here's to your health.

note: the following post is political.  it's also really long.  if you think you don't want to read an opinion that might be different than yours, i suggest you bypass this one.  i'll be back to posting about pups and austin weather tomorrow.

today, the president signs the health care legislation that passed in the house this weekend into law.  above and beyond anything else, i am so happy to see that something is being done.  do i believe this bill (law) is the answer to every issue on the matter?  not in any capacity.  but i do think it's a step in the right direction, a step towards progress, a step towards action instead of sitting around finger-pointing and complaining about how everything is going to crap but not offering a single suggestion (other than "not that crazy socialist plan!" and other such exclamatory buzz words that don't actually mean anything).  i am disappointed there hasn't been any sign of bipartisan efforts, but i am not surprised.  some people just don't play well with others.

regardless....i think, to paraphrase the wise words of my friend dr. c, the government has a few basic responsibilities: to protect us, to educate us, and to enable us to pursue life.  the us government has done a pretty good job of the protection (even if i'm not always crazy about the methodology).  it's done a piss-poor job of the education (don't even get me started), by and large (consider the wealth and opportunity in this country, then take a look at the comment posters on ANY website.  wow.).  and it's been a mockery when it comes to ensuring the RIGHT (constitutionally-given) of every citizen to pursue life, liberty, and happiness (healthiness?).

anyway....this legislation attempts to mend the path for all people to be able to afford their own healthcare.  will there be a burden on some of us?  certainly.  is there already, and wouldn't it be increasingly oppressive if we did nothing?  to be sure.  i have seen some egregious commentary (oh, facebook) about illegal immigrants and racial minorities sucking off the system.  it's a painful reminder that even though the civil rights movement happened 50 years ago, some people just still aren't moving.  my first response to this is: do you think these people aren't going to get healthcare somehow/some way if they really need it?  have you heard of the hippocratic oath?  the drain on the emergency room system comes from the same pockets as any tax burden this legislation will apply.  my subsequent response, and my gut feeling about all of this is: why is it that you deserve to be well taken care of?  is it just because you always have been?  does someone who has not had the fortune to be in your or my shoes deserve to have to fight tooth and nail for a pinch of the luxuries and "rights" that we take for granted?  just because they are poor?  or not as intelligent?  or less educated?  i think it's really easy to cite examples of the leeches - those people who feed off of our hard-earned tax dollars, giving a bad name to everyone that happens to be down-trodden.  it's just as easy to cite examples of the aristocrats who thumb their noses and their bibles at the less fortunate, maybe because they can't possibly fathom not having the silver spoon stuck in their pompous mouths.  what happened to compassion for everyone?  what happened to loving your brothers?  i'm pretty sure your bible has a few things to say about that.

before i get more heated or my words more inflammatory (i'm not innocent in the exclamatory language department), i will close with a summary one of my professors did of healthcare, in general.  for the record, this guy is brilliant.  he's a lawyer and an MBA.  one of the few people i know who really, actually sits on both sides of the fence (i really hate that fence....let's tear it down).  his blog can be found here.  this is a transcript:

It seems like there are two issues: the availability of healthcare for people who can’t afford it and the rising cost of healthcare.


Below, I’ve summarized three articles.  The first article that I read discussed the costs of healthcare from a macro perspective.  The second article is simply a summary of the likely healthcare reform bill.  The third discusses how the specific bill will be paid for.


Article 1: There’s a great (short) article about the cost of healthcare hampering our competitiveness.  Here’s the link:
Article 1 Link


The key ideas are:

1. Health insurance premiums and employee contributions averaged $12,860 per family in 2008.
2. The US spent 17.6% of GDP on health care in 2009 (more than double the percentages of Japan, Britain, Italy and Australia).
3. As a percentage of GDP, health care spending has more than doubled over the past 30 years.  It is forecast to double again by 2035, reaching 31%!
4. Healthcare is hurting competitiveness.  For example, it adds $1,500 – $2,000 to each GM car.
5. Businesses are affected in three ways: (A) paying for employee health insurance; (B) indirectly subsidizing Medicare and Medicaid via income taxes; and (C) subsidizing America’s uninsured by paying higher insurance premiums.
6. One study argued that the industries with the highest levels of employer-paid healthcare showed the slowest growth from 1987 – 2005 (manufacturing, education and finance).
7. Since 1999, employer contributions have increased 119% while employee contributions have increased 117%.
8. Americans are increasingly making job decisions based on benefits.  This may make people shun entrepreneurial start-ups.
9. Healthcare will be less affordable when it is 31% of GDP and we will lose even more competitiveness.

