Smoke & Mirrors

Here at my lovely interships, I very rarely have anything to do. This gives me ample time to sit and do nothing. Or, as I usually end up doing, reading every story on the CNN home page. This invariably led me to reading a LOT of stuff on the health care bill that's up for a vote this weekend. Of course, I didn't just read CNN's health care coverage (they fell back into their old liberally-biased ways on this particular issue). I had successfully avoided forming an opinion on health care for a good year and a half; as long as we weren't getting a single-payer, universal health care system, I didn't really care what they did. But then I read about it and saw some of the things in the bill and about lost it. While I agree with the (very) general spirit of the bill, the idea that the 30 million uninsured Americans should have help being insured, several of the particulars of the bill are just atrocious.

1. Individuals will be fined for not purchasing health care. Read that one more time and let it really sink in. The government is going to fine individuals for making an individual choice about their life. Remember the "life, liberty and the pursuit of happiness" thing from the Declaration of Independence? How exactly does this provision reconcile with those? A person in the United States is supposed to be free to lead their lives how they want; that's been the backbone of our country in theory since 1776 and in practice since about 1965. As long as it's not hurting other people, people are allowed to act however they want; that's why it's not illegal to be gay or atheist or Christian or racist or fat or a redneck.

In that same vein, people have the right to screw up their own lives if they choose. People can choose to eat and eat and eat until they're morbidly obese; the government tells them they're being stupid, but they don't criminalize being fat. Similarly, people should be allowed to buy or not buy health insurance. If they don't buy insurance, people should be informed that they are at risk of spending untold amounts of money in the event of any sort of medical problem and that medications will cost them a pretty penny as well. But if someone still wants to not buy insurance, they should be free to do so without the government fining them 2% of their income. Congress wants to control an individual's choice about their own life, which is a very good example of communism.

2. They want to fine companies with more than 50 employees who don't provide insurance to their employees. On its face, this doesn't really sound all that bad. Companies should provide their employees with insurance if they are fiscally able. But the key point there is "fiscally able." Let's imagine a company that has 60 employees. They aren't very large, and especially with the economy in its current state, they are having trouble making payroll every two weeks. Now the government is forcing them to give all of their employees health coverage. What happens?  There's a good chance that they would lay off 11 people so they could drop out of the "large employer" category; then there are 11 people out of a job and 49 still without health insurance. Alternatively, the company could choose to ignore the rule and just pay the $2,000-per-employee fine, or they could just provide health insurance for all 60 employees. Both of these scenarios could very easily lead to the company going out of business and 60 people losing their jobs. Again, how is forcing the government's will on these corporations a good thing?

3. Where on earth will we get $940 billion? My first question with any government bill is, "How will we pay for this?" With a $12 trillion debt and a $1.4 trillion defecit this year alone, we have no money. However, according the the Democrats, this $940 billion monstrosity will actually reduce the defecit by $138 billion over the next 10 years and by $1.2 trillion in the decade following that. Okay, sure. One problem, though: neither of those is close to accurate.

Those numbers come from the Congressional Budget Office, a non-partisan entity inside Congress that scores the fiscal impact of every single bill that comes through the chambers. The small number of people who work there have been working 100-hour weeks for a year and a half trying to keep up with the health care bills, as well as all the other bills that have been coming through Congress at the same time. They're tired. On a more corporeal point, they skewed their numbers heavily. They don't mention that the bill won't go into effect for four years, though the tax and fee increases will start immediately. So they'll be collecting taxes for 10 years while only paying six years worth of benefits. Second, that $138 billion in defecit reduction for the first 10 years includes $100 billion in revenue for the new CLASS long-term insurance; senior adults have to pay into the CLASS system for five years before they can start collecting benefits. This means for the first decade, the system will take in more revenue than it's spending; that's what the CBO put into their defecit estimates. However, after that first 10 years, CLASS will spend significantly more than it takes in, and the CBO didn't take that into account. The $100 billion in revenue will have to be repaid, so how can it possibly help the defecit in a real way?

What about that $1.2 trillion that will be saved next decade? Well, the CBO themselves said there is absolutely no way to guess what will really happen; that number is pure conjecture. And Medicare currently costs eight times as much as the CBO originally projected, so why should we think this health care bill would be any different?

4. Efforts to lower costs will do the exact opposite. This bill raises government fees on medical supply manufacturers, pharmaceutical companies and the like; those raised fees will be passed on to consumers, meaning they will be passed on to consumers' insurance. Along with the increased taxes on insurance companies in the bill, this will cause premiums to keep going up. People will end up paying the same amount they pay now for significantly less coverage or be forced to pay a lot more for their current level of coverage. And the subsidies the government is promising to help defray these costs will not come close to helping these people (who, remember, are forced to buy health insurance). There is no logic in any of this.

5. Medicare and Medicaid still exist. I could almost overlook all of these faults if this bill totally eliminated Medicare and Medicaid. The money that would save would more than pay for this bill as well as really cutting down on the defecit and drastically slowing the progression of the national debt. If everyone has health insurance, why on earth do we still need these broken programs?

Medicare and Medicaid are killing our country. They are the greatest burdens on our tax money, our defecit and our future. Also, they simply don't work. Pharmacies in Washington state are refusing new Medicaid patients starting in April because the system doesn't reimburse them for the nearly-free medicine they give to patients and it's driving them out of business. Doctors around the country raise rates on privately-insured patients regularly to make up for the lack of reimbursements from Medicare and Medicaid patients. These systems need to go.

But this bill leaves them in place. Sure, it cuts them back, but not nearly to the necessary degree. Like I already said, if everyone has health insurance, why will these cancers be allowed to continue existing?


With all this said, I really do think our health care system needs overhaul. Premiums are already too high and there are FAR too many people who don't have coverage. I believe patients who have been paying their premiums should not be able to be dropped by their insurance companies when they get sick, nor do I believe people with pre-existing conditions should be denied coverage.

But this bill is not the way to solve these problems. The government should give tax breaks to insurance companies that insure people with pre-existing conditions and who give lower-than-average premiums. Tax breaks don't "make the richer richer" or give some inordanant amount of power to insurance companies: they spur competiton. Creating an environment that encourages new insurance companies to rise up and become sustainable, money-making entities will help lower premiums and insure more people.

If there is even a shred of sense left in Congress, this bill should be thrown back into the fires of Mt. Doom where it was forged.