PLEASE -- if you change healthcare, do it in a way that makes sense!  If the government must take over insurance, and if the government is unwilling to consider tort reform that would truly reduce costs, then TAKE OVER PROVIDERS' MALPRACTICE INSURANCE and leave my medical insurance alone!

That would DRASTICALLY reduce costs without punishing the 85% or so of us who are happy with our coverage and do not want to see a change.  It would also encourage more people to pursue careers in the medical profession, and it would likely allow the return of many charitable hospitals and clinics.

It would also continue to reward the research and development efforts that have made the U.S. the world leader in medical care.

Per the plea on your blog, I feel obliged to report some rumors that I’ve heard circulating regarding your plan for Health Insurance Reform.  I urge you to find the source of these rumors and put an end to them immediately. 

Unsubstantiated rumors are identified by bullet points.  Rebuttal to these rumors follows in italics.

• No Discrimination for Pre-Existing Conditions

Insurance companies will be prohibited from refusing you coverage because of your medical history.

For anyone who understands insurance, this is an absolute absurdity.  If this is true, then why would anyone pay for insurance prior to becoming ill?  Insurance is based on actuarial mathematics, not blind luck.  (Would you buy a vehicle from a newspaper ad that simply said “automobile:  $20,000” without insisting that you obtain additional information about it, such as make, model, mileage, and condition?)  To eliminate underwriting principles is to ensure the collapse of the private insurance industry, thus ensuring that the only option remaining is the public insurance option, thus ensuring that all except the ultra-rich will be subject to government-controlled medical care, thus expanding rather than contracting the gap between economic classes.

• No Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays

Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.

“Exorbitant expenses” and such would be replaced by what?  The guarantee of corporate losses in an industry that is already struggling?  Any extra expense forced on a business must be made up for by either cutting costs (most likely jobs) or by finding additional sources of revenue.  Suppose every American were covered under a “competing” government plan.  These “exorbitant expenses” would be replaced by an additional source of revenue, meaning increased debt or increased taxes.  People who have never worked in a business environment seem to believe that corporations try to dream up ways to “stick it to” their customers.  People whose livelihoods depend on business understand that success depends on providing quality goods or services at a reasonable price while making enough of a profit to ensure that the business survives.

• No Cost-Sharing for Preventive Care

Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.

This is a noble ideal.  However, it will add another expense that must be compensated somehow.  Again, this will result in either higher premiums or job losses.  Both consequences are the opposite of what you profess to be working towards.

• No Dropping of Coverage for Seriously Ill

Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.

I believe this to be a smokescreen.  For people covered under individual or small group plans, perhaps a particularly high claims experience may justify an increase in premiums that makes insurance become unaffordable.  This is certainly a problem that needs to be addressed.  However, for the majority of those Americans covered under large group insurance plans, I do not believe that coverage is dropped when insured persons become seriously ill.

• No Gender Discrimination

Insurance companies will be prohibited from charging you more because of your gender.

I believe this, too, to be a smokescreen.  I believe this is not common practice.  However – fair or not – insurance is based on actuarial risk, and the medical expenses for a woman in childbearing years is most likely to be higher than the medical expenses for a man in the same age group.  This is not just a matter of mathematics; it is common sense.

• No Annual or Lifetime Caps on Coverage

Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.

Again, I would argue that since limitless care carries increased risk, the result would be increased expenses.  The natural outcome would be higher premiums or fewer jobs.

• Extended Coverage for Young Adults

Children would continue to be eligible for family coverage through the age of 26.

Ditto to the above remark (again).  Does anyone in the federal government understand that increasing expenses necessitates increasing revenues?  Of course, that assumes that the entity paying the expenses cannot borrow without limits or manufacture its own currency.  It also assumes that the entity paying the expenses holds itself accountable to those who are impacted by its success or failure.

• Guaranteed Insurance Renewal

Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won't be allowed to refuse renewal because someone became sick.

Another smokescreen.  Rates may go up as an individual’s health declines, but that is an actuarially sound decision.  I do not believe that this is a significant issue.

I do believe that there are legitimate problems with our healthcare system.  Government healthcare – or government “insurance,” as it has been rebranded for some reason – is NOT the solution.

If you must reform insurance, perhaps you should initiate government-sponsored malpractice insurance instead.

I believe you have honorable ideals.  I believe your supporters believe in your fairness.  I believe your supporters would be horrified to think that a future Republican administration might be charged with administering whatever plan you sign into law.  There may not be a Republican administration soon, but surely there will be one again someday, and by that time, there may be no private insurance available to the masses.  Ask your supporters if they would vote for a bill that would put a bureaucrat appointed by the likes of George W. Bush in charge of a federal insurance program.  I doubt that they would feel reassured with that thought.

I have no issue with your ideals that we should look out for those among us who are less fortunate than ourselves.  I believe that is a requirement of being human.  However, it is also an issue of charity, and charity is a religious principle.  Government involvement in charity is therefore tantamount to government endorsement of religion, which violates the establishment clause of the first amendment.

To be a free people means to accept that bad things will sometimes happen to individuals through no fault or responsibility of the government.  For the government to take responsibility for individuals is to deprive us of our individual liberties.  It arrogantly assumes that someone either elected or appointed is better able to care for us than we are able to care for ourselves.  Such a government would be tyrannical.

I wish you success in restoring our individual liberties at the expense of governmental controls.  Your current health reform does not qualify for my support.

Sincerely,

Tom Comeaux

aka:     Member of a “Mob”

            Too well dressed to have a legitimate point

            Naysayer

When I was a child, on the rare occasions when we went to eat at a restaurant, my father chose the restaurant. Why? Because he had the wallet.

Who pays, says.

When a manager wanted to treat my coworkers and me to a “thank you” lunch, she restricted our choices to the lunch menu. Why? Because she was picking up the tab.

Who pays, says.

When I take my kids out to eat, I often tell them they are only allowed to order water to drink. Why? Because I’m the one with the money.

Who pays, says.

When the federal government bailed out GM, the federal government insisted that the CEO needed to be changed. Why? Because they were footing the bill.

Who pays, says.

What can we expect to happen when the government pays for our healthcare? Is it possible that the entity that is paying for our healthcare might restrict our choice of doctors, restrict our choice of services, and limit the amount they’re willing to pay for?

If you believe in logic and rational thinking, then you must conclude that the federal government would definitely restrict our liberty in that area.

Why?

Who pays, says.