About anti- reform mobs

By: Barbara

Dear Jen,I was going to delete your email but I feel the need to correct ” Your 5 FACTS”

 

About anti- reform mobs. See http://freemenow.wordpress.com/2009/08/05/beware-of-the-extreme-mobs/ 

MOB Fact

1. “These disruptions are being funded and organized by out-of-district special-interest groups and insurance companies who fear that health insurance reform could help Americans, but hurt their bottom line.”

TRUE FACT

These disruptions as you call them are from ordinary average citizens, from all walks of life and all party affiliations, who are fed up with representatives who are not listening to WE the people. WE the people elected them to serve in our best interests. Our best interests are not being served so WE the people are angry.

No one “organized” and funded the mobs better the DNC.

Will you please name the insurance companies you claim who are organizing and funding these “mobs”?

MOB Fact

2. “People are scared because they are being fed frightening lies. These crowds are being riled up by anti-reform lies being spread by industry front groups that invent smears to tarnish the President’s plan and scare voters.”

TRUE FACT

People are frightened because they feel our elected representatives including the President are not being honest. People are frightened because a bill is being rushed….Again without having been read…Again. People want answers…..Again. People are not getting answers….Again, People are questioning the “crisis” constantly being referred to….Again. People are frightened that we are being bamboozeled…. Again. SLOW DOWN, PLEASE. What is the rush? Is it not more important to get this right? Do we need to beg our representatives to do their job?

Please READ the Bill.

“Front groups that invent smears” now that is funny……”The Clintons are racists” “Sarah Palin is stupid” Are those not invented smears? I guess when the DNC is doing the smears it is considered political talking points.

Why do you refer to us as “VOTERS”? Scare the “voters” you say, is that what this is about, VOTES? A campaign? Forgive me Jen, I thought it was about health care for WE the People. Interesting new concept, WE the VOTERS.

MOB FACT

3. “Their actions are getting more extreme. Texas protesters brought signs displaying a tombstone for Rep. Lloyd Doggett and using the “SS” symbol to compare President Obama’s policies to Nazism. Maryland Rep. Frank Kratovil was hanged in effigy outside his district office. Rep. Tim Bishop of New York had to be escorted to his car by police after an angry few disrupted his town hall meeting — and more examples like this come in every day. And they have gone beyond just trying to derail the President’s health insurance reform plans, they are trying to “break” the President himself and ruin his Presidency.”

TRUE FACT

Yes people are angry, big time angry. Yes, there will be some who take things too far and act “extreme”. Just like in the primary when Mayor Nutter of Philadelphia was followed and booed everywhere he went because he honored the vote of his constituents and endorsed Hillary and not Obama. That’s where the chant “BROS not HOS” came from. Just like that “MOB” who hung an effigy of Sarah Palin. Just like those “mobs” of Obama supporters who wore the “She is a C**t” T shirts. Just like when I was spit on and slapped by “mobs” of Obama supporters while on the Democratic campaign trail. The DNC organized mobs during the election “to get in their Faces” and they are still organized today. Despite our constant complaints to the DNC Not one email was sent out from the Democratic party detailing the Mob behavior and condemning it and asking their own party MOB members to stop. I hear talk of the DNC accusing mobs are being bussed into these town hall meetings. What about those bussed into Caucus sporting new IPODs and University T shirts.? Those in glass houses should not send emails about things they themselves are guilty of. Did it ever occur to you that these town hall meetings are far and few and many people, especially seniors, want to attend so a bus might be an appropriate form of transportation for one towns people to get to the town where the meeting is held? Again, Jen it worked for the DNC. A bus full of your beloved VOTERS.

“Derail the Presidency” by not supporting a health care bill that is not worth the paper it is written on?

How about do as the President promised, A Single Payer Health Care Plan? Presidents have all taken their fair share of derailment tactics look at what the liberal left did to George Bush. The media is in bed with the Democrats, you were elected because of the love affair. Talk about an organized MOB.

MOB FACT

4. Their goal is to disrupt and shut down legitimate conversation. Protesters have routinely shouted down representatives trying to engage in constructive dialogue with voters, and done everything they can to intimidate and silence regular people who just want more information. One attack group has even published a manual instructing protesters to “stand up and shout” and try to “rattle” lawmakers to prevent them from talking peacefully with their constituents.”

TRUE FACT

The MOBS goal is answers.

People want answers and when they only hear the talking points memo of the day they get angry. Are there some who do not want a conversation? Sure, that is politics, it has become a contact sport.

Many a time the three Democratic opponents Clinton, Palin and McCain had to fight to be heard over the YES we Can and GO home Bitch “conversations” on the side lines.

As far as intimidation, again…. glass house. The democratic primary was wrought with intimidation from delegates to voters.

Let’s see ACORN, The New Black Panthers. C’mon the members of your own party had to deal with intimidation. Let me be clear violence in any form is wrong. Intimidation is a new tactic in politics?

Sorry, our representatives are feeling intimidated about finally having to answer to WE the people. Why? Because we ask questions like “if this health care plan is so wonderful they why don’t you who want to vote yes accept it as your health care plan?” They run from questions asking , tell us what is in the bill? That is too intimidating? Truth is the bar was always set too low for our elected representatives. The people have moved the bar up and that intimidates them.

Who put out a “manual” play book? Is it anything like “How to get elected in Michigan without being on the ballot?”

Anything like the email to report “fishy” things being said about the health care bill directly to the White House?

Since when in this country do we report citizens for speaking? Oh yes McCarthy and the Truth Squads in Missouri and Fight the Smears etc. Now that is intimidation. A citizens right to free speech is covered under the First Amendment of the Constitution. Please take the time to READ it.

You’re treading on very dangerous ground.

What happen to it is a citizens patriotic duty to speak up to and against? Speak up as long as its not against a Democrat? You’re the majority, You’re the ones writing the bills, You’re the ones voting for the bills so that means we speak up to you and against you..

MOB Fact

5. “Republican leadership is irresponsibly cheering on the thuggish crowds. Republican House Minority Leader John Boehner issued a statement applauding and promoting a video of the disruptions and looking forward to “a long, hot August for Democrats in Congress.”

TRUE FACT

Democratic party leadership was irresponsibly cheering on sexism and misogyny during the election. The DNC leadership is encouraging censorship with its “fishy” email. The DNC is spinning the town hall meetings rather than taking a good look at what is happening, Americans are fed up with those we elected to serve us…..YOU all of YOU. Democrat and Republican alike work for us…and news flash few of them are working for us.

