Us Expats And Health Care Reform

[jazzbo]

So you also know who has read what... clairvoyant as well -- http://www.opencongress.org/bill/111-h3962/text

and the reconciliation bill is at http://docs.house.gov/rules/hr4872/111_managers_hr4872.pdf

Edited March 21, 2010 by jazzbo

[jazzbo]

... maybe all will have been brought to you by those wonderful folks at Anthem -- friends of yours?

the full 4872 -- http://graphics8.nytimes.com/packages/imag...ll/original.pdf

Edited March 21, 2010 by jazzbo

[samran]

There will be subsidies based on income. People with no money may go on medicaid. I don't how ASSETS vs. income fit into the picture, and I am very curious about that. I don't think there is any linkage between owed taxes and being eligible to obtain insurance/subsidies. After all, having insurance is going to be a requirement. I don't think there is any waiting period to get the insurance other than expected processing delays. For example, a sick expat could fly back and likely obtain insurance quickly. Sure, the devil is in the details and things can change. I also favor single payer, but that isn't possible given the political realities. What we are getting instead is rather a mess but it will help many people who are currently left out of the system. A major flaw I see now is that healthy people will skip the insurance and pay the penalty, and then sign up if they get sick. This is a good reason for single payer in my view, everyone is in the pool all the time, as they should be.

Of course, I haven't read the bill. Not many people have.

depends on cost of insurance I guess vs cost of the fine/penalty.

While Australia has universial health cover which gives you immediate and largely free access for all the important things, there private health insurance which takes you to the front of the line for non-essential stuff (glasses, ambulance cover, elective surgery etc).

The government struggled for a long time to get people to take up the private insurance, so what they did was introduce a tax penalty for those who did not take out private health insurance. The government also subsidises 30% of the cost of the private health insurance. I was pretty successful in getting people to sign up for private health insurance, even if they see no value in it (you use the state system of you are going to do anything important anyway). Many people I know take out basic private insurance just to avoid the fine, and use the public health system anyway.

The problem is of course that given the government is subsidising part of the private premiums, they've gone up quite alot as the private insurers have taken advantage of this new subsidy. I'm afriad this will happen in the US as well.

Edited March 21, 2010 by samran

[jazzbo]

"It's fully appropriate that the gentleman return to the floor and apologize," said Rep. Marsha Blackburn, another Tennessee Republican.

But none was forthcoming from Grayson — a freshman Democrat from a (Orlando, FL) competitive district — who said the first part of the GOP approach to health care is: Don't get sick.

"If you get sick, America, the Republican health care plan is this:

Die quickly

," he said.

BTW Grayson was once a law clerk for AJ Antonin Scalia prior to Scalia's USCO appointment.

BTW2 Grayson will probably be re-elected this fall for one simple reason: So far, the Republicans in Orange County, FL, have been unable to find a credible Republican who isn't scared s--tless to run against him.

Edited March 21, 2010 by jazzbo

[Jingthing]

There will be subsidies based on income. People with no money may go on medicaid. I don't how ASSETS vs. income fit into the picture, and I am very curious about that. I don't think there is any linkage between owed taxes and being eligible to obtain insurance/subsidies. After all, having insurance is going to be a requirement. I don't think there is any waiting period to get the insurance other than expected processing delays. For example, a sick expat could fly back and likely obtain insurance quickly. Sure, the devil is in the details and things can change. I also favor single payer, but that isn't possible given the political realities. What we are getting instead is rather a mess but it will help many people who are currently left out of the system. A major flaw I see now is that healthy people will skip the insurance and pay the penalty, and then sign up if they get sick. This is a good reason for single payer in my view, everyone is in the pool all the time, as they should be.

Of course, I haven't read the bill. Not many people have.

depends on cost of insurance I guess vs cost of the fine/penalty.

While Australia has universial health cover which gives you immediate and largely free access for all the important things, there private health insurance which takes you to the front of the line for non-essential stuff (glasses, ambulance cover, elective surgery etc).

The government struggled for a long time to get people to take up the private insurance, so what they did was introduce a tax penalty for those who did not take out private health insurance. The government also subsidises 30% of the cost of the private health insurance. I was pretty successful in getting people to sign up for private health insurance, even if they see no value in it (you use the state system of you are going to do anything important anyway). Many people I know take out basic private insurance just to avoid the fine, and use the public health system anyway.

