Friday, November 19, 2010

Health Reform is Waivering

1. Giving up something voluntarily, especially a right or claim; 2) Not enforcing something, to refrain from enforcing something in a particular instance; 3) Temporarily delaying something to put off something for a time.

Dictionary Definition of “Waivering”


There’s a new health reform game: waivering to escape fetters of the health reform law. Rather than accepting adverse consequences of the law, people and organizations are waiving the white flag. Because of their particular circumstances, they are insisting that they cannot afford the new law, that it does not apply to them. They want to get out while the getting is good.

The Republican party wants to waive out of the whole bill. They pledge to repeal and replace it with an incremental bill of their own. Given the inevitability of an Obama veto, this is probably a fruitless and futile partisan exercise. Nevertheless, it is fascinating process to watch.

Businesses with hundreds of thousands of young healthy employees who receive limited minimed policies want out because they claim they cannot afford comprehensive policies that meet new federal standards. Among these businesses are McDonald’s, Olive Garden, Red Lobster, and Jack in the Box, and countless other fast food franchises and retail establishments with young employees.

Then there are the unions seeking to escape the health care mandate’s onerous “Cadillac tax" on high-cost health plans. These unions are the bedrock of the Democratic base. Falling into this category are,

-- The Service Employees Benefit Fund
-- United Food and Commercial Workers Allied Trade Health and Welfare Trust Fund
-- International Brotherhood of Electrical Workers Union No. 915
-- Asbestos Workers Local 53 Welfare Fund
-- Employees Security Fund
-- Plumbers and Pipefitters Local 123 Welfare Fund
-- United Food and Commercial Workers Local 227
-- United Food and Commercial Workers Local 455 (Maximus)
-- United Food and Commercial Workers Local 1262
-- Musicians Health Fund Local 802
-- Hospitality Benefit Fund Local 17
-- Transport Workers Union
-- United Federation of Teachers Welfare Fund
-- International Union of Painters and Allied Trades (AFL-CIO)
-- International Longshoremen's Association (ILA)

Even Democratic politicians who supported the law are joining the movement, They too are waiving the white flag. These include liberal senator Ron Wyden of Oregon and Democratic senator Ben Nelson of Nebraska, of Cornhusker Kickback fame. They are waivering over such issues as individual mandates and 1099 reporting requirements for small businesses.

Republican governors, like Tim Pawlenty of Minnesota and Scott Walker of Wisconsin, are also waivering. They are insisting they will either slow, block, or waive the establishment of health exchanges in their states because their budgets cannot afford these exchanges. All told, as many as 28 state governments may join the suit to declare the health law's individual mandate unconstitutional.

Everybody, it seems, is doing what they have to do to survive the financial and bureaucratic waiveward consequences of the new health law. Even doctors, faced with draconian Medicare cuts and waves of new Medicaid patients, are threatening to waiver. Nearly half are saying they will no longer accept, or will reduce services for Medicare patients , or will retire or switch to non-clinical careers, or go into concierge practices rather than practice under oppressive government overhaul rules.

The bottom-line? The U.S. Department of Health and Human Services website says 111 waivers have now been granted to companies, unions and other organizations of all sizes who offer affordable health insurance or prescription drug coverage with limited benefits. Will hundreds of waivers become thousands? Will Americans refuse to accept the over-reaching government concept that one-size-fits-all?

The final waiver, of course, would be to repeal the whole thing. Maybe that will not be necessary if enough people and organizations, left and right, beg for waivers for protection on the basis of unaffordable costs stemming from the Patient Protection and Affordability Act. That would be the ultimate irony.

2 comments:

BobbyG said...

See http://www.thehealthcareblog.com/the_health_care_blog/2010/11/have-we-found-the-magic-acronym.html

Richard L. Reece, MD said...

By magic acronym, you mean something like SNAFU, Situation Normal All Fouled Up.

What about SNEDWITTS, Situation Normal Everybody Doing What It Takes to Survive