Universal Health Care Messaging
Bob Jensen at
Trinity University
I'm in favor of health care reform that completely nationalizes health insurance in one step with high tax pay-as-you-go restriction and strict cost-saving caps on punitive damage lawsuits. I really favor former Senator Bill Bradley's long-forgotten Canada-like proposal:
The bipartisan trade-off in a viable health care bill is obvious: Combine universal coverage with malpractice tort reform in health care. Universal coverage can be obtained in many ways — including the so-called public option. Malpractice tort reform can be something as commonsensical as the establishment of medical courts — similar to bankruptcy or admiralty courts — with special judges to make determinations in cases brought by parties claiming injury. Such a bipartisan outcome would lower health care costs, reduce errors (doctors and nurses often don’t report errors for fear of being sued) and guarantee all Americans adequate health care. Whenever Congress undertakes large-scale reform, there are times when disaster appears certain — only to be averted at the last minute by the good sense of its sometimes unfairly maligned members. What now appears in Washington as a special-interest scrum could well become a triumph for the general interest. But for that to happen, the two parties must strike a grand bargain on universal coverage and malpractice tort reform. The August recess has given each party and its constituencies a chance to reassess their respective strategies. One result, let us hope, may be that Congress will surprise everyone this fall.
Bill Bradley, "Tax Reform’s Lesson for Health Care Reform," The New York Times, August 30, 2009 ---
http://www.nytimes.com/2009/08/30/opinion/30bradley.html?_r=1
H.R. 3962 Obama-Pelosi Care is an entitlement program special-interest disaster that cannot be reversed before the U.S. economy collapses entirely. The economy is destined to collapse with or without Obama-Pelosi entitlements will most assuredly speed up the death of the United States --- http://www.trinity.edu/rjensen/entitlements.htm
IOUSA (the most frightening movie in American
history) ---
(see a 30-minute version of the documentary at
www.iousathemovie.com )
America, what is happening to you?
“One thing seems probable to me,” said Peer Steinbrück,
the German finance minister, in September 2008....“the United States will lose
its status as the superpower of the global financial system.” You don’t have to
strain too hard to see the financial crisis as the death knell for a
debt-ridden, overconsuming, and underproducing American empire.
Richard Florida, "How the Crash Will
Reshape America," The Atlantic, March 2009 ---
http://www.theatlantic.com/doc/200903/meltdown-geography
Introductory Quotations and Links
Full Text of H.R. 3962 ---
http://thomas.loc.gov/cgi-bin/bdquery/z?d111:H.R.3962
Also see (overlook the kill-granny lies) ---
www.defendyourhealthcare.us
A Personal Experience
Why many physicians will turn away their Medicare patients just like my wife was
turned away by her surgeon in the South Texas Spinal Clinic in San Antonio
because she was on Medicare ---
http://www.trinity.edu/rjensen/Health.htm#SpinalClinic
"The Worst Bill Ever: Epic new spending and taxes, pricier insurance, rationed
care, dishonest accounting: The Pelosi health bill has it all," The Wall
Street Journal, November 1, 2009 ---
http://www.trinity.edu/rjensen/Health.htm#110709
Jensen Comment
Nancy Pelosi catered to just about every special interest in the United States
(except Medicare patients) and doled out earmark frauds like jelly beans to get
economy/jobs destroying bill through the House. Please pray for Senate
sensibility.
Frightening Clauses in the Pending House Bill (H.R. 3962) in November 2009
November 10, 2009 (The Most Frightening Legislation in the Shrinking History of the United States)
Obamacare Chart --- http://www.trinity.edu/rjensen/ObamaCareChart.pdf
A Brief History of Health Insurance
in the United States ---
http://everylearner.com/bm/knowledgenews/americana/health-insurance-history-1.shtml
A key stimulus was in 1945 when the National War Labor Board made it possible
for unions to negotiate coverage.
More importantly, however, business firms could get tax deductions for health
benefits that were not taxable,
Thereby, workers did not have to pay for health insurance out of after-tax
dollars.
Humor
The Wall Street Journal Guide to
Obamacare, October 14, 2009 ---
Click Here
http://online.wsj.com/article/SB10001424052748704471504574441193211542788.html?mod=djemEditorialPage
"Follow the Money," by Ben Shapiro,
Townhall, October 21, 2009 ---
http://townhall.com/columnists/BenShapiro/2009/10/21/follow_the_money
Let me get this straight.
We're about to get a health care plan shoved down our
throats that is Written by a committee whose head says he doesn't understand it,
Passed by a Congress that hasn't read it but exempts themselves from it, signed
by a president that also hasn't read it, With funding administered by a treasury
chief who was caught not paying his Taxes, overseen by a surgeon general who is
obese, and financed by a Country that's nearly broke.
What could possibly go wrong?
IS THIS A GREAT COUNTRY OR WHAT!
Forwarded by Maureen
"How can Obama Top a Great Speech," by
Joan Walsh, Salon, September 10, 2010 ---
http://www.salon.com/opinion/walsh/politics/2009/09/10/healthcare_speech/index.html
Jensen Answer
Dear Ms Walsh, President Obama can top his great speech by filling in details of
truthful estimates of Obamacare costs and how he plans to finance these added
costs of wider coverage of health issues and more people covered. Thus far his
sweeping claims of cost savings sound like snake oil.
Video tutorial on the President's strategy and the legislative process for passing health reform legislations --- http://www.kaiseredu.org/tutorials/reformprocess/player.html
H.R. 3200 Summary
http://www.trinity.edu/rjensen/Health.htm#HR3200
Introduced in
the House on July 14, 2009
Also see
http://www.defendyourhealthcare.us/houseandsenatebills.html
H.R. 676 Summary ---
http://www.trinity.edu/rjensen/Health.htm#HR676
Introduced in House on January 26. 2009
U.S. Debt/Deficit Clock --- http://www.usdebtclock.org/
Bob Jensen's threads on pending
economic disaster ---
http://www.trinity.edu/rjensen/Entitlements.htm
Jensen Comment
Because of the present health care
system in the United States is unjust and inefficient, I am in favor of a
National Health Plan modeled after the Canadian National Health Plan where
Canadians are taxed for a huge portion of their health services irrespective of
their levels of income. Any system that does not make users of the system share
heavily in the cost of the services will be unjust, abused, and inefficient ---
http://www.trinity.edu/rjensen/Health.htm#Canada
Having said that I prefer a Canadian-style national health plan for the U.S., I wish democrats in Congress would use their power and vote one in in spite of protests around the country. With a 60-vote surplus in the House and only needing 51 votes in the Senate, the Democrats could vote in National Health Care in an instant. The reason they won't is that most of them would be voted out of office the next time they come up for re-election. They know this!
But Americans at all levels of income would have to
agree to much higher taxes
The average Canadian family
spends more money on taxes than on necessities of life such as food, clothing,
and housing, according to a study from The Fraser Institute, an independent
research organization with offices across Canada. The Canadian Consumer Tax
Index, 2007, shows that even though the income of the average Canadian family
has increased significantly since 1961, their total tax bill has increased at a
much higher rate.
The Fraser Institute,
April 16, 2007 ---
http://www.newswire.ca/en/releases/archive/April2007/16/c5234.html
Jensen Comment
I put the portion of the Canadian tax dollars going into comparable health and
social services contained in Obamacare legislation to be about 40% of each
Canadian's tax dollar where malpractice coverage and government fraud is greatly
controlled relative to the United States ---
http://www.trinity.edu/rjensen/Health.htm#Canada
Canada greatly restricts the number of free riders in the system and negotiates
much lower prescription drug prices relative to insurance companies and Medicare
in the United States. Malpractice awards in Canada are tightly controlled.
So the present (health care) system is an
unsustainable disaster, but you can keep your piece of it if you want. And the
Democrats wonder why selling health care reform to the public has been so hard?
Ramesh Ponuru, "Obamacare's Fatal Flaw:
Democrats claim their plans will save money, but they have too many conflicting
goals," Time Magazine August 17, 2009, Page 35
Jensen Comment
The problem is that they keep adding expensive medical services that sound great
on paper, but few people, companies, and certainly not government can afford
these uncapped benefits.
YouTube - ABC's John Stossel Destroys/Pulverizes/Crushes Obama's anti-American 'Health Care' Plan --- Click Here
Congressman Mike Rogers' opening statement on Health Care reform in Washington
D.C. ---
http://www.youtube.com/watch?v=G44NCvNDLfc
Jacob Hacker: Fixing America's Healthcare System (not humor)
---
http://fora.tv/2008/07/21/Jacob_Hacker_Fixing_America_s_Healthcare_System
Jack Webb on Health Care and America (Humor) ---
http://pubsecrets.wordpress.com/2009/09/05/just-the-facts-barack/
Video: Jon Stewart reveals Glenn Beck speaking about health care from
both ends of his digestive tract ---
http://www.thenation.com/blogs/notion/462437/breaking_rush_newt_and_sarah_supported_death_panels_too
Americans who want to tip the debate in the most
progressive direction should take advantage an opening provided at the last
minute during negotiations to get a bill approved by the House Energy and
Commerce Committee. And they should do so by advocating even more aggressively
for
single-payer health care.
John Nichols, "Why Single Payer
Advocacy Matters Now More Than Ever ," The Nation, August 4, 2009 ---
Click Here
Jensen Comment
Passionate advocates of universal health care are screaming "yes, yes, yes"
without even caring how health care will be funded or whether or not it will
further destruct the U.S. economy. The cannot care because they're so willing to
vote yet before a funding proposal is even put forth. I actually favor
single-payer nationalized health care but I'm unwilling to destroy by beloved
homeland in a passionate rage for the gold plated version that this debt-ridden
nation can ill afford at the present time ---
http://www.trinity.edu/rjensen/Entitlements.htm
"Schumer: Healthcare Changes This Year 'No Matter What'" ---
Click Here
U.S. Debt/Deficit Clock ---
http://www.usdebtclock.org/
Jesus, the Great Healer, wants Obamacare
according to MSNBC (even if top preachers are "dreadfully silent").
Watch the video ---
http://hotair.com/archives/2009/08/13/msnbc-host-hey-wouldnt-jesus-want-us-to-have-universal-health-care/
But what helps many Americans as individuals may
hurt society as a whole. That's the paradox. Unchecked health spending is
depressing take-home pay, squeezing other government programs—state and local
programs as well as federal—and driving up taxes and budget deficits. The
president has said all this; he simply isn't doing much about it. He offers the
illusion of reform while perpetuating the status quo of four decades: expand
benefits, talk about controlling costs. The press should put "reform" in quote
marks, because this is one "reform" that might leave the country worse off.
Robert J. Samuelson, Health Reform
That Isn't: Despite the Rhethoric, Costs (and trillion dollar deficits)
Will Rise, Newsweek Magazine, August 3, 2009, Page 26 ---
http://www.newsweek.com/id/208439/page/2
Samuelson is the author of The Great -Inflation and Its Aftermath.
For starters, $1 trillion of extra debt-financed
spending would cause the government to pay about $300 billion of extra interest
in the next decade. Moreover, the CBO's method of estimating the cost of such a
program doesn't recognize the incentives it creates for households and firms to
change their behavior. The House health-care bill gives a large subsidy to
millions of families with incomes up to three times the poverty level (i.e., up
to $66,000 now for a family of four) if they buy their insurance through one of
the newly created "insurance exchanges," but not if they get their insurance
from their employer. The CBO's cost estimate understates the number who would
receive the subsidy because it ignores the incentive for many firms to drop
employer-provided coverage. It also ignores the strong incentive that
individuals would have to reduce reportable cash incomes to qualify for higher
subsidy rates. The total cost of ObamaCare over the next decade likely would be
closer to $2 trillion than to $1 trillion.
Martin Feldstein, "ObamaCare's
Crippling Deficits The higher taxes, debt payments and interest rates needed to
pay for health reform mean lower living standard," The Wall Street Journal,
September 7, 2009 ---
http://online.wsj.com/article/SB10001424052970203585004574393110640864526.html?mod=djemEditorialPage
In 1935 President Franklin Roosevelt engineered the Social Security Act with honest and well-defined components of benefits and costs. It was intended to only be a supplemental pension program to force people to save something for their retirements. Later on Congress muddled the program up by adding social services (such as lifetime pensions for disabled people of all ages and death benefits for families of soldiers who died in service). Medicare and Medicaid health coverage was later added to massively increase the entitlements obligations of Social Security as pension fund (as originally crafted).
The Wall Street Journal Guide to Obamacare, October 14,
2009 ---
Click Here
http://online.wsj.com/article/SB10001424052748704471504574441193211542788.html?mod=djemEditorialPage
Bumper Stickers --- http://www.upyoursobama.com/
Obamacare: Call us when you're shovel ready
Bankrupt America? Yes we can
America needs a leader, not a (teleprompter) reader
Congressional pirates are the worst kind
Are you better off than $5 trillion before?
Community organize Timbuctoo
Frightening Clauses in the Pending House Bill (H.R. 3962) in November 2009
Full Text of H.R. 3962 --- www.defendyourhealthcare.us .
"What the Pelosi Health-Care Bill Really Says: Here are some important passages in the 2,000 page legislation," by Betsy McCaughey, The Wall Street Journal, November 7, 2009 --- Click Here
The health bill that House Speaker Nancy Pelosi is bringing to a vote (H.R. 3962) is 1,990 pages. Here are some of the details you need to know.
What the government will require you to do:
• Sec. 202 (p. 91-92) of the bill requires you to enroll in a "qualified plan." If you get your insurance at work, your employer will have a "grace period" to switch you to a "qualified plan," meaning a plan designed by the Secretary of Health and Human Services. If you buy your own insurance, there's no grace period. You'll have to enroll in a qualified plan as soon as any term in your contract changes, such as the co-pay, deductible or benefit.
• Sec. 224 (p. 118) provides that 18 months after the bill becomes law, the Secretary of Health and Human Services will decide what a "qualified plan" covers and how much you'll be legally required to pay for it. That's like a banker telling you to sign the loan agreement now, then filling in the interest rate and repayment terms 18 months later.
On Nov. 2, the Congressional Budget Office estimated what the plans will likely cost. An individual earning $44,000 before taxes who purchases his own insurance will have to pay a $5,300 premium and an estimated $2,000 in out-of-pocket expenses, for a total of $7,300 a year, which is 17% of his pre-tax income. A family earning $102,100 a year before taxes will have to pay a $15,000 premium plus an estimated $5,300 out-of-pocket, for a $20,300 total, or 20% of its pre-tax income. Individuals and families earning less than these amounts will be eligible for subsidies paid directly to their insurer.
• Sec. 303 (pp. 167-168) makes it clear that, although the "qualified plan" is not yet designed, it will be of the "one size fits all" variety. The bill claims to offer choice—basic, enhanced and premium levels—but the benefits are the same. Only the co-pays and deductibles differ. You will have to enroll in the same plan, whether the government is paying for it or you and your employer are footing the bill.
• Sec. 59b (pp. 297-299) says that when you file your taxes, you must include proof that you are in a qualified plan. If not, you will be fined thousands of dollars. Illegal immigrants are exempt from this requirement.
• Sec. 412 (p. 272) says that employers must provide a "qualified plan" for their employees and pay 72.5% of the cost, and a smaller share of family coverage, or incur an 8% payroll tax. Small businesses, with payrolls from $500,000 to $750,000, are fined less.
Eviscerating Medicare:
In addition to reducing future Medicare funding by an estimated $500 billion, the bill fundamentally changes how Medicare pays doctors and hospitals, permitting the government to dictate treatment decisions.
• Sec. 1302 (pp. 672-692) moves Medicare from a fee-for-service payment system, in which patients choose which doctors to see and doctors are paid for each service they provide, toward what's called a "medical home."
The medical home is this decade's version of HMO-restrictions on care. A primary-care provider manages access to costly specialists and diagnostic tests for a flat monthly fee. The bill specifies that patients may have to settle for a nurse practitioner rather than a physician as the primary-care provider. Medical homes begin with demonstration projects, but the HHS secretary is authorized to "disseminate this approach rapidly on a national basis."
A December 2008 Congressional Budget Office report noted that "medical homes" were likely to resemble the unpopular gatekeepers of 20 years ago if cost control was a priority.
• Sec. 1114 (pp. 391-393) replaces physicians with physician assistants in overseeing care for hospice patients.
• Secs. 1158-1160 (pp. 499-520) initiates programs to reduce payments for patient care to what it costs in the lowest cost regions of the country. This will reduce payments for care (and by implication the standard of care) for hospital patients in higher cost areas such as New York and Florida.
• Sec. 1161 (pp. 520-545) cuts payments to Medicare Advantage plans (used by 20% of seniors). Advantage plans have warned this will result in reductions in optional benefits such as vision and dental care.
• Sec. 1402 (p. 756) says that the results of comparative effectiveness research conducted by the government will be delivered to doctors electronically to guide their use of "medical items and services."
Questionable Priorities:
While the bill will slash Medicare funding, it will also direct billions of dollars to numerous inner-city social work and diversity programs with vague standards of accountability.
• Sec. 399V (p. 1422) provides for grants to community "entities" with no required qualifications except having "documented community activity and experience with community healthcare workers" to "educate, guide, and provide experiential learning opportunities" aimed at drug abuse, poor nutrition, smoking and obesity. "Each community health worker program receiving funds under the grant will provide services in the cultural context most appropriate for the individual served by the program."
These programs will "enhance the capacity of individuals to utilize health services and health related social services under Federal, State and local programs by assisting individuals in establishing eligibility . . . and in receiving services and other benefits" including transportation and translation services.
• Sec. 222 (p. 617) provides reimbursement for culturally and linguistically appropriate services. This program will train health-care workers to inform Medicare beneficiaries of their "right" to have an interpreter at all times and with no co-pays for language services.
• Secs. 2521 and 2533 (pp. 1379 and 1437) establishes racial and ethnic preferences in awarding grants for training nurses and creating secondary-school health science programs. For example, grants for nursing schools should "give preference to programs that provide for improving the diversity of new nurse graduates to reflect changes in the demographics of the patient population." And secondary-school grants should go to schools "graduating students from disadvantaged backgrounds including racial and ethnic minorities."
• Sec. 305 (p. 189) Provides for automatic Medicaid enrollment of newborns who do not otherwise have insurance.
For the text of the bill with page numbers, see www.defendyourhealthcare.us .
Ms. McCaughey is chairman of the Committee to Reduce Infection Deaths and a former Lt. Governor of New York state.
Making Sense of Health Care Reform (from the AccountingWeb on September 1,
2009) ---
http://www.accountingweb.com/topic/tax/making-sense-health-care-reform
President Obama's Budget for 2010 --- http://www.whitehouse.gov/omb/
The Lies and Deceptions During 2009
In 2009 President Barack Obama is engineering a universal health care bill by appealing to the with blatant and deceitful estimates of costs in a muddled up system of inclusions of social services that are only remotely linked to health care (such as marriage counseling). Some of the blatant lies are as follows:
Sadly, Medicare patients in Texas may once again be turned away by their doctors under the pending 2009 House version of Obamacare:
The health care bill recently unveiled by Speaker Nancy Pelosi is over 1,900 pages for a reason. It is much easier to dispense goodies to favored interest groups if they are surrounded by a lot of legislative legalese. For example, check out this juicy morsel to the trial lawyers (page 1431-1433 of the bill):
Section 2531, entitled “Medical Liability Alternatives,” establishes an incentive program for states to adopt and implement alternatives to medical liability litigation. [But]…… a state is not eligible for the incentive payments if that state puts a law on the books that limits attorneys’ fees or imposes caps on damages.
Unfortunately, it appears that under Obamacare, Texas will once again have to return to lawyer-ambulance-chasing days of old and revise its Constitution that presently limits attorneys' fees and imposes caps on damages. A former colleague at Trinity University on November 5, 2009 explained in a private message some of the reasonable details of the current Texas restrictions on damages in Texas (sounds reasonable to me and is more generous to patients and lawyers than Canada's really tight restrictions):
It is not true (under the revised Texas Constitution) that those who have been harmed by a physician’s malfeasance will not have their day in a Texas court. They will be able to claim real damages (economic - loss of income and medical costs) as well as punitive and pain and suffering damages – the difference is that some types of damages (non-economic) will be capped. What most of us don’t understand, is that the fear of these huge punitive damages causes physicians to practice defensive medicine – ordering more tests, ordering procedures just to make certain that they’re not missing anything. All these tests and procedures would be great and expected if they in themselves did not pose a risk to the patient, but many of them do. So, physicians must constantly balance their certainty of their diagnosis against the risk to the patient of additional tests. When we add huge punitive damages, we tip the scales in favor of more tests and procedures, which may, in fact, be more risky for the patient. And, in the end the burden for million dollar awards is borne by us all not just the physicians.
Since it is difficult to undo the health damage that has occurred, oversight of the physician is at the heart of the matter. There are ways to insure quality, standard-of-care medical practice outside of expensive court proceedings. So in addition to tort reform, the focus should equally be on systems of accountability for physicians.I think it is an outright lie that Obamacare will not cause many medical specialists to turn their backs on Medicare patients for much the same reason that Erika was turned away by a surgeon from the South Texas Spinal Clinic after having two of his surgeries. It will be amazing that any highly specialized neurosurgeon will accept the losses of treating Medicare patients.
The sad part is that Obamacare will reduce fees allowed to be charged to Medicare patients while at the same time greatly increase the cost of malpractice insurance for physicians treating those patients.
Canadian Malpractice Insurance Takes Profit Out Of
Coverage," by Jane Akre, Injury Board, July 28, 2009 ---
Click Here
The St. Petersburg Times takes a look at the cost of insurance in Canada for health care providers.
A neurosurgeon in Miami pays about $237,000 for medical malpractice insurance. The same professional in Toronto pays about $29,200, reports Susan Taylor Martin.
A Canadian orthopedic surgeon pays just over $10,000 for coverage that costs a Miami physician $140,000. An obstetrician in Canada pays $36,353 for insurance, while a Tampa Bay obstetrician pays $98,000 for medical malpractice insurance.
For those of you interested in Erika's saga with spine surgeries, you can
read about more of the details at
http://www.trinity.edu/rjensen/Erika2007.htm
She has a metal rack on her spine that extends from her neck to her hips.
Surgeons broke her back in three places before attaching the rods and screws, In
spite of the rack she can bend over while standing and pick a paper towel up
from the floor.
"The Cost of Health Care Reform,"
by Michael Tanner, Townhall, November 7, 2009 ---
http://townhall.com/columnists/MichaelTanner/2009/11/07/the_cost_of_health_care_reform
The Democratic leadership simply shifted some of the bill's cost to other bills. For example, for purposes of the health care bill, the Democrats assume that a currently scheduled 21 percent cut in Medicare reimbursements will take affect next year. However, at the same time, they have introduced a separate bill repealing those cuts at a cost of $250 billion, so that cost isn't technically part of health care reform. And your household budget would look so much better if you didn't have to pay your mortgage and car payment. (The Senate just tried to do something similar, only to have the cynical ploy rejected 53-47, with 13 Democrats refusing to play along.)
If you count that cost honestly, the bill's cost rises to nearly $1.3 trillion. And that still understates the bill's cost.
The CBO provides ten year projections of a bill's cost, between 2010 and 2019 in this case. But most provisions of the health bill don't take effect until 2014. So the "10-year" cost projection only includes six years of the bill. Again, consider your household budget. Wouldn't it be great if you could count a whole month's income, but only two weeks expenditures? If we look at the bill more honestly over the first 10 years that the programs are actually in existence, say from 2014 to 2024, it would actually cost more than $2.3 trillion. And, this doesn't include approximately $200 billion in additional spending for public health programs, a reinsurance program for retiree health care, and new preventive care programs that was added to the bill after it was submitted for official "scoring." So call the total cost somewhere in excess of $2.5 trillion.
Continued in article
We believe premiums would come down for several
reasons. Companies would no longer need to spend as much money on administrative
costs, to screen out people with pre-existing conditions (prohibited by all
reform bills). If they wanted to participate on the exchanges (and have access
to millions of new customers), the companies would also be forced to compete
with other private plans, and possibly a public option, encouraging them to
lower premiums and accept lower profits.
The New York Times Editorial, November 1, 2009 ---
http://www.nytimes.com/2009/11/01/opinion/01sun1.html?hp
"Health Cost Containment Troublesome Issue," SmartPros,
November 10, 2009 ---
http://accounting.smartpros.com/x68073.xml
Some Democrats and analysts are raising alarms that bills to reform the U.S. healthcare system fall short of President Obama's pledge to slow health spending.
Obama has made cost containment a key leg to healthcare reform. However, health economists say it isn't possible to know whether the bills would meet that goal, with many saying they doubt they would even come close, The New York Times reported Tuesday.
Both the House and the Senate propose cost-saving measures. The House bill, which passed Saturday, projects $440 billion in Medicare savings over 10 years. The Senate Finance Committee bill projects about $420 billion. White House officials said additional savings in the private sector would be realized as well.
Experts, even those whom the White House consulted, said the measures represent only small steps toward revising the existing fee-for-service system, which drives up costs by paying health providers for each visit or procedure performed -- and some lawmakers are paying attention, the Times said.
"My assessment at this point," said Sen. Ron Wyden, D-Ore., and a member of the Finance Committee, "is that the legislation is heavy on health and light on reform."
Sen. Susan Collins, R-Maine, during a news conference Monday with Sen. Lamar Alexander, R-Tenn., shared her concern about the cost-containment issue. Collins said she also has met with moderate Democrats who share her view.
"I don't believe we need more pilot projects to show us that healthcare delivery reforms are necessary," Collins told the Times. "I think people are much more upset over the cost of care than the administration is acknowledging."
Jensen Comment
You can argue for coverage of all new insureds irrespective of pre-existing
conditions on the basis of social equity, but the reasoning of the NYT editorial
above is pure hogwash. If this were true at least one medical insurance company
would've added to profits by ending pre-screening expenses. Pre-existing
conditions often require the most expensive kinds of treatment for such things
as organ transplants, cataracts, kidney dialysis, etc.
Also eliminating pre-existing conditions coupled with the inevitable coverage of illegal immigrants creates moral hazard in that when Grandma Lopez in Mexico City needs an eye operation, her relatives will float her across the Rio Grande primarily for immediate $25,000 eye surgery. If she wants to return she might even walk back across the border unassisted after she can see better.
Lie: States like Texas that have capped punitive damages in
medical lawsuits probably may not keep their limiting caps according to pending
Obamacare legislation. Such caps purportedly have significantly lowered medical
insurance rates in those states.
"Pelosi Health Care Bill Blows a Kiss to Trial Lawyers," Andrew Breitbart,
October 30, 2009 ---
Click Here
The health care bill recently unveiled by Speaker Nancy Pelosi is over 1,900 pages for a reason. It is much easier to dispense goodies to favored interest groups if they are surrounded by a lot of legislative legalese. For example, check out this juicy morsel to the trial lawyers (page 1431-1433 of the bill):
Section 2531, entitled “Medical Liability Alternatives,” establishes an incentive program for states to adopt and implement alternatives to medical liability litigation. [But]…… a state is not eligible for the incentive payments if that state puts a law on the books that limits attorneys’ fees or imposes caps on damages.
So, you can’t try to seek alternatives to lawsuits if you’ve actually done something to implement alternatives to lawsuits. Brilliant! The trial lawyers must be very happy today!
While there is debate over the details, it is clear that medical malpractive lawsuits have some impact on driving health care costs higher. There are likely a number of procedures that are done simply as a defense against future possible litigation. Recall this from the Washington Post:
“Lawmakers could save as much as $54 billion over the next decade by imposing an array of new limits on medical malpractice lawsuits, congressional budget analysts said today — a substantial sum that could help cover the cost of President Obama’s overhaul of the nation’s health system. New research shows that legal reforms would not only lower malpractice insurance premiums for medical providers, but would also spur providers to save money by ordering fewer tests and procedures aimed primarily at defending their decisions in court, Douglas Elmendorf, director of the nonpartisan Congressional Budget Office, wrote in a letter to Sen. Orrin Hatch (R-Utah).”
Lie: The U.S. infant mortality rate is much higher than even in Cuba and Europe
Longtime readers will recall that we caught Kristof playing similar games with statistics back in January 2005, when he claimed that the U.S. infant-mortality rate was worse than communist Cuba's and much worse than European rates. We pointed out that a central reason U.S. rates are high is that American physicians make heroic efforts to save extremely premature infants, who nonetheless have a mortality rate in excess of 50%. In other countries, these babies are simply discarded and not even counted in the statistics.
Wall Street Journal Editors Newsletter, November 6, 2009
Lie: Capping punitive damages does not save a significant amount of
money in medical costs.
Here’s an academic study of over 10 million insured. Although 1-2% on average does not sound very large, it adds up if you eventually count in medical insurance costs of 200-300 million insured people.
Limiting medical malpractice punitive (as opposed to damage) awards has also been shown in Canada to greatly reduce costs of the National Health Care Plan.
The Impact of Tort Reform on Employer-Sponsored
Health Insurance Premiums
Ronen
Avraham (University of Texas at Austin, School of Law(, Leemore S. Dafny
(Kellogg School of Management, Northwestern University) and NBER Max M.
Schanzenbach, (Northwestern University, School of Law)
September 2009 ---
Click Here
http://www.kellogg.northwestern.edu/faculty/dafny/personal/Documents/Working%20Papers/ADS_9_09w_ack.pdf
Abstract
We evaluate the effect of tort reform on employer-sponsored health insurance premiums by exploiting state-level variation in the timing of reforms. Using a dataset of healthplans representing over 10 million Americans annually between 1998 and 2006, we find that caps on non-economic damages, collateral source reform, and joint and several liability reform reduce premiums by 1 to 2 percent each. These reductions are concentrated in PPOs rather than HMOs, suggesting that can HMOs can reduce “defensive” healthcare costs even absent tort reform. The results are the first direct evidence that tort reform reduces healthcare costs in aggregate; prior research has focused on particular medical conditions.
Lie: Baucus' Senate bill taxes gold plated medical insurance that's
only a tax on the rich
Yeah right! How about postal workers? This is misleading at best since the many
unions have negotiated gold plated coverage for their rank and file. Some of the
best medical insurance in the U.S. is given to some of the lowest-paid
workers in the U.S. who can ill-afford a tax on their premium insurance plans.
Unions are against this tax, so it will most certainly die in the House
negotiations and force our Keystone Cops to scurry for other taxes or borrow
more trillions from China.
Lie: In an effort to rush through Obamacare in 2009, Congress
will drop demands for a government-operated health insurance competitor in
favor of a non-profit Fannie Health Insurance Cooperative
not run by the government. (this promise no longer exists in the current
House version of the the pending legislation)
This is obvious bait and switch fraud. The
bait is to get Obamacare passed this year by
making grandiose claims about not having government health insurance to compete
unfairly with private health insurance companies. The
switch is that Fannie HIC, like Fannie Mae, is doomed from get
go and will have to be taken over by the government.
Fannie HIC will insure tens of millions of minimum-wage workers, part-time workers, the unemployable, and the otherwise unemployed. There's zero chance of having premium revenues come anywhere close to cash outflows for expanded health, mental health and social service coverage demanded in H.R. 3200. Before she even commences operation, Fannie HIC will have to become a government owned and operated and subsidized health insurance company competing with private insurance companies.
One can only hope that Congress will be so proud of Fannie HIC that this cooperative-gone-government company will provide the only health insurance coverage available to members of the House, Senate, and Executive branches of Federal and State Governments. Fat Chance!
Whereas Fannie Mae cost taxpayers hundreds of billions of dollars in toxic mortgages mandated by Rep. Barney Frank and Sen. Chris Dodd, Fannie HIC will cost taxpayers untold trillions. Well, maybe not. The economic disasters Bernanke, Geithner, and Summers are agreeing to print U.S. dollars in lieu of having to tax and borrow to fund trillion dollar government spending deficits. Isn't that a brilliant idea? --- http://blog.mises.org/archives/009457.asp
Video: David Dreman Warns About 10-12% Inflation, Simoleon Sense,
August 5, 2009 ---
http://www.simoleonsense.com/videodavid-dreman-warns-about-10-12-inflation/
For starters, $1 trillion of extra debt-financed
spending would cause the government to pay about $300 billion of extra
interest in the next decade. Moreover, the CBO's method of estimating the
cost of such a program doesn't recognize the incentives it creates for
households and firms to change their behavior. The House health-care bill
gives a large subsidy to millions of families with incomes up to three times
the poverty level (i.e., up to $66,000 now for a family of four) if they buy
their insurance through one of the newly created "insurance exchanges," but
not if they get their insurance from their employer. The CBO's cost estimate
understates the number who would receive the subsidy because it ignores the
incentive for many firms to drop employer-provided coverage. It also ignores
the strong incentive that individuals would have to reduce reportable cash
incomes to qualify for higher subsidy rates. The total cost of ObamaCare
over the next decade likely would be closer to $2 trillion than to $1
trillion.
Martin Feldstein, "ObamaCare's
Crippling Deficits The higher taxes, debt payments and interest rates needed
to pay for health reform mean lower living standard," The Wall Street
Journal, September 7, 2009 ---
http://online.wsj.com/article/SB10001424052970203585004574393110640864526.html?mod=djemEditorialPage
"Fact Check: Obama Uses Iffy Math on Deficit Pledge," SmartPros, September 10, 2009 --- http://accounting.smartpros.com/x67604.xml
President Barack Obama used only-in-Washington accounting Wednesday when he promised to overhaul the nation's health care system without adding "one dime" to the deficit. By conventional arithmetic, Democratic plans would drive up the deficit by billions of dollars.
The president's speech to Congress contained a variety of oversimplifications and omissions in laying out what he wants to do about health insurance.
A look at some of Obama's claims and how they square with the facts or the fuller story:
---
OBAMA: "I will not sign a plan that adds one dime to our deficits either now or in the future. Period."
THE FACTS: Though there's no final plan yet, the White House and congressional Democrats already have shown they're ready to skirt the no-new-deficits pledge.
House Democrats offered a bill that the Congressional Budget Office said would add $220 billion to the deficit over 10 years. But Democrats and Obama administration officials claimed the bill actually was deficit-neutral. They said they simply didn't have to count $245 billion of it - the cost of adjusting Medicare reimbursement rates so physicians don't face big annual pay cuts.
Their reasoning was that they already had decided to exempt this "doc fix" from congressional rules that require new programs to be paid for. In other words, it doesn't have to be paid for because they decided it doesn't have to be paid for.
The administration also said that since Obama already had included the doctor payment in his 10-year budget proposal, it didn't have to be counted again.
That aside, the long-term prognosis for costs of the health care legislation has not been good.
CBO Director Douglas Elmendorf had this to say in July: "We do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount."
---
OBAMA: "Nothing in this plan will require you or your employer to change the coverage or the doctor you have."
THE FACTS: That's correct, as far as it goes. But neither can the plan guarantee that people can keep their current coverage. Employers sponsor coverage for most families, and they'd be free to change their health plans in ways that workers may not like, or drop insurance altogether. The Congressional Budget Office analyzed the health care bill written by House Democrats and said that by 2016 some 3 million people who now have employer-based care would lose it because their employers would decide to stop offering it.
In the past Obama repeatedly said, "If you like your health care plan, you'll be able to keep your health care plan, period." Now he's stopping short of that unconditional guarantee by saying nothing in the plan "requires" any change.
---
OBAMA: "The reforms I'm proposing would not apply to those who are here illegally." One congressman, South Carolina Republican Joe Wilson, shouted "You lie!" from his seat in the House chamber when Obama made this assertion. Wilson later apologized.
THE FACTS: The facts back up Obama. The House version of the health care bill explicitly prohibits spending any federal money to help illegal immigrants get health care coverage. Illegal immigrants could buy private health insurance, as many do now, but wouldn't get tax subsidies to help them. Still, Republicans say there are not sufficient citizenship verification requirements to ensure illegal immigrants are excluded from benefits they are not due.
