Health Care Reform

First, I am getting tired of politicians saying how much the health care system sucks in this country. If it was that bad why would leaders from around the world come to the United States for medical treatment when they have a serious medical situation? I can remember Anastasio Somoza of Nicaragua coming to Miami Beach in the 70's for treatment (I was the orthopedic technician assigned to maintain some of the equipment that was going to be used for his surgery and care), and then there was the Prime Minister of Italy that came to the United States for his care (I believe it was in 2005).

OK, now that I've unwrapped myself from the flag let me say that our system is not perfect, and I believe this country needs to do something to enhance the health care, and to assist low income persons obtain health care. That is the key word, ASSIST. However, I have serious concerns about the pending legislation; its cost, negative impact on coverage a person already has, the reduced and rationed care that is likely to result. Finally, I have a BIG problem with the speed in which this is being pushed through. My concerns are based on my experiences, as a law enforcement officer I've worked in low income areas and seen the impact the problems with the health care system have had on people.

I have another prospective as well, for five and a half years I was a trustee on the Fraternal Order of Police Miami Lodge 20 Insurance Trust Fund, nearly three years of that time as Chairperson (in the City of Miami the police run their own health insurance). It is because of this experience that I have a problem with the speed in which this legislation is being pushed, and the delays in (and rationing of) care that will be caused. At the police department annual physicals were mandatory for the sworn personnel (those personnel with arrest powers). The trust meets monthly and a part of those business meetings is to review claims for the previous month as well as year to date, hear appeals if a member was denied coverage for an issue (During my time as Chairperson our operating budgets were over six million dollars). We began to notice an increase in cancer related illnesses in the dependants of officers and retired officers. As we looked into this trend more we discovered that in most of the cases early detection would have significantly reduced the aggressiveness of the course of treatment, as well as the cost. We decided to implement annual physical coverage for dependants and retired members. Although the initial cost would increase if a large number took advantage of this new benefit, early detection would reduce our costs over a long period of time. It worked, and as a result of being able to reduce annual costs the trust was able to consider additional benefits to our members.

Another lesson that was reinforced during that time, and one that Congress and President Obama should seriously consider is that you can’t give everyone what they want without there being consequences. When the FOP Insurance Trust Fund first began (1985) the trust would reimburse for prescriptions. You could either submit your receipts and paperwork requesting the reimbursement as the expense occurred or once a year (your choice). The trust was doing well and members began to ask if we could try a prescription card instead of the reimbursement process. Finally, the trust was doing well enough that we decided to try it for a year as a test program, study the cost impact. At the end of that year our costs went crazy, the program was a financial failure because the payments were immediate, versus the reimbursement program. The largest costs were from the retirees. The trustees felt that the trust should return to the reimbursement program, it was easier to predict annual costs when preparing budgets, and the costs were spread out over a period of time minimizing the impact. That was twelve years ago and despite the financial burden to the trust the prescription card is still in place.

The proposed legislation is going to increase the number of patients, yet it does not appear to do anything to increase the number of professionals, such as doctors, nurses, and other medical personnel to care for the patients. Hospitals are having trouble staffing to care for the current patient levels, how are they going to adequately handle the proposed increase. How about dealing with that first. The federal government has implemented programs in the past to increase the people that choose law enforcement as a career, why not do similar programs for the medical field. When there is a natural disaster the military will deploy medical personnel in the affected area, they also have had programs in the past when going into a community for “Fleet Week”, medical staff will go into an area and work in a clinic. Many medical personnel are members of the medical reserves; why not have them do their weekend or two week duty in the area county hospital. Could the government offer incentive programs for people to become doctors, nurses, etc, such as assistance with student loans, or paid education in return for a commitment to work in the county hospitals for a certain number of years. I know there are arguments against, but if the government is determined to spend trillions of dollars just so they can say that they did something, regardless if their proposal will accomplish the intended goals, why not look at these types of alternatives? I would rather the government take a few more months and come up with a workable program that won’t punish me for already having coverage, or stick my great grandchildren with the debt caused by a rushed failure. President Obama likes to talk about FDR, well if the U.S. has been waiting since FDR’s time for a health care program, will a few more months really be that devastating to the country.

As I have mentioned before, history is a favorite topic of mine. As is the ole saying about being doomed to repeat history if you don’t study it. Well, previous attempts to reform health care, going back to FDR, have failed because they have been rushed and the leadership has tried to ram it through without doing due diligence.

Finally, could I please get a straight answer with details? The argument that there are fifty million people without health care is misleading. It gives the perception that all fifty million want healthcare but can’t afford it. There are a portion that can’t afford it, a portion with income in excess of fifty thousand a year that choose not to have it, a portion that are in the process of changing jobs (and coverage), and the indestructible youth that believe that they do not need coverage. Another argument that gives a false perception is that currently no one’s insurance covers pre existing conditions. Legislation was enacted in the past that addresses this. I’ve changed coverage several times in the past and none of the coverage’s refused to ever cover pre existing conditions. There was a waiting period for pre existing conditions, my experience ranged between thirty to one hundred and eighty days. It is possible that there are programs that will never cover a pre existing condition, but to borrow one of the president’s favorite words, it is disingenuous to imply that all insurance carriers refuse pre existing conditions.

I would also like a straight answer about the impact on small businesses. Two days ago President Obama was on a conference call with some bloggers (I wasn’t one of them) and he was asked about a provision in H.R. 3200 that would prohibit you from changing coverage, if you dropped your current coverage you would be mandated to go into the government plan. The president’s response was that he wasn’t familiar with the provisions in H.R. 3200. Shouldn’t you become familiar with the entire bill, all the provisions, the pros and cons of the legislation if it is enacted before you tell me that it is great and will make my life so much better. I remember as a child reading about another time when this happened, people were telling the emperor how great his new clothes were.

I have been looking at H.R. 3200, and will read it a second time, but some provisions (if I’m reading them correctly) would prohibit changes in your current coverage once this legislation is enacted. If your life situation changes you would not be able to adjust your current coverage. Like I said, once I finish reading this I am going to go over it again to make sure I have an accurate understanding (apparently there is a federal regulation prohibiting the drafting of a bill in plain/ easy to understand language rather than “legalese”) (no offense meant to my Esq. friends).

I will be listening to President Obama’s news conference this evening in hopes that he is able to provide details, give a straight answer.

I am including a link to H.R. 3200, the legislation from the House of Representatives so that you could read, or look at, the legislation for yourself (of course reading this may disqualify you from being a member of Congress, or President). That’s My Opinion, What’s Yours?

http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3200: