Friday, December 4, 2009

Sen. Mikulski’s Pandora Box Amendment passes

Yesterday the Senate starting moving forward with the amendment phase of health care reform. Sen. Barbara Mikulski (D-MD) proposed an amendment (http://mikulski.senate.gov/_pdfs/BAI09N48.pdf) will require all health plans to cover comprehensive women's preventive care and screenings at no cost to women. The amendment passed 61-39. Currently the Sen. Reid's (D-NV) health care bill relies on the United States Preventive Services Task Force to recommend minimum coverage. It was the US Preventive Services Task Force that created a stir in the health word with their recommendation that women wait until 50 years old before getting mammograms.

Not only will mammograms be available for women at no cost so will cervical cancer screenings, pregnancy and postpartum depression screenings, screenings for domestic violence, annual women's health screening, and family planning services but will not include abortion; at least not yet. Passing the bill on the surface seems like a no brainer but it is a slippery slope. Remember the goal of health care reform is to reduce skyrocketing premiums and eliminate waste, inefficiencies, and fraud in the system to reduce costs. The amendment, as scored by the CBO, will cost taxpayers $940 million over 10 years. By requiring insurance companies to provide these preventative screenings will not result in the goals of health care reform.

Whenever a company, large or small, is taxed more, in this case told to cover additional services for free, the cost of the new tax is passed along to the consumer. The company does not feel charity and absorb the cost. So ask yourself, who is going to pay for the new services being offered at no cost? Everyone that pays a premium or uses a clinic or hospital for other services since the insurance company will need to recoup their "free" services someplace else. The slippery slope aspect comes into play because the next step will be to cover preventative screenings for men too. It only makes sense from the same rationale being applied to the requirement of preventative women screenings being offered for free. Then what? Everyone will see their premiums increase and the fees for other clinic and hospital services as well.

Now do not get me wrong. I think it is important for people to obtain preventative screenings to ensure themselves better health as they age. Where I struggle is to cloak this amendment and others like it, under the guise of "Health Care Reform". It is not reform to require an insurance company to provide services for free when the goals is to reduce costs and make insurance affordable for all. The Republicans offered, what some call a dual amendment, an amendment that would remove the US Preventative Task Force from the equation and leave preventative medicine decisions in the hands of the medical profession. That amendment failed.

I do not like sounding like a broken record, especially when some construe that to me being an ideologue, but in order to get real reform in the industry we need to open up competition. The easiest way and cost effective way to achieve increase competition is to remove the anti-trust exemption and allow interstate commerce of insurance. Allow the free market forces to work for the next three years, either bill being proposed wouldn't enact "reform" for at least three years from passage, and pass a law or regulation that prevents insurance companies from denying coverage for pre-existing conditions. Americans will find that by going this route that free market forces will achieve the goals of reform in regards to lower premiums and costs. Some may argue that if that is the case, "Why does it not already take place?" To that the answer is simple; anti-trust exemption.

The questions to ask ourselves going forward are: Does the amendment create a slippery slope? If so, is the slope worth it? Does the amendment assist in health care reform? Does the amendment reduce costs? Will the amendment make health insurance more affordable for all? Nearly everyone one of these questions were ignored or not brought up when debating the amendment. We cannot obtain real reform on emotional decisions.