[Health Care] Rationing? No way...

[Tonus]

Supporters of nationalized health care tend to dismiss the notion that under government control, health care will be rationed. Even though rationing has happened under every other large-scale government health plan. In 2006, Massachussetts implemented a government-run health care system designed to provide health care to the poor. Just three years later, what are they doing?

GUESS. (http://www.boston.com/news/local/massachusetts/articles/2009/06/24/state_cuts_its_health_coverage_by_115m/)


State cuts its health coverage by $115m
Board to slow enrollment in Commonwealth Care

Overseers of Massachusetts’ trailblazing healthcare program made their first cuts yesterday, trimming $115 million, or 12 percent, from Commonwealth Care, which subsidizes premiums for needy residents and is the centerpiece of the 2006 law.

The board of the Connector Authority made the cuts as officials confronted two side effects of the recession: the state budget crisis and a surge in enrollment by the recently unemployed.

The largest share of the savings will come from slowing enrollment. An estimated 18,000 poor residents who qualify for full subsidies, but who forget to designate a health plan, will no longer be automatically assigned a plan and enrolled and thus could face delays in getting care.

The board also eliminated dental coverage for the poorest residents enrolled in Commonwealth Care, roughly 92,000 people who currently are the only ones in the program who receive that care. Regulators said that would save $10 million. Dental coverage was retained in the budget approved by lawmakers last week, and now it falls to the governor to decide its fate.

Also hanging in the balance is the health insurance status of 28,000 legal immigrants whose Commonwealth Care coverage was dropped in the budget lawmakers approved for the fiscal year that begins July 1. Governor Deval Patrick has until Monday to decide whether to veto any of that budget, which set aside $116 million less for Commonwealth Care than he proposed.

“No decision has been made’’ on restoring immigrant coverage, said Leslie Kirwan, chairwoman of the Connector Authority board and Patrick’s secretary of administration and finance. “It’s certainly going to be at the top of our list’’ of items the governor is considering adding back to the budget, she said.

But Kirwan said the $115 million in cuts the Connector Authority board approved yesterday were merely to deal with shrinking state revenues and the rapid growth in enrollment in Commonwealth Care, which has 177,000 members and was projected to grow to 212,000 in the next year.

These cuts do not provide any wiggle room for adding back the 28,000 immigrants who are facing elimination. If the governor decides to restore coverage for the immigrants, Kirwan said, he would have to find other areas to cut in the already razor-thin budget.

Patrick Holland, the Connector Authority’s chief financial officer, said enrollment spiked during the last three months, from 165,000 to nearly 177,000 members, because so many workers are losing their jobs and, with that, employer-provided health insurance.

The progress of the Massachusetts healthcare initiative is being closely watched in Washington, where Congress is crafting national legislation to extend coverage to more Americans. The Massachusetts law, cited as one model in the national debate, requires nearly everyone to have health insurance or pay a tax penalty.

The residents affected by yesterday’s cuts earn too little to be subject to the penalty. They also would be eligible for free emergency care for three months under the state’s Health Safety Net.

Leaders of Health Care for All, one of the state’s largest consumer groups, said the changes will be especially hard on residents whose first language is not English and who have difficulty understanding the complex enrollment paperwork.

But the group said state officials appear to have made the best of a bad situation. “There’s no other place to go for money,’’ said Lindsey Tucker, the organization’s healthcare reform manager. “. . . My concern is people will not get the care that they need.’’

While the group’s leaders are resigned to that cut, they said they will continue to lobby the governor to restore coverage for legal immigrants. Lawmakers said they cut this class of legal immigrants because they do not qualify for matching federal subsidies. Thus, they are more expensive for the state to insure. The move has enraged advocates for the immigrant community.

Much of the rest of the $115 million in savings, $32 million, comes from slowing payments to the managed-care health insurance companies that won bids to offer insurance through the Commonwealth Care program. Regulators said that by slowing enrollment growth, the companies would receive less money than they had banked on when they submitted their bids earlier this year.

Kirwan stressed that when the economy improves, the changes made by the authority can be revisited. She also said the changes still protect the basic eligibility rules for the program and benefits that members receive, but put the brakes only on enrollment growth during an “unprecedented time.’’

While the emergency changes approved by the Connector Authority go into effect July 1, Kirwan said the board will schedule a hearing, probably in late July, to seek public comments on the issues.
Take note of the wording used by the Globe's reporters. Cutting 1/8th of the funding for the program is "trimming." They repeat, numerous times, that there's always the possibility that cuts will be restored once the economy recovers. In the meantime, they intend to slow enrollment because otherwise the state cannot handle the burden. And say goodbye to dental coverage! Well, at least it's not being rationed... just eliminated.

And notice the particularly insidious claim that $32 million in savings comes from "slowing payments." You don't save money by SLOWING payments. You save money by ELIMINATING them. In other words, when they talk about slowing payments, they're saying that you'll get that last $32 million right around the day after NEVER.

PS- I wonder how many employees at those managed-care health insurance companies will be laid off, now that the government is going to stiff them out of money that they contracted to pay these companies.

PPS- Hey, does any of this seem familiar? Complex paperwork? The people who need the coverage the most don't know about it? It doesn't wind up covering the people who need health care?

PPPS- This plan, designed to offer coverage to only a part of the population in the state of Massachussetts, was going to cost more than $900 million by the time the enrollment increased to just the expected 212,000. Consider this: a quick trip to the MA 2008 Census page (http://quickfacts.census.gov/qfd/states/25000.html) indicates that the state's population is about 6.5 million people, and that 10% of them were below the povery line as of 2007. Assuming those numbers are similar now (and the poverty % is probably worse), this program is already running into funding problems after covering less than one-third of MA's poor.

It's not hard to imagine this program becoming a $3 billion boondoggle once it's in full swing and covering "all" of the needy in MA.

[Grunthos]

Every idiot out there thinks that "letting the government pay for it" will let them get more than they pay for... and they completely overlook the fact that every OTHER idiot out there thinks exactly the same thing.

But then, they're idiots, aren't they?

[Edmaster]

Jane Sturm to President Obama: "My mother is now over 105. But at 100, the doctors said to her, 'I can't do anything more unless you have a pacemaker.' I said, 'Go for it.' She said, 'Go for it.' But the specialist said, 'No, she's too old.' But when the other specialist saw her and saw her joy of life, he said, 'I'm going for it.' That was over five years ago. My question to you is: Outside the medical criteria for prolonging life for somebody who is elderly, is there any consideration that can be given for a certain spirit, a certain joy of living, a quality of life, or is it just a medical cutoff at a certain age?"

Obama's response: "I don't think that we can make judgments based on people's 'spirit.' Uh, that would be, uh, a pretty subjective decision to be making. I think we have to have rules that, uh, say that, uh, we are going to provide good quality care for all people. End-of-life care is one of the most difficult sets of decisions that we're going to have to make. But understand that those decisions are already being made in one way or another. If they're not being made under Medicare and Medicaid, they're being made by private insurers. At least we can let doctors know -- and your mom know -- that you know what, maybe this isn't going to help. Maybe you're better off, uhh, not having the surgery, but, uhh, taking the painkiller."

In short, even Obama admits that health care WILL be rationed. Private options will be eliminated because the companies will be unable to compete with a public entity that doesn't have to worry about maintaining a profit.

[Tonus]

To understand just how devastating government-run health care can be to an economy that is already in poor shape, read this. (http://www.cato.org/pub_display.php?pub_id=10268)


Massachusetts Miracle or Massachusetts Miserable: What the Failure of the "Massachusetts Model" Tells Us about Health Care Reform

When Massachusetts passed its pioneering health care reforms in 2006, critics warned that they would result in a slow but steady spiral downward toward a government-run health care system. Three years later, those predictions appear to be coming true:

Although the state has reduced the number of residents without health insurance, 200,000 people remain uninsured. Moreover, the increase in the number of insured is primarily due to the state's generous subsidies, not the celebrated individual mandate.

Health care costs continue to rise much faster than the national average. Since 2006, total state health care spending has increased by 28 percent. Insurance premiums have increased by 8–10 percent per year, nearly double the national average.

New regulations and bureaucracy are limiting consumer choice and adding to health care costs.

Program costs have skyrocketed. Despite tax increases, the program faces huge deficits. The state is considering caps on insurance premiums, cuts in reimbursements to providers, and even the possibility of a "global budget" on health care spending—with its attendant rationing.

A shortage of providers, combined with increased demand, is increasing waiting times to see a physician.

With the "Massachusetts model" frequently cited as a blueprint for health care reform, it is important to recognize that giving the government greater control over our health care system will have grave consequences for taxpayers, providers, and health care consumers. That is the lesson of the Massachusetts model.

On of my concerns about nationalizing health care is that it can take a few years for the main problems with it (deficit growth, rationing) to become widespread or obvious enough for everyone to notice. By that time, the system is in place, alternatives have been subsumed or eliminated, and reversing the damage becomes much more difficult even when the danger of continuing on that path becomes clear.

But in Massachusetts, the poor economy has brought their health care plan almost to a halt. Unlike the federal government, states are under real pressure to balance their own budgets, and you cannot hide the costs of a program the way the federal government can. It's a perfect test-case of the problems with nationalizing health care, because it's much harder to hide the costs, and it's also harder to hide the failures. And it's extremely difficult to blame someone else.

[Edmaster]

I guess Obama never cared for Schoolhouse Rock...

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[Edmaster]

Massachusetts: 26% Consider State’s Health Care Reform a Success
Monday, June 29, 2009

Twenty-six percent (26%) of Massachusetts voters say their state’s health care reform effort has been a success. A new Rasmussen Reports telephone survey in the state finds that 37% say the reform effort has been a failure, while another 37% are not sure.

Only 10% of Bay State voters say the quality of health care has gotten better as a result of the reform plan while 29% say it has gotten worse. Most (53%) say the quality of care has not changed.

As for cost, 21% say the reform has made health care more affordable in Massachusetts. Twenty-seven percent (27%) say health care is now less affordable while 44% see no change.

(Want a free daily e-mail update? If it's in the news, it's in our polls). Rasmussen Reports updates are also available on Twitter.

The Massachusetts Health Care Reform was enacted in 2006 by Republican Governor Mitt Romney and a Democratic state legislature. Some consider it a bipartisan model for national health care reform.

By a 37% to 17% margin, Massachusetts liberals consider the program a success. By a 55% to 18% margin, conservatives in the state say it’s been a failure.

