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8 common myths about health insurance reform

Yesterday I posted 8 ways to reform healthcare that everyone can agree with. Today I have 8 myths about reform. (received by email)

1. Reform will stop “rationing” - not increase it: It’s a myth that reform will mean a “government takeover” of health care or lead to “rationing.” To the contrary, reform will forbid many forms of rationing that are currently being used by insurance companies.
2. We can’t afford reform: It’s the status quo we can’t afford. It’s a myth that reform will bust the budget. To the contrary, the President has identified ways to pay for the vast majority of the up-front costs by cutting waste, fraud, and abuse within existing government health programs; ending big subsidies to insurance companies; and increasing efficiency with such steps as coordinating care and streamlining paperwork. In the long term, reform can help bring down costs that will otherwise lead to a fiscal crisis.
3. Reform would encourage “euthanasia”: It does not. It’s a malicious myth that reform would encourage or even require euthanasia for seniors. For seniors who want to consult with their family and physicians about end-of life decisions, reform will help to cover these voluntary, private consultations for those who want help with these personal and difficult family decisions.
4. Vets’ health care is safe and sound: It’s a myth that health insurance reform will affect veterans’ access to the care they get now. To the contrary, the President’s budget significantly expands coverage under the VA, extending care to 500,000 more veterans who were previously excluded. The VA Healthcare system will continue to be available for all eligible veterans.
5. Reform will benefit small business - not burden it: It’s a myth that health insurance reform will hurt small businesses. To the contrary, reform will ease the burdens on small businesses, provide tax credits to help them pay for employee coverage and help level the playing field with big firms who pay much less to cover their employees on average.
6. Your Medicare is safe, and stronger with reform: It’s myth that Health Insurance Reform would be financed by cutting Medicare benefits. To the contrary, reform will improve the long-term financial health of Medicare, ensure better coordination, eliminate waste and unnecessary subsidies to insurance companies, and help to close the Medicare “doughnut” hole to make prescription drugs more affordable for seniors.
7. You can keep your own insurance: It’s myth that reform will force you out of your current insurance plan or force you to change doctors. To the contrary, reform will expand your choices, not eliminate them.
8. No, government will not do anything with your bank account: It is an absurd myth that government will be in charge of your bank accounts.  Health insurance reform will simplify administration, making it easier and more convenient for you to pay bills in a method that you choose.  Just like paying a phone bill or a utility bill, you can pay by traditional check, or by a direct electronic payment. And forms will be standardized so they will be easier to understand. The choice is up to you – and the same rules of privacy will apply as they do for all other electronic payments that people make.

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I'd suggest that this needs some editing before further distribution; as is, it's needlessly confusing. For example, items 1, 4, 5, 6, 7, and 8 start by stating the truth, while items 2 and 3 start by stating the myth. Pick one form or the other, and stick with it throughout.

And if you're going to state the myth, label it "Myth: " right up front; don't state it and then say it's a myth, that form lends credence to it if somebody is just skimming quickly.

Personally, that's the way I'd state all of these, since it purports to be a post about myths.

1. Myth: .... The truth is ...

2. Myth: ... The truth is ...

etc.

Sorry, #7 is outright false.

There are LOTS of Americans, especially younger Americans, who choose cheap medical insurance with extremely high deductables. ie., they choose a plan that they'll only "tap" in case of a true, heinous, emergency.

Those sorts of plans will completely go away with the "minimum standards" that will be required.

Now, your argument might be 'but these are BETTER' (for some value of "BETTER") but:
(a) BETTER is still DIFFERENT, and
(b) BETTER is very subjective. Perhaps they don't want to have to pay for coverage they don't need. Why should the younger healthier folks have to subsidize the older sicker folks?

I've been uncomfortable with the claim that we will
be able to keep our current plan for similar
reasons.

I don't get to choose which plans are
available. My employer does. Just because
they will be able to keep the plans they
have doesn't mean they will. I've yet to
see anyone articulate how the employee
will be able to keep their plan when it's
the employer who does the choosing.

(b) simply does not fly because the huge majority of younger americans are insured by employers, and employer-purchased insurance is currently required by law to treat the entire company as one risk pool, thus the young are already subsidizing older and sicker folks.

Nothing about that changes with the new plan, except that everything will be cheaper. The young will still be subsidizing the old.

Don't let perfection get in the way of improvement.

But they'll be forced to buy coverage that they don't need. Again, lots of younger americans buy coverage plans that (effectively) only cover "the worst case scenario" and under the Obama plan, they are forced to buy into much more coverage than they need.

Who are these young people that can't afford health insurance that buy a "worst case scenario" plan? All the 18-29 year olds that I know without health coverage also can't afford "worst case scenario" plans.

I believe that "worst case scenario" plans are often purchased by younger people, but that doesn't mean that many of them do.

Do you have numbers to back up this claim?

I know we have at least two in my office, and I've met them before when I worked in other places (including at a healthcare provider).

