Three questions to ask your representatives about Health Reform and six observations to help you know if you are getting straight answers.
How much is health reform going to cost and how are we going to pay for it?
How many people in the United States don’t have health insurance and who are they?
Will you pledge to read the entire health care reform bill and make it available online for your constituents with enough time for them to review it and make comments?
1. It has been reported by the Congressional budget office each of the current health reform proposals released by Congress will likely cost just over $1 trillion.
These estimates were sobering to the president and congress, but they may be low. For example in 2002 the Trustees of the Medicare Trust Funds projected that there would be a $531.5 billion balance in the Medicare Part A Trust Fund at the end of 2008. In fact the balance in the Part A Trust Fund at the end of 2008 was $321.3 billion, a difference of $210 billion, or almost 40%. Using this clearly large miss as a guide, it is not unreasonable to expect that the cost of health reform will be closer to $2 trillion over ten years.
2. The President has stated that he is going to pay for health reform with a combination of spending efficiencies and tax increases. As an example of a spending efficiency he stated that we would save $177 billion over 10 years by changing the way Medicare Advantage plans are funded, because we spend 14% more for people in these plans than people in regular Medicare.
It is important to understand that besides covering Medicare services Medicare Advantage plans cover much or all of the deductibles, and coinsurance Medicare doesn’t cover. If those plans are paid less, the people covered by those plans will have greater out of pocket costs. That means a good portion of the $177 billion isn’t really going to be saved, it is only going to change who is spending it.
3. The conventional wisdom is that there are about 46 million people uninsured in the United States.
It seems likely that this number comes from the Census Bureau Current Population Survey. The Census Bureau indicates that 45.6 million people were uninsured in 2007. However, in notes to the survey the authors acknowledge that the number of uninsured is inflated. For example they state that their estimate of the number of people with Medicaid is low by 16.9%. This percentage translates to 7.6 million people. The number of Medicare beneficiaries also appears low. According to Medicare there were 44.3 million people with Medicare in 2007. According to the Current Population Survey there were 41.3 million with Medicare in 2007. This is a difference of 3 million. Combined these two figures demonstrate an underestimate of people with insurance of over 10.6 million. The obvious question is what other components of that estimate are wrong?
4. The same Current Population Survey shows that of the 46 million uninsured over 9.7 million are not citizens.
How many of these are here illegally? How much of the cost of Health Reform is the coverage of illegal aliens?
5. As part of health reform the president has stated that he is in favor of the government sponsoring a Medicare like plan to compete with private insurance.
See number 1. Also, in 2009, the Medicare Trustees stated that the Medicare Part A trust fund is going to run out of money by 2017. If Medicare solvency is currently an issue won’t a government run plan that will be open to everyone have even greater solvency issues?
6. House Majority Leader Steny Hoyer all but admitted recently that any health reform bill will be too long for Congressmen to read. He actually thought it was funny and he conceded that “if lawmakers had to carefully study the bill ahead of time, they would never vote for it.”
This indicates that there is a paucity of serious thinking going on in Washington. Are our representatives really going to vote for a bill that may very well change the landscape of health care in this country and cost, by official estimates, at least $1 Trillion over 10 years, without reading it?
David Rubenzahl, Esq., President, Maxon Administrators, Inc. Company Counsel
David Rubenzahl joined the company in 1979 to manage the Dental Plans in St. Louis, Missouri. Mr. Rubenzahl was responsible for all facets of their operation from equipment financing, and supply purchasing, to provider contracting and plan consulting.
Mr. Rubenzahl came to New York in 1985 as company counsel and chief consultant. His expertise is in private and public plan administration, and client and provider contracting. He also is intimately involved in systems development insuring compliance with evolving state and federal regulation.
Most recently, Mr. Rubenzahl developed an NYS GML 207 consulting program to be offered to governmental Workers’ Compensation clients.
Mr. Rubenzahl, a graduate of Lehigh University in 1974 and the University of Miami School of Law in 1977, is a member in good standing of the New York and Florida Bars.
Founded in 1955 by Stanley Rubenzahl, The Maxon Company provides all services required for the professional management of employee benefit programs. The Maxon Company offers a comprehensive range of services including total benefit administration; claims administration; stop loss insurance; preferred provider programs; pharmacy benefit management; COBRA/HIPPA administration; HRA’s, HSA’s, and Section 125 administration (flex plans). Maxon also administers self insured workers compensation programs. The Maxon Company is located in Irvington, NY. For more information, please visit www.maxonco.com.
To set up an interview with David, please contact Audrey Scolny at S3 Public Relations, [email protected] or 973-257-5533.