Tuesday, August 11, 2009

Real Questions. We want Answers

One of the best criticisms of the whole Health Care debate involves the unbeleivably high pressure put on Congress to get the bill approved. With 20% of the economy all wrapped up in this issue, people are wondering why they are insisting on the frenetic pace to get to the bill approved. I am paraphrasing, but one man remarked, “It took President Obama 6 months to choose the White House dog. Why do we have to have this monumental plan done in 6 weeks?”

The Democrats have no one to blame but themselves. They introduced a horribly complex bill that would impact every person in the country in the most profound way and then tried to rush the approval process. Fortunately, the citizens of this country are not serfs but are educated human beings. Given just a little time, they can read the bill.

What follows is very long. You may not want to read it all. I don’t blame you. Our Congressmen and Senators have not read their own versions of the bill and they certainly do not want to read these 20 questions. President Obama hasn’t read the bill and doesn’t want to answer specific questions about it. These questions come from Robert Tracinski by way of Pamela Geller’s website, Atlas Shrugs. They both encourage us to go to our own Town Hall meetings and ask questions such as these.

1. The government has been "reforming" health-care for sixty years—tax breaks for employer-provided health-insurance, Medicare, Medicaid, encouraging HMOs and managed care, and government health-insurance at the state level in Massachusetts, Maine, Oregon. Government health-care has expanded until it is now more than 50% of all health-care spending. Yet after sixty years of government "reform," the problems with health-care are just getting worse. So why should we believe that even more government is the solution?

2. President Obama keeps telling us that he's not trying to get rid of private health insurance. But the bill being debated in Congress would require all new insurance policies to be offered through a government-run exchange, in which the rates that can be charged and the coverage that has to be provided will be dictated by the government's so-called "Health Choices Commissioner." Employer-provided health-insurance will fall under the same regulations in five years. How is this insurance going to be "private" if the government controls everything about it?

3. A video on YouTube shows Barack Obama back in 2003—only six years ago—saying that he is in favor of a "single payer" system. The "single payer" is government, so this means he was in favor of socialized medicine. And just a few weeks ago, Barney Frank—one of the Democratic leaders in the House—said that he considers the current bill a step toward "single payer." So when Obama and the Democrats tell us this bill won't lead to a government takeover of health-care, why should we believe them?

4. Medicare is broke. Social Security is broke. Federal tax receipts are falling, and Congress has already voted on trillions of dollars of stimulus and bailouts in the last year. The national credit card is maxed out. So how can you justify voting for a bill that will require even more money that we don't have?

5. The health-care bill that is being discussed includes huge taxes on businesses to force them to provide more health insurance for their employees, as well as a whole set of mandates telling health insurance companies who they have to cover and what they have to cover them for. This is an enormous increase of costs for businesses and insurers. Have you considered how they're going to pay for all of this, or whether they will even be able to pay for it? How many of these companies will go out of business or lay off more workers after the government forcibly increases their expenses?

6. One of the main demands of the health-care bill is that insurers are required to cover people with "pre-existing conditions." That's like getting insurance on your car after you crash it. It's just a way of getting someone to bail you out for something that has already happened. This isn't insurance, it's a handout. So doesn't that mean that the rest of us will have to pay more for our insurance to absorb the cost of those handouts?

7. The health-care bill will mandate what costs insurance companies have to cover. For example, they will have to pay for routine check-ups and physicals, or they will have to provide every woman with maternity coverage. But what if you don't want to pay for that extra coverage? Right now, if you're young and healthy and don't need frequent check-ups, you can save money with a high-deductible insurance that doesn't cover them. Or if you don't want children, or already have children, you can save money by dropping the maternity rider on your policy. By taking those choices away from us, won't this bill actually make our insurance more expensive, not less?

8. A lot of people have been upset about Congress passing bills that they haven't had time to read—and they haven't even finished writing the health-care bill yet. But what I want to know is, with a bill this big and complex, have you taken the time to read it and understand it? Can you really say that anyone has had the time to figure out how all the parts will work together and what all of the consequences will be? With a bill this big, is it even possible to figure out all of that and really know what you're voting for?