10. Some studies argue that even though we spend more, the health of Americans is worse than many other countries.  (I don’t know how much of this is related to obesity, wealth and stress.  I can tell you that when I’m sick, the last thing that will go through my mind is that I want to go outside of the US.)

11. We need legislation that will stop the increasing cost of healthcare costs.


Article 2: WSJ article summarizes impact of healthcare legislation.

Article 2 Link


Realize that most of these benefits will occur within the year, but this is assuming that the Senate bill also includes them:

1. Insurance companies would no longer be able to cancel enrollees’ policies because they get sick.
2. No more lifetime caps on policies’ payouts.
3. Children could stay on their parents’ insurance policies until their 26^th birthday.
4. New insurance plans would have to cover the full cost of certain preventive care and exempt such care from deductible payments.  (This wouldn’t apply to existing policies until 2018.)
5. The government would create an ombudsman to help reconcile contested medical bills.
6. Starting in 2014, insurance companies could no longer exclude adults because of pre-existing conditions.  (This will start in 2010 for children.)  Until 2014, the government will set up high-risk pools to help these adults buy coverage.
7. Starting in 2014, a family of four earning up to $30K will be eligible for Medicaid.
8. For a family of four earning more than $30K but less than $88K, there will be tax credits so that the family spends no more than 9.5% of the income on coverage.  (This scales up from 3% to 9.5% as salaries rise from $30K to $88K).
9. Starting in 2014, Americans will be required to carry health insurance or they will be fined.  By 2016, the fine will reach 2.5% of income.  Of course, that is still much cheaper than health insurance for most Americans.

10. Small businesses (fewer than 25 employees and average annual wages of less than $50K) would be eligible for tax credits to cover up to 35% of their insurance premiums.

11. Companies with more than 50 workers will have to pay a $2K assessment per worker if any of their workers get a tax credit to buy coverage.

12. Companies with more than 200 employees will have to enroll all employees automatically in their health insurance plans (although they could opt out).


Article 3: I also read an article on CNN discussing the costs.

Article 3 Link

1. The plan will cost $940 billion over ten years to provide expanded coverage (per the CBO).
2. The House plan could reduce the deficit by $143 billion over the first ten years.
3. Over the following decade, this could reduce the deficit by $1 trillion.  Of course, we have no idea how this will play out, how the costs will increase or how the coverage will be amended over the years.
4. The long-term deficit reduction comes from Medicare ($500 billion) and new tax revenue ($438 billion).

The same article described where some of the money would come from:

1. Medicare tax on high-income households ($200K individual; $250K couples).  ($210 billion)
   
   
   A. Medicare payroll tax is currently 2.9% on all wages (employer and employee each paying 1.45%).  High wage individuals will pay 2.35% of wages.
   B. In addition, high-income earners will also be taxed on dividends, interest and rent income – 3.8%.
   2. Excise tax on insurers offering high-cost health insurance plans. ($149 billion)
   3. Penalties for those who don’t get coverage. ($17 billion)
   4. Taxes on employers if they don’t provide coverage and their employees qualify for federal subsidies.  ($52 billion)
   5. Fees on health care companies (drug makers, medical device makers and insurers).  The idea is that these business will profit from the new customers.  ($107 billion)
   6. Trim various health-related tax breaks.  There would be an additional 20% penalty for non-health withdrawals from health savings accounts; a $2,500 limit to flexible health spending accounts; higher limits before you could deduct medical expenses.  ($29 billion)
   7. Create a new long-term care insurance program where you must pay for five years before you can get benefits.  As a result of this set-up, this will reduce the deficit by $70 billion.  Of course, that’s absurd.  It’s like selling insurance to someone that is only good five years from now and counting all premiums as profit.  ($70 billion)