The DNC is Ignoring the fact that many of its own party members are disillusioned with what they see happening. We do not even recognize our party and even more frightening is our party does not recognize us. Your denial of our existence will be your downfall. Here is where WE the Voters comes into play. We are at these town hall meetings. We are part of the mob. Look for us, you can tell us apart from the “thugs” we have that stunned look on our faces.

What happened to transparency? What happen to CHANGE in Washington? This is the most secretive administration in our nations history. Nothing has CHANGED in Washington, if anything it has gotten worse.

Why are you sending emails as this and the “fishy one”? Dealing with a small minority. Would not your time and energy be better spent with emails that actually discuss the health care bill that affects the majority of people? Maybe do as the President suggested read the bill together line by line? But then again maybe it is not about a health care bill?

Maybe it is about politics and the struggle for power and WE the People are once again caught in the middle of the struggle.

Maybe that is why people are angry we are tired of being in the middle of a two party political system struggle for power. Now that’s a fact.

 

One Fact you got right is this

” Health insurance reform is about our lives, our jobs, and our families — we can’t let distortions and intimidation get in the way.”

So please stop with the rhetoric, and call of the MOBS you have sent out to “hit them Hard” a town hall meeting turned violent because of that email. The Democratic “thugs” take that literally. To them it is personal and not political.

I was waiting for the Race Card to be played, it is the Democratic secret weapon. Calling people Astro Turfers, right wingers, Republican Mobs, Nazis, Thugs, Nut Jobs and the whole host of other names wasn’t working because people were saying WE are none of the above WE are Americans. So you had to bring out the time tested , RACIST.

Race has not a damn thing to do with this and you know it. But when you can’t defend you attack.

It is worn out and its taking this country to a place this President swore he would be able to help mend. The party that elected the first black president is the party STILL using the word Racist to define anyone and everyone that disagrees with this President.

Barack Obama is the President PERIOD. Americans are angry with the President and his administration. PERIOD.

Stop making it about his skin color, his skin color has no affect on our lives whatsoever, his policy’s however DO effect us all.

You will never be able to govern ALL the people if you continue to walk the path of division you have chosen. I for one have chosen to not follow and I am not alone in that choice. WE the People, very powerful 3 words.

Not we the party of some of the people some of the time. WE THE PEOPLE.

Is it any wonder after reading your talking points MOB, Fishy, get in their faces emails that WE the PEOPLE are angry, disillusioned , and question the rhetoric being spewed by a power that seems to have forgotten its promise of CHANGE. Forgotten that the DNC was once the party of the people, party of inclusion, fair, honest, open Democratic party.

Is this the CHANGE we voted for? Democracy, NO Hypocrisy.

RIDs rally at Senator Schumer’s office

Not so fast  to Obamacare 

Anna Barrone organized a rally of RIDs  patriots that took a take your Hands Off Healthcare message to Senator Schumer’s office in Manhattan Tuesday night.

BettyJean Kling: Free US Now, The Majority United
http://freemenow.wordpress.com/2009/07/29/ill-accept-what-the-535-accept/

 

 Pamela Hall: Gathering of Eagles Tea party Patriots
http://nygoe.wordpress.com/2009/07/28/atlas-shrugs-joins-tea-party-patriots/

 

Pam Geller: Atlas Shrugs
http://atlasshrugs2000.typepad.com/atlas_shrugs/2009/07/dump-schumer-rally.html

 

 :Vigilant Squirrel Brigade
http://vigilantsquirrelbrigade.blogspot.com/2009/07/no-to-obamacare-7-28-09.html

 

 

10 Surprising Facts about American Health Care

Brief Analysis | Health  THE FOLLOWING IS FOUND IN PDF.

Again – Please do your homework – whatever you find in these pages are not necessarily our opinions we are presenting  what is being fed to you through the media for your perusal- Now let’s take this stuff and go find out what is or is not true. That is our Job. FOR FAR TOO LONG WE HAVE LEFT THE FOX AND WOLVES IN CHARGE OF THE HEN HOUSE.

No. 649

Tuesday, March 24, 2009

by Scott Atlas

Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world.  Economists, government officials, insurers and academics alike are beating the drum for a far larger government rôle in health care.  Much of the public assumes their arguments are sound because the calls for change are so ubiquitous and the topic so complex.  However, before turning to government as the solution, some unheralded facts about America’s health care system should be considered.

Fact No. 1:  Americans have better survival rates than Europeans for common cancers.[1]  Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom.  Prostate cancer mortality is 604 percent higher in the U.K. and 457 percent higher in Norway.  The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

Fact No. 2:  Americans have lower cancer mortality rates than Canadians.[2]  Breast cancer mortality is 9 percent higher, prostate cancer is 184 percent higher and colon cancer mortality among men is about 10 percent higher than in the United States.

Fact No. 3:  Americans have better access to treatment for chronic diseases than patients in other developed countries.[3]  Some 56 percent of Americans who could benefit are taking statins, which reduce cholesterol and protect against heart disease.  By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons and 17 percent of Italians receive them. 

 Fact No. 4:  Americans have better access to preventive cancer screening than Canadians.[4]  Take the proportion of the appropriate-age population groups who have received recommended tests for breast, cervical, prostate and colon cancer:

• Nine of 10 middle-aged American women (89 percent) have had a mammogram, compared to less than three-fourths of Canadians (72 percent).
• Nearly all American women (96 percent) have had a pap smear, compared to less than 90 percent of Canadians.
• More than half of American men (54 percent) have had a PSA test, compared to less than 1 in 6 Canadians (16 percent).
• Nearly one-third of Americans (30 percent) have had a colonoscopy, compared with less than 1 in 20 Canadians (5 percent).

