Health Care Reform Rhetoric

The Health care reform bills currently being considered in Congress have generated an avalanche of political posturing and outrageous claims on the part of the Democrat opposition. Even though they tacitly and sometimes openly admit that the ever increasing premiums and deductibles of Obamacare are unsustainable, they argue that the Republican reforms are even worse.

Let’s examine some of their objections.

Both the bill passed by the House of Representatives and the one now under consideration in the Senate came under severe criticism because of reports from the Congressional Budget Office (CBO) that between 15 and 20 million people would lose their health insurance. Political commentators and Democrat politicians were quick to jump on this estimate and paint the Trump administration and the Republicans as big, bad, meanies out to pull the rug out beneath the Nation’s needy.  

Yet, even the CBO admits that the majority of those who will lose their coverage will voluntarily drop their coverage once they will no longer be forced to buy it or pay a cash penalty. President Obama promised people they could keep their policies if they liked them, but Obamacare forced them to surrender those policies. Obamacare then forced millions of people who did not want medical insurance or felt they did not need it to buy it. It is hard to blame them since the high deductibles and premiums seemed a bad deal. In fact, millions of people chose to pay the tax penalty rather than buy those Obamacare policies.  

Opponents of the Republican bills also claim that millions of American currently on Medicaid will lose their medical benefits. However, it would appear that they are not talking about the poor and needy. Apparently, those threatened are former members of the upper and middle classes who now reside in nursing homes and whose care is paid for by Medicaid.

For decades eldercare lawyers and financial planners have been advising well-to-do clients to give away their assets to family members or family trusts before they get infirm enough to go into a nursing home. Since the government will pay their costs, their families can retain the often considerable assets of their elderly parents. Why, these advisors reason, should such assets be used for nursing home care, when, if done properly, the government will pick up the cost.

States have been long aware of these tactics and though they have tried to restrict their use and prevent last minute asset giveaways. Some States have even given tax incentives to residents who purchase nursing home care insurance policies in the hope that these insureds will stay off the Medicaid rolls. Nursing home costs are the largest part of any State’s Medicaid bill. So, who is the real victim here? It’s too bad that when people think the government will pick up the tab, it never occurs to them that their neighbors are footing the bill, or that the money could have been used for the real poor.

Actually, it does not appear that the Republican bills will directly deal with this practice. Rather, they want to give block grants to the States so that the States themselves can decide how best to deal with their poor and elderly.

Finally, how can anyone with a straight face claim that the Republican health care reform efforts lack transparency? The proposals are out there for anyone to see and criticize even though Democrats like my own Senators and representative in Connecticut have made it clear that they oppose any reform measures. What ever happened to the Nancy Pelosi strategy of passing the bill before reading it?

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Hearing Dysfunction

                                         

As far as I know, Medicare does not pay for hearing aids, and if Medicare doesn’t pay then Medicare Supplements or Medicare Advantage plans will not pay. My Medicare Advantage plan will only pay $50 toward an annual hearing exam. For that matter I do not believe that any of the insurance plans approved by the Government under the Affordable Care Act (Obamacare) will pay for hearing aids for the many who suffer from aural dysfunction.

A recent visit to an audiologist indicated that at age 75, I have suffered some hearing loss. My wife has been warning me of this for some time and likes to make fun of my many bloopers. Actually, in the audiologist’s waiting room a woman sitting next to me asked the receptionist, “Where are the cats?” I looked around and wondered if the doctor had cats that he let walk around the office. I finally asked the woman about the cats, and she replied that she had asked about her “cab” that was late in picking her up.

So, it was no surprise that the exam indicated some hearing loss, and that a hearing aid was recommended. The audiologist even offered a free two or three day trial to see if I liked them. It reminded me of the way in which pet shops would allow you to take a puppy or kitten home to see if you would like it. I guess most people decide that they like the hearing improvement.

Midway through my trial I’m not sure. These modern hearing aids are incredibly sophisticated and introduce you to a world of strange, unfamiliar sounds. The first day was really incredible. I never knew the rustling of my garments made so much noise, or that my footsteps were so loud. I never realized how deafening our old grandfather’s clock was, or how noisy it was flushing the toilet. Outside, I had never heard the neighbor’s kids screaming before.

Most incredible was the sound of my own voice. To me, I sounded like Darth Vader inside his helmut. It was like speaking through an amplifier with a slight delay. I do admit that by the second day it didn’t sound so bad.

Nevertheless, I’m not sure that I’ll go for the improvement in hearing. I am far from deaf and I can still have normal conversations with my wife despite the occasional bloopers. But I have come to realize that I sort of like my quiet world where lawn mowers or passing cars don’t sound so loud.

There is also the question of cost and that gets me back to my medical insurance. The tiny hearing devices will cost about $4000, and I believe that is in the mid range. Friends tell me they have paid almost twice that, and I’m sure there are some older models that are cheaper. The $4000 is more than the cost of my complicated and delicate eye surgery of a few years ago that was covered by Medicare.

It seems to me that a large bill like this is precisely what medical insurance is for. I see that my Medicare Advantage plan will pay for drugs like Viagra for those men who suffer from so-called erectile dysfunction. The ads are on TV every day. Why is erectile dysfunction more serious than aural dysfunction?

In the debate over the Affordable Care Act, President Obama insisted that his plan would rid the nation of sub-par plans. As far as I can tell, the only thing sub-par about these existing plans was that they did not cover the cost of contraceptives.  

Some politicians have claimed that the cost for a year’s supply of birth control pills can be $600. That is surely the high end since a web search indicated that birth control pills could cost from $15 to $50 per month. The same site indicated that organizations like Planned Parenthood sell them for much less. A letter writer to a newspaper argued that a month’s supply can be purchased at Walmart for $4.00.

Advocates argue that the pills are a necessary women’s health item. But toothpaste is also a necessary health item and no one suggests that it be covered by insurance. We expect everyone to purchase their own from the huge array that can be found on the shelves.

If I do decide on the hearing aids, I will pay for them myself even though they are a high cost item. I will make the decision on whether the potential benefit justifies the cost. I realize that there are a lot of people, especially seniors, in this country who have more serious hearing loss than me, and who cannot afford hearing aids.

Why were these people forced to pay for Viagra and contraceptives? How many, if given the option might have elected coverage that would restore their hearing? It’s too bad that there is no such thing as “aural” sex, for then hearing loss might be regarded as a more serious matter.

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