First, let me say that I believe everyone should have health care. Let me rephrase that, I believe everyone should have good healthcare that is not too expensive and that actually covers what we need.

On November 7, the House passed Obama’s healthcare reform bill. The hopes are that the bill will expand coverage to the 36 million uninsured. This would result in 96% of the nation’s population being insured.

The legislation will require that most Americans carry insurance. It worries me any time someone makes something that costs money a requirement; what are people who have little to no money (and with the unemployment rate at a whopping 10.2 percent that’s a lot of people) supposed to do? Of course, “federal subsidies to those who otherwise could not afford it” will be provided. However,  if you’ve ever tried to qualify for government help or assistance, you know how hard that can be. So, all of those people barely scraping by most likely will not get any assistance, but will still have to pay for health insurance. And we have no idea how much it’s going to cost.

According to the Associated Press, “large companies would have to offer coverage to their employees. Both consumers and companies would be slapped with penalties if they defied the government’s mandates.” I agree that large companies should have to provide health insurance. I’m not ok with private citizens getting slapped with fines if they don’t have health insurance. Now, anyone who can’t afford health insurance will be criminalized.

Read more about being forced to buy health insurance: http://www.huffingtonpost.com/bob-cesca/the-most-nightmarish-heal_b_281214.htmlThe AP goes on to say, “Insurance industry practices such as denying coverage on the basis of pre-existing medical conditions would be banned, and insurers would no longer be able to charge higher premiums on the basis of gender or medical history. In a further slap, the industry would lose its exemption from federal antitrust restrictions on price gouging, bid rigging and market allocation.”

I’m glad that insurance companies will no longer be able to deny coverage based on pre-existing conditions. The 2007 Health Insurance Portability and Accountability Act (HIPAA) attempted to provide more protection to people with pre-existing conditions. It allowed people to purchase individual coverage, mostly under state-run high-risk insurance plans. The only problem is the cost. So, you can get coverage, you just have to pay an awful lot for it (I’ve heard up to $2400 a month).  This bill is going to allow the government to sell insurance, and even the Congressional Budget Office, “forecasts that premiums for it would be more expensive than for policies sold by private firms.” I hope that we’ll have more choices, and that we’ll get better prices, but somehow, I doubt it. Insurance companies make money when they don’t cover procedures. Now, everyone will have to give the insurance companies money, or pay a fine. And the insurance companies can still raise their rates; the bill gives them that right.

Yes, there will be a public option. However, only 11 million people, or 2 percent of the population, may have access to the public plan. The public option was supposed to provide competition to the private insurance companies but that is looking less and less likely.

How are we going to pay for all of this? Again, to quote the Associated Press, “To pay for the expansion of coverage, the bill cuts Medicare’s projected spending by more than $400 billion over a decade. It also imposes a tax surcharge of 5.4 percent on income over $500,000 in the case of individuals and $1 million for families.” We’re going to cut Medicare—a program that is already in place and working. According to government and academic research, Medicare is cheaper and more effective than private plans.  According to Consumer Watchdog, “Medicare spends 2% of revenue on overhead; private insurers typically spend 25% to 27% for overhead and profit.

Medicare also comes with established relationships with health care providers which, though undercut by low reimbursement rates and a prescription drug program hamstrung by drug manufacturers, provide a solid base for expansion. Competition with a low-overhead health insurance alternative provided by Medicare will force private insurers to prove that they can be cost-effective while offering similarly comprehensive coverage.  Leveling the playing field between private insurers and the public option by requiring all players to guarantee access at a fair price would significantly reduce costs and increase access to health care.”

One of the biggest arguments centers around women’s right to choose and the right to comprehensive healthcare (including birth control).  Abortion will not be covered. Even if you have private coverage, if you are getting any help from the government, you will not be able to use this money to get an abortion, except in the usual cases of incest, rape or when the mother’s life is in danger. This is sneaky: if insurance companies cannot reject anyone, if they have to take people getting federal help, then they cannot cover abortions. Read the FDL site http://fdlaction.firedoglake.com/2009/11/07/stupak-amendment-could-likely-be-used-to-by-insurance-companies-to-discriminate-against-low-income-americans/ for more information. According to FDL’s Jon Walker, “There would be no way to prevent that at least one of the plan’s customers would be using affordability tax credits to help purchase the plan. So the effect is no plan sold on the exchange could offer abortion coverage as part of its basic package.”

This means that almost all women with insurance through the exchange will not have abortions covered.

The President of the Planned Parenthood Federation of America says, “Simply put, the Stupak/Pitts amendment…restrict[s] women’s access to abortion coverage in the private health insurance market, undermining the ability of women to purchase private health plans that cover abortion, even if they pay for most of the premiums with their own money. This amendment reaches much further than the Hyde Amendment, which has prohibited public funding of abortion in most instances since 1977. ”

Scary.

What does it mean for young adults? The 18 to 34 age group is the largest group of uninsured people. The biggest change is that the bill will allow young people to stay on their parent’s policy until their 27th birthday. So, if you currently are on your parents insurance, or if you receive health care coverage from your employer, things will most likely stay the same.

However, some politicians have been proposing “young invincible plans.” Pay attention to anything that includes the name catastrophic. Everyone needs comprehensive treatment, treatment that includes preventive screening and regular check-ups, not a plan that only covers so-called catastrophes, with low-monthly costs and very high deductibles. For example: let’s say you are in a car accident. You will be insured, after you pay your deductible out of pocket. So if your hospital bill is $10,000 and your deductible is $5800, you’ll be paying $5800 out of pocket.

For more information about “Young Invincibles”:
http://www.campusprogress.org/cribsheets/4726/young-underinsured-and-overcharged

http://yiwantchange.org/

Definitions you need to know:
Insurance Exchange: the insurance marketplace, hopefully offering more affordable options
Public option: An option administered by the government, providing competition to private insurance companies

Like I said, we all need health insurance, but we need real coverage, competitive prices and a real public option. We need health insurance that covers everyone, comprehensively, and that doesn’t treat young Americans or women like special interest groups.

What do you think?