Health Reform Roadshow: Don’t let them fool you, Cadillac health care won’t be free
by Beverly Nuckols on August 4, 2010 at 12:20 PM
Everyone wants “Cadillac” health care. The “health care reform” bill passed by Congress this year, "The Patient Protection and Affordable Care Act," claims to be able to provide it. However, anyone who can pay for “Cadillac” plans themselves – as well as their employers - will be taxed to pay for those who can’t. Not only that, but those of us who have chosen to save our own money while paying for high deductible Health Savings Accounts or choosing plans with less coverage, will be taxed and forced to pay for Cadillac plans, whether we want them or not. The tax incentives and plans under the PPACA reward the wrong behavior and punish what should be encouraged.
Along with about 100 other people, I attended the "Health Reform Road Show," which took place at the Shertz, Texas Community Center on August 2. As far as I could tell, I was the only doctor present, as well as the only small-government conservative. The Road Show was put on by the Center for Public Policy Priorities and sponsored by the New Braunfels/Schertz/Cibolo and San Antonio MoveOn Councils, The United Way of San Antonio and Bexar County, the La Fe Policy Research and Education Center, the University (of Texas) Health System, and the NAACP of San Antonio. Yes, your United Way donation helped pay for this meeting and the free chicken salad sandwiches that were provided for those in attendance.
Stacie Pogue of the CPPP did a good job of explaining some of the highlights of the new health care payment reform bill but there were a few problems in the presentation. I was impressed by her fairly even presentation, with just a bit of bias showing through. Ms. Pogue glossed over both the planned physician payment cuts and the increased taxes and the involvement of the IRS in collecting taxes to pay for the new health care bureaucracies and in confirming coverage. She claimed that the bulk of the new benefits to Medicare will be paid for by gradual decreases in payments to companies like Secure Horizons and Humana for the Medicare Advantage plans. There was no mention of the fines for employers who have more than 50 employees, if any of those employees or their family members qualify for Federal health care subsidies. She does not seem to connect increased health care costs to all of the increased bureaucracy, services and “no copay” and “no caps” required by the PPACA.
We learned that "undocumented workers" will not be eligible for the exchanges, the insurance subsidies or Medicaid. One lady was very upset that we were leaving ourselves open to flu epidemics because the government doesn't plan to pay for the vaccinations for illegal aliens. I would have liked to explain that if she gets her flu shot, she's safe from the epidemic. What she should worry about is the diseases for which there are no vaccinations, such as Dengue fever and Dengue hemorrhagic fever, which are increasing in Texas due to the number of illegal aliens who carry the virus across the border, spreading it to Texas mosquitoes and then, to Texans. The better solution would be to close our borders and discourage illegal, undocumented workers. After all, most of those illegal immigrants come from Mexico, where they have government universal access to health care.
One man was upset that the new bill is not truly "Universal Health Care" when he learned that some people might choose to pay a fine rather than obtain health care insurance under the law. Others were bothered by not being able to join the new preexisting condition Federal health care insurance plans if they are currently covered. The Federal law only covers people who are uninsured for the last 6 months.
No one questioned the new tax for health care for those singles and couples who make over $200,000 a year or the one on "unearned income," such as capital gains taxes. Ms. Pogue praised the new Long term care tax that will be deducted from our paychecks next year, unless we fill out the paper work to “opt out.” This insurance is supposed to “help keep us in our homes” as we age or get sick. However, it is not much help for people who are most likely to need it: people must pay into the insurance for 5 years before they are “vested” and able to qualify for payments. Those payments will be about $50 a day – not sufficient for in home care, in my opinion.
I was challenged (by a very rude woman who screamed at me and shook her finger in my face) for claiming that we will all subsidize the health care insurance exchanges that by law must have at least one plan that covers elective abortions. The bureaucracies that will be the exchanges will be paid for by Federal tax money in the form of grants and then eventually by a 2-3% or so fee (tax) placed on each and every health insurance policy that is sold.
Ms. Pogue made several comments about what a good deal the Federal subsidies were for the States and how much money the Federal government would be spending for the new healthcare benefits. She did not notice that, theoretically at least, We the People are the Federal government and those 50% of us who pay Federal taxes will pay for first dollar coverage of millions of people, and will see our taxes and our health care insurance costs go up. As science fiction writer Robert Heinlein wrote, “TANSTFL!” (“There ain’t no such thing as a free lunch.” )