{"id":485245,"date":"2010-03-29T00:07:00","date_gmt":"2010-03-29T04:07:00","guid":{"rendered":"tag:blogger.com,1999:blog-5587346.post-248822891705263162"},"modified":"2010-03-30T07:58:26","modified_gmt":"2010-03-30T11:58:26","slug":"health-care-reform-%e2%80%93-the-road-ahead","status":"publish","type":"post","link":"https:\/\/mereja.media\/index\/485245","title":{"rendered":"Health care reform \u2013 the road ahead"},"content":{"rendered":"<p><em>Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.<\/em>    <br \/><a href=\"http:\/\/www.quotationspage.com\/quote\/24921.html\">Winston Churchill, 1942<\/a>.<\/p>\n<p><em>One way or another I&#8217;m gonna find ya     <br \/>I&#8217;m gonna getcha getcha getcha getcha<\/em>.    <br \/><a href=\"http:\/\/www.azlyrics.com\/lyrics\/blondie\/onewayoranother.html\">Blondie<\/a>.<\/p>\n<p>In the original <a href=\"http:\/\/notes.kateva.org\/2010\/03\/summarizing-patient-protection-and.html\">Senate version of the Health Care reform bill<\/a> we find this clause \u2026<\/p>\n<blockquote>\n<p><b>Subtitle D: Improvements to Medicaid Services<\/b> &#8211; (Sec. 2301) Requires Medicaid coverage of: (1) freestanding birth center services \u2026<\/p>\n<\/blockquote>\n<p>Yes, there are a lot of funny bits in this sausage. We don\u2019t know the half of \u2018em, but I do know my family will pay for them. Now that the bill done (for now) I can say that the wingnuts were right about some things; my team\u2019s \u201c$250,000 and above\u201d slogan was nonsense. \u201cOne way or another\u201d upper 30th percentile \u201ctax-equivalents\u201d [1] will go up.<\/p>\n<p>I\u2019m good with paying for this; I expected to pay for it when I campaigned for Barack Obama. Altruism aside, there are tangible personal benefits for my family:<\/p>\n<ul>\n<li><a href=\"http:\/\/delong.typepad.com\/sdj\/2010\/03\/mark-thoma-health-care-reform-and-labor-mobility.html?utm_source=feedburner&amp;utm_medium=feed&amp;utm_campaign=Feed%3A+BradDelongsSemi-dailyJournal+%28Brad+DeLong%27s+Semi-Daily+Journal%29&amp;utm_content=Google+Reader\">We\u2019re no longer lashed to my employer<\/a>. Since I expect to be <a href=\"http:\/\/notes.kateva.org\/2010\/03\/why-we-need-to-retire-at-sixty.html\">an involuntary entrepreneur within 8 years<\/a> this is rather good. <\/li>\n<li>Not all of our children are <a href=\"http:\/\/notes.kateva.org\/2004\/05\/lurching-towards-wisdom-neurodiversity.html\">equally suited to life in the post-modern world<\/a>. This bill increases the probability that they will, at least, receive health care after my warrantee expires.<\/li>\n<li>Now my insurance provider doesn\u2019t have to <a href=\"http:\/\/notes.kateva.org\/2010\/03\/health-insurance-companies-only-demonic.html\">be demonic to survive<\/a><\/li>\n<li>America is less likely to turn into Haiti of the North. I really don\u2019t like broken glass topped walls. <\/li>\n<\/ul>\n<p>What\u2019s next? We\u2019ve been stuck in the headlights for a generation, but now we\u2019re moving. We might be charging towards the oncoming truck, but even that may be an improvement on standing still. At least with motion comes opportunity.<\/p>\n<p>The question isn\u2019t where we need to go. We\u2019ve known that for at least thirty years. We\u2019re going to the same place as everyone else on earth \u2013 <a title=\"Gordon's Notes Health care reform \u2013 lessons from Quebec\" href=\"http:\/\/notes.kateva.org\/2009\/03\/health-care-reform-lessons-from-quebec.html\">good<\/a> <a href=\"http:\/\/notes.kateva.org\/2006\/11\/healthcare-reform-faughnan-one-slide.html\">enough<\/a> <a href=\"http:\/\/notes.kateva.org\/2009\/02\/staggering-towards-health-care-access.html\">care<\/a> for everyone and luxurious care for those with money. The question is how we get there.<\/p>\n<p>Until now the American people have been completely unwilling to think about health care cost. It would have been nice if we could have cut costs before increasing access, it would have been nice if we\u2019d come up with a reform plan that made it easier to cut costs, it would be nice if we weren\u2019t charging towards the right fender of that oncoming truck. Nice \u2013 but not going to happen in a world where the GOP has gone mad.<\/p>\n<p>Now, however, we\u2019ll all be, at last, considering costs and value. It won\u2019t be pretty, but if it were pretty it wouldn\u2019t be real.<\/p>\n<p>That\u2019s progress.