While driving to work this morning I listened to the health care reform bill signing ceremony taking place in the East Room of the White House. I couldn't help but reflect back to last August when I decided to write this blog. Initially writing the blog was an outlet for my frustration in fighting with insurance companies on behalf of our practice and on behalf of patients requiring health care. Overtime, writing this blog became a forum of legitimate debate, expression of concern for the less fortunate people of the United States of America not having access to health care, and whether or not health care should be treated as a commodity like orange juice or building supplies.
I have been privileged to hear from many of you passionately expressing your views or participating in this debate. Because of this blog I have had several interactions with Senators Boxer and Feinstein, and Representatives Sherman,Waxman, and Pelosi from California. I have been very critical of President Obama and the above named legislators for their inaction and unwillingness to stop corporate america from profiteering off the sick and or injured. I have expressed criticism to all of them for allowing the insurance industry, the medical device industry, and the pharmaceutical industry to drive health care and for taking their campaign contributions. I have publicly stated my opinion that all of them were more concerned about their re-election than they were about providing real access to health care and fixing our broken health care system.
I have also been very critical of the Senate Bill which did NOT go far enough in ensuring access to quality health care. I felt and still believe that the only solution to our broken health care system is universal health care with options for additional coverage (hybrid system). I felt and still believe that aspiring medical students should be educated and trained by our government in exchange for a minimum six year commitment to public health service with reasonable salary after they complete their residency and or fellowship training. I felt and still believe that corporations should NOT be part of the basic health care equation.
Frankly, I do not like this bill because the true beneficiary of this law is the insurance industry who now has over 30 million new customers without significant limitations on pricing. Anthem Blue Cross generated a $4.7 billion profit in the last quarter of 2009. At the same time letters were sent to individual policy holders in California informing them of up to 39% increase in their insurance premiums. Two weeks ago, the Dept of Insurance in California announced their findings of an investigation that Anthem Blue Cross committed 700 insurance violations. Each violation carries a $10,000 fine. This fine will be paid for by policy holders and the constant denial or delay of claims. Blue Cross doesn't care if they violate the rules because they will never pay fines from their profits. In other words, the Health Care Reform Bill signed today by President Obama will not stop the insurance industry from delaying payment or denying claims, raising insurance premiums, violating claims rules, or passing costs from their own negligence onto policy holders and health care providers.
That being said, the law that President Obama signed today is historic in that access to quality health care will now be available to tens of millions of people, who without this law, would go untreated. The law also provides that insurance companies may not deny coverage for people with pre existing conditions and they may not terminate coverage for sick or injured policy holders. Children up to age 26 will be allowed coverage under their parents policy. These are all good things.
As with all health care plans, the young and healthy support the elderly and the ill. Mandatory insurance for all Americans will help cover the costs of pre existing conditions. It won't solve all the economic impact of the legislation, but it will help. Opposition to the bill continues to deny this fact. The fear mongering promulgated by the opposition is a cover for the attitude of caring only about oneself and the continued profiteering off of sick people. As the new law infiltrates our society, the fear will subside when people come to terms with the reality of how little they will be personally effected (unless they don't have health care coverage or earn over $250,000 each year). This bill is NOT socialism. This bill does not take away our personal freedoms. This bill only makes it possible for people to get health care.
I agree with the President that this is a beginning. Concerns such as tort reform, education and training of health care providers, limiting profiteering off the sick or injured by the insurance industry, pharmaceutical industry, and medical device industry, and eliminating waste in providing health care MUST be continuously evaluated. Access to health care and solutions to these concerns will go a long way in FIXING OUR BROKEN HEALTH CARE SYSTEM.
Since Health Care NOW is the law of the land, this will be my last post on HEALTH CARE NOW. It has been a privilege to share my thoughts, concerns, and hopes with you all. I wish you good health.
Tuesday, March 23, 2010
Sunday, March 21, 2010
House Amends Health Care Now only hours after passage
March 21, 2010 — It seemed like an anticlimax to the history that had just been made on the floor of the House of Representatives, but it was an anticlimax that mattered a lot politically to healthcare reformers in Washington, DC.
