Health Care Reform: 8 Positive Changes

Unless you’ve been living in a cave, you know the health care reform debate has been long, loud and contentious. But now that it’s over, whatever side you were on, there are positives for your future health insurance in this reform. Although many of these changes won’t be happening until years after the final bill is signed into law, exploring them now might make those opposed to the bill feel better about it.

Start by watching the following news story, then meet me on the other side for more.

So let’s go over those eight points again, this time with a little more detail.

Positive change number one: Fewer uninsured Americans should lead to a lower-cost health care system.

The core of health care reform is helping (or forcing, depending on your point of view) 30+ million uninsured Americans to find coverage. This is a direct and obvious benefit to them, but it should ultimately benefit all Americans since heath care provided to those without the ability to pay is a huge burden that resonates across the system in the form of higher costs on health care and its primary funding source, insurance.

If you don’t understand what I mean by that, check out a story I produced called “Killer Hospital Bills.” It’s about an uninsured woman who went into a hospital ER with abdominal pain and emerged with a bill for $12,000. While the size of the bill was big, the real story was that the exact same services would have been billed to a Medicare patient at $4,000 and to an insured patient at $5,000. When I interviewed the hospital CFO and asked about the discrepancy, his response was that since so many uninsured patients don’t pay at all, they’re forced to charge those that can exorbitant prices to recoup their losses.

That explanation is certainly shocking if you’re the uninsured patient facing a bill three times larger than a Medicare patient’s for the same services. On the other hand, it’s hard to blame the hospital. A store that loses millions of dollars a year to shoplifters is faced with a simple choice: charge paying customers more to recoup those losses or go belly-up. Hospitals that take patients who can’t pay (and they have to by law if a medical situation is life-threatening) are faced with the same choice: either charge those who can pay more or close their doors. Hospitals can’t charge either Medicare or insured patients more because those rates are negotiated in advance. So that leaves them with only one choice: to charge those patients who can least afford it… those without insurance… a lot more money for the same services.

Bottom line? Even if you’re an American who has health insurance and who doesn’t care at all about those who don’t, you should still be seeking out some kind of solution to a health care system that is deathly ill. It’s important to attempt to reduce the ranks of the uninsured. Any law that lowers the number of people who can’t pay should theoretically save the entire health care system a lot of money, which in turn should reduce not just the overall cost of health care, but ultimately the health insurance premiums of every American.

In addition, adding 30 million people to the overall pool of those insured means spreading the risk and expense of health care over a wider group. Over time, that should also theoretically lower the cost of coverage for all of us.

But don’t expect benefits overnight. The provision helping some Americans pay for health insurance and forcing others to (if you don’t have coverage, you can be fined up to $2,085, or 2.5% of your income) largely take place in 2014. And even then, it will be years later before we see potentially positive effects. Why couldn’t we get this key reform to take place sooner? One reason is that this legislation requires states to establish what are called American Health Benefit Exchanges: insurance pools that hope to harness increased competition to help lower prices. And establishing these exchanges will take time. Another possible reason we have to wait years is the same reason the C.A.R.D. Act didn’t go into effect immediately (thus allowing banks to raise their rates prior to enactment), because industry lobbyists wanted it that way. As the banks did when faced with laws reining in credit card abuses, expect insurance companies to attempt to make as much as possible in the years before many of these provisions become law.

Positive change number two: No more caps on coverage.

Six months after the president signs this bill, insurance companies will no longer be able to cap your coverage, either annually or over your lifetime. This is a big change, and one you’ll be happy with should you ever develop an illness that requires big bucks to address. Prior to this reform, insurance companies routinely employed lifetime caps of one to three million dollars. Which means if you spent more than that over your lifetime, you’d lose your coverage and be forced to pay every bill yourself, a virtual guarantee that you’d be bankrupt shortly thereafter.

While removing these caps could increase insurance company risk and exposure, costs that might be passed through to policyholders in the form of higher rates, it may well keep you or those who love you from going bankrupt should you run out of insurance before you run out of disease.

Positive change number three: Insurance companies can no longer refuse coverage based on preexisting medical conditions.

If you have an illness like cancer or diabetes, today, insurance companies can simply refuse to insure you, or turn you away by charging so much in premiums there’s no way you can afford to pay. Health care reform did away with that, or at least it will in 2014. Children are an exception: Starting in September, children can’t be turned down because of preexisting conditions.

