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Health Care Reform An Emotional Topic
Health Care Refrom: An Emotional Topic©
August 19, 2010
“To the Congress of the United States:
One of the most cherished goals of our democracy is to assure every American an equal opportunity to lead a full and productive life.
In the last quarter century, we have made remarkable progress toward that goal, opening the doors to millions of our fellow countrymen who were seeking equal opportunities in education, jobs and voting.
Now it is time that we move forward again in still another critical area: health care.
Without adequate health care, no one can make full use of his or her talents and opportunities. It is thus just as important that economic, racial and social barriers not stand in the way of good health care as it is to eliminate those barriers to a good education and a good job.”
This quote is not from a President Obama speech on Health Care Reform (HCR) rather it is a part of President Nixon’s address to Congress on February 6, 1971. After reading the entire text of President Nixon’s address, it is easy to see how it could be confused with a speech given by President Obama. In fact, HCR has been recognized as an issue in every Presidential administration since Franklin D. Roosevelt and each has pushed for some sort of national health care plan. Therefore, we are talking about seven (7) Democrat and six (6) Republican Presidents supported some sort of HCR. According to the publication, The Missourian , “The first federal involvement in health care was in 1798, when the Relief of Sick and Disabled Seaman Act was passed.”  With this long history and consistent Presidential support why does it seem as if America is so afraid of HCR? According to a Gallup poll, when the Affordable Health Care Act was passed in March 2010, only 49% thought it was a good idea, while 40%  did not approve of it. This article is going to explore six (6) of the arguments that have risen against HCR and why those arguments appear to appeal to people.
One argument against HCR is that it goes against the moral fiber that this country was founded on. One site, claims, “…it is the duty of free individuals to decide what and whose needs appear most important to them. In a free society, the individual is of supreme importance and should not to be used as a means to society’s ends. The individual has the right to order his actions and possessions in the manner most consistent with pursuing his own happiness and values.” If you did not see the title of this article, a person may be hard pressed to realize that it was about HCR. This article is making the claim that if individuals do not arrange their finances so they can afford health care or if they decide that health care insurance is not worth the cost, it is not the society’s fault. This argument assumes that everyone is economically on equal footing when it comes to his or her personal finances. In 2008, there were 301,041,000  Americans living below the poverty level, where any health insurance, besides government sponsored insurance, was not likely.
For a family of three (3) (a husband, wife and child) living below the poverty line means they are making less than $17,330 annually. For example, in Dover, De (a small city in rural Delaware) a living wage which covers the basic needs for that same family is $20.38  an hour (poverty wage is $7.81 and minimum wage is $7.25). That calculation includes an estimated medical expense of roughly $227 a month . The moral argument is based on the belief that everyone is economically on the same playing field, which is a false assumption. The argument loses its validity when the facts about wages and income in this country are taken into consideration.
Argument 2-Death Lists
The next argument is the HCR will lead to the creation of “death lists.” According to this headline, “OBAMA'S "HEALTH-CARE" DEATH LISTS COMING YOUR WAY ” This article goes on to say.
“Under Obama's plan, some impersonal bureaucrat, based solely on cost to the government health-care system, will now decide whether you or your sick father or mother, die. Do you need a heart operation or expensive cancer therapy to give you a chance for life? Under Obama's plan, a bureaucrat will "calculate" how much this care would cost the government.
The bureaucrat will then do a "cost/benefit" analysis, the "benefit" being extending your life or treating your cancer or heart disease. If you're too old, forget about it. The bureaucrat will have to follow rules laid down by his superiors in a big book of "rationing" rules.”
First off, this is exactly what the current health insurance system does, it makes a determination whether a procedure is cost effective or not. Is this not what the preauthorization process is all about? The following is taken directly from a brochure explaining the process of Aetna clients that are State of Delaware employees, “Sometimes you may need care that requires approval from Aetna before you get it. Your PCP  and other network doctors will get this approval for you.” For many procedures outside of a normal office visit, the patient has to get a preauthorization from the insurance company to ensure the procedure is covered. If the procedure is not covered, and the patient still wants the procedure accomplished, he or she will have to foot the bill themselves. This is a company of “bureaucrats” telling your doctor what they will or will not pay for.
Nowhere in this article does it point to anything that supports the claim of a death list. There is only the innuendo and the manipulation of fear of growing old. Other articles will use the Canadian and British healthcare systems as an example of government programs that routinely deny services to older citizens. These claims are without merit; one supporting example is the fact that on average, the citizens of Canada and Great Britain live longer than their American counter-parts.
