Practical Health Care Reform

Cautiously members of Congress are again quietly talking about passing a health care bill. The House wishes to change the Senate bill and the Senate is considering passing the altered bill by reconciliation which would only require 51 “aye” votes. This would be a gigantic mistake. The country is against both health care proposals and would be incensed if a combined bill was passed using a parliamentary trick.

Congress needs to scrap the House and Senate bills. They are toxic. Congress needs to start over with a bi-partisan bill. There are a number of areas of agreement. There are logical steps that would truly improve health care without a governmental take-over.

1. Tort Reform is essential – real tort reform not token tort reform. A “losers pay” system would greatly reduce frivolous law suits. If doctors didn’t have the threat of these frivolous suits hanging over their heads, they would not order unnecessary tests.
2. No one should be excluded from obtaining health care insurance because of a preexisting condition.
3. Do not gut Medicare as more and more seniors enter the system. The government made a promise. It needs to keep it. However we need to actively seek to cut the fraud in both Medicare and Medicaid. Why aren’t we already doing this?
4. Citizens should be able to purchase insurance across state lines. How can Congress justify regulating health insurance under the commerce clause, if we can not purchase it across state lines? We can buy everything else nationally. We should be able to purchase the health insurance that best suits our needs.
5. We need more doctors. The federal government should offer full scholarships for primary care doctors-to-be if they will work seven years in a free clinic for a set salary.

Most in Congress would agree to these five steps. Congress needs to drop their agendas and enact common sense solutions. Do not complicate the issue. This should not be about gaining power but about doing the right thing for the country.

Signed,
The Electorate

Senator Bill Nelson: "Special" Perks for Florida

You missed the point of my correspondence concerning the special benefits that Florida would receive in the Senate’s proposed health care bill. I knew that the Medicare Advantage exception that Florida would receive would apply throughout the entire state. I thought it would be grandfathered in. What I objected to was that other states – states which would not be allowed to retain Medicare Advantage – would be forced to pay for our Medicare Advantage. I do not want to profit at the expense of others. It is not right or fair. You sought this special exception for Florida. Do you think it is right or fair? If you do, you would be wise to engage in some self-examination.

Signed,
The Electorate

Health Care: Public Option

Any legislator who supports the public option should take a long hard look at the public health care options we currently have. They are not good examples of efficient, high quality health care. Is a Medicare type plan what this country really wants?

Only half the doctors in this country accept Medicare, because of the low reimbursement rate. This rate is scheduled to be reduced even more in the future. Then even fewer doctors will accept it. It does not matter if you have health insurance if no one will accept it.

Medicare denies treatments at a higher rate than private insurance companies do. The government seeks to determine what treatments are “cost effective”. More treatments will be denied in the future.

Fraud is rampant in Medicare. Medicare pays for procedures for dead people. Dead doctors bill Medicare and are paid. Medical facilities are reimbursed for procedures that were never done. It is estimated that 75 billion dollars are wasted every year due to fraudulent claims. Medicare doesn’t seem to really care. After all it’s the taxpayers money not theirs. Private insurance companies lose far less to fraudulent claims.

Medicare frequently takes at least a year to reimburse doctors. This is not an efficient organization.

Medicare will be bankrupt in eight years – if not sooner. Is this the example Congress wishes to follow?

Medicare works for older people who are more apt to be sick. Ninety percent of health care costs occur in the last year of life. Private insurers don’t really want our older citizens. Medicare helps older citizen – just not very well.

Before Congress seeks to extend this type of option to the entire country, it needs to show the public that the government can run health care in an efficient and affordable manner. Solve the problems of Medicare first. Prove to the people that the government can provide high quality health care and not bankrupt the country. Then people will consider a government run option.

Signed,
The Electorate

Paying for Health Care Reform

After all these months no one has found a good way to pay for a large health care reform bill. We can not borrow more for we are drowning in debt. The government’s uncontrolled spending has already trashed the dollar and has increased the strain on the already sagging economy. Few want to loan this country money anyway for we are a bad risk. If we print more money, the dollar will be further devalued. The only remaining way to fund an enormous spending bill is to raise taxes.

