Elmer Smith: Cling to current health care & you'll pay dearly

Columnist Elmer Smith speaks last night at a health-care reform forum at the Daily News & Inquirer Building. The forum, broadcast on WPHT (1210-AM), included politicians and health experts.
Columnist Elmer Smith speaks last night at a health-care reform forum at the Daily News & Inquirer Building. The forum, broadcast on WPHT (1210-AM), included politicians and health experts.
Posted: September 01, 2009

THE BAD NEWS from my union came in a large white envelope marked "time-sensitive benefit changes."

It told us what President Obama has been telling people in his campaign for passage of a health-insurance-reform bill.

"If you like the plan you have now," the president and my union have said, "you can keep it."

But the Newspaper Guild added a caveat that the president hasn't: You can keep it at a cost.

The Guild's health and welfare plan says that I can continue to be enrolled in the Blue Cross Personal Choice plan that I chose years ago.

But it will cost me another $50 a week.

Frosty the Snowman has a better chance of surviving summer in Miami than I do of opting to pay a $50 weekly deduction to hold onto the plan I prefer. For an additional $50 a week, I no longer prefer it.

Fortunately, my union's health-care consultant has done the research to find an alternative plan that seems almost as good. And I can maintain it for the same deductible I pay now.

My wife and I read all of the little boxes that compared the new plan with the old. We could not find enough of a difference to justify what amounts to a $2,600-a -year pay cut. Our personal choice was easy.

But what happens to people whose employers or unions can't afford a consultant to do the research and come up with an alternative? What happens to employees of small businesses who can't absorb the 10 percent increase that Blue Cross is trying to pass along?

You don't even want to know what an individual has to pay for comprehensive health care.

So, do I believe we'll be able to hold on to the plans we prefer under the health-reform proposals being considered in Congress?

No, I don't.

We won't be able to hold onto them whether Congress passes health-care reform or not.

If you consider the increases in co-pays, reduced benefits and restrictions on which doctors you can see and what procedures are covered, you'll find that very few of us are still in the plans we once preferred.

It will be fewer still in the future. Under the current fee-for-service system that is so ingrained in American culture, there is nothing to moderate the increases in health-care costs.

Most of us have no idea what our health care actually costs. We're barely even aware of what part we pay until a serious condition runs up our co-pays or we get a letter like the one I got this week.

There is no such thing as the status quo. Anyone who opposes health reform because we like what we have now is laboring under a false premise.

That ship left the dock years ago. Insurers are increasing premiums, shifting costs by changing the plan designs and bumping up co-pays whenever they can.

All of the measures that reform opponents are trying to frighten us about are already being put into effect by our beloved insurers.

The plan that my union is recommending is also a Blue Cross plan. But it uses a "capitation" system to lower costs. It prepays doctors at a flat monthly rate per patient, making them less likely to do extraordinary procedures or see you more often.

They can call it what they will, but it's a thinly veiled form of rationing. They take the veil off altogether for a lot of procedures. They simply don't pay for them and you can't do anything about it.

It's a business. Everybody is in it to turn a profit. Drug companies, physicians, hospitals, medical-equipment makers are all adding their margin.

This is a luxury we can no longer afford. If somebody is going to ration my health care, I want it to be someone who has to face me on Election Day.

Send e-mail to smithel@phillynews.com or call 215-854-2512. For recent columns: http://go.philly.com/smith.

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