Why the Health Care Reform Debate Will Not Go Away
On the Saturday before Labor Day, I found myself comfortably seated at my sister Joanne’s house sharing, like many other Americans in a family barbecue of hamburgers, hot dogs, ice cream and other forbidden high fat, high cholesterol foods and good conversation.
This Labor Day was special since my older brother, Ray, a chemical engineer who works on a project basis throughout the country, was assigned to work locally here in Pennsylvania and we may have the chance to see him for a full year. Ray, just in from his multi year stint in Minnesota, is perhaps best known in the family for his multiple daily e-mails debunking such ideas as global warming and providing photograph after photograph that demonstrate that it still snows in Minnesota.
Ray is also one of the many workers today who continues to work at age 66. He brought with him a fellow engineer on the project and his wife and we settled down to doing what I suspected many other families may have done over the Labor Day holiday. We talked about health care reform.
I suppose I should also add that the discussion continued as we moved from the dining room table to the outdoors. At some point I turned and noted that all of our group except those of us absorbed in the conversation were no longer around and it had become very dark.
Having spent 13 years of my life absorbed in health care issues, in exploring how to pay for health care, especially chronic care for seniors and legislation, I guess it is fair to say I become entranced by the subject. On that Saturday, though, I just mostly wanted to hear what people had to say.
Ray, of course, at age 66, is already on Medicare and his story of tracking down supplemental insurance plans is worth a column itself. His engineer friend, under age 65, had difficulties of his own obtaining affordable insurance. Their small employer has other concerns than health insurance.
If I took a survey I think I could safely say that few people I have spoken to generally and possibly no one at this gathering believe that the current state with private insurers is ideal. Gaps in coverage and fears of losing coverage, concerns about preexisting conditions and cost are all well known problems. On the other hand, change as wide ranging as HB 3200, America’s Affordable Health Choices Act of 2009 raises questions.
There were some reasonable points made. One is that, before signing on to a bill of more than 1,000 pages, it is a good idea to read and digest it first. Details matter.
For those who have insurance with employers, there should be little change. For those who do not or who had it and lost it perhaps after illness, how would it affect them? Since small employers would be exempt, how small is small? What would basic insurance include? The engineer wanted to know about the possibility of insuring across state lines. Cost is a major issue on both sides. Despite the fears, however, I do believe that, on a gut level, we suspect that the current path we are taking may be unsustainable and some adjustments need to be made.
One mystery to me is why surveys indicate that seniors express concerns. With the exception of reductions in subsidies to Medicare Advantage plans, the rest of the provisions actually reduce or eliminate co-pays and deductibles and expand benefits. If the government option is a concern, seniors are already covered by Medicare.
We have, in fact, had government options all along. They include Medicare and Medicaid and also the lesser known programs that are cooperative arrangements between the government and private insurers such as CHIP for children and, in Pennsylvania, Adult Basic.
I think back to the time when my father worked for General Electric Co. in Philadelphia and was diagnosed with cancer. While our family had many worries, concern about health insurance coverage was not one of them. The same was true when my eight year old brother, Steve, was taken ill with leukemia. One major difference was that Dad began to work for the company at age 19 and, except for service in the Army during World War II, continued to work for the same company until his death at age 47. That continuity and stability are no longer there and the question it raises is what mainstay can replace it. The debate on health insurance reform is part of the larger question how to provide some level of permanence in a shifting world.
About the Author Janet Colliton
Esquire, Colliton Law Associates, P.C. Janet Colliton has practiced law for over 38 years, 37 of them in Chester County, Pennsylvania, a suburb of Philadelphia. Her practice, Colliton Law Associates, PC, is limited to elder law, Medicaid, including advice, applications and appeals, and other benefits planning including Veterans benefits, life care and special needs planning, guardianships, retirement, and estate planning and administration.