A recent New York Times highlighted Maine’s attempts at comprehensive healthcare reform. Their experiences serve as a cautionary tale for Congress. The state established a public health insurance plan, expanded Medicare and Medicaid eligibility, and banned insurers from refusing to cover people with pre-existing conditions, but those actions have done little to insure more of its residents. Contrary to the promises of public option supporters, health care costs have only continued to rise in the state.
Reasons for the high health care costs range from the state-specific to the general. Unlike the bill that recently passed the House of Representatives, Maine’s healthcare reform legislation didn’t include a mandate to buy health insurance plans. It’s a vicious cycle: forcing health insurance companies to offer policies to unhealthy people with pre-existing conditions raises the rates for younger people; young adults will be even less likely to buy health insurance if their premiums go up, which results in the insurer’s risk being spread among less people. In the end, the older, unhealthier population remains in the pool and must contend with less affordable health insurance. Therefore, there is a larger uninsured population.
Granted, Maine is a market dominated by just one private health insurance company (which, with its effective monopoly, can increase premiums to their liking); and its population is older, sicker, and poorer than the U.S. in general. Senator Olympia Snowe points to her state as a cautionary tale of what may happen if drastic changes are made too fast. Snowe is a Republican that supports healthcare reform but is against the public option. Budgeting problems have caused Maine to cap enrollment of its own public option health insurance plan at under 9,000. The federal government, unlike most states, is allowed to run a deficit. However, it isn’t exactly rolling in the money right now either.
The reform bill passed in the House has the potential to change what all health insurance plans cover. An amendment proposed by Bart Stupak, which passed in the House of Representatives, prevents federal funding from being used to buy any health insurance plan that offers coverage of elective abortions. In exchange for the votes of pro-life Democrats essential to pass the legislation, the healthcare reform bill was modified. The previous language only prevented government money from being used directly to pay for an abortion.
Obviously, the public option will not include abortion coverage. However, the ban extends to private health insurers participating in the government’s insurance exchange. Low- and medium-income individuals and families will receive subsidies in order to buy a health insurance plan. A compromise proposed by Speaker Nancy Pelosi, which would serve to distinguish private dollars from federal money and allow insurers to cover abortion services with solely the latter, was rejected. Many people with employer-provided or individual health insurance have abortion coverage provided in their policies. In order to enter the potentially lucrative exchange market, insurers might eliminate that coverage entirely.
Those who pay for their entire health insurance policy out-of-pocket will still be allowed to buy plans that provide abortion coverage, although the availability and affordability of these plans will most likely decrease. Pro-choice advocates, such as Planned Parenthood, are crying foul.
Interestingly, the amendment received 240 votes–higher than the actual bill’s margin of victory. Assuming that many pro-choice Democrats voted against it, this result means that a significant portion of Republicans voted for the amendment. Whether they wanted to salvage something they wanted out of a bill that was almost certain to pass or sabotage the bill by creating a schism between Democrats, they decided to amend a bill while rejecting the bill itself.
(Image: mahalie under CC 2.0)
Healthcare reform was finally passed in the the House of Representatives after a long night. The final vote on the healthcare reform bill was very close: 220 for to 215 against. It seems that President Obama’s last minute push for the legislation worked. Despite Obama’s pep talk, nearly 40 Democrats voted against the the bill. As predicted, the vast majority of Republican representatives voted against it. However, one Republican voted for the bill. Supporters are happy that the public option was retained in the bill, and that health insurance plans will no longer be allowed to deny coverage to people with pre-existing conditions.
Now the bill must go to the Senate, where it will be debated and modified further. Some liberal representatives in the House weren’t completely satisfied with the healthcare reform proposals passed, but feel that they have a better chance of getting what they want if they pass the bill and allow their Senate counterparts to work with it. Their other option is letting it fail, possibly endangering the chances of universal health care altogether.
A 242-192 vote allowed the health care reform legislation to reach the House floor to begin with. Several representatives promised to allow the bill to reach the floor for debate, although they opposed the actual proposals to change the health insurance system.
Health insurance providers, both public and private, are looking for ways to cut spending. One of their strategies is to deny claims for treatments they deem unnecessary. The effectiveness-testing studies receiving funding in Congress’ healthcare reform bill is a case in point. While that’s a laudable goal, what if your doctor recommends an unusual course treatment?
