Health-Care Reform Passed. So What Does It Mean?

By Smriti Rao | March 22, 2010 4:22 pm

P032110PS-0787After months of party wrangling that culminated in a Sunday night political spectacle, President Obama has finally managed to push through far-reaching reform to the country’s health care system. The House voted 219-212 for final approval of the legislation, and on Tuesday the President will sign the bill into law.

The new law would require most Americans to have health insurance, would add 16 million people to the Medicaid rolls and would subsidize private coverage for low- and middle-income people, at a cost to the government of $938 billion over 10 years, the Congressional Budget Office said [The New York Times].

Here’s a primer on what some of the biggest changes will be in the current health care system. While some changes won’t come into effect till 2014, there are some things that will affect your insurance this year.

Immediate Changes (2010)

These are the changes that Obama and team call the “early deliverables,” because they would kick into effect as early as six months after the bill is signed into law. Here are a few.

  • The uninsured can finally get coverage: Adults who have been denied coverage because of preexisting conditions will be able to sign on to a federally subsidized insurance program that is due to be established within 90 days. This stopgap insurance program, whose coverage isn’t expected to be comprehensive, will expire once new insurance exchanges start operating in 2014.
  • Coverage for everyone: Insurance companies will not be allowed to drop people from coverage when they get sick, nor can they make health plans vastly more expensive for people with preexisting conditions. Lifetime limits on the amount of health care an insurer will pay for will be eliminated, and annual limits will be restricted.
  • Coverage for kids: For parents with a sick child, there’s some relief—companies won’t be able to drop kids under the age of 19 from coverage because of pre-existing conditions. Parents can also keep their kids on a family plan till they turn 26 or get a job that offers them benefits.
  • Closing the doughnut hole: An estimated 4 million Medicare beneficiaries who hit the so called “doughnut hole” in the program’s drug plan (the gap in coverage which currently begins after $2,700 is spent on drugs) will get a $250 rebate this year. The cost of drugs in the coverage gap will then drop 50 percent next year, and the hole will be closed entirely by 2020.
  • Tax credits for small businesses: For small businesses with fewer than 25 employees and average wages of less than $50,000, the government will provide a tax credit of up to 35 percent of the cost of healthcare premiums so that they may provide coverage to their employees.

Short-Term Changes (2011-2014)

  • Free annual wellness visit for Medicare beneficiaries: Medicare beneficiaries will get a free annual wellness visit, and the new health plans will be required to cover preventive services with little or no cost to patients. Medicare will also provide 10 percent bonus payments to primary care physicians and general surgeons.
  • New Medicaid program for poor: A new Medicaid plan for the poor will allow states to provide more home- and community-based care for disabled people who would otherwise require institutional help.

Long-Term Changes (2014 onwards)

  • Get insurance or face penalties: Beginning in 2014, all Americans would be expected to get insurance or face penalties. The fine depends on household income, but there’s also an upper limit; a family would pay a maximum of $2,085. Extremely low-income people will be exempt from the fines.
  • Large employers must provide insurance: Big employers are also expected to provide coverage to workers or face fines. Businesses with 50 or more workers who do not provide coverage will be fined $2,000 for each uninsured employee.
  • Extending Medicaid to cover low-income families: Medicaid, the state-federal program for the poor and disabled, will be expanded sharply starting 2014; it will now offer care to people with annual incomes less than 133 percent of the poverty level ($29,326 for a family of four).
  • Tax credits for low-income families: People with incomes up to 400 percent of the federal poverty level will receive tax credits on a sliding scale relative to their income to help them to buy insurance.
  • Buying insurance on state exchanges: State-based insurance marketplaces called exchanges are expected to go into effect in 2014, where people can pick and choose the plan that works best  for them. Once the exchanges are up and running, insurers will be barred from rejecting applicants based on their health status. The new policies sold on the exchanges will be required to cover not just hospitalizations, doctor visits, and prescription medicines, but also maternity care and certain preventive exams.

Related Content:
Cosmic Variance: Obamacare

Image: Pete Souza/ Whitehouse.Gov

CATEGORIZED UNDER: Health & Medicine
  • Brian Too

    Congratulations, this is a real accomplishment. I for one thought it wasn’t going to happen and the forces of negativity would prevail.

  • Nicole

    “People with annual incomes less than 133 percent of the poverty level ($29,326 for a family of four) will be granted subsidies so that they may purchase insurance.”

    You have it backwards- people with annual incomes less than 133% of the poverty level (or up to 133%?) will qualify for medicaid, which isn’t a subsidy, it’s just government run healthcare (some states do use private insurance to administrate it, though). People between 133% and 400% of the poverty line will receive subsidies.

  • John

    I’m torn. For someone with serious health issues who has no insurance, or must continually fight the insurance companies, this bill must seem like a godsend.
    On the other hand I know that it is destined to become another huge government debacle, gobbling trillions in taxpayer money to feed a voracious, inefficient, and expanding bureaucracy.

    Reform is needed, but this is not the solution.

  • brian

    I don’t like the feeling of not being able to choose. The idea that you must get the insurance or get fined seem like an additional problem.

  • http://aol Erin

    I applaud Obama and everyone else who worked on getting this bill passed. I am one of those people with pre existing conditions and below the poverty level, however I had to move out of state to even qualify for medicaid. I am 26 and couldnt get health insurance because I had endometriosos, I needed a hysterectomy and couldnt get insurance anywhere. My husband and I who is also unemployed had to move our three kids to TN from NC just so I could get healthcare and a hysterectomy. I know what it is to need healthcare and not have it available to you, rich or poor. At least now we finally have a president who is getting things done, whether everyone agrees with him or not.

  • TheCritic

    Whether he gets things done or not is really the question. Whatever your thoughts on whoever is president at any time, it is never the governments job to take over a free market, it is their job to keep it from being corrupt. Yeah, it was corrupt. Yeah, it needed reform. However, whenever the government can fine you $2000 for NOT purchasing something if you don’t want it, that’s the wrong path, and it’ll continue to lead us down the wrong path for awhile. The “forces of negativity” may not be just against the health care bill, they may have just been against socialism. That’s not to take a radical view of “OBAMA’S A SOCIALIST! OBAMA’S A SOCIALIST! THIS COUNTRY’S GOING TO HELL IN A HAND-BASKET!” But, anytime the government takes control of something and forces the wide majority to have it or pay fines, it’s socialism by definition.

  • PJ Davis

    @TheCritic Actually, by definition, Socialism is public control of productive capital and natural resources.

  • Jess

    So…who’s going to be paying for all this coverage that these people couldn’t afford to get on their own?? We already pay up the rear into Medicare and Social Security – both of which are broke!! This is all going to come down on me and my children. We’re already being taxed into the ground, and now we’re going to have to pay more to take care of other people, while still paying our own bills to survive, and probably be taking care of our parents because there will be no more Social Security left for them. Everyone already had access to healthcare – whether they could afford it or not. Hospitals cannot tell you no because you can’t pay.
    $940 Billion dollars…..I’m sure our children are going to appreciate having to try to fix THAT deficit when their turn comes.

