Health care reform. . .

My mom, AKA Grumpy Granny, posted a blog about her concerns about the health care reform. She asked me to comment, and because of its size, I opted to make my comment a separate blog post. Here goes!

One of the problems with this bill is that it took them a year to pass it, and it wasn't because they were trying to work out the kinks, it was because they were too busy playing their partisan games. But it's like Jules said, bipartisanship was a foregone conclusion irregardless.

The CBO has said this is actually going to reduce the deficit. That's good, I'm all for defecit reduction, but I don't like the way they're doing it. For starters, they're cutting funding to Medicare. They have millions of people who depend on Medicare, and millions more that will depend on it soon, and they're going to cut funding. I would have rather they kept the funding as-is, or maybe even increased it. A lot of people on Medicare are on fixed incomes, and can't afford regular insurance--pre-existing condition or not--on their income, so in my opinion, reducing the Medicare funding is only going to hurt them more than it's going to help, at least in the short term. I admit that I'm actually kinda in favor of taxpayer subsidy of health insurance for those who can't afford it, if anything because, being on VA benefits, the taxpayers subsidize my healthcare, so who am I to complain, right?, but it's also because at least I know my tax dollars are going for something good and not, say, research on the behavior of moose sperm that's frozen and thawed out. . .but the Medicare cuts take effect before the government subsidies do. What are they going to do in the interim?

I also have a problem with the individual mandate. They're going to force everyone to have a minimum level of coverage. Now, again, that's where the government subsidies come in, and I know that there's exceptions for people who, even with subsidies, still can't afford it, and I also know that my VA healthcare automatically satisfies the minimum coverage requirement, but I oppose it on principle--who is the government to tell me or the people I know that they MUST do something, or face a fine? And the fine's not going to cap at $750. No, the cap in the penalty for not having health insurance is $750 multiplied by the cost of living increase from Calendar Year 1992--which was 3.7%, if I remember right, meaning the actual cap is more like $2,775.

And there's the matter of requiring employers with more than 50 employees to provide health insurance, or face a penalty. In the present economic environment a lot of those busimesses are doing good to meet payroll; throwing this on them may well spell bankruptcy. And I don't remember seeing anything in the bill about government helping to fund employer-sponsored coverage, although I could be wrong on that. I did try to read the bill, but at a couple thousand pages of congressional gibberish it's hard. . .

Of course, the individual mandate and employer mandate don't kick in until 2014. Who's to say the ecomony's going to improve by then? I sure as hell hope it has but with everything that's gone on economically it's a very real possibility that it could be 2014 or beyond before we fully recover. I'm not trying to sound pessimistic, I'm honestly just trying to look at reality.

That's the other thing--why do most of the changes have to take effect in 2014? Who not 2010, or 2011? They're waiting too long to put everything in effect. Yeah, okay, the budgets for 2011-2013 are already in the works. . .MODIFY THEM! I'm pretty sure there's a way to modify budget forecasts like that so that the stuff can take effect at least in 2011.

Now, I did my research on single-payer health care, specifically the Kucinich bill that's been introduced every Congress since I believe 2004. It would basically amount to a government takeover of health care for essential services by expanding Medicare to cover everyone, and relegate private insurance to non-essentials. Health care providers would be required to be public, not for profit, in order to participate. In the bill for-profit institutions that converted would remain privately owned, which I suppose is a good thing. Now, having been under government-run healthcare for a good chunk of my life--TRICARE and VA--I can tell you that there will be problems.

When I first joined the Navy, if you weren't feeling too hot, you went to the clinic at 8:00am for sick call. The doctor saw you, made his diagnosis, and proceeded accordingly. The sick call system had been in place for literally hundreds of years; then, in '04 they did away with sick call. Now you had to make an appointment, and generally you didn't get a same day appointment. A buddy of mine was having a persistant headache. He made an appointment, but it was for a few days, maybe a week later. Well, several days later he got fed up and had someone drive him to a civilian hospital, where they ran the requisite tests and determined he was having a minor stroke. Lord knows what would have happened if he's waited for that appointment. And more recently, after an ECG found that I had some probable heart problems, I called to make an appointment. The soonest they had was nearly a month away--that was Feb. 28 and my appointment's tomorrow. Those are under government-run programs. Now, the TRICARE and the VA provides more comprehensive care than single-payer would, but, under the Kucinich bill, VA healthcare could be eliminated in favor of the government option. Indian Health Service would be eliminated, but TRICARE would remain untouched. I could see the Department of Health and Human Services turning the VA hospitals into national hospitals, but that could be somewhat far-fetched. But about the only way I could support single-payer, even a little, is if they left VA and IHS alone.

Oh, and another thing--the health care reform recently passed would expand the Public Health Service Commissioned Corps--doctors and nurses who, while not part of the military, are payed on the DOD payscale, wear Navy-style uniforms, and hold rank, just like the Navy, ensign to vice admiral--to create a reserve component and establish PHS Warrant Officers. What does expanding the size of the PHS Commissioned Corps have to do with health care reform? Sounds to me like a park-barrell project, but it may just be me.

Well, Mom, here's your comment! Sorry it's so long/