By now, most of us know the Supreme Court will review the cases being brought against the signature legislation of President Obama’s administration. Other than the controversial mandate that consumers must purchase health insurance, how much does the average American actually know about the legislation and how that legislation will impact how health care is delivered in this country. Both sides of the political spectrum seem to have visceral reactions when asked about the legislation, how it passed congress, and the impact it will have on business, yet little has actually been presented on the key provisions of the bill. There may certainly be benefits to the legislation, but the methodology used to implement the law, as well as the actual benefits, can and must be called into question.
For instance, health insurers will be prohibited from denying coverage based upon an individual’s medical history. The position of the Obama administration is based upon a report issued (and obtainable on the Health and Human Services web site, www.hhs.gov) from www.HealthReform.gov. This is an interesting fact, since the site, listed as an official U.S. Government web site, is now archived. Also, it only became active March 21, 2009 and appears to be an informational web site devoted to passing the legislation. This immediately calls into question the impartiality of the information it provided visitors, not as a wild conspiracy theory, but since the site ignores other government actions already in place. The reality of the “Pre-existing condition” is that in 1996 congress had already passed legislation called the Health Insurance Portability and Accountability Act, effectively limiting the use of pre-existing condition exclusions. While not blanket in protecting consumers from this practice, HIPAA did and does provide much of the protection the act deemed absolutely necessary to protect consumers. Therefore, it does appear the tactics being used to influence or scare people into supporting the legislation were grossly exaggerating the extent and application of insurance company’s use of the practice. Since passage of the legislation, the web site has been archived and a visitor is now re-directed to a new site advocating the benefits of the new law, www.healthcare.gov – again, with little discussion of the potential damage to the economies of working Americans. A footnote to this discussion: in 2005, Senators Edward Kennedy of Mass. (ironically, the father of the so-called health reform movement) and Frank Lautenberg of New Jersey urged the Government Accounting Agency to initiate an investigation into the use of columnists to advocate political positions as a violation of Congressional ethics. While not using columnists, certainly using government resources on official web sites to promote a political agenda is a conflict of interest concern.
Of more pressing concern is the additional costs this legislation will place on the average American. Besides the mandated coverage cost, which will directly impact Americans by either imposing costs they may not wish to be burdened with and indirectly through the subsidies the legislation requires be paid to nearly half of all Americans to pay the cost of purchasing insurance, there is also the specific limitation to just $2,500 workers can direct into flexible spending accounts (FSA’s). These popular accounts, which allow taxpayers to use pre-tax dollars to pay for known annual expenses (either medications, treatments, or other approved medical purposes), will be limited to that level so the government can recoup money through taxes which they do not take in as a result of these FSA’s. This is being done, ostensibly, to help pay for the overall cost of implementing “health-care reform”. In application, people who use the benefit to defray high recurring costs will be forced to deal with the full burden of the cost to treat their existing conditions. This flies in the face of President Obama’s pledge and guarantee that he will not increase the tax burden of “average” working Americans. This has been conveniently ignored in the overall push to rid government of the “burden” programs such as FSA’s place on the “system” – in other words, removing revenue Congress is much better at spending than some selfish, tax-dodging, rich American.
Finally, the act also imposes a 2.5% excise tax on medical devices. In case you are wondering medical devices include a range of products, from simple tongue depressors, thermometers, and glucose meters to expensive medical beds, prosthetics, and more expensive items. In total, in 2006, the annual United States trade in such devices reached $209 billion and is expected to grow at over 6% annually from that point. This obscure little tax, which every patient must pay (again, in the face of promises), will add over $72.5 million to the pockets of congress – supposedly earmarked to pay for the cost of this law, but which, in reality, like all revenue streams, go into the general fund.
Is there a need to reform the health care delivery system in the United States? As costs continue to grow beyond the rate of any other sector in our economy – probably. Does every person in America have equal treatment? Most definitely not, but then again, the mythical “equality” in our country does not truly exist in anything. Does our country provide the best care in the world? I would only ask that we look at the preponderance of the evidence to answer that question. Not many Americans leave this country seeking health care elsewhere (in proportion to the population). Yet, from every corner in the world, people come here. I may not be sure of many things, but I do not believe this would be the case if we were not doing something right with our system. Yet headlong we plunged into the task of “reforming” this system. The reform was accomplished in less than two years, without the benefit of discussions outside the triumvirate of President Obama, Speaker Nancy Pelosi, and Senator Harry Reid. Given their poor track record of improvements, we can all rest comfortably knowing how well they were looking out for us.