I promised awhile back to write some thoughts on the healthcare debate. I wanted to cement some ideas in my head, so I wrote out some thoughts.
First of all, I have always hated when Presidents or Congress make a major action on Saturday night. You can look back at previous Presidents and also our current administration. Look at who got booted from the administration or what bills were passed on Saturday night. It says a lot! "Hey look, no one is looking... let's sneak this in now!" The Obama administration has been no different.
Pelosi compared the legislation to the passage of Social Security in 1935 and Medicare 30 years later. That's simply sad! Social security payroll tax collections will begin to exceed benefits paid in 2016 and it will go bankrupt by 2040 or sooner and Medicare was promised to cost 12 billion by 1990. It was 90 billion and is now $468 billion. Hmmm... good track record.
Seems logical to me that if the motives of those who want this bill to pass is genuine, we could help the people who can't afford insurance and leave the rest of us alone. Helping people isn't the only motive. They want a take-over of health care in this country. They want more people reliant on government programs. It isn't simply about helping people. If it were, this bill would be about 1500 pages shorter.
Here are my thoughts on the basics of the House bill.
· If passed, this bill would give the government control of over half of all health care spending. Instead of having a largely private industry, it will be subordinate to government control. Anyone who has ever been "under government control" knows that is a horrible idea! If this passes, the government will control 1/6th of the US economy. To put that in perspective, that is roughly equal to the size of the entire British economy. The government doesn't have the greatest track record in handling our economy, so that concerns me.
· It continues the entitlement nature that is already running rampant in our culture. Do all Americans deserve a college education, childcare, transportation to their jobs, a house, electricity, food, a cell phone... just because they are Americans? Actually, not even citizens... do they "deserve" health care because they live in our great country? Where does the entitlement mentality stop? We're on a very slippery slope. I do not want to be forced pay for these "entitlements" out of my hard earned paycheck. I'll volunteer my money for charity instead. The non-profit free health care facilities in our community are doing a great job and meeting the needs of our community. They are open and available.
· Contrary to the President's words, the bill would impose new taxes on all Americans regardless of class or income. The employer mandate would tax the middle class and small businesses. Wow, with the jobless rate at 10.2%, that seems like a really stupid idea... especially for small businesses.
· The true cost of the bill is in excess of President Obama's $900 billion spending target. In fact, it will run into the trillions.
· I'm convinced that this plan will block innovation and patient choice. The House bill creates a new federal office, the Health Choices Commissioner. This office will make health choices for the entire nation. They will decide which surgeries and services health plans must cover or not cover. These regulations would be imposed on all private insurers and employers.
· Medicare will be substantially reduced, from the cut in Medicare Advantage (the plan that many low-income seniors use). Medicare estimates that 8.5 million seniors will be forced to join the government plan rather than keep the insurance they are happy with and have chosen.
· The age-range ratio is completely silly. The bill limits age-rating of premiums to no more than a two-to-one difference between the highest and lowest premium costs. So a 64-year old can not be charged more than twice the premium of an 18-year old. That's going to significantly impact the 20 and 30-somethings whose premiums are going to go up a lot! If you're a 20-something, I hope you have a great income!
· The CBO office says that 18-25 million Americans will remain uncovered. These people will pay heavy fines (2.5% of their income). I read yesterday that if we don't pay the fine, it becomes a penalty of $25,000 and/or 1 year in jail (Section 7203). Another section says willful evasion is punishable by a fine up to $250,000 and/or imprisonment of up to 5 years. Who ever thought that in America someone would ever go to jail for a year for not having enough health insurance?
Is there constitutional basis for requiring people to have health insurance? It's ok for a state to require automobile insurance because driving isn't a right, it is a privilege. Someone can choose not to drive. Banks can require home-owners insurance as a condition of their lending. Someone can choose not to buy a house. But how does someone choose not to live? Does the government have a constitutional right to force someone to buy health insurance? Even worse, throw them in jail when they don't pay the fine? Does the constitution even allow for the Federal government to force us to buy something? I don't even think that the commerce clause can be stretched to allow that. Even if this bill makes it through the Senate, the Supreme Court process will take forever.
· Medicaid is going to be a disaster. If you've been on Medicaid, you know that it is really hard to find a doctor now. My dad had to give up going to the doctors recommended by the Diabetes Center because those doctors didn't accept new Medicaid patients. The paper work is horrific and doctors make very little, if any, money when they accept Medicaid patients. Let's add 5 million children (who will be transferred into Medicaid from SCHIP), and the 18 million adults into Medicaid and see what happens. Is anyone doing the math? By 2019, more than half of all health spending will be through Medicare, Medicaid, or another government program. Why would anyone aspire to be a doctor if they can't make any money?
· The abortion language still isn't clear. I'm very interested in seeing what the Senate does with that ultra-important issue.
My question to you... how will the bill affect you and your family? Here is how I think it will affect me. Our HSA plan will not qualify as enough insurance so we're going to have to do the math to see if we should get more insurance coverage or if it would be better for us to just pay the fine. Initially, I think we'll pay the fine. That thought just irks me! Being fined in order to pay someone else's health insurance doesn't sit well with me!
If you've lived in a country with government controlled health care (or even visited one), you know that wait times to get into a doctor are very long. More people die. My friend in Canada says that she often forgets why she made the appointment by the time she gets in to see the doctor several weeks later.
As of 3 weeks ago when I called my thyroid doctor, he already had a wait time of 3 months. What is that wait-time going to be once we add millions of more patients and lose a good percentage of doctors? Our fatality rates are going to go up.
The members of my family who are on Medicaid are going to suffer the most. Adding 18+ million people into a system that is broken and going bankrupt is ridiculous. The wait times for basic services will be unbearable for them.
The CBO estimates that the lowest-cost family non-group option would cost $15,000 by 2016. What? How am I supposed to pay that? I think I'll be paying the fine instead.
I would also like to note that I'm very disappointed in John Salazar, Colorado's "blue dog" democrat who claims to be fiscally conservative. He voted for the bill.
There is hope in the Senate! These senators might vote no: Lieberman (CT), Bayh (Ind), Hagan (NC), Landrieu (LA), Pryor and Lincoln (Ark), Nelson (Neb), Johnson (SD), Dorgan and Conrad (ND), Tester (Montana), Engler (Col), and Feinstein (Cal). Reid will need all of these Senators to back the bill to get the 60 votes to pass it (assuming we hold Collins and Snowe from Maine).
We'll see what happens!