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. IM

    To Becky Caplan.
    You dont need to keep your daughter on a cobra plan. If you are computer savey enough to log onto this blog. I am sure you can Google, Yahoo, Bing, "Health Insurance" and you will be able to find the coverage a 25 year old needs at half if not less, what the cobra will cost you.

    Or you can just wait for Obama to solve every bodies problems. Remember he is the all knowing all powerful. I dont know how the country survived without him for 200+ years.

    December 22, 2009 at 14:34 | Report abuse | Reply
  2. Jon

    I work for a big insurer and I am scared because since day 1, we have been dubbed the bad guys. We are the ones that ask for premiums, we are the ones that don't cover pre-ex conditions (initially, but read the fine print and there's a waiting period, so yes, we DO cover them). Well since I have paid many a claim in the past, know what provider contracts look like and their reimbursement rates, it is quite obvious to me that the problem with healthcare is the doctors themselves.

    Why do people even get health insurance? Its to save them from the outrageous bills that the doctors charge. If you have health insurance, the doctor will just forget about 25% of your bill-whoosh, like it didn't even exist....so why bill that 25% extra anyway? Because when Joe the Plumber comes in without insurance, the doctor can balance bill Joe for the full amount. Of course doctors don't like insurers....they don't get that extra 25% bonus check so they can buy their Lexus for their 8 year old! Start charging $1 for a Band-Aid instead of $10 and the issues are solved. Doctors should not penalize the people they are trying to help, just so they can make back the money they paid on school with interest....a lot of interest.

    The gov't needs to regulate pricing NOW. Audit the physician bills please! And have them audited by someone middle-class or below, because Capitol Hill fat cats can still pay for their daughter's breast implants, regardless of medical necessity.

    December 22, 2009 at 14:34 | Report abuse | Reply
  3. Loretta

    This bill is not yet complete, so we all just need to stay calm! My big concern – I am one of those older Americans with a pre-existing condition. I have health care insurance and am on disability, and am worried, deeply worried, about my coverage, as I am virtually, uninsurable. If I had to "shop" for new coverage now, it would be a short, short experience. My former career was 25 yrs in the benefits industry, so I know the "game" – I am a huge risk, therefore, no company will take me on, and the drugs that I have the "luxury" of getting under the plan I have now, will quickly be denied if I lose coverage and there goes the use of my legs and arms... (I have MS). yes, the senators go on arguing but I have a much bigger question on my mind for 2014 – whether I'll be able to walk, talk and function by then. Some of us have much bigger questions, Dr. Gupta, questions of life and death....

    December 22, 2009 at 14:36 | Report abuse | Reply
  4. Isobel

    I doubt this will affect me. I work for low wages at a small business that does not offer insurance. I could not afford insurance before and cannot do so now. I was hoping that the lowering of medicare availability to 55 would go through (I'm 55) I'm hoping to find a better job next year. Until then I hope I don't get seriously sick or injured. I'm ignoring some troubling symptoms. For those of you who say to go to an er for treatment, obviously don't live in the real world of the working poor. Pretty much you get a band aid and a pat on the head when you're finally seen. I feel like I'm getting screwed with my pants on by my government.

    December 22, 2009 at 14:45 | Report abuse | Reply
  5. Marc

    I own a small business with less than 10 employees, and I currently pay 80% of employee health insurance. From everything i have read it doesn't appear that this bill will impact me or my employees either positively or negatively. Our health insurance costs increase dramatically every year. Am I correct that the Senate bill does not even provide interstate insurance competition? If so, what is there in this bill that even theoretically will help our insurance costs?

    December 22, 2009 at 14:48 | Report abuse | Reply
  6. Barbarah

    I have been reading the comments and they seem to say "I have insurance and healthcare reform is not necessary", I have insurance but it is not sufficient and I am scared" and, of course, "I have a cadillac plan and I will be taxed". I can't believe there is not cost to society at large when we have all these people uninsured or underinsured. there has to be. I current work and and have Aetna which is ok . However, I used to work in medical offices and not one of them accepted Aetna because they payed slow and low. I think the President needs to take away the congress' insurance covereage and they will be in the pot with the uninsured. They will then understand the problem and want to fix it. This would get the American people a good fix for our heath insurance problems. Anyone vote for this idea?

    December 22, 2009 at 14:51 | Report abuse | Reply
  7. Dr. G

    As a doctor, I can support NO other plan except where EVERYONE is cared for regardless of their financial resources or health status (i.e., public option or single payer). Right now I am working with several patients who are middle-class, American citizens suffering from cancer and who are having to go to South America so they can afford their surgery. THIS IS SHAMEFUL!!

    I thought America was better than this. I am ashamed of how we treat our fellow Americans. While we are certainly the richest country in the world, we have a long way to go before we become the best country in the world. A good start would be to actually start caring for each other. And if this means lowering my salary and raising my taxes, I'm all for it!!

    Dr. G.

