The latest version of the Pelosi/House health care reform is more of the same, and worse. It includes the same problems of HR3200 including the public option, the health care exchange, mandates requiring everyone to buy insurance, mandates requiring employers to provide insurance, penalties if you don’t purchase insurance, penalties on companies for not providing insurance, government real-time access to your bank accounts…more and more of the same.
I briefly reviewed the 1990 page bill and found some additional measures that were equally disturbing.
The bill is supposed to help those who have pre-existing conditions as well as those with chronic illnesses that may not otherwise be able to obtain affordable health care insurance. The bill does mandate that insurance companies accept everyone, regardless of their medical history. However, in a transition period, the government has allocated a specific budget to cover these people and this must not result in a deficit. If the expenditures are expected to exceed the budget there are three options available to solve this problem: (1) deny services, (2) increase premiums, and (3) put people on a waiting list. So those with current insurance issues may find themselves no better off once this plan goes into affect since the bill gives the government the right to ration or deny services and increase the cost of your premiums.
There are over 360 pages in the bill that directly relate to medical treatment in the Native American populations. This amounts to additional studies, addressing alcoholism issues and a number of other issues. However, the bill also allows the government to take Indian reservation lands for the purpose of medicine. The government will make those decisions and it did not appear as if the Native American population would have any control over what lands they chose to take, or if the medical facilities is even necessary for this population. How far does this abuse of power run?
I recently read articles on the Pelosi/House reform and found that it creates 111 new bureaucratic departments and/or programs…more expansion of government. The cost of this bill is estimated at approximately $1.2 trillion for 10 years.
Likewise, just as disturbing is those people who truly believe that this type of government takeover of the insurance industry is the only way they will be able to obtain health insurance. They don’t want to even consider any other options that may allow them to be covered but not destroy the health care coverage 83% of the population currently has and likes. They further expect this coverage, because of the public option, to be FREE; they are not expecting to contribute anything to their health insurance costs. Nothing is free – you will be paying for insurance premiums, co-sharing costs as well as an increase in your income taxes. If you don’t wake up now you could find yourself facing a huge medical/insurance bill you will be required to pay.
Behind the scenes in the real world anticipation over the new bills has already made an impact on the insurance industry. A health insurance agent was at a recent party we attended and she is all for this new mandate, her mouth watering at the prospect of making lots of money from all the policies she will be selling. As long as the private market can compete with the public option she will make a fortune, as she gets a commission not only when she sells a policy, but will continue receiving that commission as long as you renew your policy – and she may not have to do a thing. This bill will make her a rich woman. On the other hand, her ex voiced his opinion at her enthusiasm and stated that all this was at what expense to us. He understood the consequences.
If you think it was bad in August with the possibility of facing fines for not buying health insurance, it has gotten worse. Now we find out if you don’t buy health insurance you could be fined an additional $25,000 and face a year in jail. Jail time for not purchasing something because the government tells you it’s required! This is outrageous. You will notice Congress and government employees are immune from this system.
Here is John Shadegg explaining this new twist to the bill.
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.
So, before jumping on the government control bandwagon, look at the other proposals being offered. Every plan wants those with pre-existing conditions to be covered at costs within reasonable limits of a regular policy. Every plan wants to provide insurance coverage to all that don’t have it. No plan offers free insurance, free medical, free dental or free medicine to all. Do you want the government controlling your medical treatment and care, along with mandatory requirements, higher premiums and higher taxes? Or do you want patient choice?
The democrats’ approach to reforming the health care system makes about as much sense as amputating an arm because someone broke a finger. Instead of addressing the problems in smaller doses they are going to turn the entire system upside down. I don’t know if they have been listening, but the United States has the best health care in the world. Why would you want to destroy that? They want to model it after systems like Canada, but have they listened to the complaints and problems Canada has? People from Canada come to the United States for treatment because they can’t get it in their own country! Canadians also have to carry secondary insurance because the government insurance isn’t good enough. They also pay a HUGE percentage of their income (and not just the “rich”) to pay for these programs. Is this really what we want?
Even in our own country the state of Massachusetts has their own version of universal health care. Just recently they reported a cut in coverage to certain groups of people because they don’t have the money to keep the system running. People who once had good coverage are complaining because they now have to wait to see a doctor or get treatment. Sure, they may brag that they have the lowest uninsured population, but having the insurance and obtaining care are not the same thing. The Massachusetts system has started failing in 3 years!
