The Missed Point of Health Care Reform

This week’s discussions regarding President Obama’s health care reform plan have been well covered, with the debate revolving around Obama’s projection of costs and savings and that of the non-partisan Congressional Budget Office. Reports have been plentiful, so I will not review here.

The Democrats are again controlling the debate. All of the talk about the plan centers on the cost of the plan: whether or not the CBO takes into account the savings that Obama promises or the fact that only the “rich” will pay for it. I do not hear the Republican voices that should be loud and clear: Health care is not a right; people cannot be forced to purchase insurance; and the Constitution does not allow this action. This plan is not about making health care affordable to all, it is about government control. (See Steve Chapman’s column from July 16.)

Senator Olympia Snow of Maine has asked that the President be patient while a bi-partisan plan is crafted. Senator Grassley of Iowa says he is “hoping” to support the final package.

Once again, we are missing yet another opportunity for the GOP to define itself- but the debate must not be about cost.  This bill does not make health care a right- instead it makes insurance a requirement, arguably at the point of a gun since not having it incurs a tax penalty (for both employers and for individuals).

It is past time for the GOP to stand on principle.

Following is the best simple overview that I have seen regarding the health care bill currently being considered in Congress. It was published in today’s Charlotte Observer (July 19, 2009; page 14A), although I could not find a link online. It is well worth reading. I have added bold italic type for emphasis. From the Observer:

House Democrats’ proposed health care bill

Here are details on the House Democrats’ health care overhaul bill. Tow House committees – Ways and Means and Education and Labor- finished their portions of the $1.5 trillion, 10-year bill Friday. A third committee, Energy and Commerce, is aiming to complete the legislation by Wednesday:

  • Who’s covered: About 94 percent of nonelderly residents (those who are not covered by Medicare, which kicks in at age 65) would be covered – compared with 81 percent today. Nearly half of the 17 million nonelderly residents who remain uninsured would be illegal immigrants.
  • Cost: About $1.5 trillion over 10 years.
  • How it’s paid for: Revenue-raisers include: $544 billion over the next decade from new income taxes on single people making more than $280,000 a year and couples making more than $350,000; $37 billion in business tax increases. About $500 billion in cuts to Medicare and Medicaid. About $200 billion from penalties paid by individuals and employers who don’t obtain coverage.
  • Requirements for individuals: Individuals must have insurance, enforced through tax penalty with hardship waivers. The penalty is 2.5% of income.
  • Requirements for employers: Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payroll under $250,000 annually are exempt.
    Employers could apply for a two-year exemption from the mandate if they can prove the requirements would result in job losses that would negatively impact their communities.
  • How you choose your health insurance: Through a new Health Insurance Exchange open to individuals and, initially, small employers; it could be expanded to large employers overt time. States could opt to operate their own exchanges in place of the national exchange if they follow federal rules.
  • Benefit package: A committee would recommend and “essential benefits package” including preventive services, mental health services, oral health 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.
  • Government-run plan: A new public plan available through the insurance exchanges would be set up and run by the secretary of Health and Human Services. On average it would pay Medicare rates plus 5 percent to doctors.
  • Changes to Medicaid: The federal-state insurance program for the poor would be expanded starting in 2013 to cover all nonelderly individuals with incomes up to 133 percent of the federal poverty level ($14,404).

-Sources: Associated Press; Congressional Budget Office’ House Ways and Means Committee

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