Rodale.com: What are your overall thoughts on the bill?
Diana Zuckerman: There are some wonderful things in the bill. I preferred the version that passed the House of Representatives, rather than the Senate version, but the final bill is a major improvement over the healthcare system as it has been. And, contrary to some very vocal critics, it is NOT government-run health care. We will still have private insurance companies, but they will no longer be able to get away with unfair practices, such as refusing to pay for medical care for pre-existing conditions. And they will be required to include dependent children under 26 as family members in family policies. I predict that many people who had thought this bill was not worth supporting are going to be very happy when they realize that they are benefiting from the new law.
R: Do you have any specific advice for people relating to their insurance? Is there anything they can or should do right away?
DZ: Here are just a few examples. People with pre-existing health conditions that were not covered, or who have children with pre-existing health conditions, or who have dependent children under 26 who were not covered in a family plan, should check with their current insurance company to find out when the policies will change. And also check with other insurance companies to see if they are moving more quickly. The law requires these provisions to go into effect six months from now, but some companies may implement them sooner.
R: Is there anything new to take advantage of now, or in the near future?
DZ: In addition to the above examples, retirees over age 55 who are not eligible for Medicare will be eligible for affordable insurance in 90 days. Also, six months from now insurance companies will no longer be able to place lifetime limits on medical costs—an important benefit for people with expensive diseases. In 2011, there will be other new benefits, such as more affordable long-term-care insurance and 50 percent discounts on drugs for some Medicare patients.
R: Do people who don't have health insurance need to find something quickly to avoid a penalty?
DZ: Individuals won't be penalized for not buying health insurance until 2014. I know some people think requiring insurance is not a good idea. But until we do, those of us who are insured are going to pay more for health care, because those of us who pay for our own health care are also paying for uninsured adults and children who go to emergency rooms or have expensive surgery that they can't afford. When an insured person goes to an emergency room after an accident, for example, the bill she pays includes money for her medical care and also a proportion of the expensive unreimbursed care of uninsured people served in that same emergency room.
Read on to find out how smaller parts of the legislation, including the tanning tax, will affect you.
R: Some smaller aspects of healthcare reform, such as an immediate 10 percent tax on indoor tanning, are making headlines. What's your take on this tanning tax?
DZ: The tanning tax will result in a relatively modest increase in the cost of using a tanning salon. The increase in cost will be a slight discouragement for those who use them, although I don’t think a 10 percent tax will have much impact on usage. That’s too bad because indoor tanning increases the risk of skin cancer and adds to healthcare costs. The money from the tax will be used to help lower the costs of healthcare insurance for people who otherwise couldn’t afford it. It’s a good compromise—the tax is not high enough to have much impact on use of indoor tanning and therefore won’t put tanning salons out of business, but the money will go to a good cause. Many of us wanted the tax to be higher, and for the bill to tax some cosmetic surgery as well (particularly the kind of cosmetic surgery that tends to add to healthcare costs, such as breast augmentation). However, the cosmetic surgeons were more effective lobbyists than the tanning-salon owners, so they were not taxed.
R: And the law's new requirement for restaurant chains with 20 or more restaurants to clearly label calorie content?
DZ: We support the new requirement that larger chain restaurants must include calorie information on the menu. We know that many people make food choices that they think are lower-calorie choices but aren’t. Just as some of us learned that most McDonald’s chicken sandwiches have more calories than a Quarter Pounder; we’re going to learn that some delicious salads are higher in calories and fat than some “meat and potatoes” choices. That won’t solve the obesity epidemic in the U.S. but it will make it easier for us to make healthy choices if we want to.
I recently learned that my favorite donuts are less fattening than most muffins OR bagels—so even those of us who think we are knowledgeable will probably be surprised by the information on these menus, and will change our menu choices as a result.
It's the U.S. Food and Drug Administration's task to hash out the details of the calorie-labeling requirements, so to make it easier to cut calories until better labeling is in effect, read 10-Plus Ways to Avoid Calorie-Overloaded Fast-Food Meals.