Open email to Sen. Cornyn (Texas):
Dear Sen.
Cornyn,
Your latest newsletter letter says that Obamacare [healthcare] is
broken even before it begins. You then go on to give five principles by which
you believe health care could be reformed.
I am repeating below your five
principles and including my own comments in red.
1.) We must
make health care more affordable by addressing the rapidly rising cost of health
care. It is not an absolute requirement, but it would be
desirable. Health care consumers should have better access to
price and quality data in order to make cost-conscious and prudent decisions
about their care. Consumers don't need cost information,
since healthcare is free by Obamacare edict. Consumers are also not concerned
about quality, since they have been told they can retain their present supplier,
in which you already have confidence. Health care providers could post
their direct pay prices for their most common procedures. Consumers are not interested. Government pays.
Medicare, Medicaid, and other data could be made available to third party
entities more adept at providing meaningful quality comparisons than the Centers
for Medicare and Medicaid Services. Not necessary; see
above. Reforms, such as allowing for additional
pooling mechanisms and the selling of insurance across state lines, would put
downward pressure on premium costs. In addition, leveling the tax field for
those in the individual and employer markets would help individuals trying to
purchase insurance on their own. Consumers are not
interested in putting downward pressure on premium costs. The consumer doesn't
pay. Government pays. The consumer is not interested in purchasing insurance on
his own. Government prohibits it, and government pays.
2.)
Individuals need more choices and the ability to select plans that best fit
their needs. Obama says the consumer can retain his present
supplier. He has already selected a plan which best fits his needs.
Reforms should be made to allow employers to design wellness programs
with rewards available that cover a higher percentage of the cost of an
employee’s coverage. Why bother with this. The consumer
already has his reward with free health care. These programs incentivize
individuals to take control of their health while also lowering their out of
pocket health care costs. You can't lower out-of-pocket
healthcare costs, if it's already free. The list of permissible uses for
tax-free health savings account dollars should be expanded. In addition,
individuals should be able to roll over from year-to-year a portion of their
unused dollars in flexible spending accounts. Too complex
for the average person. He already has free health care. The government
should not impose a long list of mandates on insurance companies that make plans
unnecessarily expensive. For instance, not all individuals need to purchase
coverage for maternity care or pediatric dental and vision services.
Individuals should be allowed to purchase the specific coverage that meets their
needs. The consumer doesn't care about this. He already has
free health care. Reforms should be made to provide for increased access
to lower cost insurance. For the consumer, you can't get a
lower cost than zero. We should ensure that our laws encourage
individuals and businesses to pool together (i.e., through association health
plans and individual membership accounts) in order to purchase insurance in the
individual market. For the consumer, the government handles
all this.
3.) We must ensure individuals have access to health
insurance including those with pre-existing conditions. The
consumer already has it in Obamacare. The tax treatment of health care in
the individual and employer market should be aligned.
Individuals seeking to
purchase insurance through the individual market are currently disadvantaged as
they do not receive a tax benefit for the purchase of insurance. Individuals can't purchase private insurance. It's prohibited by
Obamacare, and Obamacare is free. Those purchasing insurance in the
individual market should be eligible for a similar tax benefit. Consumers can't purchase. Reforms could be made so that
individuals with pre-existing conditions are able to purchase affordable
coverage. Why reform? The consumer already has pre-existing
coverage with Obamacare. For instance, changes could be made to the
Health Insurance Portability and Accountability Act (HIPAA) of 1996 so that
individuals with pre-existing conditions moving from employer-sponsored coverage
to the individual market are protected and can find coverage. Consumers find that unnecessary. They already have pre-existing
coverage. Another option would be to support state high-risk pools. Consumers don't need more options. Consumers should be able
to purchase insurance across state lines. Currently, state mandates requiring
coverage of specific benefits range from a low of 13 to a high of 70.
