Polemic Assignment progress continued

I. Rebuttal, Concession, Redirection

a. Cost

i. Concede the fact that costs will rise

ii. Increased cigarette tax

b. Compliance

i. Cigarette tax curbing cost à Won’t have to force people to pay more

ii. Compliance will remain the same

c. Limited market

i. Benefits of The Connector

ii. No authority to regulate insurance

Rebuttal, Concession, and Redirection

Cost and Compliance

It is true that health care costs will continue to rise but Massachusetts lawmakers have already devised a plan to solve this problem. To help pay for the larger-than-expected enrollment in the law’s subsidized insurance plans, lawmakers have decided to raise the state’s cigarette tax by a dollar. Steve LeBlanc, Associated Press Writer for the Boston Globe writes, “Lawmakers are hoping to close the gap in part with a new cigarette tax expected to generate about $154 million a year.”8 With the cigarette tax curbing the rising cost of health care, the state will not have to force people to pay more for their health insurance. Therefore, non-compliance will not be an issue due to cost. If costs remain the same or decrease, then compliance will most likely remain the same as it is now or even increase.

Limited Market

It is true that the Connector has a limited selection of insurance options but the benefits of the Connector outweigh the detriments tremendously. The Heritage Foundation, an advocate of the Massachusetts health law states, “Markets sometimes work more efficiently and effectively when there is a single place to facilitate diverse economic activity.”7 The Heritage Foundation also compares the Connector to the Federal Employee Health Benefit Program, which both exemplify the basic features of managed competition.7 With the Connector, consumers are able to choose from a limited menu of insurance plans where subsidies are structured so that consumers choosing more expensive plans have to bear the portion of the cost.7 Also, contrary to belief, the Connector has no authority to regulate insurance. Defenders of the Massachusetts law say that the Connector “must offer for sale any and all products that have been approved for sale by the state’s Division of Insurance.”7 Therefore, the Connector solely aids as a middleman to help citizens find affordable coverage. Through the Connector, thousands of Massachusetts citizens have become insured since the law was implemented.

Polemic Assignment progress continued

I. Counter Arguments

a. Future problem – cost

i. Rising cost of health care

ii. Increasing the cost of insurance

b. Enforcement – compliance

i. Forcing people to pay more

ii. Stray from universal coverage

c. Limited market

i. The Connector

ii. Less choice

iii. Outside market will slowly diminish

Counter Arguments

Cost

One economic argument is that the Massachusetts Health Care Reform Law will be defeated by the rising cost of health care.[1] According to Jennifer Fisher Wilson, Science Reporter for Annals of Internal Medicine, “Financial pressures are a considerable concern, and the ability to keep costs down is crucial to the future of the reform effort.”[2] Health care costs are projected to rise considerably over the next few years. In a time of economic crisis, the Massachusetts health law may not survive. It was estimated in 2006 that the law would cost $725 million in the fiscal year starting in July.[3] Governor Deval Patrick set aside $869 million for the law, but those overseeing the law have already acknowledged costs will rise even higher.4 One example of the economic argument is Michael Tanner, Director of health and welfare studies at the Cato Institute, who argues that as more benefits are added to health insurance plans, the cost of the mandate will increase, placing legislators in a difficult position.[4] Legislators may be forced to put the burden on the citizens purchasing health insurance coverage.

Compliance

One legal argument is that if the state tells people they must pay more for their mandatory insurance, then there will be an increase in non-compliance with the mandate.2 One of the main goals of the Massachusetts health law was to make health insurance affordable to everyone. If the costs that citizens are required to pay for their health insurance increases, then many citizens will, again, be unable to afford it. Also, many of the citizens choose not to comply because it is less expensive to pay the fine and continue without insurance.5 For example, Michael Tanner, in his article “No Miracle in Massachusetts: Why Governor Romney’s Health Care Reform Won’t Work” writes that the law “has the perverse effect of creating penalties that are large enough to be onerous but still smaller than the cost of purchasing insurance.”5 If compliance begins to decrease, then the Massachusetts health law will no longer be seen as a successful model for other states.

