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Obama's Health Insurance Reforms Herald Major Middle-Class Relief

By August 3, 2009

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The unheralded gem of President Obama's health care reform agenda is his eight-point Health Insurance Consumer Protections plan which he unveiled at a July 29, 2009 townhall in North Carolina.

Obama's aggressive plans to reform health insurance coverage will revolutionize American lives and greatly relieve American families by putting a stop to the most egregious practices actively used by private insurers to exclude people from health coverage, and to avoid paying for health care services used by people who have paid their premiums.

These needed reforms will most help middle-class families with employer-based health insurance such as that provided by United Healthcare, Wellpoint, Kaiser and the like by entirely ending pre-existing medical conditions, capping out-of-pocket expenses, and much more.

For a listing of Obama's eight-point reform agenda, seePresident Obama's Health Insurance Reform Plan.

I know. I personally experienced the urgency of these overdue reforms when my husband, who was diagnosed in 1998 as diabetic, had kidney stone surgery two years ago. Despite careful vetting and budgeting for our out-of-pockets for his surgery, we were stunned to receive thousands of dollars in surprise doctor and hospital charges that our supposedly top-quality health insurance refused to pay.

Like millions of Americans, we had no idea we were underinsured, and being shortshrifted by our employer-based insurer, until we actually needed to use the health insurance we had been paying for over many years.

And for preventive health measures routine for diabetics, our insurer keeps raising and raising our co-payments for services, all while requiring more and more doctor visits. Yet, for all that, my husband's health has not measurably improved.

President Obama's Health Insurance Reform Plan treads a long way toward reforming the unfair, unproductive, and abusive practices of private insurers.

The burning question is: will WE allow the health insurance industry lobby to squelch meaningful insurance coverage reform, via fat contributions to Congressional Republicans, Blue Dog Democrats and so-called "centrist" Democratic senators?

I say NO! We need to fight for health insurance like our lives depend on this... because they do. I'm with you on this one, Mr. President.

(Photo taken on July 29, 2009 at a healthcare townhall in Raleigh, North Carolina: Sara D. Davis/Getty Images)


August 4, 2009 at 3:29 am
(1) hsr0601 says:

A pay for outcome / value payment system, key to the deficit-neutral, might be capable of bringing all groups together.

Supporters of the agreement say it could save the Medicare System more than $100 billion a year and ‘improve’ care, that means more than $1trillian over a decade, and virtually needs no other resources including tax on the wealthiest. (Please visit http://www.kare11.com/news/news_article.aspx?storyid=820455&catid=391 for detailed infos).

As much as 30 percent of all health-care spending in the U.S. -some $700 billion a year- may be wasted on tests and treatments that do not improve the health of the recipients, Thus the remaining $239 billions over a decade do not matter. Supposedly even the conservative number of such savings might be able to meet the goal.

Dr. Armadio at Mayo clinic says, “If we got rid of that stuff, we save a third of all that we spend and that is 2.5 trillion dollars on health care. A third of that and that is 700 billion dollars a year. That covers a lot of uninsured people.”

Apparently, just in case of the difference between the estimate and result, or the worst case of scenarios, Obama officials may have made a statement taxes may rise to pay health care. The perfect can not be an enemy of the good,
This appeal occurs to me.

August 4, 2009 at 10:29 am
(2) Gail Ganong says:

When I retired at age 62 from Blue Cross Blue Shield of Arizona I continued coverage under Cobra for 18 months ( at $720.00 a month premium), When that ran out, I tried to get an individual product form them. I was flat out denied because a I had a diagnosis of High Blood Pressure (under control with medication right after I retired from my high stress job there) and high cholesterol ( they only looked at the total which was 215 at the time while all other values were normal). They would have covered me only if I would have accepted a premium of $1240.00 a month. This is how they treat people!

August 5, 2009 at 1:11 am
(3) hsr0601 says:

The ‘innovative’ idea of a ‘pay for value / outcome’ pack came after the CBO had previously pointed out this health care reform wouldn’t work without ‘fundamental’ change in the out of date system. It is said that as much as 30 percent of all health-care spending in the U.S. -some $700 billion a year- may be wasted on tests and treatments that do not improve the health of the recipients, and this 700 billion dollars a year can cover a lot of uninsured people.