Fact No. 5:  Lower income Americans are in better health than comparable Canadians.  Twice as many American seniors with below-median incomes self-report “excellent” health compared to Canadian seniors (11.7 percent versus 5.8 percent).  Conversely, white Canadian young adults with below-median incomes are 20 percent more likely than lower income Americans to describe their health as “fair or poor.”[5]

 

Fact No. 6:  Americans spend less time waiting for care than patients in Canada and the U.K.  Canadian and British patients wait about twice as long – sometimes more than a year – to see a specialist, to have elective surgery like hip replacements or to get radiation treatment for cancer.[6]  All told, 827,429 people are waiting for some type of procedure in Canada.[7]  In England, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.[8]

Fact No. 7:  People in countries with more government control of health care are highly dissatisfied and believe reform is needed.   More than 70 percent of German, Canadian, Australian, New Zealand and British adults say their health system needs either “fundamental change” or “complete rebuilding.”[9]

Fact No. 8:  Americans are more satisfied with the care they receive than Canadians.  When asked about their own health care instead of the “health care system,” more than half of Americans (51.3 percent) are very satisfied with their health care services, compared to only 41.5 percent of Canadians; a lower proportion of Americans are dissatisfied (6.8 percent) than Canadians (8.5 percent).[10]

Fact No. 9:  Americans have much better access to important new technologies like medical imaging than patients in Canada or the U.K.  Maligned as a waste by economists and policymakers naïve to actual medical practice, an overwhelming majority of leading American physicians identified computerized tomography (CT) and magnetic resonance imaging (MRI) as the most important medical innovations for improving patient care during the previous decade.[11]  [See the table.]  The United States has 34 CT scanners per million Americans, compared to 12 in Canada and eight in Britain.  The United States has nearly 27 MRI machines per million compared to about 6 per million in Canada and Britain.[12] 

Fact No. 10:  Americans are responsible for the vast majority of all health care innovations.[13]  The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other single developed country.[14]  Since the mid-1970s, the Nobel Prize in medicine or physiology has gone to American residents more often than recipients from all other countries combined.[15]  In only five of the past 34 years did a scientist living in America not win or share in the prize.   Most important recent medical innovations were developed in the United States.[16]  [See the table.]

Conclusion.  Despite serious challenges, such as escalating costs and the uninsured, the U.S. health care system compares favorably to those in other developed countries.

Scott W. Atlas, M.D., is a senior fellow at the Hoover Institution and a professor at the Stanford University Medical Center.  A version of this article appeared previously in the February 18, 2009, Washington Times.

 

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[1] Concord Working Group, “Cancer survival in five continents: a worldwide population-based study,.S. abe at  responsible for theountries, in s chnologies, ” Lancet Oncology, Vol. 9, No. 8, August 2008, pages 730 – 756; Arduino Verdecchia et al., “Recent Cancer Survival in Europe: A 2000-02 Period Analysis of EUROCARE-4 Data,” Lancet Oncology, Vol. 8, No. 9, September 2007, pages 784 – 796.

[2] U.S. Cancer Statistics, National Program of Cancer Registries, U.S. Centers for Disease Control; Canadian Cancer Society/National Cancer Institute of Canada; also see June O’Neill and Dave M. O’Neill, “Health Status, Health Care and Inequality: Canada vs. the U.S.,” National Bureau of Economic Research, Working Paper No. 13429, September 2007.  Available at http://www.nber.org/papers/w13429.

[3] Oliver Schoffski (University of Erlangen-Nuremberg), “Diffusion of Medicines in Europe,” European Federation of Pharmaceutical Industries and Associations, 2002.  Available at http://www.amchampc.org/showFile.asp?FID=126.  See also Michael Tanner, “The Grass is Not Always Greener: A Look at National Health Care Systems around the World,” Cato Institute, Policy Analysis No. 613, March 18, 2008.  Available at http://www.cato.org/pub_display.php?pub_id=9272.

[4] June O’Neill and Dave M. O’Neill, “Health Status, Health Care and Inequality: Canada vs. the U.S.”

[5] Ibid.

[6] Nadeem Esmail, Michael A. Walker with Margaret Bank, “Waiting Your Turn, (17th edition) Hospital Waiting Lists In Canada,” Fraser Institute, Critical Issues Bulletin 2007, Studies in Health Care Policy, August 2008; Nadeem Esmail and Dominika Wrona “Medical Technology in Canada,” Fraser Institute, August 21, 2008 ; Sharon Willcox et al., “Measuring and Reducing Waiting Times: A Cross-National Comparison Of Strategies,” Health Affairs, Vol. 26, No. 4, July/August 2007, pages 1,078-87; June O’Neill and Dave M. O’Neill, “Health Status, Health Care and Inequality: Canada vs. the U.S.”; M.V. Williams et al., “Radiotherapy Dose Fractionation, Access and Waiting Times in the Countries of the U.K.. in 2005,” Royal College of Radiologists, Clinical Oncology, Vol. 19, No. 5, June 2007, pages 273-286.

[7] Nadeem Esmail and Michael A. Walker with Margaret Bank, “Waiting Your Turn 17th Edition: Hospital Waiting Lists In Canada 2007.”

[8] “Hospital Waiting Times and List Statistics,” Department of Health, England.  Available at http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/Performancedataandstatistics/HospitalWaitingTimesandListStatistics/index.htm?IdcService=GET_FILE&dID=186979&Rendition=Web.

[9] Cathy Schoen et al., “Toward Higher-Performance Health Systems: Adults’ Health Care Experiences In Seven Countries, 2007,” Health Affairs, Web Exclusive, Vol. 26, No. 6, October 31, 2007, pages w717-w734.  Available at http://content.healthaffairs.org/cgi/reprint/26/6/w717.

[10] June O’Neill and Dave M. O’Neill, “Health Status, Health Care and Inequality: Canada vs. the U.S.”

[11] Victor R. Fuchs and Harold C. Sox Jr., “Physicians’ Views of the Relative Importance of 30 Medical Innovations,” Health Affairs, Vol. 20, No. 5, September /October 2001, pages 30-42.  Available at http://content.healthaffairs.org/cgi/reprint/20/5/30.pdf.

[12] OECD Health Data 2008, Organization for Economic Cooperation and Development.  Available at http://www.oecd.org/document/30/0,3343,en_2649_34631_12968734_1_1_1_37407,00.html.

[13] “The U.S. Health Care System as an Engine of Innovation,” Economic Report of the President (Washington, D.C.: Government Printing Office, 2004), 108th Congress, 2nd Session H. Doc. 108-145, February 2004, Chapter 10, pages 190-193, available at http://www.gpoaccess.gov/usbudget/fy05/pdf/2004_erp.pdf; Tyler Cowen, New York Times, Oct. 5, 2006; Tom Coburn, Joseph Antos and Grace-Marie Turner, “Competition: A Prescription for Health Care Transformation,” Heritage Foundation, Lecture No. 1030, April 2007; Thomas Boehm, “How can we explain the American dominance in biomedical research and development?” Journal of Medical Marketing, Vol. 5, No. 2, 2005, pages 158-66, U.S. Department of Health and Human Services, July 2002.  Available at http://fraser.stlouisfed.org/publications/erp/page/8649/download/47455/8649_ERP.pdf .

[14] Nicholas D. Kristof, “Franklin Delano Obama,” New York Times, February 28, 2009.  Available at http://www.nytimes.com/2009/03/01/opinion/01Kristof.html.

[15] The Nobel Prize Internet Archive.  Available at http://almaz.com/nobel/medicine/medicine.html.

