"Ten Wrong Reasons to Oppose Health Reform"

Greetings to my conservative readers, who have vented and philosophized about President Obama's health reform drive in countless comments and e-mails. I want to talk today to you.

Obviously, it is your perfect right to oppose what Obama and Democrats are trying to do. And there are legitimate reasons to do so. Maybe you think the government shouldn't be in the business of trying to make sure all Americans have health coverage. Maybe you think that would be nice, but we can't afford it. Maybe you oppose raising any taxes or fees to help finance changes in the health care system, or you think any savings we can wring out of it should be used for other priorities.

Yet these are not always the reasons readers offer for their (sometimes ALL-CAPS, often vitriolic) opposition -- as anyone can see in the comments sections of every column I write about health care. Here are some of the charges and claims, and why I think they are not the right reasons to oppose the health overhaul before Congress:

1. It is socialism. The Democratic plan would add about 15 million people over 10 years to Medicaid, the existing federal-state program now serving about 60 million poor and low-income Americans. It also would provide subsidies to middle-income families to help them buy private coverage. The bottom line, however, is there is no new government health program in the bill. The House passed a government-run plan (the "public option") in its health bill, but the Senate bill doesn't have one and the final product won't, either. Private insurance companies would not only survive under this bill, they would get millions of new customers. That doesn't sound like socialism.

2. It is a government takeover. The federal government would certainly be more involved in regulating insurance companies. The government would also set up and regulate a competitive new exchange, or marketplace, where small businesses and the uninsured could buy coverage. But the coverage would all be plans offered by private companies. The bill is, in fact, designed to preserve employer-based health benefits and the private insurance industry. So, increased government role, yes. Government takeover, no.

3. It is being "rammed through." There's a 100-year history of failed presidential attempts to achieve universal health coverage. The topic was discussed at length throughout the 2007-2008 presidential campaign. Since last January, it has consumed 15 months of hearings, legislating and debate in Congress. The House passed its bill in November and the Senate, by a 60-40 super-majority, passed its version in December. Take your pick -- a century, three years, 15 months -- but this doesn't meet any definition of "ramming."

4. Reconciliation is "ramming" AND cheating. Reconciliation is a Senate budget process instituted 30 years ago. Since reconciliation bills can't be filibustered, they need only 51 votes to pass -- so everybody uses them to get things done. A chart of 15 major reconciliation initiatives in last weekend's New York Times shows that Republicans have used the process many more times than Democrats. And we're not talking small ball. Republican presidents have signed reconciliation bills that, among other things, cut welfare benefits, expanded health coverage, raised taxes, reduced taxes and overhauled the student aid system. In this case, reconciliation will be used to amend a bill that's already passed the Senate with 60 votes. Cataclysmic, as Sen. John McCain put it? I think not.

5. It is unconstitutional. The bill requires every American to buy health insurance, including healthy people, and offers subsidies to help middle-income families. Insurance companies sought the mandate, saying it is the only way to keep premium costs from skyrocketing once they are not allowed to deny coverage to people with pre-existing medical conditions, drop sick people or limit annual and lifetime coverage (all popular provisions of the health bill). The mandate would not be the first imposed by state or federal governments -- they already require people to buy car insurance, buckle seat belts and wear motorcycle helmets, not to mention make sure their children are educated. Conservatives used to promote the health insurance mandate on grounds of personal responsibility. It's the law in Massachusetts.

6. It has sleazy special deals. The most notorious are the Cornhusker Kickback for Nebraska (permanent federal payments for Medicaid expansion) and the Florida exemption (seniors there would get to keep private Medicare Advantage plans that cost more than regular Medicare and are subsidized by taxpayers). The final package will not have these special deals. For procedural reasons, House members must first approve the Senate bill, which does include them, but the "fix" package -- possibly to be voted on the same day -- will remove them.

7. It would penalize senior citizens by cutting Medicare. The Senate bill would save more than $400 billion over 10 years by ending subsidies to Medicare Advantage and reducing projected payments to insurance companies, hospitals, drug companies and other players (some have already agreed to keep prices down). Seniors in regular Medicare would get the same benefits they have now, as well as additional services, like free preventive care. The AARP, which has 40 million members over age 50, says it supports health reform because it will put Medicare on a sounder fiscal footing.

8. It would do too little to curb costs. Amazingly, some people argue both No. 7 and No. 8. There are, in fact, many provisions intended to control costs. They include financial incentives for doctors and hospitals to provide efficient, coordinated care (rather than getting reimbursed for every test, procedure and hospital readmission); research into what treatments work best; a focus on preventive services and chronic care; pilot programs on ways to limit malpractice suits and awards; and an independent advisory board to recommend cost-saving changes in Medicare. These and other cost-cutting steps are described here.

