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

The Answers from our President:

Watching President Obama answer questions about health care reform with 81 year old Grandma, a lifelong Republican, was revealing. She loved it. She believed everything he said, and couldn’t see how anyone could argue with what he wants for health care reform.

Then Chris Matthews and Dr. Nancy, even Ed Schultz, ostensibly more supportive than the typical life-long Republican, declared that he hadn’t made the grade with this one.

Did he answer the questions our media pundits hoped he’d answer?

* address the lies of nay-sayers – not really.

* tax health insurance from employers – no answer

*guarantee small business they won’t foot the bill to their detriment – not really

* itemize the components he wants – not really

* how will we save money – sort of – we’ll only pay for what works, the public option will keep insurance companies honest and encourage reducing administrative costs to compete.

* will he give up on covering everyone – he won’t, though inevitably a few people will reject coverage

* will the plan give the employee the right to choose his coverage – no mention

* is public option in jeopardy, without it insurance companies have no incentive to cut costs – sort of - see "how will we save money" above

* did he show graphics to explain cost cutting – no graphics, but some explanation on unnecessary duplication because of lack of sharing of test results, and that will change

* is he willing to pull back on the time-table and not rush – somewhat, but still an urgent need to act quickly, because too many people are suffering

Not much there in the way of feeding the media the meat they’re looking for.

But in fact, he framed the discussion differently, assuming we want and need to cover everyone, and addressed a lot of things Grandma wanted to hear, most notably:

Where will we come up with the money? Answer: We’re already paying 2/3 of the cost. And he wants to keep extra taxation to those who make about $1 million a year. (A million a year – can you imagine? How can anyone making that kind of money object to helping fund health care for those making $20,000 or $40,000?) He promised he wouldn't pay for it with a tax on the middle class. And he says we will change the way we fund it, paying for success instead of the volume of the care we get. Because we will have a public option, insurance companies will be forced to reduce their administrative costs to compete.

Who will have to sacrifice? Answer: Well, insurance companies are making record profits, and charging more and more for premiums, and there are additional government subsidies for much of the health care providers. At the same time, the average family take home income is shrinking. Hmmmm….. who should give a little?

If we already have the best health care in the world, why change it? Answer: If someone told you there was a plan that would guarantee doubling the cost of health care, and destroy our economy, would you go for it? That’s what would happen if we do nothing.

How about listening to ideas from the other side? Answer: If they’ve got a good idea, we’ll take it. We’ll use a neutral group of experts and consumers called MedPac (a Republican idea in the first place but never given any power) to help hammer out the details and make sure Medicare and Medicaid work efficiently.

Haven’t we already thrown enough money at the economy with TARP and the bailouts? Answer: Wall Street took extraordinary risks with other people’s money. It was fundamentally unsound. It was the right thing to step in – things would be worse if we hadn’t. We’ve seen some stabilization in the economy, we’ve stepped away from the brink, and now some banks are making a profit and paying back the money. But we haven’t seen the changes on Wall Street to ensure it won’t happen again, (example - outrageously high bonuses to executives) and we need fees for the kinds of risky transactions they were performing to help provide a backstop. They need to put something in a kitty so if they screw up again, it’s not the taxpayers who pay for it but the profits.

All in all, he pulled some punches, but seemed determined to succeed at taking a huge step toward putting the wheels back on the wagon. I guess we’ll have to wait and see if Congress is more like Grandma, or media pundits. With Harry Reid's announcement today that the vote won't happen until after the August recess, it appears the Congress pays more attention to the media pundits than it does to the people they represent.

Jacque