Thursday, September 10, 2009

Obama's speech to Congress

America listened with fatigue and weariness as the President announced his healthcare plan. This speech was aired on every news network as well as website or blog.


The president promised that people with some or the other form of insurance right now will not be forced to change anything. He said, “Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime.”


He said that people without coverage are a burden to other taxpayers because of their emergency room visits. Hence he says that it should be mandatory for everyone to carry some basic health insurance. I do find it odd that healthy young people who are unlikely to fall sick that often will be bullied into spending extra money on healthcare.


He says that a public option is mandatory for those who have no coverage and that it will be competing with private insurers and keeping them in check. He also seems to assure that the public option would not be a burden to the taxpayer. It will be run by its own revenue and not on taxation. It is a kind of unfair competition when the government includes one of its players in a game where the others are privately funded. This government-aided player will have the advantage of never failing. Money can be siphoned off from profiting governmental ventures to this player when things get rough. In other words, if the governmental ventures profit, the money won’t be returned to you as a tax refund, or a tax credit, but will actually be used to fund an institution that is not working in the first place.


Business, like evolution, does work by natural selection. Bad businesses should be allowed to fail. At no point do we need to bail out a venture that ends badly. So what if people have invested in it? That is way the game is played. You cannot be a partner in profit only.


I am confused. There is one point though. He is a good speaker. He can sell you any idea. Even when he says something like, “I am not gonna do any reform” which is what he meant when he said, “People on the left want a universal health care system, while people on the right want to abolish the tax breaks on employer provided health care. Doing either of these will be a great change for people who are happy with their health care.”


He said that people without coverage will get the big benefit of his plan, because he will introduce an insurance exchange marketplace, where insurance companies should also come on board because they would jump at the chance of getting new customers. How? These people are uninsured because they’re considered high-risk or high-maintenance by the companies. So what will change now? I believe the government will offer tax breaks to these insurance companies to make it more profitable to insure these people. So, money from your pocket will be used to insure people who are a health care risk, so much of a risk that current insurers do not want them at any cost.


To be fair to the president, we must take care to make sure that the silly myths about Obamacare are dispelled. This plan will not federally fund abortions. It will not insure illegal immigrants. Trust me, Democrats don’t have any advantages in helping illegal immigrants. Republicans benefit more from keeping illegal immigrants here because they work below minimum wage and benefit the small entrepreneur who is the republican base. The other myth is the stupid ‘Death panel’ concept. That is absolutely false. Attach Obamacare on the real points.


For example, Obama said that he wants the public option to be self-sufficient, and not supported by taxation. He said that it will be run like a regular business, but will sidestep some of the overheads and the profits that a private company has, and hence will be able to provide a better deal to the public. This is him making the case for socialized medicine. He will never use those words, but it is pretty much true. However, the VA, Medicare, Medicaid etc are government owned, and percentage of satisfied customers for all these is higher than the privately insured customer base. So, there is a point to be made for a single payer option even though, as Bill Maher puts it, “I know socialized medicine sounds like Stalin himself is going to come over to your house and perform a forced sterilization. But, really all it is, is universal health care.”


As I asked before in my earlier post about this, why can’t every person just vote his interest? Yes, the richest 1% will be paying more than us. So what! Simply put, each person should vote his interest, and not based on some principle and a fantasy of being rich someday. Even though it irritates me that healthy prudent people might be paying for others who cannot afford health or those who are irresponsible with their health, I keep thinking that this beacon of capitalism has public schools, public libraries, parks, unemployment and welfare options, affirmative action, and many other such taxpayer supported programs.


The one thing that Republicans have proposed that makes complete sense is tort reform. It should not be so easy to sue doctors who made judgment calls in the heat of the moment. Doctors who are afraid of being sued increase healthcare costs by ordering superfluous tests simply to back up their already correct diagnoses, paying a lot for malpractice insurance which cost is transferred to the patient, which helps increase his premium, and by refusing to treat patients who might die on the table.


There are a lot of people who are saying that they are happy with their healthcare. Most of them fear getting sick. Forget stuff like serious surgery, some basic visits to a hospital cost a lot. Many medications demand a high co-pay, which makes it tough for people to afford treatment. Some of these people are just lucky that something bad has not happened to them. I would love to treat healthcare as a regular business, but the truth is that people without other luxuries can find a way to live, but this is a necessity that threatens our very life if not present. At some point, when we are opposing reform, we are saying to the uninsurables, “To hell with you. You can die for all I care.”

I think the public option should be inferior to the private one. I think there should be a set of civil hospitals like we have in India: a completely parallel medical system, which does not interfere with the private medical scenario. Freedom to choose is an important right, but mere survival of the weakest of our species should be the least we can expect from people.

14 comments:

rambuna said...

