Facts Are Stubborn Things
Opponents of health insurance reform may find the truth a little inconvenient, but as our second president famously said, "facts are stubborn things."
Scary chain emails and videos are starting to percolate on the internet [sic], breathlessly claiming, for example, to "uncover" the truth about the President’s health insurance reform positions.
In this video, Linda Douglass, the communications director for the White House’s Health Reform Office, addresses one example that makes it look like the President intends to "eliminate" private coverage, when the reality couldn’t be further from the truth.
For the record, the President has consistently said that if you like your insurance plan, your doctor, or both, you will be able to keep them. He has even proposed eight consumer protections relating specifically to the health insurance industry.
There is a lot of disinformation about health insurance reform out there, spanning from control of personal finances to end of life care. These rumors often travel just below the surface via chain emails or through casual conversation. Since we can’t keep track of all of them here at the White House, we’re asking for your help. If you get an email or see something on the web about health insurance reform that seems fishy, send it to flag@whitehouse.gov.
[Emphasis mine.]
There are so many ways that the White House could have worded the above to make it appear less Orwellian and Hitlerian. Just about everything this Administration (and Congress) are doing is like something from The Onion.
The White House Blog includes videos of people saying that the Health Care Bill won't become a single-payer program.
So what does the Bill actually say?
SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE (pg 16):
(a) GRANDFATHERED HEALTH INSURANCE COVERAGE DEFINED.—Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term ‘‘grandfathered health insurance coverage’’ means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:(1) LIMITATION ON NEW ENROLLMENT.—
(A) IN GENERAL.—Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.
[Emphasis mine.]
So it is "misinformation" to suggest that the Bill doesn't gradually eliminate private insurance policies, yet the Bill itself requires that no new members are added to the rolls of private insurance after "Y1" date.
Pg 19:
(1) IN GENERAL.—Individual health insurance coverage that is not grandfathered health insurance coverage under subsection (a) may only be offered on or after the first day of Y1 as an Exchange-participating health benefits plan.
To decipher what the above means, we have to go to pg. 10:
(13) HEALTH INSURANCE EXCHANGE.—The term ‘‘Health Insurance Exchange’’ means the Health Insurance Exchange established under section 201.
Alright, I'll play. What does section 201 include?
Section 201 says (pg. 74):
(c) TRANSITION.—Individuals and employers shall only be eligible to enroll or participate in the Health Insurance Exchange in accordance with the following transition schedule:(1) FIRST YEAR.—In Y1 (as defined in section 100(c))
(A) individuals described in subsection (d)(1), including individuals described in paragraphs (3) and (4) of subsection (d); and (B) smallest employers described in subsection (e)(1).
(2) SECOND YEAR.—In Y2—
(A) individuals and employers described in
paragraph (1); and (B) smaller employers described in subsection (e)(2).(3) THIRD AND SUBSEQUENT YEARS.—
In Y3 and subsequent years—
(A) individuals and employers described in
paragraph (2); and(B) larger employers as permitted by the
Commissioner under subsection (e)(3).
Good Lord! What in the Hell does that mean? It becomes circular, to the point of distraction. If single-payer is not the ultimate goal, why do the programs (for which an individual is eligible to enroll) change in Years 1, 2, and 3? It makes no sense. It appears to read that if you're in a private plan now, you can keep it (unless the government later determines it doesn't meet a standard--and it is up to the Commissar to determine what that standard is), but is it is blurry regarding a job/insurance change after the Bill goes into effect.
Beginning on pg 82, there is a description of a survey that must be conducted by the Health
(3) REPORT.—Not later than January 1 of Y3, in Y6, and thereafter, the Commissioner shall submit to Congress on the study conducted under this subsection and shall include in such report recommendations regarding changes in standards for Exchange eligibility for individuals and employers.
So, basically, the Commissioner will conduct a study to determine what employers are providing in their health care plans and then the Commissioner will recommend whether or not those programs are adequate to remain eligible.
Based on what criteria?
There are "BASIC, ENHANCED, AND PREMIUM PLANS" described, but not the costs/benefits which must be included as each is up to the Commissioner (not the employer or individual consumer) to determine (pg 85):
IN GENERAL.—The Commissioner shall establish the following standards consistent with this subsection and title I.
