It is unpopular as written in the House with the insurance companies and the conservatives in the Congress, so it is being watered down as much as possible. The biggest lightning rod seems to be the so-called public option, which is popular with the country as a whole, but not in Congress.

What is the main stumbling block? What are people upset about in the writing of the bill?

Depends on who you ask... As Tantris points out, big insurance has politicians in it's pockets as do the hospitals and the doctor's cooperatives. they object to anything that brings competition and makes them lower their profit margins. On the flipside, the conservatives also tend to object to anything that will raise their taxes and this thing *will* raise taxes. Obama just chose to call that increase something else. This is as much a tax as Social Security, they just use different legal names to hide it and provide deniability. Kind of like Bill Clinton's testamony about his "inappropriate relations" with Monica. He never admitted to having sex because Congress defined sex as intercourse and they never had intercourse (supposedly). He used the term "inappropriate relations" when he apologized to the people of the United States.

But, in essence, he had sex and this thing will be a tax. That being said, I actually look forward to some form of UHC provided all the ramifications are studied and a good plan is presented. I will say Obama's is better than McCain's which would have made a number of companies stop offering insurance to their employees because the young folk who jumped ship would have caused the per person premiums to go up for us older and not as healthy folk, making it unaffordable to the typical SMB.

I'll use the same quote I use to explain all government - I think it's from P J O'Rourke

If you ever ask yourself "why don't they?" the answer is "money"

So has it been passed in both the Senate and Congress?

should i even care how america chooses to treat it's ill? probably, i care about how cuba treats it's political dissidents...

I think Obama said that the programme would save money in the long term, and thus no result in an increase in the national debt. Of course healthier people should in fact be more productive, so all the investment in people (education, training etc.) should become more valuable... hmm. And it looks like the bill keeps the insurance companies competing with each other thus keeping the market competitive, and not forming a government monopoly.

As far as socialism goes, i think it looks like maybe America is going to organise it in a way which might be successful.

Reform always takes a long time to get through government, it takes revisions and rerevisions etc, until everyone is happy with the final bill

Our bloated, bureaucratic government ruins everything it touches. Although in principle universal healthcare is a great idea, in practice I guarantee you that implementing it with the government as it is now will make it worse, not better. For example, MANDATORY health insurance? Thank you, no; my idea of health insurance is living healthy and trying to save something for medical emergencies. If you're going to put a gun to my head and demand that I pay more taxes so fat chainsmokers can get health care, while at the same time mandating me to pay for a horribly crippled health plan, then you can go make love to the horse you rode in on.

I'm sorry Tantris, saying "The biggest lightning rod seems to be the so-called public option, which is popular with the country as a whole, but not in Congress." is basically wrong. The prevailing opinion is NOT in favor of the public option. Especially one that the rest of us have to pay for. Heck, Congress and Obama would be exempt from it! They don't want it, but want to force it on us!

The System is broken and there is a lot of waste, but having the government run it is like having the wolves watch the sheep.

What pisses me off is the refusal of each side to listen to the other's good proposals. Was the public option a good idea? Maybe, but it's dead. Max Baucus' bill didn't have it, and that was the bill that would pay for itself. That was the bi-partisan bill that I support. But even then, the Republicans rightly point out that things like tort reform that would save millions were literally ignored. Why? It's a good idea. Obama even said so in his healthcare speech. Partisan legislators make me sick. Presently its the GOP who is taking the role of the insufferable obstructionist, but just wait, tomorrow it will be the Democrats. Cooperation and compromise are virtues in politics, virtues those cowards (save a select heroic few) seem to lack.

But as far as healthcare goes I think they need to pass SOMETHING for God's sake. The people who are saying "keep like it is" are either just rich or assholes.

@L1star
"...having the government run it is like having the wolves watch the sheep."

This is the kind of knee jerk thinking that is causing most of the problems. Governmental bureaucracy may in many cases be wasteful but at least it is to some extent accountable to the people. Private health and insurance companies are only accountable to the shareholders and the bottom line. Which wolf is more hungry?

@ "....wolves watch the sheep." [rebuttal]

That's not knee-jerk thinking; that's how it really is.

Our government is no longer accountable to the people; it is accountable only to itself and the monied powers behind the throne. Our "representatives" are so insulated from the reality that their "constituents" face daily as to be entirely out-of-touch, and are essentially owned outright through lobbying and graft by corporations and special interest groups which are not accountable to anyone but themselves. There are few things more dangerous to personal freedom than the leverage exercised by corporation-backed special interest groups; on the whole, these people seem willing to annihilate anything in the way of achieving their dangerously short-sighted crusades.

I say we do away with representative government entirely; it's a vestige of more primitive times when instantaneous global telecommunication and data-handling did not yet exist. Now that we don't have to worry about missing out on a season of farming just to go to Washington, we should switch over to DIRECT representation and SELF government, with the caveat that less hindrance is better for everyone.

@Gnome de Guerre
I agree with you but you're not addressing the current discussion of health care. You talk of "monied powers" and their short-sighted aims. All I'm saying is that it's better not to have the American health care system directly in the hands of these "monied powers" like it is now.

