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Category Archives: healthcare reform

An Opening for Republicans? Obama’s “Deficit Neutral” Health Care Reform Will Cost Twice As Much, Just As We Figured It Would

Back in 2009, when President Obama took advantage of Democrat control of the House and Senate and pushed through so-called healthcare reform, he assured the American people that the plan would be paid for and wouldn’t add to future deficits.  There were many people, especially those like myself who are familiar with health care costs and how health insurance works, were quite skeptical.  The plan did nothing to address rising healthcare costs.  Instead, it was nothing more than the opportunity Democrats had been waiting for get health insurers to change their rules for coverage and to get government-subsidized health insurance in the hands of Americans.  But to quote a popular line from “Thomas and Friends,” one of my toddler’s favorite shows, “then there was trouble.”

First, the administration can’t even get their act together regarding the mandate in the plan.  The White House said it isn’t a tax, but someone from within the administration testified on Capital Hill that it is.  Then, the CLASS act, which was a plan to tackle long term care, came under fire.  And for good reason–one of the accounting gimmicks used to make CLASS work was to make people pay premiums for the plan for years before the plan actually came into play.  Congress voted to remove it from Obamacare.

But the ultimate slight-of-hand used in getting the bill passed was to convince people the reform act would not add to future deficits, and in turn, to the national debt.  President Obama assured us that the plan would cost about $900 billion, and that the cost would be offset by money taken from Medicare savings and from revenue grabbed from insurers, medical device makers, etc.  Like Theo Huxtable in the episode of “The Cosby Show” when Bill tried to tell him it’s expensive to live on his own, President Obama deflected criticism by saying “noooo problem!”  What wasn’t apparent to average americans is that the cost projection used included years during which the plan would barely be implemented.

Now, the CBO has released projections on how much Obamacare will actually cost over the next 10 years, when fully in place.  The cost?  $1.76 trillion over the next decade.  And that number is expected to increase to $2 trillion next year.

On the one hand, the CBO also predicts that the government will increase revenue from taxes and penalties over those years so that *may* offset the additional costs.  But most people realize that while cost estimates typically run lower than actual, revenue estimates also tend to run lower, because as new taxes kick in, people tend to change their habits, which leads to lower revenues taken in by the government.  People will find ways to avoid paying additional taxes.

What we have here is another government implented program that is going to run over budget and need bailing out at some point in the future.  Maybe around that time people will finally realize that government can’t be trusted to be good stewards of our money.

Related link:
Obamacare to cost $1.76 trillion over 10 years

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Limbaugh, Fluke, and the So-called “War on Women”

If you’ve aren’t up to speed on the whole contraception bru-ha thats’ been going on, here it is in a nutshell:

A few weeks ago, President Obama essentially stated that church-affiliated institutions would have to provide access to contraception coverage for their employees.  Religious institutions, lead by the Catholic church, immediately cried foul, saying they should continue to have an exemption based on moral grounds, i.e. the church does not believe in contraception.  After a huge stick erupted, Obama issued a compromise:  that insurance companies would not only be required to provide contraception directly to the employees of such institutions, which would circumvent the the employer, but that insurers would provide the contraception for free, as part of “preventive” coverage.  Conservatives say Obama is spearheading a “war on religion.”

Soon after, there was a hearing in the US House of Representatives about the issue.  Democrats criticized Republicans because the entire panel for the morning hearing was made up of men (there was an afternoon hearing with 2 women on the panel).  Dems had attempted to have a woman, Sandra Fluke, testify, but Republicans stated she was not added to the list in time.  Democrats say this is further proof that Republicans are at war with women.

A few days later, Fluke testifies at a Democrat-sponsored hearing.  The 3rd year law student at Georgetown Law spoke of how the fact that the school does not provide contraception coverage as part of its health plan made things difficult for female students, and that the contraception mandate should stay.  Jumping on this, radio talking head Rush Limbaugh called Fluke a “slut,” basically saying she implied she and other students want to be paid to have sex since they demand free contraception.  Under fire, Limbaugh has apologized.

