How will the vote fall out on HCR this weekend?

[Sheherezade]

It isn't part of the health care bill. It was a ruling from a separate office (agency law) that was supposed to take effect last month. I think it did. They tacked a "hold" of sorts on the unemployment benefits extension bill that just passed (despite Bunning's antics to stop it). I think the Medicare part stalled the change for a year and was put on by Arlen Spector.

Again, that's not part of the health care bill. It's just the Medicare agency people trying to redistribute payments to primary care and cut their costs by changing the rules.

[weeniegeniewife]

Re: How will the vote fall out on HCR this weekend?

Unfortunately it probably will pass.
And, I very much resent that only some will be paying for the healthcare of everyone.
We are truly becoming a nanny state.

Agreed. DH and I are not happy it passed.

[SoonerTexan]

Someone posted a breakdown of the bill on my Facebook wall. I saw this section/description. What does this mean/significant?

Sec. 1202. Payments to primary care physicians. Requires that Medicaid payment
rates to primary care physicians for furnishing primary care services be no less than
100% of Medicare payment rates in 2013 and 2014 (the first year of the Senate bill’s
Medicaid coverage expansion to all individuals with incomes under 133% of poverty).
Provides 100% federal funding for the incremental costs to States of meeting this
requirement.

[Sheherezade]

Raises the Medicaid payment to equal the Medicare rate. Previously, Medicaid (for the poor uninsured) paid less. This bill tried to make the payment rate equivalent so that the segment of uninsured that will now get coverage via increased eligibility for Medicaid (expanded to unemployed adult poor, I think?) will actually get seen by docs. If the pay was too low, Medicaid would not be accepted - or so they feared - and these people would still end up in ER departments. Medicaid is paid in large part by state budgets; the assistance to states is to not put the burden on them directly.

I'd just like to point out that this is a board full of people "in the medical know", so to speak, and WE all have trouble understanding this (I'm definitely included in that WE), including lots of misinterpretation, etc. How on earth can the general public be expected to grasp this outside of the soundbites provided by their favorite FOXNews or MSNBC anchor (which then, seriously colors their perception of good or bad, of course)? It's no wonder we're all so divided.

[scrub-jay]

I'd just like to point out that this is a board full of people "in the medical know", so to speak, and WE all have trouble understanding this (I'm definitely included in that WE), including lots of misinterpretation, etc. How on earth can the general public be expected to grasp this outside of the soundbites provided by their favorite FOXNews or MSNBC anchor (which then, seriously colors their perception of good or bad, of course)? It's no wonder we're all so divided.

I agree with this. On FB today, so many people are leaving comments of: "I am so happy it passed" or "I am so angry it passed" which both are followed with: "Now I need to figure out what it is!" That attitude makes me sad, but that is what the general public can grasp. You are right, if we (in the medical field) have to dig to understand the details, the general public must struggle much much more. I respect the opinions I find around here much more (both sides) because we will feel much of the impact more than the majority of the public.

[peggyfromwastate]

I stay clear of this debates area in general. I can't believe people (anyone) is for this bill. I can not believe it. The real cost will be in the unfunded mandates to states which will jack up the state taxes. Who cares if Fed taxes don't go up much right now. With the cost of this thing costs WILL go up and the end game is nationalized health care. This bill will tip the country from being more takers than givers in society, and call me a cold hearted republican bitch, but I am not in favor of this huge expansion of govt power over every aspect of everything. I'm spitting mad, and I'm not a tea-party person, but I am just profoundly disappointed that the democrats went agains the people by such a huge margin. And the arm-twisting, the unions pushing it, come on. Union thugs harrassing Stupak's family??? Classy. This is scary stuff and DH is not going into cancer at all as a result of this bill passing. No way. He doesn't need a gov't pinhead telling him that his patient doesn't qualify for surgery because he's too old, past productive stage, whatever. He's going into facial plastics so hopefully he can still make some money on botox or whatever. And hopefully by the time he's able to get out of the military system he'll be able to be in some type of consortia of providers who don't take medicaid. If he wants to provide medical care for free (which he does), he can do that in mission work. I'm all for that. I am not for some government agency (in the hundreds of agencies that will be created thru this bill) determining what any patient gets.

So mad about this. Flame me if you want. I don't care. I can't believe anyone is for this.

[Sheherezade]

He doesn't need a gov't pinhead telling him that his patient doesn't qualify for surgery because he's too old, past productive stage, whatever.

