Built By Committee - Designed to Fail

Senator Harry Reid is fighting a deadline. The President may have wanted a bill before Labor Day, but they want ice water in Hell, too. Reid, the pragmatist, knows the real target, December 31st. The last thing he wants is to be holding a hot potato of a health care bill in January, or worse, February.

Senator Reid has a problem.

Regular readers of this blog know that I have been asking one question from the start, What is our Goal? It is unfortunate that even though our political leaders may not have had well defined, easily explained goals, they all had solutions. Creating questions to given answers is the basis of the television show Jeopardy! Creating legislation to preconceived answers puts all in jeopardy.

It is hard to describe the pending legislation as health care reform. In fact, it is not even insurance reform. The current bills appear to reposition the government’s role in the payment of health services. Based on the numbers coming from the Congressional Budget Office, some critics think that this is just Washington once again proving that it can turn wine into water.

Let’s take a quick look at a few of the issues:

PUBLIC OPTION – Previous blogs have dealt with this particular issue. If nothing else, the Senate does not have 60 votes to pass a bill containing a Public Option.

MEDICARE OPENED TO PEOPLE AGE 55 TO 64 – This idea had a two minute life span. Nancy-Ann DeParle, the director of the White House Office of Health Reform, is quoted in the December 12th Plain Dealer. “Let me be clear, it’s not adding 55 year olds to Medicare.” If this is only Medicare-like coverage, it is really the Public Option. Please see the above.

ABORTION - Once you get the government involved, really involved, in the delivery or payment of health care, abortion is almost always the first serious question. Conservatives, Democrats and Republicans, won’t allow federal money to pay for this procedure. Liberals want to pretend that they won’t back down. Again. Couples suffering from infertility issues want to insert coverage for in-vitro into this discussion.

NEW TAXES AND FEES #1 – The pharmaceutical industry thought that it had a deal with President Obama at a very fudgeable $80 billion. The House of Representatives passed a bill that would hit the drug makers for $140 billion. The Senate’s version has yet to be released.

NEW TAXES AND FEES #2 – The Senate has proposed a new, non-deductible, tax of $6.7 billion a year on the health insurers. The easiest way to make health insurance more affordable is to add huge new costs to the health insurance companies. Makes perfect sense. To Congress. You and I might also wonder if, as the President suggested, the purpose of a Public Option was to give the insurers real competition. The best way to compete? Give the insurers huge new taxes.

NEW TAXES AND FEES #3 – The Senate has proposed a new tax on cosmetic surgical procedures. The bill currently includes a 5% tax on tummy tucks, facelifts, etc… This is a tax on medical procedures that are not usually covered by insurance. The doctors are howling. Their first line of defense is to note that the majority of these procedures are performed on middle class women with an average income of $30,000 to $50,000 per year. The second line of defense will be to add that other elective procedure, abortion, which should end the conversation.

NEW REDUCTIONS IN MEDICARE PAYMENTS - The Senate bill anticipates significant cost cutting at hospitals and nursing homes. They are so sure of this happening that they are lowering Medicare payments now. We already have Medicare’s underpayments shifted to those of us with private insurance. Reductions in Medicare reimbursements simply mean more costs shifted to us which just means higher insurance premiums. The Government’s Centers for Medicare and Medicaid Services (CMS), according to that same Plain Dealer article, states that the other option from these cuts will be the forced closing of about 20% of these institutions.

Today is December 15th, nine days till Christmas Eve. Can Reid deliver a bill for Christmas? If the President and the Democrats, and at this point it is a one party bill, enact legislation, the Republicans will have a winning campaign next fall. If legislation is blocked by the Republicans, the President and his party can paint the opposition as obstructionists who were too busy saying “NO” to help solve the problems of average Americans.

Considering how awful this legislation is, will Senator Reid win now and lose next November or has he already realized that the reverse, losing now and winning later, is much better? Is this program designed to fail?

DAVE
www.bogartcunix.com

Laying In The Gutter? It's My Fault!

“It’s the insurance company’s fault that there are drug addicts walking the street.”

I did not know that. I needed the twenty year old junkie to explain this to me. After alienating her parents and step-parents, dropping off their coverage even though she is a full-time student, and suddenly getting married, she was surprised that insurance companies weren’t standing in line to welcome her in their warm embrace.

Of course, she was in my office for over a half an hour before she finally told me the truth. Thirty one years in this business has to be worth something. I could tell, I could feel that there was more than what she was disclosing. Bit by bit she released more information to me. It wasn’t until I had begun a pre-screen application that she dropped the bomb, her fourth on-going medication was an opiate blocker that costs $900 per month!

Forget everything but the math for a second. She wants to be allowed to pay $100 per month to Anthem Blue Cross so that the insurer can buy her $900 drug and three other medications. Shockingly, Anthem, Medical Mutual, et al… said “No Thanks”.

It was at this time that she informed me that her addiction is “genetic, like cancer”. Her mother is an alcoholic, so it is natural for her to have been hooked on heroin and methadone. “It is a disease. That’s what you learn at Alcoholic’s Anonymous.”

She spent an hour and a half in my office alternatively complaining about her parents who don’t want to have anything to do with her and the insurers who don’t want to have anything to do with her. She has options. Unwilling or unable to make the calls, I grabbed my phone and contacted her previous insurer, her mother’s employer, and went online to research the local university's student policy. She can be covered, but it will take some time and effort on her part.

She will not be covered.

Which part is more frustrating, the self destructiveness of the drug addiction of a teenager or the delusion that someone else is to blame for one’s behavior; the refusal to take the necessary steps to solve one’s problems or the anger that there are lifelong consequences for one’s actions? She sat there whimpering while I tried to solve her most immediate problems.

Will any of the proposed changes in Washington solve her problems? NO! Even if we have a policy that would take everyone and provide any known pharmaceutical remedy, there is no guarantee that she would even sign up. More importantly, Congress is incapable of passing a law that would force Americans to take responsibility for their actions.

DAVE

www.bogartcunix.com

By the way, Jeff Bogart,my business partner, and Michael Saltzman, my attorney, went ballistic when they read the original post of this blog. So I have made a couple of key changes to completely hide the identity of the man/woman subject of this story. I guess you can't be too careful.