---
OBAMA: "Don't pay attention to those scary stories about how your benefits will be cut. ... That will never happen on my watch. I will protect Medicare."
THE FACTS: Obama and congressional Democrats want to pay for their health care plans in part by reducing Medicare payments to providers by more than $500 billion over 10 years. The cuts would largely hit hospitals and Medicare Advantage, the part of the Medicare program operated through private insurance companies.
Although wasteful spending in Medicare is widely acknowledged, many experts believe some seniors almost certainly would see reduced benefits from the cuts. That's particularly true for the 25 percent of Medicare users covered through Medicare Advantage.
Supporters contend that providers could absorb the cuts by improving how they operate and wouldn't have to reduce benefits or pass along costs. But there's certainly no guarantee they wouldn't.
---
OBAMA: Requiring insurance companies to cover preventive care like mammograms and colonoscopies "makes sense, it saves money, and it saves lives."
THE FACTS: Studies have shown that much preventive care - particularly tests like the ones Obama mentions - actually costs money instead of saving it. That's because detecting acute diseases like breast cancer in their early stages involves testing many people who would never end up developing the disease. The costs of a large number of tests, even if they're relatively cheap, will outweigh the costs of caring for the minority of people who would have ended up getting sick without the testing.
The Congressional Budget Office wrote in August: "The evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall."
That doesn't mean preventive care doesn't make sense or save lives. It just doesn't save money.
---
OBAMA: "If you lose your job or change your job, you will be able to get coverage. If you strike out on your own and start a small business, you will be able to get coverage."
THE FACTS: It's not just a matter of being able to get coverage. Most people would have to get coverage under the law, if his plan is adopted.
In his speech, Obama endorsed mandatory coverage for individuals, an approach he did not embrace as a candidate.
He proposed during the campaign - as he does now - that larger businesses be required to offer insurance to workers or else pay into a fund. But he rejected the idea of requiring individuals to obtain insurance. He said people would get insurance without being forced to do so by the law, if coverage were made affordable. And he repeatedly criticized his Democratic primary rival, Hillary Rodham Clinton, for proposing to mandate coverage.
"To force people to get health insurance, you've got to have a very harsh penalty," he said in a February 2008 debate.
Now, he says, "individuals will be required to carry basic health insurance - just as most states require you to carry auto insurance."
He proposes a hardship waiver, exempting from the requirement those who cannot afford coverage despite increased federal aid.
---
OBAMA: "There are now more than 30 million American citizens who cannot get coverage."
THE FACTS: Obama time and again has referred to the number of uninsured as 46 million, a figure based on year-old Census data. The new number is based on an analysis by the Kaiser Commission on Medicaid and the Uninsured, which concluded that about two-thirds of Americans without insurance are poor or near poor. "These individuals are less likely to be offered employer-sponsored coverage or to be able to afford to purchase their own coverage," the report said. By using the new figure, Obama avoids criticism that he is including individuals, particularly healthy young people, who choose not to obtain health insurance.
Jensen Comment
In fairness, a single-payer medical insurance provider that covered all
Americans would probably result in cost savings in the long run. However,
President Obama realistically proclaims that such an abrupt changeover with lead
to unprecedented turmoil and inefficiencies, to say nothing of quality of care,
if the U.S. Government abruptly decided to insure 300 million Americans in one
fell swoop.
And the cost of phasing in a single-payer system would cause massive deficits, including the windfall profits that government would have to pay present medical insurance companies to operate efficiently over the years before they must operate before being terminated.
The fact of the matter is that we will be forced to live with inefficient private insurers until they are shut down or take over by government. In the meantime, government spending deficits will soar due to increased numbers of insured Americans, illegal immigrants, and expanded scope of coverage (mental health, pre-existing conditions, marriage counseling, and expanded social services).
"How Congress Is Cooking the Books," by Michael Tanner, The New York Post, September 30, 2009 --- Click Here
LAST week, the Senate Finance Committee voted 12-11 not to wait for the Congressional Budget Office to "score" its health-care bill before the committee votes on it. Imagine that: Some senators actually wanted to know how much the bill costs before voting on it.
Let them get away with something like that, and before you know it they'll be demanding honest accounting practices -- sending the whole legislative process to hell in a hand basket.
When it comes to the health-care-reform debate, you see, honest budgeting is nowhere to be seen.
Start with the simple matter of how much health-care reform will cost. The House bill, HR 3200, will cost roughly $1.3 trillion over 10 years -- or so we're told. By the same token, the Senate Finance Committee bill is supposed to cost just under $900 billion. Sure, that's a lot of money -- but it still badly understates the true cost.
The CBO provides 10- year projections of a bill's cost. But most provisions of the health bill don't take effect until 2014. So the "10-year" cost projection only includes six years of the bill.
Plus, the costs ramp up slowly. In its first year, the House bill would only cost about $6 billion; in its first three, less than $100 billion. The big costs are in the final years of the 10-year budget window -- and beyond. In fact, over the first 10 years that the House bill would be in existence (2014 to 2024), its costs would be closer to $2.4 trillion. Similarly, the real cost of the Senate bill over 10 years of operation is estimated at $1.5 trillion.
Worse, the trajectory of the costs after 10 years rises dramatically -- meaning "reform" would cost even more in its second 10 years and beyond.
Such gimmicks also infest the projections of how much reform will add to the deficit. CBO says the House bill adds $235 billion to the deficit. But that, again, cuts off arbitrarily in 2019. Beyond that date, the bill adds enormously to the deficit, about $1.5 trillion in the second 10 years. In fact, if the health-reform bill were treated like other entitlements, such as Social Security and Medicare, which are required to have a 75-year actuarial forecast, its unfunded liabilities would exceed $9.2 trillion.
Of course, the Senate Finance Bill is supposed to be deficit-neutral. But that claim relies on other forms of budgetary flimflam.
For example, the Senate bill relies on Medicare "savings" that Congress keeps refusing to make. Specifically, Medicare has long been ordered to cut 21 percent from what it pays health-care providers -- yet, each year since 2003, for reasons both good and bad, Congress has voted to defer the cuts.
Does anyone else really think that Congress is simply going to slash payments to doctors and hospitals by 21 percent across the board?
Of course, President Obama has long said we can cut Medicare by $500 billion simply by eliminating fraud, waste and abuse. That would be the same "fraud, waste and abuse" that the government has been cutting since Ronald Reagan first used the term.
The truth is that health-care reform is going to cost us a lot. And we're going to pay for it in higher taxes and more debt.
No wonder they don't want us to know.
'Liberals Seek Health Care Access for Illegals: A
group of House Democrats say it's unfair to bar illegal immigrants from
paying their own way in a government-sponsored exchange," The Washington
Times, September 27, 2009 ---
http://www.foxnews.com/politics/2009/09/27/liberals-seek-health-care-access-illegals/
Fearful that they're losing ground on immigration and health care, a group of House Democrats is pushing back and arguing that any health care bill should extend to all legal immigrants and allow illegal immigrants some access, The Washington Times reported on Monday.
The Democrats, trying to stiffen their party's spines on the contentious issue, say it's unfair to bar illegal immigrants from paying their own way in a government-sponsored exchange. Legal immigrants, they say, regardless of how long they've been in the United States, should be able to get government-subsidized health care if they meet the other eligibility requirements.
"Legal permanent residents should be able to purchase their plans, and they should also be eligible for subsidies if they need it. Undocumented, if they can afford it, should be able to buy their own private plans. It keeps them out of the emergency room," said Rep. Michael M. Honda, California Democrat and chairman of the Congressional Asian Pacific American Caucus.
Honda was joined by more than 20 of his colleagues in two letters laying out the demands.
Coverage for immigrants is one of the thorniest issues in the health care debate, and one many Democratic leaders would like to avoid. But immigrant rights groups and the Democrats who sent the letters say they have to take a stand now.
Jensen Comment
The key absurdity here is the statement "pay their own way." If a foreigner
in need of a $50,000 eye implant surgeries sneak into the U.S. for the main
purpose of paying $100 in premiums for each $50,000 surgery and then return
to their home countries, these aliens have hardly "paid their own way."
They've taken on illegal alien status mainly for getting expensive health
care on the cheap.
"What disturbs Americans of all ideological persuasions is the fear that almost everything, not just government, is fixed or manipulated by some powerful hidden hand," Frank Rich wrote in Sunday's New York Times.
That manipulation should disturb us. But contrary to Rich, it is not the work of "corporatists" who have sprung up to attack progressive reforms proposed by Obama and the Democratic majority. Manipulation is what we got many years ago when we traded a more or less free market for the "progressive" interventionist state. When government is big, the well-connected always have an advantage over the rest of us in influencing public policy.
Observe: Although President Obama and big-government activists demonize health-insurance companies, the companies "are still mostly on board with the president's effort to overhaul the U.S. health-care system," the Wall Street Journal reports; and ...
Although the activists criticize Big Pharma, "The drug industry has already contributed millions of dollars to advertising campaigns for the health care overhaul through the advocacy groups like Healthy Economies Now and Families USA. It has spent about $1 million on similar advertisements under its own name," the Times reports.
Big Pharma and Big Insurance want Obama-style health-care reform?
It's not so hard to understand. "The drug makers stand to gain millions of new customers," the Times said.
And from the Journal: "If health legislation succeeds, the [insurance] industry would likely get a fresh batch of new customers. In particular, many young and healthy people who currently forgo coverage would be forced to sign up." No wonder insurers are willing to stop "discriminating" against sick people. (Forget that the essence of insurance is discrimination according to risk.)
Not that Big Pharma and Big Insurance like every detail of the Democratic plan. Drug companies don't want Medicare negotiating drug prices—for good reason. If it forces drug prices down, research and development will be discouraged. (Depending whom you believe, Obama may or may not have agreed with the drug companies on this point.)
As for the insurance companies, they worry—legitimately—that a government insurance company—the so-called public option"—would drive them out of business. This isn't alarmism. It's economics. The public option would have no bottom line to worry about and therefore could engage in "predatory pricing" against the private insurers.
But despite these differences, the biggest companies in these two industries are on board with "reform."
It illustrates economist Steven Horwitz's First Law of Political Economy: "No one hates capitalism more than capitalists." In this case, big business wants to shape—and profit from—what inevitably will be an interventionist health-care reform. Can you think of the last time a major business supported a truly free market in anything?
In light of all this, it's funny to watch Democrats and their activist allies panic over the protests at congressional town meetings around the country. Tools of the corporate interests! they cry. But anyone opposing "socialized medicine" at the meeting can't be a mouthpiece for big business because, as we've seen, big business supports government control. Conservative groups may be encouraging people to vent their anger at congressmen who pass burdensome legislation without even bothering to read it, but that's no reason to insult the protestors as pawns. What's wrong with organizations helping like-minded people to voice their opinions? Why do Democrats, such as Speaker Nancy Pelosi, dismiss citizen participation as "AstroTurf"—not real grassroots—only when citizens oppose the kind of big government they favor?
They weren't so dismissive when George W. Bush was president and people protested—appropriately—his accumulation of executive powers.
"When handfuls of Code Pink ladies disrupted congressional hearings or speeches by Bush administration officials," Glenn Reynolds writes, "it was taken as evidence that the administration's policies were unpopular, and that the thinking parts of the populace were rising up in true democratic fashion. ... But when it happens to Democrats, it's something different: A threat to democracy, a sign of incipient fascism ... House Speaker Nancy Pelosi calls the 'Tea Party' protesters Nazis. ... "
So when lefties do it, it's called "community organizing."
When conservatives and libertarians do it, it's "AstroTurf."
Give me a break.
John Stossel is co-anchor of ABC News' 20/20 and the author of Myth, Lies, and Downright Stupidity. He has a new blog at http://blogs.abcnews.com/johnstossel.Jensen Comment
So who's against Obamacare? I think of the little people who are tired of being told that it's raining when hypocrites in Congress are peeing on our shoes. I think it's the little people who know full well that Obamacare will be neither less expensive nor less wasteful of consumer/taxpayer dollars. I think of the little people who are tired of spending deficits that are paving the road to Hell. I think it's the little people who fear the hoards of foreigners sneaking across our borders for free health care. I think it's the little people who wish that genuine photo identification should be required for voting and collection of benefits.John Stossel's right. The great divide between big government and big business is a myth. We're puppets on a string being exploited by the people in glass towers who blow up our economic bubbles and pop our balloons. Obamacare is just another way of justifying lousy health care from overworked and underpaid healthcare providers. Obamacare's another way to beat down small business and competition in America.
The Lie: How to lie with statistics
These Democrats are all over the map on where
precisely Americans place in the life-expectancy rankings. We're 24th,
according to Vice President Joe Biden and Sen. Barbara Boxer; 42nd,
according to Pennsylvania Gov. Ed Rendell; 35th, according to Washington
Post columnist Eugene Robinson; and 47th, according to Rep. Dennis Kucinich.
So the U.S. may have less of a "life expectancy" problem than a "Democratic
math competency" problem. (Coulter mentions other widely varying
medical statistics reported in the media)
Ann Coulter, "Would Your Company
Like to Sponsor the Next Installment of Liberal Lies on National Health
Care?" , Townhall, October 7, 2009 ---
Click Here
The Lie: That the
ten-year cost of the current H.R. 676/3200 is $1.5 trillion as estimated by the
non-partisan Congressional Budget Office. Even without the anticipated
massive fraud that's not factored into these estimates, there is an
accounting problem. Amidst the often emotional passions for passing
universal health (and social services) legislation, the accounting for it
will frontload revenues and defer costs
such that when President Obama finally admits his Obamacare will add to the
Federal deficit, the amounts to be added will be grossly underestimated.
This deception in accounting is what has Social
Security and Medicare entitlements in such deep, deep trouble as the cost
back loading is finally catching up with revenue shortfalls. President Roosevelt in 1935 promised a Trust Fund in which social security
revenues collected in early years would set aside for recipients in their
retirement years. Congress over the years decimated the Trust Fund for
social causes that, although very worthy, were not intended to be funded by
the Social Security Trust Fund.
"The Deficit and Health Care: Falls the Shadow,"
The Economist,
July 25-31, 2009, pp. 25-26 --- "
http://www.economist.com/world/unitedstates/displaystory.cfm?story_id=14085725
Most of the red ink results from the enormous hole the recession has punched in GDP and consequently in tax revenue, the cost of bailing out the financial system, and interest on the mounting debt. Only a small part of it comes from America’s big and growing entitlements, Medicare and Medicaid (health care for the elderly and poor, respectively) and Social Security (public pensions), whose worst fiscal problems lie beyond 2019. “Unless we demonstrate a strong commitment to fiscal sustainability,” Mr Bernanke remarked, “we risk having neither financial stability nor durable economic growth.”
Mr Obama knows all this: he promises repeatedly not to leave the problem to his successors. Yet he has done little to back up the rhetoric. His willingness to veto more F-22 spending is admirable, but the $1.75 billion at stake is immaterial. He will release an updated budget outlook in mid-August, but it is unlikely to contain any notable new initiatives. There is still no sign of a path towards fiscal tightening over the medium term as the economy recovers. Quite the opposite; Mr Obama has not wavered from his position that taxes on those earning less than $250,000 will not go up. In fact, they’ve been temporarily cut. He did say in an interview this week that he might set up a commission that could look at ways of reducing entitlements spending once the recession is over.
The president has promised that health-care reform will be deficit-neutral, but this is a slippery concept. A plan may be deficit-neutral over ten years, but add significantly to it thereafter by front-loading revenue and backloading costs. The CBO figures show that this is a big problem with the House plan, whose shortfall will balloon beyond the ten-year horizon.
Jim Cooper, one of the Democrats’ most fiscally hawkish congressmen, fears that if push comes to shove, his party will not long remain stalwart on deficit-neutrality. “Health care has been such an impossible dream for so many decades that a lot of today’s Congress would overlook the deficit problems. I hear it all the time from colleagues in leadership: ‘We always find enough money for defence. We’ll find enough for health care’.” Mr Galston, though, thinks that the public’s worries about the deficit will reinforce Mr Obama’s commitment that health reform should not boost the deficit over the medium or long term. This could mean that he ends up with a plan that covers fewer of the uninsured than many had hoped.
None of this deals with the still-gaping hole in the budget. Indeed, a truly deficit-neutral health-care plan may make it tougher to fill that hole: if the rich are already being taxed more to pay for health reform, that makes it harder to use them to address the wider deficit. There are other ways to reduce the deficit, including getting rid of the mortgage-interest deduction, raising the age of eligibility for Medicare and Social Security, altering the inflation-indexation formula, or proposing some sort of tax reform that raises additional revenue. These ideas need not be implemented immediately; that would contradict the purposes of stimulus. But the knowledge that they are in the works would help reassure the public and investors that the federal debt—forecast on current policies to explode from a net $5.8 trillion last year to a net $11.7 trillion in 2019—may be tamed.
The Lie: Business firms
will be able to carry on with their present health insurance providers. The
fact of the matter is that the present house bill explicitly puts death
conditions on Erisa-enabled self insurance plans used by millions of business firms.
The cost of switching to big insurance company coverage will be massive if
they are forced to pay for all the medical and social services mandated in
the current version of Obamacare legislation.
The Lie: The insurance industry abides by state
laws by not rescinding insurance coverage even when there is no fraud on the
part of the patient in information provided to the insurance company.
This is actually a blatant lie that Bill Moyers documented quite well ---
Video:
http://www.pbs.org/moyers/journal/07312009/watch.html
The Lie: Obama's relationship with tort lawyers
is the real driver of Obamacare costs
According to a 2007
study
by McKinsey&Company, physician
compensation bumps up health care spending in America by $58 billion
annually,on average, because U.S. doctors make twice as much as their OECD
peers. And even the poorest in
specializations
like radiology and surgery
routinely rake in around $400,000 annually. Doctors—and many
Republicans—constantly carp about the costs of "defensive medicine" because
it forces providers to perform unnecessary procedures and tests to insulate
them from potential lawsuits. But excessive physician salaries contribute
nearly three times more to wasteful health care spending than the $20
billion or so that defensive medicine does. "While the U.S. malpractice
system is extraordinary," the study notes, "it is only a small contributor
to the higher cost of health care in the United States." Meanwhile, other
studies have found that doctors' salaries contribute more to soaring medical
costs than the
$40 billion or so
that the uninsured cost in uncompensated care--the president's bete noir.
Shikha Dalmia, "The
Evil-Mongering of the American Medical Association: Obama's cozy
relationship with Big Medicine will hurt patients," Reason Magazine,
August 27, 2009 ---
http://www.reason.com/news/show/135682.html
The Lie: AARP endorsed
H.R. 3200 (Obama's Press Secretary belated admitted to the lie)
"Gibbs: Obama misspoke about AARP,"
Fox News, August 12, 2009 ---
Click Here
AARP = Armed and Really Pissed
The Lie: AARP
perpetuates a lie that government run insurance, like Medicare, is a good
deal for patients and taxpayers.
To put the reader at ease the (AARP) article says
that government run health care can’t be so bad since, after all, Medicare
is government run health care and everybody loves it. The article omits the
fact that Medicare is $38 trillion in the red. Yes, trillion with a “tr”)
and by Obama’s own admission is overrun by $500 billion of waste, fraud and
abuse. Obama says Medicare and Medicaid are responsible for our deficits. So
what does he do? He proposes the vast expansion of the Medicare and Medicaid
programs to further balloon our deficits and our health care inflation.
Herb Dennenberg, "AARP: The
Hype, The Lies, The Facts," The Bulletin (Philadelphia's oldest
newspaper), September 21, 2009 ---
Click Here
- The AARP Bulletin (September 2009) has a front-page headline on Obamacare: “The Hype, the Lies, the Facts: How to Tune Out the Fear-mongering and Misinformation and Make Sense of the Health Care Reform.” I’d add only one amendment to that AARP headline: “If you want to avoid the hype, the lies, and get the facts on Obamacare, don’t read the biased one-sided propaganda that AARP publishes in its Bulletin.”
The article is supposed to answer the question of AARP readers, “How do I know what to believe?” Anyone who reads the article critically or studies AARP history on this matter, knows they are in the tank for Obamacare, and in the guise of fair and balanced journalism they are presenting the Obamacare party line.
The article starts out by quoting Kathleen Hall Jamieson, director of he Annenberg Public Policy Center at the University of Pennsylvania, who runs FactCheck.org, a website that examines specious claims from all sides of the political spectrum. She says that health care reform has “serious consequences to people’s lives and it would be useful if as many people as possible actually understood what the proposals are about.” But, then she identifies the rise of the Internet and the decline of the mainstream press as a prime source of information which have put that prospect at risk.
Poor, pathetic Ms. Jamieson is saying, in effect, that the public was only getting the truth when they were relying on the biased, fraudulent, dishonest, and ultra-liberal mainstream media. That poor, pathetic “expert” who is “fact checking for the public” feels the truth is threatened now that multiple points of view, some of which are the opposing point of view, are presented by the Internet and now that the public is slowly beginning to realize that you can’t trust the mainstream media. (I would agree with Bernard Goldberg that the mainstream media is no longer mainstream. Until a good alternative description emerges, I’ll call it the biased, fraudulent, dishonest, and ultra liberal mainstream media.)
So, the AARP article is doing its readers a great public service by demonstrating that you can’t trust the AARP, FactCheck.org, Ms. Jamieson, and the Annenberg Public Policy Center at the University of Pennsylvania if you want fair and balanced information about such matters as Obama and Obamacare.
The article goes on to perpetuate every fraud and deceit that people like House Speaker Nancy Pelosi and the leadership of the Democratic Party have put forth to stigmatize and demonize dissent. For example, the article asks, “Could rumor-mongering affect the outcome? Recent violent interruptions at lawmakers’ town hall meetings suggest it might.” So, the AARP, which is supposed to represent senior citizens, is joining the chorus that sees those who oppose Obamacare and who exercise their First Amendment Rights at Tea Parties as mobsters, prone to violence, Nazis, Brown Shirts and all the rest. They are proving that AARP, the Democratic leadership, and the mainstream media believe in the First Amendment only for those in agreement with its radical, far-left policies.
The AARP and its editors and officers clearly have no conscience and no sense, as they would not carry forward such blatant propagandizing for Obamacare and hurl insults at their own membership. If they are in the business of informing their diverse membership, they should provide both sides of an issue, not just give the appearance of doing so while residing in the pocket of the pro-Obamacare forces.
No wonder AARP been losing membership by the tens of thousands. Sometime ago, it was estimated at 60,000 members lost and that figure is probably much higher by now. Their stance on this did not surprise me. I have already reported in one column how they, along with AMA and others, have sold out to Obama and Company to support his vision of health care reform. I’ve also reported how the AARP is not in the business of representing the interests of senior citizens, but is, in fact, a phony membership organization in the business of selling its members insurance, credit cards, mutual funds, and other services. In fact, facing the first page of the propaganda piece in question is a full-page ad for life insurance sold by AARP. The same issue carries ads for AARP mobile home insurance, AARP Medicare insurance supplements, and AARP auto insurance.
I want to be fair to AARP and its article on health care reform. It did have four words of truth in it. The inside headline reads, “The Assault on Truth.” Of course, that was intended to characterize the critics of Obamacare. However, it perfectly characterizes the article in question and AARP. Let me give you a few examples involving the questions asked and answered by the article:
Will The Government Take Over Health Care So We End Up With Socialized Medicine?
The answer is the standard party line: “No. Neither the president nor the congressional committees have suggested anything remotely resembling a government takeover of health care.”
This answer is based on the fact that Mr. Obama says he doesn’t want the single-payer, government-takeover system that is used in Canada. The article fails to state that Obama has long been on record as favoring the discredited single-payer system and has even said we will have to get there gradually. But the article doesn’t explain that you can have a government takeover without a single-payer system.
When you look at what some of these proposals do, you will see they involve the federal government deciding what kind of policies will be written, what kind of rates will be charged, what kind of government insurance companies will be established, what kind of end-of-life counseling will be provided for senior citizens. What’s more, when you start setting up dozens of new agencies and commissions to control the health care system and to decide on what is the “best” medical practice, you don’t need single-payer to bring about a government takeover. When you grant insurance to 47 million “uninsured,” you assure a shortage of health care providers that sets the stage for rationing. As Dick Morris pointed out, contrary to the view of Obama press secretary Robert Gibbs, “You don’t have to be a medical school graduate to figure that out. That’s an elementary school problem.”
If that’s not quite enough to convince you, when you populate the White House with radicals, communists, socialists and advocates of such things as compulsory abortion, compulsory sterilization, and providing medical care based on quality of life years remaining, meaning seniors will be locked out, you are setting the stage for something worse than single-payer.
The article also tries to refute the fact of government takeover by saying “socialized” medicine is also off the table. The article says socialized medicine involves government ownership of hospitals and employment of doctors, as in the United Kingdom. It says that’s not contemplated. But, again, when government and federal bureaucrats control virtually every aspect of the health care system, you don’t need formal ownership. Comprehensive control is the equivalent of government ownership, of socialized medicine, and of the discredited systems of Canada and the United Kingdom.
To put the reader at ease the article says that government run health care can’t be so bad since, after all, Medicare is government run health care and everybody loves it. The article omits the fact that Medicare is $38 trillion in the red. Yes, trillion with a “tr”) and by Obama’s own admission is overrun by $500 billion of waste, fraud and abuse. Obama says Medicare and Medicaid are responsible for our deficits. So what does he do? He proposes the vast expansion of the Medicare and Medicaid programs to further balloon our deficits and our health care inflation.
Will Private Insurance Be Outlawed Or Wither On The Vine?
Needless to say, the AARP article answers, “No. Obama and the congressional committees say their objective is to build on the current system – keeping employer-sponsored group insurance and giving more consumer protections to people who are employed by small businesses or buy insurance as individuals.”
The AARP article argues that those with employer-sponsored insurance are ineligible for the public plan. But the article forgets that many employers would stop giving coverage, as the penalty for not providing it is smaller than the cost of providing it. Even the New York Times, a lap dog for Obama, in an editorial dedicated to selling Obamacare, admitted that the public option would likely be less costly than many alternatives.
The article also ignores the fact that the public option, a government insurer, would be subject to rules made by the government, so the umpire of the marketplace would be on the side of the government insurer. That is not likely to produce a level playing field for private insurers.
Finally, the article ignores the ways proposed in Republican-sponsored bills that would encourage competition. For example, opening up a nationwide market for health insurance would be an obvious and easy way to increase competition. Now, the consumer is limited to companies admitted to do business in his state. The insurance exchanges, proposed in many bills, would also make sense, as they would ratchet up competition.
Incidentally, it is important to remember that with or without a public option or some variation of it in the form of co-ops, Obamacare still involves a government takeover. So, don’t think it is a big deal to delete the public option. The bill spells catastrophe with or without that provision.
All the other questions asked in the article also provide the wrong answers. For example, “Will Medicare be eliminated or gutted to pay for reforms?” The article answers, “No. It’s inconceivable that any lawmaker would commit political suicide by proposing to get rid of Medicare.” But the AARP article forgets that Obama has said that he would cut $500 billion in waste, fraud, abuse, and inefficiency out of Medicare. We’ve heard that line since the days of President Nixon, and we’re still waiting for that waste, fraud, abuse, and inefficiency to be eliminated. If Obama knows how to do it, what is he waiting for? Why hasn’t he proceeded to cut that waste, fraud, abuse and inefficiency out of the system to prove he knows what he’s doing and can give more than campaign speeches? He’s been in office about seven months, and yet he’s done nothing to solve this problem which he says is bankrupting the country and is responsible for the deficits. When you cut $500 billion out of Medicare and grant coverage to 47 million previously uninsured, you’re going to have to ration medical care, and that means rationing medical care for senior citizens.
The biggest barrels of red ink have been generated by Medicare and Medicaid to the tune of tens of trillions of dollars. So what does Obama do? He proposes, in effect, to vastly expand Medicare and Medicaid and to compound our problems.
The president and chief executive officer of AARP, in an editorial accompanying the article in question, endorse the lies, hype, and exaggeration in the article by writing that there has been too much fear-mongering and misinformation involved in the debate. They continue to give the false impression that they are above the fray, but then echo the party line coming from Obama and the Democratic leadership in Congress. AARP and its leadership have continued to demonstrate they are the ones getting in the way of a fair, balanced, and honest debate on heath care reform.
Meanwhile, we have the case of the Association for the Advancement of Retired Persons (AARP), and its fanciful Medicare claims. The self-styled seniors lobby is using all its money and influence to cheer on ObamaCare, even though polls show that most retired persons oppose it. AARP has spent millions of dollars on its TV ad campaign and bulletins and newsletters to its members, including eight million direct-mail letters over Labor Day. The AARP Web site claims that it is a "myth" that "health care reform will hurt Medicare," while it is a "fact" that "none of the health care reform proposals being considered by Congress will cut Medicare benefits or increase your out-of-pocket costs."
"Medicare and Gag Orders Humana gets whacked for telling the truth, AARP gets a pass for spreading falsehoods," The Wall Street Journal, September 24, 2009 --- Click Here
The Lie: "Preventative medicine as envisioned in Obamacare will make health care significantly cheaper.
So last week, CBO Director Doug Elmndorf wrote
a
letter to Congressmen explaining what cost savings they can expect from
preventive medical services: The evidence
suggests that, for most preventive services, expanded utilization leads to
higher, not lower, medical spending overall. It makes sense if you think
about what are called the “false positives”.
John Stossel, "Expanding
Preventive Care May Add to Costs, CBO Says," ABC News, August 13,
2009 ---
http://blogs.abcnews.com/johnstossel/2009/08/prevention-saves-money.html
See The Washington Post account ---
http://www.washingtonpost.com/wp-dyn/content/article/2009/08/07/AR2009080703822.html
The Lie: H.R. 3200
proposed "Death Panels" to decide when decide when to refuse health
treatments..
False charges about Obamacare don't
help. Like the end-of-life tempest. Former Alaska Gov. Sarah Palin
popularized the term "death panels." She said: "The America I know and love
is not one in which my parents or my baby with Down syndrome will have to
stand in front of Obama's 'death panel' so his bureaucrats can decide, based
on a subjective judgment of their 'level of productivity in society,'
whether they are worthy
of health care". . .
. The House bill does deal with the issue. (The
Senate Finance Committee bill did until the provision was removed the other
day.) Section 1233 amends the Medicare law to add "advance care planning
consultation" (counseling about living wills and the like) to the list of
reimbursable
services. The provision defines "consultation,"
but nowhere does it require Medicare beneficiaries to participate or
authorize death panels. (Grassley voted for a similar provision in 2003 when
his Republican-controlled Congress added
drug coverage
to Medicare.)
John Stossel,
Townhall,
August 19, 2009 ---
http://townhall.com/columnists/JohnStossel/2009/08/19/obamacares_inevitable_logic
Jensen Comment
I agree that the "death panels" arguments were straw men. But then I do see
where the Obama was relying heavily on the cost savings attributable to
five-year health consultation plans with the aged. One has to wonder what
savings were lost with the Senate decided to drop the five-year
consultations? This seems prima facia to imply that quality of
care was intended to be reduced for the aged, including such things as hip
replacements and dialysis.
The chronically ill and those toward the end of
their lives are accounting for potentially 80 percent of the total health
care bill out here.
President Barach Obama as quoted from a David Leonhardt interview
reported in The New York Times:
The Lie: Surgeons bill Medicare $50,000 for a foot amputation.
American Academy of Orthopaedic Surgeons Responds to False Allegations of
President Obama
"Orthopedic Surgeons respond to Obama on amputation comment," by Thomas
Lifson, The American Thinker, August 16, 2009 ---
Click Here
The American Academy of Orthopaedic Surgeons (AAOS) is profoundly disappointed with President Obama's recent comments regarding the value of surgery and blurring the realities of physician reimbursements. The AAOS represents over 17,000 US board-certified orthopaedic surgeons who provide essential services to patients every day. As President Obama has said, "Where we do disagree, let's disagree over things that are real, not these wild misrepresentations that bear no resemblance to anything that's actually been proposed." In that spirit, we would like to bring some clarity to his comments and underscore the value that orthopaedic surgeons bring to Americans every day of every year.
First, surgeons are neither reimbursed by Medicare, nor any provider for that matter, for foot amputations at rates anywhere close to $50,000, $40,000 or even $30,000. Medicare reimbursements to physicians for foot amputations range from approximately $700 to $1200 which includes the follow up care the surgeon provides to the patient up to 90 days after the operation. Moreover, orthopaedic surgeons are actively involved in the preventive care he mentions. We are a specialty that focuses on limb preservation whenever possible and when it is in the best interests of the patient. Our approach to amputation follows the same careful, thoughtful approach, always with the patients best interest as the primary focus.
Continued in article
The Lie: The health insurance mandate is not a tax.
"Yes, health-insurance mandate is a tax." by Donald Lambro, Townhall, September 23, 2009 ---
http://townhall.com/columnists/DonaldLambro/2009/09/23/yes,_health-insurance_mandate_is_a_taxPresident Obama absolutely refuses to acknowledge there is a huge middle-class tax in the Senate Finance Committee's healthcare bill. The president flatly denies the legislation that the White House supports contains a stiff penalty tax that would hit uninsured middle-income people the hardest -- the very folks he promised would never see their taxes rise under his presidency.
Obama has repeatedly stated that promise throughout the healthcare debate, despite evidence to the contrary, and no one in the national news media has called him on it. That is, until George Stephanopoulos raised the issue with him Sunday on ABC's "This Week."
First, Stephanopoulos reminded the president that in his campaign for the presidency he was "against the individual mandate" that all Americans be required to buy health insurance.
"Yes," Obama replied.
Then Stephanopoulos hit him with the question no one apparently had asked him before. Pointing out that the Finance Committee plan contained just such a mandate whereby "the government is forcing people to spend money, fining you if you don't," he asked, "How is that not a tax?"
Obama replied, "No, but ... but, George, you ... can't just make up that language and decide that that's called a tax increase."
"You reject that it's a tax increase?" Stephanopoulos asked. Obama said, "I absolutely reject that notion."
But if Obama looked on page 29 of Senate Finance Committee Chairman Max Baucus' legislation -- the bill he hopes will enact his healthcare plans into law -- he would have read this line: "The consequence for not maintaining (health) insurance would be an excise tax."
What part of those two words doesn't he understand? The government imposes a raft of excise taxes on all of us: the tires for our cars, alcoholic beverages, jewelry and many other purchases. Now it wants to add health insurance to the tax-revenue list as a penalty for those who do not purchase a product the feds insist you must buy or else face fines up to $950 for an individual and up to $3,800 a year for a family.
Continued in article
The Lie: A huge portion
of Obamacare will be financed by further limiting what hospitals receive
from Medicare.
This will be a lie because it just will not work. I think
this is a wrong because it creates age discrimination that should not
be allowed. If government medical insurance pays hospitals more for younger
patients than older patients it will be age discrimination. If all
government medical insurance payments to hospitals is so tight-fisted that
the hospitals lose money on every government-insured patient (which is why
the Massachusetts hospitals are suing the Mass. universal health care plan),
then hospitals will have to rely more and more on private insurance plans to
keep those hospitals in business. This, in turn, will drive up the cost of
private insurance to a point where many businesses, especially small
businesses, will shift almost entirely to part-time workers.
Democrats are now blaming the defection of elderly voters from Obama care on the phony threats of euthanasia and rationing of treatment of older people. But this is not the underlying cause of the defection. The underlying cause is the genuine threat that government health insurance will pay less for hospital and doctor care that what is being paid for younger patients. President Obama needs to assure the elderly that hospitals and doctors will receive just as much from older patients as younger patients. Why don't Barack Obama, Nancy Pelosi, Chris Dodd, Keith Olbermann and Chris Matthews ever assure us that there will be no age discrimination in claims coverage?
Michael Moore lets the Obamacare cat out of the
bait and switch bag
Free Republic, August 11, 2009 ---
http://www.freerepublic.com/focus/f-bloggers/2313338/posts
In politics, knowing what your opposition thinks and says about you and your team is critical. But listening to what they’re saying about their own side can sometimes be even more telling.