From a partisan perspective, Democrats are fairly evenly divided with 49% not sure if the reform effort has been a success or a failure. Sixty-six percent (66%) of Republicans say it’s been a failure. Among those not affiliated with either major party, 27% consider the reform plan a success while 41% say it’s been a failure.

Please sign up for the Rasmussen Reports daily e-mail update (it’s free) or follow us on Twitter. Let us keep you up to date with the latest public opinion news.

See survey questions and toplines. Crosstabs are available to Premium Members only.

Source: http://www.rasmussenreports.com/public_content/politics/states_general/massachusetts/massachusetts_26_consider_state_s_health_care_refo rm_a_success

So that "wonderful model" that reformers keep harping on about... doesn't seem to be quite so wonderful. I'd say it's "back to the drawing board," but this administration doesn't seem to have the time to read, let alone fix, their plans.

[Grunthos]

It's all so very simple:

Resources are limited.

"Need" is effectively unlimited - it expands to consume all available resource until the lack of that needed item reduces the needy population.

Therefore, rationing becomes inevitable.

Capitalism is a form of rationing, which grants greatest access to resouce to those who contribute the most value, and least access to resource to those who produce least. This is a proper negative-feedback mechanism. It is self-limiting and self-perpetuating. The genius of capitalism is that it allows the productive to bank the ability to access resources (that is, to capitalize) against LATER need of self and progeny, when their individual productivity falls.

Socialism is another form of rationing, but it provides greatest access to resources based on "need," that is, based on the ability to consume that resource, regardless of the recipient's ability to contribute to replenishment of the resource. It is a "positive feedback" mechanism, and inevitably leads to runaway consumption, shortage of resource, and dieback or dieout. th does not reward the productive with the ability to capitalize upon their efforts against future need, and thus does not encourage more than the minium effort. Under those conditions, a rational entity will produce the minimum (and also consume the maximum) in order to best situate itself for the time when resource does not meet need.

It's the law of the minimum. It's not arguable.

[Tonus]

The thing is, some people are using the argument that "everything is rationed" as a defense of national health care. A NY Times columnist pushed this idea, that since health care gets rationed anyway, the concern that it would be rationed under Obamacare is a red herring.

Let's see if he feels the same way when he, or one of his parents, is denied care because the government feels that it's not worth it to provide expensive care to someone who is almost dead anyway. Because after all, rationing is rationing... right?

[Grunthos]

The concern should properly be; WHO rations it?

Socialistically, everyone else decides what you get.

Capitalistically, you decide what you get, based on your ability and worth.

[Dr. L]

JO5-hM6xKt4

[Grunthos]

You're gonna wear that video out, sir.

[Dr. L]

Too many opportunities, I suppose.


Oh well, here's this:

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[Grunthos]

Wouldn't that be "purrrrging?"

[Tonus]

Restricting your right to choose? NO WAI!!! (http://hotair.com/archives/2009/07/16/does-obamacare-outlaw-private-insurance/)


Does ObamaCare Outlaw Private Insurance?

Investors Business Daily’s editors quickly read through the actual legislation of the House health-care reform bill looking for hidden time bombs — and they found a doozy (http://www.ibdeditorials.com/IBDArticles.aspx?secid=1501&status=article&id=332548165656854). On page 16 of over a thousand pages of text, they discovered a clause that essentially locks people into their current plan, and locks everyone out of any other plan. Well, presumably the public plan will be an exception:When we first saw the paragraph Tuesday, just after the 1,018-page document was released, we thought we surely must be misreading it. So we sought help from the House Ways and Means Committee.

It turns out we were right: The provision would indeed outlaw individual private coverage. Under the Orwellian header of “Protecting The Choice To Keep Current Coverage,” the “Limitation On New Enrollment” section of the bill clearly states:

“Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day” of the year the legislation becomes law.

So we can all keep our coverage, just as promised — with, of course, exceptions: Those who currently have private individual coverage won’t be able to change it. Nor will those who leave a company to work for themselves be free to buy individual plans from private carriers.
Surprise! You can, as Obama promised, keep your current coverage — as long as it remains available. However, if your employer stops offering health-care benefits, or if you buy it privately and your insurer cancels your plan, you can’t just pick up another private plan. Enrollments will be closed as of the first day the bill becomes law.

That will have the effect of forcing millions of people into the public plan whether they want it or not. Even worse, if insurers get barred from attracting new customers — which this clause outlaws — then they will eventually see their rolls drained, thanks to the natural flow of the market as employers drop plans and skip the expense of offering medical insurance. It won’t take long at all for insurers to exit the market and leave the field for just the public plan, which will automatically get the customers of each individual insurer as they close up shop.

Does this bill outlaw private insurance? Literally, no, but in practical terms, it makes it an endangered species and creates an American single-payer system by default.

It has to pass first, though, and Blue Dog Democrats say they’ve seen enough (http://thehill.com/leading-the-news/blue-dogs-threaten-to-bring-down-pelosis-healthcare-bill-2009-07-15.html):Centrist Democrats are threatening to oppose their party’s healthcare legislation unless House Speaker Nancy Pelosi (D-Calif.) accepts changes that make the bill more to their liking.

Seven Blue Dogs on the House Energy and Commerce Committee have banded together to draft amendments that they’ll co-sponsor in the committee markup, which starts Thursday. Rep. Mike Ross (D-Ark.), the Blue Dogs’ point man on healthcare, says if those changes aren’t accepted, they’ll vote down the bill.

“We cannot support the current bill,” Ross said. “Last time I checked, it took seven Democrats to stop a bill in Energy and Commerce.” …

Blue Dogs think the bill fails to do enough to reduce healthcare costs, jeopardizes jobs with a fee on employers that don’t provide health insurance, and would base a government-run healthcare plan on a Medicare payment system that already penalizes their rural districts.

Do not assume that the threats from "blue dog" Democrats will sink this bill. The Democrats managed to wheedle enough Republican votes to get Cap and Trade through the House. And it may not take much to buy the votes from Democrats who are on the fence.

This does give some hope that the effort will fail, though. Democrats who won in generally conservative districts will have a tough time winning a second term unless things turn around economically, and that may not happen even if C&T and ObamaCare do not become law. Losing after a single term would leave them in a bad spot-- too moderate for local office elsewhere, and with a politically bleak future in their home districts. So they've got to either force concessions, or get a seriously sweet pork package handed to them, or they have to vote against the bill.

Votes are starting to get expensive for this administration. Their other option is to modify the bill to allows its passage, with the intention of "fixing" it later on to reflect their real desires. Getting it into law with as few changes as possible is the goal, and then just treat it like Medicare-- tweak it endlessly until it's a massive, inefficient tax-guzzling monster.

[Grunthos]

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[Tonus]

The next two weeks promise to be pretty frantic in DC. The administration has staked its reputation on National Health Care and Cap and Trade, and they're going to make a furious effort to get those passed as soon as possible. Cap and Trade is effectively off the table until September because it's unlikely the Senate will pass it under the current economic conditions. But Obama wants health care passed ASAP and is planning a huge push, including a press conference on Wednesday, where it is unlikely that he will be asked about this. (http://news.yahoo.com/s/ap/20090720/ap_on_go_pr_wh/us_midsummer_s_budget_nightmare)


White House putting off budget update

WASHINGTON – The White House is being forced to acknowledge the wide gap between its once-upbeat predictions about the economy and today's bleak landscape.

The administration's annual midsummer budget update is sure to show higher deficits and unemployment and slower growth than projected in President Barack Obama's budget in February and update in May, and that could complicate his efforts to get his signature health care and global-warming proposals through Congress.

The release of the update — usually scheduled for mid-July — has been put off until the middle of next month, giving rise to speculation the White House is delaying the bad news at least until Congress leaves town Aug. 7 on its summer recess.

The administration is pressing for votes before then on its $1 trillion health care initiative, which lawmakers are arguing over how to finance.

The White House budget director, Peter Orszag, said on Sunday that the administration believes the "chances are high" of getting a health care bill by then. But new analyses showing runaway costs are jeopardizing Senate passage.

"Instead of a dream, this routine report could be a nightmare," Tony Fratto, a former Treasury Department official and White House spokesman under President George W. Bush, said of the delayed budget update. "There are some things that can't be escaped."

The administration earlier this year predicted that unemployment would peak at about 9 percent without a big stimulus package and 8 percent with one. Congress did pass a $787 billion two-year stimulus measure, yet unemployment soared to 9.5 percent in June and appears headed for double digits.

Obama's current forecast anticipates 3.2 percent growth next year, then 4 percent or higher growth from 2011 to 2013. Private forecasts are less optimistic, especially for next year.

Any downward revision in growth or revenue projections would mean that budget deficits would be far higher than the administration is now suggesting.

Setting the stage for bleaker projections, Vice President Joe Biden recently conceded, "We misread how bad the economy was" in January. Obama modified that by suggesting the White House had "incomplete" information.

The new budget update comes as the public and members of Congress are becoming increasingly anxious over Obama's economic policies.

A Washington Post-ABC News survey released Monday shows approval of Obama's handling of health-care reform slipping below 50 percent for the first time. The poll also found support eroding on how Obama is dealing with other issues that are important to Americans right now — the economy, unemployment and the swelling budget deficit.

The Democratic-controlled Congress is reeling from last week's testimony by the head of the nonpartisan Congressional Budget Office, Douglas Elmendorf, that the main health care proposals Congress is considering would not reduce costs — as Obama has insisted — but "significantly expand" the federal financial responsibility for health care.

That gave ammunition to Republican critics of the bill.

Citing the CBO testimony, House Minority Leader John Boehner, R-Ohio, on Monday accused Democrats of "burying this budget update until after Congress leaves town next month." He called the budget-update postponment "an attempt to hide a record-breaking deficit as Democratic leaders break arms to rush through a government takeover of health care."

White House budget office spokesman Tom Gavin disagreed, noting the delay was "really not something out of the norm" and is typical for a president's first year. Gavin noted that President George W. Bush's budget office did not release the mid-session review in his first year until August 22; in President Bill Clinton's first year, it did not come out until Sept. 1.

Obama also didn't release his full budget until early May — instead of the first week in February, when he put out just an outline

Late last week, Obama vowed anew that "health insurance reform cannot add to our deficit over the next decade and I mean it."

