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jstan
climber
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Dec 18, 2009 - 12:37pm PT
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As I remember it the Part D drug legislation was 2000 pages long, was submitted on a Friday and Congress was pressured to pass it immediately. I don’t remember whether it was this bill or not but in one of these many thousand page long bills someone came across a clause so unconstitutional that the Bush Congress actually removed it without a fight. It has been awhile. What comes to memory it was something that allowed Bush to change, after the fact, legislation passed by Congress.
There was a lot of pressure for fast action so that it could become law before its cost estimates could be shown to have been falsified.
Mitch McConnell’s derogation of the length of bills before Congress is right on the mark. Too bad these people don’t practice what they preach.
I suppose one can sell used cars or potato peelers on TV this way.
From Wikipedia:
The Medicare Prescription Drug, Improvement, and Modernization Act (Pub.L. 108-173, 117 Stat. 2066, also called Medicare Modernization Act or MMA) is a law of the United States which was enacted in 2003.[1] It produced the largest overhaul of Medicare in the public health program's 38-year history.
The MMA was signed by President George W. Bush on December 8, 2003, after passing in Congress by a close margin [2].
One month later, the ten-year cost estimate was boosted to $534 billion, up more than $100 billion over the figure presented by the Bush administration during Congressional debate. The inaccurate figure helped secure support from fiscally conservative Republicans. It was reported that an administration official, Thomas A. Scully, had concealed the higher estimate and threatened to fire Medicare Chief Actuary Richard Foster if he revealed it.[3] By early 2005, the White House Budget had increased the 10-year estimate to $1.2 trillion.[4]
Former US Comptroller General David M. Walker has called this "...probably the most fiscally irresponsible piece of legislation since the 1960s... because we promise way more than we can afford to keep." [5]
http://en.wikipedia.org/wiki/Medicare_Prescription_Drug,_Improvement,_and_Modernization_Act
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Ken M
Mountain climber
Los Angeles, Ca
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Dec 18, 2009 - 12:45pm PT
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I can't help but post on this subject. As you know, I am a physician, and I deal with uninsured people every day that I work.
Someone spoke about the simple explanation of why this healthcare bill is happening, and suggesting accumulation of power. No, I don't believe that. Making this change is not entirely popular, and popularity is the foundation of power (why is Rush, who holds no elective office, the most powerful man in the republican party?)
The simpler explanation is that healthcare is destroying our country, and gradually making us non-competitive with the world. This is why politicians of both parties have sought to reform the system over the years.
The financing is truly scary: every three years, one cent out of every dollar spent in America is diverted to healthcare, from whatever it is currently being spent upon. In all other first world countries, that number is ZERO. One could calculate the date, when all spending in the US will be on healthcare....but of course, that will not happen. What will happen is that the system will fall apart.
Non-US cost for healthcare is about half of what we spend, covers ALL citizens, and is essentially free (no deductibles).
On that list of countries, for outcomes, we wind up around 37th.
So, for the country as a whole, we are paying twice as much, and getting much much less. If this were a private enterprise model, how long would that last? THIS IS THE ALTERNATIVE WE ARE STUCK WITH IF THE BILL DOESN'T PASS. We simply can't imagine what the crash will look like, but it will happen, unless the course is altered.
Folks, this is not about accumulating power, it is about altering the course of disaster that the country is upon.
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apogee
climber
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Dec 18, 2009 - 12:47pm PT
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"Mitch McConnell’s derogation of the length of bills before Congress is right on the mark. Too bad these people don’t practice what they preach."
Tru 'nuff- it would be much more believable coming from the Right if they had a history of doing something, anything about improving healthcare and coverage in the US. As it is, this letter is simply another obstructionist tactic with the hope that the issue will die once, for all, and altogether.
Fact is, though, that they opposed the creation of Medicare, and have never made any effort to improve it or bring about any real healthcare reform. Fact is, if they had their way, they'd do away with it altogether.
Their position on this is no different from their yakking about spending- they have no credibility whatsoever on the subject.
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Norton
Social climber
the Middle Class
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Dec 18, 2009 - 01:06pm PT
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Jstan, Ken M, and Apogee for Co-Presidents of the United States.
endorsed by the entire Norton family
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Karl Baba
Trad climber
Yosemite, Ca
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Dec 18, 2009 - 01:11pm PT
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Thanks Ken and others. the system is broken, we're shooting ourselves in the foot and the gun companies are lobbying hard to keep us doing it.
