So why is Louisiana opposing the Health Care Plan?

I wasn’t actually out looking for this, but found this summary in a state-by-state comparison (which has nothing to do with the Health Care Plan) — From Insureme.com:

Health Insurance

Louisiana has taken great care to ensure that its residents have access to health insurance.

Here are some facts you may not be aware of in your state regarding health insurance:

If you receive coverage from a group plan, Louisiana’s nondiscrimination policy prohibits you from being denied or receiving limited coverage because of your health status.

If you become ill, guaranteed renewability ensures that your health insurance plan won’t get cancelled.

If you are a small-business owner purchasing group coverage, the guaranteed issue ensures that you cannot be turned down for medical insurance on account of your group’s age, gender or health status.

If you lose your group coverage and meet other qualifications, you may be able to purchase individual Louisiana health insurance through the Louisiana Health Plan (LHP). You won’t face a pre-existing condition period unless you have been previously denied coverage by two or more insurance companies.

Your coverage will depend on what kind of Louisiana health insurance you carry. If you receive coverage through a group plan, your coverage may provide more extensive coverage.

Individual health plans vary in benefits covered, so you’ll want to confirm what’s mandated by your state’s department of insurance before purchasing your policy.

The State of Louisiana has implemented some remarkable programs to help its 576,000 uninsured residents receive coverage. If you make a low or modest income, you may be eligible for free or subsidized health care through Louisiana Medicaid. Louisiana Medicaid offers coverage for pregnant women, families and the elderly and disabled.

The Breast and Cervical Cancer Treatment Program provides full health benefits through Louisiana Medicaid for women who are screened through the National Breast and Cervical Cancer Early Detection Program.

If your children are currently without Louisiana health insurance, you may receive full health benefits through the Louisiana Children’s Health Insurance Plan, or LaCHIP.

Is it just me, or does what our legislature has already set up sound a LOT like most of what’s in the Health Care overhaul that they are all so adamantly opposed to?

Responses

Darren Green

March 24, 2010

Perhaps folks feel that State governments make better decisions regarding the welfare of their residents than the Federal Government. State goverments tend to also do a better job of actually paying attention to the what their residents say…unlike our current congressional leadership. But…they know whats best so we will all just blindly follow.

Reply
1. Lamar White, Jr
  
  March 24, 2010
  
  C’mon Darren. Really?
  
  “Some of my libertarian friends balk at what looks like an individual mandate. But remember, someone has to pay for the health care that must, by law, be provided: Either the individual pays or the taxpayers pay. A free ride on government is not libertarian.”
  
  Who said that?
  
  Mitt Romney, 2006.
  
  The truth is that most folks don’t know much about the substance of this health care reform bill– only that is controversial.
  
  Republicans doubled down on failure with the hope that failure would precipitate in a mid-term swing for their party. As others have pointed out, this bill doesn’t even go as far as Richard Nixon’s failed attempt at health care reform.
  
  The doom and gloom scare tactics are offensive and hypocritical.
  
  Louisiana is a poor state squandering taxpayer resources in order to fight a bill that will actually help the majority of citizens, simply so that we ensure that when our Governor is raising money out-of-state for God knows what, his talking points remain consistent.
  
  Buddy Caldwell was elected as a Democrat; he was not appointed as legal counsel by the Governor. It is a crying shame that he has decided to use taxpayer money to mount a partisan attack against the President’s signature piece of legislation, seemingly at the behest of a Republican Governor who has made every indication that he intends to seek a national office.
  
  Reply
Drew Ward

March 24, 2010

I’m not sure about that necessarily Darren, as Louisiana has the 3rd highest homeowner’s insurance rates and the most expensive auto insurance. I’m not sure those are signs of the state doing what’s best.

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Kent Payne

March 25, 2010

I think the GOP’s basic argument against the constitutionality of health care reform is that it is unconstitutional for the federal government to require individuals to purchase private health insurance or be penalized. On the other hand, they see nothing wrong with requiring us to pay Medicare tax, penalizing us if we do not pay, then privatizing Medicare by allowing private insurers to offer Medicare Advantage plans.

Is there a difference here? How is one unconstitutional but not the other?

If you oppose Buddy Caldwell’s joining the Florida lawsuit, make your opinion known by joining the Facebook group, “Buddy Caldwell, You Do Not Speak for Me.”

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Tom Bonnette

March 25, 2010

Well, I think a primary concern is just how are we going to afford all this. I spoke to a guy from the DHH today who said Medicaid roles are expected to increase by 400,000 people in La. because of the new law, costing the state an estimated $350 million annually.

We know that Louisiana is already about $2 billion in debt, even with Jindal’s cuts of $108 million already cut from healthcare to close the spending gap.

Rural community hospitals, like Franklin Medical in Winnsboro are already operating in the red because more than 80 percent of patients have their healthcare paid for by government, either by Medicaid or Medicare. I know, I’ve talked to the hospital officials and doctors.

btw, Lamar, told ya I would be reading the site.

Tom
I even got the guy from the DHH to tell me that they are already looking at new rationing measures to pay for all this. Just because you give someone a Medicaid card doesn’t mean they are getting what they need with healthcare. In fact, the gov. rejects more services and treatments than private insurers. I know a little about that as a war vet who has been denied things by the VA.