  • TheCritic

    @PJ Davis

    You tax the money I make to make the payments for other people’s health care. The capital there is the money I make and the natural resource is the labor I provide to get the capital taken from me. The government wants to tax my labor and capital so they can give it to others. The government is a public institution since the only money they have is taken from the public at large.

    Government = Public
    Government taxing my capital and labor = Control of my capital and labor

  • Really

    right critic, because limits and laws arent needed, if you dont have healthcare and you can afford it its because your a retard. Its not taking freedom or your right to choose away it is making it affordable for people. The reason they fine you is because tax payers are paying for it,and if you dont use what is availibe to you they take that money back… It may be to hard for you to understand but this country went down the wrong path the first term bush was in office. Obama may not be a great president but he was handed a mess from the republican party.

  • Jess

    The Democrats are always going to blame it on the Republicans, and the Republicans are always going to blame it on the Democrats — because, of course, that’s the mature thing to do. Maybe we should just go all the way back and blame it on the people who founded this country. Thank god we have that freedom of speech to insult each other.

  • Really

    Also what do you suggest we do critic? Do you want us to stop caring about other human life? I tell you what for one second step in their shoes, you complain because your children will have to pay thoes taxes, well there children and their children and theirs will have to that 940 billion in medical exspenses. who takes care of them? Im part of the generation that has to spend the rest of my life paying taxes ill never see compansation for. But im willing to sacrifice for the good of others, but because people you dont care about other people suffering, it makes it hard for anyone else to get anywhere. This nation was not born from selfcentered people nor is it defended today by them.

  • TheCritic

    @ Everyone

    What am I suggesting we do? I’m suggesting the rest of you get off your asses and do something about it instead of resolving to let a government just take your money. If you think paying someone else to do it is doing enough that’s fine. You think I’m complaining because my children are going to have to pay? No, I don’t care about the money being spent. I care about how it’s being spent. I understand that Obama was given a s**t-storm from the Bush administration, but I didn’t make this about the Bush administration or the Obama administration. I made this about government, in general. There is no government that can run things more efficiently than a private corporation could, provided there was no corruption in the corporation. The problem is there’s corruption in both. I would suggest that the government clean up the corruption in the private sector and, if they had to pass laws, pass laws prohibiting the things they want to fix like dropped healthcare plans and denying coverage. I wouldn’t suggest they take it over entirely.


    I must ask you. Really? Thank you for making those judgments about me without taking into consideration who I am. Take your own advice and step into someone elses shoes. I’m glad you’re willing to sacrifice, but don’t insult me and think I’m not. I’m in a pre-med program at a military college right now to go on a track into the army. Med school’s hard to get into, what else am I doing? I’m an EMT. What sacrifices am I making? Hell, if I don’t get into med school through my army track, I’ll likely be a front-line medic. Take a variation of your own advice, and don’t judge people you don’t know over the internet. I’m not calling you self-centered, and it’s not very likely I know what sacrifices you are making. The main point I made was that the government, through good intentions, is making poor decisions. They always have, they always will. You want me to do something about it? I am. I’ll be the one defending your right to insult me as much as you want. I’m glad you’re making sacrifices, too.

    @ Everyone who doesn’t automatically make assumptions about people and throws insults and skips the meat of the matter

    Sorry for the rant.

    [Moderator’s note: Edited the cuss word.]

  • Joel

    Erin, the very state you have moved to has a Governor who is a Democrat and a large Obama supporter. He wrote a letter to the Congressional Representatives of TN asking them to vote against this program as he has seen first hand what a drain it can be financially. He basically said that it would set Tennessee back many years of financial recovery.

  • Wildmonk

    Thank you for the breakdown – this is quite clear.

    @Really – it is a straw man to ask whether we “stop caring about other human life.” Of course we care about human life but you have to be clear about the difference between using seed for planting versus just eating the seed.

    The social-welfare left generally tends to look at the aggregate wealth and think about how it should be used to “care” for others. Too much of this and we end up in a rapid, downhill spiral of debt, reduced growth and, eventuall, poverty and social strife (e.g. Venezuela). Not enough and we end up failing to take practical, defensible steps to ease the plight of the poor.

    The free enterprise conservatives point to history: free societies where people can use their own capital to build businesses and serve the market provide a much healthier economy and society in the long run. They also point to the *trillions* already spent on social welfare programs and ask “why is this not enough?” If the answer is always “more” then you simply aren’t seriously defending the long-term interests of society.

    So…is the bill passed by the House on Sunday responsible? Well, it sounds great when you just talk about the help that people need but I am deeply concerned that we’re entering a realm where we are simply devouring our future prospects with these wild spending sprees. Surely, there has to be *some* way we can help the needy without saddling our kids with unsustainable debt!

  • Really

    Things have to get worse to get better. Granted you do reach a limit where the debt is beyond substantial, on the other hand there are other ways to cut debt besides cut the programs in place to support the people of this nation. We were fine finacialy for many years with these Programs in place it was after a war in Iraq that we were led into blindly. If i remember correctly these programs saved our nation from destruction before and when FDR put them in place people were saying the same things about him.

  • amphiox

    “it’s socialism by definition”

    It isn’t, but even if it was, so what?

    I would argue, from an admittedly biased perspective, that universal health coverage is a moral obligation of the government, no different from defense, infrastructure, and law enforcement.

    Thus, no matter how much it costs, the government must pay whatever it can. If a government is so dirt poor that all it can afford is to pay for one aspirin per citizen who requires it per week, then that is what the government must do. Financial arguments are irrelevent except to define the minimum level of care that must be available universally.

    And even if it is inevitable that any government run program will become an overly expensive bureaucratic mess (I don’t see why it has to be, but really, what is the military if not an overly expensive bureaucratic mess, with a rigid hierarchy, codes of silence, and wasteful spending up the wazzoo?) that is just part and parcel of the price that must be paid.

    Because it is a moral obligation.

    So get the system up and running and join the rest of the civilized world. If there are problems, fix them as they come up.

    The U.S. military has sent its soldiers into battle with inappropriate, inferior, and overly expensive equipment (in every single war the U.S. has been involved in to date!), and lives have been lost as a direct result. We do not point to this as a reason for not having a military at all.

  • John Moore

    If you chose to live an unhealthy lifestyle why is my responsibilty to rpovide you with health care? When I found out Jerry Garcia “bought” his way onto the donor list for a new liver I was shocked. This drunk, cocaine smoking idiot got a liver that probably should have gone to a resposible recipient went to this idiot who after receiving the new liver continued to drink and party. All this new insurance is going to do is enable more people to make poor choices about their lifestyles.

