What Healthcare "Reform" May Mean to Me and Mary

Short answer: We may end up saving a great deal of money!

As best I understand it, the various Democratic healthcare "reform" plans have two main premises in common:

1) Insurance companies will not be able to deny individuals coverage based on pre-existing conditions;

2) Premiums will be largely "normed" so that your actual medical care needs will be largely irrelevant in terms of the amount of premiums you'll pay.

Do I have this right...??? Is this the basic concept...???

When supporters laud the recently passed House Plan and commend the supposed virtues of the proposed Senate Plan these are the two "selling points" that are most often cited.

Correct...??? Are these not two of the key pro-"reform" talking points advanced by adherents...???

Hey, it gets better! (Or so proponents claim...) Democrats insist that the "reform" proposals will "bend the cost curve" on health insurance/ health care in the public's favor. Just this morning, senior Obama adviser David Axelrod stated in no uncertain terms while debating with critics...

“To defeat a bill that will bend the curve on this inexorable rise in health-care costs is insane,” Axelrod said. "I think that would be a tragic, tragic outcome. I don’t think that you want this moment to pass. It will not come back."

Hmm... so let's see... according to the Democrats, their Plan (in final form at least) will cover insurance seekers with pre-existing conditions - at an affordable price not too far out of line with what their perfectly healthy peers will be paying in premiums - and in tandem with this the nation as a whole will experience positive "cost bending" limiting the previously inexorable rise in health care costs.

Now I don't know about the rest of you... but I don't buy it.

That said, if the Democrats are successful in their push for legislation banning exclusions for pre-existing conditions while also requiring that the insurance companies provide policies upon demand at basically the same premium rate that people without pre-existing conditions are being charged, then William R. and Mary T. Barker will be canceling our existing insurance, going, without; we'll pay the proposed $750 fine, pay out of pocket for our yearly exams and necessary "normal" medical tests, and if (when?) we run into a situation where "they've found something" and expensive tests and hugely expensive treatments are required... well... that's when we'll again sign up for health insurance and receive "coverage" and thus treatment!

Folks... understand the math.

Mary and I presently pay - out of pocket - approximately $800/mo. (add to this our yearly and per visit or per prescription deductibles) in order to "insure" that we're "covered" and thus able to get the best care possible when we require medical treatment.

So... $800 x 12 = $9,600/yr. plus let's low ball deductibles (say $400) = $10,000/yr.

Now... if I understand the Democrat's healthcare "reform" plan - what the House has already passed and what's presently before the Senate - the option they're apparently "offering" (allowing) my wife and I is to simply jettison our present $10,000 yearly health insurance/health care expenses in favor of going without insurance, paying a $750 fine (or if per person fines totaling $1,500) for not having insurance, spending a few hundred dollars (hell... let's "high ball" the estimate - let's say $1,250) for out of pocket routine yearly medicare exams and care, and if at some point in the future an exam turns up a problem... at that point we "opt back in" and purchase an insurance policy at the same premium rate we would have been paying all along!

Sounds like a heck of a deal... for Mary and I!

Under the scenario I've just laid out, we'd be saving thousand of dollars a year! Depending upon whether the fine would be $750 for the two of us (as husband and wife) or $1,500 (each fined separately as individuals) and figuring on out of pocket yearly routine medical expenses of $1,250, we'd be saving at least $7,250 on up to $8,000 (and even more if we don't spend $1,250 on out of pocket routine medical care expenses in a year).

Yes, you can look at it as "scamming the system." That's exactly what Mary and I would both call it! Yet that's what we'll do if the Democrats are stupid and irresponsible to pass legislation that would allow such "gaming the system."

Hey... we'd be stupid not to.

My advice to those of you who don't believe Congress should pass legislation that would allow the sort of scheme I've outlined... well... the first thing I'd suggest you do is call your Member of Congress and ask if such a scenario is possible according to the bill the House passed.

Just for the heck of it I just spent ten minutes on the phone talking to not one, but two staffers of my own Congressman, John Hall (D-NY 19th). Just to let you folks know, neither staffer was willing or able to tell me that my understanding of the House bill allowing such a scenario was incorrect.

(*SHRUG*)

If you can get through to the Washington DC or local state office of each of your two United States Senators you might wanna ask the staffers you speak to whether the "Barker Scenario" as outlined is viable. And if they tell you it's not... insist that they cite the specific language in the passed House bill and the specific language in the proposed Senate bill which would disallow individuals from "gaming the system" in the manner I've proposed.

(*SHRUG*)

Folks... this is the Age of Obama... the Age of Pelosi and Reid... the Age of Liberal Ascendancy... if you don't believe the Democratic Party is capable of passing legislation with a loophole such as that I've based the premise of this post on...

(*SIGH*)

Make the calls. If you don't get a straight answer from the politicians, call up your local/regional newspaper and suggest that they take a crack at getting to the bottom of this question.

Folks... this is a biggie!