I'm not american, I don't live in america. So it's kind of hard for me to fully grasp what the healthcare reform is all about.
I don't want to read about it , I want to hear what it's all about from people. Regular people. You.
So, explained simpy.. what's the dealyo ? What changes will it bring compared to the existing healthcare system ? I watched Sicko, so I got a general idea of how it is now. But is it really that bad ? Is the reform a good thing or a bad thing ?
I get the impression that the conservative crowd are against it, while the more liberal people are all for it.
Can someone explain to me the US Healthcare reform ?
What I understand, the bill will help those without insurance, but it will create even more debt.
The biggest problem seem to be that it is the insurance and medical companies that wrote the bill, which will lead to them getting an even bigger piece of the pie than before.
But I'm not living in the US, im living in sweden ... who has free healthcare for all
The Bill is a great thing, now everyone has the right to health care, as long as companies and people pay a certain amount of money to the government. There is absolutely nothing wrong about it, even Portugal has Health Care and it is the second worst country in Europe, economically speaking.
Health insurance is crazy expensive here, even with an employer covering most of it. The bill makes it mandatory to have insurance, but is supposed to subsidize those who are too poor to buy their own. The basic problem with U.S. healthcare is that it's profit based, rather than based on caring for/treating/preventing people from getting sick.
The bill does do some good things although it's still a pretty big wet kiss to big insurance.
" @floodiastus: I don't think that is accurate at all. The Bill is a great thing, now everyone has the right to health care, as long as companies and people pay a certain amount of money to the government. There is absolutely nothing wrong about it, even Portugal has Health Care and it is the second worst country in Europe, economically speaking. "No, floodiastus was mostly right.
At least about the 'the insurance companies are lovin' it' part. As for the debt, there's too much conflicting shit going around that I don't want to even start with the budgetary ramifications of this thing. The health-care reform, which, by the way, will have most of its goody goods starting at a later date (4 years, if I remember correctly) will mandate that people have health-care insurance, but there is no public option. So, cha-ching for the insurance companies. Now they have a captive market of people who have to either pay with their own money or use government subsidies to get the insurance the companies are providing. There's nothin' stopping those premiums from going up either. So, either you're paying, or the government, which is funded by your money, is paying, money to the shitty corporations that everybody with some decency feels compelled to hate.
Damn the Obama administration for giving the "only governments make monopolies" argument weight...
So, the government is going to be paying out the nose, because lots of people are going to need help paying for their health-care. This means that the Republicans can point at the Democrats, scoff, and tell the American people that the Democrats are taking all of their money away. This will be made ever worse by the fact that premiums will go up, thus draining the limited (I believe) subsidy dollars even faster. Given the fact that the government will be collecting money for this whole thing for 4 years before all of the subsidies and crap go into action, subsidy money probably won't run out (I hope) too quickly, but it will eventually, and then there will have to be a vote on whether to renew it. By that time, the Repubs will have had plenty of time to dig into the Dems for the health-care bill that, honestly, would have been pretty decent if it weren't for Republican interference. Unless the years in which people are getting helped are really noticeably better, the people will be fooled into thinking they should just go with the Republicans, and then everything falls apart.
*Gah* I'm tired. If that didn't make sense, or I got some stuff wrong, I apologize.
"People who couldn't afford Medicare now have the right to be treated in a hospital, instead of being left to die. "
your an idiot to think that people who did not have insurance can't get treated in a hospital. people that don't have insurance are about 1/3 of the patients treated in hospitals each day.
People will be forced to have health insurance. OK. How is that a bad thing? You are probably rich and can afford Medicare, but what about that kid who saw his mother die because they couldn't afford Health Insurance? The kid saw his mother die because his family didn't have enough money, and this has happened throughout America several times, don't you think it is ridiculous that the world's most powerful country has such an imbecile policy? That one has to be rich to have health? One has to be rich to survive?The health-care reform (...) will mandate that people have health-care insurance, but there is no public option.
The Health Care Bill is the best thing in years for the people who fulfill these two categories:
- Like to live
- Don't have much money
How many people do you think fulfill these two categories in the United States? You can complaint all you want, because you have Medicare you cunt, but some people are really happy with this, and it is sad, or was, that America, the world's most powerful country, did not have health care. It was pathetic.
" @floodiastus: I don't think that is accurate at all. The Bill is a great thing, now everyone has the right to health care, as long as companies and people pay a certain amount of money to the government. There is absolutely nothing wrong about it, even Portugal has Health Care and it is the second worst country in Europe, economically speaking. "
here is your other problem...everybody has the right to health care, they just need to pay for it. why do i need to pay for your health care? why do you think that you should not have to pay for your own care? do i need to pay for your high blood pressure, your heart disease, your cancer? shouldn't i pay for care for myself and my family? everyone has the "right" to own a car or a house. does the government/taxpayers need to start paying for everyone to have a house or a car? do i need to start paying for your electrical bill also because you have the right to have electricity.
1: Everyone is required to buy health care. If you're income is under a certain amount then you're exempted but most Americans will be required to have health care or risk being fined up to $2000 if I'm not mistaken.
2: Insurance companies can't drop you if you're really sick, nor can they deny you coverage over a pre-existing condition (This prevents insurance companies from screwing you over).
