House passes health care bill on 219-212 vote

[Kevin]

I don't like the bill itself. It doesn't go far enough. I do think that it's good in that it creates an entitlement which will never go away. My prediction is that the insurers will do what big companies with monopolies do and continue to drive prices up and coverage down forcing Congress to act later on to restructure costs, create a public option and all of those things we all know would really make a difference here.

For now though, baby steps work for me.

[DrPhil]

Originally Posted by PM_Mama00

This is the problem with me trying to understand what's going on. It seems that some (many on my FB) are only for this because Obama came up with it and some are against it because of Obama. People can't seem to think for themself. I was just looking for an unbiased explanation and no one can seem to give one.

Welp, human explanations are automatically biased because it will either be about how they feel about politics, the president, and/or healthcare. Or biased about how they feel about life, in general.

But, I'm more apathetic toward Obama so I'll have my own biased explanation if I find time to read a good summary of the bill somewhere. Maybe I'll use the cbsnews link.

[AOII Angel]

I just read this on CNN and really like their thoughts:

Here is the link: http://www.cnn.com/2010/OPINION/03/2...ex.html?hpt=C1

Dr. Manoj Jain, a Memphis, Tennessee-based infectious disease physician, adjunct assistant professor at Rollins School of Public Health at Emory University and medical director at Tennessee's Quality Improvement Organizations:
Last week, I saw a 55-year-old truck driver who pleaded with me to discharge him from the hospital even though his face and scalp still bore clear signs of an active staph infection. For a decade he has had recurrent staph infections exacerbated by diabetes -- yet could not afford insulin or a doctor because he lacked medical insurance. Now he begs me to let him leave, so that he will not go bankrupt from his medical bills.
I turn to his wife who says, "I am lucky. I have metastatic breast cancer, and I am covered by Medicare."
One of every 10 patients I see do not have health insurance.
I see the uninsured patients, but then make up for my losses by increasing my charges to all my patients. The cycle continues: Insurers increase premiums, choking small businesses that then drop health coverage for their employees, leading more uninsured to come to my practice.
Not providing insurance is not free; the annual health care expenditure for an uninsured adult is $1,800, according to a Kaiser Foundation study in 2004.
And there is a downside to having nearly 50 million uninsured people in America. I look them in the eye, and I know this for a fact. They will die sooner. In my opinion, lack of health insurance is a chronic illness.
The burden of this disease is most apparent among people between the ages of 54 to 65. A 2004 Health Affairs study found that lack of insurance accounts for 13,000 lives lost per year, making lack of insurance the third leading cause of death for this group, after heart disease and cancer. If we do nothing to address this problem, by 2015 lack of insurance will account for 30,000 deaths annually in just this age group.
In all fairness the present health system provides some care for the uninsured. President Bush was technically accurate when he said in July 2007, "People have access to health care in America. After all, you just go to an emergency room."
But the distinction between an acute illness -- the kind that sends you to the emergency room -- and chronic disease is artificial. For example, each year, diabetes, a chronic disease, causes 20,000 Americans to go blind, 45,000 Americans to have kidney failure and 45,000 Americans to lose a limb. Lack of health insurance is the same -- a chronic illness causing recurrent acute illnesses.
I want to lean over and shake my uninsured patients and scream, "Be a Rosa Parks. Demand health care as a right -- just as others before you have marched for civil rights and human rights."
The uninsured have become second-class citizens. Nearly 30 million of them, who are the working poor, are unable to afford health insurance, and there is no one to unite them and voice their concerns.
The Rev. Martin Luther King Jr. was not silent about people's right to health care. "Of all the forms of inequality," he said, "injustice in health care is the most shocking and inhumane." He was speaking, I believe, of both acute care and chronic care.
Vance Harris, a primary care physician in Redding, California:
The votes have been counted but, in reality, there is no clear winner.
What is clear -- our health care system is terminally ill. Bold leadership is needed to redirect precious resources. Unfortunately bold leadership is just as scarce as precious resources.
There will be no new access to health care if we do not have physicians to provide it. We must reverse the trend that sees thousands of physicians leaving primary care. Bold leadership is needed to get the brightest minds back into one of the most challenging and demanding roles. We need motivated empowered physicians with a passion for health and the ability to care for a whole landscape of disease. We must treat decisively when possible, not just shuffle everyone down the road to a specialist.
Give us five more minutes with patients to deal with a second or even a third problem so they don't access the system twice. Give us five minutes of straight talk about the impact of lifestyle on their health. Without this, I default back to putting out fires and I write another prescription.
We need "Health" Reform not just Sickness Access Reform. We are not a healthy nation. Our indulgent lifestyle of overeating and under exercising is rapidly filling the beds needed for treating disease we can't prevent. This is exactly why we have a "Sickness Care" system. However, having the resources to treat sickness is dependent on true health care.
Our battle cry must be health, not health care reform. Seek out physicians who understand the value of health. Unfortunately, we do not have many of those doctors left. Who is going to take care of us when they are all gone?