In the latest issue of Rolling Stone, Michael Moore insists that Barack Obama’s ambitions are much farther left than he lets on. Thus, the President has been deliberately lying to us about everything from healthcare reform to the war on terror. But contrary to the Bush years, when perceived presidential deceit evoked liberal rage and a film to go with it, Moore adoringly approves of what he now sees as a necessary “rope-a-dope strategy” to advance his side’s cause.
The interview, part of a larger round table discussion also including Paul Krugman and David Gergen, asks the “three leading political observers” to analyze and discuss the first six months of the Obama presidency. The most startling perspective Moore provides is in regard to the current health care debate:
I take all of the things that make me nervous about the decisions that Obama has made, and I look and them through that lens – that it’s some kind of master plan. It’s like his continued support of a government-run option for health care. If a true public option is enacted – and Obama knows this – it will eventually bring about a single-payer system, because the profit-making insurance companies won’t be able to compete with a government plan and make the profits they want to make. At some point most of them will probably have to bow out of the business.
Michael Moore"Video: Obama Explains How His Health Care Plan Will ‘Eliminate’ Private Health Insurance," Breitbart, August 3, 2009 ---
http://www.breitbart.tv/uncovered-video-obama-explains-how-his-health-care-plan-will-eliminate-private-insurance/
The Lie: Every Obamacare Critic is a Racist
Since my post below about Obama supporters who tar all
of the President’s critics as racists, Fidel Castro has weighed in. Reuters
reports that Castro says Obama is trying to make positive changes but is being
fought at every turn by right-wingers who hate him because he is black: “(T)he
extreme right hates him for being African-American… I don't have the slightest
doubt that the racist right will do everything possible to wear him down,
blocking his program to get him out of the game one way or another, at the least
political cost," (Castro) said. More than a thousand...
John Stossel, ABC News,
August 27, 2009 ---
http://blogs.abcnews.com/johnstossel/2009/08/every-critic-a-racist.html
The Lie: The House Bill
presently states that business firms can opt out of providing health
insurance coverage for employees by paying an 8% of
gross payroll good-deal penalty to the government.
This is bait and switch fraud at its worst!
By the time the government insurance option becomes viable this will
increase to X% at whatever it takes to keep most working full-time employees
out of the government health insurance option. The reason partly is due to
the fact that it will take decades before the government option can process
the claims for between virtually the entire population of the United States
plus all the illegal aliens who will sneak into the country for health
services. The reason also is that President Obama promised to keep private
health insurance viable such that he must eventually make it virtually
impossible for employers to opt out of private medical insurance plans at
lower costs.
Two weeks ago I warned about the "bait and switch fraud" in the H.R. 3200 good news bait of an 8% of gross payroll penalty for employers who do not provide health insurance coverage for employees. In a surprising move, Congress is already switching the bait to 10% even before H.R. 3200 is passed. After its passage I look for the bait to be switched to an even higher percentage, maybe 50%, such that there is no way for employers to avoid an absolutely massive expense for health care coverage under the new rules of virtually no self insurance (policies will have to be purchased from large private insurance companies). virtually all pre-existing health issues will have to be covered instantly for each new person hired, part-time workers and illegal aliens will have to receive health insurance, and an array of social services will have to be covered including marriage counseling and family counseling.
The projected cost of employer-based health coverage is so huge that even a 10% penalty would still be cheaper. But employers should count on the bait being switched once again after Obamacare is legislated. The government medical insurance plan just will not be able to insure 200 million to 300 million people instantly if all employers opt out of health coverage by paying the X% penalty. Irrespective of the bait, the switch is inevitable!
The only reason I can see for switching the bait before H.R. 3200 is passed is to deceivingly make it look more deficit neutral and once again deceive the public and dimwitted members of Congress.
Even many Democrats are revolting against Speaker Nancy
Pelosi’s 5.4% income surtax to finance ObamaCare, but another tax in her House
bill isn’t getting enough attention. To wit, the up to 10-percentage point
payroll tax increase on workers and businesses that don’t provide health
insurance. This should put to rest the illusion that no one making more than
$250,000 in income will pay higher taxes.
"The Pelosi Jobs Tax: Workers will pay for the new health-care payroll
levy," The Wall Street Journal, July 30, 2009 ---
http://online.wsj.com/article/SB10001424052970203609204574316183688201934.html#mod=djemEditorialPage
Because of the present health care system in the United
States is unjust and inefficient, I am in favor of a National Health Plan
modeled after the Canadian National Health Plan where Canadians are taxed
for a huge portion of their health services irrespective of their levels of
income. In Canada, about 40% of taxpayer's tax dollars go
for health services. Any system that does not make users of the system share
heavily in the cost of the services will be unjust, abused, and inefficient.
Also in Canada the National Health Plan greatly restricts the size of
malpractice lawsuit lotteries for lawyers ----
http://www.trinity.edu/rjensen/Health.htm#Canada
USA Today
reported on July 31, 2009, Page 10A, (using OECD data for 2008) that health
care costs in Canada were $3,505 per capita Before any Obamacare legislation
for health care the per capita cost of health care in the United States was
$6,567. In large measure this due to the cost physicians, nurses, ambulance
services, and hospitals must pay for malpractice insurance. Thousands of
gynecologists in the United States dropped the obstetrics part of their
practices because of the enormous price of malpractice insurance. Many
hospitals dropped obstetrics services for the same reason.
Why Medical Malpractice Is Off Limits in Terms of Health Care Reform
The upshot is simple: A few thousand trial lawyers
are blocking reform that would benefit 300 million Americans. This is not
just your normal special-interest politics. It's a scandal—it is as if
international-trade policy was being crafted in order to get fees for
customs agents. Trial lawyers are agents, and their claims are only as valid
as those they represent. They argue, of course, that they are champions of
malpractice victims. As Anthony Tarricone, president of the trial lawyers
association (called the American Association of Justice) put it: "Trial
attorneys see first-hand the effects medical errors have on patients and
their families. We should keep those injured people in mind as the debate
moves forward." But under the current system, 54 cents of the malpractice
dollar goes to lawyers and administrative costs, according to a 2006 study
in the New England Journal of Medicine. And because the legal process is so
expensive, most injured patients without large claims can't even get a
lawyer. "It would be hard to design a more inefficient compensation system,"
says Michelle Mello, a professor of law and public health at Harvard, "or
one which skewed incentives more away from candor and good practices."
Philip K. Howard, "Why Medical
Malpractice Is Off Limits: A few thousand lawyers have a lock on
Democrats, who refuse any legal reform," The Wall Street Journal,
September 29, 2009 ---
http://online.wsj.com/article/SB10001424052970204488304574432853190155972.html?mod=djemEditorialPage
"Dean says Obamacare authors don't want to challenge trial lawyers," by: Mark Tapscott, Washington Examiner, August 26, 2009 --- Click Here
Whatever else he said Wednesday evening at the town hall hosted by Rep. Jim Moran, D-VA, former Democratic National Committee chairman and presidential candidate Howard Dean let something incredibly candid slip out about President Obama's health-care reform bill in Congress.
Asked by an audience member why the legislation does nothing to cap medical malpractice class-action lawsuits against doctors and medical institutions (aka "Tort reform"), Dean responded by saying: “The reason tort reform is not in the [health care] bill is because the people who wrote it did not want to take on the trial lawyers in addition to everybody else they were taking on. And that’s the plain and simple truth,”
Dean is a former physician, so he knows about skyrocketing medical malpractice insurance rates, and the role of the trial lawyers in fueling the "defensive medicine" approach among medical personnel who order too many tests and other sometimes unneeded procedures "just to be sure" and to protect themselves against litigation.
Texas Gov. Rick Perry recently described in an Examiner oped the medical-malpractice caps enacted by the state legislature at his urging that reversed a serious decline in the number of physicians practicing in the Lone Star state and the resulting loss of access to quality medical care available to Texas residents. Mississippi Gov. Haley Barbor also shared some of his successes in this area in a recent Examiner oped.
Credit goes to the American Tort Reform Association's Darren McKinney for catching this momentary outbreak of political honesty by Dean. McKinney has conveniently posted an audio recording of Dean speaking here, so you can listen for yourself. Mckinney has also offered more comment here, helpfully even including a link to the Examiner's recent analysis of the degree to which trial-lawyer political contributions go to Democrats in Congress.
Those contributions are why Dean knows it would be a difficult task indeed for Obama to persuade congressional Democrats to do anything that might offend the trial-lawyers lobby. The Examiner's David Freddoso and Kevin Mooney did the reporting on this link here.
Jensen Comment
Reports are that the Texas cap on punitive damages has been quite successful in restraining outrageous settlements of malpractice lawsuits.The Impact of Tort Reform on Employer-Sponsored Health Insurance Premiums Ronen Avraham (University of Texas at Austin, School of Law(, Leemore S. Dafny (Kellogg School of Management, Northwestern University) and NBER Max M. Schanzenbach, (Northwestern University, School of Law)
September 2009 --- Click Here
http://www.kellogg.northwestern.edu/faculty/dafny/personal/Documents/Working%20Papers/ADS_9_09w_ack.pdf
Abstract
We evaluate the effect of tort reform on employer-sponsored health insurance premiums by exploiting state-level variation in the timing of reforms. Using a dataset of healthplans representing over 10 million Americans annually between 1998 and 2006, we find that caps on non-economic damages, collateral source reform, and joint and several liability reform reduce premiums by 1 to 2 percent each. These reductions are concentrated in PPOs rather than HMOs, suggesting that can HMOs can reduce “defensive” healthcare costs even absent tort reform. The results are the first direct evidence that tort reform reduces healthcare costs in aggregate; prior research has focused on particular medical conditions.
"The President's Tort Two-Step Special-interests and the health-care status," by Kimberly Strassel, The Wall Street Journal, September 11, 2009 --- Click Here
Tort reform is a policy no-brainer. Experts on left and right agree that defensive medicine—ordering tests and procedures solely to protect against Joe Lawyer—adds enormously to health costs. The estimated dollar benefits of reform range from a conservative $65 billion a year to perhaps $200 billion. In context, Mr. Obama's plan would cost about $100 billion annually. That the president won't embrace even modest change that would do so much, so quickly, to lower costs, has left Americans suspicious of his real ambitions.
It's also a political no-brainer. Americans are on board. Polls routinely show that between 70% and 80% of Americans believe the country suffers from excess litigation. The entire health community is on board. Republicans and swing-state Democrats are on board. State and local governments, which have struggled to clean up their own civil-justice systems, are on board. In a debate defined by flash points, this is a rare area of agreement.
The only folks not on board are a handful of powerful trial lawyers, and a handful of politicians who receive a generous cut of those lawyers' contingency fees. The legal industry was the top contributor to the Democratic Party in the 2008 cycle, stumping up $47 million. The bill is now due, and Democrats are dutifully making a health-care down payment.
During the markup of a bill in the Senate Health Committee, Republicans offered 11 tort amendments that varied in degree from mere pilot projects to measures to ensure more rural obstetricians. On a party line vote, Democrats killed every one. Rhode Island senator and lawyer Sheldon Whitehouse went so far as to speechify on the virtues of his tort friends. He did not, of course, mention the nearly $900,000 they have given him since 2005, including campaign contributions from national tort powerhouses like Baron & Budd and Motley Rice.
Even Senate Finance Chair Max Baucus, of bipartisan bent, has bowed to legal powers. The past two years, Mr. Baucus has teamed up with Wyoming Republican Mike Enzi to offer legislation for modest health-care tort reform in states. That Enzi-Baucus proposal had been part of the bipartisan health-care talks. When Mr. Baucus released his draft health legislation this weekend, he'd stripped out his own legal reforms. The Montanan is already in the doghouse with party liberals, and decided not to further irk leadership's Dick Durbin ($3.6 million in lawyer contributions), the Senate's patron saint of the trial bar.
Over in the House the discussion isn't about tort reform, but about tort opportunities. During the House Ways & Means markup of a health bill, Texas Democrat Lloyd Doggett ($1.5 million from lawyers) introduced language to allow freelance lawyers to sue any outfit (say, McDonald's) that might contribute to Medicare costs. Only after Blue Dogs freaked out did the idea get dropped, though the trial bar has standing orders that Democrats make another run at it in any House-Senate conference.
It says everything that Mr. Obama wouldn't plump for reform as part of legislation. The president knows the Senate would never have passed it in any event. Yet even proposing it was too much for the White House's legal lobby. Mr. Obama is instead directing his secretary of health and human services to move forward on test projects. That would be Kathleen Sebelius, who spent eight years as the head of the Kansas Trial Lawyers Association.
The issue has assumed such importance that even some Democrats acknowledge the harm. With bracing honesty, former DNC chair Howard Dean recently acknowledged his party "did not want to take on the trial lawyers." Former Democratic Sen. Bill Bradley, in a New York Times piece, suggested a "grand bipartisan compromise" in which Democrats got universal coverage in return for offering legal reform. The White House yawned, and moved on.
It isn't clear if Republicans would or should take that deal, but we won't know since it won't be offered. The tort-reform issue has instead clarified this presidency. Namely, that the bipartisan president is in fact very partisan, that the new-politics president still takes orders from the old Democratic lobby.
The Lie: President Obama
promises that millions of small mom and pop businesses will be able to stay
profitable and offer private insurance coverage under Obamacare. Wal-Mart is
promoting Obamacare precisely for the reason that smaller competitors will
go out of business. Small and medium sized businesses will fail do to the
added costs of coverage mandated in Obamacare legislation such as instant
coverage of expensive pre-existing health conditions and the cost of
mandated social services such as marriage and family counseling and vastly
increased costs of mental health coverage.
"What disturbs Americans of all
ideological persuasions is the fear that almost everything, not just
government, is fixed or manipulated by some powerful hidden hand," Frank
Rich wrote in Sunday's New York Times. That manipulation should disturb us.
But contrary to Rich, it is not the work of "corporatists" who have sprung
up to attack progressive reforms proposed by Obama and the Democratic
majority. Manipulation is what we got many years ago when we traded a more
or less free market for the "progressive" interventionist state. When
government is big, the well-connected always have an advantage over the rest
of us.
"Big Business for Health-Care Reform," by John Stossel,
ABC News,
August 11, 2009 ---
http://blogs.abcnews.com/johnstossel/2009/08/big-business-for-healthcare-reform.html
The Lie: President Obama
is promising that Obamacare will be so efficient that the cost of processing
government and private health claims will save billions of dollars each
year. The Congressional Budget Office is not buying his gross exaggerations
about such cost savings. It might be much more efficient if Obamacare were
equivalent to the Canada National Health Plan, but President Obama promises
to keep all the private health insurance companies in business at profitable
returns.
The Lie: President Obama
is promising that Obama care will be so efficient that it will not increase
the annual Federal spending deficit that that, without Obamacare, will in
2009 be about $2 trillion more outflow than inflow --- http://www.usdebtclock.org/
This is such a blatant lie it's almost laughable --- if it was not so
tragic!
The interest cost on the National Debt will soon be about a million dollars
a second.
The Lie: President Obama is promising that there will
be no new taxes on 98% of Americans to pay for Obamacare. However, he does
not say anything about the huge increases in the prices everybody will have
to pay at Wal-Mart, Safeway, Citgo, Exxon, Sears, Penneys, Burger King, KFC,
GM, Chrysler, Toyota, Honda, Deere, Kubota, etc. to pay for the added health care
insurance costs forced on employers due to Obamacare mandates.
The American Academy of Orthopaedic Surgeons (AAOS) is profoundly disappointed with President Obama's recent comments regarding the value of surgery and blurring the realities of physician reimbursements. The AAOS represents over 17,000 US board-certified orthopaedic surgeons who provide essential services to patients every day. As President Obama has said, "Where we do disagree, let's disagree over things that are real, not these wild misrepresentations that bear no resemblance to anything that's actually been proposed." In that spirit, we would like to bring some clarity to his comments and underscore the value that orthopaedic surgeons bring to Americans every day of every year.
First, surgeons are neither reimbursed by Medicare, nor any provider for that matter, for foot amputations at rates anywhere close to $50,000, $40,000 or even $30,000. Medicare reimbursements to physicians for foot amputations range from approximately $700 to $1200 which includes the follow up care the surgeon provides to the patient up to 90 days after the operation. Moreover, orthopaedic surgeons are actively involved in the preventive care he mentions. We are a specialty that focuses on limb preservation whenever possible and when it is in the best interests of the patient. Our approach to amputation follows the same careful, thoughtful approach, always with the patients best interest as the primary focus.
Continued in article
Click here: Fred Thompson: Interviews
Scroll down to Betsey MacCaughhey's audio (this is a bit too biased in tone
for my liking, but Betsey did take the time and trouble to read the July
2009 House Bill in detail.
Health Care Numbers Don't Add Up ---
http://www.mpnnow.com/lifestyle/x2141125428/Health-care-reform-numbers-don-t-add-up
President Barack Obama apparently came to believe
the myth of his messiahship and has accordingly abused and squandered his
good will and political capital and possibly self-sabotaged his socialized
medicine scheme. Of all the newsworthy aspects of this desperate "reform"
effort, none is more so than the robust democratic processes it has
reinvigorated in this nation. While Democrats insist the nationwide
grass-roots movement against his Draconian measure is contrived and
illusory, it is just the opposite. Nothing could be so real as the American
people, emboldened by their passion for liberty, standing up against a
callous, dishonest government trolling for its freedoms in exchange for
false promises.
David Limbaugh, "Obama's Forfeited
Credibility Sabotaging Obamacare," Townhall, August 14, 2009 ---
http://townhall.com/columnists/DavidLimbaugh/2009/08/14/obamas_forfeited_credibility_sabotaging_obamacare
Jensen Comment
The public just isn't buying into the lie that it's possible to widen the
scope of coverage of each person's health insurance and add 50 million
uninsured to the insurance plans without increasing the Federal deficit
and/or driving small companies out of business with requirements to pay
greatly increased premiums. The public recognizes that this is a job killer
--- their jobs.
Fact Check
Desktop Users
www.factcheck.org/politics/obamas_health_care_news_conference.html
Mobile Users
http://www.factcheck.org/mobile/article.php?id=997
Sampling Only
President Obama tried to sell his health care overhaul in prime time, mangling some facts in the process. He also strained to make the job sound easier to pay for than experts predict.
- Obama promised once again that a health care overhaul “will be paid for.” But congressional budget experts say the bills they've seen so far would add hundreds of billions of dollars to the deficit over the next decade.
- He said the plan "that I put forward" would cover at least 97 percent of all Americans. Actually, the plan he campaigned on would cover far less than that, and only one of the bills now being considered in Congress would do that.
- He said the "average American family is paying thousands" as part of their premiums to cover uncompensated care for the uninsured, implying that expanded coverage will slash insurance costs. But the nonpartisan Kaiser Family Foundation puts the cost per family figure at $200.
Note: This is a summary only. The full article with analysis, images and citations may be viewed on the above Fact Check Websites.
- Obama claimed his budget "reduced federal spending over the next 10 years by $2.2 trillion" compared with where it was headed before. Not true. Even figures from his own budget experts don't support that. The Congressional Budget Office projects a $2.7 trillion increase, not a $2.2 trillion cut.
- The president said that the United States spends $6,000 more on average than other countries on health care. Actually, U.S. per capita spending is about $2,500 more than the next highest-spending country. Obama's figure was a White House-calculated per-family estimate.
Updates on November 17, 2009
"Health Cost Containment Troublesome Issue," SmartPros,
November 10, 2009 ---
http://accounting.smartpros.com/x68073.xml
Some Democrats and analysts are raising alarms that bills to reform the U.S. healthcare system fall short of President Obama's pledge to slow health spending.
Obama has made cost containment a key leg to healthcare reform. However, health economists say it isn't possible to know whether the bills would meet that goal, with many saying they doubt they would even come close, The New York Times reported Tuesday.
Both the House and the Senate propose cost-saving measures. The House bill, which passed Saturday, projects $440 billion in Medicare savings over 10 years. The Senate Finance Committee bill projects about $420 billion. White House officials said additional savings in the private sector would be realized as well.
Experts, even those whom the White House consulted, said the measures represent only small steps toward revising the existing fee-for-service system, which drives up costs by paying health providers for each visit or procedure performed -- and some lawmakers are paying attention, the Times said.
"My assessment at this point," said Sen. Ron Wyden, D-Ore., and a member of the Finance Committee, "is that the legislation is heavy on health and light on reform."
Sen. Susan Collins, R-Maine, during a news conference Monday with Sen. Lamar Alexander, R-Tenn., shared her concern about the cost-containment issue. Collins said she also has met with moderate Democrats who share her view.
"I don't believe we need more pilot projects to show us that healthcare delivery reforms are necessary," Collins told the Times. "I think people are much more upset over the cost of care than the administration is acknowledging."
"The U.S. House of Presumptuous Meddlers," by John Stossel,
Townhall, November 11, 2009 ---
http://townhall.com/columnists/JohnStossel/2009/11/11/the_us_house_of_presumptuous_meddlers
As an American, I am embarrassed that the U.S. House of Representatives has 220 members who actually believe the government can successfully centrally plan the medical and insurance industries.
I'm embarrassed that my representatives think that government can subsidize the consumption of medical care without increasing the budget deficit or interfering with free choice.
It's a triumph of mindless wishful thinking over logic and experience.
The 1,990-page bill is breathtaking in its bone-headed audacity. The notion that a small group of politicians can know enough to design something so complex and so personal is astounding. That they were advised by "experts" means nothing since no one is expert enough to do that. There are too many tradeoffs faced by unique individuals with infinitely varying needs.
Government cannot do simple things efficiently. The bureaucrats struggle to count votes correctly. They give subsidized loans to "homeowners" who turn out to be 4-year-olds. Yet congressmen want government to manage our medicine and insurance.
Competition is a "discovery procedure," Nobel-prize-winning economist F. A. Hayek taught. Through the competitive market process, we producers and consumers constantly learn things that force us to adjust our behavior if we are to succeed. Central planners fail for two reasons:
First, knowledge about supply, demand, individual preferences and resource availability is scattered -- much of it never articulated -- throughout society. It is not concentrated in a database where a group of planners can access it.
Second, this "data" is dynamic: It changes without notice.
No matter how honorable the central planners' intentions, they will fail because they cannot know the needs and wishes of 300 million different people. And if they somehow did know their needs, they wouldn't know them tomorrow.
Proponents of so-called reform -- it's not really reform unless it makes things better -- have shamefully avoided criticism of their proposals. Often they just dismiss their opponents as greedy corporate apologists or paranoid right-wing loonies. That's easier than answering questions like these:
1) How can the government subsidize the purchase of medical services without driving up prices? Econ 101 teaches -- without controversy -- that when demand goes up, if other things remain equal, price goes up. The politicians want to have their cake and eat it, too.
2) How can the government promise lower medical costs without restricting choices? Medicare already does that. Once the planners' mandatory insurance pushes prices to new heights, they must put even tougher limits on what we may buy -- or their budget will be even deeper in the red than it already is. As economist Thomas Sowell points out, government cannot really reduce costs. All it can do is disguise and shift costs (through taxation) and refuse to pay for some services (rationing).
3) How does government "create choice" by imposing uniformity on insurers? Uniformity limits choice. Under House Speaker Nancy Pelosi's bill and the Senate versions, government would dictate to all insurers what their "minimum" coverage policy must include. Truly basic high-deductible, low-cost catastrophic policies tailored to individual needs would be forbidden.
4) How does it "create choice" by making insurance companies compete against a privileged government-sponsored program? The so-called government option, let's call it Fannie Med, would have implicit government backing and therefore little market discipline. The resulting environment of conformity and government power is not what I mean by choice and competition. Rep. Barney Frank is at least honest enough to say that the public option will bring us a government monopoly.
Advocates of government control want you to believe that the serious shortcomings of our medical and insurance system are failures of the free market. But that's impossible because our market is not free. Each state operates a cozy medical and insurance cartel that restricts competition through licensing and keeps prices higher than they would be in a genuine free market. But the planners won't talk about that. After all, if government is the problem in the first place, how can they justify a government takeover?
Many people are priced out of the medical and insurance markets for one reason: the politicians' refusal to give up power. Allowing them to seize another 16 percent of the economy won't solve our problems.
Freedom will.
"A Minority View: Constitutional Contempt," by Walter E. Williams,
Townhall, November 11, 2009 ---
http://townhall.com/columnists/WalterEWilliams/2009/11/11/a_minority_view_constitutional_contempt
At Speaker Nancy Pelosi's Oct. 29th press conference, a CNS News reporter asked, "Madam Speaker, where specifically does the Constitution grant Congress the authority to enact an individual health insurance mandate?" Speaker Pelosi responded, "Are you serious? Are you serious?" The reporter said, "Yes, yes, I am." Not responding further, Pelosi shook her head and took a question from another reporter. Later on, Pelosi's press spokesman Nadeam Elshami told CNSNews.com about its question regarding constitutional authority mandating that individual Americans buy health insurance. "You can put this on the record. That is not a serious question. That is not a serious question."
Suppose Congress was debating a mandate outlawing tea-party-type protests and other large gatherings criticizing Congress. A news reporter asks Nancy Pelosi where specifically does the Constitution grant Congress the authority to outlaw peaceable assembly. How would you feel if she answered, "Are you serious? Are you serious?" and ignored the question. And what if, later on, someone from her office sent you a press release, as was sent to CNS News, saying that Congress has "broad power to regulate activities that have an effect on interstate commerce," pointing out that demonstrations cause traffic jams and therefore interferes with interstate commerce?
Speaker Pelosi's constitutional contempt, perhaps ignorance, is representative of the majority of members of both the House and the Senate. Their comfort in that ignorance and constitutional contempt, and how readily they articulate it, should be worrisome for every single American. It's not a matter of whether you are for or against Congress' health care proposals. It's not a matter of whether you're liberal or conservative, black or white, male or female, Democrat or Republican or member of any other group. It's a matter of whether we are going to remain a relatively free people or permit the insidious encroachment on our liberties to continue.
Where in the U.S. Constitution does it authorize Congress to force Americans to buy health insurance? If Congress gets away with forcing us to buy health insurance, down the line, what else will they force us to buy; or do you naively think they will stop with health insurance? We shouldn't think that the cure to Congress' unconstitutional heavy-handedness will end if we only elect Republicans. Republicans have demonstrated nearly as much constitutional contempt as have Democrats. The major difference is the significant escalation of that contempt under today's Democratically controlled Congress and White House with the massive increase in spending, their proposed legislation and the appointment of tyrannical czars to control our lives. It's a safe bet that if and when Republicans take over the Congress and White House, they will not give up the massive increase in control over our lives won by the Democrats.
In each new session of Congress since 1995, John Shadegg, R-Ariz.,) has introduced the Enumerated Powers Act, a measure "To require Congress to specify the source of authority under the United States Constitution for the enactment of laws, and for other purposes." The highest number of co-sponsors it has ever had in the House of Representatives is 54 and it has never had co-sponsors in the Senate until this year, when 22 senators signed up. The fact that less than 15 percent of the Congress supports such a measure demonstrates the kind of contempt our elected representatives have for the rules of the game -- our Constitution.
If you asked the questions: Which way is our nation heading, tiny steps at a time? Are we headed toward more liberty, or are we headed toward greater government control over our lives? I think the answer is unambiguously the latter -- more government control over our lives. Are there any signs on the horizon that the direction is going to change? If we don't see any, we should not be surprised. After all, mankind's standard fare throughout his history, and in most places today, is arbitrary control and abuse by government.
Updates on November 10, 2009
"The Worst Bill Ever: Epic new spending and taxes, pricier
insurance, rationed care, dishonest accounting: The Pelosi health bill has it
all," The Wall Street Journal, November 1, 2009 ---
http://online.wsj.com/article/SB10001424052748703399204574505423751140690.html?mod=djemEditorialPage
Speaker Nancy Pelosi has reportedly told fellow Democrats that she's prepared to lose seats in 2010 if that's what it takes to pass ObamaCare, and little wonder. The health bill she unwrapped last Thursday, which President Obama hailed as a "critical milestone," may well be the worst piece of post-New Deal legislation ever introduced.
In a rational political world, this 1,990-page runaway train would have been derailed months ago. With spending and debt already at record peacetime levels, the bill creates a new and probably unrepealable middle-class entitlement that is designed to expand over time. Taxes will need to rise precipitously, even as ObamaCare so dramatically expands government control of health care that eventually all medicine will be rationed via politics.
Yet at this point, Democrats have dumped any pretense of genuine bipartisan "reform" and moved into the realm of pure power politics as they race against the unpopularity of their own agenda. The goal is to ram through whatever income-redistribution scheme they can claim to be "universal coverage." The result will be destructive on every level—for the health-care system, for the country's fiscal condition, and ultimately for American freedom and prosperity.
•The spending surge. The Congressional Budget Office figures the House program will cost $1.055 trillion over a decade, which while far above the $829 billion net cost that Mrs. Pelosi fed to credulous reporters is still a low-ball estimate. Most of the money goes into government-run "exchanges" where people earning between 150% and 400% of the poverty level—that is, up to about $96,000 for a family of four in 2016—could buy coverage at heavily subsidized rates, tied to income. The government would pay for 93% of insurance costs for a family making $42,000, 72% for another making $78,000, and so forth.
At least at first, these benefits would be offered only to those whose employers don't provide insurance or work for small businesses with 100 or fewer workers. The taxpayer costs would be far higher if not for this "firewall"—which is sure to cave in when people see the deal their neighbors are getting on "free" health care. Mrs. Pelosi knows this, like everyone else in Washington.
Even so, the House disguises hundreds of billions of dollars in additional costs with budget gimmicks. It "pays for" about six years of program with a decade of revenue, with the heaviest costs concentrated in the second five years. The House also pretends Medicare payments to doctors will be cut by 21.5% next year and deeper after that, "saving" about $250 billion. ObamaCare will be lucky to cost under $2 trillion over 10 years; it will grow more after that.
• Expanding Medicaid, gutting private Medicare. All this is particularly reckless given the unfunded liabilities of Medicare—now north of $37 trillion over 75 years. Mrs. Pelosi wants to steal $426 billion from future Medicare spending to "pay for" universal coverage. While Medicare's price controls on doctors and hospitals are certain to be tightened, the only cut that is a sure thing in practice is gutting Medicare Advantage to the tune of $170 billion. Democrats loathe this program because it gives one of out five seniors private insurance options.
As for Medicaid, the House will expand eligibility to everyone below 150% of the poverty level, meaning that some 15 million new people will be added to the rolls as private insurance gets crowded out at a cost of $425 billion. A decade from now more than a quarter of the population will be on a program originally intended for poor women, children and the disabled.
Even though the House will assume 91% of the "matching rate" for this joint state-federal program—up from today's 57%—governors would still be forced to take on $34 billion in new burdens when budgets from Albany to Sacramento are in fiscal collapse. Washington's budget will collapse too, if anything like the House bill passes.
• European levels of taxation. All told, the House favors $572 billion in new taxes, mostly by imposing a 5.4-percentage-point "surcharge" on joint filers earning over $1 million, $500,000 for singles. This tax will raise the top marginal rate to 45% in 2011 from 39.6% when the Bush tax cuts expire—not counting state income taxes and the phase-out of certain deductions and exemptions. The burden will mostly fall on the small businesses that have organized as Subchapter S or limited liability corporations, since the truly wealthy won't have any difficulty sheltering their incomes.
This surtax could hit ever more earners because, like the alternative minimum tax, it isn't indexed for inflation. Yet it still won't be nearly enough. Even if Congress had confiscated 100% of the taxable income of people earning over $500,000 in the boom year of 2006, it would have only raised $1.3 trillion. When Democrats end up soaking the middle class, perhaps via the European-style value-added tax that Mrs. Pelosi has endorsed, they'll claim the deficits that they created made them do it.
Under another new tax, businesses would have to surrender 8% of their payroll to government if they don't offer insurance or pay at least 72.5% of their workers' premiums, which eat into wages. Such "play or pay" taxes always become "pay or pay" and will rise over time, with severe consequences for hiring, job creation and ultimately growth. While the U.S. already has one of the highest corporate income tax rates in the world, Democrats are on the way to creating a high structural unemployment rate, much as Europe has done by expanding its welfare states.
Meanwhile, a tax equal to 2.5% of adjusted gross income will also be imposed on some 18 million people who CBO expects still won't buy insurance in 2019. Democrats could make this penalty even higher, but that is politically unacceptable, or they could make the subsidies even higher, but that would expose the (already ludicrous) illusion that ObamaCare will reduce the deficit.
• The insurance takeover. A new "health choices commissioner" will decide what counts as "essential benefits," which all insurers will have to offer as first-dollar coverage. Private insurers will also be told how much they are allowed to charge even as they will have to offer coverage at virtually the same price to anyone who applies, regardless of health status or medical history.
The cost of insurance, naturally, will skyrocket. The insurer WellPoint estimates based on its own market data that some premiums in the individual market will triple under these new burdens. The same is likely to prove true for the employer-sponsored plans that provide private coverage to about 177 million people today. Over time, the new mandates will apply to all contracts, including for the large businesses currently given a safe harbor from bureaucratic tampering under a 1974 law called Erisa.
The political incentive will always be for government to expand benefits and reduce cost-sharing, trampling any chance of giving individuals financial incentives to economize on care. Essentially, all insurers will become government contractors, in the business of fulfilling political demands: There will be no such thing as "private" health insurance.
*** All of this is intentional, even if it isn't explicitly acknowledged. The overriding liberal ambition is to finish the work began decades ago as the Great Society of converting health care into a government responsibility. Mr. Obama's own Medicare actuaries estimate that the federal share of U.S. health dollars will quickly climb beyond 60% from 46% today. One reason Mrs. Pelosi has fought so ferociously against her own Blue Dog colleagues to include at least a scaled-back "public option" entitlement program is so that the architecture is in place for future Congresses to expand this share even further.
As Congress's balance sheet drowns in trillions of dollars in new obligations, the political system will have no choice but to start making cost-minded decisions about which treatments patients are allowed to receive. Democrats can't regulate their way out of the reality that we live in a world of finite resources and infinite wants. Once health care is nationalized, or mostly nationalized, medical rationing is inevitable—especially for the innovative high-cost technologies and drugs that are the future of medicine.
Mr. Obama rode into office on a wave of "change," but we doubt most voters realized that the change Democrats had in mind was making health care even more expensive and rigid than the status quo. Critics will say we are exaggerating, but we believe it is no stretch to say that Mrs. Pelosi's handiwork ranks with the Smoot-Hawley tariff and FDR's National Industrial Recovery Act as among the worst bills Congress has ever seriously contemplated.
"Transparency Mañana Nancy Pelosi backs off her commitment to a 72-hour online," by John Fund, The Wall Street Journal, November 6, 2009 --- Click Here
Back in September, House Speaker Nancy Pelosi told reporters she was "absolutely" committed to having the final language of any health care bill posted on the Internet for 72 hours before a vote on the House floor.
Well, the bill isn't finished, with major issues such as taxpayer funding of abortions and rules governing amendments still unresolved. Nonetheless, the Speaker is rushing towards a Saturday vote on the bill.
Back on September 24, the Weekly Standard asked Ms. Pelosi at a news conference: "Do you support the measure to put the final House bill online for 72 hours before it's voted on at the very end?" Her response was "Absolutely. Without question."
But now Pelosi spokesman Brendan Daly tells the Standard: "No, [the] pledge was to have manager's amendment online for 72 hours and we will do that." The manager's amendment makes major changes to a bill (witness the 309-page monstrosity dropped on Congress just before July's vote on the "cap-and-trade" global warming bill). But it's not the final bill, so Speaker Pelosi's pledge last September was hollow.
Mrs. Pelosi viewed rushing to judgment on bills differently when she was in the minority. In 2004, she unveiled a proposed "Bill of Rights" to protect House minority interests, which included giving members enough time to read bills and a stop to the practice of holding votes open well past the normal 15 minutes. She had a point: In late 2003, Republican leaders held open a roll-call vote on the Medicare drug entitlement for three hours until they bullied enough wavering members into voting aye.
