Vail Daily letter: Some health care terms
Vail, CO, Colorado
For those of you who are getting tired of squinting at the same old scripted cue cards while keyboarding your letters of outrage over health care reform, please feel free to plagiarize from this brief compendium of terms of engagement. We will start with some of the more contentious concepts.
Pre-existing conditions: Refers to illnesses or injuries experienced prior to an application for health care insurance. Utilized by the for-profit health care insurance industry to deny any insurance coverage, to deny coverage for the specific conditions listed as pre-existing or to increase insurance premiums for those with such conditions. Considered the most extreme form of health care rationing. Will likely be abolished in a final health care reform bill.
Public option: A health-insurance option financed by the federal government to be offered to persons not covered by employer-based health care insurance or Medicare-Medicaid-VA. Persons not covered by employer-sponsored insurance can select the public option or select a benefit plan from private insurers that offer non-group benefit plans.
Likely to be a middle-of-the-road benefit plan, critics claim that it would result in government officials meddling in the patient-provider relationship. Since such meddling already exists in the private insurance sector, we have a choice of evils – the bureaucrat or the profiteer.
Critics also claim the public option will destroy the private health-insurance industry. They’re right. The public sector will not have a profit motive or shareholders to satisfy.
Will it be included in a final bill? Private health-care-sector political contributions are in the hundreds of millions. Private-sector health care employment is in the millions.
Do the math.
Employer-based health care insurance: Our unique method of financing health care insurance to the employed. It ties health coverage to employment except for the poor, who are Medicaid eligible. Its demise is long overdue. Choices and decisions regarding health care insurance should be between the insurer and the family unit.
Advanced directives: The legal means by which a person instructs family-legal trustees regarding end-of-life decisions of the individual in the event that the individual no longer has the capacity to make those decisions themselves. Also described as rationing, family style.
Death panels: An invention of Sarah Palin. Early intelligence suggested that the vision of a death panel was telepathically transmitted during a seance between Palin and her exorcist minister out of Africa. However, the rapid spread of this vision to both neoconservative and, heretofore, moderate congressional members of the GOP points toward a possible genetically linked virus. If confirmed, there is no known vaccine.
Tort reform: No. 1 on the reform list of conservatives (sometimes the only one). The focus is on restricting the types of suits to those deemed appropriate malpractice claims consistent with existing statutes and to cap or otherwise limit the amount of jury awards, particularly for punitive damages.
Keep in mind that the cost of malpractice insurance is a large percentage of the total costs of a physician’s practice and a very small amount of the total cost of a health care insurer. If the health-insurance industry is successful in lowering its malpractice costs through tort reform, will the dollars saved flow to reducing your insurance premiums or to the profit line of the health-insurance industry? Think about it.
Pulling the plug on Grandma: A dartboard hit by the GOP in attempting to misrepresent the intent of advanced directives into a government plot to ration health care by withholding care from the elderly. Also known as rationing, geriatric style. Later discovered to be a nationwide plot by NAGFUG (National Association of Grandpas for Unplugging Grandmas).
Pulling the plug on Grandpa: Just leaked by Fox News! Grandma’s revenge. You read it here first!
Allowing competition across state lines: Since all major health insurers are licensed in every state, one wonders what this is all about. If it’s aimed at getting the individual states out of the business of regulating health care insurance within their borders, then that’s a good thing.
For the uninformed, health-insurance plans (excluding indemnity insurers) require the state of permanent residency of its insureds. That is because the benefit plans, provider contract terms, marketing plans, claims administration, member service protocols, etc., are regulated by the individual states. Whatever, this reform concept doesn’t have any opposition, which tell me
it doesn’t do much to reform anything.
We can’t afford it: Probably not, but let’s not confuse affordability with priority. The U.S. has the finest military in the world bar none. In fiscal 2009, the U.S. will spend roughly $1 trillion on military-related expenses, about the same as the rest of the world combined. We can afford the best. It just depends on what priorities we put at the top.
Small government: A desire of traditional conservatism, small government was achieved through minimal regulation of the private sector, not involving government in activities more effectively pursued by the private sector, reducing government redundancy and bureaucracy and limiting government to large but focused areas that serve the public good such as national security, roads, bridges, water and sewer projects, foreign relations, public health, education and welfare, environmental protection and other such endeavors in which there is little or no private-sector interest.
Anti-government: Where small-
government advocates seem to be headed.
This movement is not new and was epitomized by a Minnesota congressman many years ago who described what he wanted from the federal government as “Protect my shores, deliver my mail, and stay the hell out of my life.” Today, he would probably drop mail delivery.
The most conservative side of this movement sees government not only as undesirable but evil, invoking a
quasi-religious connotation to its
Anti-government devotees would terminate Medicare and Medicaid. Major pieces of health care legislation such as COBRA and HIPPA would be repealed.
Government takeover of health care: From what has been proposed so far, it is a tremendous stretch of the imagination to assert that this represents a government takeover of health care.
The problems we have with our health care system are largely, but not wholly, a function of private health-insurance-industry failures of the past. It is hardly surprising that the reforms necessary to correct these failures would lead to greater government involvement in the system.
Unlike some, I have no fear of increased government involvement perhaps because I believe I have some ability to influence government (through activism and the right to vote) and have no ability whatsoever to influence the private industry (except perhaps through government).
Further, I believe our federal government is a reflection of our society.
That government imperfectly represents my interests.
The private sector doesn’t represent my interests at all.
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