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What Will Obamacare Mean –To You? Part 1.

Monday, November 30, 2009  |  posted by Hugh Hewitt

Below I asked for first person accounts of what the Senate’s version of Obamacare is likely to mean for readers. Here’s the first response, from Andrea in Sacramento:

Hi Hugh –

Thank you for taking input from plain, ordinary citizens about the horrendous “health care” the legislature wants to thrust upon us. We are a homeschooling family, and my husband Mark is self-employed, so we don’t represent the bulk of the nation; but I am very well acquainted with the costs of health care because I have had to buy it for our family for nearly 20 years. Our income is low enough that we qualify for Healthy Families and quite likely qualify for Medicare or Medicaid or whatever they call it, but we don’t believe it is the government’s job to provide health insurance for our family.[# More #]

We were priced out of HMOs years ago when our monthly premium went from about $450 to over $600 (and that was not with a change in age bracket). That was the largest increase we have had in all our years of buying health insurance, but we generally do see a 25% increase each year. I often hear that health insurance costs rise about 10-15% each year; that certainly has not been our experience. Following that huge increase, we switched to PPOs to lower the costs, and we found a great plan for $178, but it nearly tripled in cost in just three years. We then discovered that the insurance company had developed a lower tier without notifying us, so they were charging us $100 more per month than we ought to have been paying. We then began to do business through a broker, thinking that they would have informed us that there was a lower rate that we qualified for. I’ve since learned that that is not the case when earlier this year, I learned that our plan had been lowered by $30 per month; I had to follow up with both our broker and our carrier to get our premium lowered to the new, lower rate.

Every couple of years I have to find a new plan because our current plan becomes too expensive. Usually that means switching insurance companies. In California, we basically have only three choices (excluding Kaiser)–Blue Cross (now called Anthem), Blue Shield, and Health Net. Since Blue Shield was the company that overcharged us for over a year, that leaves just two options for us. Each plan that we have switched to has been a plan newly developed by the insurance company, and with each change in plan, we lose more and more benefits. Right now, for $360 per month, we have a plan with no prescription coverage and a $2,500/$5,000 deductible and a $5,000/$10,000 out of pocket maximum. We essentially pay for everything ourselves, and thankfully we rarely need to use our health insurance, with the exception of my oldest daughter who is being treated for acne.

If the government really wanted to help us (which I don’t think they do), the first thing they could do is allow us to deduct our health insurance premiums as a business deduction rather than merely as an income deduction where it is still subject to self-employment taxes. Another thing they could do would be to allow companies to sell insurance across state lines to give us more options. I’ve even heard of very low-cost programs with doctors and hospitals that are available in other states but not here in California. Through your show, I’ve also learned that the states (and California is likely at the top of the list) have certain mandates that increase the cost of insurance. If those were removed, that would also be a big help to us.

As far as guests to have on the show, the first person I thought of was Bobby Jindal. I would really like to see him run for president in 2012, and I understand he has a background in health care through the Bush administration. We need government officials committed to fixing the problems. I also would like to hear more observations and suggestions from Clayton Christensen. His ideas on innovations in the way health care is delivered seems to be the way to improve the system–using technology to help nurses take on the routine tasks and diagnoses now handled by doctors, thus allowing general practitioners to move into the more routine areas now handled by the specialists so that the specialists can concentrate on the complex cases.

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“Global Eyes on the President at West Point”

Monday, November 30, 2009  |  posted by Hugh Hewitt

The Monday morning column from Clark Judge:

Global Eyes on the President at West Point
By Clark S. Judge, managing director, White House Writers Group, Inc.

As everyone knows, President Obama will address the nation on Tuesday night and reveal his decision on what to do in Afghanistan. Most weekend commentary has focused on the announcement’s political implications at home and how various players in and around Afghanistan will see it. But there will be another and in the long run at least as important audience: national and diplomatic leaders of the major nations of the world.

As reported at the time, during the last several months I have attended conferences and presentations in various European capitals. All in one way or another concerned global security. On the side I spoke with additional political and journalistic players. The result has been a global snapshot of official and semi-official opinion from places as diverse as China, India, Russia, Palestine, and various parts of Europe, both in and out of the E.U.

What I sensed in total was growing doubt about the president. He speaks well, everyone acknowledged, but is there substance behind the rhetoric? He is given to sweeping pronouncements. But will he, can he follow through? He commands the most capable military force on the globe. But does he have the stomach for a fight? Does he have the strength to make and stick with hard choices, or any choice at all? As one globally prominent (and I would have thought friendly to the president) American journalist summed up global opinion at a conference in Geneva: “Machiavelli said it is better to be feared than loved. Mr. Obama is loved.”

So when the president addresses the nation tomorrow night, he will be addressing these global players as well as the rest of us. How they grade his presentation will have a profound impact on what he and his administration will be able to achieve in international circles in the next three years.

What we have heard about the speech and the substance of the announcement so far is not encouraging.

First, the speech itself: we have not yet heard it, of course. Drafting may not even have been completed. Different administrations work differently. But even in the Reagan Administration (where I was a speechwriter for the president and where we never had the kind of cliffhanger, last-minute drafting dramas that seems to have been common in, say, the Clinton White House) on major foreign policy speeches editing and even drafting by the president himself and appeals from various parts of the national security establishment could continue almost until Mr. Reagan appeared stepped to the podium. When he returned from his meeting with Mr. Gorbachev in Reykjavik, President Reagan was writing in long hand, on a yellow pad, parts of his report to the nation within an hour of going on camera.

