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Tuesday, March 23, 2010

Myth: The "Patient Protection and Affordable Care Act" is a terrible law

This bill stinks because the Democrats could have easily included some important essentials, including:
(1)A National insurance exchange, including a public option
(2)Repeal of the anti-trust exemption for health insurers
(3)Allowing Medicare to bargain for lower drug prices.
Ideally, a national, single-payer system (Medicare for all) would have saved us the most money and left no one uninsured. This bill allows the poor to opt out of buying insurance if they can't afford it. Huh?
But here are some of the good, and weird, parts:
Good: Insurers can't rescind (retroactively cancel) your coverage unless you committed fraud or intentionally misrepresented material facts. So if you forgot to mention that visit to the dermatologist they can't then cancel coverage after you have a mastectomy (actual case). The acne was immaterial, and, you didn't intend to conceal it.
Good: Will require health plans to report on benefits or reimbursement structures that improve health outcomes, prevent hospital readmission, improve patient safety & promote wellness. Do ya think?
Good: Maximum waiting period for pre-existing conditions will be 90 days.
Good: Requires a whole host of experimental "demonstration projects" to test various cost and care strategies. This is an admission that they can't possibly know all the best solutions up front, unlike Rush Limbaugh.
Good: Creates an ongoing "Interagency Working Group on Health Care Quality" which will have a results oriented focus on best practices.
Good: Makes Medicare reimbursement rates more equitable among the states, which will benefit Oregon and- I hope -stop the mass exodus of doctors from Medicare patients.
Good Expands student loan forgiveness to include health professionals who go to work for public health agencies.
Weird: Increases from 10% to 20% the penalty for using HSA funds for nonmedical purposes. Was that a problem?
Bad: Raises the AGI threshold from 7.5% to 10% for deductiblity of medical expenses, with few exceptions.
Weird but Good: 10% tax on indoor tanning. Yes, tanning salons should pay for the skin cancer they cause.
Weak and Weird: The requirement that everyone buy insurance. Except sometimes. This may change soon, but right now an individual making less than $150,000/yr. will be penalized $750/yr. for not buying health insurance. Over that income level, add 0.5% of the excess income to your penalty. Let's see. Should I spend $500/mo. for health insurance or pay a $750 penalty, and then when I do get sick, enroll in a plan because they can't refuse me? Might work. But what if you have an accident? Or heart attack? Or some other event that renders you unconscious or otherwise incapacitated, or, needs immediate attention? You will not be covered until you enroll in a plan. And then there's that pesky 90 day waiting period. I know that coverage will not be retroactive.


  1. I believe the whole health care issue missed the point.

    The only way to reduce health care costs is to educate people on how to stay healthy. We have way too many unheathy people that require hugh subsidies from those that have maintained good healthy habits.

    If we had a population of healthy fit citizens, the health care providers would be changing the way they provide it and their costs.

    Our government at all levels should zero in on how to live healthy rather than stick their noses in the health care provider industry.

  2. Thanks for the comment, Nancy.
    This is a free country; shouldn't I have the right to be fat and sick if that's what I want?
    I'm joking. But the problem isn't lack of government zeroing in on our health. The problem is our pathological obsession with consumption, consumption of all types. Virtually our entire society from birth is slammed with every imaginable type of media to believe that we are inadequate and NEED just one more thing or feeling or experience and THEN we'll be happy. Naturally, it doesn't and hasn't worked. In fact, all measures of happiness in this country have declined steadily since the 1950's. We're destroying our children, our environment and our own bodies and minds in the name of almighty, nonnegotiable commerce.
    Happy people don't buy crap that they don't need, they don't have any desire to hurt others, and they are interested in preserving and enhancing themselves, others and the planet.

  3. Come on, its the medias fault that people have destructive behavior? Passing blame lets people off the hook. If you are fat and lazy and watch too much TV, its your fault.
    I do not see this health bill as healthy.

  4. Yes, it is the media's fault when it's children we're talking about. Is it any coincidence that soaring child obesity (it has tripled the last 30 yrs) almost directly tracks skyrocketing media messaging urging consumption, consumption, and more consumption?
    Several different sections of the 2010 health bill address obesity, including a requirement that calorie labeling be posted on restaurant menus. If I'm paying a premium for dining out, do I have a right to know what I'm eating? Absolutely.


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