I had hoped to post something on this yesterday, but I wanted to get a clear grasp on things beforehand.Obama's speech to Congress about healthcare. Obama's vagueness left a lot of Americans believing that their best interests were being taken to heart, yet it left a lot of questions unanswered. He said a lot, but there's also a lot he didn't say.
I'd like to address this point by point.
Towards the beginning of his speech, Obama said that "in just a two-year period, one in every three Americans goes without health care coverage at some point."
He didn't say how many of those people go without coverage by choice. He didn't say how many of those people had a short lapse in coverage because they changed jobs (which happens frequently). He didn't say how long those Americans went without coverage. This statistic, in my opinion, is a distortion. He's making things seem more bleak than they really are, which is a scare tactic. More on that later.
Obama said, "More and more Americans worry that if you move, lose your job, or change your job, you'll lose your health insurance too."
Another scare tactic. The federal government addressed this very issue back in 1986 (under a Republican president, I might add) with the Consolidated Omnibus Budget Reconciliation Act - also known as COBRA. COBRA provides certain former employees, retirees, spouses, former spouses, and dependent children the right to temporary continuation of health coverage at group rates. By law, if you lose or quit your job (for reasons other than gross misconduct), are laid off, or have your hours reduced, you are still entitled to the company's insurance (unless the company has gone out of business and/or no longer offers insurance) at the group rate for up to 18 months (and sometimes longer). The only catch is that you have to pay 100% of the premiums - which is fair, considering that you no longer work for the company.
"More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick or won't pay the full cost of care."
I'd like to see examples of this "out of the blue" insurance coverage termination, Mr. Obama. In my research, the only instances I can find of this is when the policyholders lied on their insurance applications - when they didn't give full disclosure of their past medical histories. In that situation, the policyholder would clearly be in breach of contract and the insurance company would be within its right to terminate coverage.
Some people may also be confusing this with denial of benefits, not termination of coverage, which happens more frequently. There are people who will buy the cheapest insurance available, not taking into account the things that are and aren't covered by their policies. It's just like car insurance. You can buy minimum coverage... but you'll get minimum benefit. If you buy minimum health insurance, don't expect it to pay for everything.
That's why it's so important to really read through your insurance plan. If there's something you are concerned about, ask questions. Personally, I don't know of any insurance plan that provides 100% coverage for everything. If such a policy exists, then I'll bet you that it's very expensive.
Pre-existing conditions
Lots of concern about denial of coverage because of pre-existing conditions. Also addressed by the government way before this. In 1996, the government passed the Health Insurance Portability and Accountability Act (HIPAA), which, in part, limits the ability of a new employer plan to exclude coverage for pre-existing conditions.
It also:
-
Provides additional opportunities to enroll in a group health plan if you lose other coverage or experience certain life events;
-
Prohibits discrimination against employees and their dependent family members based on any health factors they may have, including prior medical conditions, previous claims experience, and genetic information; and
-
Guarantees that certain individuals will have access to, and can renew, individual health insurance policies.
"Then there's the problem of rising cost. We spend one and a half times more per person on health care than any other country, but we aren't any healthier for it."
Sir, you use this as a reason why insurance is so expensive these days, but you fail to state why health care itself is so expensive.
One of the reasons why we aren't any healthier is because Big Pharma likes us to stay sick. There are more "-itises" and "syndromes" today than you can shake a stick at... and I'm convinced that a majority of them are dreamed up by Big Pharma. All over the tv - what do we see? Commercials for the latest and greatest wonder drugs that nobody can pronouce for some -itis or syndrome that nobody has ever heard of but everybody thinks they now have. For crying out loud, there's a new drug out for growing longer, thicker eyelashes, something I'm sure we're all worried about. Pharmaceutical companies have kicked it into overdrive, coming up with newer, more expensive drugs every day. We take pills, then we take pills to counteract the side effects of the first pills. We inject, we spray, we rub, we inhale. And, no - we're not any healthier for it. Sheep medication... that's what it is.