[AOII Angel]

Originally Posted by PM_Mama00

This is the problem with me trying to understand what's going on. It seems that some (many on my FB) are only for this because Obama came up with it and some are against it because of Obama. People can't seem to think for themself. I was just looking for an unbiased explanation and no one can seem to give one.

I agree with you on this. The funniest thing is that this bill closely resembles what the GOP came up with to counter the plan that the Clintons tried to instititute in the 90s when health care reform came up last time. They thought it was a great idea back then, but it's a horrible idea now

[DrPhil]

Originally Posted by AOII Angel

I agree with you on this. The funniest thing is that this bill closely resembles what the GOP came up with to counter the plan that the Clintons tried to instititute in the 90s when health care reform came up last time. They thought it was a great idea back then, but it's a horrible idea now

Politicians align based on politics. Not based on what makes sense.

[AOII Angel]

Originally Posted by DrPhil

Politicians align based on politics. Not based on what makes sense.

Of course.

[Alumiyum]

Originally Posted by PM_Mama00

This is the problem with me trying to understand what's going on. It seems that some (many on my FB) are only for this because Obama came up with it and some are against it because of Obama. People can't seem to think for themself. I was just looking for an unbiased explanation and no one can seem to give one.

This is the reason I've found it impossible to discuss the bill with most of my peers. I don't give a damn who supports the bill and who doesn't, and because many uninsured get health care when they really need it anyway in emergency rooms we are in roundabout ways paying for the uninsured as we speak. This is a way of specifying how we do that. But the "how" in this case is the biggest problem I have with the bill. It is not at all going to help those of us who already have insurance and I don't believe for a minute those that will be covered in the future will get quality healthcare just because the government is covering it. Putting such a high burden on people who make a "large" salary is just as injust as denying healthcare to those who can't afford it. Of course I don't have the credentials to know what the best way is to solve this problem from an economic standpoint, but this can't be it.

On the plus side, keeping insurance companies from denying coverage based on pre-existing conditions, and eliminating the caps on pay outs are surely good for everyone.

It would be nice if people could stop looking at this in a "point for Obama" manner and could look at the bill itself instead of who was for it and who was against it. It's going to affect us all in some way, so there's no point in pretending it's a game.

[MysticCat]

Originally Posted by Alumiyum

But the "how" in this case is the biggest problem I have with the bill. It is not at all going to help those of us who already have insurance . . .

Except that you yourself contradict this:

On the plus side, keeping insurance companies from denying coverage based on pre-existing conditions, and eliminating the caps on pay outs are surely good for everyone.

Eliminating caps certainly can benefit those who already have insurance. And even for those of us who already have insurance stand to benefit from the elimination of denial of coverage due to pre-existing conditions if we change jobs or insurance carriers.

[Alumiyum]

Originally Posted by MysticCat

Except that you yourself contradict this:Eliminating caps certainly can benefit those who already have insurance. And even for those of us who already have insurance stand to benefit from the elimination of denial of coverage due to pre-existing conditions if we change jobs or insurance carriers.

You're right, and I shouldn't have said "not at all". To correct myself I see very few benefits to those who already have insurance.

[MysticCat]

Originally Posted by Alumiyum

You're right, and I shouldn't have said "not at all". To correct myself I see very few benefits to those who already have insurance.

Valid point. And it make some sense to me, since the thrust of the bill is the uninsured. But these two benefits to the already-insured could be major benefits for some people.

ETA: We forgot that insurance companies will also be barred from cancelling the insurance of people who get "too sick." Pretty major, I think.

[Beryana]

Originally Posted by MysticCat

Valid point. And it make some sense to me, since the thrust of the bill is the uninsured. But these two benefits to the already-insured could be major benefits for some people.

Especially when the classification of any condition is left to the discretion of the insurance company - be it broad or narrow to determine pre-existing conditions.

[AOII Angel]

Originally Posted by Alumiyum

You're right, and I shouldn't have said "not at all". To correct myself I see very few benefits to those who already have insurance.

The elimination of caps are actually a pretty big benefit for the insured. None of us who are healthy think about this, but if you suddenly get diagnosed with cancer or a major disease like heart disease needing open heart surgery and multiple heart catheterizations, you could rapidly run up your yearly and then lifetime limits on health insurance benefits. This is how people end up declaring bankruptcy after major illnesses even with health insurance.

[Alumiyum]

Originally Posted by AOII Angel

I can tell you from LOTS of experience that very FEW people know their own bodies and what is normal. We get far too many people in ERs for abdominal pain thinking they have appendicitis because they haven't taken a poop in too long, women in breast centers who think they have breast masses but it turns out to be normal breast tissue, people in doctors' offices asking why they have a twinge or pinch or ache when they do this or that motion. Unfortunately, if every doctor worked up every single complaint because every patient "knows their body" we'd spend so much money and find next to no pathology. The body has aches and pains. 98.5 is a normal temperature that you see in nobody. Why are you checking your temperature anyway? Throw away your thermometer! You are still WRONG about the thyroid and T3/T4 levels. It's rather insulting, too, that you think that your research with hypothyroid patients trumps 13 years of education that endocrinologists have with regard to the thyroid. Maybe they know what they are talking about. Taking extra synthroid may make you feel better, but it's also associated with a lot of other side effects. You do what you want, but leave the ugly commentary about physicians behind.

