The President’s Plan and My Comments on It

The President’s Plan for Health Reform

“It will provide more security and stability to those who have health insurance.
It will provide insurance to those who don’t. And it will lower the cost of health care
for our families, our businesses, and our government.”

If You Have Health Insurance,
the President’s Plan:

  • Ends discrimination against people with pre-existing conditions.
  • Limits premium discrimination based on gender and age.
  • Prevents insurance companies from dropping coverage when people are sick and need it most.
  • Caps out-of-pocket expenses so people don’t go broke when they get sick.
  • Eliminates extra charges for preventive care like mammograms, flu shots and diabetes tests to improve health and save money.
  • Protects Medicare for seniors.
  • Eliminates the “donut-hole” gap in coverage for prescription drugs.

If You Don’t Have Insurance,
the President’s Plan:

  • Creates a new insurance marketplace — the Exchange — that allows people without insurance and small businesses to compare plans and buy insurance at competitive prices.
  • Provides new tax credits to help people buy insurance.
  • Provides small businesses tax credits and affordable options for covering employees.
  • Offers a public health insurance option to provide the uninsured and those who can’t find affordable coverage with a real choice.
  • Immediately offers new, low-cost coverage through a national “high risk” pool to protect people with preexisting conditions from financial ruin until the new Exchange is created.

For All Americans,
the President’s Plan:

  • Won’t add a dime to the deficit and is paid for upfront.
  • Requires additional cuts if savings are not realized.
  • Implements a number of delivery system reforms that begin to rein in health care costs and align incentives for hospitals, physicians, and others to improve quality.
  • Creates an independent commission of doctors and medical experts to identify waste, fraud and abuse in the health care system.
  • Orders immediate medical malpractice reform projects that could help doctors focus on putting their patients first, not on practicing defensive medicine.
  • Requires large employers to cover their employees and individuals who can afford it to buy insurance so everyone shares in the responsibility of reform.

I can only support this plan if the following changes are made:

  • Also limit premium discrimination based on health status, i.e., pre-existing conditions.
  • Replace tax credits for individuals with a sliding-scale, direct assistance to buy health insurance.  Tax credits are helpful only to people who make enough money to pay taxes in excess of the credit.  Furthermore they only provide that help as much as a year after people have had to buy health insurance.
  • The public health insurance option needs to be available immediately to the uninsured, then expanded to be available to everyone.  The fastest, best way to implement it is to modify Medicare, not create a new program.  Co-ops are not acceptable because they do not control costs.
  • If premium discrimination based on health status as above is ended, there is no need for placing people in a high risk pool.  The private insurers should be able to cover them at a reasonable cost.  High-risk pools have the taint of discrimination and people often can’t afford the premiums, the deductibles  or other out-of-pocket costs.
  • Eliminate Medicare Advantage and other subsidies to the private health insurance companies related to Medicare.  They do just fine writing supplemental insurance for Medicare clients.
  • Re adjust Medicare payments so that the same reasonable reimbursement is provided to doctors and hospitals across the country.
  • Eliminate the mandate for individuals to obtain insurance.  If it is available to them at a reasonable price they will take it; we have far more people who want to be insured but can’t get it than we have people who don’t want it at all.  A mandate is meaningless without enforcement and fining people because they can’t afford insurance is repugnant.  We’re supposed to be helping people, not punishing them.
  • Taxes need to be increased on the wealthiest Americans.  If the private insurers are going to continue to take their profits out of the health care system, a portion of that needs to be returned to the system.  Alternatives are taxes on all sales of stock or stock in private insurance companies.  Another alternative is to limit deductions for the wealthiest Americans.  To say “Requires additional cuts if savings are not realized.” is meaningless.  If the savings don’t occur immediately, and they won’t, what are you going to cut, benefits?  Why not immediately tax profits taken outside the health care system?

Mary Bell Lockhart

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