Thursday, March 21, 2013

Note to the Republican Party: Do NOT Panic, Obamacare is Your Savior!

            I just got back from a month vacation in New Zealand.  While getting caught up on the news, I saw the Republican Party in full panic mode.  The newscast I watched showed several members of a committee that did a “postmortem” of the 2012 election.  The committee made some good points:  the 2012 election message was that the Republican Party was un-inclusive – the party of old white guys.  Who cares about those 47 percenters anyway?  (To prevent any trouble: please note that the last sentence is sarcasm.) 

Contrary to the postmortem committees view, I believe that the Grand Old Party needs a tune-up, not an entire makeover.

By the way, one point made by the postmortem committee was that the Republicans needed to speak more to women's issues.  BS!  Women’s issues are the same as the rest of Americans’ issues.  The Republican message was anti-gay, anti-poor, and anti-Hispanic.  It was NOT anti-women.

Yes, I am aware that the Republican message was a hand-up: not a hand-out.  However, it was delivered so poorly that it came across as anti-poor: even anti-middle-class.

The Republicans need to separate moral value judgments from policy making.  For example, if the religious zealots cannot accept gay marriage, then do not allow anyone to be “married” by a government entity.  Heterosexual and homosexual couples can both get (equally legal) civil unions from their local government.  If a couple (of either persuasion) wants to get married, they should go to their place of worship.  The Republicans can surely figure out a way of being fiscally conservative while retaining the “silent majority” of far right Christian voters.

The “civil unions for everybody” was my proposed solution before the 2012 election and it was included in my book.  Had the Republican Party used my book as its platform (and put forth a candidate that could connect with real people) we would not be having a postmortem of the 2012 election.  My book also defines America’s role in foreign affairs.  It is not in line with Senator Rand Paul’s views – but I do not believe that the Republicans should become the isolationists’ party.  Have we become so anti-Obama that a rookie senator can become a sensation just by hosting a hopeless, thirteen-hour filibuster of an Obama appointment?  Do the Republicans really want to continue their reputation of the party of “NO”?

I am not trying to convince you of an entire political platform today.  (I’d rather you buy my book so that I could make a few pennies in the process of accomplishing that.)  I just want to allay the fear and panic of the Republican Party.  Obamacare is going to be the savior of conservatism.  The implementation of Obamacare in 2014 will cause the public to starve for Republican leadership. 

The following is some background information that will support the case for Obamacare being the savior of conservatism.  The information is from the Department of Health and Human Services and the Census Bureau.

From the Department of Health and Human Services:

The charts that appear below are from the “ASPE ISSUE BRIEF - Overview of the Uninsured in the United States: A Summary of the 2012 Current Population Survey Report” that is published by the Department of Health and Human Services.  The report can be found at:


 
                             Sources of Insurance Coverage, 2011




                  Insurance Trends, 1999-2011

            I apologize for the smallness of the charts.  You can view them in their full size at the above listed website.  The charts point out that 15.7% of Americans are uninsured.  They also indicate that both "Employer Sponsored Healthcare" and "Direct Purchases" of healthcare is declining.


From the United States Census Bureau:

The following chart is expropriated from 2008 data on the Census Bureau’s website.  The website can be found at: 

 


 

Number of Employees That Work for Businesses
with Fewer than 50 Employees

 
Company Size
(number of employees)
 
Total Paid
Employees
Total Paid Employees (at business with fewer than 50 employees)
1 to 4
  6,086,291
  6,086,291
5 to 9
  6,878,051
  6,878,051
10 to 19
  8,497,391
  8,497,391
20 to 99
20,684,691    
      7,756,759  *
Employees working at businesses
with fewer than 50 employees
29,218,492
Total US employees
120,903,551

 

* It was assumed that 3/8s of the businesses that range in size from 20 to 99 employees have 49 or fewer employees.  This was based on the fact that 20 to 49 is 30 employees and 20 to 99 is 80 employees.

 
Based on the chart above, 24% of all workers in the United States (at least according to the 2008 United Census Bureau’s data) are employed by businesses that are exempt from the Healthcare Affordability Plan (Obamacare).  Obamacare does not require employees with fewer than 50 employees to provide healthcare insurance.  Furthermore, if an employer has 51 employees, it can exclude the first 30 employees from the $2,000 per employee per year tax for not providing healthcare insurance.

From the Department of Kaiser Family Foundation:

Another tidbit of healthcare information comes from the Kaiser Family Foundation at their website:


According to the Kaiser Family Foundation, in 2012 the average the average annual healthcare coverage costs $15,745 for a family of four.

