Healthcare

Healthcare reform in general is something that I strongly support.  Considering that pretty much anything can be done better (nothing is perfect after all), reform is always a potentially good thing (and always a potentially bad thing if done wrong).  But our healthcare is something that badly needs the reform.  As for governmental involvement, I strongly believe that it is the government's sole responsibility to ensure that all of its people have the basics for life (well, everyone shares that belief, we all just have different views on "basics of life"), and I feel that basic, preventative healthcare is needed (meaning checkups and doctor visits, and various example) and the benefits that it provides make it a great investment (cheaper and so saves money, reduces sick days at work so is beneficial to companies, and so to employees, cause missing work means missing pay), and if anyone wants to go above and beyond to get acute coverage or any additional coverage, they are more then welcome to get that from the free market.  It's just like a minimum wage (but for healthcare) everyone gets the basic minimum.

The government should also bring in actual doctors and nurses to write policy, since they know what is best, and not doctors that were doctors over a decade ago and moved on to do something else (like work for the insurance companies or become lobbyists), but those that are actual doctors now (or at least very recently) and know the patient needs of now.  Then, the government should bring in business people that can specialize in implementing those policies in the most cost effective and least bureaucratic way possible.

This would cover for the government's direct involvement in healthcare for people.  But there is still another aspect that needs to be dealt with, regulation of the private sector.  The insurance companies in the USA spend more money on lawsuits and lawyers then any other nation's insurance companies.  There is hundreds of billions of dollars wasted in tests that doctors know are pointless, but know that if they don't do them, they risk being sued.  The risk of being sued and the wasted money from the wasted tests, and wasted lawsuits restricts doctors from doing their jobs.  We have good samaritan laws that protect those that try to save others (if you save someone's life by performing CPR, they can't sue you if you accidentally break one of their ribs in the process), but these laws don't get extended to doctors, whose entire job is saving and helping others.

Healthcare reform, if done right, would not cost the american people any additional money, and would in fact, save money.  Since with preventative care, the overall cost goes down, and because you are replacing the service from the private sector (of preventative care, they still provide anything above and beyond) to the public sector, and not creating a new service, the cost to the people is not being increased just moving around.

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.


http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BILLSUMMARY-071409.pdf
http://www.govtrack.us/congress/billtext.xpd?bill=h111-3200
http://dodd.senate.gov/multimedia/2009/BillText.pdf