The US Senate passed a health care reform bill (HR 3590) in a rare Christmas Eve session by a party line vote of 60 to 39. The $871 billion Senate bill must now be reconciled with the House bill when Congress returns to work in January. This Senate bill marks a monumental moment in history, a moment when private interests, working in concert with so-called public government, openly plunder American citizens tax funds while also passing a law that forces citizens to buy private insurance. Dictatorships across the globe must envious. And it was all done by creating divisive public debate and stoking visceral and sometimes violent protest to successfully deflect attention from facts and the real issues, while creating a sense of 'rightness' in expressing either support or dissent.

I predict this will go down as one of the greatest mass communications schemes of all time, and combined with the selling of public support for anything private that fails, it paves the way for a new era that will be marked by bankrupt and ineffective public government, higher prices, fewer and fewer choices and the effective disenfranchisement of millions who once claimed to be among America's 'middle-class' (not to mention the poor who have been and will continue to be screwed).

Let's get right to it. Here are highlights of health care reform as passed by the Senate in plain language.

• Millions who do not have insurance (primarily because they could not afford it) will now be forced to buy it from the same private insurers who caused the problems reform was supposed to address. Yes, what you thought was your government is using the law to make you buy insurance from private insurers whether you like it or not. Now that's reform alright, but I presume not what you had in mind regardless as to whether you are a democrat, republican, christian, atheist, liberal, conservative, capitalist, socialist or whatever. President Obama has also done a major flip-flop on this issue of "mandates" which he vigorously campaigned against and attacked Hilary Clinton for supporting.
• Your costs in year one (2013) will be based on your income (2 to 12 percent depending on how much you make). But beginning in year two your costs will be based on a percentage of the premium paid in the previous year, no matter how high premiums rise. This is like the typical cable TV offer where the first six months are only $29.99, then the rate for the same service jumps to $59.99 or more without restrictions. And, because premiums historically rise faster than wages, you will pay a larger and larger portion of your income for insurance over time. Come to think of it, that's where we are now and why we needed reform in the first place.
• Employers can set health wellness targets such as body fat levels or cholesterol levels. Employees who do not reach these targets may pay more for their health insurance. Employers are incentevised and therefore likely to set targets to receive cost discounts.
• President Obama campaigned for reimportation and negotiated pricing of prescription drugs. The Senate bill does not include this provision and while the house bill does, it is not expected to make it into the final bill.
• There is a tricky budgeting scheme being used, and described as "keeping costs down" that basically sets the costs of government subsidies as low as possible which shifts the burden of any rising costs to the consumer/patient. This is especially neat for the insurance companies and providers because neither bill imposes serious cost controls on them. In case your not following, if you owned a business and priced your products or services too high nobody would buy them. You would have to adjust your prices and consequently your operating costs to sell your stuff. What's happening here is the insurers are selling at the price they want, and the government is using your money to cover the discount in the price for the first year and also forcing you to buy the product or pay a fine. So they get to sell at their price, you have to buy AND you're also paying to become a customer or not. Anyone who can help me see the consumer/patient upside here please comment.
• All these changes will hurt low income policy holders most. They now have to pay for a plan or pay not to have one. And the cost of those plans is not capped or controlled adequately according to many experts.
• Thanks to a provision in the bills called the Health Care Choice Compact insurers can sell you a policy in New York but it will be governed by the laws of the state in which it was purchased. Whats really messed up about this is that it allows insures to sell across state lines without having to spend the money and resources to setup business in each state, pay state taxes, provide state jobs, etc. And, best of all for them, if you have a problem with your coverage, too bad: the laws of the weaker state apply. This nifty law was suggested to the Senate Finance Committee by Ronald Williams, CEO of Aetna long before last years elections. The Senate liked the suggestion apparently.

Below is a list of things insures DO NOT have to do under the current bills:

• Provide coverage for state-mandated benefits like maternity care or chemotherapy. Avoiding the mandates lets them offer cheaper policies with the potential for people to be underinsured when illness strikes.
• Obtain prior approval from state regulators before marketing their policies. That's right: no passkey oversight of the fine print clauses and conditions they stick in their policies that could (and have) hurt consumers.
• Ditch the "discretionary" contractual clauses that give the companies the sole and absolute discretion to determine if a claim is valid. Many states now prohibit these clauses.
• Follow prompt payment rules that require them to pay the docs and the hospitals, within certain limits. If providers don't get their money, they may hand consumers the bill and make them pay. The prompt payment regulations were designed to prevent that, but are not present in the bills.

This bill only works for insurers, providers, politicians and a few stockholders of the previously mentioned. While your busy dividing yourself as a conservative or liberal you, your family and your community are being screwed.

Resources: Below are links to articles with more details on health care reform. Trudy Lieberman, contributing editor to the Columbia Journalism Review has done some compelling reporting and analysis on the issue.

Dennis Kucinich Explains Why He Voted No On Affordable Health Care for America Act

An archive of Trudy Lieberman's "The Devil in the Details" Articles

Health Reform's Impact on Premiums: Winners, Losers And, For Many, A Question Mark

Setting the Record Straight: The president, the press, and the public option.

The Most Underreported Health Reform Story

What's So Public about a Public Plan?