this is an excellent summary.

Why not just open the Fed employee plan to everyone that wants to join? Those joining could pay the total premium with a sliding scale of help based upon income levels.

Currently an Fed employee selects a private insurance company, benefits & joins... seems simple to me. We could have the same coverage as our employees.

Then someone should tell use exactly why existing plans need to be "grandfathered" and as per sec. 16 par a sub 2 (page 16) they will not be grandfathered if certain changes are made. There is also a 5 year grace period. Why is this in the bill and what are it's implications? If you can keep your coverage this language would not be necessary, or am I missing something. I did not read the entire bill.

Any Government Panel that rations health care eventually becomes a "Death Panel". When a procedure costs more than the allowable (Quality Adjusted Life Year)/Dollars ratio, that panel will sign your death warrant by denying you care.. President Obama's health care advisor, Dr. Ezekiel Emanuel has a utility curve describing the worth of a human being vs. their age. Find yourself on the wrong side of that curve, and you will discover the full impact of a government run health care system. And no, you won't find it in any bill. The bill will authorize the formation of the bureaucracy, a bureaucracy that will control cost by minimizing the care that patients receive in the last 6 months of their lives. After all, as President Obama says, that is where 80% of the expenditures occur.

The "grandfathering" language is apparently there to prevent disruption of service for people whose current plans may not contain some benefits considered minimal. The bill is phased in over several years.

It would be interesting to compare the benefits federal employees receive now with coverage under the proposed plans. Anyone out there a federal employee? Although, a real comparison can't be made now. The bill directs a new government body to define the benefits in each plan--basic, premium, premium plus, etc.

For summarizing the points with little bias. Too many people are taking sides without educating themselves on the facts. We all have our opinions, but truth is the axiom. "There is a distinct difference between 'critical thinking to find the truth' and 'thinking critically to justify a chosen truth'-Me :)"

Thanks or the tip! Anyone interested can see the federal employee health options here:

http://www.opm.gov/INSURE/HEALTH/INDEX.ASP

the vote (thumbsup/thumbsdown) on this article reflects political viewpoint. The piece is a great and mercifully short explanation of a very complex subject. However, for the political right, healthcare is a harpoon to hopefully mortally wound the Administration. They are not going to like any article that suggests the health care reform proposals may be reasonable.

The article says "nothing is done" and then goes on to say what the "facts" are.

I think the relevant information is available from looking at the evidence in Canada and the U.K. of how their respective systems evolved over time as those governments implemented their plans,

As we can see from recent events, human beings are naturally optimistic about the outcomes of their decisions. I am sure the record will show the high expectations that proponents of these types of plans in Canada and the U.K. had at the beginning.

In the same way that I do not believe that more debt is the answer to current economic conditions, I do not believe that more government involvement is the answer to current conditions in the health care sector of the economy.

I would humbly offer that less debt would be better for our ecohnomic sector - and less government involvement would be better for our health care sector.

The sheer massiveness of this bill indicates the layers of laws and government bodies to be added. Complication never lowers cost, and it elevates the possibilities for fraud. If this is enacted, in a very short time it will become an entitlement and political lever for interest groups and/or politicians. What large, long-term undertaking has the Federal government executed well? Show me one example. More government involvement is not the answer.

The "grandfathering" language is apparently there to prevent disruption of service for people whose current plans may not contain some benefits considered minimal. The bill is phased in over several years.

Why would my plan be disrupted if I can keep it. Seems the only plans after 5 years will be those that meet the gov. standards ( benefits considered minimal) and that have not changed since Y1.

Thanks but I don't think we really know what that means yet.

This discussion of the plan omits some serious practical issues as well as omits any discussion of the serious policy issue of how the government who is or should be the umpire for this game can also act as a player without making it unfair for the other players.
1. How can the govenment claim projected savings for for Medicare and Medicaid to pay for more than 1/2 of the projected incremental cost, when they can't document & implement these savings now?
2. How are illegal immigrants to be denied coverage when the amendments to require that they verify their legal status were voted down?
3. Per IBD, once a plan's coverage changes in any way, the current users and no new users can join it. Once it's membership is reduced substantially, its cost will make it uneconomical and it will wither away. Hence, you current paln will no longer be available. So much for keeping your current plan

It's amazing to me that people still believe that their physicians decide what care they receive.

Any medical personnel can explain that your insurance carrier decides what treatments and procedures are and are not available to you. A hospital encourages all tests and procedures that the carrier will reimburse (whether you need them or not) and otherwise avoids expenses unlikely to be reimbursed. It's that simple.

Similarly, the pharmaceutical manufacturers, in offering cash incentives for prescribing their products, play a heavy-handed role in deciding that medications will be prescribed (whether you need them or not) and what those medications will indeed be (regardless of the confluence of risks from one or from all your medications). And that's also one reason why the U.S. has such a poor grasp of integrative or Eastern medicine.

