Sew Creative: Health Care I

Well, I said I was going to address the health care situation, and since the discourse has reached the level of lies by members of congress and screaming by voters at members of congress, it's time I actually wrote something on the topic.

I recently received the following e-mail from my father-in-law:

Wayne Lauten is a good friend of mine and if he says he has read the first 500 pages of the “health bill” then he has. I do not know nor care how you voted but I certainly do hope if you voted for the “ONE” that you have by now come to your senses. Look at some ‘problems’ HE has not correctly addressed: (1) 46 million uninsured. Only if you count all illegal; all y young folks who for one reason or another have decided they don’t need insurance just yet. If the GVT wants to give health insurance to ALL who CANNOT AFFORD IT I have no objection and I do not think that number (maybe 10 million) will break the bank. (2) I happen to be happy with my insurance and medical treatment – and really do not know anyone just now who is comp[laining – most folks who have worked are satisfied maybe the cost of insurance has gone a tad high but then so has milk.,…please take the time to read the message below.

Subject: A few highlights from the first 500 pages of the Healthcare bill in...

A very frightening prospect, but this is what some idiots have voted for.

Contact your Representatives and let them know how you feel about this. We, as a country, cannot afford another 1000 page bill to go through congress without being read. Another 500 pages to go. I have highlighted a few of the items that are downright unconstitutional.

• Page 22: Mandates audits of all employers that self-insure!
• Page 29: Admission: your health care will be rationed!
• Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)
• Page 42: The "Health Choices Commissioner" will decide health benefits for you. You will have no choice. None.
• Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.
• Page 58: Every person will be issued a National ID Health card.
• Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.
• Page 65: Taxpayers will subsidize all union retiree and community organizer health plans (read: SEIU, UAW and ACORN)
• Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange.
• Page 84: All private healthcare plans must participate in the Healthcare Exchange (i.e., total government control of private plans)
• Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens
• Page 95: The Government will pay ACORN and Americorps to sign up individuals for Government-run Health Care plan.
• Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter.
• Page 124: No company can sue the government for price-fixing. No "judicial review" is permitted against the government monopoly. Put simply, private insurers will be crushed.
• Page 127: The AMA sold doctors out: the government will set wages.
• Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives.
• Page 126: Employers MUST pay healthcare bills for part-time employees AND their families.
• Page 149: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll
• Page 150: Any employer with a payroll of $250K-400K or more, who does not offer the public option, pays a 2 to 6% tax on payroll
• Page 167: Any individual who doesn’t' have acceptable healthcare (according to the government) will be taxed 2.5% of income.
• Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans will pay for them).
• Page 195: Officers and employees of Government Healthcare Bureaucracy will have access to ALL American financial and personal records.
• Page 203: "The tax imposed under this section shall not be treated as tax." Yes, it really says that.
• Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected."
• Page 241: Doctors: no matter what specialty you have, you'll all be paid the same (thanks, AMA!)
• Page 253: Government sets value of doctors' time, their professional judgment, etc.
• Page 265: Government mandates and controls productivity for private healthcare industries.
• Page 268: Government regulates rental and purchase of power-driven wheelchairs.
• Page 272: Cancer patients: welcome to the wonderful world of rationing!
• Page 280: Hospitals will be penalized for what the government deems preventable re-admissions.
• Page 298: Doctors: if you treat a patient during an initial admission that results in a readmission, you will be penalized by the government.
• Page 317: Doctors: you are now prohibited for owning and investing in healthcare companies!
• Page 318: Prohibition on hospital expansion. Hospitals cannot expand without government approval.
• Page 321: Hospital expansion hinges on "community" input: in other words, yet another payoff for ACORN.
• Page 335: Government mandates establishment of outcome-based measures: i.e., rationing.
• Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc.
• Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals.
• Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by phone).
• Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens, assisted suicide, euthanasia?
• Page 425: Government will instruct and consult regarding living wills, durable powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of time.
• Page 425: Government provides approved list of end-of-life resources, guiding you in death.
• Page 427: Government mandates program that orders end-of-life treatment; government dictates how your life ends.
• Page 429: Advance Care Planning Consult will be used to dictate treatment as patient's health deteriorates. This can include an ORDER for end-of-life plans. An ORDER from the GOVERNMENT.
• Page 430: Government will decide what level of treatments you may have at end-of-life.
• Page 469: Community-based Home Medical Services: more payoffs for ACORN.
• Page 472: Payments to Community-based organizations: more payoffs for ACORN.
• Page 489: Government will cover marriage and family therapy. Government intervenes in your marriage.
• Page 494: Government will cover mental health services: defining, creating and rationing those services.

Now I am going to go through these items, but before I do, here is the link for House Bill 3200. This is the pdf format so that you will have the same page numbers as those referenced above.

First of all, let me address my father-in-law's comments.

I do not know nor care how you voted but I certainly do hope if you voted for the “ONE” that you have by now come to your senses. Look at some ‘problems’ HE has not correctly addressed: (1) 46 million uninsured. Only if you count all illegal; all y young folks who for one reason or another have decided they don’t need insurance just yet. If the GVT wants to give health insurance to ALL who CANNOT AFFORD IT I have no objection and I do not think that number (maybe 10 million) will break the bank.

