The White House has decided to use a viral email (or at least an email they hope will go viral) to spread their health care reform message. In it they offer:
8 ways reform provides security and stability to those with or without coverage, 8 common myths about reform and 8 reasons we need health insurance reform now.
It think it is important to get a non-spin version of their 24 points (really only 21). I will assume, as much as possible, that their claims are true and show what those claims really mean to the nation. As usual it’s not nearly as straightforward as any partisan claims would have you believe. (For example, they only offer 7 unique ways reform provides security, 7 unique myths – including one I had never heard, and 7 reasons for reform now – plus one generic platitude.)
8 ways reform provides security and stability
- Ends Discrimination for Pre-Existing Conditions. This is probably a good thing – if the bill really does this.
- Ends Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays. Now a saavy consumer can spend up to their out of pocket maximum in elective procedures and get the insurance company to pony up 100% of the costs of necessary medical care later in the year – that’ll reduce our overuse of the system. This will not help unless there are some important exceptions in what counts toward the out-of-pocket maximums.
- Ends Cost-Sharing for Preventive Care. This sounds good, but at best it just means higher premiums on any plan that does not already do this.
- Ends Dropping of Coverage for Seriously Ill. This is a reform that I can support.
- Ends Gender Discrimination. Men will now pay higher premiums to match what women have to pay. This will pad the bottom line for insurance companies, but it won’t have any positive effect on the cost of health care.
- Ends Annual or Lifetime Caps on Coverage. Annual caps make economic sense for the company and the consumer – pick a plan with an annual cap you can live with. Lifetime caps should go because the longer you have an insurance plan the more likely you are to hit that lifetime cap even if you keep paying the premiums.
- Extends Coverage for Young Adults. Blah – children live off their parents long enough as it is. Few children have a legitimate need to leech off of Dad and Mom that long and those who do would most likely already have an exception.
- Guarantees Insurance Renewal. This is essentially a repeat of number 4 – I guess they could only come up with 7 ways that reform would provide security.
8 common myths
Some of the myths are presented as myths and others are presented as facts rebutting a myth – I found it necessary to rewrite the 8 myths as “Myth” – counterclaim.
- “Reform will cause rationing” – reform will end rationing. Rationing is an economic fact. The government can declare that reform will stop rationing, but it will be as effective as declaring that gravity is a repellent force rather than an attractive one.
- “We can’t afford reform” – yes we can, the president has identified ways to cut costs in order to pay for reform. They may claim that the president has identified ways to pay for reform but if that’s true why do even the most liberal media outlets fail to inform us of where the money will come from? I don’t buy this.
- “Reform would encourage euthanasia” – it does not. As much as Congress gets wrong, I’m betting that the White House is telling the truth on this one.
- “Vets’ health care is will be diminished” – the President’s budget significantly expands coverage under the VA. The quality of veterans health care is likely to continue to diminish as all government coverage does over time despite the fact that I am confident that the presidents budget allocates a larger number of dollars for that care.
- “Reform will burden small businesses” – reform will benefit small business. No amount of tax breaks will make offering insurance coverage an economic possibility for all small businesses. If there is a mandate (as I have heard there is) it will be a burden to some small businesses although some may find the tax breaks beneficial.
- “Health Insurance Reform would be financed by cutting Medicare benefits” – reform will improve the long-term financial health of Medicare. Medicare will follow the same path as VA care – more expensive and diminishing quality over time – this is again a repeat of number 4.
- “Reform will force you out of your current insurance plan” – you can keep your own insurance. No provision will explicitly say that you cannot keep your current insurance but any public option will naturally be favorably positioned in the supposedly free market. And there is or was a clause that would prevent insurance companies from offering coverage to new consumers – lose your coverage once and you end up on the government plan forever.
- No, government will not do anything with your bank account. That’s the counterclaim – I can’t even invent the myth it proports to debunk because I have heard no such myth. I guess they could only find 6 or 7 myths to address.
8 reasons we need health insurance reform now
- Coverage Denied to Millions. Here they claim 12.6 million adults being denied coverage. Is that 12.6 million individuals or 12.6 million applications – sometimes more than one application per individual? And what of the other 33.4 million of the 46 million figure usually being cited? Apparently 3/4 of the uninsured are not even trying to get coverage.
- Less Care for More Costs. They claim that average premium for a family plan purchased through an employer was $12,680 in 2008 but they fail to mention that most of that cost is covered by an employer who is not sensitive to the actual health care being delivered for the premium. This disconnect may be the primary driver for the quickly rising cost of health care. If we were to remove that disconnect people would be more likely to live more health consciously and purchase health care more cost consciously. Their plan does nothing to connect the consumer with the actual costs of coverage.
- Roadblocks to Care for Women. While this is probably true I have not heard anything that addresses the issue except the claim to make the premiums not discriminate regarding gender.
- Hard Times in the Heartland. The fact that care is less available in rural areas is an economic reality just like rationing. I have heard no claim that their proposals would increase the number of doctors covering rural areas or that they would somehow magically make it more economically feasible to practice in rural areas.
- Small Businesses Struggle to Provide Health Coverage. The answer to this is not to increase employer coverage of health care expenses, but to increase individual ownership of health care policies. They’re moving in the wrong direction.
- The Tragedies are Personal. Like number 5 the proposals under consideration do not improve this fact – they might mask it temporarily or make it more widespread (bankrupting society instead of one family at a time) but they are doing nothing to contain costs.
- Diminishing Access to Care: An estimated 87 million people – one in every three Americans under the age of 65 – were uninsured at some point in 2007 and 2008. I was part of that statistic and while the proposals being considered would have declared that I had some coverage had they been in place it would only have been by stealing from my neighbors. No thanks. At best it would have had no effect on my actions – at worst it would have made it easier for me to not get to work about getting coverage.
- The Trends are Troubling. As I said in numbers 5 and 6 – the trends of this legislation are at least as troubling as doing nothing.