The Tangled Web of Healthcare

Within just hours of the vote in the House of Representatives, I decided it was time for me to take up the topic of healthcare.  I’ve remained fairly quiet on this matter… at least publicly.  My close friends would tend to disagree with that since I have been quite vocal around them.  But with everything that has gone around in the past year, it’s time for some clarity…or what little clarity there can be with a document this large.  Yes, our current healthcare system is a mess, and it does need to be overhauled.  But do I think the current bill is the way to do it?  Not necessarily.  And I’m not trying to look at this through my eyes alone… as it would effect me in different ways than it may you.

I was having a small debate/conversation with someone on the subject of healthcare reform the other day, and the other person commented that any person that was for this bill was a moron.  Now I quickly corrected him by saying that just because they don’t agree with him is no reason to call anyone a moron.  But in his own defense, he said that with a bill so large, it was impossible to know everything that in the bill; and therefore, to be for it, would be an idiotic thing.  But isn’t being against it, then, just as stupid?  The most logical course of action is to have no opinion (which he thought meant being against it….I had to explain there is a difference between no opinion because I don’t know enough about it and being against it.)   But I don’t want to digress to far into the debate I had with him.  In short form, the basic course to take is to have no opinion on such a matter until you’ve garnered up facts (and not opinions) about what is in such a bill…and then continue to learn more and more and not be afraid to change your mind if necessary as you do.

At first, I was not at all impressed.  There were just certain parts of it that I didn’t like from the start.  For one, during the 2008 campaign, then-Senator Obama said there would be no fee or penalty for anyone that didn’t have health insurance… something that Senator McCain hounded him on time and time again.  And yet, here in this bill is a fee or penalty for anyone that doesn’t have a healthcare policy.  Sure it provides subsidies for those on Medicaid and for small businesses and individuals (like myself) who have their own policies because we can’t get them through our jobs and make under 44,000 a year.  But if that still isn’t enough…and someone still can’t afford a basic policy (which could still end up costing them plenty of money), then they’d have to pay a fee or penalty to the government on top of whatever medical bills they might accrue.

The big thing I didn’t like about the whole thing was the public option.  I was glad the Senate left it off its bill, and the bill being voted on later today won’t have it in there either.  Despite the arguments for and against it, I just can’t trust the government to be able to run something this large effectively.  Hell, the government (and even Congress) can’t even run itself half the time, and they expect me to allow them to run healthcare.  They run Medicare and Medicaid already…and both of those are in dire straights.  Why?  Because for decades, the members of Congress raided those funds to pay for other things.  And now with the baby-boomers retiring, the funds aren’t there that are already needed.  The greed and corruption of our government can be seen…and there’s nothing really to stop them from doing it with healthcare. And with a public option, what’s to stop businesses from getting rid of their plans?  Sure, this current bill does make businesses continue to offer healthcare benefits to its employees.  But to run around this, couldn’t these businesses just get theirs marked up so high that they tell their employees to pay it or go on the government plan?  It’s a possibility.  My father… who is now retired but still gets his health insurance through his former employer, is worried that such a thing could happen especially to those like him that have retired and very little leverage on the issue.  And though the independent Congressional Budget Office says that this current bill will lower the deficit by $1-trillion dollars, I’m still not buying it.  It was said in the 1960s when Medicare was passed that it wouldn’t add to the deficit.  It only took a  few years for that not to be true.  So why should I believe these current numbers to more accurate?  In all honesty, I think sometimes the CBO and Congress just make up large numbers to sound good and make their case.

Now, I’m not against everything that the current bill has to offer.  As I said, I do believe we needed changes in the way our healthcare system was run.  The first thing that almost everyone is in agreement on…. cannot be denied for pre-existing conditions and your policy can’t be terminated when you get sick.  This is huge…and I’m all for this part.  One of my cousins just had major surgery.  She had her colon removed as it was full of polyps.  So now looking at that, it’s easy to ask what insurer would offer her a “respectable” policy when it comes time for her to get one?  Not many because of that pre-existing condition that she has now had.  Luckily, right now, she is in college and is young enough to remain on her father’s plan.

But with all of the “sick” people coming back to the insurance companies, couldn’t that drive up premiums for everyone to help cover the added costs?  Indeed it very well could.  Insurance companies now are raising rates saying that healthy people are dropping their coverage because they can’t afford it…thus leaving only the sick and there’s no balance (the healthy paying for the sick).  But I also wonder if these insurance companies realize that by raising premiums, they run the risk of even more healthy people dropping their coverage.  So the one key thing with this whole not denying people with pre-existing conditions is this… will the healthy people that are needed to help keep things in balance come back as well?  And for that, we need more of a free market type of system to offer some competition to not only bring back those that have pre-existing conditions…but to also bring back the healthy individuals that had dropped their coverage because of high premiums.