  • Toni

    Welcome to the United Communist States of America! I currently don’t have insurance but the government pays for my sliding scale that all doctors and hospitals offer. Don’t people see that we are going to be in debt a lot worse than we are. Why fine someone over $2,000.00 that doesn’t want it? Thank god I live in Virginia and we just passed a bill that doesn’t require us to have health insurance. Go Ken Cucinnelli! I LOVE VA!!

  • Eric

    We needed reform so bad, and the government tried to tackle it all at once at the cost of billions to taxpayers. Should we help people get insurance – Yes. Should we help the poor – sure.

    Just this week in the news ( was a perfect example of how hand-outs have a long-term harm. Granted, you could consider this anecdotal evidence as it is just one example, but it is relevant because it affects an entire country. Giving away money, health care, or anything else is a bad idea. Giving away ideas, education – that is how you get people out of poverty.

  • Grammastola

    I was reading the bill itself, and I did not see anything about people in low income brackets being exempt. In fact, the bill specifically says that incomes normally not taxed can be used in the calculations of the fine one must pay. Also, I want to point out, it says the fine cannot be more than the basic insurance would cost. So, paying the fine would be cheaper, and since insurance companies cannot deny patients with pre-existing conditions, one has no need for insurance until one has a condition. Would this not put private insurance companies out of business, thus making everyone rely on the government for insurance?

  • Eliza Strickland

    Nicole: You’re right, we didn’t explain the Medicaid point correctly. It’s fixed now. Thanks for the catch!

    — Eliza Strickland, DISCOVER online news editor

  • Bill Boo Baggins

    [Moderator’s note: This comment was deleted because of its nasty racism.]

  • Jim

    I’m torn on this. Of the 10 trillion that has been added to the deficit since the 1980s (and the majority of which was under Reagen and Bush Jr by the way) this is easily been the best spent. But we at some point you just have to stop and I think that was long ago.

    But all hope is not lost. The debt will be manageable if we grow the population by another 100 million along with the economy. Also we can inflate our way out of the debt which seems to be happening which would sort of make this bill come at a discount.

  • Ryan T

    This isn’t the ideal, but it’s a start. There needs to be more competition and cost control. And either the non-participation penalty needs to be near the cost of participation, or it needs to be eliminated and replaced with waiting periods and higher premiums for those who drop coverage for more than a year. A health insurance pool only works well if everyone, including the healthy, participates. Otherwise you end up with a self-reinforcing cycle of spiraling costs and young, healthy people (or their employers) dropping or cutting coverage until they start getting sick. Also, I wonder how many of the people fussing over the cost of getting this program started consider the growing costs to the economy of the ill and uninsured. We’re already paying for lost revenues, and unreimbursed care (often at hospital/emergency room rates).

  • Riley

    If you are low income and chose to pay the fine instead of getting insurance and ended up getting hurt and going to the emergency room, you would be on the hook for the bill and probably would go bankrupt. If you developed some slow-moving disease then you could just sign up for insurance, but you never know when you might be in a car accident or something.

    It’s not perfect, but it’s a step in the right direction.

  • Brian Too

    Lots of negativity here!

    And 23. Bill Boo Baggins, that was racist. I don’t usually call that out but you were blatant.

  • Katharine

    Dude, healthcare reform isn’t going to tax you much if at all unless your income’s more than $250,000. Jess, if your family earns less than that, you probably won’t be paying a penny.

    No, not everybody had access to healthcare. What about people with chronic conditions? What about people whose care requires more than an emergency visit? Uninsured people cost a lot more to treat than insured people. (TheCritic, surely you should know this, since you’re a pre-med and an EMT.)

    Also, John Moore, what kind of insane idea do you have that makes you think all these health problems are because of an ‘unhealthy lifestyle’? There are people who get cancer despite doing everything right. It’s called genetics, eejit.

    In which case, you can afford to give a little as part of a functioning society. It’s a social contract of sorts. You give as part of taxes, the government gives back. For my part, I will be quite glad, when I’ve finished graduate school, to have my income taxed for national healthcare to whatever degree it is.

    And contrary to what John McCain thinks, you can live pretty reasonably on less than $1 million a year.

    Also, I’m not sure what insane person wouldn’t want health insurance. I’ve been in some nasty health situations before that I totally hadn’t anticipated, including one that sent me to the hospital for a week.

    ‘Socialism’ is kind of a big nebulous thing. Are you against ALL socialism? Then get off the road and out of our libraries. Just against some socialist things? Then be clear about what it is you don’t like.

    Toni, I also live in Virginia. Ken Cuccinelli is a dipwad and also fairly insane. Add to this the fact that you probably cost more for hospitals to treat uninsured than insured and you are also insane.

  • Katharine

    “And we just take it…just another typical day in the White House where the Ghetto Negro spends the white man’s hard earned money.”

    F**k off, racist. You can make comments here without being a backwards redneck. The ‘white man’ isn’t the only money-earning demographic in the United States.

  • JustAGirl

    “You ought to be watchful, jealous of your liberty; for, instead of securing your rights, you may lose them forever!”

    [Oops. Sorry. These words were written by anti-Federalists opposing the Constitution of the United States. Anyway:]

    In a moment I will lay out the bold and patriotic actions by which we can fight the “end of America as we know it.” But first, lest you forget, here are some of the horrors we must now endure:

    Millions of Americans will be stripped of their ability to go into bankruptcy because of crippling health care costs.

    Millions of Americans will be stripped of their ability to go into foreclosure because of crippling health care costs.

    Millions of Americans will be stripped of their choice between paying for food or paying for medicine.

    Because 32 million uninsured Americans will now have health care, the rest of us will be prevented from paying billions in tax dollars to cover medical costs incurred by the uninsured.

    Our beloved health insurance CEOs will be stripped of their right to line their pockets with premiums while denying coverage as soon as the premium-payers get sick.

    Our beloved health insurance CEOs will be stripped of their right to deny coverage for pre-existing conditions.

    Medicare patients will lose the privilege of dying from lack of medication when they enter the drug reimbursement “doughnut hole.”

    Because they will now remain covered by their parents’ insurance until age 26, millions of young adults will be stripped of their ability to endure illness and forego vital tests.

    And along with this assault on our values, the Democrats passed a jobs creation bill, AND a student loan bill that will strip away the right of our beloved lending institutions to charge usurious rates.

    This is the legacy of Obama! No wonder another patriot has cried out publically, “Our country owes all its troubles to him!”

    [Oops. That was John Wilkes Booth talking about Abraham Lincoln. Anyway:]

    Can we endure a United States of America where so many can have health care and where insurance behemoths must make do with a few billion dollars less? No. It is unimaginable.

    And so, we must fight. Cry out with me: “We know that these devilish, life-denying and destructive doctrines will be destroyed!”

    [Oops. That’s from Reich Organization Leader Robert Ley’s “The Jews or Us.” Anyway:]

    I hereby announce the formation of Degraded, Insulted Minions Whipped Into Turmoil and Schism. All of you who join will do the following to declare your outrage:

    From this moment on, DO NOT ACCEPT ANY HEALTH INSURANCE PAYMENT! Since the government has “taken over health care” ALL health care insurance is tainted. From now on, pay cash for all doctor visits, medical procedures, and medications. True, many of you will not be able to afford this, but your deaths will be remembered as sacrifices for America.

