My Plowshare

Washington Times

“President Obama took to the conservative airwaves Thursday to charge that Republican leaders are engaged in a vast right-wing conspiracy to kill health care reform in order to repeat the 1994 mid-term takeover of Congress, which followed the defeat of President Clinton’s reform plan.”

The Washington Times, August 20th article: Obama: Republican conspiracy out to kill health reform.

My take: I don’t know Mr. President. Is it possible YOU can put politics aside for just a moment? Is it possible that your plan is going to hurt more Americans then it helps or do you have yourself totally convinced that Republicans don’t want anyone to have good, affordable health care with less waste?

When you break it down, Republicans have just as many uninsured citizens as Democrats.  We are all invested in the same goal but clearly have two vastly different solutions.

Barack Obama is clearly getting in the way of himself in passing health care reform.

Many Americans, myself included, are trying to make sense of just what is happening in the big health care debate.  Instead of relying on talking heads I am committing myself to investigating the actual bill that is on the floor right now. After all, I can read and I don’t need some one interpreting it for me, right?  This blog post is a long one but covers the following issues and headlines surrounding this debate:

• Protesting “Un-American?”
• So-called Death Panels
• The Urgency of It All
• My Specific Concerns of This Bill
• Solutions

Protesting “Un-American?”
Town Hall protesters are “evil-mongers” says Senate Majority Leader Harry Reid.  (D-Nev.) at an energy conference in Las Vegas last week.

Representative Baron Hill, D-Ind., said that protesters are “political terrorists.”

Majority Leader,  Nancy Pelosi (D-Calif.) and Senator Blanche Lincoln (D-Ark.) have both called town hall protesters “Un-American.” Senator Lincoln later apologized from the comment while no apology that this author knows of has been given by Pelosi. Of course in 2006 Pelosi says she is a fan of “disruptors” protesting in 2006 at an anti-war rally.  See it here.

I’m trying to figure out where in our American history that protesting has become un-American. When was it that when one side disagrees with another it is un-American?  I specifically remember the hundreds and hundreds of protests over the wars.  There was some unjustified people that called those protests un-American. Most definitely if someone held up a sign that read “I want the terrorists to win” then I would call that un-American but I didn’t see that.

The Urgency of It All
I am amazed at how surprised many democrats are over the backlash of the health care legislation.  I believe the very lawmakers who have been passing some of the most recent bills are the very ones to be blamed for the uprising and spark of protests.

Going into the health care debate and as recently as July 22, Obama defended his decision to give a mid-summer deadline for a health care bill to be passed. Noted here.   This deadline has since expired.  Americans everywhere became very nervous that the health care bill would be passed like the previous stimulus bills—with few reading any of it.  The stimulus bills, we were told, needed to be passed quickly yet at the time of the publishing of this post we have barely spent 10% of the stimulus bill, a bill that I would argue isn’t working nor will it work. What was with the urgency then?

I will be the first to admit that health care in its current form absolutely needs to change. I don’t know any one of reason who disagrees with that statement.  However, it is of such monumental importance that it does and will take time to create a successful plan.  My baseball coach used to say “Hustle, don’t hurry” and that applies to what we are doing with health care right now.  Quite frankly, I think it shows Obama’s inexperience as a leader to even suggest such a ridiculous and unachievable deadline.  He can back peddle all he wants about why he set that deadline but that fact is that “hurry up and change” is not a good political or practical strategy when it comes to health care in America.

On “Death Panels”
If I am not mistaken, it was Sarah Palin who first coined this phrase on a Facebook page concerning the new health care bill.  Unfortunately, no one seems to be trying to understand where she would come up with such an idea. It is quite probable that we are lazy and it is easier to read just two words. “death panel” and draw our own assumptions as to what it means.

Her concern has to do with bill HR 3200 in section 1233. You can read and even comment on the whole bill here.

I encourage you to read it for yourself but summing it up it tells us that for senior citizens on Medicare,  every five years or if there is significant changes in the individuals health status, physicians must explain “the continuum of end-of-life services and supports available, including palliative care and hospice,” and the government benefits available to pay for such services.”