Argument 3- Health Care Benefit Tax
The next argument claims that Obama is taxing employee health care benefits. One article, states, “The bill that passed the Senate with such fanfare on Christmas Eve would impose a confiscatory 40 percent excise tax on so-called Cadillac health plans, which are popularly viewed as over-the-top plans held only by the very wealthy. In fact, it's a tax that in a few years will hammer millions of middle-class policyholders, forcing them to scale back their access to medical care. Which is exactly what the tax is designed to do.” This claim has a bit of truth to it; but the individual’s health benefits will not be taxed under the current plan. In 2012 employers will begin reporting on the W-2 everyone’s health benefits, then in 2018, health insurance companies and self insured businesses may be taxed on their health plans. If a health insurance policy for a single employee is above $10,200, or identifies a policy that covers an employee plus their family is over $27,500 , the funds over those amounts will be taxed. For example if a health care plan for a single employee cost $10,201 annually, the company would be taxed on the $1. A 2008  report by Kaiser Family Foundation  has the average employer-sponsored plan for a family costs $12,680, and the rate for a single employee at $5,791. Both rates are well below the purposed taxable limit.
Argument 4-Illegal Aliens
The argument that got Joe Wilson into trouble is the current plan would cover undocumented aliens. On September 9, 2010, Representative Wilson (R-SC), during a Presidential address of Congress shouted “You Lie” when the President stated that the HCR package would not cover illegal aliens. Representative Wilson thought the statement was false thus prompting him to break with protocol. He and others believe that the HCR package authorizes subsidized health care for undocumented aliens. Again, there is a grain of truth to his claim. Currently, undocumented aliens are being treated in hospital emergency rooms across the nation; no hospital is going to turn someone away for emergency medical help. Most of the cost associated with these services is being covered by the hospital and local and state governments.
Many critics are pointing to section 1557a’s anti-discrimination clause, which states:
“…an individual shall not, on the ground prohibited under title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.), the Age Discrimination Act of 1975 (42 U.S.C. 6101 et seq.), or section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any health program or activity, any part of which is receiving Federal financial assistance, including credits, subsidies, or contracts of insurance, or under any program or activity that is administered by an Executive Agency or any entity established under this title (or amendments). The enforcement mechanisms provided for and available under such title VI, title IX, section 504, or such Age Discrimination Act shall apply for purposes of violations of this subsection.”
The claim is that this clause will prevent the government from discriminating against a person’s citizenship status. However, the first part of the sentence reads, “Except as otherwise provided for in this title (or an amendment made by this title).”
Section 1312 (f)(2) clearly outline the capacity of undocumented aliens to participate in health care programs. “ACCESS LIMITED TO LAWFUL RESIDENTS.—If an individual is not, or is not reasonably expected to be for the entire period for which enrollment is sought, a citizen or national of the United States or an alien lawfully present in the United States, the individual shall not be treated as a qualified individual and may not be covered under a qualified health plan in the individual market that is offered through an Exchange.” They are not qualified for health care subsidies set up for American citizens and legal residents.
A Washington Post article asked the question, “Is health-care reform constitutional? ” The article was citing the arguments of several states, in particular Virginia, where the State’s Attorney General claims that the HCR bill violated “the plain text of both the Ninth and Tenth Amendments.” Currently there are 13 states that have filed lawsuits claiming that HCR is unconstitutional. To understand the argument, you first have to understand what the Ninth and Tenth Amendments are saying.
The Ninth Amendment States, “The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.” I had to read this Amendment several times before it made any sense. It simply means that identified or named rights cannot deny the rights of people that are not named or identified in the Constitution (that is as clear as mud). When the courts have cited the Ninth Amendment, the judiciary has not based a ruling solely on its content alone. The Ninth is used in support of another Amendment(s). I would think that citing this Amendment is dangerous for people who do not normally want to expand personal freedom.
What I do not understand is what right is being violated by the passage of HCR? The right to reject or not have health insurance? This is why the Ninth Amendment is not cited by itself, because there has to be some right that has been violated. The state of Virginia is claiming that the Tenth Amendment is the other half of their Constitutional argument. The Tenth Amendment states, “The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.” So, the argument is that the Health Insurance Industry is the exclusive jurisdiction of the states. Except that Insurance Companies operate in multi-states, interstate commerce, thus it is within the realm of the Federal Government.
Article I SECTION. 8. of the Constitution states: “The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defense and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States.” Ensuring that everyone has adequate healthcare insurance is taking care of the general welfare of the citizens of this country.