These are the two biggest rules of the new bill, it's not a public option but it's a close as we can get to one. If this works out then hopefully all citizens will be given equal treatment in hospitals, rather than just being sent home early to die simply because you can't afford a transplant.
It basically makes it easier to get insurance, you're less likely to get dropped from your existing insurance provider, and now you have to get insurance (the poor people will get subsidies to help pay for it). I'm still wondering why there was no public option?
" @Snail said:And you're a damn fool if you believe that they get equal treatment. Most patients without health insurance are sent home early where they later die at home, it's happened to plenty of cancer patients, people that need transplants to live, and other people suffering with health conditions that require longer treatment times."People who couldn't afford Medicare now have the right to be treated in a hospital, instead of being left to die. "your an idiot to think that people who did not have insurance can't get treated in a hospital. people that don't have insurance are about 1/3 of the patients treated in hospitals each day. "
" @Termite: I think I just read one of the most pathetic things in history:Yes, I'm a real "cunt" for thinking that the health-care reform, as we're gettin' it now, is a cop-out. My family has never had much money, believe me, and even if we did we wouldn't be buying Medicare, which is a different thing from health-care, in case you weren't aware of that.People will be forced to have health insurance. OK. How is that a bad thing? You are probably rich and can afford Medicare, but what about that kid who saw his mother die because they couldn't afford Health Insurance? The kid saw his mother die because his family didn't have enough money, and this has happened throughout America several times, don't you think it is ridiculous that the world's most powerful country has such an imbecile policy? That one has to be rich to have health? One has to be rich to survive?The health-care reform (...) will mandate that people have health-care insurance, but there is no public option.
The Health Care Bill is the best thing in years for the people who fulfill these two categories:How many people do you think fulfill these two categories in the United States? You can complaint all you want, because you have Medicare you cunt, but some people are really happy with this, and it is sad, or was, that America, the world's most powerful country, did not have health care. It was pathetic. "
- Like to live
- Don't have much money
I suppose I didn't make it very clear, even though I do think the little snippet you took from my quote is indicative of some dismay on my part, but I DO want people to have health-care. I just want it done right, and doing it right doesn't involve conceding everything to the Republicans to make a watered down bill that will feed money into the insurance companies, thus expanding their lobbies and making them even more of a force to reckon with as time goes on. I'd like the country to give a public option a shot, and if we're going to settle for no public option, then we should at least limit premium increases. There are good things in this bill, but it's a mere shadow of what it could have been, and I'm not entirely confident that it'll serve as much of a stepping stone towards better things either. The propaganda machine will get rolling, every success will be downplayed, and every failure will be overplayed. This was a big chance to get some real positive change, and I think it's been kind of wasted.
Now, why don't you be a bit more careful next time before you go calling people cunts. I get the feeling that you're not an American, but that's no excuse for totally misinterpreting what I said and calling me something I'm not.
I am just wondering, what are the tax rates in the US. It's probably different from state to state, but what is the average percentage?
It's around 36% for those who earn less than give or take 100 000 US dollars and around 50% for those above here in Norway.
Well, when I read your post I certainly did not get the feeling that you were for it, but if you say so. In my opinion this bill is a great thing, it might not be being executed in the best way possible but it certainly is something that past presidents have tried to make, and failed. Hats off to Obama for this. Now there won't be as many deaths per year in America than in the past years (a figure which I can't remember, but it was ridiculously big).
All in all, it's a big step forward for America.
" I am just wondering, what are the tax rates in the US. It's probably different from state to state, but what is the average percentage? It's around 36% for those who earn less than give or take 100 000 US dollars and around 50% for those above here in Norway. "
I dont know how you got it in norway, but in sweden we got around those taxes you got + a shitload of other taxes, the biggest being 25% of EVERYTHING you pay for with your money and lets not forget that the employer in sweden pays a shitload of more money just to be able to employ you before even paying you a dime :)
During the 80s and 90s some of our citizens paid over 100% tax, before they changed the rules abit hehe.
