PENNING: Our nation’s health system still sick

Jul 12, 2012

First, the fact that the Supreme Court upheld most contested portions of the legislation as constitutional does not settle the matter. For example, I’m not convinced that the government forcing people to buy a product is within its role, either under the commerce clause or its power to tax.

I’m not a lawyer, but I’m reasonably intelligent, and I find some of the justification of the court suspect. Obviously, people will disagree even as the nine justices did.

But more importantly with regard to the court, the decision does not prove the health care reform is good. The court’s majority only said the health legislation was legal, not that it was good policy or would solve the problems we have. Let me explain some of my problems with it.

I don’t like the way it was passed. A lot of information was in the bill, and it was pushed so fast that most legislators barely read it before voting. In fact, Nancy Pelosi, Speaker of the House, said Congress needed to “pass it so we can find out what’s in it.” Huh?

Legislation in the U.S. Congress is not supposed to be a piñata or gift-wrapped surprise. That Pelosi could say that with a straight face is only possible because of the Botox she recently had injected. We can only wonder if her congressional health plan had the taxpayers on the hook for that.

Also, Obama as candidate said he would post all legislation online so not only elected officials but also voters could review it before it was voted on. Add that to the long list of unmet promises by this president.

It’s also unsettling to me that many of the corporate, union and state government leaders who campaigned for the legislation have subsequently asked for and received waivers. In other words, they worked to pass health care reform for others, but are excused themselves from abiding by what it dictates for others. There’s something sick about that.

Now that it is passed, I am skeptical of its positive effect. Those who pushed it said it would mean more people will have health care. Not so fast. More people will have health insurance policies because the law forces them to buy them. But having a policy does not mean having good health care. The policies people can afford to buy may or may not have good coverage.

Employers are being forced to provide coverage for employees or face a fine. People should recall that employers offered health policies years ago as an incentive to get the best people to apply for positions. Notice how over time a free market incentive gets turned into a government mandate. It’s yet another example of well-intended bureaucrats overreaching into the private sector and most likely making matters worse. This will make it less possible for many employers to hire new workers at a time when unemployment is already high.

Also, there is already talk that many people will be told by employers to seek health care themselves on a health care “exchange” that many states will set up as part of the new law. So, if you like your policy and want to keep it, as Obama promised, that may not be the case.

A lot of the underlying problem is that the government, and by extension many in the public, confuses health insurance with health care. Insurance is about managing risk. The idea is that people put money into a pool and if you get sick you can access funds to pay for health care.

What this policy does is remove the “if.” If every person and business is required to buy insurance, and every insurance company will be told who and what they cover, it ceases to be insurance by definition. It seems that’s ultimately what the government wants though — not private insurance, but another huge government program that will be costly but not necessarily better.

The government is involved because they want to ensure more people have access to health care. But with regard to the poor, we should look at eliminating fraud and waste in Medicaid and Medicare, and also enable more nonprofit health organizations to help the poor.

With regard to those who can afford insurance but don’t get it, I still believe in the combination of liberty and responsibility over government trying to force behavior in paternalistic fashion.

People use health insurance for too much now. I’ve always considered insurance something you buy and hope you never use. But health insurance is involved in everything from a short office visit to routine health products. It’s as if our auto insurance paid for gas, after all the paperwork that would be required.

Health care would be better it went back to the free market for the majority of things — such as cold and flu, check-ups, and other minor and routine medical issues. Insurance should only be tapped for expensive prescriptions, disease and accidents that involve significant medical complications. A combination of government and nonprofit programs that are means-tested would help the minority with no access to health care.

That would be simple and effective.

But in the meantime, we have a legislation that includes 59 items, many of which we’ll find out about in the next two years. If we don’t like what’s in it then, I wonder if Nancy Pelosi and her colleagues in Congress will be willing to change it.

Tribune community columnist Tim Penning’s columns and other thoughts can be read on his blog: http://pierpoints.blogspot.com.
 

Comments

davewali

"I don’t like the way it was passed. A lot of information was in the bill, and it was pushed so fast that most legislators barely read it before voting. In fact, Nancy Pelosi, Speaker of the House, said Congress needed to “pass it so we can find out what’s in it.” Huh?"

Then I assume you have a problem with virtually ALL legislation passed by Congress. I have seen news articles stating that virtually ALL legislators vote on legislation without reading it.