Positive change number four: Keeping kids on their parent’s policy longer.

Under the new law, dependent children up to 26 years old can remain covered under their parent’s policy; twenty-one was more the norm before. Keeping kids on a parental policy is normally cheaper than insuring kids individually, and unlike the numerous provisions that wait until 2014, this one goes into effect six months after the bill becomes law.

Positive change number five: More employers will be offering coverage.

The idea behind this bill is to get as many people as possible to have health insurance. For those with no or low income, that means expanding medicaid for some and offering subsidies to others to help them pay premiums. Households that earn up to 400% of the Federal Poverty Level of $22,050 will be eligible for some sort of assistance.

But when it comes to business, the government is employing both stick and carrot to encourage more to offer coverage. The stick: By 2014, employers with more than 50 employees must provide health insurance or pay a fine of $2,000 per worker each year if any worker receives federal subsidies to purchase health insurance. The carrot: While companies with fewer than 50 workers won’t face penalties if they don’t offer insurance, they can get tax credits if they do. For example, those with 25 or fewer employees and average annual worker pay of $40,000 can get tax credits of up to 35% of the cost of the premiums in 2010, rising to 50% in 2014. These tax credits are based on the size of the business and the average pay of their workers: the smallest companies with the lowest-paid workers will get the most tax credits.

Positive change number six: Free preventive health care.

Until health care reform, preventive care coverage… like annual physicals, for example… could be subject to deductible and co-pays. The new law says this type of care is going to be free: no co-pay, no out of pocket. The idea is that this will encourage people to stay in better shape, which should theoretically translate into big health problems and big bills being nipped in the bud.

Positive change number seven: A better appeals process.

It’s hard to understand the drive for things like health care reform if you’ve never been mistreated at the hands of an insurance company or done a story about someone who has. But take it from someone who’s been a consumer reporter for 20 years: There are insurance companies that deny coverage for no other apparent reason than they don’t feel like paying. Did you ever see the movie The Rainmaker? It features an insurance company whose policy includes systematically denying all claims. While I can’t say that’s a true story, I can definitely say that many insurance companies have acted in a manner that suggests they’re more interested in their profitability than the welfare of their policy holders.

Health care reform establishes a new, more independent and consumer-oriented appeals process. So if you do have a disputed claim, your odds of having it resolved fairly should increase.

Positive change number eight: Help for seniors.

Today’s Medicare patients have coverage for the first $2,700 they spend on drugs and for any amounts over $6,154. But they’re on their own for drug expenses in-between… known as the “doughnut hole”. Starting this year, Medicare recipients who fall in that hole will get $250, in 2011 they will get a 50% discount on brand-name drugs, and by 2020, the doughnut hole will be closed with 75% of drugs costs covered.

Eight positives: But what about the negatives?

We’ve seen the positives, or at least potential positives, in health care reform. But if that were all there were, your TV screen wouldn’t have been filled with protesters night after night these last few months. So what’s the beef? The first is cost. The argument? Just because something helps somebody doesn’t mean we can afford it.

Over the next 10 years the cost of this reform is expected to be just short of a trillion dollars. Where is it coming from?

  • Fees on drug companies and insurers.
  • An excise tax of 10% on overly generous health plans.
  • A 2.9% tax on the sale of medical devices.
  • A 3.8% tax hike in your Medicare payroll taxes and on your investment income if you make more than $250,000/yr.
  • Fees on employers who don’t offer required coverage.
  • Fees on people who don’t get mandated coverage.
  • A 10 percent excise tax on tanning salons.

According to the Congressional Budget Office, these sources of revenue more than offset the $940 billion cost of health care reform. Not a penny coming from any individual taxpayer other than those who don’t comply or those that are making more than $250,000/yr. Employers (especially large ones) will be forced to offer coverage and that could divert funds for other uses, like hiring more workers. So when it comes to cost, there’s definitely room for debate. Does the government actually have it right in terms of the money coming in and going out? Will the additional company expense crimp hiring? Won’t these fees just get passed along to consumers anyway, creating higher costs? Will medicare benefits be cut? Will Medicare reimbursement for doctors get reduced, causing some to leave the profession just as we need more to join it?