    Those of you over 65, DO NOT ACCEPT ANY MEDICARE OR MEDICIAID PAYMENT! After a few months of agonized suffering, you’ll die with dignity, knowing you’ve eased the tax burden for all of us.

    If you are over 62, DO NOT ACCEPT ANY SOCIAL SECURITY PAYMENTS! Retire on your 401K earnings, or become a homeless person. If you do, remember to stick an American flag in your shopping cart (you can also stop paying SS taxes and retire to jail—no, that would mean accepting government care!).

    If you have college-age children, DO NOT ACCEPT ANY GOVERNMENT LOAN MONEY. Pay the full tuition! Or let your kids work for Wal-Mart.

    If you are unemployed, DO NOT TAKE ANY JOB CREATED BY DEMOCRAT-PASSED LEGISLATION! Continue to play FarmVille and live on pork rinds.

    Also, if your regular unemployment insurance has ended, DO NOT ACCEPT ANY ADDITIONAL UNEMPLOYMENT INSURANCE! It has been made available by Democrats.

    DO NOT DRIVE ON ANY INTERSTATE HIGHWAYS! These are Federal Roads, representing a government takeover of travel. Find charming back roads as you take your three week drive from New York to Chicago.

    Imagine the horror on the faces of Obama and his Socialist thugs as they behold the wrath of Americans. Remember, as you proudly get sick and go without food, clothing and shelter, that you are striking a blow for liberty.

    And don’t be afraid to spit, hurl invective, disrupt elected officials, and spread disinformation on the Internet. Remember, “You cannot make a revolution with silk gloves!”

    [Oops. That was Stalin.]

    (Woman: Do I detect a note of sarcasm?
    Frink: Are you kidding me? This baby is right off the charts, mm-hai.

    Couldn’t resist. Sorry.)

  • awayne2nd

    I don’t see how forcing someone to buy something they don’t want could possibly pass constitutional muster! The Federal government is not all-powerful regardless of what Obama thinks. (Go back and read the tenth amendment) If you can afford insurance and choose not to, that is your right. If you then need medical care, you – not the rest of us – pay for it. If it bankrupts you that’s tough. You should have thought of that when you made that choice. If you don’t pay, you don’t play. It’s time liberals stop excusing people for not taking responsibility for their own lives. I don’t have a problem with helping people who really need it, but millions of the “uninsured” need to deal with their own problems.

    And forcing employers to pay for insurance is idiotic. They just put in their cost calculations, add their markup to it and pass it on to you. Instead of paying a dollar for health care, you pay that dollar plus the markup. That unshakable liberal idea of the free lunch just ain’t so!

  • Katharine

    awayne2nd, I see you have not read the previous posts.

    Try a nuanced argument. It helps.

  • Katharine

    I don’t see how forcing someone to buy something they don’t want could possibly pass constitutional muster! The Federal government is not all-powerful regardless of what Obama thinks. (Go back and read the tenth amendment) If you can afford insurance and choose not to, that is your right. If you then need medical care, you – not the rest of us – pay for it.”

    Actually, it ends up being the hospital that pays for it most of the time when people who get the care can’t pay it back. It costs more to treat an uninsured person than it does to treat an insured person. Add to that the costs incurred by not getting people the cumulatively far less expensive chronic treatment they need, if they have a chronic condition, and simple prevention, and you’re wasting a lot more money than you need to. Insurance isn’t just about the person; it’s also about the local area, who will pay more in taxes to local health care if they’re spending more on uninsured people. Really, are you that dense about how insurance actually works?

    “If it bankrupts you that’s tough. You should have thought of that when you made that choice. If you don’t pay, you don’t play. It’s time liberals stop excusing people for not taking responsibility for their own lives. I don’t have a problem with helping people who really need it, but millions of the “uninsured” need to deal with their own problems.”

    It’s not always about responsibility! Sometimes it’s about being dealt a bad hand and not perhaps having the luck to come into the resources one might be able to get – sure, there are plenty that pull themselves up by their bootstraps, but how many people who are also trying to do so are there for each person who beats the odds?

    Criminy, you conservatives keep slinging words around but half of the time you have no idea what they mean and most of the time you don’t bring the evidence to support your assumptions.

  • Katharine

    You know, this is funny. A lot of conservatives appear to not believe in the idea of bad circumstances. I bet most of them think they have more control over their lives than they actually do.

    This world is one in which existence can be precarious and in which it is almost always better to hang together than to hang separately, to quote Ben Franklin.

  • Katharine

    By the way, you conservatives are the dudes that whined about the public option.

  • http://awayne2nd/ awayne2nd

    Katharine, go back and read more carfuly what I said. I am not talking about people who cannot pay. I said I am willing to help them. I am talking about those who can afford insurance, but choose not to. And yes there are millions of them.

    If the hospital “pays”, they pass that cost on to the rest of us by charging the insurance companies more. As for costing more to treat an uninsured person, I don’t understand how it would cost more to fix a broken leg on one versus the other.

    And I am not a conservative. I am a libertarian, like Thomas Jefferson.

  • Katharine

    awayne2nd, I agree that if someone doesn’t WANT insurance and can afford it, well, then, screw them; they deserve what they get if they can take precautions but don’t. Darwin will sort them out.

    “If the hospital “pays”, they pass that cost on to the rest of us by charging the insurance companies more. As for costing more to treat an uninsured person, I don’t understand how it would cost more to fix a broken leg on one versus the other.”

    FSM, have you actually THOUGHT about this? It’s not friggin’ black and white, and it says something about you that something that OBVIOUSLY requires more than sound-bite thought about DON’T TAKE MY MONEY WAH goes over your head.

    Three reasons why it is more expensive to treat an uninsured person than an insured person:
    – It is 3-4 times more expensive to treat someone in the emergency room than in the doctor’s office. If you do not have a real emergency, do not crowd the emergency room which will probably be partially full of people who have emergencies who actually CAN NOT wait a few days to deal with their problem.
    – Hospitals lose millions because of this in uncompensated care because the bills for their treatment may be so absurdly high – tens of thousands of dollars – that it is unlikely they will be paid back in that person’s lifetime, much less a few years. The money that goes to compensate this will come out of your taxes, which will be a larger amount than what goes into your premium.
    -Also, as I said, insured people have access to preventive care and regular check-ups, which decreases the likelihood that they’re going to end up in the hospital.

    Thomas Jefferson was not nearly as unthinking about the issues of his day as you are about this. Either way, it irks me when anyone, conservative, liberal, or otherwise, invokes the names of the country’s founders just to try to score points in an argument.

