Monday, March 22, 2010

Health care reform, part three


As many of you know, I am the product of two very Republican families. So Republican, that FDR was a dirty word to use in my house. I ran around yelling, "Nixon, Nixon he's our man. Kennedy belongs in the garbage can!" during the 1960 election when I was, perhaps, in 2d grade. I remember muffled cheers breaking out from some of my classmates when Mrs. Stratton told our hushed 6th grade class that President Kennedy had been shot. Later, our principal, Mrs. Barto, came into class and announced that he had died and we were released early.
My father, a pediatrician, was incredibly opposed to health care reform all his life. It was socialized medicine and to be avoided at all costs. Now the two doctors in my family, my brother and my daughter (who is in her 3d year of medical school) favor health care reform. How times change.
I am also a supporter of health care reform. I know too many people who do not or cannot get insurance and who eke out lives filled with pain and fear, and little hope. I am not an unqualified supporter of the bill that passed last night, but it is my sincere belief that the status quo could not remain without causing our country grievous harm. More than forty million people without health care. My daughter told me of one patient she saw in the emergency room recently, a young man who had taken a sabbatical from work to follow a dream of photojournalism. He came down with Type 1 diabetes a month into his vacation and as he had let his health care lapse, he was unable to resume insurance coverage at all. Hopefully, passage of the Health Care Reform Act will change that situation.
In that optimistic note, here are 18 immediate effects of the new law for your information:
The Top 18 Immediate Effects of the Health Care Bill:

1. Health Insurers cannot deny children health insurance because of pre-existing conditions. A ban on the discrimination in adults will take effect in 2014.
2. Businesses with fewer than 50 employees will get tax credits covering up to 50% of employee premiums.
3. Seniors will get a rebate to fill the so-called "donut hole" in Medicare drug coverage, which severely limits prescription medication coverage expenditures over $2,700. As of next year, 50 percent of the donut hole will be filled.
4. The cut-off age for young adults to continue to be covered by their parents' health insurance rises to the age 27.
5. Lifetime caps on the amount of insurance an individual can have will be banned. Annual caps will be limited, and banned in 2014.
6. A temporary high-risk pool will be set up to cover adults with pre-existing conditions. Health care exchanges will eliminate the program in 2014.
7. New plans must cover checkups and other preventative care without co-pays. All plans will be affected by 2018
8. Insurance companies can no longer cut someone when he or she gets sick.
9. Insurers must now reveal how much money is spent on overhead.
10. Any new plan must now implement an appeals process for coverage determinations and claims.
11. This tax will impose a ten percent tax on indoor tanning services. This tax, which replaced the proposed tax on cosmetic surgery, would be effective for services on or after July 1, 2010.
12. New screening procedures will be implemented to help eliminate health insurance fraud and waste.
13. Medicare payment protections will be extended to small rural hospitals and other health care facilities that have a small number of Medicare patients.
14. Non-profit Blue Cross organizations will be required to maintain a medical loss ratio -- money spent on procedures over money incoming -- of 85 percent or higher to take advantage of IRS tax benefits.
15. Chain restaurants will be required to provide a "nutrient content disclosure statement" alongside their items. Expect to see calories listed both on in-store and drive-through menus of fast-food restaurants sometime soon.
16. The bill establishes a temporary program for companies that provide early retiree health benefits for those ages 55‐64 in order to help reduce the often-expensive cost of that coverage.
17. The Secretary of Health and Human Services will set up a new Web site to make it easy for Americans in any state to seek out affordable health insurance options The site will also include helpful information for small businesses.
18. A two‐year temporary credit (up to a maximum of $1 billion) is in the bill to encourage investment in new therapies for the prevention and treatment of diseases.
Let us hope for a better tomorrow for all of us.

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