Now, my thoughts, in no particular order…

Is there a war on women?  Personally, I don’t think there is.  However, Republicans aren’t doing themselves any favors.  Whether it’s the Georgia House passing a bill to lower the “deadline” for getting an abortion from 26 weeks to 20 weeks, or Virginia attempting to pass legislation requiring any woman wanting an abortion to have a trans-vaginal ultrasound first (referred to as a “mechanical rape” by one radio talk show host), one could say that conservative lawmakers, who are mostly male, do seem to have women’s reproductive parts in the crosshairs.  But its nothing new.  Things like this happen every year.  In this case, however, it’s an election year.  Gotta rev up the base!  Let’s see how independent voters respond.  After all, those are the voters that will determine the winners.

Sandra Fluke.  Who and why the uproar?  As mentioned before, Sandra Fluke is a law student who testified before the House.  She is also an activist who has advocated against child trafficking and for wider contraception coverage for women.  Fluke not getting to testify in that morning hearing actually worked to Democrats’ advantage; their later “hearing” where she spoke was not a hearing, and Fluke was not required to be under oath.  Plus, the public was introduced to the third year law student, not the experienced activist–very important for PR reasons.  Her main point of argument was that the policy dictating that students at religious institutions that do not want to provide contraception coverage be given direct access via insurance companies be upheld.  The impression given was, she came to Georgetown and didn’t realize contraception wasn’t covered.  However, in a previous interview, she acknowledged she knew before enrolling that it wasn’t covered but that she was “not willing to compromise the quality of my education in exchange for my health care.”  So, she knew what she was getting into ahead of time.

Medically necessary vs choice.  During her testimony, Fluke spoke of a student who had polycystic ovary disease.  Because she could not afford the cost of birth control out of pocket, and because the college didn’t cover it, she eventually had to have an ovary removed.  Fluke stated that in reply to Catholic supporters who asked what she expected when she enrolled at the institution, she answered that “we expected women to be treated equally, to not have our school create untenable burdens that impede our academic success.” I’m not sure where the unequal treatment is here.  Comparing contraception coverage to coverage of erectile dysfunction drugs is a false equivalence–one prevents pregnancy, while one doesn’t.  I would say that birth control pills used to cover a medical condition should be covered.  But how exactly does not having coverage for contraception impede academic success?  There are other forms of contraception available that are affordable on a college student budget.  And ultimately, though it sounds old school, if one can’t afford the ramifications of having sex, wouldn’t the ultimate answer be “don’t have sex?”

Rush Limbaugh and double standards.  Long story short, Rush Limbaugh issued an apology for calling Fluke a “slut” and making other disparaging comments.  It was an opening Democrats took full advantage of, taking his comments and implying that as the de facto leader of the GOP, his comments represented how the GOP felt about women.  They also stated he only apologized because he was losing sponsors–probably a true statement.  The problem is, there seems to be a double standard.  As outlined in a piece by Kirsten Powers, a number of left-leaning talking heads have made similar statements. Ed Schultz, Lawrence O’Donnell, Keith Olbermann, and especially Bill Maher have all gone off on women at one point or another, and didn’t get the wrath of the left dropped on them. Supposedly, the difference is the amount of influence Limbaugh has with the GOP, and that he is on the “public airwaves.” But bad statements are bad statements. Excusing your side while going after the other is simply political expediency.

I finish by pointing out two things.  First, credit to the President for using the situation as a way to score some bonus points.  He called Fluke to give her encouragement and see if she was ok.  How touching.  Second, a “right” is not a “right” if you are taking someone else’s stuff.  Free birth control isn’t a right, because someone else has to pay for it.

 

Neither party is serious about debt, and the joke is on us

As of today, to pay off the entire US debt would require every US citizen to write a check for $45,400.  EVERY citizen.  The total debt is right at $14.1 TRILLION.  And neither party is really serious about doing something about it.

