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OT: HR3200 - you may read the health care reform bill as it develops

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A Davis
(@A_Davis)
Trusted Member

http://thomas.loc.gov/

Click on
"HR3200: America's Affordable Health Choices Act of 2009"

Then, click on
"Text of Legislation"

there are many in the united states virgin islands who are following this with great interest, and although i marked this post "off-topic", health care availability affects the quality of life everywhere. but here, where the cost of living is so much higher than many places, it may be your tipping point if thinking of moving here.

here is where you will be able to contact your delegate to congress and exchange info on what's in it for the u.s. virgin islands
http://www.donnachristensen.house.gov/

you may also check a very lively thread on this message board and weigh in:
https://www.vimovingcenter.com/talk/read.php?4,115040

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Topic starter Posted : August 3, 2009 1:29 am
Gerie
(@Gerie)
Advanced Member

Thank you very much for posting the Thomas link, Anita.

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Posted : August 3, 2009 4:10 am
A Davis
(@A_Davis)
Trusted Member

you're welcome gerie! thanks for checking it out.

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Topic starter Posted : August 3, 2009 11:41 pm
Bombi
(@Bombi)
Trusted Member

I read the summary and will wade through the legislation later. My first impression is, I appears to be very well thought out and detailed towards preventative care and standard practices. The pre=existing condition inclusion is very important as well
So far so good.

I'm sure representatives will be getting a lot of feedback from their people and more compromises will be made and positions taken. The fact that the legislation is still on the table and progressing is remarkable. One of the strengths of an advanced nation is the health of the people.

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Posted : August 4, 2009 12:11 pm
A Davis
(@A_Davis)
Trusted Member

it's quite a bit to run through, for sure. subject to revision as all sides weigh in.

most important is greater efficiency! we are leaking money like a sieve, and if that can be reduced, it will help and awful lot.

we may not all get exactly what we want but somewhere in the middle i'd like to see the vast majority of the people have access to affordable health care.

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Topic starter Posted : August 5, 2009 1:03 am
Jules
(@Jules)
Trusted Member

I have been using this link to read the bill:

http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3200ih.pdf

I found the site in Anita's link to be difficult to use since the bill is displayed without page numbers/line numbers and with variable pages depending on screen size.

The link I have posted shows the bill as submitted to Congress, with page numbers and line numbers. I find this helpful because many people (on other sites) who are trying to dissect and understand the bill use page numbers and line numbers when discussing their interpretations.

I'm trying to plow through this document but am finding it so full of "legaleze" that to me it's nearly incomprehensible.

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Posted : August 5, 2009 8:11 am
A Davis
(@A_Davis)
Trusted Member

thanks for this link jules, i will use it too! makes things much easier!

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Topic starter Posted : August 5, 2009 9:13 pm
Jules
(@Jules)
Trusted Member

You're welcome. If you find any links to sites that appear to have knowledgeable unbiased opinions on the interpretation (especially with references to specific lines and passages), please post them here.

Of course, I suspect that what a bill SAYS and how it might be enacted or interpreted by Congress might not be the same thing.

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Posted : August 5, 2009 11:26 pm
A Davis
(@A_Davis)
Trusted Member

well, this is still in development, we'll have to see if they can come to agreement on main points - pre-existing conditions, cutting costs, affordable private options, not cutting insurance on major illness, affordable prescriptions, more efficiency in the current medicaid/medicare, and coverage for end of life services. nothing can be worse than facing the fight of your life and having someone cut off funding for your treatments after you have been paying faithfully into their coffers.

as always i am hopeful, because i choose to be.

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Topic starter Posted : August 6, 2009 11:20 am
Jules
(@Jules)
Trusted Member

One of my major concerns about the bill is that it does not really put forth a means to decrease the cost of delivering health care.