At this point, you'd think that the various categories of Small, Medium and Large would be defined, but they're not. They're just descriptive categories that the Commissioner can codify anyway he/she damn well pleases, as long as the benefits/cost sharing get bigger in Medium and Large.
This Bill is long, but its substance is lacking.
In order for an insurance carrier to be included as an "Exchange" provider (and that means any private insurance program, not the one offered by the Federal government or various other public programs), there is a long list of requirements, including (pg 91):
(7) CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES AND COMMUNICATIONS.—The entity shall provide for culturally and linguistically appropriate communication and health services.
Orwell is laughing his ass off.
I'm sorry this post is discombobulated, but that's because the Bill is incomprehensible. You can argue just about anything in this Bill, because anything is how it is written (pg. 92).
(4) OVERSIGHT AND ENFORCEMENT RESPONSIBILITIES.—The Commissioner shall establish processes, in coordination with State insurance regulators, to oversee, monitor, and enforce applicable requirements of this title with respect to QHBP offering entities offering Exchange-participating health benefits plans and such plans, including the marketing of such plans.
And (pg. 88):
(a) CONTRACTING DUTIES.—In carrying out section 201(b)(1) and consistent with this subtitle:(1) OFFERING ENTITY AND PLAN STANDARDS.—The Commissioner shall—
(A) establish standards necessary to implement the requirements of this title and title I for—
(i) QHBP offering entities for the offering of an Exchange-participating health benefits plan; and (ii) for Exchange-participating health benefits plans; and (B) certify QHBP offering entities and qualified health benefits plans as meeting such standards and requirements of this title and title I for purposes of this subtitle.
They might as well have written "to be determined by the Health Czar at some future date, based on any criteria he/she pleases" on every page after the introduction.
The requirements put on private insurance companies is simply mind-boggling as they're written, with wriggle room for the Health Czar to add any additional requirements they want, at their sole discretion. The Commissioner can deny a carrier based on dozens of defined and yet-to-be-defined criteria, and require Herculean levels of reporting and red tape. Anyone suggesting that this government bureaucracy will reduce medical costs is a liar. The paperwork alone will triple the costs.
There are many doctors who are refusing to take Medicare patients now, because the paperwork is too cumbersome to manage and the payments can take a 120+ days to process. This Bill burdens the insurance carriers and doctors, by providing greater reporting and "accountability," but "accountability" is to be determined.
It is not unreasonable to speculate that the solution to the red tape created in this Bill would later be "fixed" by creating government-run hospitals (similar to the Veteran's Administration hospitals) with no paperwork requirements--just open the doors and let everyone in. The result would be something like the Post Office or DMV, with the "quality" of service those institutions are famous for not delivering, or the Dickensian-like monstrosities of the VA. This is speculation of course, but it is impossible to see how creating this regulatory bureaucracy could be seen as a benefit or cost saver by anyone. If we don't pass this Bill there would be no regulatory bureaucracy to fix, so let's just skip to the end and not do it at all.
It is just common sense. If you add more bureaucracy, an additional layer between the consumer and the supplier, of course your costs are going to increase. In addition, the Bill requires the establishment of a Health Commissioner and staff to handle all the paperwork, conduct studies, review insurance carriers offerings and employer insurance plans and mandate their compliance. For what benefit? If the goal is to cover the uninsured then create a Bill that does just that.
If the goal is to also provide bridge insurance (when someone is between jobs), there is already legislation (COBRA) that requires an insurance company to allow a person to pay their own premiums (for two years, I believe) during their unemployment period (until they have a new job with insurance). At the point a person is uninsured (either becuase they never had insurance, they couldn't afford their COBRA, etc.), there would be a plan they could get through the Feds. If that's the goal, then write a Bill that does just that, and/or the above. This Bill goes far beyond any of that, requiring that everyone have health insurance (and a person will be taxed for it, if they don't pay for one on their own, or are provided a government-approved plan by their employer).
I'm not recommending any of the above, only suggesting that the sound bytes about what this Bill is supposed to provide does not jive with what the Bill would create. This Bill mandates health insurance in some form and creates a regulatory bureaucracy of all insurance carriers and employers' health care offerings. That's not "cost savings." That's growing the size/cost of government.
Someone, please, report me to the White House for spreading "misinformation." Anyone who quotes the Bill could be accused of that.
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