On the right, they are making a lot of noise, but as the saying goes, “full of sound and fury, signifying nothing.”  First, after promising to cut $100 billion in spending from the next budget, they are only able to come up with about $65 billion.  After being called to task by the Tea Party, they are able to dig and find the promised $100 billion.  The problem?  Not only are the cuts based on a budget that President Obama never sent to the House, but they also used the infamous “baseline budgeting” tricks.

Quick refresher:  Baseline budgeting is a technique where by the budget of a particular department or organization is projected years in advance.  Typically, those budgets include an already-applied increase in funding.  So, a department may already have on paper that in 2011, they will be funded at $10 million, but due to a budget increase already factored in, they may know that their budget in 2012 will have $10.3 million due to an expected 3% increase in funding.

What republicans have done is to say “we are going to cut x billions,” not acknowledging that instead of truly cutting funding, they are simply reducing the already scheduled budget increase.  So instead of cutting a department’s funding from $10 million to $9 million, they are simply advocating cutting the 3% increase to 2% or some other number.  The cut isn’t really a cut.

Further, in the “fraud waste and abuse” category, some republicans are on board with funding a 2nd, alternative engine for the F-35 Lightning II project.  The F-35 is slated to replace thousands of fighter jets in the US inventory, and the building effort is being shared across many countries, including the US, Canada, the UK, and Turkey.  The engines for the plane are made by Rolls Royce, but there is an effort in Congress to secure funding for a second engine.  The reasoning given is “in case the first one has problems,” but the real reason is to secure jobs and a contract for an American firm.  Even the Pentagon has said they don’t want it.

Democrats aren’t helping.  Even thought the White House has proposed cutting funding to some programs (like a heating oil assistance program), many Dems refuse to go along with any proposed cuts in “entitlement” spending.   Though everything should be on the table, dems are resisting anything that might touch Social Security, Medicare, and Medicaid.  Obama and the democrats have also been using the baseline budgeting trick, especially with the healthcare reform bill.  Once again, a cut isn’t really a cut.

For there to be real solutions, someone on both sides needs to wake up and wake up their fellow politicians to the real threat they all know about but are afraid to do something about (don’t want to mess up their reelection chances!).  The recommendations of the Debt Committee would be a good place to start.

Another ruling against the healthcare bill

As has been widely reported, U. S. District Judge Roger Vinson ruled on Monday that the requirement to make individuals purchase health insurance is unconstitutional. Not only did he rule against that provision, he ruled against the entire law:

“I must conclude that the individual mandate and the remaining provisions are all inextricably bound together in purpose and must stand or fall as a single unit,” Vinson wrote.

As expected, the White House announced they would appeal. But what does this mean for the law?
Republicans announced right after the bill was passed that they would do whatever they could to repeal it. The House has already voted to repeal, and conservatives believe they can use procedural techniques to force a repeal vote in the Democrat-held Senate. But somewhere, Dems are nervous. While there have been two judges that upheld the new law, and now two that have ruled against, it’s highly likely the argument will not be settled until reaching the Supremes. Currently, the court leans conservatively, with no change in sight. This would seem to bode well for the right and not so well for the left–though stranger things have happened in regards to the court and their judgements (look up “Kelo” and “imminent domain“).

Politicians aren’t serious about fixing problems

President Obama has installed a Debt Commission in order to come up with ways to reduce the deficit.  The report of the commission is due in December.  Everyone knows going into this that there will be some hard decisions that will have to be made, and not everyone is going to be happy.

Wednesday, an initial copy of the Commission’s report was released.  In it they suggested many ways to get the deficit down.  Among them:

As expected, folks on both sides have gone nuts.  The idea is, yes cut the money–but not for the folks that I support!