    December 22, 2009 at 14:52 | Report abuse | Reply
  8. Ken - Lake County, Illinois

    While there has been much noise about the Senate's health care proposed bill, there seems to be little acknowlegement about one of the benefits essential to middle class families, coverage of dependents to the age of 26. Won't this provision save premium dollars (and some out-of-pocket costs if the situation permits) for parents and single adults?

    December 22, 2009 at 14:52 | Report abuse | Reply
  9. Brenda

    After working in healthcare for over 20 yrs and finally retiring, I have seen the physicians drop some of their privileges and not perform certain procedures because of low reimbursement. Many have decided to not accept Medicard, along with Medicaid. If the healthcare system continues to be bogged down by more paperwork and government red tape, those that really need to see a physician will not be able to get into a physician's office; therefore more people will be showing up in the ER. It's bad enough now with all the supposedly "cash pays." The Conagress needs to leave our Medicare and Social Security alone.

    December 22, 2009 at 14:53 | Report abuse | Reply
  10. Kelly

    The moral compass in both houses of government is clearly broken. The ethics of Sen. Ben Nelson's pork in the health care reform bill are unconscienable! What makes the great state of Nebraska any more special than the other 49 states in the union? Though a very unlikely possibility, I would like to see, just once, a bill come through that focuses solely on the issue at hand, and not so loaded with pork and "behind-the-scene" additives that it shows then no promise of actually fixing the problem that it was designed to address in the first place. Holding the Medicare program up at a "shining example" of government run health care is delusional thinking. Medicare is near bankrupt. Reimbursement for physicians is so poor that many physicians nationwide are closing their practices to Medicare patients. State run Medicaid programs do not offer any better solutions. These populations are essentially seen for near "free" based on reimbursement rates. Continuing with privitization within the health care industry is essential, but clearly our current system of high premiums, limited access to care for some populations, exorbitant bonuses for the CEOs of private health care insurance companies ... clearly the system is broken. There has to be some compromise (not loaded with pork!!) that improves coverage for hardworking Americans, for the poor, the disabled, the uninsured and underinsured, and for our senior set, who have already "paid their dues" in the work place. My opinion, for what it's worth, is that some sort of hybrid of our current system needs to be put in place. A solely goverment-run health care system (call it national health care or socialism) is not the right answer. Yet the current system needs a good long look. I have some ideas, but would likely run out of space here. We have too much evidence that the govt cannot police itself appropriately. It does not appear that representatives in both houses are truly listening to the concerns of their constituents! To turn one more thing over to the government would disatrous! ... My two cents ... for what its worth

    December 22, 2009 at 14:54 | Report abuse | Reply
  11. TimT

    I work for a corporation and for me the changes will be mostly positive. Right now my company is having to shell out more and more because their health care costs have doubled in the last 10 years. This bill will start to get that problem under control.

    Of course to really make a difference we need to have legislation that stops doctors from putting their patients through unnecessary tests just to line their pockets. Right now some doctors charge twice as much as others for treating the same condition because no one says they can't. And that means all of us pay for their vacation condos.

    December 22, 2009 at 14:56 | Report abuse | Reply
  12. Chris R

    I'm an independent contractor paying my own health premiums in full.

    I live in Massachusetts, whose "exchange" health care buying mechanism has been a model for Congress in legislation of health reform.

    While the on-line exchange is convenient, it is by no means a cure-all. Case in point: My 2010 premiums are going up 10%. My salary is not. MA is among the most expensive states for health-care premiums and the state's mandatory buy-in and exchange are doing absolutely nothing to curtail these costs. Likewise, I don't see anything in the health reform bill out of the Senate that will reduce costs and keep insurance companies in check. For most Americans, the Senate's bill is a failure and a major disappointment.

    I'm thrilled for the 31 million who will be able to obtain health insurance. But for most of us, I fear there will be no stopping the pulverizing, rising cost of premiums.

    December 22, 2009 at 15:01 | Report abuse | Reply
  13. John

    Of course I will be impacted. And that's a good thing. I currently work only to keep my health insurance. Were I to leave my current job and/or pursue other opportunities, it would be impossible for me to get health insurance – particularly if I worked for a small company. I have a child with multiple handicaps and 6 figure medical bills, so no insurance company would touch me without being required to.

    When you look at the number of people who stay in jobs solely for healthcare to take care of a spouse or child, you realize how the lack of portability is stifling economic potential. Just take a look at families with autistic children. If you have 1.5 in 100 kids suffering from this condition, do the math. Somebody had to come in and fix this.

    If congress gave more consideration to expanding the program they provide for themselves – where the government sets the rules for minimum coverage, and private insurance companies compete to sign up federal employees for their plans, things would be alot smoother. Government is involved only as a referee and we'd get to pick from a menu of appropriate private insurance plans that provide levels of insurance to match our medical needs and ability to pay the necessary premiums.

    December 22, 2009 at 15:05 | Report abuse | Reply
  14. Bryan

    I am happy this bill is finally working it's way through debate. I can attest to the horrors of what happens when an insurance company doesn't play by the rules. When your wife goes on chemo and she can no longer get the life saveing medicines she needs because in my opinion like all insurance companies when your giving them money everything fine but the moment you get sick they hang you out to dry and in this case die.

