It's the problem of the basic goal of politicians...gross numbers...numbers of voters, numbers of supporters, how many votes needed in Congress and yes, the NUMBER of uninsured. It's the nature of their VOTE FOR ME point of view that makes politicians focus on the NUMBER of insured. It's also one of the main reasons that the insurance industry has been left to hammer out the details of plans that have increasingly become unaffordable and inadequate. Promises to offer quality, affordability and access to needed medical services fall by the wayside as politicians focus on gross numbers. There's a dirty little secret out there...many have opted out of health insurance coverage because it is too expensive to purchase for what they get and President Obama is slowly sliding into that failed model.
Bottom up politics in the health industry is not the answer any more than top down health industry reform is the answer. The very poor have the Medicaid option. The very rich don't worry about health insurance. The middle class, that has shelled out billions and trillions over its lifetimes to purchase insurance coverage that ultimately is inadequate to assist in paying for needed medical care when they get sick is the root of the "crisis".
But as politicians preserve their own superior health insurance options, confirmed by the plans available to civilian governmental workers while adjusting and tweaking everyone else's coverage, President Obama seems more and more to be working for change without making that change meaningful.
If Congress catches on, health industry reform may be on the steep slide to failure.
While consumers listen to a mish mash of public options a la MA where everyone must have coverage or be fined, high risk groupings a la McCain where consumers deemed high risk will have the option to pay unaffordable prices for health insurance, technological integration a la HIPAA where the privacy of physicians and medical service providers and health insurers "protects?" patients by making their information available to everyone but their family members, and babble from Republicans about how tort reform, and a free market for insurance purchasing that OF COURSE they won't use because they have access to great civilian governmental plans, President Obama has made a critical mistake...he's desperate for SOME legislation and has pretty much overlooked what was needed...affordable, accessible, quality health services for the SICK.
It's almost uncomfortable to watch the President talk about the elimination of lifetime caps, limits on co-payments, and an insurance carousel of "choices" so that Americans can compare insurance rates as he gives away the "public" option. With a Presidential seal of approval for special insurance groups for those who have been sick, the President will do more to perpetuate the greatest flaw in our health insurance industry...the ability to overcharge individuals who become sick, for WHATEVER reason. This is the cornerstone of our "health crisis". People become sick and use their insurance and the COST of medical services is so high that insurance companies will do just about anything to avoid covering the sick. Instead, we've focused on the healthy and manipulated them into believing that they can save money by disconnecting from their "sick" fellow citizens. Even as this ridiculous argument has succeeded, because after all, if you can only get affordable insurance while you are well, why do you need insurance (because the cost of preventive care and screenings amounts to about two months of premiums and therefore the rest of your money is wasted if this is why you are purchasing insurance), insurers continue to pad their lists of uncovered conditions, conditions that will justify higher rates FOREVER, and reduce the amount of coverage available for illness.
Here's the prediction: The next thing that insurers will tackle will be the cost of preventive services. The cost of these services will amount to less than actual costs to consumers. Why? Because every other squeeze play has been exploited.
President Obama is chasing after legislation and his urgency is taking away focus.
He's looking for gross numbers....numbers of insured and failing to address the reason for uninsured, you know, the COST of insurance that doesn't cover you when you're sick, he's taken the easy way out and gone with the let's fine those who don't buy health insurance. And like his predecessors, he holds out the proverbial carrot and stick with the schizophrenic "hope" and "expectation" that EVENTUALLY, the price of insurance will come down because we all will be required to have insurance. So here are the questions I'd like answered:
1. President Obama, why have the insurance plans of governmental civilian employees, like those afforded to Congressman, remained an UNTOUCHABLE part of reform when the expenses of this superior coverage are both directly funded by taxpayers and indirectly funded by health insurance consumers who are charged more to cover the reduced profits available to insurers who get the government business?
2. President Obama, without a public option based on the model of Medicaid and Medicare, or strict limits on how much insurers can charge made available to the middle class, where is the immediate relief to middle class individuals already choked by high premiums and inadequate coverage?
3. President Obama, what are the limits on how much can be charged to consumers who fall into one of the ever-expanding special high risk groups you support such as those for smokers, those who have obesity, pre-diabetes, high blood pressure?
4. President Obama, even if you can say when I became President there were 47 million uninsured, now everyone has insurance, because of the imposition of fines for those who try to vote with their wallets, how does having insurance help consumers who face bankruptcy in the face of illness because your bill does NOT address the COST of health services. Where are the provisions that usual and customary charges and the formulas used to make those calculations MUST cover at least x% of gross dollars charged by any given provider?
5. President Obama, NOBODY ever went broke from co-payments. NOBODY ever went broke from the cost of preventive care. Why have you omitted LIMITATIONS on PREMIUMS charged to consumers?
6. President Obama, where is the incentive for companies to shop around for health insurance deals for their employees when charging CONSUMERS (through taxes on plans) for the COST of employer-provided health services (when they have NO say and NO bargaining power in obtaining those options) if they exceed a certain dollar amount?
7. President Obama, what is the value of mandating coverage for pre existing conditions if consumers CANNOT pay the premiums? Isn't this just more legislation favoring the rich?
8. President Obama, why is HIPAA still being paid for with taxpayer dollars when our PRIVACY is non-existent IF we want to obtain insurance company contribution to our bills since we have to sign that insurers can see anything in considering our claims?
9. President Obama, what are the RESTRICTIONS your bill places on WHAT is charged for insurance policies and what are the legislatively mandated MINIMUM COVERAGE levels your bill includes for such coverage?
10. President Obama, what are the RESTRICTIONS you place on physicians in terms of liabilities and fines for DEFENSIVE MEDICINE, for which consumers currently contribute part of their premium dollars? Who reviews physician practices?
11. President Obama, why are screenings not part of the services provided by health departments so that insurance companies cannot continue to provide a cancer screening when they do not provide coverage that will prevent bankruptcy in the case of cancer diagnosis? Preventive services are finite costs, insurance companies love those, but the RISK OF THE COST OF ILLNESS is the only purpose of health insurance.
We know you're desperate for numbers, and that to get that number of uninsured down you are desperate for legislation. But President Obama, is ANY change what you promised or CHANGE for the better?