[16] “The U.S. Health Care System as an Engine of Innovation,” 2004 Economic Report of the President.

A Public Option Won’t Work–Government-Run Healthcare Plans Are Flawed

By Mike EnziPosted July 13, 2009

The free market has issues, too, but they can be fixed in the long run

http://www.usnews.com/articles/opinion/2009/07/13/a-public-option-wont-work–government-run-healthcare-plans-are-flawed.html?loomia_ow=t0:s0:a41:g26:r56:c0.000687:b26436706:z0&s_cid=loomia:obama-rush-to-overhaul-healthcare-shows-a-dangerous-deficit-of-understanding

Mike Enzi of Wyoming is the ranking member of the Health, Education, Labor, and Pensions Committee and the Senate’s lone accountant.

What do you think? Is a public option a good idea for healthcare reform?

I share the president’s goal of helping all Americans get the healthcare they need. I agree with what the president has said over and over during the campaign and since taking office: We need reform that will bring down healthcare costs, help everyone get quality care, and allow Americans who like the care they have to keep it. Unfortunately, many of the ideas floating through Congress, like creating a government-run plan, would break the promises that the president has made. As we proceed with the healthcare reform debate, the Democrats in Congress must match their deeds with the president’s words.

Before I was senator, and before that a mayor, I was a small-business owner in Gillette, Wyo. I saw firsthand how our nation’s health insurance system doesn’t work for many Americans. Too often, small businesses can’t afford to purchase health insurance, and many insurers compete by selecting healthy individuals and not covering sicker ones. Premiums continue to spiral ever upward, while a small group of insurers dominates the market in many states. This denies consumers real choices and creates a situation where a single employee who develops cancer or a mother who has a premature baby can result in a small business seeing its health insurance become unaffordable. The current system also leaves many Americans trapped in jobs solely to preserve their current health benefits.

Our current system makes no sense. We need to make reforms to address problems, but I fundamentally disagree with advocates who argue that the way to fix healthcare is with a government-run health plan. A government-run plan will not meet the president’s stated goals of bringing down costs and allowing people to keep the care they have now if they like it. Advocates of a government-run plan sometimes try to cloud its troubling aspects, but at its core, such a plan reflects the belief that government bureaucrats can effectively manage a marketplace. In a government plan, bureaucrats will determine how much every doctor, hospital, and healthcare provider is paid for services. They will also decide what items and services should be covered and whether patients should get access to newer, more expensive therapies.

Sixteen years ago, opponents of a similar approach described this structure as having all the efficiency of the Department of Motor Vehicles and providing all the customer service of the IRS. Little has changed. Government bureaucracies will always be nonresponsive to consumers’ needs and waste huge sums of money by misallocating resources on politically powerful constituencies rather than investing in areas that drive down consumer costs.

When government-run plans confront the harsh reality of rising healthcare costs, they will respond as they always have, by lowering their reimbursement rates and by rationing care. This, in turn, will lead to shortages and patients being denied the ability to see the doctor of their choice. Anyone who wants to see a real-world example of this need only look to the government-run Medicaid program, with its woeful reimbursement rates and administrative hassles. Forty percent of all physicians refuse to see Medicaid patients, yet this is the model that advocates of a government-run plan are trying to force upon all of America.

Government needs to play a bigger role in regulating and policing the healthcare market. We need strong oversight to protect patients, but government needs to be the referee, not the biggest player. I support common-sense reforms that will force insurers to compete on a level playing field. We should prevent insurers from being able to cherry-pick only healthy patients and limit how much more an insurer can charge to individuals based on their previous health conditions. We also need to create ways to reward insurers who enroll sicker patients, which should be offset by payments from plans that disproportionately enroll healthier individuals.

I will push for reforms that could transform health insurance into a truly competitive marketplace, where insurers compete on the basis of the value they provide to their enrollees, rather than their ability to game the marketplace and gain unfair advantages. In a truly patient-focused healthcare system, insurers should have to work hard for your business. I believe that this type of model will really keep insurers honest, because it will allow consumers to call the shots and vote with their feet.

When individuals can choose among competing private plans, we will have a system that will far more effectively drive down costs and keep insurers honest than any government-run plan that sets prices and tries to manage the market. The new Medicare drug benefit provides a good example of what competitive markets can achieve. In Medicare Part D, consumers were given the choice of nongovernment plans, which were forced to compete in a system with clearly defined rules and consumer protections. As a result, seniors are getting the drugs they need, the program costs 37 percent less than expected, and it enjoys an 85 percent satisfaction rate.

Wyoming, even with its small population, went from just a few prescription drug plans for seniors before the program began to 48 different options today. That’s the value of competition!

We all have the same goal—helping all Americans get healthcare coverage. We just disagree on how to get there. Winston Churchill once described democracy as “the worst form of government, except for all those other forms that have been tried from time to time.” I feel the same way about competitive markets. In the long run, despite their occasional shortcomings, competitive markets are the most effective way to drive down costs and provide the greatest value for consumers. It’s about time we tried them in healthcare.

Obama Rush to Overhaul Healthcare Shows a Dangerous Deficit of Understanding

 By Mary Kate Cary
Posted July 15, 2009

White House talking out both sides of its mouth in blind rush for healthcare reform

http://www.usnews.com/articles/opinion/2009/07/15/obama-rush-to-overhaul-healthcare-shows-a-dangerous-deficit-of-understanding.html?loomia_ow=t0:s0:a41:g2:r22:c0.075991:b26506218:z0&s_cid=loomia:a-medicare-style-public-option-in-healthcare-would-kill-private-insurance

Vice President Joe Biden, speaking on ABC’s This Week recently, said that the administration “misread the economy.” Its projections for the federal deficit were too optimistic, and slower economic growth will spell even bigger deficits for the next generation.

The administration and Democrats in Congress may also be misreading the healthcare system they are trying to overhaul. President Obama has argued that such a revamp is needed for the nearly 50 million Americans uninsured each year.

So who are these uninsured? They are not the poorest of the poor, who are eligible for Medicaid. According to 2007 figures from the Census Bureau, 17.5 million uninsured Americans have household incomes of $50,000 or more; an additional 9.1 million have incomes of $75,000 or more; 21 million of them work full time. A stunning 11 million were offered coverage by their employers and declined it, according to a report released recently by the Employment Policies Institute. (Some are healthy people who would rather spend their money elsewhere; others decline it for religious reasons—take, for example, a Christian Scientist who doesn’t believe in going to the doctor.) That same report adds that 43 percent of the uninsured make more than 2½ times the poverty level and that half are under age 35 and single. So a large percentage are relatively healthy, employed young people who have made a rational economic decision to avoid healthcare premiums.

