The House Healthcare Bill: Seriously Folks
by: Stephen Erickson
11. Nov, 2009 
5 Comments
President Obama’s three objectives for a healthcare reform bill are – or were – that it cover every American with healthcare insurance, that it control costs, and that it be deficit-neutral. The bill that passed the US House of Representatives on Saturday night nearly accomplishes the first objective, probably fails to meet the second objective, and misses the last objective by a wide margin – hundreds of billions of dollars wide. The President should oppose this bill based on his often-stated objectives, but instead he enthusiastically supports it. President Obama seems either misinformed regarding the legislation or unserious about his objectives. “Unserious” was the kindest word we could come up with on short notice.
The House Bill is 1990 pages in length. Our Representatives and the public were generously given 72 hours for reading and debate. While this sounds like a lot to do in such a short time, we suppose that our Members in Congress are speed readers, that the print was exceptionally large and /or that they had little else to do except eat, sleep, and fundraise for their next reelection in the allotted period. In any case, with 5/6 of the economy left mostly untouched by the legislation, why worry about details?
As John Dingell, the 83-year-old Michigan Democrat noted, the bill covers 96% of all Americans with health insurance. That 96% figure is obviously a formidable one, since it is nearly identical to the usual US House incumbent reelection rate. Dingle, unlike the vast majority of his fellow octogenarians, will not have to worry about the deep Medicare cuts that are part of the bill. Dingle is on the government plan.
We, too, would be happy to see every American have health insurance, but only if this were a real healthcare “reform” bill that met the President’s objectives of controlling costs and paying for itself. The two issues, by the way, are not unrelated.
Calling this healthcare “reform” is like saying an obese person is “reformed” from overeating if he adds an extra helping of potatoes at every meal. Potatoes are wholesome, but unhelpful if the subject is sitting on the sofa all day long gorging himself on pizza and ice cream. Healthcare is already gobbling up a higher percentage of our GDP than any other economy on the planet and the House healthcare bill will only make this situation worse.
None of the structures driving up health care are changed as a result of House healthcare legislation. The bill does not alter the existing employer-based system, which is expensive and regressive. The “fee-for-service” model also persists, in which consumers are encouraged to consume all the healthcare services their doctors are willing to serve up, and escalating insurance premiums seem to justify every test imaginable. Doctors have no reason not to offer a full buffet of services and tests; they will continue to practice defensive medicine and themselves pay outrageous amounts in medical liability insurance since tort reform is missing from the bill. On top of this we add the potatoes. Now taxpayers are going to subsidize those who cannot on their own buy insurance and current insurance policy holders will pay higher premiums to make sure people with pre-existing conditions can get coverage. These are good components in a reformed system, but deadly in one in which the subject is still grotesquely over-consuming. Pass the gravy please, but don’t send the bill. We are still eating.
The House legislation does have a public option, which seems designed, over time, to kill off private insurance in favor of a single-payer system. Now that would be real reform, and could control costs through a diet of government-imposed rationing. But most of us would rather our doctor told us when we need an MRI, rather than a government bureaucrat. If you think insurance companies are bad, just wait, as they do in Canada, for a government-run system. Fortunately, like an Englishman who can’t get a coronary bypass in time, the public option is as good as dead. The Senate will kill it.
Our Reps justify the public option by saying it is designed to promote “competition” and keep the insurance companies “honest.” For competition, why not remove the insurance companies’ anti-trust exemption and let consumers buy insurance across state boundaries? Or is this strategy too obvious? As to keeping the insurance companies honest,” do they mean “honest” like themselves in the House of Representatives?
Supporters in the House say their legislation is paid for. Some of the money, they say, will come from taxes on small businesses and the super-rich. Obama has always said that he plans to tax the rich and the Chamber of Commerce was recently added to the White House enemies list, so these taxes must seem appropriate, never mind the ongoing recession. The White House deal with the drug companies means that the United States government will not be able to negotiate with the pharmaceutical companies for lower drug prices, but we will get free TV ads from them promoting the final Democratic healthcare bill, so that’s something. Another $10 billion is going to be paid for by shifting some financial responsibilities for existing Medicare programs to the States; perhaps some former Enron accountants have found jobs working for the Democrats. In an even more impressive display of creating accounting, several hundred million dollars of savings will be found and eliminated in Medicare “waste.” President Obama said there would be no new taxes on the middle class, so instead there is undiscovered and unspecified “waste” in Medicare waiting to be cut out like a bad gall bladder. Now that’s a relief, because for moment there, it looked like this $1,200,000,000,000 legislation was going to be expensive and that the President was unserious.