@Snail said:
@Termite said:" @floodiastus: I don't think that is accurate at all. The Bill is a great thing, now everyone has the right to health care, as long as companies and people pay a certain amount of money to the government. There is absolutely nothing wrong about it, even Portugal has Health Care and it is the second worst country in Europe, economically speaking. "
Well I don't find it good or bad, because I will not profit or not profit cuz of it (not living in the US), I just gave my version of how I interpret the media, both the mainstream media and the non-mainstream media. I bet you boys over in the states are more close to home and can wrap your head around the bill more than I can." @Snail said:
No, floodiastus was mostly right. At least about the 'the insurance companies are lovin' it' part. As for the debt, there's too much conflicting shit going around that I don't want to even start with the budgetary ramifications of this thing. The health-care reform, which, by the way, will have most of its goody goods starting at a later date (4 years, if I remember correctly) will mandate that people have health-care insurance, but there is no public option. So, cha-ching for the insurance companies. Now they have a captive market of people who have to either pay with their own money or use government subsidies to get the insurance the companies are providing. There's nothin' stopping those premiums from going up either. So, either you're paying, or the government, which is funded by your money, is paying, money to the shitty corporations that everybody with some decency feels compelled to hate. Damn the Obama administration for giving the "only governments make monopolies" argument weight... So, the government is going to be paying out the nose, because lots of people are going to need help paying for their health-care. This means that the Republicans can point at the Democrats, scoff, and tell the American people that the Democrats are taking all of their money away. This will be made ever worse by the fact that premiums will go up, thus draining the limited (I believe) subsidy dollars even faster. Given the fact that the government will be collecting money for this whole thing for 4 years before all of the subsidies and crap go into action, subsidy money probably won't run out (I hope) too quickly, but it will eventually, and then there will have to be a vote on whether to renew it. By that time, the Repubs will have had plenty of time to dig into the Dems for the health-care bill that, honestly, would have been pretty decent if it weren't for Republican interference. Unless the years in which people are getting helped are really noticeably better, the people will be fooled into thinking they should just go with the Republicans, and then everything falls apart. *Gah* I'm tired. If that didn't make sense, or I got some stuff wrong, I apologize. "" @floodiastus: I don't think that is accurate at all. The Bill is a great thing, now everyone has the right to health care, as long as companies and people pay a certain amount of money to the government. There is absolutely nothing wrong about it, even Portugal has Health Care and it is the second worst country in Europe, economically speaking. "
I do feel that healthcare should be free for all personally in an utopian world, but I also believe that people from the trillateral commission should NEVER be allowed to be in any form of government either so maybe I am biased :)
" @Termite: I think I just read one of the most pathetic things in history:Are you stupid? You don't have to be rich to have health insurance. My family is a middle class family and we have health insurance. It's like 15% or something that lacks health insurance and 99% of the time they get the care they need. By the way, Medicare is for old people dumb ass and Medicaid is for poor people.People will be forced to have health insurance. OK. How is that a bad thing? You are probably rich and can afford Medicare, but what about that kid who saw his mother die because they couldn't afford Health Insurance? The kid saw his mother die because his family didn't have enough money, and this has happened throughout America several times, don't you think it is ridiculous that the world's most powerful country has such an imbecile policy? That one has to be rich to have health? One has to be rich to survive?The health-care reform (...) will mandate that people have health-care insurance, but there is no public option.
The Health Care Bill is the best thing in years for the people who fulfill these two categories:How many people do you think fulfill these two categories in the United States? You can complaint all you want, because you have Medicare you cunt, but some people are really happy with this, and it is sad, or was, that America, the world's most powerful country, did not have health care. It was pathetic. "
- Like to live
- Don't have much money
" People who couldn't afford Medicare now have the right to be treated in a hospital, instead of being left to die. "completely wrong
Food, tobacco and alcohol are a lot more expensive in Norway. It's the reason why people go to Strømstad to shop.
I dont know how you got it in norway, but in sweden we got around those taxes you got + a shitload of other taxes, the biggest being 25% of EVERYTHING you pay for with your money and lets not forget that the employer in sweden pays a shitload of more money just to be able to employ you before even paying you a dime :)
"Is a man not entitled to the sweat of his brow? 'No!' says the man in Washington, 'It belongs to the poor!' "
" @floodiastus said:Well you also make more money :)Food, tobacco and alcohol are a lot more expensive in Norway. It's the reason why people go to Strømstad to shop. "
I dont know how you got it in norway, but in sweden we got around those taxes you got + a shitload of other taxes, the biggest being 25% of EVERYTHING you pay for with your money and lets not forget that the employer in sweden pays a shitload of more money just to be able to employ you before even paying you a dime :)
Okay, I just wrote an essay in Spanish conversation class about healthcare, meaning I'm totally informed.
WARNING - INCOMING ANSWER TO OP'S QUESTION :-)
Here are the main points of the Health Care Bill:
1. By 2016, people will have to be on a health care plan, else they'll pay ~ $695 or 2.5% of their income a year in penalties. Parents will pay half this for children, up to $2000 per family. This is supposed to force younger, healthier people to pay into the health insurance system to cover older people's butts - however, see the next point.
2. Insurance companies can't deny people coverage for preexisting conditions. This was probably the biggest problem with American health insurance before the health care law, and it's important that people w/o insurance don't get left hanging with huge hospital bills. Problem is, in coincidence with point 1, young people can just pay the $695 fine a year for not having health insurance (much cheaper than actually having insurance), and then pick up insurance once they ever land in the hospital, because they can't be denied coverage. This sort of defeats the purpose of point 1, because people aren't going to be honest - they're going to save money and exploit the system.
3. Federally subsidized credits to people making under 400% of the poverty line, to pay for health insurance. This is self-explanatory.
4. Doctors are fully subsidized by Medicare. In America we have a program for old people called Medicare, in which they pay in a part of their income their whole lives into social security and then become eligible upon retirement for very cheap health insurance. Problem is, at the moment, doctor's hardly get subsidized for taking care of Medicare patients - it's something like $7 a visit. This will change.
5. Medicaid, federal health insurance for the poor, is being expanded to 133% of the poverty line.
There are other points, as well. Conservatives blast the law as being costly and ineffective (in truth, it will cost about a trillion dollars but will lower the deficit over the next 20 years by nearly 1.4 trillion dollars, according to the Congressional Budget Office). Ultra-liberals are angry that there still isn't a public option for medical insurance (for all Americans, not just poor and elderly).