Most people agree that we have a serious obligation to provide affordable healthcare to those who need it, but most would also agree that we do not need to remake our system for millions of Americans who just don’t want it. Poll after poll shows that most Americans are happy with their current healthcare—of course, we’d all like someone else to pay the bill—but the vast majority of us want to be able to keep our doctors and hospitals.

Yet the Obama administration is going full steam ahead, with the president committed to signing legislation by the end of this year. So the rush is on: The Washington Post recently diagrammed the “record-breaking influence campaign by the healthcare industry”—a web of over 350 former government officials, including ex-congressional leaders, who have been hired by the various players on all sides, spending $1.4 million a day in lobbying fees. In the suburbs of Washington where I live, the television ads are nonstop, advocating different versions of reform, many from nebulous groups with names like Healthcare Now America, Americans United for Change, Change Congress, and Democracy for America. Whether they’re representing doctors, hospitals, insurers, employers, unions, or the political parties is unclear. Who are these people, and what are they really supporting? Nobody I know can tell you.

Every time the White House makes a pitch for healthcare reform, it seems to try a different argument. Some days it argues we’ve all got to pay for universal care for the uninsured; on others, we’re told we already indirectly pay for that care, and we’ve got to reduce the cost of it. To some audiences, it extols the virtues of a government-run public plan; to others, it promises we can keep the coverage and the doctors we already have. It’s niche marketing to various segments of the electorate and, taken as a whole, is confusing and inconsistent, if not contradictory.

It also comes across as desperate. At a recent town hall meeting in Annandale, Va., President Obama took questions that the White House said were “directly from the public.” The president called on a crying woman who couldn’t afford healthcare for her cancer treatment but, according to the Huffington Post, she volunteers for Organizing for America, the Democratic National Committee’s political operation. Other supposedly random questions came from members of the Service Employees International Union and Healthcare America Now, a coalition supporting the White House healthcare reform plan, funded by the AFL-CIO and MoveOn.org. When the White House says it’s hearing from “the public” but then calls on people from organizations it’s working with to push this through, it must realize it comes across as manipulative and cynical—something many on the left accused the Bush White House of being.

No wonder people want to keep what they have. Most Americans remember the days of exploratory surgery, X-rays instead of PET scans, and long hospital stays. They realize that we now have the world’s best healthcare, vastly improved treatments for chronic illnesses, and progress toward cures for many diseases. Sure, insurance companies

and claim forms drive everyone crazy. But the devil we know may not be as bad as the one we don’t know.

When I hear about the government taking over a huge share of our economy

by taking over healthcare, I think of the government office most people deal with most often: the post office. The U.S. Postal Service is a great example of a congressionally run “public plan” for delivery of services that people need. No thanks.

For many families, massively changing our healthcare system will affect their monthly budget and their children’s healthcare choices for a long time. For our economy, healthcare reform is big money and big consequences for future generations, especially now that the administration will be revising the deficit projections upward. It’s all just too much, too fast, and the stakes are too high. We can’t afford another “misreading.”

A Medicare-Style Public Option in Healthcare Would Kill Private Insurance

 

What works in higher education won’t work in healthcare
http://www.usnews.com/articles/opinion/2009/07/17/a-medicare-style-public-option-in-healthcare-would-kill-private-insurance.html

 

By David Gratzer
Posted July 17, 2009

What works in higher education won’t work in healthcare

My father’s first teaching appointment in North America, after fleeing communist Hungary, was at a state university. I went to a public university. One day, my daughters may pursue their education in the state college system.

University students have the freedom to choose between private and public colleges—between the private and public sectors—and post-secondary education is the better for it. Yale and the University of Pennsylvania are strengthened by UCLA and Penn State.

Many feel passionately that the government needs to do something to increase competition in health care. A majority of American workers have a choice of one healthcare plan. I understand the frustration. The Manhattan Institute offers two options on health benefits for those eligible: Take the company plan or leave it. In many states, like Vermont, it’s worse: The whole market is dominated by just one or two companies.

And so, the call for change: President Obama campaigned on the idea of creating a health insurance exchange with a menu of competing options, including a public plan option, which would be government-run and modeled after Medicare. President Obama explained recently: “This will give them a better range of choices, make the healthcare market more competitive, and keep insurance companies honest.”

The proposal has broad support in Washington. Nancy Pelosi, speaker of the House, stated that she can’t support health-reform legislation without a government option. And the enthusiasm stretches past the beltway. More than 70 percent of Americans support the idea. It seems to work for higher education; why not for healthcare?

Here’s the problem. The model for the public plan, Medicare, isn’t an insurance, it’s a federal program. As such, the public plan option would overwhelm even the best private insurers, thanks to the unfair advantage of federal status. How? Let me count the ways.

Private insurers must comply with state regulations — like what services and procedures must be covered — where Medicare coverage doesn ‘ t. Such regulations, according to the Council for Affordable Health Insurance, push up the cost of a policy by 20 to 50 percent. As well, private insurers are taxed by state governments; Medicare isn’t.

Properly funded insurance plans must capitalize future costs; in contrast, a public plan option can simply tax or borrow enough to cover costs from one year to the next (think Fannie Mae).

A Medicare-style plan will set prices with providers, not negotiate them.

The last point is probably the most significant. By paying providers less, a government option would have a major and immediate advantage over its private rivals: It could charge artificially lower premiums and provide a magnet for enrollment. In April, the Lewin Group released an analysis concluding that about 120 million Americans would shift from private plans to the public option. Lewin’s John Sheils doesn’t mince words: “The private industry might just fizzle out altogether.”

Yes, there is public and private competition in post-secondary education. But note the dramatic difference there: State colleges still pay market wages for professors. UCLA needs to reasonably compensate a talented chemistry professor, or he can pack up and move. By employing price controls, the public plan option would be at a serious advantage over its private competitors. It’s not honest to allow one athlete to start at the halfway mark of the marathon.

Fast forward 10 years and the “affordable” public plan will have captured a huge market share. President Obama will be in Illinois drafting his memoirs, but Congress will face stark choices as the plan’s costs inevitably spike. The challenges will be eerily similar to the decisions made every day by legislators in countries with government-run healthcare systems. A public plan option will lead to government-dominated healthcare, then government-rationed healthcare.

Let’s be clear: Democrats are fundamentally right in their diagnosis. American healthcare in general, and health insurance in particular, lacks enough competition. But the government plan is bad medicine, pushing the country down the road toward socialized medicine on the installment plan.