PEace
Karl
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wbw
climber
'cross the great divide
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Dec 18, 2009 - 01:17pm PT
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How does this bill alter the course of disaster that you claim we are on, Ken? In fact, how does it improves any of the problems you referenced.
I agree that the state of our health system is not sustainable, but if the "reform" does not target the problems, what's the point? This is where I think I disagree with President Obama. Simply changing the current system is not necessarily a fix.
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rectorsquid
climber
Lake Tahoe
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Dec 18, 2009 - 01:24pm PT
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All I can add to any of this is one simple fact, if 50% of the people think it is good and 50% think it is bad, there is a 50/50 chance that it is bad (excluding the possibility of 50% of the people being idiots).
NO bill should pass without a 75% vote (or some other arbitrary large number). If something is a good idea, a large number of people will see that and vote for it. This 50% majority rule thing is crap and is no different than flipping a coin on our futures.
Dave
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Studly
Trad climber
WA
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Dec 18, 2009 - 01:30pm PT
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I have not even looked at the bill, but if those two scumbags Mitch McConnell and Joe Lieberman oppose it, then you know it can't be to bad.
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PRRose
climber
Boulder
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Dec 18, 2009 - 01:30pm PT
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Complaining about the length of a bill is one of the stupidest things Republicans do--and that's saying a lot.
There are two alternatives:
1. Draft a comprehensive bill.
2. Draft a short bill and leave it up to administrative agencies to issue regulations and/or courts to decide cases that fill in the gaps.
Congress increasingly prefers the former, since it gives them the most control. It also gives immediate certainty regarding the provisions of a bill, since it can take years (or decades) for agencies or courts to do their work. That seems like a pretty damn good idea, given the scope of the bill.
Further, I would think Republicans would want a detailed bill, since the alternative (at least in the short-term) is to have the Obama Administration draft the rules for what is left unclear or ambiguous in the legislation.
Of course, Republicans are not interested in any such thing. Instead of trying to play any constructive part, they stick their fingers in their ears and go nyah nyah nyah--except, of course, when they're spreading b.s. like the bill will execute granny.
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Norton
Social climber
the Middle Class
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Dec 18, 2009 - 01:34pm PT
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HERE is What the Healthcare Bill Will do:
1. Largest Expansion Of Coverage Since Medicare’s Creation: Thirty-one million previously uninsured Americans will have insurance.
2. Low/Middle Income Americans Will Not Go Without Coverage: For low-income Americans struggling near the poverty line, the bill represents the largest single expansion of Medicaid since its inception. Combined with subsidies for middle income families, the bill’s provisions will ensure that working class Americans will no longer go without basic health care coverage.
3. Insurance Companies Will Never Be Able to Drop or Deny You Coverage Because You Are Sick: Insurers can no longer deny coverage because of a pre-existing condition. They can’t rescind coverage or impose lifetime or annual limits on care. Significantly, the bill also ends insurer discrimination against women — who currently pay as much as 48% more for coverage than men — and gives them access preventive services with no cost sharing.
4. Lowers Premiums For Families: The Senate bill could lower premiums for the overall population by 8.4%. For the subsidized population, premiums would decrease even more dramatically. According to the CBO, “the amount that subsidized enrollees would pay for non-group coverage would be roughly 56 percent to 59 percent lower, on average than the nongroup premiums charged under current law.”
5. Invests in Keeping People Healthy: The bill creates a Prevention and Public Health Fund to expand and sustain funding for public prevention programs that prevent disease and promote wellness.
6. Insurers Can’t Offer Subprime Health Care: Insurers operating in the individual and small group markets will no longer sell subprime policies that deny coverage when illness strikes and you need it most. Everyone will be offered an essential benefits package of comprehensive benefits.
7. Helps Businesses Afford Coverage: Small employers can take advantage of large risk pools by purchasing coverage through the bill’s state-based exchanges. Employers with no more than 25 employees would receive a tax credit to help them provide coverage to their employees. The bill also establishes a temporary reinsurance program for employers providing coverage to retirees over the age of 55 who are not eligible for Medicare.
8. Improves Medicare: The bill eliminates the waste and fraud in the Medicare system, gets rid of the special subsidy to private insurers participating in Medicare Advantage and extends the life of the Medicare trust fund by 9 years. It also closes the doughnut hole that affected 3.4 seniors enrolled in Medicare Part D in 2008.
