2010 Health Care Reform

The 2010 Health Care Reform Law

Does it Make Sense for America?

Before passage of the 2010 Health Care Reform Law, most Americans would have agreed that our health care system was flawed. And they would have cited high premiums, rapidly rising costs, insurance companies denying coverage at their discretion, and millions of American citizens unable to afford quality, reliable health care at affordable prices. So why now the cry to appeal health care reform, which appeared to have remedied many of those flaws?

Both political parties share responsibility for the flap-doodle. While health care misinformation is now at war-time propaganda levels, the roots of the problem began before the bill was passed. Among them were the lack of objective debate; ambiguous wording of the voluminous 1,017-page bill; wide disagreement between Democrats on how to implement universal health care; the appearance of impropriety—Washington making customary side deals to purchase passage of the law; and the inability of the President to frame the goals and objectives for reform in simple, easy-to-understand language.

To add insult to injury, we are now bombarded with distorted truths and overt misinformation about the 2010 Law. If Mark Twain were alive today, he might have diagnosed our problem as follows: “What gets most Americans into trouble in this health care debate is not that they know so little, but that they know so many things that ain’t so.”

Giving credibility to borrowing Twain’s assertion are polls showing an alarmingly disproportionate number of Americans who believe these things that ain’t so, including such fabrications as the new health care law covers illegal immigrants; Americans have no choice in the health benefits they receive; death panels will decide who lives; the government will set doctors’ wages; and no chemo treatment for older Medicare patients.

Per PolitiFact, the number one that ain’t so for 2010 because virtually every Republican leader told it repeatedly to the American public was: the health care reform law is a “government takeover of health care.”

The facts show that the 2010 Health Care Reform Law does not allow the government to operate the health care system. Unlike Canada, England and numerous European countries, public-sector or private-sector insurance companies are responsible for operations in the USA. An accurate statement is: the current health care reform law of the land provides (95%) universal coverage through regulated private markets.

So what do we do now? Do we accept the Law as currently written? Do we tweak it to improve it? Do we repeal it? And if so, what do we replace it with? If the “individual mandate,” requiring everyone to have health insurance by 2014, is deemed unconstitutional, is it possible to have universal coverage? And who pays for the medical costs of the uninsured? What happens to the one in seven Americans who did not have or could not afford health insurance before the 2010 Law? Is it still possible to have universal health care by dramatically lowering the age of Medicare?

Whatever answers we eventually embrace as a country, it is important for well-informed citizens to honestly debate health care reform. And, before axing the 2010 Law—if that’s our country’s choice—or trying to answer the aforementioned questions, we need to identify objectively the pros and cons about the current law. Branding or demonizing it as “Obamacare” or “the work of liberals” does not make for constructive dialogue.

If a person is interested in being well informed, innocent of knowing things that ain’t so, and engaging in healthy, civil debate, help is available. Several organizations, ones not beholden to any political party or private interest groups can provide accurate information about the 2010 Heath Care Law. A few of them are The Kaiser Family Foundation, Families USA, AARP, and Docs for America.

While I would like to see an amenable resolution to the health care issue, my motivation for writing this article incubated during the 2010 elections in southern Arizona. One candidate tried to unseat Gabrielle Giffords by bombarding the Tucson landscape with billboards reading, “Giffords forced Obamacare on You!” Many voters accepted this that ain’t so with little or no knowledge of the 2010 health care reform law and, they weren’t embarrassed by the lack of civil, constructive debate on this issue. After the assassination attempt on Giffords’ life, I vowed to do what I could do to try to convince people that we need to have rules for civil debate if our democracy is going to work.

P.S. As I prepared this article for a press release, I was pleased to see Bill Frist, a medical doctor and former Senate Majority Leader (R-Tenn.), telling his constituents that instead of mounting an effort to repeal the Health Reform Law, Republicans should use it as a “platform” for improvements. He further stated that the law has elements that Republicans should be able to get behind, particularly its “federalism” approach to providing health care. “(The Law) has many strong elements, and those elements, whatever happens, need to be preserved, need to be cuddled, need to be snuggled, need to be promoted and need to be implemented.”


