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September 10, 2009

10 Questions for your Congresscritter About Health Care Reform

Shortly after the President's address on health care last night, I received an email from Barack Obama asking me to contact my representative. The link went to this page, which I have captured a snapshot of here in case it undergoes the usual changes.

The President of the United States is asking his supporters to donate money and lobby Congress in support of his plan. Since we live in a democratic Republic, it would seem opponents of his plan have both the right and the responsibility to do some "community organizing" of our own. If we fail to speak up, we have no right to complain if we don't like whatever legislation is passed.

I have drafted a sample letter you can send your favorite Congresscritter. It includes links to help you look up your Representative and Senator. Below the fold are 10 questions we deserve the answers to before Congress passes what will very likely be the largest entitlement in American history. Both the letter and the questions should be included in your email.

Please send this around. You do not need to credit me if you decide to use the letter or questions - I'm more interested in making sure Congress hears from someone besides OFA. Edit it as you see fit, but DO let your Senator and representative hear from you. We may not have a fancy web site or a slick PR firm, but we can still be heard (and without having our email addresses harvested by the White House or the DNC, to boot). Sometimes simpler really is better.

TO: [Your Members of Congress]

I have grave concerns about President Obama's plan for health reform. He claims those who currently have insurance will not be required to change insurers or doctors. But his proposed reforms will force private insurers to cover high risk patients and offer more services at no extra charge. Unless they want to go out of business, private insurers will have no choice but to raise premiums or reduce covered treatments.

If my premiums go up or my current benefits are reduced, the knowledge that I wasn't "forced" to change providers will be little comfort to me. The practical effect is the same: my existing coverage will be more expensive or fewer services will be covered.

How can Congress offer affordable coverage to currently uninsured patients without subsidizing premiums with taxpayer funds or adding to the deficit? Can you guarantee the tax credits Obama mentions will not exceed the taxes these individuals pay each year? If there is a gap, won't other taxpayers have to subsidize their premiums? Didn't the President promise the public option would be paid for "up front" and that taxpayers would not have to subsidize it?

Finally, how can we contemplate such a massively expensive entitlement program at a time when the national debt is higher than it has ever been? Can you honestly promise your constituents this plan will not "add one dime" to the federal deficit?

Before you vote on whatever health care reform package comes before you, you owe your constituents honest answers to the 10 questions I have outlined below.


Your Signature

1. Tonight, the President promised those who are happy with their present insurance will not be required to change it:

...if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have. Let me repeat this: nothing in our plan requires you to change what you have.

The measures outlined in his speech and at Organizing for America may not explicitly force me or my employer to change insurers.
But the President's proposal does force my insurer to change my current plan.
If you make the terms of my current plan illegal, how can you say that "nothing in our plan requires you to change what you have"?

This is a distinction without meaning. Isn't the President misleading the American people?

2. If, as outlined at Organizing for America, Congress forces my current insurer to accept higher risk patients with expensive pre-existing conditions, remove yearly/lifetime caps on claims, reduce out of pocket expenses for patients, expand prescription coverage, and cover preventative care at no extra cost, won't my current insurer be forced to raise premiums to cover the additional risk, services, and claims this plan forces them to accept?

3. The President has repeatedly demonized insurance companies, implying they are reaping excessive profits. But my insurer is a not for profit corporation.

Many not for profit insurers are already paying out more in claims than they collect in premiums. All over America, not for profit insurers are raising their rates to cover outstanding claims. These companies already operate in precisely the way Congress says they should, yet they are losing money:

BCBSM already runs its business as Congress proposes all insurers should and should be held up as a model for health reform not villainized in the media. BCBSM is the most strongly regulated health insurer in Michigan. We are the only insurer in the state that accepts everyone for coverage regardless of their medical condition. We community rate our health care coverage for individuals -- which means we ask for the same premium regardless of the individual's health condition. We self-limit our margins -- earning just one-tenth of one percent margin over the last 20 years. We work closely with Michigan doctors and hospitals to reduce the cost and improve the quality of care. These partnerships have saved hundreds of millions of dollars and many lives in the process.

