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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. Ginny Miller

    How much is this "reformed" health care system going to cost the people going to cost? This is one of my resounding concerns. People who now have good health insurance will have to pay for the uninsured how may not benefit? This is truly scary to me.

    My other real concern is that the Pre-existing condition clause is being taken off the table, from what I understand. My son and I have multiple conditions. This would leave us potentially uninsurable under new legislation. My son is now 18 and will soon not be under our plan. I will be changing jobs soon and need new insurance.

    The current Congress has not been able to show us that they can manage Social Security and the current Medicare/Medicaid programs. How can they manage the magnitude of Universal Healthcare? Insurance companies now try to tell physicians how to manage my son's complex health issues as well as my own. I do not want the Congress to interfere in the decisions as well. They are equipped to decide on laws to govern the Land, not our health future in the volume they have taken on. They are not doctors.

    People who are uninsured do need help. What is the cost and will it be worth what is lost to the rest?

    GM

    December 21, 2009 at 20:44 | Report abuse | Reply
  2. Robert

    I'm just amused how anyone could be against Health Care Reform, when there or so many people out there that either don't have health insurance or can no longer afford the health insurance they have. It must be very nice to be one of the people who ate the whole pig while giving out the feet, tail, nose, ears, and intestines to the other poeple.

    Well let my say that, "There will come a time when does that are in the front; will be the ones that are in the rear.

    December 21, 2009 at 20:51 | Report abuse | Reply
  3. Tom B

    Will it affect me? I sure hope so.

    i m a small business owner. I cannot offer any reasonable healthcare to my employees. Why? My son was born with a pre-existing condition. We have insurance for family coverage at roughly 1500$ per month, and 2500$ deductible per person. Aside from the fact that my son is uninsurable for life, as a group, I can only offer the same coverage to other employees, which basically that means I can employ only those whose spouse have coverage (Ironically, some of these are the get the government off my back people hell bent on rejecting any reform while their spouse works for the government, so they can be on the government plan, screaming all the way: no government plan for me!). As a small business owner, that puts me at a distinct competitive disadvantage in trying to attract employees. Hopefully this will level the playing field.

    Finally I may be able to afford reasonable health insurance for my family.

    Maybe so can my neighbor.

    Maybe I can now hire the same people that large corporations can.

    Maybe my son can get health insurance when he becomes independent.

    Will it affect me I think so.

    December 21, 2009 at 20:53 | Report abuse | Reply
  4. Mary

    Why are people under the assumption that bringing more people on board and with the elimination of pre-existing conditions do anything other than increase our premiums and reduce our coverage? I am very healthy but if I need to start paying for everyone with illnesses I will need to move to Nebraska where it will be FREE, paid for by the rest of our nations citizens .

    Thank heavens for our public minded Senators. How do they, and the rest of their cohorts, sleep at night?

    December 21, 2009 at 20:57 | Report abuse | Reply
  5. Henry

    I wonder if any of the people that wrote with such apparent authority criticizing this bill have any idea about what it actually says. I have never seen such authoritative words coming out of such obvious ignorance. Where did they get their information? Probably from either Fox News or Sarah Palin's facebook page. Thank you, Amy for pointing out what a lousy job the media has done in explaining it (other than Fox News who explains well something that unfortunately has no connection to what the bill says). My favorite comment is from Mike who, after quoting a number of statistics that should cause anybody to become super impressed by his knowledge, proceeds to lay the biggest egg of all by implying that the bill will cause a "complete takeover of insurance by the government.!!!!

    December 21, 2009 at 20:58 | Report abuse | Reply
  6. Lauren

    4 years to wait is unacceptable! If the government can bailout the bankers so quickly, they can surely do the same for the many people who need help NOW!

    December 21, 2009 at 21:04 | Report abuse | Reply
  7. Josh

    I can't believe that people in these comments dare to say that a reform is not necessary because the healthcare is really good already. How ignorant can you be. 40 Million people without healthcare is okay in your eyes??

    Shame on you! I also can't believe that probably the same people that are complaining here are the most dedicated catholic church goers possible. But they are too cheap to pitch in and pay a little extra to help those in need with healthcare.

    Yes, your taxes will go up. No, this is not the end of the world. Look at your northern neighbor or Europe... and don't tell me healthcare in Europe is worse than here cause it simply is not. I bet that if you spend little more than 5 minutes talking to your friends/family, you will find somebody who is struggling because they cannot afford or don't have insurance.

    Healthcare reform is necessary, period. Even if this bill is not written by god himself, it is a step closer to a good life for many people!

    December 21, 2009 at 21:08 | Report abuse | Reply
  8. Mick

    I think people are being extremely short sighted on this bill. First, stop expecting perfection first time around. This is going to be an iterative process over decades. But we have to curb runaway costs now. Second, we need to provide health care for all Americans at a basic level. this means everyone gets basic coverage and everyone who is able needs to contribute to it.

    On the flip side of this, there needs to be action taken now to stop immediate abuses of the drug and insurance companies trying to accelerate the bilking of patients, knowing they are going to be curbed in the future. I watched my coverage of my wife and I go from $145/mo to $630/mo starting now. Basically they are resetting the baseline. Trying to say their cost basis is higher than historically, so when they are told to cut by a percentage, they can base that on the most recent premiums. Hope they do something like start it at end of 2008 premiums.

