Saturday, March 27, 2010

Is the health care reform bill right for the US?

I was asked by a physician's assistant, who happens to be Republican, what I thought of the Democratic health care reform bill. Isn't it just a big costly government program? Why am I not Republican? She asks, "You're such a smart man. Do you really, really, really believe this health care reform is good for the US?????", and then she attaches this lovely email chain-mail screed:

Let me get this straight. We're going to be gifted with a health care plan
written by a committee whose chairman says he doesn't understand it,
passed by a Congress that hasn't read it but exempts themselves from it,
to be signed by a president who also hasn't read it and who smokes,
with funding administered by a treasury chief who didn't pay his taxes,
to be overseen by a surgeon general who is obese and financed by a country that's broke.
What the hell could possibly go wrong?

Of course, it was a MUCH larger font and mostly in bold.

My answer:

I am not that smart... certainly about such things as policy. You have more experience dealing with the uninsured and under-insured, trying to get people into the system when they are sick. I know that the current situation is unsustainable. We cannot have 46 million people without insurance; 1 out of 4 people under 65 don't have any insurance and estimates are that another 20 million are under-insured. Do you really think that is sustainable? The current bill has been grossly mischaracterized as a "government takeover" when it is actually just insurance reform on the margins. The main provisions-- limiting pre-existing illness, preventing cancellation for illness, requiring basic coverage, expanding Medicaid, increasing insurance competition across state lines-- have been long overdue and all could have been passed individually very easily. I'm not sure what all the angst is about, other than the Republicans making hay while the sun shines, getting campaign contributions by stoking fear (what else is new.) The GOP had 10 years in power and did nothing-- nothing -- as the number of uninsured doubled and the percentage of our GDP going to health care went from 11 % to 17 %.

The Medicare Part D prescription plan signed by Bush in 2003 and passed by the GOP Congress is 1) more expensive, 2) covers a smaller number of people and only for prescriptions, 3) transfers more public money to private companies by disallowing price negotiation and 4) was NOT paid for AT ALL (100% is borrowed money). Seriously, Medicare Part D is such a boondoggle compared to the current insurance reform that it's not even worth discussing. Of course, the Republican legislators who wrote the bill are now lobbyists making millions from the industry.

I want to be a Republican, I really really really do. I would like to pay less taxes, drive a bigger car, make more money, lose weight, look more handsome... but let's get real. When my federal income taxes dropped in 2002, my property taxes and sales tax went up, and our public debt skyrocketed, because roads need to maintained and schools need to be funded-- and unnecessary wars became, well, necessary. I simply don't think our country can afford the Republican party. Their unnecessary wars (Iraq), corruption (Abramoff), deregulation of the financial industry (SEC, Lehamn, AIG), bank bailouts, auto bailouts, farm subsidies, payouts to the pharmaceutical industry (Medicare Part D) have or will cost me a bundle.

Are the Democrats perfect? No. But I think they are better than the GOP, that's my opinion. I think they understand the health care bill better than you give them credit for; all of the provisions in the bill have been discussed, studied and dissected for 20 years, none of it is really new or revolutionary... and personally, I think it will prove to NOT be enough, but that's just me. I truly believe the way to go is single-payer Medicare-for-all as basic coverage for preventive care, and allow people to buy insurance for better coverage as they choose-- that's the French system in a nutshell and it has better access at a much lower cost. But the GOP will get everyone stoked to win votes and we will continue to overpay for our health care. Under the current system, knee replacement salesmen make $300,000 per year; private insurers take billions of tax dollars through Medicare Advantage plans; largely because the regulatory arm of Medicare has been gutted and we have this fetish about worshiping "free markets" that don't exist.

The recent bill just passed will make YOUR life easier just by having more people required to sign up for Medicaid for which they already qualify. Furthermore, reimbursement will be higher and even working people will be required to have some coverage. So, you will have less hassle about getting folks into the system when they need it. But are all the problems solved? No. Nobody really knows exactly how it will work, and most experts agree that the bill will have to be tweaked as we go... but I have every confidence that the GOP will take seats in November and gut the bill, cutting regulation, reducing coverage, paying more-- not to doctors and PA's-- but to oxygen vendors and medical device manufacturers and drug makers. That's what the GOP does.

When I get emails like the one you sent, I just roll my eyes. We get what we deserve. The industry hacks have done a superb job of mischaracterizing the current health insurance reform bill: Mission Accomplished. The corporate elite want nothing more than to keep the rest of us unwashed and angry at our government so they can keep raking in the dough. The top 500 executives in the health insurance industry average over a million dollars per year. Ron Williams at Aetna made $24 million last year. I'm not saying that the government should mandate anything about executive salaries-- and neither are the Democrats-- but the system needs to be reformed. Insurance companies add no value to the health care product. Do they improve quality? Did Aetna show you how to do LEEP's or manage abnormal pap smears? What does society get in return for the $24 million paid to Ron Williams? We just pay premiums to them and they take 20% off the top, and try NOT to pay for services by increasing the hassle, and then drop us when we get sick.

That's my mini-rant. I have no problem with the principles espoused by the Republican party-- small govt, personal responsibility, etc-- but their actions NEVER follow these principles. They are more spendthrift and take less responsibility when they screw something up. Remember "weapons of mass destruction"? When the UN tells you over and over that there are no WMD and then you spend a trillion (borrowed) dollars, kill 100K civilians, maim 40K of your own soldiers, only to find out that you were wrong and the morons at the UN were right, how can you even show your face in public. Idiots, and that idiocy is costing you and me a lot of money-- more than any measley health insurance reform.

Sorry you asked?


Anonymous said...


Hilary said...
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Delilah said...

Oh my. I agree with you 100%. I miss our email exchanges.