Monday, March 22, 2010 at 6:34AM
Comments for this entry have been disabled. Additional comments may not be added to this entry at this time.
800-951-4110
Bachelor’s Degree and Certificates in Midwifery
100% Online, State of Minnesota registered college courses
Doula trainings, Childbirth Educator and Post Partum Doula Trainings
Join us Today! Midwives and Allied Birth Professionals hold the future!
Reader Comments (46)
Single acts of tyranny may be ascribed to the accidental opinion of the day; but a series of oppressions, begun at a distinguished period, and pursued unalterably through every change of ministers (adminstrators) too plainly proves a deliberate, systematic plan of reducing us to slavery. ~Thomas Jefferson
We are in such dire need of reform, but I can't get behind "reform" that allows the bookmaking on Wall St. to continue. This appears to me to be the best possible scenario for the insurance goons. I don't care if we embrace a fully capitalist model - meaning a truly FREE market with HONEST COMMERCE - or go socialist, its all the same in the end, either pay this way or that. Both have their benefits and drawbacks. But this is neither - it's just corporatocracy where my paid participation in the most abysmal medical care in the industrialized world is now mandated. I just can't feel good about this "reform" no matter how hard I try.
I am much more optimistic today than I've been in a long time.
This is a far from perfect bill; I can hardly be thrilled about the way women's reproductive freedoms were such a trivial bargaining chip. But maybe we needed this kick in the butt to organize better for more women candidates and prochoice representatives in general (and I'm already planning on making contributions to Stupak's Democratic challenger Saltonstall, who is prochoice).
BUT. It is a hugely important step down the road to true reform of healthcare. I work with people in the health insurance industry, and let me tell you; they are not celebrating a giveaway, because they know it's just the beginning. There may be short term profits, but they cannot deliver healthcare as cheaply as the government can, and eventually, they fear, everyone else will realize it too and move to cut them out of the middle. No celebrations in the offices of the insurance companies today.
We as a nation are royally screwed. An insurance reform that both congress and the president will be exempt from. It is extremely dangerous to give the government the power to control many aspects of our lives. I will not be surprised if we are limited on how we may birth even further. Amendment 48 of the constitution states that congress may not pass laws that are for themselves and exclude the u.s. citizrns and vice-versa yet they did just that. If you're not outraged, then you're not paying attention
This means that I can leave my government job and go to midwifery school, and know that I will be able to buy insurance as an individual on the exchange for a competitive price, despite the fact that I have a pre-existing condition (asthma). I no longer feel that I have to stay at my job just because of the health insurance.
I live far far away from America. But I have been observing the process. And I'm relieved to get to the next phase of this process.
I live in the country that seems to have Europe's most cost-efficient health-care system. Estonia can use only about 5% of GDP to health-care costs. And I'd say, we are not really in a bad system. I could talk hours about that, but that is not the topic.
So all these "death panels" and "bureaucrats between me and my doctor" seemed so ... far away from real life. There already is a bureaucrat between you and your doctor, insurance company profit-pushing one.
This bill is definitely not perfect, but it can be a good start.
Good luck implementing and improving in the future! This news definitely made my day nicer!
I have a few fears. First, homebirth. Many insurance companies and state run medical like ACCCHS (in AZ) won't pay for homebirth. Many women pay out of pocket for their homebirth. Are we still gonna have that option? Second, having not read the bill, I am a little concerned how certain aspects of our health might be managed. I would hate to see procedures denied or forced based on what the insurance co deems necessary. Sadly, I think we just gave our gov and insurance co more power to control our bodies.
I was very distressed to hear that we can no longer get medication from Canada. I still need to confirm what the details are on that, but their site is overloaded today, of course. Right now I'm able to get my thyroid med compounded, but when they run out of the powder I'm absolutely screwed. Canada was my only other option. Lots of mourning in the dessicated thyroid community.
And I guess overall, I'm mostly concerned that they haven't changed enough. This is not reform. It's still the same old for-profit corporations imposing various restrictions, limits, unreachable deductables... only now we're forced to pay into it; we cannot vote with our wallets. This does not even remotely resemble what Obama talked about up until the election. I don't understand why people are not more outraged at this bait-and-switch.
@Michelle, you're asking if we are still going to have the option to pay out of pocket for homebirth? Yes, you can still pay out of pocket for any care you want to. Healthcare providers always will happily accept your cash.
It never ceases to amaze me how much of the opposition to this bill is based on things that are demonstrably untrue.
You can basically put me down for what emjaybee said.
I’m NOT cool with the throwing of women’s reproductive health under the bus (man that phrase is so tired now), and a system that relies on the market is going to produce some violent inequities down the line, but this is better than nothing. I saw a funny tweet that said “my only problem with the current healthcare system is that it’s NOT a socialist takeover.” My ideal would be an entirely nonprofit, single-payer system, because I think that healthcare is a right, not a commodity. Some people don’t agree, and that’s cool, but I absolutely don’t understand those people.
