The working document for HR 3200, America’s Affordable Health Choices Act of 2009 (AAHCA), is over 1,000 pages long. I wouldn’t be surprised if it doubles before it is ready for a vote.
Just based on it’s complexity, and the knowledge that government cannot do anything cheaper, I’m wary of supporting any kind of national health care program.
These are just some first impressions:
I don’t like the idea that I will be forced to purchase health insurance as the plan specifies; if I don’t purchase insurance, then I will be fined at a rate of 2.5% of adjusted gross income (or, something significant like that). Isn’t this a free country ?
I did a search of the document, and found about 50 hits for the word “nurse”, and zero hits for the word “doctor”. I didn’t see anything that actually addresses patient care.
I wonder, won’t we need more doctors ? I mean, if 40 million more people will have health insurance, doesn’t that mean that there will be alot more doctor visits ?
It takes roughly nine to twelve years to educate a doctor. Even 
if the plan can entice individuals into becoming doctors, through proposed grants, and financial aid, isn’t there going to be a massive shortage of doctors for many, many years ?
And, won’t it be more difficult to entice individuals into becoming doctors if the ultimate financial reward is diluted, and reduced, by a government program that is supposed to reduce costs ? If I were a young person considering a career as a doctor, I sure would have to think long, and hard, before I would give-up nine to twelve precious years of my life, for an uncertain, and/or small financial benefit.
If we were talking about lawyers, would young people be willing to attend four years of law school if they knew that their ability to earn handsome incomes would be controlled by the government ?
If this bill were about Tort reform, and controlling the high cost of asserting legal rights, would it ever make it to a vote ? Not in a million years.
I suppose that the training of doctors could be revised; perhaps, instead of four years in medical school, it could be reduced to two years. Let’s face it, as President Obama made clear, some sacrifices will have to be made in order to implement a massive health care plan. If that means that our doctors are not first-class, then, so be it.
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And there is a major cost issue that is not mentioned: tort reform.
Because of the possibility of huge malpractice settlements, medical practitioners are forced to purchase expensive malpractice insurance, AND, they are forced to practice defensive medicine; i.e., they need to order unneeded tests, and treatments, just to be able to defend themselves against such malpractice lawsuits.
Malpractice insurance, and the unneeded tests are a huge cost component for medical practitioners, and, of course, that cost is reflected in higher health care costs.
There is no mention of the word “tort”, or “lawsuits”; no mention of tort reform. The word “malpractice” appears once, but only as a component of the cost/fee structures.
With this bill, medical practitioners are asked to accept lower rates, yet their malpractice insurance will be the same, or, quite possibly, much higher because, theoretically, there will be 40 million more potential lawsuits.
There is no way that any health care plan can contain costs without tort reform. The bean counters can theorize, and include it in their cost estimates, but, as of right now, there is no way that they can contain it, or control it.
It seems to me, that if there is a genuine desire to cut health care costs, then ignoring this major component does not make sense. The fact is, tort reform could lower health care costs without this bill. I don’t understand why tort reform is completely ignored; maybe the personal liability lawyers have too many friends in Congress.
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Right now, if this bill passes, if I were a young person trying to decide on a career path, I would choose four years in law school, over four years in medical school; the potential financial rewards will be much greater.
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And, I’ve heard that there will be a cost saving due to the benefits of preventative medicine, such as regular physicals, flu shots, medications for chronic illnesses, such as high blood pressure, etc. But, I’ve also heard that that cost savings is a myth because preventative medicine means more doctor visits, over a longer life span, and that that will offset the cost of treating more severe illnesses of individuals who die at a younger age, who did not receive preventative medical treatment. Of course, the quality of life is much better for those who practice preventative medicine; they will be healthier when they die.
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Changes I’d Like to See
I’d like to see three items/sections added to the bill:
1) First, I think that all of our elected officials, and all government employees, except the military, should be required to drop their existing health insurance plan, and enroll in the most cost-effective plan resulting from this government offering. That would include President Obama.
2) Since this bill is about health care, there needs to be a Patient Bill of Rights that establishes the minimum care standard for all participants.
3) Tort reform must be addressed.
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Anyway, there are three committees that are now massaging, and modifying, and rewriting the initial working document, so it’s probably not worth intense study until a final version is ready.
President Obama is pushing the congress to be finished with it before the August recess, which I believe is July 31st for the House, and August 7th, for the Senate. That leaves about three weeks to finalize the bill, get public comment, and then revise the bill. Of course, that is assuming that the public will be “allowed” to read it before the final vote. If it’s anything like the recent House vote on Cap and Trade, then it’ll be put to a vote without adequate public notice.
I don’t understand what the rush is, except possibly to maintain political momentum.
And that is just my opinion.
Spencer Holly
www.angrycalifornian.com
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OTHER RESOURCES
Click here if you’re interested in reading the current version of HR 3200, Library of Congress
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Obama Health Care Videos
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