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Health Care Reform

What do you think?
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Avatar universal
I just heard on the news, and maybe you did too, that one of the things the dems may have to agree to in order for the rep to be on board is to put caps on spending in a year, I think is what they said. No lifetime caps but they said they have to be reasonable caps. Well, I guess that would work for a toenail fungus but not too sure how it would work if ya get cancer? It makes me sick how these politicians are in the back pockets of the insurance companies. Just makes me sick! Of course I have learned not to believe what you hear because in 5 minutes there will be a different spin put on it. You simply cannot believe the news anymore cause it is not news but simply someones opinion. Grrrh!
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585414 tn?1288941302
I have managed to try to read through the health care reform bill in the past few months but that many pages is hard to digest. I do know that if it doesn't provide options for people but requires them that would not be right. Also the focus should be on affordable health care coverage not insurance. A good health care plan would have a variety of coverage options and the ability for people who have their own insurance not to participate if they don't want to. I have seen some articles on states that have workable health care coverage systems and this is how it is generally done.
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Avatar universal
http://waysandmeans.house.gov/media/pdf/111/AAHCA09001xml.pdf

This is the site I got the info from

That they would even put those things in for consideration in a Free Nation, is pass belief. I hope we do get to read what changes are going on before it gets passed. I hope they have scratched what they have and started over, because all the way through it in what I read is to cut cost by controling what care we do get, and they decide how necessary it is. There is certainly other means to stop abuse of the system. We should not have to pay the price at the expense of tax increase, loss of Rights, and loss of quality care. Hospitals are speaking out against it. I also hope that they all read everything in it before they vote. The kinds of things that have been purposed is why there is such an uproar. It is said over and over, it is going to change our Country, by those that are working on it, and it is too much government control. It should never have been up for dicussion, just trashed. Hopefully, our Representatives are going to stand firm on Protecting all of us from such control.  
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306455 tn?1288862071
Teko, I have to agree with you on everything you've said. I've gotten very lost on what is happening with this bill, as it seems to change daily. I'll wait to make judgement when it's finalized. At that point though, it'll be very altered and washed down. I would definitely want to see health care for all Legal Americans, some how-some way. But that's not likely. There is so much fraud in the welfare system that needs to be tightened. I've known a lot of people that get welfare/medicaid and work off the books or single moms who have BF living there with a full paycheck.And they just have another baby if they want more money! A lot of waste in Medicare. My mom is 82,on medicare and has lots of health problems. But her many doctors send her for tests and appointments that are absolutly not needed. Medicare pays for special shoes to be made for her a couple of times a year, at over 300.00 a whack. SHE DOESN"T EVEN WALK!!!! But the doctors push her for all this stuff!!?? They could save a bundle on just my mother. And my Mom says "but my doctors say I have to do this".
The illegals in this country is a sore spot with me.  I don't understand why any President hasn't addressed this situation with a strong hand. They are costing this country a fortune in so many ways.
Back to the HCR subject. I really think when everything is finalized, there will be very little change and insurance premiums will continue to spiral out of control. I don't think the government will put in place anything that will cause competition in the insurance industry and if they're forced to accept pre-existing conditions the premiums will go thru the roof. I think the end result of this bill, will be so washed out, it will not be worth the effort put into it. We'll see.
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Avatar universal
I have not nor will not read the proposed plan until they have something difinative. Right now as it stands it is still a work in progress. I do find it curious tho that hospitals are refusing to see policyholders from blue cross and blue shield. These policyholders that have paid all the big bucks for health care are no better than someone who does not have insurance. Just one of the many things needing addressed as well as the fact that someone who does not have insurance, and is seen in the local ER does not get the write off that a policyholder does. They pay full price or full price is written off, so they say. I have a sister who is on medicare and she has needed knee implants. Instead the doctor was told to do a series of steroid shots, then rehab, then surgery to repair first. Now 2 years later she is getting the knee replacement. So I do understand when they say there is major waste in medicare and,medicaid is open to any and all age groups based on income. Lots of waste there too.  Them people can afford to eat steak while I eat hamburger.  I have seen single mothers get welfare and live with a boyfriend who has a full time job. My point is there is lots of room for improvement in all arenas. It will be interesting to c what comes out of it all.
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Avatar universal
Teko, right now, everything is in an uproar because of the economy. It will get worse when all the insurance companies shut down, more unemployed.

