Health News: Basics of Healthcare Reform

18 Aug

Health care reform for dummies

Walter Gaines Jr., left, who supports health care reform, confronts a man who opposes health care reform in Alhambra, Calif. (AP Photo/Jae C. Hong)

 

Dr Tyeese Gaines ReidTheGrio.com.

 

With the bombardment of speeches, commentaries and rowdy town forums, many Americans are struggling to decipher the current state of health care reform. Understanding the ins and outs of over 1,600 pages of proposed law is daunting. Unfortunately, there is no politician or any crystal ball that can predict either plan’s success at this stage.

To date, two bills have been proposed – the 1,017-page House bill (H.R. 3200) and the 615-page Senate Health Committee bill. A third bipartisan bill is said to be in the works from the Senate Finance Committee. Until September, when Congress reconvenes, we will continue to wait and debate on the limited information we do have.

Here is a summary of those bills, commonly-raised concerns and the debate as it now stands.

1) Problem: The Uninsured
Millions are uninsured and falling ill without insurance can be financially catastrophic. Many of these are working people, or recently unemployed, who can’t afford to buy insurance plans. Others are self-employed or small business owners who also can’t afford insurance. Some are between the ages of 55 (retirement age) and 65 (Medicare-eligible age), and thus have no coverage. In 2008, the Kaiser Commission reported that 41 million were uninsured, while another 35.8 million people had no insurance during part of the year.

Proposed Solution: "Health care for all." Both bills have outlined strategies to include all Americans in some form of a health insurance plan – whether Medicaid, Medicare, the private or the public/community option.

2) Problem: Pre-existing conditions
People with any history of medical problems ("pre-existing conditions") can be denied coverage by certain insurance plans because their condition makes them too high-risk.

Proposed Solution: Ban the pre-existing condition clause for all health insurance companies, including those in the private option. The hope is that as more young and healthy Americans have insurance and pay their premiums, that money will offset the costs of taking care of the sicker Americans.

3) Problem: The under insured
Some people with health insurance have plans that don’t cover all basic health care needs (the "under-insured").

Proposed Solution: All health insurance plans will cover hospitalizations, outpatient hospital and clinic care, physician fees, equipment, prescription drugs, rehabilitation, maternity care, child care, preventive care, mental health, and marriage and family therapy. The addition of coverage for mental health and counseling is an added benefit not often covered currently.

 

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