The III Degree

“The Republican health care agenda can be inferred from bills they have offered in the last few years and from their criticism of Mr. Obama’s proposals and of Democratic bills passed by both houses of Congress last year.”

So, here is the Republican health care plan:

• “The Republicans rely more on the market and less on government. They would not require employers to provide insurance. They oppose the Democrats’ call for a big expansion of Medicaid, which Republicans say would burden states with huge long-term liabilities.”
  • This sounds like nothing but talking points to me.  Market good.  Government bad.  States good.  Federal government bad.  But, it doesn’t actually help anyone get insurance.
• Republicans want to allow insurers to sell insurance across state lines.
  • If done right, this is something I can agree with.  Insurance companies should be allowed to sell insurance across state lines, but only if the minimum state requirements are met for each state.  Let’s say Kansas has set up minimum requirements for its residents.  If an insurer in Arkansas wants to sell in Kansas, that’s fine.  But, the Arkansas insurer must meet the requirements of Kansas to do so.
  • The way that Republicans want to do it, they will allow customers to buy plans across state lines.  Sounds great, but it will states will race for the bottom.  All of the insurers will set up in which ever state is the most insurer friendly.  It will be like how national corporations are all incorporated in Delaware.
  • In sum, selling insurance across state lines can work, but only if done right.
• Republicans would offer federal money as a reward to states that achieve specified reductions in premiums or in the number of people without insurance.
  • Why pay states as a reward rather than just doing it yourself?
• Republicans would provide federal money to states to establish and expand high-risk pools, for people with chronic illnesses who cannot find private insurance at an affordable price.
  • This just emphasizes one of the main problems with the Republican plan.  It still allows insurance companies to turn down customers it doesn’t want.  High risk pools just tend to make those people who need affordable insurance pay more for crappy insurance.
• Malpractice reform
  • The big plan of Republicans.  One irony is that Republicans, who love states and hate federal government, want government to restrict punitive damages and pain and suffering damages.
  • The big thing about tort reform, is everyone thinks its great until they are the ones who get hurt.  When it comes down to you getting hurt, you want to be compensated for that.  It’s like Congress - how wasteful spending always occurs in other states.
  • What I think is a legitimate aspect of tort reform is limiting or eliminating the frivolous law suits.  When a doctor makes a legitimate medical decision that goes wrong, he or she should not be sued.  But, when a doctor screws up and a patient is hurt, the patient should be compensated.
  • So here’s my plan - All malpractice law suits must first be filed/presented to what I will call ‘medical court.’  This will be a panel of doctors who will function like gatekeepers.  The plaintiff will present its initial claim to this court.  The doctor has the right to present its own version as well.  (All of this will be in writing or hearings - no evidence).  This panel will make an initial determination as to if the claim has any merit.  If they determine there is merit, then the claim will go forward to a regular court as it does today.  If they determine that the doctor acted appropriately, then the plaintiff may still continue the case in regular court.  BUT, if the plaintiff loses the regular case, he or she will be liable for attorney’s fees for the doctor.  In a practical sense, very few plaintiffs will take the case beyond medical court if they lose.  I also think you will see a lot more settlements by insurance companies if the doctor loses in medical court.
• Health Savings Accounts - Health Savings Accounts allow you to put part of your paycheck into a tax-free account, which can then be used to pay for deductibles or other medical expenses.
  • This can lead to lots of tax savings - for people who can afford to set aside parts of their income.  While this helps people who can afford health insurance pay less taxes and pay less for health insurance, it doesn’t do anything to bring down total costs or help those people who can’t afford insurance.  In fact, it may actually make costs worse because encourages healthy people to use the high deductible plans, which makes the costs for people on normal plans more expensive.
• Increase the use of private insurers in Medicare.
  • This is one that annoys the crap out of me.  Republicans continually claim that it is better to contract out the services.  I disagree.  Medicare runs with much lower overhead costs than any private insurers.  Seniors using Medicare Advantage - put in place during the Bush Administration - costs the government more than seniors on regular Medicare.  The Obama Administration intends to end the practice of subsidizing student loans through private lenders because it is cheaper to do direct loans.  Maybe in the past or in the future, private companies will do it cheaper than government, but right now government does it cheaper.

I saw an ad for “Healthcare One”, which talks about how 50 million Americans are uninsured.  They offer their services, which offer discounts for 20-60% off health care.  While the ad never claims to be health insurance, it clearly intends for people to misconstrue the product as such.  I went to the website and they charge $70 a month per person to allow you to go to their preferred providers in order to get a discount.

What a crock of shit!

Prediction:  McCain will lose a primary, run as an independent Maverick, vote for health care, and win his seat back ala Lieberman.

It passed M*A*S*H for the most ever.