All good questions. But hardly the only ones. For example, is it constitutional to force a free people to buy health insurance from for-profit companies? Is it the obligation of those who work hard and buy health insurance to suffer any inconvenience at all to provide for those who don’t?

My personal opinion on health care reform doesn’t really matter, but if you want it, here it is. First, understand that I’m not a democrat, a republican, a tea-partier or an independent. I’m a consumer reporter, which means that my job is often about helping “the little people” battle infinitely more powerful and less-principled corporations.

Now that you know where I’m coming from, here’s my opinion: It’s an absolute disgrace for the most powerful and prosperous nation on earth to allow it’s citizens to go bankrupt simply because they get sick. And we’re the only prosperous country in the world that watches it happen to hundreds of thousands of it’s citizens of every race and economic status each and every year. That’s wrong, period. The health insurance industry needs reform.

Further recent evidence: My personal health insurance bill went up 40% this year. The CEO of the company that issued my policy, United Healthcare, received about 100 million dollars just last year. That’s enough to pay the $500 a month health insurance premiums for a full year for 17,500 people.

I’ll stop short of saying health care reform as passed is great or even acceptable. I honestly don’t know, and with the complexity of the issues involved, I can’t imagine how anyone else can either. But I am convinced of this: something needs to be done. So if you you’re one of the many who doesn’t agree with what was done, I’d love to hear your ideas on what should be done instead. As long as your idea isn’t “nothing.” Because I’m here to tell you, that wasn’t working.

To see what other bloggers think of the new law, a couple more links: Stew over at Gather Little by Little shares his thoughts on the recent healthcare legislation and Mark Riddix of Money Crashers further describes how the new health insurance laws affect you.

Note: the health care reform law is thousands of pages long. For a summary, see this 13-page publication from the Kaiser Family Foundation.

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  • Liv Christianson

    I'm thrilled we passed something, but I think we're underestimating the influence this will have on insurance premium costs. The insurance companies aren't just going to swallow the extra costs to them. A large percentage of the uninsured in America are people who theoretically could afford insurance, but choose not to purchase it. I don't see these people running out to get insurance, when the penalties are still far cheaper than the average premium costs. Why should they? With no more pre-existing conditions, they can run out and get insurance when they get sick. If there aren't a majority of healthy people paying, how will the insurance company balances out their extra costs. I think they'll hike our premiums. I'm also hearing that in reconciliation there are plans to stick it to doctors. I don't think that's helpful for our quality of health care.

  • bobmarrero

    I agree with you 100% and anything that need to be fixed later on can also be fixed.This has been a long time in waiting and it's about time. So what that people will have to pay when they do not want to.Who woul'n't want to get free health coverage? I't just don't exsist or not anymore it don't! In the long run people will look back and say why did we wail so long to do this! Thank you pres. Obama God bless America!

  • http://www.manymoneysavers.com/ Amy

    I hope these changes do indeed help us all out. For family members who don't have insurance/ or drug coverage the only thing they had was a discounted drug card and the free clinic(which provides limited care).
    I am concerned about forcing everyone to buy insurance. How will governement determine who makes too much to get financial assistance with payments? Guess we will just have to wait and see.

  • ginagash

    i have to say so far the health care reform sounds fine. my problem is i still don't know what it means for me. i was legally disabled and even started getting my social security this last year, but they told me i would have to wait 2 years before i am eligable for medicare. i believe that this is wrong, if they declare someone disabled and even give them disability i think they should be eligible for medicare right then especially since i can't even get medicaid because they say i draw too much on my disability. they told me i would have to have over $2,000 worth of medical and percription bills each month before i would be eligible for medicaid and i have to wait for 2 years before i can get medicaid. i'm only 30 years old and disabled have been told by my doctors that all i can hope for is to “manage” my pain (surgury isn't an option they said) and i'm sorry but i can't cover all my bills and medicine and doctor visits on $773 a month with out the help of my boyfriend. if it wasn't for him i don't know what i'd do.

  • http://yahoo.com/ john russell

    THE 250 DOLLARS FOR SENIORS ON MEDICARE, HOW ARE WE TO GET THAT/

  • Robert Jackman

    My email to ALL ^ Comments to you on your post and TV opinion

    This is Stacy Johnson of Money Talks on the Bama bill. He thinks it's great. He just came out of the liberal closet on the boob tube. He was on the boob tube news today exclaiming the great advantages to this bill. He's the guy that does the spots on ALL the major news network as Money Talks. Media's already promoting an increase for it. Sure, nothing serious is being exposed nor happening now or in the near future. All the fools will be fooled again. And then it'll be too late.

