Hey Americans! Remember when you had [the promise of] healthcare? Or more specifically healthcare that you could, like, afford? Yes, we remember too. The heady days of calling excitedly to schedule dentist appointments, the freedom of knowing that you could potentially break a kneecap or rupture a vital organ at any time and be optimistic about receiving lifesaving care. Well! That was nice, wasn’t it.
Unsurprisingly but still upsettingly, the Republican majority in the House does not want this to happen, or in their words, plans to “repeal Obamacare.” I will be honest from the start and admit that I am not really sure how this happens; to the extent that any of us understood what happened with healthcare before, I think we felt that something was settled. But apparently not.
Mostly, my ability to report on this subject was severely hindered by the fact that although I remembered vaguely supporting it, I could not articulate a single point of “Obamacare” or remember what it specifically entailed. So by literally typing “what is obama’s health care plan?” into Google, I was rewarded with this document helpfully titled BARACK OBAMA AND JOE BIDEN’S PLAN TO LOWER HEALTH CARE COSTS AND ENSURE AFFORDABLE, ACCESSIBLE HEALTH COVERAGE FOR ALL. It’s actually only 9 pages long, and probably it would be best for everyone if you read it. But if you’re not going to, here are some highlights. The most basic explanation of all:
Barack Obama and Joe Biden’s plan strengthens employer–based coverage, makes insurance companies accountable and ensures patient choice of doctor and care without government interference. Under the plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year. If you don’t have health insurance, you will have a choice of new, affordable health insurance options.
Specifically, they planned on:
+ adopting state-of-the-art health information technology systems
+ ensuring that patients receive and providers deliver the best possible care, including prevention and chronic disease management services
+ reforming our market structure to increase competition; and offering federal reinsurance to employers to help ensure that unexpected or catastrophic illnesses do not make health insurance unaffordable or out of reach for businesses and their employees.
Some of the parts of this plan already are already in effect, like “allowing young people to stay on their parents’ health insurance until age 26, improving drug savings for the elderly on the government’s Medicare insurance program, and creating temporary high-risk pools to help people with medical conditions obtain health coverage.” Others weren’t scheduled to be implemented til 2014. I could point out that nowhere here is “creating panels to vote on the state-sponsored murder of old and infirm people,” but I won’t, because I like to pretend that we live in a world where I don’t have to. Anyways! That is a fun read, I genuinely think you should take the time to read it. Because God knows none of the Republicans in the House have. From Reuters:
“The tree is rotten, you cut it down. If we can’t cut it down and succeed doing that all at once, we’ll prune it branch by branch,” said House Ways and Means Committee Chairman Dave Camp. His is one of four committees tasked on Thursday with rewriting the healthcare law. “Today is day one of our efforts to replace Obamacare with something better,” Energy and Commerce Committee Chairman Fred Upton said, using a derisive term for the healthcare law.
The House has since voted 245-189 to repeal the plan. The Senate is still Democratic by a narrow margin, and is not expected to vote in favor of the bill; even if they did, Obama would pretty much certainly veto it. So, the good news is the headline “House Passes Repeal of Obama’s Healthcare Law” isn’t actually as ominous as it seems. Also, one of the paltry silver linings of the massacre in Tucson is that Washington is still operating under an atmosphere “respectful debate” and “civility” for now, which means that no one has brought posters of Obama with a Hitler mustache or a loaded firearm into Congress yet.
So what’s the point of this repeal bill if they know it won’t pass? Well, it does look at the very least like they’ll be successful in terms of forcing some changes. House Democrats say they expect Obama to lay out modifications to his plan in his State of the Union address next week, and hearings will begin soon on changing any number of things about the law that’s currently in place. Basically, the Republicans are sending a message here, clearly demonstrating their intent to use every trick at their disposal to slow down and frustrate Democratic initiatives they disagree with.
Even if this bill doesn’t work the way Republicans would ideally like it to, that doesn’t mean the Affordable Care Act (as it’s officially called) is safe from repeal: Jonathan Cohn of The New Republic has written an exhaustive explanation of the legal standing of the law, and how if the Republicans are committed enough, it may end up in the Supreme Court defending its constitutionality. The key issue is the mandate that every individual must be insured by either the government or a private company; the insistence by the government that everyone must have health insurance. It’s that part that many Republicans and Tea Partiers protest, and what may end up being the deciding factor in how we do healthcare in this country from now on.