As it stands right now, there is no American health care system; there are a variety of insurance companies and health-care providers from which to choose, and you are allowed to choose any or none of them.

If Obama's health-care reform bill passes, there will be ONE government-run system which is mandatory; you cannot opt out of it, no matter how much worse it is than the current state of affairs.

Yes, currently, our choices per health-care and insurance ARE in the hands of monied powers, but we are free to choose which ones to enter into contracts with (or even start our own with sufficient savvy etc). The best thing about a free market is not just choice, but the way that the choices of the buyers affect the policies of the sellers. Because survivable companies and their smaller up-and-coming challengers endeavor to provide the most enticing deal with the best benefits at the most cost-effective prices, the shrewd consumer will pass up on anything lest than optimum and pick the choice which caters best to the consumer's desires, and the "system" regulates itself.

Wait, what did I just say? Yeah, you may be thinking "nah, it doesn't do that; there is no such competition." Well, you're partially right, and there are two reasons why:

(1) Government intervention has already been going on a long time in just about every form of business, most onerously in the form of propping up huge juggernaut companies that are "too big to fail" (with bullshit fears of market collapse in their wake) with infusions of raw money on the hammer side plus ridiculous taxes and restrictions that don't affect the big corporations as much as they crush small competitors on the anvil side. Funny that it's like that; you'll see lots of lobbyists paid for by big corporations lobbying the government for more regulations and taxes to crush anyone smaller than them in their niche in a show of laudably corrupt system-breaking.

(2) Sadly, the mouth-breathing masses either haven't the time or the care to actually exercise smart consumerism, and shuffle mindlessly to the health-care equivalents of swooshes and golden arches.

It's mostly (1), however you can blame (2) on the hypno-media, flouridated tapwater, ELF transmitters, etc. Seriously.

To bring it back to a salient point, I'd rather have the freedom to choose as I see fit something that matters a great deal to me and shouldn't be anyone else's concern than be forced to sign on to a seriously sub-par plan just because one-size-fits-all is easier to mass-produce.

From what I am hearing is that American people would rather choose not to have insurance for themselves if it means they dont have to pay anything extra so that everybody can have health coverage

@Gnome de Guerre

That's the market corrupting the government! Abolish the market! Abolish the "free" market!

@L1star:

The public option was never something funded by the government. It was to be run like any other insurance company, but non-profit and by the government. Any subsidies would be able to be used in it or any other insurance plan. As for the public opinion...these are two polls I could find on it.

http://www.washingtonpost.com/wp-dyn/content/graphic/2009/10/20/GR2009102000148.html?sid=ST2009101902502
http://www.reuters.com/article/idUSTRE5B20OL20091203

At some point, people starting wanting it, especially after the push by advocates of it after the break. These show that the majority supports it. There may be some that do not, but I didn't see them. I didn't spend too much time on it. Did a search on google, and found the results that looked most relevant.

@Gnome de Guerre:
Medicare is run at a lesser overhead than any other insurance company. That is, they use less of the money they take in for administration, salaries, and other non-health payment costs. Mandatory health insurance, or some sort of universal health care, are the only ways to solve the problem of people not seeing doctors and over-using the ER. Everyone should have at least an emergency health care plan. Those that have a high deductible(like $5,000-$10,000), but cover you after that. They aren't that expensive, from what I remember.

@Thucydides:
The public option was deemed to save the government money in the long term. By adding it to any bill, the CBO would decrease the cost of the bill by some amount of billions.

I have always heard that tort reform would really not affect things. I have since started looking at that again, and think there is something in reforming it. There is a lot of noise on both sides of that.

The Democrats tried to negotiate, but the GOP would not do so in good faith. One of them came out and even said they were just negotiating to slow things down and trip up the works.

@Gnome de Guerre:
"If Obama's health-care reform bill passes, there will be ONE government-run system which is mandatory; you cannot opt out of it, no matter how much worse it is than the current state of affairs."
That is completely incorrect. 100%. You need to actually look into the reform bill.

"Sadly, the mouth-breathing masses either haven't the time or the care to actually exercise smart consumerism, and shuffle mindlessly to the health-care equivalents of swooshes and golden arches."
One of the major problems in our current system is that all of the power is with the insurance company, unless you get your insurance through your company. If you have a pre-existing condition(been sexually assaulted? ever been sick?) You can usually not get insurance. If you get sick, the insurance company can decide you should have known about this before you signed up with them and retroactively cancel your policy. IE, you made claims against insurance for 6 months, they find out what you have, now all those claims are denied and your insurance is cancelled, leaving you to pick up the tab.

@Everyone:
Honestly, a lot of the movement against health care reform is fear of the government. That is fine. I think that, if I had to choose, I would rather have a bureaucrat deciding whether to deny me coverage than an insurance company employee that works for a company with a profit incentive to deny me coverage. IE, I like the idea of a public option. It does not look like that will happen. Some of the other reforms in this bill are really good though. Limiting overhead of insurance companies. Ending recission. I hope something passes soon.