9. Reduces The Deficit: Not only would the bill expand coverage to 30 million Americans without adding to the nation debt, it would also reduce the deficit by up to $409 billion over 10 years.
10. Reduces National Health Spending: A CAP-Commonwealth Fund analysis concludes the bill could reduce overall spending by close to $683 billion over 10 years – with the potential to save families $2,500. Even the most conservative government estimates conclude that the bill would reduce national health care expenditures by at least 0.3% by 2019.
http://thinkprogress.org/2009/12/16/podesta-passing-senate-bill/
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Ksolem
Trad climber
Monrovia, California
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Dec 18, 2009 - 01:35pm PT
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I'm still trying to figure something out.
As I understand it, the current bill requires all Americans to buy health insurance, levies a fine of substantially less than the cost of insurance on those caught not buying insurance, and prohibits insurance companies from denying coverage for pre-existing conditions.
What is to stop me from going without insurance, paying the fine if I'm caught, and only buying insurance if I develop a need for medical care since I cannot be turned down even if I am sick or hurt?
It would seem that the way not to get caught is to live in the ever growing underground economy. Can anyone say "unintended consequences...?"
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apogee
climber
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Dec 18, 2009 - 01:39pm PT
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"And the people of those countries with lower costs don't get CT scans for every scratch, biotech drugs and gamma knife surgeries."
"Now, great societies take care of their less fortunate, but at much lower service levels than the insured/affluent."
fattrad, this has been the basis of your opposition to healthcare reform, and you have repeated it ad nauseum. You and your party would like to paint those who would like to see reform as a bunch of princesses who expect everything for nothing (Hmmmm...actually, there are probably few of those around, in both parties.).
The fact is, the majority of those would like to see reform and improvement in our healthcare/coverage system would simply like to see a modest, reasonable, accessible level of healthcare for virtually anyone who can help pay into it.
Your repetitive position is simply a cover for the fact that you & the Repugs would prefer to not see any kind of reform at all, because there are potential cost impacts that might affect your income. All of the other rationales (loss of freedom, don't trust big gov't, etc.) are simply political/media strategies being used to inflame the emotions of voters so as to accomplish the ultimate goal of the Repugs: Status Quo
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Ken M
Mountain climber
Los Angeles, Ca
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Dec 18, 2009 - 02:03pm PT
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"We hold these Truths to be self-evident, that all Men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness."
Fatrad, perhaps you renounce the Declaration? "Life", as stated here, would certainly encompass care to sustain life and protect life.
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Ken M
Mountain climber
Los Angeles, Ca
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Dec 18, 2009 - 02:12pm PT
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"All I can add to any of this is one simple fact, if 50% of the people think it is good and 50% think it is bad, there is a 50/50 chance that it is bad (excluding the possibility of 50% of the people being idiots).
NO bill should pass without a 75% vote (or some other arbitrary large number). If something is a good idea, a large number of people will see that and vote for it. This 50% majority rule thing is crap and is no different than flipping a coin on our futures.
Dave"
Dave, I've not seen anyone argue for an anti-democracy(majority rules) process, for a long time. Had we followed this course, women would not vote, blacks would be slaves, and your employers would do backround checks to see what your politics were and where you were born, before deciding to hire you, and firing you if they didn't like your Supertopo posts.
Your concept of "fact" is astonishing: If 50% of people think the world is flat, and 50% think it is round, there is a 50/50 chance of it being flat?
I'd caution you to think about the result of having the American public vote on whether to allow dirtbag climbers to climb on public land at all, or whether they should pay some huge fee to cover undefined "problems". I doubt that you'd get 75% in favor of allowing it.
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Norton
Social climber
the Middle Class
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Dec 18, 2009 - 02:19pm PT
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Ksolem, yes, I suppose nothing can force you, or anyone from going without
health insurance. Certainly, no one is going to be put in jail, just see
your tax bill go up each April with the added "fine". Your choice!
But, to get to your question of just going out and buying health insurance
when it comes time that you need it, well, they call that a "pre-existing condition".
Therefore, you would pay more, a lot more, IF you could find ANY
insurance company to put you on and actually pay for your new care crisis.
The private insurers are really, really smart. They are in business NOT
to provide us with health insurance, but to make as MUCH MONEY as they
possible can for their shareholders and senior board members.
Now, when you turn 65, you are eligible for Medicare, the hated "big government"
health insurance program that has insured ten of millions of Americans
since the 1960s. They CANNOT screw you by denying you for have a pre-existing"
condition like the private insurers can right now.