Raising taxes during a recession will only deepen and prolong the recession. Yet the latest health care proposal is filled with taxes and fines on individuals and corporations. Corporations will pass their taxes along to consumers in higher prices. Individuals can not pass along their taxes. We can not afford any more taxes. We are hanging on by our finger tips now.

Congress plans on increasing the number of people eligible for Medicaid. States are responsible for almost fifty percent of Medicaid’s cost. The federal government then only has half the cost of new benefits included in its projected costs. Isn’t this a neat bookkeeping trick? Of course, the people are still entirely responsible for all the costs, but it sounds better. These are UNFUNDED state mandates unless you live in Nevada, Oregon, Michigan, or Rhode Island. The federal government will pay their share of the new Medicaid costs. Apparently they are special.

Congress needs to scale back their plans for health care reform. Reform the obvious. Allow us to buy insurance across state lines to increase competition. Follow the Texas example and enact real tort reform. It has lowered costs there and will lower costs elsewhere. Make it illegal to deny health care insurance because of a pre-existing condition. These three items will not affect our budget. Then provide scholarships for primary care doctors and provide premium subsidies for those who truly can not pay for insurance. These last two items will have a cost - but will not cost the trillion dollars that other plans will. Do not punish citizens with higher taxes or push this country over the financial precipice by significantly increasing the national debt.

Is Health Reform Meant To Save Social Security?

I am beginning to wonder if health care reform is meant to solve the social security problem. Social security is running out of funds. How can less money be spent on social security? Every year more and more people are entering the system. If fewer people received social security, the system could be saved. If medical treatment was restricted to those who received social security, the number of recipients would be reduced.

All the health care proposals being considered cut Medicare by over 500 billion dollars. As more people enter Medicare, how can costs be massively cut and benefits not be affected? Eliminating fraud alone will not accomplish this and why has eliminating fraud not been addressed long ago? The government says it will cut waste. So what does the government consider waste? Is it denying treatment to seniors when that treatment would be approved for those who are younger? Is this waste? Some of the president’s remarks indicate that it would be.

Medicare already has arbitrary restrictions. A bone density test can not be ordered without a diagnosis of osteoporosis. Osteoporosis is diagnosed by a bone density scan. It is a Catch 22. This is government bureaucracy at work.

Only half the doctors in this country currently accept Medicare. Next year, their reimbursement will be cut by twenty-one percent. Other cuts are proposed for the not so distant future. Fewer and fewer doctors will accept Medicare. Lines will get longer and in some areas cease to exist.

The current health care proposals are all a bad deal for seniors. The health care proposals are being paid for by cuts that only effect seniors. The plans are build on the backs of seniors. Plans would virtually eliminate Medicare Advantage, which supplies health care to about twenty-five percent of seniors. Many of these are low income seniors. In some sections of the country this is the only plan available. Civilizations are judged by how they treat their very young and very old. It is not about “cost effectiveness”. It’s about valuing human life.

Signed,
The Electorate

Health Care Part 2: Congress Still Doesn't Listen

This summer the American people made it abundantly clear that they did not like and did not want the health care reform being proposed by Congress. Polls show that this is still true. Two-thirds of our representatives were unwilling to meet with their constituents. I can at least respect those who were willing to “take the heat”. I have waited to see the response of our representatives. At first they ”hunkered down”, but are now again beginning to try and push this unwanted, so called, reform down our throats.

The House is trying to “repackage” and combine their proposals. The bills don’t need to be repackaged; they need to be fundamentally changed. A bad bill is a bad bill. The House needs to consider what the people want and not just what Congress thinks they need.

The Senate is working on a supposedly bipartisan bill. If the government controls a co-op, it is still a public option. The bill is now being marked up in committee. It is being changed from a true effort of bipartisan legislation into the same kind of legislation that the public has already said that they do not want.