    My Grandpa use to tell me when things got tough stay the course and everything will work out the way it's supposed too. I'm glad someone is finally standing up and fighting for common people.

    All this debate has shown me is who is in the back pocket of the insurance companies. It's sad to me that not one single republican can do what is right for the nation and help overhaul healthcare. As I was told growning up if you don't vote you have no right to complain. As far as I'm concerned the republicans have taken the stance of not participating in this process. I am a conservative republican but I also see through all this and I see that for once a single party seems to be trying to do what's right for the american people.

    My final word is were all scared were all worried by the unknown and something new but stay the course and everything will work out the way it's supposed too.

    December 22, 2009 at 15:08 | Report abuse | Reply
  15. Tim

    My wife is retired from a local government, they continue to pay for a very comprehensive paln for both of us, she pays a small co-pay for Dr visits, I am on Medicare and pay nothing for visits, referals and second opinions. We are concerned that local government will stop paying for retirees if there is a public option. Our feeling is "if it ain't broke, don't fix it." I also know we are in the minority and will probably be impacted by this useless bill.

    December 22, 2009 at 15:12 | Report abuse | Reply
  16. Tim W

    I have been unemployed since August 09, and am on COBRA through the first part of 2011 (18 months). I have a pre-existing medical condition. COBRA runs me $425 per month. What options do I have for obtaining reasonable medical coverage when COBRA ends for me? I live in Central Florida which has among the highest unemployment rate nationwide, and many people who are able to find jobs are finding only part-time work, or jobs with few or no benefits.

    December 22, 2009 at 15:22 | Report abuse | Reply
  17. Mylissa

    My employer is cheap and doesn't offer coverage so I will certainly benefit! 🙂

    December 22, 2009 at 15:25 | Report abuse | Reply
  18. Donald

    I work in healthcare finance. We are generally a group of professionals who have learned to "roll with the punches" as far as regulatory changes are concerned, but this purely political process is the final straw. I am most concerned for our country, as I see this bill as another step down the big government road. Frankly, what lessons are we teaching our children? Don't be industrious and a self starter, because the government will provide your healthcare for you? We are creating generation upon generation of people who are just looking for someone else to provide for them. I see them every day at my hospital – phantom illnesses in the ER (we are required to evaluate them all) in search of pain meds, unwed pre-teen mothers with multiple children and no life goals, diabetics who are now on dialysis because they won't eat correctly, obese adolescents looking for a cure for their own lack of willpower, etc etc etc. All we are doing is reinforcing poor behavior. Notice that issues of personal responsibility for health and wellness are sorely lacking in this entire debate. This is health FINANCING reform, not health CARE reform. This madness has got to stop.

    December 22, 2009 at 15:31 | Report abuse | Reply
  19. Marion

    If this bill will lower the payments to doctors accepting Medicare, this will eventually effect me as I am on Medicare. I have found, to my surprise, that I had a very hard time finding a primary care doctor in private practice who would accept new patients on Medicare. There are already way too few primary care doctors in private practice and if this bill reduces the already outrageously low reimbursement to doctors who accept patients on Medicare, there will just not be enough doctors to serve the millions now on Medicare. I am glad they did not expand Medicare coverage to those in the 55 to 64 age bracket. While it sounds like a good plan, for above reasons, it will only make matters worse.

    December 22, 2009 at 15:42 | Report abuse | Reply
  20. Dave

    I think it is an historic opportunity for the US to join much of the rest of the developed countries in securing a level of health care for its citizens. I personally would take the measure even further and weave health care into the fabric of rights and responsibilities of citizenship. It is a good first step and I do not fear changes that may occur in my employer coverage as a result of health care reform.

    December 22, 2009 at 15:42 | Report abuse | Reply
  21. Kevin

    Doctors hold a monopoly on healthcare and running the system into the ground. No one cares. The problem is this: Everybody is looking out for themselves, and no one is looking out for everyone. America was founded on individualism, but now this obsession with the self over others will be our undoing. Doctors have the power to change the system for the better, but can't see beyond their own interests.

    When New Mexico tried to pass a law to give prescribing privileges to psychologists, who do you think fought it the most? The people not getting access to psychiatric care? No. It was the doctors. And they all spewed the same thing: "We care about your safety, but cannot and will not care for you." In essence, the doctors were saying we would rather you have no care than care from someone else. Fortunately, New Mexico prevailed and psychologists won the right to prescribe off a limited formulary.

    To bring healthcare back to reality, we need to fundamentally rethink what healthcare is and how it is delivered. The ones who are supposed to be helping us are actually hurting us.

    December 22, 2009 at 15:44 | Report abuse | Reply
  22. dmcferrin

    Did Congress or its lobbyists bother to study countries where healthcare works? We are the, supposedly, richest and brightest country in the world. Why can't we make some meaningful, honest, good-for-the public reforms? Perhaps one usefull suggestion would be no-fault malpractice insurance; then we won't have to pay the premiums for doctors to practice. I'm sure those premiums are a large part of my insurance bill!

