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Harry Moroz

Harry Moroz

Posted: November 6, 2009 12:47 PM

Putting Off Health Care

What's Your Reaction?

Conservative blogs have transformed into a hit parade of reasons why the House Affordable Health Care for America Act will kill jobs and the unborn, stifle economic recovery, and destroy ... education. Of course, the need to unsheathe so many harbingers of doom is mostly proof of the good that the health care bill promises to accomplish.

Admittedly, questions still remain. The legislation's effect on premiums for upper middle-income households with employer-sponsored coverage is uncertain. Cuts to Medicare will require serious backbone from a week-kneed Congress. Reform of the fee-for-service system blamed for our high health care costs is not really accomplished. And the public option's capacity to create competition among insurers is limited by its small size: the Congressional Budget Office estimates that only 6 million individuals will enroll.

However, one of the bill's most significant defects is its delayed implementation. In 2010, very limited reforms, such as a ban on rescissions and improvements to cost-sharing in Medicare and Medicaid, come into effect. 2011 and 2012 are essentially down years. It is not until 2013 that the most important and substantive provisions become effective: a complete ban on denials of health care for preexisting conditions, a ban on pricing according to health status, the opening of the Health Insurance Exchange with affordability credits.

The political consequences of these delays have been well publicized: Politico has reported that Democratic Representatives and Senators are pressuring their party leadership for real results from reform that they can point out to constituents in the 2010 midterm elections.

But the economic consequences of the delays have not been addressed.

In many ways, the situation is similar to the circumstances surrounding the Credit Card Accountability, Responsibility, and Disclosure Act, which banned abusive and unfair credit card practices. As I described several weeks ago, Congress delayed implementation of these protections until next year, allowing card companies to raise interest rates and fees in the interim. Just this week, the House passed an emergency measure designed to speed up implementation of the provisions, arguing that the card companies' rate and fee hikes were harming consumers at a time of great economic stress.

The House should apply this lesson to health care. Delaying implementation only allows the relentlessly increasing unemployment rate to push up the relentlessly increasing rate of the uninsured. An immediate expansion of health care, particularly of Medicaid eligibility, would help break this causal chain.

Indeed, a recent Kaiser report on health coverage in the early months of the recession finds that the number of uninsured adults increased between 2007 and 2008 by 1.5 million people primarily because public coverage was unable to offset the decline in employer-sponsored insurance. Those who lost coverage were primarily low-income (and, for reasons also related to income, white), but not eligible for public programs. In contrast, an expansion of Medicaid and SCHIP, which offer benefits to children with much laxer eligibility requirements, ensured that a drop in the percentage of children covered by employer-sponsored insurance did not result in an increase in the number of uninsured children. In fact, the number of uninsured children declined.

Health care reform that expanded coverage to low-income adults now could keep many low-income individuals insured, not only improving health outcomes but also preventing the mutually reinforcing spiral of high medical costs and debt at a time when the economy needs financially secure consumers who are willing to spend. The House bill does just this, expanding Medicaid coverage to individuals at 150% of the poverty line. But it waits until 2013 to do so, when -- hopefully -- the downturn will be well behind us.

Hastening implementation of this provision would be a significant benefit to struggling households. Committing the federal government to funding the entire expansion for the duration of the economic downturn would ensure that reform does not exacerbate states' fiscal woes. And moving up the effective date would prevent Congress from having to return to the issue several months down the road after an already overlong debate about health care.

 

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HUFFPOST SUPER USER
Steve Gilmore
09:59 AM on 11/08/2009
One thing I don't understand about all these reform bills being composed now, is why, since Ms Hillary attempted to do "something" 16 years ago and since both sides have spoke of this issue every year since, why haven't they been constructing a serious reform bill before now? If this has been such a problem for all these years, why was it necessary for them to throw together these bills in the manner they have just recently?

If the Republicans were so concerned over tort reform why did they never address it before now, if they wanted to open the markets across states lines (to whom I don't know, all the same companies sell insurance in all the states) why did they not do it before now, they had full control of the legislature for quite some time.

Why do Republican keep citing they do not want anything run by the government because it is so wasteful, when they are part of that government, how idiotic is this? Clean up the waste and fraud since you KNOW it exist, my goodness why sit back and state your a failure instead of making government work. Hey people don't send me your money for I'll waste it but keep voting for me and sending me back here so I can waste more of your hard earned $'s.
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HUFFPOST PUNDIT
GenosseJoe
07:08 PM on 11/08/2009
"Clean up the waste and fraud since you KNOW it exist"

The problem is that government wast and fraud is impossible to clean up. Marks tried it in theory, Lenin, Stalin, Mussolini, Hitler and FRD had tried in on practice. Does not work.

The more government - the more wast and fraud.

Founding Fathers understood it 250 years ago.

If you would ask - why Republicans did not reduce government when they controlled it, I would consider it a great question.
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07:21 AM on 11/07/2009
We are not going to get real health care reform. I've accepted that.
Obama's not for it, and was apparently suprised that people took him seriously during the campaign when he said he'd fight for it. Suprised at the level of actual public desire for it, which has now made his promises to the health and pharma industries a sticky problem.
The Congress, for the most part, only grumbles and threatens, until the next bag of money shows up on their desk. Then it's back to "triggers" and "co-opts."
We are not going to get health care reform. Accept it.

That is unless you are willing to go to the streets and FIGHT for it! If you are waiting on Obama and the Congress, you'll wait a long long time.
09:41 AM on 11/07/2009
Obama is for it and has said so many, many times.

