Forcing people to buy insurance

Lawmakers now are worried about the consequences of requiring everyone to buy health insurance. That will mean lots of people are going to have to come up with the equivalent of another month’s rent in their monthly budgets:

But even after Max Baucus (D-Mont.) spoke optimistically of gaining bipartisan backing, lawmakers continued to haggle over a question at the heart of the debate: How can the government force people to buy insurance without imposing a huge new financial burden on millions of middle-class Americans? . . . .

Under the Baucus plan, described in a “framework” he released last week, as many as 4 million of the 46 million people who are currently uninsured would be required to buy coverage on their own, without government help, by some estimates. Millions more would qualify for federal tax credits, but could still end up paying as much as 13 percent of their income for insurance premiums — far more than most Americans now pay for coverage.

People further down the income scale would receive much bigger tax credits, effectively limiting their premiums at 3 percent of their earnings. But experts on affordability say even those families could find it difficult to meet the new mandate without straining their wallets.

“We’re talking about the equivalent of a middle-class tax increase,” said Michael D. Tanner, a health-care expert at the libertarian Cato Institute. “Yes, they’re paying it to an insurance company instead of to the government. But, suddenly, these people are paying more money to somebody.” . . .

Under the Baucus plan, subsidies would be offered to people who earn up to 400 percent of the poverty level ($43,000 for an individual or $88,000 for a family of four) in the form of tax credits that would be paid directly to the insurance company of the person’s choice. The credit would be calibrated on a sliding scale to ensure that people at the bottom of the income range paid no more than 3 percent of their earnings for premiums while those at the top would be liable for as much as 13 percent.

That would amount to more than $700 a month for a family of four making $66,000 a year — significantly more than most people at the same income level now pay, according to research conducted by Linda Blumberg, a senior fellow in the Health Policy Center at the Urban Institute. Families earning less than 300 percent of the poverty level also would be eligible for assistance with deductibles and other out-of-pocket expenses, but families who earn more would be on their own.

Again, if your income is low, you will get a subsidy to help pay for it, but still it’s going to mean a big hit on the household budget. The theory is to help pay for older people’s medical expenses by bringing in all these young and healthy folks who don’t have that many medical bills and who don’t currently have insurance. But is that fair? And are those who are going to be forced to pay insurance premiums which may be close to what they are currently paying for rent willing to go along with this scheme? Do any of you fall into this category? How are you going to swing paying that premium?

Obama’s Health Care Speech

Here is the President’s speech to Congress in which he makes his case for Health Care reform. Are you persuaded?

Here is his explanation of the system he wants to implement:

First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have.

What this plan will do is to make the insurance you have work better for you. Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there’s no reason we shouldn’t be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives.

That’s what Americans who have health insurance can expect from this plan – more security and stability.

Now, if you’re one of the tens of millions of Americans who don’t currently have health insurance, the second part of this plan will finally offer you quality, affordable choices. If you lose your job or change your job, you will be able to get coverage. If you strike out on your own and start a small business, you will be able to get coverage. We will do this by creating a new insurance exchange – a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices. Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers. As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage. This is how large companies and government employees get affordable insurance. It’s how everyone in this Congress gets affordable insurance. And it’s time to give every American the same opportunity that we’ve given ourselves.

For those individuals and small businesses who still cannot afford the lower-priced insurance available in the exchange, we will provide tax credits, the size of which will be based on your need. And all insurance companies that want access to this new marketplace will have to abide by the consumer protections I already mentioned. This exchange will take effect in four years, which will give us time to do it right. In the meantime, for those Americans who can’t get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill. This was a good idea when Senator John McCain proposed it in the campaign, it’s a good idea now, and we should embrace it.

What’s wrong with this? It uses private insurance companies, rather than a nationalized system, so it avoids socialized medicine. I don’t see how this system can possibly reduce the cost of health care or of health insurance, one of the urgent issues he raises in his speech. If we require insurance companies to insure everyone who applies, even if they have pre-existing conditions, and if the companies are not allowed to cap any payouts, how can this not send premiums even higher? The idea of a health insurance exchange sounds like an acknowledgment of the power of free market competition to drive down prices, but prices can’t go lower than the intrinsic cost of the commodity. If someone can explain this or can make even a theoretical case for how this plan could mean lower health care costs, please comment. I really want to know.

