Thursday, October 8, 2009

The Big Con

Excuse me, but I have some reservations and a bunch of questions about the various healthcare reform bills both houses of Congress could vote on as early as this month.

The biggest concern I have is why we taxpayers are subsidizing the private carriers to insure us. The bills are aimed at guaranteeing growing private insurance profits without regard to improving our health. Oh, there are a few caveats thrown in to eliminate companies from dumping us because of pre-exiting conditions and a bunch of other measures to right a wrong by the privateers.

But I have seen nothing in the proposed bills to force the insurance companies to be more competitive in their implementation of premiums and copays. Although politically improbable, a Medicare-for-all program is the only fiscal solution to force competition. Stop the subsidies and invest the money in a single-payer or government-option system in which enrollment is voluntary.

I'm not buying Republican criticism that the government cannot run anything efficiently and point to the U.S. Postal Service and Amtrack as examples. They say Medicare is going broke and MediCaid is blowing states' budgets. True but fixable. These are two of the highest risk demographics susceptible to demands on keeping Americans alive and well. Adjust Medicare's $96 per month premiums for all to a cost based on the individual's income. That's a starter.

Unfortunately, MediCaid recipients must be paid by tax dollars if they qualify on the lowest rung of the income ladder. In California, that's about $10,000 a year for a single person. Missing that criteria, Californians in Medi-Cal must pay $540/mo for catastrophic coverage which dooms each and every one to death. Those were the figures the state notified me when I re-certified for Medi-Cal last month. Under the current system, the feds subsidize Health Net, my private carrier, 100% with minimal copays for drugs and none for medical costs.

If you listened with earnest the one-hour special comments on our health care system by Keith Olbermann on his MSNBC Countdown show Wednesday night, you heard a similar pitch for a one-system payer or Medicare-for-all as well as a plug for free medical clinics for the impoverished. For the most part, I was disappointed although his personal confrontation with the system involving his father was poignant.

There seems to be a universal assumption by liberals that every senior cherishes Medicare despite its warts. I belong to that group because without it I would be dead. But, I don't consider myself an idiot when I hear our president claim more than $500 billion can be saved from Medicare fraud and waste. If that is true, why didn't Medicare fix the problem years ago?

The proposed healthcare legislation received a double boost Wednesday when the Congressional Budget Office issued a report that the Senate Finance bill under chairman Max Baucus would meet the president's goal that any legislation be deficit neutral. At the same time an AP-GfK poll indicated rising approval ratings for healthcare legislation now split at 40-40 compared to 49% who opposed it last month.

The report, according to the New York Times, said 25 million of the 48 million uninsured -- about one-third of them illegal immigrants -- would not be covered although Americans under age 65 with insurance would increase from 83% to 94% in 10 years. Here's a partial analysis by The Times:

In its analysis of the Senate Finance Committee bill, the budget office said a proposed expansion of Medicaid would add $345 billion to federal spending over the next 10 years. State Medicaid spending would rise by $33 billion, as 14 million people would be added to the Medicaid rolls.

The other big federal cost would be subsidies totaling $461 billion over 10 years, to help low- and middle-income people buy insurance from private carriers.

The budget office said a proposed tax on high-cost insurance policies would raise $201 billion over 10 years. Penalties paid by people who go without insurance would total $4 billion over 10 years, far less than the $20 billion expected under Baucus’s original proposal. Employers who did not provide health benefits would pay $23 billion in penalties, down from the $27 billion previously estimated.

Baucus’s bill would create a Medicare commission, with power to make cutbacks in the program, unless blocked by subsequent legislative action. The budget office said the commission would save $22 billion over 10 years.

I have a premonition advanced by Chris Mathews of MSNBC's Hardball show that President Barack Obama will finally exert his muscle and arm-twist reluctant Democrats and a few Republican Senators to support the final bill as it comes out of a joint conference committee.

Public option or not, that bill looms as a boondoggle keeping the private insurance carriers in charge of our health system and that fact in itself produces a death rattle in the throats of the American public.

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