Tuesday, February 1, 2011

Still Litigating Health Care Reform

The Associated Press reports that a federal judge declared President Obama’s health care reform unconstitutional Monday.  At issue is whether the government is reaching beyond its constitutional power to regulate interstate commerce by requiring citizens to purchase health insurance or face tax penalties.  The ruling declared the mandate to purchase unconstitutional but stopped short of voiding the entire law.  No doubt the final say in the matter will rest with the Supreme Court.
Opponents of the law immediately praised the decision.  House Speaker John Boehner said: “Today’s decision affirms the view held by most of the states and a majority of the American people, that the federal government should not be in the business of forcing you to buy health insurance and punishing you if you don’t.”
There is no question that this bill needs work.  In its entirety it is a massive, complicated document that resulted from Democrats bowing to the will of Republicans  with the results being a watered down hodgepodge that is a boondoggle to the insurance companies.
But there are good aspects to the bill that an order to repeal will eliminate.  Most Americans don’t want insurance companies to decline to cover them when they have a pre-existing condition.  Most Americans want to be able to take their coverage with them if they change jobs, are fired or laid off.  Most Americans want the flexibility of keeping their unemployed kids on their policies until age 26 if necessary.  These positive aspects would be cast aside if the entire bill is deemed unconstitutional.
While the Republicans have worked hard to quash the bill they have offered little in the way of replacement solutions.   Their recommendations thus far have been limited to a reduction in taxes for small businesses and allowing insurance companies to sell their products across state lines.  Those remedies won’t replace the items listed above.  They won’t make coverage more affordable.  And they won’t make coverage available to the now 50 million people who do not have access to decent affordable health care.
I have a family member who needed an operation.  The surgery was deemed elective and in order to be covered required a full year of physical tests, psychological tests, doctor visits and other pre-op screening measures.  All of the results of these tests were forwarded to the insurance company as they occurred.  After approximately one year the insurance company approved the surgery…in writing.  The surgery was successful.  Even though the surgery was typically performed as outpatient surgery my family member stayed overnight because the insurance company required that they do so.  It took nine months for the insurance company to pay the hospital and doctor.  They declined payment on three separate occasions citing lack of pre-authorization, lack of required documentation and lack of an overnight stay.  During this period my family member received threatening phone calls and letters from the hospital demanding payment.  Finally, after nine months the insurance company paid the bills.
My mother passed away at eighty seven years of age.  In her last years she had insurance coverage through Medicare with a small supplement. During that time my mother had the following medical procedures: knee replacement, shoulder replacement, emergency surgery for a peptic ulcer, hip replacement, heart attack and three weeks of hospice care in my home.  The only bills we ever saw were for the telephone and television in her room.  Everything else was paid by Medicare with no questions.
It appears that we may spend the remaining two years of the Obama administration litigating health care reform all over again.  Maybe this time they will get it right.  Medicare for all!  

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