<\/p>\n<p><strong>See also:<\/strong><\/p>\n<p>Post-passage commentary<\/p>\n<ul>\n<li><a title=\"Gordon's Notes Summarizing the Patient Protection and Affordable Care Act \u2013 in two pages and 10\" href=\"http:\/\/notes.kateva.org\/2010\/03\/summarizing-patient-protection-and.html\">Summarizing the Patient Protection and Affordable Care Act \u2013 in two pages and 10 titles<\/a> (worth a scan, really) <\/li>\n<li><a title=\"Gordon's Notes Best health care reform commentary\" href=\"http:\/\/notes.kateva.org\/2010\/03\/best-health-care-reform-commentary.html\">Best health care reform commentary<\/a> (all the things I don\u2019t need to say) <\/li>\n<li><a title=\"Gordon's Notes Health insurance companies only the demonic survive\" href=\"http:\/\/notes.kateva.org\/2010\/03\/health-insurance-companies-only-demonic.html\">Health insurance companies only the demonic survive<\/a> (Just before passage, but fits here. Now insurance companies can explore non-demonic options.) <\/li>\n<li><a href=\"http:\/\/www.nytimes.com\/interactive\/2010\/03\/21\/us\/health-care-reform.html#scenario-2\">How the Health Care Overhaul Could Affect You &#8211; Graphic &#8211; NYTimes.com<\/a> (try it \u2013 it\u2019s great) <\/li>\n<\/ul>\n<p>Older general discussions that are still relevant<\/p>\n<ul>\n<li><a title=\"Gordon's Notes Discovering medical prices and the problem with paying cash\" href=\"http:\/\/notes.kateva.org\/2009\/11\/discovering-medical-prices-and-problem.html\">Discovering medical prices and the problem with paying cash<\/a> <\/li>\n<li><a title=\"Gordon's Notes Health insurance we're defeated by a complexity attack\" href=\"http:\/\/notes.kateva.org\/2009\/10\/health-insurance-were-defeated-by.html\">Health insurance we&#8217;re defeated by a complexity attack<\/a> <\/li>\n<li><a title=\"Gordon's Notes The hidden insurance problem they can play the game better than we can\" href=\"http:\/\/notes.kateva.org\/2007\/11\/hidden-insurance-problem-they-can-play.html\">The hidden insurance problem they can play the game better than we can<\/a> <\/li>\n<li><a title=\"Gordon's Notes Gawande and NEJM cost of care roundtable\" href=\"http:\/\/notes.kateva.org\/2009\/09\/gawande-and-nejm-cost-of-care.html\">Gawande and NEJM cost of care roundtable<\/a> <\/li>\n<\/ul>\n<p>The future: \u201cpretty good care\u201d, aka \u201cgood enough care\u201d \u2013 where we\u2019re going<\/p>\n<ul>\n<li><a title=\"Gordon's Notes Health care reform \u2013 lessons from Quebec\" href=\"http:\/\/notes.kateva.org\/2009\/03\/health-care-reform-lessons-from-quebec.html\">Health care reform \u2013 lessons from Quebec<\/a> (pretty good care) <\/li>\n<li><a title=\"Gordon's Notes Healthcare Reform The Faughnan One Slide Presentation\" href=\"http:\/\/notes.kateva.org\/2006\/11\/healthcare-reform-faughnan-one-slide.html\">Healthcare Reform The One Slide Presentation<\/a> <\/li>\n<li><a title=\"Gordon's Notes Staggering towards health care access\" href=\"http:\/\/notes.kateva.org\/2009\/02\/staggering-towards-health-care-access.html\">Staggering towards health care access<\/a> <\/li>\n<\/ul>\n<p>[1] Federal \u201cTaxes\u201d rarely include anything so obvious as a rate increase. Tax equivalents include<\/p>\n<ul>\n<li>actions that shift services burdens to the states \u2013 which either reduce state services or increase state or local taxes <\/li>\n<li>unfunded federal state or local mandates of all varieties including regulatory or reporting burdens <\/li>\n<li>means testing that remove tax breaks (the AMT is the mother of means testing) <\/li>\n<li>elimination of tax dodging programs such as the Flex plan we enroll in (I\u2019ll be glad to see that evil scam die) <\/li>\n<li>user fees <\/li>\n<li>service taxes (such as the 10% tanning tax \u2013 which, amusingly, is aimed squarely at the Tea Party demographic of less educated paleskins). <\/li>\n<\/ul>\n<div class=\"blogger-post-footer\"><img width='1' height='1' src='https:\/\/blogger.googleusercontent.com\/tracker\/5587346-248822891705263162?l=notes.kateva.org' alt='' \/><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning. Winston Churchill, 1942. One way or another I&#8217;m gonna find ya I&#8217;m gonna getcha getcha getcha getcha. Blondie. In the original Senate version of the Health Care reform bill we find [&hellip;]<\/p>\n","protected":false},"author":711,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-485245","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/485245","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/users\/711"}],"replies":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/comments?post=485245"}],"version-history":[{"count":0,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/485245\/revisions"}],"wp:attachment":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/media?parent=485245"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/categories?post=485245"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/tags?post=485245"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}