What is Healthcare: Differences

The Republican Party has spent the past several months serving as vocal opposition to the healthcare reform bills supported by the Barack Obama administration and Democratic members of Congress. During that time, they have seen success in influencing public opinion. However, many were frustrated that Republicans hadn't offered their own plan. Surely they didn't believe that the health insurance system in the U.S. is perfect the way it is? Well, the wait is over. Senate Minority Leader John Boehner has acknowledged the public's demand for an alternative with the debut of the GOP's healthcare reform bill. Obviously, a party that has disagreements with most parts of the Democrats' bills in the House of Representatives and Senate has written a significantly different bill. How exactly are the proposals different?

Length: The Democrats' bill is a whopping 1,990 pages long. Meanwhile, the Republican version clocks in at a more reasonable 230 pages. Most politicians should find the latter's length (akin to the average novel) more manageable than the entire encyclopedia that is the former.
Mandate: Republicans have eliminated the mandate that would require virtually all individuals to buy health insurance plans, as well as one that would force employers to provide insurance. Those mandates are central to the Democratic bill; their intent is to make sure that the cost of health insurance is spread among a large pool, as opposed to only the sickest of our population.
Pre-existing Conditions: Unlike the bills proposed by the Democrats, the Republican bill would not ban health insurance companies from denying coverage to those with pre-existing conditions. This falls in line with the party's more anti-regulatory stance on business.
Interstate Insurance Sales: People will be allowed to buy a health insurance plan across state lines under the Republican bill. Insurance is cheaper in some states, since there are fewer requirements or restrictions on what insurers do or do not cover.
Abortion Coverage: The Republican bill includes stricter prohibitions on funding of abortions. Democrats have already included a provision that would prevent federal subsidies (given to low income individuals to buy insurance) from being used directly on abortion services. However, the Republicans go further by preventing people who receive the subsidies from buying any health insurance plan that covers abortion entirely--even if they never end up using that particular option. The Republican party has a stronger pro-life base, so this provision could help draw them in. On the other hand, this could also backfire against the Republicans, who have capitalized off the grassroots anger over the possibility of a government bureaucracy making your health care decisions for you.
Medical Malpractice: Trial lawyers have been loyal contributors to Democratic politicians. That may be why there isn't significant legislation involving medical tort reform in their bill. Republicans would like to limit jury awards for things like pain and suffering. The most plaintiffs could be awarded would be 0,000 in medical malpractice cases (excluding actual, proven economic harm)
Cost: The most recent estimates show the Democrats' plan as costing over trillion over the next decade, while Republicans haven't yet revealed how much their plan will cost. Given how much they complain about the Democratic proposals super-sizing the national debt, it can reasonably be expected that their bill will have a lower price tag.

Healthcare

As you can see, there are significant differences in the bills. Above all, Republicans acknowledge that their bill would insure less people than the Democratic bill. Although both parties care about lowering the percentage of uninsured individuals and families in addition to the budget deficit, there is a trade-off. The latter appears to be a higher priority for the GOP. It appears inevitable that healthcare reform will pass at some point, possibly before the end of this year. The details of the Democratic proposals have been discussed for weeks, while the solutions presented by the Republicans have just made their formal debut. Boehner plans to finalize his party's bill soon, in order for it to be presented when debate on the finalized Democratic bill begins on the House floor. So far, neither strategy for reforming our healthcare system seems ideal. Despite that, it is positive that more options are being presented to the American people. The greater number of minds put together, the faster we can fix the unavailability of affordable health insurance plans in this country.

Differences Between the Republican and Democratic Healthcare Reform Bills

Yamileth Medina is an up and coming expert on Health Insurance and Healthcare Reform. She aims to help people realize that they can get affordable health insurance plans right now while waiting for a public option, if it ever gets passed. Yamileth lives in Miami, FL.

Healthcare, it's a very popular topic these days especially with the "graying of America," one of the deepest recessions we've experienced in 25 years, and people losing their jobs and the health coverage that often comes with employment. President Obama used his intention to reform the healthcare system and get coverage for more people as one of the key issues to catapult him to victory this past November. Medicare, Medicaid, prescription drugs, physical therapy, I could go on and on,but there's not doubt it's a topic that's on many people's minds, and also one that's very misunderstood because of the many various twists and turns the topic entails. While the purpose of this article is not to sort out the topic in it's entirety (I don't think ANY one article could do that), the sub-topic I wish to address is a very basic one.

One thing that I've noticed in my practice is that people don't understand the basic type of impairments that one might experience and the care these impairments require that would cause them to go to the healthcare system for help. Without understanding the basic impairments, how they are defined, and what they entail helps explain why there is even greater confusion, and even frustration whenever there is a problem at one of the more advanced levels in the system. If what follows helps to clear up healthcare at it's most basic level for its readers, it will have done its job.

