Just a National Mandate to purchase Private Health Insurance
That’s what healthcare reform has come down to: Every person who is not a government employee, and who is too poor or too old, would have to purchase private health insurance directly or through an employer. Those that make less than the Federal Poverty Level (about $21,200 per year for a family of 4 living in the lower 48 states) and those over 65 who have Government Insurance through Medicaid and Medicare will remain exempt from this new Federal governmental mandate.
The 20% of Americans fortunately employed by our Federal, State and Local Governments, and those on active duty in the Military plus some retired Military personnel, will continue to receive health insurance through their public employers. These programs are funded by various taxes imposed on private sector employers and all employees and individuals working in both the public and private sectors.
Private sector employers will continue to reduce healthcare and health insurance benefits to their employees because extreme international and domestic competitive forces will compel them. To remain in business, they cannot financially sustain the current system for much longer. Every employer and employee should fully understand all costs associated with health insurance, and not think that someone else will perpetually foot the total expenses. In our fast-moving and changing world, to believe you will keep your same employer-provided private health insurance whether reform passes or not, is simply delusional.
BASIC QUESTIONS LEFT UNANSWERED
The various healthcare reform proposals fail to answer two fundamental and essential questions: What will most people have to pay in premiums and what health insurance will be provided? That’s probably why the American public is increasingly skeptical about the entire proposal. There are many other nebulous areas in the current proposals concerning the utter lack of meaningful controls over the growing health costs in both our public and private healthcare systems. These policy gaps are very distressing but supplemental to these two basic issues.
We have all been told for months that pre-existing conditions will no longer be a bar to purchase insurance, and there will be subsidies for some to pay for the uncapped premiums – sometime after 2013. Still, none of the major analysts, commentators, pundits, bloggers, public officials or media representatives from the right, left, middle, or anywhere else on the political and economic spectrum have told us what type of minimum policy I need to buy in the future to comply with this mandate, and what I will get in return with respect to health insurance coverage.
Most contracts to purchase goods and services specify the actual price and what will be provided in exchange. Only slimy and dishonest salespeople obfuscate these two essential parts of any agreement and Congress is quickly joining that group. I have read many different reports on the various proposals and bills with respect to possible premiums. There are numerous complex descriptions of various subsidy levels depending upon household or individual income, which still do not answer the basic question of likely costs to most voters and taxpayers.
What physician and hospital services, medical products and equipment, and prescription drugs would be included in a basic policy, plus the likely co-payments, annual deductibles, and total limitations of coverage, are all left unanswered. Even if we do not expand Medicare to more Americans, will the basic private insurance coverage be similar to Medicare or will minimal health coverage be something else? What about some forms of optical, dental and long-term nursing care that some publicly-subsidized Medicare-supplemental plans provide? Will co-pays be split on the basis of 90-10, 80-20, 65-35 or 50-50? In addition to the insurance premiums, what will be the likely out-of-pocket annual medical expenses per household or individual? Will there be some simple and understandable universal provisions or will we be handed a myriad of complex and confusing choices that are universally lousy?
Then there could be many special premiums and surcharges based upon age, sex, alcohol or tobacco use, residential zip code, personal credit scores, and a myriad of other permissible factors that are not removed by the limited ban on considering pre-existing health conditions. Thus the other major cost question is left unanswered. Finally, most of the proposed reforms are meant to kick in after 2013. Will we learn during the next 3 years the answers to these fundamental questions about coverages and premiums, or will we just continue to worry and argue about what will actually transpire after 2013?
ONLY POSSIBLE OUTCOME
Hey Democrats, is this the best you can put together under our current system of government? Probably so, and because there is no assurance that you will control Congress after the 2010 Midterm elections, you probably should pass whatever minimal reforms possible and move on quickly as you have less than a year to rehabilitate yourselves in the eyes of the very angry, frustrated and impatient voters. Carpe Diem (seize the day – act now) because tomorrow you might be politically or actually dead.
President Obama, the former Constitutional law professor, possibly understood the limits of our political system and did not press for more sweeping reforms during this nightmarish process because he knew coming into office that such would not be attainable. We still have a highly divided, ideologically-rigid, intransigent, ignorant, biased, angry, impatient, and extremely polarized electorate that is completely reflected in our public officials. Thus not much can be realistically accomplished on a national or even state level with respect to our country’s political, economic and social challenges. Furthermore our country has morphed into an oligarchy over the past 30 years that financially controls our government through campaign contributions and well-funded, highly-motivated special interests.
REALLY HUGE SUPERMAJORITIES TO THE RESCUE
Unless there are veto-proof 67% or larger majorities in both Houses of Congress, we really cannot expect much more than perpetual systemic gridlock and paralysis. All voters should understand that simple equation by reviewing our country’s history over the past few decades, and particularly over the past year. When we go to the polls in 2010 and 2012, we would be wise to elect huge super-majorities for either Republicans or Democrats in the House and Senate, not just simple majorities or even 60% majorities or expect 51-49 divisions to accomplish anything. Voters must factor in likely defections from both political parties in this analysis.
Otherwise our minority oligarchy will perpetually rule this country regardless of which party is ostensibly “in power.” If people want significant change, that is the only viable solution because there is no middle in the country or legal alternatives that can be enacted to ensure a different result. We achieve the “middle” – which is complete inaction, gridlock, paralysis and stagnation – by constricting our extreme swings from left to right so that everyone is displeased with the status quo except for our oligarchy.
Without clear allocations of complete responsibility and power, we generally avoid doing anything in our public and private lives. Instead we endlessly debate and argue, and end up blaming everything and everyone else for our perceived limitations. All successful businesses, organizations, and governments work best when someone actually takes leadership and exercises complete control. Rule “by committee” is a mirage and a pointless exercise because it does not assess any responsibilities and thereby does not produce any meaningful accomplishments. It is only meant to keep many people and groups happy in thinking they are influential or important when real power is exercised by one person or a small group of people behind the scenes.
FUTURE VOTING CONSIDERATIONS TO GET FULL SATISFACTION
If polls are shifting to Republicans in 2010, even Democrats should strongly go out and vote for Republicans so they can have an overwhelming majority to effectuate their policies. If the opposite is true, then voters should sift and vote accordingly. Since we cannot ever find any middle or bi-partisan ground in our current political system, we might as well accept reality.
Only overwhelming force is needed to move things in Washington, as it is in any military situation around the globe. Otherwise, massive special interest funding from our oligarchy will perpetually call the shots in Congress and in all parts of our government. More half-ass, timid, ineffectual, and compromise measures from either Republicans or Democrats just won’t be enough for 21st Century America to survive as the world’s pre-eminent political, economic, military and cultural power.
We have been collectively suffering through endless “foreplay” for decades when we really need to consummate things with some full-blown “sex” – whether it comes from Republicans or Democrats. We don’t need or want our politicians to perpetually dress and act up as faux liberals, conservatives, independents, or anything else. Why do you think the entire American electorate is so frustrated, angry and impatient?
At least many of our sociopathic oligarchs have been happily screwing us for years, and some of us seem to love it. “You’ve taken our virginity, trust, innocence; houses, jobs, cars, possessions, investments, health and pension security, and all our self-respect…Now do it again.”
Marc Pascal happily ranting from and having great sex with my wife (Surprise Tiger it’s possible) in Phoenix, AZ