"When we [Democrats] are shut out, they are shutting out the great diversity of America. We want a higher standard," Ms. Pelosi said at the time. In 2006, just before becoming speaker, she reiterated her plans to promote "bipartisanship" and "to ensure the rights of the minority."
That was then. Now Ms. Pelosi is intent on using her political machine to run roughshod over opposition. Republican consultant Alex Castellanos notes that Democrats are replicating the worst practices of the Bush Republicans: "It is ironic that Obama and the Democrats are becoming the very thing they worked so hard to reject. Democrats criticized George W. Bush and the Republicans for not listening to Americans and being blindly ideological and inflexible. They might as well put on his swaggering Texas belt-buckle. They have caught the disease they tried to cure."
Lie: Requiring private insurers to cover all pre-existing health conditions from Day 1 will actually reduce the premiums for medical insurance.
We believe premiums would come down for several
reasons. Companies would no longer need to spend as much money on administrative
costs, to screen out people with pre-existing conditions (prohibited by all
reform bills). If they wanted to participate on the exchanges (and have access
to millions of new customers), the companies would also be forced to compete
with other private plans, and possibly a public option, encouraging them to
lower premiums and accept lower profits.
The New York Times Editorial, November 1, 2009 ---
http://www.nytimes.com/2009/11/01/opinion/01sun1.html?hp
Jensen Comment
You can argue for coverage of all new insureds irrespective of pre-existing
conditions on the basis of social equity, but the reasoning of the NYT editorial
above is pure hogwash. If this were true at least one medical insurance company
would've added to profits by ending pre-screening expenses. Pre-existing
conditions often require the most expensive kinds of treatment for such things
as organ transplants, cataracts, kidney dialysis, etc.
Also eliminating pre-existing conditions coupled with the inevitable coverage of illegal immigrants creates moral hazard in that when Grandma Lopez in Mexico City needs an eye operation, her relatives will float her across the Rio Grande primarily for immediate $25,000 eye surgery. If she wants to return she might even walk back across the border unassisted after she can see better.
States like Texas that have capped punitive damages in medical lawsuits
probably may not keep their limiting caps according to pending Obamacare
legislation. Such caps purportedly have significantly lowered medical insurance
rates in those states.
"Pelosi Health Care Bill Blows a Kiss to Trial
Lawyers," Andrew Breitbart, October 30, 2009 ---
Click Here
The health care bill recently unveiled by Speaker Nancy Pelosi is over 1,900 pages for a reason. It is much easier to dispense goodies to favored interest groups if they are surrounded by a lot of legislative legalese. For example, check out this juicy morsel to the trial lawyers (page 1431-1433 of the bill):
Section 2531, entitled “Medical Liability Alternatives,” establishes an incentive program for states to adopt and implement alternatives to medical liability litigation. [But]…… a state is not eligible for the incentive payments if that state puts a law on the books that limits attorneys’ fees or imposes caps on damages.
So, you can’t try to seek alternatives to lawsuits if you’ve actually done something to implement alternatives to lawsuits. Brilliant! The trial lawyers must be very happy today!
While there is debate over the details, it is clear that medical malpractive lawsuits have some impact on driving health care costs higher. There are likely a number of procedures that are done simply as a defense against future possible litigation. Recall this from the Washington Post:
“Lawmakers could save as much as $54 billion over the next decade by imposing an array of new limits on medical malpractice lawsuits, congressional budget analysts said today — a substantial sum that could help cover the cost of President Obama’s overhaul of the nation’s health system. New research shows that legal reforms would not only lower malpractice insurance premiums for medical providers, but would also spur providers to save money by ordering fewer tests and procedures aimed primarily at defending their decisions in court, Douglas Elmendorf, director of the nonpartisan Congressional Budget Office, wrote in a letter to Sen. Orrin Hatch (R-Utah).”
"Canadian Malpractice Insurance Takes Profit Out Of
Coverage," by Jane Akre, Injury Board, July 28, 2009 ---
Click Here
http://www.injuryboard.com/national-news/canadian-malpractice-insurance-takes-profit-out-of-coverage.aspx?googleid=267890
The St. Petersburg Times takes a look at the cost of insurance in Canada for health care providers.
A neurosurgeon in Miami pays about $237,000 for medical malpractice insurance. The same professional in Toronto pays about $29,200, reports Susan Taylor Martin.
A Canadian orthopedic surgeon pays just over $10,000 for coverage that costs a Miami physician $140,000. An obstetrician in Canada pays $36,353 for insurance, while a Tampa Bay obstetrician pays $98,000 for medical malpractice insurance.
Why the difference?
In the U.S., private for-profit insurance companies extend medical malpractice coverage to doctors.
In Canada, physicians are covered through membership in a nonprofit. The Canadian Medical Protective Association offers substantially reduced fees for the same coverage, especially considering that their payout is limited by caps in Canada just as in some U.S. states.
In 1978, the Canadian Supreme Court limited pain and suffering awards to just over $300,000, circumventing the opportunity for a jury to decide on an award depending on the case before them.
Canadian Medical Protective Association
Here’s how it works.
Fees for membership vary depending on the region of the country in which the doctor works and their specialty. All neurosurgeons in Ontario will pay the same, for example. The number of claims they have faced for medical malpractice does not figure into their premium
"We don't adjust our fees based on individual experience; it's the experience of the group,'' says Dr. John Gray, the executive director, "That's what the mutual approach is all about, and it helps keep the fees down for everyone,” he tells the St. Petersburg Times.
If a doctor is sued, the group pays the claim and provides legal counsel.
In the U.S., the push has been on for limiting claims, no matter how egregious the medical malpractice. President Obama was booed in June when, before the American Medical Association, he said he would not limit a malpractice jury award.
"We got a crazy situation where Obama is talking about the cost of medicine but he said, 'I don't believe in caps,' " complains Dr. Dennis Agliano, past president of the Florida Medical Association. "If you don't have caps, the sky's the limit and there's no way to curtail those costs.''
But the importance of limiting jury awards may not play into the big picture on health care reform.
Malpractice lawsuits amount to less than one percent of both the Canadian and the U.S. healthcare system, meanwhile between 44,000 and 98,000 Americans die each year due to medical errors in hospitals alone, while 16 times as many suffer injuries without receiving any compensation, reports the group Americans for Insurance Reform.
Major Difference
In Canada, an injured patient is often required to pay for the initial investigation into his case. In the U.S. the contingency fee basis, usually in the range of 30 percent, allows the injured party to proceed without a financial downside.
In both the U.S. and Canada, the definition of medical negligence is that a duty of care was owed to the patient by the physician, there was a breach h of the standard of care and the patient suffered harm by the physician’s failure to meet that standard of care.
A bad outcome in itself is not the basis of a lawsuit.
The Canadian Medical Protective Association insures virtually all of the country’s 76,000 doctors, as opposed to the U.S. where private for-profit insurance companies cover physicians for medical malpractice.
In Canada, the median damaged paid in 2007 was $91,999 and judgments favored patients 25 times, doctors 70 times.
In the U.S., many physician groups are requiring patients to waive their rights to a jury trial, even though malpractice litigation accounts for just 0.6 percent of healthcare costs.
Public Citizen, the consumer group, charges that the facts don’t warrant the “politically charged hysteria surrounding medical malpractice litigation.”
For the third straight year, medical malpractice payments were at record lows finds the group in a study released this month. The decline, however, is likely due to fewer injured patients receiving compensation, not improved health safety.
2008 saw the lowest number of medical malpractice payments since the federal government’s National Practitioner Data Bank began compiling malpractice statistics. In 2008, payments were 30.7 percent lower than averages recorded in all previous years.
In the report titled, The 0.6 Percent Bogeyman, the nonprofit watchdog group states, “between three and seven Americans die from medical errors for every 1 who receives a payment for any type of malpractice claim.”
Public Citizen previously reported that about five percent of doctors are responsible for half of the medical malpractice in the U.S. that can result in permanent injury or death. #
Read more: http://www.injuryboard.com/national-news/canadian-malpractice-insurance-takes-profit-out-of-coverage.aspx?googleid=267890#ixzz0W0Z71JOP
"The Return of the Inflation Tax: The Pelosi tax surcharge applies to capital gains and dividends," The Wall Street Journal, November 6, 2009 --- Click Here
All of those twentysomethings who voted for Barack Obama last year are about to experience the change they haven't been waiting for: the return of income tax bracket creep. Buried in Nancy Pelosi's health-care bill is a provision that will partially repeal tax indexing for inflation, meaning that as their earnings rise over a lifetime these youngsters can look forward to paying higher rates even if their income gains aren't real.
In order to raise enough money to make their plan look like it won't add to the deficit, House Democrats have deliberately not indexed two main tax features of their plan: the $500,000 threshold for the 5.4-percentage-point income tax surcharge; and the payroll level at which small businesses must pay a new 8% tax penalty for not offering health insurance.
This is a sneaky way for politicians to pry more money out of workers every year without having to legislate tax increases. The negative effects of failing to index compound over time, yielding a revenue windfall for government as the years go on. The House tax surcharge is estimated to raise $460.5 billion over 10 years, but only $30.9 billion in 2011, rising to $68.4 billion in 2019, according to the Joint Tax Committee.
Americans of a certain age have seen this movie before. In 1960, only 3% of tax filers paid a 30% or higher marginal tax rate. By 1980, after the inflation of the 1970s, the share was closer to 33%, according to a Heritage Foundation analysis of tax returns.
These stealth tax increases—forcing ever more Americans to pay higher tax rates on phantom gains in income—were widely seen to be unjust. And in 1981 as part of the Reagan tax cuts, a bipartisan coalition voted to index the tax brackets for inflation.
We also know what has happened with the Alternative Minimum Tax. Passed to hit only 1% of all Americans in 1969, the AMT wasn't indexed for inflation at the time and neither was Bill Clinton's AMT rate increase in 1993. The number of families hit by this shadow tax more than tripled over the next decade. Today, families with incomes as low as $75,000 a year can be hit by the AMT unless Congress passes an annual "patch."
The Pelosi-Obama health tax surcharge will have a similar effect. The tax would begin in 2011 on income above $500,000 for singles and $1 million for joint filers. Assuming a 4% annual inflation rate over the next decade, that $500,000 for an individual tax filer would hit families with the inflation-adjusted equivalent of an income of about $335,000 by 2020. After 20 years without indexing, the surcharge threshold would be roughly $250,000.
And by the way, this surcharge has also been sneakily written to apply to modified adjusted gross income, which means it applies to both capital gains and dividends that are taxed at lower rates. So the capital gains tax rate that is now 15% would increase in 2011 to 25.4% with the surcharge and repeal of the Bush tax rates. The tax rate on dividends would rise to 45% from 15% (5.4% plus the pre-Bush rate of 39.6%).
As for the business payroll penalty, it is imposed on a sliding scale beginning at a 2% rate for firms with payrolls of $500,000 and rising to 8% on firms with payrolls above $750,000. But those amounts are also not indexed for inflation, so again assuming a 4% average inflation rate in 10 years this range would hit payrolls between $335,000 and $510,000 in today's dollars. Note that in pitching this "pay or play" tax today, Democrats claim that most small businesses would be exempt. But because it isn't indexed, this tax will whack more and more businesses every year. The sales pitch is pure deception.
As for the Senate, instead of the 5.4% surcharge, the Finance Committee bill raises taxes on "high-cost" health care plans. But this too uses the inflation ruse. The Senate bill indexes its tax proposal for the inflation rate plus one percentage point. But that is only about half as high as the rate of overall health-care inflation, i.e., the rate of increase in health-care premiums. So the Joint Tax Committee has found that a Senate tax that starts in 2013 by hitting 13.8 million Americans will hit 39.1 million by 2019.
The return of the inflation tax demonstrates once again the stealth radicalism that animates ObamaCare. In the case of inflation indexing, Democrats would repeal a 30-year bipartisan consensus that it is unfair to tax unreal gains in income, thus hitting millions of middle-class Americans over time with tax rates advertised as only hitting "the rich." Oh, and the House vote on this exercise in dishonest government will come as early as Saturday.
"Obamacare: Startling New Revelations Scare Public," by Floyd and Mary Beth Brown, Townhall, October 29, 2009 -http://townhall.com/columnists/FloydandMaryBethBrown/2009/10/29/obamacare_startling_new_revelations_scare_public
First, we learned that a $500 billion cut in Medicare will dramatically affect the quality and quantity of healthcare available to America's senior citizens. Grandma's access is being slashed to add illegal immigrants and twenty-somethings into the insurance system. However, this revelation pales in relation to what we heard this week.
Here's the latest shock: Average current health insurance premiums with likely triple under Obamacare.
The new data comes from a well regarded, state-by-state study conducted for WellPoint, Inc. The most dramatic premium boosts will hit young people. These are the actual individuals that often opt out of insurance plans now.
Reaction from the Obama White House was swift and harsh. Linda Douglass, Obama's healthcare spokesperson, had the audacity to compare the health insurance firm with tobacco companies. Since the White House refuses to argue the facts, they instead turned to using one of their favorite tactics, which is demonizing any voices of dissent.
The reason for the dramatic insurance premium increases is the result of Obamacare regulations. First cause is the mandate that insurance companies take any customer. Insurance traditionally is an actuarial business that rates different customers based on risk factors. This is the reason a driver aged 19 with two speeding tickets pays more for auto insurance than a customer aged 35 with no speeding tickets. Nineteen-year-olds have more accidents. Therefore they pose more risk.
Traditionally, health insurance companies charged customers with risk factors and chronic illness more than young, healthy 19-year-olds. Obamacare stands the concept of insurance on its head. Since an insurance company will be forced to sell to any sick patient, the incentive to buy insurance when you are healthy decreases. Why not wait until you are sick; get cancer, diabetes or some other severe illness before you buy? To circumvent this problem, Obama is riddling the program with police-state mandates on healthy, younger citizens. Perverted, negative incentives such as threats of large fines and even prison time will hang over young people's heads to force them to join and stay enrolled in Obama's healthcare scheme. Does this sound like America to you?
Democratic leaders in Congress are seeing support slip through their fingers because Americans are learning that they will end up paying more for less-adequate care. The beneficiaries of this plan are still lobbying hard. Big business will likely dump most of their current employee-based plans and pay the less expensive tax. Big unions are facing the reality that they are going to be bankrupted by their generous membership health plans. Many want to dump their responsibilities on the new government option recently revived by Senate Majority Leader Harry Reid, D-Nev. AARP is salivating at the money they will make selling new, bigger Medicare-gap plans after the current program is gutted.
Continued in article
"The Health Care Fatal Conceit," by Star Parker, Townhall,
October 26, 2009 ---
http://townhall.com/columnists/StarParker/2009/10/26/the_health_care_fatal_conceit
Nobel prize winning economist F.A.Hayek called socialism "the fatal conceit."
Why conceit? Because socialism's basic premise, according to Hayek, is that "man is able to shape the world around him according to his wishes."
Why fatal? Because, like all falsehoods and misconceptions, it leads to failure, and sometimes disaster.
Although the socialist label is being thrown around a lot now, we must recognize this isn't new. This conceit has been inflating in American hearts and minds for years, with the inexorable growth of government and the ongoing change in American attitudes about what government is about.
If there is anything new today, it's the extent to which we're taking this.
The Declaration of Independence, signed by our founders, states that man has the "unalienable rights" to "life, liberty and the pursuit of happiness" and that men form government to "secure these rights." According to Jefferson's words, the purpose of the government is to protect me.
Now Congress is moving health-care legislation in which the role of government will evolve to defining what health insurance is, forcing me to buy a policy that covers what government dictates, tracking my behavior through the IRS to see if I have complied, fining me if I haven't, and sending me to jail if I refuse to do it.
Government will expand to tell employers that they have to provide government-defined insurance to their employees or be fined. And government will tell insurance companies who they have to insure and how much they can charge to do it.
And we'll spend $1 trillion dollars or so that will come one way or another out of taxpayer hides to subsidize individuals who can't afford to buy this government defined health insurance.
Whoa! Wasn't this country supposed to be about freedom?
Didn't Jefferson write those words because the colonists who came to this then-unsettled continent wanted to get kings and tyrants off their backs?
Most of the Declaration is a long list of King George's violations of colonists' freedom.
It's worth being reminded of how it starts.
"The History of the present King of Great Britain is a history of repeated Injuries and Usurpations, all having in direct Object the Establishment of an absolute Tyranny over these States."
Continued in article
"Regarding Harry: The public option diverts attention from the legislation's real," by Kimberly Strassel, The Wall Street Journal, October 29, 2009 --- Click Here
You couldn't swing a cat this week without hitting a discussion of the public option. Somewhere, in some Capitol office, Senate Majority Leader Harry Reid is grinning.
Two weeks ago, the subject of a government-run insurance plan was a sore point with the Nevadan. He didn't have the votes for it, his base was bitter, and he didn't want to talk about it. This week, a transformed Mr. Reid devoted an entire news conference to it. Americans support the public option! His caucus supports a public option! He supports a public option! The public option is in! No problem!
In the real world, this kind of behavioral shift lands you in a psych ward. In Washington, the press just marked it down to forces bigger than Harry. The majority leader had been pushed into a public option by his liberal members, we were told. Chuck Schumer was scarier than Ben Nelson. The Huffington Post was even scarier than Chuck Schumer. Poor Mr. Reid, clucked observers, had been backed into a corner.
Maybe. Then again, maybe he is majority leader for a reason. Maybe Mr. Reid didn't just wander out of the Nevada desert. Maybe he has a plan. Maybe, just maybe, he sees a big upside in turning the public option into the centerpiece of the health-care debate. After all, what does he have to lose?
Up for re-election next year, Mr. Reid is facing Nevada polls that suggest he's lost most voters outside his base. His base too, was slipping, with Moveon.org making him a punching bag for not embracing the public option. With this week's announcement, he is once again the hero of the left, and has that baboon off his back.
Who knows? It might even work. Mr. Reid included the fig leaf of an "opt-out" for states that don't want the public option. It's a ruse, but it might provide cover for votes. If not, he's got room to maneuver. There's the "opt-in" alternative, which even some Republicans claim to like. There's the fall-back "trigger," which re-earns him Olympia Snowe.
And if it doesn't fly, well, is that so bad? Mr. Reid can still say he gave it the varsity try. He'll get it to the floor and let those swing-state Democrats amend the public option away. Not his fault! What he also knows, even if the press doesn't, is that for all the big talk of his liberal members, they are the more likely to give way. Even without a public option, this bill is a big step toward a single-payer system. And it isn't as if any of them risk losing their seats by voting "only" for a $1 trillion health expansion.
Better yet, by turning the public option into the big, bad bogeyman, he makes it more likely he'll snag those swing-state votes in the end. Nebraska's Mr. Nelson, Arkansas's Blanche Lincoln, Indiana's Evan Bayh—they can all claim victory for stripping the bill of a national insurance plan, then feel comfortable voting for all the tax hikes and Medicare cuts that remain.
Speaking of tax hikes, premium jumps and Medicare cuts, notice how nobody is today talking about them? Mr. Reid surely has. The public option might be controversial in D.C., but the majority leader knows most of the country doesn't understand it, or assumes it doesn't apply to them. Most Americans already have health care that they like, and polls show their real fear is that this experiment will leave them paying more for less. This, not the public option, is ObamaCare's exposed jugular.
The insurers get this, which is why (as they now try to bottle the genie they helped loose) they are issuing reports on how "reform" will double or triple premium prices. It is why America's Health Insurance Plans, the lobby group, has run ads in swing states warning about huge cuts to Medicare Advantage. Some of the grass roots get it, too, which is why Americans for Tax Reform is now live on TV in Nebraska noting Sen. Nelson has signed its taxpayer pledge and that he'd violate it by voting for the bill's nearly $500 billion in tax increases.
If Mr. Reid had pulled the plug on the public option, these highly unpopular policy issues would be front and center. As it is, the public-option sideshow is sucking up all the air, and will continue to. It even overshadowed liberal divisions, such as union pushback on Cadillac-plans taxes. Maybe, just maybe, Mr. Reid likes it that way.
Granted, this is the cynic's view of Democrats' health-care strategy. Mr. Reid did, after all, goof last week, failing to round up the votes to pass his party's proposed "fix" to Medicare reimbursement rates. Maybe he doesn't know which way is up. Maybe he is taking a flier.
Then again, anyone who has watched this debate has earned the right to cynicism. Democrats are determined to get a health bill, and Mr. Reid is no rube. His opponents—those trying to save the country from this wreck of a bill—would be wise not to forget it
Updates for October 26, 2009
The Wall Street Journal Guide to Obamacare, October 14,
2009 ---
Click Here
http://online.wsj.com/article/SB10001424052748704471504574441193211542788.html?mod=djemEditorialPage
Obamacare Chart --- http://www.trinity.edu/rjensen/ObamaCareChart.pdf
"Follow the Money," by Ben Shapiro, Townhall,
October 21, 2009 ---
http://townhall.com/columnists/BenShapiro/2009/10/21/follow_the_money
"WaPo/ABC poll uses skewed sample to show public-option
support," HotAir, October 20, 2009 ---
http://hotair.com/
"Brouhaha erupts over PwC private health insurance report,"
AccountingWeb, October 21, 2009 ---
http://www.accountingweb.com/topic/cfo/brouhaha-erupts-over-pwc-private-health-insurance-report
PricewaterhouseCoopers (PwC) has found itself at the center of a controversy over its estimates of cost increases in private health insurance premiums if certain provisions of the heath care reform bill passed by the Senate Finance Committee become law. PwC was engaged to conduct the study, "Potential Impact of Health Reform on the Cost of Private Health Insurance Coverage," by the American Health Insurance Plans (AHIP). Critics have questioned the methodology used by PwC, saying it does not take into consideration some of the cost containment measures in the bill and potential behavioral responses that could affect premium increases.
AHIP president and CEO Karen Ignagni told ABC News, "One of the most important things that should be done is for PricewaterhouseCoopers, a world class firm, to speak for itself about methodology."
PwC defends its analysis and conclusions in a statement provided to AccountingWEB, citing the specific parameters of the study, saying that "America's Health Insurance Plans engaged PricewaterhouseCoopers to prepare a report that focused on four components of the Senate Finance Committee proposal:
* Insurance market reforms and consumer protections that would raise health insurance premiums for individuals and families if the reforms are not coupled with an effective coverage requirement.
* An excise tax on employer-sponsored high value health plans.
* Cuts in payment rates in public programs that could increase cost shifting to private sector businesses and consumers.
* New taxes on health sector entities.The study concluded that collectively the four provisions would raise premiums for private health insurance coverage. As the report itself acknowledges, other provisions that are part of health reform proposals were not included in the PwC analysis."
By 2019, the study says, after analysis of these four provisions, the cost of single coverage is expected to increase by $1,500 more than it would under the current system and the cost of family coverage is expected to increase by $4,000 more than it would under the current system. This amounts to an additional 18 percent increase in premiums by 2019. The overall 18 percent increase is a composite of increases by market segment as follows:
* 49% increase for the non-group (individual) market;
* 28% increase for small employers (those firms with fewer than 50 employees);
* 11% increase for large employers with insured coverage; and,
* 9% increase for self-insured employers.The highest increase would be for individuals covered by private insurance.
In its discussion of a "Strong Workable Coverage Requirement," the study acknowledges it methodology as it does elsewhere in the report. "The reform packages under consideration have other provisions that we have not included in this analysis. We have not estimated the impact of the new subsidies on the net insurance cost to households. Also, if other provisions in health care reform are successful in lowering costs over the long term, those improvements would offset some of the impacts we have estimated." The analysis of the coverage requirement shows the potential impact on premiums for individuals without a broad coverage requirement."
PwC says that impacts identified in the study assume payment of tax on high-value plans, cost-shifting of cuts to public programs, and full pass-through of industry taxes.
The PwC study also states that it factored in the excise tax but not any anticipated behavioral changes: "We have estimated the potential impact of the tax on premiums," the study says. "Although we expect employers to respond to the tax by restructuring their benefits to avoid it, we demonstrate the impact assuming it is applied."
In an earlier study based on AHIP data, PwC estimated that structural reforms, such as improved wellness and prevention, disease management, value based payment reform, improvements in health information technology, comparative effectiveness, and malpractice reform, could mitigate growth in healthcare costs by between 0.5 and 1.0 percent per year after an initial investment period. See PricewaterhouseCoopers "A Review of AHIP Savings Estimates" in Appendix to AHIP, "A Shared Responsibility," 2008.
Bob Jensen's threads on the health care mess are at
http://www.trinity.edu/rjensen/Health.htm
"'Conceptual Language' Hides Health Care's Costs," by Michael
Barone, Townhall, October 12, 2009 ---
http://townhall.com/columnists/MichaelBarone/2009/10/12/conceptual_language_hides_health_cares_costs
Some of the headlines in recent days are not worthy of belief. No, I'm not referring to the headlines that Barack Obama won the Nobel Peace Prize, however odd that many seem to many (including, it seems, Obama himself). I'm referring to the headlines earlier in the week to the effect that the health care bill sponsored by Senate Finance Committee Chairman Max Baucus will cut the federal deficit by $81 billion over the next 10 years.
Yes, that is what the Congressional Budget Office estimated. But, as the CBO noted, there's no actual Baucus bill, just some "conceptual language." Actual language, CBO noted, might result in "significant changes" in its estimates. No wonder Democratic congressional leaders killed requirements that the actual language be posted on the Internet for 72 hours before Congress votes.
More significant is the number most publications did not put in their headlines and lead paragraphs: CBO's estimate that the Baucus "conceptual language" would increase federal spending by $829 billion over 10 years. So how do you increase federal spending and cut the deficit at the same time?
One way is taxes. The Baucus conceptual language includes a tax on high-cost insurance plans ($210 billion), penalties for not having insurance ($27 billion) and "indirect offsets" (whatever they are -- $83 billion).
In addition, costs are fobbed off on state governments in the form of more Medicaid spending, and savings are projected from future reductions in Medicare that will surely turn out to be imaginary (Congresses of both parties have acted to prevent such reductions every year since 2003).
We know from past experience that cost estimates of all government health care programs (except the 2003 Medicare Part D prescription drug benefit, which has private market competition) tend to understate actual costs. So the Baucus bill -- er, conceptual language -- if enacted is likely to expand government spending by more than the estimated $829 billion.
And perhaps quite a bit more. The Baucus measure enables families without employer-provided insurance to obtain it at exchanges with subsidies that make it cost less than what those with employer-provided insurance pay. The latter are a majority of voters -- how long are their elected representatives going to let this disadvantage stand?
The Baucus measure subsidizes low-income families. Say you make $48,000 a year and get a $900 subsidy. As your income rises, this subsidy would be phased out, raising your effective marginal tax rate to as much as 70 percent. How long will Congress let this stand?
Continued in article
"The Stressed German Model: It took the Germans 125 years to figure out that their health-care," The Wall Street Journal, October 10, 2009 --- http://online.wsj.com/article/SB10001424052748703746604574461573950211460.html
What if the Obama health-care proposal turned out to be the biggest public-policy mistake in 125 years?
Yesterday, these columns discussed the Congressional Budget Office's efforts to push the square peg of the Obama plan through the round hole of affordability. Meanwhile in Germany, often cited by American liberals as the "model" of a well-run health-care plan, the political debate is running in the opposite direction. Chancellor Angela Merkel's new coalition partner, the Free Democratic Party, is pressing her to claw back the state's participation in a system that now insures nine of 10 Germans.
Germany's health-care system was brought to life in 1883 by Otto von Bismarck and became the model for virtually every such state-directed national insurance plan since. Alas, the German system is starting to come apart at the financial seams. Germany's system relies on a handful of state-supported health insurers. This week they informed the government that the system was on the brink of a financial shortfall equal to nearly $11 billion.
Pointedly, the insurers made clear that cutbacks alone won't solve the problem. They said the government would have to consider raising premiums on the insured or, you guessed it, raise taxes. Currently, German workers pay a fixed-rate premium into the insurance scheme; that rate is now set at 14.9% of gross pay.
Chancellor Merkel, something of a political acrobat, was previously allied in coalition with leftist Social Democrats. She's now resisting calls from the Free Democrats to get off the state-pulled health-care train. The FDP's spokesman on health, Daniel Bahr, wants a "shift in direction away from state-run medicine." Why? Because "the current financial figures have showed us that the health-care fund doesn't work."
With Congress inching ever closer to passing a greater federal presence in providing health insurance under ObamaCare, let's hope it doesn't take the U.S. until the year 2134 to figure out it isn't working.
Updates for October 15, 2009
The Wall Street Journal Guide to Obamacare, October 14, 2009 ---
Click Here
http://online.wsj.com/article/SB10001424052748704471504574441193211542788.html?mod=djemEditorialPage
"The Trouble With Health Care Is Paying For It," by Michael Barone, Townhall,
October 15, 2009 ---
http://townhall.com/columnists/MichaelBarone/2009/10/15/the_trouble_with_health_care_is_paying_for_it
Baucus' bill would impose $829 billion in added costs, financed by a variety of taxes and spending cuts that are just as dubious. One is a tax on so-called Cadillac health insurance plans. But unions that have negotiated such plans are opposed, and House Democratic leaders are uninterested. Another is a tax on makers of medical devices that will be paid for by consumers. Critics have pointed out that most of these taxes will fall on people with ordinary incomes, far below the $250,000-plus moguls that Barack Obama said would bear all his tax increases.
Another Baucus tax is the penalties that would be paid by those who don't buy health insurance. But the penalties in his bill are so low that many will choose to pay them and go uninsured, thus foiling the goal of lowering the uninsured percentage. And as the insurers' lobbying group has pointed out, this will increase premium costs for those who are insured -- a form of tax on those behaving the way Baucus wants.
Then there are the Medicare cuts that supposedly would finance the Baucus bill. But this Congress can't bind future Congresses, and Congresses controlled by both parties have regularly cancelled projected cuts in reimbursement rates. Democratic leaders have made this easier by exempting such actions from its pay-go rules.
So as Michael Cannon of the Cato Institute points out, "Universal coverage is so expensive that Congress can't get there without taxing Democrats." So when those taxes are cut on low and middle earners, there's not enough money to finance the deals the White House has been making with health care interest groups.
The insurers and medical device people are squawking now -- look for more squawking from pharmaceutical companies, hospitals and physicians' groups when they get targeted. House Speaker Nancy Pelosi has made it clear that she doesn't feel bound by deals the White House has made.
The Senate Finance Committee got bipartisan cover from Maine Republican Olympia Snowe. But Snowe says she was just voting to "continue the process" and won't necessarily vote for the bill Senate leaders will meld from the Finance and Health committee versions.
So the learning process may not be over. We know now that it costs a lot of money to pay for insurance policies with expanded coverage for an expanded number of people. And we know that no one wants to pay the price.
We may be in the process of learning something else. Which is that insurance coverage that further insulates patients from costs results in unanticipated increases in health care spending. Yes, it bends the cost curve, but in the wrong direction. That's what has happened with the much-praised Massachusetts system.
Democratic leaders may still have the votes to jam something through. In which case it could, as the Atlantic's Megan McArdle predicts, "spin out of control and eat a gigantic hole in the deficit." Who's going to pay for that?
Also see http://www.jewishworldreview.com/michael/barone101509.php3
"The Greatest Show on Earth: Step Right Up to the Entitlement That Cuts the Deficit," The Wall Street Journal, October -, 2009 --- Click Here
Washington spent the week waiting for the Congressional Budget Office to roll in with its new cost estimates of the Senate health-care bill, and what a carnival. Behold: a new $829 billion entitlement that will subsidize insurance for tens of millions of people—and reduce deficits by $81 billion at the same time. In the next tent, see the mermaid and a two-headed cow.
The political and media classes are proving they'll believe anything, as they are now pronouncing that this never-before-seen miracle is a "green light" for ObamaCare. (What isn't these days?) The irony is that the CBO's guesstimate exposes the fraudulence and fiscal sleight-of-hand underlying this whole exercise. Anyone who reads beyond the top-line numbers will find that the bill creates massive new spending commitments that will inevitably explode over time, and that this is "paid for" with huge tax increases plus phantom spending cuts that will never happen in practice.
The better part of the 10-year $829 billion overall cost will finance insurance "exchanges" where individuals and families could purchase coverage at heavily subsidized rates. Senate Finance Chairman Max Baucus kept a lid on the cost by making this program non-universal: Enrollment is limited to those who aren't offered employer-sponsored insurance and earn under 400% of the poverty level, or about $88,000 for a family of four. CBO expects some 23 million people to sign up by 2019.
But this "firewall" is unlikely to last even that long. Liberals are demanding heftier subsidies, and once people see the deal their neighbors are getting on "free" health care, they too will want in. Even CBO seems to find this unrealistic, noting "These projections assume that the proposals are enacted and remain unchanged throughout the next two decades, which is often not the case for major legislation." Scratch "often."
Then there are the many budget gimmicks. Take the "failsafe budgeting mechanism" that would require automatic cuts in exchange spending if it increases the deficit. CBO expects 15% reductions in exchange subsidies each year from 2015 to 2018, even though the exchanges don't open until 2014. That kind of re-gifting should have been laughed out of the committee room, but the ruse helps to move future spending off the current budget "score."
Mr. Baucus spends $10.9 billion to eliminate the scheduled Medicare cuts to physician payments—but only for next year. In 2011, he assumes they'll be reduced by 25%, with even deeper cuts later. Congress has overridden this "sustainable growth rate" every year since 2003 and will continue to do so because deeper cuts in Medicare's price controls will cause many doctors to quit the program. Fixing this alone would add $245 billion to the bill's costs, according to an earlier CBO estimate.
The Baucus bill also expands ailing Medicaid by $345 billion—even as it busts state budgets by imposing an additional $33 billion unfunded mandate. The only Medicare cut that isn't made merely on paper is $117 billion in Medicare Advantage, which Democrats hate because it gives one of five seniors private insurance options.
Recall that when President Obama started the health-care debate, the goal was "bending the curve"—finding a way to reduce both Medicare and overall health spending. Budget director Peter Orszag talked about "game changers," which CBO has now outed as nonchangers. Comparative effectiveness research about what treatments work best? That will save all of $300 million in Medicare, even as it costs $2.6 billion in new taxes on premiums. More prevention and primary care will increase spending by $4.2 billion.
Meanwhile, the bill piles on new taxes, albeit on health-care businesses so the costs are hidden from customers. Insurance companies offering policies that cost more than $8,000 for individuals and $21,000 for families will pay $201 billion per a 40% excise tax, which will be passed down to all policy holders in higher premiums. Another $180 billion will hit the likes of drug and device makers, including $29 billion because companies won't be allowed to deduct these "fees" from their corporate income taxes. Then there's the $4 billion in penalty payments on those who don't buy insurance because all of ObamaCare's other new taxes and mandates have made it more expensive.
Senate Finance votes next week, and no doubt this freak of political nature will pass amid fanfare and self-congratulation that their new entitlement will reduce deficits. Never mind that such a spectacle has never happened in the history of the republic. P.T. Barnum had nothing on this crowd, and the bill hasn't even hit the Senate floor yet.
VooDoo Accounting for Obamacare?
"Too Good to Check Want to cut the deficit? Just spend $829 billion!" by James
Taranto, The Wall Street Journal Best of the Web Today Newsletter, October 8,
2009
But here's something CNN has not, to our knowledge, bothered to fact-check:
A compromise health care proposal widely seen as having the best chance to win Democratic and Republican support would cost $829 billion over the next 10 years, nonpartisan budget analysts concluded Wednesday.
It also would reduce the federal deficit by more than $80 billion, according to a report from the Congressional Budget Office.
So Congress is going to reduce the deficit by increasing spending $829,000,000,000.00? Doesn't this sound like--well, a joke? Too good a joke to check, evidently.
