Showing posts with label HR 3200. Show all posts
Showing posts with label HR 3200. Show all posts

Monday, September 14, 2009

If you misrepresent this plan We will call you out

What is the deductible?
What is the out of pocket maximum?
Who is in the network?
What is the co-pay, if there is one?
What are the coinsurance levels?
What does the plan cover?
What is excluded?
What does it cost?
Does my HSA go away?
What coverage is available for prescription drugs?

"While there are some difficult issues to be worked out...If you misrepresent this plan We will call you out"

How could someone possibly misrepresent the plan? There is no plan. There is only the expectation a newly created government bureaucracy free from any political pressure will create an insurance exchange that will define a plan options that will reduce out of pocket costs for all Americans while expanding coverage to the uninsured allowing everyone to retain coverage they like, with the doctor they like, without rationing, while preserving Medicare and not adding a penny to the deficit  while simultaneously bending the cost curve down on Medicare spending. Call me a skeptic, hell call me out Mr President but just how you propose to do these things would interest many Americans. Do tell. Americans who ask the questions above deserve answers and by the way it coarsens the national debate when David Axlerod goes on television and suggests they are wrong for asking the basic questions anyone purchasing healthcare would ask. If you are going to sell health care reform you need to have answers for basic questions about costs and benefits or else your're just asking Americans to trust you and congress to get it right. We trust you, Nancy Pelosi & Harry Reid like the Shamwow salesman on cable TVwho you increasingly resemble except that shamwow guy at least covers costs and benefits. The shamwow guy does not pretend to be anything but a salesman, a charlatan and a snakeoil salesman. You could learn from him.

Saturday, August 29, 2009

If You Build It They Will Come

As I observe the debate on health care reform, and I do use the term debate loosely, there is a fascinating battle raging underneath the surface.

On the one hand we have avowed statists like the President, Speaker Pelosi, Majority Leader Harry Reid and many congressional democrats who favor what I call the Field of Dreams approach. The essence of this approach is if you build it they will come. Components include an entirely new Federal Bureacracy including a healhcare exchange to sell you the coverage you are required to buy from the public plan which was designed by a federal committee largely appointed by the President. Proponents of this approach know they cannot come right out and take a stand for single payer for many reasons;

1. The blue dogs would be savaged in future elections by seniors who lost the Medicare Advantage coverage they loved when the reimbursement was cut to fund the coverage for the uninsured.

2. The vanguard of the proletariat that is our present near supermajority does not believe the American people are smart enough to understand the intricate issues involved in health care reform like rationing. No  matter they will act for all us little people. It is why we elected them in their minds.

3. Demonizing the insurance companies, the HMO's ( a federal creation by the way) and the rich doctors is a proven tactic which tosses red meat to their base while diverting attention from the fact the government accounts for 60% of the health care spend today.

4. Incrementalism works and Medicare remains the sacred cow.

5. Polls show many Americans are satisfied with their own coverage and their own doctors and will resist overt change as congress is learning at the townhalls.

6. Someone might point out that universal coverage mandated by the states and controlled has not stopped medical inflation in workers compensation.

On the other hand we have voices speaking out for market solutions that are being shouted down as obstructionists, mere drones who articulate platitudes from Fox News or talk radio. No one is focused on what unites us as American's. We have only the extremes and no statesman. No one is looking at the root cause of the current crisis but is rather seeking to exploit the crisis for their own self interest.

One of the insurance companies I worked for years ago developed a fully integrated product to cover health care, workers compensation, short term disability, long term disability. If we build it they will come said the visionaries in marketing. Very few employers bought the product because they wanted the flexibility to replace vendors by product. They resisted also resisted having all their products with one vendor as a problem in one area would require them to move all products. Nothing was unbundled you see. An infamous story circulated at the company where an executive stood before senior management pleading for more money time until the market recognized the value and was chastised by the CFO; "You keep coming in hereselling the same dog food and the dog just won't eat that crap". He built it but they did not come. Obamacare reminds me of that dog food. And the dog still won't eat that crap.