I have read through a lot of the Bill. What they are proposing is very scary. They will have a Commissioner, that will have more authority than we could imagine.
His Report starts at the Date of the Act, not when Year 1 comes. It includes any recommendations to ENSURE that the law does NOT provide incentives for small & midsize businesses to self insure or create adverse selection.  page 22-23

Qualified health benefits shall meet a medical loss. Method to calculate medical loss shall be set at the highest ratio loss to ensure adequate participation by QHBP

Minimum Services to be covered:
Hospitalization; Out patient Hospital & Out patient Clinic Services including Emergency Dept. Services;Professional Services of Physicians & other Health Care professionals; Equipment, supplies for physicians, health care delivery of care in institutions, drs.offices, patients home or other setting; prescriptions; rehabilitive/habilitive services; Mental Health/Substance Use Disorder   page 27-28
year limitation individual-$5,000   family-$10,000
Co-payments-Secretary-to the max extent possible use co-payments not co-insurance
Benefits provided equivalent to 70% of actual value

Commissioner to handle means of billing and collection practices
Emplement taxes, taxes on unisured-IRS
Excise Tax (not meeting certain requirements

States have to apply to Commissioner for State Based Health Insurance

Commissioner Enforcement Authorities

Grandfather Health Insurance Coverage: Subject to provisions for purposes of establishing acceptale coverage-
Limitations on new enrollment-Issuer offering coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first da of Y1

There is also "Birthing Centers" for women, with a trained person, not a dr or affliated with a dr., (stopping hospital births, how many lives will be lost because of it)

This is just a part of what I saw and I didn't make it to the end. I do remember however that a dr that orders equipment or prescriptions in basically a situation that won't go away, has to have persmission, and if the dr helps by prescription or order no matter who pays for it, is punished.

I fear to know what the rest of it says. The Commissioner has power that should not be allowed to anyone. They will have control on drs education, hospitals surviving, there is no end. I can paste the gov. site if you like.
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Avatar universal
The hospital says they will not see patients for what the insurance is will ing to pay and the insurance refuses to pay the hospital more. Stalemate, did anyone see this one coming?
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Avatar universal
I just read in my local paper tonight. 2 major hospitals in the county will discontinue carrying Blue Cross and Blue Shield of Florida. The only way they will see these policyholders is if they pay the out of network fees. Otherwise 43 thousand people will have to go to another county for their healthcare. It seems the insurance company has had to lay off people and cut back due to the large volume of people on unemployment and no longer carrying health insurance. At the same time the hospital has had an increase in people with no insurance due to the econemy and have their own cutbacks they are dealing with.  

Now, to date we have the same healthcare, no one as yet has changed it. No public option (unless you consider those to be medicare and medicaid). Who loses? the policyholder does!  Now someone tell me again what wonderful healthcare we have in America! And dont blame it on Obama for a change. And explain to me how this can continue. Not blame, just solutions would be nice for a change?
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Avatar universal
Medicare or Medicaid automatically cover at a certain age. Sure there are always fakes of disablities that aren't. I can say, that going through this state, there can't be many. Looking at a person, one can't always tell if the person has a medical problem that is not visable. If they have arms and legs, can walk and talk, doesn't mean they don't have threatening diseases, or malfunctions. It took me 6 yrs to get disability through. I go to many drs and am on a lot of meds. I take pain medication constantly. People can't see my pain, when it is too bad, I am in bed. People on dialysis, look fully functional at lot of times. It is not always so easy to judge. You can't see cancer that a person deals with unless it causes a physical disability that you can see, or loss of hair from chemo, or in the latter stages.
Medicare and Medicaid is paid out of the person's income, just as insurance. I have looked at the % paid to drs that accept it, and it is very low. Mine does not pay out the amount I pay for the coverage.

