So... I'm from England, so I'm not 100% sure on what's going on with this Bill, and wondered if someone could explain it to me? As far as I can see, it's Obama trying to set up something similar to the NHS that we have in Britain, where Health Care is run by the government and people are entitled to free health care if they can't afford to pay for it?

If that's actually what the bill is about, I can't understand why anyone in America would be against it? Surely allowing those from lower income families to have access to the health care they need is a good thing? I mean I know the NHS in Britain is FAR from perfect, but it's at least a reassurance that when you fall ill and go to hospital, all you have to concentrate on is getting better, rather than worrying if you can afford to be there?

I could be wrong though, so any help as an explanation would be great :)

It's not exactly the same as the NHS... it's somewhere inbetween their existing system and what we have. From http://obama-healthcare-reform.com/, this is a list of the main proposals:

- Require insurance companies to cover pre-existing conditions so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums.
- Create a new Small Business Health Tax Credit to help small businesses provide affordable health insurance to their employees.
- Lower costs for businesses by covering a portion of the catastrophic health costs they pay in return for lower premiums for employees.
- Prevent insurers from overcharging doctors for their malpractice insurance and invest in proven strategies to reduce preventable medical errors.
- Make employer contributions more fair by requiring large employers that do not offer coverage or make a meaningful contribution to the cost of quality health coverage for their employees to contribute a percentage of payroll toward the costs of their employees’ health care.
- Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.
- Ensure everyone who needs it will receive a tax credit for their premiums.

Like most Brits, I think this is something which could greatly benefit Americans. I find it shocking that in this day an age a country as advanced as the US has millions of people (including several million children) who do not have access to proper healthcare either because they can't afford it, or can't get it (for reasons such as pre-existing medical problems). I find it shocking that woman go into hospital to have a baby and get given a bill for thousands of pounds to cover their emergency caesarian section and the lifesaving treatment of them and their new baby. I find it shocking that women cannot choose to give birth in the way that they want to (e.g. with a midwife) because their insurance won't cover it, because it's too restrictive.

Like most Brits, I believe health care should be a right, not a privilege for the rich. The difference is, many Americans think the opposite.

The other reasons why some Americans are against the proposals:

- they do not see it as their responsibility to pay for others healthcare
- they're worried about what it'll cost them in taxes
- some seem to confuse the issue with another of Obama's health policies, the one which allows abortion to remain legal. Anti-abortion Americans (and there's far more than in the UK. Partly as we're generally a more liberal country) tend to be against Obama's healthcare reforms because all they see is the abortion policy and ignore the rest. Never mind if children are dying because they don't have healthcare... just as long as there's no abortions. Seems a bit contradictory to me... :P
- Americans tend to place far more importance than Brits on CHOICE. Brits are generally happy with going to any hospital, seeing any doctor, as long as the treatment they recieve is of a good standard, and free. Americans fear that having a national healthcare system will remove their choices... e.g. the choice to have a private room... the choice of which hospital to go to... which consultant to see (e.g. the one recommended by a friend :P). Personally this concept seems a bit bizarre to me... as someone who works in the NHS it seems the priority should be good health care for all.

The NHS works in Britain. It's not perfect, but I'm sure the vast majority of Brits would much prefer what we have to the alternative which the Americans have.

Well in the US children can get on medicaid which is state insurance, pregnant women can get medicaid as well. As well as parents with children under the age of 18. Usually the ones that get denied are people that either have no kids, or their kids are over the age of 18. Sometimes they have open enrollment where anyone can get state insurance, but it's hard to figure out when the open enrollment is.

That's all fine and swell until you turn 18. I had this happen to me. The second I turned 18 I no longer had health insurance. That means I haven't gone to the doctor in over 4 years, and even if I needed to I would feel pressure not to because of the fact I'm going to pay an arm and leg for a more than likely routine procedure. I mean, I can DEFINITELY afford health care as a poor college student (which is what I took it as even though I know that isn't the case).

Most of the opposition I'm hearing about is trying to tug at the heartstrings (or wallets) of the elderly that are going to get 'cheated'. I'm all for health care. Too many people go without it.

See, that to me is ridiculous! Here, if you can't afford things like prescriptions and the dentist, you can apply for an NHS exemption certificate. It makes the NHS truly free, because you're usually not earning enough to pay taxes if you are eligible for it.

I miss going to the dentist. I had a really good one but they didn't take Medicaid. And that was before I turned 18. After that I guess I was expected to shovel out money for my own stuff, even when I'm off to college. But oh well I suppose... :P

And? Where did I say I was against health care? I was replying to someone who had stated something about children going without insurance and pregnant women going without insurance..

