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Showing posts with label health. Show all posts
Showing posts with label health. Show all posts

Wednesday, September 02, 2009

Health Care Myth - Forced Euthanasia

Did you ever notice how the sides of any issue can stretch the truth and come out with blatant lies? Then, those lies are put into emails and every small minded person passes them on until they suddenly become "truth". People will actually believe the lies without checking them. Part of this, I think, is just laziness on the part of small minded people. They don't feel like doing the research and the email all ready states what they want to believe anyway, so they send it off. Part of this is stupidity, well, it has an important sounding name or whatever, so it must be true, because you can't send anything that isn't true, right?
It is annoying if these untruths only appeared in email, but because you know who your intellectually light friends and relatives are, you can ignore those emails, it isn't so bad. But, then some of these lie spreaders are just your cousin Todd from Buffalo, some of them are allowed to spread their lies on radio shows and TV shows. And, then it is nearly impossible to stop the spread.
Well, today, I'm going to try to stop one of these lies from going any farther.
Former lieutenant governor of New York Betsy McCaughey is going around claiming that the health care bill - H.R. 3200 (this is the bill that is in the House) - is "a vicious assault on elderly people" that will "cut your life short."1 Between her and Palin's lie spreading, it is a wonder that the truth ever gets told.
There is a provision in H.R. 3200 for end of life counseling that would be paid for by medicare.


H.R. 3200, page 425: Subject to paragraphs (3) and (4), the term ‘advance care planning consultation’ means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years. Such consultation shall include the following:

(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.

(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.

(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.

(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning … .

(E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.

(F)(i) Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders2



I do not read anything in there that states someone is going to put you down because you are no longer deemed worthy to live, as McCaughey and Palin have been claiming.

I can tell you from personal experience that the end of life decision made for a loved one is the most difficult decision ever made. I hope throughout the rest of my life that I never have to make that decision again. It is heartbreaking and one of those moments on which you look back upon and wonder - Did I do the right thing?

Having said that, I feel strongly that every one should have an end of life directive - if your wish is to be kept alive on machines - it should be followed. If your wish is no heroics, that should be followed as well.

The making / writing / drawing up of these directives should not be taken lightly. I support the health care plan to pay for counseling sessions. In fact, I think if you attend one of these sessions, you should bring along your loved ones. Your wishes should be well known in advance.

When you come to the end of your journey in this life and you sent to the afterlife to, hopefully, be in God's presence, you really have the easy part. Those of us left waiting behind to live another day, to carry out your wishes - whatever they may be - have the hard part. It is easier to lie in the bed and be sick, than to stand beside it and watch a loved one suffer.

That is why end of life counseling is so important. You need to make your wishes known, whatever they may be. You need to assist your family to know what kinds of decisions you want made. It is the least thing any one of us can do for our family members. Cheryl and I have had these conversations of what one of us would want many times. I don't want to make the decision for her anymore than she would want to make the decision for me, but the two of us know what the other one wants.

Allow me to go just slightly off course for a moment. I remember when I was a kid that Republicans didn't want any government interference with anything. Individual rights were king and that was all right by me, but now, the right wing has taken it upon themselves to turn their back on these ideals. It is NOT the business of the government to decide if you live or if you die. It is YOUR choice, but the right wing wants you only to make the decision to live. They want to take away your CHOICE. But, they are claiming to be on YOUR side. It would be a joke, if it wasn't so serious.

Let's stop the craziness. Let us only pass on truth to each other. And, let us get the entire nation covered in health care.

God Bless

1http://www.nydailynews.com/news/2009/08/13/2009-08-13_former_lt_gov_mccaughey_leads_death_panel_charge_writing_up_talking_points_on_he.html#ixzz0PldQYmhD
2 FactCheck.org - Accessed 8/31/2009

Thursday, August 27, 2009

Strong Like Bull -- And, I have the Numbers to Prove It

Around this time of year, my company conducts a health assessment. We fill out a form -- either online or hardcopy -- allow some travelling nurse to prick our finger and the company pays us $20.00. In a few weeks, we all receive a nice health assessment booklet from our insurance company. This is one of the reasons I believe that health insurance costs need to be shared by companies. My company, I'm sure, receives some sort of discount on their premimums by having their employees take the assessment. This is a good thing.

