Health Care Stories from Americans in Canada

The signing video and the final page of the bill

Yes, President Obama used 22 pens to sign the bill. Here's why.

What does the health care bill mean for Americans Abroad?

Explained at the New York Times with helpful links. There will not be fines for Americans living abroad, since they most likely already have government-run health care plans.

The Health Reform Bill in Simple Terms

The Immediate Benefits of Health Reform 

• The health reform bill passed last night is a victory for all Americans -- families, seniors, workers and small businesses.  Americans now have the security of knowing that they will not have to watch the American dream slip away if they get sick or are in an accident.
• Beginning this year, health reform will bring down costs for families and small businesses, it will end the worst insurance company practices and it will expand coverage to millions of Americans.
• This year, Americans will start to see significant benefits because of this bill and other important reforms will follow.

 
American families and small businesses will see costs go down immediately because of this bill.

In 2010 the bill will:

• Make providing employee coverage more affordable for small businesses by giving a tax credit of up to 35% of premiums to small businesses that choose to offer coverage.
• Create a temporary high-risk pool to provide affordable insurance options to adults who are denied coverage because of pre-existing conditions.
• Provide a $250 rebate for Medicare recipients who fall in to the Part D donut hole – the first step towards closing the donut hole for good.   The bill will also provide a 50% discount on prescription drugs which fall into the donut hole beginning in 2011.
• Require new private plans to cover preventative care – with no co-payments or deductibles.  Medicare will also provide free preventive care beginning January 1, 2011.
• Create a temporary reinsurance program for early retirees – this will help employers and retirees age 55-64 struggling to pay expensive premiums

 
Health reform will immediately expand coverage

This year:

• Insurers will no longer be able to deny children coverage because of pre-existing conditions – this applies to new plans and grandfathered group plans. Never again will insurance companies be able to deny coverage to a child because of his or her health.
• Young adults will be able to remain on their parents’ insurance policy until they turn 26 – this applies to new and grandfathered plans.
• Americans will be guaranteed access to the care they need. Insurance companies will no longer be able to drop coverage when someone gets sick or impose lifetime caps – restrictive annual limits will be banned for new plans and grandfathered group plans.

 
In the next fiscal year:

• Community health centers will be able to nearly double the number of patients they treat over the next 5 years with additional funding.
•  New investments in the bill will increase the number of medical professionals throughout the country – we’ll have more primary care doctors, nurses, nurse practitioners and physician assistants.

 
Immediately, health reform will strengthen consumer protections and reign in insurance companies.

• This bill will ensure consumers can appeal decisions private insurers make about their plans by creating a new, independent appeals process beginning this year.
• The bill will crack down on insurance companies and ensure they are spending your premium dollars on medical services – in the individual and small group market, insurers will be required to spend 80 percent of premiums on medical services and for the large group market, they’ll be required to spend 85 percent. Insurers who don’t meet those requirements will have to send rebates to policyholders. This will begin on January 1, 2011.
• Insurers will no longer be able to discriminate based on income beginning this year.  For new group plans, insurers will not be able to implement eligibility rules that unfairly benefit higher-wage employees.
• This bill will end the practice of unreasonably hiking up rates beginning in 2011.   Insurance companies will be required to submit justification for all premium increase requests. Companies who make excessive increases or cannot justify increases, may not be allowed in the new health insurance exchanges.
• The bill will help states create consumer assistance offices with funding coming this fiscal year.  These offices will help consumers file complaints or appeal decisions from insurance companies.

President Obama Sends a Letter at 1am in the Morning

President Obama sent this email at 1am in the morning after a long day at work on a Sunday. This man is tireless. Thank you President Obama for your unwavering commitment to America.

For the first time in our nation's history, Congress has passed comprehensive health care reform. America waited a hundred years and fought for decades to reach this moment. Tonight, thanks to you, we are finally here.

Consider the staggering scope of what you have just accomplished:

Because of you, every American will finally be guaranteed high quality, affordable health care coverage.

Every American will be covered under the toughest patient protections in history. Arbitrary premium hikes, insurance cancellations, and discrimination against pre-existing conditions will now be gone forever.

And we'll finally start reducing the cost of care -- creating millions of jobs, preventing families and businesses from plunging into bankruptcy, and removing over a trillion dollars of debt from the backs of our children.

