[Vision2020] Health Insurance is NOT Health Care

[Donovan Arnold]

Mr. Schou,
 
As someone that lives in the health care profession, I can honestly say, based on your arguments that you are unawares of the reality of the industry and mainly are relying on arguments designed to persuade people to support a bill that will do nothing for people that need health care but look good on paper. Please review your claims, and the reality. 
 
The Claim:
 
“You are wrong. The subsidy in the Baucus bill, which is by far the most conservative, is set at 300% of the poverty threshold, or around $33,000 for an individual. The more reasonable subsidy level set in the House is around $44,000, or 400% of the poverty threshold.”
The Reality:
 The Baucus bill will not pass with any substantial health subsidize for those making 300% above the poverty line because it would add trillions more to the national debt. The median income in the United States is below 300% the national poverty line. Please sit down and do the math. 
A 300% rate would mean over 150 million people would qualify for a government subsidize as a single, married, or dependant. Even a $60 subsidy for each person a month, a drop in the bucket, would add an additional trillion dollars annually to the debt. 
In addition, there is nothing in the bill to prevent the insurance company from raising their premiums or deductibles to erase any gains a family makes with a government subsidy. You also have to look at the hidden costs of implementing this subsidy, the costs of families to file tax returns and hiring tax attorneys to get the subsidy back. Also, consider the reluctance of some people to bother with the hassle, or who may not see the subsidy anyway because they owe back taxes or have garnishments.  
The reality is that in order for this plan to be affordable it will only cover people in the 100-200% percent above poverty range because most of them are already covered, in part, by the taxpayer. 
The Claim:
“You are wrong. The bill tinkers with Medicare reimbursement rates (more for primary care, less for specialist care), rolls back reimbursement for Medicare Advantage to the Medicare reimbursement rate,. . . “
The Reality:
 
Most people on Medicare need specialists. I recall few times taking a client to see a general practice physician in my years transporting the elderly and disabled, they have always been specialist with few exceptions, like getting a referral to see a specialist. To cut the care they need in favor of seeing a physician they don’t is bad medicine and it will hurt the people that need to see a specialist.  More professions and physicians are moving to specialties. 


The Claims:
 
“Medicare Advantage is a program that reimburses private insurers for medical care. It reimburses at 114% the rate that Medicare does. There is absolutely no reason for this to be the case.”
 The Reality:
There are very good reasons. Many doctors will see Medicare patients, but only so many because they make far less, and sometimes even lose money. Medicare Advantage allows many people to see doctors of their choice, or doctors living much closer to their residence. Traveling too far to see a different doctor is difficult for many people whom are elderly or have a disability, or arranging transport, which results in neglect of care when they need it.  How much easier is it for an 88 year old, who cannot drive, to arrange a ride and endure a round trip to Spokane, over that of one in Moscow, Lewiston, or Pullman? Think about what you are denying that person. 
The Claim:
“You are wrong. Illegal immigrants are ineligible to receive the subsidy. Insofar as they might be able to obtain health insurance through a health insurance exchange, they join the risk pool without subsidy, reducing insurance rates for everyone else. This is comparable to the way things work today; illegal immigrants will be no more able (but also no less able) to pay for health care health insurance than they are today.”
 
The Reality:
 
There is no requirement to provide proof of citizenship to get the health care subsidy. They will get it, the same as every other public service. 


The Claim:
“You are wrong. The majority of the savings come from diluting the insurance pool in two ways. First, the individual mandate (which requires people to buy health insurance) adds healthy people to the health insurance pool.”
The Reality:
 
Forcing people to buy something increases costs. So it isn’t saving anything, it is just taking money from private working people and giving it to the insurance companies. It also has robbed me of my freedom of choice not to give my money to an insurance company and knocked me and about 50 million others from 300% above the poverty to 200% above the poverty line. Most importantly, it misses the point of doing this in the first place, improving health care, not saving for insurance companies. 
 
The Claim:
“Second, the insurance exchanges broaden the risk pools across several insurers.”
The Reality:
You can do this simply by allowing insurance companies to pool across state lines, much more cheaply, and quickly. 
The Claim:
“Third, a public option or co-op option would cram down insurance companies' profit margins by forcing them to compete with a nonprofit option..”
 
Reality:
 
Private options already do compete with nonprofit options. It hasn’t reduced the cost of insurance or health care. Nor has it improved health care. In addition, private company profits are only about 5 cents on the dollar, not a dramatic savings considering how much more you will spend in taxes covering the subsidies. 
--- On Fri, 9/25/09, Andreas Schou <ophite at gmail.com> wrote:


From: Andreas Schou <ophite at gmail.com>
Subject: Re: [Vision2020] Health Insurance is NOT Health Care
To: "Donovan Arnold" <donovanjarnold2008 at yahoo.com>
Cc: vision2020 at moscow.com, "NicholasGier" <NGIER at uidaho.edu>
Date: Friday, September 25, 2009, 7:02 PM


 






First, if I lose my job after 4 months of work in the year, I will go broke.. Obama will force me to buy insurance, which consequentially will be about $300 a month if I lose my job (those offered COBRA, know what I mean first hand). His promise to help the poor, (those making less than $930 a month) won’t apply to me because after 4 months of work, I will be over $10,500 income mark to receive government assistance with insurance costs.  Who can afford $300 a month on $10,500 a year? Obama thinks everyone can. 

Donovan --

You are wrong. The subsidy in the Baucus bill, which is by far the most conservative, is set at 300% of the poverty threshold, or around $33,000 for an individual. The more reasonable subsidy level set in the House is around $44,000, or 400% of the poverty threshold. 









Second, one way to pay for part of this horrible plan, Obama is going to be making cuts to Medicare. This is horrible

You are wrong. The bill tinkers with Medicare reimbursement rates (more for primary care, less for specialist care), rolls back reimbursement for Medicare Advantage to the Medicare reimbursement rate, and establishes comparative effectiveness research boards. Though I doubt the "waste, fraud, and abuse" savings will be as high as they say it is, there are no Medicare "cuts.."

Yes, you tell me, but what about Medicare Advantage? Medicare Advantage is a program that reimburses private insurers for medical care. It reimburses at 114% the rate that Medicare does. There is absolutely no reason for this to be the case. 








  
Next, it would provide free medical care to anyone that could crawl, climb, walk, roll or drive, legally or illegally, into the United States. 

You are wrong. Illegal immigrants are ineligible to receive the subsidy. Insofar as they might be able to obtain health insurance through a health insurance exchange, they join the risk pool without subsidy, reducing insurance rates for everyone else. This is comparable to the way things work today; illegal immigrants will be no more able (but also no less able) to pay for health care health insurance than they are today.
 






  
Another aspect of this bill will be an increase in your insurance premiums. If everyone regardless of illness, injury, or ailment, is allowed into your insurance co-op, then there will be more medical costs, and more costs handed to you. The only way insurance companies could absorb those costs would be to raise your premiums and deductibles.

You are wrong. The majority of the savings come from diluting the insurance pool in two ways. First, the individual mandate (which requires people to buy health insurance) adds healthy people to the health insurance pool. Second, the insurance exchanges broaden the risk pools across several insurers.. Third, a public option or co-op option would cram down insurance companies' profit margins by forcing them to compete with a nonprofit option.

Literally no point you made has any foundation, as per normal.

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