[613] in Privacy_Forum
[ PRIVACY Forum ] Two of the Scariest Health Care Reform Legislation
daemon@ATHENA.MIT.EDU (privacy@vortex.com)
Sun Mar 21 16:41:10 2010
Date: Sun, 21 Mar 2010 13:17:23 -0700
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Two of the Scariest Health Care Reform Legislation Questions
That We're Not Supposed to Ask
http://lauren.vortex.com/archive/000695.html
Greetings. Recently in "Will Congress Wreck the Internet?"
( http://bit.ly/cS9CfK ), I outlined certain similarities between the
battles for better U.S. broadband and the current health care reform
debate.
Perhaps not surprisingly in retrospect, many people responded to me
regarding the health care aspects of that posting, with a variety of
often very strong opinions.
Odds are that the House will approve the Senate version of health care
reform sometime today (or perhaps in the wee hours of tomorrow
morning). Whether or not the Senate will really follow-through with
the reconciliation-based "fixes" the House wants applied to that
legislation is still an open question.
And just as nearly anything the FCC does related to broadband is
likely to trigger a cascade of court actions, the litigation response
to the health care legislation if and when passed is likely to be
nothing short of ferocious.
With that in mind, there are two questions -- I would have originally
thought relatively simple ones -- regarding the current health care
reform legislation that I have not been able to get reasonably
answered. Maybe someone in the readership can help me with this.
The legislation appears to virtually immediately impose a number of
new mandates on medical insurance companies regarding pre-existing
conditions (for children, initially, later for everyone), annual and
lifetime benefit limits, plus other provisions that in general most
observers (including myself) would consider to be quite laudable and
long overdue.
But those mandates are going to immediately increase insurance
companies costs significantly. The new state-based "insurance
exchanges" (of more use in big states than small ones) called for in
the legislation don't get started for years. The dominant insurance
companies successfully killed the "public option" or a Medicare "buy
in" plan. Promised health insurance tax credits (which temporarily
boost to higher levels under the reconciliation plan, then drop back
to Senate levels a few years later) also apparently don't even begin
until years from now. The talked about "National Rate Authority" to
help control insurance companies premiums has -- last I heard -- been
dropped from the current legislation.
I'm one of those people who got a letter recently informing me of a
40% increase on the already extremely expensive premiums for my very
bare-bones health insurance policy with poor coverage and high
co-pays -- not due to any changes in my situation, just because the
company wanted to increase rates across the board.
Though I'd much prefer a conventional full-time job, I'm self-employed
in a terrible economy -- which in my case is only a tiny notch above
being totally unemployed.
Given the new costs that the insurance companies will immediately need
to cover under the health care legislation, why wouldn't they further
boost premiums even more than before -- especially on people like me
who must buy insurance on our own without employers to help -- a
particular problem in states like here in California where state
officials do not have regulatory authority over those premiums.
Specifically, during the gap of years between the passage of health
care legislation (and the triggering of mandates on the insurance
companies) -- before the later starting up of insurance exchanges and
tax credits -- what's to protect us all from being utterly reamed by a
series of even more massive premium increases? That's question number
one.
The health care legislation also contains a requirement that
ultimately, we all have to buy health insurance, or pay penalties to
the government. Personally, I'd gladly pay whatever I could toward a
government-funded public option, Medicare buy-in, or true single-payer
system.
But I find it remarkable in the extreme that the legislation insists
that we individually must pay to further enrich enormously lucrative
insurance giants who have played such a large part in making a
terrible mess of the health care system in this country in the first
place, and who have ruined (and even prematurely terminated) so many
lives.
Like the FCC Broadband Plan, which seems to have been carefully
designed to avoid stepping too hard on the toes of the giant, dominant
ISPs, the health care legislation apparently was purpose-built to
protect insurance giants and Big Pharma.
I'm not a Constitutional scholar by any means. But I can't think of
another instance where the federal government has ordered citizens to
buy a service from commercial private parties in such a manner as is
required by the health care reform legislation.
Yes, you typically need to purchase private insurance to legally buy a
home or drive a car -- but you aren't required to be a home owner or
driver in the first place!
What am I missing here? Can anyone provide an example of previous
U.S. legislation that ordered ordinary citizens to contract with
commercial, for-profit firms in such a manner as the health care
reform legislation demands? That's question two.
While it certainly can be argued that Congress could theoretically fix
problems in the current legislation via other legislation down the
line, there is no guarantee that they'll be willing and able to do so,
especially in the current toxic political environment. Meanwhile,
there's little in the current legislation to seriously control the
current medical costs upward spiral.
I am extremely concerned -- frankly bordering on terrified -- about
where this "perfect storm" of medical needs and political theater may
be leading us.
--Lauren--
Lauren Weinstein
lauren@vortex.com
Tel: +1 (818) 225-2800
http://www.pfir.org/lauren
Co-Founder, PFIR
- People For Internet Responsibility - http://www.pfir.org
Co-Founder, NNSquad
- Network Neutrality Squad - http://www.nnsquad.org
Founder, GCTIP - Global Coalition
for Transparent Internet Performance - http://www.gctip.org
Founder, PRIVACY Forum - http://www.vortex.com
Member, ACM Committee on Computers and Public Policy
Lauren's Blog: http://lauren.vortex.com
Twitter: https://twitter.com/laurenweinstein
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