Open Letter to Rep. Ron Kind, D-WI 3
Congressman Kind,
As we are all well aware by this point, there are many in this country who have foregone reasoned, respectful, intelligent debate in favor of unseemly and unproductive outbursts, particularly on the subject of the health care reform legislation currently progressing through both houses of Congress. It is my hope that intelligence, reason, and respect still have a place in the relationship between a congressman and his constituents, and that their use may lead to a productive, beneficial dialogue.
Therefore, I bring my concerns about the pending legislation directly to you in this manner in the hopes that they may be considered, addressed, any misconceptions on my part may be dispelled, and any legitimate points help to shape your response to the forthcoming bill.
It has been often quoted that there are 50 million Americans who are presently without health care coverage. Assuming the bulk of this number are involuntarily uninsured because they are unable to afford private health insurance, and the stated goal of health care reform is to extend affordable health care coverage to every American, the problem faced by the so-called "public option" or by proposed health care co-operatives is to reduce the per-capita price for end consumers to a level where those 50 million can all afford it. The federal government has two primary ways to accomplish this: Find ways to reduce costs of services, or subsidize the difference from federal funds.
There are numerous areas where costs run to excess and overburden end users, where savings can be generated by altering federal policy. One is the burden of malpractice insurance on doctors and hospitals, and civil litigation insurance on prescription drugs. These are necessary to protect health care and pharmaceutical providers from excessive punitive damages in civil judgments, which are encouraged by the policy of winning litigators being paid a percentage of the settlement as a commission, and from the costs of defending against frivolous lawsuits. Both of these contributors to inflated health care service costs, and in turn inflated health insurance costs, can be remedied through tort reform policies.
A major contributor to end user costs is of course insurance company profit. However, in the present system, this profit is justified to a certain extent by the fact that insurance companies provide a service to their customers. They handle the bulk of the billing process, enabling their customers to entirely avoid even considering the specific costs of health care. Of course, this is a symbiotic relationship which can be used by both health care providers and insurance companies to benefit themselves to the detriment of their customers. It is beyond shameful that the health care industry is the only major service industry in this country in which one is not provided a schedule of fees or a cost estimate prior to choosing services. This perceived need for the services provided by insurance companies could be greatly reduced by compelling health care providers to give consumers the information they need to protect themselves, namely clear, detailed lists of expenses and cost estimates for services, available on demand online, in paper form at the provider's offices, and during consultations.
Neither of these options are considered in the pending H.R. 3200 to the best extent of my knowledge. Even the Congressional Budget Office acknowledges that the plan as proposed will generate a net cost of $1 trillion over the next ten years, and this cost will primarily be generated by the need to subsidize the plan to keep its costs to end users within the target amounts to ensure affordability. The proposal does little to address the costs of health care services, apart from indicating that the burden of uninsured and unreimbursed services will no longer be present (which is already considered a cost savings in the CBO's forecast figure). The end result is a federally-subsidized plan whose nominal end user cost will be much lower than private health insurance, despite the fact that the expense of operating both plans will remain largely unchanged, with the difference in the federal plan being paid from the federal budget. Private plans will be unable to compete with this federal plan, as they will have no way to reimburse more than they collect, which will force their closure, driving customers to the public plans without addressing the actual costs of health care.
This will leave the federal government with limited options: Implement price or wage controls, which will harm quality of care; reduce expenses by refusing to cover certain procedures or drugs, again reducing the quality of care available to the end user; raise more funds to subsidize the difference between real cost and end user prices by raising taxes; or raise the nominal end user plan price, which defeats the entire stated purpose of the legislation.
In its present form, these are the necessary eventual results of passage of H.R. 3200. For this reason, I must urge you to vigorously oppose this resolution, and work with your colleagues to develop solutions that address health care service cost excesses, taking the time necessary to craft a sustainable solution to this very complex problem.
I eagerly await a response regarding your position on this legislation, in the context of the concerns I have raised, and I thank you for your time and consideration of this, as you grant all your constituents.
