A Half Full Glass of Health Care Reform

The Accountable Care Act isn't perfect-but there's still a lot to love in this maligned bill that will benefit all residents of Montgomery County.

OK, People ... It’s TIME TO PAY ATTENTION. Time to act like thoughtful adults. Time to stop flinging half-truths and undocumented facts, emotional garbage and hate-filled rhetoric at people who hold differing opinions than yours. Time to stop abdicating our responsibility as American citizens by allowing talking heads and partisan pundits to make up our minds for us. Time to realize that no side has a monopoly on the truth – and that “truth” is always colored by personal experience and self-interest.

This is the first post of what I hope will be a thoughtful and thought-provoking blog on how national and state issues trickle down to the local level and effect real people in Montgomery and Bucks Counties. I plan to focus on the facts that inform my ideas, but I will never present something as fact when it is just my opinion. I want to say upfront that I am a proud liberal as defined by the American Heritage Dictionary: “Not limited to or by established, traditional, or authoritarian attitudes, views, or dogmas...Favoring proposals for reform, open to new ideas for progress...broad-minded.”

So now I'll dive right in with the hot topic of the week: health care reform. I’m for it. And I was pleased and surprised when the Supreme Court of the United States, a.k.a. SCOTUS (aside: just when did the media decide we needed an acronym for everything?) refused to overturn the Affordable Care Act. But do I think this is the best of all possible bills? Hardly. It’s a complex, convoluted, compromised whale of a bill that tried to satisfy everyone­–insurance companies, drug companies, doctors, employers, patients with insurance, patients without insurance, and, of course, competing political interests.  It's a recipe for disagreement and confrontation, if there ever was one. It’s also laughable to label the program "Obamacare" since its signature and most divisive feature –the individual mandate–was originally proposed all the way back in 1989 by the very conservative Heritage Foundation. In 1993, Republicans twice introduced health care bills that contained an individual health insurance mandate. Advocates for those bills included prominent Republicans like Charles Grassley (R-IA) and Bob Bennett (R-UT) who later decided to oppose the concept once it was embraced by a Democratic President. Candidate Barack Obama actually spoke out against the individual mandate, but later sought it as a compromise that might make health care reform more palatable to Republican members of the House. Ah, the folly of youth.

But in all the media bluster and caterwauling over the Court’s pronouncement, some fundamental points–dare I say “truths”–are being swept aside: by the time the legislation is fully implemented in 2014, 30 million more Americans will have affordable access to basic health care; all insured Americans will have access to a wider range of preventive services; vulnerable, low-income seniors won’t have to choose between buying groceries and filling their prescriptions; people with pre-existing conditions will not be denied coverage and hospitals and physicians will be incented to follow best practices and keep people well, rather than only getting paid for treating them once they are already sick.

Is the bill expensive? Yep. It sure is. But so is our current system that relives on cost shifting (i.e. a hidden tax) in the form of higher insurance premiums for everyone (including businesses that provide coverage) to cover the cost of the uninsured. In Montgomery County alone, more than 32,000 uninsured people (7.4% of county residents) are now using ERs as primary health clinics, or only seeking treatment when they are critically–and expensively–ill.

Is this bill socialized medicine? Only if you believe that allowing private insurance companies to sell policies to the majority of Americans under age 65 (with no alternative, i.e. government, option) and retain up to 20% of the premium money collected, is socialism.  Seriously, if that’s socialism ...than the NY Stock Exchange is being run by Bolsheviks.

Today’s sobering fact: 50% of all restaurants in Montgomery County are fast food restaurants, compared to 25% statewide.*

Source:  countyhealthrankings.org

This post is contributed by a community member. The views expressed in this blog are those of the author and do not necessarily reflect those of Patch Media Corporation. Everyone is welcome to submit a post to Patch. If you'd like to post a blog, go here to get started.