9. President Obama and the Democratic leadership are making us a lot of promises about what we will get and what we won't get from this health-care bill. But what is or isn't in this one particular bill is not the end of the story. For example, how many times has Medicare changed over the last forty years? As more and more of us become dependent on the government for our health-care coverage, won't we have to worry about what some future Congress or some future bureaucrat will decide to cover or not cover?

10. The defenders of the health-care bill claim that it's going to lead to all sorts of savings, not by actually cutting any services or denying care, but just by finding "inefficiencies" that will save money. Do you think this is remotely plausible? When has anybody ever said, "This project has to be lean and efficient—let's get the government do it"?

11. One of the ways that has been proposed for government-provided health insurance to save money is by substituting Medicare reimbursement rates for market rates when paying doctors and hospitals. But many private hospitals and medical practices have said that if they have to accept these lower rates, they can't cover their expenses, and they will go out of business. So doesn't this bill guarantee an immediate shortage of doctors and medical services?

12. Medicare cuts costs by paying lower rates to doctors and hospitals, who then shift these costs to those of us with private health insurance, who get charged higher rates. But if the government takes over and starts dictating Medicare reimbursement rates for everyone, who will the costs get shifted to then?

13. When the government starting portraying people in the financial industry as villains and started limiting their pay and subjecting them to more regulations, banks reported a "brain drain" as smart and well-educated people left the industry or went overseas looking for better pay and less stress. But the term "brain drain" was originally coined in the 1960s when doctors and medical researchers left Britain to escape socialized medicine. Aren't you afraid we might see the same kind of brain drain from the medical profession here in America?

14. Do you know the meaning and significance of the term "quality adjusted life year"? (For this question, you will need the answer, which you can supply if your congressman is forced to admit that he doesn't know it—preferable after some stammering and a long, awkward pause. "Quality adjusted life year" is a term used under socialized medicine to determine whether elderly patients are allowed to get expensive drugs or treatments, depending on some bureaucrat's calculation of how many good years they have left. You should ask your congressman: Can you assure us that the same thing won't happen here?)

15. One of the proposals for how the government is going to save money is that it's going to have a panel of medical experts who will dictate from Washington, DC, what the proper medical practices are that should be paid for, and what practices are supposedly "wasteful" and "unnecessary." Won't this mean interfering with decisions that would normally be made by me and my doctor? And won't this discourage innovation by requiring any new idea to get approved by a board of establishment "experts" before a doctor can even try it out?

16. Government-run health-care is not some new, untested idea. In Britain, it has led to a "postcode lottery," where the medical procedures you are allow to get depend on where you live. In Canada, it has led to a shortage of doctors and waiting lists for major surgeries. In America, Medicare ended up costing far, far morethan anyone expected. Massachusetts and Maine spent enormous amounts of money to extend government coverage to very few people. The Oregon Health Plan may not cover your cancer treatment—but it will cover assisted suicide. Given all of this experience, what makes you think that somehow this will be the exception that will avoid all of the problems that government health-care has always led to?

17. Why does "reform" always mean more government? Are you aware of proposals that have been put forward for free-market reforms of health care? Congress has already approved Health Savings Accounts, where individuals buy their own high-deductible health insurance and save money tax-free, which they can use for their out-of-pocket health-care expenses. This gives people more control over their spending on routine medical treatments while keeping them covered for a serious illness, and it allows them to keep their health insurance if they change jobs. But this program has been limited in size. Are you open to ideas like this, for free-market reform of health-care?

18. A lot of doctors say that medical malpractice insurance is what is really driving up health-care costs. Doctors have to charge more to cover their expenses, and they also have to practice "defensive medicine," ordering unnecessary extra tests just to make sure they can defend themselves in court if something goes wrong. So why isn't tort reform—for example, limiting excessive jury awards in malpractice lawsuits—being considered as part of health-care reform?

19. What part of your decision on this bill, if any, is affected by a consideration for liberty, individual rights, and the Constitution? Would you consider opposing this bill for no other reason than because it gives more power to government at the expense of the freedom and property rights of private businesses and individuals? Would you consider opposing it simply because it grants powers to the government that are not authorized anywhere in the Constitution?