The truth is that this law will probably get the Democrats ejected from office. Most of the bill's changes don't come into effect until 2014 or 2016, and we won't see positive financial returns for over a decade, yet our next presidential election is 2012, and it's still possible for the health care law to be repealed. The Republicans and the "Tea Party" and driving home hard the idea of the bill being wasteful and superfluous. Lots of people are jumping on board. So expect to see America become more politically conservative in the coming years... again...
Essentially what has to be understood is the fact that if someone get's something for free, someone else is working for it. Essentially taxes will go up, healthcare taxes will go up. So although your employer covers a percentage of it, you still might not be able to pay it and become eligible for "free" healthcare therefore the percentage of people that pay goes down while the percentage of people on "free" healthcare goes up. That's why it's moronic, I am not a genius and I am not a birth citizen of the U.S (I was naturalized). Wouldn't it be better for them to just give out healthcare at your own risk? The reason why health insurance is so high is because doctors need to cover their asses and get practice insurance because people are ALWAYS suing doctors. liability insurance is very expensive. IMHO what they should've done is make people sign AT YOUR OWN RISK papers before every procedure that might end not as the patient intended. Anyways I seem to lean more towards the Republican side. I came from nothing from a third world country and because my family worked hard and now i work hard i am able to afford a decent life. Many people are just riding the "Free" boat and working off the books and now they get to have free healthcare. I've seen BMWs parked in front of Welfare centers in New York, now those same people get free healthcare. What we needed was welfare reform and lawsuit reform.
p.s my english isnt so good but you guys can probably understand what i am trying to say
" Essentially what has to be understood is the fact that if someone get's something for free, someone else is working for it. Essentially taxes will go up, healthcare taxes will go up. So although your employer covers a percentage of it, you still might not be able to pay it and become eligible for "free" healthcare therefore the percentage of people that pay goes down while the percentage of people on "free" healthcare goes up. "Thing is, you have to consider the idea of efficiency versus waste spending. The law in its current form will end up decreasing premiums and making American health care more affordable, reducing waste and profitability of health insurance and ending up saving the government money. The only problem is that the majority of Americans think like you do, and will be led into believing the law's a waste, because there won't be enough immediate returns. That's why I think the law will end up failing, because people will become impatient and elect legislators to repeal it.
" I am just wondering, what are the tax rates in the US. It's probably different from state to state, but what is the average percentage? It's around 36% for those who earn less than give or take 100 000 US dollars and around 50% for those above here in Norway. "Ouch, that's really high! The average income tax for people making $100,000 in the US is 23%. If you make above $375,000 you still only pay 35% in income tax.
As for the Healthcare Bill, it's a total joke. The OP just does not get what is going on here. Sure the Health Care companies can't deny coverage now, but there is no limit on what they can charge for premiums. So guess what. Do you eat pizza? Smoke? Over the age of 55? Your dad has a heart condition? YOU have a heart condition? Get ready to get SCREWED with high premiums and unreasonable deductibles. And if you don't pay them you get a fine from Washington. "But but but the government with subsidize the payments if you can't make them!" Yes they will, and this program will soon be in the red and losing money faster than social security. I don't get Europe's love affair with Obama. I'll personally fly him to Brussels at the end of his term: you guys can keep him.
While treating people is good, way too many people think You have a RIGHT to healthcare, you don't at least not in the U.S, there is way too much of a sense of entitlement growing about the issue I would not be opposed to it really except for the fact we have no money to pay for it.
" While treating people is good, way too many people think You have a RIGHT to healthcare, you don't at least not in the U.S, there is way too much of a sense of entitlement growing about the issue I would not be opposed to it really except for the fact we have no money to pay for it. "The Universal decleration of human rights disagrees
You've been entitled to the sweat off a slave's brow for centuries and now you're mad that people are trying to get that money back. You can't say this then deny any obligation for reparations, or you're a fucking hypocrite. Just because its been 130 years since your grandpapy made money off slaves that's been circulating in your family and not the slave's family doesn't mean suddenly this money belongs to you or that you earned it. Gimme a fucking break. And you can pretend that's not the issue while Glenn Beck continues saying "Obama wants reparations" knowing the audience will react negatively right after talking about robin hood socialism. If ever there was a snake eating its own tail." "Is a man not entitled to the sweat of his brow? 'No!' says the man in Washington, 'It belongs to the poor!' " "