Feodor Tiorlenko July 03, 2012 at 12:34 AM
Amazing number of uninformed, biased positions, fueled by the irrational ramblings of Rush Limbaugh. Health insurance premiums are calculated by insurance actuaries. In order to become an actuary, you must pass a long series of mind bending exams. When everyone is insured, the cost of insurance is less. Why?? Because the risk pool is expanded, more healthy people are brought in (like your children up to age 26 years). Everything else is ideological fluff. You believe that people with pre-existing conditions should be excluded? You believe that quality medical care is the privilege of the wealthy. You believe that Mitt Romney, Rush Limbaugh, Mitch McConnell, John Boehner care about you and your health needs? Ignorance is troubling. Showing your ass with ignorance should be troubling to those who feel the best health coverage is that coverage available to the wealthy. Who pays for healh care for the indigent now? You do. Please educate yourself with the fundamental issues before posting. It reflects poorly upon you. Who says that's true? How about 3 out of 4 Americans and the majority of the Supreme Court including the Chief Justice.
Sue Gordon July 03, 2012 at 02:05 AM
In the Preamble of our Constitution, our founders stated that one of the purposes for establishing our government was to "promote the general Welfare." The concept of Common Good has existed from the very beginning of our nation: it's the value behind public education, public works projects, Social Security, Medicare and Medicaid. Because any chain is only as strong as its weakest link, it benefits all of us if the government can insure a basic level of education, health and stability in society. In that context, I completely disagree that the government is deciding what is best for all Americans based on the needs of the few. Our entire country will benefit from a rational and coherently-funded health care system. I believe that The Affordable Care Act is a baby step in the right direction. I do agree with you that we have major financial problems in this country - two unfunded and useless wars did that, not providing social support to the elderly and poor.
Sue Gordon July 03, 2012 at 02:16 AM
Well actually ... I do have a background in healthcare administration. I have worked in the field for 21 years. Sorry you thought I dumbed-down the issue too much, but when I hear statements like "Obamacare is the biggest tax increase in the history of the world" and realize that people actually believe it - I figure I better keep things basic.
Stephen Eickhoff July 03, 2012 at 03:12 AM
Who says that Obama or the late Ted Kennedy care about our health needs? Saying that they do by making everyone get health insurance is like claiming that the government making you shop at Whole Foods is because they care about your diet. Maybe they just have stock in Whole Foods. BY the way, insulting people is not the way to win them over to your argument. Let's face it, no one here is going to change their mind and you might as move on over to Huffington Post with the like-minded people.
Stephen Eickhoff July 03, 2012 at 03:17 AM
"Unfunded wars" - red herring. Your opponents do not support unfunded wars as a part of this debate. Claiming that anything goes because of the words "general welfare" is fallacious. If that were true, then most of the rest of the Constitution, including the part that says not to infringe on life, liberty or property without due process would be null and void. We have a mechanism for amending the constitution to make major changes like socialized medicine the law of the land; this was not done.
Stephen Eickhoff July 03, 2012 at 03:19 AM
Well, the Chief Justice of the USA seems to believe it is a tax, and the numbers from the GAO tell us it is the biggest. Those are the real authorities.
Sugaree July 03, 2012 at 03:20 AM
Excellent post once again Feodor. Even though every one of their silly and grumbling complaints can be proven wrong, it just doesn't matter to them - the aren't happy because the manipulators told them so! The grouchy old men routine of the aforementioned is getting tiresome. They've been asked repeatedly - what do you suggest in the alternative? Nothing. Silence. They have NO INTENTION of coming up with ANY solution, as evidenced by McConnell's plainly stating that 30 mil uninsured people is "not the issue'. I'd say that speaks for itself, wouldn't you? It's a darn shame those complaining about it don't realize they've pulled your chain; you've been duped, they've validated your insecurities with the politics of resentment. This isn't about 'liberty' or 'freedom' - this about insurance company profits and the insurance industry's 'freedom' and 'liberty' - not yours. This is as big as the Civil Rights Act. This is a new day for an old problem. How sad they can't see it for the enormous step forward that it is. It's easier to complain I suppose.
