Here’s the letter I recently sent to Representative Dennis Moore of Kansas…
Rep. Moore,
I believe you realize that you represent those of us in the Third District. I strongly doubt your constituents would support most of the health reform strategies on your wish list if they understood the harm that these reforms would do to Kansans. I want to give you the benefit of the doubt that you also are not aware of their unintended consequences. Let me just share a few thoughts on six of your tenants of health reform.
1. Sensible, fiscally-responsible reform that does not add to our national debt—revenue neutral reform
I’m glad you favor this. Logic tells us that paying for more services for more people will not lower costs nor be revenue neutral. We are told that we can save some 500 billion dollars by investigating Medicare fraud and other reforms. It costs money to do these investigations, but if it’s true that we can save money in this program, then shouldn’t we use those savings to help prop up Medicare which is going bankrupt? We will outline later a revenue neutral proposal that you could support.
2. A public health insurance option, for those who: a) cannot afford their employer-provided private health insurance; b) are uninsured, or; c) are unhappy with their private insurance
A government option is funded with our tax payer dollars. The two major health care bills that are pending in the House and Senate say that the government could subsidize up to 400% of the poverty level. That’s over $88,000 per year. That makes no sense. Why would we want to pay for our own private plan and help to fund another. In addition, government reimbursement to providers is so much lower than private plans. Consequently, providers charge more to private plans to make up the difference. So as the enrollment in government plans increases, the premiums on our private plans increase.
3. Allowing you to keep your current private health insurance and doctor if you are currently satisfied
See #2. We may not be able to afford to keep the plan we like. The two bills previously mentioned include an individual mandate. We understand that senior attorneys have found this to be unconstitutional. If, however, this was instituted, the government determines the basic plan which qualifies for this mandate. This limits choice. If our company’s plan or our individual policy doesn’t meet the government standard, then we are told that we could keep our plan. But the bills are clear that we may keep our plans only temporarily if they don’t meet the government’s specifications, but once we make any changes to it or add any one to it, our plan is no longer allowed. It sounds like Massachusetts where the government determined that high deductible, HSA qualified plans were not good enough so they were not considered a qualified purchase to meet the mandate.
4. Ending the practice of discrimination based on pre-existing health conditions—insurance companies increase this practice each year
What do you mean by” they increase this practice each year?” The message of insurance has always been, get it while you can qualify and stay covered before a major event happens. Risk is rated in all forms of insurance, including life, homeowners, and automobile. If we do away with our pre-existing conditions laws, people will wait to buy insurance until they need it. Some states that have “guaranteed issue” have very high rates. In Kansas few employees experience delays on treatment for pre-existing conditions in group plans, because most Kansans are careful not to have a lapse in coverage of more than 62 days. Those who have had a lapse in coverage are covered for any new conditions and their pre-existing conditions will be covered after no more than 12 months and could be as little as a 30 days wait.
If we force insurance carriers who offer individual policies to eliminate pre-existing conditions, we again force rates to be extremely high because carriers must have enough premium collected to pay for the astronomical, expected known risk. New York and New Jersey have guaranteed issue laws, along with other laws, that raise premiums. Here is an example of what a difference that makes. My 27 year old son pays a premium around $50 for his major medical, high deductible plan here in Kansas. A plan in New York would cost him around $450. We do not want rates in Kansas to be higher.
Perhaps you aren’t aware that for both group and individual policies, a carrier must accept a newborn onto a parents’ existing policy regardless of that child’s health status or pre-existing conditions. We have a risk pool in Kansas which offers health insurance for those who have exhausted COBRA, are denied coverage because they were uninsured when they developed a severe health issue, and do not have a group plan available to them. So every Kansan has access to health insurance coverage.
5. Improving Medicare for our seniors by eliminating co-pays for preventative care and closing the gap in prescription drug coverage known as “the doughnut hole”
Doing either of these may get you senior votes, but only if the seniors don’t realize that the federal government will just take back the senior’s savings by increasing the premiums. Medicare is already unsustainable. Making these changes will just make it go bankrupt faster.
6. Investing in preventative care and wellness efforts
“Invest” translates to spending more tax payer money. Some have suggested we pay people to stop smoking or lose weight. That would be a sad day when we start to bribe people to do what they should be doing anyway. That is discriminating against the folks that already make healthy lifestyle choices. Group and individual health insurance plans offer wellness and preventative, usually at 100% coverage. People need to take personal responsibility and go for their check up. I agree that everyone’s premiums would go down if we all made healthier choices.
Rep. Moore, Kansans do not want a major overhaul in health care reform that takes away their choice and raises their taxes. Here are three steps you can take toward health reform that could easily be bipartisan, will encourage people to make healthier lifestyle decisions, and will cover the uninsured without causing harm to the rest of us, and will be revenue neutral:
A) protect individual policies since most of the uninsured work for small businesses that do not offer health insurance, so these plans are a great option for them.
B) enlarge HSA maximum contribution limits and allow premiums to be paid from these accounts. Give a tax deduction for these individual policies and end the discrimination for those not on an employer plan.
C) do not expand Medicaid and SCHIP but give vouchers to these recipients so that they can purchase an individual plan or buy into their employer’s plan. This will increase the pool of those with private plans and lower the rates for all of us.
Statistics show us that the people who exercise the greatest personal responsibility are those who purchase an individual, private health insurance plan where the patient pays the premium; particularly high deductible health plans (HDHP) because the patient controls more of his health care dollars. The majority of these employees who are not offered a group plan can purchase a private plan. Why would they want this?
a) over 85% of those who apply for individual plans are offered coverage
b) there are a wide range of plan options and carriers from which to choose
c) rates are low and cannot be increased due to personal claims
d) they can’t be dropped from the plan except for nonpayment of premiums
e) a newborn, even one with severe health conditions, is accepted standard on the policy
f) the dependent on a parents’ policy is guaranteed her own policy at standard rates when the parents transition her to her own personal plan
g) the plan is portable since it is not tied to an employer
Individuals on these HDHPs have a financial incentive to stay healthy, so they have been found to make wiser lifestyle decisions, research their symptoms, have meaningful discussions with providers, and look for a better value for their dollar. They choose generics over brand names and family physicians over specialists. Unlike skeptics of HSA plans predicted, studies have shown that these patients are not more likely to forego necessary treatment than those covered by a traditional health insurance plan.
Advise your fellow representatives to end their state’s guaranteed issue and community rating laws that cause the premiums for their individual policies and group plans to be so high. Ask them to join you in passing legislation such as plans A, B, C above.
I would urge you and them to read this article by a democrat, David Goldhill, entitled “How American Health Care Killed My Father” in the September issue of The Atlantic Monthly. http://www.theatlantic.com/doc/200909/health-care
I hope this information is helpful to you as you go back to DC to debate health care reform and represent us.
Rep. Moore, you were elected on the platform that you do not vote on party lines, and you count yourself in the Blue Dog Democrats who are trying to be fiscally responsible. Please do not vote with your party for any legislation that would harm Kansans.
For a healthier US,
Beverly Gossage