| While it has been
said that good health and good sense are two of life’s
greatest blessings, the new health-care legislation is so
lengthy and complex, it is hard to know, as yet, if indeed
we used good sense in our efforts to improve our nation’s
health.
But whether you are “fer or agin” it, the legislation
just passed brings sweeping changes not only to the way
America dispenses health care but also to the way we as
a society determine what role government should play in
guaranteeing basic human necessities.
What we decide are “necessities,” translate
over time, into social reform. To our founding fathers,
voting rights were something available only to white, male,
landowners. Now we feel the voting franchise should belong
to both sexes, all faiths and national origins.
Child labor laws as well as laws regarding hours and wages
were another major social change. In our own time, Social
Security and Medicare were enacted as we expanded our beliefs
in what our government should guarantee to its citizens
to include safety nets for old age and basic health care.
Now, this country is seemingly divided on if, with the
furtherance of social reform, we include basic health care
for all and become a “social democracy” like
France, Sweden or Japan, or remain a nation where individual
freedom is paramount.
Americans have always jealously guarded their rights to
personal choice ... even if what we eat, smoke, drive or
do, increases the costs for others. We distrust anyone else,
especially the government, telling us what is best. There
has been so much lengthy discussion and “misrepresentation”
on both sides, it is important to learn how some of the
main provisions of the new legislation will affect you.
-The law bans insurance companies from cutting off payments
for people who become very sick and from denying coverage
based on an existing condition.
-It closes the “doughnut” hole in prescription
drug coverage for those on Medicare.
-Requires policies now in effect to cover a beneficiary’s
children up to age 26.
-If you are on Medicare, you will pay less for preventative
care, but will probably face higher premiums or reduced
benefits.
-If you need institutional care, states will receive incentives
to offer the alternative of home-based and community care.
-Most Americans will be required to have health insurance
by 2014 and the most affluent households (those with incomes
higher than $200,000) will contribute more from payroll
taxes.
-The new law forbids “gender rating” by insurance
companies, a practice by which companies charged women who
bought individual policies, more than men.
-Millions more will be able to get the same coverage for
mental illness as for diabetes or cancer.
-Doctors and patients will not have to modify medical therapy
to fit within coverage constraints or prescribe to patients
who can’t afford the medication or treatment.
-Bill provides money for education of advanced-practice
nurses.
Of course, the most difficult question to answer is how
all of this will be paid for. The Congressional Budget Office
has estimated that the cost will be offset by revenues from
new taxes and fees as well as reductions in spending on
Medicare and other government programs.
Critics say Medicare costs have been outpacing inflation
although the bill assumes Medicare will grow at a slower
rate because of increased efficiencies. The bill does also
not address scheduled cuts in Medicare payments to doctors.
The impact on already strained state budgets has not been
fully calculated. The capacity of the system to meet demand
will be strained, particularly in areas that currently have
high rates of uninsurance. However, since many of the insurance
reforms must be implemented by the states, it is a good
opportunity for states to design approaches that best fit
their situations.
My personal feelings on the matter is that this country
is long overdue to improve our system of health care, but
I am certainly concerned about how we will pay for it. However,
when big corporations fail or when our government takes
us into a war, we always seem able to find the money.
In April of 1967, Martin Luther King Jr. said, “A
nation that continues year after year to spend more money
on military defense than on programs of social uplift is
approaching spiritual death.” We certainly all need
to reconsider what our priorities should be.
Jean Cherni is founder of Senior
Living Solutions, a retirement advisory service. Contact
her at jeancherni@sbcglobal.net or 15 The Ponds, Branford
06405.
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is a full-service real estate company with more than 100
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Corporate and & Commercial offices are located in North
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