Through what voodoo exactly does the CBO surmise Congress will cut the deficit while spending close to a trillion dollars? CNN does not even attempt to detail the argument. Instead we have to turn to Megan McArdle of The Atlantic:
Virtually all of the extra benefit appears to come from estimating that employers will see their health care costs fall, mostly because they put those workers into federally subsidized programs, pass the resulting savings along to their workers in the form of higher wages and salaries, and that the Treasury will thereby gain, at a rough guess, about $12-15 billion a year in tax revenues.
This is somewhat confusing to me. The CBO seems to be assuming it will get just about 20% of the amount spent on subsidies back in the form of tax revenues. But the effective income tax rate on the quintiles covered by the subsidies, according to the CBO, is less than 5%. Perhaps the savings comes from the payroll tax, but even including the payroll tax, it's less than 15%. And the tax rates are directly proportional to the size of the income, while the subsidies are inversely proportional. I'm sure I'm missing something that would make the math work, but I can't figure out what.
"New Math Boosts Health Plan Budget Office Says: Senate Bill Will Trim Deficit; Democrats Still Split on Key Details," by Janet Adamy and Jonathan Weisman, The Wall Street Journal, October 8, 2009 ---
The latest Senate health bill will cost $829 billion over a decade and slightly reduce the federal budget deficit, congressional budget crunchers said Wednesday, marking a major step forward for Democrats' plans to overhaul American health care.
The nonpartisan Congressional Budget Office found the sweeping measure will cover 94% of nonelderly legal U.S. residents, up from about 83% currently. The bill will cut the deficit by $81 billion over the 10-year period, owing to trims in Medicare spending and new taxes.
The widely awaited report paves the way for the Senate Finance Committee to approve its bill in the next few days.
After appearing in peril in August, the health-care overhaul has cleared a series of hurdles in recent weeks that have given Democrats increased confidence they will pass a bill. Lobbyists on both sides of the issue have shifted their focus to what the bill will look like rather than questioning whether a measure can succeed.
But plenty of potential pitfalls remain. Democrats are still divided over core elements, including whether to create a public health insurance plan and how to pay for the overhaul. The hospital industry, a key ally, says the latest bill from the Senate doesn't expand health insurance broadly enough to meet the terms of its pledge to contribute $155 billion to the effort.
According to the budget office, the bill spends $461 billion over a decade to give tax credits to low- and middle-income Americans to offset the cost of buying insurance. It spends $345 billion to expand the Medicaid insurance program to cover a larger swath of the poor.
The bill, introduced by Senate Finance Committee Chairman Max Baucus, calls for the government to fund a series of new nonprofit health-insurance cooperatives designed to increase competition with private insurance companies. It gives doctors and hospitals incentives to improve the quality of their care and to offer fewer unnecessary tests and treatments.
Most of the bill's funding comes from $404 billion in cuts to Medicare and other government insurance programs that Democrats say will reduce waste but won't hurt recipients' benefits. An additional $201 billion comes from a 40% excise tax on particularly generous health-insurance plans levied on insurers. The rest comes from annual fees on insurers, medical-device makers and pharmaceutical companies, as well as a series of other changes to the tax treatment of health expenses.
Continued in article
"4 Senators’ Concerns Reflect Health Care Challenge," by Robert Pear and David M. Herszenhorn, The New York Times, October 6, 2009 --- http://www.nytimes.com/2009/10/07/health/policy/07health.html?hpw
Senator John D. Rockefeller IV of West Virginia is upset that a health care bill poised for approval by the Finance Committee would turn nearly a half-trillion dollars over to insurance companies, whose profits he says are “out of sight.”
Senator Olympia J. Snowe of Maine worries that the bill would require people to buy insurance they cannot afford. Senator Blanche Lincoln of Arkansas fears that the bill would be too costly for the government.
And Senator Ron Wyden of Oregon warns that the bill would lock many workers into health plans selected by their employers, without allowing them to shop for better, cheaper plans, an alternative that could help drive down costs for everyone.
Those senators — three Democrats and one Republican, Ms. Snowe — have not indicated how they will vote on the Finance Committee legislation and said Tuesday that they were agonizing over the decision.
White House officials and the committee chairman expect the Democrats to support the bill, if only to advance it to the next stage of the legislative process, the Senate floor, for what is likely to be a raucous, riveting and unpredictable debate.
Taken together, the four senators represent the spectrum of concerns Democrats will face in trying to assemble the 60 votes they need to get a bill through the full Senate using regular procedure. Satisfying each of them, without alienating the others, is the challenge facing Democratic leaders.
The committee chairman, Senator Max Baucus, Democrat of Montana, predicted Tuesday that Mrs. Lincoln, Mr. Rockefeller and Mr. Wyden would be with him “when the final votes are cast” in committee. Other Democrats said, with less certainty, that they expected Ms. Snowe to support the bill in committee as well.
While the four senators do seem genuinely undecided, by declining to commit in advance they also maximize their leverage: their ability to win changes in the legislation later on.
“I’m pondering,” Mr. Rockefeller said. “It’s an imperfect bill, with a lot of pluses and minuses.”
Mr. Rockefeller said the committee had improved the bill over the last two weeks by preserving the Children’s Health Insurance Program and by preventing taxes on expensive insurance policies for some people in high-risk occupations, like coal miners
Mrs. Lincoln, Mr. Rockefeller and Ms. Snowe said that in deciding how to vote, they would be influenced by a cost estimate soon to be completed by the Congressional Budget Office. President Obama has insisted that whatever final legislation emerges from Congress must not add to the federal budget deficit and must slow the growth of health spending in the long term.
On health care, Mr. Rockefeller illustrates the views of liberal Democrats. Under the bill, he said, insurance companies would receive more than $460 billion over 10 years to help pay for the coverage of low- and middle-income people. Congress, he said, must create a new government-run health plan, to compete directly with private insurers. The Finance Committee last week rejected his proposal to create such a public option.
Although she is a Republican, Ms. Snowe’s views reflect the concerns of many centrist Democrats. She worries that some middle-income families will find insurance unaffordable, even with federal subsidies. And she wants to give the private insurance market an opportunity to work, under new federal rules, before setting up a government plan in states where affordable coverage proves unavailable.
Centrist Democrats like Senator Thomas R. Carper of Delaware have similar ideas. Rather than setting up a single national government health plan, they would prefer to let states decide what to do.
Senator Ben Nelson of Nebraska, describing himself as a “Jeffersonian Democrat, someone who believes the laboratories of democracy typically work,” said it might make sense for states to act as a testing ground for a public option. That way, Mr. Nelson said, if the public option failed, it would do so on a small scale, and problems might be easier to fix.
But reflecting divisions that could lie ahead on the Senate floor, Mr. Rockefeller said this approach was unacceptable to him. State health plans would not be strong enough to compete effectively with big private insurance companies, he said.
Mrs. Lincoln, who is up for re-election next year in a state that voted heavily Republican in the 2008 presidential race, said she and her constituents in Arkansas would focus on the cost of the legislation and its effect on the country’s fiscal condition.
“We have got probably one of the lowest median incomes in the country,” Mrs. Lincoln said. “We have got people who know what it means when you spend beyond your means and you hit difficult economic times.”
Mrs. Lincoln said her constituents were “enormously alarmed about the amount of debt that we have.” And she said she worried that the cost of the bill could rise further as a result of amendments that might be added by her Democratic colleagues on the Senate floor.
As for how she would vote in the committee, Mrs. Lincoln said the budget office analysis would be crucial. “I am going to wait and see what the scores are,” she said.
Mr. Wyden noted that the committee’s bill would not offer additional options to the overwhelming majority of Americans who already have insurance. His concern is shared by some Democrats and also by many Republicans, who say the bill does not do enough to let the marketplace spur competition, and he said he would continue fighting on the Senate floor to make changes to the measure.
“Democrats from the president on talk about how the American people ought to have choices like a member of Congress,” Mr. Wyden said. “Now under consideration is an idea that millions and millions won’t get any choice at all, let alone what a member of Congress gets.”
“When you think about where this is headed,” he added, “you are still seeing additional patches added to the crazy quilt that is American health care.”
How to lie with statistics
These Democrats are all over the map on where
precisely Americans place in the life-expectancy rankings. We're 24th,
according to Vice President Joe Biden and Sen. Barbara Boxer; 42nd,
according to Pennsylvania Gov. Ed Rendell; 35th, according to Washington
Post columnist Eugene Robinson; and 47th, according to Rep. Dennis Kucinich.
So the U.S. may have less of a "life expectancy" problem than a "Democratic
math competency" problem. (Coulter mentions other widely varying
medical statistics reported in the media)
Ann Coulter, "Would Your Company
Like to Sponsor the Next Installment of Liberal Lies on National Health
Care?" , Townhall, October 7, 2009 ---
Click Here
Well, the Senate side, we can`t expect very much
from them. I don`t think they`re going to have public option in their final
bill. But I want to tell you something, Joy. We`re going to get it on the house
side. It`s going to be a terrible fight if we don`t get this, I mean, you know,
the bricks are going to fly. We have got to have public option.
Maxine Waters, CNN October 7, 2009
---
http://transcripts.cnn.com/TRANSCRIPTS/0910/07/joy.01.html
Updates for October 5, 2009
If the government can cobble together a cheaper
insurance policy that gives the same benefits, I see that as a plus.
Bill O'Reilly, Fox News
Jensen Comment
I think O'Reilly still holds President Obama to his pledge of new new taxes or
added national debt for Obamacare. The catch phrase is "same benefits." At a
minimum this would mean the same freedom to choose doctors and other benefits of
Medicare. The fact that Medicare is now $33 trillion dollars in the hole and
riddled with fraud probably means that no Obama is seeking to do the impossible.
I personally favor a single-payer government insurance program but dread the years of chaos and waste that would arise from a sudden shift to having the government process the gazillion claims of 300 million patients. That would not be a pretty sight.
"How Congress Is Cooking the Books," by Michael Tanner, The New York Post, September 30, 2009 --- Click Here
LAST week, the Senate Finance Committee voted 12-11 not to wait for the Congressional Budget Office to "score" its health-care bill before the committee votes on it. Imagine that: Some senators actually wanted to know how much the bill costs before voting on it.
Let them get away with something like that, and before you know it they'll be demanding honest accounting practices -- sending the whole legislative process to hell in a hand basket.
When it comes to the health-care-reform debate, you see, honest budgeting is nowhere to be seen.
Start with the simple matter of how much health-care reform will cost. The House bill, HR 3200, will cost roughly $1.3 trillion over 10 years -- or so we're told. By the same token, the Senate Finance Committee bill is supposed to cost just under $900 billion. Sure, that's a lot of money -- but it still badly understates the true cost.
The CBO provides 10- year projections of a bill's cost. But most provisions of the health bill don't take effect until 2014. So the "10-year" cost projection only includes six years of the bill.
Plus, the costs ramp up slowly. In its first year, the House bill would only cost about $6 billion; in its first three, less than $100 billion. The big costs are in the final years of the 10-year budget window -- and beyond. In fact, over the first 10 years that the House bill would be in existence (2014 to 2024), its costs would be closer to $2.4 trillion. Similarly, the real cost of the Senate bill over 10 years of operation is estimated at $1.5 trillion.
Worse, the trajectory of the costs after 10 years rises dramatically -- meaning "reform" would cost even more in its second 10 years and beyond.
Such gimmicks also infest the projections of how much reform will add to the deficit. CBO says the House bill adds $235 billion to the deficit. But that, again, cuts off arbitrarily in 2019. Beyond that date, the bill adds enormously to the deficit, about $1.5 trillion in the second 10 years. In fact, if the health-reform bill were treated like other entitlements, such as Social Security and Medicare, which are required to have a 75-year actuarial forecast, its unfunded liabilities would exceed $9.2 trillion.
Of course, the Senate Finance Bill is supposed to be deficit-neutral. But that claim relies on other forms of budgetary flimflam.
For example, the Senate bill relies on Medicare "savings" that Congress keeps refusing to make. Specifically, Medicare has long been ordered to cut 21 percent from what it pays health-care providers -- yet, each year since 2003, for reasons both good and bad, Congress has voted to defer the cuts.
Does anyone else really think that Congress is simply going to slash payments to doctors and hospitals by 21 percent across the board?
Of course, President Obama has long said we can cut Medicare by $500 billion simply by eliminating fraud, waste and abuse. That would be the same "fraud, waste and abuse" that the government has been cutting since Ronald Reagan first used the term.
The truth is that health-care reform is going to cost us a lot. And we're going to pay for it in higher taxes and more debt.
No wonder they don't want us to know.
Why Medical Malpractice Is Off Limits in Terms of Health Care Reform
The upshot is simple: A few thousand trial lawyers are
blocking reform that would benefit 300 million Americans. This is not just your
normal special-interest politics. It's a scandal—it is as if international-trade
policy was being crafted in order to get fees for customs agents. Trial lawyers
are agents, and their claims are only as valid as those they represent. They
argue, of course, that they are champions of malpractice victims. As Anthony
Tarricone, president of the trial lawyers association (called the American
Association of Justice) put it: "Trial attorneys see first-hand the effects
medical errors have on patients and their families. We should keep those injured
people in mind as the debate moves forward." But under the current system, 54
cents of the malpractice dollar goes to lawyers and administrative costs,
according to a 2006 study in the New England Journal of Medicine. And because
the legal process is so expensive, most injured patients without large claims
can't even get a lawyer. "It would be hard to design a more inefficient
compensation system," says Michelle Mello, a professor of law and public health
at Harvard, "or one which skewed incentives more away from candor and good
practices."
Philip K. Howard, "Why Medical
Malpractice Is Off Limits: A few thousand lawyers have a lock on
Democrats, who refuse any legal reform," The Wall Street Journal,
September 29, 2009 ---
http://online.wsj.com/article/SB10001424052970204488304574432853190155972.html?mod=djemEditorialPage
"Dean says Obamacare authors don't want to challenge trial lawyers," by: Mark Tapscott, Washington Examiner, August 26, 2009 --- Click Here
Whatever else he said Wednesday evening at the town hall hosted by Rep. Jim Moran, D-VA, former Democratic National Committee chairman and presidential candidate Howard Dean let something incredibly candid slip out about President Obama's health-care reform bill in Congress.
Asked by an audience member why the legislation does nothing to cap medical malpractice class-action lawsuits against doctors and medical institutions (aka "Tort reform"), Dean responded by saying: “The reason tort reform is not in the [health care] bill is because the people who wrote it did not want to take on the trial lawyers in addition to everybody else they were taking on. And that’s the plain and simple truth,”
Dean is a former physician, so he knows about skyrocketing medical malpractice insurance rates, and the role of the trial lawyers in fueling the "defensive medicine" approach among medical personnel who order too many tests and other sometimes unneeded procedures "just to be sure" and to protect themselves against litigation.
Texas Gov. Rick Perry recently described in an Examiner oped the medical-malpractice caps enacted by the state legislature at his urging that reversed a serious decline in the number of physicians practicing in the Lone Star state and the resulting loss of access to quality medical care available to Texas residents. Mississippi Gov. Haley Barbor also shared some of his successes in this area in a recent Examiner oped.
Credit goes to the American Tort Reform Association's Darren McKinney for catching this momentary outbreak of political honesty by Dean. McKinney has conveniently posted an audio recording of Dean speaking here, so you can listen for yourself. Mckinney has also offered more comment here, helpfully even including a link to the Examiner's recent analysis of the degree to which trial-lawyer political contributions go to Democrats in Congress.
Those contributions are why Dean knows it would be a difficult task indeed for Obama to persuade congressional Democrats to do anything that might offend the trial-lawyers lobby. The Examiner's David Freddoso and Kevin Mooney did the reporting on this link here.
Jensen Comment
Reports are that the Texas cap on punitive damages has been quite successful in restraining outrageous settlements of malpractice lawsuits."The President's Tort Two-Step Special-interests and the health-care status," by Kimberly Strassel, The Wall Street Journal, September 11, 2009 --- Click Here
Tort reform is a policy no-brainer. Experts on left and right agree that defensive medicine—ordering tests and procedures solely to protect against Joe Lawyer—adds enormously to health costs. The estimated dollar benefits of reform range from a conservative $65 billion a year to perhaps $200 billion. In context, Mr. Obama's plan would cost about $100 billion annually. That the president won't embrace even modest change that would do so much, so quickly, to lower costs, has left Americans suspicious of his real ambitions.
It's also a political no-brainer. Americans are on board. Polls routinely show that between 70% and 80% of Americans believe the country suffers from excess litigation. The entire health community is on board. Republicans and swing-state Democrats are on board. State and local governments, which have struggled to clean up their own civil-justice systems, are on board. In a debate defined by flash points, this is a rare area of agreement.
The only folks not on board are a handful of powerful trial lawyers, and a handful of politicians who receive a generous cut of those lawyers' contingency fees. The legal industry was the top contributor to the Democratic Party in the 2008 cycle, stumping up $47 million. The bill is now due, and Democrats are dutifully making a health-care down payment.
During the markup of a bill in the Senate Health Committee, Republicans offered 11 tort amendments that varied in degree from mere pilot projects to measures to ensure more rural obstetricians. On a party line vote, Democrats killed every one. Rhode Island senator and lawyer Sheldon Whitehouse went so far as to speechify on the virtues of his tort friends. He did not, of course, mention the nearly $900,000 they have given him since 2005, including campaign contributions from national tort powerhouses like Baron & Budd and Motley Rice.
Even Senate Finance Chair Max Baucus, of bipartisan bent, has bowed to legal powers. The past two years, Mr. Baucus has teamed up with Wyoming Republican Mike Enzi to offer legislation for modest health-care tort reform in states. That Enzi-Baucus proposal had been part of the bipartisan health-care talks. When Mr. Baucus released his draft health legislation this weekend, he'd stripped out his own legal reforms. The Montanan is already in the doghouse with party liberals, and decided not to further irk leadership's Dick Durbin ($3.6 million in lawyer contributions), the Senate's patron saint of the trial bar.
Over in the House the discussion isn't about tort reform, but about tort opportunities. During the House Ways & Means markup of a health bill, Texas Democrat Lloyd Doggett ($1.5 million from lawyers) introduced language to allow freelance lawyers to sue any outfit (say, McDonald's) that might contribute to Medicare costs. Only after Blue Dogs freaked out did the idea get dropped, though the trial bar has standing orders that Democrats make another run at it in any House-Senate conference.
It says everything that Mr. Obama wouldn't plump for reform as part of legislation. The president knows the Senate would never have passed it in any event. Yet even proposing it was too much for the White House's legal lobby. Mr. Obama is instead directing his secretary of health and human services to move forward on test projects. That would be Kathleen Sebelius, who spent eight years as the head of the Kansas Trial Lawyers Association.
The issue has assumed such importance that even some Democrats acknowledge the harm. With bracing honesty, former DNC chair Howard Dean recently acknowledged his party "did not want to take on the trial lawyers." Former Democratic Sen. Bill Bradley, in a New York Times piece, suggested a "grand bipartisan compromise" in which Democrats got universal coverage in return for offering legal reform. The White House yawned, and moved on.
It isn't clear if Republicans would or should take that deal, but we won't know since it won't be offered. The tort-reform issue has instead clarified this presidency. Namely, that the bipartisan president is in fact very partisan, that the new-politics president still takes orders from the old Democratic lobby.
"20 Questions About Obamacare," by John Hawkins, Townhall,
September 29, 2009 ---
http://townhall.com/columnists/JohnHawkins/2009/09/29/20_questions_about_obamacare?page=2
So, let's talk about the basic questions YOU should have answered to your satisfaction before you consider supporting any health care bill that comes out of Congress. As you read these questions, keep in mind that every one has been inspired by bills that are moving through Congress as we speak.
1) Medicare and Social Security are driving this country into bankruptcy. Can we afford another gargantuan government entitlement program when we know we can't pay for the programs we already have?
2) Given that the Medicare system will soon be going into the red, does it make sense to attempt to cut 500 billion dollars in funds out of the program to move over to another entitlement program?
3) One of the biggest selling points of government run health care is that it will reduce costs. How can anyone believe the same federal government that is running an almost 2 trillion dollar deficit is going to be financially responsible enough to cut health care costs.
4) Will people who have previously decided not to get health care coverage be forced to spend a significant portion of their income on mandated coverage or risk huge fines or perhaps even jail time?
5) Will abortions be covered under the health care plan?
6) Will illegal aliens be able to get coverage?
7) Will you have to deal with the IRS in order to pay your medical bills?
8) Would you be able to keep your current doctor under a new plan?
9) If you like your insurance plan, will you be allowed to keep it?
10) If the health care bill passes, will dozens of government bureaucrats suddenly have access to your private medical records, which are zealously guarded under our current laws?
11) Given that the cost of lawsuits and tort reform significantly drive up the cost of medical care for all Americans, why is tort reform not being included in these bills?
12) By simply giving tax breaks to individuals instead of employers, Congress could make health care portable; so you wouldn't risk losing your health care when you lose your job. Why isn't that being considered?
13) The employee mandates in the bill could cost as many as 1.5 million people their jobs. Does it make sense to do that in a recession?
14) The new health care plan will dramatically increase taxes on expensive plans by 1/3. But quickly, because of medical inflation, other much more modest plans will become worth enough to be hit with the tax. Does it really make sense to implement what will become a gigantic new tax on the middle class?
15) Will the health care bill destroy the insurance industry and leave the country with a single payer system run by the government?
16) There has been a lot of talk about making insurance companies compete. In fact, that is the biggest stated rationale for the public option. However, if this is so, why aren't these health plans allowing insurance companies to compete across state lines? That would inspire real market based competition.
17) You can sue an insurance company if they illegally deny your claim. Will you be able to do the same if the government is running things?
18) Obama is promising that insurance companies can't turn you down for coverage if you're sick, drop you if you lie about your coverage, or place any kind of cap on how much coverage you can get. Do you really believe insurance companies can continue to exist and function under those circumstances?
19) There are only roughly 8-10 million people who want insurance but can't afford it. Why not concentrate on helping those people instead overhauling the whole system?
20) What guarantees do the American people have that senior citizens won't be denied life saving treatment to save money as they are in nations like Britain?
The Republicans lie! They want to see you dead!
They’d rather make money off your dead corpse! They kinda like it when that
woman has cancer and they don’t have anything for her…My God, Democrats, what’s
wrong with you?! You can’t deal with these people, at all! . . . Sometimes
I think they [conservatives] want Obama to get shot. I do! I really think that
there are conservative broadcasters in this country who would love to see Obama
taken out. They fear socialism. They fear Marxism.
MSNBC Commentator Ed Schultz --- Watch the Video ---
http://www.msnbc.msn.com/id/21134540/vp/32992075#32992075
On the Wednesday evening edition of “The Ed Show,” MSNBC commentator Ed Schultz stated that Republicans want Americans to die, and that they enjoy it when middle-aged women contract cancer. He then suggested that moderate Republican Sen. Olympia Snowe of Maine should allow tumors to spread through her body if she ever gets cancer. Schultz, whose program runs between episodes of Hardball, began his program by discussing the story of a woman who came to a health-care town hall meeting sponsored by Rep. Eric Cantor, R-VA. The woman told of her uninsured friend, a middle-aged woman with stomach tumors. Incensed that Cantor did not immediately suggest socializing one-sixth of the nation’s economy as a result, an increasingly unhinged Schultz began screaming (starting at 5:14 in this clip):
Jensen Comment
Ed Schultz has become the nuttiest of the nut cases at MSNBC.
On September 14th, he lied that 9/12 protesters carried signs that read “Bury Obama with Kennedy,” as the television screen showed a full-screen shot of the correct sign, which read, “Bury ObamaCare with Kennedy.”
'Liberals Seek Health Care Access for Illegals: A group of House
Democrats say it's unfair to bar illegal immigrants from paying their own way in
a government-sponsored exchange," The Washington Times, September 27, 2009 ---
http://www.foxnews.com/politics/2009/09/27/liberals-seek-health-care-access-illegals/
Fearful that they're losing ground on immigration and health care, a group of House Democrats is pushing back and arguing that any health care bill should extend to all legal immigrants and allow illegal immigrants some access, The Washington Times reported on Monday.
The Democrats, trying to stiffen their party's spines on the contentious issue, say it's unfair to bar illegal immigrants from paying their own way in a government-sponsored exchange. Legal immigrants, they say, regardless of how long they've been in the United States, should be able to get government-subsidized health care if they meet the other eligibility requirements.
"Legal permanent residents should be able to purchase their plans, and they should also be eligible for subsidies if they need it. Undocumented, if they can afford it, should be able to buy their own private plans. It keeps them out of the emergency room," said Rep. Michael M. Honda, California Democrat and chairman of the Congressional Asian Pacific American Caucus.
Honda was joined by more than 20 of his colleagues in two letters laying out the demands.
Coverage for immigrants is one of the thorniest issues in the health care debate, and one many Democratic leaders would like to avoid. But immigrant rights groups and the Democrats who sent the letters say they have to take a stand now.
Jensen Comment
The key absurdity here is the statement "pay their own way." If a foreigner in
need of a $50,000 eye implant surgeries sneak into the U.S. for the main purpose
of paying $100 in premiums for each $50,000 surgery and then return to their
home countries, these aliens have hardly "paid their own way." They've taken on
illegal alien status mainly for getting expensive health care on the cheap.
"Max's Mad Mandate The Baucus health bill will break 50 state budgets via Medicaid," The Wall Street Journal, September 27, 2009 --- Click Here
The more we inspect Max Baucus's health-care bill, the worse it looks. Today's howler: One reason it allegedly "pays for itself" over 10 years is because it would break all 50 state budgets by permanently expanding Medicaid, the joint state-federal program for the poor.
Democrats want to use Medicaid to cover everyone up to at least 133% of the federal poverty level, or about $30,000 for a family of four. Starting in 2014, Mr. Baucus plans to spend $287 billion through 2019—or about one-third of ObamaCare's total spending—to add some 11 million new people to the Medicaid rolls.
About 59 million people are on Medicaid today—which means that a decade from now about a quarter of the total population would be on a program originally sold as help for low-income women, children and the disabled. State budgets would explode—by $37 billion, according to the Congressional Budget Office—because they would no longer be allowed to set eligibility in line with their own decisions about taxes and spending. This is the mother—and father and crazy uncle—of unfunded mandates.
This burden would arrive on the heels of an unprecedented state fiscal crisis. As of this month, some 48 states had shortfalls in their 2010 budgets totaling $168 billion—or 24% of total state budgets. The left-wing Center for Budget and Policy Priorities expects total state deficits in 2011 to rise to $180 billion. And this is counting the $87 billion Medicaid bailout in this year's stimulus bill.
While falling revenues are in part to blame, Medicaid is a main culprit, even before caseloads began to surge as joblessness rose. The National Association of State Budget Officers notes that Medicaid spending is on average the second largest component in state budgets at 20.7%—exceeded only slightly by K-12 education (20.9%) and blowing out state universities (10.3%), transportation (8.1%) and prisons (3.4%).
In some states it is far higher—39% in Ohio, 27% in Massachusetts, 25% in Michigan, Rhode Island and Pennsylvania. Forcing states to spend more will crowd out other priorities or result in a wave of tax increases, or both, even as Congress also makes major tax hikes inevitable at the national level.
The National Governors Association is furious about Mr. Baucus's Medicaid expansion, and rightly so, given that governors and their legislatures will get stuck with the bill while losing the leeway to manage or reform their budget-busters. NGA President Jim Douglas of Vermont recently said at the National Press Club that the Baucus plan poses a "tremendous financial liability" and doesn't "respect that no one size fits all at the state level." He added: "Unlike the federal government, states can't print money."
Mr. Baucus hopes to use his printing press to bribe the governors, at least for a time. Currently, the federal government pays about 57 cents out of every dollar the states spend on Medicaid, though the "matching rate" ranges as high as 76% in some states. That would rise to 95%—but only for five years. After that, who knows? It all depends on which budget Congress ends up ruining. Either the states will be slammed, or Washington will extend these extra payments into perpetuity—despite the fact that CBO expects purely federal spending on Medicaid to consume 5% of GDP by 2035 under current law.
As for the poor uninsured, they'll be shunted off into what Democratic backbencher Ron Wyden calls a "caste system." While some people will be eligible for subsidized private health insurance, everyone in the lowest income bracket will be forced into Medicaid, the country's worst insurance program by a long shot. States try to control spending by restricting access to prescription drugs and specialists. About 40% of U.S. physicians won't accept Medicaid at all.
Why? One reason is that Medicaid's price controls are even tighter than Medicare's, which in turn are substantially below private payers. In 2009 or 2010, 29 states will have either reduced or frozen their reimbursement rates to providers. Democrats love Medicaid because is it much cheaper than subsidizing private insurance, but that is true only because of this antimarket brute force. Of course, such coercion will be extended to the rest of the health market under ObamaCare.
*** The states aren't entirely victims here. Both Republican and Democratic state houses regularly game the Medicaid funding formula—which itself is designed to reward higher spending—to steal more money from national taxpayers. Then when tax collections fall during downturns, budget gaskets blow all over the place. This dynamic helps explain the spectacular budget catastrophes in New York and California. We'd prefer a policy of block grants, which would extricate Washington from state accounting and encourage Governors to spend more responsibly.
That's not going to happen any time soon, but the least Mr. Baucus can do is not make things worse. Instead, his Medicaid expansion is a disaster on every level—like the rest of ObamaCare.
Updates for September 24, 2009
One woman Michelle Obama will not mention
Yes, First Lady Michelle Obama is now aggressively crusading for her husband’s
health care takeover under the guise of championing woman who have been
“crushed” by the system . . . I blogged about Michelle Obama’s role in creating
a patient-dumping scheme for the University of Chicago Medical Center back in
March. With her husband and the Democrats unleashing
health care horror story anecdotes to gin up public
fear and build support for the beleaguered Obamacare plan, my syndicated column
today revisits the kind of “reform” the Obamas and their Chicago cronies
champion — and who benefits.Here’s a challenge to the ABC News Obamacare
infomercial producers. I dare you to ask President
Obama this question: What have you done for
Dontae Adams, lately? One
woman Mrs. Obama won’t be spotlighting? The mother of Dontae Adams.
Michelle Malkin, September 18, 2009 ---
http://michellemalkin.com/2009/09/18/one-woman-michelle-obama-will-not-mention/
ACORN could open Pandora's box
In the wake of Fox News reporting on the unfolding
ACORN scandal, ACORN is now threatening to sue the network. Now that Fox is
actually breaking news on this story by showing new videos, ACORN might just do
it. Fox News should pray that ACORN does sue, because it would blow the doors
off this story, possibly destroying ACORN and erupting into a political scandal
in Washington.
Ken Blackwell and Ken Klukowski,
Townhall, September 21, 2009 ---
http://townhall.com/columnists/KenBlackwell/2009/09/21/acorn_could_open_pandoras_box
In 2005, Citibank and ACORN Housing Corporation --
which received tens of millions of tax dollars under the Bush administration
alone -- began recruiting Mexican illegal aliens for a lucrative program
offering loans with below-market interest rates, down-payment assistance and no
mortgage insurance requirements. Instead of the Social Security numbers required
of law-abiding citizens, the program allows illegal alien applicants to supply
loosely monitored tax identification numbers issued by the IRS . . . And ACORN
advisory council member Eric Eve of Citigroup is a champion of the
ACORN/Citibank illegal alien loan program that openly undermines immigration
laws and integrity in banking. The truth is more sordid than any fictional
scenarios caught on tape: ACORN is a corrupt enterprise.
Michelle Malkin, "ACORN's Illegal
Alien Home Loan Racket," Frontpage, September 18, 2009 ---
http://townhall.com/columnists/MichelleMalkin/2009/09/18/acorns_illegal_alien_home_loan_racket
"Fact Check: Obama Uses Iffy Math on Deficit Pledge," SmartPros, September 10, 2009 --- http://accounting.smartpros.com/x67604.xml
President Barack Obama used only-in-Washington accounting Wednesday when he promised to overhaul the nation's health care system without adding "one dime" to the deficit. By conventional arithmetic, Democratic plans would drive up the deficit by billions of dollars.
The president's speech to Congress contained a variety of oversimplifications and omissions in laying out what he wants to do about health insurance.
A look at some of Obama's claims and how they square with the facts or the fuller story:
---
OBAMA: "I will not sign a plan that adds one dime to our deficits either now or in the future. Period."
THE FACTS: Though there's no final plan yet, the White House and congressional Democrats already have shown they're ready to skirt the no-new-deficits pledge.
House Democrats offered a bill that the Congressional Budget Office said would add $220 billion to the deficit over 10 years. But Democrats and Obama administration officials claimed the bill actually was deficit-neutral. They said they simply didn't have to count $245 billion of it - the cost of adjusting Medicare reimbursement rates so physicians don't face big annual pay cuts.
Their reasoning was that they already had decided to exempt this "doc fix" from congressional rules that require new programs to be paid for. In other words, it doesn't have to be paid for because they decided it doesn't have to be paid for.
The administration also said that since Obama already had included the doctor payment in his 10-year budget proposal, it didn't have to be counted again.
That aside, the long-term prognosis for costs of the health care legislation has not been good.
CBO Director Douglas Elmendorf had this to say in July: "We do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount."
---
OBAMA: "Nothing in this plan will require you or your employer to change the coverage or the doctor you have."
THE FACTS: That's correct, as far as it goes. But neither can the plan guarantee that people can keep their current coverage. Employers sponsor coverage for most families, and they'd be free to change their health plans in ways that workers may not like, or drop insurance altogether. The Congressional Budget Office analyzed the health care bill written by House Democrats and said that by 2016 some 3 million people who now have employer-based care would lose it because their employers would decide to stop offering it.
In the past Obama repeatedly said, "If you like your health care plan, you'll be able to keep your health care plan, period." Now he's stopping short of that unconditional guarantee by saying nothing in the plan "requires" any change.
---
OBAMA: "The reforms I'm proposing would not apply to those who are here illegally." One congressman, South Carolina Republican Joe Wilson, shouted "You lie!" from his seat in the House chamber when Obama made this assertion. Wilson later apologized.
THE FACTS: The facts back up Obama. The House version of the health care bill explicitly prohibits spending any federal money to help illegal immigrants get health care coverage. Illegal immigrants could buy private health insurance, as many do now, but wouldn't get tax subsidies to help them. Still, Republicans say there are not sufficient citizenship verification requirements to ensure illegal immigrants are excluded from benefits they are not due.
---
OBAMA: "Don't pay attention to those scary stories about how your benefits will be cut. ... That will never happen on my watch. I will protect Medicare."
THE FACTS: Obama and congressional Democrats want to pay for their health care plans in part by reducing Medicare payments to providers by more than $500 billion over 10 years. The cuts would largely hit hospitals and Medicare Advantage, the part of the Medicare program operated through private insurance companies.
Although wasteful spending in Medicare is widely acknowledged, many experts believe some seniors almost certainly would see reduced benefits from the cuts. That's particularly true for the 25 percent of Medicare users covered through Medicare Advantage.
Supporters contend that providers could absorb the cuts by improving how they operate and wouldn't have to reduce benefits or pass along costs. But there's certainly no guarantee they wouldn't.
---
OBAMA: Requiring insurance companies to cover preventive care like mammograms and colonoscopies "makes sense, it saves money, and it saves lives."
THE FACTS: Studies have shown that much preventive care - particularly tests like the ones Obama mentions - actually costs money instead of saving it. That's because detecting acute diseases like breast cancer in their early stages involves testing many people who would never end up developing the disease. The costs of a large number of tests, even if they're relatively cheap, will outweigh the costs of caring for the minority of people who would have ended up getting sick without the testing.
The Congressional Budget Office wrote in August: "The evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall."
That doesn't mean preventive care doesn't make sense or save lives. It just doesn't save money.
---
OBAMA: "If you lose your job or change your job, you will be able to get coverage. If you strike out on your own and start a small business, you will be able to get coverage."
THE FACTS: It's not just a matter of being able to get coverage. Most people would have to get coverage under the law, if his plan is adopted.
In his speech, Obama endorsed mandatory coverage for individuals, an approach he did not embrace as a candidate.
