ANALYZING THE CONGRESSIONAL THINKING MACHINE

ANALYZING THE CONGRESSIONAL THINKING MACHINE

What happens when you let lawyers’ reform health care?  We all know that the staff for each congressman must make sure that their boss remains electable. Since elections are very expensive, the congressman cannot offend a big contributor or deeply upset you the voting public.With  the   Senate hosting its 2074 page healthcare bill on the web, public scrutiny has begun.

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ANALYZING THE CONGRESSIONAL THINKING MACHINE

What happens when you let lawyers’ reform health care?  We all know that the staff for each congressman must make sure that their boss remains electable. Since elections are very expensive, the congressman cannot offend a big contributor or deeply upset you the voting public.  With  the   Senate hosting its 2074 page healthcare bill on the web, public scrutiny has begun.

It would be nice if we knew all the purposes and allegiances congressmen have.  Big business likes stability and predictability. Unpredictable financial solutions can hurt everyone.

Our legislators write our laws and levy taxes upon us. They have more effect on your life than our president or your governor. They are really accountable for their voting actions. Laws they pass benefit their sponsors, at our expense. We certainly have “the best government that money can buy”.

The healthcare bill proponents are companies, organizations, and individuals, who will benefit from the current healthcare reform. Their benefits will not take place for several years and they can get reelected in 2010 and 2012 before we notice.

The media act as cheerleaders for one side or the other, and will not tell us what our politicians are doing or which groups they are cuddling up to.

REPUBLICAN PLANS

Republicans plan to place a raft of amendments, showing their policy positions on a full range of issues, including issues that are not in the bill. All will fail.

The Democrats have been working for weeks on the bill in secret and are now pushing for an initial procedural votes within a couple days. Republicans want the courtesy to study the legislation, and deliberate how they should proceed. They feel that Congress must take the time to get this right.

AMA AND DOCTOR POLITICAL PAYOFFS

As a political payoff to the AMA, the Democrats have retained organized medicine as a supporter of Democratic health care reform legislation.

With arm twisting by the AMA and 127 national and state medical societies, the Democrats voted today to rewrite the controversial sustainable growth rate formula into Medicare, known as SGR, and eliminate a Medicare doctor pay cut of 21% from proposed cuts for next year.

Without this passage, the health industry said, they would not be able to back other reform initiatives. This bill, HR 3961, adds another $210 billion to the federal deficit according to the CBO. (This fix was put in a separate bill to avoid this additional deficit from showing in the reform bill.)   Thanks to this provision, the cost of the legislation now is over $1 trillion and adds another  $239 billion to the deficit.

The House Republicans had failed to introduce a substitute SGR bill that would have given physicians a 2% raise from 2010 through 2013.  They did not want to add to the federal deficit since it contained cost-saving reforms in the area of medical liability that would offset its price tag.

PUBLIC OPTION BACK IN BILL

The Senate bill includes a controversial public option, a government sponsored health plan that would compete with private plans.  Individual states could choose whether to make the government-sponsored plan available to their residents. The bill also calls for member owned co-op health plans.  If you don't obtain coverage will pay a penalty, but the government will subsidize low-income individuals and families.

If you own a business with more than 50 employees and do not offer coverage you must pay a penalty if the employees get government-subsidized coverage.  Small businesses would get tax credits toward their insurance premiums.
 
Many critics feel a government health plan would force private insurers out of business, leading to a federal takeover of healthcare.  Supporters of the public option feel that a government plan will make private insurers more competitive.

INSURANCE COVERAGE

Most Americans will be required to have insurance coverage, either through an employer, a government plan, or an individual policy--which could be purchased, by insurance marketplaces called exchanges.

With this new bill, employers will be charged $2500 per employee. There will be an excise tax on high premium insurance plans, and a 5% tax on elective cosmetic surgery. Spending cuts from Medicare of $491 billion are projected.

Once you transfer to the government option, you no longer have the ability to switch back to private insurance. The government does not have to show a profit unlike private companies.

ABORTION BACK IN THE SENATE BILL

Democratic leaders have alienated again abortion opponents with their new version of abortion health reform.  Although the bill says public option could not provide insurance for abortions, it allows the Sec. of Health and Human Services to determine that a payment plan for abortions that would not use federal money.