They have so many restrictions on qualifications for those plans, and what they cover, it is controled as to what they spend and the care a person gets. Most people have to buy a supplement coverage, and then don't get all of what they need. My mother had acid reflux. Sounds simple. She could have had an operation to fix it. It was never offered. The dr gave her a prescription that would cost her $300 per month. How many elderly people do you think could afford it? She died of esophagel cancer from it. Why do you think AARP backs the Bill? They sell supplemental insurance. My mother had it. Didn't help her a bit. I'm surprised they didn't offer to "pull the plug" as they put it. Offering end of life options to the long term sick, and elderly, is a bad thing. How many people do you know that suffer from deep depressions from those things? We have been funding abortions for years. They were aborting up to 8 months. A reliable health care worker told me that back in the 70s.

Where do you think the illegal pregnant women go to have their babies? ER The child then is taken care of by state funds.

2,000 pages to change benefits. They decide if a person is worth living or "investing". We aren't really talking about helping get better care, we are talking about giving ownership of our bodies. Don't we have freedom of control of our own body? I have to do more reading in the Bill, because I think it starts affecting us sooner, on our care, and I know we loose private insurance from simple things. Yes we do conflict on this Bill, but have we ever known anything the government does that does good for us, that doesn't end up bad for us? Besides, I like owning my own body.

Ask someone that has experienced government health care in other countries what it is, that have come here. It is not like our government to make promises and fool us in the past.

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306455 tn?1288862071
Here's some good Ques.& Ans. about the Health Care Reform Bill, if anyone is interested..........
A universal health care system has many benefits. One benefit is that doctors and providers can turn their concentration to helping patients instead of insurer demands and liability insurance for malpractice. This can increase the efficiency of doctors, who do not have to worry about restrictions as a result of insurance company policies. Other benefits include not having individuals opt out of treatments or medical tests because of the high costs that are involved.
If Congress makes history and puts a bill on President Barack Obama's desk by Christmas, how long before the uninsured get medical coverage?
If you said three years or more, you'd be right. Yet many people don't realize that to keep costs down, lawmakers made compromises that might not appeal to consumers.
"There's going to be a long period of great expectations and very modest deliveries," said economist Robert Reischauer, president of the Urban Institute public policy center. That's assuming Democrats prevail.
Some questions and answers on the House-passed bill and the version the Senate will begin debating in the week ahead; both measures were written by Democrats:
Q: How many people would be covered?
A: The Senate bill would cover 94 percent of eligible Americans under age 65; under the House bill, it's 96 percent.
That's a major improvement over the 83 percent now covered, but the safety net would have holes.
Some 16 million eligible people would remain uninsured under the Senate bill and 12 million under the House bill, according to the Congressional Budget Office. That's not counting illegal immigrants, who would not be eligible for government assistance under either bill.
Both bills would eventually require Americans to get health insurance, or face fines.
Q: Why don't lawmakers just provide coverage for everyone?
A: Part of the reason is it would cost more, at least $250 billion over 10 years. The president wants to keep the total cost to about $900 billion. But it means workers and their families would be more than twice as likely to be uninsured as older people, virtually all of whom are now covered by Medicare.
Q: How affordable is the new middle-class coverage going to be?
A: It depends.
Most people would remain in their employer plans. Self-employed people and those working in small businesses would be able to buy coverage through a new insurance marketplace, with government subsidies available for many.
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The aid is substantial for lower-income households, but drops off rapidly for the middle class.
Under the House bill, a family of four headed by a 45-year-old making $44,000 a year would pay roughly $2,400 in premiums, or $200 a month, according to the Kaiser Family Foundation.
A similar family making $66,000 would pay about $6,580 in premiums, or about $550 a month.
That's a bargain compared to current rates, which can top $1,000 a month, but it still may be too much for some family budgets. About one-third of the uninsured say they'd be able to pay $200 a month in premiums, and only 7 percent say they can afford $400.
Q: Twenty-year-olds don't have many health problems. Would they be required to get coverage?
A: You bet.
Unmarried children could stay on their parents' plan until age 27 in the House bill, 26 in the Senate plan. That change would start in 2010.
But those buying coverage for themselves could be in for sticker shock. Insurers now charge the young and healthy much less than middle-age people who are more likely to get sick. Under both bills, age-related premiums would be limited. So the young would pay more than they do now.
"The people who are going to do best are older people with a problematic medical history," said health policy expert Paul Ginsburg, of the Center for Studying Health System Change.
Q: These bills are going to ban pre-existing conditions, right?
A: Yes, but not immediately.
Both bills would forbid insurers from denying coverage to people in poor health or charging them more. That would happen in 2013 under the House bill, and 2014 in the Senate's.
The reason for the delay is that it would be unfair to require insurers to take all applicants right away. The sick would sign up, but healthy people would probably wait until they faced the threat of government fines. Such a situation could raise premiums for everyone.
Q: So if I have a health care problem, I might still have to wait three years to four years for coverage?
A: At Obama's request, lawmakers tried to take care of that by setting aside $5 billion for temporary "high-risk" insurance pools to provide affordable coverage for people whose health is frail.
But there's a problem with the patch.
According to the Congressional Budget Office, the money would run out in 2011 unless Congress pumps in more cash.
Q: Older people are concerned about what's going to happen to Medicare. Should they be?
A: Even though cuts in Medicare payments to hospitals and other providers are paying for much of the cost of covering the uninsured, benefits under traditional Medicare aren't reduced.
But those who've signed up for private insurance plans through Medicare Advantage could lose valuable extra benefits, according to the budget office.
For years, the government has been paying the private plans more than it costs traditional Medicare to deliver similar services. The plans used the money to provide extra benefits - mainly lower copayments and deductibles.
Both bills offer cheaper prescription drugs to those who fall into the "doughnut hole," the Medicare coverage gap. The House bill gradually would eliminate the gap. Both bills also provide better coverage for preventive care.