Healthcare

ACUTE CONDITION - Can be defined as a health impairment that, if not taken care of immediately, can lead to death or long term disability. In most cases, an acute impairment can strike and be completely cured such as when one gets the flu. But it could strike, and even with care, leave one permanently physically impaired like a stroke (more about this later.) When one first gets the stroke it is imperative that the person gets to the hospital immediately because the quicker it's caught, and the proper steps taken by qualified professionals the less the long term effects. This is what makes it an acute condition in the beginning. When you hear the topic of healthcare being discussed in social circles and on the news, more than likely it is financial assistance with acute care that is being discussed. When we have an acute impairment we go to the doctor, or a health clinic or hospital depending on the severity of the impairment. The treatment is paid for by health insurance that we have either through our employer or on our own, by Medicare if we're disabled or age 65 and older, or by Medicaid if qualified by income.

Healthcare - The Different Types of Health Conditions and Impairments an Their Important Differences

CHRONIC CONDITION - The next type of healthcare we're going to discuss is regarding people who have conditions that can be managed but not cured. People with chronic conditions can live somewhat normal lives, meaning they can live in their own home, cook their meals, shop, bathe, drive to the store, walk etc. without any assistance. They also might be physically or mentally impaired. Which we'll further discuss below.

PHYSICAL IMPAIRMENT - A physical impairment leaves one incapable of performing one or more of the Activities of Daily Living (ADLs) which are

1. Eating
2. Dressing
3. Toileting
4 Transferring
5. Bathing
6. Continence

A physical impairment can be an acute condition such as breaking both legs in an automobile accident, but once the bones are set and a cast or splint put on the legs, the condition is no longer in need of immediate medical care since the malady received the proper medical attention. Until the leg heals though, the person will probably need CUSTODIAL CARE, which is help in performing everyday tasks, or one of the ADLs listed above, tasks that most of us do ourselves and probably take for granted. After everything heals the person more than likely will be back to fully functioning.

A physical impairment can also be chronic such as a stroke and/or Parkinson's Disease. These conditions might require the person to have custodial care as mentioned above, which is typically performed either at home and known as INFORMAL CARE or performed at a nursing or rehab facility where the care is provided by nurses aides and is called FORMAL CARE since it is being performed by professional caregivers. The chronic physical impairment might also require SKILLED CARE which is care performed by doctors, nurses, as well as physical, occupational, and speech therapists.

This is where payment for care gets to be difficult. Typically health insurance will cover the costs of the acute condition(at least most of them). For example, the guy in the first example with the broken legs from a car accident, will be covered by health insurance that will pay for his transport to the hospital, the skilled care received there, and at least up to six weeks of physical therapy. If he's over 65 and on Medicare his hospital and post-hospital care will be covered for up to 100 days.

When the condition is chronic is where the coverage stops and the panic, fear, and frustration set in because unless one has Long Term Care Insurance, or a good Disability Insurance policy, the coverage for the chronic condition must be provided personally by the patient or family and this is where financial devastation sets in. Though some may disagree with me, I think even if some type of universal health coverage is passed, chronic condition care is still going to fall on the affected person and his/her family, because most nursing facility stays currently run 0 per day and up. For the government to cover everyone for acute conditions AND chronic conditions too would take a heck of a lot of money (meaning a HUGE increase in taxes.)

MENTAL IMPAIRMENT - Mental impairment is the final topic of discussion today. Like a physical impairment it can be caused by an acute condition, such as a stroke. It can also be a strictly chronic condition that never had an immediate care need, such as Alzheimers disease. If fate allows it there can be a double dose of destruction, both physical and mental impairment, such as Parkinson's Disease with dementia.

A mentally impaired person might need custodial care, but a different type of custodial care than a physically impaired person. A physically impaired person might have trouble performing one of the aforementioned ADLs, which is not necessarily so with the mentally impaired person. A mentally impaired person, in many cases, can go to the toilet by himself, that's something he's been doing for years. It's just his short term memory that's shot so while he can eat by himself, two hours later he will have forgotten what he ate or will not even remember eating at all. The custodial care required by a mentally impaired person might be to watch him, much like a child, so he doesn't indirectly harm himself by turning on the gas to cook and forgetting about it, or walking out the door into the middle of a heavily travelled roadway.

As you can see the topic of healthcare is more involved than providing coverage for people to get a physical, and their blood pressure prescription filled. It's even more in depth than I've covered here. Some might want to disclude out of hand those that have chronic conditions because they don't consider that to be "healthcare," but for the people and the families that are suffering from those conditions, they are health conditions that are very real. Since we can't ask us taxpayers to cover everything, where we draw the line, and who can objectively draw that line?

Healthcare - The Different Types of Health Conditions and Impairments an Their Important Differences

Christian Halas is owner and wealth manager with Halas Consulting located in Pittsburgh, PA. Halas Consulting prides itself in providing unique and objective solutions to various insurance, investment, banking, tax, and estate issues faced by individuals and small businesses. Investment services provided in conjunction with Venn Wealth and Benefit Services, a PA Registered Investment Advisor. Christian can be reached via email at chalas@venn.us with any questions or comments on this article