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Health Care Reform 101: What You Get.

  • by
  • February 24, 2010
  • 5:00 pm
Health Care Reform 101: What You Get.

Did you know that you and your family could choose the exact same health care coverage that members of Congress get? 

Or that preventive care– like getting an annual physical, mammogram or colonoscopy – will not cost you a dime out of pocket.

And no matter your age, a pre-existing condition or your family history, you can’t be denied insurance coverage.

Why don’t opponents want you to get these and other guaranteed benefits? 

We think the more you know – and the more your friends and family know – the tougher it will be for our leaders to run from our problems. Here are the key points of health care reform legislation:  

  • No company can ever deny you health insurance or drop your coverage for a pre-existing condition, or if you get sick.
  • If you get cancer or any other serious illness, there is no cap on covered care. 
  • No threat of losing your life savings, or being thrust into debt, to pay for care. Insurance companies must pay your claims. 
  • Recommended preventive care will be covered without deductibles – checkups, colonoscopies, mammograms – no matter if you buy your own policy or get coverage through your job. 
  • Programs to increase the number of primary care doctors, with incentives for them to practice in rural areas, so you get quality care no matter where you live.
  • Want the full scoop? Click here.

On Thursday, President Obama will convene a half-day health care summit. We know painfully well that this reform has been stagnating in Congress for TOO LONG! Take action today: Tell lawmakers that you expect health care reform NOW.  

*This article is the first in a three part series: Click here for the second article. 

Read more: , , , , , , ,

Photo courtesy of Listener42 on Flikr.
Written by Susan Herold. Senior Web Editor, Consumers Union.

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302 comments

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3:31AM PST on Mar 13, 2010

we do need reform but not a government takeover

12:43AM PST on Mar 12, 2010

can not say over the n h s health care is great. but we still pay for it in being over tax

10:44AM PST on Mar 7, 2010

Living as I do in the UK, I've been amazed by the negative reaction to healthcare reform by some in the US. I can understand why insurance companies would be against it (they are businesses just trying to protect their profits) but why would anyone else oppose the idea of broader, more accessible healthcare? The NHS (National Health Service) that we have in the UK is far from perfect, but I know that if I was to have an accident or get sick I will receive the care I need without worrying about how I'm going to pay for it. Surely in a civilised society healthcare, like education, should be available to everyone, regardless of means?

2:18AM PST on Mar 6, 2010

I *know* how I would benefit from health care reform -- if it went far enough.

7:29PM PST on Mar 5, 2010

Noted. Is this for real??

9:53AM PST on Mar 3, 2010

Seth,

I realize you do not disagree with me. My point is more subtle and you have pointed it out. Insurance has become synonymous with health care and this is no accident. This was a carefully orchestrated choice of words by the current administration and politicians from both parties. in the beginning of the discussion regarding health care reform the term health care was used. Then it began to morph into 'coverage" and finally to insurance. We want to make sure that all Americans have access to health insurance, that no one is denied coverage.

Very clever, i wonder how much the insurance lobby spent on advertisement agencies to come up with that beauty.

9:51AM PST on Mar 3, 2010

...continued from previous post:

Private plans already have processes to negotiate pricing for medical services, prescriptions, and anything else covered, but these could stand to be coordinated better across the board to get rid of any high outliers. For example, if a doctor charges $100 for an office visit, it might actually be more reasonable for the services to be worth $30, and Medicare might therefore allow that amount. If one private carrier allows $40 for the same service, another allows $80, and yet another allows the full $100, and obviously someone without coverage would be responsible for the full $100, this is obviously the type of situation that needs to be fixed; there's no reason for the doctor to overcharge in such a way, but there also needs to be more control to make sure no plans are allowing so much more than should be paid as this causes more expense for some people than others.

The same is true of pharmacy prices and the prices for other medical services.

Now the insurance model of financing and the negotiated pricing are also good reasons why a public option would likely work better than a single-payer system as there would still be some diversification of all the money in the system among several pools of money, and there would be competition to make sure prices stay more effectively controlled.

9:40AM PST on Mar 3, 2010

Pa,

I still don't disagree with you; my point wasn't to distinguish between "coverage" and "insurance" but more between those and "healthcare;" coverage and insurance would imply the same system of a financial means to afford the actual services to be provided by healthcare, although some people do generically refer to the coverage/insurance as "healthcare," and although this is technically incorrect, it has clearly become an accepted term to refer to the same thing.

The terminology is obviously not nearly important as what it implies, but keep in mind that even a reformed system would still have to follow roughly the same economic model as insurance, with money being paid, by way of premiums, taxes, or fees, with a pool of money readily available to pay out for claims, and a portion invested to gain interest in order to further enhance money to be available for future claims, in addition to the other money contributed by other means.

continued...

6:35AM PST on Mar 3, 2010

Seth,

I appreciate your distinction but coverage implies insurance, which is nothing more than an industry which profits from gambling against more withdrawals than contributions and then manipulates the process to ensure this.

Health care should not be for profit. Or there should be serious caps on what is allowed to be charged for services, premiums, rates, prescriptions etc. The profit is what ruins the models.

5:52PM PST on Mar 2, 2010

My gosh can you imagine what would happen to the cost of health care if every HMO was discontinued in the U.S.? Can you imagine how much money the working class would be able to save? Could that really happen in my grand child's life time???

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