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Friday, July 17, 2009

It's the hypocrisy, Part III

Congressman and doctor John Fleming had an excellent editorial in the NY Post this morning titled "Give Pols the Same Care They Force on Us."

Some of the highlights:

"I've offered a bill, HR 615, to give them a chance to put their 'health' where their mouth is: My resolution urges members of Congress who vote for this legislation to lead by example and enroll themselves in the public plan that their bill would create.

"The current draft of the Democratic bill curiously exempts members of Congress from the government-run health care option: The people's representatives would get to keep their existing health plans and services on Capitol Hill -- even though the people wouldn't.

"If members of Congress believe so strongly that government-run health care is the best solution for hardworking American families, I think it only fitting that Americans see them lead the way....

"Congress has the bad habit of exempting itself from the problems it inflicts on the American people. From common workplace protections to transparency and accountability measures, lawmakers always seem to place themselves and their staffs just out of reach of the laws they create.

"Americans don't know that there is an attending physician on call exclusively for members of Congress, or that Congress enjoys VIP access and admission to Walter Reed Army Medical Center and Bethesda Naval Medical Center.

"It is past time that we make the men and women making the laws be exposed to the same consequences as the American public."

I don't know enough about health care to feel that I've gotten my arms around exactly what's needed. I've heard both pro and con arguments concerning the current bill, but I haven't delved into the details enough to really have a feel for it myself. To really have a handle on it, you'd have to study exactly where the money goes, who profits, and how. What kind of cut do the insurance companies get? How well run are the HMO's? Exactly how much fraud there is in Medicare and Medicaid, and how do we get rid of it? How could we cut down on the nuisance malpractice suits which drive the doctors' own premiums up? Exactly why have health care costs outpaced inflation by so much? Then in order to have an informed opinion on the current bill you'd have to read all six hundred pages and figure out whether it has the answers to the above questions, and many others, such as exactly what sort of care we'd be paying for for illegal aliens. (Think any members of Congress have read all six hundred pages?)

I suspect that most people with strong opinions both for and against don't really know either. The people whose opinions I tend to trust on other political matters seem to be against the new plan, but again, I just don't know.

My general sense is that the plan would require the haves to fund health care for the have nots. This, of course, would be in keeping with virtually every other policy espoused by Obama (with the exception of his coddling of the very rich at places like Goldman Sachs). I suppose using the words "haves" and "have nots" puts a liberal spin on the topic. A conservative would say, or at least think, "responsible, hard-working people with good health habits" and "free riders."

I've heard the stories about the English and Canadian systems, and how people from those countries who want quality medical care have to come over here if they don't want months long waits and a government official deciding whether they merit more care. Do those stories accurately typify those systems?

I just don't know.

But if the plan does pass, the Congressmen who are so sure that the new plan will not result in reduced care, or long waiting periods, or less choice, should enroll themselves. If they did so, it would certainly give the American people a measure of confidence in a government-sponsored health plan. But to pass the bill while insisting on a higher standard of medical care for themselves is hypocrisy.

There are, of course, a myriad of other ways in which Congress has exempted itself from the laws which they've passed to govern the rest of us. The Freedom of Information Act does not apply to them. And they have exempted themselves from a myriad of employment discrimination and civil rights laws.

I pay $647 a month to AETNA for my family's health insurance, and get practically nothing in return. I suspect I'm paying for a whole lot of Medicaid fraud, insurance executives' perks, malpractice premiums, and the medical bills of a lot of people with unhealthy personal habits. I might conceivably be better off with a cheaper public option. I just don't know.

The one thing I am sure off is that if this bill passes, I want members of Congress along for the ride.


Anonymous said...

You make a great point. The fact that our legislators exempt themselves from the proposed government health insurance is proof enough for me.

An organization I'm involved with recently had an interaction with a government agency. It was complicated, confusing and time consuming. Form after form was sent our way, and many of them were difficult to understand and seemed to overlap purpose with other forms. After the issue had moved in one definite direction, we continued to receive paperwork which no longer made sense given the present state of affairs. A large investment in government time and labor was made over an issue of minimal potential revenue to the government. Common sense? Forget it.

