Fuck the Senate. I have no faith in this institution anymore. Same with the House.
Silly me for thinking the insurance companies could get away with less after a bill passed. I guess my gullibility is a pre-existing condition.
I love America, but I hate how reactive some people get to "socialism" and other words when they don't even know what those words mean. I hate that this is all about an old white man's ability to further control my uterus and not getting better health care for my uninsured friends and family, including a brother who has worked full-time at one job for over a year but is still considered "temporary' and therefore gets no insurance.
Because of people like my worthless senator who can still call herself a Democrat with a straight face, this is getting watered down and watered down and watered down to where it isn't even soup anymore. It's just water that someone probably peed in.
I find this has a fairly interesting explanation with some number crunching on the (semi)current version of the bill. It also has excellent links to other analysis and the bill itself, if people are interested.
My 58 year old mother has to buy her own insurance because she co-owns my family's business. She pays something like $300 a month, and has a $5000 deductible. Hardly anything is covered - no doctor visits, etc. It's basically just in case she gets hit by a car or something. If this is the type of insurance people will be forced to buy...we are fucked as a society.
This whole thing makes me want to buy some guns and develop a strong set of opinions on the sex organs of others just so I can be on a winning team for once.
Latoya, that is some fascinating history on Social Security. I had no idea it was so discriminatory in its original form.
Oddly enough, I did know about the farm labor exemption, but that's only because I wasn't able to find my grandfather in the SS Death Index (he passed away 16 years before I was born). My dad explained his absence from the index as, "He was a farmer. You think he was going to pay any taxes if he could possibly help it?"
@la.donna.pietra: Oh there's lots more to that story. I was trying to be brief, but the Color of Wealth really looks into the back stories of legislation and laws, and how those things were gamed and divide it into the major racial categories in the US at the time and how they were impacted, as well as how those lingering effects still impact wealth now. It's fascinating stuff.
We know that the bill is incredibly flawed when insurance stocks rise every time there is a concession to the conservative wing of the party. Thx guys!
I am seriously bummed about all this. I was really excited going into the debate. I was willing to make a few concessions, but my youthful naivete remained and I truly believed that things were going to get BETTER for me and millions of other Americans out there. Then things started getting dropped and things started getting cut and I was still hopeful because I had been willing to compromise. Then the public option got dropped but I still had faith because there was lip service paid to the idea of a "trigger" where the insurance companies had X number of years to lower costs on their own and I can be patient.
Now I really feel that all hope is lost. If this bill passes as-is it's going to bankrupt hundreds of thousands (if not millions) of hard working Americans who are just scraping by hoping they don't get sick. I can't even afford the $1,000/year fine for not having health insurance much less health insurance. Moreover, unless we're going to start mandating that all institutions of higher learning provide health coverage for their students, we're going to permanently put college out of the reach of millions of students whose families can't afford to provide them health coverage, which means more and more students are going to have to forgo college and opportunities in order to get a job and health insurance. That's just WRONG.
I'm one of the lucky ones, in that I have the option of scraping together a few thousand dollars up-front and immigrating to Australia since my fiance is an Australian citizen and even if he wasn't, I have a friend in Canada who would be willing to marry me. Most people don't have that option and more importantly, you shouldn't NEED that option.
@Zombie Ms. Skittles: So true about college students. When I was in law school I bought my schools health insurance. It was 2000 for the whole year (which I had to pay for out of student loans) and it was some of the shittiest coverage you could imagine.
@Zombie Ms. Skittles: I work in higher ed. We're already providing health insurance to students and employees' children up until 30. Apparently it's a NY state law?
@GiGiBird: It's great that it's a law in NY, but in NC when I was at a 4 year school it was optional. Luckily, at that time my dad's insurance covered me so I didn't need to worry. 2 year schools don't provide insurance either in NC or Texas, though, and they're usually the most affordable option for the first two years which is especially important if you're poor or on the edge financially.
@GiGiBird: It is definitely neither an Idaho nor a New Mexico state law. Both of the fine academic institutions I've worked at have an undergrad student health insurance policy that students must buy in order to attend each semester (or provide proof of insurance through their parents or another carrier). It is definitely not provided.
@bluebears: Seconded on the shittiness of the coverage. The University of Idaho's undergrad coverage, the first year it was required, did not cover BROKEN BONES unless they were the result of a varsity university sporting event. Really.
@la.donna.pietra: holy shit. Yeah I had to go to the ER at one point and I called the university services first to get the doctor ok, but it was the weekend so they weren't there and the voicemail told me to just go to the ER BUT because I didn't get the approval in a doctors whatever the hell I had to pay out of pocket. Totally worth that 2k!