So I ask again – are the democrats listening? Repackage, renaming or doing whatever creative means to disguise the same bill is still an attempt at passing the same bill. We are getting tired of the democrats and president trying to sell the same used car with a different paint job.
Reform should start with the very basics and address the problems of the system. Take it a step at a time, making changes to address the critical problems first, and then continue to monitor the system to see how much more is needed. Treat the system like a patient – don’t do radical surgery when medication or a change of diet may solve the problem.
The uninsured is one of the current issue. There are a good percentage of uninsured that have chosen to be uninsured. They are people who are making a decent living and have made a personal choice not to obtain insurance. Perhaps they are young and don’t feel the need for it. They may be a family who does not have the children covered but the parents are. Whatever the reason, it is their choice. The government should not force them to purchase insurance. However, if they have chosen not to obtain insurance then taxpayers should also not have to foot the bill for their medical issues.
The government has caused one of the problems in the system today by passing a law stating everyone has access to health care through the hospitals whether they can afford to pay for it or not. This law allows anyone, including illegal immigrants, to visit their local hospital and obtain care for anything. Many of these visits are for something that should be taken care of in a doctor’s office or clinic, but because they don’t have insurance they visit the hospital. If insurance reform is made, then this law should be revised to only include life threatening illnesses or injuries only to citizens or legal immigrants. Any minor health issues would be seen as long as the person could pay for the services, or should be referred to a clinic or doctor – which also would require payment. So, if the person makes the choice not to purchase health insurance then they would have to deal with the financial consequences – not the taxpayers and not the hospital.
I am not talking about the citizens who simply cannot afford insurance. Part of any reform should include government subsidies to help those people obtain insurance. Many are now eligible for Medicaid or a state health care system, so they are not without coverage. If they have not applied for that coverage you cannot blame the system; you have to hold the individual responsible at some point. These services should continue, but should be limited to citizens or legal immigrants only.
The health care industry has problems, just like the auto industry. But using government funds to bail out and take over another industry is not the answer. The government has already failed in running Social Security and Medicare, with both programs going broke. With a history of failure, why would another government run health care program succeed? It wouldn’t.
The government program may provide INSURANCE for everyone, but having insurance does not necessarily mean you have access to care, nor does it guarantee the quality of care you get. The government program by many speculations will result in rationing of care due to an insufficient number of doctors, nurses and other medical professionals. It will also result in longer waiting times to get an appointment. In many cases that could mean the difference of life or death, of treatment that saves money in the long term, of preventing permanent disabilities or surgeries. Being able to obtain quality care in a timely manner is of utmost importance. We cannot sacrifice that care for a government system.
People talk about the disparity of health care. If H.R 3200 or a similar program is passed, the disparity will only increase. The 15% of people who are currently uninsured may become insured, but projections are there will still remain a majority of these people who will be uninsured. There will be a greater number of people whose current coverage and care will actually decrease in quality. As companies determine if the 8% penalty outweighs the cost they contribute to employer-based health care policies, they may opt to pay the penalty and leave the employees to fend for themselves. Smaller companies may still not be able to afford the health care coverage or the penalty and may close down, leaving those employees unemployed and looking for work in a grave economy. For anyone who has been a small business owner (and I have), unless you have many financial resources, just paying the daily bills is a challenge, often with the owner living off what little is left. Small business in America could quickly disappear with more government mandates. One can only speculate how the business world will react and the consequences this will play for health insurance for the employees.
A small group of people won’t be affected by the program either way. These are the people with money. They will have their insurance plans, but most important, they will also have the resources to pay for care out of their own pocket. They will have the ability to go where they want to receive care because they will have the resources to pay for it. Granted, they have that option now. But with the prospect of rationing, having the cash to pay for service may be a determining factor in actually receiving quality care in a timely manner.
The answer is not forcing the people on plans they don’t want, especially when 85% of the people are happy with their current coverage. Why is 15% of the population going to destroy it for the rest? Penalties and taxes is not the way to fix the problem. The PEOPLE are not the problem – the insurance companies, medical system and drug industry is the problem. The reform should start with them, evaluating what changes can be made with those industries without hurting the people. Don’t punish the people when the industry is corrupt.