"Also, Obama as candidate said he would post all legislation online so not only elected officials but also voters could review it before it was voted on. Add that to the long list of unmet promises by this president."

Please introduce me to the politician who keeps all his promises made while running for office, Democrat OR Republican.

"The government is involved because they want to ensure more people have access to health care. But with regard to the poor, we should look at eliminating fraud and waste in Medicaid and Medicare, and also enable more nonprofit health organizations to help the poor."

I agree, but what about those non-poor, who cannot afford insurance? Should they be left to bankruptcy as the best alternative?

"With regard to those who can afford insurance but don’t get it, I still believe in the combination of liberty and responsibility over government trying to force behavior in paternalistic fashion."

And the taxpayer covering their medical bills?

"People use health insurance for too much now. I’ve always considered insurance something you buy and hope you never use. But health insurance is involved in everything from a short office visit to routine health products. It’s as if our auto insurance paid for gas, after all the paperwork that would be required. "

Have you ever gotten a warranty on a product? Think of it like that, like a warranty that pays for the maintenance on a vehicle. Ever gotten a free oil change on a newer car, because it was covered by the warranty? It is just like getting a check-up from the doctor, because it is covered by insurance. Insurance companies pay for that, because is is CHEAPER to catch problems early than to fix them when it becomes a major problem.

"Health care would be better it went back to the free market for the majority of things — such as cold and flu, check-ups, and other minor and routine medical issues."

Spoken like a man with a lot of money...unlike a lot of us. Maybe YOU can afford to pay for a routine physical out of pocket....I can't.

I don't have a problem with the tax for refusing to buy insurance. Call it the penalty YOU pay for forcing the taxpayers to pay for YOUR triple bypass. Then after that operation, you can STILL be eligible for insurance...unlike pre-ACA
.
Are you also against the law in Massachusetts that was the basis for the ACA? Are you calling on Romney to work to repeal THAT law also? (Unlikely that he will, since it was his law.)

I feel the ACA is a law passed for the greater good. Does it need refinement? Yes. Can more be done? Yes. Should medical costs be restrained? YES, YES, YES,

Have the Republicans done anything about the above? NO! Their solution is to "repeal and replace". They want to vote on repeal, no word on replace. The ACA was originally a Republican idea, they turned against it when the Democrats took it a ran with it. See any politics there?

truthhurts

I find some of these responses pretty arrogant:

"With regard to those who can afford insurance but don’t get it, I still believe in the combination of liberty and responsibility over government trying to force behavior in paternalistic fashion."
****And the taxpayer covering their medical bills?

I can easily afford health insurance, but I choose not to get it. The only time I had to go to the hospital was for stitches...and I paid for it in cash! Same with dentist visits and flu shots etc. Not everyone in this country in a free loading, entitlement mentality bloody sucker. The bottom line is, if you choose not to buy insurance and something happens and you can't afford to pay for it...you don't get treatment. Easy as that.

I will refuse to pay the tax, and I will refuse to buy health insurance. I also refuse to have my rights taken away that my fore fathers fought and died for me to have. I have wanted to join the service for years, but refuse to serve under Big Brothers current mentality.

Lanivan

truthhurts - I would respectfully suggest you consider a move or, if that is too extreme, a sabbatical to some country that has little or no government, taxes, health or other care systems. We'd be looking at a country like Liberia, or Haiti, as most civilized, developed countries have at least what we have in this country, or in many cases, more. Seriously, some time living in and actually experiencing what you espouse could be a good thing. Maybe you will come to appreciate how wonderful it is to have a choice, when so many in this world do not.

truthhurts

You may be right, survival of the fittest does sound good and fair to me. One thing you are spot on with is how wonderful it is to have a choice, which is one of the many freedoms we enjoy. Just like my choice to not buy health coverage. My choice does not affect you or anyone else, nor should it (that is why i say hospitals need to turn people down, sucks but that is life). Now if I had a family that I was responsible for, my health insurance choices would be quite different because that is the responsible thing to do. What does affect you and me are the people that feel they are entitled to services they haven't/can't pay for and getting it! Everyone will never agree with a choice that is made, but that is what makes America a Democracy (majority rules) and lately I am seeing America take a less than democratic approach to issues and that bothers me. The proposed health care reform may work, but I don't believe that it will fix the issues that we are currently seeing and I don't think that it will lead to better health care services, actually the opposite. If the majority of Americans vote they want obamacare, I would not object to it, I would suck it up and go with it. But that is not what has happened.