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Posted : August 6, 2009 11:41 am
A Davis
(@A_Davis)
Trusted Member

the only way to do that, is to consult with those who are actually delivering it, examine past records, and try to figure out what won't throw out a baby with the bathwater. no one expects people to go marching through offices and making determinations just on sight, it's going to take time.

i believe this can be done.

it is mentioned but one cannot list specifics without proper knowledge and information from the people who are intimately involved. i'm not just talking studies, but medical practitioners, patients and support staff should have input.

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Topic starter Posted : August 6, 2009 12:04 pm
Bombi
(@Bombi)
Trusted Member

The Standards of Care Protocol which is being kicked around. It would set standards that would be applied to treat and diagnose medical conditions. For example if Multiple Sclerosis is suspected there would be a standard test to diagnose. Then there would be a standard treatment method based on research and patient success history. A patient would be able to access this type of info and be more involved and proactive in obtaining medical care and services. Presently most every Dr. has ther own protocol and then Ins. Co's have theirs.

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Posted : August 6, 2009 12:36 pm
A Davis
(@A_Davis)
Trusted Member

i see... thanks bombi for the explanation... makes sense too!

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Topic starter Posted : August 7, 2009 8:10 pm
Jules
(@Jules)
Trusted Member

Ah yes. Standards. "Best Practices". Treatment guidelines. "Pay for Performance".

There are a HUGE number of diagnoses, variants of diagnoses, combinations of diagnoses, etc that have no agreed upon "standard of treatment". Plus, there is a tremendous amount of ongoing research. One study will give one result, everyone adopts that treatment, then the next study says "whoops, that didn't work out well, now we think this is better" , yadda yadda yadda. There is rarely a cut-and-dried, black-and-white, right-and-wrong way to treat a given diagnosis. There's often disagreement on the diagnosis to begin with!

I think it would be nice if a person's symptoms and tests could just be fed into a computer and the "correct" treatment plan outputted, but that is no where near reality. I can't imagine it becoming a good thing in my lifetime or even in the next generation's lifetime.

Medical textbooks are often out of date by the time they are printed. Committees and groups of the most respected doctors often vehemently disagree on treatments. How will treatment guidelines be invented? Who will be responsible for coming up with the guidelines? How often are they reviewed and updated? Do you think that the government will be able to keep up with treatment guidelines? If your doctor follows a treatment guideline and you have a bad outcome, can you sue? Looks like you can-- I don't see anything about tort reform in the 1017 pages of the bill. I'm sure that doctors will LOVE that-- being told how to practice medicine, being forced to provide care that is not what they recommend, and then being liable for poor outcomes when providing the pre-prescribed treatment.

Must stop now, my head is spinning again.

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Posted : August 7, 2009 10:18 pm
DUN
 DUN
(@DUN)
Trusted Member

I read today that the Drug industry backing Obama's health care plan!
That is scary!

Hope it all works out in the end, & middle income taxpayers don`t(get forced) to foot the bill!

'If the Government is big enough to give you everything you want, it is big enough to take away everything you have"

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Posted : August 9, 2009 2:05 am
A Davis
(@A_Davis)
Trusted Member

one thing is for certain. i am paying dick cheney's health care with my taxes, and i certainly pay for those who don't have insurance through higher premiums and taxes. i am in the working class and i am already paying, albeit "silently".

i am for greater efficiency and less waste. these are the things i want to see emphasized.

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Topic starter Posted : August 10, 2009 12:13 am
A Davis
(@A_Davis)
Trusted Member

the white house is asking for people to send in their concerns online via a special web site now:

http://www.whitehouse.gov/realitycheck/ (it's called "reality check")

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Topic starter Posted : August 10, 2009 5:19 pm
Jules
(@Jules)
Trusted Member

Here's a very thought provoking opinion on how to fix the health care system. It was written by the CEO of Whole Foods Market.

http://online.wsj.com/article/SB10001424052970204251404574342170072865070.html

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Posted : August 12, 2009 11:16 pm
A Davis
(@A_Davis)
Trusted Member

i am liking that article jules, particularly as regards tort reform.

