Let's be honest with ourselves: do we really understand the health care bill that President Obama just signed into law this morning? Do we really comprehend how it will affect the budget and taxes? Do our congressmen really understand these issues?
Over the past year, and especially over the past ten days, the American public has been bombarded with conflicting information from Republicans and Democrats. Republicans say this new law will end up increasing taxes for most people. Democrats say this will save the country a lot of money in the long run. Republicans say public money will now be spent on abortions, while Democrats say it won't. Democrats claim this bill will only enhance the health care that most Americans already have while providing access, for the first time, to millions who are uninsured. Republicans claim that our current system will only be worsened by the new law.
So who's right? Who's telling the truth? I think it's hard to tell, because the real meaning and impact of the legislation has been clouded by political spin and rhetoric. In addition, the new law is thousands of pages long and is written in legal language that is not accessible to the average American. How can those of us who aren't politicians or lawyers dissect these new laws, comprehend them, and formulate founded opinions on their potential for good or bad?
Let's discuss this together and see what we can come up with. Here's what I know so far (feel free to correct me if you disagree):
The bill that the Senate passed on Christmas Eve of '09 passed the House late Sunday night, and was signed into law this morning by the President.
The House also passed amendments to the bill that need to be approved by the Senate with a simple majority vote (because of the rule known as Reconciliation). The Senate has said that it will promptly consider these amendments, and if approved, will send them to the President for his signature.
The most immediate effects of the new law are that people who have not been able to get insurance because of pre-existing conditions will be able join a high-risk insurance pool within 90 days; within six months, insurance companies will not be able to deny insurance to children with pre-existing conditions; and young adults will now be able to stay on their parents' insurance plan until the age of 26.
In the year 2014, almost all Americans will be mandated to have a health insurance policy or be forced to pay a penalty; larger companies will be forced to provide coverage to their employees or face a penalty; and Medicaid will be expanded to cover 16 million people. http://www.cnn.com/video/#/video/politics/2010/03/22/acosta.what.is.in.the.health.bill.cnn?hpt=T1
In my opinion, it seems like these provisions will initially benefit needy people and hurt insurance companies. But if insurance companies and large businesses experience decreased profits because of these new requirements, that may mean higher costs and/or less income for Americans who are already insured. Indeed, ten States have already filed lawsuits against the Federal Government under the grounds that the new Law unconstitutionally mandates citizens to purchase, and businesses to provide, health insurance.
Now what's your opinion? What are your thoughts and questions regarding health care reform? Do you have some insights that can help others understand the facts? Then share them, and together let's discuss these changes in a well-reasoned, informed manner. My guess is that we can achieve greater consensus than politicians would have us believe.
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I think your point was affirmed by HHS Director Kathleen Sebelius on Larry King tonight when she stated that now that the bill has passed, the next job is go out and explain to the people what exactly is in it. While her statement left me in brief shock, after a moment I realized that had I really been interested or had the time, I could have read the bill or at least done more research than listening to NPR and Rush Limbaugh.
ReplyDeleteIn fact, if I am honest, I still do not really care enough to take the time to find out exactly what is in the bill. Like most Americans, I have a job, and hobbies, and relationships that I give priority to over politics. This is why I would generally be okay paying taxes for someone to represent me, to spend their time thinking and analyzing issues on my behalf. Even now I will likely not investigate much more about what was in the bill and will wait for Kathleen Sebelius to explain it to me. (By the way, thanks for doing just that with this blog) But this is a personal flaw, which is unfortunately multiplied millions of times over and has contributed to much of the agonizing politicizing, misunderstanding, and even greater apathy. I suppose this affirms the necessity of An Independent Think Tank.
Regarding health care specifically, I do think that the government has carried a heavy burden by insuring a larger proportion of people with greater medical needs compared to private insurance companies and that to a certain extent, insurance companies had profited from insuring a larger proportion of healthy people. But I disagree with the government forcing insurance companies to insure people with who will require more money than they will be able to put in even if the insurance company could easily afford to do so. So whose responsibility is it to care for those who cannot care for themselves? In our present society I believe this falls to government and non-profits and not private insurance.
With policy changes as large and complex as health care reform, perhaps the best way to find a good solution is by hypothesis followed by experiment. We are in the experiment phase now. Perhaps we should have experimented with a smaller sample size first, like Texas. France and Sweden don't count because too many uncontrollable variables.
Hey Nate, great comments. I appreciate this. I agree that perhaps a small-scale experiment would have been a better initial step. Some people have talked about towns in Massachusetts that have allowed government more control over their health care, and how those experiments largely failed, but I don't really know any details about that.
ReplyDeleteRegarding insurance companies, I heard on NPR yesterday that Cigna, one of the giants, only has 2-6% profit margins, and that they really can't afford to insure risky people. Some listeners commented that Cigna could cut pay to its executives to help cover more people. But I disagree because of two reasons: 1. how many more people would Cigna actually be able to help by cutting the salaries of a handful of executives? and 2. this seems to fly in the face of private enterprize. If you want to force a company to shave profits, I think you have to call them a non-profit organization.
I also agree with what you said about the government needing to care for the needy, and so I guess I am happy that this new law expands medicaid to cover more uninsured, and doesn't put all of the responsibility on insurance companies.
The bill does actually follow some logic. Regarding insurance pools, if you want to add risk (people with pre-existing conditions) you have to add some low risk (mandate coverage for all), if you mandate coverage you must provide a subsidy for people who cannot afford it (or penalize corporations for not providing it). Here are my complaints; 1. This Bill was never about controlling costs. In fact in the recently (conveniently after the Bill was signed) revised estimates, this Bill will be more expensive than doing nothing at all. 2. We increased the demand (access) on the system without addressing the supply. Does it matter who pays for a procedure that you can't get?
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