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585414 tn?1288941302
I was reading today they are already planning limitations on coverage for home health care as part of Medicare cost reductions. As I've posted the funding was supposed to be redirected towards home health care from its current nursing home bias which is a proven reduction in costs and also allows people with disabilities and elderly people to live in the community. I had supported the community choice act and president Obama when he was running had stated that he would sign that specific bill into law. The only reason it hasn't been passed in the 15 years it has been proposed is the nursing home lobby. If that doesn't go through as part of it (just one of many examples) it shows hypocrisy in politics is very contagious and a politician is only as good as their actions not their words but that is nothing new. I doubt we'll get something workable or feasible at all especially if the specific increase in taxes is enacted long before the actual coverage.
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535822 tn?1443976780
Hey what am I saying....a weak moment heck...no Public option ....
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535822 tn?1443976780
Yup teko a lot of the truth in what you have posted , I feel the same really, all I hope that whatever happens we can benefit from the new healthcare system, whatever they work out for us all.It doesnt kick in for years anyway so we are still with our insurance or whatever  . yet we will be paying for it NOW ....
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Avatar universal
I think there is enuff blame to go around as to how we got here so I do not feel the need to name names, really doesnt matter at this point anywho. I do think the majority of folks see the need for change and that is what its gonna be one way or the other. I have to tell ya tho, all this talk about public option and people not liking the idea surprises me. We already have a government option and have had for years. Medicaid and I think Medicare is right there with it. Medicaid is full of people who dont want to work and keep having babies to make sure they dont have to. I been paying into medicare for years but looks like it might be gone by the time I get old enuff to use it. I have to say that I do not totally understand everything, and I guess if I did I would not be posting on here and I would have lots more money and not have the issue of health care, but from what I do no, the current system is broken and getting more broke every day. I just wish I knw the answer.
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535822 tn?1443976780
It was a choice of many Americans especially the younger ones not to have health care and remember they counted the Illegal folks in their quoted Millions figure, actually I heard the reverse, it is not as big a figure as quoted. they have given all rights to the illegal its in this bill even though he said recently he wasnt going to. I dont know the exact figure but I have read many many Americans are  happy with what they have , he wants the illegal votes after Amnesty.. its all politics ...by the way as I have said before there are many Free clinics out there that have always given illegal people healthcare coverage , its not just the ER...wait till you see what price has to be paid out each month ..mandatory or penalties ...
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585414 tn?1288941302
I would agree about the debt as regards before but it is continuing to spiral out of control now. When Clinton was president he promised to pass a healthcare plan and that never materialized. There are millions of Americans without healthcare and there doesn't seem to be a workable solution in place. I'd rather hear promises that everyone recieve healthcare than everyone be insured because insurance can easily put in costly denials, premiums, co-pays or deductables that often make paying out of pocket easier and more affordable which is the reason a certain number of people don't apply for it to begin with.
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535822 tn?1443976780
I also do think that this started a long time back,before Clinton was in Office, but it is this President now who is spending Trillions , printing money and continueing to do so,not addressing the economy ,and making us pay now for a health care system not coming in for 5 years  how much taxes can all of us pay, its not the rich there arent that many it is all working people.....I see Ireland is up in arms about the Goverment breaking that country, I mean Sourhern Ireland not the North that is part Of the UK ....I think if you dont see what he is doing to this country you have your eyes closed..what does it take ..well keep on blaming Bush if that helps you ...
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306867 tn?1299249709
In the Hisory of America no one has run up this kind of debt , my honest opinion is we are going broke, bankrupt ....