  • Chris the Canadian

    As an observer from a nation that has universal health care AND where our companies offer us additional insurance coverage I have to say that the arguments for the continuing privatization of health care is ludicrous. I cannot believe how fearful Americans are of the “socialists” still. You will not lose your liberty and you will not lose your freedom by having universal health care. The problem boils down to the have’s not wanting to fit the bill for the have-nots. The fear of being taxed a little bit more for the greater good of the whole.

    The fining of those who choose not to take healthcare that can afford it does make me scratch my head, but if the government insists on everyone having healthcare then they have to take measures to ensure this happens. You have 4 years to get a healthcare plan. We here in Canada, and our plan is both federal and provincial (state), get basic health care (Hospital care, emergency medical etc) for free, but we also have to have additional coverage to pay for things such as prescription medications, dentist visits, eye glasses etc….

    Trust me folks, the plan you have in place may not be perfect, but it is much better than what there was in place prior to Sunday. Currently, I have an Aunt and her husband who live in Philadelphia and they pay 850.00 a month for coverage for the two of them. That isn’t even full coverage. 850.00 A MONTH!!! That is insane. Private insurance companies have been gouging Americans for years and with this bill that gouging will finally stop.

  • Jamie

    @ John Moore

    “If you chose to live an unhealthy lifestyle why is my responsibilty to rpovide you with health care? When I found out Jerry Garcia “bought” his way onto the donor list for a new liver I was shocked. This drunk, cocaine smoking idiot got a liver that probably should have gone to a resposible recipient went to this idiot who after receiving the new liver continued to drink and party. All this new insurance is going to do is enable more people to make poor choices about their lifestyles.”

    For your information, it was Phil Lesh, not Jerry Garcia who had a liver transplant. Lesh quit drinking a long time before his liver transplant, which btw, was needed due to him having Hepatitis C. In the decades since his liver transplant, Phil Lesh has done extensive fundraising for, and has brought more awareness to organ donation than almost anyone else in the entertainment industry. Judging from your uninformed/nasty/poorly spelled comment, it is safe to say that it is you who is the idiot.

  • Brian Too

    Here’s a couple things I don’t understand about the conservative positions on these matters:

    1). “Don’t tax corporations, it makes no sense, they just pass the costs along to their customers”.

    Um, really? It makes no difference at all? Well, if that were true, then corporations simply wouldn’t care. There would be no lobbying, no anti-government rants, no high profile representations from well-paid politicians, no under the radar industry groups quietly working behind the scenes. Business simply wouldn’t care and wouldn’t bother. Why spend the money? Pass the costs along to the customer and the problem is solved!

    Here’s a thought. Maybe it does matter. Maybe taxes can be paid out of many different pockets. Maybe the customers sometimes ante up and maybe sometimes it’s the corporate bottom line. Maybe a higher cost structure sometimes forces the company reorganize their products, markets and expense picture. Just a thought.

    2. “Citizens need to take responsibility for their health care. If they don’t get insurance then they bear the consequences”.

    True but it fails to account for human nature (weird since conservatives are usually better at accounting for human nature). The healthy rarely plan for sickness (it’s a bit of a downer). Young adults often believe they are invincible and will neither grow old nor lose their health. So while conservatives love to get on their high horse about this, the truth is you have to force people to pay while they are healthy. Because the average citizen doesn’t have the money to pay once they are sick.

    Now what’s the problem with simply sticking it to all these poor, deluded, insurance-less (or under-insured) people? Well, if you don’t mind living in a world where people die because they have easily treatable illnesses, except for the money, nothing!

    The problem is the people. They have hearts. Most citizens aren’t ready to simply let their neighbors die or languish. You get fund appeals for children, and adults, and the heart-rending stories they have to tell. So you wind up paying anyway. Ah, but you are a cold, heartless bastard, and you never contribute to these fundraising appeals you say!

    It doesn’t matter. Every medical organization already has a charity component to their budget. Even if you don’t mean to, or know it, the costs of those charity treatment allocations are built in to your medical costs. There’s no way you can escape paying.

    Therefore the smart move is to force people to pay while they have the money to pay. And that’s when they are healthy. If you fail to do so you fail to account for human nature. Failing to account for human nature is simply a good way to fail.

    But do continue to rant on about Socialism & Communism. You sound intelligent and sophisticated when you do that, really! Socialism & Communism failed because they too, failed to account for human nature.

  • Jackie F

    I know that we needed health care reform, but I have felt that it is not the responsibility of Insurance companies to pay for the rediculous cost that hospitals and doctors charge. Who is going to watch that? It will still cost us out the wazoo regardless. It is still a vicious circle and we are going to all pay for it. I will be glad when my son goes into the Med School at Vandy this fall…I will be able to get my diabetes supplies at cost (pennies) than what outside companies or Dr offices actually charge. Don’t let this bill fool you. Until the Hospitals and Dr.s begin to reduce the cost of everything having to do with health care, and the medicine manufacturers reduce the cost of medicine, we are all up a creek. Padding the pockets of the CEO’s, board members and stockholders (most of which are in washington calling themselves congressmen and congresswomen) is not what any hard working american wants to do. I work 60+ hours a week and am not looking forward to seeing my paycheck get cut…I work these hours to afford health insurance and still pay my rent. I am frustrated to know that we will be paying the same price for an I.V. in the ER after this bill goes into law.

  • awayne2nd

    Brian Too
    Perhaps I should have gone further in my comment about charging business for health care. Yes, they mark up theit costs and pass them along, but there is a limit to how much they can do this. We are in a global market, competing with countries who subsidise there businesses, and pay for health care with tax money. We are already the high cost manufacturer in this world market for many products. And there is a limit to what customers will pay for products. If a business does not pass cost increases to their customers, they soon are out of business. You can only increase efficency just so much, then you increase prices or go out of business. Same thing for reducing the bottom line. Why do you think so many companies are going to South America and China?
    The point is that you and I are the ones who pay for everything, whether directly or indirectly. In the real world it is cheaper to pay directly.

    By the way, I have been involved in cost accounting for most of the last four decades. I know how business works.

  • awayne2nd

    Do you mean like “better to hang together than to hang separately, to quote Ben Franklin.”

    Wait a minute, now who just said that?

    Sorry, just had to rub that in. Have a nice evening.

  • Cathy

    Coming from a country with universal health care… I’m struggling to see why people object so much. OK, our system in Australia is not perfect, but very few people here are likely to go bankrupt because of medical expenses…

    Strangely, despite having had our Medicare system in place for most of my working life, we have not become a socialist state, and I don’t really miss the % of my income that goes to fund the system. As a friend of mine just pointed out to me… if he’d lived in the US when he had his heart attack chances are he’d be dead or bankrupt (or both).

  • Jason

    This new legislation is just one more step to universal, single payer healthcare which is what they wanted all along. Our freedoms are in danger and we are on a road to universal mediocrity where there is little incentive to achieve and grow. I will never make a million dollars because of my career choice, but it was always nice to know, that being in the United States, I could apply myself and make it happen if I chose. Now those opportunities, I feel, are significantly reduced. This style of healthcare only works if they control our lifestyles. No cigarettes. No fatty foods. Mandating levels of health individuals must maintain. I’d rather die free at 50 than live to 100 as a sheep.

