Tag Archives: Health care reform

The Obama-Biden promises for health care reform – what happened? Do you still think you can have it all and not pay for it?

5 Apr

President Barack Obama walking with Vice Presi...

 For some reason back in 2008 I printed out the entire Obama-Biden website containing their positions and proposals.  Scanning the health care section recently I found some interesting statements:

“The Obama plan will lower health care costs by $2,500 for a typical family by investing in health information technology, prevention and care coordination.”

“Reduce Costs and Save a Typical American Family up to $2,500.”

“Under the plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year.”

Which is it, “by”, “up to” or “as much as?”  No matter, there is nothing in the Affordable Care Act that saves the typical family $2,500.  You can stretch this definition and say that the subsidies within the exchanges will save some families money and that’s true, but it does not lower health care costs and certainly not through information technology, prevention and care coordination.

“On health care reform, the American people are too often offered two extremes – government-run health care with higher taxes or letting the insurance companies operate without rules. Barack Obama and Joe Biden believe both of these extremes are wrong, and that’s why they’ve proposed a plan that strengthens employer coverage, makes insurance companies accountable and ensures patient choice of doctor and care without government interference.”

Interesting choice of words, the “extreme” of government-run health care, is “wrong.”

“Require insurance companies to cover pre-existing conditions so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums.”

The “fair and stable premiums” will reflect the additional cost of removing all underwriting for insurance coverage.

“Barack Obama will pay for his $50 – $65 billion health care reform effort by rolling back the Bush tax cuts for Americans earning more than $250,000 per year and retaining the estate tax at its 2009 level.”

LOL . . .

the President’s most recent budget alone contains an additional $111 billion to cover the cost of subsidies for Americans enrolled in the health insurance exchanges.

Of course, rhetoric and  promises that don’t match reality are not unique to Obama-Biden or to Democrats for that matter.  All politicians pander to the wants and fears of the voters, but on occasion it would be nice if the voters held them accountable.

Are we serious about health care REFORM or just the promotion of “more?”

27 Mar
Nancy-Ann DeParle, director of the White House...

Nancy-Ann DeParle, director of the White House Office for Health Reform, at a senior staff meeting in the Oval Office. (Photo credit: Wikipedia)

I have long maintained that health care is too emotional for any of us to look at costs and efficiency objectively. We see or hear that a person was fully covered by their insurance and it’s a good thing.  An insurer was made to pay for this or that and it’s a good thing.  The idea that we care about cost is questionable and when it comes to ourselves or a loved one, there is no question that we do not care about the cost of health care at all.  It’s human nature after all and the very reason external control of some type is necessary if we are to seriously manage costs.  That control may come in the form of managed care, following certain guidelines for care, etc.

 
That human nature factor in health care does not go unnoticed by our politicians who cannot resist playing up the individual benefits of health care reform without regard to the cost.  At the same time that the Secretary of HHS trumpets the Department declining “unreasonable” premium rate increases, the White House promotes all the aspects of the affordable Care Act that increase costs.  This is not to say helping individuals is a bad thing, but it is also a costly thing and that simply cannot be pushed under the rug as if it does not matter.
 
We all know certain individuals are benefiting from the Affordable Care Act. Any time you give people more stuff and “free” stuff somebody is going to benefit and somebody else is going to pay for it.
 
If we can’t look at the cost of our own health care objectively, we should expect our most senior policymakers to do so for us collectively.  Good luck with that as it appears their main objective is promotion of all the goodies.   That is a great disservice to us all.
 
Text of e-mail from the White House:

Good afternoon – 

Too often in Washington, politicians tell compelling stories about individuals when they are trying to make a point. But once the news cycle moves on, those people keep living their lives and confronting the same problems. 

Health reform is different. 

We met Nathan and his son, Thomas, in 2009. Thomas was born with hemophilia, and he hit lifetime limits on his health coverage with two different insurance companies before he turned seven years old. Two years ago, Nathan was hopeful about what the Affordable Care Act would mean. 

Last week we spoke with Thomas’s family again and they made it clear: Health reform has improved their quality of life. It means they can focus on making sure Thomas has the best possible care. It’s changing their lives for the better. 

It’s a powerful thing to watch. Go check it out. 

Thomas is not alone. He’s just one of the 105 million Americans who no longer have lifetime dollar limits on their coverage. 

The Affordable Care Act gives hardworking, middle class families the security they deserve. Because of health reform, 54 million Americans with private insurance have been able to access more preventive services. In the 2011 tax year, two million workers will benefit from the small business health insurance tax credit. And 2.5 million young people under age 26 have gained coverage on their parents’ plan. 