A lot of folks have been wringing their hands over what is going to happen to birth like it’s something that we have to sit on the sidelines for and just watch as it unfolds. Like we have no agency. But, correct me if I’m wrong here, aren’t a lot of the countries that have some of the highest utilization of home birth those pesky socialists, like Canadians, Brits, and Dutch? And isn't it based in the fact that it's cheaper and just as safe for low-risk pregnancies to deliver babies at home with access to emergency services if needed? I think that the Big Push, the MAMA campaign, and others have been trying to hammer home the message that midwifery care is less expensive and more appropriate for low-risk pregnancies – as we try to weed out the inefficiencies in the system, I think one of the places to trim could be in avoiding immediate recourse to the most technocratic location of birth and reaching for a scalpel to solve a problem that a well trained hand can solve …
@Nora, Michelle- While we always pay out of pocket for things, when more of our money hes to go to health care insurance, there will be much less to pay for things like midwifery & alternative medicine. Also, many of those health care provider will go out of business because less people will be able to afford them.
They haven't stopped homebirth where they've made it blatantly illegal, they won't stop it even if they refuse to cover it. And we have much rational for why our preferred type of care should be covered ('us' in this case being homebirthing moms- I know not everyone on this site is... just example)
I for one am relieved the process is moving forward. It needs refining for sure, but this is a place to start. And I have nothing left to fear from my inevitable divorce now that I can find health insurance soon. I am still (legally only) married to a lying cheating degrading demoralizing man because in my work I have had no option for health care coverage since 2002. I panicked about becoming single- not because of my kids, or lack of reliable income, or hatred of the 'divorce' label, but just because I was afraid I'd be forever sunk if I were injured again, or truly ill. Now I know there will be some option- even if imperfect.
While the whole abortion as a bargaining chip bothers me, the bill does open up medicaid to pay for free standing birth centers. I think that is a good sized step in the right direction. We just need to get homebirth legal in all states then work towards the coverage of it.
As a whole, I fell better that if my husband or I get sick, we are less likely to be bankrupted from it now. Neither of us have insurance because we'd be out 40% of our income before the insurance company would pay anything. We take our chances because we are young and healthy. The problem with the opposition to this bill is that they forget about the "working poor". They are too busy complaining that they don't want their tax dollars taking care of lazy people, but they already are. The people paying taxes will benefit from this the most.
"The doctor begins to lose freedom. . . . First you decide that the doctor can have so many patients. They are equally divided among the various doctors by the government. But then doctors aren’t equally divided geographically. So a doctor decides he wants to practice in one town and the government has to say to him, you can't live in that town. They already have enough doctors. You have to go someplace else. And from here it's only a short step to dictating where he will go. . . . All of us can see what happens once you establish the precedent that the government can determine a man's working place and his working methods, determine his employment. From here it's a short step to all the rest of socialism, to determining his pay. And pretty soon your son won't decide, when he's in school, where he will go or what he will do for a living. He will wait for the government to tell him where he will go to work and what he will do."
- Ronald Reagan, 1961, in opposition to Medicare.
I only wish the bill were kicking in quickly enough to reassure me about my health insurance prospects after my student insurance expires in August. Then I could take my first short steps to socialism and pretty soon the government would tell me where I could go to work (also helpful, because I'm still looking for a job). I'm looking forward to the socialist future!
It's fine to claim that you have a right to health care, but you don't have the right to force someone to provide you health care for free, because that would infringe on their rights to liberty and property. Rights only extent as far as they don't interfere with someone else's rights. So sure, you have a right to health care in that no one can deny you health care if you're willing to exchange something for it, but you don't have the right to force them to do it for free, otherwise doctors would never be able to feed their families, and then there simply wouldn't be anymore doctors. Does that clarify the view a little, Courtroom Mama?
As for this bill, I'm more concerned about the way it was passed. Every time legitimate, Constitutional blocks came up in the legislative process, those blocks were skirted rather than addressed. It was passed by means of shear corruption, and can exist in no other fashion. The ends do not justify the means. This bill has set a dangerous precedent that if allowed to stand will eventually result in the collapse of the republic as we know it. That may sound extreme to some people, but I believe the most significant presidential election was the first time power peacefully transferred from one party to the other. It set a precedent that allowed this country to flourish in ways others have not. This bill, as well as the way it was passed, is an insane mockery of the Constitution...not to mention that similar systems on the state level have all failed miserably.