  • Codius66

    You know, I’ve been watching how this whole talk of government healthcare has divided Democrats and Republicans almost completely down the line. Is it really about if you have an (R) or a (D) behind your name? I cannot believe how embarrassing this has all become.
    Talking to my co-workers, most agree that we don’t even know what’s in the bill and what the changes will be. It totally sucks that your options to actually find out are to either read a summary on the bill and hope it’s not biased (fat chance) or read the thing yourself… (written in legal mumbo-jumbo that is open for interpretation. At a glance, it doesn’t seem to affect me as much as some say it will because;
    I’m not a doctor
    I’m not an insurance company
    I’m not a tanning salon owner
    I’m not unemployed
    I’m not making over $250,000
    and I’m not a small business owner.

    Throwing bricks through windows and making death threats? Good Grief! Does anyone else see this as embarrassing ? You know this is on tv’s around the world with a million different spins, and they are all bad.

  • Hornet

    Here is just how corrupt the bill is and congress as well as the president know it.

    Members of Congress and their staffers currently select their health insurance plan from the pool of health care policy options that are available to all federal employees. But under the new law, unlike other federal employees, they will be required to purchase their insurance from the state-run exchanges when that part of the law goes into effect in 2014.

    But the provision appears to exclude leadership and committee staff, giving the appearance that those who wrote the bill wrote themselves out of this requirement.

    The White House is also exempt from moving from the current federal employee plan to state-run exchanges, although the White House said Wednesday that Obama will participate in the exchanges if he is still president in 2014.

  • Larry says

    Thanks to the bill being Pass, it is about time that someone care about the people that don’t have health care and don’t have a way of getting it. Everyone may not have the jobs you have, some have no way of getting the job… So thanks again to a President that care… and people.

  • JJM

    Its a shame that there will always be “followers” in the world, meaning that even the stinking no-count Republicans will have duped a certain number of people into believing more and more lies. They never made a good policy that directly helped the people without making rich companies richer. That’s the difference between the new Healthcare policy and anything a Republican ever did.

    Some people cannot stand to see others get help without some company making a profit from it. I get sick and tired of hearing about France being so good to their people. Although I mean no disrespect to them, I only envy them. America has become a place full of arrogance and you can see it by the way people abuse freedom.

    But you know. A single step in the right direction is better than a single promise played over and over and over like we have seen from Republicans for years. Its good to see we finally have a President that isn’t the same white trash as before. And I’m white.

  • DontTreadOnMe

    Obama is destroying this country from within and he is not qualified to be president. The time has come for the President to perform his duty to THIS country and show us his birth certificate. No certificate? Then all of these constitutional crimes go away; the czars, healthcare, all of it. There are too many questions, too many doubts and he has been dodging far too long. Where there is smoke there is fire. The more people that begin asking for the proof, the less he and the major broadcast networks will be able to ignore us as they have done with so many other issues. If there is the slightest doubt in your mind then you too need to be asking. We have let the seemingly small things go and look where that has taken us. I want to talk about it because they are in cover-up mode. It would be such an easy thing for any one of us to show our birth certificate. Why is it so difficult for him? Why does he treat this country as if he is ashamed of it? Why does he treat our allies as if they are enemies? Why does he encourage Congress to ignore the will of the people? Why did his wife refer to his home country as Kenya? Why will he not release his own school records? Why does he disgracefully bow to the leaders of other countries? Why does he admire dictators from other countries? This is Obama’s Watergate. There is no need to impeach someone who is not qualified to be president. Everything he has signed, ordered, or acted upon is illegal. So I ask you Mr. President: WHERE IS YOUR BIRTH CERTIFICATE?

  • http://Discover Kathleen

    I would like to say this,

    I went bed one night sound mind and body. I wokeup the next morning,and my life was changed. This was in 1986. I have M.S. With small children. A 3 year old little boy,and a baby girl in diapers. This was a devasting thing for me. My marriage fell apart and I was left to raise my children alone. The stress for me going threw this divorce kept me in and out of the hospital. I couldn’t get any Medical coverage,because the insurance companies were afraid of me. All they could is dollar signs and how they would lose money caring for me. I had no choice,but to file bankruptcy. I am living in England now. I have a girlfriend whom is British. We became good friends. Her family took me under their wing. As we all know Britian has National Health Insurance. I am a recipiant. I am taken care of . Doctors make home vistits here. Yes, I am blessed in one way. My medical is and dental is covered. I had a deciscion to make come to England and get care leaving my love ones behind, or stay there with my love ones and no insurance. I could not be a burden on my kids. I have grandchildren now. I do allot of crying why? because I had to make a choice in a country that is suppose to be all of that and a bag of chips with no holes. We don’t know what tomorrow is going to bring. I was just getting a good career going. Went to sleep, wokeup and my life was completly changed. This could happen to anybody. Oh the neurologist that diagnosed, wouldn’t see me anymore,because I had no insurance. When I get back home, I am going to make an appointment see him. This health bill is a blessing from the Lord. Quess what everybody? I can now go back and enjoy my love ones. YES THIS IS TRULEY A BLESSING FROM THE LORD!

  • http://Discover Kathleen

    Chris the Canadian,

    You are so right. I don’t understand America,and I was born and raised there. We are suppost to be free to do we want basically want. The land of the free,the home of the brave. Well if this true,what is the problem with free health care for those who need it? If we are so brave why we step up to the plate and help one another? Be a doer’s don’t complain. When we leave this world, we can’t take earthly treasures with us it will go to someone else. Think about it please?

  • http://Discover Kathleen


    I watch Fox40 news everyday. People over here don’t understand why it is such a deal concerning health care, and why is people getting violent behind this. People can still have private insurance, and national health care as a backup.

  • http://Discover Kathleen

    This bill is truely as blessing for me. I can move back to the country that I was born in, and be with my children as well my little grandchildren. It is a shame that I had to leave my country and move to another country in order to get cared for. This is not freedom to me Freedom is knowing that regardless of ones health, they will always be cared for. Now this is a peace of mind

  • http://Discover Kathleen

    I just would like to say this to those who just don’t understand how many Americans have been suffering. Just keep on living,cause nothing stays the same. YEAH I am going back to be with my children and grandchildren.

  • KSC

    It is amusing how the leaders in foreign countries come here to get cared for.
    Maybe it is because the health care in their country is socialized.
    Reform is needed, but the government running health care is Absurd to say the least.
    Everything that our government runs or manages is completely broken.
    Fix it… Don’t force a take over.