Is Congress unable or unwilling to listen to the American people? We do not want the government to run or control our health care. It doesn’t matter what Congress calls the plan. We do not want and can not afford a large, expensive new program. Congress has already spent all the money this country has and more. In this difficult time, citizens can not afford more taxes and fines are nothing but hidden taxes.

Significant changes can be made to our health care system that will make it more available and more affordable. These changes will not further bankrupt this country and will not cause more governmental intrusion in out lives. Congress needs to drop the public option. Congress needs to eliminate exclusions for pre-existing conditions. Congress needs to allow citizens to buy health care from any insurance company based in this country – across state lines. This would increase competition and lower costs. Congress needs to enact real tort reform. Cap “pain and suffering” awards and instigate a “loser pays” system for medical malpractice suits. This would discourage the practice of defensive medicine and lower malpractice insurance. This would lower health care costs. This has already been proven at the state level. Congress does need to address the fraud and waste in current government health care programs. Congress should not gut Medicare to provide health care to others. Congress can set a basic minimum of health care coverage, but not a maximum. Congress should eliminate comparative cost effectiveness in health care. People are not lab rats. These are just a few things that could be done to reform health care and would not put our country further in debt.

Signed,
The Electorate

Health Care: Seniors

You represent Florida. Florida is the land of retirees. The proposed health care bills will have a very adverse effect on seniors.

A large portion of the proposed bills will be paid for by cuts in Medicare. Medicare will be cut by over 500 billion dollars. These cuts will be made as more and more “baby boomers” enroll in Medicare. Seniors are told that their benefits will not be cut and the quality of care will not suffer. The cuts will be offset by increased government efficiency. Is this the same government that is bankrupting Medicare, Medicaid, and Social Security? Is this the same government that instigated and ran “Cash for Clunkers”? The reimbursement rates for specialists and treatments are being reduced. An example of these cuts is the reduced allowance for an echo cardiogram ( a basic diagnostic procedure ). Its reimbursement rate will be cut by 40%. By drastically reducing rates the government is, in effect, rationing treatment. People will needlessly die because of these cuts.

The stimulus bill created the Comparative Effectiveness Research (CER) panel. The House bill proposes a Benefits Advisory Board. These boards will decide what treatments are acceptable and who may receive them. Health care is to be “cost effective”. How “cost effective” will seniors be deemed to be?

I am dreading the time when I will have to depend on Medicare for my health care. Age should not be a determining factor for receiving health care. Can’t our government do better than this?

Are We Cost Effective?

A pattern is developing. The Stimulus Bill established the Comparative Effectiveness Research (CER) panel. This panel was to determine what treatments and medications would be used to treat various illnesses. It would also determine who was eligible to receive these. Cost effectiveness is to be determined by dividing the cost of the treatment by the number of years the treatment would benefit the patient. Seniors will not fare well under these recommendations.

The House bill proposes a Benefits Advisory Board. This board will be comprised of 27 appointees. It will determine what coverage constitutes “acceptable” health care coverage. All insurance plans are required to meet this standard. We do not know if this refer to only minimum coverage or if it also restricts maximum coverage. The bill also does not address abortion. Previous court decisions have ruled that if abortion is not specifically excluded, it will be included.

An Independent Medicare Advisory Council (IMAC) is proposed. IMAC, a 5 member appointed board, has the authority to curtail Medicare spending and recommend broader Medicare reform. The Administration has already stated that cuts in Medicare will help fund health care reform. Seniors are again targeted.

The concept of Quality Adjusted Life Years (QALY) is being discussed. The patient is assigned a numerical rating of 1.0 – 0.0. If treatment is not deemed, using this number, to be “cost effective”, treatmen t will be denied. This will adversely effect those with chronic illnesses, disabilities, and again seniors.

I don’t think the plug will be pulled on Granny. I think she will simply be denied treatment.

Is this what health care is really about – “cost effectiveness?