20. Thomas Jefferson said, "A wise and frugal government which shall restrain men from injuring one another, which shall leave them otherwise free to regulate their own pursuits of industry and improvement, and shall not take from the mouth of labor the bread it has earned. This is the sum of good government." Notice what is not on his list: government-provided housing, or government-provided food, or government-provided health care. And Jefferson's views on the role of government were widely shared by America's Founding Fathers. So my question is: Please explain where you disagree with the vision of our Founding Fathers, and why.

If every Congressman and Senator took the time to answer these questions, their intelligence, love for the people they are supposed to serve, and integrity would become absolutely clear to all of us.

2 comments:

Killer Bee said...

Let me try to answer a few of your questions in two parts:

#2 The "government exchange" is primarily for consumer info. Like "Travelocity", "Priceline" or even "Amazon". If you are an insurance company, you place your rates in the exchange along with all the others so there is more ease of comparison. More transparency, if you will. It's designed to PROTECT AND HELP THE CONSUMER. Stick that concept in your platform, Republicans.

#10. Ironically, #10 was one of the only two solutions Republicans had for health care over the previous eight years. Make medical record keeping more efficient. I'll talk about the second thing in a minute.

#14. Good news for neo-cons. Your fear-mongering to senior citizens has worked. The Senate has dropped Oregon Senator Earl Blumenhaur's perfectly sensible provision to fund end-of-life care discussions with patients.
Both Democrats and Republicans saw this as a good measure. But Republican political predators, including Grassley of Iowa and the ever entertaining Sarah Palin, saw this as an even better opportunity to politically and literally "scare up" opposition to health reform by talking about "death panels" and "quality adjusted life years"-- things that absolutely do not exist in all 1000 pages of any of the five bills in congress right now. Yet your lunatic fringe love to bring it up and scare people. Do you feel no shame?

Killer Bee said...

Here is the second part:

#15. 15 is probably one of the best ideas of the eventual health bill should it survive above everything else. You see, the concept of "interfering with decisions that would convertible normally be made by me and my doctor" is largely a myth. Why? Because an hour before you had your apptmt. with that doctor, he was taken to lunch by a drug or medical hardware salesman in their new BMW. And they offered him a bonus, kickback, incentive, points program -- whatever they called it -- to offer their drug or machine to treat you. That doctor had a financial incentive to offer you certain treatments.
Will the treatment work? Who knows. What does it cost? Who cares. The insurance companies will pay for it.
This is one of the truly legitimate complaints of the insurance companies. Doctors enjoy perfs to sell certain drugs or use certain medical equipment regardless of the cost or its success.
This medical panel will collect data over time to see exactly which drugs and equipment have a good history of success. The others are off the list. That is FAIR.
And I'll tell you, Congress loves this idea, and you should too. Because right now, Congress has the responsibility to decide for Medicare how many chemo treatments is enough for prostate cancer. How many for breast cancer. What drugs do and don't work for diabetes?
Do you want Congress to answer these questions? Neither do they.
This skilled drug panel has worked in other places. And it takes control away from sales departments of drug and medical equipment companies.

#18 I think it is fair for people to ask "What about 'tort reform'. The doctors and hospitals are screaming about this.
The problem in the Bush days was that this was the second and only other issue in the Republican dominated years that Congress or the White House cared to look at. Bush and Congress did not want to cross the line of the insurance, drug or hospital lobbyist; so they just blamed ambulance lawyer John Edwards for all of the Health Care problems.
It is a fair issue, but it was not the only issue. Now that Obama has turned over the whole rock of Health Care and exposed ALL of the slimy bugs and grubs underneath, we should take an honest look at tort reform being one of them. I believe lunatic fringe Democrats are solidly opposed to tort reform. I think Obama should call their bluff in the interest of getting a bill through that a majority at least partially likes.

#19 and 20: Please. Spare me the "wrapping the flag around your narrow world view" and quoting dead presidents. We all love America, freedom, liberty, etc.
Both can play at that game. I'll see your Jefferson quote and raise you two Roosevelts and a Kennedy. And where would we be?