A short bio: Richard E. Kelly is a concerned 68-year-old Tucson, AZ resident, published author, freelance writer, retired CEO (33 years) for a west Michigan manufacturing company (Clipper Belt Lacer), the survivor of 16 years growing up in a religious cult, and a political Independent. He can be contacted at rkelly3845@yahoo.com.

Comments

  1. Tom Cabeen says:

    I like your approach. As another Independent, I believe that the main problems with ObamaCare is that it was rushed through without sufficient open dialog; without taking the time to really identify the issues that were driving up health care costs, and addressing them each in the simplest way possible. Instead, we got a bill that potentially exchanges one set of problems with another. Repealing the bill is one approach, but the best that can do is to get us back where we started: needing healthcare reform. But the bill is so large (1990 pages) and contains so many provisions that have nothing to do with healthcare, repealing it (if that is even possible) and starting over may be simpler.

    Unfortunately, the current hyper-partisan political climate here in the US makes me wonder if the current crop of Representatives and Senators are even capable of working together to clearly identify what the real problems are. But if they were to do that, I think that it would relatively easy to find solutions to them. We are a rich, inventive and resourceful country, and we have more than enough resources to provide decent healthcare for everyone here. Whether or not we will marshal our resources to get that done remains to be seen. What I have seen lately from both parties does not encourage me.

  2. John Hoyle says:

    I still don’t understand why the debate is so intense. European and Central American countries provide easy access to excellent medical care to everyone, even foreign visitors, without breaking their banks.

    The real issue for America is that we need to rethink our concept of “medical care for profit.” Medical care should be a right – after all our lives depend on it.

    The government provides police and fire protection. Why? To save lives and property. The government provides basic education. Why? Because it is essential to our children’s future. Medical services and health care are absolutely essential to every American citizen, but for some reason there is an opinion that if some corporations can’t make a 25% profit, then those who can not afford their expensive health insurance (with all of their weasel clauses designed to reduce their financial exposure), then we just have to go without.

    Arizona’s Governor Jan Brewer provides us with a perfect example: If someone can’t get insurance because they can’t afford or qualify for it, then it’s just too damn bad for them and their families. The lives of common citizens are less important than new government buildings, public celebratory functions, and expensive perks for politicians.

    I don’t want to present Governor Brewer as a totally heartless person, but she certainly has her priorities skewed.

    Great article, Dick. I hope someone with some power reads it and takes some kind of action. I simply do not understand why the very people who would benefit the most from broader health care coverage seem so intent to fight it.

    Bill Frist has it right. Now is the time to protect and improve our health care options – not tear up the law and go through the legislative trauma all over again.

  3. George Stevens says:

    A good article, Dick, but I have not yet seen anyone serious (I thus exclude Michael Moore) try to explain why the Canadian model couldn’t have been followed, with a little tweaking. Universal health care here is just dismissed in America as “socialized medicine”, and disregards the fact that we pick our own doctor and usually (depending in some cases upon the family doc’s hospital privileges) can get directed to the specialist of our choice. The Canadian model certainly has some serious shortcomings, mainly the queue for elective surgery, but those line-ups are shrinking as more private clinics spring up. We do pay for that elective private surgery, but at far lower rates than in the U.S., as there is no insurance company middle-man that needs to make a profit out of our misfortunes.
    And there’s the rub with Obamacare. Universal coverage with mandated private insurers is inefficient and adds a huge cost layer to the provision of medical services. As a political matter, Obama couldn’t put the Aetna’s of the world out of business – especially in a recession, so to some extent he’s (to use his phrase) just put lipstick on the pig.

  4. Joe Malloy says:

    I think you did a great job of reporting on the situation. But personally, I think the whole thing will be a big mess.

    I think there are other ways to address many of the issues by creating a small, but different, set of rules. For example, don’t force people to get health insurance, but allow insurance companies to put people into different risk pools depending on the extent of their “insurance surfing”. That way, we can still have guaranteed issue without a coverage mandate.
    (So, for example, if you chose to go for 1-2 years without insurance (and had the means to get insurance), then, when you do resume coverage, you’ll be in a risk pool with other people who went without insurance for 1-2 years. In other words, there is a consequence for one’s choices. If you want to ally yourself with other “insurance surfers” for risk & premium purposes, go right ahead; it’s a free country, but you may find that you don’t like sharing risk with other people like you. If so, don’t be an insurance surfer. It’s all about aligning the consequences/incentives with the choices.)