    December 21, 2009 at 21:14 | Report abuse | Reply
  9. Ange

    Dr. Gupta,

    What are the specifics in regards to provider reimbursements? If you could, address both physicians AND hospitals.

    The last I heard, a separate bill passed earlier this month that negated any decrease in provider reimbursements and I sincerely hope that this has not changed.

    Medicare reimbursements already stink for providers and they have been going down. Some in my practice have already elected to pull out of Medicare and I know for sure that if any significant decrease occurs that I as well may be forced to pull out of Medicare.

    While I am on the subject, why can't providers "balance bill"?? Those providers that need patients won't charge any more than Medicare pays and those that are overbooked already will bill for a balance to keep their patient load tolerable.

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

    Any healthcare plan for the ones that right now have none is better than no healthcare plan at all.
    As the years go by, the rough spots can always be ironed as we go.
    This is a very important step forward in the nation that claims to be the richest and most powerful in the world, but yet has been ignoring the health needs of it's citizens.
    It doesn't make any sense that welfare recipients get full medical coverage for free while modest working people, that work for minimum wage get none.
    Healthcare the way it has been until now is a shame to the USA.
    Let's take care of our people right here at home before we go spend billions helping other countries.

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

    This healthcare bill is a disaster. It is very bad policy, will cost us a great deal of money and will destroy our health care system.

    December 21, 2009 at 21:22 | Report abuse | Reply
  12. Jim B

    Dr Gupta: My wife and I are 63 years old, in good health, retired, and deeply concerned about this bill. One of the major sources of funding for this bill (both House and Senate versions) is $460 Billion in "savings" from Medicare based on the government doing things "more efficiently". Remember, earlier this year there was a $787 Billion stimulus bill which contained $2-3 Billion to do "comparative analysis" studies for health care. One of the studies funded with this money was a cost/benefit analysis of mammograms. The results hit the news in the past month or so, and caused much controversy since it recommended drastic cuts in the frequency of mammograms and increase in the age at which tests should begin. This sounds like "rationing" to me and that's the only way the Government can get $460 Billion out of Medicare. What's next – reduction in PSA tests, colonoscopies, endoscopies, MRIs, CT Scans, blood tests, etc based on Government studies?

    December 21, 2009 at 21:22 | Report abuse | Reply
  13. Katie

    As long as insurance companies are "for profit" enterprises, affordable healthcare for all will remain a pipe dream. The AMA supports the Senate bill, and with their deep pocketed lobby, I have to wonder where this leaves the consumers. I'm a healthy middle aged, non-smoker who very rarely goes to the doctor at all, but because I was diagnosed with "exercise induced asthma" when I was in college, my premium for a high deductible plan is $300+/month. I simply can't afford to pay $3600/year for the priveledge of having to pay $5000 before benefits kick in. I sincerely hope this bill helps me be in a position to afford health coverage in case something big happens, but given that insurance companies will still need to weed out the riskier customers in order to show a profit, and given that the AMA is on board, I'm extremely skeptical.

    December 21, 2009 at 21:31 | Report abuse | Reply
  14. Dale

    My wife and I are 51, self-employed, also we both work part time jobs for extra income for bills. We currently pay 750 per month for premiums, with out dental. In 2009, total cost of our health care will be $11,500, more than our total house expenses. The last 2 years our prems have gone up 15% per year, you figure the math, at that rate at 55 we will pay $1311per month, at 59 $2292 per month. I guess we don't need change.
    Wake up everyone, alot of big companies have been dropping pensions over the years, soon to be competitive with foreign companies that have socialized medicine your medical benefits will be gone also as the jobs leave our borders. Don't know what the answer is but if you gain 50 lbs per year something has to give, chances are your legs will be pulled out from you. Wages and profits can't go up 3% and medical costs go up 15%. 20 years from know this will be to much weight to bear.
    Take care everybody

    December 21, 2009 at 21:34 | Report abuse | Reply
  15. Terri Richards

    I am a nurse and a new business owner. I train medical office staff how to perform prior authorization for advanced imaging studies(MRI, CT, PET and nuclear medicine scans) that are required by health insurance companies. I am a former senior nurse reviewer for one of the largest advanced imaging management companies in the country. My experience is that medical staff are poorly trained to perform this task and frequently have their studies delayed or denied because of it. The health insurance companies do not provide any comprehensive training for these medical offices. It was also my experience that some medical providers are still poorly informed about which radiological studies are appropriate for certain disease processes. Unfortunately, the denials of such studies are translated by the patient and the doctor as blatant denial by the health insurance companies. I am by no means a fan of "for profit" health insurance companies. It is my opinion that we need the government to step up to the plate to take the reins on the runaway costs of health care. I don't see anyone else doing it. Certainly the health insurance companies are not going to do it. The medical community is not going to do it. They have just accepted status quo. Many Americans are suffering right now. All you have to do is read some of the stories like those written in this blog. Here are some stats from the CDC:
    •From January to June 2009, 45.4 million persons of all ages (15.1%) were uninsured, 58.4 million (19.4%) had been uninsured for at least part of the year, and 31.9 million (10.6%) had been uninsured for more than a year.
    There is a large group of our citizens who live each day praying that they or their family members do not get injured or sick. I am hopeful that the new bill will help protect these Americans and give them some peace of mind. It is unfortunate that it is going to take several years for it be fully implemented. Some people are just not going to be able to hang on for that long. That is the sad part.