Congress has been obstructed by the Republicans and only a few Democrats who are living in the past and afraid of change.

They are using this issue for the sake of politics and probably local politics instead of stepping up to help small businesses who can't provide insurance.

They don't realize the vast number of people struck down by economics out of their control who cannot afford or will soon have no insurance and will burden the healthcare system beyond what hospitals can maintain.

Without insurance for millions of people in the event of a flu epidemic the hospitals will end up losing more money imaginable without passing healthcare to get some reimbursement in the face of a health crisis.
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TheHandyman
Death...the last new experience you will ever have
01:36 AM on 11/07/2009
If you want to know if this present health care plan is any good, ask anyone in Congress, or the President, who is supporting it if they are going to give up their govt health care plan and use this one. I'll bet everything I own that not a single one of them will say yes! There is only one plan that will do what needs to be done and that is a single payer plan with full mental, dental, and eye care like the rest of the civilized world has where they do not believe that peoples lives are a commodity! But then again, those countries don't have politicians who take bribes from the industries they are supposed to protect the people from!
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GenosseJoe
11:35 PM on 11/06/2009
Why stop at free health care for all?

Lets handle a check for 100 trillion dollars to every men, women and child. This way we will all be richer than Bill Gates.

Why does this brilliant plan will not bring prosperity?

There are many reasons, why it would be a disaster for everybody. But the first and bold one is - we do not have those money to give.

The same goes for the Obama-Pelosi health care reform.

We can not afford it.
06:45 PM on 11/06/2009
Obama promised these three things about his health care reform: 1. being forced out of their current insurance; 2. being subject to government rationing, including the outright denial of life-saving care; 3. spending themselves and future generations into deeper debt. The Democrats’ program deserves to be rejected because conditions 1, 2, and 3 are not going to be met — and because the Democrats know it and are doing their best to hide that fundamental and important fact from the American
people. This should be stopped. Period. Now, if we dont get the govt's program we will be forced to pay a 2.5% of our wages tax, if we dont pay that we will be charged with a felony, fined $250,000 and sent to jail. Sure sounds like Na zi Germany to me.

http://article.nationalreview.com/?q=NTQ2ZTI4MzcwMzNmZDY0MzRjNzgwNGY0NjQ2NGI1YTY=
05:35 PM on 11/06/2009
Delaying implementation of the reforms only gives support to those who oppose reform.

It can be used as a talking point. "What are the Democrats so afraid of". "If the Democratic bill is so good, why are they delaying implementation until AFTER the 2012 election cycle." "What is in this bill that they don't want the public to know?" etc.

The health care reform bill has devolved into the health care insurance reform bill.

I have a simple direct question that I have yet to see asked? Why are the American people being REQUIRED to deal with an industry (insurance) that has a financial incentive to deny treatment? Every dollar they save (by denying claims) goes directly to their bottom line.

One reason the European system works where ours falls down is that the base insurance policy is NON PROFIT. That removes the incentive to deny claims or coverage. They operate on a 2% gross margin, U.S. insurance companies charge over ten times that amount for profit and overhead.

We need to not only address the 45 million uninsured. We also need to address the unsustainable spiraling costs. Perhaps if this were brought more to the fore, there would be less objection to the proposed bill. Other than "government takeover" the biggest complaint I see on the net is increasing the deficit (which supposedly this bill will not do) and increasing the costs of already too expensive health care. More thought should have gone into costs controls.
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GenosseJoe
11:49 PM on 11/06/2009
Every industry, including government run Department of Motor Vehicles and Postal Service has a financial incentive to deny service, do as little as possible while collecting as much money as they can pocket. Competition fores them to work to be able to pocket the money.

Non-profit government subsidized companies would spend our money (taxes will rise) and their preferred status with the Government to kill competition. Without competition from those big-bad private insurance companies level of service will decline, while cost of it will rise.

Do you still remember 30 cents postal stamps?

BTW Your lovely non-profit Medicare is the leader in denying claims and services among private and public health insurance companies. And this is before Obama took away huge chunk of their budget to bring his imaginary cost of the "free" health care to a level bellow 1 trillion dollars. Real cost will be much larger than 1 trillion anyway.
10:56 PM on 11/09/2009
Fruitless I know but......

Who exactly competes with the DMV in your state? Granted the DMV is the most disliked government entity in most jurisdictions, but their employees have no direct incentive to deny services, they just don't work as hard as some people would like. Right now I am attempting to help enact a law in my state that would prevent insurance companies from paying out "bonuses" to employees based on NET income. Show me the government equivalent of that practice.

Non profit insurance companies in Europe compete with each other for business. It provides them a pool of customers to try and sell additional products to. I see no reason that wouldn't work here. They are not government subsidized. Low income individuals receive subsidies, but they are the ones who choose what insurance company to buy from. Competition is maintained.

I had nothing to do with creating medicare, or monitoring it. It's interesting to note that both parties representatives have little to say about medicare wastes. I absolutely loved it when Fox news (among others) were denigrating health reform and medicare, then cut to commercials about how to get your new power chair "at absolutely no cost to you!".

All individuals obtaining a service should pay at least a portion of the price of that service.

If REAL reform was being proposed by congress, prices would be dropping by 80 billion a year, not rising. Why is this not being done? Follow the money.
05:32 PM on 11/06/2009
Way to go. Help us focus Congress and the Executive Branch! But shouldn't this be done now: a complete ban on denials of health care for preexisting conditions, a ban on pricing according to health status - instead of in 2013. Wouldn't this be a very positive change that would be recognized by a far broader spectrum of the citizens of the USA?