the buzz log
Medical Charts: The Senate vs. the House on Health Care Reform
Early Christmas Eve morning, Senators are due to vote aye or nay on the Patient Protection and Affordable Care Act, otherwise known as their vision of how to reform health care in America.
The House wrangled its version last month. While President Obama says the two proposals are 95% "identical," that 5% difference has spurred some furious negotiations.
- The bill for the health care reform bill? The House version costs more than a trillion, while the Senate's is a tad cheaper at $871 billion.
- People with comfy incomes will have to pay more taxes to help pay for reform, if the House has its way. The Senate stays away from that, but adds a 10% tax on indoor tanning booths.
- Funding for abortion and a public option are two of the more heated controversies.
- A New York congresswoman wrote an op-ed tearing apart the Senate bill for, among other things, letting insurance companies keep enjoying their antitrust status.
Outlets like AP, Bloomberg, Newsweek, The New York Times, and the Kaiser Family Foundation have taken on the daunting task to compare the two versions. Below, three charts with an overview, key similarities, and key differences between the Senate and House proposals.
| Senate vs. House Health Care: Overview |
|||
| Senate | House | Notes | |
| Bill Size | 2,074 pages |
1,990 pages |
. |
| Reform cost | $871 billion (over 10 years) |
$1.05-$1.2 trillion (over 10 years) |
Health care cost Americans $2.4 trillion in 2008 and could balloon to $4.4 trillion by 2018. |
| Where's the money coming from to pay for this? |
Taxes on fancy health plans (40% excise tax); fees on medical-device makers ($2 billion/year starting 2011, then $3 billion/year in 2018); higher Medicare payroll tax for high-income folks; Medicare and Medicaid cuts; fines. Strangest of all—10% tax on indoor tanning. | Surtax on high-earners (5.4% on incomes $500k and up); taxes on Cadillac plans (40% excise tax); Medicare and Medicaid cuts, fees on medical-device makers ($20 billion over 10 years); various penalties, corporate taxes and fees; limits on flexible spending account contributions. | The tanning bed tax has pleased some doctors — using fake UV rays before age 30 has been correlated with a huge melanoma cancer risk. Rejected: The "Bo-Tax," a tax on cosmetic surgery. |
| Who gets covered? | 94% of legal residents under age 65 | 96% of legal residents under age 65 | Currently, 83% of Americans are covered. |
| Who gets left out? | 24 million people under 65 (including illegal immigrants) | 18 million people under 65 (including illegal immigrants) | Currently, 50 million (one in six Americans) are not insured. |
| When would reform kick in? | 2014, with some protections starting sooner. | 2013, although rules for insurance companies would start in 2010 | Some worry a later start allows insurance companies to jack up premiums in the meantime. |
| Senate vs. House Health Care Similarities | |||
| Senate | House | Notes |
|
| Individual mandate (get insurance or pay a penalty) | Small penalties start in 2014 ($95), then hit 2% of taxable income in 2016. | 2.5% of adjusted gross income of a certain level. | Both plans have aid for low-income people. Online sites will let consumers shop for group policies. |
| Employer mandate (insure employees or pay a penalty) | Optional, but larger companies whose employees get any insurance help from Uncle Sam would pay a penalty. | Payroll size determines the penalty. | Polls shows a divided public, but people generally support the policy that bosses should provide coverage. |
| Medicaid (federal program for low-income) |
Expanded, but leaves 23 million "non-elderly" uninsured | Expanded, but leaves 18 million uninsured | California governor Arnold Schwarzenegger, who supports health care reform, sent a letter with Medicaid concerns. |
| Pre-existing medical conditions | Insurance companies banned from using pre-existing conditions as a reason to reject coverage. Effective immediately for children. | Bans insurance companies from this tactic. | 12.6 million people have been rejected in the past three years for insurance because of "pre-existing" conditions. |
| How long are the kids covered (under mom & dad's insurance)? | Up to age 25 | Up to age 26 | People 19 to 29 make up the biggest chunk of the uninsured. |
| Senate vs. House Health Care Differences | |||
| Senate | House | Notes | |
| Abortion funding | Beneficiaries need to pay for coverage separately, and insurers have to keep that money separate from federal funds. States can block such health plans. | Public plans don't cover the procedure, but private insurers can offer "rider" policies. | Abortion funding has been the sticking issue for both branches of Congress. |
| Pharmaceutical industry drug costs | No change. | Companies would have to dicker over how much they can charge in the Medicare prescription drug program. | Health care lobbyists have spent about $400 million so far on the reform effort. |
| Public option (government alternative to private plans) | No. The Office of Personnel Management, which runs policies for federal employees, would partner up with insurers to offer two national plans (with at least one operating as a nonprofit). | Yes, to compete with private plans and encourage lower costs. | Considered dispensable by the president and unlikely by key senators, public option appears doomed. |
| Antitrust exemption for insurance companies | Status quo. |
By ending insurers' special status, the feds can penalize companies for price rigging, false advertising, and similar issues. | Health insurance companies have enjoyed the McCarran-Ferguson exemption since 1945. |
Of course, these charts cover only what has been proposed. Among the health care professionals who want to see real reform, the National Nurses Union lists 10 fundamental flaws with the Senate proposal. A seasoned physician decries the lack of portability, accountability, and affordability, and the Harvard Medical School dean rates the debate process an F. The American Medical Association, however, has given its thumbs-up.