At roughly 10:45 pm EST, the House approved a Senate bill in a 219 to 212 vote that overhauls the nation's health system and extends insurance coverage to millions more Americans. Less than an hour later, the House amended that measure in a 220 to 211 vote to incorporate key changes sought by its own leadership as well as President Barack Obama.
The revisions to the Senate legislation appear in a budget reconciliation bill that lawmakers use to change revenue and spending lines in the federal budget. Casting those changes in the form of a reconciliation bill is important to congressional Democrats, because such a bill cannot be filibustered in the Senate, where Democrats lack the 60 votes needed to override a filibuster. The Senate is expected to vote on the reconciliation bill later this week to wrap up months of congressional debate on transforming one sixth of the nation's economy.
The Senate healthcare reform legislation that the House passed and then amended would, among other things, require most Americans to obtain health insurance, help needy individuals and families buy coverage through government-operated insurance "exchanges," prevent private insurers from denying someone a policy based on preexisting conditions, and increase Medicaid enrollment by almost 50%.
Amendments Include Medicaid Pay Raise for Primary-Care Physicians
The amendments approved today do not alter the basic framework of the Senate healthcare reform bill, but they do introduce significant embellishments, some key to the measure's passage. The reconciliation bill would:
Add 16 million additional Americans to the Medicaid program compared with 15 million under the Senate plan, and raise Medicaid reimbursement rates to Medicare levels for general internists, family physicians, and pediatricians in 2013 and 2014.
Eliminate a special deal for Nebraska that would have exempted it from funding its share of an expanded state Medicaid program, and instead beef up federal Medicaid funding for all states.
Eventually close the "doughnut hole" in the Medicare Part D prescription drug plan, a coverage gap that forces Medicare recipients to bear the full cost of medications.
Make steeper cuts in payments to private Medicare Advantage plans.
Levy a 3.8% Medicare Part A (hospital insurance) tax on unearned income for individuals who earn more than $200,000 ($250,000 for married couples). This comes on top of a 0.9% increase in the Medicare Part A tax on earned income for these individuals and couples under the Senate bill.
Delay the effective date of an excise tax on high-cost insurance plans from 2013 to 2018, and increase dollar thresholds for insurance costs that are subject to the tax.
Offer more generous subsidies to individuals and families purchasing required insurance coverage.
When the reconciliation amendments are incorporated, the Senate bill translates into health insurance coverage for 32 million additional Americans over 10 years at a cost of $938 billion while reducing the federal deficit by $143 billion during that period, according to the Congressional Budget Office.
While the reconciliation bill must now receive Senate approval before the amendments take effect, the Senate bill itself — now approved by the House — will go to President Obama for his signature, according to a game plan for today's votes published on the Web site of House Majority Leader Steny Hoyer (D-MD).
[CLOSE WINDOW]
Authors and Disclosures
Journalist
Robert Lowes
Freelance writer, St. Louis, Missouri
Disclosure: Robert L. Lowes has disclosed no relevant financial relationships.
At roughly 10:45 pm EST, the House approved a Senate bill in a 219 to 212 vote that overhauls the nation's health system and extends insurance coverage to millions more Americans. Less than an hour later, the House amended that measure in a 220 to 211 vote to incorporate key changes sought by its own leadership as well as President Barack Obama.
The revisions to the Senate legislation appear in a budget reconciliation bill that lawmakers use to change revenue and spending lines in the federal budget. Casting those changes in the form of a reconciliation bill is important to congressional Democrats, because such a bill cannot be filibustered in the Senate, where Democrats lack the 60 votes needed to override a filibuster. The Senate is expected to vote on the reconciliation bill later this week to wrap up months of congressional debate on transforming one sixth of the nation's economy.
The Senate healthcare reform legislation that the House passed and then amended would, among other things, require most Americans to obtain health insurance, help needy individuals and families buy coverage through government-operated insurance "exchanges," prevent private insurers from denying someone a policy based on preexisting conditions, and increase Medicaid enrollment by almost 50%.
Amendments Include Medicaid Pay Raise for Primary-Care Physicians
The amendments approved today do not alter the basic framework of the Senate healthcare reform bill, but they do introduce significant embellishments, some key to the measure's passage. The reconciliation bill would:
Add 16 million additional Americans to the Medicaid program compared with 15 million under the Senate plan, and raise Medicaid reimbursement rates to Medicare levels for general internists, family physicians, and pediatricians in 2013 and 2014.