I support taking the test, even though on a yearly basis, since I turned 35 my doctor has been running the very same lap tests on me. Here's why: First, I like saving my company money -- no really. I'm serious. A company that can save money on health care costs can put more money in my pocket -- or at least in theory. Second, I know there's a lot of people in my company who probably don't visit the doctor on a regular basis and don't get regular checkups. This way, they have the numbers. The nurses explain what all of the numbers mean and, hopefully, co-workers with bad numbers can follow up with their doctors and head off serious issues. Finally, I happen to like the little booklet. I do. I keep last year's booklet and the new booklet will have the previous years' results and I can compare just how healthy I'm getting.

So, now for the numbers. If you know me, then you know I'm a big gal. And, being big doesn't bother me, except when someone assumes because I'm big, I'm somehow destroying the earth with my largeness. And, being big and beautiful -- as I am -- doesn't mean I'm not healthy.

My blood pressure was a little high today: 125/75. That's still normal, but my bp had been going down to the low 120's. I should note, that's the blood pressure I had when I was 21 and wearing a size 16.

My total cholesterol was 177 -- not as good as it has been, but still under that bad number of 200.

My HDL is 47 -- I've had it as high as 50, so it's lower than it's been, but still above 40 -- like it needs to be.

My LDL was slightly elevated at 112. I'll have to work on that.

Now, for the drum roll, my Triglycerides is 91 -- WAY BELOW the borderline high level. YES!

My glucose was 106 -- slightly high, but I had forgotten about the test and drank some apple juice before coming into work, so it wasn't a true fasting test.

So, I'm a big gal and I know I have friends and family that worry about my health. But, my heart test proved negative -- negative for issues, I do have one! My numbers are all where they are supposed to be, so it looks like -- if I keep this up -- I'll be around to see my grandchildren's children.

Hmmm, guess my step-children won't be happy. I won't die early enough to leave them any money. LOL!

God Bless

Oh, and keeping with my daily promise -- down with Van Hollen. He shouldn't be Wisconsin's Attorney General and I'm healthy enough to see him voted out of office. :-)