But the victory that matters most tonight goes beyond the laws and far past the numbers.

It is the peace of mind enjoyed by every American, no longer one injury or illness away from catastrophe.

It is the workers and entrepreneurs who are now freed to pursue their slice of the American dream without fear of losing coverage or facing a crippling bill.

And it is the immeasurable joy of families in every part of this great nation, living happier, healthier lives together because they can finally receive the vital care they need.

This is what change looks like.

My gratitude tonight is profound. I am thankful for those in past generations whose heroic efforts brought this great goal within reach for our times. I am thankful for the members of Congress whose months of effort and brave votes made it possible to take this final step. But most of all, I am thankful for you.

This day is not the end of this journey. Much hard work remains, and we have a solemn responsibility to do it right. But we can face that work together with the confidence of those who have moved mountains.

Our journey began three years ago, driven by a shared belief that fundamental change is indeed still possible. We have worked hard together every day since to deliver on that belief.

We have shared moments of tremendous hope, and we've faced setbacks and doubt. We have all been forced to ask if our politics had simply become too polarized and too short-sighted to meet the pressing challenges of our time. This struggle became a test of whether the American people could still rally together when the cause was right -- and actually create the change we believe in.

Tonight, thanks to your mighty efforts, the answer is indisputable: Yes we can.

Thank you,

President Barack Obama

A terrific summary of the almost 100 year long debate

A terrific summary of the debate with stats and referenced links to details.

Send this to others to know what we've been fighting for. Thank you President Obama for being such a thoughtful leader!

BREAKING NEWS: Health Care Reform Bill Passes in the House

216 "YES" votes have been voted in the House on the Senate Amendments to the Health Care Reform Bill. Next - President Obama to sign the final bill.

"This is a victory for all American people."

The final hours of the health care reform project

Well...here we are in the final hours of the Health Care Reform project. I think that 14 months makes it a project. At this time, I am looking at it all and I am glad to say that at least we have got something here. In 1994, healthcare reform was sacrificed on the altar of expediency, power politics, and corporate influence. The current healthcare reform project at the start of this year was well on its way to facing the same fate. Yet, President Obama looked at us all and reminded us that we had a job to finish. This assignment had to be handed in, and it would be completed. No ifs, ands, or buts. And if it were to get a failing grade, so be it. We would do our best to make sure it passes, but not finishing the job could not be an option. We finally understood that hey, we gotta do this. And a great many Americans have reacted like students who would prefer taking a pass on a particularly difficult assignment. Over the past year we have been subjected to the most interesting lessons on political science, the most fascinating of political analyses, and yes, a full demonstration of the successes as well as some of the failings of the American Democratic Political System. We are at the point where we are counting and re-counting votes down to the wire. The final dances with the wolves that will somehow, seemingly miraculously, get a Bill onto the President's desk for signature. And the photo op will go down in history. How do you get 218 members of Congress and 51 or 52 senators, plus the President, not to mention at least a couple of Secretaries, at least, into one big happy portrait?

HR 4872 THE HEALTH CARE & EDUCATION AFFORDABILITY RECONCILIATION ACT of 2010 amendments to be discussed at 10am Saturday March 20

Last night at 9:23pm the proposed amendments to THE HEALTH CARE & EDUCATION AFFORDABILITY RECONCILIATION ACT of 2010 were posted on the House Committee on Rules website. A meeting on these proposed amendments will happen at 10am Eastern time today Saturday March 20 2010.

http://www.twitter.com/PeteSession is live tweeting -- are any Democrats live tweeting?

Why President Obama Should Proclaim "On health care reform, you're either with us or against us!"

The health care reform is heading towards reconciliation, and from all indications all out war is being waged along partisan lines. From the many stories we have received from Americans in Canada -- over 60 to date -- most have ardently supported health care reform -- including the public option. When surveyed by Democrats Abroad Canada, over 50% of Americans in Canada consider health care reform in the US their #1 priority for the administration, above the economy and jobs. This is not really surprising.