Brian Turner July 03, 2012 at 03:22 AM
@ Stephen: that's correct. As stated, figures I cited were from 2007. The USA ranking, Life Expectancy, #50 Source: CIA World Factbook Infant Mortality: Ranking #49 Source: CIA World Factbook Couple data like that with the fact that 45-50 million citizens were uninsured -& this in a country that claims to be the leader of the civilized world. In the face of such data, there's not a CEO in the country who would not be sacked if he did not make swift, massive, fundamental changes. Only one president, ever, has had the courage to successfully take on the entrenched powers that reao huge profits from a fundamentally flawed but profitable [to them] system, whose cut of the American economy amounts to almost $1 of every $5, & whose political power and influence is intimidating.
Stephen Eickhoff July 03, 2012 at 03:25 AM
I don't see how the insurance companies WON'T make huge profits with everyone required to patronize them. What's my alternative? A constitutional amendment instituting single payer, tied to the abolition of the unfair progressive income tax and institution of a flat tax with a large standard deduction. Details on the cost of the system already done... the numbers would need to be run to determine what the tax rate must be. Like it?
E July 03, 2012 at 11:27 AM
Now if you become unemployed, you still must buy insurance or pay the tax on it. Basically the bill adds one safety net and scuttles another. It has already bent the cost curve upward in the form of increased premiums in 2012. It adds thousands of new IRS workers paid to enforce the tax. And the oddest impact of all, it is forcing top Democrats to contort their logic and call it a penalty for free riders (what a term) instead of a tax. Even though Justice Roberts called it a tax. All because, suddenly, 75% of the taxes collected will fall on those making under $125,000 per year - which breaks Obama's promises in a big way. What our essayist does not mention is the onerous burden that falls directly on the laps of small businesses. They must keep their employee count under 10 to avoid triggering IRS review. This is what happens when you pass a bill this big using tricks, lies and deceit with no support from the other party. It means elections have consequences. So if you favor repeal and replace, then vote for the party that will do that.
Smedley July 03, 2012 at 01:10 PM
Single Payer for Pennsylvania - Makes Sense. http://healthcare4allpa.org/
Smedley July 03, 2012 at 01:14 PM
Mr. E, First let me say I'm not in favor of the new healthcare act. If you want to repeal and replace it. What do you recommend we replace it with?
Joseph Finnick July 03, 2012 at 02:05 PM
Only 10 million people!?! Wow... only 10 million people... yeah... that still sounds like a lot of people to me Stephen. I don't care about percentages, I care about the actual number of people and to me 10 million is a lot.
Bruce Bailey July 03, 2012 at 02:36 PM
We're playing semantic games now, but OK - I'll play. If the mandate (originally created in a plan from the Heritage Foundation, later adopted by Mitt Romney in Massachusetts) is a tax, it is a tax that will not affect any responsible, insured, middle class American. It will only affect those who mooch off the rest of us and use hospitals and ERs as their personal physicians. That's OK by me, I'm happy to "tax" those people and get them off my back. Why aren't you?
Bruce Bailey July 03, 2012 at 02:39 PM
A flat tax is the most regressive tax possible. Substitute a highly progressive tax code similar to what was in place in the 50s and early 60s, and we might be able to talk.
Margo July 04, 2012 at 03:29 PM
If the small number of people in Washington running this country all want what is best for us why don't we have it. Remember to vote people.
Golden Cockroach July 04, 2012 at 04:56 PM
Stephen Eickhoff, you are a dolt & brain washed! Hows that for name calling. -Golden Cockroach
Ann Hankins July 04, 2012 at 05:13 PM