Individuals should be able to purchase lower cost plans that meet their specific
health needs. Why do all this? The government already has it
set up for the consumer to get free health care. 4.) We must
protect the doctor-patient relationship. Decisions about care should be left to
doctors, patients, and their families. We should increase the quality of care
by instituting physician-developed quality measures.
Physicians know best
when it comes to treating their patients. We should ensure that regulations do
not get in the way of patient care.
Currently, physicians must participate in
a myriad of government reporting programs that limit the amount of time they can
spend with patients and do little to increase the actual quality of care. We
should institute physician-developed quality measures and provide real-time
feedback to physicians in order to enhance the patient experience and produce
better outcomes. All unnecessary. Obama has guaranteed you
can keep your present Dr.; it will all be free' and if there is any government
red tape, it will only be minor. 5.) We Must Save Medicare. Why? With Medicare I have to pay 20% of
the approved Medicare amount. With Obamacare, I will not pay anything.
The current Medicare structure incentivizes quantity over quality and the
program’s price controls distort the entire health care market. Instead of a
one-size-fits-all approach, private plans should be able to compete against
traditional Medicare. Private plans have already been very successful in the
Part D prescription drug program. A national survey released in October 2012
finds that 9 out of 10 seniors are satisfied with their Medicare prescription
drug plan. Similar reforms could be made to Parts A and B of Medicare (the
portions covering hospital and physician care) that would provide beneficiaries
with greater plan choice. All too complex for the average
consumer. Obamacare says government will take care of everything, and it will be
free. Under premium support, individuals would be able to choose between
these private plans and Medicare. If an individual selected a cheaper plan, he
would retain the savings. Beneficiaries interested in selecting a more
expensive plan could elect to do so and pay the difference. Obamacare says the consumer does not have a choice. He must take
Obamacare. Other suppliers are not a consideration, and they will be going out
of business anywayThe premium support level should be set to ensure
that health care inflation does not outpace the amount of premium support
provided to individuals. Healthcare inflation does not
affect the consumer. He's not paying anything. Healthcare inflation is a
government problem, and it should take care of it. Reforms could also
include an increase in the Medicare eligibility age, changes to the rules for
supplemental insurance coverage, and means testing for premiums and
cost-sharing. Who cares about Medicare eligibility age? It
will be replaced by free Obamacare at any age. Similarly, means testing for
premiums and cost-sharing are no consequence.
Senator,
I see you have spent a lot of time in preparing
the above recipe. You have obviously done so on the basis that you consider
Obamacare to be dead but that we still have need for a governmental approach to
health care. Nothing could be farther from the truth, and you are whistling in
the dark. Obamacare is the law of the land and you will need to do something to
change it. Unless you do something, Obamacare will will remain as it is, no
matter whether 50, 60 or 70% of the people disapprove of it. However, the
average low-information voter will certainly look at each of these items in the
same way as I have indicated above in red. Obamacare is free, and we have been
guaranteed quality by maintaining our present Dr. That's a strong sales pitch,
and it really is surprising to me that in spite of that wonderful pie-in-the-sky
promise so many people actually appear to be against it.
However, the
bottom line of my suggestion is that you put your five-item recipe on hold and
devote every ounce of energy you have to repealing Obamacare. After you are
successful in that endeavor, I then suggest you scrap your five item recipe, and
let the healthcare and insurance markets take care of the situation. The
consumer will decide what is best for himself. He may not want insurance and
will pay out-of-pocket for services rendered, which he will purchase on a
cost/quality basis, as he does everything else. Some people may be so
financially destitute that they cannot afford to pay for medical attention. They
then don't need healthcare, they need medical help, and free clinics are
available. These are generally financially supported by private grants, or free
services from doctors, or in some cases, there is justifiable government
support, as we normally consider welfare. Quality may not be optimal, nor should
it be. The public always needs incentive to obtain more and better quality
products and services, and it is well aware that this can be accomplished by
increasing its access to money. They can do that through their own efforts of
work and imagination, which will build strength within them as individuals,
rather than weakening them through Obamacare or your replacement of a five/item
recipe..
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