The reason why this issue is so important to Americans abroad is that most have already experienced public health care. We don't worry about a hefty bill waiting for you when you check out of the hospital. And we don't live in fear of a potential bankruptcy. For most Americans abroad public health care is available before we are even naturalized as residents or citizens. We have the freedom to start our own business, without paying extra for a health insurance plan. We can work for a company that is not burdened with the high costs of providing health care benefits for their employees. Americans abroad actually enjoy more freedom and piece of mind as a result, and most Americans abroad are bewildered why this debate is so hotly contested by Americans back home.

What's most revealing though is the personal story for each American living abroad. We all have strong ties back to the United States. Personally, I have parents in their 60s living in Michigan. My father worked as an electrical engineer for Ford and then Visteon, a Ford spinoff, for most of his life. When forced into early retirement at 61, he was given a continuation of an existing employer subsidized health care program. My mother never had the benefits of any health care as she was self-employed for most of her life as a cosmetician, and never had health insurance on her own. Although they will be eligible for Social Security, there is always the spectre of an unexpected illness that may cost way more than they ever imagined.

An American Living in Canada Responds to Sally Pipes

Danny Williams, the Premier (Governor) of the province of Newfoundland and Labrador does not prefer American medicine. As is his right (and his choice) under the Canadian Medicare program, and under the advice of his Canadian Medicare-paid doctors, he preferred to go to Florida. And that’s not a bad idea when you’re in Newfoundland in the middle of winter. And if you have a vacation condo in Florida, as Premier Williams does, well duh!
  
Yes, some American hospitals (especially in Florida, Arizona, and California) are popular vacation destinations for about 40,000 Canadians a year, but guess what, Cuba is a lot cheaper, and will soon overtake them all! You can’t beat getting some good ol’ sun and surf in the middle of a Canadian winter! It’s pure dollar and sense wisdom.

A single-payer system in the Golden State is a wonderful idea that is only being considered because every other option simply does not make sense in the current economic climate. And Ms. Pipes may argue that government health care leads to waiting lists, rationing and lower quality of care. Yet, one thing you can’t argue with is Canada’s life expectancy rate which is almost 3 years longer than in the U.S.!

Oh yes, Canadian doctors heading south. A decade ago, a salary of $200,000 U.S. dollars was worth $320,000 Canadian dollars. Quite the premium. Very attractive. Today, however, $200,000 U.S. dollars is worth $210,000 Canadian dollars. There’s a heck of a lot fewer graduates going south. In fact, the word is that U.S. medical graduates are increasingly heading to the Great White North, fleeing the broken U.S. healthcare system, and many other U.S. professionals are joining them. There is now a waiting list for them to get in to Canada.

Most Canadians who are on waiting lists for healthcare are waiting for treatment of non life-threatening conditions, such as hip replacements and similar procedures. Yes, there are the serious cases. My brother in-law was on a list for a liver transplant for about four months. He received a liver, but his body rejected it. Within less than two weeks, he received another one. If your condition is life threatening, you shoot to the top of the list. This approach applies to the emergency room, as well. If you break your wrist, you may wait a few hours depending on the hospital and how many people are showing up. If you are having a heart attack, you will see a doctor within minutes.

Government spending on healthcare over the past 20 years in Canada has decreased, overall, creating major challenges for healthcare management and delivery of service, but nothing near what the U.S. has faced. In fact, the per capita cost of healthcare in Canada has been kept low (at about half the cost in the U.S.) precisely because it is publicly regulated and controlled. Private market driven healthcare costs are impossible to control centrally, regionally or nationally. This has been proven, quite spectacularly, in the U.S. 

Canadian doctors and healthcare professionals are generally more prudent in using healthcare resources. Waste not, want not. In the U.S., for example, malpractice fears alone have doctors sending far more patients for costly procedures and tests than are actually necessary.  As for pharmaceuticals, how many Americans are importing medicine from Canada over the internet? You just can’t beat generic drugs available at a fraction of the cost. You can’t beat good quality healthcare at a fraction of the cost. You can’t beat the fact that not one Canadian, not one, has ever lost their house or gone bankrupt because of healthcare bills.  

And you just can’t really argue with that, eh?

Larry Rousseau
American in Canada with dual American-Canadian citizenship
Ottawa, Ontario, Canada

Reference:
Sally Pipes opinion piece.
"Why Canadian premier seeks health care in U.S."
San Francisco Chronicle