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The circus is finally wrapping up and about to leave town. Surprisingly, this circus has managed to create a new health care system in the United States and come to near Universal care.  Bravo! Against all odds, Obama and the Democrat Party have managed to reform a system that needed urgent reform.  The bill has already been signed into law, Tuesday, March 23, 2010. After this the bill will go onto the Senate to complete the process of reconciliation.

The Senate will either adapt the changes made by the House or they will add their own changes. This process could take a few days or a few weeks, depending on how much of a fight the Republicans put forth.  My guess is they will delay it for as long as possible.  But, the Senate will adapt the House position and this bill, The Patient Protection and Affordable Care Act otherwise known as HR 3590 will become the law of the land.

So, some people are wondering. How does this affect me? And, how did they manage to pass this bill?

First, let me explain my position so we have no misunderstanding. My position is most closely aligned to that of Rep. Dennis Kucinich’s position. There is a huge problem in health care and it is because it is a private industry. I was hoping we would get a single-payer universal health care system.

Here is why.

“I like to think of a single-payer system as being similar to Wal-Mart.  Wal-Mart negotiates with its vendors to provide their supplies for a much lower rate than they would to other companies. This is due to the fact that Wal-Mart is the largest company in the United States and is capable of selling massive amounts of merchandise.  Wal-Mart has a philosophy that if they are not getting a reasonable price then they are not going to sell that product, which will hurt that company a lot more than it will hurt Wal-Mart.”

That was from my article, Universal Healthcare Part 1. Click here.

I am strictly interested in what is best for the United States and its people. The US needs to have a strong and vibrant economy and we need to also have solid infrastructure and health care. Too often in the past has the interests of business trumped those of the common person. Even though this bill does not have single-payer universal coverage, it comes close. Recently, most liberals have agreed that this is a good start.  Even if it is not exactly what we all wanted.

Dennis Kucinich said it well,

“One of the things that has bothered me is the attempt to try to delegitimize his presidency. That hurts the nation when that happens. We have to be very careful that President Obama’s presidency not be destroyed by this debate. . . . Even though I have many differences with him on policy, there’s something much bigger at stake here for America.”

Fortunately for America the Democrats were able to enact this legislation and bring about this much needed reform.

So, now that you know where I stand, let me explain this bill a bit.

According to “The Huffington Post.”

Effective six months after passage

• All insurers are fully prohibited from discriminating against or charging higher rates for children based on pre-existing conditions.
• Adults with pre-existing conditions will be eligible to join a temporary high-risk pool, which will be superseded by the health care exchange in 2014.
• Children and young adults will be permitted to remain on their parents’ insurance plan until their 26th birthday.
• Insurers are prohibited from charging co-pays or deductibles for preventative care and medical screenings on all new insurance plans.
• Individuals affected by the Medicare Part D coverage gap will receive a $250 rebate, and 50 percent of the gap will be eliminated in 2011.
• Insurers’ abilities to enforce annual spending caps will be restricted, and completely prohibited by 2014.
• Insurers are prohibited from dropping policy holders when they get sick.
• Insurers are required to reveal details about administrative and executive expenditures.
• Insurers are required to implement an appeals process for coverage determination and claims on all new plans.
• Indoor tanning services are subjected to a 10 percent service tax.
• Enhanced methods of fraud detection are implemented.
• Medicare is expanded to small, rural hospitals and facilities.
• Non-profit Blue Cross insurers are required to maintain a loss ratio of 85 percent or higher in order to receive tax benefits.
• Companies which provide early retiree benefits for individuals aged 55-64 are eligible to participate in a temporary program which reduces premium costs.
• A new website installed by the Secretary of Health and Human Services will provide consumer insurance information for individuals and small businesses in all states.
• A temporary credit program is established to encourage private investment in new therapies for disease treatment and prevention.

Effective by 2014

• All insurers are fully prohibited from discriminating against or charging higher rates for adult individuals based on pre-existing medical conditions.
• All insurers are fully prohibited from establishing annual spending caps.
• Expand Medicaid eligibility; individuals with income up to 133 percent of the poverty line qualify for coverage
• Establish health insurance exchanges, and subsidization of insurance premiums for individuals with income up to 400 percent of the poverty line.
• Offer tax credits to small businesses that have fewer than 25 employees and provide health care benefits for them.
• Impose a tax penalty on employers with over fifty employees who do not offer health insurance to their workers.
• Impose an annual fine on individuals who do not obtain health insurance; exemptions to fine in cases of financial hardship or religious beliefs.
• Creation of a new voluntary long-term care insurance program.
• Creation of tax credits for individuals who purchase private insurance policies
• Employed individuals who pay more than 9.5 percent of their income on health insurance premiums will be permitted to purchase insurance policies from a state-controlled health insurance option
• Pay for new spending, in part, through spending and coverage cuts in Medicare Advantage, slowing the growth of Medicare provider payments, reducing Medicare and Medicaid drug reimbursement rate, cutting other Medicare and Medicaid spending.
• Revenue increases from a new $2,500 limit on tax-free contributions to flexible spending accounts (FSAs), which allow for payment of health costs. Raising various taxes, and creating a new excise tax for high cost “Cadillac” insurance plans.
• Chain restaurants and food vendors with 20 or more locations are required to display the caloric content of their foods on menus, drive-through menus, and vending machines. Additional information, such as saturated fat, carbohydrate, and sodium content, must also be made available upon request.

By 2018, all existing health insurance plans must cover preventative care and checkups without co-payment.

As you can see these changes will take time, but the overall reform is great and is far-reaching. Not too many people will be completely unaffected by this reform.

I am pleasantly surprised that the Democrats were able to pass this reform. They tried to compromise and adjust their position, and they did adjust quite a bit. No matter what they did, the Republicans would not vote ‘yes’ on any health care reform.

I went back and forth on this legislation and my main concern was no public option or single payer system. The Single Payer system is the most fiscally conservative and responsible system out there today. It is because of the malicious Republican opposition that Democrats had to scrape these ideas.

Here are links to my two other major health care articles.

Number 2.

Number 3.

As you can see my opinion was conflicted, as was the majority of America. However, my concerns were at least addressed and hopefully over the next ten years we will have a true single-payer, universal health care system in the United States.

It comes down to two types of people in the world. Those who see the world for what it is and try to make it work and those who see the world for what it is and try to improve it. This week, the latter one and I will rest easier knowing we are better prepared for the future.