Back to Basics

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.

Another tip of the hand came when it was open enrollment time for my daughter.  Her options had been greatly diminished in health insurance coverage.  Option A would give her a set office visit cost of $30/visit, a $750 deductible and she would be responsible for 40% of her medical bills.  Option B would have given her a set office visit cost of $35/visit, a $1500 deductible and again she would be responsible for 40% of her medical bills.  For this reduction in coverage she would enjoy a minor increase in premiums.  Yes, she can say she is “covered” by health insurance but with the deductibles and cost-sharing responsibilities she cannot afford medical care or treatment!  This is from a very large insurance company, so one has to ask if this is the direction we can expect the government plans to be heading.  Is this the type of coverage that may be offered in a basic insurance plan?  If so, then although the government could claim more people would be insured, it would not necessarily mean people would be able to obtain medical care or treatment because they may not be able to afford it.

While the House healthcare bill does little or nothing to decrease medical costs and is anticipated to actually increase insurance premiums, one has to wonder what the real motives are behind the bill.  Is this just a bill to grant the government more control over our lives and denying us personal freedoms…with more government expansion?  With insurance agents waiting in the wings to jump at the vast money making opportunities, whose interests – or special interests – were really in mind?  Does being insured actually make medical care and treatment affordable…or will the cost of the insurance policy and cost-sharing expenses make it even more unaffordable?

Time is running out.  The House is expected to start debate on this issue this week.  The people spoke this summer at Town Hall meetings.  Did Congress get the messages?  It is time we remind them.  Call, write, fax and email your representatives before it’s too late.  The life you save may not only be yours but the country.

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?

I urge everyone to really understand the bills being proposed – read them!  The concerns out there are very real.  This is your future – your life!  Nothing the government provides is free, and the health care reform is no exception.

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 second group of uninsured are those with pre-existing conditions or chronic illnesses who cannot afford coverage or have had coverage cancelled or been declined coverage.  Congress has already passed a bill that allows states to set up high risk pools to provide insurance for these individuals.  The system has already been established, but many states have failed to create that system.  Some states have done a great job, others have struggled.  You have to start holding states responsible.  Take those states that have created the system that works and make it mandatory for all states to create a system that models the ones proven to work.

Another group of uninsured are those whose employer does not offer health insurance or the small business owner.  There are some policies offered to cover these individuals, but in my own search for a policy I found it difficult to find, more expensive with less coverage.  There is no reason creating new pooling systems to provide insurance policies to these people cannot be done.  The insurance companies need to be responsive to the need and demand for these policies and they need to be allowed the opportunity to create such pools.  The policies should be equivalent to those offered to large corporations at similar rates.  Further, anyone that pays for their own insurance policy should be given some sort of tax advantage, similar to what employees receive when they purchase insurance through their employer.

Insurance policies should also be customizable to individual needs.  Your basic insurance plan needs to be established to cover all the basic medical needs anyone may encounter.  The individual should then be able to determine and purchase additional options to customize their care.  If you are a single male or a female beyond childbearing age or have had a hysterectomy, then you would not need to “add” maternity coverage to your policy.  If you don’t smoke or drink alcohol then you wouldn’t need to add coverage to address those issues.  You may want to “add” chiropractic services to your plan, maybe naturopathic medicine, children’s well care checkups, hair replacement treatments, or any number of other options that would meet your needs and personal beliefs to address your health issues.  Other options would include what deductibles you want to set, co-pays for office visits or other services, and the percentage you want to be responsible for.  In this manner people would be paying only for the services they want and need instead of some inflated policy covering medical issues they will never use.  These policies should be made affordable and each individual would have control over their costs.  If they can only afford the basic coverage, then that would be their choice.  If they really want cosmetic surgery covered, then maybe that is an option they could add that they would also pay an additional premium fee for.  The choice should be up to the customer – not the insurance company or employer.

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.