Someone I know was talking to a Medicare representative and having a lot of trouble. The person complained to the Medicare representative about the messy process - the Medicare representative with something like "what do you expect from the government"?

Many people have had similar interactions with government agencies. Why then do so many people think a government controlled health care system will be a great solution?

Here are a few thoughts.....

1) eliminate health insurance as a benefit to full time employment - further, eliminate all connection between health insurance and employment. This practice began when marginal tax rates were so high that paying the employee an extra dollar was not worth it, so tax free benefits were substituted for monetary income. Companies don't pay for your car insurance, house or mortgage insurance - why does it make sense for them to pay for your health insurance? The company sponsored insurance as a benefit creates a two tiered system that is unfair to people who don't work full time, or for a company that doesn't offer health insurance.

2) Pre-existing conditions: People can be forced out of their health plan - for example, they are laid off from work, exhaust their COBRA, and then they're out. Say you've had cancer treated and though you've 'paid in' to the health insurance system for your entire life, and you are out through layoff / COBRA benefit expiration. Now, still out of work, you are a pre-existing cancer patient who can't get insurance. (this is another reason to eliminate work sponsored health insurance).

3) Better sensitize people to the costs of their treatments. There are two types of health procedures that have decreased in cost: Lasik eye surgery and plastic surgery. Why? Because they are not covered by health insurance, so to make sales doctors had to find a way to bring the price to a level where there was demand. Health insurance should be there to cover extraordinary expenses - cancer, traumatic injury, etc. It should not be designed to cover basic medical expenses. Therefore, high deductible policies would seem to help both create a savvy health consumer, and to drive doctors to reduce costs to a level that people can afford to pay out of pocket for routine care.

4) Death is a great way to reduce health costs: Other government controlled health systems (Canada for example), make you wait a long time to get expensive MRI's, etc. A friend of mine has an older relative in Canada who had been put off from getting an MRI for over 6 months. The person went to another country to get it done, and was found to have cancer. Had the cancer been detected more than 6 months sooner, chances for successful treatment would have been much better. Are we ready for this in the US? Sorry Mom and Dad our new government system would rather see older folks die than pay for protracted care in your old age.

This is a tremendously complicated problem, and like you I don't pretend to have a full understanding. I just can't imagine a government controlled system is the best answer.

- Ed

John Craig said...

Thanks Ed. I didn't really make the point, John Fleming did in the Post, I just quoted him and echoed it.

You make several good points though. I'd never thought about whether health care ought to be employer-based or not. You make a good case against it.

It is hard to believe that putting government in charge is going to improve things.

Anonymous said...

That Congress would exempt themselves from health care options offered to the rest of us doesn't surprise me. And like most people, I don't know enough about what's coming to determine whether the new system (whatever it turns out to look like) will be an improvement over what we have now.

It's interesting though that the supporters of the bill are making such an effort to squelch comments from the opposition. Check out the UTube video recorded on 8/31 of an HCAN (Health Care for America Now)organizer giving instruction on how to block comments from the opposition. ["HCAN Organizer explains how to block opposing views"]. If the new health care plan will be such an overwhelming improvement over our current system, why not just clearly explain the pros to the public rather than resorting to such tactics as these? It certainly makes me think otherwise when our elected officials don't want to be part of it.

John Craig said...

Thank you, just watched the video. Yes, that is illuminating. I've always been struck by how much more the left tries to drown out their opposition than does the right -- just look at the way conservative speakers on campus are shouted down, while this almost never happens to leftist speakers.

I've actually come around since I originally wrote this post, from being agnostic on the issue to being against the bill. I still won't claim to completely understand it, but I have the general sense that, given Obama's priorities, it will mean less for the Baby Boomers and more for the urban poor, less for the native-born and more for illegal aliens. And it will definitely mean less choice in the long run for most of us. I'm not carrying a torch for the insurance companies, but I carry even less of one for the government.