Eliminate a special deal for Nebraska that would have exempted it from funding its share of an expanded state Medicaid program, and instead beef up federal Medicaid funding for all states.
Eventually close the "doughnut hole" in the Medicare Part D prescription drug plan, a coverage gap that forces Medicare recipients to bear the full cost of medications.
Make steeper cuts in payments to private Medicare Advantage plans.
Levy a 3.8% Medicare Part A (hospital insurance) tax on unearned income for individuals who earn more than $200,000 ($250,000 for married couples). This comes on top of a 0.9% increase in the Medicare Part A tax on earned income for these individuals and couples under the Senate bill.
Delay the effective date of an excise tax on high-cost insurance plans from 2013 to 2018, and increase dollar thresholds for insurance costs that are subject to the tax.
Offer more generous subsidies to individuals and families purchasing required insurance coverage.
When the reconciliation amendments are incorporated, the Senate bill translates into health insurance coverage for 32 million additional Americans over 10 years at a cost of $938 billion while reducing the federal deficit by $143 billion during that period, according to the Congressional Budget Office.
While the reconciliation bill must now receive Senate approval before the amendments take effect, the Senate bill itself — now approved by the House — will go to President Obama for his signature, according to a game plan for today's votes published on the Web site of House Majority Leader Steny Hoyer (D-MD).
[CLOSE WINDOW]
Authors and Disclosures
Journalist
Robert Lowes
Freelance writer, St. Louis, Missouri
Disclosure: Robert L. Lowes has disclosed no relevant financial relationships.
Congress Passes HEALTH CARE NOW
March 21, 2010 — The great healthcare reform battle of 2009 and 2010, for the most part, is over.
Congressional Democrats today finally passed their bill.
The only thing it needs now is the signature of President Barack Obama to become the law of the land.
In a 219 to 212 vote, the House today approved a bill enacted by the Senate last December that represents the most sweeping government initiative in healthcare since the creation of Medicare and Medicaid in 1965.
Most notably, the legislation will require most Americans to acquire health insurance, help cash-strapped individuals and families purchase it through government-operated insurance marketplaces called exchanges, increase Medicaid enrollment by almost 50%, and impose regulations on private insurers that would prevent them from denying someone coverage based on preexisting conditions.
After the historic vote, the House is expected to turn today to a budget reconciliation bill that would amend the now-approved Senate bill more to the House's and the president's liking. Taken together with this reconciliation bill, the Senate reform package would extend insurance coverage to 32 million more Americans over 10 years at a cost of $938 billion, although it would reduce the federal deficit during that period by $143 billion, according to the latest estimates of the Congressional Budget Office (a few days ago, the CBO had released slightly different dollar amounts).
If approved by the House, the budget reconciliation bill will go before the Senate, where Senate Majority Leader Harry Reid (D-NV) says he has the minimum 51 votes required to pass it. Reconciliation bills — which adjust revenue and spending lines in the federal budget — cannot be filibustered in the Senate. It takes 60 votes in the Senate to override the endless speeches and procedural motions that characterize a filibuster and force a vote on legislation. Republican Senators, who unanimously opposed the reform bill approved by their chamber last year, command 41 votes.
Today's House Vote Makes History in More Ways Than One
In addition to dramatically reshaping the American healthcare system — which accounts for one sixth of the nation's economy — the legislation passed by the House today was historic for other reasons. For the first time, the American Medical Association supported a plan for government-orchestrated healthcare reform after having denounced earlier proposals, including legislation creating Medicare and Medicaid, as dangerous experiments in "socialized medicine." Other major medical societies that backed today's bill were the American College of Physicians and the American Academy of Pediatrics.
The fear of federalization still resonated, though, among Republican politicians who formed a thick stone wall against the legislation. Their arguments against what they called a government takeover of medicine at times reached rhetorical fever pitches that will be remembered for years.
Sarah Palin, the former governor of Alaska and the Republican vice presidental candidate last year, warned that under the Democrats' reform plan, bureaucratic "death panels" would deny care to the disabled and elderly in the name of cost-saving. Even though the likes of the AARP called these claims unfounded, the debate about complex healthcare policy soon featured the catch-phrase "pulling the plug on granny."
