Parenting

Thursday, November 26, 2009

What the Health Reform Means for Your Family

Does health reform have you completely baffled? Same here. So we asked Jennifer Tolbert, a principal policy analyst at the nonpartisan Kaiser Family Foundation (and a mom), to break down some of the key issues.

By Colleen Egan

Q. What's happening with health-reform legislation?

A. There are two bills out there right now: the House Tri-Committee bill (H.R. 3200), which has been passed out of three committees of jurisdiction in the House, [and] also a bill in the Senate that came out of the Senate Health, Education, Labor, and Pensions (HELP) committee. There's a second committee in the Senate, the U.S. Senate Committee on Finance, that is also working on a bill that's likely to look very different from the other two. The problem is that when you start talking about health reform and what it will mean and the implications, it may mean one thing under the provisions in the House bill and a little bit different under provisions in the Senate HELP Committee bill, and then [it's] likely to look much, much different when we finally see a bill out of Finance.

Related: BPA-Free Baby Bottles

Q. Tell us about the House bill.
[Ed. Note: This is the main bill in play right now.]

A. What the House bill does is establish a floor of coverage, what is referred to as an essential-benefits package, that specifies what benefits have to be covered and sets limits on the amount of money that people have to pay out of their own pockets for health care, in the form of either deductibles or copayments. Any employer plans that don't meet those minimum standards today will have five years to come into compliance.

Related: What to Know About Online Medical Records

Q. Will health reform affect people who have insurance through their employer?

A. People who have employer-based coverage are not likely to see much change after health reform.

Q. What about the public option?

A. The public option is part of this debate, but it's only one plan among many private plans that would be offered in this newly created health-insurance exchange. And this exchange, I like to think of it as a virtual marketplace—it's like Travelocity for health insurance. It's simply a place where people can go and compare plans on a number of different measures. [The exchange] will enable people to choose the plan that best meets their and their family's needs. This public option, if it does remain in the bill, will simply be one plan choice among many in this exchange. You will still have a choice of many different private plans.

Related: The Debate Over Autism and Vaccines

Q. What is the debate over the public plan?

A. The advocates of the public-plan option would say that one of the goals of having the option in place is to spur competition, to provide people with additional choice of plans—particularly in areas where there may not be, right now, much choice. The supporters of the public plan would say the goal is not necessarily to drive out private coverage, but simply to spur competition among plans. Critics ... say that it's a kind of a step toward erosion of private coverage entirely, to the extent that the public plan can offer lower premiums than the private plans, which simply can't compete, and eventually everyone will choose that public-plan option because it's cheaper.

Continue reading about health care reform...

Check out more new stories from Cookie:

Jenny McCarthy Speaks About Her Son's Autism
Creative Birthday Cake Designs
Celebrity Moms We Love
The Best Twin and Double Strollers
Children's Birthday Party Invitaions
25 Delicious Healthy Snacks

Syndication:

From the Community…

Comments 1-10 of 12
  • Lorie L's Avatar
    Posted by Lorie L Tue Sep 15, 2009 7:22am PDT

    What she fails to say is anything at all.

    The truth of the matter is that there will be a lot more people going to doctors. However, there is no plan to open more availabilities at universities for medical school openings (all the schools are currently at max capacity), and there is no plan to open more residencies at doctors' offices and hospitals. So, what is going to happen is either doctors' offices will close themselves to accepting new patients: i.e. people formerly without insurance or people who recently moved to the area. The other option is that you will have to wait much longer to see a doctor. Also, since General Medical Practitioners make less money (and still have the same amount of student loans), there is already a shortage of these doctors. So, soon, you may have to wait 4-6 months to see a doctor about a cold.

    And then people will flood the emergency rooms leaving longer wait times and possible health risks for those who have an actual emergency.

    These are the things no one wants to talk about, but Congress needs to look at them because providing free or cheap healthcare will not help anyone if there are no doctors available to see them.

    Report Abuse
  • frank's Avatar
    Posted by frank Tue Sep 15, 2009 9:06am PDT

    nice reali nice!

    Report Abuse
  • Mysterious Gryphon's Avatar
    Posted by Mysterious Gryphon Tue Sep 15, 2009 10:03am PDT

    Lorie L-

    Could you please explain how the proposed legislation would flood emergency rooms? I understand what you are saying about a doctor shortage, but I don't see how ERs would be worse off. If people had the option to see a regular physician, they would; the reason they go to the ER right now is because they are uninsured and the ER cannot refuse to treat them, whereas a physician's office can. Please explain.

    Regarding a potential doctor shortage: I see your point. Even now, I have to wait a month to get a routine checkup like a pap smear - and I have insurance. What do you think should be done? Should we increase the number of openings in medical schools? Should that be accomplished by further legislation? And is there any danger that doing so would lower the quality of people accepted to medical school?

    I think that one way to correct this problem is to ensure that more osteopathic and optometric doctors are allowed to enter the playing field - that is, make sure they are included in the public plan. Right now, these doctors are paid less by Medicare to provide the exact same care to their patients as an MD does. Once DOs and ODs are fully incorporated into the system at the same level as the MDs, there will be plenty of medical care for everyone.