    So I suspect there are ways to address the problems by putting in place a small set of different rules/incentives. And I do think competition can work in the health insurance market.

    My $0.02.

  5. John Hoyle says:

    One more thing: Remember that fellow down south whose house burned down while the local fire department sat in their trucks and watched – doing absolutely nothing – because he hadn’t paid a $75 surcharge to the city? Just watched it burn even though a neighbor offered to give them the money?

    Our medical care system is like that now. If you don’t have insurance or the funds to pay up front, then you are basically told to “take two aspirins and go to bed, or go to the Emergency Room.”

    There were periods in my life where I simply could not pay for any kind of insurance – auto, life, or medical. I would have if I could have, but I was simply too poor and had to take my chances. Food and a roof over our heads were first priorities.

    Later in my life, I moved from one state to another. I had medical insurance in the old state, but because of my past heart surgery could not get standard coverage in my new state. I had to sign up for new state funded pool insurance – one that had so many deductibles and co-pays built in that it was practically worthless. It’s premiums were over $300 a month just for me. When my old insurance company kept sending a “previous coverage” letter to our old address (after near daily phone calls to ask them correct the address they had and to hurry), I finally got the letter on day 60 – and immediately faxed it to the insurance company. They still didn’t acknowledge it for seven days, but eventually gave me credit for four days, which meant nothing. But according to them, because I’d missed the 60-day cutoff (at no fault of my own), my new insurance bill automatically doubled to nearly $600 per month and any treatment I might need for my heart condition was 100% excluded for six months. The following year, instead of going down, my “state guaranteed insurance pool” policy went up 25% to $750 per month. I hadn’t collected a single dime of benefits for the whole year I was in the plan. Not to mention I was out my $6000+ out-of-pocket for premiums.

    I ask the other authors of the other comments: Is this really the level of service and insurance coverage we want our citizens to endure? Have you been so lucky as to have always been able to get decent coverage for a reasonable price – without so many restrictions that the insurance becomes worthless? Millions of our fellow citizens face that dilemma every day.

  6. Gerry Brenner says:

    Dick, I was part of a group that put on a three-day symposium on health-care reform back in ’91-92, believing, as we did then, that with the new Clinton administration about to take office, such reform would surely take place. Naïve, huh?

    Nevertheless, by the end of the symposium—to which we also invited reps from various insurance companies, including Blue Cross—the public that attended (some 250 participants) were overwhelmingly in favor of reform. At that time there were “merely” some 27 million citizens w/out health care!

    My role in the symposium was to gather stories from near and far in Montana of people who had been poorly served by our existing “system.” Each of the three sessions each day began with a narrative with pictures of the nine families who agreed to be interviewed and have a story done on them by me. [My wife edited the stories and my youngest son created and performed theme music for the stories, a tune I still can hum. It was a gratifying experience, even if the result didn’t occur until 19 years later.

    Also, I should mention that I served on the board of The [Univ of Montana/St. Patrick Hospital] Institute of Medicine and Humanities, an organization that hired a director and has organized numerous activities and conventions since c. 1996. It grew out of a once-a-month book club of docs and profs, one that gave me a lot of pleasure between about 1988 and the time I retired, 2003.

    I mention this background simply to give you some sense of why your article struck a vital nerve. But I’ve been away from all of this since I retired and am interested largely as a carry-over. That is, I’m not the firebrand I once was.

    Good luck with your piece. Best wishes,

    Gerry Brenner

  7. Rules for Civil debate (civilized civil debate) are definitely called for. No matter what political party one endorses, we each have, at the very least, one thing in common: a human body with (eventual) health issues. I would thoroughly enjoy a debate where human bodies seated themselves together and discussed health. Good health for everyone… no matter how they voted in the last election. The more these people argue about gun control, the economy, the need to spend billions on our armed services, or Global Warming, the more stress and hypertension they cause, thus our health suffers merely from listening to all the “flap-doodle” as you appropriately called it. Just when I decide to stop watching cable news and quit reading the newspapers, you come along and put a little more balance into life. Thanks for writing this editorial. Also, thank you for inserting the WhiteBoard at the upper left.

