H.R. 3962 “Affordable Healthcare?” – Playing Games

On September 9, 2009, President Obama said, “Well the time for bickering is over. The time for games has passed. Now is the season for action. Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do.”   Did he mean it or did he mean to say, “The time for Republican games has passed”?  It must have been the latter, to wit:

Senator Harry Reid has just come forward with a health care plan that has a “public option” with an “opt out provision.”  It is an  obvious joke, a game.  The only problem is it will be the law of the land, and will be financed by all the taxpayers.  So who will want to opt out and only pay for the new government bureaucracy while getting no benefit from it?   The real intent is for the government to step in and “compete” with a plan that is less expensive than what can be offered by the highly restricted insurance companies.  The government can do that since it sets the rules and the rates.  It doesn’t have to worry about the market pressures.  Like it does now with Medicare, it short pays for almost every service and the cost is passed on those who are insured privately and to taxpayers in general.

Then Speaker Pelosi unleashes her 1990 page Health Care Act (H.R. 3962, the Affordable Health Care for America Act).  Tell me she is not playing games calling it the “Affordable” Health Care for America Act.  She doesn’t seem to notice the irony of adding $1 Trillion in programs for taxpayers to pay for in an act called “Affordable.”  Since CBO Director Elmendorf was dressed down by the President in July, CBO markups of bills coming out of Congress have been uncritical of the Administration position.  So, for the CBO markup of H.R. 3962 to show that it adds $1.055 Trillion in Government provided or subsidized programs, we can assume it is at least that high.  Does this make it affordable?  As Mr. Lincoln said, “Calling a tail a leg doesn’t make it a leg.”

In fact, I think the game is being played to the limit.  For example, look at pages 1441 to 1443 of the Health Care Act (sorry, can’t bring myself to call it the “Affordable” Health Care Act any more.).  “Section 2531, entitled “Medical Liability Alternatives,” establishes an incentive program for states to adopt and implement alternatives to medical liability litigation. [But]…… a state is not eligible for the incentive payments if that state puts a law on the books that limits attorneys’ fees or imposes caps on damages.” This is pure “game.”   Mrs. Pelosi is paying back her biggest supporters, the Trial Lawyers.  No way this could be a law on its own, but buried 1400 pages into a 1900 page document, she is hoping no one will notice.

Somehow, I missed Mr. Obama’s speech where he he reminded Congressional Democrats that “The time for Games has Passed.”

Who is in Favor of Health Care Reform as Proposed – And Why?

I’m convinced that those who are in favor of current efforts at healthcare reform are in favor of it for three key reasons:

First, they don’t trust big business, especially the insurance industry which has been made the villain by politicians in Washington, D.C.   Part of the distrust is due to the belief that most people in the insurance industry are out for profits and have no other concerns.  Part of it is because they see most in the insurance industry as rich people who have more assets than they do.   When politicians want something, they often resort to dividing up the parties and helping them to fight against one another.  It is easy to get a majority of folks to dislike and not care about “the rich” because most people don’t see themselves as part of that group.  It has taken very little effort to demonize the rich insurance executives and make people distrust them.

Second, many people see the current health care proposals as a way to get something for nothing. When told that the new proposals by both the House and the Senate will lower the cost of health care, most people want to believe it.  We all want to get something for nothing.  Unfortunately, the majority of the savings claimed by Congress comes from massive increases in the number of people covered by Medicare and Medicaid.  That means that medical providers will be forced to accept Medicare reimbursement schedules.  That will definitely lower the amount that medical providers receive but it will not cut costs.  Costs can only be cut by lowering what medical providers must pay to provide a service.  If a procedure requires a provider to buy a heart valve at a cost of $5,000, and, the government reimburses at a rate of $2,000, the cost is still $5,000.  The only thing that has changed is that the provider must find some way to raise the $3,000 it lost upon selling that heart valve to the government.  What happens is the provider must cut other costs (quality?) or charge more for other services (to private payers).

This, of course, is closely related to the distrust of business at all levels due to the publicity of fraud by misbehaving companies like Enron.   But, it also reflects a desire to have things without the pain of having to earn them.  Many who like the current proposals for healthcare reform do so because they would rather not have to deal with the issue and don’t think they lose much freedom by letting their government do the dirty work for them.  It may be easier to have Mom wash your clothes and feed you but as long as you accept her free labor and the free roof over your head, you are subject to her rules. Like not having to be responsible for your own decisions on health, it seems so easy and giving up just a little of your freedom seems worth it.

Third is a feeling of guilt.  Most people feel that it is a good thing to be kind and helpful to those who are less fortunate than ourselves.  Typically, people do things to be kind to the less fortunate because they have a deep guilt and wonder why they are so blessed to have enough food, clothing, and shelter while many others do not.  Also, typically, Politicians like to assuage their guilt by doing nice things for the underprivileged using other people’s money.  Those who favor the current proposals want to use other people’s money to make life better for those less fortunate.  People who do not like the current proposals but who want to make life better for others resolve the conflict by using their own money to contribute to charities that help the underprivileged.

So, in summary, many people want to do good for others but they want to use other people’s money to do so, they are lazy and want the government to take care of them, they distrust big business and the insurance industry in particular, and they feel government control of healthcare will get them something for nothing. There seems to be a general feeling among the politicians who are in favor of the current proposals that these proposals will increase their power to control both the health industry and the dollars and votes that come with it.

You can see my post on Who is Against the Current Proposals and my analogy to the health care reform issue at the highlighted links.

In one of my next posts, I will make another attempt to give my plan to lower costs, retain or improve quality of care, and improve access.  In the meantime, you can read previous related posts here, here, and here.