Help me understand the ruckus against Health Care Reform

As an independent voter, it affords me with the vantage point of seeing very strident views on topics where people lack information. The ruckus by those against (and even those zealously in favor) have been interesting as well as frustrating to observe. With the Supreme Court decision behind us, it is quite obvious Health Care Reform is a pawn in a political game rather than a piece of legislation that will largely do our American public good. There is a serious form of cognitive dissonance underway in the hearts and minds of many who are against Health Care Reform, not because of its features, but because of who passed it and that it must be defeated based on opinions of pundits and politicians who fully do not comprehend what it is. In all fairness, there are some who favor it for similar reasons, but from where I sit it is a much bigger lightning rod for our conservative friends.

I have reached out to my state’s senators and representative for my area to avoid the colossal waste of time to have a phony repeal vote. I have encouraged them instead to make this imperfect law better, as no law is perfect and this one has some needless complexity. But, on the whole, it has with the early implemented concepts and will with the future ones, move us further down the path of improving health care in this country. I also added that there is a lot of misinformation about the law much of it coming from politicians, so the American people do not have a clear-cut idea of what it is and isn’t.

One of the key pieces of misinformation provided is when pundits and politicians tout our existing health care system as the highest quality in the world. According the World Health Organization (WHO), that is not even close to being accurate, as we are rated 38th in the world in health care quality. We are number one in two areas – we have the highest cost health care system in the world and we are the most obese country in the world. So, we are not getting a lot of bang for the buck. We are over-medicated, over tested and less transparent about the cost. We are also the most prolific fast food eaters and we bring the words “super size me” to an ugly art form.

When we look at the Affordable Health Care Act (note I am avoiding the words Obamacare and the political connotations that come with it), it is ironic that the conservative voices are so against it. Why? It is similar to the bill set forth by Republicans in the 1990’s as an alternative to the National Health Care idea espoused by President Clinton. The other irony is it is very similar to the plan put in place by then Governor Romney in Massachusetts, which is working pretty well. This is Romney’s centerpiece legislation and his greatest success as governor, yet he has to hide from it. To tell you the truth, when you change your mind about your biggest achievement, that might be the biggest flip-flop of them all.

Yet, what is it about this law that has people so up in arms? It is not National Health Care, so when people say it is a government takeover of health care that is actually not the case. It is more of a widening of coverage opportunities that will largely benefit the health care insurance companies with greater numbers of participants. Medicaid will also see an uptick in covered individuals for whom the Medicaid option is better suited than the insurance or employer options. We have already seen nearly 2 million young adults added to coverage due to the part of the law already operational that lets kids under 26 (not in college) remain on their parents plans. The college extension already existed. Also, the removal of pre-existing condition exclusions for children and lifetime limits on coverage that are now in place have been most helpful to families and others.

I have seen Congressmen say it will cause employers to get out of their health care employee  benefits for employees. Senator Cornyn of Texas cited a McKenzie study that said 30% of employers would do so. He failed to mention that study was discredited by two different consulting firms who are in the health care consulting business – Mercer and TowersWatson who said employers would do this at a clip of around 8% – 10%. What these two consulting firms have reported is employers will have to be better communicators on the more viable options for their employees. Dependent on their demographics and salary, some employees will benefit more under their employer plan, some will benefit more under the state exchange and some will benefit more under Medicaid. So, the employee will have more choices. It will be more complex, no doubt. Yet, for pundits and politicians to say they will have fewer choices is not true unless an employer exits its health care plans.

The major argument has been the mandate and this one is interesting. Americans do not like being told what they must do, but we have numerous examples where they are and live with it. The mandate will aid the concept of insurance. The better risks pay for the worse risks. It has always been thus, and it will always be thus. Yet, the better risks need insurance against a catastrophe – car accident or unexpected illness. Absent this mandate and what happens now, the insured are paying for these unexpected consequences, but in a costly manner. With no insurance, people will go to the emergency room with a crisis and to the extent they cannot pay, the insured pay for these costs. ER costs are high as they are geared around crisis intervention. This is not where you want most of your health care done. The most interesting and saddest discussion occurred during the GOP primaries where the audience cheered when one of the candidates said they should just let the patient die if he did not have coverage. I am sorry but that is a crock of BS. If it were one of those audience members relatives, they would not hold to that opinion. And, what happened to “love they neighbor as you love yourself?” The mandate is important to the success of the law and must be in place. It will spread the risk over many, making the care more affordable. The people who cannot afford coverage will be afforded with subsidies to buy it. And, if you do decline, the first year penalty is $95 graded up to $695 in ensuing years.