    Report Abuse
  • Andygirl's Avatar
    Posted by Andygirl Tue Sep 15, 2009 11:26am PDT

    so Lorie, you're saying that when people can all afford health care go to the doctor, it will flood the health care system and then no one will receive care? is that right?

    so, is it safe to assume, then, that in the interest of only those who can afford it, we should deny rights to a subset of the population simply because of their class? only the rich should get to see their doctors because the poor would overwhelm the system?

    Report Abuse
  • HotCrossBuns's Avatar
    Posted by HotCrossBuns Tue Sep 15, 2009 1:16pm PDT

    Newsflash: It isn't just the poor who can't get proper health care in this country! Health Insurance issues aren't all about affordability. My husband and I, who are raising 3 children, are middle class, small business owners who earn a respectible living and pay our taxes. However, my husband has high cholesterol and I have Crohn's disease (which is very expensive to maintain with or without insurance) and was previously mis-diagnosed with MS. We have been denied coverage by every private insurance company we've tried (we even had an insurance broker working on for us with no luck). We're too "rich" for public assitance or clinics and too "poor" to pay the $1000+ medications, labworks, doctors visits, etc etc etc that are needed on a regular basis.

    We've been told by folks opposing the HCReform that we just need to "stop being lazy and get better jobs" and "work harder to get what we want"...However, no matter how many more hours we put in at our business or how much our income growns, my entire family is still left without health care coverage because of circumstances completely out of our control.

    Something has to change!

    Report Abuse
  • Meena's Avatar
    Posted by Meena Tue Sep 15, 2009 1:26pm PDT

    one thing i want to say is to those that have a problem with immigrants recieving free health care. many illegal immigrants are from latin america and just remember, it was the white people that took their land from them in the first place. they killed people in california, texas, new mexico, arizona, etc. to take what was not their's. the majority of these people work menial blue collar jobs and are at times treated like intruders, scum. the least we could do is offer some kind of worker status card, and, yes, include them in the public health option. just remember who cleans your house, watches your children, what would the economy be without them?

    Report Abuse
  • Gerbianne's Avatar
    Posted by Gerbianne Tue Sep 15, 2009 5:35pm PDT

    Yes this is right then OK. When we come over here we can come to here to work for our monies. Coming here to New Mejico AZ and Texas is to come home for many for this lands was Mejico old lands. The US need to take care of this peoples. A man can do for his family here the rogt one way there can be loans and arrangemints to be made to help te Mejico warker to ceceed and sned te monies to the economy so poor there. Ter is plennty to come aroun for all for identificaton and loan Some Free health for all is a ood thing no?

    Report Abuse
  • HotCrossBuns's Avatar
    Posted by HotCrossBuns Tue Sep 15, 2009 7:33pm PDT

    The "we were here first" argument does not hold water. Anyone who is not a tax-paying citizen of our country does not deserve to receive services paid for by the taxes paid by its citizens, while those same hard working tax-paying citizens go without!

    Do you two really think this land was the first land ever to be taken from its original natives? Pick up a book and read some World History! For centuries upon centuries invaders have come, wars have been fought, victors have taken over.

    I raise my own children and clean my own house, and we do not hire illegal immigrants to work for our business. In a time of widespread unemployment, DO NOT try to tell any American citizen that we are better off for having non-citizens take our jobs and send our "monies" across the border! If you want a fair wage and fair treatment..become a citizen and stop mooching off the rest of us!!!

    Report Abuse
  • Angela's Avatar
    Posted by Angela Tue Sep 15, 2009 8:16pm PDT

    I'm glad that others responded to Lori L.'s comments. Attempting to argue against health care for all because those who are suddenly able to afford health care for the first time might create an inconvenience to those of us who have had health is unacceptable.

    Here in PA, practices regularly close their doors to new patients. Two of the doctors I see are not accepting new patients, and one of them would not even see my husband because he would have been a new patient. The docs I work for have considered closing their doors to new patients, but have decided not to do so. Instead, we have 4 new patient slots available per week, and are scheduling our regular patients at the beginning of December. We used to have 2 new patient slots per day, but we can't handle taking that new patients.

    Before any schools start broadening any of their programs, they're going to have to see that there's a reason to do so. At this time, no health care reform has been passed. Broadening existing programs would be premature. Schools are also going to have show that they enough QUALIFIED candidates. Then they're going to have to be able to meet funding needs. Schools just went through major budget cuts, just like every other industry.

    Report Abuse
  • Angela's Avatar
    Posted by Angela Tue Sep 15, 2009 8:19pm PDT

    HotCrossBuns,

    I was so happy to read your post. You and your family are EXACTLY the kind of people who deserve health care, and are exactly the kind of people that national health care is designed to help. Your family is just one example of millions of Americans who work hard, contribute to our nation, and are yet failed by it. That's unacceptable, and it can't be allowed to continue.

    Thanks for sharing your story.

    Report Abuse
Comments 1-10 of 12

leave your comment

You must sign in to post a comment

Sign In for personalized information

New User? Sign Up

Updates Chatter on Shine…

parenting byte

When entrusting your child's health to a pediatrician, you are bound to have concerns about whether you are picking the right practice or doctor. Here are five questions to ask when choosing a pediatrician.