AS OF THIS WRITING, there are several versions of HR 3200 and no agreement within Congress as to which bill to use for a mark up.
President Obama will not sign a Health Care Reform Bill, unless...
The Bill accomplishes three goals:
1. To lower the cost of health care for the customer;
2. Make sure those Americans who are currently happy with their health care coverage can keep it; and
3. Provide coverage for all those who are currently uninsured, whether because of pre-existing conditions or because they simply cannot afford it.
NOW WHICH OF THESE OBJECTIVES DO YOU OBJECT TO?
OVERALL OBJECTIVE: Fix what is broken. As a precondition to fixing the problem, government should not come between doctor and patient. A patient should have a full right to choose.
What are the Options of Choice?
OPTION ONE: The existing health care system, as is. Those who are happy with the current system, the option to keep the health care coverage is protected by provisions in Sec. 102 of the Affordable Health Choices Act
OPTION TWO: An alternative option under which the Uninsured can have Affordable Health coverage.
Currently, the Uninsured neglect needed medical services until health issues become a crisis. It is then they seek healthcare in the emergency room (ER Care). This charity healthcare comes at the expense of our county.
Early treatment could prevent the latter cost. In fact, a combination of preventative care, early diagnosis, and early treatment could very well help an expectant single mother access prenatal care, as opposed to an abortion for a medically neglected fetus. HOWEVER, this bill should fund, in any way, abortions.
The infant mortality rate among African-Americans in Tarrant County is over 17.0 per 1000. This is comparable to a Third World country.
The problem here is inaccessibility to healthcare and a lack of public information. It is now a cumbersome process to become Medicare/Medicaid qualified, plus the inability of most poor being able to pay the co-pay (sharing obligations). Single mothers in their teens to twenties fall through the gap, between Medicare, Medicaid, and charity care.
Of this group are the unemployed, underemployed, marginally employed, and temps. These “at will” workers are also “at risk” workers. For example: The immigrant employee who servers a finger in an OJT accident. As a small business with no employee healthcare coverage, he pays the doctor bill only, and sends the worker back to work, as if it is the worker’s fault.
Should there be a reduction in tort liability for medical malpractice?
In the above case scenario, whose responsibility is it to provide healthcare coverage? Who is responsible for covering accidents on industrial property? There must be equity and fairness in the treatment of employees, as it relates to company healthcare liabilities. An employer should not be self-insured, unless they have sufficient capital reserves in store or provide a covetable (affordable) COBRA program. [COBRA provides continuity in existing employment healthcare insurance programs]
As for doctors who pay high medical liability insurance cost, this is the CURRENT SITUATION, and not necessarily the future situation. For sure, health insurance premiums are going to go up and up, with or without Tort Reform. It is simply the escalating cost of doing business, with provisions for profits.
Despite the rising business and personal health insurance rates, the insurance companies have profited beyond reason. Just look at the property holdings of insurance companies as proof of what becomes of “excessive” profits. They buy buildings and businesses. In the meantime, the customer gets no reduction in rates.
If nothing changes, this is the scenario with which we will continually live.
The insurance companies must be forced to reduce its profit rate at the expense of customers desperately in need of health care coverage. The American people should not be held hostage to the insurance companies and its system of arbitrary coverage and denial of service without notice to the terminally ill.
Under the current employment-based healthcare plans, most employees are satisfied, despite their level of payroll deduction. Under these plans, people are satisfied with their coverage and their family doctors. But some employment-based healthcare plans may not option to become Qualified Health Benefit Plans (QHBP). Self-insurance should not become an option.
And, what of those employers who opt for the government QHBP Exchange option, WOULD THIS FORCE EMPLOYERS TO DROP THEIR CURRENT EMPLOYEE-BASED HEALTHCARE PLAN AND BUY INTO GOVERNMENT INSURANCE? WILL THIS DESTROY THE PATIENT-DOCTOR RELATIONSHIP?
We should phase out frontier medicine, where doctors are woefully behind the times in medical record keeping, technology, and knowledge. Although some patients may love their frontier family doctor, that a family may have had for over 100 years, at some point medical records will outlive doctors, and these patient records should be accessible through a centralize medical database system to insure continuity of health care.
FINANCING by Upside Down Tax
Those of the upper income bracket should be able to pay a little more in order to insure more people. We should, therefore, start taxing at the richest of the rich, and work our way down.
There is already a bottom-to-top tax financing system, through worker payroll deduction.
The Federal Insurance Contributions tax consists of both Social Security and Medicare taxes. Social Security and Medicare taxes are paid both by the employees and the employer. Both parties pay half of these taxes. Employees pay half, and employers pay the other half. Together both halves of the FICA taxes add up to 15.3%
. The 15.3% FICA tax is broken down as follows:
• Social Security (Employee pays 6.2%)
• Social Security (Employer pays 6.2%)
• Medicare (Employee pays 1.45%)
• Medicare (Employer pays 1.45%)
FICA CAP LEVELS
FICA CAP for 2000 was $76,200.00
FICA CAP for 2001 was $80,400.00
FICA CAP for 2002 was $84,900.00
FICA CAP for 2003 was $87,000.00
FICA CAP for 2004 was $87,900.00
FICA CAP for 2005 was $90,000.00
FICA CAP for 2006 was $94,200.00
FICA CAP for 2007 was $97,500.00
FICA CAP for 2008 is $102,000.00
FICA CAP for 2009- [An Upward adjustment here would be viewed as a tax hike on the middle class]
Start at the Billionaire level.
COBRA premium assistance credit. The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) provides certain former employees, retirees, spouses, former spouses, and dependent children the right to temporary continuation of health coverage at group rates. COBRA generally covers multiemployer health plans and health plans maintained by private-sector employers (other than churches) with 20 or more full and part-time employees. Parallel requirements apply to these plans under the Employee Retirement Income Security Act of 1974 (ERISA). Under the Public Health Service Act, COBRA requirements apply also to health plans covering state or local government employees. Similar requirements apply under the Federal Employees Health Benefits Program and under some state laws. For the premium assistance (or subsidy) discussed below, these requirements are all referred to as COBRA requirements.
The American Recovery and Reinvestment Act of 2009 (ARRA) allows a credit against “payroll taxes” (referred to in this publication as “employment taxes”) for providing COBRA premium assistance to assistance eligible individuals. For periods of COBRA continuation coverage beginning after February 16, 2009, a group health plan must treat an assistance eligible individual as having paid the required COBRA continuation coverage premium if the individual elects COBRA coverage and pays 35% of the amount of the premium.
An assistance eligible individual is a qualified beneficiary of an employer's group health plan who is eligible for COBRA continuation coverage during the period beginning September 1, 2008, and ending December 31, 2009, due to the involuntarily termination from employment of a covered employee during the period and elects continuation COBRA coverage. The assistance for the coverage can last up to 9 months.
The 65% of the premium not paid by the assistance eligible individuals is reimbursed to the employer maintaining the group health plan. The reimbursement is made through a credit against the employer's employment tax liabilities.