He proposed during the campaign - as he does now - that larger businesses be required to offer insurance to workers or else pay into a fund. But he rejected the idea of requiring individuals to obtain insurance. He said people would get insurance without being forced to do so by the law, if coverage were made affordable. And he repeatedly criticized his Democratic primary rival, Hillary Rodham Clinton, for proposing to mandate coverage.
"To force people to get health insurance, you've got to have a very harsh penalty," he said in a February 2008 debate.
Now, he says, "individuals will be required to carry basic health insurance - just as most states require you to carry auto insurance."
He proposes a hardship waiver, exempting from the requirement those who cannot afford coverage despite increased federal aid.
---
OBAMA: "There are now more than 30 million American citizens who cannot get coverage."
THE FACTS: Obama time and again has referred to the number of uninsured as 46 million, a figure based on year-old Census data. The new number is based on an analysis by the Kaiser Commission on Medicaid and the Uninsured, which concluded that about two-thirds of Americans without insurance are poor or near poor. "These individuals are less likely to be offered employer-sponsored coverage or to be able to afford to purchase their own coverage," the report said. By using the new figure, Obama avoids criticism that he is including individuals, particularly healthy young people, who choose not to obtain health insurance.
Jensen Comment
In fairness, a single-payer medical insurance provider that covered all
Americans would probably result in cost savings in the long run. However,
President Obama realistically proclaims that such an abrupt changeover with lead
to unprecedented turmoil and inefficiencies, to say nothing of quality of care,
if the U.S. Government abruptly decided to insure 300 million Americans in one
fell swoop.
And the cost of phasing in a single-payer system would cause massive deficits, including the windfall profits that government would have to pay present medical insurance companies to operate efficiently over the years before they must operate before being terminated.
The fact of the matter is that we will be forced to live with inefficient private insurers until they are shut down or take over by government. In the meantime, government spending deficits will soar due to increased numbers of insured Americans, illegal immigrants, and expanded scope of coverage (mental health, pre-existing conditions, marriage counseling, and expanded social services).
The Lie: AARP perpetuates a
lie that government run insurance, like Medicare, is a good deal for patients
and taxpayers.
To put the reader at ease the (AARP) article says that
government run health care can’t be so bad since, after all, Medicare is
government run health care and everybody loves it. The article omits the fact
that Medicare is $38 trillion in the red. Yes, trillion with a “tr”) and by
Obama’s own admission is overrun by $500 billion of waste, fraud and abuse.
Obama says Medicare and Medicaid are responsible for our deficits. So what does
he do? He proposes the vast expansion of the Medicare and Medicaid programs to
further balloon our deficits and our health care inflation.
Herb Dennenberg, "AARP: The Hype,
The Lies, The Facts," The Bulletin (Philadelphia's oldest newspaper),
September 21, 2009 ---
Click Here
- The AARP Bulletin (September 2009) has a front-page headline on Obamacare: “The Hype, the Lies, the Facts: How to Tune Out the Fear-mongering and Misinformation and Make Sense of the Health Care Reform.” I’d add only one amendment to that AARP headline: “If you want to avoid the hype, the lies, and get the facts on Obamacare, don’t read the biased one-sided propaganda that AARP publishes in its Bulletin.”
The article is supposed to answer the question of AARP readers, “How do I know what to believe?” Anyone who reads the article critically or studies AARP history on this matter, knows they are in the tank for Obamacare, and in the guise of fair and balanced journalism they are presenting the Obamacare party line.
The article starts out by quoting Kathleen Hall Jamieson, director of he Annenberg Public Policy Center at the University of Pennsylvania, who runs FactCheck.org, a website that examines specious claims from all sides of the political spectrum. She says that health care reform has “serious consequences to people’s lives and it would be useful if as many people as possible actually understood what the proposals are about.” But, then she identifies the rise of the Internet and the decline of the mainstream press as a prime source of information which have put that prospect at risk.
Poor, pathetic Ms. Jamieson is saying, in effect, that the public was only getting the truth when they were relying on the biased, fraudulent, dishonest, and ultra-liberal mainstream media. That poor, pathetic “expert” who is “fact checking for the public” feels the truth is threatened now that multiple points of view, some of which are the opposing point of view, are presented by the Internet and now that the public is slowly beginning to realize that you can’t trust the mainstream media. (I would agree with Bernard Goldberg that the mainstream media is no longer mainstream. Until a good alternative description emerges, I’ll call it the biased, fraudulent, dishonest, and ultra liberal mainstream media.)
So, the AARP article is doing its readers a great public service by demonstrating that you can’t trust the AARP, FactCheck.org, Ms. Jamieson, and the Annenberg Public Policy Center at the University of Pennsylvania if you want fair and balanced information about such matters as Obama and Obamacare.
The article goes on to perpetuate every fraud and deceit that people like House Speaker Nancy Pelosi and the leadership of the Democratic Party have put forth to stigmatize and demonize dissent. For example, the article asks, “Could rumor-mongering affect the outcome? Recent violent interruptions at lawmakers’ town hall meetings suggest it might.” So, the AARP, which is supposed to represent senior citizens, is joining the chorus that sees those who oppose Obamacare and who exercise their First Amendment Rights at Tea Parties as mobsters, prone to violence, Nazis, Brown Shirts and all the rest. They are proving that AARP, the Democratic leadership, and the mainstream media believe in the First Amendment only for those in agreement with its radical, far-left policies.
The AARP and its editors and officers clearly have no conscience and no sense, as they would not carry forward such blatant propagandizing for Obamacare and hurl insults at their own membership. If they are in the business of informing their diverse membership, they should provide both sides of an issue, not just give the appearance of doing so while residing in the pocket of the pro-Obamacare forces.
No wonder AARP been losing membership by the tens of thousands. Sometime ago, it was estimated at 60,000 members lost and that figure is probably much higher by now. Their stance on this did not surprise me. I have already reported in one column how they, along with AMA and others, have sold out to Obama and Company to support his vision of health care reform. I’ve also reported how the AARP is not in the business of representing the interests of senior citizens, but is, in fact, a phony membership organization in the business of selling its members insurance, credit cards, mutual funds, and other services. In fact, facing the first page of the propaganda piece in question is a full-page ad for life insurance sold by AARP. The same issue carries ads for AARP mobile home insurance, AARP Medicare insurance supplements, and AARP auto insurance.
I want to be fair to AARP and its article on health care reform. It did have four words of truth in it. The inside headline reads, “The Assault on Truth.” Of course, that was intended to characterize the critics of Obamacare. However, it perfectly characterizes the article in question and AARP. Let me give you a few examples involving the questions asked and answered by the article:
Will The Government Take Over Health Care So We End Up With Socialized Medicine?
The answer is the standard party line: “No. Neither the president nor the congressional committees have suggested anything remotely resembling a government takeover of health care.”
This answer is based on the fact that Mr. Obama says he doesn’t want the single-payer, government-takeover system that is used in Canada. The article fails to state that Obama has long been on record as favoring the discredited single-payer system and has even said we will have to get there gradually. But the article doesn’t explain that you can have a government takeover without a single-payer system.
When you look at what some of these proposals do, you will see they involve the federal government deciding what kind of policies will be written, what kind of rates will be charged, what kind of government insurance companies will be established, what kind of end-of-life counseling will be provided for senior citizens. What’s more, when you start setting up dozens of new agencies and commissions to control the health care system and to decide on what is the “best” medical practice, you don’t need single-payer to bring about a government takeover. When you grant insurance to 47 million “uninsured,” you assure a shortage of health care providers that sets the stage for rationing. As Dick Morris pointed out, contrary to the view of Obama press secretary Robert Gibbs, “You don’t have to be a medical school graduate to figure that out. That’s an elementary school problem.”
If that’s not quite enough to convince you, when you populate the White House with radicals, communists, socialists and advocates of such things as compulsory abortion, compulsory sterilization, and providing medical care based on quality of life years remaining, meaning seniors will be locked out, you are setting the stage for something worse than single-payer.
The article also tries to refute the fact of government takeover by saying “socialized” medicine is also off the table. The article says socialized medicine involves government ownership of hospitals and employment of doctors, as in the United Kingdom. It says that’s not contemplated. But, again, when government and federal bureaucrats control virtually every aspect of the health care system, you don’t need formal ownership. Comprehensive control is the equivalent of government ownership, of socialized medicine, and of the discredited systems of Canada and the United Kingdom.
To put the reader at ease the article says that government run health care can’t be so bad since, after all, Medicare is government run health care and everybody loves it. The article omits the fact that Medicare is $38 trillion in the red. Yes, trillion with a “tr”) and by Obama’s own admission is overrun by $500 billion of waste, fraud and abuse. Obama says Medicare and Medicaid are responsible for our deficits. So what does he do? He proposes the vast expansion of the Medicare and Medicaid programs to further balloon our deficits and our health care inflation.
Will Private Insurance Be Outlawed Or Wither On The Vine?
Needless to say, the AARP article answers, “No. Obama and the congressional committees say their objective is to build on the current system – keeping employer-sponsored group insurance and giving more consumer protections to people who are employed by small businesses or buy insurance as individuals.”
The AARP article argues that those with employer-sponsored insurance are ineligible for the public plan. But the article forgets that many employers would stop giving coverage, as the penalty for not providing it is smaller than the cost of providing it. Even the New York Times, a lap dog for Obama, in an editorial dedicated to selling Obamacare, admitted that the public option would likely be less costly than many alternatives.
The article also ignores the fact that the public option, a government insurer, would be subject to rules made by the government, so the umpire of the marketplace would be on the side of the government insurer. That is not likely to produce a level playing field for private insurers.
Finally, the article ignores the ways proposed in Republican-sponsored bills that would encourage competition. For example, opening up a nationwide market for health insurance would be an obvious and easy way to increase competition. Now, the consumer is limited to companies admitted to do business in his state. The insurance exchanges, proposed in many bills, would also make sense, as they would ratchet up competition.
Incidentally, it is important to remember that with or without a public option or some variation of it in the form of co-ops, Obamacare still involves a government takeover. So, don’t think it is a big deal to delete the public option. The bill spells catastrophe with or without that provision.
All the other questions asked in the article also provide the wrong answers. For example, “Will Medicare be eliminated or gutted to pay for reforms?” The article answers, “No. It’s inconceivable that any lawmaker would commit political suicide by proposing to get rid of Medicare.” But the AARP article forgets that Obama has said that he would cut $500 billion in waste, fraud, abuse, and inefficiency out of Medicare. We’ve heard that line since the days of President Nixon, and we’re still waiting for that waste, fraud, abuse, and inefficiency to be eliminated. If Obama knows how to do it, what is he waiting for? Why hasn’t he proceeded to cut that waste, fraud, abuse and inefficiency out of the system to prove he knows what he’s doing and can give more than campaign speeches? He’s been in office about seven months, and yet he’s done nothing to solve this problem which he says is bankrupting the country and is responsible for the deficits. When you cut $500 billion out of Medicare and grant coverage to 47 million previously uninsured, you’re going to have to ration medical care, and that means rationing medical care for senior citizens.
The biggest barrels of red ink have been generated by Medicare and Medicaid to the tune of tens of trillions of dollars. So what does Obama do? He proposes, in effect, to vastly expand Medicare and Medicaid and to compound our problems.
The president and chief executive officer of AARP, in an editorial accompanying the article in question, endorse the lies, hype, and exaggeration in the article by writing that there has been too much fear-mongering and misinformation involved in the debate. They continue to give the false impression that they are above the fray, but then echo the party line coming from Obama and the Democratic leadership in Congress. AARP and its leadership have continued to demonstrate they are the ones getting in the way of a fair, balanced, and honest debate on heath care reform.
Meanwhile, we have the case of the Association for the Advancement of Retired Persons (AARP), and its fanciful Medicare claims. The self-styled seniors lobby is using all its money and influence to cheer on ObamaCare, even though polls show that most retired persons oppose it. AARP has spent millions of dollars on its TV ad campaign and bulletins and newsletters to its members, including eight million direct-mail letters over Labor Day. The AARP Web site claims that it is a "myth" that "health care reform will hurt Medicare," while it is a "fact" that "none of the health care reform proposals being considered by Congress will cut Medicare benefits or increase your out-of-pocket costs."
"Medicare and Gag Orders Humana gets whacked for telling the truth, AARP gets a pass for spreading falsehoods," The Wall Street Journal, September 24, 2009 --- Click Here
"Government Medicine vs. the Elderly: In Britain in 2007-08, 16.5% of
deaths came after 'terminal sedation," by Rupert Darwall, The Wall Street
Journal, September 14, 2009 ---
http://online.wsj.com/article/SB10001424052970203917304574412680569936844.html?mod=djemEditorialPage
Rarely has the Atlantic seemed as wide as when America's health-care debate provoked a near unanimous response from British politicians boasting of the superiority of their country's National Health Service. Prime Minister Gordon Brown used Twitter to tell the world that the NHS can mean the difference between life and death. His wife added, "we love the NHS." Opposition leader David Cameron tweeted back that his plans to outspend Labour showed the Conservatives were more committed to the NHS than Labour.
This outbreak of NHS jingoism was brought to an abrupt halt by the Patients Association, an independent charity. In a report, the association presented a catalogue of end-of-life cases that demonstrated, in its words, "a consistent pattern of shocking standards of care." It provided details of what it described as "appalling treatment," which could be found across the NHS.
A few days later, a group of senior doctors and health-care experts wrote to a national newspaper expressing their concern about the Liverpool Care Pathway, a palliative program being rolled out across the NHS involving the withdrawal of fluids and nourishment for patients thought to be dying. Noting that in 2007-08, 16.5% of deaths in the U.K. came after "terminal sedation," their letter concluded with the chilling observation that experienced doctors know that sometimes "when all but essential drugs are stopped, 'dying' patients get better" if they are allowed to.
The usual justification for socialized health care is to provide access to quality health care for the poor and disadvantaged. But this function can be more efficiently performed through the benefits system and the payment of refundable tax credits.
The real justification for socialized medicine is left unstated: Because health-care resources are assumed to be fixed, those resources should be prioritized for those who can benefit most from medical treatment. Thus the NHS acts as Britain's national triage service, deciding who is most likely to respond best to treatment and allocating health care accordingly.
It should therefore come as no surprise that the NHS is institutionally ageist. The elderly have fewer years left to them; why then should they get health-care resources that would benefit a younger person more? An analysis by a senior U.K.-based health-care expert earlier this decade found that in the U.S. health-care spending per capita goes up steeply for the elderly, while the U.K. didn't show the same pattern. The U.K.'s pattern of health-care spending by age had more in common with the former Soviet bloc.
A scarcity assumption similar to the British mentality underlies President Barack Obama's proposed health-care overhaul. "We spend one-and-a-half times more per person on health care than any other country, but we aren't any healthier for it," Mr. Obama claimed in his address to Congress last Wednesday, a situation that, he said, threatened America's economic competitiveness.
This assertion is seldom challenged. Yet what makes health care different from spending on, say, information technology—or any category of consumer service—such that spending on health care is uniquely bad for the American economy? Distortions like malpractice suits that lead to higher costs or the absence of consumer price consciousness do result in a misallocation of resources. That should be an argument for tackling those distortions. But if high health-care spending otherwise reflects the preferences of millions of consumers, why the fuss?
The case for ObamaCare, as with the NHS, rests on what might be termed the "lump of health care" fallacy. But in a market-based system triggering one person's contractual rights to health care does not invalidate someone else's health policy. Instead, increased demand for health care incentivizes new drugs, new therapies and better ways of delivering health care. Government-administered systems are so slow and clumsy that they turn the lump of health-care fallacy into a reality.
According to the 2002 Wanless report, used by Tony Blair's government to justify a large tax hike to fund the higher spending, the NHS is late to adopt and slow to diffuse new technology. Still, NHS spending more than doubled to £103 billion in 2009-10 from £40 billion in 1999-2000, equivalent to an average growth rate of over 7% a year after inflation.
In 1965, economist (and future Nobel laureate) James Buchanan observed of the 17-year old NHS that "hospital facilities are overcrowded, and long delays in securing treatment, save for strictly emergency cases, are universally noted." Forty-four years later, matters are little improved. The Wanless report found that of the five countries it looked at, the U.S. was the only one to be both an early adopter and rapid diffuser of new medical techniques. It is the world's principal engine driving medical advance. If the U.S. gets health-care reform wrong, the rest of the world will suffer too.
Mr. Darwall, a London-based strategist, is currently writing a book on the history of global warming, to be published by Quartet Books in Spring 2010.
Jensen Comment
If and when I become gaga please sedate me to the max.
The Lie: The health insurance mandate is not a tax.
"Yes, health-insurance mandate is a tax." by Donald Lambro, Townhall, September 23, 2009 ---
http://townhall.com/columnists/DonaldLambro/2009/09/23/yes,_health-insurance_mandate_is_a_taxPresident Obama absolutely refuses to acknowledge there is a huge middle-class tax in the Senate Finance Committee's healthcare bill. The president flatly denies the legislation that the White House supports contains a stiff penalty tax that would hit uninsured middle-income people the hardest -- the very folks he promised would never see their taxes rise under his presidency.
Obama has repeatedly stated that promise throughout the healthcare debate, despite evidence to the contrary, and no one in the national news media has called him on it. That is, until George Stephanopoulos raised the issue with him Sunday on ABC's "This Week."
First, Stephanopoulos reminded the president that in his campaign for the presidency he was "against the individual mandate" that all Americans be required to buy health insurance.
"Yes," Obama replied.
Then Stephanopoulos hit him with the question no one apparently had asked him before. Pointing out that the Finance Committee plan contained just such a mandate whereby "the government is forcing people to spend money, fining you if you don't," he asked, "How is that not a tax?"
Obama replied, "No, but ... but, George, you ... can't just make up that language and decide that that's called a tax increase."
"You reject that it's a tax increase?" Stephanopoulos asked. Obama said, "I absolutely reject that notion."
But if Obama looked on page 29 of Senate Finance Committee Chairman Max Baucus' legislation -- the bill he hopes will enact his healthcare plans into law -- he would have read this line: "The consequence for not maintaining (health) insurance would be an excise tax."
What part of those two words doesn't he understand? The government imposes a raft of excise taxes on all of us: the tires for our cars, alcoholic beverages, jewelry and many other purchases. Now it wants to add health insurance to the tax-revenue list as a penalty for those who do not purchase a product the feds insist you must buy or else face fines up to $950 for an individual and up to $3,800 a year for a family.
Continued in article
Updates for September 15, 2009
Updates for September 3, 2009
Under H.R. 676
[Text of Bill],
Medicare would be extended and improved so that all individuals residing in the
United States would receive high quality and affordable health care services.
They would receive all medically necessary services by the physicians of their
choice, with no restrictions on what providers they could visit. If implemented,
the United States National Health Insurance Act would cover primary care,
dental, mental health, prescription drugs, and long term care.
Michael Moore ---
http://www.michaelmoore.com/sicko/what-can-i-do/petitions/pnum649.php
Jensen Comment
Mike will never understand that there will be no decent health care for anyone
in the United States when the annual budget deficit hits $20 trillion and nobody
will invest in our National Debt. He never took Economics 101.
There are times when Americans’ attitude toward
health-care reform seems a bit like St. Augustine’s take on chastity: Give it to
us, Lord, but not yet. In theory, the public overwhelmingly supports
reform—earlier this year, polls showed big majorities in favor of fundamental
change. But, when it comes to actually making fundamental change, people go all
wobbly. Just about half of all Americans now disapprove of the way the Obama
Administration is handling health care.
James Surowiecki, "Status-Quo
Anxiety," The New Yorker, August 31, 2009 ---
http://www.newyorker.com/talk/financial/2009/08/31/090831ta_talk_surowiecki
Jensen Comment
The fact of the matter is that liberals like Surowiecki cannot mention universal
health care, economic disaster, and deficit spending in the same article.
Opponents are all ignorant sheep being guided by the demonizing GOP. Not once
does Surowiecki discuss how to pay for the many costly provisions in H.R. 3200.
Congressman Mike Rogers' opening statement on Health Care reform in
Washington D.C. ---
http://www.youtube.com/watch?v=G44NCvNDLfc
"Dean says Obamacare authors don't want to challenge trial lawyers," by: Mark Tapscott, Washington Examiner, August 26, 2009 --- Click Here
Whatever else he said Wednesday evening at the town hall hosted by Rep. Jim Moran, D-VA, former Democratic National Committee chairman and presidential candidate Howard Dean let something incredibly candid slip out about President Obama's health-care reform bill in Congress.
Asked by an audience member why the legislation does nothing to cap medical malpractice class-action lawsuits against doctors and medical institutions (aka "Tort reform"), Dean responded by saying: “The reason tort reform is not in the [health care] bill is because the people who wrote it did not want to take on the trial lawyers in addition to everybody else they were taking on. And that’s the plain and simple truth,”
Dean is a former physician, so he knows about skyrocketing medical malpractice insurance rates, and the role of the trial lawyers in fueling the "defensive medicine" approach among medical personnel who order too many tests and other sometimes unneeded procedures "just to be sure" and to protect themselves against litigation.
Texas Gov. Rick Perry recently described in an Examiner oped the medical-malpractice caps enacted by the state legislature at his urging that reversed a serious decline in the number of physicians practicing in the Lone Star state and the resulting loss of access to quality medical care available to Texas residents. Mississippi Gov. Haley Barbor also shared some of his successes in this area in a recent Examiner oped.
Credit goes to the American Tort Reform Association's Darren McKinney for catching this momentary outbreak of political honesty by Dean. McKinney has conveniently posted an audio recording of Dean speaking here, so you can listen for yourself. Mckinney has also offered more comment here, helpfully even including a link to the Examiner's recent analysis of the degree to which trial-lawyer political contributions go to Democrats in Congress.
Those contributions are why Dean knows it would be a difficult task indeed for Obama to persuade congressional Democrats to do anything that might offend the trial-lawyers lobby. The Examiner's David Freddoso and Kevin Mooney did the reporting on this link here.
Jensen Comment
Reports are that the Texas cap on punitive damages has been quite successful in restraining outrageous settlements of malpractice lawsuits.
"Straight talk on the federal budget deficit," EPI News, August 25,
2009 ---
http://www.epi-data.org/epinews/epinews20090825.html
Some little-known facts about the federal budget deficit: It grew slower than was expected just a few months ago, stimulus spending accounts for only a small sliver of its total, and the leading health care reform proposal would provide coverage for most uninsured Americans without adding a penny to its total. Although the federal deficit is commonly dangled as the reason to block further public investment or comprehensive health care reform, that argument ignores some basic truths about the deficit.
On August 25, the White House released an updated estimate of the federal budget deficit, which shows it now totals $1.6 trillion or 11.2% of GDP. This is $262 billion less than what was estimated in May. The Congressional Budget Office showed a smaller improvement. In anticipation of that release, EPI produced a series of reports (see below) examining the roots of the deficit and the potential impact that health care reform would have on it.
Don’t blame Obama
For all the criticism President Obama has received for running up the deficit, it turns out that Obama’s policies have been a very small factor in the expansion of the federal budget deficit. Bush-era policies, including aggressive tax cuts and spending on the wars in Iraq and Afghanistan, have added significantly more to the totalIn The 2009 Budget Deficit: How Did We Get Here? EPI's Research and Policy Director John Irons notes that George Bush inherited a budget surplus in 2001. Irons and a team of researchers parsed the data to show that 42% of the $2 trillion reversal of fortunes since then reflects Bush-era policies. Another 42% of that $2 trillion reflects the impact of the recession on tax revenues and spending on programs such as unemployment insurance. By contrast, the American Recovery and Reinvestment Act (ARRA), which so often is blamed for the growing deficit, accounts for just 7.6% of the total.
Irons sums up his findings in the analysis Roots of Deficit Pre-Date Obama, where he notes that Bush-era tax cuts combined with revenues lost during the current recession will produce a level of federal revenue in 2009 which, as a portion of GDP, is the lowest since 1950. “An economic downturn will automatically create deficits because job loss and income declines reduce tax revenues, and because they create more demand for public services such as unemployment, nutrition assistance, and increased Medicaid spending,” Irons writes.
Health care reform and the deficit
Economist Josh Bivens, meanwhile, notes in Reform We Can Afford that efforts to block health care reform out of fear of the swelling deficit are misguided for a number of reasons, mainly because the House bill outlines ways to fully pay for the reforms it proposes, meaning that it would provide health insurance to the majority of Americans who do not have it, without adding to the deficit. The reform bill also ends a longstanding budget gimmick that projects steep cuts in Medicare reimbursement rates and then rescinds them at the last minute. Including those costs, which have really been in the budget all along (though largely disguised), would result in the reform bill adding about $239 billion to the deficit over the next 10 years. To put that figure in context, it is roughly 15% of the cost of the tax cuts passed during the Bush administration, or 25% of the cost of spending on wars in Iraq and Afghanistan to date, Bivens notes.Numbers aside, Bivens makes the point that a philosophical opposition to spending that could increase the deficit is as misguided as, say, an opposition to borrowing money to buy a home or pay for a college education. During an extremely steep economic downturn, curtailing spending to protect the deficit is especially foolhardy. “Green eyeshades just have no place at all in current economic debates,” Bivens writes. “The U.S. economy has lost 6.7 million jobs in the past 19 months as private spending has collapsed. Literally the only thing keeping another economic depression at bay has been the very large rise in the federal budget deficit…. Normally, it would be considered a bad idea to dump a bucket of water on your living room rug. When that rug is on fire, however, it’s not just a good idea, it’s absolutely necessary.” Indeed, EPI’s recent report The Recovery Package in Action by Irons and Policy Analyst Ethan Pollack outlines how spending made this year under the Recovery Act has been integral in stopping the economy from going into “a full-blown nose dive.”
Replacing No Child Left Behind
EPI Research Associate Richard Rothstein recently published a piece in Education Week magazine outlining some of the recommendations made by the Broader, Bolder Approach to Education campaign for providing students a well-rounded education that would help them succeed in life, rather than just on standardized tests. Rothstein’s opinion piece is available on EPI’s Web site.In the news
As a debate heats up over whether an economic recovery is underway, a number of news stories discussing the persistently weak job market quote EPI. An Arizona Republic story cites EPI data showing that the United States has lost virtually all the jobs gained since the last recession ended in 2001. A Seattle Times story quotes EPI’s analysis on the high ratio of job seekers to job openings. EPI Vice President Ross Eisenbrey was interviewed for a Nightly Business Report story on the same topic. Eisenbrey pointed out that large numbers of unemployed have not received unemployment insurance, or will soon exhaust those benefits.
The Lie: Obama's relationship with tort lawyers is the real
driver of Obamacare costs
According to a 2007
study by McKinsey&Company, physician compensation
bumps up health care spending in America by $58 billion annually,on average,
because U.S. doctors make twice as much as their OECD peers. And even the
poorest in
specializations like radiology and surgery
routinely rake in around $400,000 annually. Doctors—and many
Republicans—constantly carp about the costs of "defensive medicine" because it
forces providers to perform unnecessary procedures and tests to insulate them
from potential lawsuits. But excessive physician salaries contribute nearly
three times more to wasteful health care spending than the $20 billion or so
that defensive medicine does. "While the U.S. malpractice system is
extraordinary," the study notes, "it is only a small contributor to the higher
cost of health care in the United States." Meanwhile, other studies have found
that doctors' salaries contribute more to soaring medical costs than the
$40 billion or so that
the uninsured cost in uncompensated care--the president's bete noir.
Shikha Dalmia, "The
Evil-Mongering of the American Medical Association: Obama's cozy
relationship with Big Medicine will hurt patients," Reason Magazine,
August 27, 2009 ---
http://www.reason.com/news/show/135682.html
From Former Liberal Senator Bill
Bradley
The bipartisan trade-off in a viable health care
bill is obvious: Combine universal coverage with malpractice tort reform in
health care. Universal coverage can be obtained in many ways — including the
so-called public option. Malpractice tort reform can be something as
commonsensical as the establishment of medical courts — similar to bankruptcy or
admiralty courts — with special judges to make determinations in cases brought
by parties claiming injury. Such a bipartisan outcome would lower health care
costs, reduce errors (doctors and nurses often don’t report errors for fear of
being sued) and guarantee all Americans adequate health care. Whenever Congress
undertakes large-scale reform, there are times when disaster appears certain —
only to be averted at the last minute by the good sense of its sometimes
unfairly maligned members. What now appears in Washington as a special-interest
scrum could well become a triumph for the general interest. But for that to
happen, the two parties must strike a grand bargain on universal coverage and
malpractice tort reform. The August recess has given each party and its
constituencies a chance to reassess their respective strategies. One result, let
us hope, may be that Congress will surprise everyone this fall.
Bill Bradley, "Tax Reform’s Lesson for Health Care Reform,"
The New York Times, August 30, 2009 ---
http://www.nytimes.com/2009/08/30/opinion/30bradley.html?_r=1
"Dean says Obamacare authors don't want to challenge trial lawyers," by: Mark Tapscott, Washington Examiner, August 26, 2009 --- Click Here
Whatever else he said Wednesday evening at the town hall hosted by Rep. Jim Moran, D-VA, former Democratic National Committee chairman and presidential candidate Howard Dean let something incredibly candid slip out about President Obama's health-care reform bill in Congress.
Asked by an audience member why the legislation does nothing to cap medical malpractice class-action lawsuits against doctors and medical institutions (aka "Tort reform"), Dean responded by saying: “The reason tort reform is not in the [health care] bill is because the people who wrote it did not want to take on the trial lawyers in addition to everybody else they were taking on. And that’s the plain and simple truth,”
Dean is a former physician, so he knows about skyrocketing medical malpractice insurance rates, and the role of the trial lawyers in fueling the "defensive medicine" approach among medical personnel who order too many tests and other sometimes unneeded procedures "just to be sure" and to protect themselves against litigation.
Texas Gov. Rick Perry recently described in an Examiner oped the medical-malpractice caps enacted by the state legislature at his urging that reversed a serious decline in the number of physicians practicing in the Lone Star state and the resulting loss of access to quality medical care available to Texas residents. Mississippi Gov. Haley Barbor also shared some of his successes in this area in a recent Examiner oped.
Credit goes to the American Tort Reform Association's Darren McKinney for catching this momentary outbreak of political honesty by Dean. McKinney has conveniently posted an audio recording of Dean speaking here, so you can listen for yourself. Mckinney has also offered more comment here, helpfully even including a link to the Examiner's recent analysis of the degree to which trial-lawyer political contributions go to Democrats in Congress.
Those contributions are why Dean knows it would be a difficult task indeed for Obama to persuade congressional Democrats to do anything that might offend the trial-lawyers lobby. The Examiner's David Freddoso and Kevin Mooney did the reporting on this link here.
Jensen Comment
Reports are that the Texas cap on punitive damages has been quite successful in restraining outrageous settlements of malpractice lawsuits."The President's Tort Two-Step Special-interests and the health-care status," by Kimberly Strassel, The Wall Street Journal, September 11, 2009 --- Click Here
Tort reform is a policy no-brainer. Experts on left and right agree that defensive medicine—ordering tests and procedures solely to protect against Joe Lawyer—adds enormously to health costs. The estimated dollar benefits of reform range from a conservative $65 billion a year to perhaps $200 billion. In context, Mr. Obama's plan would cost about $100 billion annually. That the president won't embrace even modest change that would do so much, so quickly, to lower costs, has left Americans suspicious of his real ambitions.
It's also a political no-brainer. Americans are on board. Polls routinely show that between 70% and 80% of Americans believe the country suffers from excess litigation. The entire health community is on board. Republicans and swing-state Democrats are on board. State and local governments, which have struggled to clean up their own civil-justice systems, are on board. In a debate defined by flash points, this is a rare area of agreement.
The only folks not on board are a handful of powerful trial lawyers, and a handful of politicians who receive a generous cut of those lawyers' contingency fees. The legal industry was the top contributor to the Democratic Party in the 2008 cycle, stumping up $47 million. The bill is now due, and Democrats are dutifully making a health-care down payment.
During the markup of a bill in the Senate Health Committee, Republicans offered 11 tort amendments that varied in degree from mere pilot projects to measures to ensure more rural obstetricians. On a party line vote, Democrats killed every one. Rhode Island senator and lawyer Sheldon Whitehouse went so far as to speechify on the virtues of his tort friends. He did not, of course, mention the nearly $900,000 they have given him since 2005, including campaign contributions from national tort powerhouses like Baron & Budd and Motley Rice.
Even Senate Finance Chair Max Baucus, of bipartisan bent, has bowed to legal powers. The past two years, Mr. Baucus has teamed up with Wyoming Republican Mike Enzi to offer legislation for modest health-care tort reform in states. That Enzi-Baucus proposal had been part of the bipartisan health-care talks. When Mr. Baucus released his draft health legislation this weekend, he'd stripped out his own legal reforms. The Montanan is already in the doghouse with party liberals, and decided not to further irk leadership's Dick Durbin ($3.6 million in lawyer contributions), the Senate's patron saint of the trial bar.
Over in the House the discussion isn't about tort reform, but about tort opportunities. During the House Ways & Means markup of a health bill, Texas Democrat Lloyd Doggett ($1.5 million from lawyers) introduced language to allow freelance lawyers to sue any outfit (say, McDonald's) that might contribute to Medicare costs. Only after Blue Dogs freaked out did the idea get dropped, though the trial bar has standing orders that Democrats make another run at it in any House-Senate conference.
It says everything that Mr. Obama wouldn't plump for reform as part of legislation. The president knows the Senate would never have passed it in any event. Yet even proposing it was too much for the White House's legal lobby. Mr. Obama is instead directing his secretary of health and human services to move forward on test projects. That would be Kathleen Sebelius, who spent eight years as the head of the Kansas Trial Lawyers Association.
The issue has assumed such importance that even some Democrats acknowledge the harm. With bracing honesty, former DNC chair Howard Dean recently acknowledged his party "did not want to take on the trial lawyers." Former Democratic Sen. Bill Bradley, in a New York Times piece, suggested a "grand bipartisan compromise" in which Democrats got universal coverage in return for offering legal reform. The White House yawned, and moved on.
It isn't clear if Republicans would or should take that deal, but we won't know since it won't be offered. The tort-reform issue has instead clarified this presidency. Namely, that the bipartisan president is in fact very partisan, that the new-politics president still takes orders from the old Democratic lobby.
Updates for August 26, 2009
"What The Health Care Bill Actually Says," by Professor John David
Lewis (Duke University), August 6, 2009 ---
http://sweetness-light.com/archive/what-the-health-care-bill-actually-says
Dr. Anne Doig (incoming President of the
Canadian Medical Association) says patients are getting
less than optimal care and she adds that physicians from across the country -
who will gather in Saskatoon on Sunday for their annual meeting - recognize that
changes must be made. "We all agree that the system is imploding, we all agree
that things are more precarious than perhaps Canadians realize,"
Jennifer Graham, "Overhauling
health-care system tops agenda at annual meeting of Canada's doctors," The
Canada Press, August 15, 2009 ---
Click Here
[Waste is about] half of the $2.2 trillion
the United States spends on health care each year, according to the most recent
data from accounting firm PricewaterhouseCoopers'
Health Research Institute. What counts as waste?
The report identified 16 different areas in which health care dollars are
squandered. But in talking to doctors, nurses, hospital groups and patient
advocacy groups, six areas totaling nearly $500 billion stood out as issues to
be dealt with in the health care reform debate . . . "Sometimes the motivation
is to avoid malpractice suits, or to make more money because they are
compensated more for doing more," said Dr. Arthur Garson, provost of the
University of Virginia and former dean of its medical school. "Many are also
convinced that doing more tests is the right thing to do." "But any money that
is spent on a patient that doesn't improve the outcome is a waste," said Garson.
Some conservatives have suggested that capping malpractice awards would help
solve the problem. President Obama doesn't agree; instead, his reform proposal
encourages doctors to practice "evidence-based" guidelines as a way to scale
back on unnecessary tests.