Even with our recent rate increase, Blue Cross will continue to lose money on its individual products because costs will exceed premiums collected for these individuals....

Our actual medical loss ratio on individual products in 2008 was 127 percent. That means we paid out $1.27 in claims for every $1 we collect in premiums. Compare that to commercial insurers operating in Michigan, and you'll find a much lower loss ratio, likely between 50 percent and 60 percent.

The same story is playing out in Connecticut, California, Florida, Maine, and Pennsylvania. If you force not for profit insurers to bear even higher risk and costs, won't that drive up premiums for individual purchasers of health insurance? If their current plans become unaffordable, isn't this just an indirect way of forcing these individuals onto the public option?

4. Why is there no mention on Organizing for America of the individual mandate forcing all Americans to purchase insurance? It was in the President's speech:

...under my plan, individuals will be required to carry basic health insurance - just as most states require you to carry auto insurance....we cannot have large businesses and individuals who can afford coverage game the system by avoiding responsibility to themselves or their employees. Improving our health care system only works if everybody does their part.

Isn't it dishonest to leave out such a drastic change to current law? What part of the Constitution authorizes Congress to force citizens to purchase a service?

5. The President has repeatedly said he opposes forcing Americans to purchase health insurance. Will Congress levy fines on individuals who refuse to buy health insurance? If not, how will Congress enforce the individual mandate?

Americans would be fined up to $3,800 for failing to buy health insurance under a plan that circulated in Congress on Tuesday as divisions among Democrats undercut President Barack Obama's effort to regain traction on his health care overhaul.

6. How can Congress offer "tax credits" to individuals without insurance and 95% of small business owners and still claim health care reform will be deficit neutral? Don't tax credits reduce tax revenue?

If your plan decreases tax revenue, how can the President claim it "Won’t add a dime to the deficit and is paid for upfront"?

7. The President has repeatedly ridiculed the notion that some "panel" might refuse care to the elderly or disabled, yet his plan relies on the creation of "... an independent commission of doctors and medical experts to identify waste, fraud and abuse in the health care system" to reduce costs.

With 80% of health care costs going to chronic illness/end of life care, how will Congress control costs without limiting care to chronically ill/elderly patients?

THE PRESIDENT: ...the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.

INTERVIEWER: So how do you — how do we deal with it?

THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance.

...Obama’s example accurately represents the type of murky water we wade into when we consider the issue of health care and costs.

That said, the President of the United States who is - at least in theory - the driving force behind Obamacare is explicitly saying that we need a “group” to give guidance on what the government should and should not pay for in just such heart-wrenching situations. Sounds panel-ish to me.

Sounds "panel-ish" to me too. Does that make me a "liar"?

8. When explaining the public not for profit option plan, the President stated that private insurers:

...argue that [they] can't fairly compete with the government. And they'd be right if taxpayers were subsidizing this public insurance option. But they won't be. I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects.

Yet on Organizing for America, he says those who can't afford insurance and small businesses will get "tax credits" to pay for a public option plan. What will Congress do if an individual's public option tax credit exceeds the taxes he paid that year?

Won't other taxpayers be forced to subsidize these public option tax credits? If Congress does this, how can the President claim the public option won't be subsidized by taxpayer funds?

9. How will Congress offer low cost coverage to high risk patients? How can such a program pay for itself without charging premiums commensurate with [higher than normal] expected claims? To keep premiums affordable, won't Congress have to subsidize "high risk pool" premiums with taxpayer funds?

Immediately offers new, low-cost coverage through a national “high risk” pool to protect people with preexisting conditions from financial ruin until the new Exchange is created.

10. Why is it "scare tactics" for health reform opponents to voice their concerns, but not "scare tactics" for the President to engage in blatant fear mongering like this?

PRESIDENT OBAMA: Everyone in this room knows what will happen if we do nothing. Our deficit will grow. More families will go bankrupt. More businesses will close. More Americans will lose their coverage when they are sick and need it most. And more will die as a result. We know these things to be true.

Why is it wrong for Rep. Joe Wilson to point out untrue statements, but perfectly acceptable for the President to call his opponents liars?

