Undernews is the online report of the Progressive Review, edited by Sam Smith, who covered Washington during all or part of one quarter of America's presidencies and edited alternative journals since 1964. The Review has been on the web since 1995. See main page for full contents

September 11, 2009


New York Times - The legislation approved by three House committees clearly states that only lawful residents will qualify for new health insurance subsidies. "Nothing in this subtitle," it says, "shall allow federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.". . .

The president said that "if you are among the hundreds of millions of Americans who already have health insurance" through an employer or the government "nothing in our plan requires you to change what you have."

That is technically true. But there is a real possibility that existing policies could change as a result of the legislation. The government, for instance, would set new standards, and employers that already offer insurance would have to bring their plans into compliance.

Some existing policies might not be sustainable given the new requirements. Doctors, for example, could end up refusing to accept insurance plans patients now use.

The Congressional Budget Office predicts that far more people will obtain health insurance as a result of the legislation, but whether existing benefits will remain the same for everyone who is now covered is far from certain.

That's correct, as far as it goes. But neither can the plan guarantee that people can keep their current coverage. Employers sponsor coverage for most families, and they'd be free to change their health plans in ways that workers may not like, or drop insurance altogether. The Congressional Budget Office analyzed the health care bill written by House Democrats and said that by 2016 some 3 million people who now have employer-based care would lose it because their employers would decide to stop offering it. In the past, Obama made repeated statements such as, "If you like your health care plan, you'll be able to keep your health care plan, period.'' Now he's stopping short of that unconditional guarantee by saying nothing in the plan "requires'' any change. He's dropped the "period.'' - Boston Globe

Mr. Obama also seemed to stretch things a bit when he declared: "Not a dollar of the Medicare trust fund will be used to pay for this plan. The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud as well as unwarranted subsidies in Medicare that go to insurance companies."

Critics of the president's plan have said Americans ages 65 and over could find their Medicare benefits reduced as a result of the health care overhaul. Congressional Democrats certainly do not intend to cut benefits, but they are proposing big cuts in government spending on Medicare and not all of it would come from eliminating waste.

The legislation seeks to trim Medicare payments for most services, as an incentive for hospitals and other health care providers to become more efficient. Other cuts would come from reduced payments to drug makers. Such cutbacks could inadvertently reduce access to some types of care.

The changes could also create new co-payments for services, including some laboratory tests that are now provided without charge.

Mr. Obama, in his speech, forcefully rejected contentions that the legislation would limit end-of-life care or even encourage euthanasia. Both of those claims are indeed false.

The Times and Obama operate on the presumption that cutting costs and increasing "efficiency" will not result in patient or medical decisions that have the effect of reducing end of life care just as is now the case with insurance company policy limitation. This is, to put it kindly, naïve - TPR

At one point, Mr. Obama made future health benefits seem more generous than they may actually turn out to be. "Insurance companies," he declared, "will be required to cover, with no extra charge, routine checkups and preventive care like mammograms and colonoscopies."

The president's plan would establish a minimum package of benefits that all private insurers would have to provide as a condition for participating in new government-regulated insurance markets or "exchanges" where consumers could shop for plans.

Insurers would have to include the cost of minimum benefits, including preventive care in their basic premiums. So while there might not be an "extra" charge, the services would not be free.

Boston Globe - OBAMA: Requiring insurance companies to cover preventive care like mammograms and colonoscopies "makes sense, it saves money, and it saves lives.''

THE FACTS: Studies have shown that much preventive care - particularly tests like the ones Obama mentions - actually costs money instead of saving it. That's because detecting acute diseases like breast cancer in their early stages involves testing many people who would never end up developing the disease. The costs of a large number of tests, even if they're relatively cheap, will outweigh the costs of caring for the minority of people who would have ended up getting sick without the testing. The Congressional Budget Office wrote in August: "The evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.'' That doesn't mean preventive care doesn't make sense or save lives. It just doesn't save money.


Anonymous Anonymous said...

How is the fact that your employer may choose a different insurance company under the reform plan any different from the current situation, where your employer may switch the company plan to a new insurer every freaking year anyway?

September 11, 2009 11:24 AM  
Anonymous aaroncrowe said...

Health care or not, I’m partisan to a president that can lower my taxes and fix what the housing market “greed” created… Just get the job market back up and avoid more scams…

September 11, 2009 2:28 PM  

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