GOP releases healthcare plan; actual plan not included

...his presentation was marred by assertions that were more opinion than fact and by proposals that lacked enough detail to allow evaluation.

One of the Congressman's statements was a bold assertion that doctors find dealing with Medicare as difficult as dealing with insurance companies. I stated from first hand experience as a psychologist in private practice that this is not my opinion. To his credit, Mr. Blunt acknowledged that I may have more direct understanding of the Medicare and insurance company billing process than he does, and by extension that my opinion is my opinion.

I don't believe that either Mr. Blunt or I have a reliable survey of service providers in various specialties to claim to have a valid opinion on what doctors in general believe. All providers grumble about reimbursement rates, but that is true about Medicare and private insurance rates.

Mr. Blunt also offered the opinion that 80% of Americans are happy with their private insurance. As I recall, it was David Helling who said in the meeting that people seemed to be very satisfied with the government Medicare system as well.

I pointed out that the 80% statistic about satisfaction levels is meaningless. Surveys in Canada, Britain and France also show that over 80% of the people are satisfied with their systems. A more meaningful survey would be to ask people who have had a serious medical problem (cancer, heart disease, etc.) how satisfied they are with their insurance. Nobody worries about his/her insurance until it is needed for a problem. Then the fat gets thrown into the fire.

My guess (and it's just a guess because I don't have clear data either) is that people who have serious medical problems and get denied benefits or have to pay large deductibles or get befuddled trying to figure out the complicated blizzard of paperwork they accompanies illness would rate their insurance unfavorably.

I don't know with certainty how Americans with serious health concerns look at their insurance compared to Canadians with serious health problems. I do know that many bankruptcies in America occur in families who do, in fact, have health insurance and that this is not a major problem in Canada, Britain or France.

But it was Mr. Blunt's response to my criticism that was most revealing. He said, anecdotally, that he has had serious medical problems and that he was very satisfied with his health care.

The response revealed two major areas of confusion. First, a patient's satisfaction level with his/her health care is not the same as satisfaction with the health care payment system. The first could be great, the second awful.

More significantly, Mr. Blunt has the finest health care insurance money can buy, and he's a member of Congress. Does he really think the insurance company (or the health care provider) would do anything but treat him as a VIP?

Of course Mr. Blunt is likely to be satisfied with how he's treated.

But ask John Doe who does not have a vote in Congress how his insurance company treats him when he has an expensive illness. Mr. Blunt confuses (or conflates) his experience with what the average American gets.

Another careless statement by Mr. Blunt detracted from his presentation.

He commented that anyone could buy a Blue Cross/Blue Shield policy for $500 to $600 per month. (At least this is what I thought he said. There is a video of the meeting, and I would like to verify exactly what Mr. Blunt did say.)

In any event, I confronted Mr. Blunt with my experience.

First, no, many people can't get insurance at any price because of preexisting conditions. Second, there are high risk insurance pools in Missouri and Kansas, but these plans cost $1,500 per month, and they provide poor coverage.

Mr. Blunt said that his plan provided the opportunity for individuals to buy coverage in high risk pools, but I never understood how his proposal was different from the current system of high risk pools created by the states. It is possible that this is better explained in his written proposal, which I have not seen.

Another assertion Mr. Blunt made seems to be based on beliefs and not data. He said that people should make some co-payment for health care because people "value what they pay for." This statement struck me as a belief that could apply to some transactions but not necessarily health care. For example, do we believe that people who have intense pain and need a root canal "value" the pain relief more if they pay $100 for the procedure? I doubt it.

I believe Mr. Blunt was getting at something else. The position that people should make co-pays is often offered to argue that this would reduce over-utilization of services. But does anyone believe that people will go get an extra colonoscopy just because the co-pay is low? I doubt it. But this isn't really my point. I believe Mr. Blunt has the obligation to offer evidence that his beliefs and proposals based on those beliefs are supported by evidence. He didn't do it, at least in the meeting I attended.