Monday, December 21, 2009

Healthcare Bill

So I figured that I would start with this, as seeing the news that they've finally managed to agree to a date to vote on the bill (wow, and they consider that a major success, to agree to vote on it).  But lets start with this particular healthcare bill, then go into the government's role in healthcare in general.

But first, lets remember that this current bill in the senate is only one of two bills (there is also the bill in the house of reps) and once both are passed (in their respective houses) they will then be merged and reconciled and then voted on by both houses one last time before going to Obama.  So just because some features pass in the Senate bill doesn't mean that it will be in the final bill.

some of the key differences between the two bills are...

1) the Senate bill allows the states to opt out of the public option (so if a highly conservative state doesn't want to be in it, they don't have to, and a highly liberal state can if they want), the House bill does not have this opt out feature.

2) in regards to abortion, both bills prevent the use of federal funds to pay for abortion.  But the House bill requires that if you want an elective abortion, then you have to get alternative insurance altogether.  So if you want an abortion, not only will the house bill not cover the abortion, but they won't cover you at all afterwards.

3) Paying for the bill is another way the two bills differ greatly.  They all impose various taxes and fees, but each bill does different taxes on different things, and there are a multitude of different taxes.  For example, the house bill imposes a 2.5% tax on medical devices and ends some tax breaks for multinational companies.  The senate bill increases the payroll tax for Medicare (from 1.45% to 1.95%) on high income families (individuals making 200k and families making 250k).

Both bills pretty much only raise taxes on those making 200k a year or more, or imposing taxes for elective stuff (like a nose job or some cosmetic thing).

While there are some other differences between the two (such as mandates for individuals and companies), these are some of the bigger ones politically (not much stirs up political divide like, money, abortion, and the public option), and these will need to be reconciled before the final bill is voted on and sent to President Obama.

Some of the key features that both bills have (that would effect the people) is the public option.  Everyone would have an option of going through the government for healthcare.  Now we've seen the government fail miserably at time efficiency (DMV) and spectacularly succeed (DEQ), so this could really swing either way, hopefully if it becomes really bad, they'll scrap the model and design a better one.  Also, everyone would be required to have healthcare of some kind (be it through the government, your employer, or a private selection) this presents it's own pros and cons.  For one, those without health insurance still use the healthcare system and pass the bill onto others, making them have coverage will drive down the overall costs, however, it also takes away and option.  Right now, I can choose to not have coverage if I don't like the options, so if I think it is too expensive, I can say "screw you" and go without.  When you take away the "go without" option, it drives costs up, since the "go without" option is actually a competitor in the health insurance industry, and the government is taking away a competitor (though adding a competitor in the public option).

One thing that is not in either bill (and never was) is death panels.  These death panels (in the myth) were a bunch of number crunchers that would say whether your got to live or die, depending on your issue and how much it would cost to treat it.  The reality, like all insurance coverage, they rely on science to tell them what the best treatment if for a particular condition.  Like for severe burns, you may read somewhere on the internet that covering the body with a microfilm of gold plating is a sure fire way to cure the person, but your insurance company is not gonna fork over for some unproven treatment off the internet, when doctors know that a chemical induced coma while providing skin grafts is the best current solution.  But if you are confident enough to pay for it out of pocket, you can.  It is no different with a government public option then it is with the current insurance companies.  Both will have individuals making the determination of what will be and what will not be covered.  So if you think that the government is gonna have "death panels" then your current insurance provider already has an army of "death panels."

Another concern is with the "pork" which is the case in any bill that needs to be passed, people play politics and sell off votes for money to supporters or to their state or where ever.  If they can get money for their vote they will, even if they planned on voting that way anyway, many will hold out just for money.  This bill is no different.  However, thankfully, much of the pork is less pork and more bacon (meaning good, though still fattening).  Most of the earmarks are for medicaid for individual states, so at least it is money going to a relevant topic to healthcare, and not to some bridge to nowhere or more corn bio-diesel.  Now we shouldn't need to be doing this and the very act of selling your vote, in my opinion, is worth not getting re-elected, regardless of your stance on issues.

How it will be when it comes to a final vote is likely gonna be different, and I'll probably do another post when that final bill comes out.

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