    December 22, 2009 at 15:49 | Report abuse | Reply
  23. Lora

    Under the new health insurance bill will insurance companies have the right to ask you what prescriptions you are currently taking and what underlying medical conditions you have? I recently was shopping for a new health insurance plan for our company and I know they ask you these questions and base your rates on your medications and past medical conditions.

    December 22, 2009 at 15:52 | Report abuse | Reply
  24. Sarah

    This bill will help me. My employer does not provide insurance, so I purchase individual coverage. My deductible is $3000, then coverage is 70/30 after that is met. As a result, my medical expenses are high, but I am healthy so I can manage to pay them. I am expecting and estimate that my out-of-pocket expenses in 2010 will be about $9000. With our current system, I fear developing any kind of a chronic medical problem, because it would mean that I could no longer get insurance in the free market. Changing the law so that companies cannot deny people individual coverage will eliminate a big worry from my life.

    December 22, 2009 at 16:07 | Report abuse | Reply
  25. Carolyn McLuskie

    True health reform would legislate health insurance companies out of existence. Like many who have written here, Mary Pagels' story of being denied care by the health insurance industry brought tears to my eyes. Mary Pagels' name should be on a class-action lawsuit against the entire health insurance industry.
    Dr. Gupta, please do everything you can to bring her story to light. It's a perfect example of why the health insurance industry needs to be declared illegal and disbanded.
    The elephant in the room that this health reform has never addressed is the health-insurance industry cartel. The only way ALL Americans will get fair and equal access to health care is the complete dissolution of the corrupt health-insurance industry that has created such on-going criminal negligence as Mary Pagels is currently enduring.
    The only way to have true health care in this country is to have a one-payer system. When Canada created its national health-care system in 1966, the single-payer system was created PRECISELY to prevent the kinds of criminal abuse that the health insurance industry commits here in the States against Mary Pagels and others like her.
    The fact that Mary Pagels has been denied health insurance - BECAUSE she has a life-threatening illness caused by an incompetent doctor - is proof that allowing the health insurance industry to exist constitutes criminal negligence.
    The one-payer system will immediately create massive savings for all Americans - dropping the health insurance industry will slash costs dramatically. The one-payer system is efficient and cost-effective - one bill that goes from the doctor to the government.
    No $12-an-hour clerk denying life-saving medical care. No doctor ordering thousands of dollars of additional tests to protect against malpractice suits. My girlfriend is still paying off over $3,000 of unnecessary tests that her doctor insisted on - even though he and she both knew, and the medical evidence showed, that she actually had a hernia. Of course, her health insurance company refused to pay for the additional tests the litigation-fearing doctor had ordered. None of this will happen under a one-payer system.
    For those who scream socialism - funny that they have no problem with our socialized police and fire departments - just look at how the stocks of health insurance companies have soared over the last week. What does that tell you?
    If any lawyers are reading this, please take a moment to consider the historical impact of a class-action suit against the health insurance industry. In this country, class-action suits are virtually the only way that American citizens have been able to overcome such legislated violations of basic human rights.
    One last comment regarding the insertion of abortion as an issue in the health-care debate. The right-wing fixation on denying women such a basic human right claims to be a "pro-life" agenda. But it does not get to the root of the problem: how to stop unwanted pregnancies BEFORE they happen.
    The solution is ridiculously simple. As every schoolboy knows, women cannot get pregnant without male sperm. Therefore, I have "a modest proposal" (with apologies to Jonathan Swift): Mandatory vasectomies as soon as males reach puberty. This will protect men from unwanted pregnancies and obviate the need for women to undergo invasive surgery after the fact.
    Mandatory vasectomies will ensure that no man is ever forced to breed against his will. He can have his vasectomy reversed at any time, pending proof that the woman actually does want to have a child with him.
    Let's insist that all men have this basic human right - so that they are never subjected to the financial and emotional fallout of an unwanted pregnancy. Relieved of the dread of being blackmailed by a woman who was only a one-night fling and not a candidate for marriage and children, men will be able to relax and enjoy their new-found equality.
    Education will be provided to those uninformed men who incorrectly believe that the ability to get women pregnant makes them "a man."
    Men seeking a prescription for Viagra will be required to provide proof that they have had a vasectomy and do not plan to use their drug-created tumescence to irresponsibly procreate.
    Such legally mandated protections of male sperm will undoubtedly reap many additional benefits to society: reduced violence against women once men are relieved of the burden of fear of an unwanted pregnancy, and reduced costs to prosecute those who assault, rape, and murder the unwanted children of unprotected sperm.
    And that's something EVERY Republican can get behind.

    December 22, 2009 at 16:10 | Report abuse | Reply
  26. Charles MD

    I read Mary Pagel's story and sympathize with her. She had a KNOWN bad outcome/complication of a common procedure. This happens and it happens with all procedures to all doctors. It's the odds game. This is why we as surgeons go over risks and benefits before every case before a patient signs a consent sheet. We cannot predict who will have these rare adverse outcomes AND unlike cars, repairs don't always work. After all, we are living things and we all function slightly differently. This is why medicine is more and art than a science. Would she have had a bona fide malpractice case? Who knows? Probably not unless the cardiologist was truly negligent or failed to provide the appropriate standard of care. Unfortunately naming this physician in a suit would cost him or her time away from work, attorney fees and other expenses even if the case was dropped or found in the physician's favor. This adds to overall costs of healthcare.

