We don't NEED to PASS the Senate Bill to get Communtiy Health Centers.

[bvar22]

We already have them.
They are already perfectly legal,
and already exist.

Here.
Find the nearest Federally Funded Community Health Center:
http://www.findahealthcenter.hrsa.gov/

Those who were paying attention will remember that "Community Health Centers" was the first Republican Argument against the need for a Public Option in early 2009.

This is a particularly nasty piece of Machiavellian Marketing...
Put something we ALREADY HAVE in the bill to make it seem more palatable!

WE do NOT need to give the Health Insurance Industry a Trillion Dollars to get CHCs.
We do NOT need to MANDATE that every American BUY For Profit Health Insurance to get CHCs.
We do NOT need to de-fund Medicare by -$500Billion Dollars to get CHCs.
We do NOT need a massive transfer of Public Money to Private Pockets to get CHCs.

We do NOT need to give the Health Insurance Industry ANYTHING to get CHCs.
We certainly don't Need to PASS the Senate Bill to get Community Health Centers.

It would take very simple legislation that would be very popular with America to expand the already existing network of Community Health Centers.

CRCs are NOT a good argument for supporting the Senate Health Bill (new and improved with Obama's picture on the label).
In fact, it is NO argument AT ALL.
We ALREADY have them!

[uponit7771]

1. FUCK FACTS!!! /sarcasm

[Ozymanithrax]

2. So you prefer the system we have now. Many of us do not, including Rachel Maddow.

Pass the Senate Bill.

Send it to the President for his signature.

Pass the fixes promised.

It is progressive to enact law that improve peoples live.

It is regressive to refuse to make changes.

[Political Heretic]

3. It's not progressive to pass a bill that does more long term harm than good.

[Ozymanithrax]

6. Expanding Medicare to cover millions more of the poor will hurt.

Ending pre-existing conditions will hurt.
Stopping insurance companies form ending coverage because people are sick will hurt.
Doing something to help the 45,000 people who die every year simply because they have no health care will hurt.

But that hurt is to these Insurance companies.

This is the most progressive health care bill since Medicare and Medicaid was enacted. It will help millions. Sometimes the good of the many outweigh the good of the few. All progressives should look forward to paying mandates, well except the poor. More of the poor than ever will be covered by free Medicaid and will be expempt from paying the mandate.

Health Insurance Companies have spent 300 million dollars to stop this bill. Are you saying they spent that money as a sort of reverse psychology?

[girl gone mad]

11. This bill will not end pre-existing condition exclusions.

I think it's crazy how many people push this talking point. It's completely hollow.

[subterranean]

18. What is your basis for that assertion?

I'm curious, because from what I've read in the bill, ins. companies will no longer be able to exclude people on the basis of pre-existing conditions.

[Hello_Kitty]

20. It allows for recission for "fraud or misrepresentation", with no specific definition

- beyond that verbiage. That's a loophole you can drive a truck through and you can bet that insurers will exploit it to the hilt.

[Political Heretic]

29. Yup. And many, including the largest nurses union in the nation has been screaming "foul"

about this, and no one cares - the OMG pass health care so I can feel better about things bandwagon is too great.

[subterranean]

35. I know about that one, and am concerned about it.

Although they won't be able to refuse coverage for pre-existing conditions or charge more for them, that loophole will allow them to rescind your policy if you use your insurance too much -- exactly as they do now. I can think of no other reason why this clause was put into the bill.

On the other hand, unlike the current situation, you would be able to purchase a different insurance policy.

[stillwaiting]

40. Rescission occurs now when insurance companies claim "fraud" so they will just continue doing so.

The exact same way they are now. Literally nothing in the legislation that I've seen will prevent what currently happens with rescission.

They say it's "fraud" when someone forgets to mention they had acne treatments on their ridiculously long applications (an example from one high profile case) and then gets breast cancer. Their investigative claims departments are literally getting away with allowing more Americans to die yearly than "terrorists" have killed.

They should be FORCED to underwrite their applicants at the time of application like car insurance companies and then be required to honor the contract they entered into with their paying customers.

It's such a scam that it infuriates me.

Oh, and the pre-existing escape clause in the senate legislation works out pretty damn well for the insurance companies too.

I just can't believe how many are supporting this corporate giveaway. It's very disheartening.

I guess it will take another few decades of continued corporate abuse before we'll get the collective willpower to forcefully DEMAND truly universal health care.

[girl gone mad]

25. Basic logic.

If insurance companies were genuinely forbidden from excluding those with PEC, then too many people would simply choose to pay the fines until they were diagnosed with something serious, thereby saving tens of thousands of dollars and costing the insurers big profits. The lobbyists and the bought and paid for politicians aren't about to let something like that happen. Insurers already have all the loopholes they need to essentially preserve the status quo on PEC.

