Tuesday, August 18, 2009

Correcting the Health Care Crazies -- Part 2

A few days ago, I received an email about the House health care bill that included so many inaccuracies and outright lies, that I was compelled to respond. This is the second post in rebuttal to that email. Earlier discussion of the health care debate is here.

Yesterday, I looked at self-insured plans and out-of-pocket maximums. Today's topics are those folks the crazies say will get to dictate your health plan and illegal immigrants.

• Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)

I think this is supposed to be scary because it is "the guvmint" whose committee will set guidelines; otherwise, this is no different than what goes on today. Here is the text of the bill:
(1) IN GENERAL.—There is established a private-public advisory committee which shall be a panel of medical and other experts to be known as the Health Benefits Advisory Committee to recommend covered benefits and essential, enhanced, and premium plans.
Of course, every health insurer already has a panel that "decides what treatments and benefits you get." When you get your benefits book (assuming you already have insurance), there will be a very long section listing which conditions are not covered, which treatments are not allowed, or which procedures will only be partially paid for. Those decisions were made in advance by a committee of doctors, actuaries, and accountants who decide what should and should not be covered.

The bill calls for a committee to make recommendations to those insurers who are part of the health exchange. These recommendations will ensure that those carriers offering coverage through the exchange meet minimum standards of coverage. If you purchase insurance through the exchange and want to have a procedure done that is not covered by the plan you choose, you can pay out of pocket for the procedure...just as you can today.

And because you have the option to buy a private plan through the health care exchange (or through your employer), you will have the option to appeal...just as you do today.

• Page 42: The "Health Choices Commissioner" will decide health benefits for you. You will have no choice. None.

The "Health Choices Commissioner" is the head of the agency, like the Postmaster General or the Director of FEMA. From the bill:
(a) DUTIES.—The Commissioner is responsible for carrying out the following functions under this division:

(1) QUALIFIED PLAN STANDARDS.—The establishment of qualified health benefits plan standards under this title, including the enforcement of such standards in coordination with State insurance regulators and the Secretaries of Labor and the Treasury.

(2) HEALTH INSURANCE EXCHANGE.—The establishment and operation of a Health Insurance Exchange under subtitle A of title II.

(3) INDIVIDUAL AFFORDABILITY CREDITS.— The administration of individual affordability credits under subtitle C of title II, including determination of eligibility for such credits.

(4) ADDITIONAL FUNCTIONS.—Such additional functions as may be specified in this division.
The Commissioner is charged with setting the standards that companies who wish to offer insurance through the exchange must meet. He or she is responsible for administering this exchange of plans. He or she is also coordinates the subsidy paid to people who make less than three-times the federal poverty limit.

You will have a choice. You can choose to keep the plan you have with your employer or not. If not, you can choose from any number of plans in the exchange. If you are not wealthy, your premiums through the exchange may be subsidized. The commissioner runs the plan. He or she does not make any of those decisions for you.

• Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.

Oh brother. Let's just go to the bill:
(a) IN GENERAL.—Except as otherwise explicitly permitted by this Act and by subsequent regulations consistent with this Act, all health care and related services (including insurance coverage and public health activities) covered by this Act shall be provided without regard to personal characteristics extraneous to the provision of high quality health care or related services.
"Personal characteristics extraneous to the provision of high quality health care" is pretty ambiguous. When I read that, it tells me that participants cannot be discriminated against for any host of reasons--religion, race, gender, age, etc.--but let's assume the Crazies are right and this is a way to sneak illegal immigrants into the bill. Even if we concede the point, this section only allows undocumented immigrants to purchase health care through the exchange.

In order for someone to qualify for "free health care," one would have to be so poor that they would receive a full subsidy for their care (which would not happen because participants who are that poor would get their care through Medicaid, not the exchange). However, illegal immigrants cannot receive subsidy credits. From page 143 of the bill:
Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.
That's about as plain as legislative language gets. "No Federal payment for undocumented aliens." So if there is no Federal payment, there is no free (or subsidized) health care. Period.

Next time: Big Brother wants your checking account.

For the eleventy-billionth time, Leominster is NOT IN WESTERN MASS.!

Hey, Jon Keller. I know that you have this Pavlovian need to whack Deval Patrick like a mole in an amusement park game every time he is presented in even the slightest positive light. But please, if you're going to cite statistics in doing so, at least get them right.

