It’s sheer impotent fury… the kind that makes you want to stamp your feet, break something fragile or shout till your throat hurts. I’m so angry about healthcare, and the worst part, besides the utter disregard for my wishes by those elected to represent me, is that no one really cares. I’m just an ordinary, hard-working, law-abiding, tax paying member of society… a group no one wants to heed, let alone acknowledge.
Before you dismiss me as ignorant or uninformed, as touting some right-wing agenda, let’s see if we can’t agree on some pretty basic things in terms of healthcare.
- We all need quality healthcare that is accessible AND affordable.
- While development of medicines/technology is expensive, it does not justify OBSCENELY overpriced medications/procedures that force people to choose between food, heat, financial survival or the care they truly need.
- We want our doctors/nurses/specialists making decisions in our best interest, not to satisfy (or avoid) red tape, not because of fear of ruinous legal action or because of a system that doesn’t support patient care.
- We understand the obligation to care for those unfortunate citizens (whose ranks any of us might at any day join) who need medical care, but in equal measure to those who pay for those same services.
Frankly I think we’d end up with a much better set of healthcare reforms if we had one representative of each area (general practitioners, surgeons, nurses, therapists, patients, insurers, administrators) sit in a room together. No one leaves until they come up with something. No lobbying. No special interests. A week of debate, then reps vote on the plan — yes you like it, no you don’t. Abide by the final number and move on. Oh and the issue cannot be re-introduced for one calendar year from the date of defeat, this lets us move on… there ARE other problems facing the nation.
But that’s a fantasy, and this dear readers is hard, cold, unyielding reality.
The truth is, my own representatives were not one bit intimidated by my disapproval… leaving me no choice but to watch, beyond frustrated as Mr. Obama signed H.R. 3590 — Patient Protection and Affordable Care Act — the long-awaited, hotly debated, two thousand plus page health care legislation into law earlier this week. There appear to be some last-ditch efforts from the Senate to repeal the whole thing, a response from our President worthy of a line in a bad movie, while the courts gear up to have their say.
Apparently I’m not alone in my frustration, my anger. There have been reports that as representatives head home for their Easter break, the FBI, the Capital Police and the Office of the House Sergeant at Arms have been warning members about angry constituents, violence and even death threats that have already taken place. In this I add my voice to others who say, take out your anger at the ballot, not in some foolish, futile gesture that ruins your lives and the lives of others.
It’s just galling to realize that no matter what “we the people” think… no matter how we shout or protest, politicians, lobbyists, corporate bigwigs and the like will do what they want. Small comfort the new CNN poll that reports fully 59% of Americans oppose the health care reforms as they stand… see if any one of them remembers that on election day. Not surprisingly the latest Gallup poll finds Mr. Obama’s job approval number at 51%, slightly improved from where his ratings stood for most of the month.
So now that our government has jammed healthcare reform down our unwilling throats, what happens next?
There are some changes that take effect right away. Only the most jaded among you will find it odd that one of the immediate provisions of the reform includes a $250 check payable to every senior in America. Remember, that’s the age group who actually show up at the polls to do their civic duty, and the politicians never forget this. 2010 IS an election year, you know. The bill also makes an effort to close the “donut hole” in the Medicare prescription drug program, though it takes until 2020 for that closure to be complete.
Beyond that $250 check, seniors didn’t make out all that well, and will find their choices in caregivers and services starting to be limited next year. While guaranteed Medicare benefits under federal law will not change, about 10 million seniors also get supplemental coverage and this will.
Plans like Medicare Advantage offer lower co-pays and extra benefits like eye care, hearing aids and gym memberships. Federal payments to insurers under the Medicare Advantage programs will begin to drop off in 2011 and be cut back by a total of $206 billion in the end. Anyone using this program will start feeling the pinch as the plan tries to find ways to make up for the lost government subsidies. This may well force them into a more expensive supplemental plan to make up for the loss in coverage.
Another immediate change is that parents can continue to provide for their non-insurance-carrying-adult children by keeping those up to age 26 on the family insurance plan… for a price. Not only will they be living in your basement, eating your food and generally being underfoot, but now you can keep paying for them to get proper medical care.
Irony gets little respect these days… maybe because so few truly understand it. And this legislation has a whopper of an ironic twist — that promise of “universal coverage” that we’ve all heard so much about remains just out of our grasp. If you don’t have insurance today, you will still be uninsured tomorrow. This won’t stop speechwriters from their glowing, sound bit driven pronouncements — after all the reforms will deliver insurance coverage to 32 million more Americans… by 2019. Hope they don’t mind waiting.
True to form, this new legislation saves the hardest hits for some distant future. In this case, the big changes come in 2014 when the individual and employer mandates kick in. Everyone in America will have to have a government approved health insurance plan or pay a penalty equal to 1% of your income. Note the words “government approved”. If you own a business with more than 50 employees and don’t provide insurance to the low wage workers on your payroll, you’ll end up paying a penalty of $2,000 per employee.
Small businesses will be eligible for tax credits to help with some of the costs for offering insurance to employees, but that’s the only good news for business owners. Medicare payroll taxes will go up by 0.9% on those earning over $200,000 a year… a nice income, but hardly in the league of the “idle rich”. There’s also a new 3.8% tax on investment income and capital gains… gee can’t imagine who’ll be paying those.
Already large companies are reacting — reporting hits to profits.
Even though a growing number of us are spending upwards of 10% of their income on healthcare expenses (out-of-pocket and premiums) according to the Washington-based think tank Center for Studying Health System Change, keeping costs under control isn’t any part of the final healthcare legislation. The rate setting commission that Mr. Obama had mentioned didn’t make it in. Cost containment won’t take effect for may years. The Congressional Budget Office (CBO) believes insurance premiums will double in the next couple of years.
Great, so now the set of reforms that I didn’t want is going to cost me more. I can’t believe how much my family is already spending on insurance premiums, prescriptions, co-pays, dental care, eyeglasses and such. I can see, and have seen first hand, how a chronic illness can become an inescapable financial burden. That’s just wrong.
If there’s one bright spot in this whole healthcare mess, it’s this. Insurance companies can no longer deny coverage to children with pre-existing conditions, or limit lifelong coverages. This change is long overdue. The adult ban on pre-existing conditions doesn’t kick in until 2014, a welcome benefit for all of us.
Score one for the little, sick guys.
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