[Now, we'll see what happens, if I get a response!]
As we are all well aware by this point, there are many in this country who have foregone reasoned, respectful, intelligent debate in favor of unseemly and unproductive outbursts, particularly on the subject of the health care reform legislation currently progressing through both houses of Congress. It is my hope that intelligence, reason, and respect still have a place in the relationship between a congressman and his constituents, and that their use may lead to a productive, beneficial dialogue.
Therefore, I bring my concerns about the pending legislation directly to you in this manner in the hopes that they may be considered, addressed, any misconceptions on my part may be dispelled, and any legitimate points help to shape your response to the forthcoming bill.
It has been often quoted that there are 50 million Americans who are presently without health care coverage. Assuming the bulk of this number are involuntarily uninsured because they are unable to afford private health insurance, and the stated goal of health care reform is to extend affordable health care coverage to every American, the problem faced by the so-called "public option" or by proposed health care co-operatives is to reduce the per-capita price for end consumers to a level where those 50 million can all afford it. The federal government has two primary ways to accomplish this: Find ways to reduce costs of services, or subsidize the difference from federal funds.
There are numerous areas where costs run to excess and overburden end users, where savings can be generated by altering federal policy. One is the burden of malpractice insurance on doctors and hospitals, and civil litigation insurance on prescription drugs. These are necessary to protect health care and pharmaceutical providers from excessive punitive damages in civil judgments, which are encouraged by the policy of winning litigators being paid a percentage of the settlement as a commission, and from the costs of defending against frivolous lawsuits. Both of these contributors to inflated health care service costs, and in turn inflated health insurance costs, can be remedied through tort reform policies.
A major contributor to end user costs is of course insurance company profit. However, in the present system, this profit is justified to a certain extent by the fact that insurance companies provide a service to their customers. They handle the bulk of the billing process, enabling their customers to entirely avoid even considering the specific costs of health care. Of course, this is a symbiotic relationship which can be used by both health care providers and insurance companies to benefit themselves to the detriment of their customers. It is beyond shameful that the health care industry is the only major service industry in this country in which one is not provided a schedule of fees or a cost estimate prior to choosing services. This perceived need for the services provided by insurance companies could be greatly reduced by compelling health care providers to give consumers the information they need to protect themselves, namely clear, detailed lists of expenses and cost estimates for services, available on demand online, in paper form at the provider's offices, and during consultations.
Neither of these options are considered in the pending H.R. 3200 to the best extent of my knowledge. Even the Congressional Budget Office acknowledges that the plan as proposed will generate a net cost of $1 trillion over the next ten years, and this cost will primarily be generated by the need to subsidize the plan to keep its costs to end users within the target amounts to ensure affordability. The proposal does little to address the costs of health care services, apart from indicating that the burden of uninsured and unreimbursed services will no longer be present (which is already considered a cost savings in the CBO's forecast figure). The end result is a federally-subsidized plan whose nominal end user cost will be much lower than private health insurance, despite the fact that the expense of operating both plans will remain largely unchanged, with the difference in the federal plan being paid from the federal budget. Private plans will be unable to compete with this federal plan, as they will have no way to reimburse more than they collect, which will force their closure, driving customers to the public plans without addressing the actual costs of health care.
This will leave the federal government with limited options: Implement price or wage controls, which will harm quality of care; reduce expenses by refusing to cover certain procedures or drugs, again reducing the quality of care available to the end user; raise more funds to subsidize the difference between real cost and end user prices by raising taxes; or raise the nominal end user plan price, which defeats the entire stated purpose of the legislation.
In its present form, these are the necessary eventual results of passage of H.R. 3200. For this reason, I must urge you to vigorously oppose this resolution, and work with your colleagues to develop solutions that address health care service cost excesses, taking the time necessary to craft a sustainable solution to this very complex problem.
I eagerly await a response regarding your position on this legislation, in the context of the concerns I have raised, and I thank you for your time and consideration of this, as you grant all your constituents.
[Now, we'll see what happens, if I get a response!]