Recently, I received an email from a relative concerning the health care debate in our country. It included a long list of concerns about one of the versions of the health insurance reform bills as they work their way through Congress. I sent a reply addressing some of the points, and I thought I would share them here.

I've followed the health care debate very closely and I find that the list of concerns at the bottom of the mailing list is one of the most misleading lists I've seen. The bottom line is do you believe that citizens of the United States should be given a choice between a government run health care program, like people on Medicaid and members of congress get, or should the insurance companies be allowed to prevent us from making that choice.

Personally, I'm all for free competition and it really offends me the amount of money that the insurance companies have taken from my premiums to try and prevent me from having the option to continue to use them or to select a government run program.

With that, I will add a few notations to the list below

Page 29: Admission: your health care will be rationed!
Currently, health care is rationed by the insurance companies. Have you ever had a claim denied? I sure have.
Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)
Can you tell me the appeals process for your insurer? For all practical purposes your ability to appeal decisions by your private insurance company is less than the options with a public plan. Of course, if a public option were available you would be able to chose between a public plan and a private insurance company plan, but the private insurance companies
Page 65: Taxpayers will subsidize all union retiree and community organizer health plans (read: SEIU, UAW and ACORN)
Right now, we pay for union retiree benefits in the higher cost of goods that we buy. Ever wonder why the car companies are going under? It is because unlike their competitor in other countries they need to pay health care insurance costs for their employees and retirees. This is one of the key reasons why we really need health insurance reform. The current system makes American companies less competitive than companies overseas. If you want to protect American jobs and have a stronger America, we must change the insurance system.
Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter.
Umm, people with Medicaid are already in a public health care system. This is one of the most ridiculous things I hear time and time again, people on Medicaid saying that they oppose government run healthcare systems.
Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives.
Flat out false. It is clearly contradicted by statements below about companies not offering the public option.
Page 167: Any individual who doesn’t' have acceptable healthcare (according to the government) will be taxed 2.5% of income.
This was actually a concession to the private insurance companies. One of the biggest issues right now is the millions of people with no insurance. If they can get insurance at any point, the insurance companies argue, they will wait until they need medical insurance, and then apply. The ideas of taxing people without health insurance was an idea from the insurance industry to make sure that this doesn't happen and to protect their profits. I have mixed feelings about this. I can see the point, but I'm not sure that this small part stuck in by the private insurance companies is all that bad.
Page 253: Government sets value of doctors' time, their professional judgment, etc.
Currently, the private insurance companies do this. While I'm not a fan of big government, I do believe they will do better than the private insurance companies do.
Page 268: Government regulates rental and purchase of power-driven wheelchairs.
Don't they do this already for Medicaid patients? Or can anyone on Medicaid get a power-driven wheelchair, no questions asked? Sure, if you want to rent one on your own, you can do that, just as you always could. But, if the government is paying for it, they need to make sure that the power-driven wheelchairs are really needed. This is just like how private insurance companies regulate all the services they get, but no one seems to be complaining about that!
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.
This is really good idea. We need to hold doctors more accountable. If they don't do the job right, they should be penalized. One of the biggest expenses in the Medicaid system is Doctors who say their patients are well enough to go home when they aren't, causing the patient to be readmitted. Do you know people that were ever kicked out of a hospital before they were ready because the Doctor, under pressure from private insurance companies released them? I sure do. It was bad for my friends and it is bad for the heath care companies.
Page 321: Hospital expansion hinges on "community" input: in other words, yet another payoff for ACORN.
I must say that the irrational fear of ACORN is really amusing. Anytime a public facility seeks to expand, it should depend on community input. Do you want an airport expanding next to you without community input? Do you want schools expanded next to you without community input? Do you want a new superhighway built next to you without your input? It only seems reasonable that the same should apply for hospitals.
Page 335: Government mandates establishment of outcome-based measures: i.e., rationing.
Outcome based measures. Seriously, are people opposed to rewarding those who have the best outcomes and punishing those with the worst outcomes? I sure don't want the government protect those who are under performers.
Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc.
Umm, the government already has this. Don't you have an insurance commission in your state? We sure have one in our state. Unfortunately, it doesn't do that good a job and allows the private insurance companies to raise rates at 2 1/2 to 7 times the rate of inflation, without any opportunity for citizens to comment. Personally, I believe that the government does have a responsibility to protect and defend its citizens, and some of that is protecting against insurance companies that are scams and rip off people.
Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals.
Umm, you mean they, and the insurance companies don't do that already? Give me a break
Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by phone).
Personally, with my wife's health problems, I've been very pleased at the opportunities for my wife to talk with doctors and nurses via the telephone. There are times that this is just a much better way of communicating with a doctor and getting the right information, instead of having to wait for an appointment, go downtown, wait in the office, etc. I can't see how anyone can oppose this, except maybe doctors trying to increase their billing hours.
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: A dvance 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.
This whole "Death Panel" discussion is one of the most misleading ways in which the private insurance companies are trying to strike fear in the hearts of Americans to make sure that we do not get a chance to choose any insurance option except for private insurance companies. This section of the bill makes it so that if a patient and his family want to talk with a doctor about options on how a person lives out the final days of their lives, the discuss with the doctor is covered by insurance. The government doesn't dictate how a person's life ends, nor does the doctor. Instead, the family gets MORE information about what is best for the family in their specific situation. When your mother died, did you get a chance to talk with doctors about whether to keep her on machines as long as possible, or when the best point to let her go peacefully was? Did you get a chance to talk to doctors about whether she should spend her final days in intensive care or with your sister? Did you know all the options available to you? The proposed legislation would allow you to have those discussion with your doctor and make up your own mind. The insurance companies are the ones that don't want to pay for those sort of discussions.
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.
Are the people who sent this suggesting that therapy and mental health services should NOT be covered? The failure to cover such services is more of an intervention by the government and private insurance companies that covering it would be. If some family is having difficulties, perhaps because they can't afford private insurance any more, they ought to be able to get marriage therapy. If they can't, things well be worse. And remember, with this, and any sort of medical service, you can still get the service if the insurance companies or the government won't pay for it.

The bottom line is that the insurance companies want to limit your choices. The more choice you have, the more competition they get. Personally, I believe in competition. I believe we will be much better off with a public option than if we are not given such an option.

What do you think?