On the surface you may say, “big deal, they are just explaining their options.” The concern is that seniors may view this as a recommendation to accept minimal end-of-life health care costs and to sign end-of-live directives in which they feel their life does not hold value.  The bigger concern is the intentions behind this section when it is in a bill that clearly states that the main goal of it is “to reduce the growth in health care spending.”

If reducing spending on health care is the main goal we have to be very careful about how it is recommended that they do this.  This is why so many are bringing this to light.  There is too much room for interpretation.  As of the writing of this post, it has been said that this paragraph will be dropped from the bill.  In light of this news, it is not such a bad thing that people are speaking loudly about their concerns in the bill, right?

My Specific Concerns on Other Parts of this Bill
#1 Reason for concern: Ideology Behind The Bill
The overall ideology of the president and those who have authored this health care bill wish to create a single payer health system.  That’s a nicer word for a universal, government-sponsored plan.  See the definition here

The idea is not a new one and has many flaws in it that are not suitable for the United States. The fact is that a single payer system is what Obama has wanted even though he denies it now.  This can be backed up by his past speeches:

In his speech shown in this video he also goes on to say that they can’t implement a single payer system until

“we (democrats) take over the house, take over the senate and take over the presidency.”

Now you may see why he has such urgency to pass this bill.

Forget about the topic of health care wait times in other countries for a moment. I have not been able to find a reliable, scientific source that can cite these times.  Plus common sense will tell you that with more people needing care and less medical professionals because of the smaller pay in countries like Canada, of course there are going to be longer waits.

A better barometer of a system’s success is the fatality rate.  Here are a few common medical conditions from both countries an an example.

UPDATE 8/18: Further evidence can be found in an article about the upcoming annual meeting of the dire need of change in the Canadian health care system. The new president said that the Canadian health care system is imploding.  Read the article HERE

#2 How Will We Pay For This?

There aren’t any mysteries to paying for something.  In this case we have a few options.  To pay for this bill we will need to decide on one of the following; higher taxes, rationing health care, borrow more money from other countries, or printing more money.  Aside from holding bake sales inside of hospitals that just about covers our options. The most reasonable is higher taxes of course and the reality, whether it is this plan or something else, we will need more money to fund it.

It still amazes how little the funding of this bill is talked about. It’s almost as though money is no object.  Although that’s the way our new government seems to be operating these days.  All of you who were upset with how much money the Bush administration was spending should be irate now.  Our government couldn’t be more broke and eventually you and I will need to start paying for their free spending.

One way in which part of this bill will be funded is by those awful ‘rich’ people.  Section 59C shows that there will be a tax surcharge (one of many more to come).  It breaks down like this by income bracket:

$350-$500,000 = 1% tax surcharge
$500k-$1mil = 1.5%
$1 mil + = 5.4%

#3  If You Work For A Small Business You Will Go On A Government Plan

Here are the problems with the debate going on with this bill.
CONCERNED CITIZEN: Will this plan force private insurance providers out of business?
POLITICAL REPRESENTATIVE: No where in the bill does it say that private business can’t continue to offer insurance.

This is true but does not paint the reality of what will happen.  Take a look at Section 313:

(a) In General- A contribution is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment (determined by taking into account all employees of the employer and in such manner as the Commissioner provides, including rules providing for the appropriate aggregation of related employers).”

It goes on to say that any small business paying out more than $400,000 in salary ( a combo of all employee salaries) will pay an 8% fee into a government trust account.

The company I work for is still considered a small to mid-sized company making less then $25 million a year.  The health benefits are tremendous and I don’t pay a penny for my own health care except for a small deductible.  Health care costs for our company are high but employees know that they have great coverage and it is a tremendous benefit.  Under section 313, our business has two options. 1. Pay the much higher costs to fund its employees or 2. Reduce its health spend by about 18% and tell their employees to go to the government option.  It won’t take long before business opt to reduce their costs.  It won’t take long before private health providers won’t be able to match the government’s costs.  As you will learn later, you also won’t be able to buy back up to the health care you were receiving.  Private insurance will in fact go out of business.  The government is doing all they can to refute this but if read, the bill speaks louder than they can.

