Saturday, August 15, 2009

Key Points in Health Care

Listening to Democrats on the Sunday talk shows it seems clear that they are actually backing away from the "public option." A Democrat in the Senate said that there never was the votes and there aren't the votes now. I cannot tell you how relieved that makes me. It was literally like a big rock lifted from my heart. If this reform goes through without the public option, then it will truly be the people's voices were heard. It will be amazing that the Democrats have all the power and this historical well liked President, and yet the people's desires will have WON. And this will have happened over the demonizing by Democrat leaders of the American people who dared to protest. Harry Reid recently called us "evilmongers." Pelosi said we carried "swastikas." It's beyond surreal that they thought insulting the American people was going to work. And it didn't.

Keith Hennessey,former Assistant to the U.S. President for Economic Policy and Director of the U.S. National Economic Council, has put together a memorandum that looks at what Obama said at this heath care townhall and debates some points that Obama made at the townhall. I thought it would be informative to go over some key points.

I'm going to try to whittle down some of it for you.

1) THE PRESIDENT: Under the reform we're proposing, if you like your doctor, you can keep you doctor. If you like your health care plan, you can keep your health care plan.

And yet here is what the CBO said about the House Bill:

CBO: In addition, CBO and the JCT staff estimate that nearly 6 million other people who would be covered by an employment-based plan under current law would not have such coverage under the proposal. That figure includes part-time employees, who coudl receive subsidies via an exchange even though they have an employer's offer of coverage, and about 3 million people who would not have an employer's offer of coverage under the proposal. Firms that would chose not to offer coverage as a resul of the proposal would tend to be smaller employers and those that predominantly employ lower-wage workers-people who would be eligible for subsidies thought exchanges also would not have coverage available though their employers. Whether those changes in coverage would represent the dropping of existing coverage of a lack of offers of new coverage is difficult to determine. (page 5)

So basically Obama is overpromising, and it's simply not true that everyone can keep the health care they like.

2) THE PRESIDENT: You will not be waiting in lines. This is not about putting the government in charge of your health insurance.

Keith Hennessey: And yet section 3103 of the Senate HELP Committee bill would give the Secretary of Health and Human Services authority to appoint a Medical Advisory Council that would determine what items and services are "essential" for a "qualified health plan," and by implication, which benefits are not essential. The House bill is parallel but less specific, creating an "independent public/private advisory committee." in which the members are chosen by the government.

So in reality government officials ( or people appointed by them) will determine benefit packages, co-payments and deductibles, premiums, plan expenses, and profits.

If that's not putting the government in charge of your health insurance, I don't know what is.

And pray tell how the President knows there will be no waiting lines?? With 47 million more people suddenly insured, you don't think the lines will be long?

THE PRESIDENT: And finally--this is important--we will require insurance companies to cover routine checkups and preventive care, like mammograms and colonoscopies...(later) And I would like to see a mental health component as part of a package that people are covered under, under our plan.

So the government will REQUIRE that all insurance companies cover these things and we are still suppose to believe that the government is not in charge of our health insurance? A little honesty here would be nice.

THE PRESIDENT: ...because there's no reason we shouldn't be catching disease like breast cancer and prostate cancer on the front end. That makes sense, it saves lives; it also saves money-and we need to save money in this health care system.

CBO: Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, and not lower, medical speading overall.

In other words, it's fine and good to say we need to catch cancer and other diseases early on, but it's simply not true to claim it will save money. It will not. It will increase the medical spending. Mainly because expanding preventive care for everyone, will cost much more than the few it catches early to save more expensive care.

CBO: Judging the overall effect on medical spending requires analysts to calculate not just the savings from the relatively few individuals who would avoid more expensive treatment later, but also the costs for the many who would make greater use of preventive care.

This is probably the President's biggest falsehood:

THE PRESIDENT: And we will do this without adding to our deficit over the next decade, largely by cutting out the waste and insurance company giveaways in Medicare that aren't making our seniors healthier. (later) First of all, I said I won't sign a bill that adds to the deficit or the national debt. Okay? So this will have to be paid for.

*CBO says the House bill would increase federal deficits by $239 billion over the next ten years.

*CBO says the House bill would increase the deficit in 2019 by 65 billion, meaning the bill fails the President's "10th year test."

*CBO says the House bill would result in increasing deficits beyond 2019, because the ndew spending would grow faster than 8% a year, while offsets would grow only about 5% per years.

*THe House bill would not just slow Medicare growth, but would also raise taxes on high income individuals and small business owners.

THE PRESIDENT: We have AARP on board because they know this is a good deal for our seniors.

Simply untrue. The AARP has not endorsed any bill.

THE PRESIDENT: And so I do think it's important for particularly seniors who currently receive Medicare to understand that if we're able to get something right like Medicare, then there should be a little more confidence that maybe the government can have a role-not the dominiat role, but a role-in making sure the people are treated fairly when it comes to insurance.

Keith: But Medicare is fiscally unsustainable. The President already said that in an earlier discussion. So Medicare is not a successful model for a new system, because we can't afford it.

THE PRESIDENT: I don't have to explain to you that nearly 46 million American don't have health insurance coverage today. In the wealthiest nation on Earth, 46 million of our fellow citizesn have not coverage. They are just vulnerable. If something happens, they go bankrupt, or they don't get the care theyneed.

The Truth about those 45.6 million people:

*6.4 million are enrolled in Medicaid or SCHIP and just gve the Census taker the wrong answer. This is called the Medicaid undercount.
*Another 4.3 million are eligible for Medicaid or SCHIP and have not enrolled. If they need care, the hospital generally enrolls them.
*Another 9.3 million are non-citizens.
*Another 10.1 million have income more than three times the poverty line. They chose not buy insurance
*Leaving about 15.6 million remaining uninsured of whom about 5 million are childless adults.

In a country with 305 million people and only a little over 15 million truly uninsured, I think we can find a way to insure them and require the others to insure themselves without radically changing our healthcare system.