Report abuse | Reply
  43. Allen Windsor

    One would think after 40 years of debate the whole package could have been planned better. We have many examples of programs all over the world to study and choose the best parts from. As well as how to put them into place quickly. 2014 is not an acceptable time line. Many Americans need help now due to the poor economic times we are in. What we really need is a one term limits so these people can concentrate on representing the people and not be reelected.

    December 21, 2009 at 16:27 | Report abuse | Reply
  44. irene

    it will affect ALL of us..we will pay more taxes and get less of service.my brother in law is in europe right now and needs to see a neurologist..guess what he has to wait 6 month.hope he makes it until then...may have a braintumor...
    this is criminal...

    December 21, 2009 at 16:27 | Report abuse | Reply
  45. crb

    Of course it will affect all of us. Typically they attempt and usuall y fail to level the benefits to all citizens. This means that while some will gain others will lose. Those losing will be the people who have worked hard played by the rules and earned our benefit programs. There are those who due to mental and physical handicaps are unable to earn these programs and THEY should be taken care of . The others will bring our society down.
    An interesting argument is that illegal immigrants will not be eligble; how long do you think it will take an ACLU lawyer and a liberal judge to declare this as discrimination and force us to pay for their benefits.

    December 21, 2009 at 16:28 | Report abuse | Reply
  46. Tammy

    Question #1: What about illegal immigrants? If they still use our hospitals & medical care for free, bringing children to the ER constantly without insurance & not paying their bills, how will that change? won't they still be a drain on the system?

    Question #2: Why should I be forced to have insurance? I can't afford it? My husband and I are reasonably healthy & find it's better to put our money in savings, where it earns interest, and then if something comes up, we'll either pay the bill or work it out.

    December 21, 2009 at 16:31 | Report abuse | Reply
  47. Jeanne Navagh

    Interesting question... I am covered along with my son and husband under his employer's high deductible plan. I work in a small accounting firm that offers our small business clients health insurance. (we are the broker, I do the paperwork)

    From my perspective, I see health insurance premiums go up between 10 – 15% each year. I have seen little discussion of that particular problem with regards to health care reform, I haven't seen anything that addresses the cause of these increases . (for example our local Blue Cross has over 10,000 different plans that are active)

    I think that the cost of health insurance will simply continue to increase for both businesses and individuals, at some point this will start causing serious problems. (A typical EPO here in Rochester NY runs around $950.00 per month for a family, and $300.00 for a single... if you make $10.00 an hour....)

    December 21, 2009 at 16:32 | Report abuse | Reply
  48. Alan

    Until benefits kick in, I'm not paying a dime for coverage I won't receive. I also refuse to pay a penalty for refusal to buy into insurance that does nothing for my immediate medical needs. Does that mean I have to go to jail? And what of the costs? A lot of hearsay being thrown around that the so-called "exchanges" will provide for low cost insurance, but how much are the premiums going to be and what are the deductibles? As a single, middle-aged, self-employed person, I can't afford the options available now, and I see nothing that says I'll be able to afford them once this legislation passes. Last time I checked for "affordable" insurance, I was quoted $300 per month at $10,000 yearly deductible, and NO pre-existing conditions. Is this new law going to be able help me do better than that? I have serious doubts.

    I'm sorely disappointed in this and seriously thinking of moving to another country that supports the health of it's citizens.

    December 21, 2009 at 16:36 | Report abuse | Reply
  49. Joshua

    I live in Boston, Massachusetts and I am a Registered Nurse working in the Emergency Room in an area hospital. I have worked in the Emergency Room setting for many years now and I enjoy the challenges associated with my profession and work environment. I have also returned to school to pursue my advanced nursing degree to become a Nurse Practitioner. In my experiences, I have witnessed an increase in the amount of patients presenting to the Emergency Room with primary care needs. Patients cite that they are unable to get appointments in their primary care offices, and therefore turn to the Emergency Room for their needs. In my opinion, these patients would be better served in a primary care setting. Primary care practices are familiar with their patients and their care plans, whereas the Emergency Rooms are not.

    I would like to know how the US health care reform will improve access to and quality of health care for Americans. So far, I am only hearing that the focus of health care reform is to provide insurance coverage for Americans. I do not understand how an insurance policy or insurance card will help someone if he/she cannot get an appointment with a primary care provider. It seems like providing insurance coverage to Americans is only part of the solution. Another large part of the solution is providing access to health care providers. Since fewer physicians are electing to pursue primary care, and patients are having a difficult time obtaining appointments, I think access to health care is another critical issue that needs to be addressed. How is the health care reform bill going to ensure that all Americans have access to health care and providers? As you may know, nurse practitioners are primarily trained to care for the primary care needs of patients. Is there any plan for US health care reform to develop and expand the role of the nurse practitioner to enhance access?

    I believe that the nurse practitioner role is a valued role that is essential to improving access to the American health care system. It would be a shame to go to all the trouble of health care reform without addressing how Americans will be cared for. It would be like the government giving everyone in America a membership to a video rental store, but not making sure that there are enough videos for everyone to rent.


    December 21, 2009 at 16:40 | Report abuse | Reply
  50. Amy

    The media have done a lousy job of explaining what's in the bill. They focus on the political drama of right vs. left, instead of what will actually happen. People are deciding they are for or against this bill without the slightest idea how they will be impacted. How about some clarity Dr. Gupta?

    December 21, 2009 at 16:41 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.