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Issues of the New Health Care Law, Many Single Payer Would Have Cured!

This is a preliminary list of issues relating to the new health care law. Please add, correct or comment. (I began to overlap my researched characteristics so I ended up clumping all the sources at the end. Forgive the slapdashery!)

Lack of Real Cost Control

o Windfall for pharmaceutical giants - govt. can’t negotiate drug prices or import drugs, gives name brand drug makers 12 years of monopoly.

o No govt. bulk discount negotiating opportunity

o No cost controls

o Can charge three times more based on age plus more for certain conditions

o Double charge employees who fail "wellness" programs because of diabetes, high blood press., high cholesterol, or other medical conditions.

o As plans grow more expensive workers taxed and will have to switch to poorer, skeletal plans

o Anti-trust exemption for companies

o Hundreds of thousands of bankruptcies each year

o Companies can cherry-pick healthier, less costly enrollees

o There is no standard benefits package as frame of reference

Weak Enforcement

o No meaningful restrictions on claims denials

o Permitting insurers to sell policies "across state lines", exempting patient protections passed in other states. Will set up in least regul. states.

o Insurers may continue to rescind policies, drop coverage, for "fraud or intentional misrepresentation" -- the main pretext used

o There is no standard benefits package to use as frame of reference to aid monitoring

Individual Mandate Burden

o Massive expansion of IRS or government coercion on taxpayers

o Billions of dollars of new customers to insurance companies that have been price gouging already and denying adequate care

o Demands younger, healthier customers who might have suspended health care for economic reasons sign up or be penalized

Restrictions on Abortion and other Women’s Rights

o Takes away abortion coverage of millions of Americans. Women mandated to buy into insurance plan that may not provide them w/ a legal medical procedure! Law imposes bizarre requirement on enrollees who buy coverage through exchanges to write two monthly checks (one for an abortion care rider and one for all other health care). Even employers will have to write two separate checks for requesting abortion rider.

o A new executive order from the President for the votes of anti-abortion Democrats, reinforces and extends safeguards to states and entities who withhold access to abortions according to the Hyde Amendment, affirms that there be no federal funding for abortions (establishing double standard for women in terms of access in America, rich vs. poor). Catholic bishops and extremist abortion rights opponents know that it will greatly restrict of access to safe abortions, one of the most common medical procedures for women.

o Gender rating -- practice in which insurance companies charge women more for their premiums than men for identical coverage. Obama’s health care reform bill would only partially remedy this. Once the exchanges are up and running (after 2014), companies will be banned from setting different premiums based on gender unless company has more than 100 employees. For these larger groups not until 2017 will it be stopped.

o On average, women under 55 charged premiums up to 48 percent higher than those for men of the same age –maternity coverage excluded.

o Today’s law revives federal funding for an abstinence-only-until-marriage program that Congress correctly allowed to expire in 2008. The ACLU has long opposed abstinence-only programs on the grounds that they censor vital health information, promote gender stereotypes, discriminate against gays and lesbians and sometimes use federal dollars to promote one religious perspective. (ACLU article)

o The bill permits age-rating, the practice of imposing higher premiums on older people. This practice has a disproportionate impact on women, whose incomes and savings are lower due to a lifetime of systematic wage discrimination.

Immigration Discrimination and On Others Uncovered

o Undocumented immigrants would not be allowed to buy insurance on the new exchanges, even if they are willing to pay the full cost of the insurance with their own money.

o The bill imposes harsh restrictions on the ability of immigrants to access health care, imposing a 5-year waiting period on permanent, legal residents before they are eligible for assistance such as Medicaid, and prohibiting undocumented workers even to use their own money to purchase health insurance through an exchange.

o The bill covers only 32 million of the 47 million uninsured in this country,

o Right now there are 45,000 premature deaths of American citizens each year due to inadequate or no health care.

o By 2019 there will be 23 million without coverage, averaging 23,000 premature deaths each year.

Medical Industrial Complex Lobbying Statistics (Paul Street article)

o The health sector poured a remarkable $178,252,901 into congressional and presidential campaigns between the beginning of the 2008 election cycle and the summer of 2009. The insurance industry invested $52,739,320. Obama received more than $19 million from the health sector for the 2008 election cycle – a new record. The prolific author and former New York Times reporter Chris Hedges reports that “the five largest private health insurers and their trade group, America’s Health Insurance Plans, spent more than $6 million on lobbying in the first quarter of 2009. Pfizer, the world’s biggest drug maker, spent more than $9 million during the last quarter of 2008 and the first three months of 2009.”