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

    Well said Mike! I agree with most of your comments except the last paragraph. Referring to government participation in healthcare, and government regulation of healthcare as "complete takeover of insurance" is wrong.

    In any sport (industry) you al ways need the rules of the game, and referees who are empowered to monitor conformance to the rules. Without them, the natural tendency is for people and businesses to cheat and bend the rules in order to win.

    In the current system, there are many examples of practices that are unfair becuse they are not against the current rules. It is unfair to not allow people with existing conditiond to get insurance. It is unfair to raise ones premium becuse they suddenly become sick. It is wrong and even sad that insurance cannot be carried across states. And most of all, there is something fundamentally wrong with the amount of money charged for medical procedures!!! And there appears to be no ceiling to the ammount that can be charged!

    Perhaps the public option – as a low cost alternative to the profit-motivated health insurance industry is really what is needed! I believe that we need a lower cost option - for sure! If government can provide it, that is a wonderful thing, not something to bve derided!

    Cheers,
    David

    December 21, 2009 at 21:37 | Report abuse | Reply
  17. John Patterson

    Given the advertised savings of 500 billion on medicare, as one of those of us that are seniors on medicare , it defies logic to think those kinds of savings can be achieved without severe cuts to the system we depend on. It seems that the democrats have pretty much written us off as being conservative voters that really dont matter to the democratic party. Even the AARP who are charted to look out for the best interest of seniors seem to have sold us out. Unlike the rest of the provisions, the medicare cuts come immediately. Yet the congress does not seem to have the will to cancell the antitrust exemption for insurance companies, or cap the damage awards for malpractice, or even to have the ability for the government to negotiate drug prices. However, they are quick to buy votes anyway they can to pass an unpopular bill. I am afraid that the people we trusted to represent us have betrayed us all. .

    December 21, 2009 at 21:42 | Report abuse | Reply
  18. Horse

    I am genuinely frightened as I read most of these e-mails. Barely any of them have listened to or read your postings before..., or even CNN's very helpful "fact or fiction" analysis they have done from time to time. Most writers seen to only listen to the Sara Palins of the world (death panels) or their neighbors who listen to Sara Palin.

    I'm very glad you have started this blog because the degree of apparent hysterical ignorance is alarmingly pervasive.

    December 21, 2009 at 21:46 | Report abuse | Reply
  19. EMT

    I'm sick and tired of hearing about the billions of dollars this bill will "save" over 10 years.

    Guess what? We're be spend AT LEAST 1 TRILLION DOLLARS much, much sooner than that!

    We're already TWLELVE TRILLION DOLLARS in debt!!!

    Enact tort reform.
    Open up every private insurer to residents of all states.
    Seal the border.
    Remove illegal aliens.
    End the "dry feet" policy in regards to immigration.

    Those 5 measures will save more money, and insure more people, than anything Harry Reid can come up with.

    December 21, 2009 at 21:59 | Report abuse | Reply
  20. norm

    Just find it hard to believe that the richest country on earth continues to treat health care as a for profit business. this the first small step but the only solution is a single payer medical system, the day will come but far to late for many.

    December 21, 2009 at 22:05 | Report abuse | Reply
  21. TK

    I lost my mom to a very aggressive uternine cancer when I was only eight, she was only forty. The type of cancer she had was leiomyosarcoma. My mother was diagnosed at 28 and lived with cancer for twelve years, she rarely missed any days of work and she worked so she could keep her insurance. She was proud of her job and she knew that she had to work hard to keep the health coverage she needed. Sadly she died in 1992, but her health insurance left us with very few medical bills.

    My father was recently diagnosed with prostate cancer, unfortunately the type where "watchful waiting" is not an option. He is 64, and underwent cyberknife and is expected to have a full recovery. He is on government insurance since he worked for the government for nearly forty years. From my understanding, this bill will not cover cyberknife nor will it cover many cutting-edge treatments.

    Dr. Gupta, many people who already have insurance barely have the access they deserve. I believe in healthcare reform but not this way and not this fast. As the daughter of parents who have had cancer, I am saddened that this may pass. Without my mother's insurance she could have died much sooner than she did and my father would not have received the cyberknife treatment. I already lost one parent and I am very fortunate that my father beat his cancer before this legislation passes. This healthcare will not provide the access that everyone thinks they will receive, it will only push it back. People who do not have insurance now do deserve coverage regardless of pre-existing conditions and they should not be dropped when they are "capped out." But, there are many Americans, nearly 65% of us, who are opposed to this reform and are happy with the coverage we have.

    Am I really supposed to believe that if my employer has an option of paying for an employee-sponsored plan versus a public option that I won't be forced to a public option? Our politicians don't have our best interest at heart and it's very unfortunate that they are oblivious to the cries of the American people.

