ObamaCare in Guarded Condition

A zillion proposals are kicking around Congress, Republicans are in full attack mode, and the right wing hot air-osphere is in full throat with lies and distortions.  In other words, the August recess figures to be a very perilous time early in the Obama Administration.  I am not going to sit here and claim that this idea or that idea is better or worse.  I am not an accountant, nor am I an insurance actuarialist.  Just on their face some ideas strike me as better than others, but I haven’t really blogged on this subject yet because I don’t have a clear plan for what needs to be done beyond the general sense that we need reform because everyone needs access to health insurance.  I hate employer-based systems for that reason; we don’t have full employment in this country even in the best of times, and some of the people that do work are for themselves or small companies that don’t have the resources to provide that kind of expensive benefit.  I might be inclined to say put everyone on Medicare and screw the private insurance companies, but I try to live in the real world so I know that won’t happen.  But I did want to address some of the disinformation that is out there.

1) You won’t get to pick your doctor.  Excuse me, but people with insurance really don’t get to “pick their doctor” now.  Your insurance tells you what doctors participate in their plan, and you go from there.  When you have to have a non-emergency procedure performed, you go to a facility covered by your insurance.  When your primary care physician referrs you to a specialist, you go to a specialist approved by your insurance company.  When your doctor prescribes medication, you get a brand that is approved by your insurance.  Basically, you don’t have choice now.  If anything, reform will INCREASE your options, but in any event its not like you have free choice now.

2) There will be rationing.  No there won’t, beyond the certain extent that there is always rationing.  You make an appointment to see your doctor, you don’t just drop in when you feel like it.  When you need to have a procedure performed, its scheduled; you don’t just drive over to the hospital and announce that your opthamologist suggested a laser procedure be performed.  Sometimes its scheduled a month or more in advance.  That’s now, under the current system.

3) You won’t be able to keep your doctor.  There is no guarantee you will now under the current system.  Remember, for most people, insurance is provided by their employer in a group plan.  For any number of reasons mostly related to cost your employer might change to a new plan provider on a yearly basis.  The new provider might not cover your old doctor, forcing you to find a new one.  Or to change your medication to the formulation they cover.  That’s normal and that’s how it works now.  If anything, government reform might be able to prevent that sort of hassle from happening.

4) We can’t afford reform because of the recession and the burgeoning national debt.  Um, we need reform becasue of the recession; more unemployed means more people that don’t have an employer to provide them with benefits, and being off work makes COBRA rather hard to afford.  As for the national debt; that’s been there forever under Presidents and Congresses of all political stripes and I suspect that won’t change.  Besides, reform done right will actually save money.

5) The President doesn’t have the authority to do this because he wasn’t even born in this country.  lol; we can make fun of the birthers anytime.

For more on the subject, here is yesterday’s thoughts from liberal columnists Paul Krugman and Joe Conason: http://www.nytimes.com/2009/07/31/opinion/31krugman.html?th&emc=th

http://www.salon.com/opinion/conason/2009/07/31/bill_betsy/index.html?source=newsletter

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