  • Bob

    I don’t understand all the negativity! Our government asks us to pay a fee to register your car, boat, or plane, and we all pay it every year, mostly without complaints! Why can’t we change and have a Government health plan that will help people with medical problems get insurance; while allowing all of us to have annual health care from competent doctors! Sure, there are going to bumps in the road along the way, and it may cost us all a little more money, but can’t we get on with it! We can do it, and we can do it well! It will take time and hard work! Not Negativity towards either party!


    if the health care bill is studied detailed… like i have taken the personal responsability to do so… oo yea… every single page…. there are things that come up and that should be address i think:
    1- we will all soon have to wear a microchip, read about it… is no joke… and it is interesting becasue not only there is a warning about this in the bible, but also becasue by having this thing…. what will stop government to take over ? but what do i mean, what i mean is that if u think about it… be it conservative or liberal… this can be used as a powerfull weapon: tracking device, all info on here, ( long story short they turn this off and they could literally deleate u from the face off the earth… u simply wouldnt exist, or if u r making too much noise, they could change the system and create a false record of u being somewhere….. hits… a crime or something”… im sorry but that is just the beggining… this thing gets better… so in other words so far…. we got a bill that “literally puts the mark of the beast on us”…. yea yea i know uuuuu !!!! , but if u see it from a perspective look at all the bills the administration has done…. they have slowly but surely started to take control of everyhting… banks, big industries( bailout…o yea i read that one too … ), and this government is also compromised to a lot of people who supported his campaign… that is why we have not seen most of the bailout… it is becasue they all start taking place jsut in time to raise his popularity again for the next election…. which in turn will give him four more years to continue doing what he is currectly doin, “separating america”…. this bring me to my second point
    2-examine and look perspectively at what is happening….. everyone!!!! , democrats and republicans are more separated thatn ever!!!, but not the officials… no no no… us …. we are being played by the media in this big circus in whihc for example fox and abc go back and forth…. putting more coal in both fractions… separating us even more…. which will pretty soon get to the point where even a second civil war might break out…. and if this does not destroy us…. the overwhealming debt that the current administration is creating overseas will…, i mean we are in the hole…. and deep with china specilally…. furthermore….. this new bill will only hurt us more…. because let me tell u what it does in the end…. it ends up costing more…. so in other words… it is just further weakening our already weaking country due to several issues….
    3- wich goes back to the bible and israel having to face armageddom and all that stuff on itself… “its allies will be unable or unwilling to aid it”…. think about it for a second…. IF WE ARE NOT THE POWER THAT WE ARE… WHO IS WILL THEN BACK UP ISRAEL….? NO ONE… and u can call me a church freak…. but quite honestly im not… im just an educated person who likes to be informed….. and i dont go either way wiht the parties here….
    4- this bill is unconstitutional…. but u already know that… that is why so many states are already saying that they wont adopt it…. so then we got those who support and go wiht this bill, and then we got those who dont… hmmmm…. interesting… 2 fractions? O WAIT U NEED 2 TO FIGHT!!!! , then it is obious this will turn into a race thing due to the stigma that this country still has from slavery…. once again u need to look for proof of this no farther than in the fact that every institution is requiered to have a certain percent of minorities… or for example if u are in a college…. there has to be the same amount of sports for men than for women….. how sad that it has come to this….
    5- perhaps we really are in the time in which we will see how not only this country cahnges…. but also the world…
    6- also in case u are not informed…. pretty soon the U.S dollar will be replaced by the conuterpart to the EURO… it is called the AMERO….. yup…. canada….. us…. and mexico… sharing a currency…. look it up and be surprised…..
    7- yea i know my spelling sucks….. but the idea is what matters…. notice that i dont take parts… i just call em like i see them…. this is the sad truth….. “We are living in a time…. in which everyhting we know will change… remeber those brave men who founded this country, and why they did it… because america has grown fat and lazy, we have grown conformist to the government changing our livestiles, we were born all equal, but trough our work and sweat we can attain and have more than others, if u want somehting and u have a dream, it was the believe of our founding fathers that we would be able to get it trough determination and hard work… “pursue of happiness”….”
    8- i would write more but i gotta start my homework due tomorrow… lol…. yep im still in college boys and girls, triple mayor, one minor, academically a senior even though im just a sophomore, d1 athlete, and the list goes on…. ight well u all think about that. I LEAVE U ALL WIHT HIS THOUGH…. “think… whetever ur religious or not…. u have a wonderfull gift which is ur mind… never go without questioning somehting…. that is our nature as humans… that makes us humans” (myself) (:-P)

    that is how this country was founded too by the way


  • DJ


    You would “sound” a lot more intelligent and informed if you wrote less like
    a 5th grader.

  • Why

    Please explain to me why the top 5% or even top 30% of the countries income earning people should have to pay for the bottom 30%? I never have understood that. Why cause he/she went to school for 10-15 years and was killen themselves in books and being responsible learning and bettering themselves. Spending hours and hours and years in classes. NEVER TAKIN A DIME from the system. And the others where out partyin and havin a good time or just screwing off. So once again there paying a price for dedication?

    Please explain to me why they should have to foot the bill? Why shouldnt the person making 40,000 a year not give a extra 10% of his income to ENSURE u have Health care. If this continues dont fool yourself. ALL UR TAXS WILL increase as they have “Overruns and Unforseen cost” hahaha

    I dont think its fair that the top 50% of this countrys working people have to pay for the bottom 50%. They work hard for there money and time away from there familys to be FORCED into given up more and more. Of what they have worked so hard for. Shame on you for thinking anything differant. I give to non-profits. That should be my choice. Not you forcing yet another “U HAVE TO DO THIS OR ELSE” crap.

    Enough with the taxes…..STOP

  • norris hall

    I’ve lived in a country where there is universal health care and a country (the US) where health care is a jumbled mess and I can say that I prefer the former.
    In fact, health care in the US is so expensive for anyone who doesn’t work for a big company that I go back to the “old country” whenever I need health care.
    There doctors make a good salary but being a doctor isn’t a ticket to wealth.
    An operation that costs $2500 here only costs $100 there. So even after airfare and hotel I can save a lot of money by using universal health care.
    If employers here would just give their employers a stipend for health care and say “here, go out and purchase your own insurance” people would get the shock of their lives.
    The average worker gets 60-70% of his premiums subsidized by his employer.
    You don’t make the employer buy your food or clothing. Why should employers buy your health insurance?
    In the US if you work for the government or a big company you get a welfare grant for health care. That subsidy gets passed on to everyone else in the form of higher prices for goods and services. It leaves US companies unable to compete with the rest of the world .
    This reform is a step in the right direction. But it would be better to divest employers of the responsiblity for paying health care costs and let the individual go out in the market and pay his own insurance bill.
    When you get employees paying the average premium of $10,000 a year…you can bet you will hear screams for health care reform