But neither the Constitution nor the judges who have interpreted it ever suggested the government had the right to regulate non-activity—which is a fair description, according to these lawsuits, of a decision not to obtain health insurance. Like many good constitutional arguments, the argument can be put a lot more simply: If the government can penalize you for not buying insurance, can it also penalize you for not buying a television or a GM car?
Which, of course – and not to make this whole thing fraught with more tension than it already is – just ends up tossing the ball back into the Supreme Court’s court once again. All our eyes are turning to the Supreme Court Justices for more and more far-reaching decisions about our future – Prop 8 is likely headed there, which means DOMA could be as well. In the next few years, those nine justices could be deciding the legal status of our families, as well as whether we’re able to have any kind of support for them if they get sick. It really brings all that back-and-forth about Sonia Sotomayor and Elena Kagan into a whole new light, huh?
The takeaway here is that we have no takeaway. We don’t know what’s happening; no one actually knows what’s happening, not the President of the United States or any of the other smartest people in the country. Everyone is very scared and loud and opinionated. We have all had a tough few years, maybe a tough decade or just tough lives, and we don’t have a lot going for us right now and are angry because we worry that someone is going to take away the few things we do have. A lot of us are poor. Some of us are sick, and the rest of us are afraid of getting sick. That’s really all we can report from the front. We hope that people will be both psychologically and emotionally sane; we hope that everyone can be cared for, by the medical community and the people in offices in Washington and by their friends and families and neighbors and that all of us can remember to take care of each other. As a Mr. Barack Hussein Obama said earlier this week:
“As we discuss these issues, let each of us do so with a good dose of humility. Rather than pointing fingers or assigning blame, let us use this occasion to expand our moral imaginations, to listen to each other more carefully, to sharpen our instincts for empathy, and remind ourselves of all the ways our hopes and dreams are bound together… what matters is not wealth or status or power or fame, but rather how well we have loved, and what small part we have played in making the lives of other people better.”
Dear Rachael,
I like you because you can sum up complicated, hard to understand, political topics in an easy to understand way. Now I will be able to talk about this in a more informed manner.
Also, I feel like this took you a long time to write so I wanted to thank you.
<3
Dear TheVegetarian,
I like you because you read the things I write and make me feel like they were worthwhile, even if by the time I finished I was so tired that spending $18.95 on a tofu mold from the internet seemed like a good idea. I feel like you are a good person, so I want to thank you.
<3
Ooh Rachel, you look fantastic in your new picture! This is not to say you didn’t before, but this is new and exciting and wonderful.
aw. jc. you’re cute.
I also wanted to say well done on the article. But now I want to say: tofu mold? You are so gay! Again, well done (I’m talking about the gayness this time).
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I have a couple thoughts here.
1. The right is just entertaining their lunatic fringe. Healthcare will not be repealed. Historically, retrenchment is difficult of popular social programs.
2. I’m not sure if it is unconstitutional. Now I am no legal expert, but doesn’t the government compel us to buy car insurance?
Oh look what I found. An article by Erwin Chemerinsky, a top constitutional law scholar about how the healthcare bill is constitutional.
http://www.politico.com/news/stories/1009/28620.html
I heard him speak at a panel about prop 8 and same sex marriage. If I remember correctly he believes denying same sex marriage rights is unconstitutional.
Ok, so this is semi-unrelated. I was talking to my brother who is a lawyer about this article, Erwin Chemerinsky, and EC’s views on marriage equality and my brother said:
“everyone knows there is no reason gay people should not be allowed to marry if you believe in any kind of constitutional system.”
I love him. He is so great in his matter of fact declarations. I had to share, sorry.
The reason this law is being repealed is that millions of people voted for something they KNEW NOTHING ABOUT or UNDERSTOOD! You see the politician’s draft huge bills that take up thousands of pages and bury horrible policies, regulations and laws into it. These atrocities rear their ugly head’s years from the point the law takes into effect and by then its too late. You see the ultimate fact here remains the same – By making universal health care a reality. We will ultimately clog the system and revert to a health care system that determines who lives and who dies, who suffers more and who suffers less.
It’s intrinsically better to remain on a system that requires the individual to choose, select and purchase their own health care or utilize a plan sponsored by their employer than to let the gov dictate how your medical destiny will be played out. One only has to look at the foreign countries that offer universal healthcare to see what our future would be like, for instance, there are people in Australia, Sweden, Canada just to name a few who die because they can’t get the desperately needed surgeries they need because the gov places them on a list. Sadly, because our country was so determined to have a “new way” it will take having Obamacare supporters to die waiting for a surgery they could more easily have received under an individual plan to realize that they were deceived.
