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First mandate sought in Senate health plan, cost increases to follow
Tony Ondrusek is founder and publisher of Insurance & Financial Advisor and IFAwebnews.com.
The first of what is surely to be many, many well-intentioned mandates has found its way into the Senate health reform plan, setting the stage for the proposal to go far beyond initial cost estimates.
Two weeks ago, a task force within the U.S. Department of Health & Human Services suggested that screening for breast cancer need not begin until age 50. Women’s groups and those who have experienced the pain and loss associated with breast cancer, went ballistic.
In steps Sen. Barbara Mikulski (D-Md.), who is seeking to add an amendment to the Senate health reform bill that will make it mandatory to provide women with free coverage for mammograms. (click here for story)
A worthy goal, to be sure. Makes sense. Women should get mammograms (and early), and the procedure should be covered as preventive care.
But now the cat is out of the bag. The first salvo in what is sure to be a deluge of mandates has been tossed. This one, simple, worthy mandate has now made all the cost estimates of the Senate plan null and void.
Why? Because this first proposed mandate will cost about$1 billion over the course of 10 years. And the cost has yet to be added to Sen. Harry Reid’s (D-Nev.) health reform proposal.
Legislators want to appeal to every constituency, and will add mandate upon mandate to their health care plans, until the program becomes an unwieldy work of horror. Consider the permutations and endless number of changes to the IRS tax code. It is one of the most complicated and unintelligible documents in the world.
Combined, there are more than 2,100 separate mandates in group health plans in the 50 states. According to NAHU (National Association of Health Underwriters), mandates account for up to 50% of increases in premiums each year.
The states with the highest number of mandates are: Rhode Island (70), Minnesota (68), Maryland (66), Virginia (60) and Washington (57).
Some of the mandates sound good; diabetic supplies, substance abuse treatment, emergency care, mental health care, etc.
But even those, and other mandates — services and coverages that are part of the plan for everyone — don’t make sense when one consider that the coverage must be offered to every person who is part of the plan.
Autism treatment covverage for a single woman who is beyond child-bearing age? HPV (cervical cancer) screening for an unmarried man? Domestic partner coverage for a man and woman who have been married for 50 years? And what about mandates that pay for athletic trainers, circumcision, hair transplants and Oriental medicine? All of the above are mandates in at least one state; many are mandated in multiple states.
Surely, there are reasons to add coverages. But in the case of a federally run health plan as proposed by the House and the Senate, the mandates will be proposed, voted on and passed fast and furiously. If the states can’t bring it under control, what is to make Americans believe that Congress, which never saw an expenditure that it could pass up, will be able to keep mandates to a manageable number? And the costs will add up.
In Mikulski’s own home state, Maryland, insurers state that there will be no changes to their coverage. (click here for story) But this is Congress, and they are trying to put these insurers out of business, thus, any promises on their part are mute.
According to the Congressional Budget Office, Mikulski’s amendment will add slightly less than $1 billion to the cost of the Senate health plan. This is only for screening. Not major services or products or surgery. Imagine the costs if the government adds 10, or 20, or as the case is in several states, more than 60 mandates. Well, you get the cost picture.
Before I get comments and emails stating that I am against breast cancer screenings, let me state: “I am not.”
What I am against is a federal government that believes it has the right to implement a health care system that will force millions out of private coverage and into a system that will only become more and more bloated, costing much more that even they can estimate.
The bill itself is under intense debate. (click here for story) Let’s hope the votes aren’t there, and we can begin to “reform” health care and insurance in a rational, systematic and cost-effective manner.
* * NOTE * * On Dec. 3 (after this blog post was written), the Senate approved Sen. Mikulski’s amendment. Click here for story.
One Response to “First mandate sought in Senate health plan, cost increases to follow”
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Bill Griffin Says:
December 2nd, 2009 at 2:09 pmI regret that the term athletic trainer was included in your comment about what’s the next mandate to be covered. It sounds as if it was meant to be derogatory and I wanted to make sure the term is being properly applied.
An athletic trainer is a health care professional. We are often confused with personal trainers whose main focus us improving the fitness of an individual. An athletic trainer, certified by the Board of Certification, Inc. (www.bocatc.org) is trained to prevent, evaluate, diagnosis, treat and rehabilitate injuries sustained by athletes and other active individuals. We are currently regulated in 47 states. We have been working with congress for 6 years to be recognized by Medicare as a provider of physical medicine and rehabilitation services . The services we provide are already mandated for payment; when provided by a physician or other recognized health care providers. The difference is that when physical medicine and rehabilitation is provided by an athletic trainer, the patients tend to get better faster and to a higher level of function than when performed by other health care providers. So yes there is a price tag associated with “mandating” athletic trainers in a health care environment, but the end result would be decreased costs and improved quality of life.
For more information, please contact me or go to the National Athletic Trainers’ Association web site (www.nata,org).
Thanks and have a great day!