[subterranean]

37. If that happens, they'll simply increase the fine.

I don't believe the insurance companies will be able to explicitly deny coverage to people with pre-existing conditions, although I expect they will find indirect methods of avoiding them.

My biggest problem with the bill is that for-profit health insurance is fundamentally incompatible with the idea of universal health care. The primary purpose of a for-profit insurance company is to deliver steadily rising returns to investors -- not to deliver access to affordable health care -- and the reform bill will not change that fact.

[subterranean]

13. Expanding Medicaid could also be done without the Senate bill.

[Political Heretic]

31. This is why our country is a mess. Because ordinary people are to ignorant about public policy

to even know what bills will and won't do.

I guess we get what we deserve, in the end.

[RaleighNCDUer]

32. Actually, they've spent 300 million to keep a public option OUT of

this so-called reform bill. A public option or medicare-for-all would be REAL reform; the rest is just cosmetic and easily circumvented with a good lawyer - and they have some of the best. Their real push is against a public option which would undercut their privatizing of the system - the more pressure they keep on the bill as a whole, the less chance that a PO will be re-introduced.

You see, EVERYTHING that remains after the PO is out of the bill is in THEIR hands - their lawyers can tweak it, they set the standards, they are in control. A PO is something that is real competition, which they cannot face, and is OUTSIDE their control - it is a government agency that is in control, and if it is well run it will drive down costs which will hurt the private insurers' bottom line, because their profits DEPEND on ever increasing costs.

If this bill passes as is, they will not be unhappy. Not in the least. Their push is against any changes, any improvements.

[bvar22]

43. Health Insurance Corporations have spent $300Million Dollars...

..to ENSURE that THEY get an Individual Mandate with NO Public Option or NO Medicare Buy In.

The spent 300 million dollars to buy an "exchange" where they will get to form a Consortium and co-operatively shear 45 Million MANDATED sheep of all their wool with NO FEAR of actual competition from a REAL Public Option.

They have spent 300 million dollars to make sure that THEY get to write the "regulations" that they will be able to easily evade, duck, end run, or simply NOT comply and force through the courts for YEARS with their army of lawyers they keep on staff (just like they do now).

They spent their money well.

[bvar22]

5. NO.

Break out these "good" pieces and present them as simple, easy to understand stand alone bills.
Force them to The Floor for Up or Down Roll Call votes.
Let the Republicans oppose these individual reforms that are very popular with the American People.

Instead of "The Republicans oppose the government take over of Health Care",
the Republicans would be forced into a position of "The Republicans support Health Insurance Corps dumping sick people."

We do NOT have to accept the HORRIBLE to achieve some moderately good crumbs.
We do NOT have to bend over to EXTORTION from the Health Insurance Industry and their bought politicians.

[tridim]

8. You're being extorted by the Insurance industry right now.

They want to continue extorting you and don't want to be regulated, which is why they are spending millions to defeat the bill.

Why are you yelling?

[RaleighNCDUer]

10. So the way to deal with extortion is to give them billions MORE?

How does that work?

[tridim]

21. Look up "regulation" in the dictionary.

There is NO regulation now.

[Hello_Kitty]

23. Look up "campaign contributions" and "lobbyists".

The bill leaves regulation in the hands of state agencies, many of which are weak and compromised.

[tridim]

24. And the national HHS office.

[Hello_Kitty]

33. That has only been proposed. eom

[eridani]

41. There won't be any after "reform" either n/t

[Laelth]

4. Hear, hear! This is important. k&r n/t

:dem:

-Laelth

[Ms. Toad]

7. CHCs are certainly good - BUT they are not adequate

to provide for much beyond basic wellness care. My 19 y/o daughter has two chronic illnesses which require regular management by specialists. The local CHC provides primary care and assistance in locating a specialist - but makes no suggestion that they would actually cover the $60,000 a year her regular monitoring and prescription coverage costs - as long as nothing bad happens - if something bad happens, it costs more. Nor can she as a struggling college student afford it and no insurance company will pick her up because they don't have to.

If we can't have health care reform, we AT LEAST need stop-gap insurance reform. CHCs only cut it for those with the means to get to them (the closest to us is 5 miles away with no public transportation available; the closest to my daughter is 12 miles away - again with no public transportation available), who have fairly routine health care needs.

Unfortunately, it is not just our daughter who is medically unlucky - I am home recovering from fairly expensive surgery, and my spouse appears be heading for a long slowly declining illness that will ultimately require nursing home care - or expensive surgery - we're just beginning the diagnostic process. Our family is fortunate enough to have insurance (which will not cover our daughter much longer - particularly if her illness continues to make it challenging to impossible to either work or stay in school). I guess if we weren't lucky enough to have insurance we (and others in our situation) deserve to just to curl up and die just to prove a point that if congress can't agree on a perfect bill - progressives are duty bound to fight against anything less than perfect. :sarcasm:

Edited to add: Sorry - but at this point, with what we are facing - and with the similar situations I know others are facing - I have very little patience for those who would throw away a bill that will help a significant number of people with pre-existing conditions who currently shut out from access to health care AT LEAST have access to insurance that costs in the range of $8000 a year rather than $15,000 (at age 19) merely because the bill isn't everything we hoped it might be.