Mr. President - I don't see you calling Big Pharma out on the carpet. Instead, I see people who try to use tried-and-true homeopathic remedies being labeled as being "on the fringe" or "radical." Tell me, how did your grandparents treat the flu? I'm certain it wasn't with Tamiflu.
The long list of provisions
Obama went on to spell out a long list of provisions. No exclusions because of pre-existing conditions. No loss of coverage due to illness. No annual/lifetime benefits cap. Limits on out of pocket expenses. Free routine and preventive care. The new, competitive "insurance exchange." Low cost catastrophic insurance. And then he mandated that all people, including "irresponsible" individuals who would otherwise opt-out of buying insurance, would be required to carry insurance.
Nice things to have, right? Well, all those goodies don't come cheap. The kicker was the cost. His estimate: $900 BILLION over 10 years
Even better was how he said it would be paid for.
He said that it wouldn't add to the deficit and wouldn't touch the Medicare trust fund.
He said that the money would come from eliminating fraud, waste and abuse.
Read that again.
Apparently, there is 900 BILLION dollars worth of fraud, waste and abuse going on in current government healthcare spending.
How in the hell can you waste 900 BILLION bucks and not notice it? Why, fellow Americans, hasn't anybody said anything about this before now? Why?
Because it's fiction.
Oh, don't get me wrong. I'm sure there's plenty of fraud, waste and abuse going on. And I'm sure there are plenty of areas that can be better managed. But 900 BILLION dollars worth?
I didn't just fall off the turnip truck yesterday... and neither did you. As a Tennessean, this kind of plan should sound familiar.
With regard to President Obama's plans to use savings from Medicare waste, fraud and abuse, Governor Phil Bredesen noted similar arguments were made with regard to TennCare, an effort in 1994 to expand the state's version of Medicaid to cover many more people.Truth be told, if all those things are enacted into law, the government won't be paying for it with all the loose change dug up from between the cushions of all the "fraud, waste and abuse" couches that are apparently all over the place.
"Tennessee has been there and done that," said Gov. Bredesen, who became governor in 2003. "That's exactly the argument for TennCare and it didn't turn out that way."
- Chattanooga Times Free Press
They'll make the employers pay for it. Which, in turn, means that we'll be paying for it in the end. Sky-high premiums - for COMPULSORY insurance, I remind you - and taxes. According to Tennessee Senator Lamar Alexander's estimates, Tennessee's share would be “about the amount of money a new 10 percent state income tax would raise.” Just imagine a 10% state income tax ON TOP OF the nearly 10% sales tax we already pay. Not to mention property taxes and such.
Forget tax cuts. You can kiss your pre-tax health insurance premiums goodbye... and flexible healthcare saving/spending accounts.
But in the end, Obama upbraided those people who had resorted to scare tactics. Yet, he used them himself.
He said that if we do nothing:
- The deficit will increase
- More families will go bankrupt
- Businesses will close
- More people will lose their insurance coverage when they get sick
- People will DIE
Just wait. That's not the scary part.
This is - a direct quote from Obama's speech:
"sometimes government has to step in"
Try swallowing that pill.
I only have one personal account of that termination of insurance, but I do have a friend who's husband was diagnosed as an adult with a serious heart condition. The insurance company (one of the large, reputable ones...a typical "through the company" policy) determined that even though there had never been any symptoms and it was never diagnosed before, this condition was congenital and therefore pre-existing. They refunded all of the premiums the family had paid and dropped his insurance. They were left to completely cover open heart surgery out of pocket. They "lucked out" with a surgeon who was interested in this condition an volunteered to do the surgery without charge, but they still had to cover the very considerable hospital bills.
ReplyDeleteThere is also the other issue of "denial of coverage".....such as when my mother quit her job (yes, voluntarily) to care for my grandmother, who is suffering from Alzheimer's. She took her COBRA coverage as long as she could and spent the entire time searching for insurance. She wasn't offered higher premiums, she was outright denied. She isn't old enough for medicare, and due to my dad's income (through a company that doesn't offer health insurance) doesn't qualify for medicaid.