I don’t know if you guys have ever taken someone to a doctor’s office that treats Medicaid patients, but I have. It means sitting for hours in a crowded room waiting for a doctor to treat you who most likely looks at you as a number. If you doubt it, visit Dr. Craig’s clinic on Lee Street sometime.

If you need a specialist in Alexandria that accepts Medicaid, forget it. I know a lady who was driving to Lafayette. I imagine there will be less and less providers that stay in the program.

Reply
1. Lamar White, Jr
  
  March 25, 2010
  
  Tom, thanks for the comment, and it’s always good to hear from you.
  
  But dude, I AM ON MEDICAID, and I don’t believe your description of the current situation is accurate.
  
  Reply
  1. Tom Bonnette
    
    March 26, 2010
    
    I admit that my experience with Medicaid has been from the outside looking in, so you would know more than I. Common sense, however, makes me question how this is all going to work without rationing or degrading of healthcare.
    
    I agree that healthcare is way too expensive in this country, which I believe is due to most relying on third party payers.
    
    I would have like to have been a healthcare bill with some tort reform and a national Medical Savings Accounts plan. Throw in the ability to buy insurance across state lines.
    
    I’m really concerned about the financial stability of our nation.
    
    We are facing some tough challenges right now including 10 percent unemployment and two wars and we are busting the bank. Maybe our priorities should be different now, especially considering other gov. programs like Medicaid and Social Security will be broke soon. No one really knows what this new program is going to cost or how we are going to pay for it.
    
    Passengers on the Titanic were treated to a multitude of luxuries unheard of in 1912, including a heated swimming pool, Turkish bath, squash court , gymnasium.electric elevators, four grand pianos and intricately decorated ball rooms.There was even a state-of-the-art refrigeration system to provide cold water and ice, also a rarity in the era.
    
    Priorities were to spare no expense on the ocean liner, something that should have been a priority ultimately made all the difference on the Titanic’s maiden voyage —life boats.
    
    There were only 20 to hold 2,227 passengers.
    
    no one on the Titanic could get ice from the ship’s high-dollar refrigerator after she struck an iceberg and lay at the bottom of the ocean.
    
    Reply
    1. Kent Payne
      
      April 1, 2010
      
      With the “Louisiana Purchase” and the feds’ additional contributions to Medicaid in the next few years, I’d say Louisiana’s public fisc would be worse off without the bill than with the bill for quite some time.
      
      Jindal’s opposition is part of the Republicans’ overall attempt to make Obama look weak, nothing more. It is hard to see anything in the bill that hurts Louisiana in the near-term.
      
      Reply
2. Robert
  
  March 27, 2010
  
  As a disabled Medicaid recipient let me say how ill-informed much of Tom’s post is. I get my care from Rapides Primary Care on Willow Glen. I have had private insurance before, so I can make a comparison. My doctor there is the best doctor I have ever had. When I needed surgery, I had no problem getting the surgery I need. My doctor listed several surgeons in the area that accepted Medicaid. I asked who was the best for Medicaid patients. He told me that the best doctor in the area for my procedure also accepted Medicaid. The surgeon did a great job. I had no complications. The only thing I owed was a small 60 dollar payment.
  
  Yes, Medicaid doctor’s offices are often crowded, waits can be long. That is a problem, but the actual care I get is top-notch. I feel my doctor REALLY cares, and I trust him completely. He listens, he’s non-judgmental, and he has a great “bedside manner.” I’ve had private insurance before, and many of the doctors that I had on private insurance seemed cold and distant.
  
  As far as prescriptions go, everybody should have my plan. The most expensive meds that I am on cost me $3 dollars each. Recently, I came down with an ear infection. I got my anti-biotics for — hold your horses — 50 cents!
  
  Now, there are things Medicaid could be better with — like mental health coverage. Many of the people referred to public mental health clinics are referred by courts/parole officers/what have you, and some of the staff at public mental health clinics can be rude to patients by presuming that criminal behavior is the reason you are receiving care. I had one psychiatrist at a public mental health clinic treat me like dirt. Turns out he’s a forensic psychiatrist, and his presumption is that everybody is guilty of something. He didn’t give me care, he gave me the third degree.
  
  Luckily a family member pays a private counselor for me, and I have my primary care doc do my med administration so that I can avoid the public clinics. It would be better if Medicaid would pay private therapists and psychiatrists rather than rely on the public clinics.
  
  Reply
Michael D. Smith

March 25, 2010

Drew,

1) Even if the health reform bill was close to what Louisiana is doing for its citizens (which it isn’t), conservatives like Jindal would have opposed it, because it handed a victory to President Obama. Their opposition is based on politics, not policy. That should be obvious.

2) Despite what insureme.com has to say, Louisiana does not do well for its citizens in regards to health insurance access, health care access, or health status outcomes. I find this sentence very ironic: “The State of Louisiana has implemented some remarkable programs to help its 576,000 uninsured residents receive coverage.” Hahahaha! If the state has such remarkable programs, then why the hell are there 576,000 uninsured citizens! The number of uninsured is rising in Louisiana, not falling.