As i had commented earlier to your post..the poor should be taken care by the government but those who can afford as well decide/opt what health care plan they want... should be left alone. There can be no health care plan imposed on any one. Is the government asking for funds or corpus? What is the problem with the existing plan people have? why should they change??

rambuna said...

tort reform is welcomed as that will encourage doctors to help in deserving cases but a universal health plan will not work..health insurance though necessary, it cannot be imposed on those who cannot afford...comparing with auto insurance is not right..everyone does not have a car!

Liberal said...

@rambuna
The problems with existing healthcare:

-Ever increasing premia
-Loss of coverage when treatment is needed most
-Preexisting conditions like acne used by insurance companies to avoid payment in severe cases like cancer
-High co-pays for getting medication
-Doctors over-testing patients for fear of getting sued
-High malpractice premia leading to high cost

and many more..
As I mentioned, under Obama's current plan, no one has to change anything. This plan will first deal with the uninsured and give them basic coverage. When this federal insurance will expand as a business, it will probably start to compete with other insurance players. So, right now, no one really has to make any changes. To those who are 'happy' with their healthcare, it will be as though there is no reform at all.

Also, the comparison was perfunctory as in...everyone who has a car should carry auto insurance...and everyone has health..so expecting them to have minimum coverage may not be completely unfair...simply because it seems immoral to refuse emergency care in the US to the uninsured...and the uninsured take advantage of this and go to the ER for all their problems, thus burdening the taxpayer with unnecessary costs like ambulance and EMT services (even in cases where there is no real emergency, but going to ER is cost-expedient).

Some form of health care reform is needed, because the current system is broken.

buddy said...

the more i read, more my views differ. good write up though

avalok ishwar said...

your reply to the comments is a lot more cogent and on the line than your column. In your column, you seem to vacillate between taking care of the weak and indigent versus just letting them go.. Of what use is a government of the people, by the people, for the people if it does not take care of the people. There will always be folks who will seem or be undeserving. The good in us, however, should continue to prevail. Obama is making a start in that direction. The republicans, whores of corporate lobbies want the status quo. Forget them !

rambuna said...

i understand better after reading your comment..but where 47% are not insured in US..how do you bring about change especially in a immigrant/ democratic (public option?)population ..many are illegal too.If compared with france,germany, singapore, middle east countries where we have universal health coverage...they are smaller/ monarchy ruled countries and the conditions are not the same as in US. And it is not that this has not been tried earlier by past presidents!

Liberal said...

@rambuna
47million are not insured. Not 47%!

rambuna said...

47 out of total 305 million is about 15.4% which is not really bad compared to other countries.sorry for the error. actually i do not get much time to read,write on the blog! But, i try and contribute.. i was surprised to know that in India Joseph Bhore committee had proposed universal health care in the year 1946, but six decades later...97% of health expenditure is done from 'out of pocket' supported through corporate health insurance. LIC ( govt body)...wait and watch whether the bill is passed?

rambuna said...

and we have some best govt. hospitals here charging very low ( tata memorial,Nair, Sion hospitals in mumbai, for eg)and there are 25 insurance companies providing health care insurance in competition etc at good rates...doctors easily available...so it is not bad at all in india...

Liberal said...

@rambuna
15.4% uninsured is good compared to countries with much lower GDP. Developed countries like the US all have some or the other form of healthcare for every citizen.
I agree with you that the system in India is very good. Let's forget the civil hospitals because most people try to go to private hospitals if they can afford it. In our case, a person does not have to go through the insurance mess if he justs visits his doctor. How many of us need insurance for regular medical expenditure, or even dental for that matter? Our system, though seemingly flawed ensures that even a dhobi or a doodhwalla gets some primary non-emergency healthcare that is affordable to him.
In the US, the insurance companies haggle with the doctors so much and (pay them a fraction of what they charge) that the doctors overcharge at the beginning in the hope of getting at least some of it from the insurance guys. This affects the uninsured as it nearly bankrupts them. Even the insured have a few scars to show as their premium increases or their coverage is denied.

Ironically, a system like we have in India, has the low medical costs that the left would like and the freedom to choose a hospital or doctor that the right likes!

Liberal said...

@avalok
If by cogent and on the line, you mean 'a little more Obamalike', I assure you it was only because I was rebutting rambuna who took a rather right-wing approach to the problem.
I am truly vacillating.
While we would like to take care of the underprivileged, can it not be done using private tax-deductible charities which have better oversight and more professional systems?

rambuna said...

i know that india is popular destination for medical tourism...even for americans/europeans besides arabs who frequent often ....so US can emulate indian system favoring right and left.

Anjana R said...

health care is tricky. I believe the Clintons, during their time, did the best they could/had the right idea.

Liberal said...

there isn't much being done now, nor was done by Clinton...the senate just rejected the single payer system...Obama does not know how to negotiate