The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens. Such a charge would be laughable if it weren't so cynical and irresponsible. It is a lie, plain and simple.

Was CNN "lying" when they noticed the same thing?

Immigrants living illegally in the United States could be mandated to have health insurance under the proposed health care reform bill but would be ineligible to receive subsidies to afford such coverage, a report from the Congressional Research Service says.

The report, prepared by the nonpartisan policy research arm of Congress, provides a close reading of the treatment of noncitizens in the House bill on health care reform, HR 3200.

While the report found that federal subsidies to obtain health coverage would be restricted to U.S. citizens and legal residents, it also noted that the bill does not specify a citizenship verification system, something that critics say creates a loophole for undocumented immigrants to receive subsidies anyway.

Rep. Xavier Becerra, D-California, rejected a citizenship verification system, calling rules it called for "unworkable."

The report, released Tuesday, "undermines the claims of the president and others that illegal immigrants would not be covered under the House version of the bill," Mark Krikorian, executive director of the Washington-based Center for Immigration Studies, told CNN.

Is everyone who questions the President's plan a liar?

Posted by Cassandra at September 10, 2009 01:36 AM

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Hopefully Cass, you live in the 6th District, where "Lone" Roscoe Bartlett will pay a kind ear to your missive. Down here in the 5th District it will only cause Steny a contemptuous chuckle.

And forget about "Fireplug" Mikulski and Cardin. They are beyond hope.

Posted by: Boquisucio at September 10, 2009 09:27 AM

I guess I am stubborn :p

I just refuse to allow them to think I'm that gullible.

Posted by: Cassandra at September 10, 2009 10:37 AM

"Is everyone who questions the President's plan a liar?"

You must have missed a payment on your *attention* bill again.......no, everyone who questions Xerxes' [plan] is not a liar.
They're racist!
Geez, Cass, get with the *meme* here.

Posted by: DL Sly at September 10, 2009 11:13 AM

Heh :)

Good point. I get so confused sometimes!

Posted by: Cassandra at September 10, 2009 11:22 AM

Very nice.

I've copied this into a mail message to send to friends and relatives.

Fortunately my Congressman is one of those fellows with a plan, like H.R.3400. A plan which, oddly enough, does not seem to exist in the Obama/Democrat's reality. Must be due to all that drug use during their formative years...

My Senators are fully oppose to the gub'ment takeover of medicine too. IOW, my preaching to them is preaching to the choir. But I suppose that I do have a reputation to uphold.

Anyway, thanks for all the thought and work that you put into this villainous joint Cass.

Posted by: bt_Careful-with-that-reconciliation-Eugene_hun at September 10, 2009 12:45 PM

I might just send this whole thing to mine. Maybe they're smart enough to use it.

Posted by: Grim at September 10, 2009 12:59 PM

Anyone who is paying close attention realizes that those who disagree with The One are lying, racist, haters.

Posted by: Sandi at September 10, 2009 01:16 PM

Hi, Sandi!

Posted by: Miss Ladybug at September 10, 2009 01:39 PM

Anyone who is paying close attention realizes that those who disagree with The One are lying, racist, haters.

You know, for a typical white person that was an unusually perceptive statement :p

Posted by: Barack Obama at September 10, 2009 01:44 PM

"You know, for a typical white person that was an unusually perceptive statement."

I always found a better perspective could be obtained when viewed from the other side....... of the street.

Posted by: ObamaNanna at September 10, 2009 04:26 PM

*waving back*
Hi, Miss L.

BO, there you go making (faulty) assumptions again. I am most definitely not a "typical white person." Your racist views have once again led you astray.

Posted by: Sandi at September 10, 2009 10:24 PM

Health care or not, I’m partisan to a president that can lower my taxes and fix what the housing market “greed” created… Just get the job market back up and avoid more scams…

Posted by: aaroncrowe at September 11, 2009 03:11 PM

Cass has a pretty good list, but from LGF comes this link to the mother-load of GREAT questions (all unanswered at this point) on BHO "healthcare"


Posted by: Frank at September 12, 2009 09:21 AM