From this perspective, all of the political cant over faceless government bureaucrats controlling the quality of care decisions is nonsense because it frames the issue in terms of keeping the decisions in the control of the internist and the physicians to whom your internist refers you. That just doesn't happen. Quality of care decisions are financial decisions that are economically determined. Any way you cut it.

"If that sounds like a poor business model, it seems to have worked for the private insurers for some time now."

Is that why costs have been going up? Is that the ultimate source of ever-rising healthcare costs: that healthy people end up paying for the care of the unhealthy?

Does anyone care how destructive this is to the family bonds that (are supposed to) reward good parenting by creating children who care for their parents? I suppose, since it's been going on for decades, that very few do. Is it time to wake up yet?

"Any medical personnel can explain that your insurance carrier decides what treatments and procedures are and are not available to you.

My insurance just decides the reimbursement rate. Anything is available if I pick up the difference.

Why should we believe you when members of Congress, the President, and all sorts of pundits are all contradicting each other?

Why should we believe you when vast portions of the bill are vague and ambiguously-worded so as to allow bureaucrats and regulators to implement whatever Khafka-esque nightmare that they feel like? Ad Khafka-esque is not something I like to see with healthcare.

Why should we believe you when the President is on record as saying he wants to kill private healthcare insurance over a 10-15 year timeframe in incremental movements towards one-payer, government-provided socialized medicine?

Why should we believe you when senior Senatorial leadership was telling the members of that chamber that they don't even need to read the 1,000+ page bill?

Why should we believe you when other socialized medicine and/or government systems are a disaster, underfunded, and killing people?

Why should we believe you about no death panels when the President's own healthcare czar is on record as saying that healthcare should only be provided to the productive citizens or those citizens capable of being productive? Who gets to define what productive citizen or citizen capable being productive mean? And who gets to make those determinations?

Why should we believe you on costs of the bill when even the Congressional Budget Office says that the bill that passed the House will cost trillions?

Your summary dismissal of key arguments on varying provisions in the various versions of the bill shows entire lack of either ability or effort towards dealing with this highly complex issue. Even the President himself has shown that he does not know what is in the plan or plans.

Why don't they spend effort fixing the problems that already exist in the already failing social security, medicare, medicaid, the banking system, FDIC, PBGC, etc., etc., etc. before they set off destroying that which really does not need much fixing?

And lastly, since the Congress, the Senate and White House, over the years, have created and worsened all of those problems, why should they be trusted to actually fix anything like healthcare?

It's too bad there is so little understanding of healthcare by those that are attempting to reform it. The truth is that it is the government that sets the rates for Medicare Advantage plans as well as fee for service medicare. The plan they designed to determine the appropriate premium for a Medicare Advantage plan was one crafted by their actuarties to compensate plans for the level of care required by their patients (Risk Adjustment). It is an administrative nightmare and one that has driven up dramatically the cost of care.

When healthcare reform comes along, it will affect those with coverage currently. Medicare Advantage plans are being forced to reduce benefits in order to deliver care with the reduced dollars provided by CMS. What does this mean? Extra benefits such as vision, dental, zero copays and drug gap coverage will be gradually reduced until the Medicare Advantage plans have benefits more closely in line with fee for service Medicare? Who loses? The beneficiary (the senior) that is currently paying very little for a very rich health plan.

.. Actually, 99% of the HealthCare Town Hall Meetings were peaceful and productive... apparently the Health Insurers only sent paid hecklers to a few meetings, then told the Media which meetings to attend, as well...

Hey Carol don't worry this article will put on the top of the Obama list for the next spot!! Get real.

This article reads like a very nice expanded explanation of all the White House talking points. Before reading this, I was worried that a bill covering 16% of the US economy moving through the legislature at startling speed was something to worry about. Now that I know how my government is going to make it all better (as long as I am not one of those few rich people), I see I have no reason to worry.

Your article is deceptive and reveals that you have not read and understood the niceties of this piece of totalitarian legislation, which for one thing entails the hiring of millions of useless but highly paid bureaucrats. In any event, not a thing that proponents like you want to accomplish can't be accomplished a thousand times better by freeing insurance companies from the restrictions of state regulation and the hundreds of state and federal mandates that make insurance unnecessarily expensive. Of course Congress and the States wouldn't want to do that because it would destroy their ability to extort large contributions from the companies. I am an attorney who has worked on major legislation in DC, and it is not a process generally driven by efficiency or interest in public benefit.

Not even mentioned in the legislation, apparently due to the great power of the Trial Lawyers lobby over the Democratic party. In our state, ruled by Obama and his corrupt friends, there has been a steady exodus of doctors to friendlier locales, and a particular drain of specialists whose malpractice premiums have gone to the moon. Defensive medicine?--count on it.

The best way to explain everything is to go to: Her Name is Ms Ann, on YOUTUBE. A MUST READ!