Finally, I see lots of people upset about a for-profit system. There's nothing evil about profit! Profit is what allows you to provide food, clothing, and shelter for your families. That's not evil! If doctors could not provide food, clothing, and shelter for their families as doctors, they'd choose to be something else, and then what are we left with? No doctors (or a lot fewer doctors)! If you're upset about how MUCH profit they're getting that's a different story, which can only be fixed through competition, which this bill stifles. It is designed specifically to put private insurance companies out of business (you can find those videos on youtube).
As for pre-existing conditions, that's not so black and white. Insurance only works if people pay for it while they're healthy AS WELL as when they're sick, otherwise they'd always be in the red. If I can join when I have a preexisting condition, why would I bother to ever pay when I am healthy? I understand the dilemma if you lose your job though. Many insurance companies will cover you if you've had continuous coverage somewhere else for a certain amount of time, but not all. I think it would be best if all insurance were private (but tax-deductible), and not provided by employers. That way you can choose which insurance is best for you, and if you lose your job, you still have insurance.
And ACTUALLY, the very best thing for medical prices is for insurance companies to only cover catastrophic events (like cancer and what not). That way you're constantly comparing prices between medical providers. The competition will drive prices down, where before it's $25 to you no matter where you go.
To my prochoice friends, I would just like to point out that this bill doesn't prevent anyone from getting abortions, it just makes it so tax dollars don't go to it. It's not a matter of blocking funding, it's a matter of protecting those people who truly believe abortion is murder. Whether or not it is, isn't the point. How would you feel if your tax dollars went to paying for forced unnecesareans?
Anyway, this post was longer than intended. I think this reform was not the way to go, and too expensive to boot! Remember there's a difference between deficit and debt. To say they shrunk the deficit just means they shrunk the amount of the loan. With debt like ours, we shouldn't be taking out loans at all, but paying off the ones we have.
It seems to me that the for-profit insurance industry IS part of the problem. Of course, no one expects medical personnel to dole out care for free, but costs are astronomical and getting to the point where many (most?) people can't afford care. I pay more than $14,000 in annual premium for a family plan, so I get it why people take their chances in going without coverage. We've all heard of the examples of a bandage costing $5, and so on. Where do we cut costs? We can't drastically slash the salaries of medical personnel, so we need to use cheaper procedures whenever possible (e.g. reducing unnecesareans) and/or cut the overhead of the insurance companies. Hence, non-profit status could help.
Because insurance companies must turn a profit, they must also try to cover as little as possible, reimburse at as low rates as possible, and increase premiums as much as possible. That's just not sustainable.
Also, every private insurance plan I've ever had covers elective abortions, which makes the focus on not covering them in the federal plan kind of interesting to me. Do most people not know that they are already subsidizing abortions via their private insurers?
Regarding concern about doctors working for free, see this press release from Friday:
AMA Supports House Passage of Health System Reform
Will work with Congress and the administration to make critical changes that cannot be addressed through the reconciliation process
For immediate release:
March 19, 2010
Washington, D.C. – After careful review and consideration, the American Medical Association (AMA) today announced its qualified support for the current health reform bill as a step toward providing coverage to all Americans and improving our nation’s health system.
“The pending bill is imperfect, but we cannot let the perfect be the enemy of the good when it comes to something as important as the health of Americans,” said J. James Rohack, M.D., AMA president. “By extending health coverage to the vast majority of the uninsured, improving competition and choice in the insurance marketplace, promoting prevention and wellness, reducing administrative burdens, and promoting clinical comparative effectiveness research, this bill will help patients and their physicians.”
“While the final product is certainly not what we would have devised, we strongly support the parts of this bill that are desperately needed by millions of Americans who are struggling to get or keep health insurance coverage,” Dr. Rohack said. “We will continue to work with Congress and the administration to solve important issues that cannot be addressed through the reconciliation process.”
“This is not the last step, but the next step toward real health system reform,” Dr. Rohack said. “We will remain actively engaged with Congress and the administration to ensure that before Congress adjourns there are additional important changes to our health system. Congress must act to preserve access to care for seniors and military families by permanently repealing the Medicare physician payment formula that will cut Medicare payments by 21 percent next month. According to an AARP poll, nearly 90 percent of people age 50 and older are concerned that the Medicare physician payment cuts threaten their access to care.”
“Congress must also move immediately to correct problems with the Independent Payment Advisory Board,” Dr. Rohack said. “The current IPAB framework could result in misguided payment cuts that undermine access to care and destabilize health care delivery. The AMA will be relentless in our pursuit of permanent repeal of the Medicare physician payment formula, corrections to IPAB, and other important changes that we outlined in a letter today to House Speaker Nancy Pelosi.”
“Every day physicians see the devastating effect that being uninsured has on the health of our patients: They live sicker and die younger,” Dr. Rohack said. “Physicians dedicate their lives to helping patients live healthier and longer, and we have an historic opportunity to do just that.”
From: http://www.ama-assn.org/ama/pub/health-system-reform/ama-supports-reform-passage.shtml