(Just a quick post to get this down for posterity, and in case you were curious.)

It certainly does strike one as odd that the federal government is requiring its citizens to buy a specific type of product—a health insurance plan—with the 2009 health-care reform. Even a fan of big guv’mint like me can, at first blush, jump back to his libertarian instincts when it’s described like that. It can really be boiled down to two questions: can they do something like that, constitutionally? And second, should they?

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Real quick followup to my previous post: I poked around and discovered that, indeed, the HCR bill includes some promising provisions for expanding the use of accountable-care organizations (ACOs) like you see at the Mayo Clinic and in other communities.

I actually took a crack at reading the bill itself, which is incredibly dense in some places but pretty straight-forward here. To wit:
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After being re-linked to it by my friend Peter, I finally got around to reading one of the most-cited pieces about HCR:

McAllen, Texas and the high cost of health care

To overstate things a bit, this article is a classic in the media discussion of health-care reform, at least from the number of times I’ve seen it referenced. Here’s the main points I took away:
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We’re about to talk about abortion for awhile, so let’s start off with a precious kitty:

Except it's a baby, which reminds you of abortion. Dammit.

Okay, so. It seems like the abortion issue is one of the more bizarre aspects of the debate—and it’s been a very bizarre debate—because people have been so diametrically opposed on the facts of the matter. On the one hand, a Republican yells out “Baby killer!” (or It’s a baby killer, depending on who you believe) during debate on the bill. On the other hand, some liberal blogs I’ve read have described the bill as the “biggest step backwards in reproductive rights” in many years. So conservatives think the HCR bill loves aborting fetuses, whereas liberals believe that it firebombs Planned Parenthood clinics on its days off.

The good news is this is a matter of fact, not speculation. So we can sort out the actual truth of the matter. Right? Lessee…
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3/22 Update: One thing that my list below didn’t convey is how much of the plan will be rolled out over time; for example, the Cadillac plan tax isn’t implemented until 2018. This excellent Reuters article outlines the whole plan in chronological order:

http://www.reuters.com/article/idUSN1914020220100319

In the interests of not exploding from near-constant frustration, I’ve deliberately avoided blogging about (or, as much I can, thinking about) the health-care debate as Congress has been even more ridiculous than usual bringing it to fruition.

To review: on November 7, 2009, the House passed the Affordable Health Care for America Act by a vote of 220-215. On Christmas Eve, the Senate passed the Patient Protection and Affordable Care Act (what’s with these names, honestly) by a vote of 60-39. In the 2½ months since, Congress has done a spectacular job getting a whole lot of nothing done, and the filibuster, that most delightful of obstructionist legislative tools, has turned into the Republicans’ new best friend:

Way to govern, amigos.

But. Despite the GOP’s most valiant of efforts… despite President Obama being surprisingly aloof through most of the adventure… despite the American public becoming justifiably fed-up with the whole affair… it’s finally come together. And even in its worst, most compromise-weakened form, it’s still the most dramatic reform of American health care since Medicare and Medicaid in 1965.

First of all, just the facts. Rumors and implications and unintended consequences aside, exclusions and rejected ideas aside, what does this bill actually do? Well, a whole hell of a lot, actually. Unlike the vast majority of Congressional legislation, it’s a grab-bag of new laws, restrictions, taxes, allowances, and three or four kitchen sinks.
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…In response to the previous email, I just sent my Congressman the following email. It built on the research I’ve conducted so far (and required a couple hours’ additional reading) but I’m relatively proud of it.

Congressman Carter,

Thank you for your thoughtful reply to my email, in which I expressed my support for health-care reform proposals currently being discussed. I hope you don’t mind if I offer a point-by-point response.
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As I mentioned in my very first health-care-related blog post, my Congressman—John Carter—sent an email poll asking what his constituents thought of Congress’s health-care proposals. Rather than clicking a button, I sent a quick response indicating my general (and uninformed) support for Democratic proposals.

Congressman Carter, or one of his employees, responded not long after with a lengthy and impressively thorough description of exactly why he thought the Dem plans were a bad idea. I’m reprinting his letter here, then I’ll post what I just sent him.

From: Congressman John Carter
Subject: Responding to your message
Date: July 31, 2009 4:38:49 PM CDT
To: house@happywaffle.com
Dear Kevin:

Thank you for contacting me to express your support for President Obama’s health care plan. Access to quality health care is a critical issue facing our country, and I appreciate your input.

America has the highest quality health care in the world. A recent medical study on cancer survivability rates showed that Americans are in a lot better shape than Great Britain, Norway, and the European Union nations, all of which have government run health care. For example, the survival rate for those diagnosed with prostate cancer in European Union countries is only 77%; it is 99% in the U.S. Additionally, all female cases of cancer have a survivability rate of 62.9% in the United States, but only 52.7% in England.
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Let me lead off the discussion of Her Majesty’s National Health Service with an interesting op-ed by Mr. Stephen Glover:

I deeply resent the Americans sneering at our health service – but perhaps that’s because the truth hurts

In it, Glover does an appreciable job knocking down some of the sillier rumors about health care in the UK whilst (whilst!) affirming that it’s not all lollipops and zero-quid bills on the other side of the pond. (Captain Obvious alert: dentistry is a particular problem.) Continue reading →

I commented earlier about how tort reform for doctors seems like a good idea. This NYT editorial is informative on the topic:

http://www.nytimes.com/2009/06/17/opinion/17wed2.html

With regards to overall health-care spending, it looks like frivolous lawsuits (obnoxious as they are) don’t contribute much to the big problem we’re facing. “[The CBO] estimates that caps on damages would ultimately reduce malpractice premiums for medical providers but would have a ‘relatively small’ impact on total health spending, reducing it by less than half a percent.” So, Republicans who gripe about frivolous lawsuits with regards to the big honkin’ health-care money problem aren’t really swinging at the right piñata.

I Googled for doctor piñata.

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I wasn’t going to post about it, since the info is readily available elsewhere, but I might as well link to what factcheck.org says about Obama’s speech…

http://factcheck.org/2009/09/obamas-health-care-speech/

— Joe Wilson’s wrong and Obama’s right about whether the bill covers illegal immigrants. It doesn’t. But it’s not quite as simple as that; the GOP argues that the bill lacks a proper enforcement mechanism to make sure people taking advantage of the public option are US citizens, or even legal immigrants. Good point, except any illegal immigrant who applies for a public insurance plan is committing insurance fraud and taking on a rather huge risk of being caught. Would some still do it? Sure, there’s always weasels. But certainly not enough to constitute a significant drain on public resources. Seriously, I think Republicans have a secret crush on illegal immigrants or something.
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