One Trick Pony

Harry Reid revealed what many of us already know; that when it comes to health care reform the Democrats are a one trick pony. Their only idea for fixing the issue, or any issue, is a government take-over, also known as a public option. That's it. If that doesn't happen then they are out of ideas.

Harry Reid has said that there is no purpose to health care reform if there is not a public option, and yet the public support for that public option is dwindling -- pretty rapidly. According to previous statements by the President this means you want the status quo, but that's not true either.

The "my way or the highway" statements of the president have indicated that if you don't support the public option then you don't support reform. This must be because they have no other ideas, no inkling of how to institute reform without the government taking over the industry. The problem is that even though they are out of ideas, other people aren't and yet the Dems are unwilling to listen to anything that does not include their one and only public option solution.

They are definitely a one trick pony and their only trick is to take a big ole crap on the American people. Maybe it's time they learn a new one.

White House Misinformation

The largest bit of misinformation is what is coming out of the white house about being able to keep your coverage if you like it. All you have to do is read the text of the bill to find out that this is absolutely not true. Well, it's sort of true I guess, you can keep it for 5 years if it meets the government standard and your employer doesn't change a single thing in your benefits for those 5 years.

I found the text of the bill, one that didn't crash my computer when I tried to pull it up, at http://energycommerce.house.gov/Press_111/20090714/aahca.pdf and I encourage everybody to read it.

Sec 102 beginning on page 16 of the bill is laughingly titled "Protecting The Choice To Keep Current Coverage". Here's the rundown on this section.
subsection (a)describes individual coverage and defines grandfathered as any insurance in effect before year 1 of this new bill and which does not change.
subsection (b)defines the grace period for employer based health plans. If we get to keep it if we like it then why exactly is there a grace period? Here's what it says...
10 (1) GRACE PERIOD.—
11 (A) IN GENERAL.—The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.

So this means that we get to keep the insurance we like for up to 5 years if, and only if, it meets the requirements set down by the government. They even define "acceptable coverage" and your plan has to meet their definition of this acceptable coverage in order for you to keep it, and then you can only keep it for 5 years before being forced off of it. Your employer may still be able to offer you a plan after that, but it will be whatever plan the government deems "acceptable".

The bill also includes information to determine whether your employer has the right to be "self insured" which means that they write the plan and absorb the costs while paying an insurance company to administer the benefits. So the government can come back and tell your employer that -- although your business has decided to self insure and your accountants are sure you can support it-- being self insured is just too risky and you can't do it. Gee, guess you better put your employees on that government plan. Nice!

So tell me again Mr President how I am going to be able to keep my coverage if I like it. Lie to me one more time.

Pre-Existing Conditions

If you can't get insurance because of a pre-existing condition you should probably shop around. There are many plans that will not apply a pre-existing condition clause, and for those that do, most will waive that if you had insurance before your current effective date.

The real purpose of a pre-existing condition clause is to prevent people from only spending the money on insurance after they know they need it. Insurance is supposed to be a "just in case" situation and the premiums are based on the risk of the health care costs you will accrue. The idea is that you'll pay while using it little and that money will be there if you need to use it a lot.

Is it fair to the company which will cover you to go without insurance until you know you need it, and then expect them to pay for everything you've let go for years? I can already hear many people saying, yes it is, those evil insurance company bastards just want to steal my money and not cover me. This might be a slight exaggeration.

The healthy people paying their insurance premiums are paying for the sick people paying their premiums. It all goes into one big pool and the insurance company prays that they don't have to pay out more than they take in. The pre-existing clause is designed to help with that goal.

Would you wait until after a tornado struck your home to obtain homeowners insurance and then expect the new company to pay for the damage done before your coverage began? Waiting until you're sick to try to obtain insurance is basically the same thing. The tornado has struck and now you're saying "oh shit I better get covered."

HIPPA regulations currently limit the wait time for a pre-existing condition to be covered to 12 months, but most companies will waive this, again, if you've had insurance previously. This is due to the probability that you've been receiving treatment for it and have not just allowed it to get worse (and exponentially more expensive to address).

Insurance companies are companies; they do not print their own money and they do not have limitless resources. If there are no pre-existing clauses the alternative is to set the premium based on the anticipated expenses, which means that your coverage will cost you. A lot. The funny thing is that people who decide not to get coverage until they're sick expect to pay the same premium as a healthy person, and if you shop around enough you may be able to find a company with a wide enough margin to give that to you, but don't count on it.

Elimination of a pre-existing clause while simultaneously keeping the premium low is like telling somebody you'll pay them $500 a month for the use of their credit card and then charging $20,000 a month to it. You're leaving that person holding the bag for the extra $15,000; is that really fair? Maybe if they have lots of other people paying $500 per month and charging less than that. It's a big maybe.

So what's the answer to this issue? Simple, get coverage while you're healthy.

Fearmongering

We've been hearing a lot about fearmongering as it relates to any political debate. Right now the opposition to government run health care are being accused of spreading misinformation and fearmongering; so what exactly does that mean?

Wikipedia defines it as: is the use of fear to influence the opinions and actions of others towards some specific end. The feared object or subject is sometimes exaggerated, and the pattern of fear mongering is usually one of repetition, in order to continuously reinforce the intended effects of this tactic, sometimes in the form of a vicious circle.[citation needed]

Merriem Webster defines a Fearmonger as somebody who incites alarms needlessly.

If we use the Wikipedia definition then isn't anybody who says, "hey this bad thing could happen" considered a fearmonger?

If we use the Webster definition then is pointing out potential and probable issues around government health care really raising a needless alarm?

The biggest question though may be why it's ok to be a fearmonger when you oppose something, but bad to have a fearmonger opposing what you support? For example, does anybody remember the attempt to fix social security by phasing it out; giving the young people another option while leaving people over a certain age on the social security program? What happened to that? Opponents screamed that seniors would have their benefits taken from them and be left to die in the streets. Completelly untrue according to the information proposed but I guess that wasn't bad fearmongering because it was done by the same people crying about fearmongering now. But what is the fearmongering now? Is saying that there will be rationing of healthcare in the US based on what has happened in every other nation who has tried this type of program really fearmongering? Is telling the truth as you see it, calling out a consequence there is a high probability of occuring, fearmongering?

So here's how I see it -- Telling both faced lies about a proposed legislation and using those lies to scare the shit out of the general population is not fearmongering, but showing the true and actual potential problems of a piece of legislation is bad fearmongering.

Do I have this wrong?

Bend Over For The President

While in Italy the President was captured checking out a backside reportedly attached to a 16 year old girl. This could be just a man appreciating a thing of beauty, after all, who hasn't looked at something that caught your eye just to find out it was something you really shouldn't be looking at? I'd give him the benefit of the doubt if it wasn't for the fact that, since he took office, he's been asking every American to bend over and grab their ankles.

But here we have a man who is trying to pass legislation, and pass it quickly, which will grow the federal government to the largest it's ever been. He's taking us further and further away from the government listed in our Constitution and the ideals set forth in our Declaration of Independence. He is single minded in his goal to turn us into Europe, the one thing our Constitution was supposed to protect us from. But maybe he only wants to be someplace where he can ogle a teenage girl's backside with impunity. But if that's the case, I wish he would have moved there on his own and left us the hell alone.

And why do you think it is so important to pass the healthcare legislation before the August break? Is it because the crisis that they've been talking about for 20 years just can't wait a day more? Will all of us be bankrupt from our medical bills by the time Congress comes back? Nope. But if the congressmen get back to their own districts and find out just how upset people are about the high cost and low return, his bill will really be in trouble. People may want a healthcare bill, but they also want a good one.

I for one am a little ticked at the idea of our healthcare reform bill including money for parks, walking paths and street lights. They may say it's an encouragement for people to exercise, but if you don't go out and walk now, streetlights aren't going to help.

So when it comes right down to it, I'd rather have our President looking at a teenage girls butt instead of him asking me to bend over and present him with mine.

If You Build It...

I just watched the Nancy Pelosi weekly press conference (have I mentioned that I love working from home)and healthcare was addressed. The congress is looking mainly for a government run option which would follow their pattern of spending as much money as they can as fast as they can.

When asked about the cost of the public option that the majority support, Pelosi indicated that the Congressional Budget Office has not factored in the savings from prevention and early intervention, and that they need to look for every bit of savings they can find. Savings, savings, savings, is what she said. But that savings would be very difficult to calculate. Should we base the savings on the assumption that if you build it they will come? There are many people, like me, who just don't go to the doctor regularly. And I have preventative care as part of my insurance. How then can we calculate the cost of the savings when we don't know how many people would actually use their new preventative benefit? History has already shown us that their estimates on the costs of their programs is usually way off, and this could be why. If they are going to count on savings that won't actually ever come to pass, we should be concerned.