Monday, August 17, 2009

My Healthcare Plan

Let me come clean and tell you which plan was written by whom:
Plan A is the House Democratic Bill. Plan B is the Senate Health, Education, Labor and Pensions Committee's Bill. Plan C is a plan under discussion by a bipartisan group of six senators on the Finance Committee. Plan D is the House Republican proposal. All of these can be found here: http://www.desmoinesregister.com/article/20090813/NEWS/90813006/-1/NEWS04 It is the news site where I found them.
Now, I try to stay positive about all of the plans, but I have to say I'm highly disappointed in Plan D – the House Republican proposal. It pretty much leaves things as they are and that bothers me. I know Republicans don't want a government run plan. I know Republicans think that government interference is a bad thing and I can understand that. But, what I can't understand is how they can just continue to ignore the fact that the system is broken. 47 million American citizens have no health insurance. That is 13% of the population. It is a high enough number to swing an election. On top of that, those 47 million Americans leave the rest of us paying a much higher price. Hospitals, when they provide care and aren't reimbursed, have to make up the money loss somewhere and that means charging more for the care those of us who are insured receive. Which means the insurance companies pay more and the premiums go up and so on and so on. We all suffer.
Now, I'm not saying I'm extremely happy with any one of the four plans, but I think combining them might not be a bad idea.
First, the who is covered: the Senate Health, Education, Labor and Pensions Committee bill aims to cover 97% of Americans, as does the bipartisan, Finance Committee's plan. This is very important. The whole point is to get as many people covered as possible.
Second, the cost: I think the Senate plan at being only $650 million over ten years and covering 97% of the people is a little unrealistic. I think the $1 trillion mark sounds about right. This doesn't mean I think we should spend that much, but that it is a reasonable to believe the healthcare plan will cost that much over ten years.
Third, how's it paid for: Let's face it, a plan with this much coverage is going to cost us some dough. The Republican plan, which didn't even offer a proposed cost, states no new taxes. Boy, that sounds good. The plan implies that by reducing Medicare and Medicaid fraud, the plan would be paid for. Unfortunately, I don't have the numbers for the amount of money lost due to Medicare and Medicaid fraud, but I'm thinking it probably isn't enough to pay for any plan. Now, I would be interested in hearing or reading someone's idea on how it could. I wrote Paul Ryan regarding his plan and I still don't have an answer. (Which I'm very disappointed, he is usually right on the ball.)
I think a combination of all four plans might be the answer to how to pay for this. Raising taxes on singles who earn more than $280,000 a year seems reasonable to me. Most of the people I know don't come anywhere near that figure. Raising taxes on families that earn more than $350,000 isn't a bad idea either. The highest tax bracket in this country is 33%. We jump from 15% to 25%, but after 25%, the jumps are much smaller. Trust me, a single person earning $280,000 a year will be able to afford a two percent tax raise. I'm also for raising the taxes on other items, such as cigarettes or liquor, but I think I'm alone in that regard.
I'm not for cutting Medicare nor am I for cutting Medicaid. No cuts. The elderly have enough problems. No cuts, but rooting out fraud -- that's a good idea.
Further – charging companies a portion of the insurance costs the government pays is a terrific idea. I think that it is only fair. Companies benefit from their workers' hard work. More and more companies are expecting more from their employees – especially salary employees – without offering raises. Being penalize if they allow employees and employees' children to be on a government program is a good thing. Penalizing companies such as, oh, I don't know, Wal-Mart, could help pay a great deal toward the program.
I think the combination of rooting out Medicare and Medicaid fraud, a small tax raise on the wealthy and penalizing large companies for not providing affordable health insurance should be able to pay for the plan. I think not purchasing the F-22 from Lockheed, which has cost us the taxpayers over $351 million in overruns is an example of government waste we could cut and use to help pay for the plan.i
Fourth, the mandates: I know the government mandates a lot of different things and that's not always a good thing, but the only way any healthcare plan will work is if we all have insurance. The healthcare costs of those people who are uninsured are staggering. This is not to say that we all have to have fancy group coverage. The bare minimum should be catastrophe insurance, along with a pre-taxed Health Savings Plan. I know that some people say, well, rich people don't need health insurance, so they shouldn't be forced to carry it, but even a rich person could have their entire wealth wiped out by the cost of cancer treatments.
To support my argument further, let's consider this: everyone of us who has care insurance has coverage that includes uninsured and under-insured motorists. And, why do we do that? So, we can still be protected if someone that doesn't have insurance slams into our car. Hospitals will need the same protection. There are some people out there who can cover $3200 out of pocket expense for a cardio-test, but I'm not one of them. Had I had to pay for the test myself, I'd still be making payments. And, the hospital would still be waiting for their money, which is one of the reasons hospitals have to charge so much. If everyone is covered by health insurance, hospitals wouldn't to write off unpaid bills, thus reducing their overhead. Of course, I'm notoriously cheap and I probably wouldn't get the test. I would be the type of person who would take chances with her healthcare. In interest of full disclosure, in this case, I would be okay without the test. My heart is strong, like bull.
Fifth, how to choose the health insurance plan. I like the exchange idea, but I was just reading an articleii that in Massachusetts the exchange isn't working. That being noted, I think if the Massachusetts plan isn't working, we use it to take what does work and throw away what doesn't. I, also, like the idea that the exchange is state run, with Federal standards. Each state should know what its citizens need and is better prepared to make changes for what doesn't work more quickly than the Feds.
Sixth, for the benefits, I like the Democratic plan, so I just copied it verbatim: “A committee would recommend an "essential benefits package" including preventive services, mental health services, oral heath and vision for children; out-of pocket costs would be capped. The new benefit package would be the basic benefit package offered in the exchange and over time would become the minimum quality standard for employer plans. Insurers wouldn't be able to deny coverage based on pre-existing conditions.”iii
Finally, the government run plan, I like the idea of a government run plan to a point that competes with private insurers. I think private insurers deserve a little unfair competition. However; I think it should be limited to cover those who don't qualify for any other plan or subsidy. Let's not create a huge fiasco here. Also, I like the part in the Senate where the plan would “would pay doctors and hospitals based on what private insurers now pay.”iv
Okay, that's it. That's my plan in a nutshell. I think it works better and is better for all of us than the four plans.
This is a pretty long blog post, but I wanted to include as much as I could. I'm posting this as a PDF, as well, so you can print it out and share it. If you like my idea, please feel free to post it on your own blog – as long as you link back to mine. Further, send it to your representative and say you support it. I'm sending it to mine. We need to improve healthcare in this country, but none of those four plans mentioned are going to cut it. If you don't like what I've outlined, I'd love to hear why and I encourage you to come up with your own plan. I, also, encourage you to make sure you write your representative. Healthcare is too important to leave up to the politicians and lobbyists.
God Bless
iMother Jones September / October 2009, page 41
iihttp://www.motherjones.com/mojo/2009/08/obamas-insurance-plan-comes-right-wing-think-tank
iiihttp://www.desmoinesregister.com/article/20090813/NEWS/90813006/-1/NEWS04
ivibid

