Fathoming Obamacare

I really, really want to understand President Obama’s health care proposal. By all indications, a reconciled version of the House and Senate bills, mixed in with the president’s latest proposals, will be sent through Congress and likely adopted. I want to know what all that means for me and my family.

Answers to that question are hard to find.

That the status quo needs to change is obvious.

I buy insurance for my family. It’s an okay policy, but not the best out there. We paid the premiums for two years without a claim. Then the insurance company wanted a price increase. No claims on our part, but the “cost of business” has gone up. So we threw a hissy fit and changed policies and still ended up paying more.

Last Thursday, our youngest boy burned himself falling onto the woodstove (the little idiot was tap dancing on the ping-pong table, fell, and landed on the stove). First we took him to a local private clinic, but because we had the effrontery to have an accident ten minutes before closing time, the doors were locked and the envelope-licking lackey inside was unresponsive to my wife’s door knocking.

The local hospital was just up the street. But did we want to put in a claim and see our premiums soar – we already know what they do when we pay the bill and DON'T USE THE DAMN INSURANCE. So thanks to a few savvy moms in the neighborhood and a nephew who has just finished CNA training, we self-medicated. He’s doing better now.

I would love to have better insurance options. The problem with the current health care bills is that no one – and I mean no one – is doing a good enough job explaining to schmoes like me why the proposed bills will do us any good.

The national media gets failing grades in this respect, and it’s shameful. I’ve yet to see an “in-depth” explanation of how any of the bills will help me and my family. They typically boil down their explanations to maybe sixty to ninety seconds of bullet points: You’ll get tax credits based on the percentage of income you spend on health care! Deficit reductions due to the reforms! This will make your health care more affordable! Those on Cadillac plans will pay taxes to help out the poor schmoes! And then they spend much more time on the politicking of health care reform, rather than telling me, the average American, why I should be excited about it. The media is much more intent on painting the Republicans as the Party of No and as obstructionist and as in the pocket of insurance companies than telling me why I should be excited about the proposed reforms. You’re failing me, mass media. Get off the politics and tell me what’s going to happen if these reforms go through.

What’s even worse is that the White House isn’t doing much better. I’ve spent a lot of time reading what information the White House is offering on the bills, on reconciliation, and on Obama’s proposals and I still don’t know much more beyond what the pretty boys and pretty girls of the media are telling me.

So there are tax credits. Based on income and the amount of money I spend on health insurance, will I qualify for them? I don’t know. The information at www.whitehouse.gov is too vague for me to decide. My interpretation tells me that to qualify for the credits, I’d have to spend between 8 and 9 percent of my income on health insurance costs. Right now, I pay about 5 percent. So to save money, I have to spend more money? No wonder y’all can’t sell this. But if I’m in error, the only way to find out is to submit an e-mail question that’ll take who knows how long to get a response.

Here’s the information I’m getting:

The Act will provide the largest tax cut for health care in American history. Millions of families will receive hundreds of billions of dollars in tax credits to help them pay for insurance in the new exchanges. This tax relief for working families will make insurance more affordable for those who can’t get it through work or whose employer insurance is too expensive.

I pay about $3,360 a year in premiums. As a percentage of income, that equals about 5 percent. Now, I don’t exactly have a Cadillac plan – more coverage would be better. But unless the tax credits pay for a significant portion of the increased amount of money I’d have to spend to qualify for them, I just don’t see the use. The percentage I’m using, as provided by the White House, is for a family of four. We’ve got five. Maybe that’ll make a difference, but from what I’m being shown, I can’t tell.

Then there’s this:

Both the House and Senate bills include significant reforms to make insurance fair, accessible, and affordable to all people, regardless of pre-existing conditions. One essential policy is “rate review” meaning that health insurers must submit their proposed premium increases to the State authority or Secretary for review. The President’s Proposal strengthens this policy by ensuring that, if a rate increase is unreasonable and unjustified, health insurers must lower premiums, provide rebates, or take other actions to make premiums affordable. A new Health Insurance Rate Authority will be created to provide needed oversight at the Federal level and help States determine how rate review will be enforced and monitor insurance market behavior.

As a subcontractor to an outfit that contracts work for the federal government, I’ve seen firsthand how well bureaucracy does in saving money, and I don’t say that facetiously. For the most part, the system works. But there are instances where the bureaucracy causes expense, rather than cutting it, so I’m wary.

And then there’s this:

Every member of Congress will be required to purchase their insurance from the new health insurance exchange.

Big deal. They make more money than I do and, as a consequence, can afford better health care. To put us on equal footing, they should also be required to give up their lifetime pensions, with which they can pay for their insurance.

