1. You are young and don’t want health insurance? You are starting up a small business and need to minimize expenses, and one way to do that is to forego health insurance? Tough. You have to pay $750 annually for the “privilege.” (Section 1501)
2. You are young and healthy and want to pay for insurance that reflects that status? Tough. You’ll have to pay for premiums that cover not only you, but also the guy who smokes three packs a day, drink a gallon of whiskey and eats chicken fat off the floor. That’s because insurance companies will no longer be able to underwrite on the basis of a person’s health status. (Section 2701).
3. You would like to pay less in premiums by buying insurance with lifetime or annual limits on coverage? Tough. Health insurers will no longer be able to offer such policies, even if that is what customers prefer. (Section 2711).
4. Think you’d like a policy that is cheaper because it doesn’t cover preventive care or requires cost-sharing for such care? Tough. Health insurers will no longer be able to offer policies that do not cover preventive services or offer them with cost-sharing, even if that’s what the customer wants. (Section 2712).
5. You are an employer and you would like to offer coverage that doesn’t allow your employees’ slacker children to stay on the policy until age 26? Tough. (Section 2714).
6. You must buy a policy that covers ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services; chronic disease management; and pediatric services, including oral and vision care.
You’re a single guy without children? Tough, your policy must cover pediatric services. You’re a woman who can’t have children? Tough, your policy must cover maternity services. You’re a teetotaler? Tough, your policy must cover substance abuse treatment. (Add your own violation of personal freedom here.) (Section 1302).
7. Do you want a plan with lots of cost-sharing and low premiums? Well, the best you can do is a “Bronze plan,” which has benefits that provide benefits that are actuarially equivalent to 60% of the full actuarial value of the benefits provided under the plan. Anything lower than that, tough. (Section 1302 (d) (1) (A))
8. You are an employer in the small-group insurance market and you’d like to offer policies with deductibles higher than $2,000 for individuals and $4,000 for families? Tough. (Section 1302 (c) (2) (A).
9. If you are a large employer (defined as at least 50 employees) and you do not want to provide health insurance to your employee, then you will pay a $750 fine per employee (It could be $2,000 to $3,000 under the reconciliation changes). Think you know how to better spend that money? Tough. (Section 1513).
10. You are an employer who offers health flexible spending arrangements and your employees want to deduct more than $2,500 from their salaries for it? Sorry, can’t do that. (Section 9005 (i)).
11. If you are a physician and you don’t want the government looking over your shoulder? Tough. The Secretary of Health and Human Services is authorized to use your claims data to issue you reports that measure the resources you use, provide information on the quality of care you provide, and compare the resources you use to those used by other physicians. Of course, this will all be just for informational purposes. It’s not like the government will ever use it to intervene in your practice and patients’ care. Of course not. (Section 3003 (i))
12. If you are a physician and you want to own your own hospital, you must be an owner and have a “Medicare provider agreement” by Feb. 1, 2010. (Dec. 31, 2010 in the reconciliation changes.) If you didn’t have those by then, you are out of luck. (Section 6001 (i) (1) (A))
13. If you are a physician owner and you want to expand your hospital? Well, you can’t (Section 6001 (i) (1) (B). Unless, it is located in a county where, over the last five years, population growth has been 150% of what it has been in the state (Section 6601 (i) (3) ( E)). And then you cannot increase your capacity by more than 200% (Section 6001 (i) (3) (C)).
14. You are a health insurer and you want to raise premiums to meet costs? Well, if that increase is deemed “unreasonable” by the Secretary of Health and Human Services it will be subject to review and can be denied. (Section 1003)
15. The government will extract a fee of $2.3 billion annually from the pharmaceutical industry. If you are a pharmaceutical company what you will pay depends on the ratio of the number of brand-name drugs you sell to the total number of brand-name drugs sold in the U.S. So, if you sell 10% of the brand-name drugs in the U.S., what you pay will be 10% multiplied by $2.3 billion, or $230,000,000. (Under reconciliation, it starts at $2.55 billion, jumps to $3 billion in 2012, then to $3.5 billion in 2017 and $4.2 billion in 2018, before settling at $2.8 billion in 2019 (Section 1404)). Think you, as a pharmaceutical executive, know how to better use that money, say for research and development? Tough. (Section 9008 (b)).
16. The government will extract a fee of $2 billion annually from medical device makers. If you are a medical device maker what you will pay depends on your share of medical device sales in the U.S. So, if you sell 10% of the medical devices in the U.S., what you pay will be 10% multiplied by $2 billion, or $200,000,000. Think you, as a medical device maker, know how to better use that money, say for R&D? Tough. (Section 9009 (b)).
