Reform 2010: A Positive Outlook

What seems like a neverending story, its finally a done deal. Obama finally got his healthcare reform past but there is going to be great up roar about the constituitionality of the this passage and you can count on a fight. Although this bill is not perfect, it has a lot of useful options and seems appropriate to take a step back and look what this bill has to offer.
Medicare:
- Closes the Medicare prescription drug "donut hole" by 2020. Seniors who hit the donut hole by 2010 will receive a $250 rebate.
- Beginning in 2011, seniors in the gap will receive a 50 percent discount on brand name drugs. The bill also includes $500 billion in Medicare cuts over the next decade.

Medicaid:
- Expands Medicaid to include 133 percent of federal poverty level which is $29,327 for a family of four.
- Requires states to expand Medicaid to include childless adults starting in 2014.
- Federal Government pays 100 percent of costs for covering newly eligible individuals through 2016.
- Illegal immigrants are not eligible for Medicaid.

Insurance Reforms:
- Six months after enactment, insurance companies could no longer denying children coverage based on a preexisting condition.
- Starting in 2014, insurance companies cannot deny coverage to anyone with preexisting conditions.
- Insurance companies must allow children to stay on their parent's insurance plans until their 26th birthday.

Abortion:

-  The bill segregates private insurance premium funds from taxpayer funds. Individuals would have to pay for abortion coverage by making two separate payments, private funds would have to be kept in a separate account from federal and taxpayer funds.

- No health care plan would be required to offer abortion coverage. States could pass legislation choosing to opt out of offering abortion coverage through the exchange.

**Separately, anti-abortion Democrats worked out language with the White House on an executive order that would state that no federal funds can be used to pay for abortions except in the case of rape, incest or health of the mother. (Read more here)

Individual Mandate:
- In 2014, everyone must purchase health insurance or face a $695 annual fine. There are some exceptions for low-income people. This is similar to having car insurance, and buying insurance is required because driving is considered to be a privalege. Having the best access to health care should be considered a privalege and buying insurance should be a requirement.

Employer Mandate:

- Technically, there is no employer mandate. Employers with more than 50 employees must provide health insurance or pay a fine of $2000 per worker each year if any worker receives federal subsidies to purchase health insurance. Fines applied to entire number of employees minus some allowances.

Immigration:

- Illegal immigrants will not be allowed to buy health insurance in the exchanges -- even if they pay completely with their own money.

Summary:

On a seperate note payment for this bill is that of shifting costs and less actual savings. They plan on covering 30 million more Americans and dumping them into a pool of people who's inurance pays so poorly that nobody will see them. Walgreens has even quit filling their presciptions in Washington. Medicaid paid 72% of Medicare rates in 2008, which is substantially lower than private insurance pays. All this does is create an even bigger pool of people whom will continue to get poorer and more scarce healthcare than originally desired. The cuts in payments to physicians from Medicare and Medicaid are being slashed again and soon nobody is going to see them. Working for free isn't a healthcare initiative. This does not provide them the access they need. Cost shifting is not the approach, its a poor effort to address the real problem with medicaid and medicare. And once again they failed to address the 21% medicare cuts that are planned to hit again. They are just hiding billions of dollars and sweeping them under the rug for some one else to deal with.



When it comes down to it this bill has some great focus. The question that remains though is, can they deliver. Government is notorious for making empty promises and their historical lack of follow through and lack luster production is one major reason the people don't want them to be involved.

Further Reading
Health Care Reform Bill Summary: A Look At What's in the Bill
Twenty-six Lies About H.R. 3200

http://www.politicsandmedicine.com/
By: Dr. Travis Smith