" @VillianHead said:Is this a joke post? Please tell me it is. I honestly can't believe people think that the US government (or it's citizens) owes anyone else reparations for slavery.You've been entitled to the sweat off a slave's brow for centuries and now you're mad that people are trying to get that money back. You can't say this then deny any obligation for reparations, or you're a fucking hypocrite. Just because its been 130 years since your grandpapy made money off slaves that's been circulating in your family and not the slave's family doesn't mean suddenly this money belongs to you or that you earned it. Gimme a fucking break. "" "Is a man not entitled to the sweat of his brow? 'No!' says the man in Washington, 'It belongs to the poor!' " "
So if your family benifited from money made on slaves, and the slave's family squallered in poverty because of the money they weren't given for their work, a hundred years later, the priveledges that money afforded your family belong to you 100%? Fucking tool. Once more it goes right against the grain of this "don't take money out of my pocket to pay for lazy poor (coincidentally primarily black) people" ethic. You took money out of someone elses pocket and you've had it so long you've decided it belongs to you or that somehow it was earned fairly. Pathetic. You can't bloviate about what you're entitled to and forget the whole of American history." @ryanwho said:
Is this a joke post? Please tell me it is. I honestly can't believe people think that the US government (or it's citizens) owes anyone else reparations for slavery. "" @VillianHead said:
You've been entitled to the sweat off a slave's brow for centuries and now you're mad that people are trying to get that money back. You can't say this then deny any obligation for reparations, or you're a fucking hypocrite. Just because its been 130 years since your grandpapy made money off slaves that's been circulating in your family and not the slave's family doesn't mean suddenly this money belongs to you or that you earned it. Gimme a fucking break. "" "Is a man not entitled to the sweat of his brow? 'No!' says the man in Washington, 'It belongs to the poor!' " "
" @LRP21 said:But you can't believe the CBO. They lie. They use accounting tricks and lie about the costs. For example, the bill is expected to raise wage rates in the United States as business stop offering Health Care to workers. The CBO clams that the increase in wages will increase income generated by SS tax: this will lower the deficit. Sounds great until your realize that workers that earn more get more SS benefits when they retire. There is no reduction in the deficit. They are playing with numbers to make it look good. Also do not forget that the government must set up the programs to run the entitlements in the new bill. The funds for these programs have yet to be voted on, so tack that onto the CBO estimate." Essentially what has to be understood is the fact that if someone get's something for free, someone else is working for it. Essentially taxes will go up, healthcare taxes will go up. So although your employer covers a percentage of it, you still might not be able to pay it and become eligible for "free" healthcare therefore the percentage of people that pay goes down while the percentage of people on "free" healthcare goes up. "Thing is, you have to consider the idea of efficiency versus waste spending. The law in its current form will end up decreasing premiums and making American health care more affordable, reducing waste and profitability of health insurance and ending up saving the government money. The only problem is that the majority of Americans think like you do, and will be led into believing the law's a waste, because there won't be enough immediate returns. That's why I think the law will end up failing, because people will become impatient and elect legislators to repeal it. "
In 1965 Medicare was enacted. It was suppose to cost $9 Billion a year until 1990. In 1990 the program cost $67 billion. In 2010 it is going to cost us $521.3 Billion.
In 1972 the End Stage Renal Disease Program was setup by the government. It was projected to cost $100 million. In 2007, ESRD cost $23.9 Billion.
Or how about a more recent example: Massachusetts's universal coverage plan. Projected cost in 2008: $472 million. Real cost in 2008: $628 million.
I could go on. This always happens. Don't be shocked when this thing is in the red in 20 years. And trust me I am not making these numbers up: I can give you sources for all of them if you don't believe me. Or you could look them up yourself (preferred).
Stole this from Reddit a while back. Hopefully some people can discuss it for a bit.
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 a 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 tax forms.
- An annual fee is imposed on pharmaceutical companies according to 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 for that income group.
- A 2.9 percent excise tax in 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.
The great American story about showing up on a boat with nothing and taking advantages of opportunities the country afforded you by rolling up your sleeves and doing your share of the work. That happened. In New York. If you were in the south you got a little economic stimulus from slavery. And now people in New York are supporting legislation that helps out the less fortunate because the slave progeny for the most part moved north with their freedom and lived in squalor out of site from the people who put them there. And the people who put them there are now complaining that some of their taxes might help the people they put in squalor. Or no, its just a coincidence that the Tea Party is white and southern and the modern poor are mostly black. It is what it is.