From factcheck.org:

How many of the uninsured are U.S. citizens?

I have heard there are 47 million people without health insurance. How many of these are U.S. citizens? What is the makeup of the remainder?

The vast majority of the uninsured are citizens from working families.

The "47 million uninsured" figure is from the 2006 U.S. Census Bureau report. In 2007, the Census Bureau reported that the number actually declined somewhat, to 45.7 million people under 65 (the age of Medicare eligibility).

Ever since health coverage became a major issue in the 2008 presidential campaign, we've received periodic questions from readers who wonder whether a large percentage of the uninsured are non-citizens or illegal immigrants. They're not. According to the nonpartisan Kaiser Family Foundation, 79 percent of the uninsured are native or naturalized U.S. citizens. The remaining 21 percent accounts for both legal and illegal immigrants.

Kaiser does acknowledge that non-citizens are more likely to be uninsured than citizens, because they are often restricted from public coverage and "are more likely to have low-wage jobs and work for firms that do not offer coverage." (Around 60 percent of Americans have insurance through their employers.) According to the Census Bureau, 43.8 percent of non-citizens are uninsured, versus only 12.7 percent of native-born citizens and 17.6 percent of naturalized citizens. But saying that non-citizens are more likely to be uninsured is not the same as saying that most of the uninsured are non-citizens.

What else can we say about the uninsured? More than 80 percent are from families in which at least one person works (70 percent from families where at least one person works full-time, and an additional 12 percent from families with a part-time worker). Two thirds are near or below the poverty line, making less than 200 percent of the federal poverty level. Only a small number (20 percent) are children, but nearly half are below the age of 30. Non-Hispanic whites make up two thirds of the population but less than half of the uninsured, and they are also more likely than any other race to have private insurance. The Kaiser Family Foundation has released a report, incorporating 2007 Census data, that covers these and other characteristics of the uninsured. -Jess Henig

Again from FactCheck.org:

Claim: Many of the uninsured are young people who think they're invincible. The National Review Institute writes: "More than half of the uninsured are between 18 and 34 years of age, a group which has relatively few expensive health issues and for whom self-insuring (paying their own medical bills) makes sense." Actually, only about 40 percent of the uninsured are between 18 and 34, according to the Census.

Is this younger group uninsured by choice? KFF said young people lack insurance for a variety of reasons: "Many low-income young adults lack access to affordable private coverage since few are full-time students or full-time employees, few have jobs that offer employer coverage, and few have access to coverage through their parents."

Similarly, the Institute of Medicine reports that "adults who decline offers of [employer-sponsored insurance] ... are more likely to be in poor health with high-cost medical conditions." So those who turn down available coverage don't always do so because they're in great health and don't want to pay for it. Many find it to be unavailable, or can't afford it at the price offered.

Claim: Many of the uninsured can afford private health care. About 9.1 million of the uninsured have household incomes greater than $75,000, and 10 percent (about 4.7 million) make more than 400 percent of the federal poverty threshold, according to KFF. In 2007, the most recent year of Census statistics, a family of four at 400 percent of the poverty level would have a household income of $84,812 or more.

So it's true that many of the uninsured could, in theory, spare the $3,354 average annual employee contribution for employer-sponsored family coverage, or even the $5,799 average premium for individually purchased family coverage. But it's also true that 66 percent of the uninsured make less than 200 percent of the poverty level according to KFF, which is less than $42,406 for a family of four in 2007. And a family's premium costs may actually be much higher than the average for individually purchased insurance, depending on the number of dependents, the ages of family members, their state of health and the state in which they live. For instance, the average annual premium for individually purchased family coverage in Massachusetts, according to America's Health Insurance Plans' Center for Policy and Research, was $16,897 in 2006-2007 (before the state changed its insurance plan), and in New York it was $12,254.

Furthermore, even those who can afford coverage cannot always get it. AHIP found that 72 percent of 2006 applications for health insurance were eventually approved, while the rest were withdrawn, not processed, or denied for medical or non-medical reasons. And of those who got coverage, 11 percent had to pay a higher rate than requested.

Claim: Many of the uninsured already are eligible for public coverage. That's true – NIHCM found that in 2006, 12 million of the uninsured were eligible for Medicaid or the Children's Health Insurance Program (formerly SCHIP) but were not enrolled. These were disproportionately children – 6.1 million of the 12 million are under the age of 18, versus only 20 percent of the uninsured as a whole. NIHCM posits a number of possible explanations: People may be unaware of the programs or not know how to enroll in them; they may experience administrative hurdles to enrolling or staying in the program; or they may fear the stigma of public assistance. Some states also periodically institute CHIP enrollment caps, which may keep eligible people out of public programs. Utah, Georgia and Florida all had caps in 2007.

Here's another group that does fact checking; I like their "truth-o-meter: PolitiFact.com

This is already really long, so I'm going to post it, run a few errands and be back soon. Post your comments!