Parija B. Kavilanz, CNN Money,
August 10, 2009 ---
Click Here
http://money.cnn.com/2009/08/10/news/economy/healthcare_money_wasters/index.htm?section=money_news_economy
Jensen Comment
Another excess cost is the number of
support staff needed to process claims forms. Erika and I have doctor in a
clinic that has four doctors (the only source of revenue) and 24 staff (a major
source of expense), many of whom are just there to process reimbursement forms
sent to private insurance companies, Medicare, and Medicaid.
Since much of the added paperwork is for fraud prevention and detection, this is a classic problem of calculating the cost of fraud plus fraud prevention plus billing errors juxtaposed against losses expected to be incurred with less costly prevention and alternate delivery systems. Our doctor is contemplating opening a new practice, but front end costs of setting up a small practice makes this virtually impossible. For example, just setting up an Medicare billing system and Medicare Supplemental Claims authorization takes thousands of pages and tens of thousands of dollars. Then there’s the nearly impossible cost of malpractice insurance for a solo doctor practice.
Since all proposed health care reform legislation calls for continued private health insurance coverage and continued high cost of malpractice insurance, it’s doubtful that anything on the table comes anywhere close to the savings obtained from national health care plans (such as in Canada) for bureaucratic efficiency and caps and other restraints on malpractice awards.
Add all this to the fact that the GAO refuses to sign off on audits of the Pentagon on the grounds that defense spending cannot be audited with any degree of confidence. This is not accountancy’s finest era.
"Study Calculates Economic Cost of Higher Tax Rates, Health Care Surtax,"
Tax Foundation, August 14, 2009 ---
http://www.taxfoundation.org/news/show/25008.html
The actual economic costs of the proposed health care surtax and the expiration of the 2001 and 2003 tax cuts will be twice the amount of revenue the government intends to collect. According to a new analysis from the Tax Foundation, the higher tax rates are estimated to raise $88 billion in 2011, but the economy will incur an additional burden of $76 billion—or "deadweight loss"—as a result, which raises the total cost of the tax increases to $164 billion, roughly double what lawmakers intend to raise.
Tax Foundation Special Report No. 170, "The Excess Burden of Taxes and the Economic Cost of High Tax Rates," attempts to put a price tag on the cost of pending rollbacks of the Bush tax cuts (which would raise the top tax rate to 39.6%) as well as the proposed health care surtax (ranging from 1% to 5.4%). This loss in economic efficiency is also known as the "excess burden" or "deadweight loss" of taxes—the income that would need to be given to people to compensate them for the resources that are lost due to the distorting effect of taxes. The Special Report is available online at http://www.taxfoundation.org/news/show/25003.html.
"The notion that the total burden is nearly twice the revenue collected should give lawmakers some pause when considering these higher tax rates," said Tax Foundation Senior Fellow Robert Carroll, Ph.D., who authored the paper.
"Lawmakers need to understand that the current income tax system already costs the economy between $110 billion and $150 billion above and beyond the $1 trillion the government actually collects in taxes," Carroll said. "This means the actual economic cost of our income tax system is at least $1.10 for every dollar the government collects. The proposed higher tax rates could boost those deadweight costs to more than $1.20 for every dollar of tax revenues collects."
"The burden is particularly high for the higher income tax rates being considered by the Congress," says Carroll. "With every dollar in additional revenue, these tax increases impose an extra burden of 86 cents." For example, in 2011 a couple earning $500,000 will pay $112,437 in income taxes. But the excess burden to them of that tax payment is $16,664, about 15% of their tax burden. The increase in the top two tax rates plus the health care surtax would boost their income tax payment an additional $7,719 to $120,156. However, that tax hike would also increase their excess burden by $8,748, larger than the tax increase itself.
"When totaled over all taxpayers, this means," says Carroll, "that the total economic cost of the higher tax rates will be close to twice the amount lawmakers hope to collect."
"Lawmakers should be wary of policies that are purported to make higher-income taxpayers 'pay their fair share' but that impose very substantial burdens on all taxpayers—nearly twice the revenue that is raised—and waste substantial economic resources," Carroll concluded.
The Tax Foundation is a nonpartisan, nonprofit organization that has monitored fiscal policy at the federal, state and local levels since 1937.
"Ingrates! The Angry Left turns its wrath on President Obama," by James Taranto, The Wall Street Journal Newsletter, August . 24, 2009
The Angry Left is angry at the president of the United States. That makes it official. Nothing changed when Barack Obama became president.
"A backlash in the progressive base--which pushed President Obama over the top in the Democratic primary and played a major role in his general election victory--has been building for months," writes former Enron adviser Paul Krugman, the Angry Left's tribune, in the New York Times. Krugman faults the Obama administration for being insufficiently tender to terrorists and not harsh enough with bankers--but it's clear that what's brought the anger to the surface is the political failure of ObamaCare:
On the issue of health care itself, the inspiring figure progressives thought they had elected comes across, far too often, as a dry technocrat who talks of "bending the curve" but has only recently begun to make the moral case for reform. Mr. Obama's explanations of his plan have gotten clearer, but he still seems unable to settle on a simple, pithy formula; his speeches and op-eds still read as if they were written by a committee. . . .
There's a point at which realism shades over into weakness, and progressives increasingly feel that the administration is on the wrong side of that line. It seems as if there is nothing Republicans can do that will draw an administration rebuke: Senator Charles E. Grassley feeds the death panel smear, warning that reform will "pull the plug on grandma," and two days later the White House declares that it's still committed to working with him.
It's hard to avoid the sense that Mr. Obama has wasted months trying to appease people who can't be appeased, and who take every concession as a sign that he can be rolled.
As we all know, you can't appease terrorists. Oh wait, sorry--appeasing terrorists is worth a try. It's Republicans you can't appease.
Krugman's colleague Bob Herbert echoes the complaint:
Mr. Obama, who has a command of the English language like few others, has been remarkably opaque about his intentions regarding health care. He left it up to Congress to draft a plan and he has not gotten behind any specific legislation. He has seemed to waffle on the public option and has not been at all clear about how the reform that is coming will rein in runaway costs. At times it has seemed as though any old "reform" would be all right with him.
It's still early, but people are starting to lose faith in the president.
What ingrates! Obama has been courting political ruin by pushing for the policies these guys want, but do they give him any credit? Far from it. Instead they damn him for not being clear or forceful enough in his advocacy.
What would a clear and forceful case for ObamaCare look like? We don't have to look very far. Here's former Enron adviser Paul Krugman in a YouTube medley we've cited before:
Politically, it's hard to do in one step. You have to convince people to give up the insurance--forget about mollifying the insurance companies; that's not going to happen. But you're going to have to convince people to completely give up the insurance they have, whereas something that lets people keep the insurance they have but then offers the option of a public plan may evolve into single-payer, but you can do it politically.
Under the "public option," the central provision of ObamaCare, the government would become a health-insurance company. Under "single payer," Krugman's ideal, the government would have a monopoly on health insurance. As the YouTube video demonstrates, Krugman is far from alone in hoping that the "public option" would "evolve" into the only "option."
"You can do it politically," Krugman opines, but it's clear that you can do it only if you are able to conceal your true aims--hence the opacity that frustrates Herbert. If Obama is failing, it is not because he has been too accommodating but because people have managed to figure out that he has been pushing for a bad and unpopular policy--Krugman's policy--despite his best efforts to make it sound palatable.
Instead of denouncing the president, Krugman ought to be honoring him for the political sacrifice he has made in what appears likely to be a losing effort. But then some people just can't be appeased.
Would ObamaCare Lead to an Obamonopoly?
President Obama has been insisting of late that he does not support a government health-insurance monopoly ("single payer"). Here he is two weeks ago in Portsmouth, N.H.:I have not said that I was a single-payer supporter because, frankly, we historically have had a employer-based system in this country with private insurers, and for us to transition to a system like that I believe would be too disruptive. So what would end up happening would be, a lot of people who currently have employer-based health care would suddenly find themselves dropped, and they would have to go into an entirely new system that had not been fully set up yet. And I would be concerned about the potential destructiveness of that kind of transition.
All right? So I'm not promoting a single-payer plan.
As we noted last week, this contradicts what Obama said in 2003:
I happen to be a proponent of a single-payer universal health care program. I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14% of its gross national product on health care, cannot provide basic health insurance to everybody. And that's what Jim is talking about when he says everybody in, nobody out. A single payer health care plan, a universal health care plan. And that's what I'd like to see. But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House.
Now he says he does see a reason, namely the "destructiveness of that kind of transition." This is his rebuttal to people who say he supports a government insurance monopoly. Tellingly, though, on Jan. 21, 2008, when he was running against Hillarly Clinton, the Web site of his "grass-roots" outfit, Organizing for America, featured an item titled "Fact Check: Obama Consistent in His Position on Single Payer Health Care":
Rhetoric: "Today, he opposes single payer health care, and attacks Sen. Clinton for proposing a plan that covers everyone"
Reality: Obama Has Consistently Said That If We Were Starting From Scratch, He Would Support A Single Payer System, But Now We Need To Build On The System We Have
If Obama Were Starting From Scratch, He Would Support A Single Payer System. The New Yorker wrote, " 'If you're starting from scratch,' he [Obama] says, 'then a single-payer system'-a government-managed system like Canada's, which disconnects health insurance from employment-'would probably make sense. But we've got all these legacy systems in place, and managing the transition, as well as adjusting the culture to a different system, would be difficult to pull off. So we may need a system that's not so disruptive that people feel like suddenly what they've known for most of their lives is thrown by the wayside.' " [New Yorker, 5/7/07]
If Obama Were Starting From Scratch, He Would Support A Single Payer System. "At a roundtable with a handful of invited guests at Lindy's Diner in Keene, Obama said if he were starting from scratch, he would probably propose a single payer health care system, but because of existing infrastructure, he created a proposal to improve the current system." [Concord Monitor, 8/14/07]
If Obama Were Starting From Scratch, He Would Support A Single Payer System. Obama said, "Here's the bottom line. If I were designing a system from scratch I would probably set up a single-payer system...But we're not designing a system from scratch...And when we had a healthcare forum before I set up my healthcare plan here in Iowa there was a lot of resistance to a single-payer system. So what I believe is we should set up a series of choices. . . . Over time it may be that we end up transitioning to such a system. For now, I just want to make sure every American is covered . . . I don't want to wait for that perfect system . . . The one thing you should ask about the candidates though is who's gonna have the capacity to actually deliver on the change? . . . I believe I've got a better capacity to break the gridlock and attract both Independents and Republicans to work together."
And indeed Obama's position in 2008 is consistent with his position in 2009--but back then, it was a rebuttal to those who said he opposed a government insurance monopoly. Given that so many pro-monopoly politicians and commentators have enthusiastically endorsed the so-called public option, it seems to us there is ample reason to believe that Obama was more honest about his intentions in 2008 and 2003 than he is in 2009.
"5 Liberal Lies About Obamacare," by John Hawkins, Townhall,
August 25, 2009 ---
http://townhall.com/columnists/JohnHawkins/2009/08/25/5_liberal_lies_about_obamacare
Barrack Obama and his pals in the mainstream media are doing everything in their power to keep people from finding out the truth about the health care bills that are winding their way through Congress.
Rather than engaging in an honest debate about the pluses and minuses of socialized medicine, they've abandoned all significant attempts to work with the GOP, they've demonized American citizens who've dared to voice their concern at townhalls, and they have lied more than Bill Clinton probably did the first time Hillary mentioned the name "Gennifer Flowers" to him.
Liberal claim:
The public option won't kill private health insurance. When that sleazy old terrorist Yasser Arafat was alive, he was famous for telling Westerners he wanted peace in English, while telling his own people in Arabic to kill the Jews. Liberals are using the same tactic with the public option.When they're talking to the general public, they assure them that the public option won't kill private insurance and if people like the plans they have, they'll be able to keep them.
But when liberals talk to each other, they explicitly admit that the public option is designed to kill private insurance so the government can take complete control.
There are many examples of this, but this quote from Barney Frank is so crystal clear about what they're doing that no more examples are really needed,
I think if we get a good public option, it could lead to single payer and that's the best way to reach single payer. Saying you'll do nothing until you reach single payer is a sure way never to get it.
Liberal Claim:
Illegal aliens won't be covered If you want to know why Americans don't believe Congress or the mainstream media, the sort of slick deception that's being practiced here is typical of what's driving the distrust.There is indeed a clause in the House bill that says illegal aliens aren't covered. The mainstream media looks at that clause and then dutifully reports, as if it were a fact, that illegal aliens won't be getting taxpayer funded health care.
However, here's the catch: there's no enforcement provision. Texas Congressman Lamar Smith explains how the scam will work:
The Democrats’ bill in the House, H.R. 3200, contains gaping loopholes that will allow illegal immigrants to receive taxpayer-funded benefits. And these loopholes are no accident.
The legislation contains no verification mechanism to ensure that illegal immigrants do not apply for benefits. Republicans offered an amendment to close this loophole — it would have required verification using the existing methods that are already in place to verify eligibility for other federal benefits programs. But when they were asked to put the language of the bill where their words were, in a party-line vote, House Democrats rejected the amendment to require verification and close this loophole.
In other words, the Democrats can claim that illegal aliens won't be covered by the bill and even point to a provision in it that says it won't happen. Meanwhile, if the health care bill passes, millions of illegals aliens will have their health care picked up on the taxpayer's dime -- just as the Democrats planned all along.
Continued in article
"No Maine Miracle Cure: Another state 'public option' that failed," The Wall Street Journal, August 21, 2009 --- http://online.wsj.com/article/SB10001424052970204619004574322401816501182.html#mod=djemEditorialPage
Want a preview of ObamaCare in action? Sneak a look at what has happened in Maine. In 2003, the state to great fanfare enacted its own version of universal health care. Democratic Governor John Baldacci signed the plan into law with a bevy of familiar promises. By 2009, it would cover all of Maine's approximately 128,000 uninsured citizens. System-wide controls on hospital and physician costs would hold down insurance premiums. There would be no tax increases. The program was going to provide insurance for everyone and save businesses and patients money at the same time.
After five years, fiscal realities as brutal as the waves that crash along Maine's famous coastline have hit the insurance plan. The system that was supposed to save money has cost taxpayers $155 million and is still rising.
Here's how the program was supposed to work. Two government programs would cover the uninsured. First the legislature greatly expanded MaineCare, the state's Medicaid program. Today Maine families with incomes of up to $44,000 a year are eligible; 22% of the population is now in Medicaid, roughly twice the national average.
Then the state created a "public option" known as DirigoChoice. (Dirigo is the state motto, meaning "I Lead.") This plan would compete with private plans such as Blue Cross. To entice lower income Mainers to enroll, it offered taxpayer-subsidized premiums. The plan's original funding source was $50 million of federal stimulus money the state got in 2003. Over time, the plan was to be "paid for by savings in the health-care system." This is precisely the promise of ObamaCare. Maine saved by squeezing payments to hospitals and physicians.
The program flew off track fast. At its peak in 2006, only about 15,000 people had enrolled in the DirigoChoice program. That number has dropped to below 10,000, according to the state's own reporting. About two-thirds of those who enrolled already had insurance, which they dropped in favor of the public option and its subsidies. Instead of 128,000 uninsured in the program today, the actual number is just 3,400. Despite the giant expansions in Maine's Medicaid program and the new, subsidized public choice option, the number of uninsured in the state today is only slightly lower that in 2004 when the program began.
Why did this happen? Among the biggest reasons is a severe adverse selection problem: The sickest, most expensive patients crowded into DirigoChoice, unbalancing its insurance pool and raising costs. That made it unattractive for healthier and lower-risk enrollees. And as a result, few low-income Mainers have been able to afford the premiums, even at subsidized rates.
This problem was exacerbated because since the early 1990s Maine has required insurers to adhere to community rating and guaranteed issue, which requires that insurers cover anyone who applies, regardless of their health condition and at a uniform premium. These rules—which are in the Obama plan—have relentlessly driven up insurance costs in Maine, especially for healthy people.
The Maine Heritage Policy Center, which has tracked the plan closely, points out that largely because of these insurance rules, a healthy male in Maine who is 30 and single pays a monthly premium of $762 in the individual market; next door in New Hampshire he pays $222 a month. The Granite State doesn't have community rating and guaranteed issue.
One proposal to get people into the DirigoChoice system is to reduce the premiums, presumably to give the uninsured a larger incentive to join. But that would explode the program's costs when it already can't pay its bills. A program that was supposed to save money by reducing health-care waste and inefficiencies has seen a 74% increase in premiums. But even those inflated payments can't keep the program out of the red.
Last year, DirigoCare was so desperate for cash that the legislature broke its original promise of no tax hikes and proposed an infusion of funds through a beer, wine and soda tax, similar to what has been floated to pay for the Obama plan. Maine voters rejected these taxes by two to one. Then this year the legislature passed a 2% tax on paid health insurance claims. Taxing paid insurance claims sounds a tad churlish, but the previous funding formula was so complicated that it was costing the state $1 million a year in lawsuits.
Unlike the federal government, Maine has a balanced budget requirement. So out of fiscal necessity, the state has now capped the enrollment in the program and allowed no new entrants. Now there is a waiting list. DirigoChoice has become yet another expensive, failed experiment in government-run health care, alongside similar fiascoes in Massachusetts and Tennessee.
Not everyone sees it this way. Noting the similarities between the Maine program and the Congressional initiative, Karynlee Harrington, the executive director of the Dirigo Health Agency, boasted recently: "DirigoChoice is consistent with what we think the definition of a public health option is." It certainly is.
"What If Obamacare Actually Happens?" by Austin Hill, Townhall, August 23,
2009 ---
http://townhall.com/columnists/AustinHill/2009/08/23/what_if_obamacare_actually_happens
What if a health care bill actually passes in the Congress, and President Obama signs it into law?
Given the ways in which his “hope” and “change” are being embraced across the nation right now, such a legislative “victory” for Mr. Obama could be the worst thing, politically, for his presidency and his party.
Earlier this year, I contemplated here in this column how Obama’s behavior tends to be woefully inconsistent with his rhetoric, and how our President has a propensity for “doing the opposite” of what he says. For example, as a candidate Obama insisted that he is not a “big government” advocate, but then as President proposed a federal budget in excess of $3.5 trillion (Treasury Secretary Tim Geithner is now asking Congress to raise the federal debt ceiling above $12 trillion for fear that there won‘t be money to fund Obama‘s budget after October of this year). As a candidate Obama decried the “petty distractions” and “partisan politics as usual” that stifle honest dialog, and prevent people from focusing on the real important issues. Yet from the White House Obama unleashed an intentional and strategic game of publicly demonizing talk show host Rush Limbaugh earlier this year; it appeared that members of his Administration “organized” their “friends” to demonstrate in front of the private homes of AIG Executives to harrass them for having earned bonuses from their employer last Spring; and last week Obama himself told participants in a faith-based organizing conference call that he needed their help to sell his health care take-over plans, admonishing that “I need you to knock on doors, talk to neighbors, spread the facts and speak the truth” (great “community organizing,” but not particularly presidential).
But just as President Obama has established a clear pattern of ignoring many of his campaign promises and “doing the opposite” in so many areas of his presidency, it is also true that on many economic matters, Obama is essentially in lock-step with what he promised on the campaign trail. He campaigned as an economic redistributionist. As President, he has most certainly been a redistributionist, and has displayed little comprehension or respect for the free-market economy.
As a candidate he expressed all-out disdain for business, and repeatedly promised to dramatically increases taxes and regulations on corporations, expressed anger and “outrage” when corporations reported profits that were “too big,” and promised to “give back” corporate profits to “the American people.”
So for those who have been paying attention, “Obamacare” should be no surprise. The candidate promised a “single payer” health insurance plan, and even once lamented that it may take “ten to fifteen years” to get private insurance companies out of the health insurance market entirely. When single-payer proposals began emerging in Congress and were met with staunch opposition from American citizens, President Obama changed his position on single-payer insurance, insisting that all he wanted was an “option” of government funded insurance.
And now it appears that Congress, owing to Obama’s community organizer instincts, is about to begin demonizing health insurance company executives, trashing their lavish lifestyles and portraying them as perpetrators (you thought the treatment of the AIG folks was rough? Stay tuned).
So what if some form of “Obamacare” actually comes to pass? It will likely be woefully unpopular, it could cost the Democrats dearly in the 2010 election, and could set-off an uprising far greater than anything we’ve seen in this summer’s congressional “townhall” meetings. Yet such a “reform” plan would likely be consistent with President Obama’s big-government, centrally-controlled economic sensibilities, complete with governmental conrols over what procedures physicians will perform, and how much money they will be compensated for performing them.
If “Obamacare” comes to pass, it will be a significant fulfillment of President Obama’s vision of a “transformed” America. But it will not be what Americans want.
America, what is happening to you?
“One thing seems probable to me,” said Peer Steinbrück,
the German finance minister, in September 2008....“the United States will lose
its status as the superpower of the global financial system.” You don’t have to
strain too hard to see the financial crisis as the death knell for a
debt-ridden, overconsuming, and underproducing American empire.
Richard Florida, "How the Crash Will
Reshape America," The Atlantic, March 2009 ---
http://www.theatlantic.com/doc/200903/meltdown-geography
Bob Jensen’s threads on impending disaster --- http://www.trinity.edu/rjensen/2008Bailout.htm#NationalDebt
Updates for August 17, 2009
We hear the trillion-dollar figure all the time, but
how much would ObamaCare really end up costing? If we've learned
anything from
previous
government programs, it's that the actual price
almost always shoots far beyond the advertised price. Is there any reason to
think things would be different this time around?
Watch the video ---
http://reason.com/blog/show/135279.html
The Lie: The public health insurance
option is essential to having efficient private alternatives
To the Democrats, I say this: If you want
competition in health care, you won’t get it if the public option can make deals
its competitors can’t. So either give the Republicans hard assurances that the
public option would have to break even and not get special treatment, or, better
yet, just give it up to ensure that some useful health care reform is passed. A
public option is neither necessary nor sufficient for achieving the real goals
of reform, and those goals are too important to risk losing the war.
Professor Richard Thaler, "A Public
Option Isn’t a Curse, or a Cure," The New York Times, August 16, 2009 ---
Click Here
So the present (health care) system is an
unsustainable disaster, but you can keep your piece of it if you want. And the
Democrats wonder why selling health care reform to the public has been so hard?
Ramesh Ponuru, "Obamacare's Fatal
Flaw: Democrats claim their plans will save money, but they have too many conflicting
goals," Time Magazine August 17, 2009, Page 35
Jensen Comment
The problem is that they keep adding expensive medical services that sound great
on paper, but few people, companies, and certainly not government can afford
these uncapped benefits.
Obama Must Condemn NY Times Race-Baiting Tactics, Black Group Says
The Project 21 black leadership network, New York Times
liberal columnist Paul Krugman Obama Must Condemn NY Times Race-Baiting Tactics,
Black Group Says Washington D.C. — The Project 21 black leadership network is
condemning New York Times liberal columnist Paul Krugman (Nobel
Economist and Princeton University Professor) for
scurrilously pinning racist motives on critics of President Obama’s health care
proposals. The group is calling upon President Obama to condemn all efforts to
derail legitimate public debate, specifically including this effort to stifle
debate with race-baiting tactics.
Bob Parker, Canada Free Press,
August 8, 2009 ---
http://canadafreepress.com/index.php/article/13533
Jensen Comment
There will be ice caves in Hell before President Obama criticizes the GOP-hating
New York Times.
"Drug Dealers: The White House buys Big Pharma’s," The Wall
Street Journal, August 8, 2009
---
http://online.wsj.com/article/SB10001424052970204908604574336460960419516.html?mod=djemEditorialPage
Democrats are trying to explain opposition to ObamaCare as a sinister conspiracy controlled by the hidden hand of the health-care industry. Psychologists call this projection. Why bother with a new conspiracy when you’ve already clinched a secret deal with the President?
Part of the Obama health strategy has been to assiduously co-opt the key health “stakeholders,” primarily with the leverage that legislation was inevitable so they might as well negotiate. Doctors, hospitals, insurers and the drug makers bought it—or perhaps it is more accurate to say were bought. This week it emerged that the pharmaceutical industry’s supposedly voluntary peace offering to cut drug costs by $80 billion to help finance ObamaCare was an explicit quid pro quo in exchange for White House protection.
After the industry trade group PhRMA announced the plan in the Rose Garden in June, liberals on Capitol Hill promptly declared that they were “not bound” by it, as Henry Waxman and Nancy Pelosi repeatedly put it. If the industry could do Mr. Obama the favor of $80 billion, liberals wanted it to eat $100 billion in cuts, or $160 billion, or more.
“The President made the agreements he made,” Mrs. Pelosi said. “And maybe we’ll be limited by that. But maybe not.” Sure enough, the House health bill pockets the money and then imposes price controls in Medicare and other “rebates” from manufacturers, much like Medicaid requires now.
Chief pharma lobbyist Billy Tauzin’s clients were probably wondering about the return on their investment. Then, lo, Mr. Tauzin disclosed this week in a page-one story in the New York Times that, yes, the concessions were capped at $80 billion, no further. “We were assured: ‘We need somebody to come in first. If you come in first, you will have a rock-solid deal,’” Mr. Tauzin said. “Adding other stuff changes the deal.” The White House confirmed Mr. Tauzin’s account.
It’s astonishing to watch the press corps pass all this off as just another day at the Oval Office. During the Bush years, even eye contact with a business, CEO or lobbyist was treated as prima facie evidence of corruption. There was the furor over Dick Cheney’s “secret energy task force,” and even the Iraq war was engineered to benefit Halliburton, Blackwater and Big Oil. But apparently having corporate America dictate public policy is fine as long as it’s the largest expansion of the welfare state since the Great Society.
As for Mr. Tauzin’s gambit that playing nice would spare his industry, he evidently missed the sign hanging above Congress’s chambers: “Abandon all hope, ye who enter here.” Mr. Waxman responded, “PhRMA would like to see if they can get a bargain. I think that PhRMA should contribute more than PhRMA wants to contribute.” Senator Dick Durbin chimed in that “I don’t think any, if many, of us feel bound by any understanding or agreement along those lines.”
What this Abbott and Costello routine exposes is the industry folly of thinking that liberals could be appeased. By now it is beyond obvious that Democrats view whole segments of the health-care industry as expendable. After all, what do insurers really do, besides bilk consumers? Government already pays Medicare bills; it can handle the under-65 crowd too. Over time doctors can be transferred into the civil service, but if they’re good sports maybe at a higher pay grade than the DMV. As for drug research and development, the National Institutes of Health can fill in—and as a bonus, all those government-funded professors won’t care about profits either. For the Democrats running Congress, merely allowing a business to continue to exist is a concession.
Even if Mr. Tauzin’s strategy works this time around, it will only push his clients deeper into Mr. Waxman’s embrace as government pays for the majority of American medicine. If ObamaCare is defeated, it will be due to the common sense of the American people, not to the health-care lobbies that have become its political partners.
The Poster Child of Universal Health Care is In Financial Troubles
"France Fights Universal Care's High Cost," David Gauthier-Villars, The Wall
Street Journal, August 7, 2009 ---
http://online.wsj.com/article/SB124958049241511735.html
France claims it long ago achieved much of what today's U.S. health-care overhaul is seeking: It covers everyone, and provides what supporters say is high-quality care. But soaring costs are pushing the system into crisis. The result: As Congress fights over whether America should be more like France, the French government is trying to borrow U.S. tactics.
In recent months, France imposed American-style "co-pays" on patients to try to throttle back prescription-drug costs and forced state hospitals to crack down on expenses. "A hospital doesn't need to be money-losing to provide good-quality treatment," President Nicolas Sarkozy thundered in a recent speech to doctors.
And service cuts -- such as the closure of a maternity ward near Ms. Cuccarolo's home -- are prompting complaints from patients, doctors and nurses that care is being rationed. That concern echos worries among some Americans that the U.S. changes could lead to rationing.
The French system's fragile solvency shows how tough it is to provide universal coverage while controlling costs, the professed twin goals of President Barack Obama's proposed overhaul
"French people are so attached to their health-insurance system that they almost never support changes," says Frédéric Van Roekeghem, Assurance Maladie's director.
Both patients and doctors say they feel the effects of Mr. Sarkozy's cuts. They certainly had an impact on Ms. Cuccarolo of the firetruck birth.
She lives near the medieval town of Figeac, in southern France. The maternity ward of the public hospital there was closed in June as part of a nationwide effort to close smaller, less efficient units. In 2008, fewer than 270 babies were born at the Figeac maternity ward, below the annual minimum required of 300, says Fabien Chanabas, deputy director of the local public hospital.
"We were providing good-quality obstetric services," he says. "But at a very high cost." Since the maternity closed, he says, the hospital narrowed its deficit and began reallocating resources toward geriatric services, which are in high demand.
In the Figeac region, however, people feel short-changed. "Until the 1960s, many women delivered their babies at home," says Michel Delpech, mayor of the village where Ms. Cuccarolo lives. "The opening of the Figeac maternity was big progress. Its closure is perceived as a regression."
For Ms. Cuccarolo, it meant she would have to drive to Cahors, about 30 miles away. "That's fine when you can plan in advance," she says. "But my little girl came a month earlier than expected."
France launched its first national health-care system in 1945. World War II had left the country in ruins, and private insurers were weak. The idea: Create a single health insurer and make it compulsory for all companies and workers to pay premiums to it based on a percentage of salaries. Patients can choose their own doctors, and -- unlike the U.S., where private health insurers can have a say -- doctors can prescribe any therapy or drug without approval of the national health insurance.
Private insurers, both for-profit and not-for-profit, continued to exist, providing optional benefits such as prescription sunglasses, orthodontics care or individual hospital rooms.
At a time when the U.S. is considering ways of providing coverage for its entire population, France's blending of public and private medical structures offers important lessons, says Victor Rodwin, professor of health policy and management at New York University's Wagner School. The French managed to design a universal system incorporating physician choice and a mix of public and private service providers, without it being "a monolithic system of Soviet variety," he says.
It took decades before the pieces fell into place. Only in 1999 did legislation mandate that anyone with a regular residence permit is entitled to health benefits with no strings attached. Also that year, France clarified rules for illegal residents: Those who can justify more than three months of presence on French territory, and don't have financial resources, can receive full coverage.
That made the system universal.
In the U.S., health-overhaul bills don't attempt to cover illegal immigrants. Doing so would increase costs and is considered politically difficult.
Continued in article
Jesus, the Great Healer, wants Obamacare
according to MSNBC (even if top preachers are "dreadfully silent").
Watch the video ---
http://hotair.com/archives/2009/08/13/msnbc-host-hey-wouldnt-jesus-want-us-to-have-universal-health-care/
Bob Jensen's threads on Obamacare are at http://www.trinity.edu/rjensen/Health.htm
Updates for August 7, 2009
The President Bombs in Peoria
His news conference the other night was bad. He was filibustery and spinny and gave long and largely unfollowable answers that seemed aimed at limiting the number of questions asked and running out the clock. You don’t do that when you’re fully confident. Far more seriously, he didn’t seem to be telling the truth. We need to create a new national health-care program in order to cut down on government spending? Who would believe that? Would anybody? The common wisdom the past week has been that whatever challenges health care faces, the president will at least get something because he has a Democratic House and Senate and they’re not going to let their guy die. He’ll get this or that, maybe not a new nationalized system but some things, and he’ll be able to declare some degree of victory. And this makes sense. But after the news conference, I found myself wondering if he’d get anything
Peggy Noonan, "Common Sense May Sink ObamaCare: It turns out the president misjudged the nation’s mood, The Wall Street Journal, July 24, 2009 ---
http://online.wsj.com/article/SB10001424052970203517304574306533556532364.html#mod=djemEditorialPagePresident Blames Doctors for Health Care Costs --- http://townhall.com/columnists/KenKlukowski/2009/07/24/president_blames_doctors_for_health_care_costs
Jensen Comment
Of course the fact that lawyers are the cause of dysfunctional health care insurance costs is never mentioned by our lawyer-loving President Obama.Video: Rep. Tom Price (also a surgeon for 25 years) admonishes govt-takeover of healthcare ---
http://www.youtube.com/watch?v=SD_YOlUBoIk
It falls on deaf ears.Nobel Prize winner Paul Krugman is the liberal economics professor at Princeton University and a leftist columnist for The New York Times. Until now he unfledgingly promoted Obamacare.
Newsbusters, by Seton Motley, July 28, 2009 --- Click Here
http://newsbusters.org/blogs/seton-motley/2009/07/28/nyts-krugman-conducts-informal-canadian-health-care-poll-result-bad-moNYT's Krugman Conducts Informal Canadian Health Care Poll; "Result: 'Bad Move On My Part"
Watch his truth time video --- Click HereDiscussing from The Economist magazine on how the U.S. spends more than any other nation on health care and receives less for its buck than many other nations ---
http://www.economist.com/research/articlesBySubject/displaystory.cfm?subjectid=348945&story_id=13899647"What disturbs Americans of all ideological persuasions is the fear that almost everything, not just government, is fixed or manipulated by some powerful hidden hand," Frank Rich wrote in Sunday's New York Times. That manipulation should disturb us. But contrary to Rich, it is not the work of "corporatists" who have sprung up to attack progressive reforms proposed by Obama and the Democratic majority. Manipulation is what we got many years ago when we traded a more or less free market for the "progressive" interventionist state. When government is big, the well-connected always have an advantage over the rest of us.
"Big Business for Health-Care Reform," by John Stossel, ABC News, August 11, 2009 ---
http://blogs.abcnews.com/johnstossel/2009/08/big-business-for-healthcare-reform.htmlWal-Mart Does a Flip Flop on Obamacare in a Quest for Greater Monopoly Power
Here's Wal-Mart's Plan Before Obama Care
"I have diabetes, a pre-existing condition that requires regular doctor’s appointments. Wal-Mart suggests that I take its insurance and wait the two years until I become eligible. This means that I would pay about $2,000 or more and still not be covered for two years."
http://walmartspeakout.com/speak-out/stories/c/health_careHere's Wal-Mart's Plan After Obama Care
In what some see as an about face, Wal-Mart is now in favor of Obamacare, but the suspected reasons is that its smaller competitors will be put out of business because of the higher costs.
“It will drive their smaller, less efficient competitors out of business. There are a lot of mom and pop operations — and some that are their own small, regional chain stores — that are struggling to stay afloat right now. This new requirement will cause at least some of them to throw in the towel.” ---
http://pajamasmedia.com/blog/why-wal-mart-embraced-obamacare/"Businesses Hit Hard With Obamacare, Say Goodbye to Mom and Pop Stores," by Werner Todd Huston, July 2, 2009 ---
http://www.canadafreepress.com/index.php/article/12534The most insidious part of Obamacare is the backdoor taxes, and defacto control of our healthcare by the nanny state that President Obama’s plan is loaded with. And here is another one that is not getting much play. Employers would be socked with requirements to pay for 72.5 percent of the cost of insurance premiums for their full-time employees under the plan being considered in the House.
They would also be required to pick up an as yet undetermined percentage of the insurance plans for part-time employees, as well. This alone will insure that part-time jobs across the nation are terminated for the destructive cost involved in having them.
Or, conversely, many full-time jobs will be eliminated if the costs of insurance is so steep and that of part-timers less so. Either way, jobs will be lost because of these new, never before seen expenses. According to the draft legislation in the House, businesses would be required to pay the federal government a fine of 8 percent of their payroll if they do not offer a basic insurance package to their employees. The House bill has yet to determine how large a small business must be before they are forced into this requirement.
Let’s think about what this means, though. This new mandatory expenditure will greatly drive up the costs of business for small and medium sized businesses and force many of them to close up shop. They will not be able to compete with the larger corporations that will have the resources to offer insurance plans even for part-time workers.
This means the permanent elimination of mom-and-pop business nationwide and the proliferation of large, corporate held shops of all sorts. From the corner market and small book store to the local garage and sandwich shop, small businesses will be hounded out of business by overweening government mandates. This will naturally open the business to even more national chains of all sorts. It seems to me that the self-same people that claim they want nationalized healthcare are the same sort that decry the giants like WalMart. But here they are pushing an idea that will give them more WalMats from sea to shining sea!