[Cleita]

17. Also, on the job as a medical assistant, I hear a lot of complaints about our

local community health centers, the long waits and never seeing the same doctor twice.

[Ms. Toad]

28. And continuity of care is critical for

the treatment of many chronic illnesses. Subtle differences that might be noticed by a physician who has seen the patient numerous times may well be missed until they become so gross they require much more significant intervention when the patient is seen by a different doctor each time.

[RaleighNCDUer]

19. do you really think that this bill will provide insurance that will keep

your daughter's costs at $8k/yr? When these private insurers MUST cover everyone they will raise the rates (and it will all be very reasonably explained to congress as to why) and you will STILL be paying $15000 minimum.

The private insurers are NOT going to cut their profits, nor are they going to accept a loss - therefore the only way they can offer the insurance is to raise rates, which WILL go through the roof. And if you really think they will dedicate 80% of premiums costs to actual healthcare - as the bill says they will - then I've got a nice bit of property in Okefenokee I'd like to sell you. They will have the best paid lawyers not on Wall Street parsing the bill for every way to take the money and give nothing back.

And will will be giving them BILLIONS of dollars to pay for those lawyers.

Meanwhile, the supremes have made it possible for these companies to put and/or keep their bought and paid for politicians in congress to keep anyone from 'fixing' the glaring flaws in this bill.

The bottom line is that this bill will help virtually nobody but the insurance industry. I can understand your hoping otherwise, but you need to look at the facts, not the hope.

[Hello_Kitty]

22. Supporting this HCR requires a level of trust in the insurance industry that is utterly unfounded.

Unbelievable how willing people are to hand a rapacious and parasitic industry billions in public dollars and force people to buy their products, while trusting them to act in good faith and in the government officials they've bought off for decades to regulate them.

[upi402]

27. Dems should take a stand for single-payer or public option. or they'll lose

Teabaggers and Rethugs will oppose anything Dems do, so forget 'em already.

Polls show a majority want single payer -medicare style- Health Care Reform. Not this middle of the road hand-out to more corrupt and corrupting corporations. And our "leaders" sit on their soft hands while composing apologies.

[Ms. Toad]

26. The average cost of medical care is around $5000 a year.

The bills require all to participate (which means that for many they will be collecting premiums and paying out very little), and places a cap on profits. So yes, at least to start, the cost for insurance will be around $8000 a year. There have been numerous sites set up to calculate premium costs based on age, income, etc. - and it is very likely that she will qualify for a full subsidy because at this point she is not capable of working anything close to full time hours.

I have looked at the facts, and read the bills. You need to do more research, and stop insisting that because this bill isn't everything you hoped it would be that nothing should be done. The last significant change in health care was made in the late 90s, and guaranteed that if you already had insurance and could afford whatever outrageous rates the insurance companies wanted to charge, you could keep your insurance. This bill goes well beyond that - and I'd rather live with well beyond what we have now, even if it is far short of perfect.

[RaleighNCDUer]

36. Please see post #22 above.

Do you REALLY believe that the industry which has made BILLIONS off denying life-saving care to insured clients will accept a cap on profits? What in their history gives you any confidence that they will not take these new billions and use that money to buy their way out of any real regulation? If they can't buy a politician, they will simply replace him with one they can buy.

That last reform is costing people their entire life's savings as unemployed people are trying to come up with $2k/mo to come up with Cobra (very aptly named for a deadly viper) payments. If I lost my job today, I'd last two months. Despite the housing collapse, the primary cause of foreclosures is STILL medical costs.

At a time when salaries are stagnant, when unemployment is approaching 20% (in the real world, that is) the industry you are putting your faith in increased its profits by nearly 50% last year - and you KNOW that any so-called caps will be based on these inflated numbers, guaranteeing their continued profits until their lawyers find their way around the caps.

I really wish that you were right - but there is NO reason to believe it. There are no controls that the industry does not itself control. And what always happens when you put regulation in the hands of those being regulated?