How many more strings do the democrats need to pull to try pushing through a health care plan that isn’t going to solve the problems but create more? They talk of compromise and throw out alternatives to the public option. The entire bill is needs to be scrapped!
Removing the public option only addresses a small portion of the bill. The exchange program itself is a large part of the problem. The exchange program is the government takeover of the health care system. It is through the exchange program that the government will take control over what policies will be sold, will establish the benefits and will set pricing standards for the policies. Setting up the exchange alone costs billions of dollars, expands government, and creates a whole new government entity to control the insurance industry. It is through this exchange program that people will end up losing their current coverage. If all insurance policies within the next 5 years have to go through the exchange then in 5 years the government will have control over all insurance policies whether the public option is part of the program or not. The exchange program is the government brokering insurance policies! Why should the government go into the business of insurance brokerage? The fact is – they SHOULDN’T. The government needs to leave this to private industry.
Private industry needs to be given the parameters to address the current insurance needs and concerns, and there are a number of alternative bills that address these issues. None of these bills call for a government takeover of insurance. None of these alternative bills create a government exchange program to broker policies. None of these bills penalize individuals for not purchasing insurance.
What the alternatives do is give responsibility to each individual to determine their insurance needs, not the government. It allows them to choose the policy they feel meets their needs and make adjustments so they may afford the policy. If individuals are responsible for their insurance needs then maybe they will make better choices when it comes to purchasing a policy and the utilization of the medical care under those policies. The alternatives give a tax credit to individuals and families to apply toward the purchase of these insurance policies if they are not otherwise covered under an employment-based plan. It also gives the individual options, so if the employer makes the choice to decrease coverage or chooses a plan that doesn’t meet the needs of the individual, then that employee could purchase a plan outside of the employer and receive the tax credit to help offset the cost. These alternatives keep the employee from staying in a job just because of insurance, and if they become unemployed an outside insurance policy would come with them, making the expensive Cobra payments a thing of the past.
The alternatives allow the insurance companies to create new pooling mechanisms, providing new opportunities to offer policies. They would require the insurance companies to provide affordable insurance plans to people with pre-existing conditions, at only a slightly higher premium cost. Some alternative plans would even permit the sale of insurance across state lines.
Equally important, the alternatives do not take away care for our seniors. The problems with the Medicare system need to be addressed separately. You cannot take money away from the senior population to provide insurance for the uninsured. That doesn’t solve any problems and only creates new ones.
Likewise, the pork or earmarks in the House bill are not in the alternatives. There is over $88 billion in earmarks in H.R. 3200 that further expand the role of government, support illegal immigrants and support labor unions!
How much will the H.R. 3200 cost? Historically, the cost estimates of every medical program implemented by government has cost more, often significantly more. Massachusetts passed a universal-coverage plan in 2006, which required all residents to have health coverage and gave subsidies for lower-income uninsured families. Sounds like the plan the government wants to pass for the country. The plan was estimated at $472 million for 2008, yet the actual figures for that year were $628 million. They made some assumptions that proved incorrect. They assumed that as more people joined the system the premiums would go down across the board. They further assumed that as more people became insured the number of people visiting the emergency room would drop dramatically. They assumed this would save them money. It backfired! None of these things happened and the health care reform that was supposed to save money has cost more money than expected!
Similar budgetary problems have been seen in Federally run programs.
When Medicare, Part A was established in 1965, covering the hospital insurance portion of the program, the cost was estimated at $9 billion annually by 1990. The actual spending in 1990 for Part A was $67 billion.
In 1967 the new Medicare program was estimated at $12 billion for 1990. The actual Medicare spending for the program in 1990 was $110 billion.
A universal entitlement to kidney dialysis was enacted in 1972 at a cost of $100 million for 1974 and actual spending was $229 million for that year.
The DSH program established in 1987 which states use to provide relief to hospitals serving large numbers of Medicaid and uninsured patients was estimated at a cost of less than $1 billion in 1992. The actual cost for that year was $17 billion.
When Medicare’s home care benefit was changed in 1988 the projected cost for 1993 was $4 billion. The actual cost in 1993 was $10 billion.