Then I see this nifty little feature. Wow! I can see what “reform means to me!” So I answer the question: I buy my own insurance. I get this answer:

• You will likely pay less---perhaps much less. If you buy coverage like you have today on your own, premiums are expected to drop by 14 to 20 percent. If you get coverage through your job, premiums could decline by up to 3 percent.

• In addition, many Americans buying coverage in the individual market will qualify for tax credits that reduce their premiums by an average of nearly 60 percent – and they will get better coverage than what they have today.

Likely and many. It’s still too vague.

And, yes, this is what it comes down to. Show me the money. Because right now, if my wife or a kid needs to go to the hospital for an urgent need, I'll take them there, lousy insurance or not. If Obama's health care proposals will make that less of an agonizing choice, or make it easier for us to afford, say, dental insurance, or make an occasional visit to the doctor not so much of a financial burden, I'm all for it. Whether my congressmen have to buy insurance from the same pool, or whether the government will work to make forms easier to understand (they've certainly done a great job of this at the IRS) isn't important to me. What I want to know is will this make better insurance more affordable. At this point, I get the vague understand that, yes it will, but until I see the numbers, I don't know to what extent that affordability will extend.
So I submitted my e-mail to the lackeys at the White House. I’ll post updates as they arrive.

UPDATE: The Kaiser Family Foundation has a nonpartisan explanation of the various health care proposals that is actually helpful. Incldued in this link is a calculator that'll show how the tax credits work. It appears under the Obama plan we would qualify for about $3,300 in tax credits -- but that's on yearly premium payments of about $9,000 -- far more than we pay now. Admittedly, the policy picked for this calculator is a bit more on the Cadillac side than what we've chosen for ourselves. Still, it shows a tax credit would be there.

But how is it going to be paid for?

Ah. Here again from the Kaiser Family Foundation. Savings in Medicare and Medicaid. Penalties on companies and individuals who opt out of insurance coverage. And taxes on the rich folks.

This brings me to the second bullet point above: Better health care for my family through these plans. Sure, that appears possible. But I can get better health care now if I just pay more. And by all estimates, if I want better health care under the proposed plans, I have to pay more. Maybe not as much as I would outside the plans, but still more. And since the difference is made up in tax credits, which we get back with our income taxes, we still have to come up with the additional money to pay for the fancier care and then wait for a reimbursement. Maybe that makes for easier accounting, but since premiums are paid on a monthly and not a yearly basis, it still makes it tough on the ol' coconut.

I should note that I found this information thanks not to any national media outlet, which are still, in general, focusing on the politics, but thanks to a local news station which did a story on local college students studying the plan. Thanks, Local News 8.

State of the Union

I have to confess: He does give a good speech. And I've grown cynical over the last year, hearing the flowery speeches but seeing little action. But then I realized, hell, could I get done in a year what President Obama bit off? Probably not. Not, certainly, given the animosity from the GOP who say no to everything, even if it's good, and the blind insistence from the Democrats that they get everything they want or nothing at all.

Two bits to tonight's State of the Union stood out to me. First, clean energy:

[T]o create more of these clean-energy jobs, we need more production, more efficiency, more incentives, and that means building a new generation of safe, clean nuclear power plants in this country.

It means making tough decisions about opening new off-shore areas for oil and gas development.

It means continued investment in advanced biofuels and clean-coal technologies.

And, yes, it means passing a comprehensive energy and climate bill with incentives that will finally make clean energy the profitable kind of energy in America.

Here, big bugaboos for the left. He did indeed say "a new generation of safe, clean nuclear power plants in this country." This is big news for Idaho and the Idaho National Laboratory, where work on the Next Generation Nuclear Plant is underway, and where French energy giant Areva plans to build a $2 billion uranium enrichment plan, despite what State Rep. Tom Loertscher might have to say about the situation. Clean coal. New off-shore oil and gas development. The left is going to hate this. But if we want energy independence -- which we could have had thirty or forty years ago if the left had't been the Party of No as much as they accuse the Republicans of being such today -- we've got to do this. Especially nuclear. I have never understood why, with Idaho's nuclear legacy, that we do not have commercial nuclear power in this state. We need this.

Then there's health care. I like what I'm hearing, if I'm not perfectly pleased with the bills currently being debated in Washington:

I took on health care because of the stories I've heard, from Americans with pre-existing conditions whose lives depend on getting coverage, patients who've been denied coverage, families, even those with insurance, who are just one illness away from financial ruin.

After nearly a century of trying -- Democratic administrations, Republican administrations -- we are closer than ever to bringing more security to the lives of so many Americans.

Our approach would preserve the right of Americans who have insurance to keep their doctor and their plan. It would reduce costs and premiums for millions of families and businesses.