Author Info
“But most of us would rather our doctor told us when we need an MRI, rather than a government bureaucrat.”
Not that a gov’t beaurocrat is an honest person, however, we need to wake up and realize that big businesses are just as greedy and corrupt. As are mid-sized local businesses. Such as all the doctors that work for the same local network (I won’t mention any names, but I live in Dover), that have sent my wife for the same tests numerous times (CT scans, xrays, MRIs, etc) and of course always come up short of a result from the test. However, I still incur the bills. Yes my insurance company pays for 80% of it, and as the years go on my premiums go up by a lot each year.
I also love how after spending money on repeated (literally) tests, procedures, and general stabs in the dark, they all seem to a) not share information or communication with each other, b) not share test results, and c) always fall back on “pushing” drugs on her. Unrelated ones like anti-depressants, antacids, and dangerous pain killers. Hmmm… i reckon they must make commission from the drug companies for selling these.
Now… how does an anti-depressant help a non-depressed person with a neck injury? Well it doesn’t.. but it sure helps pay for gas to fuel the doctor’s mercedes. Ahh yes the honesty and integrity of big business. It trickles down to the smaller local businesses.
Stephen,
Excellent column. I followed your link from The Sensuous Curmudgeon. I’m glad you commented on his related article there.
Steve,
I very much enjoyed your unhumorous analysis of the House Health Bill, which I think should make most of us quite sick while significantly increasing our health costs. The real question is, “how much will our health costs actually go up?”
When the present Health Insurance Companies have to comply with the newly mandated requirements (take people with preexisting conditions, etc.), their premiums will be increased to cover these additional exposures. The only question is how much, which our Representatives have conveniently overlooked.
Tort reform is a must, if we are truly serious about reducing health care expenses. There must be some country that has successful attacked this legal abuse problem. Perhaps, we could use that country’s program as a model, if we can’t figure this out on our own. Maybe the Democrats, strongly supported by attorneys, don’t actually want to solve this expensive problem.
I don’t know where the cuts will come in Medicare or how transfering more Medcaid costs to the states will reduce our expenses. However, it sounds like the old “shell game” to me. As for Medicare fraud, why isn’t our government agressively pursuing this right now? We don’t need a new law to go after fraud. Perhaps, after real tort reform, they could hire those plantiff attorneys who lose their jobs, if there aren’t enough attorneys.
Increasing the taxes on the rich always sounds good, at least politically, however these are the very people who own businesses and are professional people. What do you thinks they will do when their taxes are increased? It’s my guess that they’ll pass that tax right on to their customers – that would be you and me.
Hopefully our Seantors will be a lot more honest with us regarding ALL of the real costs of their Health Care Reform Bill. In light of our present recession, which is far from over, I don’t feel that it is prudent nor responsible for our government to pass more costs on to the middle class, who are still bailing out our financial institutions that our government failed to properly regulate, but that’s another sad story.
Tom Ayres
I applaud the article as well, and would add one ingredient to the discussion that many people don’t think about when considering tort reform aspects in particular. With all the accumulated knowledge about health and human physiology that exists, it is still the case that far less is known than remains unknown in medicine. I have personal experience in the past with a health problem that recurred for almost 3 years that was never diagnosed. I was examined by scores of doctors, interns, and even students at Tufts Medical Center, and all their research gave no answers. Even recently when I have tried searching the web for relevant literature, I find nothing that matches what my now long-past condition exhibited as its peculiar combination of life-threatening symptoms. I was not and still am not an exception. But like with most aspects of society, people want definitive answers fast with no room for uncertainty. Health care is full of uncertainty. Test after test can come back negative and that doesn’t mean the doctors are incompetent or dishonest. Though some may be, the vast majority are just doing the best they can in a field where there still more unknown than known. Like it or not, much of medicine is still guesswork, and tort reform is necessary to stop driving up costs by punishing good doctors for what they don’t know.
The House bill mocked tort reform. Pelosi will give some $$$ to states to study it, but they cannot consider caps or attorneys’ fees. What’s left? To those who deny the significance of defensive medicine, just talk to an honest physician who’s still breathing. Very nice post. http://www.MDWhistleblower.blogspot.com