Health care reform 2009

So, with Mr. Obama's press conference last night, I thought it was time to weigh in on this extremely complicated issue.

While I did vote for Mr. Obama, I must confess that I don't quite understand the nuances of this reform package (I probably could be paying more attention but there are other things in life frankly). With all the stakeholders involved, it would be great to see the flow of the new system, especially compared to the existing system (if you can call it that). The reason for wanting to see some kind of flow (I'm talking about the money cuz that's what most people care about) is to see what we, the American taxpayer and citizen, are going to have to pay.

So, I have a number of questions:

1. What type of public plan will be offered? Will it be basic coverage that focuses on preventative care? I'm sure that more detail on this answer would be better for everyone. Will private companies sell me a supplement if I want more coverage? What kinds of premiums are we looking at for the public plan? Will there be a sliding scale based on ability to pay? Will there be additional premium for smokers or other unhealthy lifestyles?
2. Will the public plan offer regional payment schedules or will it be one national payment schedule? This will have massive implications for small communities across the country.
   
3. Who is going to police the providers that are submitting claims to this new system? Who can do a better job than the existing agencies that can't handle the fraud in the existing government programs?
4. If the current health care system is paid by American citizens, taxpayers and businesses through insurance premiums, taxes and private pay, how will this change in the new system? With the requirement for insurance companies to not turn down applications due to pre-existing conditions, how will premiums NOT go through the roof like they would today?
   
5. What is the meaning of "affordable health coverage"? Seems like it all depends on how much money you make and how you choose to spend it. Will the public plan be "cheap" for some and still "out of reach" for others? Bottom line: how are you going to price it?
   
6. How are small businesses (I'm talking 20 employees or less) going to survive if they are required to provide insurance? Will they have to pay part of the premium? If so, how much? With small business being the engine of new jobs, a requirement to pay for part of employee's premiums could be the death knell for many. Remember Washington, many small businesses cannot offer health insurance benefits because they cannot afford it now.
7. What new regulations or restrictions will be put in place on insurance companies? Will they be required to offer an identical plan to the new public plan? Sure would make it easier to pay if you were going to purchase a supplemental insurance policy from the same insurance company.
   
8. How will my taxes change? (listen to the optimist that thinks there may be a possibility for them to go down) Will payroll taxes be impacted? Will businesses have to pay a higher percentage for payroll taxes? Any tax increase will have profound negative psychological affects for the economy during the current recovery.
   
9. How will existing insurance premiums be impacted? Will benefits change? What about companies that self-insure their health benefits for their employees? What about existing state-funded programs?
   
10. If someone wants better coverage, can they pay for it (assuming that private pay is still an option for the wealthy)?
11. What is going to be done about tort law? Are we going to continue to allow people to sue for millions putting unnecessary burdens on premiums and taxes and requiring providers to practice defensive medicine (one of the biggest money wasters in the current system)?
12. Will it be more difficult to get tests that the patient feels are needed? We currently have to manage our own care since medicine today is more about covering lower rear portions than it is about providing care. What about hypocondriacs? Instead of massive numbers of emergency room visits, will the new system allow for these patients to get the psychiatric care they need? Right now we have insurance examiners that decline people and procedures every day. What will be different? What standards of care will change?
    
13. Who is going to standardize the medical records? In this day and age, this is probably the most frustrating, aggrevating, unconcionable activity in today's "system". Come on people. This is just another example of no one at home policing the industry. Associations such as the AMA haven't done it. Who then? The insurance companies? The government? I say bring together a handful of the top software companies in the business together, put them in a room, lock the door and tell them that they have to come out with a solution. They are the ones with the vested interest. Let them come up with a solution.
14. What about illegal aliens? Are we going to continue to subsidize their free emergency room care (not the best solution for them either)? Are they going to have to pay to play? As citizens we will be required to pay into this new system either through taxes or premiums, so why not have illegals and visitors pay as well?

So these are just some of the questions that I have come up with in the past day. I'm sure that there are many more that the American people want to have answered. If you have accurate, reliable sources of answers to these and other questions on this topic, PLEASE comment on this blog entry and let's pass it along. I would also love to see a simplified chart that visually shows the old system and the new system with the major stakeholders and the money flows, current and projected.

I welcome your feedback that sticks to the facts!