It's just unbelievable how quickly we forget the Bush presidency, and what a broken mess that was handed to this current president.
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Avatar universal
Left as things are currently, medicaid, medicare and social security will be null and void in a decade. We all have our own views of the problems and/or the solutions to them. I do not think everyone will be happy no matter what happens.  America has many issues facing it today and we brought it all upon our selves. We live in a different world than we did 20 years ago and unfortunately change is the name of the game. Things cannot and will not continue as they have been. I think they call it progress. Each generation down thru the years have been unwilling when it comes to change. People said the same things when social security came about. lol  We are a peculiar bunch! I have many misgivings just like everyone else, but also realize that if I go throw myself out in front of the white house, the only thing they are gonna do is put me in jail!  At least I would have health care tho! (meant as humor only!)
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535822 tn?1443976780
You have hit the nail on the head RJ I think a lot are begining to see the light, and what you have quoted is only a small part of what they are trying to do, they keep the big issues out in the spotlight whilst passing all kinds of stuff we dont know about, dont listen to a word he says but watch what he does, also Foreign Policy is up the shute ,he doesnt know what he is doing, there are a miriad of problems, the economy should be the most important thing to address, and jobs, but NO he has spent all years focused on other countries most of whom are laughing at him, Germany came out and called him a wimp recently.I actually think he knows what he is doing, he never liked America and you can tell by his punishing/negativity he  doesnt .He called for Transparency and said everything would be open as you have just said its all behind closed doors..and where on earth does everyone think trillions and trillions of Dollars are coming from..the tooth Fairy ? In the Hisory of America no one has run up this kind of debt , my honest opinion is we are going broke, bankrupt ....
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Avatar universal
According to the plan, insurance is mandatory. Those that do not buy insurance will have to pay a fine and face jail time. The plan they have is still going to leave a large number of people without insurance coverage. It doesn't make sense to fine people that don't carry it because they can't pay for it, then fine them and put them in jail. What has been accomplished from that? They don't advise people of their methods to get their money from those that don't pay, either, and believe me they will get their money, even if you won't have food to eat when they get finished. Many don't carry insurance because they can't live off of their paychecks, those that still get one.

From what I see, one of our biggest problems is illegal people. They get medical help at hospitals that we pay for in taxes. Not being a citizen, they can't make them pay for it. There is no way to collect the money on a non-citizen because collection laws do not apply to them. So, States have to cover by taxes, be it state or federal. Citizens however can go through their Social Services for care and what they pay is determined by their income. In Virginia, those that go through that system get excellent care by going through a medical college hospital. Top drs train others to be drs, and everything is monitored by the teaching physician. They have all the newest technology, and only the best of drs are chosen to teach. Though I have insurance, I still go through those same drs, because they are the best at what they do.