Limited Market

One Republican argument is that the Massachusetts health law has a limited health insurance market and constrains the choices of citizens. The law set up an authority, known as the Commonwealth Health Insurance Connector, which sets subsidy levels, sets the affordability standards for the individual mandate, and decide what insurance plans can be offered through the Connector.[5] According to Tanner, “Anyone who receives any subsidy is limited to a choice among a more limited menu of insurance options that have low deductibles and limited cost sharing.”[6] Therefore, anyone who chooses or is forced to find health insurance through the Connector is subject to a limited choice of health insurance providers. There is small group or individual insurance available outside the Connector, but the subsidies and tax advantages are available only within the Connector.7 Opponents argue that “the Connector will become a monopsony purchaser of health insurance.”7

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[1] Crook, Clive. "The Massachusetts Experiment." National Journal 38.25 (24 June 2006): 18-19. Academic Search Premier. EBSCO. 18 Nov. 2008 .

[2] Wilson, Jennifer Fisher. "Massachusetts Health Care Reform Is a Pioneer Effort, but Complications Remain." Annals of Internal Medicine 148.6 (18 Mar. 2008): 489-W102. Academic Search Premier. EBSCO. 18 Nov. 2008 .

[3] LeBlanc, Steve. "At two-year mark, Mass. health care law still a work in progress." Boston.com. 11 Apr. 2008. The Boston Globe. 17 Nov. 2008 .

[4] Tanner, Michael D. "No Miracle in Massachusetts: Why Governor Romney's Health Care Reform Won't Work." 6 June 2006. CATO Institute. 16 Nov. 2008 .

[5] "MA HEALTH CARE REFORM LAW OF 2006." Affordable Care Today. 2007. 17 Nov. 2008 .

[6] Tanner, Michael D. "No Miracle in Massachusetts: Why Governor Romney's Health Care Reform Won't Work." 6 June 2006. CATO Institute. 16 Nov. 2008 .

Polemic Assignment progress

I've decided to use this blog and future blogs to share the progress of my Polemic Assignment with the rest of the class. I plan to post the outline of each section along with the section as it will be seen in my paper. To start off, I will post the Introduction here.

I. Introduction

a. Establish the context

i. Massachusetts Health Care Reform Law

ii. Recent history of the law

b. Identify your stake

i. Affects on me as a citizen

1. Possible national health care plan

2. Possible mandatory health care in RI

c. Thesis

i. This law should be evaluated as a potential model for other states with similar health care characteristics as Massachusetts

1. Percentage of citizens without health care insurance

2. Size/Population of the state

ii. Begin with local plans instead of a national plan

The number of Americans without health insurance has become a serious issue in the United States. Along with every other state, Massachusetts has had a growing number of uninsured citizens. From 2004 to 2006, the average number of people without health insurance coverage in Massachusetts was 653,000, or about 10.3 percent of the total population.[1] This number was relatively small compared to the number of uninsured citizens in other states, but it still had a large impact on Massachusetts. Massachusetts has found a way to resolve their problem of uninsured citizens but the question is whether or not other states can do the same.

Introduction

Context

As the Obama Administration strives for national health care, they might want to take a look at what the state of Massachusetts has done to improve their health care system. The Massachusetts Health Care Reform Bill, also known as Chapter 58 of the Acts of 2006, was signed into law by former Massachusetts Governor Mitt Romney on April 12, 2006.1 The law contains many terms: an individual mandate, an employer mandate, a new Commonwealth Health Insurance Connector Authority, and the Commonwealth Care Health Insurance Program.1 For more details on the terms of the law, look at “The 2006 Massachusetts Health Care Reform Law: Progress and Challenges After One Year of Implementation,” an article written by Alan G. Raymond, a writer and communications consultant with 25 years of professional involvement in health care and health care reform.