@Zombie Ms. Skittles: Yep. I was bewildered that they restricted it even further into varsity-only athletic events. Were there points for being extra-Dickensian, or something?
Mr. Pietra broke his leg two years later; thank goodness the school had switched to a different policy that actually covered routine medical care.
Without the public option, I'm not sure you get coverage that is affordable enough to realistically mandate that all people need to buy it. And if not buying it carries a penalty of a certain percentage of one's income, I can see wanting to get reform right before anyone signs anything.
However, even if the minimum that goes through is the revocation of the "pre-existing condition" and tighter regulation of the insane and fraudulent current business model of the insurance industry, much good will still have been done for millions of chronically and fatally ill people. But it is not going to be enough to ensure, much less mandate, that the poorest of the poor get coverage. Which as I understand it, is kind of the point of having reform in the first place.
@Hooplehead: I believe that you don't pay if you make up to 400% of the current poverty lines. Which is $88k a year for a family of four. The extension of SCHIP and earlier enrollment in Medicare will help tons as well.
@battleaxonista...is a humorless bitch: I'll need to double check, but I believe those provisions are ones that got the axe. Medicaid is getting a small expansion, Lieberman, Snowe and some other conservatives killed the early option to enroll in Medicare due to expansion and cost, and the 400% of current poverty lines is one of a bunch of estimates floating around right now. It's not something to bank on. Especially as other ones discussed 150% which is a different scenario. And even with subsidies, the estimates for out of pocket cost per family are still astronomical.
@battleaxonista...is a humorless bitch: The subsidy covers a portion of the premium, and the subsidy goes down as income goes up. Only the lowest incomes will get a full subsidy.
My family wouldn't be in debt, my mother would not be dying, and several people I know would still be alive if this 'shitty' bill had been enacted 5 years ago. It astounds me every day that people insist on killing a bill that can save millions of lives because it's not perfect. I would rather endure 20 years of glacial improvement than waste another 20 years waiting for some mythical Liberal unicorn parade to pass the Uber Single Payer Healthcare plan of awesome.
@battleaxonista...is a humorless bitch: I understand your plight because I have, and currently am witnessing the same issues first hand. However, if people are fighting to make the bill the best it can be and not just pass a very flawed bill that may do more harm than good, that's a fight worth taking on. The progressive dems are fighting for something that the Obama admin and Harry Reid bargained away from the beginning. They gave no concessions to the progressive wing of the party and let the conservative wing hijack and destroy what could otherwise be a substantive bill.
The flaws are so big that millions of people just like you may again have to suffer while waiting decades for any chance of change. So if we have to work to change this bill, even if it goes past the deadline Obama wants- his State Of The Union speech (just so that he can claim a win, no matter how shitty, in his column). Working it out a few days,weeks or months longer is worth the fight for a better, truly public friendly bill.
@battleaxonista...is a humorless bitch: I know where you are coming from -- i will not go into a litany of the tragedies related to this in my own life -- but people are not buying into the "kill the bill" thing just because this bill is not "perfect", but instead because they feel it is deeply flawed and fear that it is written to make things worse. To me, to force everyone to get coverage basically in the overpriced, in humane system we have now hurts those who need help, while making sure that the industry gets even richer.
@battleaxonista...is a humorless bitch: You've got a great point that's been getting lost. Yes something is better than nothing, but this bill is getting closer and closer to making things actively worse. Like a lot of people, I want health care reform so bad it makes me cry every time the topic comes on the news. But an ammendment that'll take us back to the coat hanger days? A mandate that everyone get health care but no public option to make that financially possible? A tax on people lucky enough to have the kind of healthcare the rest of us want? It's not a reform bill, it's a handout to the insurance companies and the religious right at this point.
More importantly, sympathies to your family and your mother in particular. Hopefully something not shit can be done in time to help :(
@Questioning Everything: Oh but see, the conservative wing doesn't have to vote for these people. They can always vote Republican. What are the progressives going to do besides yell? We're certainly not going to vote Republican!
@Questioning Everything: Public support is already waning against this bill and 'progressives' are already tearing the administration apart. What leverage do they have to improve this bill over weeks or months? The votes are NOT going to change in our favor the longer the media and the Republican wing can continue to pile on this bill as being something terrible and worthless. This is IT, this is THE END and I don't think people really get it. Is this bill failing going to magically bolster the American public to go vote a shitton of Kucinich's and Dean's into the Senate? No, it certainly won't. And liberals are already sneering that they hope Obama enjoys his only turn in office. This bill is our fucking Waterloo. If we win, we get massive public support to 1) improve other fucked up things in this country and 2) pass amendments to improve this bill. Shooting it down does us NO GOOD, NONE.