Pro-Medicare for All Statistics (Paul Street article)

o 69 percent of Americans think it is the responsibility of the federal government to provide health coverage to all US citizens (Gallup,2006).

o 59 percent of Americans support a single-payer health insurance system (CBS/New York Times poll, January 2009).

o 59 percent of doctors back a single-payer system (Annals of Internal Medicine, April 2008).

o In a remarkable CBS-New York Times poll conducted late Sept.2009, 65 percent of more than 1,000 Americans randomly surveyed by CBS and Times responded affirmatively to following question: “Would you favor or oppose the government offering everyone a government-administered health insurance plan – something like the Medicare coverage that people 65 and over get – that would compete with private health insurance plans?”


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Submitted by libbyliberal on

Here is what to expect if the Senate passes the House's changes and President Barack Obama signs the entire package into law.

Within the first year of enactment

* Insurance companies will be barred from dropping people from coverage when they get sick. Lifetime coverage limits will be eliminated and annual limits are to be restricted.

* Insurers will be barred from excluding children for coverage because of pre-existing conditions.

* Young adults will be able to stay on their parents' health plans until the age of 26. Many health plans currently drop dependents from coverage when they turn 19 or finish college.

* Uninsured adults with pre-existing conditions will be able to obtain health coverage through a new program that will expire once new insurance exchanges begin operating in 2014.

* A temporary reinsurance program is created to help companies maintain health coverage for early retirees between the ages of 55 and 64. This also expires in 2014.

* Medicare drug beneficiaries who fall into the "doughnut hole" coverage gap will get a $250 rebate. The bill eventually closes that gap which currently begins after $2,700 is spent on drugs. Coverage starts again after $6,154 is spent.

* A tax credit becomes available for some small businesses to help provide coverage for workers.

* A 10 percent tax on indoor tanning services that use ultraviolet lamps goes into effect on July 1.

What happens in 2011

* Medicare provides 10 percent bonus payments to primary care physicians and general surgeons.

* Medicare beneficiaries will be able to get a free annual wellness visit and personalized prevention plan service. New health plans will be required to cover preventive services with little or no cost to patients.

* A new program under the Medicaid plan for the poor goes into effect in October that allows states to offer home and community based care for the disabled that might otherwise require institutional care.

* Payments to insurers offering Medicare Advantage services are frozen at 2010 levels. These payments are to be gradually reduced to bring them more in line with traditional Medicare.

* Employers are required to disclose the value of health benefits on employees' W-2 IRS forms.

* An annual fee is imposed on pharmaceutical companies based on market share. The fee does not apply to companies with sales of $5 million or less.

What happens in 2012

* Physician payment reforms are implemented in Medicare to enhance primary care services and encourage doctors to form "accountable care organizations" to improve quality and efficiency of care.

* An incentive program is established in Medicare for acute care hospitals to improve quality outcomes.

* The Centers for Medicare and Medicaid Services, which oversees the government programs, begin tracking hospital readmission rates and puts in place financial incentives to reduce preventable readmissions.

What happens in 2013

* A national pilot program is established for Medicare on payment bundling to encourage doctors, hospitals and other care providers to better coordinate patient care.

* The threshold for claiming medical expenses on itemized tax returns is raised to 10 percent from 7.5 percent of income. The threshold remains at 7.5 percent for the elderly through 2016.

* The Medicare payroll tax is raised to 2.35 percent from 1.45 percent for individuals earning more than $200,000 and married couples with incomes over $250,000. The tax is imposed on some investment income at a rate of 3.8 percent for that income group.

* A 2.9 percent excise tax is imposed on the sale of medical devices. Anything generally purchased at the retail level by the public is excluded from the tax.

What happens in 2014

* State health insurance exchanges for small businesses and individuals open.

* Most people will be required to obtain health insurance coverage or pay a fine if they don't. Healthcare tax credits become available to help people with incomes up to 400 percent of poverty purchase coverage on the exchange.

* Health plans no longer can exclude people from coverage due to pre-existing conditions.

* Employers with 50 or more workers who do not offer coverage face a fine of $2,000 for each employee if any worker receives subsidized insurance on the exchange. The first 30 employees aren't counted for the fine.

* Health insurance companies begin paying a fee based on their market share.

What happens in 2015

* Medicare creates a physician payment program aimed at rewarding quality of care rather than volume of services.

What happens in 2018

* An excise tax on high cost employer-provided plans is imposed. The first $27,500 of a family plan and $10,200 for individual coverage is exempt from the tax. Higher levels are set for plans covering retirees and people in high risk professions.