I’ve linked to a breakdown, as done by radio host Neal Boortz.  Some don’t like him, but read it anyway, since he breaks down each of the suggestions:
Let the Games Begin.
As mentioned, the negative responses weren’t slow in coming:
Response to deficit plan–tepid to “unacceptable”.
They just aren’t serious about fixing things.

Flashback to 2008 and the Democratic Party wave

While reading an article from 2008 that discussed the victories of the Democrats during that election cycle,  one thing really jumped off the screen:

Nearly two-thirds of those polled after they cast their ballots called the economy the most important issue facing the country — the most single-minded electorate in two decades of exit polling.

So much of the country puts the economy as the number one priority. So what do the Dems do? Ram through a stimulus package that was inefficient and then spent months on health insurance reform. In other words, the recent loss shouldn’t be a surprise to anyone. And its not so much that the American voters were fickle as it was that the American voters spoke–but the Dems didn’t listen.
From 2008, In congress, a Democratic Wave.

A shot at Bush and Republicans–from a Republican

Many times, I’ve tried to explain that the anti-spend, anti-government angst didn’t just start when Obama took office.  Many conservatives’ ire began during Bush’s 8 years in office.  Many were upset at how much money was being spent by Bush and the republicans in congress, but such complaints were overshadowed by the war and the economy to an extent.  Now, re-elected governor Rick Perry takes a shot at Bush and his republican congress:

“They cowardly and selfishly empower themselves politically by compromising liberty issue by issue, often selling principle for a bridge, a museum, or some building named after them back in their home district or state,” writes Perry in the 187-page polemic.

Read the rest here:

Rick Perry knocks George W. Bush, Mitt Romney for ‘big government’ policies

QuickHit: Show me REAL Healthcare Reform

People are thinking that Republicans have a snowball’s chance in Hades of repealing the so-called Health Care Reform bill.  That’s a waste of time.  You know what would impress me?  If they turn around and say that they are going to create legislation to provide REAL healthcare reform.  Reform that addresses what the previous bill should’ve addressed–the rising costs of health care.  Every year, the costs of getting medical care goes up.  Ladies and Gentlemen, THAT is the main reason the cost of health insurance goes up every year.  So let’s see if someone comes up with a way to address that.

Healthcare Reform–What is MLR and how it may affect you

Healthcare Reform.  A topic that dominated the airwaves for months as President Obama and the Democrats attempted (and succeeded) to passing major legislation changing the way we do health care in America.  Later, we will discuss how what was passed wasn’t as much healthCARE reform as much as it was healthINSURANCE reform, but we’ll discuss that later.  For now, lets discuss MLR.

MLR, or medical loss ratio, is the amount of each dollar an insurer takes in that much be used to pay for medical coverage.  The concept is simple:  when you the insured pays a dollar of premium to, say, United Health Care, UHC is required to spend a certain amount of that dollar on things related to patient care.

Currently, that ratio is all over the map and depends on carrier as well as individual state mandates.   One may find that one carrier’s ratio may be in the 70s, while another carrier may be in the 90s.  But that is about to change.  New rules will require all carriers to have a MLR in the 80% to 85% range.    If a carrier is found to have a ratio exceeding that, they will be require to pay a rebate or refund to plan participants.  So, consumers are definitely going to get more bang for the buck, right?

Maybe.  Maybe not.

There are at least 2 ways that the new provision will most likely negatively affect consumers.  First, there are already carriers that are getting out of the major medical insurance business because they will not be able to comply.  “Big deal!” most will say.  But we all know what happens when we have fewer providers to pick from.  The amount we as consumers spend goes up because each carrier gone reduces competition.  Second, carriers are going to begin cutting commissions to insurance brokers and agents.  For many, that’s not a big deal and they could care less about it.  But there are a significant number of consumers who prefer the ability to deal with an agent who is available to explain plans and coverages as opposed to calling a particular carrier’s customer service line.  When those agents disappear, consumers will find themselves on their own in regards to figuring things out.

All this isn’t to say MLR is a bad thing.  But knowing how it may affect you is a GOOD thing!