Let me come clean and tell you which plan was written by whom:
Plan A is the House Democratic Bill. Plan B is the Senate Health, Education, Labor and Pensions Committee’s Bill. Plan C is a plan under discussion by a bipartisan group of six senators on the Finance Committee. Plan D is the House Republican proposal. All of these can be found here: http://www.desmoinesregister.com/article/20090813/NEWS/90813006/-1/NEWS04 It is the news site where I found them.
Now, I try to stay positive about all of the plans, but I have to say I’m highly disappointed in Plan D – the House Republican proposal. It pretty much leaves things as they are and that bothers me. I know Republicans don’t want a government run plan. I know Republicans think that government interference is a bad thing and I can understand that. But, what I can’t understand is how they can just continue to ignore the fact that the system is broken. 47 million American citizens have no health insurance. That is 13% of the population. It is a high enough number to swing an election. On top of that, those 47 million Americans leave the rest of us paying a much higher price. Hospitals, when they provide care and aren’t reimbursed, have to make up the money loss somewhere and that means charging more for the care those of us who are insured receive. Which means the insurance companies pay more and the premiums go up and so on and so on. We all suffer.
Now, I’m not saying I’m extremely happy with any one of the four plans, but I think combining them might not be a bad idea.
First, the who is covered: the Senate Health, Education, Labor and Pensions Committee bill aims to cover 97% of Americans, as does the bipartisan, Finance Committee’s plan. This is very important. The whole point is to get as many people covered as possible.
Second, the cost: I think the Senate plan at being only $650 million over ten years and covering 97% of the people is a little unrealistic. I think the $1 trillion mark sounds about right. This doesn’t mean I think we should spend that much, but that it is a reasonable to believe the healthcare plan will cost that much over ten years.
Third, how’s it paid for: Let’s face it, a plan with this much coverage is going to cost us some dough. The Republican plan, which didn’t even offer a proposed cost, states no new taxes. Boy, that sounds good. The plan implies that by reducing Medicare and Medicaid fraud, the plan would be paid for. Unfortunately, I don’t have the numbers for the amount of money lost due to Medicare and Medicaid fraud, but I’m thinking it probably isn’t enough to pay for any plan. Now, I would be interested in hearing or reading someone’s idea on how it could. I wrote Paul Ryan regarding his plan and I still don’t have an answer. (Which I’m very disappointed, he is usually right on the ball.)
I think a combination of all four plans might be the answer to how to pay for this. Raising taxes on singles who earn more than $280,000 a year seems reasonable to me. Most of the people I know don’t come anywhere near that figure. Raising taxes on families that earn more than $350,000 isn’t a bad idea either. The highest tax bracket in this country is 33%. We jump from 15% to 25%, but after 25%, the jumps are much smaller. Trust me, a single person earning $280,000 a year will be able to afford a two percent tax raise. I’m also for raising the taxes on other items, such as cigarettes or liquor, but I think I’m alone in that regard.
I’m not for cutting Medicare nor am I for cutting Medicaid. No cuts. The elderly have enough problems. No cuts, but rooting out fraud — that’s a good idea.
Further – charging companies a portion of the insurance costs the government pays is a terrific idea. I think that it is only fair. Companies benefit from their workers’ hard work. More and more companies are expecting more from their employees – especially salary employees – without offering raises. Being penalize if they allow employees and employees’ children to be on a government program is a good thing. Penalizing companies such as, oh, I don’t know, Wal-Mart, could help pay a great deal toward the program.
I think the combination of rooting out Medicare and Medicaid fraud, a small tax raise on the wealthy and penalizing large companies for not providing affordable health insurance should be able to pay for the plan. I think not purchasing the F-22 from Lockheed, which has cost us the taxpayers over $351 million in overruns is an example of government waste we could cut and use to help pay for the plan.i
Fourth, the mandates: I know the government mandates a lot of different things and that’s not always a good thing, but the only way any healthcare plan will work is if we all have insurance. The healthcare costs of those people who are uninsured are staggering. This is not to say that we all have to have fancy group coverage. The bare minimum should be catastrophe insurance, along with a pre-taxed Health Savings Plan. I know that some people say, well, rich people don’t need health insurance, so they shouldn’t be forced to carry it, but even a rich person could have their entire wealth wiped out by the cost of cancer treatments.
To support my argument further, let’s consider this: everyone of us who has care insurance has coverage that includes uninsured and under-insured motorists. And, why do we do that? So, we can still be protected if someone that doesn’t have insurance slams into our car. Hospitals will need the same protection. There are some people out there who can cover $3200 out of pocket expense for a cardio-test, but I’m not one of them. Had I had to pay for the test myself, I’d still be making payments. And, the hospital would still be waiting for their money, which is one of the reasons hospitals have to charge so much. If everyone is covered by health insurance, hospitals wouldn’t to write off unpaid bills, thus reducing their overhead. Of course, I’m notoriously cheap and I probably wouldn’t get the test. I would be the type of person who would take chances with her healthcare. In interest of full disclosure, in this case, I would be okay without the test. My heart is strong, like bull.
Fifth, how to choose the health insurance plan. I like the exchange idea, but I was just reading an articleii that in Massachusetts the exchange isn’t working. That being noted, I think if the Massachusetts plan isn’t working, we use it to take what does work and throw away what doesn’t. I, also, like the idea that the exchange is state run, with Federal standards. Each state should know what its citizens need and is better prepared to make changes for what doesn’t work more quickly than the Feds.
Sixth, for the benefits, I like the Democratic plan, so I just copied it verbatim: “A committee would recommend an “essential benefits package” including preventive services, mental health services, oral heath and vision for children; out-of pocket costs would be capped. The new benefit package would be the basic benefit package offered in the exchange and over time would become the minimum quality standard for employer plans. Insurers wouldn’t be able to deny coverage based on pre-existing conditions.”iii
Finally, the government run plan, I like the idea of a government run plan to a point that competes with private insurers. I think private insurers deserve a little unfair competition. However; I think it should be limited to cover those who don’t qualify for any other plan or subsidy. Let’s not create a huge fiasco here. Also, I like the part in the Senate where the plan would “would pay doctors and hospitals based on what private insurers now pay.”iv
Okay, that’s it. That’s my plan in a nutshell. I think it works better and is better for all of us than the four plans.
This is a pretty long blog post, but I wanted to include as much as I could. I’m posting this as a PDF, as well, so you can print it out and share it. If you like my idea, please feel free to post it on your own blog – as long as you link back to mine. Further, send it to your representative and say you support it. I’m sending it to mine. We need to improve healthcare in this country, but none of those four plans mentioned are going to cut it. If you don’t like what I’ve outlined, I’d love to hear why and I encourage you to come up with your own plan. I, also, encourage you to make sure you write your representative. Healthcare is too important to leave up to the politicians and lobbyists.
iMother Jones September / October 2009, page 41