1. Isn’t it Congress’ job to revise legislative problems as they arise, like how the republicans are theoretically doing so right now? So why can’t healthcare bill problems be dealt with in that manner?
2. Actually, instead of clogging the system one could argue that the government will be able to streamline the system, reducing the amount of administrative costs that the current healthcare system incurs.
3. There are a lot of successful stories of universal healthcare coverage in other countries. Like my cousin in England who was born with serious and rare genetic deformities who required several surgeries before she reached her teens all of which were covered. Her parents wouldn’t have been able to afford even just one of those. Her life has been substantially improved because of it. Certainly, no system is perfect, but I would rather have a system that attempted to cover everyone then a system which incentiveizes denying people coverage and leaves the most vulnerable to fend for themselves.
4. From my understanding, the government is now offering people a choice of government healthcare or private healthcare. No one is being forced to buy government run healthcare.
5. To be frank, I would rather trust the government with my health then a private corporation. Healthcare should not be a business. Profit margins should not be the part of any calculus that determines someones quality of life. At least with the government there is some oversight. And no, not everyone has the marketplace privilege to just move to another provider if they are unsatisfied with their healthcare. And certainly not with the previous precondition exclusions that were in place before the current healthcare bill passed.
Dave, individual citizens didn’t vote on healthcare. It was voted on by Congress, just like every other bill.
Also, I think arguing about the merits of universal healthcare in the comments may ultimately be a poor choice, but: do you really think that people in America aren’t dying because they can’t get desperately needed surgery? I don’t have healthcare right now, and if I needed heart surgery right now what do you think I would do?
I have to jump on in here as an Australian. Our public health system is far from perfect and without question overloaded. But there are some definite perks of living here.
Last night, I had a GP come to my house at 11pm and bring with him enough of the medication I needed until I could get my script filled. Both the visit and the medication were at no (direct) cost to me. When I did fill that script it was on the Government subsidised list of drugs and cost me $11. I’ve never paid out of pocket for a GP visit. When I needed a counsellor, I was put on a government plan that allowed me 12 free sessions with a psychologist that charged $195/hour because there was no way I could afford that. When I used up that 12, the rest cost me $17 out of pocket, the remainder picked up by Medicare (the public health system). I’m pretty sure that kind of thing is worth paying a bit more tax.
I was covered under my parents private health insurance until I turned 25, when I chose to buy my own -30% of which is rebated to me by the government. I pay out of pocket for it but it is not dependent on having an employer who provides it. I’m not limited to certain care providers, though I get discounts if I do choose from my insurance company’s preferred list. I’ve never had to fight my insurance to pay for anything.
We don’t have enough beds in hospitals, the wait in Emergency departments can be hours long for non-life threatening problems, and the wait for elective surgery in the public system and be months or more. But no one here goes bankrupt because of medical bills or is denied care because they don’t have insurance. If you need care you get it without huge out of pocket costs and lengthy fights with insurance providers.
It’s faaaar from perfect, but universal healthcare ain’t half as bad as you make it out to seem mate.
>>We don’t have enough beds in hospitals, the wait in Emergency departments can be hours long for non-life threatening problems, and the wait for elective surgery in the public system and be months or more.>>
I’d just like to point out that this is the case in many parts of the US, too. Especially for the uninsured!
Okay, I get that it sucks for people who can’t afford health care right now, but Obama’s health care needs to be re-written. It covers illegal immigrants, governments gains full access to our bank accounts, cancer hospitals will ration care according to patient age, doctors will all be paid the same regardless of specialty, etc etc it’s not right yet.
I see the problem with everything except ‘it covers illegal immigrants’.
So they don’t have a visa, they don’t warrant access to healthcare? I can see all the ‘well, lets just invite them right in’ arguments happening from here, but at the end of the day they ARE there and they are also human beings. Denying them healthcare because they don’t have paperwork seems kind of callous…
I agree with Cat (a lot of undocumented workers pay taxes without having access to any of the benefits that taxes go towards) but also want to point out that I’m like 98% sure it doesn’t cover illegal immigrants. That would require them to be documented in the system well enough that they could be cataloged and assigned coverage by an overarching government agency, which is kind of a “don’t” if you’re trying to live under the radar.
I’m very open to being corrected, though; can anyone point us towards any documentation on that?
Correct me if I’m wrong but I’m pretty sure page 50/section 152 states that Obama-care would cover all non-US residents, even if they are here illegally. Don’t get me wrong, undocumented workers who pay taxes SHOULD be covered. I only take issue with those who get benefits they don’t pay for.