CJ1987

OMFG!!! The government is going to FORCE us to buy something!?!?!?!?!

OH! But wait. I drive my car all the time... What do I have so I can drive my car....OH yeah, AUTO INSURANCE!!! I can't drive my car unless I have AUTO INSURANCE!!!!

So the government FORCES ME to buy auto insurance. If I DON'T have auto insurance I get FINED!!! So that must mean that the government is FORCING ME to buy auto insurance. So the government FORCING ME to buy something is NOTHING new!!!! WOAH!!!!

Now, let's use our brains when we say the government shouldn't be able to "force us" to pay for anything because CLEARLY the government DOES and HAS been forcing us to pay for something for A VERY LONG TIME.

Use your brains people. THINK!

truthhurts

You clearly need to think outside of the box. This is VERY different. Auto insurance is a must, because everytime you get into your car, your life is in others hands. My personal daily health is not at risk because you're a crappy driver or because you choose to eat unhealthy.

Zippy Jones

So "truth", if you are not insured and have tuberculosis, HIV, a flesh eating bacteria, symptoms of Zombieism, or some infectious disease, and you cannot afford to go to the doctor, you are saying that your state of health is not a risk to me and others?. Got it. Brilliant. Logical. ...just joking, man. Not really...logical.

truthhurts

that is a good point. That is the point of these disscusions. There is no need to be cynical, it makes you sound foolish, even though you made a valid point.

Lenus

Every time you breath, walk or go anywhere you are putting your health at risk -- should the government be responsible for your health in case you get sick or injured.. I'm sure you will say no they are not - then who is, when you trip on a sidewalk and break your ankle, turn in front of a car with your bicycle and get hit or heck even come down with some ailment that requires hospitalization ----

I know each person should be responsible -- Ah but we don't require them to have insurance, so who ends up picking up the bill... Hospitals, which pass the costs on to their paying customers, who pass it on to their insurance carrier, who passes it on to those that have policies.......

Funny how that works is it not.... So are we better off to make everybody share in the cost or just those that have health insurance....

Lanivan

This is but another piece regarding the ACA that is full of misinformation, propaganda, and flat-out untruths. I didn't know where to start, but thank you davewali for providing some accurate information. Tim - what's your point exactly? Going back in time is simply not an option - we have big government because we are a big country with lots of diverse people living in a global economy. The ACA is a complicated piece of legislation about a hugely complicated issue (the health of Americans) which dominates our society and touches each and every one of us. This legislation was passed by the Congress, the President, and upheld by the Supreme Court. The American people do not want the ACA repealed because they are beginning to understand how much it will help them individually and as a society to be healthier and more productive. Yet the GOP, driven by the far-right extreme radicals in the party, have attempted to repeal the ACA 33 times at a cost of 50 MILLION DOLLARS of taxpayer money, knowing full well it would not get past the House of Representatives. But these same clowns haven't voted ONCE on the President's Jobs Bill that would create jobs and help the economy recover. Now that's government waste and corruption. What's with the snide and juvenile comments about Nancy Pelosi, Tim? Sure hope it's not because she's a powerful woman! Oh, another thing, you use the word "force" a lot in this piece. A scary word that incites fear, but, again, not accurate. The ACA doesn't "force" any one to do anything. You are at liberty to go the rest of your life without insurance coverage if you so choose. However, you and about 1% of the general population that chooses to go down this road will pay a simple penalty via your tax return. How about moving forward and writing a future piece about how the GOP is creating all those jobs they promised in their campaigns - you know, something positive for Americans instead of spending all their time and our money on looking like real sore losers.

Zippy Jones

Another "Hooray for Me" opinion by Mr. Penning.

Free Market...to take care of "health and well being"? Really? A non-insured person goes into "Emergency" for ___fill-in-what-ever-you-wish____ and can't pay. Who "pays?" Doctors? Insurance companies? Then insurance rates go up to maintain profit and you and I pay. Free Market is not the utopia many deem it to be. The Free Market isn't 'free" if you've been paying attention. There is a cost, it's just hidden under the mess.