Jensen Comment
As of August 3, 2009 we still don't have final passage of an Obamacare package such that it is not clear what things might be added to or deleted from the bill to protect smaller businesses. In my mind, Huston is entirely correct unless some type of relief is given to the mom and pop stores that provide more U.S. employment than the national chain stores. There also is an issue of seasonal business that needs to be resolved. Will business firms that are only open for three or four months each season have to pay year-around health insurance for full-time and part-time employees?The 8% of gross payroll good-deal-penalty still sounds like a great opt-out for millions of mom and pop stores across the U.S. As I've said repeatedly, however, the massive bureaucracy needed to process enrollment of between 100 million and 200 million people into the new Government Health Insurance Agency (GHIA) and process possibly billions GHIA claims for their health care each year just is not feasible for over a decade or more.
Hence I think the 8% good-deal-penalty is a bait and switch fraud just to get the plan passed in 2009. In order to keep private insurance companies afloat and reduce the number GIAA enrollments of working people down to a manageable number, the 8% bait used to get Obamacare legislation passed will be switched around 2014 to a much higher penalty such as X=50% that either forces employers to enroll employees into private medical insurance plans, go out of business, or move the business to another country such as Mexico (if that is possible for that line of business).
The X% no-longer-good-deal penalty will probably be bifurcated between full-time and part-time employees. Employers will have to provide private-plan coverage for their full-time employees because the X% is too high for opting out of the system entirely. The X% of gross payroll may still be the best deal for part-time employees when the percentage of work time (such as 20 hours per week divided by 40 hours per week) and number of weeks worked (such as 20 weeks divided by 52) are factored into the penalty payment for part-time workers.
There are some other disturbing features that I found in the current House Bill, but I will not dwell on them now except to say that
- There is rationing of health care treatment (which I don't object to in principle),
- Equalization of payments for services such that brain surgeons who spent 12 years in medical school may not get any more income than primary care physicians who spent four years in medical school (which I object to in principle because there is no incentive to sacrifice time and money to become a specialist),
- Various expensive social services built into health care (such as coverage of marriage and family counseling).
Probably the most disturbing to me is the increased opportunity for fraud. This bill is a bonanza for community organizing groups in from big cities to tiny villages. ACORN (by whatever its series of deceitful name changes) and other "organizing groups" will have an unbelievable cash cow for signing up real and fictional people and providing home services to both real and fictional people. For example, people who aren't really married will probably get a lot of ACORN-reimbursable counseling where half goes to the fraudulent client and half goes to an ACORN-like counseling firm manned by professionals with phony diplomas.
People who aren't really crippled will get a lot of scooters for their new scooter street ball games. Many will get expensive elevators (lifts) installed in their houses. What we now call Medicare fraud for home equipment and medications will be a drop in the bucket compared to the fraud to come. And the multiple-trillion dollar cash cow will be impossible to police given the cleverness of the fraudsters we cannot now detect in the Medicare claims service.
July 23, 2009
Video tutorial on the President's strategy and the legislative process for passing health reform legislations --- http://www.kaiseredu.org/tutorials/reformprocess/player.html
The major stumbling block, apart from political gaming, is how to finance health care. Clearly, there's a limit to stacking more trillions on the trillions of budget deficits already in place. It's naive to think that any one cohort such as the top 3% of wage earners can pay for health care reform of the masses. Surtaxes on higher income people have enormous adverse impacts on employment opportunities in small business companies, incentives to take financial risks for new ventures, support of charities and colleges, tax cheating, etc. Even worse is that costs of universal health care are being so fraudulently underestimated that even total confiscation of high incomes would only be a drop in the bucket. For example, the massive fraud losses in Medicare will increase 100-fold under universal health care, and these new fraud losses have not been factored into the present cost estimates.The only sensible solution is to spread the pain of universal health care among virtually all recipients of the health insurance coverage. This means significant increases in taxes for all wage earners at all income levels, much like the cost of health care is spread out in Canada even if total nationalization of health care in the U.S. is not politically feasible at the moment.
Moral Hazards of Precondition Coverage in Employer Health Insurance
My major concern in the proposed universal health insurance legislation is the disastrous proposal that employers must pay for health insurance coverage of preconditions. This presents all sorts of moral hazards and financial risks that will either force employers out of business or force employers to shift to replacing nearly all full-time employees with part-time employees who do not have to be covered in the employer's health insurance plan.As an illustration of the moral hazard, consider the following scenario. A nurse-mom makes high wages as an excellent, albeit part-time, physician’s assistant. The wages are so high that she now affords to buy private health insurance that will not cover organ transplants. She discovers that one of her children needs a heart transplant. She then switches jobs to a become a minimum wage full-time filing clerk at a small private college in the community just so she can get precondition coverage the heart transplant. The small private college that has its own employee insurance coverage pool is now stuck with having to fund a child’s million dollar heart transplant as a precondition required by law by employers who hire new employees. Even if the college has a major medical kick-in policy, the cost of such a major medical policy will sky rocket when preconditions are required by law to be covered.
Her income as a full-time filing clerk is about a tenth of her income as a part-time physician's assistant. After her child's heart transplant this nurse-mom goes back to being a highly paid part-time physician’s assistant.
Another moral hazard will be when a worker’s family member in any nation has an expensive medical precondition. If the worker sneaks into the U.S., the entire family is eligible for the House version of the universal health care plan ---
http://townhall.com/columnists/MichelleMalkin/2009/07/22/obamacare_for_illegal_aliens
Also see http://www.avherald.com/h?article=41a81ef1/0037&opt=4608
In other words a worker who would not otherwise sneak into the U.S. to become an illegal alien is motivated to do so just for the health insurance coverage of very expensive procedures such as organ transplants and neuro surgeries. The family might then return to their own home country after beating the U.S. health care system.Actually this scenario is unrealistic because, after the universal health care legislation requires employers to cover preconditions, the local college will probably adopt a new policy of hiring only part-time employees, including faculty, so that the new hires do not have to be covered in the health insurance plan.
Many contracts that write in pre-existing coverage greatly limit the amounts to be paid out for pre-existing conditions relative to conditions arising after the insurance goes into effect. I grant you that it is more of a problem in individual plans but you’ve oversimplified the complications --- http://snipurl.com/preexistingissues [www_medsave_com]
Title I of HIPPA currently limits restrictions that a group health plan can place on benefits for preexisting conditions. Group health plans may refuse to provide benefits relating to preexisting conditions for a period of 12 months after enrollment in the plan or 18 months in the case of late enrollment. This moral hazard protection will of course all change under the proposed health care legislation.
Do we want to become a nation of part-time workers having to carry multiple jobs?
Do we want to require health coverage for part-time and seasonal workers such that there are no part-time or seasonal jobs available?
I would prefer that the government take over all health insurance coverage and seriously tax everybody covered in the system. But if the mess of private and government insurance coverage comes into place, it is extremely important for government to somehow pick up the coverage of expensive preconditions such as organ transplants, AIDs, and severe mental health needs of some family members. To shunt these precondition costs onto employers will destroy full-time career opportunities throughout the land as employers fear the financial risks of preconditions. The repercussions will be enormous.
Below is a message I recently sent out to the AECM listserve.
Hi James,
Health care is politically charged at the moment and should probably be avoided on the AECM. I would like to add that some studies contend that government-administered health insurance will be more expensive in terms of administrative costs per person covered.
"Medicare Administrative Costs Are Higher, Not Lower, Than for Private Insurance," by Robert Book, The Heritage Foundation, June 25, 2009 --- http://www.heritage.org/Research/HealthCare/wm2505.cfm
It’s probably unfair to compare private versus public health insurance if the two are not direct competitors. For example, private health insurance often, these days, is mostly administering employer-funded insurance that employers keep a close eye on for cost efficiency often by capping such risks as mental health coverage to $10,000 or less. I know of one small university that had seven children of employees who, in less than a year, wiped out the entire multi-million balance set up in a health coverage fund. After that a cap was placed on certain types of coverage. Medical costs for the seven children were shifted to taxpayers.
I’m reminded of the guy whose only reason for committing a felony was to get into a California prison so he could get a “free” heart transplant. Who was really being held up here?
I think the big issue in the short run will focus on preconditions that may soon be required by law to be funded by employers. These leads to real moral hazards.
Medicare covers most people on permanent disability. These persons often have more frequent medical billings that require more costs to administer. My wife has been on permanent disability for over twenty years at a Medicare cost of over $2 million not counting the enormous cost of administering her claims --- http://www.trinity.edu/rjensen/Erika2007.htm
Erika now has special-alloyed metal from her hips to her neck that costs more than the metal in a Mercedes. I tease her by trying to figure out what I could get on eBay by selling her as scrap. She jokes back that I’m worth zero in the scrap market.
By the way, I disagree with you regarding quality of care at U.S. hospitals and surgeons and home therapy. I can’t think of any other nation where I would want to send her for better care from year-to-year.
If we leave health insurance out of the debate, there is evidence that privatization has led to many innovations and efficiencies in various, but not all, industries. Certainly not much good in the way of innovation tends to come from private or public monopolies that do not have to maintain a competitive edge in terms of effectiveness and efficiency.
Heads of state in other nations are frequently sent to the U.S. for medical treatments that are just not as good in their own nations. The U.S. has advanced medical services more than any other nation. And many poor people have access to the best services, especially people of all ages and income declared permanently disabled that automatically get Medicare coverage. The problem is making the best services available to everybody at price they can afford.
I'm tempted to say that being declared permanently disabled and getting Medicare at a young age is a ticket to heaven. But that's probably going a bit too far. Certainly there's a lot of fraud where people are declared disabled who are not in the least disabled. They simply managed to game the system. Others like Erika live in constant severe pain and have no bowel or bladder control.
One media myth is that that the cost of having to cover preconditions must be picked up by fat cat health insurance companies. Since so many employers are now funding (177 million workers under this 1974 Erisa provision of the law) their own employee health insurance, the employers themselves will have to absorb the expensive precondition costs such as the need for organ transplants. State universities can pass these costs along to their states, but small private universities will have to cover the possibly huge costs with higher tuition and appeals to benefactors. I fully anticipate that some private colleges will go out of business because of changes in the health insurance law.
Certainly employers will move more and more into a part-time labor force because of changes in the health insurance law. This, in turn, will force more and more “ weary workers” with three or four part time jobs into the government’s insurance plan. The tragedy is that they can't get full time jobs because of potential employers would be paying far more on average for workers' family medical coverage, especially with precondition coverage, than for the labor cost per se.
Health care will have to be rationed no matter what --- http://www.nytimes.com/2009/07/19/magazine/19healthcare-t.html?pagewanted=1&em
I'm reminded of a former colleague with advanced bone cancer who was given two hip transplants just weeks before he died. This made no sense to me since he was in more misery after the transplants as he was before the transplants.In Canada the average Canadian is willing to give 40% tax revenues a National Health Care Plan, where taxpayers at nearly all levels pay substantially for health care thereby restricting the number of free riders in the system. This is the only way to go in the U.S. for either a nationalized health plan or a nationalized insurance plan. The current proposal of taxing less than three percent of the people of for government insurance for the other 97% is absurd.
The most absurd situation is to keep borrowing trillions of dollars and passing the bills along to future generations. That will bankrupt the entire United States. Welcome to Zimbabwe!
It will be painful, but even people earning minimum wage must give up a significant portion of earnings to pay for health care. Illegal immigrants must pay a large portion of their earnings toward health care that is now free to them in emergency rooms. Middle income people must pay about 50% of their total earnings for health care. That’s the only way it will be a sustainable system.
Perhaps 50% won’t even be enough!
We need a better system. I think socialized medicine is the answer with high taxes and no private insurance companies. It will be rough for a while with 30% or higher unemployment for a time due to tax rises, but with Democrats in monopoly control of Congress now is the time to bite the tax bullet.
Taxes Must Increase On Average (for everybody) Nearly 50% to Balance the Federal Budget
(that does not include added taxes for universal health care and carbon capping legislation trillion dollar costs)
(that does not include added taxes for unbalanced state budgets)
And if you think high taxes are bad, wait until you experience Zimbabwe-like inflation?
"The Real Era of Big Government," by Robert Samuelson, American Issues Project, July 13, 2009 --- Click HereBob Jensen
PS
One added worry about moral hazard that is extremely controversial.Another moral hazard will be when a worker’s family member in any nation has an expensive medical precondition. If the worker sneaks into the U.S., the entire family is eligible for the House version of the universal health care plan ---
http://townhall.com/columnists/MichelleMalkin/2009/07/22/obamacare_for_illegal_aliensIn other words a foreign worker who would not otherwise sneak into the U.S. to become an illegal alien is motivated to do so just for the health insurance coverage of very expensive procedures such as organ transplants and neurosurgeries. The family might then return to their own home country after beating the U.S. health care system.
One thing that is not clear to me is how private insurance will survive since, under the proposed House Bill, employers can opt out of providing health insurance for workers by paying an 8% penalty to the government. For virtually all employers this 8% option is by far the cheapest alternative and is much less that virtually all employer insurance benefit programs will cost when pre-condition health needs are factored into the coverage.
I’m beginning to think the 8% parameter in the House Bill is really a blatant bait and switch fraud designed to only obtain passage of the legislation in 2009. After universal health care insurance is mandated the government will in no way be able, at least for the next couple of decades, to administer health insurance for hundreds of millions of worker families plus the families of all unemployed persons plus the illegal immigrants and their families.
The bait and switch will be to increase the 8% employer-penalty parameter dramatically to something like 50% such that, even when paying for precondition coverage, employers have little choice but to cover full-time workers. The adverse externality here, however, is that employers will increasingly shift from full-time to part-time workers where part-time workers have little choice but to enroll in the government insurance plan. Full-time employees will then not be allowed into the government insurance program and are left with zero choice other to enroll in the employer’s plan (which will be funded in most instances by private insurance companies making a profit).
Of course the government will not make a profit on health insurance. It will be quite the opposite because government will have to cover both fraud and tens of millions of unemployed and very low income people who can only get part time jobs. The government plan eventually will add trillions of dollars to deficit spending in spite of what Obama is promising unless covered people at all levels of income share the pain of health care insurance taxation. But a huge increase in taxation for health care may permanently inhibit economic recovery in the United States.
The only answer in the long run will be inferior health care which is all this nation can afford if it wants universal health care in the presence of its $100 trillion unfunded entitlement programs before passing universal health care legislation. We all can expect waiting rooms filled to capacity that spill out into hallways while weary physicians dispense with assembly-line medicine limiting each patient to five minutes. Expensive procedures such as organ transplants and neurosurgeries will be dispensed by lottery so that the system is indeed fair to one and all.
But the system will never be fair to one and all. The rich will simply pay for excellent medical care offshore. Medicine will become a booming business in places like Sweden, France, India, and yes even Cuba.
And in the long run fewer foreigners will be sneaking into the U.S. because the medical system in the U.S. will become too inferior relative to alternatives in their own countries. Then again a foreigner might sneak in just to take a chance on the health care organ transplant and neurosurgery lottery.
The crazy thing is that all of these negatives will not make me vote against some form of universal health care. The current system is just too unjust and inefficient. Perhaps we need to sacrifice quality for quantity at this juncture. But then I only have to worry about all this for two more decades or less. And if need be I can afford a trip to Cuba.I’m really glad I’m not young any more.
July 20, 2009 message sent to Trinity University on July 20, 2009
I forget who said “there are lies and then there are damned lies.”
Whoever said this is absolutely correct with respect to media coverage of the health care debate that seldom, if ever, mentions the huge adverse impact of the changed rules of the game such as new rules for preconditions and new rules for how big the self-insured insurance pool would have to become to continue self insurance like Trinity presently uses to fund health care coverage.Everybody at Trinity should read the “Repealing Erisa” article below, because Trinity University still has (I think) Erisa-enabled self insurance with a major medical kick-in. It will virtually impossible for Trinity to continue an Erisa-enabled health plan if the present House Bill is not revised to make it easier to keep such plans. But keeping such plans is probably out of the question anyway because of the risks of frequent and large precondition claims.
In order to keep its present health coverage plan, I think that the universal health care legislation will have to exclude coverage of preconditions (as is the case under Trinity’s present coverage). Secondly, the universal health care legislation would have to encourage rather than discourage Erisa-enabled plans. I don’t think this Congress will save Erisa-enabled plans for organizations the size of Trinity University. It might be possible to save such plans if governmental insurance picks up the precondition claims.
Actually Trinity will be between a rock and a hard place, because going back to coverage by large insurance companies will be much more expensive even if preconditions are excluded. Adding on premium costs for preconditions will make employer medical insurance premiums out of sight. I anticipate a huge migration to part-time employees at Trinity.
An employee at Trinity University asked, in a private response, why doctor shortage is not being raised as a huge issue in the health care debate.
Doctor shortage has been one of the enormous problems encountered in the Massachusetts Universal Health Care Plan initiated by, then, Gov. Romney. People line up in emergency rooms because they cannot find primary care physicians. Another problem is that Boston’s leading hospital is now suing the State because the cost of providing minimal health care to poor people greatly exceeds what the hospital is being paid by the State under the MUHCP.
But doctor shortage is a “no-no” in the health care debate. The legitimate argument is that the poor should have equal opportunity access to the limited supply of doctors. The irony here is that the proposed reduction of fees paid to doctors reimbursed by Medicare (and presumably the forthcoming government insurance fund for others) will drive more doctors out of participating in the plans. This exacerbates the doctor shortage problem. But such fee reductions are necessary as another ruse to cost-justify the proposed universal health care plan.
Unless we bite the bullet and move entirely to a Canadian-style nationalized health care program, anything less will be an absolute disaster.
There’s one factor Trinity University should plan for is the likely impossibility of continuing its self-funded health insurance plan under Erisa. Partly due to required coverage of preconditions, it will be very, very hard for organizations the size of Trinity to fund its own Erisa-allowed claims (backed by a major medical kick-in for enormous claims).
Trinity officials involved in health care alternatives should carefully read the following article:
“Repealing Erisa,” The Wall Street Journal, July 21, 2009
http://online.wsj.com/article/SB10001424052970203946904574298661486528186.html#mod=djemEditorialPageOne by one, President Obama’s health-care promises are being exposed by the details of the actual legislation: Costs will explode, not fall; taxes will have to soar to pay for it; and now we are learning that you won’t be able to “keep your health-care plan” either.
The reality is that the House health bill, which the Administration praised to the rafters, will force drastic changes in almost all insurance coverage, including the employer plans that currently work best. About 177 million people—or 62% of those under age 65—get insurance today through their jobs, and while rising costs are a problem, according to every survey most employees are happy with the coverage. A major reason for this relative success is a 1974 federal law known by the acronym Erisa, or the Employee Retirement Income Security Act.
Erisa allows employers that self-insure—that is, those large enough to build their own risk pools and pay benefits directly—to offer uniform plans across state lines. This lets thousands of businesses avoid, for the most part, the costly federal and state regulations on covered treatments, pricing, rate setting and so on. It also gives them flexibility to design insurance to recruit and retain workers in a competitive labor market. Roughly 75% of employer-based coverage is governed by Erisa’s “freedom of purchase” rules.
Goodbye to all that. The House bill says that after a five-year grace period all Erisa insurance offerings will have to win government approval—both by the Department of Labor and a new “health choices commissioner” who will set federal standards for what is an acceptable health plan. This commissar—er, commissioner—can fine employers that don’t comply and even has “suspension of enrollment” powers for plans that he or she has vetoed, until “satisfied that the basis for such determination has been corrected and is not likely to recur.”
In other words, the insurance coverage of 132 million people—the product of enormously complex business and health-care decisions—will now be subject to bureaucratic nanomanagement. If employers don’t meet some still-to-be-defined minimum package, they’ll have to renegotiate thousands of contracts nationwide to Washington’s specifications. The political incentives will of course demand an ever-more generous “minimum” benefit and less cost-sharing, much as many states have driven up prices in the individual insurance market with mandates. Erisa’s pluralistic structure will gradually constrict toward a single national standard.
Yet a computer programming firm, say, and a grocery store chain have very different insurance needs, and in any case may not be able to afford the same kind and level of benefits. Innovation in insurance products will also be subject to political tampering. Likely casualties include the wellness initiatives that give workers financial incentives to take more responsibility for their own health, such as Safeway’s. Some politicians will claim that’s unfair. High-deductible plans with health savings accounts are also out of political favor, therefore certain to go overboard. If you have one of those and like it, too bad.
The new Erisa regime will be especially difficult to meet for businesses that operate with very slim profit margins or have large numbers of part-time or seasonal workers. They may simply “cash out” and surrender 8% of their payroll under the employer-mandate tax. A new analysis by the Lewin Group, prepared for the Heritage Foundation, finds that some 88.1 million people will be shifted out of private employer health insurance under the House bill. If those people preferred their prior plan, well, too bad again.
The largest employers—though not all—may clear the minimum bar, at least at first. But in addition to the “health choices” administrative burden, the cost of labor will rise because the House guts another key section of Erisa. Currently, lawsuits about employee benefits are barred under the law, allowing large employers to avoid the state tort lotteries in disputes over coverage. No longer. As a gratuity to the trial bar, Democrats will now subject businesses to these liabilities in the name of health “reform.”
So when Mr. Obama says that “If you like your health-care plan, you’ll be able to keep your health-care plan, period. No one will take it away, no matter what,” he’s wrong. Period. What he’s not telling the American people is that the government will so dramatically change the rules of the insurance market that employers will find it impossible to maintain their current coverage, and many will drop it altogether. The more we inspect the House bill, the more it looks to be one of the worst pieces of legislation ever introduced in Congress.
Jensen Comment
Several people responded with questions or comments about universal health care in Massachusetts (that was enacted in 2006 under the guidance of Governor Mitt Romney) which I will refer to here as MITT. Firstly I would like to note that danger lurks in comparing the MITT with any universal health care plan being proposed at the Federal level. Firstly, none of the 50 states has the power to simply print money to pay its bills, as is being done on a relatively small scale by the U.S. Treasury at the moment to pay for its excesses. Secondly, MITT is not universal in that it is restricted to low income residents of the state. Thirdly, MITT survives heavily on Federal subsidies, whereas nobody will subsidize any Federal health care plan from above, although a small number of wealthy people may one day make benevolent contributions toward universal health care. Thus far Bill Gates and Warren Buffett have been focused more on Africa's health issues such as TB and polio.An excellent, albeit brief, summary of MITT is provided at http://en.wikipedia.org/wiki/Massachusetts_health_care_reform
Health coverage is very limited in scope and the number of insured has increased substantially. But many uninsured poor people still manage to slip through the cracks.An enormous problem has been the shortage of primary care physicians such that those with newly-acquired MITT insurance cannot find a primary care doctor. Most specialists refuse to treat patients who are not referred to them by a primary care physician. Hence, there were and are long lines at Emergency Rooms both before and after MITT was enacted even though many in those lines have MITT coverage. The lines could be worse. MITT will not cover many costly procedures.
The MITT program is in deep financial stress at the moment and has had to make cuts in scope of coverage and in amounts paid to doctors and hospitals during the current economic crisis ---
http://liveshots.blogs.foxnews.com/2009/07/17/massachusetts-universal-health-care-cuts/
Hospitals complain that the promised coverage is far from sufficient to cover their costs. Some, including the huge Boston General Hospital, are now suing or plan to sue the State to recover some of their losses under MITT.Under financial stress hospitals in Massachusetts have had to take huge budget cuts. Rather than spread those cuts across the board to all departments, some hospitals have decided to concentrate on dropping the most money-losing departments. You probably can guess the leading candidate for being eliminated --- the obstetrics department.
My neighbor down the road has a second home up here in the White Mountains. However, he still practices cardiology in a Boston suburb. He says that obstetrics departments are leading candidates for elimination, in large measure, because of the high cost of malpractice insurance covering obstetrics services.
Lawyers file cookie-cutter lawsuits against doctors, nurses, and hospitals for every defective baby irrespective of the facts in any given case. The reason is the tendency of sympathetic juries to make multimillion dollar awards to a mother of a defective baby irrespective of the facts in the case. Many juries feel that fat cat insurance companies owe it to the unlucky woman (and her lucky lawyers) who must nurture and raise a severely handicapped child. Juries make such awards even when the doctors, nurses, and hospitals performed perfectly under the circumstances. Paul Newman showed us how to love it when lawyers beat the medical system in favor of the "poor and powerless" in The Verdict --- http://www.youtube.com/watch?v=zVZFlBJftgg
But fat cat insurance companies adjust rates based upon financial risks. The rates became so high for obstetrics that across most of the U.S. (less so in states that cap punitive damages) thousands of gynecologists dropped the obstetrics part of their services. And under MITT in Massachusetts some strained hospitals dropped obstetrics services.
Health Care Reform Will Indeed Be Universal --- Tort Lawyers Are Fully Covered
This raises the whole issue of costs of malpractice insurance in the entire health system of the United States. Although a few states like Texas have managed to put some restraints on punitive damages, President Obama wants no such restraints placed on the tort system for virtually any legislation under his term of office. Obama is a lawyer, and he can attribute much of his political success to the financial and other support from tort law firms across the land. He owes them and most of our legislators are themselves lawyers. As a result there's virtually zero chance that any restraints will be placed upon the number of malpractice lawsuits and sizes of awards in any universal health care legislation. In fairness the U.S. Congress and some states years ago put some restraints on runaway malpractice claims --- http://www.redorbit.com/news/science/2593/house_passes_medical_malpractice_limits/
But in 2009 in Washington DC there is no sentiment for putting further malpractice insurance cost restraints into the forthcoming universal health care legislation.In 2009 lawmakers in Washington DC are taking no lessons from malpractice stinginess in the Canadian National Health Plan. Perhaps stinginess is what comes with national health care plans that eliminated private insurance company fat cats.
"Why 98 percent of Canadian Medical Malpractice Victims Never Receive a Penny in Compensation," by John McKiggan ---
Click Here
"What The Health Care Bill Actually Says," by Professor John David Lewis (Duke University), August 6, 2009 ---
http://sweetness-light.com/archive/what-the-health-care-bill-actually-says
Jul 29, 2009 01:23:57 PM, sorg@stny.rr.com wrote:
It is almost unbelievable that this Bill could have any chance of being adopted, but Obama is working hard to have the Federal Government dictate all matters relating to our health care. Since so much money is spent on the elderly toward the end of their lives and on special needs children these persons are considered to be expendable under this Bill. Their helth care will be rationed. However, illegal immigrants will be well taken care of. What a disaster this administration is. They want to take over every aspect of our lives.
Subject: Health Care or confiscation (H.R. 3200 - All 1017 Pages)
Must be widely circulated. Extremely frightening!!!!
-----
Absolutely incredible...it is difficult for me to comprehend that this could have any possibility of being put into place......
H.R. 3200 America's Affordable Health Choices Act of 2009
Full House Bill --- http://thomas.loc.gov/cgi-bin/query/z?c111:H.R. 3200.IH:
Introduced in the House on July 14, 2009Subject: Fwd: Health Care or confiscation (H.R. 3200 - All 1017 Pages)
Attached is the H. R. 3200 - all 1017 pages with comments by Peter Fleckstein. He has only covered the first 500 pages so far.
Peter Fleckstein (aka Fleckman) is reading it and has been posting his findings on Twitter. This is from his postings (Note: All comments are Fleckman’s).
Pg 22 of the HC Bill
MANDATES the Govt will audit books of ALL EMPLOYERS that self insure!!
Pg 30 Sec 123
THERE WILL BE A GOVT COMMITTEE that decides what treatments/benefits you get
Pg 29 lines 4-16
YOUR HEALTHCARE IS RATIONED!!!
Pg 42
The Health Choices Commissioner will choose UR HC Benefits for you. You have no choice!
PG 50 Section 152
HC will be provided to ALL non US citizens, illegal or otherwise
Pg 58
Govt will have real-time access to individual's finances & a National ID Healthcard will be issued!
Pg 59 lines 21-24
Govt will have direct access to your banks accts for electronic funds transfer
PG 65 Sec 164
Is a payoff subsidized plan for retirees and their families in Unions & community orgs (ACORN).
Pg 72 Lines 8-14
Govt is creating an HC Exchange to bring private HC plans under Govt control.
PG 84 Sec 203
Govt mandates ALL benefit packages for private HC plans in the Exchange
PG 85 Line 7
Specs for of Benefit Levels for Plans = The Govt will ration your Healthcare!
PG 91 Lines 4-7
Govt mandates linguistic approp services. Example - Translation for illegal aliens
Pg 95 Lines 8-18
The Govt will use groups i.e., ACORN & Americorps to sign up individuals for Govt HC plan
PG 85 Line 7
Specs of Benefit Levels 4 Plans. #AARP members - Your Healthcare WILL be rationed
PG 102 Lines 12-18
Medicaid Eligible Individuals will be automatically enrolled in Medicaid. No choice
PG 124 lines 24-25
No company can sue GOVT on price fixing. No “judicial review” against Govt Monopoly
PG 127 Lines 1-16
Doctors/ #AMA - The Govt will tell YOU what you can make.
Pg 145 Line 15-17
An Employer MUST auto enroll employees into public opt plan. NO CHOICE
Pg 146 Lines 22-25
Employers MUST pay for HC for part time employees AND their families.
Pg 149 Lines 16-24
ANY Employer with payroll 400k & above who does not provide public opt. pays 8% tax on all payroll
PG 150 Lines 9-13
Business with payroll between 251k & 400k who doesn't provide public opt pays 2-6% tax on all payroll
Pg 167 Lines 18-23
ANY individual who doesn't have acceptable HC according to Govt will be taxed 2.5% of income
Pg 170 Lines 1-3
Any NONRESIDENT Alien is exempt from individual taxes. (Americans will pay)
Pg 195
Officers & employees of HC Admin (GOVT) will have access to ALL American's financial/personal records
PG 203 Line 14-15
“The tax imposed under this section shall not be treated as tax” Yes, it says that
Pg 239 Line 14-24
Govt will reduce physician services for Medicaid. Seniors, low income, poor affected
Pg 241 Line 6-8
Doctors, doesn't matter what specialty you have, you’ll all be paid the same
PG 253 Line 10-18
Govt sets value of Doctor’s time, prof judg, etc. Literally value of humans.
PG 265 Sec 1131
Govt mandates & controls productivity for private HC industries
PG 268 Sec 1141
Fed Govt regulates rental & purchase of power driven wheelchairs
PG 272 SEC. 1145.
TREATMENT OF CERTAIN CANCER HOSPITALS - Cancer patients - welcome to rationing!
PG 280 Sec 1151
The Govt will penalize hospitals for what Govt deems preventable readmissions.
PG 298 Lines 9-11
Doctors, treat a patient during initial admission that results in a readmission - Govt will penalize you.
PG317 L 13-20
OMG!! PROHIBITION on ownership/investment. Govt tells Doctors what/how much they can own.
PG 317-318 lines 21-25,1-3
PROHIBITION on expansion- Govt is mandating hospitals cannot expand
PG 321 2-13
Hospitals have option to apply for exception BUT community input required. Can you say ACORN?!!
PG 335 L 16-25 Pg 336-339
Govt mandates establishment of outcome based measures. HC the way they want. Rationing
PG 341 Lines 3-9
Govt has authority to disqualify Medicare Adv Plans, HMOs, etc. Forcing peeps into Govt plan
PG 354 Sec 1177
Govt will RESTRICT enrollment of Special needs people! WTF. My sis has down's syndrome!!
Pg 379 Sec 1191
Govt creates more bureaucracy - Telehealth Advisory Committee. Can you say HC by phone?
PG 425 Lines 4-12
Govt mandates Advance Care Planning Consultant. Think Senior Citizens end of life
Pg 425 Lines 17-19
Govt will instruct & consult regarding living wills, durable powers of atty. Mandatory!
PG 425 Lines 22-25, 426 Lines 1-3
Govt provides approved list of end of life resources, guiding you in death
PG 427 Lines 15-24
Govt mandates program for orders for end of life. The Govt has a say in how your life ends
Pg 429 Lines 1-9
An “adanced care planning consultant” will be used frequently as patient's health deteriorates
PG 429 Lines 10-12
“advanced care consultation” may include an ORDER for end of life plans. AN ORDER from GOV
Pg 429 Lines 13-25 -
The govt will specify which Doctors can write an end of life order.
PG 430 Lines 11-15
The Govt will decide what level of treatment you will have at end of life
Pg 469
Community Based Home Medical Services=Non profit orgs. Hello, ACORN Medical Svcs here!!?
Page 472 Lines 14-17
PAYMENT TO COMMUNITY-BASED ORG. 1 monthly payment to a community-based org. Like ACORN?
PG 489 Sec 1308
The Govt will cover Marriage & Family therapy. Which means they will insert Govt into your marriage
Pg 494-498
Govt will cover Mental Health Services including defining, creating, rationing those services
You can read the following at http://www.defendyourhealthcare.us/houseandsenatebills.html
Here are a few one liners from the House health bill:
Pg 22 of the HC Bill MANDATES the Govt. will audit books of ALL EMPLOYERS that self insure!!
Pg 30, Sec 123 of HC bill - THERE WILL BE A GOVT. COMMITTEE that decides what treatment you get.
Pg 29, lines 4-16 - YOUR HEALTH CARE IS RATIONED!!!
Pg 42, of HC Bill - The Health Choices Commissioner will choose YOUR Health Care Benefits for you. YOU HAVE NO CHOICE!
PG 50, Section 152 - Health Care will be provided to ALL NON-US CITIZENS, ILLEGAL OR OTHERWISE!
Pg 58, - Govt. will have real-time access to individual's finances & a National ID Healthcard will be issued!
Pg 59, lines 21-24 - Govt. will have direct access to your bank accounts for electronic funds transfer.
PG 65, Sec 164 is a payoff subsidized plan for retirees and their families in Unions & community organizations (ACORN).
Pg 72, Lines 8-14 - Govt. is creating a Health Care Exchange to bring private Health Care Plans under Govt. control.
Pg 84, Sec 203 HC bill - Govt. mandates ALL b enefit packages for private Health Care Plans in the Exchange.
Pg 85, Line 7 - Specifics for Benefit Levels for Plans = the govt. will ration your Health Care!
Pg 91, Lines 4-7 - Govt. mandates linguistic appropriate services, i.e, translation for illegal aliens.
Pg 95, Lines 8-18 - The govt. will use groups, i.e., ACORN & Americorps, to sign up individuals for govt. HC plan.
Pg 85, Line 7 - Specifics of Benefit Levels for Plans. AARP members, your health care WILL be rationed.
Pg 102, Lines 12-18 - Medicaid Eligible Individuals will be automatically enrolled in Medicaid. NO CHOICE.
Pg 124, lines 24-25 - No company can sue GOVT. on price fixing. No judicial review against Govt. Monopoly.
Pg 127, Lines 1-16 - Doctors/AMA, the Govt. will tell YOU what you can make.
Pg 145, Line 15-17 - An Employer MUST automatically enroll employees into public option plan. NO CHOICE.
Pg 126, Lines 22-25 - Employers MUST pay for Health Care for part time employees AND their families.
Pg 149, Lines 16-24 - ANY Employer with payroll 400k & above who does not provide public option pays 8% tax on all payroll.
Pg 150, Lines 9-13 - Businesses with payroll between $251k & $400k who doesn’t provide public opt pays 2-6% tax on all payroll.
Pg 167, Lines 18-23 - ANY individual who doesn't have acceptable Health Care according to the govt. will be taxed 2.5% of income.
Pg 170, Lines 1-3 - Any NONRESIDENT alien is exempt from individual taxes. (Americans will pay.)
Pg 195, HC Bill - officers & employees of HC Admin. (GOVT) will have access to ALL Americans' financial and personal records.
Pg 203, Line 14-15 - The tax imposed under this section shall not be treated as tax. (Yes, it says that!)
Pg 239, Line 14-24 - Govt. will reduce physician services for Medicaid. Seniors, low income, po