Don't Do It

No. We cannot afford to have a health care reform bill that is merely lip service.

Literally. We can’t afford it.

Senators, congressmen, please vote down any bill that doesn’t have, at the very least, a fully operational public option, not a trigger option, not a co-op. Though we are completely convinced that reform is essential to a healthy future for our country, both people and economy, we also understand that the “reforms” that mandate individuals to purchase an insurance policy from the private industry, without significant cost control mechanisms, is a recipe for disaster.

Follow my logic. The Finance Committee’s bill offers a bunch of “reforms” but no constraints on profits, and no publicly run insurance option.

Eliminating “pre-existing conditions” is a moral imperative. But without removing the “rating” – inflated premiums – that are charged, the cost of such insurance will be out of reach of most of the 47 million currently uninsured. (We personally would have to pay more than $2000 per month right now, even if they exclude coverage for our pre-existing conditions.)

That would lead to subsidies by the federal government (or, as some amendments propose, state governments) to try to make it affordable. Tax dollars. That would go directly to private insurance companies, who are at record profit levels today.

The Baucus plan doesn’t require employers to provide insurance, and it would fine anyone who doesn’t purchase a private plan. The latest number we saw is $1,500 a year. What would they get for that? Nothing. (Oh, that’s right – charity, or the opportunity to sell everything they own, spend it on treatment, then sign up for a government program like Medicaid - this advice from those bleeding heart Republicans.)

And who would get the $1,500? The government, so they can forward it to the private insurance companies, to help them pay for covering all those sick people with pre-existing conditions.

Despite the Congressional Budget Office’s estimates that this bill will reduce the deficit, it will surely lead to continuing escalation in the cost of insurance for individuals.

Whose costs are we trying to reduce? The individuals? The taxpayers? Aren’t they the same people? Ah, there’s the rub. Corporations are taxpayers, too. They’re also currently footing the bill for most American’s health insurance premiums.

Without a serious mechanism to contain the amount of money we pay to health care service providers, and cut back the overhead of insurance companies (currently at more than 25%, compared to Medicare at 3%), the number of dollars spent on “health care” will climb. If individuals and employers have to keep up with increasing premiums (or pay fines), and co-pays go up, out-of-pocket maximums go up, we will be paying out more than the current 1/6th of our GDP. It may not build up the government’s deficit, but it will surely build up personal deficit for each of us individually.

So how you do you contain costs? How do you do it at home? Discipline. Efficiency. Practicality. Shopping around.

The current system, and the “reformed” system without a public option, doesn’t encourage these things. When the cost of an ultrasound goes up, insurance companies just charge more for premiums, and deny any claims they can get away with. Those of us with “good” health insurance plans don’t see or appreciate the actual costs of the care they receive. As Senator Schumer pointed out recently, if a doctor says ‘Hmmm, I don’t think it’s really necessary, but I suppose we could do a CT scan’, neither the patient nor the doctor has a second thought about what it costs because they don’t pay it directly. So unnecessary tests are done, and the overall cost goes up.

Medicare, the only “public option” in existence right now, uses all those cost containment principles, very effectively. But with the private insurers letting costs creep up, Medicare has to keep increasing its payment rates, too, or providers will drop out of participation. So individuals costs go up, and government costs go up.

When the costs strangle our economy, voters will go crazy and Republicans will capitalize on that by claiming the “reforms” were to blame, and we can kiss true reform goodbye. Congress will tinker some more as our economy turns us into a third-world debtor nation.

We have three choices – 1) make it illegal for insurance companies to make profits and put severe regulations on their operations, or 2) maintain more of a free market and make them compete with a non-profit public option to force prices down, or 3) expand our successful Medicare program to all Americans.

Since the Dems took 3) off the table before they even started negotiating, we don’t have any hope of that one. Choice 1) would take an act of God, not just an act of Congress.

The public option has to be big enough, and strong enough, to have the cost-containing impact we need. If, as some Republicans are crying these days, it would be so good people would leave private insurance companies in droves and head to the public option, destroying the profitable industry, we ask: what is your priority? Affordable and great health care for all, or profits to a heartless industry that controls our very lives?

Quoting Wil Rogers, "Even if you are on the right track you will get run over if you just sit there."

Congress, if some of you don’t have the heart and balls to put real health care reform into play, then show your true selves to the electorate and let us all show you what we think.

JM