{"id":15310,"date":"2010-04-07T07:48:58","date_gmt":"2010-04-07T13:48:58","guid":{"rendered":"http:\/\/www.nmpolitics.net\/index\/?p=15310"},"modified":"2010-04-08T08:39:38","modified_gmt":"2010-04-08T14:39:38","slug":"health-care-reform-is-anything-but-scary","status":"publish","type":"post","link":"https:\/\/nmpolitics.net\/index\/2010\/04\/health-care-reform-is-anything-but-scary\/","title":{"rendered":"Health-care reform is anything but scary"},"content":{"rendered":"<div id=\"attachment_15389\"  class=\"wp-caption module image alignright\" style=\"max-width: 300px;\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-15389    \" title=\"Health care\" src=\"http:\/\/www.nmpolitics.net\/index\/wp-content\/uploads\/2010\/04\/Health-care.jpg\" alt=\"\" width=\"300\" height=\"245\" \/><\/a><\/dt>\n<dd class=\"wp-caption-dd\">\n<div><a rel=\"&quot;cc:attributionURL&quot;\" href=\"&quot;http:\/\/www.flickr.com\/photos\/italintheheart\/&quot;\">http:\/\/www.flickr.com\/photos\/italintheheart\/<\/a> \/ <a rel=\"&quot;license&quot;\" href=\"&quot;http:\/\/creativecommons.org\/licenses\/by\/2.0\/&quot;\">CC BY 2.0<\/a><\/div>\n<\/dd>\n<\/dl>\n<\/div>\n<p>When <a href=\"http:\/\/www.radiojim.com\/\">Jim Villanucci<\/a> was kind enough to invite me on to KKOB for a few hours last week, I was expecting the usual tea party accusations that health-care reform is a government takeover of 1\/6 of the economy.<\/p>\n<p>What I wasn&#8217;t expecting was to hear such a high percentage of callers admit that they, or someone in their family, receives some kind of taxpayer-subsidized health care.<\/p>\n<p>They uniformly said current government health programs were working just fine.  Strangely, though, many callers claim that the newly passed reform is a socialist government takeover.<\/p>\n<p>Beyond the hypocrisy of enjoying government health care while trying to deny it to others, the tea partiers have missed the biggest story about reform: \u00a0It is the furthest thing imaginable from a government takeover of health care.<\/p>\n<p>All health-care reform does is take the current private system and ensure access to care for sick people.  That&#8217;s it.  That one basic principle of guaranteed issue requires three follow-ups: community rating, full participation and some subsidies, but those are simply necessary components to enforce the idea that pre-existing conditions shouldn&#8217;t stop you from getting care, whether you currently have insurance or not.<\/p>\n<div class=\"mceTemp\">\n<dl id=\"attachment_15378\" class=\"wp-caption alignright\" style=\"width: 185px;\">\n<dt class=\"wp-caption-dt\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-15378\" title=\"BundyNew\" src=\"http:\/\/www.nmpolitics.net\/index\/wp-content\/uploads\/2010\/04\/BundyNew.jpg\" alt=\"\" width=\"175\" height=\"221\" \/><\/a><p class=\"wp-caption-text\">Carter Bundy<\/p><\/div>\n<h3>How else?<\/h3>\n<p>Seems pretty common sense that a health-care system should cover sick people.  In order for sick people to get care, the first thing you have to have is &#8220;guaranteed issue.&#8221; That just means that insurance companies have to offer coverage to everyone, and they can&#8217;t kick you off if you get sick or if your illness is an expensive one.<\/p>\n<p>But, of course, that means nothing if the insurance company smiles at you and says &#8220;sure, we&#8217;ll cover you.  For $5,000 a month.&#8221;  There have to be caps on what the premiums are, or there&#8217;s not even a chance of covering pre-existing conditions.<\/p>\n<p>Caps are called &#8220;community rating,&#8221; and the new reform has a weak version of community rating.  The new law doesn&#8217;t require everyone to pay the same thing &#8211; insurance companies can charge healthier people as little as 1\/3 of what sick people pay.  But at least there is some community rating.<\/p>\n<p>Guaranteed issue and some community rating are necessary elements to covering people when they get sick, but they&#8217;re not sufficient.  If you know you can buy insurance even after you get sick, don&#8217;t you have a strong incentive to not pay anything until then?  Yes.<\/p>\n<p>That&#8217;s where the &#8220;individual mandate&#8221; comes in.  If you did everything else right, but didn&#8217;t require everyone to participate, existing insurance pools would suffer from &#8220;adverse selection&#8221; &#8211; only the sick would be in the pools.<\/p>\n<p>After all, why would you ever pay a dime into the system if you knew you could get coverage if you became sick?  The real term that ought to be used is &#8220;full participation,&#8221; because that&#8217;s all it is.  Without full participation, the system collapses.<\/p>\n<p>What I&#8217;d love to hear from opponents of full participation is how else the system can take people with pre-existing conditions without collapsing from adverse selection.  