I don't participate in the forum as much as I used to, so many of the newer members don't recognize my name, but I stopped by tonight and saw the title of this thread and had to poke my head in.
I guess having been (and still am, until my Medicare kicks in) in a similar boat to Undetermined Dimension, I know what it feels like to have little or no (in some areas) health insurance. I think the issue is a very complicated one, and am not surprised that members of Congress haven't read the bill - that is common. Most of the time it's their staff who do the research and know the details, but by the time most bills are passed they are such a patchwork that they often are confusing and contain things that likely don't belong there, but it's the compromising that gets the needed votes. Messy, yes, but that's how the system works in the U.S. democracy (beats violence, at least in my book!). And it's a normal part of the process to have the regulations drawn up by the Department that has the responsibility to implement the law.
As someone who's also been a health care provider, running a sole proprietorship (up until last year) and being an approved provider by all my area's major insurance companies, decisions were taken, by and large, out of the hands of doctors and other health care providers decades ago with the start first of what were called DRG's (Diagnostic Related Groups), which evolved into HMO's. So all the complaining that the government, or a committee, are going to take decisions out of the hands of our doctors --- well, that's already happened. The ideal is that policies of Medicare (government insurance which most people wouldn't give up, even with its flaws), as well as private insurance companies, are based on what's called the "standard of care" - developed from medical research on what's the best procedure, treatment, etc. for a given diagnosis. Unfortunately, money can and does enter into the equation, sometimes in unscrupulous ways, although some of that has been made illegal. Insurance companies are basically out to make a profit, and that influences the overall policies of the insurance company way more than it should. But that's already happening. Having a government committee making decisions on the standard of care isn't going to be much different than what already happens in Medicare. And those people are doctors, but they are also bureaucrats. The doctors who work for the insurance companies and help make the decisions about
care now are compromised, too. My point is it's already happening, and has been for awhile.
I think what's getting confused in the mess of it all is that Congress did not re-authorize reimbursement rates for Medicare earlier this year, and I believe that goes into effect Jan. 1, 2011. That may be mixed into the health care reform package, but it's an authorization that would have needed to happen independent of any health care reform. Unfortunately, it's going to result in a 20% cut in Medicare payments to doctors. That is what is currently upsetting a lot of doctors and hospitals, and, IMHO, rightfully so. Medicare reimbursement rates are not very high to begin with, but a 20% cut is a lot to absorb for any business. Plus with the concerns over our deficit here in the U.S., that cut may become permanent. The answers aren't easy, as health care costs are going up here in the U.S., with or without health care reform. They have to, with the aging population and many of us baby boomers now hitting the Medicare age. So costs are a problem that need to be addressed one way or another. I just hate to see all the problems blamed on health care reform when either way, we're facing problems with health care costs.
Going back to my personal situation, I have to say I was pleasantly surprised to find that one aspect of health care reform was already going to help me. My limited health insurance (which I've paid for with the help of my cousin because I wasn't eligible for Medicaid) had a limit of $1,000 for diagnostic testing. I feared I couldn't get the MRI I needed on my knee. But when I called my insurance they told me one provision of the new health care reform that went into effect lifted the limits on diagnostic tests, so I could get my MRI without worrying I would get a bill for it later. That was HUGE to me, as I need knee surgery and still will not be eligible for Medicare until next July (2 year wait after disability determination). So you see there are some good things in those 1000 pages. I only hope we don't throw the baby out with the bathwater on this. Some of us desperately need it.
BTW, Jim I have a favor to ask. There is a forum rule about
not getting political, and I think referring to health care reform as "Obamacare" tends to put it in that direction. Would you mind changing the title of the thread to something more generic, like health care reform? I'm not a moderator, so I'm only asking as a favor. This topic is an important one for all of us, as we will, sadly, need and consume more health care services because we have chronic illness. I think it is very worthy of thoughtful discussion, but I'd hate for it to turn political. I am NOT saying this thread has done that; as a matter of fact I think there are several thoughtful replies, and that's why I posted.
Guess you all got way more than my 2 cents worth! Maybe it's because I've not typed a post in a long time!
Post Edited (PAlady) : 12/5/2010 5:27:35 PM (GMT-7)