@battleaxonista...is a humorless bitch: Are you sure your family would have been able to afford coverage in the first place under this bill? My fear of this bill is that some uninsured will get coverage and some insured will lose coverage.
@bluebears: How so? Please link me to articles/sections of the bill that will cause 'more harm than good'. It quite frankly sounds more like a meme that has caught wildfire with no substantive backing.
@Lymed: With the current wording I am familiar with, with even up to 150% to 200% poverty line coverage my family would have been able to afford it. There is also a cap of how much of your yearly earnings can be spent to purchase insurance. For example, if the cheapest available insurance plan through your insurance exchange exceeds 8% of your yearly income you are exempt from the mandate.
@bluebears: I reread it and I saw a lot of misinformation on 1) The current form of the bill 2) What the prior forms of the HCR bills actually covered 3) The triggering and application of the mandates and what they mean.
@battleaxonista...is a humorless bitch: Which basically means that if you were poor and not able to afford insurance before, you will still not be able to afford insurance. You only won't have to buy it. Yay for not paying a fine out of a paltry income.
8% is actually ridiculously low... For a $50000 a year income, that's a cap of $4000 a year on insurance. I'm pretty sure that most family insurance plans are going to be at least that much, and $50000 is well above the poverty line for a single family household.
@Apollinarius: If you're poor, you will receive subsidized assistance to be able to afford insurance. If you are under 400% (original wording) of the poverty line, you will receive subsidized assistance to be able to afford insurance (which comes out to $88k for a family of 4. If, that has indeed been halved as stated previously that's roughly 44k). If the cheapest plan available is still over 8% of your yearly income you will be exempt. I fail to see how it will become an onerous mandate.
The mandate 'fine' also starts at under $100 and takes over 5 years to reach the maximum penalty. Also, you are exempt if you've been uninsured for less than three months at the time of filing. If your insurance company booms your premium by 300% in retaliation for eliminating pre-existing conditions, you are probably going to shoot right out to the exempt pocket while you look for a better deal. If EVERY insurance company in the exchange program followed one-another lockstep the only thing they'll do is open the door for a government plan to swoop in and do the mop work. This has worked successfully in other states and with work it can work nationwide. Not perfectly, but it can work.
@battleaxonista...is a humorless bitch: I'm having a pretty tough time going one way or the other on this debate because I'm still wading through the wonkfest. I'm still trying to get a handle on exactly how much more expensive and how much less comprehensive a subsidized exchange plan would be than the public option, if that's the measuring stick (most progressives seemed okay with the mandate assuming the PO would be affordable enough). I don't really know why Latoya blew off the Nate Silver exchange as "arguing in circles"; I think it's pretty important stuff to read. At the end of the day, this is about logistics, and it's complicated. Oversimplifying this is dangerous.
And for the firedoglake crew: spare us the sanctimoniousness. There's something awkward about opposing a mandate because it will inflict pain on the poor, and then turning around and banking on increased suffering by these same people to expand your grassroots support.
I don't have a problem with this tax, but I don't get why everyone is saying cosmetic procedures, or the tax on them, is only going to hit the upper classes. Do you think all the girls with boob jobs on Rock of Love or some other MTV/VHI reality show were able to afford them due to their upper class backgrounds? Do you think the admin assistants on plastic surgery forums (like on Makeup Alley, or Doctor's websites) are all married to millionaires? Definitely not.
Plastic surgery and botox has become relatively affordable. Doctor's have payment plans, so you can pay off your procedures over the course of years. The American public is not generally freaked out about the idea of carrying a credit card balance- why wouldn't you just throw down your card for this? Millions of people do. Even if you were going to pay out of pocket. 500 dollars X 2times a year= 1000 dollars/12 months= 83 dollars a month. A good number of middle class people have 83 dollars a month to spend on this if it is a priority.
Dear Dr. Plastic,
You need to recalibrate your understanding of middle class. No middle class people I know are getting a toxin injected into themselves for cosmetic purposes. File this tax under "rich people problems."
@SharonTaint: It may not be life saving, but neither is reconstructive surgery for someone who's had a mastectomy. For some people with migraines Botox may be the only thing that helps them live a normal life.