    We document everything and order way more tests all to cover our "you know whats". I saw a man recently who has had 4 CT scans of the abdomen and pelvis for abdominal and back pain all done within a 6 month period of time. And each one was non-diagnostic. Talk about waste, especially since they were all ordered by the ER. Talk about a waste of resources. He also had not seen his family doctor in a year.

    As for the AMA, I am not a member and will never be one as they do not represent my interests. That group is essentially run by a bunch of academic physicians who don't know the realities of everyday medical practice because they are shielded by their respective institutions and residents. Trust me, I am a resident (in my 5th year) and see it daily.

    I am in full agreement with others' posts about insurance reform, cost reform, pre-existing conditions and access to care but we as a country need to reform the entitlement and malpractice problem.

    Oh and if your wondering why I am posting and not working, I am on a much needed vacation because I was burned out. That is a major problem with all healthcare providers. Right Jodi RN?

    December 22, 2009 at 16:12 | Report abuse | Reply
  27. norm

    The political right are throwing up so much smoke a lot of people don't get what is going on as to compared to what is needed, the only solution is a single payer national health care plan, the present system of health care with people's lives depending on profit is unconscionable. Any system that has takes a profit margin more seriously then the health and well being of it's citizens is barbaric. Anyone realize that even Cuba has a better health care system than the US, our northern neighbour has a national health care system that has problems but trust the main point no Canadian has to decide between food housing or medical care and no one has to declare bankruptcy if they have a major illness, to hear how some of our politicians slag Canadian medicare you would think the Canadian government decided which doctor or treatment the citizens receive. To find out how canada implemented a national health care plan look up Tommy Douglas as he was the driving force behind it being implemented.

    December 22, 2009 at 16:36 | Report abuse | Reply
  28. Mike B.

    I am eligible to retire but will not until I reach Medicare age. I would not be able to buy medical insurance due to "pre-existing conditions". It would be nice to have a low cost, low deductable medical insurance plan but "my" Senators and House member (all Republicians) voted against this...

    December 22, 2009 at 16:42 | Report abuse | Reply
  29. Susan in Wyo

    I don't think it will affect me – i am thankful to have blue cross through my employer (altho a very high-deductible plan).

    I hope the reform will help my friends who are self-employed or who work for small nonprofits - they are being gouged by insurance companies who give them the runaround when they try to get the benefits they have overpaid for. I am worried this bill doesn't do enough to keep insurance companies from overcharging, & disappointed the public option didn't pass.

    I have friends who live in Europe (UK, Germany, Spain) and despite the flaws in their systems they all prefer it to the U.S. system. Why can't we grow up, pay the necessary taxex and take care of our people? Greatest country in the world, my a$%

    December 22, 2009 at 16:44 | Report abuse | Reply
  30. Ronald Reiser

    Under the healthcare reform bill now under consideration "officers and employees of government health care bureaucracy will have access to ALL american financial and personal records (page195). Also "The federal government will have direct, real-time access to all individual bank accounts for electronic transfer" (page59). HOLY COW!
    So they can remove your funds at will. What if they make a mistake? Take funds from an ira account? What recourse will you have?
    This is illegal! and against constitutional law. If this bill passes, I strongly suggest that everyone file a class action law suit against the government immediately! This is no joke!

    December 22, 2009 at 16:46 | Report abuse | Reply
  31. LucyRicky

    I forgot one other thing regarding this health care bill. If the insurance companies are required to cover preexisting conditions – at what cost and at what deductible. I doubt very seriously that we will be able to afford it. Also our property tax bill includes payments to the local hospital district already to pay for indigent care. Don't think we aren't already helping the indigent. We could be there some day if something isn't done about the insurance companies wealth.

    December 22, 2009 at 16:55 | Report abuse | Reply
  32. Chris

    The fact that the lobbyists have been out in full force trying to sink this health care reform makes it obvious that Obama is on the right track.

    Those people that have been collecting outrageous premiums while providing the minimum in health care that they can get away with don't need your sympathy. They will adapt as they always do, and will find new ways to fleece you.

    December 22, 2009 at 17:03 | Report abuse | Reply
  33. Kathryn E.

    I work two part-time jobs, both of which offer insurance only to full-time employees. I work 39 hrs a week at one job and 15 at the other. I am uninsured.

    I can't afford insurance, and right now my plan if I get very sick is to go to the ER and later declare bankruptcy to clear any medical bills. I am barely making enough to get by (and I have student loans to pay off) so there aren't any other options available for me right now.

    I don't think this reform will affect me much because employers only need to provide health insurance to full-time employees. But, hopefully by 2014 the job market will improve and I'll be able to find a full-time job with benefits.