Sunday, August 16, 2009

I am Blessed...

This morning in my email there was a notice that a subscriber to my blog has unsubscribed. This is always a sad thing for a blogger to lose a reader. Broke my heart a little to thing that someone in this big old world doesn't think I'm worth reading anymore. But, then I saw the reason, which was Content no longer relevant and I had to chuckle a little. The reader's email ended in au, which I think stands for Australia and considering all I've been writing about lately has been the health care debate in America, I can see his or her point.

Anyway, this set to me thinking about health care. I've seen some articles and comments on blogs where people are complaining about the protesters outside of the townhall meetings held by various members of the government and I think they're dead wrong. It's okay to protest. It's okay to disagree with our government. It's okay to disagree with each other. The very thought of making changes to our health care system scares the hell out of a lot of people. I don't blame them -- it scares the hell out of me, too. I can understand how someone doesn't want the status quo to change -- especially if they have company provided health care. There's a part of me that doesn't want change. It's a "I've got mine, the hell with you" attitude. And, I can understand it, because I feel that way, too. I have to be honest here. I don't want my health insurance benefits taxed. I don't think that's fair. I've come too far to have to pay taxes on something I've earned.
And, that has led me to thing about this...
In 1994, I earned - roughly - $16,000. I didn't have health care. I didn't see doctors for routine medical care. I was involved in a car accident that year where I hurt my back and bruised a kidney. It wasn't my fault. The other driver turned left in front of me and although I tried to avoid her, first by changing lanes when I thought she had stopped turning and then by slamming on my brakes, I slammed into the side of her Ford Escort in my Dodge Dakota Truck at 30 miles an hour. Up to that point in my life, it was the scariest thing to ever happen to me while I was behind the wheel of my truck.
I had no health care insurance. I supported myself and, despite doctor's orders to the contrary, I returned to work the following day. I didn't sue her and, since I felt I had to take care of myself and no one could help, I didn't even ride to the hospital in an ambulance -- like I should've. If my insurance agent, a man named Marty, hadn't told me I was covered, I wouldn't have gone to the hospital at all. I had so little money back then, I couldn't afford to fill the pain prescription I was given. Good thing I have a high tolerance for pain.
Now, I don't tell you all of this to have you feel sorry for me, because you shouldn't. My kidney healed and my back is strong. My truck managed to run for another seven years until the engine blew and it is fifteen years later and I make almost four times as much as I did that year. And, I have health insurance. If that same accident happened again today, I would ride to the hospital in an ambulance and, more importantly, I would listen to my doctor. I have disability insurance, both personal and via work, so I wouldn't worry about not being able to pay my bills.
And -- this is important -- I feel lucky. That's right, lucky. I've put in years of hard work and study to become the person I am today. I worked full time and went to school part time. I busted my butt to graduate and I work hard at my profession to be the best I can be. And, I'm lucky. I'm lucky because when it was too hard and I wanted to quit, Cheryl would drag me kicking and screaming to my homework. And, she did all the housework, so I could study. (Truth be told, she still does most of the housework.) And, when I would cry at night that this was just too hard and I wasn't smart enough or good enough to see it through, she would hold me and tell me I was. She was a big pain in my ass when I needed a swift kick to my ass and she was a soft shoulder on which to cry when I just needed a place to fall. And, I couldn't have gone from the living over a bar from paycheck to paycheck to owning a home and installing new kitchen and bathroom floors if I hadn't had her pushing me.
And, I know that I am blessed.
And, then I think, there's a lot of 28 year olds out there who don't have a Cheryl in their lives. For that matter, there are a lot of people who don't have anyone pushing and fighting for them. They just go to work and do the best they can do and they are who I used to be. They have just enough to get by and they can't see past next week, because they can't afford to dream. They clean our waste baskets, they ring us out at the grocery store, they wash our car and they bring us our dinner whenever we eat out. They're the 47 million Americans who can't afford health insurance. And, then I think how lucky I am that I never caught a disease I couldn't pay for. Never needed medicine where I would have to make a choice between the medicine or eating. (Once, when I was uninsured, my asthma medicine cost $75.00 for a one month supply. That was nearly a quarter of one of my paychecks and a huge chunk of take home pay. If I hadn't had Cheryl, I might've forgone the medicine.)
And, I think about those people and how lucky I am I'm not one of them - for by the Grace of God go I - and I realize, we do need to make some changes and we're all going to have to sacrifice a little for the good of everyone.
God Bess