We have lost control here, but it is not our fault, it is our leaders not doing their job. We also allow people to come here and work by having authorization through the government, but they are non-citizens. My husband worked with one for years. He braged to other workers that he got his whole paycheck because he paid no taxes. He had to go home every so often to keep his status, then come back and work at the same job. He had a girlfriend that he had several children with. She was taken care of by Social Services because she is a citizen. He still lived with her, but was not made to take care of their children the way any other man can by law, because the laws did not apply to him. He told all of that to his co-workers and laughed. All that he did, was protected, because of laws that did not apply to him.

We can have a big heart and want to help everyone, but we cannot take care of the world. There has to be a limit to what is allowed. There are thousands working and taking jobs from others that are citizens, because they will work for lower wages, well they can do that if more than 1/3 of their pay is not taken the way it is for citizens. They can work for less, and still get a larger paycheck. Now the government wants to provide their care by taking more money in federal taxes, and make us take their insurance. They can say they won't but they will. Obama's own aunt is illegal and living in government housing. Now how did that happen? Qualifying for govt housing, she qualified for govenment care, food stamps, or whatever. Who foots the bill? The bill says we can have our insurance, but, if anything changes, coverage, cost, anything, we cannot continue it and have to go with the government insurance. They have a date listed in the bill that begins and ends our choice of coverage, and grandfather clause. Does anyone think the government is going to give us choice about anything that they can make money on? The illegal will still get care, and still not pay. Citizens that can't afford it, and there are many, will be fined, and the government will collect their money by whatever means possible, taking savings, clearing out checking accounts, taking all of your paycheck, or taking anything you own. I have seen it happen. It is called IRS.

Other Countries monitor the ins and outs of their borders, preventing just what we are dealing with. Can people that are not working pay for insurance? So, where does that leave them? Don't think that illegal workers are not taking jobs that citizens are losing their jobs over, because they are. The type of work my son does, and there are many in his field out of work, is now filled with people that have crossed the boarder. He has done that type of work for over 20 yrs and knows many, many people that are out of work in that same field, all saying the same thing. Does the government do anything about that? Would those workers be working and able to carry insurance if they had those jobs?

There is more to correcting the Health Care than the government control. Premiums go up because salaries go up, cost of care goes up when hospitals and drs are trying to provide better techniques for their patients and taking additional education to give better care. Our cost of living is higher, so is theirs. If we could shop for insurance, the competition would help us. If unemployment wasn't through the roof, more people could afford it. If illegal people weren't taking jobs, our economy would recover. Not one thing is even mentioned cleaning that mess up. Everything is just getting worse and worse and the government extends their hand and in the end they own us. If the government closes down insurance companies, that is going to be even higher unemployment. Obama is suppose to be so smart, he can't figure out anything but government control, and less freedom? I think it is a shame to pay for votes by including big money for a State, as one example, and meetings behind closed doors only with his party, for another. So what is going on that it has to be hidden?
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649848 tn?1534633700
teko, you are right -- we are paying for those who don't have insurance, but with the new health care reform --- who is going to decide how *I* can pay for insurance premiums??  Just because a certain amount is affordable for one person, doesn't mean it's going to affordable for someone else -- so one of my major problems is the idea of *affordable* --- we know the dimwits in Washington have so much money, they don't know what to do with it, so what if THEY decide that a figure of something around $2000/month is "affordable" --  not for me, it isn't!!!  

And I haven't even touched on the fact that they are taking away MY right to decide what's best for ME and my family.  
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Avatar universal
The problem with that barb, at least from my standpoint is that we will be in the same boat we are in now. The uninsured are treated at the ER and when they do not have insurance, guess who foots the bill. Everyone who does have it pays the premiums to cover those persons.  If we can get affordable health insurance, should not all be required as to prevent the very problem we now face?  Im just thinkin out loud here, but if they make it affordable? I think they said they will be options for those who still cannot get it, like Medicaid if they qualify. Anyways, it will be interesting to c what comes out of all this. I am afraid after all is said and done it will be a watered down version and that is a different story altogether. As far as the subject of freedom, not being able to get it is not what I call freedoms either.
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535822 tn?1443976780
Barb thats what makes me mad a lot of young folks dont want it and hey we dont know what its going to cost per month that we HAVE to have ...truly freedom is down the drain,what about the fact that the taxes are starting now this next tax year yet it wont be for 4 years that healthcare starts   ....
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