Friday, August 7, 2009

The Healthcare Bill Town Hall Meeting Guide

In order to assist interested parties seeking to read and review the health "reform" legislation (H.R. 3200) introduced by House Democrats, the Republican Conference has compiled a list of important page numbers and provisions in the 1,018-page "America's Affordable Health Choices Act:"

Page 19 - Section 102(c) prohibits the sale of private individual health insurance policies, beginning in 2013, forcing individuals to purchase coverage through the federal government

Page 30 - Section 123 establishes a new board of federal bureaucrats (the "Health Benefits Advisory Committee") to dictate the health plans that all individuals must purchase-and would likely require all Americans to subsidize and purchase plans that cover any abortion

Page 74 - Sections 202(c) and (d) protects Members of Congress with existing federal employee coverage (as defined in Section 100(c)(6) on page 9) from joining the government-run health plan offered through the Exchange

Page 116 - Section 221 establishes a new government-run health plan that, according to non-partisan actuaries at the Lewin Group, would cause as many as 114 million Americans to lose their existing coverage

Page 139 - Section 245 includes language requiring verification of income for individuals wishing to receive federal health care subsidies under the bill-however, the bill includes no requirement for individuals to verify their citizenship or identity before receiving taxpayer-subsidized health benefits

Page 167 - Section 401 imposes a 2.5 percent tax on all individuals who do not purchase "bureaucrat-approved" health insurance-the tax would apply on individuals with incomes under $250,000, thus breaking a central promise of then-Senator Obama's presidential campaign

Page 183 - Section 412 imposes an 8 percent "tax on jobs" for firms that cannot afford to purchase "bureaucrat-approved" health coverage; according to an analysis by Harvard Professor Kate Baicker, such a tax would place millions "at substantial risk of unemployment"- with minority workers losing their jobs at twice the rate of their white counterparts

Page 197 - Section 441 imposes additional job-killing taxes, in the form of a half-trillion dollar "surcharge," more than half of which will hit small businesses; according to a model developed by President Obama's senior economic advisor, such taxes could cost up to 5.5 million jobs

Page 331 - Section 1161 cuts more than $150 billion from Medicare Advantage plans, potentially jeopardizing millions of seniors' existing coverage

Page 425 - Section 1233 makes end-of-life care consultations eligible for Medicare reimbursement

Page 501 - Section 1401 establishes a new Center for Comparative Effectiveness Research; the bill includes no provisions preventing the government-run health plan from using such research to deny access to life-saving treatments on cost grounds, similar to Britain's National Health Service, which denies patient treatments costing more than £35,000

Page 835 - Section 1802(b) includes provisions entitled "TAXES ON CERTAIN INSURANCE POLICIES" to fund comparative effectiveness research, breaking Speaker Pelosi's promise that "We will not be taxing [health] benefits in any bill that passes the House," and the President's promise not to raise taxes on families with incomes under $250,000.

6 comments:

Anonymous said...

Frank,

These talking points -- where'd you get them from? Who excerpted them? Who is the expert behind the synopsis of the bill?

Let me ask something more personal: Is someone other than yourself paying for your health care premiums? If so, who? And, what percentage of your income do you pay towards health care premiums? What is your deductible?

My premium went up from $690/mo to $810/mo at the beginning of 2009. That's 12-14% with a $1,000 deductible per person. I fully expect the premium to go up again. This is a good chunk of my monthly income towards coverage that is decent at best. I find it onerous.

I have friends who go without health insurance because it is too expensive to get a policy with a reasonable deductible (as in less than $5K per person). These are productive, responsible, tax-paying individuals.

Paying taxes, while not exactly my favorite past-time, is necessary in order to receive services. Right now I receive fewer services from any of the governments around me as fewer people can pay their taxes, property and otherwise. Schools are cutting back on programs. Not paying taxes means someone pays for you.

I tell the story of my friend's great uncle, who never had a social security card. Wasn't he a cowboy? Then, as he needed a nursing home, he got a social security card. When he could've paid in, he let someone else pay. Now that he needs help, someone is still paying and he's simply taking.

This system does not work. Putting everything into private hands is not the answer.