Argument 6-We have the greatest Healthcare System in the world
One argument is that we have the greatest health care system in the world and we do not want to diminish the quality of care we receive. I understand that there are many factors that go into determining the quality of a health care system. Two measures that I would like to look at are infant morality rate and life expectancy. In 2010, if you compared the United States to other industrialized countries such as Germany, England and Canada you will see that we have a higher infant mortality rate and a lower life expectancy. Even Cuba has a lower infant mortality rate with a comparative life expectancy. The small country of Monaco has the lowest infant morality rate and the longest life expectancy of any country. If you compare U.S. to Canada you will find that Canada has a lower Infant Mortality Rate, a higher Life expectancy, and a lower Death Rate (7.87 Canada verses 8.38 United States).
I am not questioning the quality of healthcare providers in this country. My medical history is a testament of the excellent care that I have received. Thankfully, I had insurance that allowed me access to that care. However, that is not to say that there were no problems along the way. There are fights between what my doctors believe is in my best interest and what the insurance company believes I need. In one instance, for an operation that I had to have to save my life, the insurance company agreed to pay the surgeon’s costs, but not pay the hospital where he practiced. The point of this section is simply that industrialized/capitalistic nations which have a national health care system provide quality of life equal to or better than the United States.
Reason verse Emotion
All this information does not answer the question of why America would be so against a national health care plan. The insurance and medical industries profit by maintaining the status quo, which does not benefit the average American. We have seen health care costs sky rocket over the past 10 years; and, we have seen health insurance companies profits increase as well. The table below show the profit margins for five (5) of the health insurance companies in America. 
Some may want to point to the President’s race as a reason people are fighting. While that is a factor it is not the primary reason for the opposition. Remember HRC reform, in some form, has been apart of every Presidential agenda since Franklin D. Roosevelt. All of President Obama’s predecessors were Caucasian and many of their efforts were out right defeated. But, still you have to take into consideration the varicosity of the attacks against the President and the current HCR movement. The verbal assaults often come as personal commentary of his ancestry rather on the policy that he is putting forth.
Even if I could definitely prove that a national health care program is a good thing for this society, the sociological wiring of this country will continue to make it hard to accept. Part of the blame goes to how effective American politicians were at demonizing everything that appears to be anti-capitalist. With HCR there seems to be this unreasonable fear that medical professionals will be not be allowed to practice their art, and that the health insurance industry will no longer exist. Health care providers will continue to do their job and health insurance companies will continue to exist and make a profit.
I think that the bottom line is that we have a problem with giving something to people that we believe they do not deserve or earned. This is a hard argument to overcome, because it is less than a rational position, but instead an emotional response. I have to go back to President Nixon’s address where he states, “Without adequate health care, no one can make full use of his or her talents and opportunities.” Access to good health care is a need and a right that every American should have. Without it their ability to contribute to the greater good of the nation becomes hampered.
1. http://www.kaiserhealthnews.org/Stories/2009/September/03/nixon-proposal.aspx Accessed August 13, 2010
2. Heisdorffer, Allison The Missourian. http://www.columbiamissourian.com/stories/2010/03/23/presidential-influence-health-care-reform-throughout-20th-century/. March 23, 2010. Access August 13, 2010
3. Saad, Lydia. Gallup. http://www.gallup.com/poll/126929/slim-margin-americans-support-healthcare-bill-passage.aspx. March 23, 2010. Accessed August 13, 2010
10. Primary Care Physician
11. Bob Herbert. A dishonest health-care tax: The Senate version of the bill has a nasty surprise for the middle class. Wednesday, December 30, 2009. http://www.post-gazette.com/pg/09364/1024395-109.stm. accessed August 12, 2010
12. These amounts will be adjusted over time to account for inflation
13. Employee Health Benefits: 2008 Summary of Findings. http://ehbs.kff.org/images/abstract/7791.pdf. access August 12, 2010
14. ttp://www.kff.org/ Access August 12, 2010
15. Barnett, Randy E. Washington Post. Is health-care reform constitutional. http://www.washingtonpost.com/wp-dyn/content/article/2010/03/19/AR2010031901470.html. March 21, 2010. Accessed August 13, 2010
17. Source Health Insurance for America Now report which is based finance reports filed by the identified insurance companies. http://hcfan.3cdn.net/d605c2281191ac1f04_kam6bn3ga.pdf. accessed August 15, 2010
© 2010 Mark Monroe