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I listened, I heard, I’m puzzled
Our president addressed Congress and the nation last week to explain his proposal to rescue health care. I listened closely. I came away even more puzzled by what he did not say than by what he did say. The president told us his proposal would do several things and would not do some others. I want to check his facts.
1. Individuals will be required to carry health care insurance. I am not sure what section of the Constitution the president is reading, but I can find no authority for the federal government to mandate every citizen purchase health care insurance or impose fines on those who do not. Not stated, but the only way to enforce the mandate is to require self reporting. Any doubt the IRS will be the agency we report to? The president noted it would be like auto insurance, but that is incorrect. You only need auto insurance for a vehicle that is to be driven on public roads. With auto insurance you get to choose the coverage you want to pay for.
2. Businesses will be required to provide health care for employees. Another mandate without any authority to back it up. This is the best way to drive small business from the market place and to further impede the ability of American business to compete equally in the international market place.
3. No illegal immigrants will be covered. That’s what the words say, but hardly the case. There are no provisions in the proposals to mandate proof of citizenship before medical care is provided. The same unpaid “emergency room” care his proposal will “eliminate” for citizens and legal residents remains a viable health care opportunity for illegal immigrants. Nothing is changed. The major expense continues.
4. Insurance companies will be forced to provide coverage for pre-existing conditions. If that is the “cost of doing business” for insurance companies, the result will be either fewer insurance companies or increased premiums for all. Some how our president fails to recognize insurance companies are in business to earn a return on investment for their shareholders. Each time government mandates a new requirement, the cost is passed to the consumer.
5. The plan will not add one dime to our deficits. The intent is to cover the cost with “savings” from Medicare and Medicaid. If $900 billion could be saved in those programs, why are we not doing that now? Why do we need a new program to eliminate the waste and abuse from the current government-run systems? If we eliminated the waste, perhaps those programs could actually pay the real cost of service and the shortfall would not have to be passed to private insurance holders. Maybe we could reduce cost to all and increase coverage by simply doing what needs to be done to fix the problems in the current government-run programs. Sounds like a better plan to me.
6. Mandatory coverage of “preventive care” by insurance companies. Cost-based studies have demonstrated that widespread preventive testing is more expensive than targeted testing. Once again, this mandate only increases cost for all with no significant increase in health benefits for individuals.
7. You can keep your policy and your doctor. This sounds nice, but the reality is if your provider revises the terms of coverage or goes out of business, you also have to change. The proposals offered by the president do not have any impact on the state policies that limit companies that may offer insurance in a state. Unless the federal government nationalizes the insurance business, this claim cannot be maintained.
Finally, and perhaps most significant, is the timeline for implementation of the proposal. The president insists his proposal be passed now, today. However, that plan does not go into effect until 2013. There is an obvious disconnect in the “urgency.” Would we not be better off to actually work to eliminate the current problems with Medicare and Medicaid, reduce the harmful impact of government intervention in private insurance at the federal and state levels and create a system that offers coverage for all who want it without mandating personal coverage?
Jack Hamilton can be reached at email@example.com.