The Building Tradesman Newspaper

Friday, April 02, 2010

New health care law offers good and bad, but much of the same

By The Building Tradesman



The health care revision is law, though implementation will take quite a while.  We still think that it lacks meaningful cost controls –  except for a commission that could ride herd on insurance company premium hikes – and that the 40% excise tax on the value of present insurance above a minimum of $27,500 per family (the so-called Cadillac plans) was the last straw.

If you really want to curb health care costs, do what Congress never seriously considered: A government-run single-payer system.  That would abolish the health insurance industry and its 20%+ overhead, high co-pays and deductibles, denial of care and 44,780 annual deaths it causes.

But Congress didn’t enact single-payer.  And pressure from Sen. Joseph Lieberman, (Independent-Conn.), threatened to sink the whole bill unless single-payer’s weaker cousin, the “public option” of government-run insurance available to selected groups and individuals, was dumped.  So the public option went in the trash, too.

All that said, there are some good features to the legislation, curbing some of the health insurers’ most outrageous and evil practices: No more denial of coverage for “pre-existing conditions.”  Three months from now, people with those would be covered in high-risk pools, instead (no details about premiums).  Six months from now, no more dropping customers when they get sick.  Kids get covered virtually immediately.  Next year: Limits on the insurers’ overhead and administrative costs.

But subsidies for the poor and near-poor don’t start until 2014.  Same thing with requiring all but the smallest employers to cover their workers — and requiring everyone to buy coverage.  That excise tax on “high-value” insurance?  Try 2018.

Do you notice something here?   All of this is built on top of the present jury-rigged, dysfunctional, high-cost, low-coverage health insurance non-system.   President Obama’s constant mantra has been “If you like your coverage, you can keep it.”  It’s just going to be better, more pro-worker, more pro-family, less pro-insurance company.

But what happens if you don’t like your insurance – because it rips you off or rips the country off or rips your doctor off or denies you care or, usually, all the above?

Forget it.  You’re still stuck in the insurance company system.  Even if you change companies, the system stays the same.  And not only are you stuck in it, but the insurers, by 2019, get at least 32 million more now-uninsured people to milk.

So here’s the $64,000 question: Is the current system, with the law’s changes, better than the current system alone?  Yes.  Indeed, almost anything that hurts the insurance companies is better than the current system alone.

But that’s damning with faint praise.  The current system still must be junked in favor of something truly revolutionary that every other developed country has: A government-run single-payer health care system.  We have three government-run systems now, with low overhead and no profit motive: Medicare, the military and veterans’ care.

And that lack of a government-run system is where the health care revision law – which Obama in January carefully renamed as a “health insurance revision” law – falls far, far short.