In no case, was this health care reform going to be a single payer system, which is apparently the boogie man that some of the posts above are sure is happening.

"I think that, if I had to choose, I would rather have a bureaucrat deciding whether to deny me coverage than an insurance company employee that works for a company with a profit incentive to deny me coverage."

that's crazy talk...

I don't get why would anybody be deciding who gets and who is denyed health care????

Sorry I just cant compute that concept but it seems that it happens quite often and people think this is a norm.

Don't get me wrong, I'm not against healthcare reform, I'm against the government running it. There need to be limits put on charges and liabilities. The reason healthcare costs are so high is the need to carry high malpractice insurance. Hospitals are expensive because of the number of writeoffs they have to take due to non-payment. Everyone should have some form of health insurance, but I want the choice of going with my employers plan, or independent coverage.

"I think that, if I had to choose, I would rather have a bureaucrat deciding whether to deny me coverage than an insurance company employee that works for a company with a profit incentive to deny me coverage."

There's no difference at all between a low-level government cubicle rat choosing to approve or deny insurance claims and a low-level corporate cubicle rat making the same decisions. Except that the corporation that employs the latter makes more money if they refuse to pay my claims.

A frequent argument against UHC is that a government-run health care plan will lead to "rationed health care". I don't know about the people who make this argument, but my private insurer's health care plan is pretty specific about what kind of procedures, tests, or medications that I can get, how much of it they will cover, and how often I get it. Where's the difference between that and "rationing"?

@L1Star:
The government wasn't going to run it. They were going to make an alternative option to private insurance companies. That is all. Malpractice insurance was shown to be one reason costs are high, though there have been studies showing that judgements haven't been increasing, which is strange. I do think some sort of tort reform is necessary to keep malpractice insurance cheaper. I don't think that is the problem though. If you look at insurance company overhead, it has increased by almost 200% in the last 10 years. It was around 95% in 1993, though that was the highest. But, in the early 1990's, it was around 90%. It is now around 80%. This is the amount of money insurance companies spend, other than on health expenses (which they amusingly call the Medical Loss Ratio).
http://www.pwc.com/us/en/healthcare/publications/popups/medical-loss-ratio.jhtml

You would always have a choice of your companies plan, a private insurance plan, and in some proposals a non-profit plan run by the government. In the non-profit plan, you would still pay premiums, and they would still pay claims. Just like any other insurance company.

@Nostradumass:
"There's no difference at all between a low-level government cubicle rat choosing to approve or deny insurance claims and a low-level corporate cubicle rat making the same decisions. Except that the corporation that employs the latter makes more money if they refuse to pay my claims."
That assumes no policy, encouragement, reward or pressure from above, to deny claims.

I agree on your statement about rationing.

I think that the idea that your employer will make a better profit if you deny claims than if you approve them provides a fair amount of pressure, even without an official policy.

There's nothing wrong with the free market; how do you expect to feed yourself if you're not allowed to conduct commerce as you see fit? The most sensible contracts are the ones which are only subject to those directly involved. Everything not directly relevant -- insurance, licensing, agency involvement, etc -- really only hurts those who are materially involved in whatever deal they intrude upon.

Nothing wrong with the free market? Nothing, not one thing? you can feed yourself in a less than free market, you can buy food, but pay tax based on how far the food has travelled (effectively distorting the 'free' market to increase the cost of foreign imports, and help 'encourage' food producers to remain local, reduce the demand for transport, and hence reduce oil consumption - there are arguements, good or otherwise for distorting the market in various ways, but they are all arguements against a pure unguided market which only considers profit (and therefore increased consumption) Especially if we live in an enviroment which has limited resources (cause infinite resources would mean we could always increase consumption to create growth)

Seeing this is a discussion on HEALTH CARE not the free market and it's pros and cons, I will get to the point of why the bill is being held up in the Senate. Essentially, from my perspective Republicans are trying to oppose Obama in any way necessary, regardless of the needs of a vast majority of US citizens who are uninsured. They have (GOP'ers) once again succeeded into scaring people into following them by maligning Obama as a fascist, socialist, communist (at least FOX news and many avid supporters of the Rep party have claimed so) and trying to make sure that in general he fails (in approval rating they've done so very well, rotten bastards) so that when the next election comes, they can shove another conservative tightwad down the throats of America's liberals! Their main argument of course is the cost of such a reform to include the public option, but in the grander scheme of things, once again it's American Politics taking the foreground in front of helping people...

@Gnome de Guerre
Your idea of a free market is an outdated idealist's illusion. I have lived for ten years in a country where the government does not intrude upon the contract between employer and employee and I have seen the absolute misery this causes. Workers here are forced to work 12-16 hours a day for wages that can barely provide food let alone housing or luxuries like seeing a doctor. The "free" market is a fallacy. No market is free. If the market is not governed by laws then those with power will step into the vacuum and control it for their own interests.

@otto - Are fucking nuts? A vast majority (that means significantly more than 50%) of US citizens are uninsured? that would be more than 150 million people! Try less than 50 million people at any point in time, or just over 15% of the population on the high side.