Government over-reach? Road Apples!!!

Author: Barrett Rainey

I’ve had mixed emotions about our nation’s new health care law since it was enacted nearly two years ago. But it wasn’t til a recent email exchange with a friend that I finally made up my mind: I support it. If you want to go to the rock pile to get some for the stoning, go ahead. I’ll wait. But I’m going to say my piece before things start flying.

It’s officially called the “Patient Protection and Affordable Care Act.” The shorthand title – used mostly by critics and the media – is Obamacare. I hate that name because the law is much more than that. So, for our purposes, it’s PPACA.

In terms of size and sweep for a government program, it ranks up there with Medicare and Social Security. Cost, too. While mostly the ignorant and far right – oops, repeated myself there – oppose it for “personal rights infringement” or “government overreach,” it’s really neither. We’ll get to that. Others oppose it on a cost basis which, at the moment, is unknown and climbing. And it will likely climb some more. But the alternative costs are climbing even more. And quickly!

For the record, I believe the out-of-proportion costs of health care in our nation will eventually drive us to a single-payer reality with the feds and some very large contractors replacing the health care system we now have. When I talk to medical professionals, most agree. That’s a major reason so many are selling their practices to hospitals and other large entities. Most see big changes coming and want to be “out front.”

If you, too, accept that premise, we’re on the same page. If you don’t, then you’re going to be in a constant state of anger as the world of administering care, insuring care and the financial tools to pay for care go through a lot of massive and expensive changes in the next dozen or so years. It will happen. You can bet the farm!

But back to PPACA. Many years ago I learned a valuable lesson from real political pros. When you want to tackle a large issue – like health care, tax reform, etc. – you work like hell to get at least the guts of what you’re after written into law. Modify, amend, give a little, compromise. Do whatever it takes to get it on the books. The reason: it’s much easier to amend and fix there than to keep fighting against those who want to stop you.

That’s what the President and his supporters did in this case. And unless the entire nation’s electorate joins the lunatic fringe November 6, PPACA will not be killed in the next congress. Amended? Probably. Should it be? Probably. But carefully. And with an eye to the very significant and fast-moving changes going on now in health research, coverage and delivery.

As a nation, we pour about 17% of our gross national product into health care. We can’t afford that. Percentage cost increases year-to-year are way out of control. These facts are forcing political and economic decisions that adversely affect all of us. It’s not sustainable. In my ever-so-humble opinion, PPACA will add to that cost burden. Which may force the single-payer decision sooner rather than later. As a consumer, that ain’t all bad.

Now, about “overreach” and “rights.” The U.S. Supreme Court will hear six hours of arguments Mar. 26-28 on some of that with a decision expected in about 90 days. It’ll be interesting to hear the kinds of questions from justices as we “sidewalk lawyers” try to guess the eventual ruling.

Absent a legal background, I can’t address interstate law and constitutional issues. There may be language in the law requiring changes to accomplish what needs to be done. Portions may have to be rewritten, added or deleted. But there are very common sense goals in what PPACA backers are trying to get done.

The loudest complaint from opponents is they’re being told they must buy health insurance or post a large bond to assure care when – not if – when they run up a large health care bill. “Government shouldn’t be making such personal decisions.” Oh, you mean like the car insurance you MUST buy to use public highways? Or you mean the driver’s license you MUST have for the same reason? Or the mandatory birth certificate MUST have to get said license? Or the Social Security paycheck withhold you MUST pay each week or month? Or the Medicare deduction? Or federal and state taxes you MUST pay? All written into existing law. If they weren’t, would you buy them or pay them? Most of us would. Many would not.

But my guess is many of those doing a lot of the complaining about “government forcing me to buy health insurance” may be short on car insurance or a valid driver’s license. Just a guess – based in part on the arrests for such violations that appear nearly every day in our small town newspaper. And of course, there are the motorcycle helmet laws in most states. And those mandatory fishing and hunting licenses. Planning and zoning laws that allow – or prohibit – certain things on your property. The laws of eminent domain held by nearly all levels of government.

But have to buy health insurance? “Damned government overreach!” Road apples!

As for “rights,” we all got ‘em. Me and mine, for example, have the “right” to not be expected to pay for anyone’s uninsured hospital care through higher insurance premiums and “creative” hospital billing. We have the “right” to not pay for someone’s hospital emergency room visits when he/she crashes a motorcycle. Without a helmet. Drunk. Our “right” doesn’t extend to paying for someone’s end-of-life care after years of smoking. Or the liver problems from a lifetime of alcoholism.

Above all, we have the “right” to expect all persons to be responsible for taking care of their families and themselves. We have those“rights” but massive, long-term evidence assures us we will not enjoy those rights because so many won’t be responsible. Won’t do what’s – right.

If you’re one of the responsible ones, a mandate to have health insurance will never be a problem. If you’ve not, that mandate can be a comfort to the rest of us.

Personally, I see nothing wrong with my grandkids being allowed to stay on their parents insurance until age 26; no problem with co-pays being eliminated for people who can’t pay them so they can get care; removal of lifetime insurance benefit caps for lifetime problems of disease or handicap; the Medicaid qualification being increased to 400% of poverty level when I remember all the long-term unemployed; health insurance exchanges run by the states for individuals and small businesses to shop for lower premiums; minimum standards/coverage for ALL health insurance policies.

More than all that, I have friends with pre-existing health conditions that have been denied health care coverage all their lives; the same coverage I and mine have enjoyed – and taken for granted – all OUR lives.

Our new health care law certainly needs revision. I’d be surprised if something that large could be written and enacted without amendment. But it needs to be done carefully – surgically – mindfully. It must be done with full consideration of today’s realities and not because voices ignorant of those realities feel “oppressed.” Unless this is done right – by the right people – with the right approach – the cost of keeping us well could make us economically very unhealthy.

All right. Throw your stone.

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