[Ms. Toad]

38. There are controls in the bill.

As for the last reform - anyone with a brain knew the last one (HIPAA) and the one before it (COBRA) were going to do nothing real for anyone who did not have access to money. The bills themselves were very clear. There were no limits on insurance companies - they had to make coverage available; they could charge whatever they wanted for that coverage. Although I knew that at the the time they were passed, I was selfishly glad because I happen to be a stingy old broad who has been lucky with employment and has been saving since I opened my first savings account in the 50s. I live in an almost-paid-off house that is worth less than I make in a year - by choice. It might break my personal bank - but HIPAA (and to a lesser extend COBRA) meant I would never be without coverage. But that was personally selfish - I was glad both of them passed - but neither were significant that I would have fought very hard if people wanted to tank them because they weren't single payer, or didn't include a public option. They benefited a few people - including me (I've been on COBRA, had the pre-existing condition waiting period waived because of HIPAA, and my spouse has converted a group policy to an individual one under HIPAA), but those advances were a drop in the bucket- and not worth fighting for.

These reforms are different.

Although this bill will also personally benefit my family - specifically my daughter - unlike COBRA and HIPAA, there are controls that will make the insurance provided by it within the reach of lots more people than any previous reform - and I have been watching health care reform since the 1970s. I am under no illusion that what is currently on the table is health care reform, or that the insurance will cover everyone. The bills will make coverage available to most middle/upper middle class people with pre-existing conditions who are currently shut out of the market unless they are lucky enough to have access to insurance through their employer. It will make subsidized (or free) coverage available to people with almost no means. The people left out in the cold will be the ones at the upper end of the subsidy scale - those who make too much money for a subsidy that makes insurance truly affordable.

Profits are capped - requiring that at least 85% of what is taken in as premiums be spent for care in the house bill. In the senate bill and Obama's version the structure is different - it is a look-back approach requiring rebates be paid to consumers when less than 80 or 85% (depending on the plan) of the premiums taken in is paid out for care. There were no such limits in the COBRA bill, and there were no such limits in the HIPAA bill. It is disingenuous to compare the two with respect to that feature. Spend some time with this chart: http://www.kff.org/healthreform/upload/housesenatebill_final.pdf then go back to the bills and verify that what the chart says is in the bills (and the proposal) are really there (I've checked the things that are important to me (including price limits), but you seem skeptical, so knock yourself out)

Is it what I would have planned if I had a blank slate and were granted dictatorial powers? Absolutely not. Is it better than what we have now? There is absolutely no question it is better than what we have now - and I am not about to toss out the merely good because it isn't perfect.

[RaleighNCDUer]

39. As you said, I'm skeptical. And I would be more than happy if proved wrong,

if this bill passes. I do not believe I will be.

I do believe that if this passes and there are even the most marginal improvements, that there will be no more reform for a generation - there will be no 'fixes' to this bill. There will be no significant medicare expansion, and certainly no introduction of a public option or (gawd forbid) single payer - the insurance industry cartel will set the tune and congress will dance to it.

The industry would not write limits into a bill that they cannot circumvent. It is as simple as that. This bill lost me when it lost the public option.

[bvar22]

42. Profits ARE capped at a certain percentage of premiums

but Premiums are NOT.
If you want to INCREASE Profits,
simply increase Premiums.

The Health Insurance Industry WROTE the Regulations.
They know every loophole, trapdoor, end around, and intentionally vague piece of language in them.

You know the ARMY of Lobbyists and Lawyers that have descended on DC to kill the Public Option and embed the Individual Mandate as the foundation of HCR?
They are on retainer.
Once they have successfully gotten Everything they WANT from this "Reform" Bill,
they WILL go directly to work circumventing ANY "regulation" that gets in their way.
They won't declare victory and leave.
They won't take a day off.
They won't stop.
They are like terminators.
Unless WE shove a Medicare Expansion down THEIR throats,
they WILL pick every piece of meat off this carcass of a reform bill.

[bvar22]

30. Thats EXACTLY what the Democrats said....

...when it was the Republicans pushing CRCs in early 2009.

NOW, the Democratic Party Leadership and their Winged Monkeys have adopted the Republican Talking Points and selling CRCs as a reason the vote FOR the Senate Bill!

We do NOT need to Pass the Senate Bill to GET CRCs.
AS your testimony pointed out, we already have them.

We NEED much, MUCH more.

[Hello_Kitty]

9. Nor do we need to pass this steaming pile of shit to expand Medicaid.

Just frigging expand Medicaid and cover half the 31 million Americans supporters of the bill are forever banging on about. Extend Medicaid to people with preexisting conditions too.

[slipslidingaway]

14. Yes, another piece that can be passed separately. n/t

[slipslidingaway]

12. knr n/t

[Echo In Light]

15. k/r

[Cleita]

16. They get a lot of their patients from Medicaid recipients.

The senate bill will expand Medicaid availability to the uninsured and mostly they will end up in community health centers as most doctors don't want to accept Medicaid patients. Of course if we expanded Medicare to include everyone under 65 who wants to buy into it instead of private insurance, it would be worth while. However, this is why the insurers have made sure that a public option such as Medicare never gets into the bill.

[leftstreet]

34. We shouldn't have to hang around clinics with a bunch of poor people!

just in case:

:sarcasm: :sarcasm: :sarcasm: