Health Care Reform: The immediate benefits #HCR

★ Here is a nice breakdown of the immediate benefits of the Health Care Reform Bill by Reuters

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.

Putting Obama’s First Year in Perspective

★ Some thoughts, from following Frank Schaeffer, on President Obama’s first year in the White House

We faithful Obama supporters still trust our initial impression of him as a great, good and uniquely qualified man to lead us.

Obama’s steady supporters will be proven right. Obama’s critics will be remembered as easily panicked and prematurely discouraged at best and shriveled hate mongers at worst…

The Context of the Obama Presidency

Not since the days of the rise of fascism in Europe, the Second World War and the Depression has any president faced more adversity. Not since the Civil War has any President led a more bitterly divided country. Not since the introduction of racial integration has any President faced a more consistently short-sighted and willfully ignorant opposition – from both the Right and Left.

As the President’s poll numbers have fallen so has his support from some on the Left that were hailing him as a Messiah not long ago; all those lefty websites and commentators that were falling all over themselves on behalf of our first black president during the 2008 election.

The Left’s lack of faith has become a self-fulfilling “prophecy” — snipe at the President and then watch the poll numbers fall and then pretend you didn’t have anything to do with it!

Here is what Obama faced when he took office– none of which was his fault:

  • An ideologically divided country to the point that America was really two countries
  • Two wars; one that was mishandled from the start, the other that was unnecessary and immoral
  • The worst economic crisis since the depression
  • America’s standing in the world at the lowest point in history
  • A country that had been misled into accepting the use of torture of prisoners of war
  • A health care system in free fall
  • An educational system in free fall
  • A global environmental crisis of history-altering proportions (about which the Bush administration and the Republicans had done nothing)
  • An impasse between culture warriors from the Right and Left
  • A huge financial deficit inherited from the terminally irresponsible Bush administration…
    And those were only some of the problems sitting on the President’s desk!

‘Help’ from the Right?

The reactionary white, rube, uneducated, crazy American far Right, combined with the educated but obtuse neoconservative war mongers, religious Right shills for big business, libertarian Fed Reserve-hating gold bug, gun-loving crazies, child-molesting acquiescent “bishops”, frontier loons and evangelical gay-hating flakes found one thing to briefly unite them: their desire to stop an uppity black man from succeeding at all costs!

What did the Republicans and the religious Right, libertarians and half-baked conspiracy theorists — that is what the Republicans were reduced to by the time Obama took office — do to “help” our new president (and our country) succeed? They claimed that he wasn’t a real American, didn’t have an American birth certificate, wasn’t born here, was secretly a Muslim, was a white-hating “racist”, was secretly a communist, was actually the Anti-Christ, (!) and was a reincarnation of Hitler and wanted “death panels” to kill the elderly!

They not-so-subtly called for his assassination through the not-so-subtle use of vile signs held at their rallies and even a bumper sticker quoting Psalm 109:8. They organized “tea parties” to sound off against imagined insults and all government in general and gathered to howl at the moon. They were led by insurance industry lobbyists and deranged (but well-financed) “commentators” from Glenn Beck to Rush Limbaugh.

The utterly discredited Roman Catholic bishops teamed up with the utterly discredited evangelical leaders to denounce a President who was trying to actually do something about the poor, the environment, to diminish the number of abortions through compassionate programs to help women and to care for the sick! And in Congress the Republican leadership only knew one word: “No!”

In other words the reactionary white, rube, uneducated, crazy American far Right,combined with the educated but obtuse neoconservative war mongers, religious Right shills for big business, libertarian Fed Reserve-hating gold bug, gun-loving crazies, child-molesting acquiescent “bishops”, frontier loons and evangelical gay-hating flakes found one thing to briefly unite them: their desire to stop an uppity black man from succeeding at all costs!

‘Help’ from the Left?

Those that had stood in transfixed legions weeping with beatific emotion on Election Night turned into an angry mob saying how ‘disappointed’ they were that they’d not all immediately been translated to heaven the moment Obama stepped into the White House! Where was the ‘change’?

What did the Left do to help their newly elected President? Some of them excoriated Obama because they disagreed with the bad choices he was being forced to make regarding a war in Afghanistan that he’d inherited from the worst president in modern history!

Others stood up and bravely proclaimed that the President’s economic policies had “failed” before the President even instituted them! Others said that since all gay rights battles had not been fully won within virtually minutes of the President taking office, they’d been “betrayed”! (Never mind that Obama’s vocal support to the gay community is stronger than any other President’s has been. Never that mind he signed a new hate crimes law which included language punishing hate crimes against homosexuals for the first time!)

Those that had stood in transfixed legions weeping with beatific emotion on Election Night turned into an angry mob saying how “disappointed” they were that they’d not all immediately been translated to heaven the moment Obama stepped into the White House! Where was the “change”? Contrary to their expectations they were still mere mortals!

And the legion of young new supporters was too busy texting to pay attention for longer than a nanosecond… “Governing”?! What the hell does that world, uh, like mean?”

The President’s critics Left and Right all had one thing in common: impatience laced with little-to-no sense of history (let alone reality) thrown in for good measure. Then, of course, there were the white, snide know-it-all commentators/talking heads who just couldn’t imagine that maybe, just maybe they weren’t as smart as they thought they were and certainly not as smart as their President. He hadn’t consulted them, had he? So he must be wrong!

The Obama critics’ ideological ideas defined their idea of reality rather than reality defining their ideas — say, about what is possible in one year in office after the hand that the President had been dealt by fate, or, to be exact, by the American Idiot Nation that voted Bush into office… twice!

Meanwhile back in the reality-based community — in just 12 short months — President Obama:

  • Continued the draw down the misbegotten war in Iraq (But that wasn’t good enough for his critics)
  • Thoughtfully and decisively picked the best of several bad choices regarding the war in Afghanistan (But that wasn’t good enough for his critics)
  • Gave a major precedent-setting speech supporting gay rights (But that wasn’t good enough for his critics)
  • Restored America’s image around the globe (But that wasn’t good enough for his critics)
  • Banned torture of American prisoners (But that wasn’t good enough for his critics)
  • Stopped the free fall of the American economy (But that wasn’t good enough for his critics)
  • Put the USA squarely back in the bilateral international community (But that wasn’t good enough for his critics)
  • Put the USA squarely into the middle of the international effort to halt global warming (But that wasn’t good enough for his critics)
  • Stood up for educational reform (But that wasn’t good enough for his critics)
  • Won a Nobel peace prize (But that wasn’t good enough for his critics)
  • Moved the trial of terrorists back into the American judicial system of checks and balances (But that wasn’t good enough for his critics)
  • Did what had to be done to start the slow, torturous and almost impossible process of health care reform that 7 presidents had failed to even begin (But that wasn’t good enough for his critics)
  • Responded to hatred from the Right and Left with measured good humor and patience (But that wasn’t good enough for his critics)
  • Stopped the free fall of job losses (But that wasn’t good enough for his critics)
  • Showed immense personal courage in the face of an armed and dangerous far Right opposition that included the sort of disgusting people that show up at public meetings carrying loaded weapons and carrying Timothy McVeigh-inspired signs about the “blood of tyrants” needing to “water the tree of liberty”… (But that wasn’t good enough for his critics)
  • Showed that he could not only make the tough military choices but explain and defend them brilliantly (But that wasn’t good enough for his critics)

Other than those “disappointing” accomplishments — IN ONE YEAR — President Obama “failed”! Other than that he didn’t “live up to expectations”!

Who actually has failed…

…are the Americans that can’t see the beginning of a miracle of national rebirth right under their jaded noses. Who failed are the smart ass ideologues of the Left and Right who began rooting for this President to fail so that they could be proven right in their dire and morbid predictions. Who failed are the movers and shakers behind our obscenely dumb news cycles that have turned “news” into just more stupid entertainment for an entertainment-besotted infantile country.

Here’s the good news: President Obama is succeeding without the help of his lefty “supporters” or hate-filled Republican detractors!

The Future Looks Good

After Obama has served two full terms, (and he will), after his wisdom in moving deliberately and cautiously with great subtlety on all fronts — with a canny and calculating eye to the Possible succeeds, (it will), after the economy is booming and new industries are burgeoning, (they will be), after the doomsayers are all proven not just wrong but silly: let the record show that not all Americans were panicked into thinking the sky was falling.

Just because we didn’t get everything we wanted in the first short and fraught year Obama was in office not all of us gave up. Some of us stayed the course. And we will be proven right.

Obama’s Health Care Speech

★ I thought that Pres. Obama killed it in his Health Care speech to congress last night. A lot of his address simply called out the right-wing on their misleading rhetoric and all around childish behavior. I only caught pieces of the speech, because I was watching it while coding away at an application I’m building, but here are some of the highlights that stuck out to me.

Fiscal Conservatives -
Obama delivered a blow to the argument of some of the self-professed fiscal conservatives. He decried how the Bush tax cuts, the Bush war in Iraq and the Bush prescription drug plan helped explode the deficit, squandering the Clinton surplus and plunging us deep in debt. No one who voted for that unholy trinity can credibly oppose Obama’s health reforms on fiscal grounds.

Public Options -
He explained why the competition that a public option would create is a good thing because it would keep pressure on private insurers to keep their prices affordable and treat their customers better. I like the example he chose to use:

“Public colleges and universities provide additional choice and competition to students without in anyway inhibiting a vibrant system of private colleges and universities.”