Monday, September 14, 2009

CONFUSION IN HEALTH CARE

A recent column in Citizen News brought forth letters and articles, information and misinformation.. Let’s correct some, starting with the luminaries’:

Pres. Obama. Illegals are not provided for in our bills. Not so. There have been two amendments barring illegal aliens from being benefited by health-care, and both have been voted down. The independent Congressional Research Service says there are numerous loopholes in the bills which allow illegal immigrants to benefit. Example: Where one family member qualifies for inclusion, his whole family is included.

If you like your policy, you can keep it,” repeated many times). Maybe, maybe not. . HR3200 provides that at the moment it becomes law, there will be no more enrollments in Medicare, and those who have lost their insurance for whatever reason will be put into Public Option. No choice.

Congressman Christopher Murphy: “There’s no reason why members of Congress shouldn’t . . . choose between the public option and private plans like everyone else.” [No one else can do that.] “I am willing to place my own health care coverage needs in it to prove my faith in this effort.” [Nobody else is.]

Sen.Coburn’s amendment asked senators if they would give up their federal policy for Public Option, and all voted NO except the two in charge who had to show support, Senators Dodd and Mikulski. They, all congressmen, and federal employees have the wonderful Federal Employees Health Benefits Program which during the campaign but not since, Mr. Obama reiterated we could have.

Cheryl Reedy: “Will this plan put private insurance companies out of business? No, private insurance companies will compete to sell plans that cover things the government plan doesn’t.” (CN Aug 19, p.13). If the government lets them. Government can regulate whatever it can’t get through legislation.

Public Option, free to increase its budget, free to run up debt (as has Medicare, which has trillions in unfunded liabilities), will under-price private insurance companies. Being heavily regulated, they will not be able to cover things Public Option doesn’t, and may go out of business or work for Medicare as claims adjustors.

Sen. Coburn’s idea is for each family to have an annual voucher from government (say $5600) which can be used to pay medical bills. What is left over would stay in its account, and be used for whatever purpose it is wanted. These are Health Savings Accounts.

Thomas Piel: “In last week’s Citizen News we were treated to yet another heavy reform because 70% (or was it 74%) are satisfied with their health care . . . just fine and dandy if we don’t do anything.” (CN, Aug. 26, p.10)

Not at all. Everyone, even those satisfied with their health care, say changes have to be made. Economist Laffer lists many: Patients should play a role in the process. Mandating minimum coverage; discriminating against pre-existing health conditions; medical-malpractice reform; preventing insurance companies from competing across state lines; permitting individuals to buy policies with pre-tax dollars as employers can. I listed all these in my Aug. 19 column.

T.P. says the World Health Organization places us 37th among countries in “medical outcomes.” Not medical outcomes, but, because we lack universal coverage and care is a financial burden for many, in quality of care. If we were 37th in medical outcomes, how come 400,000 foreigners came here for medical care in 2008? Two professors of medicine caught this myth (“Sorting Fact From Fiction on Health Care,” WSJ Aug 31, p.A13) Assigning a quantity to quality is arbitrary and meaningless.

Lizabeth Skalski: A public health plan option is crucial to lowering costs. [No.] By creating honest competition, a public plan will help bring down these out of control costs . . . ” (CN Aug. 26, p.13)

Public Option will stop all competition. Pres. Obama kept saying that enrolling the millions of uninsured people will lower costs, till the day when the Congressional Budget Office announced he’s wrong: Costs will increase by $1 trillion to $1.6 trillion (nearer $2 trillion, says economist Milton Feldstein, WSJ Sept. 8, A21).

It’s costly for hospitals, too. Dr. John Garrett speaking for Virginia Hospital Center says Medicare only reimburses 80% of the Hospital’s costs (Lewin Group says 70% on average). The hospital has to rely on private insurer companies to make up the difference. Private insurers are subsidizing the government, passing along their added cost in increased premiums of policy-holders.

There are over 1300 private insurance companies. But they can’t effectively compete because of a law which forbids crossing state lines to buy a policy. Public Option would under-price all private insurance companies, making it impossible for them to make a profit, which would drive them out of business or absorb them into Medicare.

Costs would go down, premiums would be cheaper, if policies could be bought across state lines and if medical-malpractice judgments were capped. Health Savings Accounts, making the system patient-centered, would help lower costs. The federal tax should stop favoring employer-sponsored insurance over self-purchased insurance. Each of these cost-savers could be put in a separate bill and easily passed.

The sure way to control costs when you run out of money is to ration health-care, as England and Canada, single-paying countries, are doing.

By Natalie Sirkin
c2009
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