Although someone mentioned downthread that it's a tax on the procedure, and not the poison itself, so it wouldn't be taxed for someone who needs it for a geniune medical reason. Which, if that's the case, maked the whole medical arguement moot.
@Elle O. Elle: I totally understand, except there are a lot of drugs on the market for migraine sufferers (and I am one of them) so to me it's a little disingenuous to get Botox for a migraine.
I just with people would be upfront about their vanity. There's nothing wrong with wanting to feel better about your appearance.
@SharonTaint: I sort of am, I had them at least once a week when I went through puberty, and if I'm around a trigger I'll still have them, so I wouldn't need some as drastic as Botox. Even if I did I wouldn't choose to go that route, needles scare me so much that I had a panic attack outside a tattoo parlor once, no needles for me unless it's necessary, and even then I ain't goin' down easy.
But everybody is different, some people will respond well to the first medicine they try, some have to try a few to find the right fit, and for some people the usual methods just won't work, so they have to try something a bit more extreme. I don't doubt that there are people out there who don't get relief from traditional migraine meds. I also don't doubt that there are more people using it for that reason than genuinely need it.
But for the ones using it purely for vanity, I say tax the shit out of it.
PS - Jeez, the end of my last reply is atrocious, I was heading out the door to grab lunch when I wrote that last bit, I swear.
@SharonTaint: Cosmetic surgery is a medical, life-saving necessity for most trans people. This is not a tax on just Botox but 'elective' surgeries as well, as far as I know.
@Catabolic: I am not very well versed in the plight of transgendered people so I apologize if I sound callous but how is getting gender reassignment surgery life-saving? In the literal sense, that is.
As opposed to, say, a kidney transplant?
Isn't it still cosmetic? Or is the understanding that this type of situation yields psychological issues that therefore make it life-saving?
@SharonTaint: It's sex reassignment, not gender reassignment - the physical sex is reassigned to align with the person's gender identity.
Yes, I am referring to the psychological issues here, and obviously not being able to access sex reassignment surgery won't kill anyone directly. So, yes, technically it's cosmetic, and also elective in the same way some heart surgeries are - these surgeries markedly improve the quality of life of the patient but are not still elective.
These may not be emergency surgery like an appendectomy but they're still as life-saving as other technically non-life-saving, elective procedures such as angioplasties or hysterectomies.
12/18/09
Silly me for thinking the insurance companies could get away with less after a bill passed. I guess my gullibility is a pre-existing condition.
I love America, but I hate how reactive some people get to "socialism" and other words when they don't even know what those words mean. I hate that this is all about an old white man's ability to further control my uterus and not getting better health care for my uninsured friends and family, including a brother who has worked full-time at one job for over a year but is still considered "temporary' and therefore gets no insurance.
Because of people like my worthless senator who can still call herself a Democrat with a straight face, this is getting watered down and watered down and watered down to where it isn't even soup anymore. It's just water that someone probably peed in.
12/18/09
I find this has a fairly interesting explanation with some number crunching on the (semi)current version of the bill. It also has excellent links to other analysis and the bill itself, if people are interested.
12/18/09
12/18/09
The Democrats: Even when we win, we lose!
12/18/09
12/18/09
12/18/09
Oddly enough, I did know about the farm labor exemption, but that's only because I wasn't able to find my grandfather in the SS Death Index (he passed away 16 years before I was born). My dad explained his absence from the index as, "He was a farmer. You think he was going to pay any taxes if he could possibly help it?"
12/18/09
12/18/09
12/18/09
12/18/09
Now I really feel that all hope is lost. If this bill passes as-is it's going to bankrupt hundreds of thousands (if not millions) of hard working Americans who are just scraping by hoping they don't get sick. I can't even afford the $1,000/year fine for not having health insurance much less health insurance. Moreover, unless we're going to start mandating that all institutions of higher learning provide health coverage for their students, we're going to permanently put college out of the reach of millions of students whose families can't afford to provide them health coverage, which means more and more students are going to have to forgo college and opportunities in order to get a job and health insurance. That's just WRONG.
I'm one of the lucky ones, in that I have the option of scraping together a few thousand dollars up-front and immigrating to Australia since my fiance is an Australian citizen and even if he wasn't, I have a friend in Canada who would be willing to marry me. Most people don't have that option and more importantly, you shouldn't NEED that option.
12/18/09
12/18/09
12/18/09
12/18/09
@bluebears: Seconded on the shittiness of the coverage. The University of Idaho's undergrad coverage, the first year it was required, did not cover BROKEN BONES unless they were the result of a varsity university sporting event. Really.