 

To summarize all of the above charts and statistics:

  • The employers of 24% of American workers will not be required to provide healthcare to their employees,
  • In 2011, 15.7% of all Americans were uninsured,
  • The trend of healthcare coverage for both employer provided and individually purchased (“Direct Purchase”) is going down, while
  • The trend of government provided healthcare and the uninsured is going up, and
  • Healthcare costs are too expensive for the average American to afford without either employer or government assistance.

 
Now to the part where the Republicans panic should be abated…

Obamacare-2012:  Ah, life is wonderful.  Everyone will receive free healthcare.  The government will take care of all our needs.  Why should anyone vote for anybody by President Obama?

Obamacare-2014:  What do you mean I have to purchase my own healthcare coverage?  President Obama told me that I was getting it for free.  You must be kidding - I will be fined by the government if I do not purchase healthcare insurance?  This cannot be true, President Obama promised me free healthcare – and I voted for him.  Why can’t we just raise more taxes on the rich so we can have free healthcare?

There it is – the salvation of conservatism.  To sum up how Obamacare is the salvation of conservatism: there is no such thing as a free lunch!

The one caution of this essay is included in the sentence above that stated: “Why can’t we just raise more taxes on the rich so we can have free healthcare?”  I can imagine the Democrats stating that they intended to make healthcare free for everyone but the Republicans refused to raise taxes on the rich – so it’s the Republicans’ fault that we cannot afford free healthcare.  To the Republican Party: please be prepared to answer that question.  It is not a difficult question.  Then again, I remember so well the delivery of the message during the 2012 election.  So be prepared with the easy answer and deliver it in a sensitive manner – PLEASE.

A Few Obamacare Facts:

(1)  Most hard-working Americans that cannot afford healthcare insurance today think that on January 1, 2014, they will be receiving free healthcare from the government.  They will not.

(2)  Those same hard-working Americans will be taxed for not purchasing the healthcare that they thought they were getting for free.  Most are not aware of this new tax.

(3)  Americans with more substantial means will pay more for the healthcare they already have.  This has already been felt by increased rates the past few years because children must be covered until they reach the age of 26, reproductive healthcare must be provided, etc...  More increases to those that can afford healthcare are coming.  And, those premium increases will make healthcare more unaffordable to many Americans that struggle to purchase it themselves today.

(3a)  The federal government is establishing the minimum standards for healthcare insurance.  These standards will cost everyone more and they are excessive.  They are establishing “bronze”, “silver” and “gold” level plans – with “bronze” being the minimum required coverage. 

(3b)  The “bronze” plan has a maximum “out-of-pocket” deductable of $2,000 per year.  I personally identify with this $2,000 maximum deductable.  My wife and I are in our mid-50s.  We are both healthy and we have enough money in the bank that we can afford a higher deductable.  Instead of paying $2,000 per month for healthcare insurance with a small deductable, we have elected to purchase a healthcare plan with a $5,000 per year deductable.  In doing so, we save $1,000 per month on our premiums.  With Obamacare, we “Direct Purchasers” of healthcare will be forced to pay an extra $12,000 per year.  Thank you Mr. President.

(3c)  We have already accepted that children must be covered until they reach the age of 26 and that birth control medication must be provided.  There will be many more requirements.  For a preview of the minimum healthcare benefits that will be required check out the government employee healthcare plan.  Then ask yourself if we can afford to provide that level of benefits to every American.

(3d)  The “bronze” level plan also requires more mental healthcare coverage than the typical employer sponsored plan.  Therefore, employers and employees will have to pay more.  You can bet there will be many more “minimum” requirements that are above the average plan of today – so hold on to your hat with regard to the premiums that you (and your employer) will have to fork over.  The underlying problem is that our dear government employees have Cadillac healthcare coverage.  If the government establishes minimum requirements less than those now enjoyed by our dear government employees (read Congressman and Senators) then, our dear government employees’ benefits may have to be trimmed.  Else wise, our dear Congressmen and Senators may be criticized for pinching pennies while doling out “free” healthcare while they live high off the hog.

(4) Employers with fewer than 50 employees have no requirement to provide healthcare to their employees.   For employers with more than 50 employees they only have to pay a $2,000 per employee, per year fine for not providing healthcare coverage.  Remember 24% of working Americans work for companies with fewer than 50 employees.  Also consider that the trend of employer provided healthcare coverage is going down (see the above charts).

I am a small business owner.  Recently, I participated in a nationwide bid for my services.  The purchaser is one of America’s top corporations.  After submitting my bid on an electronic bidding website; I received a message that my bid – and all my competitors’ bids were too high.  The message then directed all the bidders to an “expected pricing” list.  The pricing list was stated on a cost per man-hour basis.  The price was so ridiculously low that I immediately realized that I could not compete.  However, some of my competition caved and gave the purchaser the price they demanded.  The price per man-hour was less than the minimum wage plus the cost of employer paid taxes and workmen’s compensation insurance.  It was well below the minimum wage (excluding employer paid taxes and insurance) plus the average, family of four healthcare costs. 

