Saturday, March 27, 2010

How Tough Do You Want To Be?

My friend called in a furor.  Those horrible Democrats had finally succeeded in passing healthcare, thereby turning our once great Democracy into a communist dictatorship (or whatever combination of isms you prefer).

Her main outrage was that her partner would be forced to purchase health insurance even though he is 62 and perfectly healthy and has other things on which he'd rather spend his hard-earned dollars and that should be his God-given right as an American!

My question to her was: "okay, so let's say he has a heart attack tomorrow. How tough do you really want to be?  Do we say to people like him that they have an option but if they choose not to insure themselves, they are on their own? Do we say, "don't bother calling 911 because you've made your choice and now you'll live or die by it?"

No, of course, she wouldn't want that. If she called an ambulance, she'd expect it to come, she'd expect the emergency room to jump into action to save her partner's life, she'd expect them to administer whatever treatment was needed to fix him.

So, if he doesn't have insurance, who is going to pay for all that? Well, I guess it would be us taxpayers. If that's the case, don't we have an equal right to insist that he pitch in a little by maintaining his own health insurance?

And anyway, my friend is going off half-cocked because she doesn't even know all the facts. As it turns out, her partner's insurance would be subsidized by the government because his income is between the 133 percent and 400 percent of poverty level. There would be a cap on how much he'd have to pay out of pocket on a sliding scale. Likewise, an exchange will be created for small businesses to purchase coverage starting in 2014.

Here is what else is in this bill:

- by 2020, it will close the "donut hole" for seniors getting their prescriptions through Medicare.

- Medicaid will be expanded up to 133 percent of poverty level ($29,327 for a family of four) and will also require states to offer Medicaid to childless adults starting in 2014, with the government paying 100% of costs through 2016. Illegal immigrants are NOT eligible for Medicaid.

- Insurance companies will no longer be able to deny children coverage due to a pre-existing condition (within six months of enactment). Starting in 2014, they cannot deny coverage to an adult based on a pre-existing condition. Children will be allowed to stay on their parent's insurance until age 26.

- In 2014, everyone must purchase health insurance or pay a $695 annual fine (with some exceptions for low income). So my friend doesn't have to worry because her partner will be 65 by then and covered by Medicare.

- There is no employer mandate as such although any employer with over 50 employees must provide health insurance or pay a fine of $2000 per worker per year if any of their employees receive federal subsidies to purchase their own health insurance.

- Illegal immigrants cannot buy health insurance through the insurance exchanges - even if they pay the premiums out of pocket.

- Abortion - suffice it to say the bill goes to great lengths to separate private and public funds to ensure that no American can be forced to pay for an abortion against their moral code. (Hell, the Iraq War was against my moral code but no politician care enough about my sensitivities to exempt me from paying for it).

- According to the Capitol Budget office, the cost of the plan is $940 billion over 10 years. It would expand coverage to 32 million Americans now without health insurance.  Supposedly, the way the plan is paid for will reduce the deficit by $130 billion in the first decade and by $1.2 trillion in the second 10 years. Believe this or not. We're all pretty familiar with how askew with how Congress' financial predictions often are (i.e. Iraq/Afghan Wars).

- To pay for this bill, 1) the Medicare Payroll Tax will be expanded to include unearned income starting in 2012, amounting to a 3.8 % tax on investment credit for families making more than $250,000 or individuals making over $200,000 - 2) As of 2018, insurance companies will pay a 40 percent excise tax on "Cadillac" insurance plans (those worth over $27,500 for families or $10,200 for individuals. Dental and vision coverage are exempt - 3) A 10 percent tax will be levied on indoor tanning services.

And there you have it. That's pretty much it in a nutshell. So, do you think it's worth all this screaming and shouting and tearing out of hair the Republicans and Tea-partiers and Glen Beck and Rush Limbaugh and their followers are doing? How about you? Will you be better off or worse off or no different than before?

If my friend's partner has a heart attack, I'm willing to kick in some extra to help pay for his treatment (as I do now) but I want him to kick in some extra too.