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Health Care Reform Questions & Answers

2013 July 12
by Sarah Fields

John asks…

Why support National Health Care?

Why do so many people want the government to control every aspect of their life? If the government controlled our healthcare, what real decisions would we have in life? Why are people willing to give so much power to government when they can’t even run programs like social security, welfare, medicare, Medicaid, education, and taxation?

Sarah Fields answers:

Confusion is why there are so many health care reform questions.

NHI has been seen in certain contexts to address, though not perfectly, the two major problems of health care: cost and coverage.

And that’s why people talk about national health insurance.

The plans offered recently by politicians, it should be said, are largely universal coverage personal mandates, not national health insurance. (The Massachusetts plan, basically.) They basically require that citizens have private health insurance, and that companies that don’t offer it pay into a government fund that helps offer it to uninsured workers who don’t have their own individual policies. The insuring agencies in those contexts would be expanded Medicare and the government’s federal workers insurance plan.

You’ll note that such plans only address coverage, and not cost. Cost is, in my opinion, an exponentially greater problem of higher priority, exerting direct controlling influence over the question of coverage.

National health insurance, to take a look at it, of the Canadian, Japanese, or European varieties, tends to reduce administrative costs by up to half (by cutting out the middlemen insurers), it eliminates the figure of uninsured, and in many forms it allows for prioritizing and rationing of care (see Oregon’s or Arizona’s Medicaid plans, for examples) as a means of holding down the percentage of GDP spent on health care (in taxes and so on). This would mean no frilly MRIs for stubbed toes, discouragement of hypochondriacs, HMO-style triage treatment, etc.

I’m personally in favor of either a pure private system with price signals, or a pure public system. That will clarify future expectations about healthcare financing, and likely reduce costs the most. Both options, I think, work best when attempting to cut costs and curtail GDP spending on healthcare (which requires rationing; whether in less care to the poor in a purely private arena; or prioritized care in a public system, as described above). (We have rationing now to a great degree, anyhow.)

I think the responsible course of action, therefore, is not to talk about the “evils of socialized medicine,” or the “evil tyrannical conservatives,” or whatever; but to talk about the macro elements of healthcare economics, to figure out a more simplified (less expensive) system, and to act on all sensible ways to reduce costs and to reduce the rapid rightward shift of the healthcare demand curve.

Neither national health insurance, individual-mandate universal private coverage, the current system, or an entirely pure private marketplace with price signals … Will work at all if the costs exceed the ability to pay. And that’s the formula that needs to be worked out, somehow.

(And I also believe, for the health, balance, and diversity of the economy, its sensible for a nation to hold down healthcare spending below 20 to 25 percent of GDP — a main reason why I believe in rationing and cost-cutting. [Admittedly, the 20 percent figure will be impossible to achieve in the near term with the Baby Boomer retirement; I think all possible cost-reduction means should nevertheless take place; and a below-20-percent goal should be set for past the year 2040.])

Helen asks…

Understanding Obama’s health care plans..please help?

WASHINGTON – Missouri voters’ overwhelming opposition to requiring nearly all Americans to buy health insurance puts one of the least popular parts of President Barack Obama’s health care reform law back in the political cross-hairs.

Even if the vote sets no legally binding precedent, it will help mobilize foes of Obama’s agenda in the fall midterm elections, and that could make a difference in some states with close congressional races that could decide the balance of power in Washington.

On Tuesday, Missouri voters cast 71 percent of their ballots in favor of a state measure to bar the government from requiring people to carry health insurance, and penalizing those who don’t.

That approach is at the heart of the federal health care law that Obama signed in March. Starting in 2014, Americans would be required to carry coverage, with exceptions for financial hardship. Government would help pay premiums for millions, but those who still refuse to sign up would face a tax.

There’s little chance that Missouri can wall itself off from the insurance requirement, since federal law usually supersedes state law. But sponsors of the measure were looking to send another kind of message.

“The Missouri vote is significant politically because it will help rally people who oppose the Obama administration to go to the polls in the fall elections,” said Robert Blendon, a Harvard public health school professor who tracks opinion trends on health care. “It shows the debate is still alive, and that’s what the sponsors wanted to do. They wanted to reintroduce the idea that there is still a debate going on.”

At least two other states — Arizona and Oklahoma — have similar measures on the ballot in November. And sponsors of Florida’s version are appealing to reinstate it after a state judge struck the measure from the ballot, ruling that a summary for voters was misleading.

In Colorado, supporters submitted 130,000 voter signatures to the state last week for a ballot measure challenging the insurance mandate, about 50,000 more names than are required.

Arizona, Colorado and Florida are states with House and Senate races rated as toss-ups in November. A few years ago, state ballot measures against same-sex marriage helped turn conservatives out in the contest between incumbent President George W. Bush and Massachusetts Democratic Sen. John Kerry. Bush won.

Foes of the health care law also seek to overturn the insurance requirement in federal court.

Twenty states have joined one of the cases, pending in Florida. This week, a federal judge rejected the Obama administration’s request to dismiss Virginia’s lawsuit, allowing the case to proceed to formal arguments.

Opponents of the mandate argue that the federal government overstepped its constitutional authority by requiring individuals to purchase a particular product, especially one that costs as much as health insurance.

The administration says the requirement is well within the government’s authority to regulate interstate commerce, and penalties for those who don’t comply stem from the power of Congress to levy taxes. The obligation in the new health care law was originally a Republican idea, dating back to the 1990s. Mitt Romney signed such a requirement into law at the state level as Massachusetts governor in 2006.

An individual decision not to carry insurance affects society because others have to pay when that person gets sick and seeks treatment, supporters also argue. Reforms in the law — such as requiring insurers to accept people with medical problems — won’t work if individuals are allowed to postpone getting coverage until they need it.

Democrats sought to play down the significance of the Missouri vote.

Maryland Rep. Chris Van Hollen, who’s coordinating the Democrats’ strategy for hanging on to the House, pointed out that the turnout in Missouri was low — less than 25 percent and overwhelmingly Republican, given a number GOP primaries up for grabs.

“That doesn’t tell you what people’s view of health reform is,” Van Hollen said. “The numbers are totally distorted because of the lopsided turnout.”

Missouri Democratic Sen. Claire McCaskill, who backed the health care law, said the results reflect the fact that voters have been bombarded with anti-government criticism of the new law and aren’t fully aware of its positive aspects.

“‘Big government, bad government, don’t trust ‘em’ is a pretty simple message,” said McCaskill.

Missouri voters interviewed at the polls expressed a general frustration about the government telling them what to do.

“This is a free country and government needs to stop,” said Cassandra Bosch, 34, a stay-at-home mom from Jefferson City. “You don’t have to come into my home and tell me repeatedly what to do.”

CAN SOME ONE PLEASE HELP
I need help understanding this article.
What it means for the people and what is so important about the “mid-term” election?

Sarah Fields answers:

The stay at home mom is the only one with an ounce of sense.

Since when do we need the government to tell us what to do every moment. LEAVE US ALONE

Taking over every aspect of our lives is communist.. And unfortunately that is who Obama and his followers are.

We need to get rid of him asap!

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