The nation's debt — the total of accumulated annual budget deficits — now stands at $11.6 trillion. In the scheme of things, that's more important than talking about the "deficit," which only looks at a one-year slice of bookkeeping and totally ignores previous indebtedness that is still outstanding.

Even so, the administration has projected that the annual deficit for the current budget year will hit $1.84 trillion, four times the size of last year's deficit of $455 billion. Private forecasters suggest that shortfall may actually top $2 trillion.

Budget updates in previous administrations have given rise to charges that the White House was manipulating its figures to offer too rosy an outlook. Critics will be watching closely when the White House's Office of Management and Budget releases the new numbers.

Still, the update mainly involves plugging in changes in economic indicators, not revising program-by-program details. And indicators such as unemployment and gross domestic product changes have been public knowledge for some time.

Standard & Poor's chief economist David Wyss said part of the problem with the administration's earlier numbers is that "they were just stale," essentially put together by budget number-crunchers at the end of last year, before the sharp drop in the economy.

Wyss, like many other economists, says he expects the recession to last at least until September or October. "We're looking for basically a zero second half (of 2009). And then sluggish recovery," he said.

Even as it prepares to put larger deficit and smaller growth figures into its official forecast, the administration is looking for signs of improvement.

"If we were at the brink of catastrophe at the beginning of the year, we have walked some substantial distance back from the abyss," said Lawrence Summers, Obama's chief economic adviser.
The last quote is just mind-boggling. Expanding the budget deficit at an explosive pace that dwarfs any previous year is considered 'walking some substantial distance back from the abyss'? Ever hear of that old expression "you've gone from the frying pan into the fire"? This idiot is standing in the fire and saying "whew! We're safe now!"

Obama does have an answer for any inquiry into the delay in reporting the budget numbers, as indicated in the underlined section. But I want a reporter to ask that question anyway, because it leaves the impression that he's hiding something. And this is the candidate who criticized the previous administration's secretive ways while promising "transparency."

Well, we're getting transparency, all right. Just not the sort that the President intended.

[Grunthos]

Yeah, transparency... right.

[Tonus]

Argh...

FACT CHECK: Obama's health care claims adrift? (http://news.yahoo.com/s/ap/20090723/ap_on_go_pr_wh/us_obama_fact_check)


WASHINGTON – President Barack Obama's assertion Wednesday that government will stay out of health care decisions in an overhauled system is hard to square with the proposals coming out of Congress and with his own rhetoric.

Even now, nearly half the costs of health care in the U.S. are paid for by government at all levels. Federal authority would only grow under any proposal in play.

A look at some of Obama's claims in his prime-time news conference:

__

OBAMA: "We already have rough agreement" on some aspects of what a health care overhaul should involve, and one is: "It will keep government out of health care decisions, giving you the option to keep your insurance if you're happy with it."

THE FACTS: In House legislation, a commission appointed by the government would determine what is and isn't covered by insurance plans offered in a new purchasing pool, including a plan sponsored by the government. The bill also holds out the possibility that, over time, those standards could be imposed on all private insurance plans, not just the ones in the pool.

Indeed, Obama went on to lay out other principles of reform that plainly show the government making key decisions in health care. He said insurance companies would be barred from dropping coverage when someone gets too sick, limits would be set on out-of-pocket expenses, and preventive care such as checkups and mammograms would be covered.

It's true that people would not be forced to give up a private plan and go with a public one. The question is whether all of those private plans would still be in place if the government entered the marketplace in a bigger way.

He addressed some of the nuances under questioning. "Can I guarantee that there are going to be no changes in the health care delivery system?" he said. "No. The whole point of this is to try to encourage changes that work for the American people and make them healthier."

He acknowledged then that the "government already is making some of these decisions."

___

OBAMA: "I have also pledged that health insurance reform will not add to our deficit over the next decade, and I mean it."

THE FACTS: The president has said repeatedly that he wants "deficit-neutral" health care legislation, meaning that every dollar increase in cost is met with a dollar of new revenue or a dollar of savings. But some things are more neutral than others. White House Budget Director Peter Orszag told reporters this week that the promise does not apply to proposed spending of about $245 billion over the next decade to increase fees for doctors serving Medicare patients. Democrats and the Obama administration argue that the extra payment, designed to prevent a scheduled cut of about 21 percent in doctor fees, already was part of the administration's policy, with or without a health care overhaul.

Beyond that, budget experts have warned about various accounting gimmicks that can mask true burdens on the deficit. The bipartisan Committee for a Responsible Federal Budget lists a variety of them, including back-loading the heaviest costs at the end of the 10-year period and beyond.

___

OBAMA: "You haven't seen me out there blaming the Republicans."

THE FACTS: Obama did so in his opening statement, saying, "I've heard that one Republican strategist told his party that even though they may want to compromise, it's better politics to 'go for the kill.' Another Republican senator said that defeating health reform is about 'breaking' me."

___

OBAMA: "I don't know, not having been there and not seeing all the facts, what role race played in that. But I think it's fair to say, number one, any of us would be pretty angry; number two, that the Cambridge police acted stupidly in arresting somebody when there was already proof that they were in their own home, and, number three, what I think we know separate and apart from this incident is that there's a long history in this country of African-Americans and Latinos being stopped by law enforcement disproportionately."

THE FACTS: The facts are in dispute between black scholar Henry Louis Gates Jr. and the white police sergeant who arrested him at his Cambridge, Mass., home when officers went there to investigate a reported break-in. But this much is clear: Gates wasn't arrested for being in his own home, as Obama implies, but for allegedly being belligerent when the sergeant demanded his identification. The president did mention that the professor was charged with disorderly conduct. Charges were dropped.

___

OBAMA: "If we had done nothing, if you had the same old budget as opposed to the changes we made in our budget, you'd have a $9.3 trillion deficit over the next 10 years. Because of the changes we've made, it's going to be $7.1 trillion."

THE FACTS: Obama's numbers are based on figures compiled by his own budget office. But they rely on assumptions about economic growth that some economists find too optimistic. The nonpartisan Congressional Budget Office, in its own analysis of the president's budget numbers, concluded that the cumulative deficit over the next decade would be $9.1 trillion. Putting aside the Gates thing (why did a reporter ask about that during a press conference about health care? It's not as if the President hasn't been accessible to the press. It's idiotic.)... it's the last portion that really shows how inured we've become to government mismanagement.

Note that Obama isn't talking about the national debt (which is at just over $11.6 trillion at the moment), he's talking about the deficit. In other words, the difference between what government takes in and what it spends. This is an old trick-- few presidents ever talk about the debt, they talk about deficits, because you can talk about lowering the deficit and people feel as if you're making progress, even though you're still increasing the debt. It's a con game, and since most people probably have no idea what the distinction is, it works.

The real issue is that Obama is talking about deficits (not debt) that run between an optimistic estimate of $7.1 trillion and (less optimistic) $9.3 trillion over ten years. Over the last ~30 years government has been running up larger and larger deficits (aside from the Clinton years, when the dot-com bubble and two tax increases provided enormous revenues) and Bush43 had continued this trend even before the 2007/2008 economic meltdown. But this is an increase that is incredibly out of proportion even with Bush's worst deficit. And yet, the President speaks as if "lowering" the deficit to $7.1 trillion is some sort of accomplishment.

Memo to the government: you could lower the deficit to zero in any given year, simply by NOT SPENDING MONEY YOU DON'T HAVE. Dipshits.

[Grunthos]

To me, this seems obvious, but apparently there are those who contend that the detached "wisdom" of a few dozen amateurs is far better at defining efficient distribution that is the collective decisionmaking power of hundreds of millions of people with "skin in the game."

The Arrogance of Health Care Reform
Why do politicians with no business experience think they can run 15 percent of the economy?
John Stossel | July 23, 2009

It's crazy for a group of mere mortals to try to design 15 percent of the U.S. economy. It's even crazier to do it by August.

Yet that is what some members of Congress presume to do. They intend, as the New York Times puts it, "to reinvent the nation's health care system."

Let that sink in. A handful of people who probably never even ran a small business actually think they can reinvent the health care system.

Politicians and bureaucrats clearly have no idea how complicated markets are. Every day people make countless tradeoffs, in all areas of life, based on subjective value judgments and personal information as they delicately balance their interests, needs and wants. Who is in a better position than they to tailor those choices to best serve their purposes? Yet the politicians believe they can plan the medical market the way you plan a birthday party.

Leave aside how much power the state would have to exercise over us to run the medical system. Suffice it say that if government attempts to control our total medical spending, sooner or later, it will have to control us.

Also leave aside the inevitable huge cost of any such program. The administration estimates $1.5 trillion over 10 years with no increase in the deficit. But no one should take that seriously. When it comes to projecting future costs, these guys may as well be reading chicken entrails. In 1965, hospitalization coverage under Medicare was projected to cost $9 billion by 1990. The actual price tag was $66 billion.

The sober Congressional Budget Office debunked the reformers' cost projections. Trust us, Obama says. "At the end of the day, we'll have significant cost controls," presidential adviser David Axelrod said. Give me a break.

Now focus on the spectacle of that handful of men and women daring to think they can design the medical marketplace. They would empower an even smaller group to determine—for millions of diverse Americans—which medical treatments are worthy and at what price.

How do these arrogant, presumptuous politicians believe they can know enough to plan for the rest of us? Who do they think they are? Under cover of helping uninsured people get medical care, they live out their megalomaniacal social-engineering fantasies—putting our physical and economic health at risk in the process.

Will the American people say "Enough!"?

I fear not, based on the comments on my blog. When I argued last week that medical insurance makes people indifferent to costs, I got comments like: "I guess the 47 million people who don't have health care should just die, right, John?" "You will always be a shill for corporate America."

Like the politicians, most people are oblivious to F.A. Hayek's insight that the critical information needed to run an economy—or even 15 percent of one—doesn't exist in any one place where it is accessible to central planners. Instead, it is scattered piecemeal among millions of people. All those people put together are far wiser and better informed than Congress could ever be. Only markets—private property, free exchange, and the price system—can put this knowledge at the disposal of entrepreneurs and consumers, ensuring the system will serve the people and not just the political class.

This is no less true for medical care than for food, clothing, and shelter. It is profit-seeking entrepreneurship that gave us birth control pills, robot limbs, Lasik surgery, and so many other good things that make our lives longer and more pain free.

To the extent the politicians ignore this, they are the enemy of our well-being. The belief that they can take care of us is rank superstition.