12/18/09
12/18/09
12/18/09
Mr. Pietra broke his leg two years later; thank goodness the school had switched to a different policy that actually covered routine medical care.
12/18/09
However, even if the minimum that goes through is the revocation of the "pre-existing condition" and tighter regulation of the insane and fraudulent current business model of the insurance industry, much good will still have been done for millions of chronically and fatally ill people. But it is not going to be enough to ensure, much less mandate, that the poorest of the poor get coverage. Which as I understand it, is kind of the point of having reform in the first place.
12/18/09
12/18/09
12/18/09
12/18/09
12/18/09
12/18/09
12/18/09
12/18/09
12/18/09
12/18/09
The flaws are so big that millions of people just like you may again have to suffer while waiting decades for any chance of change. So if we have to work to change this bill, even if it goes past the deadline Obama wants- his State Of The Union speech (just so that he can claim a win, no matter how shitty, in his column). Working it out a few days,weeks or months longer is worth the fight for a better, truly public friendly bill.
12/18/09
12/18/09
More importantly, sympathies to your family and your mother in particular. Hopefully something not shit can be done in time to help :(
12/18/09
12/18/09
12/18/09
12/18/09
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12/18/09
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12/18/09
8% is actually ridiculously low... For a $50000 a year income, that's a cap of $4000 a year on insurance. I'm pretty sure that most family insurance plans are going to be at least that much, and $50000 is well above the poverty line for a single family household.
12/18/09
12/18/09
The mandate 'fine' also starts at under $100 and takes over 5 years to reach the maximum penalty. Also, you are exempt if you've been uninsured for less than three months at the time of filing. If your insurance company booms your premium by 300% in retaliation for eliminating pre-existing conditions, you are probably going to shoot right out to the exempt pocket while you look for a better deal. If EVERY insurance company in the exchange program followed one-another lockstep the only thing they'll do is open the door for a government plan to swoop in and do the mop work. This has worked successfully in other states and with work it can work nationwide. Not perfectly, but it can work.
12/18/09
12/18/09
And for the firedoglake crew: spare us the sanctimoniousness. There's something awkward about opposing a mandate because it will inflict pain on the poor, and then turning around and banking on increased suffering by these same people to expand your grassroots support.
12/17/09
12/17/09
12/17/09
12/17/09
12/17/09
Plastic surgery and botox has become relatively affordable. Doctor's have payment plans, so you can pay off your procedures over the course of years. The American public is not generally freaked out about the idea of carrying a credit card balance- why wouldn't you just throw down your card for this? Millions of people do. Even if you were going to pay out of pocket. 500 dollars X 2times a year= 1000 dollars/12 months= 83 dollars a month. A good number of middle class people have 83 dollars a month to spend on this if it is a priority.
12/17/09
You need to recalibrate your understanding of middle class. No middle class people I know are getting a toxin injected into themselves for cosmetic purposes. File this tax under "rich people problems."
12/17/09
No amount of argument could convince me that it's a medical, life-saving necessity.
12/17/09
Although someone mentioned downthread that it's a tax on the procedure, and not the poison itself, so it wouldn't be taxed for someone who needs it for a geniune medical reason. Which, if that's the case, maked the whole medical arguement moot.
12/17/09
I just with people would be upfront about their vanity. There's nothing wrong with wanting to feel better about your appearance.
But you can't bullshit a bullshitter, as it were.
12/17/09
But everybody is different, some people will respond well to the first medicine they try, some have to try a few to find the right fit, and for some people the usual methods just won't work, so they have to try something a bit more extreme. I don't doubt that there are people out there who don't get relief from traditional migraine meds. I also don't doubt that there are more people using it for that reason than genuinely need it.
But for the ones using it purely for vanity, I say tax the shit out of it.
PS - Jeez, the end of my last reply is atrocious, I was heading out the door to grab lunch when I wrote that last bit, I swear.
12/17/09
12/17/09
As opposed to, say, a kidney transplant?
Isn't it still cosmetic? Or is the understanding that this type of situation yields psychological issues that therefore make it life-saving?
12/18/09
Yes, I am referring to the psychological issues here, and obviously not being able to access sex reassignment surgery won't kill anyone directly. So, yes, technically it's cosmetic, and also elective in the same way some heart surgeries are - these surgeries markedly improve the quality of life of the patient but are not still elective.
These may not be emergency surgery like an appendectomy but they're still as life-saving as other technically non-life-saving, elective procedures such as angioplasties or hysterectomies.