Sunday, August 9, 2009

What Does HR 3200 REALLY Say?

This past week’s dust-ups at various “Town Hall” meetings dealing with the subject of healthcare have done nothing to advance public discourse with each side accusing the other of being mean spirited and each side invoking the specter of Nazism and brown-shirted thugs. I’m convinced that a huge part of the problem is that very few- -on either side- -have actually read HR 3200 relying instead on third-party analyses coming from people and organizations with vested interests and axes to grind. So, for what it’s worth your friend “The Sage”, who has actually READ the bill, has a few observations that may add some understanding to this subject.

The US population is just over 300 million. That number includes the often cited 12 million un-documented workers. According to a recent government report about 60% of us or 180 million people are covered by private healthcare plans offered by employers. Another 25% of us or 75 million people are covered by Medicare or Medicaid and the remaining 15% or 45 million people- -including those here illegally- -are not covered at all. Now if ObamaCare was simply a plan to cover those 45 million people alone we probably wouldn’t be hearing all the screaming and shouting coming from both camps. But it isn’t. In a nutshell here’s how it works and here’s what’s causing so much of the angst.

· HR 3200 doesn't create a new program per se but expands and amends the Social Security Act, which includes Medicare and Medicaid, beyond the 75 million or so people now covered, to include the 45 million people not covered- - -including 12 million or more illegals.
· If private medical coverage through an insurance company represents the "Gold" standard of coverage and Medicare represents the "Silver" standard of coverage, ObamaCare represents the "Bronze" or maybe Tin standard of care.
· Current Medicare recipients and boomers who will be retiring in the next few years who, for the most part have paid the maximum amount each working year into the system and have an expectation of getting the "Silver" standard of coverage, will now be reduced to the "Bronze" standard in order save enough money to help pay for those coming into the plan who may have never paid a dime in payroll taxes. This is what the Congressional Budget Office meant when it reported that one third of the $1.5 trillion cost of ObamaCare would be paid for by cuts to Medicare and this is what has ‘boomers’- -those born between 1946 and 1964- -turning out in large numbers and screaming to be heard and understood. THIS MUST BE FIXED.
· If Gen X (born between 1965 and 1980) and Gen Y folks (born between 1981 and 1995) are covered with a "Gold" standard plan by their employer and lose their job they will be forced to go to the "Bronze" plan and even if rehired will not be able to go back to a "Gold" plan. Over time, as the attrition from private plans continues, the end result could be a single-payer, completely nationalized healthcare system. Gen Xers should be in revolt over this. Even that ultra-liberal, Barney Frank, realizes this is not a desirable outcome and has spoken out against it. THIS, TOO, MUST BE FIXED.
· A huge concern, that should have the American Bar Association AND the ACLU up in arms, is the fact that under the proposed bill (Section 1651, pages 734 and 735) the provisions of HIPAA are all but negated by the fact that the DOJ will be given access to our previously 'private' medical records. And while the intent of the bill is to allow the AG to prosecute frauds and cheats, it does not specifically prevent the AG from using medical information to prosecute someone for an alleged crime NOT related to the healthcare system. What this means is that if the DOJ has you in their sights for prosecution of an alleged crime they can access information known previously only to you and your doctor and use it against you. So much for “doctor/patient privilege”. This is a serious Constitutional issue and must not be allowed to stand.

But, many of the aspects of the plan, especially those related to reducing fraud are quite good and should NOT be opposed by healthcare providers. If you are a healthcare provider or biller expecting to take payments from the government there’s no reason you shouldn’t prove that you are qualified to provide the care and services for which you are billing and that those billings are not fraudulent.

The medical community is also up in arms about the establishment under the bill of a “National Health Services Corp”. The idea behind this is that med school grads who attained their education through tax-payer funded government loans should spend some time working in community health centers in return for a reduction in the amount of their loans. I’m OK with this. After all, if auto companies and banks who have taken tax-payer money have to meet certain government conditions why should the medical community be exempt?

Overall, no one seriously doubts that our current system is deeply flawed and needs some overhaul. But when taken in its entirety HR 3200 creates more problems and social unrest than it cures. Besides, if ObamaCare is so good why aren’t the 535 members of Congress lining up to enroll? Perhaps James Madison, the “Father of the US Constitution” put it best when he said:

The truth is that all men having power ought to be mistrusted.”



kat's nips said...

Thanks for explaining this Bill in easily understandable terms and for providing a rational perspective to the various issues involved.
The one thing you omitted in your analysis is the need to address the high cost of malpractice insurance, which is one of the major factors in the increasing cost of health care. If Congress really wants to "reform" our system, they need to place a cap on how much $$ trial attorneys can be paid for representing plaintiffs and how much can be awarded to plaintiffs.
Take the exhorbitant profit out of every little hangnail incident, and maybe those attorneys will quit chasing ambulances and ginning up dissatisfaction where none previously existed.

Anonymous said...

VERY well explained, however many of us who voted for change were looking to move more away from statism, not more into govt. ownership and control. We should be following the constitution and creating laws to protect the people from the scams and fraud of the private systems, not going into the healthcare business further like they have done in the banking and auto industries. Many are just 'waking up' to what is happening. We don't need to re-write the bill, just don't do it!

The Sage of Tampa said...


Obama told the AMA in their meeting last month in Chicago that he had no intentions of putting caps on malpractice awards. No caps, no reduction of malpractice insurance premiums. And given the fact that the Trial Lawyers contributed over $245 million to the Democrats in the last election cycle- -including over $45 million to Obama's campaign- -you can bet the Dems will do everything possible to make certain the ambulance chasers and slip and fall artists continue to extort money from corporations through the tort laws. Tort reform will never happen in our lifetime. NEVER! (See the June 20 post for more detail on this.)