9. It isn't popular. Did voters in Virginia, New Jersey and Massachusetts send clear messages -- by electing Republicans -- that they don't want this health package? Inconclusive at best. The economy is almost always the primary factor in election outcomes. Beyond that, Democrats had exceptionally weak candidates in all three states. The latest national poll from Gallup found slightly more people saying they'd advise their representative to vote against rather than for health reform. In a new poll from The Economist, 53 percent said they support Obama's proposed changes to the health care system. It's fair to say the country is split. In any case, Obama and Congress are not bound by polls.

10. It doesn't give us the same coverage as Congress. Actually, Congress is trying to provide similar coverage through these state exchanges. They are modeled on the Federal Employees Health Benefits Plan, which looks like this. The offerings are mostly from private insurers and every federal employee -- including members of the House and Senate -- pays for his or her own coverage. In time, I'm betting people who get coverage at work will be jealous of those who get it on the exchanges. They'll have choices, just like Congress does. Eventually the exchanges may open up to the rest of us as well.

Comments for this Article of Interest

I am a 51 year old gay man. I am a liberal Democrat. I have great respect for your talents, as well as for your political opinions and savvy Ms Streisand. In fact, I have often turned to your comments and statements as part of my own research on topical issues. However, I must take issue with you when it comes to the recent health care overhaul. First and foremost, we must put an end to partisan politics, as it only serves to further divide our nation. To this end, I feel we must stop labeling issues as either Democratic or Republican, or Liberal or Conservative. I am a liberal democrat, and I opposed this bill for numerous reasons. I hate to think that I lose my standing as a liberal democrat because I do not support this, or any given issue, that the Democratic Party, or given democrats have taken on as part of their political agenda. The Health Care Bill wasn’t about Democrats vs. Republicans, but rather it was about differing views as to how we handle the cost of our health care while maintaining the quality of health care that we now have. Some liberal democrats opposed the bill because they felt it didn’t go far enough, or because it doesn’t allow for public funding of abortions. Personally, one of my grips about this bill is that it does not allow federal dollars to fund abortion. A controversial opinion to be sure, but it is mine. I also opposed this bill because it does not include a provision to regulate the price of insurance premiums. One of the biggest arguments for passage of the bill was that it will reduce the cost of health care, and yet there was no provision to regulate rate increases by the insurance companies. I am also concerned about how this bill will be financed. Many aspects of the funding seem punitive to me. If one has a so-called “Cadillac” plan, it will be subject to a 40% tax (this tax to the insurance companies will be passed along to the consumer). As a self-employed professional, I have always paid for my own insurance coverage, and I see to it that I have a good plan. Yes, it is expensive, but I know the necessity of having quality coverage, and I have been willing to make certain sacrifices to ensure that I can pay my premiums. Every person must set their own priorities and make some sacrifices. The decision to buy good/expensive coverage does not mean that one is wealthy. And the government’s definition of wealthy is often unrealistic if one lives in a large city (the government’s definition is also ever changing). Which brings me to yet another point of opposition to this bill: it was passed on the promise of a “fix” in the Senate. Whether or not the Senate does indeed “fix” the bill, I feel it is irresponsible to pass any bill on a “promise”. Surely we have all had promises made to us that were broken. Surely we have all broken promises that we have made, even when we had every intention of keeping that promise. And are politicians not notorious for breaking almost every promise they make? And any bill that is close to 3000 pages is too long. And not to be read and understood by the lawmakers voting on the bill…well I am greatly disturbed by this type of reckless governing. And the “deals” that were made to pass this legislation! I know that there is the promise to “fix” these “deals”, but I cannot ignore the fact that they were put there in the first place. In my opinion, process is important. This administration was elected in part, on the promise of a new political approach. Seems to me we have more of the same old…These are just a few of my thoughts about this bill. I do want to thank you for the opportunity to respond to your thoughts. You expressed some interesting and enlightening opinions—you certainly gave me something to consider. Hopefully I have given you some. I bet you would be fun at a dinner party—the conversation would sure be exciting and thought provoking. Keep on blogging and I will continue to read your thoughts and ideas.

I have been waiting patiently for someone to address the Health Care bill in layman's terms and just want to thank you for doing so. I don't know if the bill is going to pass but you have made me realize that if I needed to cast my vote it would be for and not against.

Donna

Barbara, I appreciate your stance and your commitment. However, I disagree with you.

I own an insurance agency and my agents as well as myself provide SERVICE to our clients whom we have sold health insuracne to. It is a SERVICE industry which I do not believe that government has the infrastucture to educate and train government employees to properly handle. (THIS COSTS MONEY) I have waited on long lines at the DMV just to get a license renewed or tags and the service there is horrible. All this costs money.
I have many,many doctors as clients and not one is in favor of this overhaul. They are sure that they will lose patients as the requirements made upon the government will be difficult for these doctors to handle. The cost of running an office, malpractice insurance etc added to receiving less money from the insurance companies for patient care can actually put doctors out of business or at the very least, stop some young student from spending 100's of thousands of dollars on an education where the future earnings are limited.
There is no stipulation of who these uninsured people are. Are they American citizens?
It needs to be more defined.
Also, when I say I have many doctor clients...I have 210..to be accurate.