Now for someone like me that makes less than $44,000 a year and doesn’t get health insurance through work there would be subsidies to help me buy my own health insurance (and not a government health insurance plan since that doesn’t exist in this bill).  And on a selfish note, I wouldn’t mind the help in paying for my monthly premiums.  Every year, it goes up another $5.  That might not sound like a lot of money, but my wages don’t.  So therefore, that’s another $5 that leans heavy on my already cramped up budget.  And to go to the doctor, it still costs $50-$60 in the end.  And I am a fairly healthy guy, luckily.  But there is another step to this that needs to be added to this part.  Though the government is offering subsidies for those of us that could use the help (this is separate from the Medicaid subsidies, too), the government also needs to do away with state boundaries when it comes to buying health insurance.  I’ll use myself as an example again.  A couple of years ago, I moved from Illinois to Missouri….just a quick jump across the river in the grand scheme of things.  Because I decided to keep my primary care physician that I have had for years which is in Illinois, I decided to keep my health insurance from Illinois.  But because I now officially lived across state lines, my health insurance went up by $10 automatically.  This isn’t right either.  And in some states (like Alabama…and there are more), there is only one real healthcare provider for the entire state.  So there is nothing to check them into place on what they charge people.  By eliminating the state lines, it opens up the free market.  Healthcare would be a little like auto insurance in the fact that all the companies would be competing on a national market.  Sure, some small state insurance companies could pop up here and there, but the major ones would be competitive across the board.

Small businesses would also get some help.  They would be allowed to pool together with other small businesses to buy policies for their employees…thus giving them more bargaining power.  This would be done through an exchange… which wouldn’t be in place until 2014 at the earliest.  Though it would take some time to roll this out, this is a good thing….allowing small businesses that can’t afford good plans on their own, as they would be too expensive, to work with other small businesses to help spread out the costs.

And here are some things to ask yourself.  Why didn’t a plan to have a federal commission to review rates and reject unreasonable increases in premiums get off the table?  And what constitutes an unreasonable increase?  Why doesn’t the legislation beef-up the FTC and it’s ability to stop brand-name drugmakers from cutting deals with generic drugmakers to postpone the release of generic (and cheaper) versions of brand name drugs?  And why is there no tort (or malpractice) reform in this bill?  This last thing has been a Republican idea from the very beginning and is actually needed.  I’m not saying that all medical lawsuits are wasteful.  There really are legitimate cases out there that need to be dealt with properly and through the court system.  However, there are such cases out there that are utterly ridiculous and are a waste of taxpayer time and money… in which some lawyer is just trying to get rich off someone else’s “suffering.”

This has all been one huge tangled mess from the beginning.  Even writing this for all of you has been a tangled mess with several different tangents.  If you read it properly, I’m hoping you saw some of the Democrats ideas and some of the Republican ideas… and some that haven’t even been brought up.  When you get a bill this big and this complex, it makes one wonder what is hiding on the inside that we aren’t seeing.  I don’t think any of us have enough years in our lives to actually read the entire thing from front to back  and understand it all.  So why can’t all of this be done in steps or smaller bills.  Start with the things that we can all agree on…such as no denial for pre-existing conditions and go from there.  Both sides have some (and I can’t stress that word enough…some) good ideas.  But both sides also have ideas that pretty much should just fall off a cliff.  The point is that the two sides need to work together…and neither side has.  I do agree with the Republicans on this final bit… kill this bill and start over  Sure, we’ve wasted over a year of debate and a lot of money then.  But, in order to do this kind of overhaul properly, the basic ideas from both sides need to be incorporated.  And when the American people see our leaders working together to solve the problem, then we, too, will calm down and work with them as well.  We all deserve good, affordable healthcare.  The course we take to get there is a story unto itself that could have dire consequences down the road if it’s not done properly now.

The tangled web in which we weave today for all the later generations to figure out.

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4 Responses to The Tangled Web of Healthcare

  1. Allison Benoit says:

    You make a lot of good points and I think I agree with you for the most part. I strongly am against the fines for people who don’t have insurance. I read somewhere that the qualifications for Medicaid are going to change, but to what I don’t know. However, my partner, as it stands now, is unemployed and does not qualify for Medicaid. She has no income and I don’t make enough to pay for insurance unless someone can find me a decent $1 a month policy. So how can she pay fines if she can’t pay for insurance? It makes absolutely no sense.

    I just wonder, if this doesn’t pass today, will Obama and the Dems keep going after healthcare, or will they finally focus on real job creation. Not some trickle-down crap that isn’t going to get to the people who need it. Unemployment should have been focus #1, and while I agree that healthcare reform is important, it’s not going to do much good for people who have zero income.

  2. Hey, I read a lot of blogs on a daily basis and for the most part, people lack substance but, I just wanted to make a quick comment to say GREAT blog!…..I”ll be checking in on a regularly now….Keep up the good work! 🙂

    • James S. says:

      Thanks, Pete, for checking out my blog, and I’m glad that you are enjoying it. It gets annoying to read and hear what people think when they can’t really back it up with fact. And I respect people that can disagree with me so long as they can stand up for what they believe in without a bunch of BS. So even if there comes a time when you disagree with something I’ve written, I at least hope that I can get you to pause and think of the subject matter in the way I have written it. Thanks for reading and keeping checking back for new posts.

  3. Pingback: The Healthcare Mandate: Fed vs. State – In Declaration

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