    December 22, 2009 at 17:07 | Report abuse | Reply
  34. Jeff Bindell

    Just a question ... I am old enough for Medicare but I am still working so I don't feel threatened.

    But the question: When I get my statements from BCBS, a typical test might cost $100. I pay 20% bringing the amount down to $80.00. Next, BCBS pays about 10-20% of the bill and the cost is considered covered. So at worst, the testing organization gets about 10-30% of the bill and is happy. Someone without insurance pays the full amount.

    This seems to show that the people who can't afford insurance pay the most and this suggests to me that the cost can be reduced for everyone. Why isn't it???

    That was my question.

    December 22, 2009 at 17:19 | Report abuse | Reply
  35. Paul

    I am deeply troubled by the proposed healthcare legislation. It should be unacceptable to any American to have legislation of this magnitude and import rushed through without deliberate consideration of the cost and impact on the economy.

    There appears to be very little certainty in this legislation other than the cost which is at a minimum of $800 billion. Proponents suggest that, despite the pricetag, the legislation will reduce costs by removing inefficiencies, fraud and waste. This is purely speculative. If we know that ineffiency, fraud and waste exist now with Medicaid, why not take steps to remove those first? Would it not be prudent to figure out what can be actually be saved as opposed to passing this behemoth and hoping that savings come in the end?

    Americans are currently paying into Social Security that has been looted by Congrees for decades and is projected to go broke. We are paying into Medicaid that is broke and acknowledged to be inefficient and fraught with waste. There has yet to be a major government program that has been managed properly by the government and come in on the projected budget. Why would anyone assume that such dramatic change in healthcare managed by the government would ever be efficient or cost effective?

    Lastly, the cloak and dagger, behind closed doors, deliberations of this legislation fail to inspire any confidence or comfort. If anything, the covert method in which the legislaiton is being deliberated only inspires more distrust in the government. This is particularly true when the senate majority leader buys votes with OUR tax dollars. We do not sit still when elected officials are bribed by corporations with corporation dollars – why should we sit still when elected officials are being bribed with OUR money? It is appauling.

    December 22, 2009 at 17:21 | Report abuse | Reply
  36. Wally

    I am so angry at the Democrats for ramming this bill through Congress even though they know the vast majority of the public is opposed. First of all, since health insurance premiums will be constrained by government imposed cost controls, expensive treatments for heart problems, cancer, etc. will slowly be eliminated (as too expensive), and research into expensive new treatments and drugs will be cut drastically. Second, premiums will increase markedly since most young/healthy individuals will opt to simply pay the small penalty and wait to pick-up health insurance only when they need it. Third, Medicare will be cut (even though it already underpays providers by 20%) so that seniors will suffer. And fourth, government costs will be much higher than estimated and savings will be much lower than estimated (as is always the case with government programs) leading to much higher taxes for those who pay taxes. Finally, we will lose control over our healthcare choices as government will control when, where and from whom we can receive treatment. In summation, I think this is the worst piece of legislation for individuals and for our country as a whole as I have witnessed in my 60 years.

    December 22, 2009 at 17:23 | Report abuse | Reply
  37. Lori

    I am a long term administrator for a state Medicaid program. I watched carefully as Medicare Part D rolled out. Even tho Part D was intended to help, and it does, it had major impacts to folks who had existing private plans. Mainly – insurance companies saw this as a good way to save money. By considering Part D as an entitlement, many insurance companies began to require current participants to enroll in Part D or lose their plan altogether. This was a hardship to folks who would much have rather been left alone in their retirement years. Now they have to deal with monthly Part D premiums that go up every year, Part D plans (PDP) that expire, re-enrolling in new plans, acting as a go between with their PDP Plan and their private insurance companies, etc etc. Many aren't savvy enough to negotiate the battles and end up paying for things, expensive things, out of pocket that they can't really afford and shouldn't have to pay because either the PDP or the private plan should pay. This is money in the pockets of both plans – plans that the participants has paid for.

    My MAJOR concern with the healthcare reform plan is exactly the same issue. When my private plan sees this as an entitlement and forces me to join, I will have to pay the ever increasing premiums, learn all of the rules of conduct and keep a watchful eye on all of my claims, negotiate between the two, try to find a docs who are willing to take on both plans. What happens to my PPO agreement? The thought of all this is overwhelming.

    I am a 23-year long employee of the Medicaid program in my state. I was the federal liaison between federal programs and our Medicaid program for years. I am currently a policy and program administrator and have been for the last several years. So I can confidently say that I have first-hand knowledge of exactly how screwed up things can get when a government program is thrust upon a person's life. Don't even get me started on what happens to veteran's who also have Medicare and Medicaid.

    Bottom line: I have some major doubts that the issues facing us, the privately insured middle working class Americans, have been accurately and thoughtfully identified and thusly addressed in this reform package. I just seriously doubt it. It scares me and with good reason. Ask any older privately insured retiree who was forced into Part D. The whole thing makes me cringe.

