Health Care Reform and Repeal

One frequently hears these days about how “angry” people are because of the passage of the health care reform bill. In reports I have recently heard, it has become clear to me that most of the people complaining about health care reform actually know nothing about it. Thus, they have been influenced by the dire predictions of health insurance companies, Republicans in Congress, and Tea Party activists. These complainers have not read the bill or any summary of the bill, or any newspaper, magazine, online news source, or other material about the bill. There is a great deal of material out there for people to read and become educated about health care. But most of the people who are complaining are not the kind of people who bother to become well informed about any subject before voicing their opinions.

These people believe that health care reform will bring about huge deficits and bankrupt the country. They are also convinced that because of its large cost the bill will require huge increases in taxes on the middle class. They are totally unaware of the fact that the law will actually lower deficits by $138 billion over the next decade, and by one trillion over the following decade. This has been certified by the non-partisan Congressional Budget Office.

People objecting to the new law do not realize that there are no new taxes on the middle class, but that there are tax increases on people earning over $350,000. Moreover, the increased taxes on high earners are not so bad that they will do harm to the earners or the economy.

One complaint I have heard is that the law will bring-in millions of new patients and make it hard for ordinary people to get an appointment with the doctor. This is apparently what happened in Massachusetts when that state, under Mitch Romney, enacted its health care reform bill. While this may be a temporary problem, the complainers do not realize that the law also provides immediate new massive investment in training programs to increase the number of primary care doctors, nurses, and public health professionals.

The complainers fail to recognize that the big increase in people going to the doctor is a good thing, not a bad thing. It means that millions of people who couldn’t get insurance or couldn’t afford it will now be able to see a doctor. The 45,000 people who die each year because of lack of health insurance will now be able to be treated. Organizations like RAM, which go around the country treating people for free, will be able to return to their original mission of treating people in other countries.

The new rallying cry for Republicans is “Repeal!” They claim that they intend to repeal the health care reform law as soon as they get control of Congress. One wonders whether this slogan will appeal so strongly to voters in November after they have had a chance to understand some of the benefits that will accrue to them as a result of the legislation. It may be that the angry shouts of “repeal” will sound like an effort to take-away benefits that voters have come to like, just as some Republicans wanted to take-away Medicare and Social Security.

Would seniors, even strongly conservative seniors, really want to repeal the part of the bill that provides for gradual elimination of the coverage gap or “Doughnut Hole” in Medicare Part D coverage over the next ten years? The reduction of the Doughnut Hole will begin immediately.

Would people, even devout Republicans, who have been turned-down for health insurance because of preexisting conditions, really want repeal of the provision that forbids insurance companies from denying health insurance because of prior conditions? That is another provision that takes effect immediately.

Will anybody want to repeal the provisions of the new law that forbid insurance companies from canceling peoples’ insurance after they become sick, or after reaching an annual or lifetime cap?

Would parents, even right-wingers, who have children over 18, really want repeal of the provision of the law that requires insurance companies to continue carrying children on their parents’ health insurance, if the parents want to keep them on, until the children are 26? This is another provision that will begin right now.

Do business people want to repeal the provisions of the bill that offer tax credits to about 4 million small-business men and women to help them cover the cost of insurance for their employees?

Will people want the Republicans to repeal the provisions of the bill that require all new insurance plans to offer free preventive care, such as pap smears, colonoscopies, breast X-Rays, prostate exams, blood tests and many others?

Will people want to repeal the provisions of the bill that will immediately allow displaced workers to keep their COBRA coverage until the Exchange is in place and they can access affordable coverage.

It is probable that the great mass of people who have voiced opposition to this bill are doing so for reasons other than health care or under a set of mistaken assumptions. Such people may oppose the President Obama and the Democrats in Congress on political grounds. They may be motivated by things like abortion, same-sex marriage, guns, and immigration. They may actually have no direct opposition to health care reform itself.

People opposing health care reform are willing dupes when it comes to the myths being spread by the insurance companies, Republican leaders, and Tea Party zealots. A little bit of study would dispel such myths. Among the silliest myths are the following.

Death Panels

Sarah Palin, who ran for Vice President of the United States without having even the minimum amount of education or intelligence that one would expect in a Vice President, spread the falsehood that the new law would create “Death Panels” that would decide whether old and disabled people should live or die. There was no such provision or anything like it. The only thing the bill provided for was the right of a person in a terminal condition to get a free consultation with somebody who could advise them about end-of-life questions such as living wills etc.

Government Takeover

There will be no government take-over of health care. We will still have private health insurance, doctors, hospitals, and clinics. There will simply be a law in place that lowers the cost of health care and guarantees it to most Americans. As Paul Krugman pointed out: “If having the government regulate and subsidize health insurance is a ‘takeover,’ that takeover happened long ago. Medicare, Medicaid, and other government programs already pay for almost half of American health care, while private insurance pays for barely more than a third (the rest is mostly out-of-pocket expenses). And the great bulk of that private insurance is provided via employee plans, which are both subsidized with tax exemptions and tightly regulated.”

Long Waits

One of the widely spread myths is that health care reform will lead to long waits for treatment in America just as there are long waits in Europe. In fact, the health care reform law will not lead to the kinds of problems they claim for countries with single-payer systems--longer waits for necessary procedures, rationing of health care, and bureaucratic meddling in health care decisions. Just as none of this has been true under Medicare, it will not be true under a health care reform. People who have put-off necessary medical treatment will now be able to go in before it is too late. It was never true that Canada and Europe had far longer waits than the United States. The only waits in those places were for elective surgeries. In Canada and Europe the wait for emergency surgeries is the same as if not better than the United States. The new health care reform law is not a single-payer system or even a public option. It is far different from the laws in Canada and Europe. Nevertheless, people in Canada and Europe love their single-payer health care systems, and we should adopt the single-payer model as soon as possible.

Rationing

Under the new health care law there will be no government-imposed rationing. The fact is that we now have rationing by private insurance companies. As Dr. Sanjay Gupta, CNN's chief medical correspondent explained: "[P]eople always say, 'Is there going to be rationed care?' And I can tell you, as a practicing physician, as someone who deals with this on a daily basis, rationing does occur all the time.” Insurance companies ration care by rescinding coverage on the grounds that people had preexisting conditions. There will not be any rationing under the new law.

Illegal Immigrants

Another claim by anti-health care reform people is that it will cover undocumented aliens; not true! The law specifically states that those “not lawfully present” in the U.S, may note receive subsidies to purchase insurance.

Tax on Small Businesses

There is a claim that the law will cause staggering taxes on small businesses; not true. Only 4.1 percent of all small businesses will have tax increases. The legislation would establish a 1 percent tax on joint income exceeding $350,000 but not greater than $500,000 per year; a 1.5 percent tax on joint income exceeding $500,000 but not greater than $1 million per year; and a 5.4 percent tax on joint income exceeding $1 million per year. That would exclude 95.9 percent of all small businesses from the tax.

There is a solution to people’s problems with health care reform. It is called education. Knowing what you are talking about is a great advantage. If people studied the law and paid attention to all of the information available in papers, magazines, and the internet, they would not be “angry” about the law. They would pleased with it and hungry for more.