Time for a Health Reform Do-Over?

Last Updated Nov 4, 2010 8:06 PM EDT

Open Letter to President Obama: The Republican Congress is going to try to repeal the health reform law and you should let them.

Before you balk at the notion of reversing one of the key accomplishments of your administration, listen up. When Americans sent your democratic colleagues packing earlier this week, it wasn't because they disliked the notion of having health insurance for everyone. They voted against the legislators who voted for health reform because they hate the specific reform that passed.

Why? It's 2,000 pages of complexities and loopholes and it still does one thing that's begun to rankle us like nothing else. It allows irresponsible people to throw the cost of their care onto the responsible members of society -- the people who already feel as if they were kicked in the teeth because they never defaulted on a mortgage nor filed bankruptcy after running up a pile of credit card debt.

We responsible taxpayers are already shouldering trillions of dollars in new debt thanks to bail outs of Wall Street, banks and delinquent homeowners. We ask you not to make us shoulder health care costs for those who simply don't want to pay them, too.

Why do we think this health reform law will do that to us? Current law says that hospitals have to care for people who wander in without the ability to pay -- and that's not changing. So if we want everyone to have insurance, we need to create a significant penalty for those who choose not to buy it. What's the penalty in your health reform law? In 2014, it's $95. Not monthly-- annually. That's less than it costs for one dinner for two in New York.

The penalty is going to ratchet up each year, you say? So true. In 2016 it's a whopping $695 a year.
Seriously, I just talked to a friend who pays $1,100 a month for insurance premiums for her family of four. Exactly why would she be worried about this silly $695 annual fine?

She wouldn't. But both she and I probably still will want to do the responsible thing and have health insurance anyway. And that's where your plan really gets us.

Because the plan mandates that insurers take all comers regardless of pre-existing conditions, and it doesn't have significant penalties for those who don't buy coverage, we can assume that the people who will buy coverage outside of workplace plans are going to be sick. Healthy people need not bother. That's likely to mean that premiums will soar. An analysis that I did last year found that a policy that costs $270 a month in California could cost $3,400 in New York, where the state law is similar to what you've demanded through health reform.

Do we need health reform? Yes. But we don't need a 2,000 page health care law with a zillion new mandates and loopholes. What we need could be written on a napkin.

We need a bare-bones, low-cost, high-deductible insurance policy that would be available to anyone who wants it. You could keep your own insurance, if you have it. But if you don't have insurance, you must buy the low-cost policy or something better. (This is similar to California's auto insurance law, which mandates a minimum amount of coverage.)

What's a reasonable penalty if you don't buy insurance? You could be turned away when you need medical care.

What about the people who can't afford even a low-cost policy? We already have Medicaid.

What about those who can't afford the deductible? There are already non-profit groups that help people with medical bills. My guess is that more of these groups would form and they'd get more money so that no one would be turned away in the end.

What this would do is force everyone -- healthy and not -- to buy insurance. That spreads the cost around and makes it more affordable for everyone.

It also sends a message that we all must be responsible for our own financial decisions. America is not going to save you if you refuse to save yourself. That's not such a bad message really.

I understand that asking Congress to pass legislation that demands personal responsibility could be tough. Keeping it free of special-interest loopholes might even be tougher. That's what leadership is all about. That's why we elected you, President Obama. That's your job.

When you were running for office, you said that we, as a country, needed to make some tough choices. We needed to accept an era of shared sacrifice to fix the country's ills. I believed you. I voted for you.

But since then you've been throwing the cost of pandering to the irresponsible on the backs of my future grandchildren by piling more and more debt on to the federal balance sheet. That's got to stop.

It's time for you to stand up to your colleagues on both sides of the aisle. Scrap this tragically flawed health reform law. Write the new law on a napkin. Expose anyone who defies reason, or asks for a pay-off to get their vote, to public scrutiny. I guarantee you that we voters and taxpayers are angry enough to take care of them.

I'm asking you, President Obama, to be the leader that I voted for before I'm forced to vote for someone else.

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