The average family of four healthcare cost ($15,745) is about $7.87 per hour (assuming an employee only gets 10 days paid time off per year).  The cost of healthcare is more than our minimum wage.

Unfortunately, I had to eliminate healthcare benefits to my employees four years ago – before the cost escalation of Obamacare.  I could no longer afford the benefit and remain competitive in my line of business.

I was not willing to participate in the low-ball bidding my perspective client demanded.  However, there were plenty of other vendors that were willing.  I now realize that my business has no room to grow.  I cannot compete in the cut-throat tactics of today’s business world.   I have almost 50 full-time employees.  The realization has sunk in – I can not grow any larger.  I cannot compete with more than 50 full-time employees.  I cannot add $8 per hour of healthcare to my cost of service.

Wait a minute, I can grow.  I can just pay the $2,000 per year tax for not providing healthcare coverage.  That is $1 per man-hour.  Furthermore, (per Obamacare) I can exclude the first 30 employees from my fine calculation.  SMACK:  I just woke up from that dream.  In my business, I cannot add $1 of cost and remain competitive.  I am stuck at 50 employees.  My poor employees make too much money to qualify for free healthcare and too little to purchase their own.  I feel sick about this. 

(5)  The reality is that more and more small businesses will not be able to afford the “bronze” level healthcare insurance.  More and more employers will be forced to drop their healthcare benefits.  The trend that has already started in declining employer provided healthcare benefits (see the chart above) will be accelerated by Obamacare.  Most employees that lose their healthcare benefits will not be able to afford to purchase it themselves.  Instead, they will be taxed for not purchasing it.

(6)  Large companies that are “self-insured” do not have to provide the “bronze” level healthcare benefits.  “Self-insured” means that a business has enough money that it pays for all its employees’ healthcare services.  They usually hire a healthcare insurance company to “administer” their healthcare benefits (line up approved doctors and process the medical claims).  They pay the healthcare insurance company a fee to be their “third party administrator” but they pay all the costs – no matter how high.  Mid-sized companies cannot afford this because the risks are too high.  One employee with cancer can cost hundreds of thousands of dollars per year.  To save money, some midsized companies utilize a hybrid approach to “self-insured”.  In the hybrid mode, the mid-sized companies purchase catastrophic insurance so that the healthcare insurance company only pays if a single employee’s annual healthcare costs exceed a certain amount (say $200,000) or if the entire populations of employees annual cost exceeds a certain amount (say $200,000,000).  Under Obamacare, these hybrid healthcare plans do not receive the exemption that the “self-insured” companies receive.

(6a)  An easy conclusion to reach from fact number (6) above is that large corporations that can afford to be “self-insured’ will be better able to manage their healthcare costs because they are exempt from Obamacare.  They do not have to provide the “bronze” level minimum requirements.  The follow-on corollary is that mid-sized companies will not be able to compete against the large companies.

(6b)  If you work for a large corporation, you will never get healthcare benefits that are equal to your Senator and Congressmen.

(6c)  If you work for a mid-sized company with a hybrid healthcare plan, your premium contributions will be going up.  Or, you may loose your healthcare benefits altogether.

The Bottom Line:
 
The mid-term elections of 2014 and the presidential election of 2016 are far enough away for Obamacare to have tipped over the apple cart.  Republicans need to get off their moral high-horse but they do not have to become liberals.  America desperately needs fiscal conservatism.  We also need compassion.  So when the failure of Obamacare provides you Republicans with the opening to election victories – please have sane solutions for our healthcare problems. 

Obamacare is severely flawed, but it does provide us with a chance to do something about healthcare.  It is easier to fix something that is broken than to build something from scratch in Washington.

Healthcare should be affordable for every American.  Let the public become aware of President Obama’s false promises.  Then fix healthcare by establishing a reasonable minimum standard of health benefits that should be available to every American.  And, figure out how to pay for it without giving large corporations an advantage over the little guy.  If you want some more ideas, read my book (yes, that was a shameless plug).

Finally, while all this plays out: stop being the party of NO.  Pretend that you are big boys and girls and practice a little compromise.  A party that has done a postmortem on how it conducted itself during the last election should realize that stopping all progress in the name of conservatism is not “holding ground”.  It is moving backwards.  America needs spending cuts, but we need more revenue too.  By the way, a Grand Bargain will not only help America, it will help restore the Republican brand.  It will even prevent the Democrats from blaming you for the government not being able to afford free healthcare for everybody.