    December 21, 2009 at 22:09 | Report abuse | Reply
  22. M.J. in Dallas

    I'm reading comments such as the one from Kathy Bates @ 3:09 p.m. and I continue to be stunned at the comments people make about the potential impact of health care reform. The time is long gone when people can afford to remain uninformed about the actions of government and its representatives. Americans can either make the effort to get the facts independently from a range of sources and different perspectives, or they can be fed a further line from any party that supports their existing preconceptions and tendencies. It's that last lazy option for obtaining info that seems to be winning the "information" wars and the results are frightening.

    December 21, 2009 at 22:14 | Report abuse | Reply
  23. vince

    As a senior resident in a surgical subspecialty at a major trauma heavy institution, I've had the opportunity to view this from both perspectives. While this bill may improve access of some of the "uninsured" to some basic level of care, it will do so with huge tradeoffs that think it will leave us all gravely dissatisfied. This bill allows government direct access to the doctor patient relationship and will allow beurocracy to dictate the manner in which surgeons treat patients. With an incomplete resolution of the medicare/medicaid issues and limiting reimbursement for procedures, patients will deal with longer delays for elective nonemergent procedures and limited options. For an example of a government run healthcare system, look no further than the VA system to see a model of inefficiency and frustration that will only be magnified... one that the millions of Americans with private insurance would not tolerate. It will be curious to see whether we face the same issues we do now, with fewer specialists being able/willing to treat certain types of coverages. Will the government "force" doctors to cover certain patients or will physicians continue to adopt more of an "out of pocket payor" attitude with respect to non-emergent surgeries? I agree with posts above that the amount of $ saved is ultimately pretty close to a wash. Furthermore this bill does little to address tort reform. It's no wonder that so many are starting to realize that change for the sake of change is a huge mistake. One that will leave us all with a horrible taste in our mouth. Good luck to all.

    December 21, 2009 at 22:36 | Report abuse | Reply
  24. ann

    I can't understand AMA asking for plastic surgery breaks and turning a blind eye to tort reform.

    December 21, 2009 at 22:37 | Report abuse | Reply
  25. Sourav

    Will the health care reform cover ABA therapy for Autism for Self Funded Employers insurance plan?
    If notthen that's sad; if yes when will the coverage start?

    December 21, 2009 at 22:42 | Report abuse | Reply
  26. Kevin Snyder

    I have a child with autism. Will this reform involve mandating coverage for proven therapies for treating autism? My insurance company will not cover ABA therapy, and will only cover a limited number of other therapies such as speech and OT/PT. My child also benefits from diet and other non-traditional treatments which are not currently covered.

    December 21, 2009 at 22:42 | Report abuse | Reply
  27. Don from Nevada

    Let me get this straight. It's 2100 pages+/- compiled behind closed doors that was released less than 48 hrs before they voted on wether to end the debate on it. Numerous Democrat Senators "sold" their votes in exchange for "special treatment" for their states and they are bragging about it. The CBO has said it will cost a trillion dollars or so, based on the numbers they have been provided with by Reid, but does this include the cost of the payoffs and special deals to the various states, which is hundreds of million of dollars, some annually
    paid to the various "special states" in the form of Medicare/Medicaid subsidies. And we have to pass this by year-end for what reason???

    I guess I don't need to go to my proctologist this year, the Congress beat him to it!

    December 21, 2009 at 22:53 | Report abuse | Reply
  28. C L

    Anytime we taxpayers & citizens have to depend on the government for anything, we're screwed!

    When did the oval office perpetuate clandestine votes on something that affects each of us.

    Where was the information posted online & televised so we taxpayers & voters would know what we were getting sucked into? President Obama promised the American people that everything under his administration would be transparent.

    We won't know what this truly means to us until long after the next presidential election. Heaven help us with the the politicians currently in office & their sneaky-underhanded dealings.

    Shame on the President!

    Shame on the Senators in office who refuse to put the information out publicly so taxpayers can be informed & see what we're going to be stuck dealing with & paying for. Shame on the Senators who listen to party lines more than they listen to the voice of the taxpayers. This should be put to a vote by taxpayers, not the elected officials.

    How many people would have voted for Pres. Obama if he would have campaigned for Health Care Reform? Why won't the elected officials implement Torte Reform instead of screwing with our individual health. My health is my business. I certainly don't want the government involved in my health care. That's between me & my doctor!

    December 21, 2009 at 23:01 | Report abuse | Reply
  29. Alleycat

    They up on the hill could make this very EASY.......ON PAY!
    Based on a sliding scale, everyone pays what they can......
    Other countries do this as well as some other states.
    My father who would be 90 if he was still alive never had employee insurance.

    Taxes should be the same way.......same percent across the board..no deductibles just based on a percent...PERIOD.
    Think of all the taxes that would save the Gov't that pays these paper pushers.........

    This won't happen because too many elected officials are filling their bank accounts on the backs of the middle class.

    December 21, 2009 at 23:03 | Report abuse | Reply
  30. Dave Kirkey

    1. The dealings by Obama and Reid on the Health Care payouts is shameful... and equates to a Whore and a Prostitute negotiating for favors nothing less!

    2. I actually believe that when Obama talked about Nationwide Healthcare as he was talking about "Free Healthcare" what will these 30 – 40 million say when they find out that not only will it cost them $500-$1,000 per month and if they don't pay it, they will be fined.. This will start quite an uprising in the country....