It's not just young people, though. One of the people I worked with at a former job had such a plan because she had done the math and decided "I spend XXXXX each year on insurance, and I only take back YYYYY from their payouts to providers. It's more cost-effective for me to pay YYYYY+ZZZZZ to pay the providers directly, and pay for a worst-case-scenario plan in case something comes up."

Again - this is the plan that THEY are comfortable with, and that THEY want to have, but which will be unavailable to them under Obamacare.

shandrew, I agree!

Plus, the young people (age 18-26) that haven't yet settled into jobs with healthcare are a burden on the emergency care system, which we all pay for. The plan would require companies to let children stay on their parent's healthcare plan until age 26. By raising the age it is a double-win!

I agree "Don't let perfection get in the way of improvement".

The question is whether or not it DOES represent an improvement. There is some considerable debate on that very topic. :-)

I've yet to see any part of the plan that I find compelling or even an improvement over the current status-quo. Do I *like* the status-quo? Not necessarily, but I don't see any of the proposals as improvements, just more places and ways it can get more screwed up through gov't involvement.

Yeah, but has there ever been a law that was proposed that you didn't feel would just screw things up?

Sure, lots of times. A couple of examples that come immediately to mind?

- There was the time the NY State Gov't repealed bans on ticket-scalping.
- There's the slowly growing number of states who have passed laws affirming equal-protection for same-sex couples.
- California's law allowing for medical use of marijuana

The commonality to all of those, though, is that it's the gov't passing laws to "get itself uninvolved in something"... stopping interference in the free-market, getting out of the business of determining "who should be allowed to marry whom", not getting involved in the determination of whether or not something has "medical value" and letting that be a decision between the doctor and patient, etc.

Banning ticket-scalping? Government intervention: preventing two consenting adults from making a contract. However, this is ok because it inches us closer to a free market by making a level playing field for everyone.

Equal protect for same-sex couples? Government intervention by being the sole arbiter of what is a family. However, this is ok because it inches us closer to a free and equal country by expanding the definition.

California's law for mm sets up a HUGE list of government regulations. However, this is ok because it inches us closer to a free market for what we put into our bodies.


So, your examples all INCREASE government intervention because it inches us closer to a free market.

Similarly, the healthcare insurance reform increases government intervention but it inches us closer to a better system.

In New Jersey my hospital bill is 3x what it should be because I have to pay for the uninsured. The bill used to literally show that:

Cost of thing1: $500
Cost of thing2: $100
Cost of thing3: $200
----------------
subtotal: $800
uninsured surcharge 3x:
---------------
$2400

It was RIGHT ON THE BILL. You'd see that your pimple removal was $200 but then they'd triple it. The NJ courts declared it was unconstitutional, so now they triple the original prices. However, I *literally* pay for the uninsured.

If we force everyone to get insurance then I don't have to pay for them. Plus, by having insurance they get preventive care which costs 1/10th as much. So, yes, I'm paying for them by taxes instead of at the cash register, but there is a inventive for them to use services that cost 1/10th as much.

This, plus all the other changes, it sounds like a net win to me.

Yes, there are some things I don't like about the bill as it stands, but in politics you never get 100% of what you want. If you think THAT can change, you'll need a bigger hammer.

You have some REALLY weird definitions of "gov't intervention".

If a law is taken off the books (re: scalping), that's hardly "government intervention". That's getting one more gov't intervention elimination.

Same-sex couples : you know my opinion on this from previous discussions. What I *want* is for gov't to get out of the marriage business entirely. "Marriage" is a religious institution and should have no legal weight or definition at all. If "married" couples also want to get some sort of civil union to protect their joint property, etc., then that's a different story altogether.

MM : Sure, it sets up regulation today, but -- again -- it's a poor stop-gap/proxy for what I really want, which is for gov't to shut the hell up and let people put into their bodies whatever they want to. If I can be a responsible adult and use heroin, why shouldn't I be allowed to? You want to super-criminalize "behavior while under the influence" (e.g., increase the penalties for all manner of crimes committed while doing something stupid like drugs)? OK, fine, but if a guy can manage to smoke some pot, or do some H, without harming anyone else, they should have that right. CA's MJ laws inch us a little closer to getting the gov't out of that process. Certainly not to my "ideal" but they're steps in the right direction.

Re: "uninsured surcharges"... y'see, here's perhaps the fundamental difference of opinion we have. I don't have a problem, ethically, with denying care to the uninsured. If you've chosen to be uninsured -- whether by conscious decision, or poor life choices -- then we as a society can direct you to a number of charitable organizations who exist to help people pay their bills.

You want to come up with a gov't plan that covers just kids or the disabled (e.g., people too young to condemn for other peoples' decisions, or people who simply were never born with an option to get insurance)? You can probably sway me with such a plan. But forcing people to pay for insurance, and forcing taxpayers to pay for other peoples' insurance, strikes a fundamental chord with me that is unlikely to change.

Well, we agree on Marriage Equality and MM. I think you have isolated the fundamental difference on how we feel about healthcare.


I'm reminded of a great line from West Wing... when John Goodman, as Acting President Walken is talking to CJ....

"The things that unite us are far greater than the things that divide us."


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