You can start with the following geographical truth: Leominster, Fitchburg, Gardner, Athol and all of Worcester County are not in Western Mass.

Here's Keller, on a recent poll suggesting that the governor is actually popular in Western Mass:
...if western Mass. residents were legitimately polled, their approval of the governor's work might more closely reflect the reality of life out there. Compared with a statewide jobless rate of 8.7%, as of July 1 the Leominster/Fitchburg/Gardner area was suffering from 10.9% unemployment; Athol, 10.8%, Springfield, 9.1%, up from only 5.8% a year ago; North Adams, a disastrous 9.5%, and so on. One bright spot: Amherst, at only 6.7% unemployment.
Well, if Keller were legitimately informed, his point might more closely reflect the reality of life out there. And that reality is that Central Mass.--which includes Leominster, Fitchburg, Gardner, and Athol--gave the governor the highest disapproval rating of any region at 60% unfavorable.

So yes, the region of the commonwealth with the highest unemployment holds the governor in the lowest regard.

If Keller would venture outside of 128--or at least look at a map--he would know that region is NOT IN WESTERN MASS.!

Monday, August 17, 2009

Correcting the Health Care Crazies -- Part 1

As you know, I've just about had it up to here with the misinformation surrounding the national health care debate. Well, last week I received a chain email from a conservative friend of mine that has just about put me over the edge. I'm not going to post the whole thing here (if you want to read the whole email, I've preserved a PDF of it), but here is the introduction:
If you don't have the time to read the whole health care bill, it's not a problem. The work has already been done for you. WAKE UP!

If you haven't seen any of this stuff, be prepared to be shocked. If this becomes widely known, there will be rioting in the streets a la Iran after the recent election.

I'm scared to death to know what the next 500 pages will say. This is worse than anything even I foresaw.

A few highlights from the first 500 pages of the Healthcare bill in congress....

I have highlighted a few of the items that are down right unconstitutional
It then goes on to list 48 provisions that are allegedly in the first 500 pages of the bill. Now, I realize that I probably shouldn't even try to argue with someone who starts by saying "The work has already been done for you." I mean, why not just take this guy's word for it, he's already read it! But I'm a sucker, I guess. So I pulled up the text of the house bill and actually read the sections that the email writer referenced. Funny, but I don't think it says what he or she thinks it says.

So over the next little while, I'm going to go through the email charge by charge and relate to you what it actually says. The first two charges (the text of the email is in bold):

Page 22: Mandates audits of all employers that self-insure!

Employers who self-insure essentially pay their employees' health care costs out of pocket (the premiums that the employees pay goes into a pool that the employer uses to pay claims). The suggestion here is that the government is trampling on the rights of these employers by auditing all of them.

Here is what the bill says (emphasis mine):
(1) STUDY.—The Commissioner, in coordination with the Secretary of Health and Human Services and the Secretary of Labor, shall conduct a study of the large group insured and self-insured employer health care markets. Such study shall examine the following:

(A) The types of employers by key characteristics, including size, that purchase insured products versus those that self-insure.

(B) The similarities and differences between typical insured and self-insured health plans.

(C) The financial solvency and capital reserve levels of employers that self-insure by employer size.

(D) The risk of self-insured employers not being able to pay obligations or otherwise coming financially insolvent.

(E) The extent to which rating rules are likely to cause adverse selection in the large group market or to encourage small and midsize employers to self-insure.
The bill doesn't mandate that all self-insured plans be audited, it calls for a study of both self-insured and fully insured to compare their effectiveness and to determine whether or not both approaches adequately cover employees. The bill does not require that all self-insured plans open their books (which would be an audit). What it does do is give the government the broad information necessary to determine whether or not self-insured plans are providing an adequate level of care.

Page 29: Admission: your health care will be rationed!

This is one of my favorite lies. Here is the offending text (emphasis mine):

(1) NO COST-SHARING FOR PREVENTIVE SERVICES.—There shall be no cost-sharing under the essential benefits package for preventive items and services (as specified under the benefit standards), including well baby and well child care.


(A) ANNUAL LIMITATION.—The cost-sharing incurred under the essential benefits package with respect to an individual (or family) for a year does not exceed the applicable level specified in subparagraph (B).