Friday, August 14, 2009

Healthcare Plan D

Here's the second summary. The whole thing was written by the Associated Press, so I take no credit. I tried to actually find this on the Associated Press website, but I couldn't find it.

WHO'S COVERED: The House GOP's plan, in outline form for now, says it aims to make insurance affordable and accessible to all. There aren't estimates about how many additional people would be covered.

COST: Unknown.

HOW'S IT PAID FOR: No new taxes are proposed, but Republicans say they want to reduce Medicare and Medicaid fraud.

REQUIREMENTS FOR INDIVIDUALS: No mandates.

REQUIREMENTS FOR EMPLOYERS: No mandates; small business tax credits are offered. Employers are encouraged to move to "opt-out" rather than "opt-in" rules for offering health coverage.

SUBSIDIES: Tax credits are offered to "low- and modest-income" Americans. People who aren't covered through their employers but buy their own insurance are allowed to take a tax deduction. Low-income retirees younger than 65 (the eligibility age for Medicare) would be offered assistance.

BENEFIT PACKAGE: Insurers would have to allow children to stay on their parents' plan through age 25.

GOVERNMENT-RUN PLAN: No public plan.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: No new purchasing exchange or marketplace is proposed. Health savings accounts and flexible spending plans would be strengthened.

CHANGES TO MEDICAID: People eligible for Medicaid would be allowed to use the value of their benefit to purchase a private plan.

Healthcare Plan C

Here's the third summary. The whole thing was written by the Associated Press, so I take no credit. I tried to actually find this on the Associated Press website, but I couldn't find it.

WHO'S COVERED: Around 97 percent of Americans. Illegal immigrants would not receive coverage.

COST: Around $1 trillion over 10 years.

HOW'S IT PAID FOR: Possible sources include cuts to Medicare and Medicaid; a tax as high as 35 percent on very high cost health insurance policies; a requirement for employers to pay into the Treasury for their employees who get their insurance through public programs or receive government subsidies to help pay premiums. Looking to raise $90 billion by taxing health insurance companies as much as 35 percent on policies valued at $25,000 or more.

REQUIREMENTS FOR INDIVIDUALS: Expected to include a requirement for individuals to get coverage.

REQUIREMENTS FOR EMPLOYERS: In lieu of requiring employers to provide coverage, lawmakers are considering a "free rider" penalty based on how much the government ends up paying for workers' coverage.

SUBSIDIES: No higher than 300 percent of the federal poverty level ($66,150 for a family of four).

BENEFIT PACKAGE: The government doesn't mandate benefits but sets four benefit categories — ranging from coverage of around 65 percent of medical costs to about 90 percent — and insurers would be required to offer coverage in at least two categories. No denial of coverage based on pre-existing conditions.

GOVERNMENT-RUN PLAN: Unlike the other proposals the Finance Committee's will likely be bipartisan. With Republicans opposed to a government-run plan, the committee is looking at a compromise that would instead create nonprofit member-owned co-ops to compete with private insurers.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: State-based exchanges.