The problem is of course that given the government is subsidising part of the private premiums, they've gone up quite alot as the private insurers have taken advantage of this new subsidy. I'm afriad this will happen in the US as well.

Yes it will be a big challenge to get healthy people to go for the insurance as the penalty for no insurance is much less than the cost of insurance. In the US, the requirement doesn't kick in until 2014 and there will be no base universal coverage.

[flying]

Gavel to Geavel live feed if your Internet connection is good.....

http://cspan.org/Watch/C-SPAN.aspx

[TheItaliann]

This is an absolutely terrible decision by Congress. The reason why healthcare is so expensive is because of government involvement. And now the solution is more government. Look at plastic surgery, costs have been going down over the years. Obama is an egomaniac and a true podium man.

The US debt is through the roof and there is no way that this is going to cost the 1 trillion they say it will. Can the American people please have a fiscally responsible president? Its so frustrating.

Edited March 22, 2010 by TheItaliann

[TheItaliann]

The democrats have laid the ground work, now they can tighten the screws over the years. And, it won't be long before the tax increases are spread beyond those making $250,000.

Its no different than how the war in Iraq ended up costing 15 times more than initial lies, I mean estimates.

[Naam]

Why the Health-Care Bills Are Unconstitutional

If the government can mandate the purchase of insurance, it can do anything.

advanced countries have since decades mandatory health insurance coverage. third world countries don't!

[Naam]

Why the Health-Care Bills Are Unconstitutional

If the government can mandate the purchase of insurance, it can do anything.

governments mandate payment of taxes, mandate that it is a misdemenour to ignore a red traffic light, mandate draft and go to wars... YAWWWWNNNN...

[jazzbo]

At a recent town-hall meeting in suburban Simpsonville, (SC), a man stood up and told Rep. Robert Inglis (R-S.C.) to “keep your government hands off my Medicare.”

“I had to politely explain that, ‘Actually, sir, your health care is being provided by the government,’ ” Inglis recalled. “But he wasn’t having any of it.”

[TheItaliann]

^^^

At a McDonalds a lady said "Why the government no pay for my doctor. I gots the crabs again and I is broke".

Lets keep along these lines I think we are really getting somewhere.

[Jingthing]

Once this is law, it will be almost impossible to rescind. No serious commentators believe the constitutional challenges will succeed. Anyway, be careful what you wish for. People will end of loving the idea that insurance companies have to take everyone. They won't give that up, any more than they will give up social security and medicare. If the mandate doesn't work, the next step is more universal care, rather than going backwards. Deal with it, this is the new reality.

[Misty]

Overall summary, overall impact on expats rather minor, but for a small percentage of us (those under 65 needing to repatriate after 2014) it could be life saving.

Thoughtful editorial in the IHT today called "Is any illness covered?" by Nicholas Kristof. Kristof writes about an American couple living in HK who had purchased expat health insurance from a UK based broker. After the wife was diagnosed and partially treated for late stage stomach cancer, the insurer decided it no longer was required to cover her (due to the insurer's definition of "chronic condition"). As the couple is under 65, the old US system wouldn't pick her up either. Serious tough luck story, and a scenario that some US expats don't always consider when they buy these kinds of policies.

[Naam]

(Reuters) - The U.S. House of Representatives gave final approval to a sweeping healthcare overhaul on Sunday, expanding insurance coverage to nearly all Americans and handing President Barack Obama a landmark victory.

[Jingthing]

(Reuters) - The U.S. House of Representatives gave final approval to a sweeping healthcare overhaul on Sunday, expanding insurance coverage to nearly all Americans and handing President Barack Obama a landmark victory.

It is indeed historic, and will likely define Obama's presidency, at least the first term.

One important thing I am confused about. I have read that immediately children can not be excluded from getting insurance due to pre-existing conditions, but have heard different things about adults. Will they immediately be able to get insurance, or have to wait until 2014? I do know that the requirements and penalties phase doesn't start until 2014. This bill has been such a moving target its hard to keep track of, that's for sure.

[fiddlehead]

Yes, a historic day for sure.

Trying to find out about it is not so easy just yet.

I have heard that if you make 133% of the poverty level, it will be free. (poverty level seems to be around $10,800 for one person, $22k for a family of 4)

With subsidies up to $88k income.

I believe we will have to buy it if not in those guidelines. (but when will the requirement start? Who knows?)

I'm sure most American's don't know the details yet and there will be a rush to inform.