Who will save us from these despots? What Adam Smith said about the economic planner applies here, too: The politician who tries to design the medical marketplace would "assume an authority which could safely be trusted, not only to no single person, but to no council or senate whatever, and which would nowhere be so dangerous as in the hands of a man who had folly and presumption enough to fancy himself fit to exercise it."

http://www.reason.com/news/show/134987.html

[Grunthos]

The other opinions of the source notwithstanding, I think this may be the most succinctly I've seen the truth regarding "what is and isn't a right" summed up. Better even than when Bill Whittle tackled it.

I can find no fault in it, nor any particular in which I disagree.


What Is a "Right"?
I'd like to clarify something that some people seemed to be confused about.

Health care is not a right. (Neither is education, or food, or housing, or a job.)

How can I be so sure?

Anything that requires the labor of someone else cannot be a universal human right.

Our Constitutional, Natural Law rights require only that others leave us alone. They require no labor, action, payment, participation or sacrifice of anyone else on our behalf.

We have the right to NOT be interfered with when we speak, practice religion, gather, or bear arms. We have the right NOT to be imprisoned without due-process, to be searched without cause, to be made to testify against ourselves.

See how that works?

But the "rights" that the Progressives pretend we have, like health care, education, food, housing and jobs...all require the participation of others.

Health care requires the labor of doctors.
Education requires the labor of teachers.
Housing requires the labor of builders.

What if doctors quit? What if teachers quit? What if builders quit?

To provide YOU the "right" to healthcare, doctors would be forced to labor.
To provide YOU the "right" to education, teachers would be forced to labor.
To provide YOU the "right" to housing, builders would be forced to labor.

If you take any supposed "right" and you push it to its logical conclusion—and the only solution would entail the coercing of any individual—it's not a right at all.

It's just a greedy, selfish Want.

In a nutshell—nothing that demands the labor or sacrifice of another is your right.

This simple formula can be used to determine the truth about all those supposed "rights" the Progressive/Fascists are trying to sell us.

They, it seems, are perfectly willing to use government force, and confiscation to make sure somebody gets their Wants fulfilled.

Question is, who gets the goodies and who's forced to labor to provide them??

The Gunslinger
Enemy of the Imperial State (EOTIS)
Vampire/Cannibal Hunter

(emp. mine)

http://gunslingersjournal.blogspot.com/2009/07/healthcare-clarification.html

[Shady]

Our local radio station changed (without warning, I might add) while I was out of town. I was a little put out when I came home and the only station worth listening to--which had Lex & Terry in the morning and played somewhat alternative music--had the format changed to talk radio.

However, during the past week I've realized that this is a conservative talk radio station and grown to enjoy it (I used to listen to NPR at lunch just to laugh). I get a couple of local people in the morning who seem fair enough, Rush at lunch, and Glen Beck on the way home.

Now that I've taken the long way around to my point, I think I heard Rush giving this same editorial yesterday during lunch. I was surprised I agreed with him so much. I didn't think I would care for his show or his antics. But, he is great for comedic value, and each day there is a nugget within at least one of his tantrums I nod my head to in understanding.

Very strange. I've suddenly become very old. =(

[Tonus]

You know your plan isn't good when even CNN is bashing it. (http://money.cnn.com/2009/07/24/news/economy/health_care_reform_obama.fortune/index.htm?postversion=2009072410)


5 freedoms you'd lose in health care reform
If you read the fine print in the Congressional plans, you'll find that a lot of cherished aspects of the current system would disappear.
The kicker is that while people complain that the current system is bad and we must do something about it, the current bill would remove a lot of the good things about our current system and replace them with less-desirable options, while leaving a lot of the things that make the current system so bad intact!
NEW YORK (Fortune) -- In promoting his health-care agenda, President Obama has repeatedly reassured Americans that they can keep their existing health plans -- and that the benefits and access they prize will be enhanced through reform.

A close reading of the two main bills, one backed by Democrats in the House and the other issued by Sen. Edward Kennedy's Health committee, contradict the President's assurances. To be sure, it isn't easy to comb through their 2,000 pages of tortured legal language. But page by page, the bills reveal a web of restrictions, fines, and mandates that would radically change your health-care coverage.

If you prize choosing your own cardiologist or urologist under your company's Preferred Provider Organization plan (PPO), if your employer rewards your non-smoking, healthy lifestyle with reduced premiums, if you love the bargain Health Savings Account (HSA) that insures you just for the essentials, or if you simply take comfort in the freedom to spend your own money for a policy that covers the newest drugs and diagnostic tests -- you may be shocked to learn that you could lose all of those good things under the rules proposed in the two bills that herald a health-care revolution.

In short, the Obama platform would mandate extremely full, expensive, and highly subsidized coverage -- including a lot of benefits people would never pay for with their own money -- but deliver it through a highly restrictive, HMO-style plan that will determine what care and tests you can and can't have. It's a revolution, all right, but in the wrong direction.

Let's explore the five freedoms that Americans would lose under Obamacare:In other words, you will spend more and get less. This is an improvement????
1. Freedom to choose what's in your plan

The bills in both houses require that Americans purchase insurance through "qualified" plans offered by health-care "exchanges" that would be set up in each state. The rub is that the plans can't really compete based on what they offer. The reason: The federal government will impose a minimum list of benefits that each plan is required to offer.

Today, many states require these "standard benefits packages" -- and they're a major cause for the rise in health-care costs. Every group, from chiropractors to alcohol-abuse counselors, do lobbying to get included. Connecticut, for example, requires reimbursement for hair transplants, hearing aids, and in vitro fertilization.

The Senate bill would require coverage for prescription drugs, mental-health benefits, and substance-abuse services. It also requires policies to insure "children" until the age of 26. That's just the starting list. The bills would allow the Department of Health and Human Services to add to the list of required benefits, based on recommendations from a committee of experts. Americans, therefore, wouldn't even know what's in their plans and what they're required to pay for, directly or indirectly, until after the bills become law.Great, bait and switch from your own government! One important point to note is in the second paragraph. What is one of the factors that has led to high insurance costs? Government interference in the insurance market. How does Obamacare plan to resolve this problem? By expanding government interference to cover the entire market!

It also bears noting that the federal government will not full subsidize the state government exchanges, which means you'll pay additional taxes. But since those aren't directly coming from the federal government, they don't show up in cost projections. Convenient for the White House, not so much for taxpayers. This is an improvement???
2. Freedom to be rewarded for healthy living, or pay your real costs

As with the previous example, the Obama plan enshrines into federal law one of the worst features of state legislation: community rating. Eleven states, ranging from New York to Oregon, have some form of community rating. In its purest form, community rating requires that all patients pay the same rates for their level of coverage regardless of their age or medical condition.

Americans with pre-existing conditions need subsidies under any plan, but community rating is a dubious way to bring fairness to health care. The reason is twofold: First, it forces young people, who typically have lower incomes than older workers, to pay far more than their actual cost, and gives older workers, who can afford to pay more, a big discount. The state laws gouging the young are a major reason so many of them have joined the ranks of uninsured.

Under the Senate plan, insurers would be barred from charging any more than twice as much for one patient vs. any other patient with the same coverage. So if a 20-year-old who costs just $800 a year to insure is forced to pay $2,500, a 62-year-old who costs $7,500 would pay no more than $5,000.

Second, the bills would ban insurers from charging differing premiums based on the health of their customers. Again, that's understandable for folks with diabetes or cancer. But the bills would bar rewarding people who pursue a healthy lifestyle of exercise or a cholesterol-conscious diet. That's hardly a formula for lower costs. It's as if car insurers had to charge the same rates to safe drivers as to chronic speeders with a history of accidents.Note the bold portion. Once again, what is one reason for the current mess? Government interference! Insurance companies will be forced to soak the young in order to subsidize the old, even when the old can afford it and the young cannot! And here I thought Democrats were in favor of taking from the rich to distribute to the poor, not the other way around. This is an improvement???
3. Freedom to choose high-deductible coverage

The bills threaten to eliminate the one part of the market truly driven by consumers spending their own money. That's what makes a market, and health care needs more of it, not less.

Hundreds of companies now offer Health Savings Accounts to about 5 million employees. Those workers deposit tax-free money in the accounts and get a matching contribution from their employer. They can use the funds to buy a high-deductible plan -- say for major medical costs over $12,000. Preventive care is reimbursed, but patients pay all other routine doctor visits and tests with their own money from the HSA account. As a result, HSA users are far more cost-conscious than customers who are reimbursed for the majority of their care.

The bills seriously endanger the trend toward consumer-driven care in general. By requiring minimum packages, they would prevent patients from choosing stripped-down plans that cover only major medical expenses. "The government could set extremely low deductibles that would eliminate HSAs," says John Goodman of the National Center for Policy Analysis, a free-market research group. "And they could do it after the bills are passed."Once again, an option that helps keep insurance costs DOWN (by opting out of the inefficient part of the market) will be removed, and people will be added to the insurance rolls even though they were doing just fine by keeping only major medical. This will drive up costs because now they're covered by insurance for costs that they were able to cover on their own. Instead of spending money only when they need care, they spend it no matter what. This is an improvement???
4. Freedom to keep your existing plan

This is the freedom that the President keeps emphasizing. Yet the bills appear to say otherwise. It's worth diving into the weeds -- the territory where most pundits and politicians don't seem to have ventured.

The legislation divides the insured into two main groups, and those two groups are treated differently with respect to their current plans. The first are employees covered by the Employee Retirement Security Act of 1974. ERISA regulates companies that are self-insured, meaning they pay claims out of their cash flow, and don't have real insurance. Those are the GEs (GE, Fortune 500) and Time Warners (TWX, Fortune 500) and most other big companies.

The House bill states that employees covered by ERISA plans are "grandfathered." Under ERISA, the plans can do pretty much what they want -- they're exempt from standard packages and community rating and can reward employees for healthy lifestyles even in restrictive states.

But read on.

The bill gives ERISA employers a five-year grace period when they can keep offering plans free from the restrictions of the "qualified" policies offered on the exchanges. But after five years, they would have to offer only approved plans, with the myriad rules we've already discussed. So for Americans in large corporations, "keeping your own plan" has a strict deadline. In five years, like it or not, you'll get dumped into the exchange. As we'll see, it could happen a lot earlier.

The outlook is worse for the second group. It encompasses employees who aren't under ERISA but get actual insurance either on their own or through small businesses. After the legislation passes, all insurers that offer a wide range of plans to these employees will be forced to offer only "qualified" plans to new customers, via the exchanges.