    3. What else can you expect, Obama comes from Illinois a state political atmosphere that has been filled with Crime, bribery and filth for years... Obama is now just carrying on his normal way of business on a national scale!

    4. I would love to see the press address line by line, what Obama promised and what he failed on.. but it seems like the Thugs watching his back have to much power to let that happen.. .

    What I found when asking my investment counselor in what to invest in next year.. . All he did is smile and tell me to invest in Canned Goods and Ammunition.... I actually think he is right..

    God Bless America and hope Obama's 4 years of destruction goes quickly!

    December 21, 2009 at 23:04 | Report abuse | Reply
  31. James

    I work for a large medical device firm that pays good wages, great benefits and provides jobs. We are a growing business. Although I support expansion of healthcare for all I have many concerns. First, the government has asked my industry for price concessions to control costs while double dipping with the innovation tax on medical devices. Our company already reduces the cost of healthcare through development of less invasive procedures which shortens hospital stays and recovery time. Why isn't the government taxing the scofflaws like Walmart who don't offer meaningful benefit programs? Meijer, a competitor who is unionized has always offered full benefits to anyone working over 20 hours per week. Why not Walmart who is privately held by billionares? Second, I suspect that my healthcare will be deemed a "Cadillac" policy so I will be taxed. I'm already taxed on "imputed" income for my domestic partner's benefits and I estimate it's probably well over $1000.00 per year in taxes. I expect it to at least double. I understand they will repeal the domestic partner imputed income tax but it would be replaced by the same tax with a different name. Will this be on just the employer portion or are we, in effect, going to lose the pre-tax deduction for our healthcare premiums as be taxed on that portion as well? Third, there should have been some type of public option to compete with these greedy insurance companies. There is too much profit taking by these firms which significantly increases the costs. That being said, I do not favor a single payer system which would allow our inefficient and corrupt government to control healthcare. What about illegal immigrants? Someone must be paying for them even today since no hospitals check their citizenship prior to admittance. Our next target should be a strenuous immigration reform bill to stop these illegals from costing states billions in health care and law enforcement costs.

    December 21, 2009 at 23:12 | Report abuse | Reply
  32. Jonathan

    As a physician, I feel that Congress has been thoroughly disingenuous billing this as a health care reform bill. Not even a shread of tort reform, which would have, overnight, reduced cost dramatically.
    Ignoring the sheer numbers of healthcare professionals who feel the new measures will make it harder for everyone to find a doctor, Congress will have done the worst of injustices to the American public.
    I feel bad for all the senior citizens who were duped into voting for President Obama. Now they have to reap what they sowed.

    December 21, 2009 at 23:19 | Report abuse | Reply
  33. karen

    Corba runs out for my husband in February 2010 and will have to find a policy that will take him due to highblood pressure, diabeties, etc. until he becomes 65. Anything congress does will be too late to help us now because whatever is passed will not go into effect until 2013 or later.
    By the time compromises are made between the House and Senate we will have nothing but donut holes. Politiations win,people loose.

    December 21, 2009 at 23:28 | Report abuse | Reply
  34. Fred Bridgers

    The most disturbing aspect of the Health Care reform bill is that no one person can really tell what the personal impact will be. The far right and far left in Senate have intentionally confused the issues in public statements and debate for purely political gain. They don't want the American electorate to understand the future of health care (as we currently know it or as it may look after reform), They just want to use healthcare as an issue to gain advantage in the upcoming 2010 elections. The insurance and drug lobbies only want to make certain that Healthcare reform either maintains or increases their current levels of profitability. No matter how many times you repeat the fact that most of the healthcare reforms included in this bill do not kick in until after the end of the first Obama administration, I seriously doubt that most people will pick up on this until after a Reform Act is passed and they begin asking "where's the beef". The 2010 mid-term elections will give Washington its first inkling as to how the American electorate feels about the efforts of this Congress and I am afraid that it will be open season on all incumbents. And that may not be a bad thing.

    December 21, 2009 at 23:33 | Report abuse | Reply
  35. Liam

    I really don't think this bill will affect me except to raise my taxes and my sons taxes and my grand children's taxes. However there are a few questions I would like answered. Why reinvent the wheel instead of fixing what we already have? What is the reason for the rush to get it passed? Could it be that they don't want the people to find out how really bad it is until it is already passed. If this program is so good why are members of Congress exempt from being covered by it? If it is good enough for you and me it is also good for members of Congress. If it is so good why did the Democrats have to buy votes through the use of Pork to states of hesitant. This from a man who promised during his campaign NO MORE PORK; another lie. The members of the Senate and the House would sell their own mothers to say they passed another "feel good" piece of legislature. Come November vote ALL the INS out.

    December 21, 2009 at 23:40 | Report abuse | Reply
  36. Dotti McKee

    I spent months caring for my sick daughter in Australia. Her medical expenses were paid for. Never a pharma ad on TV, her meds including oxycoten were almost free and her doctors were great. Australia spends it money on its People. We spend our money on big business, big pharma, big banks which don't give back, illegals, big defense for Iraq and Afghanistan. Greedy politics is well exposed in this Medical Bill. How much longer will our citizens permit such despicable actions by our pathetic politicians. Will our voices ever be acknowledged? Will they stop before they destroy this country?