3) Health care reform differs in a lot of ways from what Louisiana is doing. There are new taxes and fees, and the rules for eligibility for public subsidy have been dramatically altered. Under the new law, a family that makes less than 400% of the Federal Poverty Level – FPL – (88K for a family of 4) is eligible for government subsidies for a private health insurance plan. The current assistance, through Medicaid, is a public health plan which will only cover a family if it makes less than 150% of the FPL, and if you are a man with no disability, it doesn’t matter how broke you are, you aren’t eligible for Medicaid. It’s only for the disabled, women with kids, minors, and destitute seniors.

Insureme.com is an industry website trying to whitewash the image of a very broken status quo to feed the narrative that only small incremental changes are necessary to address the health care system’s problems.

Darren,
Though many Louisiana residents have been pointing out the problems of having over 500,000 uninsured residents to their state congresspersons, nothing is improving. Your argument has no weight.
What most “fiscal conservatives” and Tea Partiers and libertarians miss is the fact that strategic investments in health are budget neutral or have long term budget benefits that outweigh the costs. Which is why Bobby Jindal sticks his foot in his mouth when he says that there is no way to increase spending and reduce the budget deficit, which is pretty much exactly what the CBO says will happen with this bill (936 Billion dollar bill, reduces the budget deficit by 150 Billion over 10 years). Jindal is an educated person and he should understand this. His talking points are based on political aspirations, not the realities of sound fiscal policy.
Let me explain:
We can spend $10 Billion in mandating and subsidizing a policy that all health insurance plans must include free preventative care check-ups once per year (part of the health reform bill). This policy would probably save us $50 Billion down the road. Why?
About 32 million people who may have never had a preventative care check-up, and about 300 million people who have had to pay for it out of pocket or with a co-pay if they needed one, will get these services for free. The preventative care check-ups can detect a number of diseases in their sub-clinical stage (disease is present but no symptoms yet). The highest killers of Americans, such as serious cancers like colon, prostate, breast, testicular, etc., as well as cardiovascular diseases and diabetes can be detected this way. Early detection means early treatment, which is typically more expensive in the short term (starting treatment rather than no treatment), but much less expensive in the long term (aggressive chemo/radiation rather than a simple surgery). Since the federal government already pays for expensive end of life care via Medicare, and pays with the states for very expensive ER care, we are already paying for these expensive treatments down the line. If we got them early, then they’d be a lot cheaper. That is what cost-benefit means.

Get it? The reason it works the same way with health policy and your own health, is that the population’s health status is, yes, an aggregate of individual health status.

Lamar,

What Mitt Romney was referring to when he spoke of the “health care that must, by law, be provided,” was the fact that it is against federal law for ERs to turn away the sick. This is the most expensive option, and is paid for with Disproportionate Share Hospital funds (a huge source of Louisiana reimbursement), which is, yes, paid by the tax payers. So, we get to save a bunch of money by getting these people into the doctor’s office for a regular visit, rather than waiting until they are desperate and go to the ER.
Are you paying attention Darren?

Kent,
Generally, you are right. They are hypocrites, or they are confused.

However, there is a nuance to the legal challenge that wouldn’t affect Medicare payroll tax.

Regarding the constitutionality of the federal mandate, what is at issue is whether the feds can impose regulations on intrastate commerce (such as health insurance, which is regulated at the state level), since it is mandated only to regulate interstate commerce. Also at issue is whether they can regulate the absence of commerce (not having insurance at all) rather than existing commerce (having insurance).
From what I understand, if this case ever makes it to the Supreme Court, the decision will likely be 8-1 vote in favor of the constitutionality of the current plan. Only our old friend Clarence Thomas will vote against it. The reasons are that there are current precedents that allow for regulation of intrastate commerce that significantly affects interstate commerce (which health insurance clearly does) and that the feds can also regulate the absence of commerce, because non-participation is actually a market option chosen by the individual.

The difference with Medicare is that though everyone who makes an income is taxed for it, not everyone is mandated to participate (if you don’t enroll, you don’t get it. Also, if you are ineligible, you don’t get it).

So, unless you are trying to score narrow political points, there is no point at all in the legislation.

Hope this has been helpful. At least take some cheer in the fact that Health Care Reform has been mostly driven and implemented by people like me, who are professionally trained to know the best way to manage public health systems. Which despite the hype, does not include Bobby Jindal.

Reply
1. Lamar White, Jr
  
  March 25, 2010
  
  Amen, amen, amen, Michael.
  
  Thank you for your insightful comments.
  
  Reply
2. Drew Ward
  
  March 26, 2010
  
  Good Call Michael about that being an industry whitewashing site. I should have pointed that out. I don’t quite buy the peachy version they present, but I still find it interesting that the bullet points they present are very similar to the overhaul (which the industry supposedly hates so much).
  
  Reply
Michael D. Smith

March 25, 2010

Ooops, I meant “unless you are trying to score narrow political points, there is no use for the court challenge.”

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Gel Fuel

December 1, 2010

health plans may be expensive but it is really very necessary to get one for yourself ~:~

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