(B) APPLICABLE LEVEL.—The applicable level specified in this subparagraph for Y1 is $5,000 for an individual and $10,000 for a family. Such levels shall be increased (rounded to the nearest $100) for each subsequent year by the annual percentage increase in the Consumer Price Index (United States city average) applicable to such year.

(C) USE OF COPAYMENTS.—In establishing cost-sharing levels for basic, enhanced, and premium plans under this subsection, the Secretary shall, to the maximum extent possible, use only copayments and not coinsurance.
The emailer is trying to make people believe that the "Annual Limitation" of $5,000 or $10,000 is referring to a limit on the amount of health care available to you. Thus, your "ration" would be $5,000 ($10,000 for your whole family). This is entirely 180 degrees backwards. The "Annual Limitation" is commonly referred to as an "out-of-pocket maximum" and is a feature of nearly all health insurance plans. It is literally the maximum an employee would pay out of pocket for health services in a particular year. So if you suffered a catastrophic event and needed hundreds of thousands of dollars in medical services, the most you would have to pay is $5,000. The insurance company would pick up the rest.

Instead of the government rationing health care, the out-of-pocket maximum ensures that a provider will not ration your health care because of your inability to pay. So rather than the government limiting the amount of health care you receive, it is limiting the amount you will have to pay for the health care you need. And it is doing so by requiring that private health insurance companies that want to be offered through the Health Care Exchange continue to offer reasonable out-of-pocket maximums, which most insurers already do.

Next time, the Health Choices Commissioner and illegal aliens.

Thursday, August 13, 2009

Times and Courier gets health care debate right

Gatehouse Media and its local papers--including the Times and Courier--have been doing a fantastic job the last week or so covering the local discussion on health care reform. Instead of concentrating on the heat of the battle between reform opponents and supporters, Gatehouse has written a couple of articles this week about the substance of the bill and the debate about the bill’s merits.

I realize that actually covering the issues instead of the emotional outbursts shouldn’t be worthy of praise, but the entire discussion about health care over the last three weeks or so has been about death panels and socialists and shouting and near-fist-fights. There has been very little about the actual words of the proposals themselves.

Against this backdrop, the coverage in the Gatehouse papers is refreshing. In their coverage of a town hall meeting held Saturday by Rep. Niki Tsongas, writer Chloe Gostis sets the scene by mentioning the tension in the hall, but then steps beyond the shouting and actually looks into the claims made in the meeting:
But some skeptics like Mary Crantz of Chelmsford, don’t think the government is responsible for helping people who can’t afford insurance or are unemployed.

“This is a land of opportunity,” said Crantz, an Air Force veteran. “Opportunity to work and serve. And the ability to choose. 250 million Americans have the privilege of insurance because they work to pay for it. Please Congresswoman Tsongas, represent the 250 million people who are willing to pay for their healthcare....”

Opponents of the bill have been disseminating information that says the Health Care Commission will decide a person’s plan and coverage. But according to Politifact.com, a nonpartisan fact-checking Web site run by the St. Petersburg Times, consumers can choose their plan and coverage.

Still, some forum attendees said the bill would rob them of their choices.
This is far, far better than what we’re getting from most media. The reporter here takes two sides of an argument and then goes to a source to actually find the truth. Most media organizations stop at presenting the two arguments. They have confused balance with objectivity. Reporting two views is balance. Reporting the underlying facts (in this case a congressional bill) is objectivity.

But that’s not all the Times and Courier has on the subject. On the day before the town hall, Tsongas sat down with the media for what appears to be a wide-ranging discussion of the issue. Yesterday, the T&C posted a long-form interview with Tsongas, complete with a glossary of health-care related terms, a listing of places to get further information, and the contact information for Rep. Tsongas and Senators John Kerry and Ted Kennedy.

Gatehouse media and the Times and Courier are doing an exemplary job covering the issue. Readers and other media outlets should take notice.

Wednesday, August 12, 2009

Congressmen from Crazytown

I’m trying to figure out when congress became Crazytown. It’s bad enough that hysterical mobs call President Obama a socialist and a Nazi and accuse him of all sorts of nefarious plots and schemes, but when a congressman does the same thing it makes one wonder:
[Georgia Republican Rep. Paul] Broun, who last year made national news by comparing Obama to Hitler, called Cuba's former dictator Fidel Castro and leftist Venezuelan President Hugo Chavez Obama's "good buddy."