Euthanasia British style

A scandal is breaking out in England over revelations that the National Health Service has been implementing a policy of routinely–and apparently without consulting either the patient or the family–cutting off intravenous food and fluids for patients deemed to be close to death, instead just pumping them up with sedative drugs until they die. From the London Telegraph, Sentenced to death on the NHS:

Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.
But this approach can also mask the signs that their condition is improving, the experts warn.
As a result the scheme is causing a “national crisis” in patient care, the letter [from concerned physicians] states. . . .

“Forecasting death is an inexact science,”they say. Patients are being diagnosed as being close to death “without regard to the fact that the diagnosis could be wrong.

“As a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients.”

The issue being raised here is that the diagnoses of being close to death can be wrong, with the sedation preventing doctors from seeing signs of improvement. But I don’t see how denying a patient food and water can ever be right. Even if the plan is to just “let the patient die,” the active step of withdrawing food and water goes beyond that and seems especially cruel. The patient is allowed to die of thirst and starvation. How does that even rise to the questionable standard of “mercy killing”?

The Christian origins of health care

Christianity Today reviews Medicine and Health Care in Early Christianity by Gary Ferngren, a book that undercuts the new atheists’ claims about how bad Christianity has always been for civilization:

When an epidemic struck in the ancient world, pagan city officials offered gifts to the gods but nothing for their suffering citizens. Even in healthy times, those who had no one to care for them, or whose care placed too great a burden on the family, were left out to die.
Christians found this intolerable, and they set about to take care of these people and others similarly afflicted. They did so because, Ferngren writes, “Early Christian philanthropy was informed by the theological concept of the imago Dei, that humans were created in the image of God.”

This led not only to a belief in the responsibility to aid others and the inherent worth of every human being, but also to a belief in the sacredness of the body itself. “It was to save the body that Christ took on flesh in the Incarnation. Not only the soul, which in traditional pagan thought was eternal, but the composite of body and soul, which constituted man, was to be resurrected.”

The idea of imago Dei also led to a redefinition of the idea of the poor. Rights in a city or society were given to members, and all members received benefits. Those outside were offered none. Christianity, in addition to seeing all people as “neighbors,” developed a special consideration for the poor. Just as God demonstrated in the Incarnation his solidarity with those who suffer, so the members of his “body” must demonstrate their solidarity with the suffering poor.

The classical understanding of civic care for those who suffered “was not merely insufficient to provide the motivation for private charity; it actively discouraged it,” writes Ferngren. “Christianity, however, insisted that the love of God required the spontaneous manifestation of personal charity toward one’s brothers: one could not claim to love God without loving his brother.”

As a result of these theological beliefs, Christians developed a robust system for caring for the poor, the ill, widows and orphans, and other members of society in need of care. When the plague struck, this system provided an opportunity for churches to quickly expand and care for those outside the church.

As early as A.D. 251, according to letters from the time, the church in Rome cared for 1,500 widows and those who were distressed. A hundred years later, Antioch supported 3,000 widows, virgins, sick, poor, and travelers. This care was organized by the church and delivered through deacons and volunteer societies. The churches in major cities had significant resources at their disposal, and though their care was not professional, it is likely to have saved lives and aided the growth of the church.

When the plague of Cyprian struck in 250 and lasted for years, this volunteer corps became the only organization in Roman cities that cared for the dying and buried the dead. Ironically, as the church dramatically increased its care, the Roman government began persecuting the church more heavily.

Dionysius, bishop of Alexandria, wrote, according to Ferngren, “that presbyters, deacons, and laymen took charge of the treatment of the sick, ignoring the danger to their own lives. … Their activity contrasted with that of the pagans, who deserted the sick or threw the bodies of the dead out into the streets.” This care was extended even to those persecuting the church at the time.