The employees who got their coverage before the law goes into effect can keep their plans, but once again, there's a catch. If the plan changes in any way -- by altering co-pays, deductibles, or even switching coverage for this or that drug -- the employee must drop out and shop through the exchange. Since these plans generally change their policies every year, it's likely that millions of employees will lose their plans in 12 months.Investor's Business Daily has gotten a lot of flack for claiming that Obamacare would make existing private plans "illegal." The fact is that it won't, and the IBD headline is incorrect. But the point they're making is spot-on: Obamacare is designed to bleed private insurers to death, and once it does, then the government is the only plan in town. The same guys who turned Medicare and Medicaid and Social Security into an unsustainable clusterfuck? Yeah, they'll be running the whole show. This is an improvement???
5. Freedom to choose your doctors

The Senate bill requires that Americans buying through the exchanges -- and as we've seen, that will soon be most Americans -- must get their care through something called "medical home." Medical home is similar to an HMO. You're assigned a primary care doctor, and the doctor controls your access to specialists. The primary care physicians will decide which services, like MRIs and other diagnostic scans, are best for you, and will decide when you really need to see a cardiologists or orthopedists.

Under the proposals, the gatekeepers would theoretically guide patients to tests and treatments that have proved most cost-effective. The danger is that doctors will be financially rewarded for denying care, as were HMO physicians more than a decade ago. It was consumer outrage over despotic gatekeepers that made the HMOs so unpopular, and killed what was billed as the solution to America's health-care cost explosion.

The bills do not specifically rule out fee-for-service plans as options to be offered through the exchanges. But remember, those plans -- if they exist -- would be barred from charging sick or elderly patients more than young and healthy ones. So patients would be inclined to game the system, staying in the HMO while they're healthy and switching to fee-for-service when they become seriously ill. "That would kill fee-for-service in a hurry," says Goodman.

In reality, the flexible, employer-based plans that now dominate the landscape, and that Americans so cherish, could disappear far faster than the 5 year "grace period" that's barely being discussed.

Companies would have the option of paying an 8% payroll tax into a fund that pays for coverage for Americans who aren't covered by their employers. It won't happen right away -- large companies must wait a couple of years before they opt out. But it will happen, since it's likely that the tax will rise a lot more slowly than corporate health-care costs, especially since they'll be lobbying Washington to keep the tax under control in the righteous name of job creation.

The best solution is to move to a let-freedom-ring regime of high deductibles, no community rating, no standard benefits, and cross-state shopping for bargains (another market-based reform that's strictly taboo in the bills). I'll propose my own solution in another piece soon on Fortune.com. For now, we suffer with a flawed health-care system, but we still have our Five Freedoms. Call them the Five Endangered Freedoms.One of Obama's talking points was that under the current system, doctors might choose a less expensive treatment for a problem instead of the best treatment. He promised that Obamacare would fix this. But it does the opposite! It will incentivize finding the most cost-effective treatment, regardless of actual need. Remember, Obama has explained that if you're looking at an expensive treatment in your old age, you might be better off "taking a painkiller" because it's cheaper.

No, this is not an improvement. It's an abomination. It is designed to replace a system that is flawed but working, and replacing it with a system that is flawed and expensive, and won't work as well.

[Grunthos]

You mean, Obambi's lying to us to get something he wants? There's a shock, all right... after all, he's done nothing else to get elected each time he's run for office.

[Edmaster]

It's an abomination.

Pretty much.

:|

[Grunthos]

Do we really want THESE people in charge of our medical options?

EPA changes fuel economy numbers ahead of 'Cash for Clunkers'
By Peter Valdes-Dapena, CNNMoney.com senior writer
On Tuesday July 28, 2009, 9:24 pm EDT

Some car shoppers are finding that their trade-in vehicles, which qualified for a Cash for Clunkers rebate last week, don't this week because of changes in the EPA's fuel economy ratings.

In some cases, car buyers say, dealers are backing out of sales they've already made because the EPA changed the fuel economy figures on their trade-in.

"My wife just received a call from the sales manager saying that our clunker doesn't qualify anymore, and that we could either pay the extra $4,500 or return the new car (and get our old car back)," Greg Straka wrote Tuesday on a message board at the Edmunds.com automotive Web site.

He had signed a document agreeing to provide additional documentation needed to process his trade-in, but had not done so yet, Straka wrote.

He had made the deal for his new car last Saturday, the day after program rules were supposed to have been finalized, Straka wrote in an e-mail to CNNMoney.com. But the fuel economy information on the car apparently changed the next day, he said.

Straka declined to name the dealership or the specific car models involved in the disputed transaction.

Another car shopper e-mailed CNNMoney.com saying he went to the Environmental Protection Agency's fueleconomy.gov Web site on Saturday to double-check the fuel economy rating for his 1987 Mercury Grand Marquis. When he had visited previously, the car's combined city and highway fuel economy was rated at 18 miles per gallon, making it eligible for the program.

But on Saturday, he found something different: The fuel economy for his car had been raised to 19 mpg -- one mile per gallon over the maximum fuel-efficiency allowed under the Car Allowance Rebate System (aka Cash for Clunkers). As a result, he became ineligible for a trade-in credit worth up to $4,500.

Even though the program's basic requirements have been known since it was created by Congress earlier this year, Cash for Clunkers didn't become official until Friday. So as part of the official launch, the EPA conducted "quality assurance and quality control effort regarding fuel economy calculations on more than 30,000 vehicle model types spanning the past 25 years," according to an e-mail sent by EPA spokesman Dale Kemery.

As a result, 86 car models became newly eligible for the program. However, 78 models became ineligible, EPA spokeswoman Cathy Milbourne said in a statement released Tuesday night.

The EPA completed its changes by the time the rules were finalized on Friday, Milbourne said.

The updates, which involved calculating average fuel economy out to four decimal places, were required by the legislation, she said.

Car shoppers have been posting comments on various Internet message boards, including several at the automotive Web site Edmunds.com, describing their frustration with the changes.

The owners of a 1993 Camry V6 wagon, a 1995 Saab 900S and a 1988 Toyota 4Runner all describe their vehicles becoming suddenly ineligible for the program around the time the rules officially went into effect.

Consumers who believe their eligibility may have been hurt by EPA's changes should contact the National Highway Traffic Safety Administration, which administers Cash For Clunkers.

"They should call our attention to it," said Rae Tyson, spokesman for the NHTSA. He did not promise, however, that the agency would bend the rules.

Cash for Clunkers benefits are retroactive to July 1, so dealers have been able to make deals since that date. But they had to wait until Friday to file for their reimbursement checks.


"Oh, sorry; you would have gotten a kidney last week... but the requirements changed just last night..."

http://finance.yahoo.com/news/EPA-changes-fuel-economy-cnnm-770299897.html?x=0&sec=topStories&pos=6&asset=&ccode

[Diniden]

Lack of conviction in their decisions is a fatal mistake for a leadership position...it yet agains returns to looking like a bunch of clowns are in government again.

[Tonus]

Piling on. (http://www.qando.net/?p=3849)


HR3200, the House’s version of health care reform, can be found here (http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3200ih.txt.pdf), at the GPO’s web site, in PDF format. All 1017 pages of it. You’ll need some time to read it. It’s dense. Too dense, in fact, for Congressmen to read, apparently.

Or, you can read this PDF file (http://www.qando.net/wp-content/uploads/healthcare_overview_obama_072909.pdf) instead, which is a summary of the high points provided by Liberty Counsel, a conservative, pro-life legal firm, which apparently did read it. They reference the GPO’s file directly, so you can quickly track down the references they cite. A randon selection from the critique:• Sec. 205, Pg. 102, Lines 12-18 – Medicaid-eligible individuals will be automatically enrolled in Medicaid. No freedom to choose.

• Sec. 223, Pg. 124, Lines 24-25 – No company can sue the government for price-fixing. No “administrative or judicial review” against a government monopoly.

• Sec. 225, Pg. 127, Lines 1-16 – Doctors – the government will tell YOU what you can make. “The Secretary shall provide for the annual participation of physicians under the public health insurance option, for which payment may be made for services furnished during the year.”

• Sec. 312, Pg. 145, Lines 15-17 – Employers MUST auto-enroll employees into public option plan.

• Sec. 313, Pg. 149, Lines 16-23 – ANY employer with payroll $400,000 and above who does not provide public option pays 8% tax on all payroll.

• Sec. 313, Pg. 150, Lines 9-13 – Businesses with payroll between $251,000 and $400,000 who do not provide public option pay 2-6% tax on all payroll.

• Sec. 401.59B, Pg. 167, Lines 18-23 – ANY individual who does not have acceptable care, according to government, will be taxed 2.5% of income.

• Sec. 59B, Pg. 170, Line 1 – Any NONRESIDENT alien is exempt from individual taxes. (Americans will pay for their health care.)

• Sec. 431, Pg. 195, Lines 1-3 – Officers and employees of HC Administration (government) will have access to ALL Americans’ financial and personal records.

• Sec. 441, Pg. 203, Lines 14-15 – “The tax imposed under this section shall not be treated as tax.” Yes, it says that.
It’s actually quite an interesting read, even minus Liberty Counsels alarmist tone and worst-case-scenario suppositions.

The scary thing is…maybe they aren’t being alarmist.

Also, note the tax rates above very carefully for employers who don’t provide health insurance. If you don’t think those rates are low enough to positively incentivize employers to dump private health coverage and turn it over to the government, then you just aren’t a very astute observer. 8% of payroll is nothing, compared to getting rid of the administrative headaches.

It’s not called “single-payer health care”. But, objectively, that’s precisely what it is. Private health insurance won’t be outlawed, of course. It’ll still be perfectly legal to provide it, or acquire it. It will just be starved to death under this plan, because employers will stop buying it. It’ll be easier and cheaper just to push the employees over to the “public option”.

I wonder if our NHS ID cards will have our pictures on them.
None of this is really new, it's what we've been getting warnings about for some time. When Obama says that you'll be able to keep your plan and your doctor, he's being dishonest. Employers get penalized for not offering the "public option" (ie, taxpayer funded health care), but that's almost superfluous. Employers will want to offer the public plan, and they'll want to drop private plans, because it means less administrative expenses for them. And if you're a private insurer who is being priced out of the market by the government plan? Too bad, you have nowhere to turn for redress of grievances.