Stake

As a citizen of the United States, I have a personal stake in this issue. There is a possibility that the Obama Administration could use the Massachusetts Health Care Law as a model for the national health care plan that they are striving for. If health care was ever to be nationally mandated, I and every other citizen of the US would be affected in some way. There is also a possibility that Rhode Island, my home state, could adopt a health care plan similar to Massachusetts. If that were to happen, then a majority of my family and I would be affected as citizens of the state of Rhode Island.

Thesis

The Massachusetts Health Care Reform Law should be evaluated as a potential model for other states that are looking to resolve the problem of citizens lacking health insurance coverage. The states that choose to use the MA law as a potential model should have similar characteristics as Massachusetts when it comes to health care and the percentage of uninsured citizens in the state. If the Obama Administration ever decided to use the MA law as a model for the nation, they should form a plan that is based locally rather than nationally.

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[1] Raymond, Alan G. "The 2006 Massachusetts Health Care Reform Law: Progress and Challenges After One Year of Implementation." May 2007. Blue Cross Blue Shield of Massachusetts; Massachusetts Medicaid Policy Institute; The Massachusetts Health Policy Forum. 16 Nov. 2008 .

Final Paper Outline

Polemic Assignment - Massachusetts Health Care Reform Law

I. History/General Overview

a. Before the bill was passed
i. # of uninsured
ii. health insurance system
iii. cost to care for the uninsured
b. The Statute (Chapter 58 of the Acts of 2006)
i. Individual mandate
ii. Employer mandate
iii. Commonwealth Health Insurance Connector Authority
iv. Commonwealth Care Health Insurance Program
c. After the statute (now)
i. # of uninsured
ii. statistics on businesses who choose not to provide health insurance still
iii. statistics on individuals who choose to remain uninsured

II. Specific Question

a. Whether or not the new health care law will work
i. Costs
ii. Universal coverage
iii. Surviving through an economic crisis
b. MA vs. other states or the nation
i. Can this plan be implemented in other states?
ii. Can this plan be implemented in the US as a national plan?
c. Thesis
i. Effective law; remain the same
ii. Implement in states with similar health care system and percentage of uninsured as MA
iii. Would not work as a national plan

III. Arguments against Chapter 58

a. Government takeover
b. Limited market
i. Not many insurance providers to choose from
c. Overgenerous subsidies
i. Gives too much to the lower class
ii. Bankrupting the middle class
d. Rising costs of health care
i. Making people pay more (increasing non-compliance)
ii. Increasing burden on businesses


IV. Arguments in favor of Chapter 58

a. # of uninsured has dropped dramatically
b. Accessibility
i. Easier to access health insurance (employer or individual)
c. Portability
i. Able to take from job to job
ii. Able to combine insurance for people with multiple jobs
d. Money saver
i. Less paid towards hospitals for care of uninsured
ii. Competition lowers costs

President Barack Obama

On November 4, 2008, around 11:00pm, Barack Obama was named President of the United States. I had just finished watching 27 Dresses on HBO and figured I'd turn to some of the news channels to see how the election was going. When I turned it onto some news channel (I can't remember which), they were discussing how the election all depended on California at this point. They were waiting for the polls to close on the west coast to find out, so I figured I'd wait and see what the outcome was. Obama won in California and ended up winning the presidential race. I had a feeling Barack Obama was going to win the election but I thought it was going to be a lot closer than it was. Obama ended up winning by a good amount.

I wasn't really partial to either candidate so the outcome honestly did not matter in my mind. I admit that I feel more content with Obama because his views mirror my views more than McCain's do. Either way, I would not have complained. I really do not think I would have had any place to, anyways, seeing I did not vote. It was just something I chose not to do. I'm used to getting the reaction of "I can't believe you didn't vote! You need to vote!" but I have my own views on it and I don't pass judgment on those that do vote.

