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Wednesday, March 17, 2010

Health Care

Health Care... Just saying those words elicits feelings of hope, depression, anger, bewilderment, and concern. I don't really know how to feel about all of it. This weekend may mark passage of this monumental bill, but what will it do?

President Obama says it will bring down costs, so I ask how. The theory seems to be that if everyone is required to buy health insurance including the young and healthy who might consider it fine to risk going without it, then premiums should be reduced. Sounds kind of like requiring safe drivers to have car insurance. The counter point to this though is that we want people with pre-existing conditions to not be denied coverage. That would mean costs going up. To me the 2 combined sound like a wash, but I don't have the data (and doubt anyone does but some actuarists at insurance companies) to know what net effect this will have on the premiums.

A second counter point to lower premiums is that if more people now find themselves with insurance will they visit the doctor or hospital more than they did before causing a larger overall cost of health care in the country? If the cost is higher than before, the average weighted cost of what each american is paying for health care is going to be higher.

Another way it might bring costs down is for those that pay for individual coverage and don't get the discounts like people in large companies. Companies often don't go along with just getting less revenue so how will this be offset? One point is that since there are more people having to buy in, they are getting more revenue. Well that may be nice theory, but if a "discount" becomes standard, then there is no longer a discount. I think it's logical to conclude that this legislation is to do away with the discounts now enjoyed by employees of large companies. I don't have a problem with this, but to me that seems the logical outcome.

Another thing President Obama said is that this will not increase the deficit and will actually bring savings. So again I ask how. Insurance companies will be making just as much money if not more than before. Pharmaceuticals... Hospitals... Malpractice lawyers... I really don't see who will be getting less money so how will the government be paying less? Someone has to either be paying more or getting less for this to happen. We are decreasing the medicare budget but have this new budget for providing subsidies for those that can't afford the premiums. Who qualifies and how do we know how much we will be paying out for subsidies?

The biggest unknowns to me on this legislation still is how will it handle care for illegals? Is this bill going to change anything for them?

Maybe all the secret meetings over this is politics as usual, but it makes me hope they don't pass this any time soon because I still don't know what it is going to do.

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