As many of you know, I have been following the development of health care legislation for more than a year. I have read details of all the pending bills; I have participated in endless conference calls and spoken directly with scores of congressional staffers who participate in drafting this legislation. I have attempted to look at all this in the context of my 48 years of experience in health benefits, running HMOs and working with insurance companies from the employer’s perspective.
You have read when I used the terms bait and switch or shell game. As we come down to the wire in all this, my views have not changed. What we are about to receive is a massive new government program that will not raise the quality of health care in American, will not lower costs for the average American, will increase the federal debt, and will disadvantage Americans with health care benefits and those on Medicare, especially the 10 million who currently use Medicare Advantage plans.
What is happening will provide coverage to millions of Americans without that benefit today, but at great cost, additional strain on state budgets and by creating a massive new entitlement program for future Congresses to manipulate.
Under the guise of lowering costs, we in fact have expanded a flawed system to millions more and not lowered costs for anyone. Under the guise of affordability we have yet to define that term while Medicare beneficiaries pay 30% of more of their income in out of pocket medical costs. Under the guise of quality health care we are initiating scores of new programs, studies and pilot projects that should they prove of value are initially directed at the Medicare population with any positive impact on the majority of Americans more than a decade away, if ever.
We fail to address the fundamental problems of malpractice costs or why health care costs so much in favor of blaming the premium increases required by insurance companies. We have diverted the discussion to easy targets while avoiding the difficult. In other words we treat the symptom and not the disease.
The accounting used to justify all this is questionable at best with money moving from one federal program to another new program, with costs shifted to the private sector and estimates over a ten year period that at best are guesses based on the assumed behavior of individuals and organizations.
In his letter to Rep Charles Rangel indicating the cost of the House version of health care reform, the Director of the CBO says, “Those estimates are all subject to substantial uncertainty.”
So is the future state of health care in America.
While you may not agree with the editorial views of the Wall Street Journal, I suggest you read its editorial on health care reform appearing in the November 2, 2009 issue.
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