" @ManMadeGod said:O god. Please explain to me in detail how your system of reparations would work; I would love to hear it before I blow up. Michelle Obama has slave ancestors. She's the first lady. Does she deserve money from some poor descendant of a slave owner? Or you would only take from the rich white guys? There are so many problems with your thinking that I can't even begin to list them all. Reparations would be a mess. Please enlighten me to how this system would work.So if your family benifited from money made on slaves, and the slave's family squallered in poverty because of the money they weren't given for their work, a hundred years later, the priveledges that money afforded your family belong to you 100%? Fucking tool. Once more it goes right against the grain of this "don't take money out of my pocket to pay for lazy poor (coincidentally primarily black) people" ethic. You took money out of someone elses pocket and you've had it so long you've decided it belongs to you or that somehow it was earned fairly. Pathetic. You can't bloviate about what you're entitled to and forget the whole of American history. "" @ryanwho said:
Is this a joke post? Please tell me it is. I honestly can't believe people think that the US government (or it's citizens) owes anyone else reparations for slavery. "" @VillianHead said:
You've been entitled to the sweat off a slave's brow for centuries and now you're mad that people are trying to get that money back. You can't say this then deny any obligation for reparations, or you're a fucking hypocrite. Just because its been 130 years since your grandpapy made money off slaves that's been circulating in your family and not the slave's family doesn't mean suddenly this money belongs to you or that you earned it. Gimme a fucking break. "" "Is a man not entitled to the sweat of his brow? 'No!' says the man in Washington, 'It belongs to the poor!' " "
" @ManMadeGod said:Dude, the American Civil War ended in 1865. A lot has changed since then. A lot. If you think that people still owe monetary reparations to the descendants of slaves, I'd love to know the logic behind how you think that should work. Particularly since many white Americans, or Americans in general regardless of race, are descendants of families that were not slave owners, or of families who actively fought against slavery. So please, generalize away and explain how this system would work.So if your family benifited from money made on slaves, and the slave's family squallered in poverty because of the money they weren't given for their work, a hundred years later, the priveledges that money afforded your family belong to you 100%? Fucking tool. Once more it goes right against the grain of this "don't take money out of my pocket to pay for lazy poor (coincidentally primarily black) people" ethic. You took money out of someone elses pocket and you've had it so long you've decided it belongs to you or that somehow it was earned fairly. Pathetic. You can't bloviate about what you're entitled to and forget the whole of American history. "" @ryanwho said:
Is this a joke post? Please tell me it is. I honestly can't believe people think that the US government (or it's citizens) owes anyone else reparations for slavery. "" @VillianHead said:
You've been entitled to the sweat off a slave's brow for centuries and now you're mad that people are trying to get that money back. You can't say this then deny any obligation for reparations, or you're a fucking hypocrite. Just because its been 130 years since your grandpapy made money off slaves that's been circulating in your family and not the slave's family doesn't mean suddenly this money belongs to you or that you earned it. Gimme a fucking break. "" "Is a man not entitled to the sweat of his brow? 'No!' says the man in Washington, 'It belongs to the poor!' " "
All descendants of slaves are owed money. Maybe you should think about that more than who doesn't have to foot the bill. Or is that the more important thing? I guess we better do nothing then because even though family trees are incredibly easy to trace back to this period, which is well documented, it might be inconvenient for some people. So I guess nobody gets what they're owed. On account of the inconvenience. None of this matters so long as the mouthpieces on the right are framing reparations as a dirty word because that speaks to who they think they're talking to. IE, people who would lose money through reparations." @ryanwho said:
Dude, the American Civil War ended in 1865. A lot has changed since then. A lot. If you think that people still owe monetary reparations to the descendants of slaves, I'd love to know the logic behind how you think that should work. Particularly since many white Americans, or Americans in general regardless of race, are descendants of families that were not slave owners, or of families who actively fought against slavery. So please, generalize away and explain how this system would work. "" @ManMadeGod said:
So if your family benifited from money made on slaves, and the slave's family squallered in poverty because of the money they weren't given for their work, a hundred years later, the priveledges that money afforded your family belong to you 100%? Fucking tool. Once more it goes right against the grain of this "don't take money out of my pocket to pay for lazy poor (coincidentally primarily black) people" ethic. You took money out of someone elses pocket and you've had it so long you've decided it belongs to you or that somehow it was earned fairly. Pathetic. You can't bloviate about what you're entitled to and forget the whole of American history. "" @ryanwho said:
Is this a joke post? Please tell me it is. I honestly can't believe people think that the US government (or it's citizens) owes anyone else reparations for slavery. "" @VillianHead said:
You've been entitled to the sweat off a slave's brow for centuries and now you're mad that people are trying to get that money back. You can't say this then deny any obligation for reparations, or you're a fucking hypocrite. Just because its been 130 years since your grandpapy made money off slaves that's been circulating in your family and not the slave's family doesn't mean suddenly this money belongs to you or that you earned it. Gimme a fucking break. "" "Is a man not entitled to the sweat of his brow? 'No!' says the man in Washington, 'It belongs to the poor!' " "
You can't call the color dichotomy of poor people and the people who don't want to help the poor a coincidence when the contrast is so staggering. So either slavery and years of segregation created generations of people unable to escape poverty while other people of another color benefited from that money circulating in the family, either that, or its a magic coincidence, or racial and cultural values determined the state of these people in which case Obama shouldn't be wearing the Hitler mustache so much as the person carrying the sign. Which of these 3 options is most reasonable?