I second that.

Thank you for the unbiased summary.

What a piece of biased garbage! You ignore the "inconvenient truth" that a public plan, with its enormous purchasing power, will eventually lead to a single payer system and that such a system is the stated goal of the leftists who are pushing this monsterous bill. You also fail to mention that the bill for this "universal coverage" will fall squarely on small business in the form of higher income taxes and payroll surcharges and that these charges are in addition to the tax increases scheduled for 2011. This will certainly hamper job creation and economic growth.

You conveniently refrain from stating that the only way "that a public plan, with its enormous purchasing power, will eventually lead to a single payer system" is if the private plans fail to compete. As it is, they get to cherry-pick their customer base. Also, opponents of reform claim that people who have health insurance now are generally satisfied with it. If the relatively young and healthy customer base is happy with what they have, then the private insurance companies stand to lose little if anything. If they are overcharging their customers, and if they are jacking up "administrative costs" to a degree that the public plan is an attractive alternative, they have a choice: offer a competitive product, or go out of business.

Slander doesn't help you convince anyone. No one in my acquaintance who attended the Arlen Specter meeting was "sent" by anyone nor paid. But the union Brownshirts who sent a black conservative to the emergency room by beating him during a Town Hall WERE sent, and paid.

It is apparent from reading Ms.Kopp's column that she has not taken the time to actually read HR 3200,but would rather repeat the flip-flop fallacies expoused by this administration and its lovesick admirers in the media. It can be found on several government websites including the health,education, labor, and pension comm.'s site. This type of reporting may explain why MSNBC and CBS are minor players at best in the news field.

1. It is amazing to me that anyone would think that their physician is not in charge of the treatment that a patient receives.

2. Physicians to do not get any cash incentive for prescribing certain medicines.

If this is the case with you, I suggest that you get a new doctor.

Yeah, right. When an illegal shows up at an ER, what are they going to do--turn them away?

Maybe that is addressed somewhere in the 2000 page bill. How about you go through it and get back with me, ok?

According to the law, I believe anyone who shows up at the emergency room and needs life-saving care gets it, illegal or not. However, no emergency room care is free; you get a hefty bill, especially if you do not have insurance. Ten years ago, I got stitched up for keeping my two dogs from killing each other. That and a pill to lower my very high blood pressure cost me $350, which took me six months to pay off. So I no longer go to the emergency room because I can't afford it. I guess you assume illegals, after getting the hospital bill, pack up and move away in the night.

IF GOVT PLAN PAYS CLAIMS SAME AS MEDICARE IT IS IMPOSSIBLE FOR OTHER INS TO COMPETE AS THEY HAVE TO PAY MORE FOR SAME CLAIMS. UNFAIR COMPETITION AS THEY CANT GET BY WITH PAYING AS MEDICARE. THEREFORE PREMIUMS WOULD BE HIGHER THAN GOVT PLAN. GOVT TAKE OVER VIA BACK DOOR.

Why not try the following first:

1. Price Transparency. Except for an emergency room, a doctor may not recommend a procedure or provide care without stating the price (from all providers). Every doctor has to post their exam costs - for example $100 for 20 minutes of listing to what is wrong. Dentists have to post their costs for exam, x-rays, cavities, root canal etc. Eye doctors, same thing, this much for exam, contacts, this much for lenses and this much for frames. This would allow the public to shop around.

Now as a consumer we would also need to reference to the quality of the Dr., state licensing should post where the Dr got his degree and # of complaints in the last year. Medicare and Medicaid should have the patient pay a little so the patient attempts to control the cost and have a reporting tool so the patient can report excess charges, like ... this Doctor billed $1,300 to freeze a bump off my face and called it surgery in the billing".

In return, Doctor's can turn away patients that they don't believe will pay.

2. Tort reform. When seeing a doctor or entering a hospital the patient decides if he wants to pay for the malpractice insurance so he can sue the doctor or hospital for $50 million when they mess up or they can select a limited coverage and a mediator will decide or they can select the "I'll take my chances" and get the lowest cost possible.

3. Pre-existing conditions, if you were covered under any insurance policy when the condition occurred then that insurance company keeps you and the premium you pay is the rate any non-conditioned person pays. For example, my son was born with a disability, no reason, just happened -- that is what insurance is for -- when I change jobs, my family should stay with that insurance company and pay what any other family pays at the previous place of work or some other equitable solution.

Try these 3 things first before we commit to a cost we can't measure.

I'm still thinking about the children, like school maybe society should pick up the first 17 years, but each state administers the program and decides what they will cover, how they tax and pay the Doctors. This seems VERY costly. I'm not sure what the solution is to protect children from parents who refuse to buy insurance and then can't pay their bills.

BUT if Obama wants to go ahead, why not pilot his plan in Nevada (Reid), Calif (Pelosi) and Illinois (Obama) first and let those states pay for it.