So, this week I’m discussing the controversial healthcare platform WonderBoy enacted for the people of America despite their apparent distaste for such a measure. Last week I discussed the hasty process that yielded a proposal that was made official despite a number of obvious flaws, and that column was an illuminating experience for me. I wanted to have a discussion based on ideas, an exchange of information that wasn’t shaped by the talking points the media is obsessed with. I didn’t expect to encounter so many people who were more interested in vilifying my views than examining things from another perspective. With that in mind, I’ll take a more detailed approach here, though that is somewhat contrary to my intent. For the record, while much of the feedback I received last time week was predicated upon what the talking heads have to say, I am always more interested in what the average citizen has to say. I know the notion of democracy is troublesome to this administration, but it is supposed to be government by the people as opposed to government by the people on the basis of what various pundits have told them. In addition, I firmly believe that much (if not all) of the voting public is capable of shaping their own opinions, but truthfully many people readily embrace being told what to think or do in a given situation.
PART ONE
So, this week I’m discussing the controversial healthcare platform WonderBoy enacted for the people of America despite their apparent distaste for such a measure. Last week I discussed the hasty process that yielded a proposal that was made official despite a number of obvious flaws, and that column was an illuminating experience for me. I wanted to have a discussion based on ideas, an exchange of information that wasn’t shaped by the talking points the media is obsessed with. I didn’t expect to encounter so many people who were more interested in vilifying my views than examining things from another perspective. With that in mind, I’ll take a more detailed approach here, though that is somewhat contrary to my intent. For the record, while much of the feedback I received last time week was predicated upon what the talking heads have to say, I am always more interested in what the average citizen has to say. I know the notion of democracy is troublesome to this administration, but it is supposed to be government by the people as opposed to government by the people on the basis of what various pundits have told them. In addition, I firmly believe that much (if not all) of the voting public is capable of shaping their own opinions, but truthfully many people readily embrace being told what to think or do in a given situation.
Regardless, here are a few things I learned after posting my last column on the subject:
1) Do not expect those who favor this plan to appreciate your opinion. You will be given a label of some sort and lumped in with right-wing zealots if you have questions about the process. People may even insist you essentially plagiarized your own opinion, no matter how laughable that is. Apparently, so far as this plan is concerned, you either love it or you’re dealing in propaganda. Don’t expect any acknowledgement of grey areas in this process from those who see our current president as a messiah. If you’re a fan of this administration, apparently anyone who disagrees with you is a racist, a homophobe, or at the very least a right-wing nutbag who steals their views from other sources. Stick to the playbook and you’ll never encounter a meaningful challenge to your narrow-minded views.
2) People really believe they’re getting healthcare for free, but that isn’t the case for most Americans under Obamacare. So many people champion this plan because they can’t afford insurance, and a great deal of them haven’t bothered to do the math to see where they fall under this initiative. Under Obamacare, those of us who don’t receive a handout must obtain insurance (obtain = pay for) or we get penalized, which is decidedly unconstitutional. I knew the penalty aspect is a loophole, but the constitution strictly forbids our government from mandating the purchase of any good or service, and this plan clearly defies the spirit of that passage. Whether you like the plan or not, you should be frightened by the precedent this sets.
3) People can’t differentiate between socialist leanings and textbook socialism.
4) Too many people think that anyone who suggests the plan was rushed is stalling for time and trying to repress change. Guess what? This is a big idea and it entails broad changes taking place in a miniscule amount of time. While some might suggest spending more time on the plan as a ploy to buy time, it is foolish to believe the plan wouldn’t benefit from additional research and development. Additionally, if you truly understand the scope of this massive endeavor, you can see why a faulty plan will do more harm than good for the people, the economy, and healthcare in general. Make no mistake, this plan was rushed, it has problems, and lives will be impacted because this president is more interested in his legacy than presenting a plan that was given adequate time to gestate.
5) There are people out there who think the post office and the DMV absolutely rock. Take heed, dear readers, for these individuals aren’t in asylums or the mental ward at your local hospital, they are roaming free with the rest of us. Scary, isn’t it?
This week, I’ve elected to advance beyond detailing the current attempt at revamping healthcare in a real big hurry even if it means strongarming or buying off your own party to do so, and instead I’ll be shedding some light on some of the particulars of the plan itself. So wake up, class is in session, and all of those people who are riding the big wave of rhetoric should definitely pay attention. This concerns you, and with any luck maybe some of you will come to the realization that WonderBoy isn’t really going to make it rain free healthcare on the masses.
Healthcare II: the plan
Let’s kick things off with one of Ben Franklin’s best-known adages, a pertinent assessment if ever there was one as we evaluate this plan: “People willing to trade their freedom for temporary security deserve neither and will lose both.” That’s a big part of it, not only is this plan ill-conceived, but those rushing to take advantage of the promises that constitute this colossal gaff are going to be asking themselves why they didn’t think this through in a few years. Actually, I take that back, the people who support this measure will probably blame the government once they start to take notice of the flaws. They will claim that Obama got one over on them, but in truth the writing is on the wall. If those who back the prez weren’t so interested in labeling critics and avoiding any real discussion with those who don’t have a glowing opinion of this administration, they would find a wealth of troubling facts at their disposal.
