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Wednesday, July 8, 2009

A Study on Healthcare Reform for You and Me

One of the first things I learned as a debater (as a Christian debater) is to always represent your opponent’s viewpoint accurately. With that said, researching and coming up with a truthful representation of the President’s proposal for healthcare reform is one of the most difficult things I have ever had to do. Coming to an understanding of the bottom-line for the President’s plan was more frustrating than getting my cat to play fetch while preparing my itemized tax returns. Understanding the details of how the system works today was equally breathtaking. The whole of the healthcare industry, both existing and now proposed, is riddled with double talk and subterfuge. One gets the impression like the super heroes of Bikini Bottom, that evil is a foot.[1]

The debate surrounding healthcare is based on one thing and one thing alone: Money. The quality of healthcare in the United States is actually very good if you have access to it (we all do to varying extent). We can all talk about how great our doctors and nurses are, and we can talk about how advanced the technology employed in the medical industry is. I suspect we could all sit around a camp fire in agreement, bragging of the high quality of our healthcare to the world. That is until you start mentioning anything to do with the money in healthcare. Many of the articles I read implied with certainty that if you have received healthcare, you have probably been over charged for something as made clear in an article titled, “10 ways to avoid outrageous hospital overcharges.”[2] In that same article, the author instructed the readers to always ask for an itemized bill from your healthcare provider and then send it to a professional to translate it for you. Hospitals don’t write things in plain English; the itemized bill you receive will be coded. For example, one hospital charged a man $129.00 for a “Mucous recovery system,” which is a box of Kleenex.[3]

Suffice it to say that our healthcare system as it exists today has problems; very few people disagree on that point. We do disagree on how to solve these problems. I would venture to say that if you were to ask all of the three million Americans living today, to submit a plan to solve the problems in our healthcare system, you would probably get three million different ideas on how to do it. Yet I believe all the different ideas break down in to two main schools of thought.

1. A Government run system (the single payer plan is the ultimate expression of this; the government collects all the money and pays all the bills)

2. A privately run system

Some people may suggest some form of a hybrid; both government and privately ran, but I would suggest that such a plan would fall under a government run system because of the power of our government. As a matter of fact, that is exactly what our president is proposing: A hybrid of privately ran healthcare. He is going to accomplish this by introducing a government option to the American people.[4] And it is now to the president’s plan that I turn my attention.

The evolution of the president’s plan can be found first in an eight hundred and fifty page discussion draft bill for healthcare reform. This version of the bill was forwarded by Democrats in the House of Representatives.[5] The national outcry for its one trillion dollar price tag led to the formulation of a new, “Affordable Health Choices Act,” by Senate Democrats, most notably Ted Kennedy and Christopher Dodd.[6] This bill will “only” cost tax payers 650 billion dollars (we don’t have $650 billion either). Within one day of publishing the “Affordable Health Choices Act,” President Obama publicly endorsed the bill. So I don’t think I am being presumptuous when I say this bill represents the president’s plan for fixing healthcare. I read both of these bills (not exactly easy reading as it is written by lawyers who use fifty words when they could use one). The following, in my opinion, are the highlights:

1. The bill would require the secretary of health and human services (HHS) to establish a "public health insurance option" to compete against private health plans on a "level playing field" in a national health insurance exchange.

2. The bill expands eligibility for the existing Medicaid program up the income scale to 150 percent of the federal poverty level.

3. The public plan's payment to providers would be based on Medicare payment rates plus 5 percent. Healthcare providers must bill the government at this rate.

4. The bill would create a National Health Insurance Exchange in order to "facilitate access of individuals and employers, through a transparent process, to a variety of choices of affordable quality health insurance, including a public insurance option."

5. The bill would require every American to have health insurance coverage that Congress would define as "acceptable coverage." Under the terms of the bill, existing coverage at the time of enactment would be "grandfathered," but health plans would be legally required to conform to federal standards over time.

6. The bill contains both an individual and an employer mandate. Under the terms of the bill, an individual would be required to enroll in an "acceptable" health plan or face a tax penalty. The only exception would be "hardship" cases. For an individual, the tax would be equal to 2 percent of their income up to the "national average premium amount."

7. "Medium and large" employers would be required to offer an "acceptable" health plan, under the terms and conditions of the House bill, or pay an "assumed" 8 percent payroll tax until the situation is remedied. If the employer resumes coverage within 30 days, no penalty will be assessed.

8. Healthcare reform will be enacted in December of 2012. (Very convenient to implement this in an election year – vote for me and get free healthcare or roll your dice with the other guy – these are my words)

Furthermore, President Obama added the following:

1. A $177 billion in unwarranted subsidies to insurance companies under something called Medicaid Advantage will no longer exist.

2. That $177 billion will be used to help families so that they could have insurance and preventive healthcare.

3. His new healthcare reform will cost approximately $100 billion a year; $950 billion over the next 10 years. Two-thirds of which he will pay for by reallocating money the other third by tax increase.[7]

Much more could be said about the president’s plan for healthcare reform, for example that there will be a healthcare secretary overseeing the whole thing and that this secretary will advise you through a board of physicians (not your own) if you need things such as a second opinion. If you have the stomach for it I would encourage you to read the bill for yourself.

This article is a departure from my usual opinion pieces in that it is more of a report on my findings, a news article if you will. You have the basics with the tools for further research via the footnotes. I would like you to consider two things however.