    December 21, 2009 at 23:44 | Report abuse | Reply
  37. Sandy Tracey

    I am glad you explained that this bill goes into effect in 2014. I am a former Republican legislator from WV. and I want this Health Care reform.
    I think there is alot of information not being considered, because of my party's effort to hurt President Obama and the Democrat Party. Frankly, I'm disappointed with them.

    First the conference committee can and will make a lot of changes. Instead of just saying no, it would be in the interest of the country if we could have an honest discussion on the specifics. So, it would be great if the media offered the options in logical explanations and limited the political attacks.

    Next, the bill provides for gathering information that will provide real facts, so we can find out what things wil cost before it goes into affect.

    I have priorities I would like to see in the bill. I am 62 and I am on a Widow's pension. My insurance premiums are $600 a month. I am judged healthy, but I have a previous event that makes it impossible for me to switch carriers. I would really like to buy into Medicare.
    I also would like to find long term care insurance. No carriers will insure me because of my previous incident. I don't want to have to go on Medicaid if I need to go into a long term facility, I want to purchase insurance instead.

    If we get health care reform legislation passed into law, then Congress can make changes or adjustments as they have with Medicare or other legislation. We need to get it started by passing it into law.

    As a country, we have intelligent people who care about the future and many of them have endorsed passing legislation: doctors, nurses, physical Therapists, AARP, Hospitals, Clinics, and people like me who are taxpayers.

    2014 is 5 years away. It needs to be passed now. We need it. We need to stop the attacks and make Health Care available for all of our citizens in five years .By that time I will be 67. So I am asking for my children and grandchildren.

    December 21, 2009 at 23:54 | Report abuse | Reply
  38. Harry

    Do I understand it correctly, that if I don't buy insurance I would be fined $750/year? At the same time Insurance companies will have to insure everyone, even with pre-existing medical issues. Am I missing something, but logic would suggest that I pay my annual $750 fine, wait till I need insurance for a serious medical problem and then apply and get full coverage, even if I end up in the emergency room unexpectedly I'm still covered.

    The money I would save between what insurance actually costs me and the $750 will more than cover most all of my annual medical costs. Sound like a great plan, too bad this will cause premiums to rise materially forcing more people to opt out and pay the relatively cheap fine....

    The other sad outcome, is that young people will be forced to buy insurance when many really don't need it- which essentially is a tax to cross subsidize the older and sicker clients. Its another wealth transfer this time from the youth to the elderly, rather than the usual soak the rich because they can. Well at least its a change of pace. I actually think it will convert many young democrats to the republican party when they realize what just happened to them.

    What is so tragic, is this administration is moving forward when so many are against it- I cant wait till mid term elections- I'm going to dontate to the republican party like never before- the democrates will be out of office for a very very long time. Stupid stupid stupid- actually sad sad sad!!!!
    Harry

    December 21, 2009 at 23:58 | Report abuse | Reply
  39. Bob

    Well,

    It won't affect me at all, I live in a country with universal single payer health care that has better outcomes than the US system at about 50% of the costs.

    Actually, now that I think about it, it does affect me. It depresses me that my American friends must suffer under such a screwed up health care system and that their political system is too corrupt to really fix it.

    December 21, 2009 at 23:59 | Report abuse | Reply
  40. John L.

    The bill, as I understand it, only penalizes people that don't get insurance with a fine of $750/year. But the bill also says that insurance companies must accept you, even if you are sick (pre-existing condition) at any time.

    So why wouldn't I just pay the $750 yearly fine and, if I DO come down with a "serious illness", just immediately sign up for the insurance? My premiums won't be any higher than someone else who has been insured by the company for several years that becomes suddenly sick with the same illness (the bill prohibits that, from what I understand).

    So what's the incentive for someone like me to buy health insurance now? Wouldn't I be better off financially if I just pay the $750/yr fine and then sign up for healthcare several years down the line when I do get seriously ill?

    December 22, 2009 at 00:12 | Report abuse | Reply
  41. C. Harmon

    There are many heartbreaking stories about people who are denied health care or are unable to afford it. There are stories about people losing their homes and jobs. Is the government really going to fix all of these problems or make it worse? They can't provide health care for everyone just by passing a law. Where will the money come from?

    Is it really a constitutional right to be married and receive health care when you can't afford it? Should you really sue to make others pay for the bad things (accidental) that happen in life? Do we really want to be a socialist country that lets the government make our decisions for us?
    We need to start asking questions. What will happen when all of the doctors leave health care because of this legislation? (My husband is a physician who is considering leaving his profession if this legislation passes, along with many of his colleagues.)
    Hospitals are already struggling to provide high quality care when many patients aren't paying bills and the government run programs don't even reimburse costs. Is this bill going to decrease the quality of care available and stop advances in medicine?
    By demanding high quality care at low cost are these politicians really going to be able to just say it and make it happen? Are they magicians? Why aren't the members of the media asking more questions?
    Printing more money is sinking the dollar, increasing the national debt is sinking our economy, and writing a bill that just states wishful thinking is going to sink the quality of health care available. We haven't won any lotteries and Obama doesn't have any magic powers. Why isn't Obama focusing on creating jobs that will continue to be in demand? ( production jobs for necessities, not luxuries)
    We really need to start questioning the authorities we have given our politicians and hold them accountable for the mess they are creating.