This care likely led to much higher rates of survival for Christians. And after the plague, with a staff of workers and an existing administrative structure, “Christian medical care became outwardly focused, now enlarged to include many who were victims of the plague.”
Finally, when Emperor Constantine legalized Christianity, these services were formalized in a number of institutions, including the first hospitals. “The experience gained by the congregation-centered care of the sick over several centuries gave early Christians the ability to create rapidly in the late fourth century a network of efficiently functioning institutions that offered charitable medical care, first in monastic infirmaries and later in the hospital,” Ferngren writes.

Does the health care plan cover abortion, or not?

Even the different factcheckers are getting confused about this critical question. The answer turns out to be very complicated, as is trying to understand this complicated bill. this article comes up with this helpful conclusion: “Those who claim abortion clearly is covered, and those who say it clearly isn’t, are both wrong.” Read the explanation at the link. A sample:

When advocates claim that the “public plan” — a government-administered health care option — does not cover abortion, they’re being literally accurate…but slippery. The two main bills (so far) do not, in fact, require a plan to cover abortion. However, they don’t prohibit abortion coverage either, instead leaving it up to the Secretary of Health and Human Services to decide, later, whether abortion would be included in a basic benefits package.

Pro-life activists say that if abortion can be covered, it will be covered. It’s certainly not an unreasonable prediction, given that the Secretary and the President are both pro-choice (though neither side talks about the flipside: When President Palin is in the White House she could reverse the policy through a simple executive order). . . .

(Memo to the White House press corps: Please ask Mr. Obama, Robert Gibbs or Kathleen Sebelius the following: “The health care legislation gives the HHS Secretary the authority to decide whether abortion is covered. Will you commit right now that abortion will not be covered?”)

Half of Americans will get swine flu and 90,000 will die?

The White House is putting out dire warnings about swine flu:

Swine flu may infect half the U.S. population this year, hospitalize 1.8 million patients and lead to as many as 90,000 deaths, more than twice the number killed in a typical seasonal flu, White House advisers said.

In a report by the President’s Council of Advisers on Science and Technology, President Barack Obama today was urged to speed vaccine production and name a senior member of the White House staff, preferably the homeland security adviser, to take responsibility for decision-making on the pandemic. Initial doses should be accelerated to mid-September to vaccinate as many as 40 million people, the advisory group said.

Seasonal flu usually kills about 36,000 Americans, said Tom Skinner, a spokesman for the U.S. Centers for Disease Control and Prevention. Swine flu, also called H1N1, causes more severe illness needing hospitalization among younger people than seasonal flu, while leaving people 65 and older relatively unscathed, said Mike Shaw of the CDC.

“This isn’t the flu that we’re used to,” said Kathleen Sebelius, U.S. Secretary of the Department of Health and Human Services. “The 2009 H1N1 virus will cause a more serious threat this fall. We won’t know until we’re in the middle of the flu season how serious the threat is, but because it’s a new strain, it’s likely to infect more people than usual.” . . .

“We are making every preparation effort assuming a safe and effective vaccine will be available in mid-October,” Sebelius said today at the CDC’s Atlanta offices.

According to what the advisory report describes as a “plausible scenario,” 30 percent to 50 percent of the country’s population will be infected in the fall and winter. As many as 300,000 patients may be treated in hospital intensive care units, filling 50 percent to 100 percent of the available beds, and 30,000 to 90,000 people may die, the report said.

Do you expect it to be that bad? It sounds like we’ll have a vaccine fairly soon, which should mitigate these worst case scenarios. Why scare people like this?

It has been said that governments often instill fear in their populations as a way to seize more power. Oh, the terrorists are going to kill us all. We’d better let the government take us to war. Oh, the economy is collapsing and we’re going to have the Great Depression all over again. We’d better let the government take over the economy. Oh, the plague is coming. We’d better let the government take over health care.

Of course, there ARE legitimate dangers that we have to deal with. How can we tell the difference between those and political fears? It seems that panic, in general, is a bad thing when facing any danger. FDR, though we might question his ideology, was a good leader and in facing the actual depression he first calmed the country down, saying that people should NOT fear. Shouldn’t we be automatically suspicious when our leaders–of any party– try to scare us to death?