    30 Million uninsured will get coverage.

    Sure. Paid for by tax paying citizens who are also paying for their own coverage. With a MAJOR CUT IN MEDICARE MONEY. Like 500 Billion.

    No more caps on coverage.
    While removing these caps will increase insurance company risk and exposure, costs that will be passed through to policyholders in the form of higher rates, it may well keep you or those who love you from going bankrupt should you run out of insurance before you run out of disease.

    You use “might” YOU DO NOT USE “WON'T” That's because you know the word is WILL. You use “may well” instead of WILL because you know it “might NOT” Hedging and playing with words for those with STUPID printed across their forehead.

    Insurance companies can no longer refuse coverage based on preexisting medical conditions.
    Right. But they sure as hell CAN and WILL charge higher premiums.

    Keeping kids on their parent’s policy longer.
    26???? Who wants a 24, 25, 26 year old living at home? And if they are still in college at 21 they're already covered. If they're NOT in school why aren't they out with their own job getting their own insurance. If not out at least with their own job and ins. Where have you been hiding? Family coverage premiums are higher. OR cost for this will come from working and retired taxpayers whether they are the parents or not.

    Free preventative health care.

    FREE? Besides your lowest cost example of annual physical there are other “preventative” MAMMAGRAMS, COLONOSTPY (sp?), ETC., ETC., Nothing's FREE. Working and Retired taxpayers will pay for this.

    Help for seniors.
    First of all this is Medicare Part D for which an additional premium has to be paid. It's NOT FREE. The donut hole is $3454. Over $2700 your'e on your own out of pocket until you reach $6154. God forbid husband AND wife are on serious medication. $250. Rebate. Big Deal. With the cost of drugs this won't touch the actual expense. 50% discount next year on BRAND NAME DRUGS. WOW BRAND NAME will still cost more than generic. The percentage retail markup is outrageous. Then in 2020, the donut hole will be closed with 75% of drugs costs covered. Huh? 75% covered and drug hole of $3454 closed? What kind of math is that? Oh, CBO math Stacy!!!!!!!!!!!!!

    Eight positives: But at what cost?

    When I’ve encountered people vehemently opposed to health care reform, it’s usually for one of three reasons. The first and most common is that they don’t really have a clue just what it’s about and are simply parroting some specious nonsense they’ve recently heard on a talk show.

    This is a BS Smart Ass Wise Guy condescending remark

    The second is that they feel a free people shouldn’t be forced to buy health insurance or anything else. I agree. In my opinion, if a society has collectively decided that it’s immoral to let its poorer citizens get sick and die in the streets, the solution isn’t to subsidize insurance for the poor and force the rest to buy private health insurance from for-profit companies. The solution is for the government to supply health care, just as most developed countries in the world do and ours does for its citizens 65 and older.

    But that's what this does. Subsidizes insurance for the 30 million at taxpayers expense. Most developed countries? Name them! Talking about Canada and England? It's socialism and it doesn't work there. Our GOVERNMENT DOESN'T supply health care for citizens 65 and older. I am 70 and my wife will be 69. First, there's a reason for supplemental ins. which is another problem. Medicare AND supplemental ins is a constant fight. WE PAY A MONTHLY PREMIUM FOR “GOVERNMENT” INSURANCE. IT'S NOT AN OPTION. THERE'S A PRIVATE COMPANY WHO ADMINISTERS IT. I'M SURE THEY DON'T DO IT FOR NOTHING. WE ALSO PAY A MONTHLY PREMIUM FOR SUPPLEMENTAL INSURANCE.

    But since we have a rabid minority who insist that government-run health care is tantamount to communism, this apparently isn’t an option today. So the next best choice is passing a law that makes private health insurance available to all so that those with preexisting medical conditions or those who are either too poor, greedy or uniformed to purchase insurance for themselves don’t become a financial drain on the rest of society.

    Rabid Minority. Not just a minority. But a RABID one? Greedy? Uninformed? Boy, you're pretty free with the insults hiding behind a TV Camera or a Web site. Up close and personal could get you a wall to wall counseling and a lesson in manners.