1) First, consider what I said about a hybrid healthcare system involving the government and the private sector; the government will overpower the private sector so that what we end up with is government run healthcare. One of the main criticisms of the president’s healthcare reform is the fact that the government will be a player and the referee; how pray-tell can the playing field be level? Obama’s response to this criticism is to reiterate the fact that if you like your healthcare insurance or doctor, you can keep it and/or him.[8] Notice however, all the restrictions on healthcare providers and insurers stated in this bill. For example you must accept what we (the government) offer as payment for providing healthcare; you must under penalty of law and taxes provide healthcare insurance to your employees and you must as an individual, avail yourself of healthcare. Our prospects are for government run healthcare…period.
2) Finally, do you really believe that our government has two-thirds of a trillion dollars available to it via reallocation? If you believe that, I have some health insurance to sell you.

I have given you the facts but you ultimately must decide if you want what Obama is pushing or if you want him to return to the drawing board? I say it’s back to the drawing board and bring me something with no tax increases and no government takeover.

Danian Michael,
Political Agenda


Footnotes:

[1] Bikini Bottom for those of you who don’t have kids is an under sea city in the children’s program, “Sponge Bob Square Pants. Where there exist two elderly super heroes, Mermaid Man and Barnacle Boy – Mermaid man is always yelling, “Evil is a foot.”

[2] The website MSN Money in an article titled, “10 ways to avoid outrageous hospital overcharges” reports on how hospitals tend to overcharge patients and how they do it. (Read the article at: http://moneycentral.msn.com/content/Insurance/Insureyourhealth/P74840.asp)

[3] Ibid.

[4] On the website, “Say Anything” you can find in an article titled, “White House Clarifies Obama’s Health Care Statements: The President Shouldn’t Be Taken Literally,”some of the President’s quotations for his government option; this hybrid of which I am speaking. (Read it for yourself at: http://sayanythingblog.com/entry/white_house_clarifies_obamas_health_care_statements_the_president_shouldnt_)

[5] Read the bill for yourself: http://energycommerce.house.gov/Press_111/20090619/healthcarereform_discussiondraft.pdf

[6] Read the bill for yourself: http://help.senate.gov/BAI09A84_xml.pdf

[7] In a Town Hall meeting held in Annandale, Virginia on July 1, 2009. President Obama gave a short speech and fielded questions on his plans for healthcare reform. (Read the transcript at: http://latimesblogs.latimes.com/washington/2009/07/obama-health-care-townhall.html)

[8] The website Sayanythingblog.com (http://sayanythingblog.com/entry/white_house_clarifies_obamas_health_care_statements_the_president_shouldnt



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12 Comments:

Blogger Puzzle Again said...

After breaking my ankle, I was once charged $170 for a one minute exam by a foot specialist. Of course, the bill was written in code, but the rationale for the cost was that "the doctor touched your foot." I noticed upon later visits that he was careful not to make physical contact, despite the fact that I indicated some concern about the lack of healing.

To me, this example is a clear opportunity for cost reduction and care improvement without creating a government run so-called hybrid system.

July 8, 2009 at 9:09 PM  
Blogger Danian Michael said...

In my research for this article I came to the realization that what happened to you has happened and is happening to a lot of people.

One of the things I wanted to include in this article, but didn't because I was already at 3 pages, was the fact that for most people, they never deal with the healthcare provider directly. Most people don't know this is going on; the consumer is flying blind. FYI: healthcare providers must provide an itemized bill if you ask for one, by law. I have been receiving healthcare for how long now, and I have never seen a bill. I simply pay my deductible and I'm gone.

July 8, 2009 at 9:49 PM  
Anonymous Anonymous said...

The following..

7. "Medium and large" employers would be required to offer an "acceptable" health plan, under the terms and conditions of the House bill, or pay an "assumed" 8 percent payroll tax until the situation is remedied. If the employer resumes coverage within 30 days, no penalty will be assessed.

I currently pay enough and provide bennies, but if I didn't, and was medium large I would have to..

1. Fire 10% of the workers and make the others own up to higher expected performance levels.
2. Cut wages by 8% and let the government do its dirty deed. Less paperwork, and elimination of a benefits department would be my windfall.

Unintended consequence I am sure, because what decent person could even CONSIDER such actions that I have suggested.. oh my!

by JGillman

July 9, 2009 at 12:12 PM  
Blogger Danian Michael said...

JGillman,

Thank you for reading and responding. I think it would be a worthwhile venture for business owners like you to inject a dose of reality into this debate. I would be willing to bet that any of your employees who might be on-board with Obama's plan might rethink their support if they understood how all this would affect your bottom-line and by implication, theirs.

July 9, 2009 at 12:14 PM  
Anonymous Anonymous said...

You'll definitely get an award for your post.

I think that this is the first time that I've ever seen footnotes included.

My argument on healthcare reform usually boils down to one point: past performance.

The federal government's current foray into health care insurance (Medicare), produced yearly reports on the status of the program.

According to their latest report, they are looking at the health insurance portion of Medicare going broke by 2017 (Page 9, under long range results: Read the report

That is typically all of the arguing that I need when I talk to people about government ran health care.

July 9, 2009 at 12:37 PM  
Blogger Danian Michael said...

Anonymous,

You included quite a compliment in your comment and all I can say is thank you.

Your quotation represents irrefutable evidence that any government plan will have a very short life span. I really appreciate the link also, lest anyone tell us, "well that's just your opinion."

Local governments everywhere are going broke, so why do people think that adding such a huge financial burden to our federal government won't bring about its own demise, and by implication all the people who will now be benefiting from any government program?

Medicare is going bankrupt, social security is going bankrupt, state governments are going bankrupt the federal government is bankrupt but universal healthcare won't go bankrupt. I tell you that a lot of people have their heads in the sand Ostrich-style about Obama's plans... all of them.

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