Experts recommend that you never tell your health insurance plan that you are receiving an “investigational” or “experimental treatment; or if you are enrolled in a clinical trial. These phrases are codewords that make insurers more likely to look closer and reject your claims. First off, health insurance plans will cover treatment your physician considers medically necessary. When it comes to insurance, you obviously shouldn’t lie (that could lead to cancellation of your policy, leaving you uninsured); but you also shouldn’t give more information than is specifically asked for.
You may even be wrong about the experimental status of the procedure. Some procedures aren’t typically used, but are proven medically effective nonetheless. In that case, health insurance plans should cover it. Check with your doctor, even if he or she used wording such as wanting to “experiment with a treatment”. Don’t let semantics cost you!
Continuing the use of technology that fueled his successful presidential campaign, President Barack Obama is now using Facebook and other social media sites to push the Democratic healthcare reform bill. By reaching the younger demographics most supportive of the public option where they congregate, Obama hopes to motivate them to call their representatives and express their support of reform. Generations X and Y live on the Internet, and are also the portion of the population most likely to be uninsured. Some of them might think that they’re healthy now and therefore invincible, but others realize the importance of having a health insurance plan at any age.
The House of Representatives will most likely be voting on healthcare reform this weekend, and representatives will no doubt be hearing from their constituents about it. Opponents of the Democrats’ reform are fired up, and the Obama administration’s goal is to light that fire under supporters who believe it’s the best way to provide affordable health insurance to the nation. They must hope that Obama’s millions of Facebook friends and Twitter followers keep up with their news feeds and become inspired to get involved in helping him enact part of the change he promised them. Their presence was sorely lacking for Democrats earlier this week, when Republicans won governor’s races in two states in off-year elections–largely fueled by anger over reform, and fears of people scared of losing their existing health insurance plans. We’ll see if Obama’s final push pays off.
Yes, you read that right. South Carolina Representative Joe “You Lie!” Wilson has proposed an amendment to the healthcare reform bill lumbering through Congress, which would require all congresspersons to enroll in the public option health insurance plan. He hasn’t switched sides and decided to vote for the Democrats’ bill; rather, his amendment is a stunt intended to point out what he sees as the failures of the public option.
Ironically, supporters of healthcare reform have pointed to the government-subsidized insurance enjoyed by senators and representatives as evidence that there should be a public option–if health insurance is good enough for our politicians, shouldn’t it be good enough for the rest of us? (In fact, although the federal government subsidizes their healthcare, it is actually administered by private insurers.) Wilson turns that strategy on its head, by saying that if a public option is suitable for average Americans, it should also be suitable for Washington D.C.
It’s quite unlikely the amendment will be ratified in the House. The current language simply allows Congress to sign up for the public option. Most Democrats probably won’t vote for this ‘poison pill’ provision; as they have admitted, most Americans would prefer to keep their existing health insurance. Republicans might vote for it as a lark, although they might refuse to dignify Nancy Pelosi’s bill with any type of ‘yes’ vote. Joe Wilson has 72 hours to get his own mandate into the bill, before it reaches the House floor.
Blue Cross Blue Shield is one of the most famous health insurance plan providers. They offer a variety of options to consumers, and part of their opposition to healthcare reform is based on its potential to limit their ability to sell certain types of plans. So why are they only allowing their Florida employees to sign up for a high-deductible health insurance plan in 2010? They’re part of a growing trend of employers passing a larger percentage of healthcare costs to the consumer. These plans are tied to a tax-free Health Savings Account, to which the company will contribute a certain sum (individual employees can add more money to the HSA).
On the positive side, HSAs force people to give more thought to their spending; they could cut unnecessary costs, making healthcare reform more affordable. Unfortunately, many consumers aren’t knowledgeable enough to make informed decisions–they could forgo needed treatment to save money, eventually costing them more in both financial and wellness terms. BCBS is trying hybrid HSA health insurance plans, in which they offer either 10% or 20% co-insurance to lower the cost of annual physicals and other preventative care. In addition, the health insurance company covers basic screenings (e.g. colonoscopies, mammograms) that may otherwise be avoided.