He also spoke of a "socialistic elite" - Obama, House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid - who might use a pandemic disease or natural disaster as an excuse to declare martial law.

"They're trying to develop an environment where they can take over," he said. "We've seen that historically."
Look. If there is one thing that is not going to happen, it’s the cancellation of an election. We’ve held elections nine times during bona fide wars; we’re not going to cancel one because of the flu or an earthquake. (In 1918, we held midterms election despite fighting a world war and a flu pandemic. God forbid, but I’m sure we can do it again if we have to).

Sadly, it’s not just the crazies in the Republican caucus who get so hysterical that they develop delusions about canceled elections and martial law. In July, 2007 our very own Rep. John Olver said “at [a] meeting with constituents that he could envision the United States attacking Iran and Bush declaring martial law, suspending the 2008 elections.”

Can we just discuss the issues as they are presented, and not try to figure out how our political opponents are trying use those issues to become dictators? Because as far as I can tell, that is not and has not been part of anyone’s plan. On either side.

Monday, August 10, 2009

What it means to be a conservative

I have no idea who originally wrote this, but here is conservatism at its core:
This morning I was awoken by my alarm clock powered by electricity generated by the public power monopoly regulated by the U.S. Department of Energy.

I then took a shower in the clean water provided by a municipal water utility.

After that, I turned on the TV to one of the FCC-regulated channels to see what the National Weather Service of the National Oceanographic and Atmospheric Administration determined the weather was going to be like, using satellites designed, built, and launched by the National Aeronautics and Space Administration.

I watched this while eating my breakfast of U.S. Department of Agriculture-inspected food and taking the drugs which have been determined as safe by the U.S. Food and Drug Administration.

At the appropriate time, as regulated by the U.S. Congress and kept accurate by the National Institute of Standards and Technology and the U.S. Naval Observatory, I get into my National Highway Traffic Safety Administration-approved automobile and set out to work on the roads build by the local, state, and federal Departments of Transportation, possibly stopping to purchase additional fuel of a quality level determined by the Environmental Protection Agency, using legal tender issued by the Federal Reserve Bank.

On the way out the door I deposit any mail I have to be sent out via the U.S. Postal Service and drop the kids off at the public school.

After spending another day not being maimed or killed at work thanks to the workplace regulations imposed by the Department of Labor and the Occupational Safety and Health administration, enjoying another two meals which again do not kill me because of the USDA, I drive my NHTSA car back home on the DOT roads, to my house which has not burned down in my absence because of the state and local building codes and Fire Marshal's inspection, and which has not been plundered of all its valuables thanks to the local police department.

And then I log on to the internet -- which was developed by the Defense Advanced Research Projects Administration -- and post on Freerepublic.com and Fox News forums about how SOCIALISM in medicine is BAD because the government can't do anything right.

Tuesday, August 4, 2009

Anti-healthcare mob comes to Worcester

There are a few things that I have absolutely no use for. I can't stand bullies who shout and intimidate instead of carrying on with a discussion. I have no use for people who won't listen to an argument. And I have no use at all for someone who resorts to calling people Nazis.

So you can imagine what I think of this:
WORCESTER — U.S. Reps. James P. McGovern and Richard E. Neal were heckled and booed after trying to rally support today for President Barack Obama's plan for a comprehensive national health insurance program.

The two Worcester-area Democratic lawmakers were shouted down several times by people attending a packed “town hall” meeting at the University of Massachusetts Medical School.

UMass officials threatened several times to end the gathering because of the raucous behavior, which occurred despite a heavy police presence.

At one point, Mr. McGovern was likened by an attendee to Josef Mengele, the Nazi officer who performed experiments on concentration camp survivors.
Look, if people want to oppose the bill, go right ahead. Ask tough questions, be skeptical, let people know what you think.

But why yell? Why attempt to intimidate? Why suggest that our congressmen are no different than Nazi criminals? Because the opponents know they cannot win this fight on the merits.

They know that if the question is whether or not all Americans deserve health care, a universal health care system will win.

They know that if the discussion is about banning insurance companies from discriminating against people with preexisting conditions, the health care reformers will win.

They know that once the American people understand that competition from a public plan will force private companies to cut their costs to compete, a public plan will win.

So instead of arguing otherwise, they attempt to intimidate.

Earlier tonight, Rachel Maddow had a report exposing the medical industry lobbyists behind the "hooliganism."



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