Congress should consider reforms that will build on what already works in the American system. Here are few ideas:

First, Congress should make it easier for people to buy insurance. For a family attempting to get coverage, state regulations drive up the cost. In regulation-heavy New York, as an example, a family of four would pay $12,000 a year for coverage; in Wisconsin, a similar policy would be just $3,000. Why not allow people to buy policies across state lines? Not only would this save money, but it would help insure millions of uninsured—roughly 12 million, according to an analysis by University of Minnesota’s Stephen Parente and Roger Feldman.

Second, Congress should make it easier for small companies to provide coverage. An easy reform: Allow companies to band together and purchase health insurance collectively. Some estimates suggest that this one regulatory change could shave a third off the cost of plans for some employers. For organizations like the Manhattan Institute, the advantage would not only be lower costs, but it could help provide its employees with more options.

Third, Congress should address the tax code’s discrimination against the self-employed. Today, people who get their health insurance from the workplace get huge tax advantages; the self employed don’t. Congress should level the playing field, making health insurance more affordable for the fastest growing segment of our workforce.

These initiatives would create a more competitive and affordable market for health insurance—increasing our choices, not killing them.

http://www.usnews.com/articles/opinion/2009/07/17/a-medicare-style-public-option-in-healthcare-would-kill-private-insurance.html

Democrats Grow Wary as Health Bill Advances

NYT – http://www.nytimes.com/2009/07/18/health/policy/18health.html?em

News Analysis By ROBERT PEAR and DAVID M. HERSZENHORN
Published: July 17, 2009

WASHINGTON — Three of the five Congressional committees working on legislation to reinvent the nation’s health care system delivered bills this week along the lines proposed by President Obama. But instead of celebrating their success, many Democrats were apprehensive, nervous and defensive.

Even as Democratic leaders and the White House insisted that the nation was closer than ever to landmark changes in the health care system, they faced basic questions about whether some of their proposals might do more harm than good.

And while senior Democrats vowed to press ahead to meet Mr. Obama’s deadline of having both chambers pass bills before the summer recess, some in their ranks, nervous about the prospect of raising taxes or proceeding without any Republican support, were pleading to slow down.

Democrats had three reasons for concern. The director of the Congressional Budget Office warned Thursday that the legislative proposals so far would not slow the growth of health spending, a crucial goal for Mr. Obama as he also tries to extend insurance to more than 45 million Americans who lack it.

Second, even with House committees working in marathon sessions this week, it was clear that Democrats could not meet their goal of passing bills before the summer recess without barreling over the concerns of Republicans and ending any hope that such a major issue could be addressed in a bipartisan manner.

Third, a growing minority of Democrats have begun to express reservations about the size, scope and cost of the legislation, the expanded role of the federal government and the need for a raft of new taxes to pay for it all. The comments suggest that party leaders may not yet have the votes to pass the legislation.

Mr. Obama tried Friday to shift the political narrative away from the grim forecasts of the Congressional Budget Office. He said he and Congress had made “unprecedented progress” on health care, with even the American Medical Association endorsing the House bill this week.

He acknowledged a treacherous path ahead, saying, “The last few miles of any race are the hardest to run,” but insisted, “Now is not the time to slow down.” And he vowed: “We are going to get this done. We will reform health care. It will happen this year. I’m absolutely convinced of that.”

On Capitol Hill, the picture is more complex. Representative Jared Polis, a freshman Democrat from Colorado who voted against the bill approved Friday in the Education and Labor Committee, said he worried that the new taxes “could cost jobs in a recession.”

To help finance coverage of the uninsured, the House bill would impose a surtax on high-income people and a payroll tax — as much as 8 percent of wages — on employers who do not provide health insurance to workers.

Mr. Polis said these taxes, combined with the scheduled increase in tax rates resulting from the expiration of Bush-era tax cuts, would have a perverse effect. “Some successful family-owned businesses would be taxed at higher rates than multinational corporations,” he said.

In a letter to the House speaker, Nancy Pelosi, Mr. Polis and 20 other freshman Democrats said they were “extremely concerned that the proposed method of paying for health care reform will negatively impact small businesses, the backbone of the American economy.”

And in the latest sign of lawmakers’ chafing at Mr. Obama’s ambitious timetable, a bipartisan group of six senators, including two members of the Finance Committee, sent a letter to Senate leaders pleading with them to allow more time.

“While we are committed to providing relief for American families as quickly as possible,” they wrote, “we believe taking additional time to achieve a bipartisan result is critical for legislation that affects 17 percent of our economy and every individual in the United States.”

The group included three senators, Ben Nelson, Democrat of Nebraska; and Olympia J. Snowe and Susan Collins, Republicans of Maine, who met with Mr. Obama at the White House this week and urged him not to rush the bill.

“The legislative process right now is going in the wrong direction,” said Senator Joseph I. Lieberman, the Connecticut independent, who also signed the letter. “I think it’s extremely doable to get this done before the end of the year. But just to try to get it passed in the Senate before we leave for the August recess seems just about impossible. It’s just too big a bill.”

The House education committee approved the bill, 26 to 22, on Friday morning, after an all-night session. Three Democrats crossed party lines and voted no.

The vote came eight hours after the House Ways and Means Committee approved a nearly identical bill, 23 to 18, with 3 Democrats voting no. On Wednesday, the Senate health committee approved a generally similar bill on a party-line vote, 13 to 10.

The House and Senate bills would require insurers to take all applicants and vastly expand coverage, with federal subsidies for millions of people.

But the director of the Congressional Budget Office, Douglas W. Elmendorf, testified on Thursday that doing so would come at a steep cost and that the proposals would not curb the rise in health spending by the federal government, which he called “unsustainable.”

A budget office analysis released Friday said the House bill would “result in a net increase in the federal budget deficit of $239 billion” over 10 years, partly because of an increase in Medicare spending to avert sharp cuts in payments to doctors.

House Democrats who voted no cited various concerns.

“We are not doing enough to reform the health care delivery system, to change the incentives so reimbursement will be based on the value, rather than the volume, of services,” Representative Ron Kind of Wisconsin said.

Others worry that a government-run health plan, to be created under the House bill, would underpay doctors and hospitals by using Medicare reimbursement rates. “I have a serious problem with the public plan in this bill because it’s based on Medicare rates,” Representative Earl Pomeroy of North Dakota said. “North Dakota is underpaid by Medicare.”

Mr. Obama said he was confident that Congress and the White House would reach a deal on how to pay for the bill, and lower health care spending over the long term — an optimistic view that not all lawmakers share. But on one of Mr. Obama’s points, there was no dispute: “We’re going to be putting in a lot more hours,” the president said. “There are going to be a lot more sleepless nights.”