    The third common reason for opposition to health care reform is cost. A legitimate concern. Over the next 10 years the cost of this reform is expected to be just short of a trillion dollars. Way cheaper than the Iraq war, but still a lot of money. Where is it coming from?

    Way cheaper than the Iraq war? You are a wise guy smart ass. Smart ass remarks like this having nothing to do with the cost of this abortion exposes your left wing liberal position. The logos for all the major networks are on your web site. Your Money Talks piece is on all of them. That means you get paid for all of them. Care to divulge your income. I'm betting you will NEVER have to worry about this abortion of a bill. I'm betting you're independantly wealthy and travel in the company of the likes of Moore, Soros, et al. Your using your position to voice your left wing liberal position and you even say so on your site inviting somebody to challenge you. Well here's the way it going to go. Most everybody don't know what you're like. So we will spread you around the internet with your position and smart mouth and let's see how many will be interested in “Money Talks” advice.

    Fees on drug companies and insurers.
    Which will be passed on to the consumer.
    An excise tax of 10% on overly generous health plans.
    Punish them for providing better coverage than the government.
    A 2.9% tax on the sale of medical devices.
    Right. Another tax or additional sales tax, depending what state you live in, on the taxpaying citizen.
    A 3.8% tax hike in your Medicare payroll taxes and on your investment income if you make more than $250,000/yr.
    A tax increase on the working citizen and punishment for wisely investing to make money if you make money.
    Fees on employers who don’t offer required coverage.
    No. This bill says FINE not FEES.
    Fees on people who don’t get mandated coverage.
    No. This bill say FINE not FEES
    A 10 percent excise tax on tanning salons.
    This just went into effect. Have you got any idea what the equipment costs? The bulbs are outrageous and far from lifetime.
    Tanning salons are SMALL BUSINESSES owned by Small Business Owners. Yep, hit them over the head more.
    According to the Congressional Budget Office, these sources of revenue more than offset the $940 billion cost of health care reform. Not a penny coming from any individual taxpayer other than those who don’t comply or those that are making more than $250,000/yr. Granted, employers (especially large ones) will be forced to offer coverage and that could divert funds for other uses, like hiring more workers. But all in all, I just don’t see what the hubbub is about. These changes appear to benefit the poor and sick among us as well as society at large. The costs are largely borne by those who profit most from health care: drug companies, medical device companies and insurance companies.

    Quoting the CBO figures after the numbers have been cooked is an outright lie. Not a penny coming from any individual taxpayer other than… If you're not smoking anything and you are allegedly smart enough to give Money advise than you ARE AN OUTRIGHT LIER AND PAWN FOR THE LEFT WING LIBERAL SOCIALISTS WE ARE DEALING WITH. BRAINWASHED? NO. PUPPET? NO. FOLLOWER AND SPOKESMAN? YES!!!!!!!!!!!!!!!

    Other than waiting years for the positive changes to take effect, what’s not to like?

    IT IS YEARS FOR THIS BILL. NOTHING SERIOUS BEFORE 2013. HEY, 2012 IS RE ELECTION TIME!!!! IN FACT THE MAJOR COSTS AND CHANGES START TOWARDS 2020.

    P.S. Your vanity picture on your web site is WAY OUTDATED!!!!!!

    If you think I’m missing something, or am just a brainwashed, left-wing media puppet, kindly explain below where I’ve missed the mark.

  • ConcernedTexan

    Thanks Robert for taking the time to debate or correct Stacy's article. You are exactly right. What these people don't understand, is this bill will break the backs of tax paying citizens. If they believe that the money will continue coming in to cover all of these insurance plans for those who can't afford it, they're crazy. What we are really fighting is Obama turning us into a socialist government, or worse. We have to continue fighting this and educating those who have been scammed by ObamaCare. They don't even know what these new Gov't insurance plans will cover or not.

  • Bobby Segars

    If you think I'm missing something, or am just a brainwashed, left-wing media puppet, kindly explain below where I've missed the mark.

