The Day After “Armageddon” – The Healthcare Roundup

Apologies for the overblown title to this post, but Rep. John Boehner (R-OH) just amused me to no end last night with his claim that it was Armageddon for America. I love hyperbole, especially about the Apocalypse; and it doesn’t get much more hyperbolic than saying the world is going to end in judgment and damnation if we do something. Anyway, on with a little recap of what happened yesterday.

First off, what does the new legislation do? The New York Times and the Washington Post each have good overviews. I honestly don’t understand why these easy-to-understand recaps were so elusive in the weeks leading up to yesterday’s votes.

Who wins and who loses in the healthcare bill? In a nutshell, around 32 million uninsured people and the name-brand drug companies gain the most, followed closely by people with pre-existing conditions. For doctors, hospitals, insurers, and generic drug companies, it’s a mixed bag of gains and loses.

In my opinion, the people leaving the most empty-handed seem to be the Republicans who proposed legislation very similar to this in the 90s but didn’t pursue it aggressively. And then over this last year — depending on your point of view — were either shut out of crafting the healthcare reform law or sat out in protest. Despite claims to the contrary, the plans are very heavily centered in the private sector, bringing lots of new healthcare consumers to private insurers, favoring private insurers over public plans, preserving drug company profits, and bringing federal dollars to hospitals, doctors, insurers, etc.

The costs and benefits for individuals/patients/consumers are mostly positive (in my opinion). There’s more access to insurance and less chance that it will be taken away or capped. New high-risk pools bring insurance options back for many of us. There are some tax increases on the wealthy (families making more than $250K per year would pay an additional tax on payroll and investments). And there are modest (probably too modest) penalties for people who don’t buy insurance; subsidies and low-cost options should make it possible for everyone to buy insurance.

The opinions of working-age people with chronic illnesses are mixed, just like in the rest of the population. Kerri at Six Until Me writes about how she feels liberated to start a new business now that she isn’t tied to one employer for her health benefits. Meanwhile, Sarah of Sugabetic wonders whether we’ll be paying the same amount for our healthcare plus a bit more in taxes. Mainly there’s a lot of wait and see and hope that it makes things better.

For one Canadian’s perspective — which sounds a lot like what my Canadian coworkers have said, though from a somewhat religious perspective — check out what Sarah at Emerging Mummy. She prefers universal, single-payer healthcare and doesn’t understand (or like) the tone of the last couple weeks down here.

Almost in the background of the healthcare debate, there’s healthcare. Not many doctors write on weblogs compared to patients. “Who has the time for that?” they ask. (It’s too bad, because patients are putting a lot of effort into our own health 24/7 and exposing our difficulties and vulnerabilities; but . . . that’s a post for another day.) Anyway, two cardiologists with blogs engaged in a thought experiment about what would happen to two hypothetical patients — one wealthy, one not — who are having heart attacks in England and the US.

If you really, really want more political and media meta-analysis about what happened, check out Dan Kennedy’s as-always well-written take on David Frum, Paul Krugman, and Rep. Steven Lynch (D-MA).

As for myself, I feel surprisingly upbeat. Soon I’m sure I’ll feel like Debra Gordon, who wants to pull the covers up over her head, but for now I’m happy. Because hopefully things like this and this will be leaving our social discourse.

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