Back to Basics

Did I miss something in the new health care reform proposals?  When did the democrats’ proposals provide free office visits, free medications and free medical procedures to everyone?

I recently had a conversation with a friend that has a pre-existing medical condition and is very concerned about being able to obtain affordable health insurance.  He is currently insured and is paying what I would consider a very reasonable price for his monthly premiums (less than $200/month).  He must also take medications that run about $2000 per year.  Understandably he is concerned about health care issues.  He indicated a friend of his is on some government insurance plan (he didn’t specify which one) and that this friend is able to obtain all of his medical and dental treatments and medications at no cost to him.

It seems that some people in favor of the democrats government run proposals are assuming that this health care is somehow not going to cost them anything, other than maybe a monthly insurance premium.  They assume the cost of office visits, medical treatments, medications and dental services are going to be provided free of charge.

I read H.R. 3200 and have heard the reviews on the Baucus bill.  Nowhere would I interpret these bills as providing free medical and dental treatments for all, with the only obligation being a monthly insurance premium.  People with certain income levels could qualify for government assistance in paying for the monthly premiums and co-pays, but it certainly did not come with a free price tag.  In fact, I read some reviews on the Baucus bill indicating the co-pays and other costs the consumers would have to pay would actually make health care less affordable to middle-class Americans.

Until the health care reform became an issue, I assumed that once someone retired and was on Medicare that those medical premiums would also be free.  I found out otherwise when talking to my parents.  When on Medicare after you retire you pay a monthly insurance premium, which is taken out of your Social Security check to cover your Medicare health insurance.  Further, you continue have out-of-pocket expenses, like cost-sharing, for medical treatments received.  If you are on the government medication system you also continue paying a portion of the medication.  My grandmother was paying out of her own pocket $1200 a year for her medication and she was on Medicare and had a secondary medical insurance policy.

So you have to wonder if those in favor of the government health care actually understand the consequences of the program.  The government program would not be a free system – you will be paying for premiums, co-pays, and cost-sharing.  You will further be paying to supplement those who cannot afford insurance and the cost of medical treatment.  If you think your premiums and cost today are high, they will only go higher with government controlled plans.  As a bonus to the higher costs you will have no choice but purchase these plans because now it becomes a law that you must have insurance.  If you don’t, you will be penalized by the IRS, and may also face imprisonment.

As I initially read and took notes throughout this section I really didn’t grasp the absurdity of the program.  When I started writing this column I was overwhelmed by the stupidity of the thought that someone would actually think this was health care reform and not just a government take over of the health industry.  The public option is based on the same business model (if you could actually call it that) of the Medicare system – the system that is currently failing and going bankrupt today!  So why would one think that applying the same standards of a failing business to another model is going to create success.  Did any of the members participating in the creation of this bill have any business background?  Failure x 2 does not equal success.  With that said, I will continue on my quest at reporting on bill H.R. 3200.

The Public Health option is the portion of the bill allowing the government to sell insurance.  The Public Option is basically a Medicare type program offered to those who do not quality for Medicare, operating concurrently and competing against the private plans offered in the Health Insurance Exchange.  The government controls the Health Insurance Exchange, controls the policies offered within the exchange, and would now be able to sell government policies.  Try side stepping this all you want, but this is a government take over of health care.

Some of the bill’s BS (sorry) just could not be reworded or interpreted, so I had to quote the bill so you could fully understand the vague references and enthusiastic goals of the Public Option.

The Magic Wand of Health Care

The bill establishes the administration of a Public Health Insurance Option, an exchange qualified plan, which is supposed to “ensure choice, competition and stability of affordable, high quality coverage.”  The Secretary of Health & Human Services is responsible to create a “low-cost plan without compromising quality or access to care.”  WOW!  Apparently the magic formula has been discovered to have low-cost insurance premiums that will give accessible and quality care, and if you listen to Obama’s promises, this will not raise taxes.  Since this is similar to Medicare, one would have to wonder why this magic wand hasn’t already been applied to Medicare to ensure the same quality of care without bankrupting the system.