    Gladly,
    1. $12,000 for uninsured, $4,000 for Medicare and $5,000 for insured, but you failed to find out what the cost to the hospital is? That information is critical. I would expect that hospitals lose money on Medicare patients too. Therefore it may not only be the people who absolutely cannot afford care that are forcing higher costs for the rest of us. It is the government program that supposedly provides care for the majority of the consumers of health care (i.e. seniors). Why don’t you find out what the losses that hospitals incur for caring for Medicare patients and compare that to those who cannot pay their bill? I’d be willing to bet the former dwarfs the latter. Also, please explain to me how the people who cannot afford their care now are going to be contributing to the system once they are “insured” but that insurance is subsidized by the rest of us…seriously, their still not paying into the system b/c we just established that they can’t afford it!
    2. No more caps: I think I just blew your savings from 1 out of the water, but in case I didn’t convince you, this and #3 should be more than enough to cancel out any imaginary cost savings from #1. I do think insurance companies should offer no cap insurance, but a cost-benefit analysis must be done by the insurance buyer to determine if it’s worth it to pay for the extra peace of mind. It will HAVE to cost more.
    3. No more pre-existing conditions: Again, I think I just blew your savings from 1 out of the water, but in case I didn’t convince you, this and #2 should be more that enough to cancel out any imaginary cost savings from #1. How are pre-existing conditions any different than the carrot you so proudly explain in #5? It provides incentive for people to purchase insurance BEFORE they get sick. Insurance is a pooling of risk, not a Christmas club savings account where you’re just trying to budget your costs over time. If you don’t understand this concept I suggest you stop writing articles about insurance companies.
    4. Covering until children are 26: Well if there’s anything we need to do to create an independent, capable, autonomous next generation, it’s coddle them for longer periods of time.
    5. Employers: The funny thing about this whole debate is that I believe the reason so few people are happy with their insurance is that it is provided by their employer. If you’re insurance company mistreats you, it costs too much to just drop them in favor for another company b/c your employer is footing some of the bill. It’s expensive to switch b/c more than likely your employer isn’t going to put the difference of opting out of their plan in your pay.
    6. While this should provide for a healthier population, to argue that it will reduce cost is absurd. Obviously a primary care doctor’s time isn’t worth anything. More people coming in for every little ache and pain will more than offset any savings from the 1 in 10,000 whose ache and pain is something serious…just a guess on the ratio.
    7. Finally we agree on something. If you sell insurance, you need to pay out when legitimate claims are filed.
    8. Medicare is complicated. These folks paid in most of their lives and should get the benefits they deserve. I just wish they had provided for a personal account where each person has built up a fixed amount of money and they can spend it like they want, but when it’s gone, it’s gone and if they don’t spend it, it can be passed on to heirs. This way it cannot be borrowed against by politicians and provides a mechanism for market forces of supply and demand to work. Before you think I’m too cruel, we do have the Medicaid safety net to catch those who, for reasons beyond their control, end up exhausting their funds and savings on medical expenses.

    Finally, “According to the Congressional Budget Office, these sources of revenue more than offset the $940 billion cost of health care reform. Not a penny of it comes from any individual taxpayer other than those who don't comply or those who make more than $250,000 a year.“ With all due respect, you can’t be that ignorant. It will cost us. Whether it is in the form of inflation, higher interest rates, a slower economy, dying b/c of excessive wait times or some other hidden cost, the bill for this will most certainly be paid by more people than that.

  • Bobby Segars

    Sorry for the gramatical errors. :0(

  • jtd

    You’re full of shit. You have made way too many rosey assumptions. The fact of the matter is, you don’t know what affects this legislation will have on individuals anymore than anyone else.

  • http://www.politicalamorality.com/ Kevin

    You're thrilled we passed something that has the potential to bankrupt the country like similar legislation is bankrupting Massachusetts?

  • http://www.politicalamorality.com/ Kevin @ Political Amorality

    The government isn't going to save you. I would suggest looking elsewhere.

    If the government hadn't of screwed up the insurance industry and skyrocketed health care costs since World War 1, you'd probably be able to find a doctor that would treat you on a sliding scale paying cash for cheap care.

    But that's not a possibility now that the government has driven everyone onto 3rd party payer systems, locked you into the Social Security ponzi scheme, and is now denying you access to the bankrupt Medicare system (I thought rationing wasn't a possibility…hmm.).

    What's going to suck is when the government is the only option. Then who do we cry to? I guess that's called “shit out of luck.”

  • http://www.politicalamorality.com/ Kevin @ Political Amorality

    26,000 new IRS agents should solve that. I wonder if they'll be armed? I guess we'll find out. Nancy said we had to pass the bill to find out what's in it. I guess we should just trust her.