Here seems to be the best source I've found so far: http://www.reuters.com/article/idUSN1914020220100319

[Jingthing]

This little tool will help people test out different income/insurance scenarios and how they will be effected if they repatriate or want to repatriate to access needed health care.

http://www.washingtonpost.com/wp-srv/speci...l-means-for-you

It seems really poor people, based on INCOME, will be put on Medicaid.

Thanks for the Reuters link. I think it answered my question. There is relief for adults with pre-existing conditions before 2014.

*Uninsured adults with a pre-existing conditions will be able to obtain health coverage through a new program that will expire once new insurance exchanges begin operating in 2014.

I think most families in the US have family members who have suffered from the pre-existing conditions exclusions. This may end up being much more popular than the opposition hopes for.

Edited March 22, 2010 by Jingthing

[ThailandLovr]

(Reuters) - The U.S. House of Representatives gave final approval to a sweeping healthcare overhaul on Sunday, expanding insurance coverage to nearly all Americans and handing President Barack Obama a landmark victory.

Now Pelosi can get back to the business of spending more money. She has said she will now begin work on the next Jobs (erm "Stimulus") bill. More spend, then tax more, then spend more, then tax more, and more ..

[Thongkorn]

I thought America was the land of the free, Well God is blessing America ,40 milion people in fact .who dont have health care,

[TheItaliann]

and penalizing all those who have to pay for it

I thought America was the land of the free, Well God is blessing America ,40 milion people in fact .who dont have health care,

[britmaveric]

Yanks can't afford it - going to be 3-4 trillion in the first 10yrs. I for see them bankrupt if this really goes to fruition.

However I for see the Repubs taking the house/senate in Nov and repealing this law. BO will veto and then it will be overridden. Not to mention the vast majority of yank states seem to be suing over this. I have a feeling this will all be tied up in court for sometime.

[ThailandLovr]

For Obama and Pelosi to go from the jaws of defeat (when Brown won Kennedy's Maryland senate seat) to last night's success boggles the mind. Obama is the most persuasive U.S. president ever, and Pelosi one hel_l of an attack dog. 55% of Americans opposed it, but no matter. It will be signed into law next week. Brit, from what I've heard, repeal may be next to impossible.

[britmaveric]

^not impossible all the Repubs need is to win majority of both houses and override a veto. From consensus - Dems will be slaughtered with elections in the fall.

[samran]

This is an absolutely terrible decision by Congress. The reason why healthcare is so expensive is because of government involvement. And now the solution is more government. Look at plastic surgery, costs have been going down over the years. Obama is an egomaniac and a true podium man.

What you are saying runs contrary to mainstream economics. Do you have any proof for your statement? Government "run" systems pool risk more effectively, cut down administration costs and target preventative medicine so as to keep long run costs down. They also ensure equity. (I say government 'run' as in many countries with universal health insurance, doctors are private for all intents and purposes).

Your comment sounds like an ideological statement more than anything else.

[up-country_sinclair]

^not impossible all the Repubs need is to win majority of both houses and override a veto. From consensus - Dems will be slaughtered with elections in the fall.

To override a veto, the Republicans would need 2/3 of the votes in the house and the senate.

Sure some are predicting that the Republicans might take back the House of Representatives, but do you really think they are going to win enough seats to have a 2/3 majority?

I don't think anyone reputable is predicting that the republicans will reclaim majority of the senate--much less take 67 seats.

Edited March 22, 2010 by up-country_sinclair

[britmaveric]

^maybe, maybe not. But from what I read.... this bill is a complete disaster.

[ThailandLovr]

Right Up_c, plus there are practical problems reversing certain changes which would already be in effect. BTW, personally I am very much against the bill, so I make the previous statement with regret.

Edited March 22, 2010 by ThailandLovr

[britmaveric]

Right Up_c, plus there are practical problems reversing certain changes which would already be in effect.

It seems most doesnt go in affect until 2014, so it would be quite easy.

[Jingthing]

Realistically, reversal is very unlikely. There will be supreme court challenges and they will take years. By that time there will likely be a more liberal court, even if Obama doesn't get a second term, he is likely to get one or two more picks. The republicans taking congress in 2010 will not reverse it. It is law the moment Obama signs it, which is very soon. The most realistic approach, away from the predictable ideological divisions, is to assume this is for real, and personally figure out how it might effect you.

Edited March 22, 2010 by Jingthing