Just a heads up - my husband has been in cancer work for 10 years now and he is constantly having insurance companies tell him that his patient doesn't qualify, is too old, procedure too new, etc. What follows is hours of office work to get the patient comp'ed by hospital or drug company (for chemo) or patient mortgages home, borrows excessively, etc and risks bankruptcy. This is already happening and had been for years and years. The bill doesn't put government in charge of these decisions - in fact it regulates insurers and provides protections to patients when insurers do these types of things. These are the fundemental reasons that DH has always been in favor of these changes. Watching older people battling for their life have to wade through paperwork and justify each and every cost while dealing with chemo effects leans you towards change....even if it will cost us in taxes.

[Thirteen]

This is such a sticky subject --

I will do my best to be simple and short in response and questions. My response is this: I think we need a public health option, and it hurts me to see people fall through the cracks, or overpay, or get dropped.
On the other hand, the way the debate/talks/voting/speeches were handled does not sit well with me. The fact that things were not clear, or people and interests were used as leverage, bothers me. I really wanted to have a vote where the American public understands what's REALLY going to happen, step-by-step, and the political officials vote based on our interests and wants, not their own.

DH is a PCP, and he's scared to death. While I'm not as pessimistic as he is, it does concern me that no one seems to really know what's in the bill fully, and how it will affect us.

My 2 cents.

[rainbabies]

I'm against it. And I also admit, I'm having a hard time understanding it. I agree with Peggy....but I also like reading everyones responses

I also wonder (but maybe I missed it?) when will the insurance companies and pharma companies be delt with? I think they're so seriously effed up. Also, admins of hospitals, pharma, and insurance companies....where's THEIR cut?

[Pollyanna]

I stay clear of this debates area in general. I can't believe people (anyone) is for this bill. I can not believe it. The real cost will be in the unfunded mandates to states which will jack up the state taxes. Who cares if Fed taxes don't go up much right now. With the cost of this thing costs WILL go up and the end game is nationalized health care. This bill will tip the country from being more takers than givers in society, and call me a cold hearted republican bitch, but I am not in favor of this huge expansion of govt power over every aspect of everything. I'm spitting mad, and I'm not a tea-party person, but I am just profoundly disappointed that the democrats went agains the people by such a huge margin. And the arm-twisting, the unions pushing it, come on. Union thugs harrassing Stupak's family??? Classy. This is scary stuff and DH is not going into cancer at all as a result of this bill passing. No way. He doesn't need a gov't pinhead telling him that his patient doesn't qualify for surgery because he's too old, past productive stage, whatever. He's going into facial plastics so hopefully he can still make some money on botox or whatever. And hopefully by the time he's able to get out of the military system he'll be able to be in some type of consortia of providers who don't take medicaid. If he wants to provide medical care for free (which he does), he can do that in mission work. I'm all for that. I am not for some government agency (in the hundreds of agencies that will be created thru this bill) determining what any patient gets.

So mad about this. Flame me if you want. I don't care. I can't believe anyone is for this.

Everything Peggy said. Like I have mentioned before I cannot even discuss this without wanting to throw up. Obama wants to change the fabric of our nation and it disgusts me. Our children and grandchildren will be paying for this for the rest of their lives. We already know dozens of docs ready to hang up their hats, this bill will benefit no one,

[Rapunzel]

Here's what sits like a rock in the bottom of my stomach:

There is NO going back.

Once you've started down this particular path there is no real way to untangle the mess. We're in it for good. And, I DO think this is just the first step for a single-payer system which I DO expect to be introduced before the end of Obama's term.

Analogy: It's kind of like a democracy deciding to vote in a monarch for leader - you've made it impossible to go back (to the original democracy) without something very drastic happening (and, by drastic I'm talking non-peaceful government change). Caesar and Rome come to mind.

[JaneDoe]

It looks like many states, including Washington to the north of us, have joined together in a multistate challenge of the constitutionality of the Health Care Reform Act once it's signed into law. This will be interesting.

[Sheherezade]

Do you know if they are challenging the whole bill or just the mandate? I know that mandated purchase is the constitutional issue -- but I'm not sure how it works. Do you challenge everything or just one part of the bill? Do you have an article?

[JaneDoe]

It looks like it's just the federal mandate to purchase health insurance. Here's a link to what the Washington AG is saying, which isn't much yet . . .

http://www.atg.wa.gov/pressrelease.aspx?&id=25402