FACTBOX: U.S. healthcare overhaul begins to take shape

[Joanne98]

(Reuters) - Details of a proposed overhaul of the U.S. healthcare system are beginning to emerge as two Senate committees writing the legislation prepare to hold public reviews in coming days.
President Barack Obama, who spoke to the influential American Medical Association on Monday, has voiced support for the creation of a new government-run insurance plan to compete with private insurers. But this proposal has met resistance from Republicans and some fiscally conservative Democrats.

Senators, meanwhile, are considering a potential compromise that instead would create federally chartered nonprofit cooperatives, owned and operated by their members, to compete with private insurers to provide medical coverage to individuals and small businesses.

Following are some details from the draft legislation proposed so far.

INSURANCE MARKET REFORMS

* A new government-run insurance plan would be created with payments to hospitals and doctors set at 10 percent above the government's Medicare health insurance program for the elderly and disabled.

* Employers and individuals would be required to obtain health insurance coverage, with subsidies to help those who cannot afford it.

* Insurance companies would be barred from refusing to cover people because of health history.

* Insurers also would be required to cover some preventive services.

* Annual or lifetime limits on coverage would be prohibited.

* Children would be allowed to stay on parents' insurance plans up to age 26.

INSURANCE GATEWAY OR EXCHANGE

* Grants would be provided to states to create "gateways" to act as a clearinghouse for individuals and small businesses to buy insurance.

* Reinsurance funding would be provided for plans participating in the gateway.

* A Medical Advisory Council to establish a minimum benefit for companies participating in the gateways would be created.

* Gateway participants would be encouraged to upgrade their information technology to help reduce duplication of treatments and lower costs. Continued...

http://www.reuters.com/article/reutersComService_2_MOLT/idUSTRE55E69J20090615

[Cleita]

1. OMG an insurance carriers wet dream. They are giving away the store!

Bastards! Congress, read my words; no government funding of insurance companies and HMOs. No cutting benefits to Medicare recipients and most of all NO COOPERATIVES! The only public plan option acceptable is putting Medicare on the market for small businesses and individuals to buy into. That is real choice and real change. Anything else is Wall Street business as usual.

[Ms. Toad]

3. Right -

Insurance companies are just itching to cover people regardless of pre-existing conditions.

They can also barely wait to be forbidden from setting their premiums based on pre-existing conditions. (in the bill, but not summarized in the OP).

Finally they've really wanted to cover pre-existing conditions all along, but the curent laws wouldn't let them. (another point in the bill not summarized in the OP).

In case I need to say it:

:sarcasm:

NO - it isn't perfect, but the three points I've listed above (along with subsidies) will open up access to health care to people the insurance companies have so far declined to serve at all - or without charging premiums most anyone who is truly ill can afford.

[Cleita]

4. If you really believe that's going to happen, I have a bridge to sell you

in San Francisco. As soon as the bill is passed and no one is looking, the riders to roll those rules back will start appearing on other bills in Congress being passed.

[Ms. Toad]

8. Whether it wil happen is not the point.

I was responding to your characterization of a specific plan as an insurance company's wet dream. The the bill you were characterizing that way is pretty much the opposite.

I agree - it may well change, but perhaps not if enough people understand the good that is actually in the bill and start making lots of noise. Putting the bill down as just what the insurance companies may discourage people paying attention to what is actually in the bill (particularly since people around here tend to read comments, rather than the underlying supporting documents).

[Cleita]

9. I don't have a dog in this fight as I'm covered as far as health care is

concerned and I'm still feeling secure, but I don't want to see the American public hoodwinked again for corporate gain and profit, especially on something as necessary as health care, than can be the difference between life and death.

[Ms. Toad]

11. Then I would hope you would read what is being proposed

and support bills (or provisions in the bills) that take significant steps to limit the insurance companies' ability to reject folks without reason, charge them an arm and a leg, and refuse to pay for anything that started under someone else's watch.

If all it does is place these limits on insurance companies, that will be significant progress. I would certainly rather they be out of the picture - but I don't think we're going to get there this time. If we're not going to get there - the only fighting chance we have is for people to recognize the essential pieces of the bill and dig their heels in to at least impose restrictions like those in this bill.

My concern is that dismissing the bill that does propose significant restrictions as just what the insurance companies want makes us allies with the insurance company in fighting the bill - rather than opponents to keep the restrictions that will ultimately make health insurance more available (and a less profitable business as a side benefit).

[Cleita]

12. I have read all the proposals and none of them measure up. n/t

[YewNork]

10. And President Obama would then veto those bills.

[DavidDvorkin]

2. The first asterisk point

sounds like the hoped-for public option. Am I missing some negative there?

[Cleita]

6. I would need more details and why are they throwing senior citizens

on Medicare under the bus with a 10% increase? Look at the Gateway option. It looks like public funding of private insurance to me, which is unacceptable to most of us who care for a meaningful plan.

[madrchsod]

5. well there `s a load of bullshit

nothing changes in the grand scheme of things. the great unwashed get`s crumbs from the table..


if i can last 2.5 years i`ll have medicare.

[Cleita]

7. They are also cutting funds from Medicare instead of cutting the insurance

companies out of Medicare that are causing a drain on the funds.