    December 22, 2009 at 17:24 | Report abuse | Reply
  38. Fernandez

    If this health care plan is so good for us, will the senators who voted for this plan switch to the new plan and start paying for it in 2010 to get the benefits in 2014?

    Hopefully taxpayer will not fund the premium of these career politicians

    December 22, 2009 at 17:30 | Report abuse | Reply
  39. Rhonda A

    My family owns a small heating & air conditioning business. The number of employees fluctuates seasonally between 8-15. We are not a "construction company", but obviously work with home building contractors. I recently read, "a provision was slipped into the health care bill that unfairly targets small construction industry firms by mandating that they provide health insurance if they employ more than five workers." Is this true? Will our company be inpacted by this rule?

    As a small employer, what else do I need to know about this new law that I won't find out until after it's passed?

    December 22, 2009 at 17:30 | Report abuse | Reply
  40. Denny

    It is a sad state of affairs for America that we essentially have to buy
    the votes of our elected officials to pass legislation. If the Senator from Nebraska truly felt this was not good legislation he certainly should not have sold his vote. Unfortunately, our current two party system has created an environment in which the only way to get legislation passed is to attach numerous earmarks to special interest groups in states where votes are needed. Our current two party system is absolutely broke!!! What we need is to actually elect representatives of the people that will represent the people. What ever happened to government of the people, by the people and for the people? Too much power has been entrusted to the Federal government rather than in state and local government. If I were President Obama or members of Congress I would be embarrassed to call this historic legislation and a great day for Americans for succeding on health care reform. I know I am embarrassed to know that we had to buy votes to accomplish this and that our elected officials give up their beliefs for money. I guess this has now become the American way – how sad.

    December 22, 2009 at 17:40 | Report abuse | Reply
  41. Brian

    I work currently for a small hospital system.
    I am an EMT. most already dont understand what or why do what we do.
    None understands the impact on US, which is the impact on YOU.

    I am very much against this bill, as are my co workers, and we are all vexed that we werent even asked what will happen. 31 million more. thats a lot of ambulances...

    December 22, 2009 at 17:40 | Report abuse | Reply
  42. GTJMD

    This is a bad bill, put together by persons who do not take care of patients on a daily basis. The "deals" just coming out are despicable and the "honorable" senators from Nebraska, Vermont and Louisiana, to name a few, should be ashamed, since they really are acting like a sleazy bunch of scallywags. Two things that should never be seen in public: making laws and making sausage! Both smell to high heaven and are composed of less than ideal components. Tort reform is not addressed at all. The cost of defensive medicine is significant and if a physician says, he does not practice defensive medicine, then he is either not practicing in the real world or is totally
    naive. The ambulance chasing vultures who advertise on television really precipitate a tremendous amount of unnecessary tests since they are always looking for any mistake, even the ones of no consequence. I am not going to jeopardize my practice or my future with any patient that seems to be looking for any reason to bring litigation against us.

    This bill does not need to be shoved down our throats so quickly without more information for all concerned. All of us agree that reform is needed, but this bill, put together by politicians, accountants, and God knows who else, smells more like rotten "sausage" and will turn out to be totally a fiasco.

    We will also see it more difficult to get bright people to go into medicine for a career. Why work 8-10 years AFTER college ( I was 9 years) to be faced with long term debt from school with the lack of ability to take care of patients as they would like with a drop in income. We do not go into medicine for the income, but the costs of practicing along with the longer time in training make it more difficult to justify that to some of the "best and the brightest".

    December 22, 2009 at 19:11 | Report abuse | Reply
  43. sdMike

    My question is: throughout this debate why has the entire focus been on insurance companies when a major problem is that doctors and hospitals charge WAY too much for many services. Is it not politically popular to target doctors and other medical professionals and demand that they lower some of their ridiculous costs? For some reason nobody has a problem talking about tort reform and going after the money lawyers make, but doctors are off limits? They are in it for the money just like everyone else.

    December 22, 2009 at 19:25 | Report abuse | Reply
  44. Joe W.

    I'm really not all too hot on the whole 'reform' concept. I know what I should EXPECT... and I know what I should WANT... but the bottom line is that I KNOW what I will get – and I'm pretty disgusted about it.

    With the reported donations that health care companies have made to politically run organizations... it's pretty clear that the true concerns, those of everyday men and women are not being addressed.

    The BUSINESS of healthcare is out of control.

    My wife was in the hospital for 5 days for an infection. It was made pretty clear to us that the only reason she was in the hospital and not at home was because of insurance company mandates.

    There is no reason for the cost of medication to be so high. I understand that there is technology and research involved in finding solutions/cures, but the astronomical profit margins support the idea that the final price of the product is 1000's times the cost of the development and production of the product.

    Bottom line is, health care 'reform' or not... I'm just going to put on my badge and gun and go to work tonight... dedicating 20% of my gross income to the insurance policy that covers 70% of what it did five years ago.