HSAs can be very useful to younger people in good health; they often result in lower premiums, since you only pay for the care you need. However, they’re not for everybody. A PPO or an HMO could be a better option for you. While some employers are no longer allowing you to choose, there are still options on the open market. You should always talk to an insurance agent to see what’s best for you.
Health insurance companies are constantly in search of ways to save money. Some of their methods, such as refusing to cover those with pre-existing conditions that their underwriters deem too high risk, have drawn fire from consumers and politicians. Now, some insurers are promoting alternative medicine. With some exceptions, consumers pick up the majority of the costs of services like acupuncture and chiropractic, as well as herbal supplements. While most of these remedies are unproven, they have become increasingly popular with consumers. Therefore, promoting it seems to be a win-win situation for insurers.
Kaiser Permanente and Aetna are among the HMOs that offer dietary supplements and herbs to their patients. However, these supplements aren’t covered in most of their health insurance plans. If someone takes a conventional medication, the cost of their prescription will mostly be covered by their insurer, less a small co-payment. If they use a non-prescription herbal supplement instead, the patient must cover the entire cost out-of-pocket. The same applies when someone visits an alternative practitioner as opposed to a physician. In that respect, it is financially advantageous for insurance companies to encourage the usage of alternative medicine–although they surely won’t admit it.
Some people want Congress to include alternative medicine coverage in the healthcare reform bill. Do you wish alternative medicine was covered in your health insurance plan?
I recognize that healthcare reform is a serious issue that has the potential to change the lives of millions of Americans. I also acknowledge that many people are worried that such a bill will endanger their existing health insurance plans; their fears shouldn’t be downplayed. However, when healthcare reform proposals are compared to “domestic terrorism”, isn’t that going a bit too far? North Carolina Republican Virginia Foxx recently took to the House of Representatives floor to express her vehement opposition to the Democrat-written bill. The representative was quoted in the Associated Press as saying that the nation has more to fear from the bill’s potential passage than it does from terrorists. While hyperbole is a standard feature of modern politics, Foxx has reached a new level.
One of the identifying features of terrorism is the intent to cause a feeling of terror in a population. Many may disagree with Nancy Pelosi’s plans of healthcare reform that include a public option, but keep in mind that congresspersons of both parties genuinely believe that what they are doing will help America. They may be wrong–and their policies might have disastrous results–but neither Democrats nor Republicans are purposely trying to destroy the United States. Therefore, comparisons to the likes of Osama bin Laden are off-base. The worst thing about her comments is that they serve to cheapen the legitimate concerns people have. Foxx doesn’t like the bill because she believes it will allow the government to force people to buy health insurance, raise taxes, and and give bureaucrats more power. These are all valid arguments that deserve to be debated, but some people may tune them out due to her inflammatory statements.
Our infamously long-winded Vice President once said that he tried to never question a person’s motives, no matter how much he disagrees with their policies. All of our politicians would do well to take that advice. Both parties are striving to achieve what they think is best for America. Their varied opinions on healthcare reform deserve to be discussed civilly, without resorting to the modern equivalent of Godwin’s Law. In my opinion, that would be best for us all.
(Image: U.S. Army under CC 2.0)
Although it seems like the Democrats’ healthcare reform bills have been zooming through Congress, Senate Majority Leader Harry Reid predicts that there will soon be roadblocks. To the chagrin of the Obama administration, Reid believes that a final bill won’t pass before the ball drops on Times Square and 2009 draws to a close. The White House wanted a bill passed prior to Ryan Seacrest’s countdown to the new year. Why is that so important? Well, 2010 is an election year; the entire Congress will be up for re-election. Judging from the few elections held yesterday, things don’t look good for the Democrats. Their prospects will be even worse if the fight to reform the health insurance industry continues to drag on, instead of allowing the public’s memory to fade.
Unlike the House of Representatives, which is already close to voting on its bill, the Senate may not begin debate until December. There is some speculation that Reid is waiting for the final cost analysis from the Congressional Budget Office. He commented publicly that he doesn’t want to rush such an important bill. However, he is still striving to pass Obama’s top domestic priority by years’ end. They may be worried that waiting too long will make more likely that this administration’s attempt at providing more affordable health insurance will follow the failing path of Clinton’s.
This new development is just another example of why you shouldn’t wait for the public option if you can afford a health insurance plan now.