At the same time, the new Tea Party movement entered the fray, holding rallies, flooding congressional townhall meetings, and wavings signs with messages such as "Save Granny. Defeat Obamacare" and "Get Government Out of Our Lives." Such protesters showed up today in force in Washington, DC, as the House casts its vote.
Fiery denunciations of reform legislation also resounded inside the Capitol building up until the time of the vote.
"My colleagues are celebrating the birth of a great new entitlement program," said Rep. Marsha Blackburn (R-TN). "Only they see dependency on the federal government and the death of freedom as a cause for celebration. Freedom dies a little bit today."
Last-Minute Promise of Executive Order Against Abortion Funding Secured Key Votes
One obstacle to House Democrats rounding up enough votes for victory was the issue of federal funding of abortions in an overhauled healthcare system.
When House Democrats crafted and passed their own reform bill last year, they included language that would prohibit any woman receiving an insurance premium subsidy from purchasing a health plan that covered an abortion other than a federally sanctioned one to save the life of the woman or in cases of rape and incest. The Senate bill contains a complicated anti-abortion restriction that resembles the House version in intent, but Democratic reform advocates in the House like Rep. Bart Stupak (D-MI) who are also abortion opponents said the Senate language was not strong enough for them to support the bill in good conscience.
Earlier today, President Obama convinced Rep. Stupak and his coalition of like-minded Democrats to change their votes to "Yea" by promising to issue an executive order that would ensure no abortions would be federally funded under the reform bill before the House on Sunday. President Obama released the text of the order and said he would sign it as soon as the House passed the bill.
It was good enough for Rep. Stupak.
"We've been able to come to an agreement to protect the sanctity of life in healthcare reform," Rep. Stupak said Sunday.
Two Medical Societies Applaud Reform Bill, But Say More Legislative Work Remains
In a press release issued tonight, American Medical Association President J. James Rohack, MD, said that by extending health insurance to millions more Americans, the bill passed by the House "will help patients and the physicians who care for them."
"Every day physicians see the devastating effect being uninsured has on the health of our patients," Dr. Rohack said. "Physicians dedicate their lives to helping patients, and we have an historic opportunity now to do just that."
Similarly, Lori Heim, MD, the president of the American Academy of Family Physicians, hailed the bill's passage in a written statement. "As a result of today's vote, Americans can look forward to health security because they soon will have the chance to buy health insurance that meets their needs without emptying their bank accounts," Dr. Heim stated.
Both Dr. Heim and Dr. Rohack said that their societies will continue to work with Congress on what they see as the unfinished business of healthcare reform, particularly medical liability reform and a permanent solution to the problematic formula for setting Medicare reimbursement for physicians, which calls for a 21.2% pay cut this year.
[CLOSE WINDOW]
Authors and Disclosures
Journalist
Robert Lowes
Freelance writer, St. Louis, Missouri
Disclosure: Robert L. Lowes has disclosed no relevant financial relationships.
Congressional Democrats today finally passed their bill.
The only thing it needs now is the signature of President Barack Obama to become the law of the land.
In a 219 to 212 vote, the House today approved a bill enacted by the Senate last December that represents the most sweeping government initiative in healthcare since the creation of Medicare and Medicaid in 1965.
Most notably, the legislation will require most Americans to acquire health insurance, help cash-strapped individuals and families purchase it through government-operated insurance marketplaces called exchanges, increase Medicaid enrollment by almost 50%, and impose regulations on private insurers that would prevent them from denying someone coverage based on preexisting conditions.
After the historic vote, the House is expected to turn today to a budget reconciliation bill that would amend the now-approved Senate bill more to the House's and the president's liking. Taken together with this reconciliation bill, the Senate reform package would extend insurance coverage to 32 million more Americans over 10 years at a cost of $938 billion, although it would reduce the federal deficit during that period by $143 billion, according to the latest estimates of the Congressional Budget Office (a few days ago, the CBO had released slightly different dollar amounts).
