Thursday, March 25, 2010

Health Care Reform

It’s all the buzz this week. Healthcare Reform is everywhere in the news, all over Facebook, and getting people rankled. There isn’t a news media outlet you can trust with all the facts because they aren’t given all the facts to start with or they want to skew the facts so they look good. The Democrats and Republicans in Washington are fighting like kids on a school playground: just trying to win and not really caring about the central issue. Yes, I know they all say “we care about the people of the United States” but let’s just be honest for a few minutes and say they long ago forgot what their real jobs are, and are now only feeding their own egos. If they weren’t, there wouldn’t be any pork added into anything….every item up for vote would have its own line, no bundled votes. Time consuming, yes, but then again, isn’t that their jobs? What else do we pay them to do?

The second biggest issue I see is the ability of the insurance companies to do whatever they want as a group monopoly. It’s just like the gas companies. Technically they are all separate companies, but in reality they work together to set prices and policies. As a group, they don’t have a single company who stands out by not denying claims and paying for benefits without hassles. On the other hand, I understand the insurance companies’ primary job is to make money. They really aren’t a service organization.

And so the main crux is upon us as a country. Do we want to be sure everyone has basic needs like a socialist society or do we want to preserve capitalism in its most pure form of Survival of the Fittest? Or wait - can’t there be a middle ground with healthcare? We already have it in the postal service and in education. You can use the US Post Office or you can go to UPS, FedEx, or Goin Postal. Public and private working in the same market. You can send your child to the public school or pay for a private one. The choices come in what you consider your priorities. Of course the basic system isn’t as well funded or fancy – that’s the definition of basic. I agree we need improvements in our basic systems, but at least they are there and that’s really a different topic altogether.

So the rest of today’s blog is a fact day from No opinions (except mine). I figure this will help in our effort to come up with some real discussions and solutions without the extra ego crap getting in the way of progress. This is our country and we need to take care of it. Let’s begin our education with the recent Health Care Reform Bill just passed in the Senate. Please remember that not everything in this bill starts the minute the President puts his signature on the paper. Some of these are years in the future.