" @Hailinel said:Then enlighten me. How do you determine how much money they're owed, and who actually gets the money? Not all African Americans are the descendants of slaves. Do they, too, have to pay into this pot?All descendants of slaves are owed money. Maybe you should think about that more than who doesn't have to foot the bill. Or is that the more important thing? I guess we better do nothing then because even though family trees are incredibly easy to trace back to this period, which is well documented, it might be inconvenient for some people. So I guess nobody gets what they're owed. On account of the inconvenience. None of this matters so long as the mouthpieces on the right are framing reparations as a dirty word because that speaks to who they think they're talking to. IE, people who would lose money through reparations. "" @ryanwho said:
" @ManMadeGod said:Dude, the American Civil War ended in 1865. A lot has changed since then. A lot. If you think that people still owe monetary reparations to the descendants of slaves, I'd love to know the logic behind how you think that should work. Particularly since many white Americans, or Americans in general regardless of race, are descendants of families that were not slave owners, or of families who actively fought against slavery. So please, generalize away and explain how this system would work. "So if your family benifited from money made on slaves, and the slave's family squallered in poverty because of the money they weren't given for their work, a hundred years later, the priveledges that money afforded your family belong to you 100%? Fucking tool. Once more it goes right against the grain of this "don't take money out of my pocket to pay for lazy poor (coincidentally primarily black) people" ethic. You took money out of someone elses pocket and you've had it so long you've decided it belongs to you or that somehow it was earned fairly. Pathetic. You can't bloviate about what you're entitled to and forget the whole of American history. "" @ryanwho said:
Is this a joke post? Please tell me it is. I honestly can't believe people think that the US government (or it's citizens) owes anyone else reparations for slavery. "" @VillianHead said:
You've been entitled to the sweat off a slave's brow for centuries and now you're mad that people are trying to get that money back. You can't say this then deny any obligation for reparations, or you're a fucking hypocrite. Just because its been 130 years since your grandpapy made money off slaves that's been circulating in your family and not the slave's family doesn't mean suddenly this money belongs to you or that you earned it. Gimme a fucking break. "" "Is a man not entitled to the sweat of his brow? 'No!' says the man in Washington, 'It belongs to the poor!' " "
No, and I'd appreciate you not throwing red herrings around. Obviously descendants of slave owners and descendants of slaves would be the ones involved, not these larger groups I never mentioned that you're including to make my stance seem unreasonable. If you have truth on your side, stop warping my words." @ryanwho said:
Then enlighten me. How do you determine how much money they're owed, and who actually gets the money? Not all African Americans are the descendants of slaves. Do they, too, have to pay into this pot? "" @Hailinel said:
All descendants of slaves are owed money. Maybe you should think about that more than who doesn't have to foot the bill. Or is that the more important thing? I guess we better do nothing then because even though family trees are incredibly easy to trace back to this period, which is well documented, it might be inconvenient for some people. So I guess nobody gets what they're owed. On account of the inconvenience. None of this matters so long as the mouthpieces on the right are framing reparations as a dirty word because that speaks to who they think they're talking to. IE, people who would lose money through reparations. "" @ryanwho said:
Dude, the American Civil War ended in 1865. A lot has changed since then. A lot. If you think that people still owe monetary reparations to the descendants of slaves, I'd love to know the logic behind how you think that should work. Particularly since many white Americans, or Americans in general regardless of race, are descendants of families that were not slave owners, or of families who actively fought against slavery. So please, generalize away and explain how this system would work. "" @ManMadeGod said:
So if your family benifited from money made on slaves, and the slave's family squallered in poverty because of the money they weren't given for their work, a hundred years later, the priveledges that money afforded your family belong to you 100%? Fucking tool. Once more it goes right against the grain of this "don't take money out of my pocket to pay for lazy poor (coincidentally primarily black) people" ethic. You took money out of someone elses pocket and you've had it so long you've decided it belongs to you or that somehow it was earned fairly. Pathetic. You can't bloviate about what you're entitled to and forget the whole of American history. "" @ryanwho said:
Is this a joke post? Please tell me it is. I honestly can't believe people think that the US government (or it's citizens) owes anyone else reparations for slavery. "" @VillianHead said:
You've been entitled to the sweat off a slave's brow for centuries and now you're mad that people are trying to get that money back. You can't say this then deny any obligation for reparations, or you're a fucking hypocrite. Just because its been 130 years since your grandpapy made money off slaves that's been circulating in your family and not the slave's family doesn't mean suddenly this money belongs to you or that you earned it. Gimme a fucking break. "" "Is a man not entitled to the sweat of his brow? 'No!' says the man in Washington, 'It belongs to the poor!' " "
The idea of people opposing reparations is truly baffling to me. Honestly.
Though honestly, egg on my face, I transitioned a debate about universal healthcare into reparations so that would be me implying everyone in America should be paying for reparations or that this bill in any way is attempting reparations. That's not what I'm saying. I just like having rants about slavery and reparations with right wing people.
LOL most of us can't even explain original American Healthcare to you...Let alone the reform.
America is cursed to allways have a sub standard of living compared to quite a few other 1st world countries, unless your rich...then you have a high standard of living.
