On Health Care Reform – the Devil is in the Spin

By John F. Di Leo (via Illinois Review)

The Obama administration, along with their pelosireidian enablers in the United States Congress, gave a great deal of thought to the timing of various events in the Obamacare process.

They passed it through the House when the American public was distracted by the massacre at Fort Hood… they passed it through the Senate when the nation was distracted by Christmas Eve celebrations… they designed it so that the taxes would begin to be collected immediately, but the benefits wouldn’t start for four years, so they could pretend to stretch ten years of taxes to fund six years of benefits.  Of course this accounting sham would collapse in its second decade, but that didn’t matter to them; once it was fully effective, they were sure it would never be repealed, no matter how incredibly destructive it turned out to be. And they may be right; that window of opportunity for a second chance at redemption is rapidly closing.

With all their concentration on timing, however, they neglected to consider one key, unchangeable moment, now locked into the American corporate world:  healthcare open enrollment sessions are almost always in October, as employees can choose their plans for the following year.  And that all happens now, within weeks or even days of casting our ballots.

The Annual Presentation

Most companies now offer a presentation to their employees – the larger the company, the more presentations – at which Human Resources professionals explain the options for next year, the changes from the prior year’s program, what it’s going to cost, what the employees need to do by the end of the open enrollment period.

There will be changes this year, many changes.

If you like using the Flexible Spending Account option – the program of paying your medical, dental and vision bills with pretax dollars, you’ll see a big change, as the old $5000/year maximum shrinks to $2500 for 2013.  This doesn’t matter to most of us…  most people just use a few hundred dollars per year in this use-it-or-lose-it account to cover doctor visit copays and prescription copays.  But to those with a couple of kids who need braces, or those with expensive vision work, or other surgeries planned, the loss of that $2500 means an increase in the price of those services… an increase that goes directly into the government’s coffers.   The hundred dollars you pay the orthodontist or other surgeon won’t change; he’s still getting the same hundred dollars.  But now that it’s paid with post-tax money, you’ll be paying another ten, twenty, or thirty percent of it to the government.  It’s a windfall for Washington.

The insurance companies have been given a mandate.  The law now requires that new prescriptions must be from the ranks of generic drugs, at least until it can be determined whether the generic works or not.  The doctor may well know that, for you, the generic or other cheaper substitute won’t work… and the insurance company and the pharmacist may all know that too… but the law requires that they try.  In some cases, that’s relatively harmless.  But in other cases, when the law mandates a postponement of the known right one for a week or two, it could mean severe results.   They say it’s to fight overprescription and abuse of expensive drugs and to save money; the more cynical will question these purported reasons.

Premiums and copays will go up.  Not all of them, of course.  Every company tries to take care of its employees by driving a hard bargain with the insurance companies, trying to keep the increases down.  But still they must go up somewhat.  In an age of two or three percent inflation, healthcare premiums are going up by five to ten percent, or even more, just like in the days leading up to the passage of Obamacare.  And people are asking: if premiums are still going up, why on earth are we paying trillions for Obamacare???

Every year, things get worse.  Copays increase a bit, premiums increase a lot; coverage is reduced, coverage is removed.  In some areas, coverage increases too much; we must all now pay for those things that the government insists that we pay for, whether we want to be in an insurance pool that covers them or not.   Covering other people’s “children” at an age when they should have been working for five years by now, covering other people’s procedures of which we disapprove, or prescriptions that people should be buying on their own; all these things are now mandated as part of every policy, so all our premiums go up.

I must pay for you, and you must pay for me; Heaven forbid either of us should ever pay for ourselves, or choose to be in an insurance pool any smaller or more focused than three hundred million.

What’s the Spin?

Each speaker, when giving one of these presentations, has a choice to make.  How much to editorialize, how much to avoid politics.  We all want to avoid politics in the workplace; it can be unpleasant, even depressing.  But when the government has placed targets on everyone in the room, it really is fair to respond in kind.

How does the speaker spin the prescription drug rationing?  We can say “it’s to reduce abuse, because one drug had a shortage once, so we’re trying to protect against that ever happening again.”  Or we can say, “the government wants to cut the costs of the program by forcing the healthcare industry to give the cheaper and less appropriate drug, unless the patient is angry enough to raise a fuss about it.”

It’s plain that the crafters of Obamacare care more about nationalizing healthcare than about seeing people cured.  Requiring a generic version of the same drug is usually a reasonable rule for a budget plan, but there are no budget plans anymore; they’re all designed by the government.  And requiring that a cheaper similar drug must be used, if there’s no generic option for the right one, isn’t just being penny-wise, it’s being careless and negligent.  But that’s the requirement, in the brave new world of Obamacare.