[Ythogtha]

All I know is I’m screwed no matter what happens. I need two heart medications a day so I don’t drop over and die. My son has major issues with his bone development in his feet ($800 this month for him) and my wife has really bad asthma. My health insurance gets more expensive every year. It covers more than the present government programs, which is nice, but it eats up more of my paycheck. So, I get good insurance, but I can’t eat or buy my son clothes.

If I go on government insurance (which I have been on in the past) it doesn’t cover as much. I eat, but it’s a pain in the ass to get my medicine. Not to mention I’m at risk for being kicked off for every little thing.

I can’t get HIPP or anything like that, because I make too much for assistance ($5 past the limit), but not enough to actually afford private insurance.

I’ve been through this shit since I was 21 years old. I know how insurances work (government or otherwise). I’m screwed either way.

[Grunthos]

Insurance, frankly, is responsible for much of the high price of health care. Providers can't charge what recipients can't pay, unless someone else picks up the tab.

Hell of it is, without the market skewing force of insurance having been in the mix for 40+ years now, would your son's treatments only cost $50... or would they never have been developed?

[dooge1992]

I think we need national healthcare. But, the way Obama's doing it is wrong. The problem is 3 pronged:

High Insurance Rates
Malpractice Lawsuits
Drug Companies

Insurance keeps going up because drug companies keep charging more. It also keeps going up because if a doctor performs a risky procedure, let's say 50% chance of success, unless an agreement was reached for them not to sue, the family will sue (apparently the fact it was risky and they agreed to have it means nothing apparently).

All in all, it's not the medical field, so much as those who use it for money.

[Ythogtha]

Insurance, frankly, is responsible for much of the high price of health care. Providers can't charge what recipients can't pay, unless someone else picks up the tab.

Hell of it is, without the market skewing force of insurance having been in the mix for 40+ years now, would your son's treatments only cost $50... or would they never have been developed?

My son has custom insoles for his shoes. They consist of two types of rubber. They were $768.00. Some how I think rubber insoles would have been developed.

Now, the procedure for my heart surgery, that's a different question. Maybe, maybe not.

Of course, it really will not matter what treatments are developed from the private market when I can't afford insurance at all.

[Shady]

Insurance keeps going up because drug companies keep charging more.

I'm not sure if there's anything to this or not. But drug companies don't just "charge more," they are paying for the continuous development of new and better drugs. Yeah, there's probably a bit of a racket there, but US drug companies are constantly researching and developing better drugs with less side effects. Something no other country can claim.

It also keeps going up because if a doctor performs a risky procedure, let's say 50% chance of success, unless an agreement was reached for them not to sue, the family will sue (apparently the fact it was risky and they agreed to have it means nothing apparently).

No, not at all.

People can sue doctors all day long, but having a successful lawsuit against a doctor is another thing entirely. People do not sue for unsuccessful risky procedures. They may want to, but they are not going to be able to find an attorney who is willing to accept their case.

Lawsuits against doctors for amputating the wrong limb, extracting the wrong tooth, or removing the wrong organ fail all the time. Most don't even make it to discovery. Death is the only occurrence that can conceivably bring about an economically viable suit, and even then wanton negligence has to be proven. Not only is that difficult and very expensive to prove, it's near impossible to persuade a jury (even with compelling evidence) that a doctor was grossly careless.

Med Mal cases are not part of the reason that health insurance premiums are high. Even if Med Mal cases were more common and successful, that has no relation--directly or indirectly--to insurance premiums at all.

[Shady]

My son has custom insoles for his shoes. They consist of two types of rubber. They were $768.00. Some how I think rubber insoles would have been developed.

Now, the procedure for my heart surgery, that's a different question. Maybe, maybe not.

Of course, it really will not matter what treatments are developed from the private market when I can't afford insurance at all.

What are your circumstances that you can not afford health insurance? You said earlier you earn too much to qualify for HIPP (which I assume is a CHIP type of program offered in your state). Does your (or your wife's) employer not offer health insurance? Are there no plans available in your area you can get on your own at an affordable rate?

I'm not grilling you, I'm genuinely interested. I'd also like to help if I can.

[Tonus]

Insurance keeps going up because drug companies keep charging more.
Maybe. The thing is, when a market is allowed to function without interference, prices become a function of normal market forces. Drug companies would not simply be able to charge more, because then they'd lose out on potential sales and make fewer profits.

When you have a system that is designed incorrectly to begin with, and then add government meddling into the mix, you get a system that is expensive and grossly inefficient. The idea that insurance should cover every cost is irrational on its face. It also creates a bureaucracy that adds to the inefficiency. The farther you move away from a normal market, the lower the incentives for companies to develop new drugs and treatments and the lower the incentives for doctors to focus on your needs and not his costs.

It is a backwards system, due to the idea that medical service is a right and must be guaranteed to everyone. Not surprisingly, any attempt to force this turns into an expensive mess that doesn't cover everyone, and which often fails to cover those who "need it the most." Although in the USA, a lot of the poor who aren't covered have programs available to them, but either they do not know about them or never bother to enroll.

In fact, the whole "47 million Americans do not have health insurance" line is ridiculously overblown. Almost 10 million of that number are non-citizens who don't qualify for care. 14 million are people who already qualify for government coverage but have not applied for it. Close to 13 million are people who make more than $50,000 a year and simply choose not to get health insurance, even though they can afford it.

[Grunthos]

Med Mal cases are not part of the reason that health insurance premiums are high. Even if Med Mal cases were more common and successful, that has no relation--directly or indirectly--to insurance premiums at all.

But the costs of insurance against Med Mal cases definitely are, because they are a part of the provider's direct overhead, and overhead gets covered nowhere else than out of the provider's bottom line - - which is in turn paid by the health insurance company, whose primary source of income is premiums.

[Ythogtha]

What are your circumstances that you can not afford health insurance? You said earlier you earn too much to qualify for HIPP (which I assume is a CHIP type of program offered in your state). Does your (or your wife's) employer not offer health insurance? Are there no plans available in your area you can get on your own at an affordable rate?

I'm not grilling you, I'm genuinely interested. I'd also like to help if I can.

No, not really. I seem to fall into that small category where nothing seems to be available. Though I am working on it. Hopefully I'll get somewhere. Due to my health I've always had problems with insurances. Needless to say they are not my favorite institution.

My employer provides health insurance; it's what I have now. It's also due to go up soon. I was receiving help with paying for it, but I received a .50c raise and lost it. Almost makes the raise not worth it.

[Tonus]

Now, what do we have here? (http://www.qando.net/?p=3897)


One of the questions constantly posed as the debate over health care insurance reform rages is, “if we have such a great health care system, why is our life expectancy lower than countries with socialized care?”

Well apparently it is our propensity to murder each other and die in car accidents which obscures the fact that with those factored out, we actually enjoy the longest life expectancy. James Joyner (http://www.outsidethebeltway.com/archives/us_life_expectancy_were_number_1/) provides the numbers and a handy little chart.


But the bottom line is when you remove homicide and car crashes, we jump from number 15 with a life expectancy of 75.3 to number 1 with a life expectancy of 76.9.


So we must be doing something right in the medical field wouldn’t you say – certainly more so than anyone else if you want to hang your hat on life expectancy data that only focuses on what medicine can help. Drive safely and avoid getting on the losing side of a gun fight and you can expect to be around for longer than any of those in the so-called “more advanced” countries.


And, as Dodd points out, there’s even a way (http://www.outsidethebeltway.com/archives/increase_us_life_expectancy_without_increasing_the _power_of_government/) to improve the homicide numbers:
Homicide, however, we could impact immediately and irrevocably right now simply by decriminalizing most (or all) currently illegal drugs. Remove the artificial, government-created scarcity, and the profits and incentive to engage in underworld violence that goes with it, and the homicide rate would fall significantly. More of our young men would survive to middle adulthood, hundreds of thousands of prisoners would be freed (or never created) to engage in productive work, and our life expectancy at birth would jump immediately and permanently. All without the government having to nationalize one-sixth of the economy and expropriate trillions more dollars from the private sector to pay for the hope that the outcome will be improved.
He’s right, of course – remove profit, remove incentive. The drug market today is a government created market. And it reacts to the distorted incentives prohibition introduces into such a market.


We know how to regulate such markets legally. We do it fairly successfully with alcohol. And we don’t have booze gangs shooting it out in turf wars or finding bunches of bodies from bootleg deals gone wrong.


Why we don’t consider reform in this area is beyond me. Life expectancy numbers would certainly see an increase if we did. So would our freedom and liberty numbers.


That whole "life expectancy" canard is used all of the time to criticize the US health care system. But when you remove just two factors that skew the data, suddenly the US shoots to the top of the list.

Apparently, we're seeking to spend money on the wrong type of preventative care. How about we spend those trillions of dollars on rolling back those disastrous CAFE standards, building sturdier cars, writing and enforcing tougher drunk driving laws... and putting more cops on the street?

[Grunthos]

I'm willing to bet that Homicide is less than 1/20th the influence on that statistic that car crashes are... but focusing on the majority problem doesn't advance the legalization meme, so we ignore the majuscule to the benefit of the miniscule.

[Shady]

But the costs of insurance against Med Mal cases definitely are, because they are a part of the provider's direct overhead, and overhead gets covered nowhere else than out of the provider's bottom line - - which is in turn paid by the health insurance company, whose primary source of income is premiums.

I've seen no compelling evidence that successful Med Mal cases are on the rise, and the cases that are successful are receiving larger judgments. If you ask around my office (filled with plaintiff's attorneys who would love to make more money by taking on even more cases) Med Mal is almost non-existent.

Health insurance premiums are not on the rise because of Med Mal claims being paid out. Med Mal is actually on the decline and has been for over a decade according to information taken from the National Practitioner Data Bank Public Use File.

Med Mal cases are just not economically viable unless there is obvious breech in the standard of care. It's not something many plaintiff's attorneys will mess with because of the difficulty in proving liability and expense of doing so.

Granted, socialized health care would theoretically reduce Med Mal cases. Reducing the number of doctors practicing would likely reduce the number of incidents that might trigger the desire to file a case against a physician. Add to that the possibility that less people will be able to receive covered care from a doctor in the first place, and there's an even smaller chance of a physician faces Med Mal charges.

But I digress. The first and most crippling aspect of our current coverage system is the Medicare Fee Schedule, which most carriers use as a basis to figure their own "reasonable and customary" fee schedules. Most medical practices pretty much have to enter into a contract with the major carriers because if they don't, the "out of network" rate is even lower than the agreed to "reasonable and customary." Or, they can just not accept insurance at all and require payment prior to service, which would effectively reduce their patient load to almost nothing.