The expected Benefits of this ‘innovative idea’ are as follows ;

1. Meet the objective of revenue-neutral.
Supporters of the agreement say it could save the Medicare System more than $100 billion a year and ‘improve’
care, that means more than $1trillian over next decade, and virtually needs no other resources including tax on the
wealthiest. Supposedly even the ‘conservative’ number of such savings might be able to meet the objective of

2. Quality and affordability.
If you are a physician, and your pay is dependant upon your patient’s outcome, you will most likely strive to
prescribe the best medicine earlier in the process, let alone skipping the wasteful, unnecessary treatments.

3. No intervention in decision-making.
The innovative idea of ‘a pay for outcome’ will more likely prompt team approach and decision, as at Myo clinic.
Under the ‘pay for outcome’ pack, for good reason, best practices as ‘recommendations’ would simply help them
make a better decision, and the government won’t still have to meddle in the final, actual decision-making
process as a non-expert.

4. Speed up the introduction of IT SYSTEM.
The pay for ‘Outcome’ pack is most likely to expedite the introduction of Health Care IT SYSTEM.
The synergy effect of the combined Health Care IT & a pay for ‘outcome’ system may allow the clinicians to
‘correctly’ diagnose and effectively treat a patient earlier in the process so that it can measurably scale back the
crushing lawsuits and deter the excuse for unnecessary cares to make fortunes.

5. Accelerate the progress in medical science, in return, it saves more cash.

6. Settle the regional disparity.

7. Reduce the emergency room visits & save immense costs.
Public health insurance plans such as Medicare and Medicaid paid for more than 40 percent of U.S. emergency
room visits in 2006, according to government figures released recently. Many experts say reducing these hospital
visits would be an important way to lower the enormous, and growing, expense of U.S. health care.

Thank You !

August 5, 2009 at 4:43 am
(4) hsr0601 says:

-Some say we don’t have faith in government, others say, we will be forced out.-
What kind of music does this reform dance to ?

I share the opinion that unlike the insurer-friendly, baseless senate plan by ‘some’ members, only a ‘strong’ public option will be capable of getting the premium inflation under control and saving the U.S in turbulence.
To my knowledge, a dual system tends to deliver better results than a pure single payer system. Supposedly, to be or not to be might be up to the innovations like a pay for value program, otherwise, the forthcoming start-ups may fill the void with competitive deals. The competition based on ‘fair’ market value would be a beauty of true capitalism, not monopoly, an objective for anti-trust.

August 7, 2009 at 5:59 am
(5) HSR0601 says:

According to the scoring of CBO on the prevention & wellness program, all fitness centers around the world should close down immediately and all media have to end reporting health tips about prevention.

Immune System & Levee System :

All of the excellent health systems seem to have one thing in common, a expansive, systematic preventative program requiring immense investments. I think a prevention system works as a ‘levee’ built against flood by the government, similarly, it also needs non-profit investments from the government ‘on a large scale’.

This might offer us the clue of why all of the free states have public insurance policy in place.

It won’t be easy to draw some specific numbers on the economic effect of the ‘levee’ , but the flood measure lacking a stable ‘levee’ would be a house on sand, as the too high level of ‘preventable’ chronic diseases in America shows.

At present, about 75 percent of each health dollar goes to treating chronic conditions.
When tests reveal patients are at risk of a chronic disease, physicians have no benefit to help them make necessary changes to stay healthy. Rather, the system today is designed around treating patients once they become sick.

If current health care system could shift a small percentage of total spending into programs that help prevent people from getting sick in the first place, it would dramatically reduce the overall cost of care.

Thankfully, the health care reform bill currently before Congress makes several key investments in preventive care, and those pieces of the PUBLIC OPTION must be maintained.

“An ounce of prevention is worth a pound of cure.”, said Benjamin Franklin , and ‘Early Detection’ goes beyond monetary value as we see the recent case.

As far as I’m concerned, the congress affected by the special interests has impeded the budget request for prevention program in Medicare & Medicaid. Let’s imagine the costs and invaluable lives following the levee breach.

Thank You !

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