Perhaps it’s that the crafters of Obamacare, in their heart of hearts, just don’t approve of the profit motive.  They detest the fact that Abbott or Genentec can charge a hundred dollars for the original when Watkins or Barr can charge a fraction of that for their copy once the patent runs out.  The crafters of Obamacare don’t understand why the developers of a drug should get compensation for the years of costly research that went into it.  The healthcare-nationalizing left wants us to buy our all our drugs on deep discount, even from foreign manufacturers; they have no use for the American pharmaceutical industry, and wouldn’t mind its destruction a bit.

The elites of the American left will tell us not to worry about this rule, because we should be engaged in our own healthcare.  If the pharmacist is restricted by law from filling the prescription as written, we can fight; we can pick up the phone and ask our doctors to file the objections, in duplicate or triplicate or quadruplicate, because they have plenty of time to rethink and reargue a decision they had already made, consciously, when the diagnosis was fresh in their minds.  The American left doesn’t appear to value the time of our medical community either; if they did, perhaps they wouldn’t have cut $710 billion out of Medicare in order to fudge the numbers on Obamacare enough to pretend it was affordable.

What of the immigrant community that the American left claims to support?  I can comfortably call my doctor and tell him I need him to fight for a prescription; so can the elites of the American left.  But can the Polish immigrant on the assembly line, the Mexican immigrant at the distribution center, the Russian immigrant at the construction site?  They may be first generation immigrants, not yet strong enough in their English speaking skills, or not well-enough educated or self-confident to argue as equals with distant bureaucrats.  Their company is paying ten or twenty grand for this insurance policy for them; they shouldn’t have to fight to receive the benefits they deserve.    Their government shouldn’t be skewing the service from good to bad, balancing the budget of leftist dreams on the backs of the sick and the working poor.

Why is it, after the passage of Obamacare, that none of its promises has come true?  Why are insurance costs still going up, and healthcare being jeopardized for all?   My huge employer is  terrific at negotiating these packages, and it pays three-quarters of the cost of the plan, but even so, it went up this year by a thousand dollars – another $250 from me, another $750 from my employer.  For less service, in so many ways.

How will the Human Resources people spin it?  Will they tell the truth, that this was all the government’s way of forcing through Obamacare, and our higher costs and suffering service are just the collateral damage from that effort… or just repeat what they’ve been told: passing on the government line that it’s all for our own good?  “Who ya gonna believe, anyway, Washington DC or your lyin’ eyes?”

If the HR folks don’t identify these changes as mandates from the government, the American employee will likely assume that it was just another cost-cutting method from their penny-pinching employer.

Think of the worker refused the right drug in favor of the wrong one.  Think of the employee who is forced to pay more for braces for his kids because of these changes to the flexible spending program.  He’ll hold it against his employer, maybe even wishing to himself, “oh, if only the government did all this for me, so I wouldn’t have these cheapskate insurance companies or pharmacies or hospitals cheating my kids out of the right drugs or out of affordable braces.”  He’ll never know that it was the government itself that set them down this path, the American Democratic Party that set out to deny him affordable coverage, naming their vicious plan after the very opposite of what it was really intended to do.

Expect more of this, every year.  Fewer doctors’ offices as they flee the industry; fewer rural hospitals as they flee the regions.  Fewer  insurance companies providing healthcare insurance at all, as they come to the realization that homeowners’, marine, auto and life insurance are all better business models nowadays than the vilified and handicapped healthcare insurance trade.

We were promised that we could keep our insurance, our doctor, our hospital, if we wanted to.    What we weren’t told was that the deck would be stacked against these private providers; they would be driven out of business, driving the American people into the waiting arms of Obamacare – Stage Two.

There is only one way out.  We’ve lost four years in the healthcare reform debate – four precious years in which we could have, and should have, been fixing the various legal obstacles to a thriving free market in the healthcare sector.  There were pages and pages of recommendations from the right , recommendations that the Democrats wouldn’t even allow to be debated in the House of Representatives, once Obamacare was on the table.  We had to pass it to see what was in it, said then-Speaker Nancy Pelosi.  Now we’ve seen it, and we’ve seen it spun, but we’ve also seen its effects.

We must repeal Obamacare, root and branch, and get right to the business of doing healthcare reform right, before it’s too late.  And there’s only one way to do it: by firing the bill’s namesake in November, and by electing Republican leadership in the Senate as well.

In January, 2013, we can finally get started on making quality healthcare affordable; it can indeed be done.  When the Democrats use healthcare as a tool … a tool to elect demagogues, empower bureaucrats, raise taxes, and drive employers out of business, there’s only one thing to do.  Fire the Democrats, and elect the Republicans instead, because the Republicans are the party that actually thinks of heathcare as healthcare!

Copyright 2012 John F. Di Leo

Advertisements