It seems to be if you’re undocumented you won’t be able to buy healthcare on the exchange that the bill will create, but they can (even now) buy private healthcare with their own dough. They will not be entitled any subsidies. However they cannot be turned away from A&E, which was always the case.
http://firstread.msnbc.msn.com/_news/2009/09/11/4431362-wh-on-health-care-illegal-immigrants
http://www.cbsnews.com/8301-503544_162-20000846-503544.html
Do you have a link for “cancer hospitals will ration care according to patient age” and “doctors will all be paid the same regardless of specialty”? Thanks, I couldn’t find anything about those things.
Page 241 and 253 for info on the doctors pay. Page 272 section 1145 on rationing care for cancer patients.
page 241 of what? can you include a link?
Of the actual bill. Look it up, you’ll find it.
Um…Federal law has required ER services to provide emergency medical treatment to ANYONE who walks through the door since 1986….including illegal immigrants…and everyone else without insurance/money.
Of course they have to provide care. But the people receiving it then have to pay out of pocket if they aren’t covered by insurance.
Eh, they get billed…not the same as them actually paying. And they are not supposed to be turned away for unpayed bills, either. Most hospitals will write it off.
Passing a bill that isn’t even written yet is NEVER a good idea!!!! Nancy Pelosi said, “We have to pass the bill so we can see what’s in it.” Human beings, especially American humans, have a serious propensity to legislate for their own personal benefit…… left or right. After 50 years of un-supervised blank check writing, I am happy to see America taking back the reins, albiet slow and horribly painful. This bill, along with every other piece of legislation should be re-evaluated for their individual merit. We can no longer afford to pay for all of the junk that we find ourselves buried under.
You cannot pass a bill that hasn’t been written. I agree that it wouldn’t be a good idea, but I’m pretty sure it’s technically impossible.
I’ll be cheering on Vermont:
http://www.democracynow.org/2011/1/21/vermont_governor_peter_shumlin_moves_to
Repeal or modify an already conservative bill? Good luck you lot.
Rachel K, I’d like you to become my therapist. Or my mother.
In a less creepy translation, I’ve been covering my ears and going “lalala, I can’t hear you” whenever this comes up, which hasn’t been helping me get stuff done because I listen to NPR basically every free moment that I have and I’ve yet to learn to do the dishes with my elbows. Now, though, I feel like I can face this upsetting news. You’ve made it standable.
So…. thanks!
therapists probably have health insurance. i feel good about this, let’s do it.
Raising Women’s Voices (http://www.raisingwomensvoices.net/) is a really good resource for anyone trying to figure out what’s going on with healthcare. The National Coalition for LGBT Health also has this new report about health care reform that is pretty interesting if you feel like doing some reading (http://lgbthealth.webolutionary.com/sites/default/files/ACA%20final.pdf).
(This is my first comment and it’s very boring but understanding health care reform is part of my job!)
thank you
I liked it. *nerdhug*
Rachel, thanks again for providing your amazing talents to what I normally see as a repeat of the regular new topics. :)
Rachel thank you so much. The only other people who talk about this are my parents and they have a pretty strong bll o’reilly bias when it comes to things like this.
Okay so let me just sum up everyone’s real thoughts with these wise words:
“Smart chicks are so hot.” – Xander Harris, Buffy the Vampire Slayer
You’re welcome.
<3
maybe this is a stupid question from a canadian with healthcare, but if it were offered or mandatory in the states, why would people chose to “opt out”? like why don’t people want to be covered medically?
dave said “It’s intrinsically better to remain on a system that requires the individual to choose, select and purchase their own health care or utilize a plan sponsored by their employer than to let the gov dictate how your medical destiny will be played out.” but that doesn’t really make sense to me. i don’t feel like my government is dictating my medical destiny. when i get sick, i go to the doctor and they prescribe me antibiotics. all i have to do is pay for the antibiotics, and if i’m lucky, i might have some sort of health insurance from my job and then i won’t even have to pay for antibiotics.
if i found out i had cancer, i wouldn’t want to sit there trying to choose, select, and then purchase a plan. i would want to go to the hospital and get treated, and know that i wasn’t getting lesser treatment than someone who has more money than i do. sorry, but everyone deserves to be saved equally.
this is the healthcare i get , and it’s working pretty well for me so far i’d say.
they would opt out because they would prefer their own private insurance to government-sponsored insurance, i believe.
basically this whole thing comes down to the fact that a lot of insurance companies have a lot of money and a lot of senators in their pockets. this country is at a fucking standstill because PER USHE everything is about who has enough money to buy enough senators’ support and who has enough money to brainwash enough people to support these ridiculous ideas.
i think i’ve gone off the deep end
i love you emily choo
also actually emily it’s not even possible to find out you have cancer and then get health insurance because pretty much if you are already sick or even seem predisposed to get sick, most private insurers won’t cover you. so, yeah, i would say you can continue feeling good about your health insurance.
