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Debicella vs. Himes and Lamont

On Monday night I had the pleasure of attending the health care debate between congressman Jim Himes, Ned Lamont, and State Senator Dan Debicella. The participants offered up a comprehensive review of Democratic and Republican talking points that are worth a quick analysis. We’ll start with the Democratic talking points:

1. We have a moral obligation to cover all those without insurance.

I think many Americans agree with that statement. And we actually do cover all Americans today because no one can get turned away in an emergency room. A related question to ask is: why don’t these Americans have insurance? In many states, like Connecticut – and in Massachusetts prior to healthcare reform – almost half of the uninsured individuals are, in fact, eligible for Medicaid. They may not sign up because the state makes it difficult to enroll or the individual does not take the time to enroll. It seems like one prescription for our health care problem is: let’s get people enrolled in a program we have today.

The next big batch of uninsured Americans is illegal aliens. This is one of the toughest issues in healthcare reform – what do we do with the 10-15 million illegal aliens in the United States that do not have health insurance. I wish I had a prescription but unfortunately there is no easy answer on this one. The next batch of the uninsured are “risk takers.” Unfortunately, the risk takers are risking the taxpayers’ money and the money of those who are insured, not their own. If they get really sick we treat them anyway! A prescription for this problem is, in fact, a mandate. Finally, the rest of the uninsured population is people who are too sick to qualify for health insurance. Those people need financial assistance.

2. We need more competition (more insurance companies). Therefore, we need a public option.

Interesting point but completely irrelevant in Connecticut. In Connecticut’s individual insurance market we have Cigna, Aetna, Connecticare, Anthem Blue Cross, Time Assurant, Celtic, Golden Rule, and a few other no-names. Clearly, lack of competition is not a problem. So I’m not sure why Himes raised this talking point.

3. Insurance companies are bad.

Congressman Himes skewered the insurance companies; referring to their “pernicious” practices of rescinding policies after issuing them. In reality, this practice of “rescission” is rare. At Health Plan One, we have sold thousands and thousands of policies and have never had one client’s policy rescinded. Rescission occurs in the event of fraud perpetrated on the insurance company and its policyholders. For example, if an insurance applicant has cancer and intentionally misrepresents his/her condition, an insurance company may face hundreds of thousands of dollars of liability and has one of two choices: rescind the policy, due to fraud or take those losses and charge all their honest customers. Pretty easy choice for the policyholders and insurance company. Not sure who Mr. Himes thinks should pay for insurance fraud?

4. Medicare represents a $40 trillion unfunded liability.

Wow! Kudos to Congressman Himes for bringing this up. He got off the talkpoint memo. The insolvency of Medicare and $40 trillion unfunded liability is our ultimate problem and everything else we’re doing is working on the margins. Unfortunately, after announcing this financial bomb, the Congressman had no solutions other than to cut Medicare Advantage which is a cut to seniors’ benefits, but sounds like cuts to the insurers which is more politically palatable. He offers no clear solutions for a big problem.

5. Eliminate preexisting conditions.

Good idea. Who’s going to pay for it? You can’t have a functioning insurance market with no preexisting conditions unless you mandate that everyone gets in the insurance pool. For proof, go to the New York insurance department where they implemented no pre-existing conditions. Every insurer in the state has moved out and prices are 10 times what they are in Connecticut or Pennsylvania. The weak $750 mandate will not be sufficient to obligate people to buy health insurance.

Republican talking points:

Senator Debicella started out strong with the salient point that escalating costs are the key problem. Then, on to Republican talk points:

1. Tort Reform

The cornerstone of any Republican plan is tort reform. Certainly a good idea and should be part of any plan. Reduce physician costs and mitigate wasteful defensive medicine.

2. Electronic medical records (also a Democratic talking point)

EMRs are a good idea and cost a lot of money, but they might save a lot of money in the future.

3. Buying insurance across state lines.

Great idea if you live in NY, RI, VT, and a whole bunch of states that have blown up their individual insurance market. You have to fire a lot of state regulators, though, so Dems hate this idea.

4. Introducing high deductible plans.

This is a great point. Higher deductible plans have lower premiums and introduce the concept of cost-sharing to the consumer. For example, at Health Plan One, we carry many high quality, high deductible plans that are great options, especially for younger consumers who are healthy. Reducing health care costs must include patient cost-sharing and innovation on health benefit designs. Current congressional bills prohibit this.

5. Wellness (also a Democratic talk point)

Who could argue with wellness? Wellness is a great idea but you’ve got to have a plan to implement it. Close McDonald’s?

Prospective governor talk points:

Mr. Lamont made it very clear he will run for governor. He pointed out that Connecticut has not created a lot of jobs over the last 20 years and believes that the high cost of health care is part of the problem. We’ve heard a lot about the problems which were largely accurate but the prescription is unclear.

A fun event but, unfortunately, Congressman Himes could not adequately defend the House or Senate health care bills that he wants to pass.

Score one for Debicella – start again!

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