Monday, June 22, 2009

Health Care Reform, The Deficit, Polls, And Nonsense

On the drive home from work this morning, I heard a brief promo for Cokie Roberts' usual Monday morning "analysis" bit she does on NPR's Morning Edition. I have made it clear in the past there are few pundits I despise more than Mrs. Roberts, and even the brief ten seconds or so I heard was enough make me shout and push a CD in so I didn't have to hear her.

Much has been made of a recent poll that shows Americans are "concerned" about the growing federal budget deficit. Quite a few people, both politicians and commentators, have taken this as a sign that some kind of public option on health care is a non-starter because the price tag would be prohibitive. At a time of contracting economic activity, growing joblessness, and the continuing effects of the Bush-era tax cuts, the deficit is growing. Yet, as been repeated ad nauseum since the beginning of the economic downturn, shrinking federal spending at a time when economic activity is stagnant will only make things worse. While the deficit is, indeed, worrisome, it is not, and should not be, at the top of our political "to do" list. Indeed, in the long run, offering a publicly-funded health care option will do far more to save money than anything currently being offered.

What's surprising about all this talk about health care vs deficits is that it takes place in the midst of discussions about the truly abysmal way health insurance companies treat policy-holders. On the very same program in which Mrs. Roberts waxed stupid about our national angst over deficits, came this story:
Insurers Revoke Policies To Avoid Paying High Costs
by Joanne Silberner

According to a new report by congressional investigators, an insurance company practice of retroactively canceling health insurance is fairly common, and it saves insurers a lot of money.

A subcommittee of the House Energy and Commerce Committee recently held a hearing about the report's findings in an effort to bring a halt to this practice. But at the hearing, insurance executives told lawmakers they have no plans to stop rescinding policies.

The act of retroactively canceling insurance is called rescission. It happens with individual health insurance policies, where people apply for insurance on their own, not through their employers. Their application generally includes a questionnaire about their health.

The process begins after a policyholder has been diagnosed with an expensive condition such as cancer. The insurer then reviews the health status information in the questionnaire, and if anything is missing, the policy may be rescinded.

The omission from the application may be deliberate, to hide a health condition that might have made the applicant ineligible for insurance. But sometimes there's an innocent explanation: The policyholder may not have known about a health condition, or may not have thought it was relevant.

The rescissions based on omissions or immaterial conditions incensed many lawmakers.

"I think it's shocking, it's inexcusable. It's a system that we have in place and we've got to stop," Energy and Commerce Committee Chairman Henry Waxman (D-CA) said at the hearing.

From the other side of the aisle, Rep. Joe Barton (R-TX) was also appalled.

"Doesn't it bother you to do this?" he asked Don Hamm, CEO of Assurant Health, who appeared with the CEOs of UnitedHealth's Golden Rule Insurance Co. and WellPoint's Consumer Business.

I'll take National Health over this kind of evil, immoral garbage any day of the week.

On the same issue of health care reform, I would like to raise a point of contention with Bob Somerby from his Friday Daily Howler. In it, he attempts to portray the "real fears" some people have about "rationing health care", and compares it to a long article that addresses the issue of "health care rationing" without, as he claims, actually dealing with their "fears". I would submit that, in fact, the "fears" expressed by those interviewed in the first part of Sombery's piece are both misguided and based on nothing more than propaganda. The way the issue of "rationing" is addressed in the piece he sharply criticizes in the second part of his post in fact addresses the issue head on - without treating false ideas and fears created by political propaganda as worth notice.

The entire question of "rationing", especially in light of the story about insurance companies dropping people so they don't have to actually pay money to cover them, ends up being a non-existent issue. As does the debate over whether or not "some bureaucrat" stands between an individual and his or her doctor. See, as it stands now, some bureaucrat does, but its a faceless, unaccountable number cruncher at a private health insurance company. If a public option is offered, not to replace but just to compete with existing health insurance companies, it migh raise the standards across the board.

Somerby takes a writer to task for not addressing fears, when those fears are misguided. Somberby takes a writer to task for addressing the issue of "rationing" in a thoughtful, substantive way, without pandering or talking down to his readership. Is it any wonder we can't have a serious debate on health care reform?

Virtual Tin Cup

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