Health Care Bill of Rights for Seniors

The Republican National Committee has just published what it is calling a "bill of rights" for seniors regarding health care. The six tenets of the proposal are:

1. Protect Medicare from cuts made in the name of healthcare reform
   
2. Prohibit intrusion by government in the doctor-patient relationship
   
3. Don't ration healthcare based on age
   
4. Don't let government interfere with end-of-life discussions between a patient and doctor
   
5. Allow seniors to keep their current coverage
   
6. Preserve current healthcare programs for veterans
   

Republican Party Chairman Michael Steele discusses the Seniors' Healthcare Bill of Rights on Fox News' Fox and Friends show below:

This is a good start for Republicans who were shamefully late in getting to the healthcare party. But, in my estimation, it does not provide enough thought leadership in the healthcare debate to counter the Democrat pitch which has been 15 years in the making. 

The first proposal is somewhat disingenuous for both parties since it was Republicans whom the Democrats excoriated in the 1980s when they tried to make cuts to rein in Medicare spending. Now the shoe is on the other foot. 

Proposal #4 is similarly problematic. House Bill 3200, the healthcare bill, does indeed reference end-of-life discussions. But the context is to allow doctors to be paid for the time it takes to carefully explain all options to a patient and his or her family. Anyone who has ever dealt with a terminally ill family member knows these discussions. They are useful for the patient, the patient's loved ones, and I suspect, the physician as well. Currently this time is not reimbursable by Medicare. This would allow physicians to get paid for their advice and counsel, which is the correct thing to do.

Here's where we get wrapped around the axle on end-of-life: Many of the people who support the bill in general do not share the pro-life beliefs that many of the bill's opponents hold. Proponents, for example, are more likely to favor euthanasia as an end-of-life choice, an anathema to anyone who favors life over death. The Blogosphere is replete with stories about Oregon and its assisted suicide law, and with tales of Oregonians who could not get life-prolonging drugs, but could easily get a prescription for euthanasia drugs. No wonder that so many pro-life people are wary of this end-of-life requirement. 

Proposals 3 and 5 are much more on target. Nationalized healthcare proponents point frequently to the British and Canadian healthcare systems as models we should follow. But these systems, because of their tremendous cost are forced to ration healthcare based on age. The National Health Service in the U.K. uses quality adjusted life years, or QALY scoring to calculate the cost benefit of a particular health intervention for a patient before agreeing to pay for it. 

This is similar to a company doing a cost-benefit analysis on the purchase of a piece of equipment: what is the cost of the purchase, how long will it take to recover the cost of the expense, and what will the purchase yield in terms of revenue.  QALYs analyze how old the patient is, how much the procedure will cost, how many years will it add to the patient's life and what the quality of those years will be. 

Those of us opposed to this kind of approach believe that when you're on the back nine of life you deserve the dignity of not being analyzed like a dump truck or a trash compactor. But it all comes down to money. Universal coverage is so expensive that hard decisions like this have to be made.

Proposal #5 addresses another real concern for seniors. Pres. Obama says repeatedly that under his socialized medicine plan you can keep your private coverage. But, either the President does not really understand the healthcare debate and is doing a really, really good job of faking it, or he's hiding the truth. Take your pick. Should ObamaCare become law you will be able to keep your policy. But as time rolls on, more and more people will be forced into the government's program. 

Businesses will probably be the first. Rather than pay a payroll tax or a large portion of their revenue in group healthcare insurance premiums, they'll just cancel their policies and force their employees into the "government option." These are the younger healthier people who use less healthcare than seniors. When the private sector insurance customers skew too much towards seniors who use a lot of healthcare, costs will escalate to the point that seniors will be forced into the government plan.

The President said in 2003 that he favored a single-payer plan, but admitted that it might take awhile to get there. So he's like the used car salesman who brags about the four new tires on that shiny '74 Cordoba, but "forgets" to tell you that the transmission has about another 500 miles of life.

ObamaCare is problematic for seniors, no doubt about it. But the Republican Healthcare Bill of Rights for Seniors is problematic for the party, exposing its basic weakness on healthcare and everything else, frankly. Its first official foray into the healthcare debate is on behalf of old white people. The Democrats are making their appeal to the two fastest growing segments of the population: Hispanics and young adults. Healthcare is  a game Republicans can't win on numbers alone. The President and his party simply have to wait them out, as Barack Obama said in 2003, unless the GOP can come up with something better than this.

Just thought you might like to know.