It’s tough being a liberal, wanting a national health care plan, not thinking it could get done, then when it seems it’s done not liking many things about it. That may be a bit much, but there are enough things I don’t like about it that I already know, and trust me I haven’t read the more than 2,000 page report so I might hate even more later on.

What’s good about it? This is the easy one. A majority of people who don’t have health care coverage now will finally have something, and most of the coverage they’ll get will be comparable to health care plans that everyone else who has health care now has. What I haven’t seen is whether there will be deductibles or copays for services, and how they’re going to handle prescription drugs, but the plan says that people will be able to go to whichever doctor they so choose. I wonder if that means no referrals from a primary care provider will be needed for things such as physical therapy and diabetes treatment. I guess we’ll see.

What’s bad about it? Here are 5 gripes I have with the plan as it is known right now:

1. It’s going to hurt the middle class. Didn’t President Obama run on a platform that said any health care bill he signed wouldn’t hurt the middle class? No, it’s not going to hurt everyone, but the people it’s going to hurt the most are middle class. Individuals who don’t have insurance will have to pay a yearly penalty of either $950 or $3,800, depending on whether they’re single or in a family. That’s a lousy deal, no matter who you are.

2. It’s going to hurt small businesses. Now, I’m not one of those people who believes companies shouldn’t be covering their employees as far as health insurance is concerned, but I don’t know that I like some parts of this provision. For instance, though it states businesses of more than 50 employees, the federal government overall considers small businesses as any that have fewer than 200 employees. Also, did you know there’s a new provision that was added that states construction companies get penalized if they have more than 5 employees? At $750 a pop for the year it won’t break the bank, but it’s inherently unfair to isolate one industry like this, even if that industry has had to be reigned in by many states for its lackluster worker’s compensation record.

3. It’s still pricey. Here’s the deal. If you fit in an income class that’s higher than Medicaid but lower than the government’s arbitrary rate, you’ll get your coverage for free. However, if you have to pay into it, it’s going to cost you around $400 or so a month. So, that’s $4,000 a year as opposed to that $3,800 family penalty, but if you’re an individual in good health where’s the deal? It doesn’t take into account medical savings plans that many independent business proprietors have, which pretty much makes medical savings accounts for these folks moot. Yes, they’ll still be able to write off medical expenses over $400 a year, but that doesn’t quite seem balanced.

4. There’s still no plan for electronic medical records (EMR). Has anyone heard any government official talking about EMR lately? This is something President Obama has talked about wanting and having to be in the health care bill, but I haven’t heard anything about it. Of course, my gripe with it is that it’s easy saying all hospitals and physicians must have it. It’s hard for them to help identify just how such a process is supposed to be rolled out, especially in rural areas where neither the hospital nor the physicians have either the money or the technical expertise to get it done.

5. Absolutely no bipartisanship whatsoever. Yeah, I’ll say it, this one is the Republican’s fault totally. Sure, they didn’t want anything to begin with, but to only have one Republican who even participated in the talks, that being Olympia Snowe of Maine (female senators from Maine have always been contrary; gotta love them for that), is a darn shame. It was a farce seeing Orrin Hatch on TV last week saying he wished there had been more bipartisanship on this bill; you have to be in the game to have a chance to play. I keep wondering if things might have played out differently if Bill Frist, who not only was the previous Republican leader of the Senate but a medical doctor by trade, would have had a much different impact on how things played out as the minority leader and one of the few people with a health care background.

I actually do have a number six, that being that almost no health care professionals were a part of this conversation. I’m thinking that the American Medical Association, the American College of Healthcare Executives, the American Association of Healthcare Administrative Management, the Healthcare Financial Management Association and a few independent health care consultants in finance and revenue cycle matters would have really improved what’s on its way.

So be it. Those are my gripes with this bill. I will only say that I hope this bill is enough to overcome medical bankruptcy filings and offer more people quality health care, while not hurting the states.

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