But we do know one detail about Mr. Obama’s speech, its location. Virtually all past major presidential addresses on global security matters have been broadcast from either the White House itself-usually the Oval Office-or the House of Representatives, as the president addressed a joint session of Congress. I am talking about all presidential addresses here, going back to Franklin Roosevelt. These settings convey majesty. They convey the seriousness of the moment and weight of the Constitutional office the man occupies. When addressing Congress on such matters, they represent an appeal for the coming together of all the branches of the American government behind the common mission of ensuring the nation’s security.

On Tuesday Mr. Obama will speak from West Point. Surely the speech will be well advanced. The visuals will be impressive, perhaps even moving. But on at least on a subliminal level, the choice of setting is more likely to heighten rather than ease global doubts about the man and the administration. For Team Obama has chosen to give their man a stage set that, in the context of this moment, suggests they and he are thinking in terms of a candidate in campaign, not a president of the United States at a moment of decision. And here, too, is the essence of global doubts about the president — that he is a campaigner, not a leader.

Regarding the speech’s substance, the one detail-no one seems to know if it is true or not-is that, while announcing troop levels in the 30,000 range, he will also announce a comparatively slow deployment, more like Johnson in Vietnam than Bush for the surge in Iraq. If true, the international impression of indecision, lack of strength, dearth of seriousness in the president and his circle will become larger and more vivid.

There come moments in presidential communications when impressions coalesce and either the man in the office becomes larger-as Reagan and Roosevelt unfailingly did at such moments-or smaller in global eyes. For the nation’s sake, let’s hope Mr. Obama is seen as larger after last night.

But first signs are not encouraging.

What Will Obamacare Mean –To You?

Sunday, November 29, 2009  |  posted by Hugh Hewitt

The next month of broadcasting and blogging will be given over almost exclusively to the debate over Obamacare in the Senate. The bill will mean massive changes to the future of every American if it passes, and unless a major disaster strikes, most of media, new and old, should be focusing on it and the stakes involved. That coverage should also be specific and in-depth: What will the Senate version of Obamacare mean if passed, exactly?

I’d like to ask my readers and listeners for (1) suggestions on whom they would like to hear interviewed on this topic, both opponents and supporters and (2) what exactly you think the passage of anything like the Senate version will mean for you.

Seniors, how much more do you expect to be paying? How much longer do you expect to wait for appointments? Do you think you’ll be able to get the same level of service you are currently enjoying?

Employers: Do you expect to make changes in your group coverage?

Doctors: Do you expect your income to fall and if so, by how much?

Here’s an illustration of the sort of coverage that does more harm than good to the debate ahead.

Nicholas Kristoff has his typically very well-written column in Sunday’s Times, and it tells a heart-tugging-tale about John Brodniak. Mr. Brodniak has been living a medical nightmare, one that compellingly illustrates many of the woes of our current health care system.

But what the column doesn’t tell us is if the Senate’s version of Obamacare will do anything for Mr. Brodniak. Indeed, there is buried in the column an alarming warning about the Senate bill:

In August, [Brodniak] qualified for an Oregon Medicaid program, but he hasn’t been able to find a doctor who will accept him as a patient for surgery, apparently because the reimbursements are so low.

The Senate version of Obamacare promises a big expansion of Medicaid-like coverage for the poor and near-poor, but will it simply worsen the already large and growing problem of providers refusing to treat patients whose coverage simply doesn’t provide enough of a reimbursement to make it worth a doctor’s while to treat? This single sentence in Kristoff’s column hints at and then abandons the crucial issue of reimbursement rates, but if these are pushed too low, doctors will simply refuse to treat patients that cannot help them pay the overhead or make a living. As the Investors Business Daily poll of 10 weeks ago showed, doctors will simply leave the field rather than work for reimbursement rates that drive them towards longer and longer hours for declining income and lousy quality of life. Mr. Brodniak’s situation won’t be improved by a bill that shatters the current system and drives providers from the profession.

That’s the real question in the debate ahead, one every senator even those from the hard left have got to ask themselves: Are they making the system better or just scoring political points? Right now, as Charles Krauthammer argued on Friday, the answer is very clearly the latter. I’d like to see Nicholas Kristoff follow up with another column about Mr. Brodniak, one that tells us how the Senate bill will work to improve his life, and if so when? One that will also tell us the impact of the Senate bill on his one-time employer as well as on the doctors that will be treating him if the new system arrives, as well as on the economics of the hospitals in his area, or the medical research that ultimately allows for any sort of new cure or innovation in treatment.

I’ll be happy to interview any credentialed advocate who wants to defend the bill on the Senate floor, because that is the only question that matters right now. We know there are problems, but will the senate version of Obamacare fix them? If the answer is either “no” or “we don’t know,” or even “there’s a good chance it will help some people while hurting others,” it is not just a lousy bill, but an immoral one, a feel-good bit of posturing that won’t help Mr. Brodniak, and may in fact condemn millions more to the same scarcity that he is presently experiencing.

So, please send along your e-mails suggesting experts and predicting your own personal outcomes. The e-mail box is hugh@hughhewitt.com.

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