Age Discrimination in Heath Care Bill

Older citizens do not fare well in any of the health care proposals. Age discrimination is rearing its ugly head. At a time in one's life when they most need health care, our older citizens will be the least likely to receive it. Since hospital and doctor fees are being reduced in Medicare, fewer and fewer health care providers will accept Medicare. Currently, only about half this country's doctors accept Medicare. Fewer MRI and CT scans will be allowed. No doubt other procedures and treatments will also be limited. The stimulus bill provided for a panel that would determine what treatments are "cost effective". The cost of treatment will be divided by the years of benefit that may be derived from the treatment. Older citizens will be at the bottom of that list. Using this policy, the President's mother would have just been denied treatment and would not have struggled with all the paperwork.

Side thought - Why didn't her lawyer son help her with the paperwork?

As medical costs rise for older citizens, they will become disposable. Good-bye Grandma! Good-bye Grandpa! It's been nice knowing you. You were once useful, but we don't need you anymore. Treatment denied - by a bureaucrat. This is, in effect, forced euthanasia. We can be judged by how we treat our oldest and youngest citizens. How do you wish to be judged?

Any health care reform passed should not be an anti "old folks" bill.

Signed,
The Electorate

Health Care: Problems, Not Crisis

To Congress:

Our health care system does need to be improved, but we do not have a health care crisis. The problems we face now are the same problems we have faced for decades. Only 16% of Americans are uninsured - some by choice. Crisis is merely the vehicle being used to rush through hasty legislation that can not be debated or even read.

Have you yet signed the pledge to read this bill before voting on it? As of this morning you hadn't.

Even though we need improvement in our health care system, 84% of Americans are satisfied with their health care plan. Why is Congress seeking to throw away these plans and replacing them with a plan that has a history of only failure? Nationalized health care is socialized health care. Universal health care is socialized health care. Don't play word games.

The United Kingdom and Canada have nationalized health care. It has worked poorly in these countries. There are long waits, limited and denied treatment, and their health care systems are very expensive. Health care is driving these countries into bankruptcy. Massachusetts has universal health care. The results here are echoing those in the United Kingdom and Canada. If you wish to see how the United States government would run nationalized health care, you only need to look at Medicare, Medicaid, and the VA health care system. They too have long waits, limited and inferior treatment, and high expenses. This is compounded by fraud and bureaucracy. Now you want to share this misery with everyone else in the country. We say "No Thanks". We do not want your government run, government controlled plan.

The only thing Congress needs to do is to address uninsured citizens who can not afford health care insurance and are not eligible for Medicaid. This can be done in the private sector. Leave the rest of our plans alone. A government run plan would destroy private plans.

Signed,
The Electorate

Government Run Health Care

To Congress,

The ABC special didn't address the problems of a government run, government subsidized health care plan. I would like to address why this type of plan is a very bad deal for the American public.

1/ It is too expensive. Private plans could cover the uninsured at a much lower cost.

2/ A government run, government subsidized plan would force private plans out of business - leaving us with only the government plan. Private plans can not compete with a tax subsidized plan.

3/ The government would decide what treatment, if any, would be allowed. The government should not control our life and death medical decisions.

4/ A government plan must result in rationing. We have a limited number of doctors. Each doctor must treat more and more patients. There will be long waits to see doctors and others just won't be seen.

5/ Doctors will be driven from the medical field or students will decide on other careers. Medicare now only pays a percentage ( 81% ) of doctors fees. More cuts are already being proposed and malpractice insurance costs are not being addressed with tort reform. Doctors will not be able to afford to be doctors.

6/ The government run plan will result in inferior medical care, because of overburdened doctors, limited treatment, and long waits.

These are a few of the reasons the American public does not want a government run plan. We have all dealt with government bureaucracies and their inefficiencies. We do not want our medical decisions to go down this road. There is an old joke. If you think your HMO is bad, just wait until the government gets involved. Don't get the government involved!

Signed,
The Electorate

Retaining Our Health Care

To Congress,

We are told that if we are happy with our current health care plan, we can keep it. The government will do nothing to prevent this. This is not correct. Private insurance plans can not compete with a government run, tax subsidized health care plan. Using Medicare as an example, the government only pays 71% of normal hospital fees and 81% of normal doctor fees. The remaining cost is transferred to other payers. This forces the cost of insurance up for other payers.

