Okay, let’s go over this one more time

Okay, let’s go over this one more time

- in Weekly Briefing

A user-friendly review of some key facts about healthcare reform

Facts versus fear: that's what the national healthcare reform debate has boiled down to. While proponents put forward wonky number crunchers like the experts at the Center on Budget and Policy Priorities, the opponents rely on bullies and blowhards like Glenn Beck and the tea bagger crowd and the self-serving claims of millionaire executives like the over-paid bosses at Blue Cross Blue Shield of North Carolina.

Happily, as last weekend's vote in the House of Representatives showed, facts can (and often still do) prevail in such contests. At some point, the data become so striking that no amount of screaming or distortion from industry-funded ad campaigns can sway a majority of voters or elected officials.

Now of course, as the debate moves to the Senate and inches closer to the finish line, opponents are likely to become increasingly desperate and resort to all kinds of outlandish claims and tactics. In such an environment, it will be more important than ever for reformers to redouble their efforts to make sure that fact-based policymaking wins the day.

In keeping with this important objective, here are five key facts to keep in mind (and to tell everyone you know about) in the weeks ahead.

Fact #1 – The most costly choice is to keep the current system. Reform opponents will no doubt continue to throw tantrums about the supposed costs of reform. You know this mantra: "liberals just want to saddle Americans with a costly new program that will bankrupt the country."

Here is the truth as set forth last week in a letter by the nonpartisan Congressional Budget Office (the same organization that accurately projected how outrageously expensive the Medicare prescription drug changes passed by the Republican congress with help from the pharmaceutical industry in the early part of the decade would be):

"The Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) have estimated the direct spending and revenue effects of H.R. 3962, the Affordable Health Care for America Act, as introduced on October 29, 2009, incorporating the manager's amendment that you proposed on November 3, 2009…. CBO and the staff of JCT estimate that, on balance, the direct spending and revenue effects of enacting H.R. 3962, incorporating the manager's amendment, would yield a net reduction in federal budget deficits of $129 billion over the 2010-2019 period (see Table 1)." (Emphasis supplied).

Got that? The reform bill brings health insurance coverage to millions of the uninsured, provides security to those who have insurance and cuts the federal deficit.

Is the bill perfect in this regard? Of course not. As the Center on Budget and Policy Priorities noted last Friday:

"Policymakers could further improve the legislation by incorporating, at some stage of the legislative process, a provision to limit the tax exclusion for employer-sponsored health insurance such as a modified version of the excise tax on high-cost plans in the Senate Finance Committee's health reform bill."

In other words, by following the Senate's lead in placing a modest surcharge on high end health insurance packages (the kind that provide every imaginable benefit at little or no charge to the insured and that are typically provided to CEO's and other highly compensated individuals) the plan could reduce the deficit even further. This may be something that finds its way into the final reform package.

But, to reiterate, the bottom line is this: enacting the bill passed by the House last week will help bring expenditures in line and shrink the deficit. Keeping the present system will only assure that things continue to deteriorate.

Fact # 2- Reform will make huge improvements to the private insurance market. As almost all of us have become personally aware – either through a friend of family member – one of the great evils of the current American healthcare system is its scandalous treatment of sick people. As the darkly humorous saying goes, "Modern health insurance works great…until you get sick."

One of the most important changes in all of the reform packages under serious consideration is the provision that would bar insurance companies from denying coverage or charging higher premiums to enrollees with health problems (i.e. "preexisting conditions"). Just think of the peace of mind this will bring to tens of millions of Americans.

The House bill would also greatly limit insurers' ability to charge higher premiums to individuals simply because they are older (rates could be no more than double those of the youngest policyholders) and set minimum standards regarding what insurers could offer, including an annual cap on out-of-pocket costs and a prohibition on annual or lifetime benefit limits (which can cause coverage to shut off for some people who become very sick or have a chronic illness). The Senate versions are weaker in these areas and still need strengthening.

Fact # 3 – Reform will assure that most of the uninsured will gain decent, affordable coverage. Under the House bill, 96 percent of non-elderly legal residents in the United States would have health insurance by 2019. According to CBO estimates, this means that 36 million Americans, or two-thirds of the current uninsured population, would be covered by 2019. The bill would cover seven million more of the uninsured by 2019 than the bill that the Senate Finance Committee passed last month.

Fact #4 – Reform will strengthen and improve Medicare. Contrary to the mythmaking advanced by the right and parts of the healthcare industry, reform will not harm Medicare, but make it work better. Here's the Center on Budget's take:

"The House bill includes a number of provisions that would make Medicare more efficient, which would help slow the growth in health care costs as well as help pay for health reform and desirable beneficiary improvements to Medicare (including improvements to the Medicare drug benefit and making more low-income Medicare beneficiaries eligible for help with their premiums, deductibles and co-payments). Many of these provisions are in line with the recommendations of the Medicare Payment Advisory Commission (MedPAC), Congress' expert nonpartisan advisory body on Medicare payment policy, on how to modify provider payment rates and encourage efficiency while ensuring that payments are adequate so that beneficiaries continue to have access to health care providers."

Specific Medicare improvements include:

  • Elimination of the overpayments providers receive through "Medicare Advantage" program. Currently, the federal government pays 14% more per person on average than for traditional Medicare.
  • Lowering the cost of prescription drugs.
  • Providing large incentives to hospitals and other providers to focus on patient outcomes rather than revenue generating procedures and admissions.

Fact #5 – In sum, reform will build on and shore up our current system.  Opponents claim, of course, that reform amounts to a "government takeover" of healthcare. This is simply an inaccurate and downright silly argument for multiple reasons.

First of all, anyone who thinks that the U.S. government hasn't been and isn't always going to be a giant force in the healthcare system in this country is delusional. More to the point, however, it's simply absurd to seriously suggest that a group like the United State Congress – a group that's largely bought and paid for with corporate money – is going to seriously threaten the survival of a giant and profitable industry like the healthcare monolith.

Rather than "a government takeover of healthcare," what reform actually promises is a modest relaxation of the takeover of government that the health and insurance industries effected many years ago; a modest restoration of the national balance between common good and profits. If, in the long run, reform accomplishes nothing other than this, it will still have been an enormous success.

About the author

Rob Schofield, Director of NC Policy Watch, has three decades of experience as a lawyer, lobbyist, writer and commentator. At Policy Watch, Rob writes and edits daily online commentaries and handles numerous public speaking and electronic media appearances. He also delivers a radio commentary that’s broadcast weekdays on WRAL-FM and WCHL and hosts News and Views, a weekly radio news magazine that airs on multiple stations across North Carolina.
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