  • Nat

    This is just my story.
    So why not just make healthcare like it is in many other countries, Free!
    I’m a US citizen who currently lives abroad and I have come to relize the US healthcare is BS. When I lived in the US, I thought I had it all. It was just my husband and I, both working and enjoying life. My husband earned about 28,000 a year and I earned 29,000. ( I know its not much but we were happy)
    Just before the recession began I lost my job (i was the only one with health insurance) AND found out I was pregnant. In the comeing months as my belly grew I couldnt get any company to hire me. Time was passing quick and I found myself not being able to go to my prenatle Dr visits because I had no insurance and it was too much for us to pay out of pocket. My husband earned enough to pay our home, bills ect… we worried how we would manage once the baby arrived, knowning that it involved more money; for childcare if I ever found another job. I tried asking for these gov. programs help but according to them, my husband earned enough. I was adviced by someone once that if I lied and said i was no longer with my husband and was about to be a single mother, i could get the help from the gov., but i refused to do that. It was unbelievable to my husband (who is foreign) that something as natural as having a baby was going to cost so much (apperantly about 10,000 with no compliactions). One night, we made a decision. we sold our home and all our belongings and move to his home country, the UK. It was the best thing we ever did. I had my 2 children here and it didnt cost us a penny. I even had some major complications that kept me in the hospital for over 5 weeks. How on earth I would have ever been able to pay that kind of bill in the US is beyond me. I was just an all American girl trying to live the dream but because I lost my job and decided to have a family, all that just disapeared into thin air and i had to leave my country behind , just so I wouldnt get stuck in healthcare debt. Looking back, i just think its so crazy how the US can be so behind on its healthcare system. The UK has its hiccupps but I thank god everyday that if my child get sick in any way shape or form I can just go to the hospital and I have the peace of mind, no bills will be coming my way.
    So its not just about the rich getting taxed for the healthcare reform, nor about poor people who choose to be where they are and its their problem thay cant afford it. Its about people like me who tried as much as we could and played by the rules and still it wasnt enough. I do miss my country very much and it makes me sad to know that going back means debt. because of healthcare. Something desperatly need to be done.

  • Debbie Hawley

    Why does the insurance company say because my son turn 25 September 25th it had to be dropped because we renewed our Insurance in March 2010 and would have to wait until next year to add him back on when he has been on my insurance all these years and never dropped until now.

    Debbie Hawle

  • MSmith

    Mortality Amenable to Health Care, 1997-98 and 2002-03
    For selected countries, ranked by country, lowest to highest mortality


    This study compared trends in deaths considered amenable to health care before age seventy-five between 1997–98 and 2002–03 in the United States and in eighteen other industrialized countries.

    Such deaths account, on average, for 23 percent of total mortality under age seventy-five among males and 32 percent among females.

    The decline in amenable mortality in all countries averaged 16 percent over this period. The United States was an outlier, with a decline of only 4 percent. If the United States could reduce amenable mortality to the average rate achieved in the three top-performing countries, there would have been 101,000 fewer deaths per year by the end of the study period.

    The authors also note that “it is difficult to disregard the observation that the slow decline in U.S. amenable mortality has coincided with an increase in the uninsured population, an issue that is now receiving renewed attention in several states and among presidential candidates from both parties.

    “It is startling to see the U.S. falling even farther behind on this crucial indicator of health system performance,” said Commonwealth Fund Senior Vice President Cathy Schoen. “By focusing on deaths amenable to health care, Nolte and McKee strip out factors such as population and lifestyle differences that are often cited in response to international comparisons showing the U.S. lagging in health outcomes. The fact that other countries are reducing these preventable deaths more rapidly, yet spending far less, indicates that policy, goals, and efforts to improve health systems make a difference”.

    In 1997–98 the U.S. ranked 15th out of 19 countries on the “mortality amenable to health care” measure. However, by 2002–03 the U.S. fell to last place, with 109 deaths amenable to health care for every 100,000 people. In contrast, mortality rates per 100,000 people in the leading countries were: France (64), Japan (71), and Australia (71). The other countries included in the study were Austria, Canada, Denmark, Finland, Germany, Greece, Ireland, Italy, Netherlands, New Zealand, Norway, Portugal, Spain, Sweden and the United Kingdom.

    Study authors state that the measure of deaths amenable to health care is a valuable indicator of health system performance because it is sensitive to improved care, including public health initiatives. It considers a range of conditions from which it is reasonable to expect death to be averted even after the condition develops. This includes causes such as appendicitis and hypertension, where the medical nature of the intervention is apparent; it also includes illnesses that can be detected early with effective screenings such as cervical or colon cancer, and tuberculosis which, while acquisition is largely driven by socio-economic conditions, is not fatal when treated in a timely manner.

    “Cross-national studies conducted by The Commonwealth Fund indicate that our failure to cover all Americans results in financial barriers that are much more likely to prevent many U.S. adults from getting the care they need, compared with adults in other countries,” said Commonwealth Fund President Karen Davis. “While no one country provides a perfect model of care, there are many lessons to be learned from the strategies at work abroad.”

  • Inversion table

    Congrats to Obama. So much non support for this reform and yet it is the most vital thing needed for americans. How long it will take to make an impact in the lifestyles of americans who knows? Well done

  • Kyle J

    Well I think it is a good idea. Some of the people here make a separation of the haves and the have nots to be directly related to their performance in life or lack there of. I can tell you that I am college educated but due to the recension unable to find full work. I am currently uninsured and hope every day that there will not be a major accident that will put me into huge medical debt before I can even make some money. right now I would love the health insurance and strongly support the plan.

  • Cheryl

    I thought it would be great, but it is not. I have a pre-existing condition and have not been able to get insurance or even work. I made $0 last year, but have been living on some money my mother left me, so am not able to get the state medical. I checked into the “pool” and it was $1020 a month to get insurance. It takes 3 months before you get it, then it is $500 deductible, $7,500 a year limit and $75,000 lifetime limit. Not so good.

  • Kathy C.

    I am disabled and unable to work. I have numerous health problems, emotional & physical. The only money I have is what I receive from Social Security. I am actually on my Father’s work record because I qualify to be. I am receiving Social Security checks that he would have received had he lived to enjoy his retirement. He worked hard all his life. I also have a Medicare HMO. I have co-pays I must pay in order to see my doctor and specials, but because I don’t have the money for the co-pays, I haven’t been able to get the medical care I need. This is wrong. Also, a person can have Lupus & Chron’s whether they are slender or heavy. They can have arthritis, cancer, or a number of other conditions regardless of weight. It’s not always because one is heavy or smokes, etc.

  • Kathy C.

    I’m sorry, in my rely, I meant doctors & specialists!
    Also, we are not here on Earth just for ourselves. We need to have compassion for others. I’m not saying for people who truly can work, but for those who truly need a helping hand and are in a desperate situation through no fault of their own. I’ve never married and never had kids. I knew from an early age that I had too many health issues and I would be better off by myself. I tried to be as responsible as I could. I hope Congress can come up with a solution that is good for everyone.

  • rentenvosorge

    Ich war zu finden dieser internet-site.I gebraucht in Ihre Zeit für diese wunderbare Sprachreisen! I definitiv Spaß mit jedes kleine bisschen und ich Zum einen Blick at neue Slideshows Sie weblog schreiben.


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