I understand that. :P I wasn't saying that you were against health care. I was just adding that more people go without it, too. None of which is all that fair.

Well I misunderstood you then.

I actually wasn't only talking about pregnant women who don't have insurance, but also the restrictions put on their choices in pregnancy and delivery, by their insurance company (and the fact that even those WITH insurance can end up with a huge bill afterwards). How is it fair for an insurance company to say "no, you can't give birth with a midwife at a birthing centre. It must be in a hospital."? Surely that should be the mother's choice!

Over here I have never heard of a woman being denied where she wants to give birth. But then again, in Michigan, there's mostly hospitals, and not as many birthing centers.

It happened to Christina (MadetoShine). Her insurance company wouldn't allow her to use a birthing centre, only a hospital. And I'm sure it happens to many others.

(Christina, I hope you don't mind me using you as an example!)

And perhaps there's not many birthing centres as they won't get many customers i the insurance companies won't pay?

I have no idea. I had my 5 year old at a hospital. And the one I'm currently pregnant with I'll be having a birthing center. Just because of the different areas I'm in. There's 2 hospitals less than 10 mins from me, as well as a birthing center and the hospitals here actually don't deliever babies.

No kidding. As I have said before, and it bears repeating-in my state it is ILLEGAL for a midwife to deliver babies. They can only assist. So I have no choice but to have an OB deliver any children I have while we live here, regardless of my insurance coverage.
Goodness knows midwives could be very valuable, particularly in rural, poor areas of the state where they could give people care locally. There are groups that have tried to influence our state legislature but so far I guess they they don't care if Alabama mothers have choices. It's so ignorant.

Are all children entitled to medicaid then? I didn't realise that. I thought it was only children from the poorest families who were entitled to it. Why then does the Campaign for Children's Healthcare (http://www.childrenshealthcampaign.org) say that there are 9 million children without health insurance? Reports from Families USA also showed that 11% of American children had no health care coverage in 2007.

So I'm a bit surprised by your comment.

As far as I know all children ARE entitled to medicaid.. Some parents are just too proud to ask for help.

Not according to this government website - http://www.cms.hhs.gov/MedicaidEligibility/03_MandatoryEligibilityGroups.asp

Children under age 6 and pregnant women whose family income is at or below 133% of the Federal poverty level. (The minimum mandatory income level for pregnant women and infants in certain States may be higher than 133% percent, if as of certain dates the State had established a higher percentage for covering those groups.) States are required to extend Medicaid eligibility until age 19 to all children born after September 30, 1983 (or such earlier date as the State may choose) in families with incomes at or below the Federal poverty level. Once eligibility is established, pregnant women remain eligible for Medicaid through the end of the calendar month in which the 60th day after the end of the pregnancy falls, regardless of any change in family income. States are not required to have a resource test for these poverty level related groups. However, any resource test imposed can be no more restrictive than that of the AFDC program for infants and children and the SSI program for pregnant women

Yeah but after you have that baby, you're off of medicaid. Unless you are old, a kid, or pregnant there is no type of health coverage for you.

uhm, actually i kept medicaid after i had my son for 4 years until i found a job that provided health insurance i then took myself off medicaid. i became pregnant after losing my job and had no choice but to get medicaid.

Huh. I guess the rules are different for each state. That's cool though!

I take particular interest in this bill working in healthcare billing. It really is TOO hard to be eligible for Medicaid services. Unfortunatley, even if you have children under the age of 18 in the house that NEED healthcare because you can't afford any other health coverage, you can be denied based on income. Unless you're pregnant, disabled, or over the age of 65 you're most likely going to be denied for Medicaid. I see people coming in that will DIE without operations and are denied Medicaid. I'd like to see this bill progress.

Thank you. That's what I thought.

Healthcare in the US is a business. It's sad.

Obviously I am for reform, but from what I can gather, most people against this are upset about the cost.
We already have Medicare and Medicaid, as another blooper noted-and that costs a lot of money. There have already been debates about how we can continue to pay for it and ensure it continues. Given that Obama wants a public option in the final edition of this bill, opponents don't believe that will be paid for in addition to keeping Medicare and Medicaid running as they are, without it costing taxpayers more money.

Also, people assume a public option will be poor quality.

Generally, I don't think people believe Obama when he says they can keep their private plans if they like them. Just the idea of a public option competing with private companies is something people think will be badly run.

Of course it costs money. But so does insurance. And so do health bills. And our taxes aren't insanely huge in the UK as a result of our national health service.