What would Jesus do? Read for example what Matthew says about it: “Jesus went about all Galilee, teaching in their synagogues, and preaching the good tidings of the kingdom, and healing all manner of sickness, and all manner of disease among the people. And his fame went throughout all Syria; and they brought unto him all sick people that were taken with divers diseases and torments, and those that were possessed with devils, and those which were lunatic, and those that had the palsy; and he healed them” (Matt. 4:23, 24). “And Jesus went about all the cities and villages, teaching in their synagogues and preaching the Gospel of the kingdom, and healing every sickness and every disease among the people” (Matt. 9:35).

"Sorry dude, can't heal ya. No Master Card, no Insurance. We have a Free Market mow in Galilee. I have a car elevator in my home to pay for by the way. I don't do "free".

Truthhurts: Which founding father? Ben Franklin? Did you know he and a doctor friend founded the very first hospital...giving treatment to those in need....free...of...charge? "Bond and Benjamin Franklin were long-standing friends. Bond was a member of Franklin's Library Company and helped establish the American Philosophical Society and the Academy of Philadelphia, which evolved into the University of Pennsylvania.

Around 1750, Bond "conceived the idea of establishing a hospital in Philadelphia for the reception and cure of poor sick persons." The idea was a novelty on this side of the Atlantic, and when Bond approached Philadelphians for support they asked him what Franklin thought of the idea. Bond hadn't approached his good friend because he thought it was out of Franklin's line of interest, but because of the reaction he received, Bond soon turned to Franklin. After hearing the plan, Franklin became a subscriber and strong supporter. Franklin's backing was enough to convince many others that Bond's projected hospital was worthy of support."

How about John Adams? You know, a "fore father" to whom you infer: In July of 1798, Congress passed - and President John Adams signed - "An Act for the Relief of Sick and Disabled Seamen." The law authorized the creation of a government operated marine hospital service and mandated that privately employed sailors be required to purchase health care insurance.
Keep in mind that the 5th Congress did not really need to struggle over the intentions of the drafters of the Constitutions in creating this Act as many of its members were the drafters of the Constitution.
And when the Bill came to the desk of President John Adams for signature, I think it's safe to assume that the man in that chair had a pretty good grasp on what the framers had in mind....

A few other "founding fathers": Jefferson believed that education should be under the control of the government, free from religious biases, and available to all people irrespective of their status in society.
Benjamin Franklin worked most of his life to educate the youth of Philadelphia and, in fact, he was instrumental in starting free, public High Schools in Philly. I would venture to say that his time at the Boston Latin School (the first free public High School) had plenty to do with this. It should also be noted that John Hancock and Samuel Adams also attended.
Noah Webster, often referred to as the father of American education, believed that education was the key to a healthy republic. Writing in “Securing the Republic (1788)“, Webster said:

Truthhurts: Your last two lines prove that you cannot be taken too seriously (as with the majority of your posts). BTW, my buddy was drafted against his will (ACA) into the military. .

truthhurts

That was a lot of irrelevant religious propaganda there. I am glad that what I wrote struck a chord with you.

Zippy Jones

Too much truth? The post is all related in the big scheme of things- helping others, founding fathers' viiews on healthcare and education, etc, but apparently, the truth hurts.

truthhurts

good one

Lenus

CDC Query Results for Cancer by age groups 1999 - 2006... Showed that there were app. 500,000 cases of cancer in the age group 20 - 40. These are the age groups who have the highest rates of uninsured.

This was only cancer, how many of these people thought they were going to come down with cancer in that age group? Probably none of them. How many of them did not have insurance, I would bet a majority. Who picked up the tab, more than likely you did. Hospitals are required to treat anybody that comes into the Emergency room until they are stable. Ronald Reagan signed into law the Emergency Medical Treatment and Active Labor Act (EMTALA) in 1986 which forced this upon hospitals.

We looked just at cancer but how many kids in that age group think they are going to come down with a social disease -- I bet you the 10 million or so that have it never ever dreamed they would contract a social disease.

Lanivan

For those of you who would like to get more facts and less personal opinion and misinformation regarding the ACA, try going on the following website. It is easy to read, and clarifies a lot of the lies and propaganda swirling around this new law. It is: healthreform.gov/newsroom/keeping_the_health_plan_you_have.html

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