So, where do we begin? How much will Obamacare cost us? That seems like a good starting point to me, and the answer to that question is $243 trillion over 10 years. The plan isn’t supposed to add a dime to our deficit, but even some of the more optimistic fans of this reform doubt that will remain a reality for long. One thing is for certain, the plan comes with a hefty pricetag, and anyone who doesn’t think you should take adequate time with a 243 trillion dollar decision is impulsive at the very least, and quite possibly utterly insane. The gigantic pricetag is one of many reasons I personally feel we shouldn’t have rushed this measure into action. $243 trillion is a lot of money to throw at a problem we haven’t done nearly enough research on. I can already hear some of the idiots in the peanut gallery talking about how expecting more scrutiny is just a stalling tactic, but look at that dollar amount one more time. I don’t know about you, but if I was unveiling a plan that cost that much it would have to be the best damn plan I could have possibly conceived. This president didn’t allow enough time for that, but hey, it isn’t even his money we’re talking about. I’m sure he values his legacy a lot more than our money. If for some reason you’re not worried about the cost as it stands, ask yourself this: how many government plans only cost what they say they will? Senate Budget Committee chairman Kent Conrad has gone so far as to label the budget for this plan “a Ponzi scheme of the first order,” comparing it to something Bernie Madroff would have concocted.
Wait a minute, some of you will say, Obama says this plan will cut the deficit. Right. When was the last time a big government program cut the deficit? In fact, if we’re going to ask questions about big government initiatives, here are a few that come to mind: how many sizable government plans improve competition or foster choice? How many government plans of this stature are bolstered by competent bureaucracy or honest accounting? How many lofty government plans improve efficiency and limit fraud, waste, and poor implementation? Our government has its selling points, but it also has a troubling history of functioning poorly when it attempts to accomplish too much, particularly if the plans being proposed aren’t properly prepared and implemented. Questions of this magnitude are troubling to say the least, but let’s get to the heart of the matter.
How will this plan impact the quality of healthcare? This is a big talking point, and just so we’re clear, I’m equally interested in what it means for you and I as consumers and how it will effect our physicians and the other employees who labor in this industry. So many people are so concerned with the cost of insurance that they don’t even stop to think about the doctors and nurses who make healthcare a reality, a great number of whom are overworked and underpaid before Obamacare starts cutting costs in the coming years. For instance, a New York Times article noted the following just last year: “Some doctors—often internists but also gastroenterologists, gynecologists, psychiatrists and other specialists—are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage. The doctors’ reasons: reimbursement rates are too low and paperwork too much of a hassle.”
Now, consider that Obama has pledged to slash physicians’ Medicare fees 21%, and his plan also dictates that hospital reiumbursements for Medicare be cut a whopping $1.3 billion. How long will the medical community here in the U.S. be able to tolerate such conditions? I firmly expect a number of doctors and hospitals to begin refusing treatment (with exceptions for legitimate emergencies) to Medicare patients in light of these trying circumstances. Medicare aside, how will our already over-burdened doctors react to the infusion of 32 million new patients into the healthcare industry coupled with the abundance of red tape this plan will add to their daily lives? Some of you don’t want to think about anything but your own healthcare needs, but if this plan results in greater access for all Americans to a crippled medical community, what is the net gain? Lastly, who is speaking up for our physicians in this matter? Even those stalwarts who do so much for their communities at so little gain are being grouped with the most advantageous and greedy of the lot as this administration goes about its looming overhaul.
Who is most at risk aside from the healthcare community itself? Obama enjoys a wealth of support from the youth of this country, so perhaps we shouldn’t be surprised to find that our seniors stand to lose a lot once Obamacare takes hold. I’m all for making healthcare more available to the masses, but our seniors deserve more as it stands, and the sacrifices we will impose on this community during the coming reform are deeply troubling. While you’re celebrating whatever benefits you’re able to reap from this controversial proposal, keep in mind that seniors will be hit particularly hard by increased taxes on medical devices and prescription drugs, and this plan does away with the tax deductibility of the well-received federal subsidy for employers who offer drug coverage to retirees. New federal premium taxes and the excise taxes will also impact our senior citizens. Also, seniors, like the rest of us, will find fewer choices at their disposal under Obamacare. Once Medicare Advantage payments are frozen in 2011, Congress will have effectively set the table for a progressive reduction in seniors’ access to the highly popular Medicare Advantage health plans. It’s no secret that there are numerous holes in Medicare coverage, to include the lack of catastrophic protection. That’s why so many of our seniors resort to purchasing supplemental insurance, and without Medicare Advantage, more seniors will find themselves paying two separate premiums for two plans. Obamacare seriously expands the struggling program Medicaid, which shares Medicare’s poor reimbursement rates, and such expansion will cover nearly half of the 32 million newly-insured Americans. To recap, we’re enrolling millions of Americans in plans that are already floundering and we’re looking to cut those plans despite the fact that many doctors are tired of dealing with the low reimbursement rates to begin with. This is clearly a problem of the highest order, and no one is apt to be hit harder by the ramifications than our senior citizens. For many of you, that’s fine so long as you get yours, but I can’t embrace such an approach. I also believe this is another example of a serious issue with the plan that additional time and thought might have alleviated, and the fact that elderly Americans may suffer because this was a rush job greatly offends me.