My other concern is their insistence that a bill, any bill, must be passed this summer. This continues their trend of being more concerned with doing something fast than doing it right. Look at how that worked out with the stimulus package. We had to pass it without reading it so the money could get into the system immediately. And 4 months later only 10% of the money has been spent. Shouldn't we instead take the time to ensure that a program which will impact the country for decades, if not forever, is the best possible bill that it can be? Shouldn't they be looking for a plan that delivers the best solution for the lowest cost instead of trying to cook the books to make the plan they want more palatable to the people? Shouldn't this fall under the old cliche of "if it's worth doing it's worth doing right"?

I am very concerned with the way Congress is spending our money. It appears, to me at least, that they are using our money to fund the growth of the government instead of the growth of the economy. And should we burden an already struggling economy with another $1 trillion in debt?

Delay is preferable to error. - Thomas Jefferson

Disabled Debbie From the Town Hall

I didn't watch much of the Health Care town hall meeting because I was actually working, but one thing has caught my attention. That is the woman, Debbie, who spoke about how she can't work, has no insurance, and a new tumor.

Let's set aside for a moment that this woman was placed there as an Obama supporter. She's actually a volunteer for one of the organizations working toward health care. I can see her being a volunteer due to her situation, but as somebody who deals with insurance, her situation raised some questions for me.

Obama answered her situation by saying a nation this rich should be able to take care of people in her situation. My question is, don't we already? If she is really unable to work isn't she on SSI Disability? And if she is, then guess what, she qualifies for Medicare if she has paid into it. If she hasn't, then she's eligible for Medicaid. So our current socialized health care programs actually cover her situation.

So why isn't she on Medicare or Medicaid then? Could it possibly be that SSI Disability has a policy of denying every claim on it's first submission and only reconsidering on appeal? But wait a minute, this is a government program. Isn't it only the evil private insurers who would do something so diabolical? And she did say that SSI has denied her claim saying renal failure is not a qualifier for disability. This is the government program folks. This is the people we plan on putting in charge.

She also said she doesn't qualify for Medicaid because she has to be on disability. And Medicare eligibility occurs for renal failure, but only once you've started dialysis.

This is why Debbie is disabled but not already covered under that umbrella? My deepest sympathies go out to her for the health issues she is going through, and I hope her issues are resolved soon, but sadly, this is more of a condemnation of our government insurance programs than our private ones.

Congress Could Benefit From Some Risk Management Classes

I was watching the news (I don't know why I do that) and the Universal Health Care issue was raised. People from both sides presented and it was stressed that employees happy with their current coverage could keep it. The reporter asked what would keep a company from deciding not to offer benefits to their employees anymore, as there would be another option for them, and thereby eliminating the coverage that the person liked. A reasonable question as far as I was concerned and one that would need to be addressed. What was the response? That's a Republican talking point and not our intent.

Not our intent. How many times do we hear that from Congress. That is just a talking point from the other side and not the intent of our legislation. They even sometimes get hostile over the suggestion that their legislation could have unintended consequences. But risk management is a necessity for the design of any product. And that's what Congress is doing. Designing a product. And yet they do no risk management at all. They make no effort to determine how their legislation could go wrong, how often it would happen, and the impact if it did happen. These are necessary pieces of information to have so that you know what loopholes need to be closed and can figure out how to close them. This is a basic FMEA (Failure Modes and Effects Analysis) a great tool for risk identification and mitigation. So why won't Congress use it?

Instead of using a simple tool to identify risks, they write legislation that is so long and convoluted that they can't even take the time to read it before voting on it. The stimulus bill for example. An important piece of legislation according to them. Had to be passed quickly. But they paid more attention to doing it fast than doing it right. So what has happened? The money is being misused because they didn't try to figure out how that might happen and how to stop it. And a lot of the money isn't being spent. It had to be passed so quickly so the money could get into the economy but that hasn't happened. That bill was 1,200 pages long. One giant opportunity for unmitigated risk.

To give you some perspective on the absurdity of the length of that bill, and it's just an example of many like it, I have a copy of the Constitution that is pamphlet sized. Pretty small cover and pretty small pages. And yet, that little book is still only 48 pages long. That is our Constitution and all of it's amendments. That's 48 pages to set the rules of our government, but it took 1,200 pages to spend money. And spend it badly.

Is it really so much to ask that our legislatures make an attempt to identify gaps in their legislation before they pass it? Oh, but I guess they'd have to actually read it in order to be able to do that.