Obama's War On Healthcare

With the passage of a health care bill through the House this week, we are moving closer than we ever have to massive health care reform in this country. However, the reality of this bill is that it will not only become a back door to the socialization of health care in the United States, but it will leave the entire American public on the hook to pay for it, especially the “rich” and the elderly. It is a massive trillion dollar package that will threaten to destroy our economy and quality health care as we know it.

The statistic that is constantly thrown around by proponents of this package is that there are 47 million uninsured people in the United States. Sounds like a lot doesn’t it? Well, the truth is there are very good reasons why there are that many uninsured. According the U.S. Department of Health and Human Services, 27% of the uninsured have incomes that are greater than 300% of the poverty line. These people should usually find insurance affordable. However, for whatever reason, they chose not to have it. Furthermore, 21% of the uninsured are illegal immigrants. These people have already broken the law just by being here, so it is unreasonable to think that the American people should have to pay for them. There is also a certain segment of the uninsured that qualify for assistance programs, however, they are just not signed up. So, the number of 47 million is really a large overestimation. See the report here.

The 1,018 page bill that Democrats pushed through the week includes a variety of changes. The largest of these is arguably a government health insurance plan that is apparently needed to “compete” with private insurers. First of all, since when have we needed the government to stimulate competition? The reality of this provision is that it is intended to eventually convert everyone onto the public option and create a single payer system. Don’t believe this is the case? A report on Investor’s Business Daily found that on page 16 of this bill, there is a provision making individual private insurance illegal in some instances. For example, those who currently have private insurance will not be able to change it. Also, if one chooses to leave their current job to work for themselves, they will not be allowed to buy a private plan. See the article here. It is estimated by the U.S. National Institute of Health that about one fifth of the population experiences a change in their insurance every year. So, by this standard, it wouldn’t take more than 5 or 6 years before we would all be enrolled in the public option, effectively socialized medicine.

This plan would be a disaster for the economy, healthcare providers, and patients. In the current economic environment, it would not seem prudent to pass a trillion dollar package that will be paid for by increased taxes. It is pure common sense that increasing taxes in a recession is counterproductive. About half of the bill will be paid for by increasing taxes on households making more than $350,000, $500,000, and $1,000,000 by 1%, 2%, and 3% respectively. These rates would likely increase as more funds are needed in the future. The estimated cost of 1 trillion dollars is most likely a large underestimation for this bill. In Massachusetts, where a universal health care plan is already in effect, they have more than doubled the estimated cost. The notion that we should tax the highest earners in the middle of a recession defies logic. These are the people we need right now to expand their businesses, start new businesses, and hire new workers. Most people are not employed by those who are low on the income scale. They are employed by those who have successfully earned a larger income and consequently need other workers to expand their venture. The entrepreneur and small business owner are the backbone of this economy and should not be left out in the cold by this bill. After all, small businesses make up 60 to 80 percent of the jobs in this country. Conversely, the government makes up less than 8 percent. The balance of the bill is supposed to be paid for by savings from Medicare and Medicaid, which are already incredibly underfunded. For the government to reap savings from Medicare and Medicaid, they could do either two things. The first would be to cut reimbursement rates to healthcare providers even further. The second would be to cut the coverage to their clients and ration care for people currently under these programs. The latter is what is being done in Massachusetts. They are planning to cut tens of thousands legal, taxpaying immigrants out of the program. If we enact the former and cut reimbursement rates, fewer doctors than ever will accept these programs or, if we are forced to accept them, doctors will flock from the profession. If they cut and ration coverage from Medicare and Medicaid, sick people will not get the care they need. Sounds like bad situation either way.

We don’t need to look any further than Medicare, Medicaid, and the Veterans Affairs health care system for a model of what our current system will morph into under this bill. Medicare and Medicaid are extremely in debt and have massive amounts of unfunded IOU’s. If the entire nation were on a system like this, the government would have no choice but to raise taxes higher on just about everyone. In the VA system, I recently had a patient who just got on the waiting list for a shoulder replacement. His estimated wait time? Two and half years. Welcome to the world of government medicine.

The reality is that this program is being hurried through Congress under the disguise of a reform. They are hoping that by calling the government insurance a “public option” it will achieve better public support. The name implies we will have a choice but clearly we will not.

The implementation of government medicine will, most importantly, decrease the quality of the care that patient’s receive. There are a certain number of doctors and providers available to treat patients now. That same number of providers will soon be asked to care for millions more. It stands to logic that rationing of our healthcare resources will be their answer to this inevitable problem. It will also not be economically feasible to care for that many people under a government plan as there is no incentive for cost savings. No consideration will be given to healthcare savings since everything will either be paid for by the government or insurance companies. Therefore, further rationing or wildly increased tax rates will be rampant.

If this is not the answer than what is? Reform on many different levels would provide an overall healthier healthcare system. Tort reform and limiting the payment for pain and suffering awards in frivolous law suits against healthcare providers would have a large effect. These cases should be reviewed by an independent panel of board certified physicians that have no monetary connection to the case. After it is deemed that a healthcare provider deviated from the acceptable standard of care, then the case would be allowed to proceed. Also, the tax treatment of current health benefits needs to be altered. Currently, the health benefits that one receives from their employer are not taxed. However, if an individual goes out and buys the same policy on their own, they do not receive the same tax benefits. Allowing the same tax benefits to individuals would allow more people to get in the market for health insurance and would end the dependence of people on their employer for healthcare. Portability of health insurance is another major issue in this country. Currently, a person may not buy insurance from a company in another state. If the trade barriers were brought down between states (such barriers are unconstitutional to begin with) there would be a much larger market for people to choose from. A larger market means companies must compete more for consumer’s business. More competition means lower prices and more affordable premiums. If more competition is what the government says we need, than this is the way to do it. An added benefit could come in the way of increased use of health savings accounts. These are a good option for some patients as they include a tax free savings account that is coupled with a high deductible catastrophic health insurance plan. This means that routine medical care would come out of the tax exempt savings account and would be owned by the individual. Being owned by the individual means there would also be incentive for cost savings. Currently, there is no incentive to reduce cost because everything is paid for by a third party, the insurance company or the government. This would give people a stake in their healthcare and encourage preventative treatment. They, or their employer, could make tax free contributions each year toward health expenses. They would be free to see what doctors they choose and go to any hospital they desire, thus increasing competition further. The unused funds would roll over year after year and could be withdrawn for a reason other than healthcare after being taxed as income. If a severe illness or catastrophic event happens, the aforementioned insurance plan would come into effect after a deductible is met. This account would not be for everyone and has its flaws as does every plan, however, it should be recognized as a legitimate option and treated as such under law. In addition, instead of getting more people on Medicaid, an alternative would be to give tax credits or income subsidies to those with lower incomes so they could purchase their own private insurance.

While these are just a few options, it is clear that a government health insurance plan is not the answer to healthcare reform. Click here to get the contact information for your Congressman and voice your opinion.

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