Okay, so many of you don’t care about the pricetag or the elderly so long as you’re covered, but what are you personally sacrificing along the way? How about freedom? Isn’t that the bedrock this country was built upon? Remember that Franklin quote? Here’s where it figures in. If you’re not bothered by a budget that could be disastrous for our country’s economic well-being or the plight of senior citizens under this divisive reform, let’s take a moment to discuss some of the sacrifices you will make. For one, you’re mandated to have insurance. There are plenty of young people in this country who are capable of obtaining insurance, but for whatever reason that isn’t an expense they want on their budget. What’s wrong with that? Why shouldn’t they have that right? Because Obama must pay for this flawed monstrosity, that’s why. If someone doesn’t want coverage, our government really has no right to penalize them, but they’re going to anyway. It’s as simple as that. What if you maintain your health and you want a plan that reflects that? Sorry, you’re on the same plateau as an obese chain-smoker who likes to drink himself to sleep every night. Maybe you want to save money by choosing a plan with lifetime or annual limits on coverage. Sorry about that. Insurance providers will no longer be able to provide such plans even if that is precisely what their customers want. You will be forced to purchase a plan that covers ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services; chronic disease management; and pediatric services, including oral and vision care. What if you’re a woman who can’t have children or a single guy with no kids? Welcome to government healthcare, people, where one size fits all and premiums are rising.
Wait a minute, you say, premiums are supposed to fall in light of this healthcare revolution. Sorry again, but that’s an empty promise, folks. Did you know that the same nonpartisan Congressional Budget Office that the prez frequently quotes advises that the average family’s premiums will rise by as much as 13% by 2016 despite Obama’s bogus claim that premiums will go down. Falling insurance premiums is a lie, but rest assured that rising premiums will soon be a reality.
Well, that doesn’t change the fact that this reform will create jobs, some of the plan’s supporters will tell you, but that’s simply another myth. Yes, there are going to be new positions created within the IRS to penalize all the Americans who can’t afford (or don’t want) healthcare under the new plan, but the losses within the medical community may be truly catastrophic. The Lewin Group (a nonpartisan entity) states that up to 600,000 people will lose their jobs due to new employer health care mandates included in this reform. That figure is a bit lofty in my humble opinion, but divide it by the number of your choice and it’s still imposing. Jobs will be lost and our woeful economy will continue to lag.
So, what’s the best-case scenario? Maybe our government will work together in an inspired effort to correct the flaws in this reform, and maybe they will accomplish something in that regard so that the prez can fulfill some of his promises. What’s the worst-case scenario? Well, that would entail countless Americans paying mounting insurance premiums in addition to funding the government’s efforts to regulate healthcare while both the quality of said care and the number of qualified professionals working in the field declines. Even if that means that we’re able to provide some Americans with coverage they couldn’t afford before, I don’t believe it will be a situation where the net result justifies the means.
Still feel good about the prez and all of his big promises?
Here are a few more you may recall:
Remember Obama’s pledge to allow Americans to buy their medicines from other developed countries if the drugs are safe and prices are lower outside the U.S.? There’s no mention of that vow in this sweeping reform. What about his tepid efforts to strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance as he promised?
Remember his declaration that “Under my plan, no family making less than $250,000 a year will see any form of tax increase. Not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes.” Will someone explain to me how taxes on those who smoke or tan (or those who are happy without insurance) don’t void that bold claim?
There’s a saying about things that sound too good to be true, and while our country rides a mounting wave of rhetoric, we may be setting ourselves up for a painful reality. I would like to state again that I don’t favor any party, and I would love to see a feasible universal healthcare plan put into action, but this is clearly not that plan and I don’t think any amount repairs to this initiative will yield such a plan. In the interest of clarity, I’ll point out that while I’m convinced that our president cares far more about his legacy than his constituents, I don’t think his grand design is a villainous attempt to sell his country a bogus healthcare plan. I do believe that he is out of his depth and his haste in ramming this reform through despite the better wishes of his people has given birth to a monster. If you want to foster a myth, you can continue to believe that a wonderful new dawn is unfolding before us where every American will be able to take advantage of adequate healthcare at a reasonable cost. Those of us who deal in reality see an overburdened industry that is about to be pushed to the limit, impacting both the quality and quantity of healthcare as millions of additional patients find their way into the fray. In the end, we will wind up paying for this plan whether it works or not, and there are too many flaws and too many empty promises to believe that it will be a success.
