Sunday, August 30, 2009

What HR 3200 Would Mean for Louisiana's 7th Congressional District

Republican Congressman Charles Boustany is an ardent opponent of HR 3200, "America's Affordable Health Choices Act of 2009," ostensibly because it amounts to a government takeover of healthcare.

Like his other Republican colleagues (particularly his fellow Louisiana Republican Physicians Cassidy and Fleming), Boustany is misrepresenting the what is in the bill in a concerted attempt to scare people into opposing health care reform in general, and the public option in particular.

What these Republicans know, but cannot afford to say in public, is that the plan embodied in HR 3200 responds to the crisis in a limited, precise, (dare I say) surgical way. It is not introduced socialized medicine into the working age segment of the U.S. population. No hospitals are being bought (the Frists can still own HCA and all that debt) and doctors will not be becoming civil servants (the three-Bimmer garage is safe, y'all!).

What HR 3200 represents is a rationale attempt to respond to the crisis in healthcare that is at hand without destroying those elements of our system that are working and worth preserving.

The first thing to understand is that the biggest threat to the health insurance coverage that people now have through their jobs is that without healthcare reform, premiums for that coverage will outstrip the ability of the company to pay for the coverage (a trend already accelerating) or the employer is going to have to shift more of the costs of that coverage onto employees (sound familiar? I though so.).

Under HR 3200 and all the legislation that has been formulated by Congressional Democrats, people can keep their current coverage if they so choose, and insurance companies will no longer be able to deny coverage due to pre-existing conditions and they won't be able to cancel your coverage when an adverse diagnosis is delivered (something called 'recision' by the industry).

But beyond that, the extension of insurance coverage to just about all Americans (97% by best estimates), HR 3200 will put an end to cost-shifting that providers do in order to cover the costs of providing care to those who cannot afford it. That is, with universal coverage, hospitals and doctors will have more paying customers coming through their doors. This in turn will reduce the price pressure on private sector insurance providers, who have been the deep-pocketed target of providers seeking revenue to cover the costs of uncompensated care.

I believed Tip O'Neill when he said, "All politics is local." So, what will HR 3200 mean in the 7th Congressional District, the place Congressman Boustany claims to represent when he is in Washington?

Here are some facts (PDF)on that as compiled by the House Energy and Commerce Committee:
up to 14,100 small businesses could receive tax credits to provide coverage to their employees; 6,600 seniors would avoid the donut hole in Medicare Part D; 700 families could escape bankruptcy each year due to unaffordable health care costs; health care providers would receive payment for $206 million in uncompensated care each year; and 100,000 uninsured individuals would gain access to high-quality, affordable health insurance.
But, aren't small businesses opposed to HR 3200? Not really. The U.S. Chamber of Commerce is opposed and the National Federation of Independent Small Businesses is opposed, but these are ideologically based opponents who ignore the actual positive impact of this legislation on businesses and their workers.

According to the Energy and Commerce Committee analysis, "Under the legislation, small businesses with 25 employees or less and average wages of less than $40,000 qualify for tax credits of up to 50% of the costs of providing health insurance." Since something like 73 percent of the businesses in Louisiana are considered small businesses and maybe 30 percent of those businesses offer health insurance to their employees, the tax credits and subsidies in the bill would be a tremendous help to those businesses.

Why? Because affordable coverage would mean workers would be able to get treatment for chronic diseases before the conditions reached critical states. The Milken Institute estimates that untreated chronic disease costs Louisiana businesses $22 billion per year in lost productivity.

Good for seniors? Aren't seniors among those protesting the loudest against the Democrats' healthcare reform plans? Well, yes, they are protesting loudly but those protests are based on deliberate distortions of what is contained in the legislation, much of it put forth by Republicans like Congressman Boustany and his colleagues.

Under HR 3200, here's how seniors in the 7th District would benefit:
"Each year, 6,600 seniors in the district hit the donut hole and are forced to pay their full drug costs, despite having Part D drug coverage. The legislation would provide them with immediate relief, cutting brand name drug costs in the donut hole by 50%, and ultimately eliminate the donut hole."
If you know a senior on Medicare Part D, you know just how hard it is to make it to the other side of the doughnut. The costs of medicines are even calculated differently when they are in the doughnut, meaning it does not take long to get there but it costs a hell of a lot more to get out before the end of the year. The doughnut has been very good for pharmaceutical companies but bad news for seniors. HR 3200 will put an end to that trickery by phasing out the doughnut.

HR 3200 will remove the risk of financial ruin from the diagnosis of a disease. Currently, something like 60 percent of all bankruptcies in the United States involved medical costs. 75 percent of those who declare bankruptcy due to medical costs HAD health insurance at the time those costs were incurred. This legislation will end this nightmare in the 7th District in this way:
There were 700 health care-related bankruptcies in the district in 2008, caused primarily by the health care costs not covered by insurance. The bill provides health insurance for almost every American and caps annual out-of-pocket costs at $10,000 per year, ensuring that no citizen will have to face financial ruin because of high health care costs.
Cost-shifting by providers to cover the costs of uncompensated care is a major contributor to the ever increasing costs of care and health insurance. HR 3200 will help end that and in so doing will improve the financial stability of hospitals across the country — and in the 7th Congressional District. Here's how:
In 2008, health care providers in the district provided $206 million worth of uncompensated care, care that was provided to individuals who lacked insurance coverage and were unable to pay their bills. legislation, these costs of uncompensated care would be virtually eliminated.
Covering the cost of what is now uncompensated care will remove the hidden tax on private health insurance that every policy holder now pays.

How will the bill accomplish this? By providing coverage to those currently without health insurance:
There are 120,000 uninsured individuals in the district, 18% of the district. The Congressional Budget Office estimates that nationwide, 97% of all Americans will have insurance coverage when the bill takes effect. If this benchmark is reached in the district, 100,000 people who currently do not have health insurance will receive coverage.
Can we afford to do this? Yes! The Congressional Budget Office says that HR 3200 is budget neutral, and will actually create several billion dollars in savings over the next ten years. That means that over that period of time, the U.S. was going to spend the same amount of money on healthcare without reform that it will spend under HR 3200. The difference is that we will, as a nation, as a state, and as a community, be getting more bang for our bucks.
The cost of health care reform under the legislation is fully paid for: half through making the Medicare and Medicaid program more efficient and half through a surtax on the income of the wealthiest individuals. This surtax would affect only 2,530 households in the district. The surtax would not affect 99.1% of taxpayers in the district.
I know. This is not what you've been hearing in the media and in the coverage of the town hall meetings. The fact is that there has been an orchestrated campaign of disinformation and distortion about this legislation, its content and its intent by people (like Republicans) who have no policy answers but want to score political points, and those (like insurance companies and others) who have a vested stake in the outcome of this legislation.

The best thing proponents of reform have going for us is that millions of Americans have had their own direct experiences with the system as we now know it. They know that there is something fundamentally wrong with the system.

As the word has gotten out about the distortions and lies being used by opponents, people have begun to take a closer look. There is a significant portion of the population (even in Louisiana) that knows things must change and want to make sure that the proposed changes will make things better rather than worst.

From the numbers on the 7th District, it is clear that HR 3200 will be good for the district, good for the state and good for the nation.

You can look at the numbers for each congressional district here.

Knowledge is power. Arm yourself with it.

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