Journalism in the Public Interest

What’s Next With Health Care (And Why This Process Was Madness)

Sometimes things are a little clearer in retrospect. Now that health care reform has passed in the House, it seems there are two main questions in people’s minds:

  • What’s next?
  • Why, procedurally, was the legislative process so confusing and painful to watch?

Let’s answer that second question first. To help do that, we’ve drawn up some helpful infographics.

Exhibit A - How, originally, we thought health care legislation would play out procedurally. This is typically how proposed legislation is melded between the two houses.

Exhibit B - How things would’ve worked under “deem and pass,” or a self-executing rule. After questions were raised about the constitutionality of “deem and pass,” the House ended up not going that route.

Exhibit C - How it looks like it’s going to happen, after all.

In that last graphic, the yellow marker (5) is where we’re currently at. President Obama reportedly will sign the Senate bill on Tuesday, which means that part of health care legislation is law. The House-passed reconcilliation portion, consisting of 153 pages of “fixes” to the Senate bill (compare the two bills with our side-by-side comparison app), will then move to the Senate (6), and if it passes, on to presidential sign-off (7).

As for the “What’s next” question, Kaiser Health News has a good list of some of the provisions that will take effect in 2010. Most of the bigger changes that will affect millions don’t go into effect in 2014.

So, in order to jam this down our throats, the Democrats still managed to ues parlimentary tricks to pass this much hated piece of legislation. I’m certainly not alone when I say I am completely disgusted with them at this point. They will pay the price at the next election and we can count on Congress wasting ANOTHER 14 or 15 months to unwind or blunt this legislation. In the mean time, critical policies dither and wither in the wings.

What’s next is that we pay a lot more for the exact same amount of health care being provided by the same number of doctors, nurses, and hospitals and the extra money goes into insurance company, big pharma, and government pockets. This bill was never about health care. It was about spreading the wealth around. Want to guess which companies’ stocks just went up?

I am thoroughly disgusted with Obama. I read his book Dreams from My Father and thought he was truly someone with integrity.  Turns out he is just another venal,  liberal politician who is willing to cut deals, work the back room, reneg on his campaign promises and do whatever it takes, no matter how ugly to get his way. His ego is bigger than I ever imagined. His Chicago street fighter ‘whatever it takes’ background is serving him well. He will serve up what HE thinks is good for us, regardless of what we really want. Hope and change?  HA, HA, HA on us!

Billy from SloTown

March 22, 2010, 8:06 p.m.

Both sides are guilty of doing what they need to do…Let’s not argue about process, ,lets talk policy,wokay?
IT stinks-backroom deals, fluffying up a for-profit healthcare system is just wrong.I am not happy-I will just excercise, eat organic, stay away from toxins, and pray I don’t have any problems..If I do, I’ll just die, I guess…I had a good run.What the hey.

Gadema Quoquoi

March 23, 2010, 8:01 a.m.

Whether you are a Democrat, a Republican, or an Independent, with this Historic Passage of The Healthcare Reform Bill, now it is Time for us to Refocus on, using our Healthcare Information Technology (HIT) to CONTAINED our Skyrocketing Healthcare Spending.

We must used some of the Stimulus Funds, in combination with a 50/50 Joint Venture of the Government, and the Private Sector Investment, and used the combined Funding (i, e, it may Cost up to $300 Billions), to BUILD Smart/Intelligent Infrastructure Services for:  Broadband, Healthcare IT, Smart Transportation Systems, and Smart Grids.

FCC BROADBAND PLAN - We must make maximum Use of our Spectrum Resources.  We need to Used our Technological Strength, to Increased the Capacity of this Very Limited Resource ( i, e, Increased Air Interface/Spectral Efficiency).

BROADNAD SERVICES - The ENGINE of Economic Growth in this 21st CEntury is “BROADBAND.”  We can start by, Deploying a pure Packet-based, All Optical/IP, Multi-Service National TRANSPORT (BackHaul) Network Infrastructure, using Optical Ethernet throughout this National “Network of Networks.”  This Connect All Optical Islands, Nationwide.

HEALTHCARE IT -  Proper Deployment of Health Information Technology (HIT) Solutions and Training will Increased Productivity (i, e, medical data mining/warehousing, risks treatment, service delivery), Efficiency (i, e, medical errors, redundant and inappropriate care), and have a Costs Savings of around 20-30% of our Annual National Healthcare Expenditures (2009, $ 2.5 Trillions).

the Investment in this National “Network of Networks”, in addition to New Jobs Creation and Economic Recovery, can Serve as a Business Driver for:  Law Enforcement (FOP) Nationwide Network, e-Government, e-Commerce, e-Education, e-Healthcare, Energy and Transportation Systems, BioSurveillance, Social Networking, Entertainment, etc. 

