Cross posted at Dirigo Blue
It is pretty simple to understand, which is why it is so frustrating.
If America’s Affordable Health Choices Act of 2009 (H.R. 3200) is to be enacted in anything like its current former, but without a public option, it will only increase the cost of premiums while not providing more health care.
Or, in other words, a windfall for insurers.
Among other things, H.R. 3200 mandates three things that when combined together, will bankrupt our Treasury and crush our economy.
There's more:
Sec. 111. Prohibiting pre-existing condition exclusions does exactly what the title suggests - no longer will insurance companies be able to deny coverage to their customers because the costly cancer or degenerative disease wasn't obvious when the policy was signed.
Sec. 122.b. Essential benefits package defined lists the minimum services to be covered. These include:
(1) Hospitalization.
(2) Outpatient hospital and outpatient clinic services, including emergency department services.
(3) Professional services of physicians and other health professionals.
(4) Such services, equipment, and supplies incident to the services of a physician’s or a health professional’s delivery of care in institutional settings, physician offices, patients’ homes or place of residence, or other settings, as appropriate.
(5) Prescription drugs.
(6) Rehabilitative and habilitative services.
(7) Mental health and substance use disorder services.
(8) Preventive services, including those services recommended with a grade of A or B by the Task Force on Clinical Preventive Services and those vaccines recommended for use by the Director of the Centers for Disease Control and Prevention.
(9) Maternity care.
(10) Well baby and well child care and oral health, vision, and hearing services, equipment, and supplies at least for children under 21 years of age.
And in Sec. 301. Individual responsibility, every American is required to purchase and maintain "acceptable coverage," that is, insurance that provides all that described in Sec. 122. Some will claim that coverage isn't mandated, since there is an opt-out clause. Sec. 401. Tax on individuals without acceptable health care coverage defines it as:
a tax equal to 2.5 percent of the excess of--
‘(1) the taxpayer’s modified adjusted gross income for the taxable year, over
‘(2) the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer.
Just to be clear - a two and a half percent tax, with an exception for those whose income is less than the standard exemption (6012(a)(1)).
So why are Republicans and those Democrats that are beholden to corporations that donated hundreds of thousands of dollars to them willing to impose this system?
Money.
We can use Medicare Part D as an example as to what is likely to occur, except on a much larger scale. The New England Journal of Medicine studied the impact of Medicare Part D on medical spending, and concluded:
We found that Part D led to increases in overall pharmacy spending among all beneficiaries," said the study's lead author, Yuting Zhang, Ph.D., assistant professor of health economics at the University of Pittsburgh Graduate School of Public Health. "These increases were offset by decreases in spending on other medical care services in those with little or no drug coverage before they enrolled in Medicare Part D, which was one-third of the beneficiary population studied. The majority of Part D enrollees in our study population - those with relatively good prior prescription coverage - spent more on prescriptions as well as other medical services.
Medicare Part D specifically banned the Fed from bargaining with pharmaceutical companies to obtain lower prices. Rather than lower overall costs, use of medications actually increased, as did the amount spent on them.
The same will likely occur should H.R. 3200 be enacted without a public option, that is, without insurance coverage where making a profit (and increasing that profit) is not required. Since private insurers would now be required to cover more claims, they will demand ever increasing premiums, and Americans will have no choice but to pay - insurance coverage is mandated.
Think Enron, but on a nationwide scale.