Seriously, let's put the blame where it belongs; the government. It's not Med Mal, and I stick to that as fact.

[Diniden]

Interesting about the make drugs legal propaganda shpill. Ever wonder how high the life expectancy would rise if no one smoked, drank, or did drugs? We'd probably be hitting the 90's on average if those were gone. I think he was fighting for a cause with the wrong backing. Drugs definitely lower life expectancy regardless if people are fighting over them. Plenty die from early heart attacks and cancer from doing the hard core drugs or just from doing very stupid stuff while under the influence.

[Shady]

No, not really. I seem to fall into that small category where nothing seems to be available. Though I am working on it. Hopefully I'll get somewhere. Due to my health I've always had problems with insurances. Needless to say they are not my favorite institution.

My employer provides health insurance; it's what I have now. It's also due to go up soon. I was receiving help with paying for it, but I received a .50c raise and lost it. Almost makes the raise not worth it.

Lost my focus for a moment. What state do you live in?

Also, a .50c raise does not sound worth it. That's only $80 a month (gross). If your insurance has increased more than $80 a month it is certainly not worth it. Especially since insurance is a pre-tax deduction. Are your paychecks smaller with the raise? If they are, you're better off without it.

I'm really not trying to get all into your personal business. You genuinely might be better off not taking the raise and continuing with the assistance with health insurance coverage. I know that sounds weird, but it is always something to consider your pay AND benefits to know if you are being compensated what you feel you should.

Many professional fields will pay more in salary if you opt out of their insurance plan. Insurance is part of the compensation package even if you pay for it, believe it or not. Then again, the insurance premiums they deduct from your pay are pre-tax, which means less of your earnings go to the government and more go towards your own necessities. Weighed carefully, a raise or opting out of employer insurance plans can greatly effect your take home pay, and your tax bracket at the end of the year.

That's why I say I really want to help you, but I do need more details. If you don't want to post them here but want to take me up on my offer you can PM me. If you don't want to mess with it at all you can tell me and that's fine.

I just really do believe there is a way for almost everyone to have access to health insurance coverage. Even with pre-ex conditions like your heart and your son's feet. As long as you are covered for 365 days prior to entering in to a new policy and can get a certificate of credible coverage (which carriers are required by law to provide), you're covered for drugs and procedures that the plan would cover for anyone.

I think, if you want me to, I might be able to find something that works for your family. If I can't, I will set up a Paypal account for your son's orthotic shoes and start it off with $50.00. I really do want to help.

[Tonus]

Honest, it's not as if I'm trying to pile on. There is already enough evidence that Obamacare will be a disaster. But, well...

Piling on. (http://hotair.com/archives/2009/08/08/cbo-missed-obamacare-cost-by-1-trillion/)


CBO missed ObamaCare cost by $1 trillion?

posted at 10:45 am on August 8, 2009 by Ed Morrissey



The Congressional Budget Office has done a good job of sticking to its independent analysis, even in the face of unprecedented attempts to intimidate director Douglas Elmendorf into backing away from his positions on the deficit damage ObamaCare will do. However, Dr. Stephen Parente of Minnesota’s Carlson School of Management says that the CBO used outdated models to determine short- and long-term costs of Barack Obama’s health care reform package. Newer and more applicable models that the CBO declined to use show that the actual cost will be more than double the CBO estimates (http://city-journal.com/2009/eon0805sp.html) (via Newsbeat1 (http://www.newsbeat1.com/)):The CBO is actually being kind to the would-be reformers. Its analysis likely understates—by at least $1 trillion—the true costs of expanding health coverage as current Democratic legislation contemplates. Over the last few months, my colleagues and I at the consulting firm Health Systems Innovations have provided cost estimates of health-care reform to both Republican and Democratic members of Congress, and we’ve posted these estimates on our website as well. We believe that the Democratic bills currently under consideration in the House and Senate would cost $2.1 trillion and $2.4 trillion, respectively—much higher than CBO’s figures.



[…]


Why the difference in these estimates? We believe that we have better data on this issue than the CBO, which uses simulation models of health-insurance plans based on much older health-plan data—typically from 2001 or even 2000. Our estimates are grounded in 2006 commercial-insurance data to which the CBO doesn’t have access (the data are not publicly available and the CBO didn’t make provisions to purchase them). These data reflect the advent of much cheaper, high-deductible health plans and limited-provider network plans. If the government modeled its public option on these inexpensive plans, the result would be cheap enough to lure far more people away from private health insurance than the CBO estimates.


Our model has a good track record. The last time government introduced a major health-insurance innovation was 2004, which saw the introduction of Health Savings Accounts. We used the same model to predict that 3 million people would adopt these HSAs by the beginning of 2006. Our estimate, which we published in the peer-reviewed journal Health Affairs, was spot-on, predicting the market response more accurately than most other models, which produced adoption-rate estimates at least one-third lower.
The higher rate of adoption will mean higher payouts from the government as people dump private insurance, especially employers who want to rid themselves of the direct costs of providing health insurance. That places a much higher burden on the government, which amplifies the effect on the deficit and the need for taxation. After all, the tax income in the CBO chart below isn’t indexed to enrollment, and the revenue remains fairly constant regardless of how many people wind up in the plan:


http://hotair.cachefly.net/images/2009-07/cbo-neteffects.jpg


Perhaps someone can suggest to Elmendorf that the CBO should pay to get the data and check its models once again.



The administration has been accused of putting pressure on both the CBO (a highly inappropriate move) and fellow Democrats in order to get them to fall in line and prevent them from undermining the proposal with such underhanded tactics as telling the truth. As it happens, the CBO has been doing the administration a favor by understating the likely costs of Obamacare.

And it's not just based on outdated data. Note the last comment? The CBO did not make adjustments to allow for the steady increase in enrollment into the public plan (which will happen under the bill as currently written). Neither the costs of the plan nor the tax burden are properly modeled-- they skew in favor of Obama's plan. And these are the estimates that the administration felt were too high!

One potential benefit from this mess is that the adminstration has stuck its neck out so far in order to get it passed, that either way they've expended any and all political capital they had, and then some. If it fails to pass, Obama may very well be a lame duck in his first term, especially if the Democrats lose control of the House or Senate in 2010.

[Grunthos]

Let's just cut to the chase, call this bill "cash for grandma," and start handing out checks to old people who are willing to off themselves early so "poor children" can have a chance to live better.

It's where it's ultimately heading, anyway.

[Tonus]

Obama is taking the approach that if you repeat something often enough, people will accept it as truth.

LINK (http://hotair.com/archives/2009/08/16/this-isnt-about-politics/)


This isn’t about politics?

As part of his full-court press in the media on behalf of his flagging health-care system overhaul, Barack Obama penned an op-ed for today’s New York Times. He garnered a key Sunday slot, which is the opinion journalism equivalent of a prime-time press conference, so one might expect that Obama has something new to add (http://www.nytimes.com/2009/08/16/opinion/16obama.html?_r=1&partner=rss&emc=rss&pagewanted=print) to the debate. Instead, he gave the same stump speech that Obama uses in every town hall, or greenhouse, as Jim Treacher (http://www.jimtreacher.com/) calls them in honor of the many plants that appear in these forums.

Picking apart the entire essay would be an exercise in redundancy. Most of the claims he makes, like “If you like your health care plan, you can keep your health care plan,” have been thoroughly rebutted, since his overhaul will provide financial incentives for businesses to dump employee coverage in favor of the government-run public option, as the fines for dropping coverage will be far smaller than the costs of providing health insurance. Obama never even mentions the individual mandates imposed in the House versions of the bill, which will fine people who don’t buy insurance, especially those middle-class taxpayers who don’t make enough for subsidies but can’t afford an expensive policy.

One argument caught my eye, however, and it comes at the end:In the coming weeks, the cynics and the naysayers will continue to exploit fear and concerns for political gain. But for all the scare tactics out there, what’s truly scary — truly risky — is the prospect of doing nothing. If we maintain the status quo, we will continue to see 14,000 Americans lose their health insurance every day. Premiums will continue to skyrocket. Our deficit will continue to grow. And insurance companies will continue to profit by discriminating against sick people.

That is not a future I want for my children, or for yours. And that is not a future I want for the United States of America.

In the end, this isn’t about politics.
It’s not about politics? Barack Obama wants to impose a sweeping takeover of the health-care industry by the federal government, and he has the audacity to claim that politics has nothing to do with this? It has everything to do with it. Any government program has politics at its basis by definition.

Government will mandate comparative effectiveness models to influence treatment by government-funded providers. Those decisions will get made not by doctors or patients, but by elected officials who primarily are lawyers, not physicians. Does anyone believe that politics has nothing to do with the imposition of this kind of rationing?

Democrats have tried a number of strategies to sell ObamaCare to an increasingly skeptical and angry public. At first, they tried insisting that everyone hated their own status quo, until Gallup polls showed that 83% of people were satisfied with their current coverage. After that, they tried demonizing insurance executives. Does that sound as though politics has nothing to do with this proposal?

Up to 10% of medical costs in the US relate to lawsuits. Providers overuse resources in order to practice defensive medicine to protect themselves from predatory and abusive lawsuits. Yet not one sentence in the ObamaCare proposals in Congress deal with tort reform, which would immediately cut costs in the health-care industry. Trial lawyers, not coincidentally, heavily contribute to the Democratic Party currently writing all these bills. Are we to believe that’s not all about politics?

This is all about politics, which is why Obama had to write the op-ed in today’s Times. If he loses this battle, he’s wounded politically, and the rest of his agenda will be in deep trouble.