CHANGES TO MEDICAID: Everyone at 100 percent of poverty would be eligible. Between 100 and 133 percent, states or individuals have the choice between coverage under Medicaid or a 100 percent subsidy in the exchange. The expansion would be delayed until 2013, a late change to save money — the start date had been 2011.

Healthcare Plan B

Here's the second summary. The whole thing was written by the Associated Press, so I take no credit. I tried to actually find this on the Associated Press website, but I couldn't find it.

WHO'S COVERED: Aims to cover 97 percent of Americans.

COST: About $615 billion over 10 years, but it's only one piece of a larger Senate bill.

HOW IT'S PAID FOR: Another panel — the Senate Finance Committee — is responsible for figuring out how to cover costs.

REQUIREMENTS FOR INDIVIDUALS: Individuals will have to have insurance, enforced through tax penalty with hardship waivers.

REQUIREMENTS FOR EMPLOYERS: Employers who don't offer coverage will pay a penalty of $750 a year for each full-time worker. Businesses with 25 or fewer workers are exempt.

SUBSIDIES: Available up to 400 percent poverty level, or $88,000 for a family of four.

BENEFITS PACKAGE: Health plans must offer a package of essential benefits recommended by a new Medical Advisory Council. No denial of coverage based on pre-existing conditions.

GOVERNMENT-RUN PLAN: A robust new public plan to compete with private insurers. The plan would be run by the government but would pay doctors and hospitals based on what private insurers now pay.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: Individuals and small businesses could purchase insurance through state-based purchasing pools called American Health Benefit Gateways.

OTHER PROVISIONS: Creates a new voluntary insurance program that would provide a modest daily cash benefit to help disabled people stay in their own homes instead of going into nursing homes.

Healthcare Plan A

Here's the first summary. The whole thing was written by the Associated Press, so I take no credit. I tried to actually find this on the Associated Press website, but I couldn't find it.

Plan A

WHO'S COVERED: Around 94 percent of non-elderly residents (those not covered by Medicare, which kicks in at age 65) would be covered — compared with 81 percent today. Nearly half the 17 million non-elderly residents who remain uninsured would be illegal immigrants.

COST: About $1.5 trillion over 10 years.

HOW IT'S PAID FOR: Revenue-raisers include $544 billion over the next decade from new income taxes on single people making more than $280,000 a year and couples making more than $350,000; $37 billion in business tax increases; about $500 billion in cuts to Medicare and Medicaid; sizable penalties paid by individuals and employers who don't obtain coverage.

REQUIREMENTS FOR INDIVIDUALS: Individuals must have insurance, enforced through tax penalty with hardship waivers. The penalty is 2.5 percent of income.
REQUIREMENTS FOR EMPLOYERS: Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payroll under $250,000 annually are exempt. That level could rise to $500,000 under a deal between House leaders and fiscal conservatives.

Employers could apply for a two-year exemption from the mandate if they can prove the requirements would result in job losses that would negatively affect their communities.

SUBSIDIES: Individuals and families with annual income up to 400 percent of poverty level ($88,000 for a family of four) would get sliding-scale subsidies to help them buy coverage. The subsidies would begin in 2013.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: Through a new Health Insurance Exchange open to individuals and, initially, small employers; it could be expanded to large employers over time. States could opt to operate their own exchanges in place of the national exchange if they follow federal rules.

BENEFIT PACKAGE: A committee would recommend an "essential benefits package" including preventive services, mental health services, oral heath and vision for children; out-of pocket costs would be capped. The new benefit package would be the basic benefit package offered in the exchange and over time would become the minimum quality standard for employer plans. Insurers wouldn't be able to deny coverage based on pre-existing conditions.

GOVERNMENT-RUN PLAN: A new public plan available through the insurance exchanges would be set up and run by the secretary of Health and Human Services. Democrats originally designed the plan to pay Medicare rates plus 5 percent to doctors, but under Wednesday's deal with the fiscal conservatives the HHS secretary would instead negotiate rates with providers.

CHANGES TO MEDICAID: The federal-state insurance program for the poor would be expanded starting in 2013 to cover all non-elderly individuals with incomes up to 133 percent of the federal poverty level ($14,404).

DRUGS: Grants 12 years of market protection to high-tech drugs used to combat cancer, Parkinson's and other deadly diseases.

I want to hear what you think.

God Bless