All about ideas…

A letter to my Congress people regarding health care reform.

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After reading the Senate Finance Committee Health Care Plan this morning, I decided to write my Congress people to state my views. Here is the letter I wrote.

As soon as the Washington Post published the Finance Committee health care reform plan, I downloaded the pdf and read it. Unfortunately, I was not overwhelmed or happy about it. Certainly, it has some good points to it, but overall it seemed to me to be another give-away to big corporations. And haven’t the American taxpayers given enough – and continue to give – to Corporate America?

There was really nothing in the bill that reduced costs to purchasers – or any incentive for health care providers or health insurance companies to reduce cost. As someone facing the situation of having to decide whether to buy health insurance or pay rent (I can’t do both on my income), I am deeply concerned about this issue. I want it done right so that the American public can afford and get medical care they need.

At a meeting with Wall St., health insurance CEO’s discussed how to increase their lagging profits resulting from reduced employment. Part of their strategy for the coming year, they told Wall St, was to increase premium costs. Medical care costs, for far too many especially in this economy, are beyond the affordability of far too many American individuals, families and businesses. Paying more to increase profits only intensifies the problem.

Forcing all Americans to get insurance that they cannot afford only further punishes the American people, unless insurance costs are dramatically reduced. For example, why is a fairly large company given per employee rates of about $340/mo while HIPAA premiums from the same health insurance carrier nearly $1000/mo? Further, if a person or family cannot afford monthly insurance premiums, how will a tax deduction make it better for them? How will a tax deduction in April enable a cash-strapped family pay for insurance premiums and deductions and co-payments and their 20% of the bill in June or September of an already over-priced insurance policy? Tax deductions actually do nothing to reduce costs, nor do they help those who most need cost reductions.

It appears that neither the House nor the Senate is focusing on the “elephant in the room”: the cost of health delivery/care. Here is an interview with Frederic S. Goldstein, president of U.S. Preventive Medicine, Inc. – http://bit.ly/4iFCrs – which lays out a perfectly sensible idea to reduce – or at least contain – costs.

In addition, here is my reasoning in favor of a public option:

1- If run correctly, rather than punitively as most public programs are, the public option can experiment with methods to reduce costs through better health management and payment options that the private health insurance sector heretofore has failed to incorporate.

2- The public plan, because it has the financial backing of the Federal government, has the ability to put the best open-source medical IT in place which in itself will reduce costs as has been shown in Taiwan.

3- A purchaser-paid non-profit public insurance plan will cause health insurance companies to innovate to become more competitive. Fed Ex went up against the 200-year old Post Office monopoly and won because they were more innovative and thus more competitive.

4- A purchaser-paid non-profit public plan would allow people not covered by an employer but who are above 200% of poverty Medicaid requirement levels to purchase insurance on a sliding scale, based on income. Who really thinks that an individual making $22,500 gross can afford $12,000/yr in premiums plus $2,500 to $3,000 deducible plus co-pays on an 80-20 plan? The overall costs per year could amount to well over 75% of gross income.

5- A purchaser-paid non-profit public plan could be managed by the States, rather than creating yet another expensive bureaucracy. The States already have the infrastructure in place to manage the program efficiently and effectively.

The experiment in Utah is worth reviewing too. Utah’s plan is an exchange – with stated State-approved acceptable levels of benefits – in which each person buys his own health insurance from a number of health insurance companies and his company kicks in an amount to pay for the insurance. If people want a policy with even more benefits, they pay the additional costs out of their own pocket. This too adds competition into the market place, as employees will be able to decide for themselves which policy and pricing they choose.

Another argument to consider is breaking down state barriers to provide more competition. Why is it that so few health insurance companies are allowed into a state? That reduction of competition increases costs as the majority health insurer has no need to compete in an open market place. Not there really is such a thing as an open competitive market place anymore in Corporate America. When huge companies, through their lobbying and fund raising capabilities, are allowed to buy their way into Congressional and Legislative offices to affect legislation then competition, and thus a free and open market place, suffers.

Nevertheless, it is possible to design a program in which certain criteria must be met to conform to state laws but will allow people to buy from carriers outside the state. For example, a carrier in South Dakota can sell into California as long as it meets the requirements set by the California State Insurance Commission.

Another matter to consider in reform legislation is the cost of lawsuits. While I do not support limits on damages as some do, I do believe that “junk” (my term) lawsuits create a huge cost to medical providers which result in higher costs to the patient and thus to insurance companies to pay for enormous malpractice premiums and unnecessary tests to protect against malpractice suits. Paying for court and lawyer costs should be the price paid to penalize people who bring these kinds of suits, purely for egotistical and personal gain.

An idea put forward is to set up “medical courts” staffed by people who know medicine. Although that would be an expansion of the court system, it might – should – reduce costs for medical providers which should by all rights lead to lower malpractice insurance costs which would lead to lower costs overall.

Perhaps if doctors didn’t have to practice “defensive medicine”, medical care costs could decrease. However, for that idea to become a reality, medical associations and state regulatory agencies, of necessity, would have to become far more pro-active to get rid of the bad players and a national communications ability would have to come into play so that any doctor barred in one state would not be able to practice in another.

Finally, we need fundamental and all encompassing tax reforms around the health care issue. For example, why is R&D, in any industry sector, taxed? And why is capital gains taxed so lightly for short-time holders of equities? The government should be rewarding innovators – the companies who make something useful to people – rather than people who make nothing but profits on speculation. As Dylan Ratigan says each and every morning, why are people and companies who do nothing but pull money out of system rewarded so highly when people and companies who make things people actually want don’t?

Instead of putting band-aids on this whole issue of health reform, we really need Congress to take a holistic approach to reforming the entire system. I urge you to step forward and say the entire system needs to be reformed in ways that benefit society as a whole, rather than yet again putting more band-aids on a broken system. The ideas I’ve put forth in this letter are not mine alone. They come from a variety of experts in the field of health care. I have only combined their best ideas potentially to develop a system that makes economic sense.

If you agree with me, send a similar letter to your Congress people. And if you have an even better idea.let me know. Solving the cost issue of health care is more than a national issue, it’s a issue that affects every business in this country and our national competitiveness. Every major international company in this country has stated that health insurance costs is one of the major reasons why they have off-shored jobs. It’s not wages, it’s health insurance. This is not a Democrat vs Republican issue, it’s a jobs and financial issue.


Written by Valerie Curl

September 16, 2009 at 6:25 PM

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