For the record, there are plenty of things being discussed with health care reform that I don't like, but I also find it ridiculous that my insurance company pays less than half what I would if I had to pay out of pocket for the exact same service with the exact same doctor/dentist---if there was a set fee for a set service, I would be much happier with the current system, because it would be much more feasible to pay out of pocket when necessary. I think of the whole shebang as a bit of a catch-22...There are some serious flaws in both the reform being discussed and the current system.
Sorry for the long comment ;-)
TZ - there isn't very much you and I disagree on, but healthcare seems to be one thing.
ReplyDeleteI don't like the form that the current "reform" is taking, but I'm glad to see SOME action.
Every American expects the government to provide roads, electricity, and national security via the military...
I just don't see how basic medical care is not on that list.
@ Hills: Thank you for sharing those stories. It would be interesting to see the reports or letters from the insurance companies to see their reasoning behind the denials.
ReplyDeleteI do like your idea about lower, set fees for routine service. You might find this quote interesting:
"For decades, the U.S. healthcare system was the envy of the entire world. Not coincidentally, there was far less government involvement in medicine during this time. America had the finest doctors and hospitals, patients enjoyed high-quality, affordable medical care, and thousands of private charities provided health services for the poor. Doctors focused on treating patients, without the red tape and threat of lawsuits that plague the profession today. Most Americans paid cash for basic services, and had insurance only for major illnesses and accidents. This meant both doctors and patients had an incentive to keep costs down, as the patient was directly responsible for payment, rather than an HMO or government program.
The lesson is clear: when government and other third parties get involved, health care costs spiral. The answer is not a system of outright socialized medicine, but rather a system that encourages everyone – doctors, hospitals, patients, and drug companies – to keep costs down. As long as “somebody else” is paying the bill, the bill will be too high. " - Ron Paul, 2006 (THREE years ago!)
@ Ranger - I also understand what you're saying and sympathize. Lots of people are hurting and they don't know where to turn. I just don't agree that the government is the source for relief. The constitution only guarantees citizens life, liberty and the right to keep the fruits of our labor. Healthcare isn't a right.
ReplyDeleteI fear that the titlement mentality has gotten us into a majority of the mess that our country faces today, on multiple levels. I see it in court nearly every day.
Thank you for opening the debate! I'm glad to see it and I appreciate your opinion.
You and Hills show exactly how its done - respectfully and mindfully. And that kind of debate will always be welcome here!
I don't know about mindful, but I can't help but be respectful to someone I respect.
ReplyDeleteI'm an idealist as opposed to a realist when it comes to government - always have been.
The way I see it though, if I'm going to pay taxes, I want more than the baseline constitutional guarantees.
I also believe that a healthcare system that focused on preventative care would eliminate much of the waste and cost...but since it's not profitable for big-pharma, I'll be surprised if it ever happens.
What I'd like to see is a baseline system of preventative and emergency care that's public and free, as well as a for-pay system for other things.
That was a very interesting post. You really took his words apart. It reminds of something a teacher once said, "Figures don't lie, but liars do figure". I guess he figures we'll blindly accept everything he says.
ReplyDeleteThanks for dissecting the speech, TennZen! I think your evaluation is honest and on the money.
ReplyDeleteThere are only 3 thing that I desire from the federal government: 1)defend our borders from invasion, 2)defend our country's interests abroad, and 3)stay the heck out of my way and out of my wallet and let me and mine do for ourselves!
Government can NOT be trusted with power, be it the power to tax income or the power to "provide healthcare". Our founding fathers understood this and sought to limit the government with the restrictions of the Constitution. But alas, Americans now prefer to trust the lying cheats in DC than their own neighbors. When the lessons of history are ignored, reality can be a harsh teacher...