If approved by the House, the budget reconciliation bill will go before the Senate, where Senate Majority Leader Harry Reid (D-NV) says he has the minimum 51 votes required to pass it. Reconciliation bills — which adjust revenue and spending lines in the federal budget — cannot be filibustered in the Senate. It takes 60 votes in the Senate to override the endless speeches and procedural motions that characterize a filibuster and force a vote on legislation. Republican Senators, who unanimously opposed the reform bill approved by their chamber last year, command 41 votes.
Today's House Vote Makes History in More Ways Than One
In addition to dramatically reshaping the American healthcare system — which accounts for one sixth of the nation's economy — the legislation passed by the House today was historic for other reasons. For the first time, the American Medical Association supported a plan for government-orchestrated healthcare reform after having denounced earlier proposals, including legislation creating Medicare and Medicaid, as dangerous experiments in "socialized medicine." Other major medical societies that backed today's bill were the American College of Physicians and the American Academy of Pediatrics.
The fear of federalization still resonated, though, among Republican politicians who formed a thick stone wall against the legislation. Their arguments against what they called a government takeover of medicine at times reached rhetorical fever pitches that will be remembered for years.
Sarah Palin, the former governor of Alaska and the Republican vice presidental candidate last year, warned that under the Democrats' reform plan, bureaucratic "death panels" would deny care to the disabled and elderly in the name of cost-saving. Even though the likes of the AARP called these claims unfounded, the debate about complex healthcare policy soon featured the catch-phrase "pulling the plug on granny."
At the same time, the new Tea Party movement entered the fray, holding rallies, flooding congressional townhall meetings, and wavings signs with messages such as "Save Granny. Defeat Obamacare" and "Get Government Out of Our Lives." Such protesters showed up today in force in Washington, DC, as the House casts its vote.
Fiery denunciations of reform legislation also resounded inside the Capitol building up until the time of the vote.
"My colleagues are celebrating the birth of a great new entitlement program," said Rep. Marsha Blackburn (R-TN). "Only they see dependency on the federal government and the death of freedom as a cause for celebration. Freedom dies a little bit today."
Last-Minute Promise of Executive Order Against Abortion Funding Secured Key Votes
One obstacle to House Democrats rounding up enough votes for victory was the issue of federal funding of abortions in an overhauled healthcare system.
When House Democrats crafted and passed their own reform bill last year, they included language that would prohibit any woman receiving an insurance premium subsidy from purchasing a health plan that covered an abortion other than a federally sanctioned one to save the life of the woman or in cases of rape and incest. The Senate bill contains a complicated anti-abortion restriction that resembles the House version in intent, but Democratic reform advocates in the House like Rep. Bart Stupak (D-MI) who are also abortion opponents said the Senate language was not strong enough for them to support the bill in good conscience.
Earlier today, President Obama convinced Rep. Stupak and his coalition of like-minded Democrats to change their votes to "Yea" by promising to issue an executive order that would ensure no abortions would be federally funded under the reform bill before the House on Sunday. President Obama released the text of the order and said he would sign it as soon as the House passed the bill.
It was good enough for Rep. Stupak.
"We've been able to come to an agreement to protect the sanctity of life in healthcare reform," Rep. Stupak said Sunday.
Two Medical Societies Applaud Reform Bill, But Say More Legislative Work Remains
In a press release issued tonight, American Medical Association President J. James Rohack, MD, said that by extending health insurance to millions more Americans, the bill passed by the House "will help patients and the physicians who care for them."
"Every day physicians see the devastating effect being uninsured has on the health of our patients," Dr. Rohack said. "Physicians dedicate their lives to helping patients, and we have an historic opportunity now to do just that."
Similarly, Lori Heim, MD, the president of the American Academy of Family Physicians, hailed the bill's passage in a written statement. "As a result of today's vote, Americans can look forward to health security because they soon will have the chance to buy health insurance that meets their needs without emptying their bank accounts," Dr. Heim stated.
Both Dr. Heim and Dr. Rohack said that their societies will continue to work with Congress on what they see as the unfinished business of healthcare reform, particularly medical liability reform and a permanent solution to the problematic formula for setting Medicare reimbursement for physicians, which calls for a 21.2% pay cut this year.
[CLOSE WINDOW]
Authors and Disclosures
Journalist
Robert Lowes
Freelance writer, St. Louis, Missouri
Disclosure: Robert L. Lowes has disclosed no relevant financial relationships.
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