May I repeat?

Private health care insurance companies can not compete. Private companies will be force out of business.They are not publicly subsidized. Their price has to be more than any subsidized plan. Most workers pay for part of their work health care plan. Even if the government does not tax our health care benefits, which they would like to do, eventually we will not be able to afford the work plan. We will be forced into the government plan. Businesses will find it equally hard to continue to offer health care. Government costs and regulations will make it fiscally infeasible for businesses to offer health care at work.

The government will tax behavior it does not want and reward behavior it does want. It's the old carrot stick theory - used against us. Eventually everyone one will be forced into the government run plan. That is the end game - the one insurer plan.

Signed,
The Electorate

Continuing on the Health Care Theme

From June 8, 2009:

Congress is considering more middle class taxes. Before the elections, candidates promised not to raise taxes on the middle class. Now thy propose taxing health benefits from work as income. This will increase our taxes by approximately two thousand dollars a year. We cannot afford more taxes. We are struggling to keep our heads above water now. Don't pile more taxes on our shoulders. When we go under, you will too.

There is a big difference between want and need. Congress wants a massive health care plan that will eventually cover everyone. What Congress needs is a plan - preferably within private plans and supplemented by government financial help for lower incomes - for the 16% who are uninsured. Not only do we not want the government involved in our medical decisions, but we can't afford the tax increases that would be required to pay for this all inclusive government health care plan.

From June 9, 2009:

84% of Americans have health care insurance and 16% do not. Do you really think that the 84% want a government run plan? Any government run plans has to contain rationing, since there are not enough health care providers. Do you think the 84% want to wait months to see a doctor? Do they want government bureaucrat to determine what treatment they are allowed to have or, even worse, the treatment they are denied because it is not deemed "cost effective?"

The stimulus bill set up a committee that would determine what treatment is cost effective. The cost of treatment would be divided by the number of years the patient could benefit from it. Do you think the 84% want the government to determine what treatment they are allowed; what doctor they see; or, what medicine they take? Do you think the 84% want the government to make their life and death decisions?

Obviously, the answer is a resounding NO. We also don't want our benefits to be taxed to provide the benefits for the 16%. We can't afford our current taxes?

From June 10, 2009:

Please do not create a massive government run health care plan. We already have Medicaid and Medicare and cannot afford them. They are, at best, inferior plans filled with billing corruptions, limited treatments and medications, an subjective decisions by bureaucrats. They demonstrate how a national government health care plan would work - badly. Only 16% of Americans do not have health care insurance. Create a plan within the private sector to insure these citizens. The government could supplement insurance payments for those whose income meets a certain criteria. Do not create a one size fits all government run plan and do not tax health care benefits as income to try to force us into that plan.

Rushing Health Care Legislation

To Congress,

Please do not rush through health care legislation. Take the time to thoroughly discuss it and consider all the ramifications. Is it really wise to cut over $300 billion from Medicaid and Medicare benefits to pay for a new government run plan? This is a fine example of robbing Peter to pay Paul. Is it wise to tax work health care benefits to pay for a new government health care plan? Taxpayers are already overburdened. They can not afford these new taxes. In these harsh economic times perhaps a more limited plan would be advisable.

Perhaps Congress should only address the 46 million who do not currently have insurance. Even the 46 million number is inflated. At least 12 million of this number are illegal immigrants. The actual number could be many times this amount. While emergency care should be available for them, a government health care plan should not be. Others choose not to join a health care plan. They choose to gamble that they will not need it. If they are financially sound perhaps they could be required to join a plan that would only cover large medical expenses and pay smaller charges out of pocket.

Congress should consider these more limited, less expensive options. The large majority of Americans are satisfied with their plans. Private insurance companies can not compete with a government run, government subsidized plan. Private plans will be forced out of business. Americans would then be forced into the government program. We do not want to be forced into a government controlled plan.

Signed,
The Electorate