Among the issues most commonly discussed are individuality, the rights of the individual, the limits of legitimate government, morality, history, economics, government policy, science, business, education, health care, energy, and man-made global warming evaluations. My posts are aimed at thinking, intelligent individuals, whose comments are very welcome.

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29 July 2009

Tully -- 5 Freedoms You'd Lose in Health Care Reform

Shawn Tully, Fortune, wrote an excellent article on the two main Democrat health care "reform" bills of the House and the Senate. Unlike our Congressmen and Senators, he has actually read the two bills despite each being about 1,000 pages long. His article is excellent and you can read it here.

Broadly, he says that we will lose the freedom to:
  • Choose what is in our health care insurance plan.
  • Be rewarded for healthy living, or pay our real costs.
  • Choose high deductible plans.
  • Keep our existing plan.
  • Choose our own doctors.
As you surely recall, Obama promised us that we could keep our present plan. For some people this is a flat out lie, while for others it is the act of a magician and a tightrope walker. It is a lie to those who are covered by health care plans commonly offered by large companies under the Employee Retirement Security Act of 1974 or ERISA. Large companies offer these in good part because they are not restricted by the state by state health plan requirements that drive up the costs of the health plans available to most Americans personally or to most small businesses. For 5 years, employees covered by ERISA plans can keep their coverage if their employer allows them to, but then they are all dumped into the government run exchange of government approved health insurance plans. They lose the plan they were promised they could keep.

How about those for whom Obama is walking the tightrope of truth? Yes, if you have a plan now and you want to keep it, you can, if there is no change, no matter how insignificant in your plan. If your plan changes any of the following, you lose it and are thrown into the government-run health insurance exchange as the Christians were thrown to the lions:
  • A deductible change
  • A co-pay change and remember plans often have many different co-pays for different purposes
  • a change of coverage for any drug, even the addition of a new drug not previously available
Clearly, no plan can stay static in this way for long. Indeed, almost all plans change on a yearly basis. So, when Obama says you can keep the plan you have and like, he means this only for those plans frozen in time. No plan of any quality at all can be so frozen, so you lose your plan of choice. It is only the ultimate quibble to claim that Obama did not lie to the entire set of people with health care plans they like and want to keep.

So, we are all soon destined to be thrown into the lions den of the government-run health insurance exchanges for each state which will only offer government qualified plans. There, just as with many present state requirements, we will have very limited choices for the health insurance plan with which to cover ourselves. First, the Senate bill bars insurers from charging more than twice as much for any person's coverage as that charged for another with the same coverage. This ensures that the young will have to pay much more than they will use to help cover the costs of the older workers. This feature of many state requirements already is the reason that many young people choose to be uninsured. The plans will also not allow premium differentials based on the health of the insured person. There will be no discounts for non-smokers, for those who exercise, or for those who are not obese.

The Senate bill requires coverage for prescription drugs, substance abuse programs, mental health benefits, and that parents provide coverage for their "children" until they are 26 years old. The Dept. of Health and Human Services is authorized to add to this list of requirements. We can be sure they will add significant requirements. Connecticut requires reimbursement for hair transplants, hearing aids, and in vitro fertilization, so we can be sure that lobbyists for many health service providers will be working hard to get the DHHS to add requirements for their services to the qualified plans. This will ensure that the cost of coverage will go up even further with time, just as most states have already managed to push health insurance plan costs up.

Many people now have high deductible health insurance plans. They can readily pay for normal expenses and only have a need to cover major expenses. Or they have a Health Savings Account (HSA) of tax-deductible money to cover the expenses up to the high deductible limit. This will be lost. Unfortunately, these are the people who exercise some personal concern about health care costs and have put at least part of the health care industry under some pressure to insure that costs are not greater than is justified by the benefits bestowed. 5 million people now have HSAs. Gone they are, for the Democrat clique never thought they were cool.

Tully also points out:
The Senate bill requires that Americans buying through the exchanges -- and as we've seen, that will soon be most Americans -- must get their care through something called "medical home." Medical home is similar to an HMO. You're assigned a primary care doctor, and the doctor controls your access to specialists. The primary care physicians will decide which services, like MRIs and other diagnostic scans, are best for you, and will decide when you really need to see a cardiologists or orthopedists.
This control of tests, procedures, and access to specialists will a the primary means of controlling expenses to the government qualified plans, after they have been loaded up with as many bells and whistles as possible in their requirements for qualification. You might have a very wide range of possible choices if only your unchosen primary care physician who works for the government, not you, allows you access to them. One of his primary duties will be to ration the health care you receive.

Now, it is not looking highly probable that these drastic socialist plans will be passed as written. But, we must do more than stop them in their present form. The compromise bills that will be passed down the road in the House and Senate will still be disasters in their own right. At the least, they will cost the taxpayer a fortune, will continue to transfer large sums of money from the better-off to the less well-off, and will continue to underpay and over-control doctors working with the new federal plans, causing them to charge patients on private plans still more. More people will be put on Medicaid, making it still more of a drain on taxpayers than it already is. Congress is determined to increase the federal debt for health care, even though huge, unfunded liabilities already exist for Medicaid and Medicare. These, they will not address. Indeed, they are apparently planning to raid the Medicare system for some of the money to fund their so-called "reform" health plan.

I wish to thank Paul Cohen for directing my attention to this article by Shawn Tully.

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