Two small businessmen worry — but disagree

Government can’t spend my money better than me.

By Jonathan Yaeger

have started and operated a few small businesses since 1986. I have always provided health insurance for my employees as an important benefit that helps to retain good people. I also felt that it was the “right” thing to do, so long as I could afford it.

Nonetheless, I agree with many others that the present private health care insurance situation is broken and reform is sorely needed. Until recently, the annual cost for insuring my family of four with a PPO policy was $19,100, including the deductible.

The deductible that we have chosen has risen every year along with the costs of basic coverage. I simply cannot afford a lower deductible. I dread each renewal anniversary; I am certain that each new year will bring higher costs.

Our family is relatively healthy. But I live in fear that any new medical condition will result in higher rates, and the prospect that we could be dropped and then be unable to get any kind of coverage that is not prohibitive.

Thus, my family visits practitioners only when it is necessary, knowing that certain diagnostic codes could ruin our insurability. I am in my 50s, and so the prospect of age-related infirmities is ever-present.

Nevertheless, I believe that the bill in Congress is flawed, and if enacted as written, my family will receive lower-quality care at a higher cost.

I am deeply troubled that legislation of this magnitude is presented as something that must be passed in haste, without sufficient debate, analysis and discussion. Like Social Security, Medicare and Medicaid, this sort of social engineering is long term and not likely to be repealed. It must be as good as it can be from the start. It is disgraceful that people with genuine concerns have been labeled as unpatriotic — or worse.

I believe that the president or Congress should have appointed a blue-ribbon panel of experts to explore various ideas and their consequences before crafting such important legislation. Such a panel should include experts from the arenas of public health, private care, insurance, economics and social policy. The panel should be given a concrete set of goals and firm time line for producing recommendations that would form the basis of new law.

Whatever legislation that is generated must apply to the members of Congress as well as all government employees. The concept of one health care scenario for privileged lawmakers, and another for the hoi polloi, is untenable.

I was disappointed to find no mention of badly needed tort reform in the bill. The obscene cost of malpractice insurance is certainly a major deterrent for many who are otherwise drawn to practice medicine.

While government does some things well, I do not share the belief that the government knows how to spend my money better than I do. As a small business owner, I also do not feel that “more” government is necessarily “better” government, and I am deeply skeptical of the ability of a large bureaucracy to deliver services efficiently and cost-effectively.

Others have pointed out that the decision of the federal health care secretary is final. Giving one individual or office so much unchecked power is a sure recipe for abuse at best, and tyranny at worst.

I am sure that the availability of national insurance will prompt certain carriers to drop the less profitable policyholders. Eventually, it will be difficult for private carriers to compete with a plan that is subsidized by taxpayers, and there will remain few, if any viable choices.

Any concept of individual responsibility for health care seems to be lacking from the bill. Should the policy cost for a nonsmoker be less than for a smoker? What incentives will be given for participants to maintain wellness and “healthy” lifestyle choices?

Change for its own sake can be disastrous as well as progressive. In the meantime, I’ll keep my expensive personal insurance policy until I am convinced that Congress has come up with a better plan for my family.

Jonathan Yaeger of Atlanta is the owner of Data Savers LLC.

Are government bureaucrats worse than insurers?

By Jay Solomon

There are parts of the insurance debate I just don’t understand. Why are people so afraid and so angry?

My family has pretty good health insurance. And, being self-employed, we pay the cost ourselves. It costs my healthy family of three over $19,000, including a $5,000 deductible. The cost has gone up every year. If you do the math, it’s costing me roughly $10 per hour, 40 hours per week, to provide health care for my family.

Don’t get me wrong — I’m glad I can afford to do that. But I know that not everyone can.

If something happens to one of us, the first call is to 911. The second is to my insurance company. My “good” health insurance is only good if I get advance permission for treatment — and then only from certain hospitals or doctors. Some insurance bureaucrat decides if the treatment I think I need — or my doctor orders — is going to be covered.

So I don’t understand: Why should I be more concerned about a “government bureaucrat” deciding what health care I can have than I am about my insurance bureaucrat doing the same thing?

I recently turned 60 — and following the recommendation of the CDC, I went to Walgreen’s to fill my doctor’s prescription for a Zoster (shingles) vaccine. They took my insurance card, called my carrier and gave me a shot. Two weeks later, I got a bill for $219.99 because my insurance company decided not to cover the vaccine. I paid it out of pocket — luckily for me and for Walgreen’s, I could do that.

During my last physical, blood tests were over $500. The doctor was happy to take the negotiated payment of less than $150 from my insurance company. If I didn’t have insurance, I would have paid more than $500. Is there any reason to believe government couldn’t negotiate a rate as good as my insurance company? Medicare does that very well now.

How many can’t afford to pay for “good” health insurance? Maybe 40 million — maybe more.

Luckily, many employers provide coverage. But when my best friends lose jobs, they lose their insurance. Sure, for six months they can pay for COBRA coverage — if they can afford it. But good luck after that. And if they have a spouse or child who is ill — or they get injured or sick — will they be able to get insurance at all?

Insurance, as we have it now, works great — if you make a good living — and if you and your loved ones stay healthy. And if you stay employed. But if you lose your income, get too sick to work, wind up with a pre-existing condition, your insurance is either gone — or you are trapped with a policy that has decreasing benefits and increasing costs.

When my mother was in her final days, it was a blessing to check her out of a hospital, where she was being literally tortured with standard “care” that was doing nothing to prolong her life or ease her pain, into a hospice where she was given whatever was available to make her comfortable and preserve her dignity. A blessing for her and the entire family. She had a living will — so we knew what she wanted.

Why would I object to anyone being told about the advantages of a living will — or the availability of hospice care? We knew — and no one forced her out of a hospital against her will. No one denied her the heroic care that probably would not have prolonged her life, but would have increased her suffering.

I don’t understand the fear-mongering by people opposed to counseling sessions for end-of-life issues. I’d call it cheap political advantage, but the cost to impacted families isn’t cheap.

We’re a great country, but we don’t have the world’s best health care system. Maybe the most expensive, but surely not the best.

So I just don’t understand the fear and the anger of the folks who are so vehemently protesting reform. The need for reform and the desirability of universal health coverage should be premises for debate — not issues. Let’s debate how we get there — not where the journey’s end should be.

Jay Solomon of Marietta is an Atlanta attorney.