I cannot afford to be insured, and cannot afford to be uninsured. I think all options need to be on the table and open to discussion, NOT mob rule or the loudest voice. Calling people Nazis is strident, at best, and an insult to many in my family who died in ghettos and concentration camps. Putting up signs with Obama's face as Hitler's is insulting both to the man, the office and those who voted for him. It strikes me as racism of the ugliest kind, and it leads nowhere except to more hatred and one person with a grudge doing something incredibly stupid and destructive.

All I would ask is for everyone to step back, refrain from pre-judging outcomes and allow discussion to move forward. Please encourage your readers to believe the best in people, and exercise good judgment in their remarks and actions. Above all, treat those who see things differently as just that -- another point of view -- and refrain from name-calling, bigoted slurs and invocations of the Holocaust.

Frank Canzolino said...

I am retired, but not yet on Medicare or Social Security. I pay for my own healthcare insurance. The excerpts are from the bill, HR3200. The synopsis is from the Republican Conference staff.

The system is not free market, having onerous government control. Tort reform, ability to buy insurance across state lines, portability, allowing individuals and small businesses to pool resources are all common sense changes that would improve the healthcare system at little or no cost to the taxpayer.

After a couple of years of a program with these changes, we can reassess where we are and go from there in a thoughtful, logical manner. Anyone who thinks one-sixth of a multi-trillion dollar economy can be overhauled in the manner the liberals propose with this healthcare proposal is at best unrealistic.

Anonymous said...

Frank,

Republican Conference staffers can hardly be called non-partisan. There are any number of non-partisan groups taking a hard look at any number of bills floating around both houses of Congress. Why not trumpet their concerns and questions? Please provide us all with more information from the CBO or GAO or other sources such as these, as you seem to feel so passionately about this issue and want to inform others so they can take action.

This system we have certainly IS free-market, as my health insurer can decide to hike their rates without oversight from any agency. As there are precious few options out there for those who are self-employed, it would seem that health care insurance supply is inelastic, as is electricity supply and demand. We all NEED electricity, so changes to those rates are regulated in order for EVERYONE to have the opportunity to participate. Are you suggesting that there are some people who do not deserve to have electricity? Are there those who do not deserve health insurance? If so, who are they? (Let's leave illegal immigrants out of the equation, as there does not seem to be a credible debate about helping them out on either side of the aisle. If there is, it is a sideshow and a distraction).

Tort reform is necessary across the board, but I would suggest that it needs to be a two-sided agreement. I want doctors to be freed up from onerous (that nasty word again) medical malpractice insurance premiums, just as I want my medical insurance company (privately held) to give me a break on my premiums. I also want the right to go after irresponsible parties of any stripe (that means corporate entities, too) who break the law, put people at risk, and so forth. Tort reform, however, is NOT really germane to health care reform. It seems to be much larger than medical malpractice, and another hot-button issue muddying this debate on health care coverage for all.

Buying coverage across state lines and portability? States' rights is a hot-button issue for Republicans. Are you saying that each state should make its own laws, and then call on other states to work with them? Does that seem workable to you, even in the short-term? Which Republican is helping in that effort?

I would also find it helpful if you would tell your readers that liberals are not a monolithic mass of anonymous people; that espousing one point of view does not a liberal or conservative make; that there can be intelligent discussion and disagreement between progressives, evangelicals, libertarians, etc., and that there is no 'enemy' needing to be attacked.

Most of all, I would request that you ask others why they are crying about wanting their country back. I am curious to know why they feel the way they do, what incident(s) they can point to that spells out where things went wrong for them, and how they would like the country to be going forward.

Frank Canzolino said...

I never claimed that the comments are non-partisan. I invite you to read the referenced pages of HR3200 and draw your own conclusions. I have done so, and the interpretations given herein are also my interpretations.

I contend that the current system is not free market. The health insurance industry is tightly regulated by each state, and varies from state to state. A free market system is much more evident in the auto insurance industry, where consumers are free to shop around for coverage. Increased competition for healthcare insurance would drive prices down, at least I believe so.

States rights is really not an issue with auto insurance, why would it be an issue with healthcare coverage? The only reason would be a problem with legislators catering to special interests.