The Congressional Research Service has issued their report regarding the treatment of noncitizens in H.R. 3200. There has been a lot of debate over this topic, with the president and democrats saying illegals are not covered, while those opposed to the bill saying they are. A number of loopholes in the bill, including no provisions for checking immigrations status, prove illegal immigrants can and will be covered by the bill, at the taxpayers’ expense. The Summary of the report is include below. If you would like to read the entire report, please click on CRS Report.
August 25, 2009
Treatment of Noncitizens in H.R. 3200
Congressional Research Service
Summary
This report outlines the treatment of noncitizens (aliens) under H.R. 3200, America’s Affordable Health Choices Act of 2009. In particular, the report analyzes specific provisions in H.R. 3200, and whether there are eligibility requirements for noncitizens in the provisions. Within the bill, noncitizens are treated differently in several provisions. In 2008, there were approximately 37.3 million foreign-born persons in the United States. The foreign-born population was comprised of approximately 15.1 million naturalized U.S. citizens and 22.2 million noncitizens.
H.R. 3200 includes an individual mandate to have health insurance, with tax penalties for noncompliance. Individuals who do not maintain acceptable health insurance coverage for themselves and their children would be required to pay an additional tax. Some individuals, including nonresident aliens, would be exempt from the individual mandate. “Nonresident alien” is a term under tax but not immigration law. For federal tax purposes, alien individuals are classified as resident or nonresident aliens. In general, an individual is a nonresident alien unless he or she meets the qualifications under a residency test. Thus, legal permanent residents, and noncitizens and unauthorized aliens who qualify as resident aliens (i.e., meet the substantial presence test), would be required under H.R. 3200 to have health insurance.
In addition, under H.R. 3200, a “Health Insurance Exchange” would begin operation in 2013 and would offer private plans alongside a public option. The Exchange would provide eligible individuals and small businesses with access to insurers’ plans, including the public option, in a comparable way. Individuals would only be eligible to enroll in an Exchange plan if they were not enrolled in other acceptable coverage (for example, from an employer, Medicare and generally Medicaid). H.R. 3200 does not contain any restrictions on noncitzens participating in the Exchange – whether the noncitizens are legally or illegally present, or in the United States temporarily or permanently. Nonetheless, only aliens who could be classified as resident aliens would be required under the bill to have health insurance.
Under the title of Public Health & Workforce Development are a number of grants, scholarships and other programs, providing training, services and a whole new array of studies relating to health care – a lot of money being spent to support the expansion of government, special interests, illegal immigrants and labor unions, but little to help solve the health care issues.
The first expansion is the establishment of the Public Health Investment Fund, which requires deposits from the revenues of the Treasury in the amount of $88,700,000,000 over 10 years. This money is authorized to be appropriated by the Committee on Appropriations of the House and Senate for carrying out the activities under the designated public health provisions. These areas include Community Health Centers, National Health Service Corps Program, National Health Service Corps Scholarship and Loan Repayment Programs, Primary Care Loan Funds, Primary Care Education Programs, Nursing Workforce Development, The National Center for Health Statistics and the Agency For Healthcare Research and Quality.
To make these programs even more appealing is the stipulation that “Amounts appropriated under this section, and outlays flowing from such appropriations, shall not be taken into account for purposes of any budget enforcement procedures including allocations under section 302(a) and (b) of the Balanced Budget and Emergency Deficit Control Act and budget solutions for fiscal years during which appropriations are made from the fund.” More spending without any concern for balancing the budget or controlling the country’s deficit. We don’t have it, but let’s spend it!
The first program – Community Health Centers – will obtain increased funding in the amount of $38,800,000,000.
The National Health Service Corps is being amended allowing the Secretary to issue waivers to individuals who enter into a contract for obligated service to pay for their education. It further raises the loan repayment amount from $35,000 to $50,000 and will be adjusted thereafter to reflect inflation. Additional appropriated funds for this program are $796,000,000 over the next 10 years. Additional funding is authorized in the amount of $3,171,000,000 over 10 years to cover the National Health Corps Scholarship and Loan Repayment Programs.