#4 Rationing Health Care

There is much to be said on this one but the most concerning language in the bill comes from section 1151 titled: Reducing Potentially Preventable Hospital Readmissions.  The biggest issue with this section is it couldn’t be more clear that this is the government rationing that everyone has been talking about.  It  leaves much open to interpretation which will be decided by a Secretary of Health.  As stated in section 1151, part 6 there is also no room for someone to appeal a decision to the courts.  Currently, by law, even those big bad insurance companies that everyone hates allow for an appeals process.

‘‘(6) LIMITATIONS ON REVIEW.—There shall be no administrative or judicial review under section 1869, section 1878, or otherwise of— . . .”

It gives our government an open-ended ticket to decide what is an applicable medical condition and what will be covered as described in part A of this section.

(A) APPLICABLE CONDITION- The term ‘applicable condition’ means, subject to subparagraph (B), a condition or procedure selected by the Secretary among conditions and procedures for which–

It goes on to say that the secretary of health will control which hospitals and medical conditions will be allowed. Wouldn’t it be nice to know how this will be decided?  Will it be decided based on cost since that is what this bill states as its main objective or will it be based on the need’s of American patients?

#5  Reduced Need For Health Savings Account

Plans, such as health savings accounts, that allow for catastrophic coverage where the insured pays for routine coverage will no longer be legal under section 122.  This section defines what acceptable coverage is.

#6 Unlimited Government fees and Payments

You may think I am exaggerating but once again this allows the government to charge anything for fees. Section 223 is a train wreck waiting to happen.  They have also written in a line that would not allow a judicial review of the prices they put into place. Do you trust your government that much?

(f) Limitations on Review- There shall be no administrative or judicial review of a payment rate or methodology established under this section or under section 224.

#7 Let’s Hope They Don’t Lose Your Paperwork!

Do nothing and you’ll be in the government plan automatically.

Outreach and enrollment of Exchange-eligible individuals and employers in Exchange-participating health benefits plan:

(3) AUTOMATIC ENROLLMENT OF MEDICAID ELIGIBLE INDIVIDUALS INTO MEDICAID.—The Commissioner shall provide for a process under which an individual who is described in section 202(d)(3) and has not elected to enroll in an Exchange-participating health benefits plan is automatically enrolled under Medicaid.

And, page 145, section 312:

(4) AUTOENROLLMENT OF EMPLOYEES.—The employer provides for autoenrollment of the employee in accordance with subsection (c)

Solutions
This may be hard to believe but there are better solutions out there.  Most of these are being proposed and ignored in the house and senate because they do not reflect a single payer system.  So much for Obama uniting partisan politics.

There are a couple of ideas that have not been fully endorsed but are great alternatives to what is on the table right now. Real Clear Politics sums it up best:

The Ryan-Burr proposal would allow employees to opt out of their employer-based insurance plan and get a $5,000-per-family tax credit to buy health insurance or pay medical bills.

It would also allow individuals and businesses to form pools and buy insurance anywhere in the country, not just in the state where they live.

As Ryan puts it, “This will greatly expand the choices of coverage available to consumers and will also encourage broader competition and diversity among insurers.”

Along with practically every other plan, Democratic and Republican, the conservative plan would require insurance companies to offer insurance regardless of a person’s pre-existing medical condition.

Meantime, Kirk and Dent’s Medical Rights and Reform Act is designed to lower the cost of insurance policies through legal reform – which will reduce the expensive practice of “defensive medicine” – and also create interstate pools.

According to Kirk, the average cost of insurance in states like California, which have limits on medical malpractice awards and allow large-scale pooling, is less than half that in lawyer-friendly states like New Jersey.

Both the conservative and moderate plans would allow low-income Medicaid patients to get vouchers to buy private insurance and encourage states to experiment with insurance market reforms.

Yes, change in health care does need to happen but that fact is that 70% are happy with the coverage they have now.  We all know and what change to the existing health care system. We need to some how offer insurance to those who don’t currently have it but we must do this in a way that does not strip every one else away from what they have and like.