  • http://www.politicalamorality.com/ Kevin @ Political Amorality

    Was that English?

  • mjl9280

    I thought I’d take a moment and comment on your article, point by point:
    1) There is no proof that insuring more people will lead to lower costs. Even in the example you cited of the uninsured person going to the emergency room, this is a wide spread falsehood. Here’s another way to think about it. If in any given month, 3,000 patients show up in the emergency room and 1,000 each have Medicare or private insurance. The remaining 1,000 have no insurance. If all things are held equal, the cost for treating all of these people is a number, probably a very large number. The first two groups (insured) pay the hospital. In the third group, some people pay and some don’t (apparently 1 out of 3 pay, which explains the multiples in cost variation). However, the cost for treating these 1,000 people is collected; otherwise, the hospital would go broke. Of the 1,000 uninsured, 300 pay their bill. The much higher price tag on the service covers the 700 that aren’t paying their bills (or can’t). The point is no medical costs are reduced. The costs are spread to the insurance company. When this happens, insurance premiums will increase.
    2) “costs that might be passed through to policyholders in the form of higher rates” You’re kidding, right? The insurance companies are absolutely going to increase premiums. Where do you think they get the money to pay claims? Why are you sugar-coating this? I know you needed eight positives, but seriously, how stupid do you think your readers are?
    3) Of course, this will also lead to higher premiums. Insurance companies are businesses, and they expect to make a profit. You should be happy they make a profit. If they didn’t, they would be unable to pay your medical claims.
    4) “Keeping kids on a parent's policy is normally cheaper than insuring kids individually” Have you given any thought to why this is true? The assumptions here is that they are living with their parents or are in college, both of which are controlled environments compared to living on your own. Additionally, the age component figures into the risk assessment. Try not to be surprised when every child’s insurance premium increases. There are not going to be any “free rides” as a result of this bill.
    5) “More employers will be offering coverage” This, of course, is relative. Have you any idea how many employers have less than 50 employees? Approximately 5,800,000 with approximately 35,000,000. These people will most likely continue to be uninsured. And a tax credit of 35% is not enough to offset the cost of the insurance. Most businesses can’t be concerned with the “morality” issue of providing insurance to their employees until after they make a profit. Again, without money how will the premiums be paid?
    6) Everyone, including me, hopes that preventative treatment will reduce costs by “nipping it in the bud.” However, do you really believe most of our healthcare issues are the result of too few tests and doctor’s visits? You’re deluding yourself and your audience. Start with a proper diet and exercise, a reduction in smoking and alcohol consumption, and then I know you’re serious. Go interview a doctor (more than one) and see how many patients he/she has that smoke. Ask if the doctor instructs the patient to quit. Ask how many patients then quit. This bill doesn’t fix any of the underlying problems in healthcare. And while it may be true that physicals and such will help, it won’t be the panacea you think.
    7) “While I can't say that it's a true story, I can definitely say that many insurance companies have acted in a manner that suggests they're more interested in their profitability than the welfare of their policyholders.” Why say this without some proof? Actually, you’re correct. Insurance companies are businesses. In order for any business to exist, there has to be a need for the service, a market, and there has to be a way to deliver the service or product profitably. So, first and foremost, insurance companies have to be concerned about their profits. Without profits there would be no shareholders. The stock’s value would plummet and there would be no investors. More importantly, if the insurance company doesn’t make a profit, how in God’s name do you expect them to pay to pay claims? There is no magic to money, either you have it or you don’t.
    8) Starting this year, Medicare recipients who fall in that hole will get $250, in 2011 they will get a 50% discount on brand-name drugs, and by 2020, the doughnut hole will be closed, with 75% of drugs costs covered. The donut hole fix is probably a good thing. Although, I’m not convinced $250 is as big a deal as some would have us believe. This 50% discount in drugs thing is more nonsense. Prices will be adjusted elsewhere (non-senior patients) to compensate for the lost revenue. Again, drug companies are businesses and they have to make a profit.

