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Vail Valley Voices: Fix what’s broken – don’t destroy what’s not

GREG ZEBORAY
Vail, CO Colorado

I’m asking that you please vote “no” on the health care/ insurance reform legislation! Public opinion polls show a growing majority is opposed to it, and I can’t think of a better time to remind you that you were elected to represent the wishes of the people, not your chamber’s leadership and/ or the president. My suggestion would be that you vote as if your job depends on it because it very well may. And, whatever you do, don’t even consider voting ” yes” until you have personally read every single page – even if that delays things by a few weeks. This practice of voting on bills you have not read in their entirety is dangerous and a vio-lation of your duty.

And we do not have the luxury on this matter for you to rely on what others tell you.

The current health- insurance system may need some work, but it’s not as ” broken” as some people would have us believe. I’d like to point out a few facts that really need some con-sideration: • Keeping insurance companies honest: It is documented fact that the nation’s health insur-ers pay an average of 86 percent of every premi-um dollar collected on claims. So, considering that 14 percent goes to salaries, business over-head and marketing, just how much of a cost reduction is possible without complete tort reform and the elimination of mandates? Con-sidering that salaries and business overhead will remain constant ( whether a government or pri-vate entity), limiting access to care is the only way to achieve that. And how are you going to limit care when the providers still face the potential of malpractice claims? No reputable doctor in their right mind will limit testing or procedures when faced with that exposure.



• Mandates: Why does the government insist on mandates? Health insurance should be no different from – say – car insurance. You select the specific coverages you want and pay accord-ingly. Nowhere is a vehicle owner forced by law to purchase coverage that they have no need for ( beyond general liability). The same should apply to health insurance.

• Paying for this: All costs of any program you consider must be borne entirely from premiums collected based on actuaries prepared by veter-an insurance professionals. All accounting gimmicks and taxes must be taken off the table. Let’s be honest here: The U. S. government has an extremely poor history of forecasts being correct – take a look at the original fore-casting done for Medicare and Social Security, and you’ll see my point.



• Ten years? Let’s talk eternity: We keep hear-ing about what this plan will cost over 10 years. It is time you consider what it will cost for gen-erations to come. You must not lose sight of the fact that our budget deficits have grown and continue to grow exponentially, which means the portion of our federal budget allocated to interest payments will continue to grow year after year. The ultimate result of that will be few-er dollars available for normal government func-tions and entitlements. Our country is at the breaking point. It cannot afford to take on one more program that has any potential of revenue shortfalls.

• Keep your own insurance? Let’s deal with reality here. When the president states, ” If you like your current insur-ance, keep it,” he is not being entirely honest. Truth is, if you lose your private coverage and want it back, you must select a plan that meets the coverage guidelines established by the govern-ment, and even if you don’t lose your current private insurance, you have to switch to a plan that meets these cover-age guidelines after five years ( when all private companies will be limited to them).

• Not good enough for congressional members: When asked July 31, Rep. Hen-ry Waxman admitted that congressional and Senate members would not be forced onto the government plan. I find it very concerning that it is not good enough for the elite but is good enough for the common folks – the ones who hire you, by the way. Think about that!



• HSAs: The only good thing to happen lately, and you want to kill them. The elimination of HSAs is a huge mistake for reasons I will explain in the next paragraph.

• Insureds will lose their only advocate: Citizens lose their ability to purchase insurance from an insurance broker, whose future help is often vital to the insured in resolving matters such as claim issues. One must remember that, by law, brokers work for the insured, not the insurance company, and have a fidu-ciary responsibility to the client. The gov-ernment will have no such obligation.

• Considerable job losses: Have you considered how many health- insurance agents ( and their staff ) will be put out of work? So how do you reduce insurance costs and maintain the current system of private insurers? It’s actually quite sim-ple: Enact complete tort reform, end mandates, and go back to the old indem-nity- style PPO plans, where the insured has a deductible of $ 250, $ 500 or $ 1,000 and then is responsible for 20 percent of all charges after the deductible is met until they’ve reached their stop loss ( aka maximum annual out of pocket) of – say – $ 5,000. The bottom line is that if peo-ple have their money on the line, they will be far more cautious of how they uti-lize health care, and that also will help to significantly reduce premiums. That is exactly why HSAs are a win- win for everyone involved. And by severely lim-iting ( if not outright eliminating) mal-practice claims, the providers will feel far more comfortable in only suggesting and prescribing tests, procedures and pre-scription drugs that are really necessary. This policy of low office-visit co- pays and little to no cost for other services began with the introduction of HMOs and has significantly increased the cost of health insurance. It has turned insur-ance into a usage plan, and if the govern-ment plan continues that practice, the taxpayer will be responsible for a never-ending shortfall. So now we’re down to the 16 percent of Americans without health insurance, and after you remove those who don’t want it or consider expensive cars, flat-panel TVs and entertainment to be high-er on their ( financial) priority list, or those who are residing here without per-mission, you are probably down to 8 per-cent of the American public.

Start working on a health- care bill that addresses the needs of those people, beginning with insurance reform as I outlined above, and allow the rest of us to continue with the private marketplace. If you fix what is broken, all Americans will applaud you. If you destroy what is good, all Americans will fault you. Slow down, and give this issue some real, careful thought. This is serious business and not something that can be undone when it proves to be a failure.

As Gen. Colin Powell said to President George W. Bush prior to the Iraq inva-sion, ” You break it, you own it.”

Somehow, I still have enough faith in you that you’ll recognize this as some-thing you don’t want to own!

Greg Zeboray owns an insurance agency in San Clemente, Calif. He is the brother of Gypsum resident Marty Lich.


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