If you thought that the recently passed Health Care Reform bill would cure all that ails this country’s health care system, think again. Even under the new law, Americans may still lose their homes the same as a well-insured insured couple featured in Michael Moore’s 2007 documentary Sicko, which took a whack at the United States’ dysfunctional health care system in comparison to other countries, did. In this week’s episode of Wellness for the Real World, Dr. Veronica enrolls in Healthcare Reform 101 as J. D. Daskalakis, an attorney, economic expert and lobbyist, schools her on the pros and cons of the new law.
Daskalakis, who represents several companies, is among the thousands of lobbyists, many of whom are registered. First, he explains to Dr. Veronica what a lobbyist is—and isn’t. “A lobbyist is someone who is an advocate and above all you’re an educator,” he says. “People have the misimpression about lobbyists that you can go in and ply legislators with campaign contributions, sex, drugs and other things. Most of us will keep the sex and money for ourselves. They can have the drugs.”
Turning serious again, he addresses the bad reputation of lobbyists, whose character is viewed as so questionable that President Barack Obama put hiring restrictions on them within his administration. “You’re seen as peddling influence behind the scenes, taking care of special interests although most people don’t realize that they’re probably members of infinite special interest groups,” Daskalakis says. “Everybody is part of a special interest.”
That special interest could be a professional organization or union or one for a specific group such as AARP. And it is these special interest groups that can help you be heard when it comes to matters such as health care reform. Though Daskalakis also suggests sending comments to the U.S. Department of Health and Human Services, which he says is required by law to read.
On March 23, President Obama signed into law a health insurance reform law that, which according to the White House, will give families the relief they need from skyrocketing health insurance costs, and will ensure Americans have secure, stable, affordable health insurance. By 2014, all Americans must have health insurance or risk a fine. Subsidies will be offered to families that cannot afford health insurance, provided certain financial conditions are met.
However, Daskalakis does not think much will change when it comes to insured Americans filing for bankruptcy because they can’t pay their medical bills. As recently as 2007, when Moore’s Sicko was released, 62% of all bankruptcies filed were linked to medical expenses, according to a nationwide study released by the American Journal of Medicine. That was nearly 20 percentage points higher than in 2001. And of those who filed for bankruptcy in 2007, nearly 80 percent had health insurance.
“I don’t see anything that is going to keep medical costs, even for insured people, from being the primary driver of bankruptcies in the country,” Daskalakis tells Dr. Veronica.
The federal government will offer states “significant incentives” tostates to create their own co-ops and not-for-profit agencies but Daskalakis doesn’t think a state handling its own affairs is necessarily the answer if history is to be taken into consideration. The state of Tennessee runs TennCare, a medical assistance program designed for people who are eligible for Medicaid, as well as for some children who do not have insurance. Launched in 1994, TennCare has run into an array of problems and a study initiated by current Gov. Phil Bredesen concluded that TennCare was not financially viable.
“There are going to be major financial burdens to the states,” Daskalakis predicts. “Looking at it from the economics point of view with states taking on additional Medicaid obligations, you wonder if the numbers are really going to work, particularly given the fact that states are already in a huge revenue crush. Now, supposedly, the federal government is going to absorb the costs of these additional people going on to Medicaid rolls up to 2019.”
Then there’s the so-called “Cadillac tax,” an excise tax levied on insurance companies for high-premium plans that is expected to be passed along to employers. It’s a no-brainer that companies will reduce their benefit package in order to avoid the levy.
The good news is there are plenty of positives in the bill. For starters, effective this fall, insurance companies can no longer deny coverage because of pre-existing conditions. Adult children can stay on their parents’ plan up to the age of 26. And tax credits will become available to small businesses that offer coverage to employees. Also, beginning in September 2011, chain restaurants must post the calorie count on menus and supermarkets that offer prepared foods must do the same. Some states, such as California, already have such a law in place.
Another benefit is the creation of a $15 billion fund for programs designed to promote prevention and wellness, such as efforts to address obesity and to help patients manage chronic diseases. The law also establishes a National Prevention, Health Promotion and Public Health Council to coordinate federal efforts to promote healthy living. Employers will receive significant tax benefits for implementing wellness programs, Daskalakis says.
“This whole process has a long ways (to go),” Daskalakis says. “Just because the bill has passed doesn’t mean that the debate isn’t going to rage on. There are implementing regulations. There’s going to be lawsuits. I’m certain there are going to be efforts to repeal the Cadillac tax before it takes effect. It’s a work in progress.”