Monday, November 16, 2009

I Feel A Rant Coming On: Health Care, Illegals, Geo Metro NO

Hi all,

I've been swamped.  My daughter was in a serious car accident, I went into a serious funk over it, and my work piled up in the meanwhile.  A deer jumped in front of the car of 24-year old husband, father and Templeton police officer Jeremy Hempel.  He hit the deer, lost control, jumped the median and collided with my daughter head-on at 70 mph. Here's the story and a video.

My daughter's car is the blue Mazda with side airbags and a front-end propensity to collapse upon impact.  The other car - a red Geo Metro - did the thing where the front-end proceeds into the passenger compartment.  Jeremy suffered two broken legs, and extensive internal injuries that required multiple surgeries. He is still hospitalized, while my daughter, thank God, got away with extensive soft tissue injuries and some slight, temporary fuzziness.  She worked her first return shift yesterday - albeit slowly and not without pain.  The deer, btw, is dead. The moral of this story is...side airbags YES.  Geo Metro NO.

Sorry for the absence.  I can't say things have eased up yet, but my daughter seems to be recovering nicely, and it seemed time to return to the rest of the real world.  And I do have something to set before you today.

This morning I ran across a report issued by the Health & Human Services Department's Centers for Medicare and Medicaid Services' chief actuary, Richard Foster.  The document is 31 pages long, and a lot of it is statistical analysis.  But parsing through the explanatory materials (all I had time for) yielded a few pieces of information that I want to share.  The link to the entire report is below.  Source:

1. This is non-tax financial cost estimate for the program, for the years 2013 through 2019:  $935 billion overall cost; $529 bil net "reform" savings for medicare, medicaid etc, for net cost of $406 bil.

2.  Surcharges and other revenues generated by the legislation would approximately offset the $406 bil., for a very small net reduction to the Treasury.

3.  The bill would reduce number of uninsureds from 57 million to 23 million (e.g. add 34 mil to insured rolls).

4.  Of the 34 million newly insureds, 21 million would be newly added to the expanded medicaid eligibility rolls (legal residents making under 150% fed poverty level).

5.  Significant revenues expected to offset the costs will come in from businesses who pay a penalty rather than offer required insurance, and individuals who opt to pay a penalty rather than purchase required insurance.  It is assumed that the main body of individuals opting out will be young, healthy people for whom the penalty is less expensive than the premium.

6.  Approximately 2 million people who are currently insured by employers will be transferred to the exchange when employers decide to stop offering coverage.

7.  Premiums for those under 150% FPL will be subsidized; premiums for those between 150-400% of FPL are capped at 12% of the payee's income.  DOES THIS MEAN OUR INSURERS GET TO COLLECT OUR INCOME INFORMATION?

8.  Individual penalties for failure to purchase insurance would be 2.5% of modified adjusted gross income above exemption amount; Public plan coverage would average 4% less cost to run, but for some reason, premiums are expected to be 5% HIGHER????

9.  The report does not identify a specific penalty amount for employers failing to offer coverage, but suggests that firms with many part-time, or low-earner employees would be doing their employees a favor to opt out, making the employees eligible for the heavily subsidized exchange insurance. $118 billion in employer penalties are estimated.

10.  Statistics on remaining 23 million uninsureds: 5 million undocumented illegals (who would still, i assume, utilize emergency room health care); 18 million will be opt-outs, prefering to pay a penalty over the higher premium. Some of these, too, will find their way to the emergency room.

11.  These statistics represent the meat from just the first 8 pages of this 31 page report. The figures are for the implementation years 2013-2019.

This is just a snapshot of the Health Care bill's financial impacts.  This is critical data for Medicare/Medicaid.  The agencies will have to gear up for an immediate and huge influx of new clients if the bill passes.  I am personally less focused on the costs and revenues generated by the bill than I am on the impacts for individuals - e.g. whether the bill will result in more, less, or different types of coverage.   I'm concerned about the fact that 5 million illegals will be without coverage, all because some Dems feel the need to pander to an ideological crowd hell-bent against tax-payer support of illegals in order to get the necessary votes.  This, even though our economic system is dependent upon the labor of our south-of-the-border brethren.  And even though these illegals will surely need health care, and we will be paying for it anyway when they show up at emergency rooms everywhere.  It seems to me to be nothing more than empty rhetoric to insist that we not use "federal dollars" to support health care for illegal residents, when taxpayer dollars will subsidize those emergency room visits anyway.  And emergency care always costs more, so technically, we'll end up paying MORE for those illegals' health care than we would if we'd included them.  So who benefits from including them?  Politicians who cowtow to the ideologues who support their campaigns.  Not real men and women.  Real men and women would stand up with real solutions, not succumb to political ones.  Where the hell is Barry Goldwater when you need him?  And where the hell is the business community?  I know a local business owner whose primary work force is Hispanic.  They do collect the documentation they're supposed to collect from their employees, but they also know there's underground traffic in forged documents.  This business last year lost a husband and wife team who were sent back to Mexico after they'd worked the shop floor for many years.  Where are these business owners?  Why doesn't the business community ever rise up and defend and protect their workforce?

It's hard for me to forget that my grandparents were immigrants.  Unless you are a Native American, you, too, are descended from immigrants.  They work hard, they pay taxes, they contribute.  What is your problem, America?  Oh, I forgot.  You're worried we're going to end up with an Hispanic majority and then what kind of country would this be?

Whoa!  Somebody pull me off this soapbox.  Sorry...

Ok, ok.  Breathing deeply and getting back to business.

And what about the other 18 million opt-outs?  They will be paying a penalty and yet, receiving NO coverage.  I hope these penalties will be adequate to subsidize emergency care services for the 23 million who still won't be insured.

This is far from the extent of my concern.  I personally would have liked to see an Administration with the cajones to set up a universal health care option to truly cover everyone.  It's not that it would have cost more.  The cost of a tetanus shot is the cost of a tetanus shot, no matter who administers it.  It would simply have shifted the revenue sources.  It will always come out of our pockets one way or another. 

And I would have liked to see Obama stand up like the Commander-in-Chief that he is supposed to be and keep the Health Care bill off the abortion battle field.  Instead, we have the the anti-choice Stupak amendment that not only makes the Hyde amendment (prohibiting federal dollars from use to subsidize abortion services) permanent, but as a practical matter will also reduce privately-funded insurance coverage for abortion - thus changing the abortion-availability landscape as a cost of passing the Health Care bill.  Where the hell is Barry Goldwater when you need him?

Well, that felt good.  What pieces of the Health Care bill do you love and hate?  I'd love to hear what you think.

And remember, side airbags YES.  Geo Metro NO.

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