GOP’s distortions troubling
It would be easier to take Republicans in Congress seriously on health insurance reform if they didn’t keep spouting mischaracterizations and distortions about what really happens in the system today.
Let’s just take some assertions Fort Worth, Texas, area U.S. House members have made to justify their vote to repeal the Affordable Care Act.
Their claim: “The current law cuts $550 billion from Medicare, and so far no one has been able to explain how to do that without decreasing benefits.”
A cynical response: These folks crab about entitlements but now are crabbing about a plan aimed at controlling dangerously increasing costs.
Rebate check
A factual response: The new law expands some benefits to Medicare clients, who primarily are age 65 and older, plus some people with disabilities. For instance, more than 3 million seniors have received a one-time, tax-free $250 rebate check to cover prescription drug costs that fall in the uncovered “doughnut hole,” with that gap gradually closing by 2020. An initial physical now will be free, along with an annual wellness visit and routine preventive services.
But some higher-income Medicare recipients will have to contribute more toward their premiums. And the government will pay lower subsidies to Medicare Advantage plans, which were being overpaid for services.
Republicans also object to the new Independent Payment Advisory Board, with 15 members appointed by the president and confirmed by the Senate.
When Medicare goes over spending limits, the board will recommend cost-saving measures to take effect unless Congress develops alternatives.
But the IPAB isn’t accountable to the electorate. On the other hand, Congress too often ignored suggestions from the less-powerful Medicare Payment Advisory Commission, set up in 1997. How, then, do we get a handle on Medicare expenses?
The claim: A government-appointed panel discussing what insurance companies will be required to cover “will answer questions usually decided by your doctor,” such as what type of dialysis or chemo you get.
A cynical response: In what universe do you and your doctor really decide that? More often than not, coverage is decided by your employer and your insurance company when they formulate the options workers get to choose from. My policy used to pay for blood work with each annual physical; now it’s every two years. My input was deciding what level of insurance I could afford.
A factual response: The government sets baselines for what car and home insurance plans must offer. What’s wrong with ensuring that health coverage includes essentials and preventive care, such as mammograms and flu shots, and doesn’t, say, pay for Viagra but not birth control?
The law requires that new plans purchased as of Sept. 23 cover preventive services such as prenatal and new baby care, without charging deductibles, co-payments or co-insurance.
Catastrophic illnesses
The law also prevents insurers from placing lifetime limits on coverage, so the companies no longer usurp power over treatment options for catastrophic illnesses.
The claim: The law “devastates” public hospitals’ budgets by “taking away millions in federal funding” for indigent care.
A cynical response: Do these conservatives advocate less federal spending or not?
A factual response: The federal government pays states billions of dollars each year to reimburse public hospitals for treating uninsured indigent patients. All too often, these are people who wait to seek care until they’re sicker, then go to emergency rooms, where treatment’s more expensive. Those costs get passed on to paying patients and taxpayers. The new law aims to expand enrollment in Medicaid and the Children’s Health Insurance Program so fewer patients go uninsured, reducing hospitals’ expenses for treating the indigent.
Health insurance reform remains exceedingly complicated. If the Republicans have realistic proposals that would provide better care for more people at lower cost, let’s get them enacted. Just saying “no” doesn’t accomplish that. Neither does simply throwing up straw men to be knocked down.
Linda P. Campbell is a columnist and editorial writer for the Fort Worth Star-Telegram. Distributed by McClatchy-Tribune.