And according to the Congressional Budget Office, the independent organization that both parties have cited as the official scorekeeper for Congress, our approach would bring down the deficit by as much as $1 trillion over the next two decades.

Still, this is a complex issue. And the longer it was debated, the more skeptical people became. I take my share of the blame for not explaining it more clearly to the American people. And I know that with all the lobbying and horse-trading, this process left most Americans wondering, "What's in it for me?"

But I also know this problem is not going away. By the time I'm finished speaking tonight, more Americans will have lost their health insurance. Millions will lose it this year. Our deficit will grow. Premiums will go up. Patients will be denied the care they need. Small-business owners will continue to drop coverage altogether.
I will not walk away from these Americans, and neither should the people in this chamber.

As temperatures cool, I want everyone to take another look at the plan we've proposed. There's a reason why many doctors, nurses, and health care experts who know our system best consider this approach a vast improvement over the status quo.

But if anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know.

Here's what I ask Congress, though: Don't walk away from reform, not now, not when we are so close. Let us find a way to come together and finish the job for the American people. Let's get it done.

Here, bugaboos for the Right. I'd like to hear the GOP answer this challenge -- if they think what's being proposed is so terrible, where are their ideas? And don't tell me the private market or the status quo. I've seen the status quo. I saw my Dad cash in his retirement savings in the 1980s because of a quadruple arterial bypass operation he had to have to live that he couldn't afford otherwise because we couldn't afford health insurance. I've seen my own private sector health care premiums soar even without us ever filing a claim. The status quo stinks, GOP. If you're the Party of No, I left you with good reason, and good riddance.

I like as well that on health care he's sending a message also to the Democrats and to the mass media. So you don't have that filibuster-proof Senate majority. Don't crumple and give way. Don't listen to the media who want you to give way so they can blame it all on the GOP and their Party of No attitude. Sincerely, and with due diligence, get off your fat, federally-pensioned and insured fannies and see if you can't make the system better for the rest of us. And if you can't, GOP, I'd like to see all of your heinies off the Cadillac health and pension plans you get in the federal system and deal with life as it's tossed to the rest of us. You can have the health insurance policy that I have for my family that will cover us if we have a catastrophic accident, but won't cover us for the incidentals, making us not want to use what the private sector asks us to pay for. You want to talk about rat holes, GOP? Live on the insurance I've had for a year. Pay that $300 monthly premium and then don't ever use the insurance because it won't pay unless I'm in a car crash, and then when it does, whoa nellie do my premiums go up, up, up.

A few other topics: I can't say I'm thrilled with what's being proposed to help the middle class. What's being proposed won't help my family much at all. But there are families out there it will help. So go for it. See what you can do as a bipartisan congress to make things better.

A full transcript of the State of the Union -- without media spin -- is available here. Read it.

Republican response by Gov. McDonnell of Virginia is here. Read it, too. And Gov. McDonnell, what is worse? A government that tries to do too much, or a government that does too little? And to hear the GOP squawk about budget deficits just makes me laugh out loud. Pot, Meet Mr. Kettle.

The New Freedom

First a little reading, then a quiz.

We have come upon a very different age from any that preceded us. We have come upon an age when we do not do business in the way in which we used to do business -- when we do not carry on any of the operations of manufacture, sale, transportation, or communication as men used to carry them on. There is a sense in which our day the individual has been submerged. In most parts of our country men work, not for themselves, not as partners in the old way in which they used to work, but generally as employees -- in a higher or lower grade -- of great corporation.

The first two or three sentences you might think this quote is contemporary (which it is not) given the language about how things have changed so much in vital areas such as manufacture and communications. But by the time you get to the end of the passage, it's clear that that change being described is not necessarily the change we're experiencing today.

This passage is from The New Freedom, a collection of campaign speeches by Woodrow Wilson complied in a book published in 1913. What's interesting to me is that at this time, with mass manufacturing and the advent of the gigantic corporation, there wer ample societal challenges, just as we face today, and, frankly, just as large and as vexing as the challenges faced by any generation.

I've heard our modern age described as just about everything from the Age of Stupid, which is, of course, a cynical and completely inaccurate description, to the Electronic Age, which might be more apt but does little to really explain what the heck is going on. By reading this book by Wilson, I think it'll be interesting to consider that in any age, the people facing the difficulties they have to face will think they are in a unique time with heretofore unseen political and social challenges. Those who don't look at history, or those who choose to remain ignorant, while bandying about labels like the Age of Stupid for their own current time are the ones really showing off their stupidity.

I'm a few dozen pages into the book and, frankly, a lot of the things Wilson talked about are still being talked about today. It's interesting to see that fancy rhetoric doesn't solve problems, nor does the ability to place compromise above everything else.