MN-02 : Does John Kline Relate to John Q. Public ?

During the Healthcare Summit, orthopedic surgeon John Barrasso (Senate-R-WY) stated “I do believe we have the best health care system in the world” and although the cameras didn’t roll to Mr. Kline, no doubt he agreed with that sentiment.

The key to that statement is “we”.
Who is “we” ?
John Kline has an annual compensation of $176,000 and has a choice of healthcare plans. If he needs surgery, most members of Congress will have it done at National Naval Medical Center in Bethesda Maryland. Nothing but the best health care for some.
Conversely, John Q. Public is limited to his ability to purchase from a health insurance company that will dictate which hospitals and services it will cover. Or, John Q. Public may be fortunate enough to have an employer that “dictates” the insurance program for him. Oh sure, with enough money, you can purchase the best health care in the world in America. Or, as many John Q. Publics do … accepts the “hope and pray plan” --- hope you don’t need medical care and if you do, pray for an early death.
If you have insurance, your premiums are paying for the emergency care for those that don’t … if you don’t have insurance, you’re probably ignoring medical problems.

Let’s return to Senator Barrasso who advocated that “people with catastrophic plans are the people that are best consumers of health care in using the way they use their health care dollars”.
Essentially, “the best health care system in the world” should only be used for catastrophic events.

President Obama then questioned Sen. Barrasso : “I'm just am curious. Would you be satisfied if every member of Congress just had catastrophic care? Do you think we’d be better health care purchasers? I mean, is that a change that we should make?

SENATOR BARRASSO: Yes, I think actually we would. We’d really focus on it. You’d have more, as you say, skin in the game -- and especially if they had a savings account, a health savings account. They could put their money into that --

THE PRESIDENT: Would you feel the same way if --

SENATOR BARRASSO: -- and they’d be spending the money out of that.

THE PRESIDENT: Would you feel the same way if you were making $40,000, or you had -- that was your income? Because that's the reality for a lot of folks. I mean, it is very important for us -- when you say, to listen -- to listen to that farmer that Tom mentioned in Iowa; to listen to the folks that we get letters from -- because the truth of the matter, John, is they’re not premiers of anyplace, they’re not sultans from wherever. They don't fly into Mayo and suddenly decide they’re going to spend a couple million dollars on the absolute, best health care. They’re folks who are left out.

And this notion somehow that for them the system was working and that if they just ate a little better and were better health care consumers they could manage is just not the case. The vast majority of these 27 million people or 30 million people that we're talking about, they work every day. Some of them work two jobs. But if they're working for a small business, they can't get health care. If they are self-employed, they can't get health care.

And you know what, it is a scary proposition for them. And so we can debate whether or not we can afford to help them, but we shouldn’t pretend somehow that they don't need help. I get too many letters saying they need help.”

President Obama understands John Q. Public … he’s making $40,000 and should have good, quality coverage.

Disappointingly, Mr. Kline didn’t seem to listen. Kline issued a press release stating “Key to expanding an affordable health insurance market for smaller employers would be to establish small business health plans. These partnerships would allow small businesses to band together in associations and spread the risk of issuing insurance, thereby lowering the cost of health care for employers and employees. [SNIP]This contrasts with the majority leadership’s plan, which would subject employers to a new federal bureaucracy that will dictate a raft of rules and red tape”

President Obama, summarized how John Q. Public is affected : ” we agree on is the idea that allowing small businesses and individuals who are right now trapped in the individual market and as a consequence have to buy very expensive insurance and effectively oftentimes just go without insurance could be solved if we allowed them to do what members of Congress do, which is be part of a large group. Again, the idea of an exchange is not a government takeover.” [SNIP] “It sounds like we've got some philosophical difference as to whether there should be some minimum benefits in that exchange, some baseline of coverage. Again, there's a baseline of coverage for members of Congress. And the reason we set that up is because we want to make sure that any federal employee who is part of this big pool is getting good, quality coverage -- not perfect coverage, not gold-plated coverage, but adequate coverage. It may be -- and I'd ask my Republican colleagues to look and see, is that an area that can be resolved.”

In essence, the Democrats are pushing “exchanges” while the Mr. Kline and the Republicans want Association Health Plans(AHPs).
So what are some of the differences ?

How about costs … specifically how John Q. Public is treated.
According to a Congressional Budget Office analysis, Kline’s AHPs : “some provisions of the legislation would tend to decrease the premiums paid by all insurance enrollees, while other provisions would tend to increase the premiums paid by less healthy enrollees or would tend to increase the premiums paid by enrollees in some states relative to enrollees in other states.
While Urban Institute evaluation of the House and Senate bills, states “ Health status rating, gender rating,
and rating based upon industry of employment would be prohibited. In this way, the health care risks of workers in small firms would be spread more broadly than they are today in the vast majority of states, shared across all those enrolled in coverage through the insurance exchange in which it participated. Not only would workers in small firms have a choice of insurance plans—a situation extremely unusual for small groups today—but those that have been priced out of the market due to health issues or an older workforce in the past may have affordable access to coverage for the first time.

Actually, the Urban Institute (which is a source that Mr. Kline has cited before) presents a strong case for the Democrat proposal that John Q. Public should like :
-- New insurance market regulations would prohibit preexisting condition exclusion periods.
-- All those enrolling in insurance coverage through the proposed national or state health insurance exchange would have the option of remaining in the exchange, even if they change employers or leave the workforce.
-- Some financial assistance to the low income to cover some of the cost sharing associated with health insurance.

AND, John Q. Public’s employer will also benefit as the administrative costs will be less and there are tax credits to assist small, low to average wage employers contributing to health insurance coverage for their employees.

Of course, Mr. Kline “fears” that small businesses will suffer because of the requirement to offer insurance or pay a penalty. But that fear-mongering is over exaggerated as data from the Census Bureau’s Survey of US Businesses indicate that 87 percent of the over 6 million firms in the US would NOT have a penalty.

This should be a Win-Win … a Win for John Q. Public and a Win for those of us that are incurring higher premiums for the uninsured.

What is the consequences of not doing something ?
Just ask Tom Simmons, president of a small business, who was just informed that his monthly family premium would go up to $1,596 a month from $908, a nearly 76 percent increase. "This industry is getting out of control. It makes me fearful of future years and what could become of things if something doesn't change." Simmons ultimately was able to reduce the increase to about 16 percent, but only after switching to a plan with a higher deductible and other higher out-of-pocket expenses ... surely not what he wanted for himself nor his employees.

Oh, and those Health Savings Accounts that Senator Barrasso was touting are also having significant rate increases. These policies, known as HSAs, were created by the Bush administration in 2003 as way to trim health costs. The policies are supported as a market solution to rising health costs because they require members to pay more of their medical expenses out of pocket to use fewer services. "We were paying out more in claims than we were collecting in premiums," said Aron Ezra, spokesman for Blue Shield adding "We lose membership because fewer people can afford to get it."

John Kline needs to come to the real world … talk to John Q. Public and he will learn that his plans don’t work. While it's good to know that for some that “we have the best health care system in the world”, we are not happy with it.