July 8, 2012
The health care bill implications
The Supreme Court has approved the
health care bill that is commonly known as Obamacare with two
exceptions. The first, deals with the wording in the law requiring
that a penalty be paid by anyone who could afford to, but then chose
not to buy insurance. The court stated that the penalty would have to
be called what it actually is...a tax. The second removes from the
law the threat that said, in effect, if a state fails to expand its
Medicaid offering as part of the health care expansion, they would
lose all federal monies currently being paid to them for the
program...that amounts to 90% of the state's costs for medicaid.
These two exceptions will prove to be critically important as this
important debate continues.
Mr. Obama and his fellow Democrats are
lauding this as a victory for the American people. The Republicans
are, of course, proclaiming it to be a disaster of epic proportions.
This will result in this issue being a significant debating point for
both sides in the remaining months of the election. We must all hope
that the more important issues such as jobs, debt, and unfunded
entitlements aren't ignored.
Since it is pretty clear that the
health care and Insurance lobbies led the process of writing this
bill in their favor are the primary winners. Their enthusiasm,
however, has to be tempered by the fear of the Republican's promises
to repeal the law if they win a majority of both houses and the
presidency. Any bets on where these same special interests will be
placing their support this fall? Any doubts about what a GOP
candidate will have to promise in return for their financial support?
It's easy to see that the 10% of
Americans without insurance have also won. Who are the losers? Well,
let's begin by looking at the other 90% of Americans who currently
have some form of health insurance. Does anyone imagine that this
majority population isn't about to see the beginning of the most
incredible negative changes to their health care imaginable? The
President stated before and after the court's decision that folks who
are already insured will be allowed to keep their insurance. He, of
course, did not say that this majority will have to bear most of the
burden for all of these newly insured via higher costs or reduced
services, or both. Can you imagine that insurance providers of all
types will not end up raising fees to make up for expected higher
costs? Do you think that the number of employers providing health
insurance in this new reality will increase or decrease? It doesn't
matter if you happen to be covered by private, Medicare, Medicaid,
Government, or the VA; you might be able to maintain coverage, but
these all will be affected by higher costs and reduced services. It's
a simple matter of economics; our nation is deeply in debt and cannot
afford to pay for these additional insureds and increased services
for baby boomers without additional revenues and/or reduced services.
Think about the supply of primary care providers required by the
growing twin demands of the newly insured and the baby boomers. The
supply of primary care providers has for many years been failing to
grow at a rate that even matches current demand. In America today,
driven by shrinking reimbursement rates for service, our primary care
specialists are among the lowest paid of all physicians. Why would
anyone logically want to make this their chosen medical specialty?
During these very trying economic times it seems indisputable that
this new law initiates a period of declining quality of health care
for the vast majority of all Americans for the foreseeable future.
Last year I wrote a series of articles
dealing with health care realities in our nation. I stated that we
are the only developed country in the world not providing universal
health care for all of it's citizens. Clearly that must not be
allowed to continue in a nation that remains, in spite of our
problems, the wealthiest in the world. To me this requirement to
provide health care access for all citizens falls under the “Life”
portion of “life, liberty, and the pursuit of happiness” sentence
of our Declaration of Independence. However, for our leaders to have
created this version of health care reforms that more benefits the
powerful special interests than the vast majority of our people is
not the best way accomplish that goal. We have transferred all
control of our health care into the hands of the politicians,
bureaucrats, and the insurance and health care industries. As I wrote
then, and am even more convinced today, the right thing to do would
be to offer everyone a Medicare option. After all, over half of all
Americans are already on some form of public health coverage when you
include those covered by Medicare, Medicaid, Government, and the VA.
The infrastructure is already in place, and most current recipients
think that these health care delivery systems work pretty well. The
real negative of that option would, of course, be for the special
interests...and they certainly are more capable of influencing the
lawmakers than we the people. Meanwhile we just keep voting the
incumbents back into office?? Will we never learn?
These are my opinions. What do you
think?
Mike Tower
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