GUILFORD — It could have been the beginning of the national health-care debate that this country has needed for decades. Instead, the great health-care reform debate of 2009 has turned into the usual political circus of fear, ignorance, and distorted sound bites.
The anti-government reactionaries are showing up in large numbers to yell down any attempt by members of Congress to explain what is being proposed in Washington health-care reform legislation.
Defense of what is really in proposals has been difficult because congressional leaders, including the president, have been forced into a defensive posture to simply deny the lies and distortions.
All sides in this debate have done a poor job of moving forward in a way that should help the American people. The best we can do now is to explain what is on the table and try to sort fact from fiction.
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The major piece of legislation that most people have been referring to in public town-hall meetings is HR3200, a bill that is the product of three House committees. More on that later.
The Senate Finance Committee is the other major player, but they have not created a bill in the Senate.
According to the Kaiser Family Foundation Web site, www.kff.org,“The Senate Finance Committee released a series of papers laying out options for health reform. While not a formal proposal, these papers offer a framework for achieving health reform goals and present the range of options the committee will consider as it works to draft health-reform legislation.”
These options, according to Kaiser:
• “Require all individuals to have health insurance.
• “Create a Health Insurance Exchange through which individuals and small businesses can purchase health coverage, with subsidies available to individuals/families with incomes between 100 and 400 percent of the federal poverty level.
• “Impose new regulations on the non-group and small-group insurance markets.
• “Expand Medicaid and chip [Children's Health Insurance Program] and offer a temporary Medicare buy-in for the pre-Medicare population.”
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Sen. Max Baucus (R-Montana) chairs the Senate Finance Committee, and he is leaning away from the so-called public option in any Senate bill.
President Obama does not have a plan, and so far has only laid out a few basic principles for health care reform that he wants.
The White House Web site (www.whitehouse.gov) outlines the president's priorities. The administration believes that comprehensive health reform should:
• Reduce long-term growth of health care costs for businesses and government
• Protect families from bankruptcy or debt because of health care costs
• Guarantee choice of doctors and health plans
• Invest in prevention and wellness
• Improve patient safety and quality of care
• Assure affordable, quality health coverage for all Americans
• Maintain coverage when you change or lose your job
• End barriers to coverage for people with pre-existing medical conditions.
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The most contentious issue to date has been the public option for insurance, but direct reference to what this actually is may be hard to find. The language in the House bill is vague.
There is reference to a health insurance exchange, one of the key elements of the legislation. It is similar to the “connector” that Massachusetts uses to provide insurance. An agency will be created to compile information about a number of insurance plans that people may choose from to make the process of buying insurance easier.
The public option will be only one plan among many that people can choose from, but they will be able to compare all plans in what is envisioned as some sort of one-stop shopping venue.
Cost has become a big factor in relation to the public option, as the bill provides $2 billion to establish that fund. In doing so, the government assumes the risk for all insurance claims under the public option the same way any other insurance company does.
Some may look at this as a government takeover of health care, but what is really happening is that the government is getting into the health insurance business to provide people with more choice.
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The government has a track record of administrative efficiency when it comes to health insurance. Medicare's administrative costs run around 2 to 3 percent. The private insurance industry is saying it is unfair competition because their administrative costs run anywhere from 18-31 percent, and many insurance companies have to provide profit for shareholders.
It seems paradoxical that there are those who say the government can't do things efficiently, yet many of those same people argue that if the government gets into the health insurance business that is unfair competition. Why not let the government compete with the private sector and see what happens?
What should be a more contentious provision in HR3200 is getting almost no press at all.
The bill would require all Americans to buy insurance or pay penalties. If the exchanges offer only private insurance options, then affordability becomes an issue. Even with a public option, affordability will be an issue, and Americans should be protesting about insurance mandates instead of “death panels” and the specter of socialized medicine.
And what about the “death panels” rumors?
Despite the fact that there are no death panels - a fabrication by Sarah Palin and other fearmongers - many people still believe the health care bill will force older people to die instead of getting care.
Read the bill. Decide what it really means. The bill text is available at www.thomas.gov, and there are all kinds of reliable summaries.
In this information age, there is no excuse for the ignorance and the level of uninformed outrage that we have been witnessing these past few months.