    As for your reasons that people are opposed:
    1) simply parroting some specious nonsense they've recently heard on a talk show. I’m not seeing how your article is any different. Your facts aren’t substantiated (and some of them could have been). Your reasoning isn’t well thought out. In many instances you ignore what real world behaviors.
    2) The solution is for the government to supply health care, just as most developed countries in the world do and ours does for its citizens 65 and older. I’m not sure “most developed countries” provide health care to their population. First, try defining what a developed country looks like today. When you do that, your argument isn’t helped. For instance, are Brazil, Argentina and Mexico considered developed? I’m not aware of socialized medicine being provided. Now consider China, India, and Russia, some of the largest populations in the world. I’m reasonably sure they’re considered developed; however, I don’t remember socialized medicine being high on their list of priorities. Whereas it is true that Canada, Britain and a lot of European countries have public healthcare, I don’t think you’re entirely accurate by stating that “most developed countries…” In fact, those countries in the aggregate don’t even make up the majority of the world’s population.
    3) The third common reason for opposition to health care reform is cost, a legitimate concern. Over the next 10 years, the cost of this reform is expected to be just short of a trillion dollars. That's way cheaper than the Iraq war, but still a lot of money. Where is it coming from?
    • Fees on drug companies and insurers.
    • An excise tax of 10% on overly generous health plans.
    • A 2.9% tax on the sale of medical devices.
    • A 3.8% tax hike in your Medicare payroll taxes and on your investment income if you make more than $250,000 a year.
    • Fees on employers who don't offer required coverage.
    • Fees on people who don't get mandated coverage.
    • A 10% excise tax on tanning salons.
    According to the Congressional Budget Office, these sources of revenue more than offset the $940 billion cost of health care reform. First, what most Americans, me included, would say to your comment about the Iraq war is this, “Two wrongs don’t make a right.” Even if I agree with you that we shouldn’t be in Iraq, that doesn’t justify the additional expense of healthcare reform. If your argument is “remove Iraq and we could have healthcare reform without spending any additional money” that’s a nonstarter. Remove funding for Medicare, or welfare, or schools, or roads, or etc. Anyway, you see the point.
    As for the bill being funded with that list of fees, you’re joking. How is it that 10 years of additional taxes to pay for six years of service became fully funded? Only in the US Congress is that possible. In the real world, it would be 10 for 10 or 6 for 6. And what are we going to do in the second decade? Suspend the program for the first 4 years? And now, here’s another consideration for you. What happens if everyone does the right thing and none of the penalty fees are collected? What happens if the medical device market’s revenue decreases (decreasing the tax revenue)? What happens if investment income stays low (didn’t the market just crash last year)? People that don’t get insurance are going to pay a fee (if they don’t, then what, put them in jail? Hold their tax refund checks? Good luck with that). The fact is this bill will be overspent in its first 10 years. You and all the liberals in Congress are counting on the fact that nothing can be done about it.
    And finally, as for the idea that we will save $140 billion because of this bill, that is simply nonsense. You cannot add 40 million people to the program and save money without rationing services, lowering the quality of those services, reducing the payouts to doctors, hospitals and drug companies. When you attempt to do this, they will respond predictably—as a business—to cut costs by reducing services or product quality. And when that can’t be done, they will simply turn patients away. I’ve heard “rumors” of doctors already turning away Medicare and Medicaid patients.

  • kevin

    Do you think that “drug companies, medical device companies and insurance companies” aren't going to pass on these costs that you insist they will bare? Of course, the insurance companies are going to benefit by having 30 million more people added to their roles that we other, insured taxpayers will pay for.

    Also, what about : “A 3.8% tax hike in your Medicare payroll taxes”…isn't that more than “Not a penny coming from any individual taxpayer”?

  • herbansan

    It's about time a country as great as ours finally taking care of the people. If we can pay for two wars with tax payer money, we can pay for healthcare for it's citizens.

  • http://www.politicalamorality.com/ Kevin @ Political Amorality

    1. Spending one place doesn't justify spending another place. War is an actual function of government; mandating that people buy insurance and subsidizing the millions who can't pay for it is not. But just so you know, this plan costs more in one year than both wars did over 9 years. Either you're terrible at Math or you don't know what you're talking about.

    2. The government's job is not to take care of you.

    3. The government can't take care of you without enslaving you. Let's all take care of ourselves and our neighbors and we don't need the Imperial Federal Government trampling all over us in the name of “helping” us.

  • Rescueman

    Just reading your reply (or trying to) explains why this country is in the shape it's in! Thanks for helping us better understand how we got here.

  • bobmarrero

    No problem It's good to get some feed back? or at least a half responds?