This is the problem. We all know there are hypochondriacs in the doctor's office every day, but that's life. On the other hand I've been brushed off repeatedly by doctors who refuse to believe I'm anything but a hypochondriac. Muscle and joint pain so bad I sometimes cannot leave bed, fatigue so severe I sometimes can't get out of bed (yes I have a regular sleep schedule, have cut out all caffeine, etc.), and bouts of hair loss (which, yes, is a cosmetic issue and fortunately because my hair is thick in my case not a noticeable one, but is also a symptom of a problem elsewhere in the body) make it obvious there is something wrong with me. But again, because I don't appear to be dying, I have not gotten a diagnosis. I have no problem doing my own research on these and my many other symptoms to come up with some possibilities, but I am not a health care professional and obviously cannot diagnose or treat myself. Your average person, myself included, does know the difference between normal and not when it comes to their body. When something changes rapidly and radically (like totally healthy to daily moderate to severe pain) a patient can be reasonably certain there is something up and just because one or two tests don't present an immediate answer doesn't mean that one doesn't exist. I think if doctors would treat everyone the same-pay attention to them, order only necessary tests, and follow up quickly, those of us with a disorder or disease could be diagnosed and sent on our way with the correct treatment, and the hypochondriacs could be reassured that they are very healthy and could be sent on their way as well.

Originally Posted by AOII Angel

The elimination of caps are actually a pretty big benefit for the insured. None of us who are healthy think about this, but if you suddenly get diagnosed with cancer or a major disease like heart disease needing open heart surgery and multiple heart catheterizations, you could rapidly run up your yearly and then lifetime limits on health insurance benefits. This is how people end up declaring bankruptcy after major illnesses even with health insurance.

You'd be surprised at what some of us know from experience.

[AOII Angel]

Originally Posted by Alumiyum

This is the problem. We all know there are hypochondriacs in the doctor's office every day, but that's life. On the other hand I've been brushed off repeatedly by doctors who refuse to believe I'm anything but a hypochondriac. Muscle and joint pain so bad I sometimes cannot leave bed, fatigue so severe I sometimes can't get out of bed (yes I have a regular sleep schedule, have cut out all caffeine, etc.), and bouts of hair loss (which, yes, is a cosmetic issue and fortunately because my hair is thick in my case not a noticeable one, but is also a symptom of a problem elsewhere in the body) make it obvious there is something wrong with me. But again, because I don't appear to be dying, I have not gotten a diagnosis. I have no problem doing my own research on these and my many other symptoms to come up with some possibilities, but I am not a health care professional and obviously cannot diagnose or treat myself. Your average person, myself included, does know the difference between normal and not when it comes to their body. When something changes rapidly and radically (like totally healthy to daily moderate to severe pain) a patient can be reasonably certain there is something up and just because one or two tests don't present an immediate answer doesn't mean that one doesn't exist. I think if doctors would treat everyone the same-pay attention to them, order only necessary tests, and follow up quickly, those of us with a disorder or disease could be diagnosed and sent on our way with the correct treatment, and the hypochondriacs could be reassured that they are very healthy and could be sent on their way as well.

And I wouldn't call you a hypochondriac, but a lot of vague illnesses also are difficult to diagnose. The problem with our current health care system is that primary care physicians are NOT reimbursed to spend 20 minutes or more with a patient to figure out what is wrong with them if it isn't run of the mill hypertension or diabetes. That being said, you can get a referral to a specialist...I would recommend a rheumatologist given the symptoms you are complaining of. They even have research physicians at places like the NIH that specialize in hard to diagnose cases (kinda like House but not fake.) That being said, not everything is a sign of a disease. I think that losing hair may or may not be a problem. Joint pain/swelling for over 6 months is a problem and may be a sign of a serious disease. I wouldn't take no for an answer.

As for Beryana...If I am the reason you don't go to doctors, you are a fool.

[Ghostwriter]

The problem as I see it is that long term this program is not sustainable. (reference Medicare, medicaid and Social Security) We (the U.S.) already are in debt up to our ears. How do we pay for these programs?

If one really believes that Health Care for everyone will ultimately save us money and not effect our national debt I really think they are mistaken. When you have to cover everyone the premiums will go up as the risk is now greater. Small insurers will not be able to compete because they can not make money and they will go out of businesss or be gobbled up by larger companies. The effect is that there will be less competition. Private companies will find it easier to pay the % fine to the Government instead of offering their employees health insurance coverage as it will be cheaper. Ultimately, as the premiums increase and competition decreases there will be a renewed call by the left for Nationalized Health Care. This will in turn have to be paid for by increased taxes and fees and we will be left to foot the bill. As with anything the Government runs the quallity and service will diminish and the price will escalate due to the inherent inefficiencies of our out of control bureaucracy. Let's face it. Our fiscal house is a disaster and if we keep going down this path we are in really big trouble. I am truly worried about the fiscal stability of our country. I see a time when our bonds are junk and the Chinese will call us on them.