Saturday, June 20, 2009

The Health Care Lie - Keeping Your Coverage

As Senator, and now President, Barack Obama has proclaimed adamantly that

"you'll be able to get the same kind of coverage that members of Congress
give themselves," and "if you like your current policy, you can keep it."

Just remember that as I go over a few facts about Congress, their health care and how those statements are not only misleading, but a flat out lie. I can appreciate his eloquent ability to parse words, but when you lie to the face of the American people, it's unacceptable.

From the Affordable Health Choices Act, drafted by Sen. Dodd & Kennedy
- Specifically exempt are members of Congress and federal employees (section 3116)

Exempt. Say it again. Members of Congress are exempt. They do not have to follow the same rules we do. If this type of health care is the best system for the country, then why would members of Congress and the federal government not be required to participate? They will be allowed to keep their wide selection and best coverage, while everyone else will be required to enroll in a "qualified" plan. If Congress' plans fell into the "qualified" category, then they would not need a specific exemption to the health care bill.

The U.S. Office of Personnel Management says members of Congress "enjoy the widest selection of health plans in the country," and "can choose from among consumer-driven and high deductible plans that offer catastrophic risk protection with higher deductibles, health saving/reimbursable accounts and lower premiums, or fee-for-service (FFS) plans, and their preferred provider organizations (PPO), or health maintenance organizations (HMO)."

- If you don't enroll in a "qualified" health plan and submit proof to the federal government, you will be fined. (sections 3101 & 6055)

"Qualified" means that it meets all of the criteria placed into the legislation, and whatever additional criteria are added by the Secretary of Health and Human services once the bill becomes law.

- If you are already enrolled in a plan that is payed entirely by you or your employer, you will still be fined if it is not a "qualified" plan. (section 161)

So "technically" they are not lying to you when they say you can keep your coverage. I love semantics. So does the government, especially when it comes to cheating on your taxes. We cheat, we go to jail, government officials cheat, it was an "honest mistake." Just ask Wesley Snipes.

- The cost of the fine will be enough to "accomplish the goal of enhancing participation in qualifying coverage. (section 161)

How big will the fine be? One aide working on the bill says it will have "penalties eventually reaching 75% of the cost of the least expensive plan." So who decides who pays a fine and who gets free coverage, paid for by those paying the fine? What if your 25, just out of school and don't want/need a plan and would rather use the money to pay off school loans? Oh that's right, paying off debt is bad old-world policy of the past, just ask SC Gov. Mark Sanford.

- The bill suggests that only plans with managed-care controls such as "medical-home" will meet the definition of a "qualified" plan. (sections 3101 & 2707)

In December 2008, a Congressional Budget Office report on drafts of major federal health care bills noted "medical-homes" were very likely to be like the HMOs of 20 years ago, especially if cost control is a priority.

- In the Kennedy bill, "medical-home" providers will have a "payment structure" based on "incentives" rather than payments for each doctor visit or procedure. (section 3101)

This report focused on a specific type or requirement called a "withhold." HMOs would hold back 10% or more of the fees it paid a physician, and only pay back the money at the end of the year to physicians who met specific goals for limiting how many referrals to specialists or diagnostic tests their patients used.

The goals were so strict, that if a physician exceeded them, the cost of what he prescribed to you would come from his own pocket at the end of the year. This creates a conflict of intrest between you and your doctor. I don't want my doctor worried about paying penalties or facing fines when it comes to making decisions about my health! People complain about Police Officers "having to make their quota". This is the same thing, except that it deals with your health and well being.

President Obama recently said "if doctors have incentives to provide the best care, instead of more care, we can help Americans avoid unnecessary hospital stays, treatments and tests that drive up costs."

That sounds great, but what's the incentives he's talking about? Not having to pay fines and penalties for providing "more care" than the government allows? I want my doctor worried about me, not his wallet. Often times, the "best care" is "more care," and I don't want my doctor being told by the government how much of either to provide.
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