Behind each of those numbers is a person like Thomas. Two years after President Obama signed the Affordable Care Act, life is a little better for millions of Americans from all over the country. 

So take a moment to hear some of their stories and hear why this matters for Americans across the country: 

http://www.whitehouse.gov/health-care-story 

Thanks,

Nancy-Ann 

Nancy-Ann DeParle
Deputy Chief of Staff 

P.S. — Learn about more individuals who are benefiting from the Affordable Care Act with our map that shows the impact of reform, state by state.

 
 
 
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The five real problems with the health care reform law

23 Mar

May_30_Health_Care_Rally_NP (397)

Left, right or center, you can find people who have major problems with the Affordable Care Act.  Then at one end of the extreme are people who see it as the greatest thing since sliced bread and at the other a near end to our republic.  But all those folks are missing the point.  While there are attempts to tweak the health care system (with regard to Medicare) contained within the Act, the primary goal is expanding coverage above all other considerations. 

And that leaves us with the real problems.

  1. The Affordable Care Act reinforces the idea that much of our health care should be “free” or at virtually no cost. 
  2. The Act promotes the idea that health care costs are the premiums we pay rather than the cost of the health care we receive. 
  3. The Act falsely transfers blame from individuals (patients) and the system to insurance companies
  4. The Act creates the impression that costs can be managed while maintaining the status quo in terms of access to unlimited health care or merely by cutting payments to some health care providers
  5. The Act deceives Americans with employer-based coverage by claiming their coverage will not change as a result of the Law.

 It is for these reasons that it is unlikely the Act will make health care truly “affordable” to individuals or to the government, or raise the quality of our health care.   

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2012 Retirement Security Survey Ha! Ha! Ha! LOL

24 Feb
 
English: A member of the audience holds a &quo...

Thank you indeed, we will take all we can get, even from the millionaires and billionaires

I recently received the “2012 Retirement Security Survey” in the mail.  Great I thought; somebody is really looking at this important subject.  I will fill this one out for sure.  Oops, upon closer examination the document turns out to be propaganda from Democratic National Headquarters and a request for a donation.  There is no serious attempt to gain any valuable information.

Of course, Democrats are not alone with such nonsense, but some of the text of the “survey” really caught my eye because it is so outrageous in its claims and more than anything else it panders to people (mostly elderly) while ignoring the consequences for us all of staying a course of unlimited entitlements, irresponsible spending and long-term growing liabilities.

Here is an example:

“Republicans are working to turn back the clock on civil rights, destroy trade unions and the right to collective bargaining, deny women health care and vital family planning services, dismantle the Environmental Protection Agency, slash investments in education and medical research and to repeal President Obama’s historic health care reform.”

Another few examples:

“They (Republicans) abandoned seniors who fall into the prescription drug “donut hole” to give tax breaks to millionaires and billionaires. And they’ve developed plans to cut Social Security by slashing benefits and raising the retirement age.”

I’m still trying to figure out how much of this has to anything do with a retirement survey, but of course I know the real purpose of this mailing which is to scare the hell out of people, especially seniors.  This message and misleading information is not unlike that frequently issued by the AARP.

Then we have the objective questions contained in the actual survey:

  • Do you oppose the decision by House Republicans to end Medicare while protecting tens of millions of dollars in subsidies for Big Oil?
  • Do you oppose the Republican Party’s position of cutting Medicare for future retirees so they can extend the Bush tax cuts for millionaires and billionaires?
  • The health care reform law passed last year closes the Medicare prescription drug benefit donut hole.  Do you support this plan to help seniors pay for expensive prescription drugs?

How is all that for an objective set of survey questions?  Hey, doesn’t everyone love Big Oil, billionaires and donut holes? 

Within this blog I have addressed many of these issues over the last few years, especially why it is so important to future generations for this generation to fairly and prudently address the growing costs of Medicare and Social Security.  Any political party that panders to people creating the we can have it all expectation and the only thing that needs to change is to place higher taxes on millionaires and billionaires (defined as families earning $250,000 or more) is doing a great disservice to this Country and its citizens.

Extreme right Republicans who believe that the average American can do without many government programs is equally irresponsible.  The left underestimates Americans and sees them as totally dependent on government and the right over estimates the American ability or willingness for self-sufficiency.  Dare I say that puts us some place in the center?

I see no purpose in addressing the other side of some of these claims, but I can’t resist pointing out a few items.

