AN OPEN LETTER TO PRESIDENT OBAMA, CONGRESSMAN SCHIFF, SENATOR BOXER AND SENATOR FEINSTEIN
David O. Powell, Pasadena
I am a part of the constituency you were elected to serve. I am a well-educated and intelligent person but I find myself mystified by the provisions of the revised health care program proposed by President Obama and under current consideration in the House and Senate. I find the information being disseminated by both proponents and opponents to be heavy on rhetoric and light on substance.
So I would like to pose a few questions. I am looking for pertinent, concise and responsive answers–hopefully with an indication of the basis therefor. I am not looking for lectures.
(1) There are obviously many people involved in the administration of health care insurance: insurance company employees; administrative staff in the offices of doctors, hospitals and other direct health care providers; state and federal government employees administering Medicare and Medicaid; government employees involved in the regulation of health care insurance: etc. What percentage of the nation's total costs for providing health care do such overhead costs presently represent?
(2) The adoption of many of the changes being discussed will call for additional personnel to formulate and oversee the additional regulations which will be required to implement the expanded health care program. These personnel will be required on the staff of both regulators and the entities regulated. What will be the resultant increase in cost of health care administrative overhead, expressed as a percentage of total health care costs?
(3) What are the costs associated with medical malpractice litigation, expressed as a percentage of total health care costs? Such costs include: legal fees incurred by plaintiffs, insurance companies and regulators; medical malpractice insurance premiums; and medical services provided primarily to protect against malpractice suits rather than to meet real medical needs.
(4) Under existing tax law, that portion of the income of an individual or a couple which is used for approved medical costs is excluded from income taxes. Will any presently deductible medical costs lose their deductibility under the proposed new legislation? If so, what specific costs will no longer be deductible? What will be the overall total magnitude of the resulting increase in income taxes?
(5) Families with annual incomes in the range of $100,000 to $250,000 would fall in the category of middle class families who are to be beneficiaries of improved health care. They could also be families who would not find it beneficial to insure against routine medical care such as routine dental care, routine eye care, the Medicare "doughnut hole", etc.. What percentage of fall within the aforementioned income range? Will they be required to insure against such routine costs?
(6) Some elderly persons choose to have as their primary doctor (under private contract) one who does not accept Medicare patients. Will such option be available under the new program? If so, is there any way in which this can be changed by administrative fiat without further legislation?
(7) I have seen it claimed that, under the new program, elderly people will be visited periodically to advise them on living healthy lives. Is this correct? If so, what obligation does the advisee have to follow that advice? Will penalties be imposed? If so, what will such penalties be and under what terms and condition?
(8) I understand that there will be an advisory panel to determine (perhaps among other duties) what constitutes healthy living. How broad will be the discretion granted to this panel? For example, will it have the power to declare that non-vegan diets are unhealthy? Will it have the power to enforce such dietary restrictions on unwilling Americans? Please note that my question is not directed to what decisions you expect the panel to make–it is directed to what power it will have.
(9) I am unclear as to the restrictions which will be placed on the private health insurance programs in which Americans will be able to enroll. If there are such restrictions, what will they be? Will such restrictions apply to existing , or will such existing contracts be grandfathered?
May I thank you in advance for early replies to my questions? You or members of your staffs may communicate with me by Email or postal mail.
I assume that I am free to share your responses with others.
David O. Powell