The Public Option will only be made available through the Health Insurance Exchange, so if you cannot obtain insurance through the exchange for whatever reason, you will also not be able to obtain the Public Option insurance either.  (For further information, please visit article H.R. 3200 – The Health Insurance Exchange.)

The Public Option must comply with the requirements that apply to an exchange plan, including benefits, benefit levels, provider networks, notices, consumer protections and cost-sharing.  Different levels of plans will also be offered.  The Secretary enters into the contracts for the public option.  This is similar to that of the Commissioner on the Health Insurance Exchange.

The Secretary sets the premiums for the public option and may allow for geographic adjustments.  The rates must be set at a level sufficient to fully finance the cost of the health benefits provided by the public options and all administrative costs related to operating the public option.

House Democratic Bill H.R.3200

Listed below are key provisions from H.R. 3200 – the health care “reform” bill currently moving through the U.S. House of Representatives.

Forcing Employer-Based Plans to Change
Page 17 – Section 102(b)(1)(A) forces every employer-based plan to conform to new benefit mandates, uniform marketing standards, cost-sharing, actuarial value, medical-loss ratio and other new requirements of this bill. Even if you are happy with your coverage, you will be forced to change your plan.

Prohibition on the Sale of Coverage in the Individual Market
Page 18 – Section 102(c) prohibits the sale of private health insurance policies on the individual market, beginning in 2013, and forces individuals to purchase federal government-approved coverage through a new “National Exchange.” Plans sold in the Exchange will be forced to comply with new benefit mandates, uniform marketing standards, cost-sharing, actuarial value, medical-loss ratio and other new requirements of this bill – making private health coverage less affordable and more expensive for the average American.

Creation of a Health Benefits Advisory Committee to Dictate the Terms of Your Health Coverage
Page 30 – Section 123 establishes a new board of federal bureaucrats (the “Health Benefits Advisory Committee”) to dictate the content of health plans that all individuals must purchase. Along with the Secretary of HHS and a new “Health Choices Commissioner,” this new Committee will decide what type of health plans will be available to you and your family.

Unelected Bureaucrat Becomes Second Most Powerful Government Official in America
Page 41 – Section 141 creates a new “Health Choices Commissioner:” an unelected bureaucrat who can impose penalties, take away your current health coverage, and will become the second most powerful person in Washington behind President Obama.

Protection for Members of Congress
Page 74 – Sections 202(c) and (d) protects Members of Congress with existing federal employee coverage (as defined in Section 100(c)(6) on page 9) from joining the government-run health plan offered through the Exchange.

Establishment of a New Government-Run Health Plan
Page 116 – Section 221 establishes a new government-run health plan that, according to non-partisan actuaries at the Lewin Group, would cause as many as 114 million Americans to lose their existing coverage.

Penalties for Individuals without Health Coverage or Government-Approved Health Care
Page 168 – Section 401 imposes a 2.5 percent tax on all individuals who do not purchase health insurance or who fail to purchase “bureaucrat-approved” health insurance.

Penalties on Employers who Cannot Afford to Provide Government-Approved Health Coverage
Page 183 – Section 412 imposes a new payroll tax as high as 8 percent for firms that cannot afford to purchase “bureaucrat-approved” health coverage. This new penalty will lead to job loss, decreased wages and impose a massive burden on American small businesses. Though Democrats have argued this bill would give an exemption to small businesses, firms with payroll as little as $250,000 would be forced to comply with the new tax.

Higher Income Taxes for American Small Businesses
Page 197 – Section 441 imposes additional job-killing taxes, in the form of a half-trillion dollar “surcharge,” ore than half of which will hit small businesses; according to a model developed by President Obama’s senior economic advisor, such taxes could cost up to 5.5 million jobs.