The bill contains an ambiguous provision that could bar any government run insurance plan or public option from providing abortion coverage. Page 118 of the bill authorizes the health secretary to require coverage of any and all abortions throughout the public option program. The Senate bill creates new tax supported subsidies to purchase private health plans that will cover abortion on demand.

No matter how hard they try to disguise abortion funding, it will still be federal government funding of abortion.  The abortion issue will come in the House-Senate conference where a final bill will be proposed.

NO ONE DENIED COVERAGE

Private insurers cannot deny coverage to individuals with pre-existing conditions for non-elderly legal residents, and must provide coverage for 94% of them. About 31 million people will be added to the bill.

Voters agree that a person who has cancer should get the medical care they need to save their life without being bankrupt or put into lifelong debt. To cover these people with pre-existing conditions, we have tragically layered that requirement onto insurance company saying that was part of a coherent scheme of pooling risk.

SENIORS MEDICARE ADVANTAGE CUTS

Medicare advantage will be drastically cut. The seniors love the Medicare advantage program because this private plan offers them many perks.

There is low copayment, comprehensive prescription drug, and coverage, even gym memberships. The downside is that many of these services are limited to certain doctors and hospitals.

The elderly can either participate in traditional Medicare administered by the government, or in Medicare advantage. The latter was subsidized as managed care plans administered by private insurance companies.

In 2003,  Congress wanted to make sure seniors and rural areas had access to a range of managed care plans.  So it agreed to pay health insurers more per person than it would cost if they were in a traditional Medicare plan. Today that gap is about 12%.

Higher premium subsidies have been a target for budget savings and cuts. The White House insists they are not cuts to Medicare and health care reform packages but others see it differently.

If the subsidy to Medicare advantage decreases, the plan will likely pass their increased costs to the people, resulting in higher premiums.  The house bill cuts $172 billion from the medical advantage plan and insurers will be paid the same amount now paid for traditional Medicare. As subsidies decrease, seniors living in rural areas, will have fewer Medicare advantage plans to choose from.

MANAGED CARE

The Senate bill blocks managed care plans from charging people more than traditional Medicare for services such as chemotherapy, renal dialysis, and skilled nursing care. Plans that offer superior quality of care and care coordination would be given bonuses. To obtain these bonuses, high quality plans would have to list high quality and improved quality plans.

Both Senate and House plans provide free preventive services. Both houses provide for reducing fraud and waste, which drives up Medicare costs.

HMOs generally require approval from a gatekeeper doctor's for many services. PPOs encourage patients to use providers in the network by imposing higher cost sharing for outside services.

COMMENTARY

After nine months of town hall meetings, numerous hearings, and CBO reports, the average Congressman has no idea what's within the thousands of pages of the health reform bill. They blindly will vote for it for political reasons.

As the Senate plan allows a public option, the government will subsidize it, and put the private insurance industry out of business.   As one gets older, Medicare will continue to be under-funded. And one would have to justify the cost of maintaining their medical care or be euthanized. Nurses and doctors will be forced into labor unions.

The Medicare part D. prescription drug bill denied the government the power to negotiate for the best drug prices. The drug industry, whose lobbyists wrote the bill, created huge budget problems and this new benefit was not funded. The prescription drug bill was a gift to the drug industry.  This bill will be a repeat performance with the AARP the big underwriters.

The Republicans have been constantly locked out from any input on this reform bill. President Obama promised bipartisanship during his campaign. Texas lowered their health costs by 20%, just by passing tort reform. Tort reform has been totally left out of the bill because the trial lawyers financially support the Democratic Party.

This health reform bill ensures health care costs will be 21% of the economy and costs will continue to go up. Obama said the current health-care of 16% was way too high. Yet Obama will declare it a victory. As this bill becomes law, we will realize that we will be worse off than we are now.

It would be nice to approach this reform and a slower more incremental manner. By prioritizing and fixing each problem one at a time, we would insure we don't take on more than we can effectively handle.

The relatively expensive Democratic health-care bill does not fix the fundamental problems with the current system. Why the rush to push this bill through so quickly dumbfounds me.

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