    December 22, 2009 at 00:17 | Report abuse | Reply
  42. C. Harmon

    There are many heartbreaking stories about people who are denied health care or are unable to afford it. There are stories about people losing their homes and jobs. Is the government really going to fix all of these problems or make it worse? They can't provide health care for everyone just by passing a law. Where will the money come from?

    Is it really a constitutional right to be married and receive health care when you can't afford it? Should you really sue to make others pay for the bad things (accidental) that happen in life? Do we really want to be a socialist country that lets the government make our decisions for us?
    We need to start asking questions. What will happen when all of the doctors leave health care because of this legislation? (My husband is a physician who is considering leaving his profession if this legislation passes, along with many of his colleagues.)
    Hospitals are already struggling to provide high quality care when many patients aren't paying bills and the government run programs don't even reimburse costs. Is this bill going to decrease the quality of care available and stop advances in medicine?
    By demanding high quality care at low cost are these politicians really going to be able to just say it and make it happen? Are they magicians? Why aren't the members of the media asking more questions?
    Printing more money is sinking the dollar, increasing the national debt is sinking our economy, and writing a bill that just states wishful thinking is going to sink the quality of health care available. We haven't won any lotteries and Obama doesn't have any magic powers. Why isn't Obama focusing on creating jobs that will continue to be in demand?
    (production jobs for necessities, not luxuries)
    We really need to start questioning the authorities we have given our politicians and hold them accountable for the mess they are creating.

    December 22, 2009 at 00:19 | Report abuse | Reply
  43. Ron Bodary

    If I read the CBO's letter to Sen Reid ,Dec 19,2009, correctly(bottom of page 13), I wonder how much access Medicare patients will have to physicians when Medicare cuts payments to physicians by 21%... beginning in Jan 2010.

    December 22, 2009 at 00:30 | Report abuse | Reply
  44. Brian

    I think this bill is a good thing. We really needed the public option, but some reform is better than no reform. I have paid for my insurance through group and private plans for my entire working career, and anyone can see costs are rising. I have no doubt that it really will be unsustainable eventually, and I applaud the Senate and House for the steps they have taken.

    When my daughter was born she was in NICU for two weeks. The total bill was $21000. The hospital and/or Humana decided to code $20000 of the bill under "miscellaneous charges", and Humana prompted told us they did not pay miscellaneous charges and proceeded to wreck our credit over the next two years. Finally we received advice to contact the Department of Insurance in our state, and we did, and they resolved the issue within a matter of days. This is not the first nor the last time I was disappointed with medical insurance. I have always purchased the best plans available, and they usually fall short.

    In my experience, you simply cannot rely on insurance companies to do the best for you. They will do the best for their profit margins. Regulation is sometimes a good thing.

    December 22, 2009 at 00:30 | Report abuse | Reply
  45. PeterH

    I truly understand wanting to get people insurance, especially those who had it and were dropped or have a pre-existing condition and can't get it. Unfortunately, I don't think the "health reform bill" is the answer. When it is so convoluted, that very few people have read it, it is going to be as screwed up as our tax laws. And if this is the right thing to do, why is it taking backroom maneuvers and special provisions for different states to get it through. As has been pointed out numerous times, no government agency is ever the model of efficiency. We haven't done it with social security, medicare, etc... President Obama pointed out that we can save money by curtailing spending/fraud in the Medicare system. If everyone knows it's there and it is so easy to identify, why don't we correct that first and then with the money we save, do something, instead of the other way round. I think doing something to say we are doing something is wrong, just like a "vote for change" isn't necessarily a vote to make the right changes. Haven't seen the transparency that was promised.

    December 22, 2009 at 00:31 | Report abuse | Reply
  46. arclight, Sonoma County, California

    General: I am mightily disappointed by the current legislation, since, in simple terms, WE CAN'T AFFORD IT and, ultimately, it will end up being "too much too late!" And the pols, our ever hapless pols, who are hip-deep into and consumed by this thing as if they have always wanted it, they can't even tell the public, honestly, what the projected costs will be! Non of these clowns have read it. Even the CBO has been waivering on real costs in the past couple days. (I don't think the CBO is independent at all! This is an urban myth.) So, for right now, I repeat, the legislation WILL NOT BE AFFORDABLE and what is being developed in our un-hallowed halls of congress just might end with the cure (Obamacare) being worse than the disease (our present state of healthcare)! Why couldn't our feckless pols get this one right and attack one facet at a time vis a vis healthcare, like put $20BN into a fund that would exclude anyone from BK due to medical bills, for a start.

    Economic Control: Also I am now confused, as are too many politicians involved in this thing, will the U.S. government come to control 1/6th of the U.S. economy which represents healthcare's share of our GDP as things look now? This is a frightening thought if this were actually to come to pass. This would be akin to using a cannon to shoot off one's foot!

    Pork: And just how much pork is in the legislation as of right now? I think there must be billions of earmarks attached to this political fraud in motion. What has come together certainly is not a altruistic exercise and you would think healthcare for those "who don't have it" would be an altruistic concern. Alas, there will be gigantic heapings of pork as a part of something we already CANNOT AFFORD! Further, I view the current healthcare fury, the hell bent for leather approach with midnight seances and daily backroom deals to get Obamacare done this week as the Democrats Christmas present to an ever more "my way is always best" president. The gift appears to be VERY BAD legislation. This does not mark the leader of the western world as a boy scout. On the contrary. He seems to want a victory at any cost and that is what he is going to get - any cost!