The job of reconciling the House and Senate bills will fall to a conference committee. That'll take some time: As Politico notes, there's winter break (ending January 11 for the House, January 17 for the Senate), and the committee will want the White House to weigh in. Then the Congressional Budget Office will do the math, after which the House and Senate vote on the final bill, and Obama must sign off. There may be a holiday truce, but the debate will come back in the new year.
Filed under: Health, Government, Law
Going Up: Obesity Rates
Here's a heavy subject: If obesity trends continue, more than 40% of the U.S. will be obese by 2018. According to a new study, that's not the only number to go up: The health care costs associated with a tubby country will quadruple to $344 billion a year, making up a rotund 21% of all health costs.
That's a lot to swallow. The reason? Health care economists who authored the study say that obesity is connected to other illnesses, like diabetes, heart disease and even cancer. Unhealthy people are costly to the health care system.
Japan has been attempting to rein in weight with a mandated measure on waist size, spurring chubby residents into unhealthy behavior like crash diets to make their numbers. But it's hard to imagine the U.S. doing anything of the kind. Or that it would work.
The solution, say researchers, is to keep the obesity level the same. (You're obese if you're 30 pounds overweight.) The states most at risk to tip the scales are Kentucky, Maryland, and Mississippi. While the slimmest areas are led by Connecticut, Massachusetts, and D.C. But even the least obese state of Colorado estimates its obesity health costs to be over $3 billion.
It's not like Americans aren't trying to lose weight. The quest for the ultimate diet that will magically shed the pounds (preferably painlessly) is an ever-popular quest. Lookups on "400 calorie diet," "bellyfat diet," and "low protein diet," all top the search box.
Scientists are also offering up their solutions, like investing communities and employers in a nationwide weight-loss effort. Paging Richard Simmons.
Filed under: Health
Blackouts, Eruptions, and Amendments: What's the Buzz
Our picks from the day's hottest searches.
- Brazil Blackout (+3,067%). A storm left 60 million in the dark,and now the government's busy defending its grid as the country preps for a good economy and the 2014 World Cup.
- Carl Sagan (+1,199%). His 75th birthday on Monday prompted a Stephen Hawking musical salute, and now people are surfacing up the astronomer's own musical talents.
- Mayon Volcano (+903%). Philippine's most active volcano is spewing again.
- Stupak Amendment (+563%). The US Conference of Catholic Bishops got the anti-abortion amendment into the health care bill, prompting concerns about its constitutionality and viability.
- Route 66 (+99%). The Santa Monica Pier got formal cred as the Western Terminus of the historic highway's 83rd anniversary.
Filed under: Health, Travel, Politics, Music, Weather, Science, Astronomy
Fat in Japan: Break the Law
While most Americans gain a pound (or 10) over the holidays, the only repercussion is tight clothes. In Japan, employees must face an annual physical exam that includes the dreaded tape measure. If your waist is over the mandated limit, you don't just run the risk of looking bad, you — and your business — get in trouble.
Faced with high health care costs that the country links to obesity, the law of the land now requires employers to keep the numbers of fatties to a certain low level or risk fines — and be required to pay in more for health care coverage. And those health care costs aren't getting any cheaper.
Apparently, the Japanese take this annual humiliating ritual pretty seriously, going on crash diets and joining gyms to whittle their waists down to government-acceptable levels.
Here's the biggest irony: Japan's obesity rate, according to the Global Post, is actually the world's lowest. (A skimpy 5% compared with a scale-busting 35% in the U.S.) But in the last three decades, the population's weight has ballooned, along with worrisome levles of diabetes. Their solution: Legislate weight.
Oh, and if you're planning to visit anytime soon, rest assured: The law doesn't apply to tourists.
Filed under: Health
Take It to 111: Britain's Loudest Snorer
Here's one for the record books. Britain has found its loudest snorer. Given that her noisy sleep sounds move the dial to an ear-shattering 111 decibels — louder than a low-flying jet — we've decided we'll take her word for it, and turn down any invites for a sleepover.
The British woman is 60 and has had the problem her entire life. One of her earliest memories, according to the Telegraph, is bring awakened at age five to her sister pinching her nose closed to make the noxious sound stop.
Except for invasive surgery, Jenny Campbell has tried every late-night TV gizmo to make her a silent sleeper, but nothing has worked. And no wonder: Her sounds can drown out a washing machine, a diesel truck, and a speeding train. You gotta feel for the British woman's long-suffering husband, who sleeps in another room five nights a week.
For the record, the snoring wonder was discovered because she attended a sleep seminar that recommends holistic remedies. Save keeping the retired banker in a sound-proof room, her snoring won't go away any time soon. (That's something many annoyed women already know, since the affliction tends to be a trait of middle-aged men that keep many a mate awake.)
One suggestion from the seminar: Cut out the alcohol. Campbell says she's willing to try anything else. Anything. But giving up the drink, that's too much to ask. We hear you, Jenny Campbell. And so does everyone else.
Filed under: Health
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