But, we all know how much we hate the government, until we need it of course.
So, the trick is to already have health insurance, so when you get sick
as hell, it is written in your agreement with them that they pay out.
That's how all insurance works, life, home, auto, and health.
Not lecturing because I am no expert, just stating what I know from reading.
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John Moosie
climber
Beautiful California
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Dec 18, 2009 - 02:33pm PT
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Norton, what Kris was saying was "if" the bill passes, then why couldn't he do what he suggested, as the bill does not allow insurance companies to deny one coverage based on pre-existing conditions. I imagine they might be able to delay covering you, leaving you with the hospital bills or surgery bills. Would you go straight from an accident to an insurance company if you were unconscious?
This is what concerns me. They can't deny you coverage based on a pre-existing condition, but I haven't found anywhere where it limits how much they can charge you. If they can charge you any price for coverage, then this will in effect, be denying you coverage. I couldn't pay 1 million dollars a year for coverage of my health problems. So I would have to go without. Yet they would fine me for not having coverage.
This is just what I see. If anyone can help me understand this part of the bill, I would appreciate it.
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Norton
Social climber
the Middle Class
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Dec 18, 2009 - 02:50pm PT
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John, yes, the bill DOES make it "illegal" for the private insures to deny
health insurance (pre existing condition) if you are ALREADY signed up and paying them.
So, in this instance, the assumption is wrong that you can go along WITHOUT
health insurance, and THEN, when you get sick, suddenly sign up.
Nope.
That is NOT what the bill says, and its does NOT allow that sort of "gaming"
Let's say you already have health insurance, and you wake up with a breathing
problem, you go to your assigned doctor and he does some tests and tells you
that you have lung cancer and are going to die in six months.
Now, the insurance company sure does NOT want to pay out hundreds of thousands
of dollars to keep you alive because that cuts in to their profits, so they
look through your initial application with them and they see that you lied,
or forgot, to tell them that you smoke cigarettes. This is called a
pre existing condition, and so they legally do not have to pay out anything.
Now, the bill working it's way through congress will not let them cut
you off for having this pre existing condition, because you may not have
"intentionally" been trying to deceive them with your smoking.
Another example would be if you had a childhood disease that they found
out about when they were testing you for your present sickness and the
two are related. You were a two year old at the time and did not even remember
to tell them, or you just did not know about this. NOW, they can cut you
off. The bill makes this illegal.
But, the bill also allows them to charge you whatever they want, higher,
in many cases, much higher, for having a pre existing condition.
The bill just makes it illegal for them to NOT offer you coverage IF you
can afford to pay their higher monthly premiums.
What the bill does NOT do, is GUARANTEE you healthcare if you have a
pre existing condition AND you can't afford to pay the higher premium
In that case, too bad. As Fattrad believes, if you can't afford good
healthcare, well, too fuking bad because it is a privilege of the wealthy,
and NOT a "human right".
The Democrats stand 100% opposed to Fattrad and the Republican's position on this.
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John Moosie
climber
Beautiful California
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Dec 18, 2009 - 02:54pm PT
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So what you are saying is that this bill wont help me get health insurance because I have pre-existing conditions with no coverage.
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apogee
climber
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Dec 18, 2009 - 02:56pm PT
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"This is what concerns me. They can't deny you coverage based on a pre-existing condition, but I haven't found anywhere where it limits how much they can charge you."
Yeah, me either. It's one of the frustrating and scary things about the bill as it currently stands: it creates an individual mandate, penalizes those who don't get insurance, and places very few cost controls (which is the heart of the healthcare reform issue). Have you noticed how quiet the insurance industry & big pharma voices have been of late? That's because the current bill is a giant gift to them- they're psyched at the direction it's going.
Setting aside the Repugs and their 'no reform or healthcare for the masses under any circumstances' attitude, there are a bunch of Dems who feel the current bill should be scrapped and start the whole process over (Howard Dean being one of the most prominent voices). Given the 'sh*t-sandwich' state that it's in (to use Chaz' description), there's a part of me that agrees. However, the reality is that if it does fail, all political momentum to change it would be lost for the rest of Obama's first (and probably last) term, and it wouldn't likely be picked up again for many, many years. Some say that, while the current state of the bill is far less than ideal, it's a start, with enough regulatory framework within it to be able to revisit and modify to something closer to ideal. For those who would have liked to see real, meaningful reform, it seems this is about the best hope that we have in this current bill.
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