The Problem with H.R 3200 America's Affordable Health Choices Act of 2009

I have seen quite a bit of traffic lately going into my article on True Healthcare Reform. Specifically, people have come to it trying to figure out why people are against healthcare reform.

Let me first say, I do not think anyone is against healthcare reform. I believe everyone agrees that the system needs some changes. That is just an undeniable fact. When you hear about polls stating that people believe we need healthcare reform, they are agreeing to that generic statement. What I and many other people have a problem with is the way that healthcare reform is currently taking form.

There are some basic principles of the system that are what cause a lot of grief. Sometimes it is not what is exactly in the bill, but what roads it will make us go down. I understand that there are different version of the House bill, so I am not going to talk about all of the proposed amendments and will stick with H.R 3200.

Here are some of the concerns I and others have with this bill:

1. You cannot have an entity participate and create the rules. If the government is one of the active players who can offer insurance, they will have an unfair advantage over all other insurers. Anyone who has ever worked with the government is well aware of a nice little clause they place on all of their contracts. This clause is called “Most Favored Nation”. What this clause basically states is that no entity can get a better price than the government. That means that even if another insurer sends more patients to a doctor, hospital, etc. they cannot get as good of a discount as the government. This gives the government an unfair advantage compared to other insurers. Add on top of that, that there is no requirement that this government sponsored/public plan make money, the government does not have to worry about shareholders, profitability, etc. The only requirement is that the plan is deficit neutral. With everything I said here being true, how can a for profit or even a non for profit company compete with a government entity that always has the upper hand. Add to that, the government can and does change the rules when it sees fit. If you just look at Medicare Part D, the government is changing the way it pays for prescriptions so that they are guaranteed to pay a lower reimbursement for drugs than its non Medicare competitors. Just so you know, Medicare prescription coverage is not the largest insurer out there, so they are not getting the best price because they bring the most customers to the table.


2. Government oversight is a big concern to a lot of people. The idea that a government entity could choose the best treatment based upon an unknown set of codes is problematic at best. Right now, doctors use standards that are set up by professional organizations made up of practicing peers. Insurance companies use a similar standard made up of licensed nurses (who have worked in offices and hospitals), doctors (who have worked in offices and hospitals) and management within the insurance company. There is no guarantee that the government will do the same. If the current standard is any indication, this board would be made up of academics that have never practiced or have not practiced in over 15 years as well as bureaucrats. This is where the whole concept of the death panel Sarah Palin has talked about came from. When President Obama states that he questions the logic of giving a new hip to a terminal cancer patient, that sounds all well and good, but it is what he is not saying that is important. Like many people, I have had and known people who had terminal cancer and were given 6 months or less to live. These same people wound up living for 3 or more years. Randy Pausch is a perfect example of this as he was given 3 to 6 months and lived a year. Randy gave what may be one of the best lectures ever in The Last Lecture. Based upon things Obama has said, a person diagnosed with terminal cancer would cease to get treatments. In other words, a panel would judge your worth and determine if you are worthy of having money spent on you. I do not think anyone wants the government making that determination. That is a slippery slope that a government can go down and one that leads to allusions of Logans Run.


3. Why does this have to be passed so quickly? It sounds great to say that you want to get this passed quickly so every American can be covered. That is completely bogus. To put together a working program to cover a country and population this size, you must take your time and ensure that there are not loopholes. President Obama promised as a candidate, transparency and committed to showing the forums and discussion on C-Span. Where is the transparency? The whole program has been rushed through. Congressmen admit that they have not had a chance to read it, yet Nancy Pelosi and the like want to vote on it immediately. Why? This does not make sense. It is as if they do not want everyone to know what is in the bill. Why not take the time to put together a good bill that everyone can read and reflect upon. This is not a national emergency. We are not in a state of crisis. Many Democrats argued that the Patriot Act was rushed through Congress before everyone had a chance to review it.


4. Why is the standard they asked for during the Bush Administration any different now?
   No one can seem to agree with what is in the bill. If you blog, read the papers and watch the news like I and many Americans do, you will find that anytime a Congressman or Senator get off of talking points, they say things that are contradictory from their peers. Today alone Congresswoman Zoe Lofgren was caught on video admitting that one of the proposed House bills would require the public plan cover abortions, when others state that is not the case. Which is it? President Obama states that you can keep your insurance if you want to, yet on page 16 of the latest version of the healthcare bill it states that no new policies can be enacted after a certain date. Read the bill which you can find here. Which is it. As I stated earlier, why does it have to be passed so quickly, especially when those that are voting on it do not even know what it says.

Let us have a civil debate. I know President Obama promised healthcare reform. We all want to see some sort of healthcare reform, but it does not need to be rushed through. Put together something that patients and healthcare providers can work with. Put together a plan that works piecemeal, with stop gaps. We are talking about a program that would be bigger than any other healthcare plan in the world. Let's do it right the first time.