" @Hailinel said:It's not a red herring. And how do you determine if someone is the descendant of a slave owner? How close does the relation need to be? Further, how much money would an individual descendant be forced to pay out? Why should they even feel inclined to pay money out? The descendants had nothing to do with slavery, and any status or money earned off of the slaves' backs isn't necessarily going to be present today. Sure, the great great great grandparents of someone might have made a fortune on a tobacco plantation, but all of that wealth could easily have been lost through events like the Civil War, the stock market crash, the Great Depression, donation to charity, or simple financial incompetence.No, and I'd appreciate you not throwing red herrings around. Obviously descendants of slave owners and descendants of slaves would be the ones involved, not these larger groups I never mentioned that you're including to make my stance seem unreasonable. If you have truth on your side, stop warping my words. The idea of people opposing reparations is truly baffling to me. Honestly. "" @ryanwho said:
" @Hailinel said:Then enlighten me. How do you determine how much money they're owed, and who actually gets the money? Not all African Americans are the descendants of slaves. Do they, too, have to pay into this pot? "All descendants of slaves are owed money. Maybe you should think about that more than who doesn't have to foot the bill. Or is that the more important thing? I guess we better do nothing then because even though family trees are incredibly easy to trace back to this period, which is well documented, it might be inconvenient for some people. So I guess nobody gets what they're owed. On account of the inconvenience. None of this matters so long as the mouthpieces on the right are framing reparations as a dirty word because that speaks to who they think they're talking to. IE, people who would lose money through reparations. "" @ryanwho said:
" @ManMadeGod said:Dude, the American Civil War ended in 1865. A lot has changed since then. A lot. If you think that people still owe monetary reparations to the descendants of slaves, I'd love to know the logic behind how you think that should work. Particularly since many white Americans, or Americans in general regardless of race, are descendants of families that were not slave owners, or of families who actively fought against slavery. So please, generalize away and explain how this system would work. "So if your family benifited from money made on slaves, and the slave's family squallered in poverty because of the money they weren't given for their work, a hundred years later, the priveledges that money afforded your family belong to you 100%? Fucking tool. Once more it goes right against the grain of this "don't take money out of my pocket to pay for lazy poor (coincidentally primarily black) people" ethic. You took money out of someone elses pocket and you've had it so long you've decided it belongs to you or that somehow it was earned fairly. Pathetic. You can't bloviate about what you're entitled to and forget the whole of American history. "" @ryanwho said:
Is this a joke post? Please tell me it is. I honestly can't believe people think that the US government (or it's citizens) owes anyone else reparations for slavery. "" @VillianHead said:
You've been entitled to the sweat off a slave's brow for centuries and now you're mad that people are trying to get that money back. You can't say this then deny any obligation for reparations, or you're a fucking hypocrite. Just because its been 130 years since your grandpapy made money off slaves that's been circulating in your family and not the slave's family doesn't mean suddenly this money belongs to you or that you earned it. Gimme a fucking break. "" "Is a man not entitled to the sweat of his brow? 'No!' says the man in Washington, 'It belongs to the poor!' " "
" @ryanwho said:Just try and ignore him in his stupidity charging descendent's of Slave owners to pay reparations is the stupidest and dumbest thing I have ever heard , and if anyone deserved reparations (which they don't) they would go to Native Americans first." @Hailinel said:It's not a red herring. And how do you determine if someone is the descendant of a slave owner? How close does the relation need to be? Further, how much money would an individual descendant be forced to pay out? Why should they even feel inclined to pay money out? The descendants had nothing to do with slavery, and any status or money earned off of the slaves' backs isn't necessarily going to be present today. Sure, the great great great grandparents of someone might have made a fortune on a tobacco plantation, but all of that wealth could easily have been lost through events like the Civil War, the stock market crash, the Great Depression, donation to charity, or simple financial incompetence. "No, and I'd appreciate you not throwing red herrings around. Obviously descendants of slave owners and descendants of slaves would be the ones involved, not these larger groups I never mentioned that you're including to make my stance seem unreasonable. If you have truth on your side, stop warping my words. The idea of people opposing reparations is truly baffling to me. Honestly. "" @ryanwho said:
" @Hailinel said:Then enlighten me. How do you determine how much money they're owed, and who actually gets the money? Not all African Americans are the descendants of slaves. Do they, too, have to pay into this pot? "All descendants of slaves are owed money. Maybe you should think about that more than who doesn't have to foot the bill. Or is that the more important thing? I guess we better do nothing then because even though family trees are incredibly easy to trace back to this period, which is well documented, it might be inconvenient for some people. So I guess nobody gets what they're owed. On account of the inconvenience. None of this matters so long as the mouthpieces on the right are framing reparations as a dirty word because that speaks to who they think they're talking to. IE, people who would lose money through reparations. "" @ryanwho said:
" @ManMadeGod said:Dude, the American Civil War ended in 1865. A lot has changed since then. A lot. If you think that people still owe monetary reparations to the descendants of slaves, I'd love to know the logic behind how you think that should work. Particularly since many white Americans, or Americans in general regardless of race, are descendants of families that were not slave owners, or of families who actively fought against slavery. So please, generalize away and explain how this system would work. "So if your family benifited from money made on slaves, and the slave's family squallered in poverty because of the money they weren't given for their work, a hundred years later, the priveledges that money afforded your family belong to you 100%? Fucking tool. Once more it goes right against the grain of this "don't take money out of my pocket to pay for lazy poor (coincidentally primarily black) people" ethic. You took money out of someone elses pocket and you've had it so long you've decided it belongs to you or that somehow it was earned fairly. Pathetic. You can't bloviate about what you're entitled to and forget the whole of American history. "" @ryanwho said:
Is this a joke post? Please tell me it is. I honestly can't believe people think that the US government (or it's citizens) owes anyone else reparations for slavery. "" @VillianHead said:
You've been entitled to the sweat off a slave's brow for centuries and now you're mad that people are trying to get that money back. You can't say this then deny any obligation for reparations, or you're a fucking hypocrite. Just because its been 130 years since your grandpapy made money off slaves that's been circulating in your family and not the slave's family doesn't mean suddenly this money belongs to you or that you earned it. Gimme a fucking break. "" "Is a man not entitled to the sweat of his brow? 'No!' says the man in Washington, 'It belongs to the poor!' " "
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