    December 22, 2009 at 20:57 | Report abuse | Reply
  45. Susan Keim

    I feel that health care is a right – not a privledge. I am currently without health insurance due to being laid off in May, 2009. Fortunately, I am healthy and do not take any prescription medications. I believe the only fair way to distribute health care assets is thru a single plan which covers everyone from birth to death. Leave profit-making insurance companies out of it! For those of you who think you don't want the government making decisions on their health care, what do you think your insurance company is doing right now under your nose? I have personal experience with a health care company and they are constantly making decisions which benefit ONLY their bottom line. Most policies have a formulary for prescription drugs which either forces patients to pay a higher co-pay or pay the full cost for medications not on the formulary. These formularies are based on the cost of medications. And does anyone wonder why the insurance companies have killed health care reform measures? It's simple – profit! They are collecting premiums from policy holders (consumers) and also collecting premiums from doctors (providers) for malpractice insurance. They are making profits from both ends in the health care industry. Hell, I certainly don't blame them for trying to hold onto this racket for as long as possible. The United States is the only industrialized country without universal healthcare. Also, the #1 leading cause of bankruptcy in this country is a serious medical condition. But it's time that all Americans stand up for the only right plan for every single one of us – the same coverage for all.

    December 22, 2009 at 21:11 | Report abuse | Reply
  46. Dwane

    Ok, so a lot of people have a story or opinion on this matter and no one is certain or even hopeful that help is on the way. We are a cynical society with good reason to be skeptical of anything our leaders tell us. I don't know what this bill will do for me or my family. All I know is I'm going broke trying to maintain the private insurance premiums I have now as my rates have been by 30% each year over the past four years. At this rate of increase I expect my healthcare premiums will exceed my total income within seven years from now for a family in their 30s with no previous conditions. So to all of the skeptics and myself included, is this reform bill bad? maybe... will it help me? maybe... is leaving the system the way it is now the better choice? ABSOLUTELY NOT!!

    Bring on the bill no matter what it is because short of suggesting eugenics we will be far better off with this reform than without it.

    December 22, 2009 at 21:30 | Report abuse | Reply
  47. Paul Krolowitz

    I have been purchasing health insurance out of my own pocket for 12 years now. 10 years ago it cost $5500 a year for family coverage, now it cosy $13,500 for less insurance, the Increase is staggering, Iv personally have paid insurance companies $72,000 over the last 10 tears, and the cost is not projected to decrease, only increase. I have no conditions, nor do the family members I insure. Anything t he government does to bring down these increase in costs will be appreciated. And,, for 2 of the past 10 years I had no health insurance, paid out of pocket, just as I do now,,, $13000 per year in premium with a $3000 deductible, the cost are mamoth. I am fortunate that I can pay,,,, thankfully I or my family members of three children had a catastrophic health event when we were out there with no insurance,, maybe this law will help. For sure with the repubs lack of effort,,, and grasping of the status quo, my cost and coverage was only going up in cost and down on coverage.

    December 22, 2009 at 21:49 | Report abuse | Reply
  48. Student considering going into medicine

    I am a year and a half away from getting my bachelor's degree and potentially going to medical school. There will be no other way for me to pay for medical school other than relying on student loans. I have wanted to become a doctor so i can help people, not so i can become rich. If I won't even be able to pay off my student loans why become a doctor? Can someone please help me see how this bill encourages me to become a doctor?

    December 22, 2009 at 21:49 | Report abuse | Reply
  49. Saman C

    As a physician, I will be the first one to admit this bill makes me sick. Of course there needs to be health care reform, i don't think anyone would dispute that. But the way that they are going about it is completely wrong! Cutting funding for Medicare? With an ageing population? I just don't understand it. The cost of this plan is also grossly underestimated. They are averaging approximately $2500 for each person who is uninsured to be covered. I have no idea how they are going to pull this off (who are we kidding, they're NOT going to pull it off for that price!) We'll see taxes go through the roof, the quality of healthcare to the toilet, poor physician quality because of lack of reimbursement, all to satisfy politicians desires to say they have done something. It makes me so angry that I lose sleep at night. The 2010 senator election is going to reflect the american people's feelings on this matter. We will see a huge shift to Republicans. I think that we should write our Congressman and let them know our feelings before it is too late!

    December 22, 2009 at 22:02 | Report abuse | Reply
  50. Edwin G

    I wonder why many of our conservative voters have turned into a gullible state, anything their politicians tell them to do or said, it is a fact and dogma. They have no care for other Americans who are unemployed, uninsured and are sick today, it is all about "my" money, my taxes when it was already determined by CBO that the new bill will save 140 billion in 10 years. That alone, is a good start for health reform. Once it is in force and there are some flaws into it, then go again for amendments just like our Constitution abd remedy it but first and foremost, go for the reform as the first hurdle. On the democratic side, it is all or nothing for the public welfare. Gosh, we already have 12 trillion debt, those who are unemployed should get employment in the next 4 years. Roll on your sleeves and get go for your family. Those habitual recipients should be sent to Africa or Asia where they are starving and could not find shelter, clothing and lastly food. Those who are neither conservative or extreme liberal are caught in the middle, nobody want reform but protect their own vested interest.

    December 22, 2009 at 22:07 | Report abuse | Reply
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