Tort reform would also help drive down costs. Reasonable awards via trial are certainly warranted in malpractice cases, but frivolous lawsuits and outrageous awards are a problem, causing increased premium costs which are passed to the consumer.

The current canard being proposed by liberals is that the healthcare system is broken, and conservatives hare at fault. Nonsense. There is plenty of blame to spread around, but polls show 70% are happy with their current plan. Another canard is 46 million people are without insurance. My breakdown shows that getting when eliminating illegals, and those who make over $75k who elect to not have insurance or do not take advantage of existing programs, the number is much less.

So it comes down to whether a $1 trillion program which will increase the the deficit $250 billion is cost effective to handle what is a much smaller problem than is being represented by politicians of all stripes, but primarily liberals. Conservatives would contend that it is prudent to institute measures that address a set of issues that maximizes the bang for the buck.

The President says that there re billions of dollars in fraud and waste in the current healthcare system. Why not do those first?

Anonymous said...

As an economics student, I have an opinion here that I can't let go unspoken despite the fact that I know quite well how much we need health care reform.

First of all, health care is a consumer commodity. It is not a right or just another optional consumer good. We need it in order to have a decent quality of life. The current players in the health care market are caught in a circle of inflationary pressure, having no incentive whatsoever to bring down costs. This isn't car insurance. Your car only costs as much as its blue book value to fix or replace, so risk is sharply limited. Your body, on the other hand, can cost millions to keep ticking if things go really wrong. What recourse do you have if the cost is too high for your taste? Death, basically. No, people who need care frequently don't have a choice and people who work in the profession, especially insurance, know this and exploit it to people's detriment.

What is in this plan that brings down cost? Realistically, nothing except the judgement of bureaucrats. Since I tend to look at most politicians and bureaucrats as being every bit as fallible and mistake prone as the rest of us, I don't think they will be able to smell every bit of fraud throughout the entire industry and fix it. If anything, the huge new layer of government that will be created to monitor everything will make the entire process more expensive, and although it might not be directly represented on your medicaid bill, it will come through in higher taxes or inflation, assuming the Fed can be convinced to devalue the currency in light of unsustainable budgets.

Meanwhile, the bill gives a tremendous amount of control over the market for healthcare to government. Namely, what constitutes adequate coverage is spelled out in the bill, and it includes things like drug treatment and mental health counseling that I'm quite sure I will never need. Also, the conflicts with my car insurance are now apparent: Does this mean we no longer have to pay for bodily injury coverage on our auto insurance? Or am I now legally required to double up on my protection for no reason?

The thing stinks. If I don't want coverage at all, I get hit with a new tax. Fine. If I own a business and I don't want the government plan, I get hit with a much bigger tax, and that's for companies with under $300,000 in payroll. Basically, if you hired more than ten people, you should read this carefully. It might hurt, especially if you run a business with tight margins and you don't provide coverage. I know what that will mean for employment. There's a tremendous level of access that the government is giving itself with this thing, too. Is this control really necessary and helpful? Because historically a bureaucracy that takes this kind of control over a huge population usually ends up hurting things more than helping.

It would be great if people took more personal responsibility for this kind of thing, learning more about medicine, taking better care of themselves, grouping together to manage co-ops and run hospitals on a local level to control costs. Something other than giving up personal control. Of course, that doesn't happen anymore. Now, the government has to step in to keep companies from fleecing people and to make decisions for an ignorant populace that's too self absorbed to understand that there are economic limits to what we can do and not do for them.

Will it pass? I hope not. Do we need something better that directly addresses the economic questions without defining what sufficient care is for everyone in this country? I think so. Are we smart enough to understand that as a nation? I doubt it. I have no idea what will happen, but this crap won't solve the problems, and will probably create new ones.

Frank Canzolino said...

Thanks to this latest reader for reinforcing my long held positions. The healthcare debate breaks down into a few basic categories:

Cost effectiveness
Government control of the economy
Individual rights

Our politicians and the media ill serve the American public by not exploring these issues with the seriousness they deserve.

It is up to we bloggers and their faithful readers to analyze these issues since the profession pundits are failing miserably.