    December 22, 2009 at 00:37 | Report abuse | Reply
  47. Solo75

    45,000 Americansv and 2,500 vets die every year because they can afford health insurance.

    December 22, 2009 at 00:43 | Report abuse | Reply
  48. Doug

    Two big things left out: Tort reform and capping non-economic damages in malpractice suits (and ending defensive medicine which is tremendously expensive).

    Also MIA is some system to produce more primary care docs (FP's peds, internists). We have a large shortage of them now, and only about 1-2% of med students are opting for those. For most, other specialties are more lucrative and involve much less administrative hassling with insurance companies. You're going to suddenly have 31 million people insured who weren't, but you're not going to have primary care doctors to take care of them. Nurse Practitioners can take up some slack, but lack the education/training to fully compensate for the lack of MD's.

    December 22, 2009 at 00:45 | Report abuse | Reply
  49. Rane Arroyo

    I have aging relatives without insurance, family members. In fact I went to a restaurant and a woman 8 months pregnant served us because she "noi choice." Where is the generous spirit of America, especially towards our own.

    Finally I want to know what benefits all these senators and representatives get. I want to know what Dr. Gupta gets, as well as other reporters. I live in Ohio where jobs with any benefits are rare. Past all the political talk, these are real people here with real problems.

    December 22, 2009 at 00:49 | Report abuse | Reply
  50. Michele

    It scares me that so many people think this is a windfall for insurance companies. Really? $6.2 billion in new federal taxes? Spending an ungodly amount of money to fill out tons of new forms and reports for the government to not do anything with? All kinds of new regulations on how to price? Right now health insurance employees wonder if they'll have a job in 5 years.

    This is not health care reform. This is government takeover of the private insurance industry. All of the nuances of the bill that have not been shared with the American public are set up to mandate the health insurance companies to fail so Obama can justify government health care. I don't see a single thing in the bill that addresses the actual cost of providing health care. Does a person go bankrupt because he doesn't have insurance or is it because he can't afford his $1 million hospital bill? Is there any hospital stay that should be worth $1-5 million?

    You can't keep down insurance costs unless you keep down the actual costs of health care.

    Approximately 30% of health care spending goes towards redundant or inappropriate care. For example, people utilizing the emergency room for something a primary care physician can take care of. The cost difference? $1000 for the ER visit versus $65 for a primary care doctor visit. Two reasons – education and access.

    Just because the proposed legislation doesn't cover the illegal immigrants doesn't mean we're not paying for it. The hospitals aren't writing off all of that cost, they're passing it on to those of us who are legal citizens whether or not we have insurance.

    My 10 minutes with my primary care doctor nets him $65. If he sees 5 patients an hour, he's earning $325 an hour! Must be nice. A specialist gets around $100 for that same amount of time, or about $500 an hour. .There are fewer than 10 people in any health insurance company that earn anywhere close to those amounts an hour.

    The average cost of ONE DAY in a hospital is $10,000. If it's surgery, make that over $20,000. Yet hospitals demand increases of at least 10% a year. It's not uncommon to see demands of increases of 30% or more. Why is this okay yet it's not okay for health insurance premiums to go up?

    5% of health insurance premiums pay for fraud by both patients and providers. Up to another 10% of premiums pays for medical liability and defensive medicine (additional services not needed but provided to avoid potential malpractice). Does it really make sense for an OB to pay $200,000 a year for malpractice insurance?

    I take a generic drug that costs $98 a month. That seems to border on the ridiculous. Has anyone looked at the profit margins of pharmaceutical companies? They are often 20-40% or more compared to the 3-4% profit margin of the health insurance companies.

    The $750 annual penalty is a joke. The average annual health care premium is $4000-$5000 and it will go up when all of the new government regulations take place. Oh, and now that a healthy person doesn't have to worry about pre-existing conditions, there is really no reason not to pay the $750 and stay uninsured until he needs the coverage. This is the same as waiting until your house burns down to buy property insurance.

    Medicare charges a penalty if you don't buy coverage when you're eligible. The penalty goes up the longer you wait and has to be paid for the rest of your life. Why is there no talk of a penalty for those who wait until they are really sick to buy insurance, driving up costs for everyone else.

    Insurance is priced on a pool. This means, for example, claims for everyone on small group policies are added together and divided by the number of covered people just to get a base rate. That has to be trended forward to cover health care cost increases which are almost always higher than inflation increases. Then tack on administrative expenses, state and federal taxes, commissions to brokers, and a small amount for profit. The more healthy people in the pool, the lower the average cost. Without any incentive to stay insured, healthy people will drop out, raising the cost for everyone who is left. Then add on the cost of those with pre-existing conditions and just imagine what health insurance premiums will look like.

    There are other ways to cover the 3% of Americans that need it without sacrificing the 75-80% of Americans who have at least decent coverage.

    The politicians are more concerned about meeting Obama's self-imposed deadline than they are about what is right for the American people.

    God help America because our elected officials certainly won't.

    December 22, 2009 at 01:04 | 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.