Pun Salad

I received a reply to the mail I sent last month to my state's US senator, Jeanne Shaheen. It's clearly a canned reply, as it doesn't respond to the actual point I made. And it's stupid to respond to a form letter.

I'll do so anyway:

December 3, 2009

Dear Paul,

Ah, we're on a first-name basis.

Thank you for contacting me about health care reform. This is one of the most important issues facing our nation and I appreciate hearing your thoughts and suggestions for how we might address it.

Jeanne, I'd take that a lot more seriously if there were any indication whatsoever that you had actually paid attention to anything I said.

In New Hampshire and across the country, rising health care costs are threatening the stability of our families and the competitiveness of our small businesses. In the past 10 years, health care costs have increased 131 percent, far outpacing wages, which increased by 38 percent over the same period. Medical bills are now the leading cause of personal bankruptcy in the United States, with three-fourths of those bankruptcies befalling people who have insurance.

Jeanne, that's fine, but I wish you'd think for a bit about what has brought us to this pretty pass. We're here as a result of decades of government restrictions, mandates, regulations, taxes, subsidies, and penalties, all aimed at the health care sector. Your claim is that this time, your new set of restrictions, mandates, regulations, taxes, subsidies, and penalties will (somehow) bring us to health care nirvana. Even if I didn't know anything else about your proposed legislation, I'd say the past history of government behavior in this area allows us to be very skeptical about that.

Unfortunately, we do know the details of your proposed legislation, and the evidence is mostly the other way. The Congressional Budget Office (CBO) released an analysis a few days ago that revealed some ugly math: estimated premiums for some people would go up by 10%-13% more than what's projected under current law. And some argue that the CBO report is overly optimistic.

The dean of Harvard Medical School recently noted: "In discussions with dozens of health-care leaders and economists, I find near unanimity of opinion that, whatever its shape, the final legislation that will emerge from Congress will markedly accelerate national health-care spending rather than restrain it. Likewise, nearly all agree that the legislation would do little or nothing to improve quality or change health-care's dysfunctional delivery system."

The actual winners and losers, costwise, will be unknown until well after the legislation is enacted.

I'm afraid there's no evidence for your glib implication of significant savings for most people. During the campaign, President Obama promised that "reform" would save "the typical family $2500 a year in lower health care premiums." He's not mentioning that now.

The "bankruptcy" claim, by the way is a myth; it's unlikely that "reform" will make any significant dent in bankruptcy filings.

For our small businesses, rising health care costs are hurting their ability to compete and killing jobs. From 2002 to 2006 in New Hampshire, there was a more than 40 percent increase in the premiums businesses paid for an individual plan for their workers. And for our smallest businesses, those with fewer than 10 employees, the increase was almost double that - a more than 70 percent increase. We are on an unsustainable path.

Jeanne, I'm well aware that you can count on the support of business, large or small, if you can credibly claim that you can use the tools of the coercive state to shift costs that they currently bear onto others. Generally (and regrettably), businesses are not reliable supporters of free market principles.

That said, many businesses are not convinced that you're here to help them out. The National Federation of Independent Business doesn't support the current version of your legislation; neither does the US Chamber of Commerce. If you're really concerned about business health, shouldn't you be listening to them?

It's time to hold health insurance companies accountable. In America, it should be against the law to deny coverage to people with pre-existing conditions such as diabetes, cancer, or heart disease. It should be against the law to cap insurance coverage so that patients lose their coverage right when they need it most. And, nobody should have to lose their health insurance when they lose their job.

Please note that you just got done bemoaning skyrocketing health costs. Now you are proposing measures that will inevitably increase the cost of health insurance further. Do you see a problem there?

While we look to stabilize costs for those Americans with insurance, we also need to create some affordable options for the 30 million Americans with no health care at all. I support a public option that would encourage competition in the insurance market and provide an affordable option for the uninsured. I believe the public option is the best solution but I am willing to consider other proposals that lower costs and increase access to health care.

I wish you were serious about that, Jeanne. You might start with Charles Krauthammer's recent column that presented three good ideas:

1. Tort reform.

2. Abolish the prohibition against buying health insurance across state lines.

3. Tax employer-provided health insurance.

These ideas got nowhere in the legislation under consideration. Krauthammer suggests you junk those bills and start over. Are you willing to consider that? If three proposals are too few, see John Mackey's blog for additional ideas.

While there are many things wrong with America's health care system, the quality of services and choices for consumers are working and must be protected. We have the best hospitals, the best doctors, the best nurses and the best medical technology in the world. Americans can choose their own doctors, choose their own insurance, and make decisions about their treatment. That's what's right about our health care system. We must keep what's right and fix what's wrong.

Jeanne, I realize that this sort of empty feelgood rhetoric is common practice in form letters, but it's still kind of soul-deadening to read it. Needless to say, I have little confidence that the proposed legislation will do anything approaching what you claim.

One thing you don't specifically mention is medical innovation. Many feel that under your legislation, American dominance in this area will be doomed. Are you comfortable with that?

The time to reform our health care system is now. We cannot wait any longer. Middle class families and small businesses are depending on us. We need health care reform that stabilizes costs, holds health insurance companies accountable and protects quality and choice.

Just as an aside, one of the widely noted gimmicks used to hide the true costs of the bill you seem determined to vote for is to delay significant outlays until 2014. So your insistence about hurrying up rings a bit hollow here.

Thank you for sharing your thoughts with me. I will keep them in mind during the coming weeks as we debate health care reform in the U.S. Senate. Please do not hesitate to contact my office with any future questions or concerns.

Sincerely,

Jeanne Shaheen United States Senator

Jeanne, I find your form-letter reply to my specific concern disappointing, and I don't for a moment believe that you will keep my thoughts in mind. Sorry.