Besides the fact, though, after they announced Obama as President, I was too tired to watch McCain's and Obama's speeches, so I decided to find them on the internet and watch them now. To me, they both seemed like very well thought out and admirable speeches. I admire McCain for being the "good sport" that he was, especially when he constantly quieted the boo's every time Obama's name was mentioned. He also said a great deal of remarkable things about Obama. This speech was probably the best speech I've ever seen McCain give. He was calm and collected and chose his words wisely. He spoke eloquently and just seemed completely natural and confident. He fought a good fight and I'll give that to him. Obama was, as always, eloquent and motivating. It seemed like he thanked every possible person that could be thanked. All-in-all, Obama won the race, by far, and I think it was well deserved. I'm anxious to see what will happen once he's in office.

This Blog Endorses...

This blog endorses Senator Barack Obama for president of the United States. This blog is not particularly fond of either candidate but this blog believes that Obama would be the "lesser of two evils," I guess you could say.

Obama would make a great president because he is highly intelligent, being a Harvard graduate. He has acquired the sufficient knowledge that he needs to bring him to the top in this presidential election. He is also a very eloquent speaker and debater, unlike McCain. The citizens of the United States see Obama as a very intellectual man who can come up with successful ideas and policies and then effectively communicate his plans to everyone. He is very personable and a majority of people seem to like that. Obama comes off intelligent, understanding, and confident.

Obama focuses more on issues within the United States. An editorial in the Washington Post explains that Obama would focus his attention on improved education, a better health-care system, and restoring and promoting prosperity. At this time, we need a president who is focused on these things. These are where are major issues are at: the current economic situation, healthcare, and education. Obama would be the better candidate to tackle these issues.

Critics may say that Obama's resume contains little evidence of leadership and accomplishment. It is true that Obama has not been around as long as McCain has but Obama has turned this flaw around by surrounding himself with "top-notch, experience, centrist economic advisers." He chose Joe Biden as his running mate; a man who has been around and has a great deal of experience.

On the other hand, McCain chose Sarah Palin as his running mate. This may be considered somewhat hypocritical of McCain; criticizing Obama for be inexperienced and then choosing Palin as his VP. McCain had a number of "supremely qualified Republican women" to choose from. If, god forbid, anything were to happen to McCain, Sarah Palin would not be fit to be president.

Obama has more of a presidential look and sound. His policies and plans would lead to more change for the better. Although he lacks experience, his running mate and others he plans to work with have a great deal of experience. Therefore, this blog endorses Senator Barack Obama for president of the United States.

Chapter 16

The title of Chapter 16 is "Thinking Critically about Mass Media." The title explains a great deal about the chapter. In this chapter, Lazere discusses something that everyone should be aware of: bias is everywhere, especially in the media. We need to be able to recognize this bias (if it is not told to us) and analyze what is said or shown, based on the bias. If we just accept everything that we hear or read from newspapers, magazines, journals, radio, television, ect, then we are straying from independent thinking. In order to form our own opinions, views, and beliefs, we must question and analyze everything that is given to us.

I found it interesting that Lazere stated there is a more conservative bias in the media. For some reason, I thought that media would be more liberal. It might be because I'm thinking of media being "free speech" "free press" and just painting a liberal picture in my mind. I just was surprised to see that most newspapers, local TV, and radio are conservative.

This chapter also discussed objectivity and subjectivity in the news media. We discussed these terms in class regarding our Convention Analysis. When giving information it is important to be objective and let the reader or listener form their own opinion but this does not always happen in the news media. Lazere states that "the directors of news media often insist they are committed to objectivity in their news pages or newscasts and that they limit subjective viewpoints to their editorial and opinion pages or broadcast commentaries" (396). This has often been proven false, though. People of news media often report subjectively. I believe this is just human nature, though. It is possible to relay information objectively but everyone has their own opinions and many people feel the need to let other people know what their opinion is. This is why we must learn to detect bias and analyze everything we read or hear.