Mayo Clinic calls House plan bad medicine

Washing Times Tuesday, July 21, 2009
http://www.washingtontimes.com/news/2009/jul/21/mayo-clinic-calls-house-plan-bad-medicine/?feat=home_cube_position1

A world-renowned clinic that President Obama held up as an example of good medicine said Monday that the American people would be “losers” under the House’s health care proposal, joining the growing chorus of critics the Obama administration is trying to fend off as the debate intensifies from Capitol Hill to Main Street.

Minnesota’s not-for-profit Mayo Clinic, which Mr. Obama has repeatedly hailed as offering top quality care at affordable costs, blasted the House Democrats’ version of the health care plan as lawmakers continue to grapple with several bills from each chamber and multiple committees.

The Mayo Clinic said there are some positive elements of the bill, but overall “the proposed legislation misses the opportunity to help create higher quality, more affordable health care for patients.”

“In fact, it will do the opposite,” clinic officials said, because the proposals aren’t [R]patient-focused or results-oriented. “The real losers will be the citizens of the United States.”

Repealing Erisa

WSJ- JULY 20, 2009, 11:54 P.M. ET
 http://online.wsj.com/article/SB10001424052970203946904574298661486528186.html

One by one, President Obama’s health-care promises are being exposed by the details of the actual legislation: Costs will explode, not fall; taxes will have to soar to pay for it; and now we are learning that you won’t be able to “keep your health-care plan” either.

The reality is that the House health bill, which the Administration praised to the rafters, will force drastic changes in almost all insurance coverage, including the employer plans that currently work best. About 177 million people—or 62% of those under age 65—get insurance today through their jobs, and while rising costs are a problem, according to every survey most employees are happy with the coverage. A major reason for this relative success is a 1974 federal law known by the acronym Erisa, or the Employee Retirement Income Security Act.

Erisa allows employers that self-insure—that is, those large enough to build their own risk pools and pay benefits directly—to offer uniform plans across state lines. This lets thousands of businesses avoid, for the most part, the costly federal and state regulations on covered treatments, pricing, rate setting and so on. It also gives them flexibility to design insurance to recruit and retain workers in a competitive labor market. Roughly 75% of employer-based coverage is governed by Erisa’s “freedom of purchase” rules.

Goodbye to all that. The House bill says that after a five-year grace period all Erisa insurance offerings will have to win government approval—both by the Department of Labor and a new “health choices commissioner” who will set federal standards for what is an acceptable health plan. This commissar—er, commissioner—can fine employers that don’t comply and even has “suspension of enrollment” powers for plans that he or she has vetoed, until “satisfied that the basis for such determination has been corrected and is not likely to recur.”

In other words, the insurance coverage of 132 million people—the product of enormously complex business and health-care decisions—will now be subject to bureaucratic nanomanagement. If employers don’t meet some still-to-be-defined minimum package, they’ll have to renegotiate thousands of contracts nationwide to Washington’s specifications. The political incentives will of course demand an ever-more generous “minimum” benefit and less cost-sharing, much as many states have driven up prices in the individual insurance market with mandates. Erisa’s pluralistic structure will gradually constrict toward a single national standard.

Yet a computer programming firm, say, and a grocery store chain have very different insurance needs, and in any case may not be able to afford the same kind and level of benefits. Innovation in insurance products will also be subject to political tampering. Likely casualties include the wellness initiatives that give workers financial incentives to take more responsibility for their own health, such as Safeway’s. Some politicians will claim that’s unfair. High-deductible plans with health savings accounts are also out of political favor, therefore certain to go overboard. If you have one of those and like it, too bad.

The new Erisa regime will be especially difficult to meet for businesses that operate with very slim profit margins or have large numbers of part-time or seasonal workers. They may simply “cash out” and surrender 8% of their payroll under the employer-mandate tax. A new analysis by the Lewin Group, prepared for the Heritage Foundation, finds that some 88.1 million people will be shifted out of private employer health insurance under the House bill. If those people preferred their prior plan, well, too bad again.

The largest employers—though not all—may clear the minimum bar, at least at first. But in addition to the “health choices” administrative burden, the cost of labor will rise because the House guts another key section of Erisa. Currently, lawsuits about employee benefits are barred under the law, allowing large employers to avoid the state tort lotteries in disputes over coverage. No longer. As a gratuity to the trial bar, Democrats will now subject businesses to these liabilities in the name of health “reform.”

So when Mr. Obama says that “If you like your health-care plan, you’ll be able to keep your health-care plan, period. No one will take it away, no matter what,” he’s wrong. Period. What he’s not telling the American people is that the government will so dramatically change the rules of the insurance market that employers will find it impossible to maintain their current coverage, and many will drop it altogether. The more we inspect the House bill, the more it looks to be one of the worst pieces of legislation ever introduced in Congress.

Ten Questions on the Health-Care Overhaul

By:Janet Adamy 

The Effort to Change the System Enjoys More Support Than Past Attempts, but the Complications Are as Acute as Ever 
- July 21, 2009
http://online.wsj.com/article/SB124812571962066393.html

It is crunch time for health care. Lawmakers who are trying to fundamentally remake one-sixth of the U.S. economy say this might be the most complicated legislation they have undertaken.

Here are some basics that everyone can grasp — and probably ought to, because the health bill, if it passes, will affect almost everyone.

1. What is the problem with health care, anyway? Is it as bad as they say?

The problem, as advocates for change see it, boils down to two big areas: high costs and lack of coverage. For some households and employers, the cost of care already is out of reach, and many more will struggle to afford it if costs keep escalating. Medicare is eating up a bigger share of government spending, and a growing number of bankruptcies and home foreclosures are linked to medical expenses.

Even though the U.S. spends $2 trillion a year for health care, some 46 million people don’t have health coverage. To be sure, that oft-cited number from the Census Bureau is somewhat misleading because it includes illegal immigrants, healthy young adults who don’t think they need insurance and poor people who are eligible for Medicaid.

Still, as the recession wears on, the number of uninsured appears to be rising. One study, by the left-leaning Center for American Progress Action Fund, found that as many as 14,000 people are losing their health insurance every day because of job cuts. Families who have insurance pay an additional $1,000 a year in premiums to effectively subsidize all the people who receive care but don’t pay for it, according to a separate study by the liberal group Families USA and actuarial consultancy Milliman Inc.