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Topic starter Posted : August 12, 2009 11:42 pm
Jules
(@Jules)
Trusted Member

I thought you might find that one interesting, Anita. Here's another one that raises good points. It a Washington Post op-ed. The author also discusses the origins of employer-financed health care and argues that it is a significant cause of the problems in health care today (that and the medical lottery mentality of malpractice suits)

http://www.washingtonpost.com/wp-dyn/content/article/2009/08/06/AR2009080602933.html

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Posted : August 12, 2009 11:52 pm
A Davis
(@A_Davis)
Trusted Member

i am usually annoyed my mr. krauthammer, but he has a point about employer sponsored health insurance. people will often take jobs for the benefits, which includes health insurance, and will stay in jobs that they hate because they cannot "afford" to work anywhere else.

if we make health insurance attainable (affordable), people will get it, it's just that it's impossible to get unless you are in your employer's group plan or you work for the government.

i am hoping that over this summer recess, this dialogue will result in greater resolve to bang the heads necessary and send the lobbyists packing, and create something that people will be able to use and feel safer with. there is no excuse for anyone dying because they cannot afford medical care. there's the so-called "death panel" right there. when you walk into a medical facility and can't get past the front desk unless you have insurance.

no wonder so many people treat the emergency room doctor as primary physician. this is one of the things that makes health care so expensive to all of us. we pay it out in greater taxes, and higher premiums for people who are underfunded and have no choice but to walk away from their obligations. imagine the average working stiff all of a sudden responsible for tens of thousands of dollars for a few days' illness. it literally puts people under.

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Topic starter Posted : August 13, 2009 11:30 am
stiphy
(@stiphy)
Trusted Member

Thanks for the links Jules, they are great.

As I've looked into the issue it seems more and more like we've gotten where we are as a direct result of government intervention and policy, not because a lack of it. Employer sponsored health plans are a result of FDR's misguided wage and price controls. The tax exemption on employer sponsored health plans also encourages this ridiculous practice.

The worst part of employer sponsored health plans is that when one most needs their plan, because they are sick, they often can't keep working to afford it. What other kind of insurance is there for you when you don't need it but not there for you when you do?

The second big issue is tort reform which they both hit on. What we need is a "loser pays" system of justice so that if you sue someone and lose the judge can force you to pay the defendant's costs for representation. Currently there is no disincentive to bringing a frivolous lawsuit. We are one of the only "western" countries to not have this sort of system, consequently our tort system is a mess.

One issue not brought up in those articles that I had researched years ago was the AMA's interference with the supply of doctor's by working to limit accredited medical schools. I remember reading years ago that there hadn't been an increase in the number of accredited medical schools in the US in the last 50 or 100 years despite a huge growing population. When demand goes up and supply stays the same prices increase. I would have to dig up the backing for it but this is another interesting wrinkle in the health care debate that I rarely see mentioned.

At the end of the day the government has interfered with health care more than any other market with horrible results. It is tough to sell me on the idea that interfering more will lead to a better outcome.

Sean

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Posted : August 13, 2009 8:19 pm
trw
 trw
(@trw)
Expert

pay your employees yet sean?

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Posted : August 14, 2009 9:09 am
trw
 trw
(@trw)
Expert

i know i'm tired of seeing all the 'bubbas"on cnn and fox railing against reform,i guess i don't understand why the population does not want to do the right thing

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Posted : August 14, 2009 9:33 am
Jules
(@Jules)
Trusted Member

trw, most people I know are FOR reform-- they are just not for this 1017 page bureaucratic bloat of a bill that does nothing to decrease the cost of health care and allows for a scary amount of government control. Have you read it? Or tried to-- as I said it's long and complicated.

It's not just the "bubbas" that are raising concerns. People from all walks of life, all income levels, and all political leanings are becoming skeptical of this bill. I think that the bill might be useful as a starting point or as a way to expose and discuss several aspects of health care delivery. We have to start somewhere, right?

Do you really expect a first attempt to work? It's a massively complex problem that deserves to be fully understood and discussed by citizens. If nothing else, this bill is a good tool for initiating these important discussions.

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Posted : August 14, 2009 9:38 am
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