Senator: Lawmakers Having Second Thoughts on Taxing Health Care Benefits
WASHINGTON -- A key lawmaker says senators at work on health care legislation are having second thoughts about imposing a tax on high-end insurance coverage that workers receive on the job.
Sen. Kent Conrad says polling shows widespread public opposition to the idea, and lawmakers are now considering other options to help pay for an expansion of care to millions of people who now lack insurance.
The North Dakota Democrat did not go into details Tuesday.
In a compilation of four public opinion polls shown to lawmakers, opposition to taxing health care benefits ranged from 59 percent to 70 percent. In private talks, lawmakers have been discussing a tax on workers who receive coverage that has particularly high premiums.
This is all well and good, and not too shocking. The question though is, how are they going to pay for it?
Estimates of the cost of the program mostly hover around $1 trillion with the Congressional Budget Office going as high as $1.6 trillion. 1 trillion dollars is $3,300 for every man, woman and child in the country, or for my family of 5, our share would be $16,500. Considering none of my kids have a job, I'll likely be picking up their tab. If we go as high as $1.6 trillion, which if history with the federal government is a guide we will go with the higher estimate and add 20%, the cost to our family goes to $26,200.
Obviously the above numbers are a silly play with numbers, we will not directly be paying this amount. They do help put things in perspective though and shows just how much of a hurdle health care reform is.
We need to take a closer look at how we fund health care for people in this country.
I am in favor of health insurance for all. I do not view health insurance as a constitutional right, I do not view at as a God-given right, I view it as a way to save money. I am a firm believer that we would save money providing insurance for most people and working towards preventive medicine than to pay for a chronic disease that we could have headed off or lessened in severity with regular care. What happens now is people do not seek medical help until they have a heart attack when we could have been working with them all along to treat their high blood pressure, cholesterol, educate them on healthy living, etc. It is a living example of the saying "an ounce of prevention is worth a pound of cure".
One stipulation to this, I do not think it should be a lifetime of coverage. We need to stop the practice of entitlement being a career choice.
We already have universal health care in the US, we just distribute it poorly.
Because of a law called EMTALA (Emergency Medical Treatment and Active Labor Act) anyone presenting to an emergency room, irregardless of ability to pay, must be examined by a medical provider and treated for any emergent condition. Further, any woman presenting in labor must be treated, again, irrespective of ability to pay.
This is kind of a simplified explanation of the law but the point is that ERs have to treat patients with no regard to their ability to pay. Hospitals face a $50,000 fine for a violation of this act.
For the record, I am in favor of this law. A humane society would not let a man die of a heart attack because he cannot afford his hospital bill nor would we allow a woman to have her baby out on the street because they cannot pay up front.
The problem is how we implement the law. What the law does not say is that we have to treat everybody who presents to the ER. We only have to assess them for an emergent condition. ERs have defensively taken the law to it's extreme and treat everyone who presents to us.
I can tell you stories that would make you grit your teeth to the point of chipping.
I have asked people why they did not go to their personal physician for their presenting complaint and they will tell me "the doctor makes me pay". So they duck out on a $60- $70 office visit and let the public pay their approximately $1000 ER visit.
I had one woman ask for us to pay for her Ibuprofen prescription because she had no money. I had seen this same woman tuck a wad of bills under her pillow for safe keeping while in her hospital gown.
Don't even get me started on smokers. If you want to piss off an ER nurse or doc, tell them a smoker wants the hospital to pay for their prescriptions because they cannot afford them.
My point is that we need to reform the entire process.
Here are some statistics on the uninsured:
-28% are above 300% of the federal poverty level. The authors estimated that someone above 300% should be able to afford their own health care. (source)
-Illegal immigrants represent about 15% of the nation's 47 million uninsured people — and about 30% of the increase since 1980. (source)
-Overburdened by the uninsured and overwhelmed by illegal immigration (search), public health care in Los Angeles is on life support.
Sixty percent of the county's uninsured patients are not U.S. citizens. More than half are here illegally. About 2 million undocumented aliens in Los Angeles County alone are crowding emergency rooms because they can't afford to see a doctor. (source)
So using these numbers, approximately 7 million of the 47 million are illegals and 13 million are people that can afford the insurance but choose not to. Right off the bat let's drop them, that cuts our cost by 43%.
Next we apply a sliding scale to the rest of the people that we do insure. In other words, if someone makes 250% of the poverty level, subsidize their insurance, not pay for it all.
Some are not comfortable cutting out illegals, I am. As I said above, a just society would not let someone die because they cannot pay and we should not do so because they are not a citizen. For routine care, colds, tooth pain, etc, turn them away. Let them go home and have the taxpayers of their own country foot the bill.
As far people who can afford to pay and choose not to, same thing. Life is about choices and sometimes these choices come with risks. If one chooses not to get health insurance and they incur a large hospital bill, then they can pay for it. Finally we need to get more aggressive collecting these debts. Hospitals often write these bills off, which means you pay for it ultimately. This may be cruel and it may ruin someone's life. This would be sad but avoidable. We need to make people take personal responsibility.
I'm for health care reform and I am for assisting people who cannot pay, we just need to use some common sense.