I have tried my BEST to refrain from commenting on here mostly because there is no one specific answer to any of the questions. I DO wish however to ask this of the general population." We're all being told health insurance will now " cost less" if everyone has it. "....What is " less" ? Am I now going to pay 40.00 a year less? Maybe 4,000.00 a year less? We all tend to agree if everyone has it, it will cost " less". If you get an estimate for work done at your house and I come along and say I'll do it for less, wouldn't you at least want to get a ballpark idea of what you'd be paying me? Lets face it, Hospitals,pharmaceutical companies, health insurance company's and the conglomerate doctor offices of today are business and as such are run by corporate leaders who's financial obligation to their shareholders is paramount. I fully understand that the new health bill is written to curb overcompensation for CEO's and their ilk but don't kid yourself into thinking they all haven't had company lawyers burning the midnight oil just to find a way around it. Health care for all Americans is a wonderful Idea but I am not foolish enough to think it will become any more affordable than it is right now.
Golden Cockroach July 04, 2012 at 06:00 PM
You should've kept your comment to yourself. Unplug your keyboard Ann! -Golden Cockroach
Sue Gordon July 04, 2012 at 10:18 PM
Following up on an earlier comment about the size of the "tax increase" that will result from healthcare legislation (I do not agree it is a tax, but for the sake of argument and comparison, let's assume it is ...) The following is taken directly from a post on Politifact.org - the non-partisan fact checking website known for skewering people on both sides of the political fence. They were addressing the quote by Rush Linbaugh that this would be the biggest tax increase in the history of the world: "Depending on your rounding, that would mean the tax increases resulting from the health care law would be about the size of tax increases proposed and passed in 1980 by President Jimmy Carter, in 1990 by President George H.W. Bush and in 1993 by President Bill Clinton. "The health care-related tax increases are smaller than the tax increase signed into law by President Ronald Reagan in 1982 and a temporary tax signed into law in 1968 by President Lyndon B. Johnson. And they are significantly smaller than two tax increases passed during World War II and a tax increase passed in 1961. "The tax increases in the health care legislation do reverse a trend of federal tax cuts and represent the first significant tax increases since 1993. But they are NOT the largest in the history of the United States. Rush's comments were rated "Pants on Fire."
Mimi July 05, 2012 at 12:12 AM
Referring to what Herman Cain calls it, "Obama Doesn' Care," I would like to know if it is so wonderful, why has Obama let so many unions and others be excluded from it?
Mike Shortall Sr July 05, 2012 at 01:28 AM
In my view, there's no way this ends up costing us less. The CBO estimates $1.76 billion in additional costs, which is up from their $970 billion initial estimate. We may not be paying that in healthcare insurance, but we will be paying it in deficit reduction efforts through higher taxes. Yes, the insurance part of health costs MAY go down; but I'll believe it when I see it. I did not go to actuarial school to "learn their trade", but the way I figure it the younger, more healthy Americans who will tend to bring the risk of health costs down will probably be offset by those poorer entrants with bad life habits, poor nutrition, living in higher crime neighborhoods, etc., etc. Yes, we already pay the costs of their treatments when they go to the ER or hospital. And I suspect will pay collectively higher premiums in recognition of their higher risks. Maybe I'm wrong. We'll see. But you can be sure that insurance companies will be using every manipulation possible to offset the added risk, even if it means they have to pay back excess premiums (although I'll probably pass out if I ever see a premium rebate from an insurer). On to of that we will now add another layer of bureaucracy to oversee the insurance industry, to help set-up and oversee the development and oversight of state-run exchanges, to manage the expansion of Medicare, etc. etc. And on top of all that is the realization that little - if anything - the Government ever touches ends up costing us less.
Sugaree July 05, 2012 at 02:11 AM
Golden Cockroach! I'm a fan of your work, keep slamming those slumlords up there in Pottstown!
Mimi July 06, 2012 at 04:02 AM
A tax increase is a tax increase!!!!! Why are so many unions being excluded and some states are opting out. How good can it really be?
Locally Involved July 07, 2012 at 02:39 AM