    Joanna Foreman

  8. Chuck Vona says:

    Dialogue, nice word but when has it ever been a part of our political system. A conversation is a dialogue not a monologue.

    I once heard a man say that dialogue is a noun most often used in politics when the party in power suffers an ignominious defeat. Obama, Bush, Clinton all used the word. The time for true dialogue is when one holds the power. Unfortunately, Obama fell into the same trap and went from dialogue before his election to monologue after he was elected. It didn’t work so he’ll change (for a while) in an attempt to get the power back.

    I, like many, are not as upset about healthcare overhaul as I am at the way it was achieved. No, I don’t believe that the bill has a death panel BUT we do have a panel that sentences people to death. We do have a panel that decides at what point a fetus can be aborted.

    Health care cost can only go up, especially in the United States with its aging population. It isn’t a leap of imagination to believe that someone, someplace, sometime has to make a decision about when a treatment for a person age 70+ is too costly or as you accountants would say, lacks cost-benefit. What would cause me to think this way; I lived in Australia for 3+ years and saw how the government dictated what pills to use what quantity to be dispensed and what treatment would be allowed. I’ve seen Doctors shrug their shoulders and say “my hands are tied”

    Oh, I know this isn’t how the current bill is written. The point of objection is how it was approved and given a change in the Washington power structure will it morph into something else at a later date. Democrats may object to the Obama care label but trust is earned by example not words. Remember, it wasn’t so long ago that the Democrats were calling it Bush’s War

    Finally, how do we fix healthcare without fixing the cause of most illness? The Law, as it’s now written, wants to mandate when we MUST have health insurance coverage, yet it allows the sale of tobacco products, the cause of most illnesses. If the government is going to begin mandating what we must do then they must start with the difficult and unpopular tasks first. Let’s stop putting air into a leaking tire. How the hell do families go hungry in this county when we put corn products in gasoline or pay farmers subsidies not to plant wheat?

    Federalism, Alexander Hamilton is spinning.

    No, we don’t use dialogue in our political system. We use debate, an argument to change the other side.

    BUT, WHAT DO I KNOW; I’VE NEVER HAD STRONG OPINIONS.

    I have to go now, must start working on my paper for FOX NEWS. Okay, that’s a bad joke. The truth is that I have never watched Fox or any of the other broadcast news stations. I use BBC news. Yes, I have to go overseas to find out the straight scoop on what is going on in my backyard.

    PS: We have the best system of government in the world. The ability to stop runaway liberalism or suffocating conservatism is truly a freedom to be cherished.

    PSS: I’ll make one fast point and get off of it. Tobacco is not banned in this country because it is truly too big to fail. States have billions tied up in muni’s backed by tobacco income. Ban the product and down goes the State. So, let them smoke, we’ll keep raising the tax on cigarettes and issue more bonds backed by the revenue. Think about it. Could that be called a Death Panel? They die but we make tax income on the product. Don’t they put the mafia in jail for thinking up plots like this?

  9. Mark Evans says:

    A nice article, and a good reminder that anyone who argues against civility in politics should study the oratory during events leading to WWII.

  10. Bariordan says:

    The trouble with the government trying to make decisions on health care, is that they are not involved in health care. I am an RN and have been taking care of patients for 30 years. Technology that allows us to save or extend lives has increased greatly and is expensive. Also a lot of money is wasted on families emotions, they are not ready to see a loved on go and therefore we spend 10′s of thousands of dollar per patient per day to keep them alive until the family is “ready”. There are far too many issues to go into here, but government is also ignoring the American attitude of “I have a right to eat what I want, smoke if I want, spend all my time on my couch if I want. ” Then expect the healthy, working people to pay for their care. These habits start in childhood. Now lets see the government fix that!




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