How do they avoid people dropping out and free-riding until they&#8217;re sick?<\/p>\n<p>Finally, if you&#8217;re going to require full participation, you also have to make sure that no one&#8217;s budget gets busted in the process &#8211; whether individuals or small business &#8211; so there have to be subsidies for lower-income people.  Businesses with fewer than 50 employees aren&#8217;t required to buy insurance at all, but if they want to (and many do) they&#8217;ll get help as well.<\/p>\n<p>Who pays for those subsidies?  The short version is that unless you&#8217;re a millionaire or run a private company that scams profits off of taxpayers and seniors in Medicare Advantage, it&#8217;s not you.<\/p>\n<h3>What&#8217;s so scary?<\/h3>\n<p>That really is the bulk of health care reform.  Insurance companies have to offer coverage within a range of prices, they can&#8217;t cut you off, everyone has to participate, and there will be subsidies for those who can&#8217;t afford it and for small businesses.<\/p>\n<p>We&#8217;re using the same system we&#8217;ve had for a century, we&#8217;re using the same private providers, and we&#8217;re using the same private insurance companies.  The only difference is now insurance companies can&#8217;t exclude or kick people out for being sick.  That&#8217;s socialist in what way?<\/p>\n<p>If anything, the 2010 version of health care reform is timid.  After all, it&#8217;s nothing more than the 1994 Republican alternative to the Clintons&#8217; proposals, and even as recently as 2006 Republican superstar Mitt Romney was defending <a href=\"http:\/\/en.wikipedia.org\/wiki\/Massachusetts_health_reform_law\">Massachusetts&#8217; individual mandate<\/a> &#8211; the one he signed into law as the Republican governor of Massachusetts.<\/p>\n<p>So let&#8217;s not pretend that the health-care reform that just passed is some socialist plot, or government takeover, or the end of freedom as we know it.  Only two types of people make those claims:  those ignorant of what&#8217;s in the bill, and those who know better but who are hoping for political gain based on fear.<\/p>\n<p>Conservatives will talk of &#8220;repeal and replace,&#8221; but not a single conservative alternative passes the first principle of any health reform:  ensuring coverage if you get sick.<\/p>\n<p>While there is some merit in some of the conservative ideas that didn&#8217;t make it into this year&#8217;s reform, particularly on some cost issues, their plans ultimately boil down to &#8220;don&#8217;t get sick.&#8221; That&#8217;s not reform, and it&#8217;s certainly not health care.  All they&#8217;re left with is pretending that health care reform is scary, when the truth is it&#8217;s anything but.<\/p>\n<p><em>Bundy is the political and legislative director for <\/em><a href=\"http:\/\/www.afscme.org\/\"><em>AFSCME<\/em><\/a><em> in New Mexico. The opinions in his column are personal and do not necessarily reflect any official AFSCME position. You can learn more about him by clicking <\/em><a href=\"http:\/\/haussamen2.blogspot.com\/2007\/06\/about-carter-bundy.html\"><em>here<\/em><\/a><em>. Contact him at <\/em><a href=\"mailto:carterbundy@yahoo.com\"><em>carterbundy@yahoo.com<\/em><\/a><em>.<\/em><\/p>\n<p><a href=\"http:\/\/www.nmpolitics.net\/index\/about-carter-bundy\">Bundy bio<\/a> \u2502 <a href=\"http:\/\/www.nmpolitics.net\/index\/category\/bundy-columns\">Archives<\/a> \u2502 <a href=\"http:\/\/www.nmpolitics.net\/index\/category\/bundy-columns\/feed\">Feed<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Let&#8217;s not pretend that health-care reform is some socialist plot, or government takeover, or the end of freedom as we know it. Only two types of people make those claims: those ignorant of what&#8217;s in the bill, and those who know better but who are hoping for political gain based on fear.<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5,1192],"tags":[117,116],"class_list":["post-15310","post","type-post","status-publish","format-standard","hentry","category-bundy-columns","category-commentary","tag-health-care","tag-washington"],"_links":{"self":[{"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/posts\/15310","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/comments?post=15310"}],"version-history":[{"count":0,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/posts\/15310\/revisions"}],"wp:attachment":[{"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/media?parent=15310"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/categories?post=15310"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/nmpolitics.net\/index\/wp-json\/wp\/v2\/tags?post=15310"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}