Finally, there are those who say it has already added to cost. First, it is not fully implemented (someone said it added to cost the day it was signed, which is a neat feat). From what I have seen it has dampened cost increases somewhat and BCBS of NC noted that only 1% of the cost increases they have seen are due to Health Care Reform. Truth be told, we will continue to see cost increases, not because of this law, but because of the demand for care. Per the above, we are a nation of fat people who are getting older. In other words, we are train wrecks waiting to happen. In the meantime, we have marketers telling us to take the purple (and all the other colored) pills to make us feel better or cure a newly named disease. I firmly believe some diseases are named to enhance drug sales. So, health care costs will increase no matter what we do.

Yet, here is where some of the improvements to the law can occur. It has some specific features and by the mere expansion of coverage, will permit more preventive care. The law also supports the investigation of best practices that will improve the quality of care. That is good. However, in addition to finding some simplifications, if we can promote more prevention, incent going to better quality of care providers, etc. we should introduce them into the law.

At this point, it is interesting to note that several GOP Congressmen have been tracking the features of the law  that they would like to see continue should it have been repealed. Further, several insurance companies have noted they would continue some features irrespective of whether the law was upheld. So, we already have a good starting point for discussion. So, Speaker Boehner and Senator McConnell, please do not waste your or our time with the “beating on the chest” repeal mantra. Let’s focus on jobs first and then improving this law, not repealing it. And, take it from an independent’s view, I am not too impressed with Governor Romney flip-flopping on his greatest success story. If he wins and repeals this law, he will have done America a disservice.

13 thoughts on “Help me understand the ruckus against Health Care Reform

  1. Great analysis! To me, this law is one of the biggest gifts to health insurance companies of all times, but also a significant expansion of coverage, which is critically needed. We are so behind other coutries on this particular issue. For me, the elimination of pre-existing conditions for everyone (it started with kids, but expands to everyone at some point soon – I can’t remember when) is a big deal. Who doesn’t have SOME pre-existing condition by the time they are 20??? And no copays for prevention – I got my physical earlier this week and didn’t pay a dime and I have to get my first mammagram this year and won’t have to pay. That is a pretty decent incentive for taking care of prevention. I think the opposition is purely political at this point, which is disappointing. Thanks for laying this out so clearly!

    • Many thanks. Good luck with your first mammogram. The anecdotes you noted need to be told and retold. So few know the details and are just debating this thing that they must defeat. I watch the BBC America News and caught it the day of the decision. At the end of the analyst’s review, the broadcaster asked “why do Americans have it against social medicine (which this law stopped short of)? It works so well in other places?”

      • I honestly think Americans have a knee-jerk reaction to the word “social.” This is the result of clever propaganda from the right over the years. Indeed there are a great many highly successful countries that have managed to blend socialism with democracy.

      • I think we all need to watch BBC news more often! I dare say it would be more enlightening than most of the news we can watch over here — which is largely entertainment. 🙂

  2. Great blog. This is a fair and balanced discussion of a complex issue. Nicely done! With (or without) your permission, I will re-blog this and put it on Facebook. Thanks.

  3. Wonderful piece. For the wiser amongst us, this battle is over. For a few stubborn Republicans, such as Boehner, Cantor, McConnell and Rand Paul, they will continue to marginalize themselves and their party.

    • Thanks for your comments and following. Interesting, I read today the Senator Jim DeMint sent a letter to President Bush in 2007 advocating the work Romney did on health care reform in MA and arguing for the mandate. His letter said there was bi-partisan support. This same article said Senator Charles Grassley as late as 2009 was pushing for the mandate as well as Presidential Candidate Newt Gingrich.

      • I wonder if people aren’t reacting to the word “mandate” the way they react to the word “socialist.” They don’t know what it means, but it scares them. Strange business all around.

      • I think it is back to the cognitive dissonance. Someone whom they have latched onto as their spokesperson has said it is a bad word, so they must think it is a bad word.

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