2. Can Democrats and Republicans agree on anything?

Actually, yes. There is broad support for changing the way hospitals and doctors are paid so that they are compensated for the quality of care they provide, not the quantity of procedures they do. Democrats and Republicans also back the idea of creating online marketplaces where consumers and small businesses can comparison-shop for plans.

Both parties want to bar insurance companies from denying coverage to people who are already sick. The insurers are willing to make that concession, as long as lawmakers also require most people to carry insurance, since that would force young, healthy people into the insurance system.

It amounts to a twin mandate — one on insurers to sell policies, and another on Americans to buy them. Although there are pockets of Republican opposition to the latter idea, both have enough bipartisan support to pass. These steps alone would represent big changes to the status quo.

3. Where are the main points of disagreement?

The sharpest divide between the two parties: Whether to create a government-run insurance plan (otherwise known as a “public plan”) that would go up against private plans in online marketplaces. President Barack Obama says a public plan will keep private insurers honest. Republicans say it would give the government too much control over health care.

The other main battle, which doesn’t break down as easily along party lines, is how to pay for a plan expected to cost at least $1 trillion over a decade. Many lawmakers think it makes sense to impose a tax on employer-provided health-care benefits, a perk that currently is tax-free.

Then they looked at the poll numbers. Many voters hate the idea of paying taxes on something that right now costs nothing. So Democrats have instead proposed raising taxes on the rich.

Congress also remains divided over whether to make employers (except really small ones) provide insurance. House Democrats propose that if companies don’t offer insurance, they should contribute as much as 8% of their payroll spending toward helping workers buy insurance on their own. Republicans argue that companies will make up for it by cutting jobs and lowering wages.

4. What would a public plan look like?

The country already has a huge public plan — Medicare, which covers the elderly and some other groups. It generally pays doctors and hospitals less than private insurers. Liberal Democrats would like to replicate it in the new marketplaces. They want the government directly to set premiums and services under the plan, perhaps with basic and premium options.

That isn’t going to fly in this Congress, despite Democratic control of both chambers. Republicans are more opposed to having a government plan than Democrats are bent on having it. Conservatives figure the government would quickly drive private insurers out of business by undercutting them on price.

Two other scenarios have emerged as compromises. One is to hold off on creating the plan and instead impose heavy regulations on insurance companies aimed at making coverage accessible and affordable. If that doesn’t work, then the government insurance plan would kick in after several years. The other idea is to create a batch of regional nonprofit insurance cooperatives to compete with private insurers. But many liberals consider that a far stretch from the original idea, since the government wouldn’t run those plans.

One point that gets overlooked in the debate is that most people probably wouldn’t even be eligible for the public plan. Only individuals without affordable employer-provided insurance and businesses that aren’t big enough to buy reasonably priced plans on their own would qualify.

5. Why is the total price of the overhaul so expensive, especially considering that it is designed to bring down costs?

The cost mostly comes from giving people subsidies to buy insurance, and from expanding Medicaid, the federal-state insurance program for the poor, to cover more low-income Americans.

The theory is that once more Americans carry insurance, the entire health system will spend less money caring for them. Those people will have more access to care that prevents them from getting sick in the first place, and they would rely less on costly forms of treatment such as visiting the emergency room. But it could be years before that really reduces health costs, if it ever does.

President Obama often talks about more fundamental fixes for high costs, like paying for quality and blocking doctors from boosting their income with unnecessary tests. But Congress has limited power to change that.

 

6. What are the most likely ways to pay for the overhaul?

The White House has proposed about $950 billion in savings over 10 years to pay for the plan that include things like lower reimbursements to hospitals that treat Medicare patients.

The wealthy are a natural target. One proposal is limiting itemized tax deductions for families who earn more than $250,000 annually, a campaign idea of the president. House Democrats want to impose a surtax on wealthy individuals. Less likely are new taxes on soda and sugary drinks, which many lawmakers see as politically unpopular.

7. Which industries are most likely to lose, and which to gain, from any overhaul?

Perhaps no industry stands to gain more from the changes than health insurers, who would get tens of millions of new customers because Americans would be required by law to carry health insurance. Pharmaceutical companies would sell more prescription drugs because more people would have coverage for drugs and access to doctors who prescribe them. Hospitals and doctors wouldn’t have to provide as much free care as they do now.

But each of those groups also could take hits, particularly the health insurers if some kind of public option drives down their profit margins. The big losers would be retailers, restaurants and other businesses with low-income workers who provide little or no health insurance, since they would be forced to start paying for it.

Businesses that are too small to afford health insurance but not tiny enough to fall below the proposed $250,000 annual payroll cutoff that exempts them from providing coverage also could get squeezed by the legislation.

8. I already have insurance through my job – what happens to me?

Not too much at first. A handful of tax-free perks for the insured could get axed. For instance, lawmakers want to end the practice of allowing people to put money into so-called flexible spending accounts, which allow them to pay for everything from cosmetic dental work to surgery with tax-free dollars.

Longer term, a lot could change. For instance, your employer could drop coverage, preferring to pay the penalty for doing so and deflecting employees to Uncle Sam’s plan. Cost-cutting efforts in other parts of the system could eventually affect employer-provided plans as well.

9. Politicians have tried for decades to push universal health insurance. Why did they always fail before? Why would this time be any different?

These efforts stretch back to the 1930s, when President Franklin Roosevelt proposed creating a compulsory health-insurance system for all Americans, run by the states. Doctors, worried it would hurt their pay, helped kill the measure, buoyed by opposition from business and labor groups. Other major health overhaul attempts, most notably President Bill Clinton’s 1993-94 effort, died because powerful interest groups feared their members would either earn less or have to pay more under the new system.

What is different now is that major health and other interest groups are on board with the idea. Many insurers, hospitals, doctors and drug companies agree that the system is so flawed it isn’t sustainable, and they see a bill as a chance to push through improvements like adopting electronic health records, broadening the use of data to show which treatments work best and reducing the threat of malpractice lawsuits. Employers see it as a chance to curb the sharply rising price of covering their workers. Almost no one is arguing that the system is fine the way it is. Mr. Obama’s high popularity, coupled with wide Democratic margins in Congress, also grease the wheels for passing a bill.

10. What happens if the effort once again fails?

Lawmakers would likely scale back their plans and try to at least pass a measure that partially expands insurance coverage or helps stall the increase in health costs. But so many parts of the legislation are intertwined that they will be less effective, and perhaps impossible to achieve, if done piecemeal. Lawmakers might be reluctant to take up the controversial legislation ahead of congressional elections next year. So it would probably be several years before lawmakers tried again.

Write to Janet Adamy at janet.adamy@wsj.com