1) The Congressional Budget Office (CBO as their friends call them) thinks that for those in the group market — those who get insurance through their employers — premiums would largely stay the same (which has been a steady increase each year for many years). The average premiums for those who buy insurance on their own would go up, however, by 10 percent to 13 percent. The reason is that benefits could become a lot better for this section of the market under this bill. Also, most people buying their own coverage could receive subsidies that make their net costs for these plans substantially lower than they otherwise would be. Those people, though, could not be on Medicare, Medicaid, or on their employer’s insurance plan.
2) Despite the fact that the federal health insurance plan (a.k.a. the “public option”) is now gone from the bill, Republicans and conservative groups have continued to claim that the bill institutes a system like the one in the United Kingdom, Sweden, or Canada, or otherwise amounts to a government takeover. It doesn’t. A pure government-run system was never among the leading Democratic proposals. Instead, the bill builds on our current system of private insurance, and in fact, drums up more business for private companies (as if they need more money) by mandating that individuals buy coverage and giving many (but not all) subsidies to do so. There would be increased government regulation of the insurance industry, however, not enough to really help the overall situation the industry has sunk our country into in the first place. These “government-run” claims have also included heavy criticism of health care in Canada and the U.K. = such as the assertion by former U.S. Surgeon General C. Everett Koop that seniors would be “too old” to qualify for artificial joints and pacemakers in the U.K. If that is true, why are the majority of those getting joint replacements and pacemakers in the U.K. seniors? Someone is qualifying.
3) “If you like your plan, you can keep it.” Obama has repeatedly made this claim, and it’s true for the most part. But not for everyone. Employers could still drop coverage under this bill — just as they can do now. Basically, this is just talk because it changes nothing. Though all employers with over 50 employees must provide some kind of health insurance for their employees, it really could be cheaper for them to just pay the fine ($2000/employee) annually…and that only counts if an employee has to use the federal subsidies to get their own insurance. I can see a ton of ways to get around that fine. Another time…
4) Medicare cuts or Medicare savings…whatever you want to call them, it’s a $500 billion reduction in the growth of future spending over 10 years, not a slashing of the current Medicare budget or benefit. It’s true that those who get their coverage through Medicare Advantage’s private plans (about 22 percent of Medicare enrollees) would see fewer add-on benefits; the bill aims to reduce the heftier payments made by the government to Medicare Advantage plans, compared with regular fee-for-service Medicare. The bill also boosts certain benefits: It makes preventive care free and closes the "doughnut hole," a current gap in prescription drug coverage for seniors.
5) As for Medicaid….eligibility level is expanded to $29,327 as a household income. The Federal Poverty Limit for a family of four is $22,050. (Freaking SAD!!!) It’s also stated that some adults with no children will be able to qualify, but not illegal immigrants.
6) “The health care plan would be the largest middle-class tax cut for health care.” Note the “for health care" part of this claim that has been made. This may be technically true, given the qualifier. But who would even maintain a list of the biggest “middle-class” tax cuts, since there is no agreed upon definition of who is “middle class.” (The vast majority of Americans say they’re "middle-class," making this a popular buzzword for politicians.) This grandiose-sounding assertion, however, is only being made about tax cuts for health care. The bill includes about $460 billion over 10 years in subsidy money. Incidentally, President Bush’s 2001 tax cut totaled about $1.3 trillion over 10 years, with about 42 percent of the benefits going to the middle 60 percent of all income earners, according to a breakdown by the Tax Policy Center. That amounts to $566 billion over 10 years, a bigger cut for the middle earners than the health care tax cut.
7) Economic studies simply do not support the claim that medical malpractice suits are a major driver in health care spending. Many Republicans strongly back limiting liability awards in medical malpractice cases, and it’s true that doing so would save some money = about 0.5 percent (roughly $11 billion in 2009)." That’s real money, but it’s a very tiny part of the more than $2 trillion spent on health care annually in the U.S. There’s disagreement over what exactly the biggest drivers of spending are, but medical malpractice doesn’t top the list. About 75 percent of spending, for instance, goes to taking care of chronic disease.
8) Here’s a bit of hub-bub about the “Union/Cadillac plans”. The bill places a tax on high-cost employer-sponsored plans – specifically there’s a 40 percent tax on the value of plans above $10,200 for individuals and $27,500 for families, starting in 2018. The tax falls on insurers, but we all know it would be passed along to policyholders one way or another. The thinking behind it isn’t to raise money by slamming workers with a 40 percent tax…the existence of the tax will supposedly prompt employers and employees to choose less expensive health plans (as if there are some to choose from – see second paragraph). In lieu of the higher cost benefits, employers would raise salaries. And that’s how the government really makes its revenue here: on payroll and income taxes on those higher paychecks. My question is…who said the employers will raise salaries for the commoners? And if given a choice, would you rather have greater benefits or a higher salary? Those healthy youngsters without kids want money, where most moms and dads are begging for benefits. Again, it’s all about your priorities.
9) The insurance companies are getting a bit of a slap on the wrist in that they can no longer deny coverage for children with pre-existing conditions, and starting in 2014 can’t deny coverage for anyone at all for a pre-existing condition. WOO HOO!!! That’s not saying they can’t charge you into premiums and co-pay bankruptcy, only that they can’t deny you coverage.
This is nowhere near the whole of it. As usual, the bill is full of crap that really has no purpose or bearing on healthcare but is bribes for votes. Disgusting, I know. It’s not a Democrat or Republican lonely practice, they both do it every day. As you might tell, I wouldn’t do well as a politician. “Kids need healthcare? Well, give it to them damn it! I don’t care if your bonus will only be $1 million instead of $2 million.” I have an attitude problem. I’m okay with that. I like me.
What are your thoughts?

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