This Investment is like the Investments made in the past, in ERA, TVA, RailRoad, and the National Transportation Inter-State, which Increased Productivity and our GDP.

Please See: for NHIN Summary Deployment Plan.

Gadema K.  Quoquoi
President & CEO

Moderator - I corrected the spelling errors in the comment I sent you earlier. Please use the corrected version below. Thanks.

It will not be the same number of doctors, nurses and hospitals. This health care reform bill will make jobs, for doctors, nurses, aides, clerks, medical assistants, physician’s assistants, in home health care workers, durable and disposable medical supply manufacturing workers and stores, etc.  All these people will pay state and federal income taxes, and sales and property taxes, and spend their money locally creating retail jobs for others who will pay taxes. This will lower unemployment thus saving money. The bill will almost pay for itself in jobs and taxes paid by all those with these new jobs. Many of these jobs only take a year or 2 of training. Many LPN’s can upgrade to RN within a year or 2 more training. Every year many qualified candidates are turned away from medical school. These are real concrete services we need and want not more telemarketers or junk and decorative items from China.  They are always talking about retraining displaced workers.  Well here are jobs that will not disappear, jobs that there will be a real demand for.  Only difference is they are more above board than say jobs for business executives who trade in derivatives, or credit card company jobs that charge exorbitant rates.  If jobs are created in the medical field someone will want them. Yes it will take more years to get the doctors trained, but there are many people with premed degrees trying now to get into medical schools, an also physicians assistants that want to go to medical school. These people are already half way there.  Also the insurance of 36 million uninsured and the emphasis on preventive care for all, will lower the demand on emergency rooms, and keep many people from getting seriously ill.
Also would you pay 8% to 30% for online bill pay at your bank? All insurance is a glorified overpriced bill pay service, that takes our collective premiums and those of our employers or former employers (and if poor those premiums of our government) and the insurance companies then use these premiums to pay our collective bills. They don’t provide health care, they just process the payments. So why are they allowed to make the exorbitant profits???  Because most insurance is provided by just a few major corporations, like some private monopoly where they make their own rules, and control the products available.  What insurance companies do is limit our choice of providers and doctors, and try to make a big profit for the insurance company and the executives who make up to 154 million a year.  Why do we put up with a insurance company telling us which doctors we can choose from. While I support anyone’s right to have an insurance company beauracrat handle their health care payments, should not I have the same right to choose a government bureaucrat to handle mine. (Democracy does NOT equal with unfretted corporate capitalism.  The big corporations would like you to think that, but they are not the same.  After all, they say democracy stops at the factory door.  If corporations were democracies would not the people that do the work gets a fairer share of the profit, rather than ever and ever greater amounts going to the few executives.  Many of these corporations don’t even keep their profits in the US.)  Give me the choice of the public option. Government is not taking over health care. In fact, one has more choice in their health care providers if they sick with regular Medicare.  Look at how small the networks are in some private insurance companies or HMO’s. Government under the public option would just be handling paying your bills from your and your employers’ premiums. Health care is provided by your providers and doctors not the government, and the broader the plan, the more providers you have available the more freedom one has.  What the new law should help with is insuring that your insurance company actually spends more of your premiums on your health care rather than insurance company CEO bonuses, and that they can’t collect your premiums for 30 years while you’re healthy and then keep changing the coverage until l your plan hardly pays for anything when you’re really sick. In other words it will set some minimum benefits that the insurance companies can’t fall below. Right now everyone is just one pink slip away from being uninsured. And many an apparently solvent company has closed or done a legitimate or questionable bankruptcy to get out of paying workers health insurance or at least tired to dump their health care for their retirees after they got a lifetime of work out of them.  Personally, my former employer (as a conditional of keeping our company supplement for which we worker a lifetime)  forced all the retirees off of the real Medicare and onto Medicare Advantage with private insurance companies and no guarantee you can see all Medicare providers available under the real Medicare, and is now set to take away traditional coordination of benefits for the Medicare retirees, and will let the insurance require and end of care directive and probably tell us where to put it, maybe at a central registry, or pay $300 more per year. The next step will they want to interpret it to our physicians and family,  and probably will want us to put certain phrases in. While I support living wills, it is not the place of a for profit insurance corporation to dictate my legal matters,  when their bottom line is their corporate profit,  and CEO salaries etc. of up to 154 million apiece. Unfretted capitalism at work!!!!

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