A few Republican governors have taken on public employee unions and rightly so and in the best interests of all of a state’s citizens. 

Republicans are the ones who started Medicare drug coverage in the first place, albeit with no funding to pay for it.

Nobody is denying women health care or vital family planning services, not even a big bad insurance company denies anyone health care . . . think about it.

Nobody is proposing to slash Social Security benefits, but rather to slow the growth in future benefits, quite modestly as a matter of fact once you look at the numbers.

Nobody is going to destroy Medicare or Social Security, but to keep denying the need for meaningful reform will cause just as much harm.

You may want to review the Social Security, Health Care and Medicare categories on this blog for additional discussions on these topics.

Health care systems around the world; what people in other countries think of their health care systems … you may be surprised.

2 Feb

The US seems to be in constant turmoil over health care.  For decades we have been arguing over the problem and how to fix it, in fact we aren’t even sure what the problem is.  Americans can’t seem to agree on what they want or how to pay for it. In the meantime most other developed countries have a system in place. They may have problems, but their citizens seem pleased with what they have.

Why do Americans have such a difficult time structuring a system for every citizen?  Is the rest of the world just smarter than we are or do Americans simply have unrealistic, we can have it all, expectations?

I have a strange hobby, I visit other countries and ask people how their health care works and if they like it.  In my most recent post on the Health Insurance Illuminated blog I report some of my findings

Take a look at what people in different countries have told me.

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Consumer driven health care is a myth and aiming at the wrong target

5 Jan

The CEO of Humana recently gave a talk on the health care system in which he correctly noted some of the fundamental problems in the system (unnecessary care being provided, little concern for cost (of care) by the consumer, lack of electronic medical records, variations among practice patterns and others). However, he incorrectly concludes as do many other “experts” in and out of government that consumerism by the patient is the key to solving our health care cost problem. In other words, if you shop for health care as you do for a new television, you will be more prudent and cost conscious when it comes to receiving an MRI or CT scan.

Let’s see what you actually know about that new television. You certainly know the price and you also know that if you go to a big box, no frills store you may save money. You may know something about the perceived quality, probably from word of mouth or perhaps a consumer report of some kind. And you also know something else; if you guess wrong in your purchase you may return it for a refund or replacement, or if all else fails you throw it out, learn your lesson, chalk up the loss of a few hundred dollars to a bad experience and start over.

Sure, buying a TV is exactly like that severe pain your child feels on her left side accompanied by a very high fever; start shopping!

 
Health care systems

Pick a system, any system

I have worked with thousands of people over the last fifty years as they navigate the health care system, deal with major illness, doctors, hospitals and their health insurance. Not one of those people knew the true cost of health care, not one could accurately assess the quality of care they received, not one knew if all the care received was necessary or appropriate. What they did know was that they or someone they loved were ill and wanted to get better, sometimes desperately so. On occasion (after the fact) there would be consternation over a high balance bill from a non participating physician, but more often than not the concern was that the insurer paid too little not that the doctor charged too much … “he saved my life.”

When it comes to health care we humans are not and can never be objective consumers motivated by cost (and sometimes even quality; witness the reaction to new guidelines for certain screenings that question popular wisdom).

All the well-known problems in the system must change, but it is the system that must change, not the consumer/patient. Why would we attempt to solve our problems by seeking to have 300 million people learn to question the next recommended MRI as opposed to changing the system so that we have confidence the next MRI is appropriate, necessary and cost efficient?  Let’s face it; if we believe that only external pressure from consumers can change the system, we are also saying the quality of health care in America is generally poor, overpriced, defensive and motivated largely by profit maximization.

Reporting value of employer-provided health benefits on W-2 effective January 2012 … Is taxation of health benefits far behind?

30 Nov

Starting in 2012 employers will be required to report the  cost of employer-provided health care benefits in box 12 of your form W-2.  The amount will use code “DD”.

The amount shown on the W-2 is for information purposes and is not taxable . .  . for now.  However, do not lose site of the fact that the tax-free status of health benefits is the single largest revenue loser for the federal government.  The Simpson-Bowles Commission recommended a gradual phase out of this tax break.

Employer Provided Health Care Insurance: Exclusion capped at 75th percentile of premium levels in 2014, with cap frozen in nominal terms through 2018 and phased out by 2038; Excise tax (on high cost plans) reduced to 12%.

Given the failure of the super committee of Congress to accomplish anything, this employee tax benefit is a prime target for dealing with the federal deficit.  A change is unlikely to come all at once and it may be income sensitive, but it is hard to see how this plum will be left on the tree for much longer.

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