Tax, fine, penalty, toll - whatever. It doesn't matter unless you choose not to purchase health insurance either through the exchanges or from your provider. You have a choice. Just like people who smoke and pay a $1.00 or more in taxes per pack. You don't care. You don't smoke. You're not paying that tax. Do you pay tolls when you drive? You're paying a tax to use those roads to support those roads. A toll is a tax. I don't care if you pay that toll - you're using it, you pay it. Most people I know pay additional uninsured motorist insurance - they don't care. They're actually paying insurance for someone who doesn't have insurance! So, if you have insurance - why care? You're not paying anything. UNLIKE NOW - where $1000 a year of your insurance premiums go to pay for those who choose or cannot buy insurance because the 2 insurers in their area won't sell it to them. Now those who are refused insurance have a choice. They can buy insurance. Still leaves those who choose not to buy insurance. Now, all you who do have insurance will no longer have to support them. The uninsured will pay an additional tax to cover their healthcare, and you are off the hook. Does this mean insurers will rebate you? Probably not, they enjoy their $26M a year salaries as CEOs. However, the exchanges will provide competition for those shopping the best $ for their healthcare - combine the two and cost pressure should lower premiums. Works for me.
Josephine July 07, 2012 at 11:07 PM
http://news.yahoo.com/tax-man-cometh-police-health-care-115736849--finance.html EVERYONE PLEASE CLICK ON THE LINK SHOULD COME UP
Jenna Reese July 08, 2012 at 06:00 AM
whatever the govt gives you, it can take away. Once the govt goes to single payor and it will, you are at their mercy. They will decide who gets care and who doesn't. Grandma won't get anything but a pill and end of life counseling every 5 years with a push for physician assisted suicide which is being pushed. Oh and also, govt control over pharmaceuticals will cost many lives, they have been doing some dry runs with drug "shortages". Your private healthcare info won't be private. Now the govt can mandate/tax us to do whatever they believe to make healthcare more affordable - for them - not us. Affordable healthcare does not mean quality healthcare. Of course nothing is free - someone will be paying for all the freebies - us. Now according to the Georgia Stones - the human population needs to be reduced and kept at under 500,000,000. That is in line with UN Agenda 21 - go to the UN website - it's all there. So just think of the possibilities now that big brother will control healthcare. There is no private insurance - it's public-private Partnerships - i.e. govt control of private insurance companies. Now for all the useful idiots that are still under the delusion that the govt wants to "help" the people, take your heads out of your butts and smell the coffee - game over.
Josephine July 08, 2012 at 03:24 PM
I agree with Jenna rightfully put...
Mike July 09, 2012 at 02:18 PM
Sue, interesting way of starting a "thoughtful & thought provoking blog, using a lecturing tone. Anyone who has not read the bill and hired a law firm to interpret it, should not comment. Like reading 3 chapters of Moby Dick, and writing a blog on the whole book. Not even the people who wrote the bill, know what the outcome of this bill will be. This is what scares most of us. A bill this huge, written by a group considered to be the worst ever at their job. This topic does show what the biggest problem facing all Americans is. The idea that Dem and Rep officials are different. They are exactly the same. They have sold us on that idea. They will all do & say whatever is needed, to stay in office forever. How can any American be only liberal or only conservative? Tell me that, and I am thru listening. They are ALL the same. Self serving people playing a game at our expense. Anyone who says Rep are bad or Dem are bad, is a fool. Make them regular Americans. Term limits, no free healthcare (they don't participate in bill btw) and pensions for life. Every "opinion" on here, does not belong to the person who wrote it. It was given to you by a television program, newspaper article, or some other source. Discussing cost ramifications of the bill, what a joke. NO ONE can, or does know. A bill of this magnitude should not have been passed, even though there are some good ideas in it, that most of us agree on. The ideas are easy, the execution of the ideas is the problem.
Mimi July 13, 2012 at 03:31 AM
One of the 21 new taxes is on 'medical equipment' and we will all pay for that even if you have insurance through your work place one way or another. Insurance is NOT free and many companies are now terminating company-sponsored insurance as mine is intending to do.


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