Health care

I have to make a comment regarding the Health Care bill. None of the newsers seem to be mentioning the $500B cut to Medicare. That’s $B not $M. It’s a no brainer what that means – more good doctors will quit taking Medicare patients. That leads to the classic Socialized medicine problem – long waits, poor service, and limited access to anything on the leading edge. It also means that premiums for supplemental insurance will rise dramatically as the supplement picks up more and more of the total cost. Medicare becomes Medicaid. The folks that will be hit hardest are the ones now using a Medicare Advantage program. Those plans will disappear forcing the current recipients into straight Medicare or into far more costly supplementals.

Of course they’ll maybe save something by closing the prescription drug doughnut hole. I actually thought the gap was a clever idea because it drove more people to use generics instead of the higher priced proprietary drugs. But the new provision that really made me laugh was the one that now allows an annual wellness checkup. I never knew you couldn’t do that because Nancy and I have had annual checkups for the last 10 years. So when I heard that the new legislation allows that, I assumed that our supplemental must have paid for it in the past. Turns out that assumption was wrong. It all has to do with how the doctor defines the visit. If they call it a “physical”, it’s not paid for; but if they call it a “follow-up” visit or an “annual checkup”, it’s covered. Can’t imagine there are very many doctors who don’t understand how to work the labeling game.

The provision that really causes me to scratch my head is the one that will fine employers $2000 per employee if they don’t provide health insurance. As a former employer I know that it was costing us roughly $650 per employee per month for health insurance (in 1998) so I’m not sure why it still won’t make sense for a small business guy to just pay the fine – sort of a brand new tax – rather than spring for $7500 + insurance will cost.

The really great thing about our political system is that we have an election coming up in 8 months that will most likely become a referendum on the health care legislation. If the voters like the bill and how it was handled or just the opposite, we’ll get to count votes. Usually we don’t get to see such direct feedback but in this case with all the focus having been on Health care, it won’t be difficult to draw a line between that one piece of legislation and the results of the election.

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