That is actually kind of heartbreaking. What is the point of having insurance if its not going to pay for your healthcare? Do you have to pay for insurance> And what do people do if they’re turned down for cover?
“What is the point of having insurance if its not going to pay for your healthcare?”
to yield a profit for insurance companies
“Do you have to pay for insurance”
yes
“And what do people do if they’re turned down for cover?”
go to the emergency room. If their name is not called after 9 hours go by, they leave.
Bloody hell. It just seems so blatantly wrong that you’re paying for a service that turns you down when the care you need is presumably (?) deemed too expensive. I think there might actually be riots here if one of the insurance companies tried to pull something like that.
Health care is just one of many aspects of American society rotating around the bowl rapidly.
I think one of the regulations that’s already gone into effect prevents insurance companies from rejecting people due to preexisting conditions, or there is a high risk pool thing that people can buy into in the meantime (I don’t remember the specifics).
sorry to keep asking probably stupid questions, but what happens if you have insurance and then you get a terminal disease. can they drop you from the insurance? do insurance companies exist to take your money and make their CEOs rich?
1. They used to be able to. One of the perks already in effect from the healthcare bill is that they can’t deny coverage because of preexisting conditions or drop you if you get sick.
2. Yes. *cries*
As a fellow Canadian living in the States right now, I understand your confusion. Healthcare is pretty messy here. But things have gotten a bit better with this bill IMHO.
this is a confusing subject, but your article made me feel slightly less insane about healthcare things–thanks for your wonderful writing!
i’m a few months away from qualifying for insurance at work, and then i can take up dangerous hobbies like parkour and roller derby and bouldering, but my job is terrible. alas :/
OMG parkour! I love watching that scary stuff. “District B-13” was kinda cool. Those folks are like flying squirrels!
Try scuba.
I believe that there are many changes that could be made to the healthcare law. Unfortunately, the Republicans will try to go in the exact opposite direction of any changes I would make. Especially sad when you realize that this law, as written, is very similar to proposals put forth by Republican lawmakers and/or thinktanks in the past.
Rachel- your writing makes a confusing world a bit more sensible. Thank you!
Is it too much to ask in this country to be able to live without the fear of getting sick/injured? :(
HOLY SH*T AUTOSTRADDLE HAS EMOTICONS :D :) :P
Hey, thanks for this awesome post. It does seem like a lot of very big and important stuff is heading towards the Supreme Court. Pretty crazy.
dear rachel,
thank you for this.
love, e.
Here’s my true life story about why I want better healthcare. Luckily, I have had health insurance my entire life first through Medicaid (I think) and then through private insurance once my mom got a better job. I have several health issues that keep me in and out of the doctor’s office constantly and take a good amount of medication on a regular basis. Despite having health insurance, the prices are still through the freaking roof. We still have so, so, so many bills from various healthcare institutions.
A few semesters ago, I ended up getting dropped from a class and therefore, was an hour short of being a full-time student. I freaked out. I was having a hard time anyways which is one of the reasons I’d gotten dropped in the first place. I ended up not being able to get my wisdom teeth removed over the summer, because I wasn’t technically covered. My story isn’t even that bad considering all the people I know without health insurance.
One of the reasons it takes so damn long in the emergency room is due to lack of affordable coverage. All the people who get sick and aren’t covered eventually have to see a doctor so they can avoid little things like death. They only place for them to go is the ER. Which means that if you come in with something like an asthma attack (*ahem* I may or may not have experienced this several billion times), you have to wait forever and ever. They do rate the people who come in by severity, but basically, if you aren’t dying right that second, you’ll be spending your entire evening there.
I recently dealt with a bad asthma attack overnight and went to my doctor the next day just to avoid the ER. I knew I might as well just wait at home comfortably than in those sad ER waiting rooms.
One more thing, and then I’ll stop talking so much. What are the consequences of allowing people to opt-out of coverage all together? I don’t know why in the hell you don’t want any health insurance whatsoever, but what is the harm if you do feel that way? Does anyone know? I don’t understand legalese.