The Frontline Health Providers Loan Repayment Program will be established to address unmet health care needs in certain areas, populations, or facilities as designated by the Secretary. Individuals participating in this program must agree to serve for a period of 2 years in a health professional needs area specified in the program. This program has a clause that if there are an insufficient number of applicants for the program, then all excess funds from the program will be transferred to the National Health Service Corps to recruit more people to take advantage of this fund.
The Secretary shall establish a primary care training and capacity building program consisting of grants and contracts to plan, develop, operate or participate in accredited professional training in the field of family medicine, general internal medicine, general pediatrics or geriatrics. Funds for this program are from the Public Health Investment Fund in the amount of $3,023,000,000 for 10 years and will include the following:
Capacity Building in Primary Care – grants to specialties of family medicine, general internal medicine, general pediatrics or geriatrics, with preference given to entities that train individuals who are from underrepresented minority groups or disadvantaged backgrounds.
Training of Medical Residents in Community-Based Setting – a program established for the training of medical residents in community-based settings, with preferences given to entities that support teaching programs addressing the health care needs of vulnerable populations or are a Federally qualified health center or rural health clinic, as well as preference to those training individuals from underrepresented minority groups or disadvantaged background.
Training for General, Pediatric or Public Health Dentists and Dental Hygienists – grants and contracts to plan, develop, operate or participate in an accredited professional training program or oral health professionals, with preference given to individuals who are from underrepresented minority groups or disadvantaged backgrounds.
Grants for Health Professionals Education – Advanced Education Nursing Grants is being amended, including increases in dollar amounts for the Nurse Faculty Loan Program. Funding for this program is $1, 450,000,000 over 10 years.
I am truly amazed as I continue to read through the bill how anyone could interpret this bill as one that would not increase medical costs, insurance premiums and taxes. Each section only adds more responsibility to the government, which falls again upon the taxpayer. This section alone creates a whole new welfare system intended to not only support people requesting assistance, but the bill actually calls for the government to recruit (by identification methods) people to in order to assist them, even when they have not asked for it!
Employers must offer health insurance to all employees, full and part-time, or face penalties, often for actions out of their control. The pressure on employers could cause adverse consequences in the workplace. Does the employer start basing hiring decisions on the likelihood that a candidate may or may not participate in the company offered insurance plan? Will part-time employees now become less of an asset to employers since they too will require benefits? How does this impact the job market and availability of jobs when the country already has high unemployment? What appeared to be fairly straightforward (what was I thinking!) turned into many “what if “scenarios. I’m sure you will develop your own. If you have any questions regarding the bill, please contact your representatives.
This portion of the bill covers how individuals who cannot afford health insurance coverage or their portion of cost-sharing (co-pays, deductibles) will receive medical insurance and care. Ultimately these costs have to be absorbed by someone. The government is going to expand the medical welfare system and pay for premiums, as well as any out of pockets expenses for medical treatment, in the form of affordability credits. Since it is a known fact that people who have insurance will use medical services more often, then one might expect an increase in medical treatment for newly insured individuals covered by the taxpayer – financed by increased premiums for those who can purchase insurance and higher taxes.
The bill will give eligible individuals affordability credits consisting of affordability premium credits to be applied toward the cost of insurance premiums purchased through the Health Insurance Exchange, and affordability cost-sharing credits to reduce the cost-sharing responsibility of these individuals.
Individuals can apply to the Commissioner for these credits through the Health Insurance Exchange. The Commissioner can further deem individuals eligible on the basis on information otherwise obtained. It doesn’t specify what information or how it will be obtain, but somehow the Commissioner is going to get information on individuals without their application or consent, to determine if they may also qualify for affordability credits. The Commissioner must also establish effective methods that ensure individuals with limited English proficiency are able to apply for affordability credits. Interpreted by many as a means of providing health insurance and related costs to illegal immigrants or amnesty immigrants – all at the taxpayers expense.
The Commissioner may also determine that a State Medicaid agency has the ability of determining eligibility for affordability premiums and credits, and if that agency does so they will be reimbursed for the costs in conducting those determinations. So now the intrusion into our private lives is being expanded, not only to the Federal government,. but the state government; and guess who is paying the bill – the taxpayers.
If it is determined the individual is eligible for Medicaid, they will be enrolled under the State Medicaid plan. No option. I thought Medicare and Medicaid were already having financial problems, so now the government will add how many more to a failing system?