The reconciliation package turns that into a 2.9% excise tax for medical device makers. Think you, as a medical device maker, know how to better use that money, say for research and development? Tough. (Section 1405).
17. The government will extract a fee of $6.7 billion annually from insurance companies. If you are an insurer, what you will pay depends on your share of net premiums plus 200% of your administrative costs. So, if your net premiums and administrative costs are equal to 10% of the total, you will pay 10% of $6.7 billion, or $670,000,000. In the reconciliation bill, the fee will start at $8 billion in 2014, $11.3 billion in 2015, $1.9 billion in 2017, and $14.3 billion in 2018 (Section 1406).Think you, as an insurance executive, know how to better spend that money? Tough.(Section 9010 (b) (1) (A and B).)
18. If an insurance company board or its stockholders think the CEO is worth more than $500,000 in deferred compensation? Tough.(Section 9014).
19. You will have to pay an additional 0.5% payroll tax on any dollar you make over $250,000 if you file a joint return and $200,000 if you file an individual return. What? You think you know how to spend the money you earned better than the government? Tough. (Section 9015).
That amount will rise to a 3.8% tax if reconciliation passes. It will also apply to investment income, estates, and trusts. You think you know how to spend the money you earned better than the government? Like you need to ask. (Section 1402).
20. UPDATE: Taxing cosmetic surgery was part of the final bill (section 10907). However, it was replaced by a later section of the bill that taxes tanning salons (section 10907). So, If you get a tan at a tanning salon, you will pay an additional 10% tax. Think you know how to spend that money you earned better than the government? Tough.
Bob:Hi, insurance company. I'd like to buy some health insurance.
Insurance company:No. You had cancer when you were 3 years old, and the cancer could come back. We're not selling you health insurance.
Bob:It's not my fault I got cancer when I was three! Besides, that was years ago!
Insurance company:If we sell insurance to you, we'll probably lose money, and we're not doing it.
Bob:But I need insurance more than anyone! My cancer might come back!
Insurance company:We don't care. We're not selling you insurance.
Obama:Hey, that's totally not fair. Bob is right, he does need insurance! Sell Bob some insurance.
Insurance company:If we have to, I guess.
Mary:This is cool. Obama said the insurance company has to sell insurance to anyone who needs it.
Sam:Hey, I have an idea. I'm going to stop paying for health insurance. If I get sick, I can always go buy some insurance then. The insurance company won't be able to say no, because Obama's told them they have to sell it to anyone who needs it!
Dave:that's a great idea! I'm not paying for health insurance either, at least not until I get sick.
Insurance company:Hey! If everyone stops paying for insurance, we'll go bankrupt!
Obama:Oh come on Sam and Dave, that's not fair either.
Dave:I don't care. It saves me money.
Obama:Oh for god's sake. Sam, Dave, you have to keep paying for health insurance, and not wait until you're sick. You too, Mary and Bob.
Mary:But I'm broke! I can't buy insurance! I just don't have any money.
Obama:Mary, show me your piggy bank. Oh, wow, you really are broke. Ok, tell you what. You still have to buy insurance, but I'll help you pay 95% of the cost.
Obama:I need an aspirin.
Insurance company:We're not paying for that aspirin.
People don’t understand that she does all this for irony, she was always ironic. She is the reason why there are these bitches trying to be pop singers.
Stop being so fucking childish and search about pop music.
because a woman that acts like a man is still, even in 2012, a polarizing figure in the world, and her success is the salt on the wound. and again, like they did twenty years ago with the ‘erotica’ era, society proves its hypocrisy. madonna’s superbowl halftime show performance was the single-most watched music event in television history, her ‘mdna’ record hit #1 in 40-plus countries without having had a physical single release and without proper promotion, and her current ‘mdna tour’ has already out-sold every other act that is currently on tour - again, without promotion. people can trash madonna until their blue in the face, it makes no difference - the numbers speak for themselves. this isn’t the first time the media has portrayed madonna as a failure when history and hindsight have gone on to show that she was anything but and that criticism of the time was wrong and absurd. it’s not that madonna flat-out refuses to relinquish her power, it’s that she seems oblivious to the fact that surrendering her power and humbling herself before men is what society demands of a woman. women must not revel in their power, and madonna does. this is why there is so much hatred for madonna right now - because people cannot stand their own failures and mediocre existences. but it’s irrelevant, finally, because madonna is the future. -r