And if anyone thinks that a government-run health-care system won’t have political considerations entering into treatment decisions, let’s revisit this video (http://hotair.com/archives/2009/08/10/video-how-obamacare-will-ration-care/) from the Independence Institute (http://www.patientpowernow.org/). It explains how treatment gets funded in the Oregon public plan.
Bruce McQuain carves up the editorial as well:


Barack Obama’s Health Care Editorial (http://www.qando.net/?p=4108)

Barack Obama editorial in the NY Times is another part of cranking up the left wing scream machine in effort to counter the detrimental effect townhall protesters have had on the Democrat’s health care grab. It is mostly appeals to emotion and the repeating of discredited talking points (to include the “AARP supports this” nonsense). But these lines especially caught my attention (http://www.nytimes.com/2009/08/16/opinion/16obama.html?_r=1&partner=rss&emc=rss):We are bound to disagree, but let’s disagree over issues that are real, and not wild misrepresentations that bear no resemblance to anything that anyone has actually proposed. This is a complicated and critical issue, and it deserves a serious debate.
They totally contradict this line within the same editorial:I hear more and more stories like these every single day, and it is why we are acting so urgently to pass health-insurance reform this year.
This is a familiar Obama tactic. Give lip service through high sounding rhetoric about “serious debate”, but in reality be focused on “urgently pass health insurance this year” and avoiding debate. It is supposed to fool you into thinking he’s committed to debate while in reality he’s trying to push this legislation through as quickly as possible.

Serious debates are not time sensitive – they go on until the debate is settled to everyone’s satisfaction. That is not at all Obama or the Democrat’s intent.

That takes us to the most disingenuous line in the op/ed:In the end, this isn’t about politics.
That, of course, is nonsense on stilts. In the end, this is all about politics and that point is demonstrated by the rush to pass the legislation.

If, as Obama asserts, this is about “people’s lives and livelihoods” and also a “complicated and critical issue, and it deserves a serious debate”, then you have to ask – what’s the rush? Don’t “complicated and critical issues” deserve close scrutiny and extended debate?

On the other hand, if he actually believes it is about “people’s lives and livelihoods” and we must rush to accommodate the people, why does the bulk of the proposed legislation not kick in until 2013? If it’s not about politics, why is the implementation date one year after a second term would start? How does that start date support the rhetoric about the “urgency” of the matter?

In reality, there is no final bill and there has been no real debate anyone can point too in Congress. In fact it has taken the people going to townhall meetings and passionately expressing their displeasure to [I]start the debate.

The “not about politics” is more of the glib Obama nonsense that people are beginning to see through. This is all politics – because he and the Democrats know that if they actually have a “serious debate”, this most likely wouldn’t pass. The rush to pass it is specifically to avoid that debate, gloss over the details and get it into law while Obama still has some political capital.

That effort, as we’ve seen through the polls, is in serious trouble now and Democrats can deny that or try to wave it away until the cows come home – but that won’t change anything.

However, and again despite Barack Obama’s rhetoric to the contrary (”But let’s make sure that we talk with one another, and not over one another.“), this op/ed is an attempt to talk over the opposition, not with it. And it is beginning of an attempt by the left to ramp up an effort to talk over the townhall protesters and lessen their obvious impact which has been negative for the administration. Again, if you don’t believe that, simply read where Obama contradicts his high sounding rhetoric by doing precisely what he condemns:In the coming weeks, the cynics and the naysayers will continue to exploit fear and concerns for political gain.
Obviously, at least according to Obama, you can’t have a valid argument against his political health care prescription, but must instead be a “cynic” or “naysayer” trying to “exploit fear” for “political gain”.

And, of course, we all know Obama and the Democrats would never do that, don’t we?
I like McQuain's point that there was no debate until protesters started storming town halls and forcing their representatives to respond to their concerns. It became obvious that congressmen expected the town halls to be a formality, because they were uniformly unprepared to give substantive responses to the questions asked and the demands made. Some of them were imperious and dismissive, which simply added to the concern that they didn't intend to have any sort of debate and that they were just your typical politicians, going through the motions to keep the public pacified while they did whatever they felt like doing.

Thus the DNC and leftist supporters of Obamacare decided that the best course of action was to engage in honest debate. Wait, no, that's not what they did, they decided to demonize town hall protesters as tools of a devious Republican scheme. Town hall protesters have been called racist, un-American, nazis, fear-mongerers, and so on. Seeing that this tactic is backfiring, we see others claim that they're not really using a broad brush at all! They're just damning those few who organize this. Aside from being disingenuous, it tars the protesters with the argument that "we don't think you're evil, just really stupid." Yes, that's going to go over well with an angry public.

The only reason that health care reform is not completely dead is because the President and his administration has pulled out all the stops in order to get it passed. Instead of putting the legislation out there and testing the waters, he tried to jam it through and it's become a political hand grenade that he just can't seem to get a grip on.

[Tonus]

Just not the change you might expect... (http://www.breitbart.com/article.php?id=cp_x081502A.xml&show_article=1)


Overhauling health-care system tops agenda at annual meeting of Canada's doctors

Jennifer Graham, THE CANADIAN PRESS SASKATOON - The incoming president of the Canadian Medical Association says this country's health-care system is sick and doctors need to develop a plan to cure it.

Dr. Anne Doig 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," Doing said in an interview with The Canadian Press.


"We know that there must be change," she said. "We're all running flat out, we're all just trying to stay ahead of the immediate day-to-day demands."


The pitch for change at the conference is to start with a presentation from Dr. Robert Ouellet, the current president of the CMA, who has said there's a critical need to make Canada's health-care system patient-centred. He will present details from his fact-finding trip to Europe in January, where he met with health groups in England, Denmark, Belgium, Netherlands and France.


His thoughts on the issue are already clear. Ouellet has been saying since his return that "a health-care revolution has passed us by," that it's possible to make wait lists disappear while maintaining universal coverage and "that competition should be welcomed, not feared."


In other words, Ouellet believes there could be a role for private health-care delivery within the public system.


He has also said the Canadian system could be restructured to focus on patients if hospitals and other health-care institutions received funding based on the patients they treat, instead of an annual, lump- sum budget. This "activity-based funding" would be an incentive to provide more efficient care, he has said.


Doig says she doesn't know what a proposed "blueprint" toward patient- centred care might look like when the meeting wraps up Wednesday. She'd like to emerge with clear directions about where the association should focus efforts to direct change over the next few years. She also wants to see short-term, medium-term and long-term goals laid out.


"A short-term achievable goal would be to accelerate the process of getting electronic medical records into physicians' offices," she said. "That's one I think ought to be a priority and ought to be achievable."


A long-term goal would be getting health systems "talking to each other," so information can be quickly shared to help patients.


Doig, who has had a full-time family practice in Saskatoon for 30 years, acknowledges that when physicians have talked about changing the health-care system in the past, they've been accused of wanting an American-style structure. She insists that's not the case.


"It's not about choosing between an American system or a Canadian system," said Doig. "The whole thing is about looking at what other people do."


"That's called looking at the evidence, looking at how care is delivered and how care is paid for all around us (and) then saying 'Well, OK, that's good information. How do we make all of that work in the Canadian context? What do the Canadian people want?' "


Doig says there are some "very good things" about Canada's health-care system, but she points out that many people have stories about times when things didn't go well for them or their family.


"(Canadians) have to understand that the system that we have right now - if it keeps on going without change - is not sustainable," said Doig.


"They have to look at the evidence that's being presented and will be presented at (the meeting) and realize what Canada's doctors are trying to tell you, that you can get better care than what you're getting and we all have to participate in the discussion around how do we do that and of course how do we pay for it."
Bear in mind that these doctors are not asking for Canada's system to be overhauled or replaced with a US-style system. But they admit that without changes to their system, it cannot be sustained. They would like to see private practices become available to help relieve the burden.

The interesting point here is that we often hear about how the USA spends far more per-capita on health care than other nations. The implication is that wasteful spending could be reined in under a nationalized health care system. Well, maybe the reason that other countries don't spend as much is because they're not spending enough. And maybe when it is looked at under that reasoning, we can understand where the concerns over rationing come from.

"Try our system, we spend less!" is a great slogan until you realize that when you spend less, often times you also get less. Or does anyone have a compelling reason to believe that government isn't wasteful?


EDIT: Apparently this is old news... to the guy who designed the Canadian system. (http://www.ibdeditorials.com/IBDArticles.aspx?id=299282509335931) <-- mostly just adding that as a reference for the next time people crow about how great Canada's system is.

[Grunthos]

I heard an interesting comment on the radio today regarding the Dem attitude with regard to this - - don't recall who said it, but as I thought about it, I realized how true it rang.

Basically, when someone thinks they are possessed of the only legitimate answer to a problem or question, two things happen; 1) it becomes impossible to even consider that anyone who disagrees with them might be acting in good faith from legitimate concerns, and instead it becomes necessary to assume an ulterior motive behind any opposition, and 2) because they are convinced that they have the 'One and Only True Answer (TM)'... they never have a backup plan.

[Tonus]

Well, Obama's claim that AARP is on board with Obamacare is having a clear effect... unfortunately for AARP. (http://hotair.com/archives/2009/08/18/video-seniors-voting-with-their-feet/)

*Visit the link to see the video


Video: Seniors voting with their feet

CBS News (http://www.cbsnews.com/stories/2009/08/17/eveningnews/main5247916.shtml) reports that the AARP’s dance with ObamaCare has produced real results for the senior advocacy group — really bad results. Over 60,000 members have left the AARP (http://www.aarp.org/), angered by the group’s support for Barack Obama’s health-care reform efforts and silence on cuts to Medicare that will pay for them. Many have joined a new group with a more conservative outlook on health-care reform:

Watch CBS Videos Online (http://www.cbs.com/)
CBS News has learned that up to 60,000 people have cancelled their AARP memberships since July 1, angered over the group’s position on health care.


Elaine Guardiani has been with AARP for 14 years, and said, “I’m extremely disappointed in AARP.”


Retired nurse Dale Anderson has 12 years with AARP and said, “I don’t wanna be connected with AARP.”


Many are switching to the American Seniors Association, a group that calls itself the conservative alternative as CBS News Investigative Correspondent Sharyl Attkisson reports.
The big problem is the cuts to Medicare and the attacks on Medicare Advantage. The American Seniors Association (http://www.americanseniors.org/) minces no words in its opposition to ObamaCare and the cuts to the two plans. They don’t need to see the final bill, as the AARP spokeswoman suggests in the interview, to know it’s a bad deal.


Seniors can be forgiven if they sense a heapin’ helping of hypocrisy from the AARP. The organization bitterly opposed (http://www.usatoday.com/news/washington/2005-01-24-aarp-ss_x.htm) efforts to reform Social Security four years ago, claiming that the Bush administration’s privatization plans amounted to a “dismantling” of the retirement plan, even before they’d actually seen the proposal. Now, when Obama offers big cuts in actual coverage in Medicare and Medicare Advantage, suddenly they want to play coy about reading the bill. Their lack of response is easily taken as tacit endorsement, considering the hysterical response four years ago.

(http://pajamasmedia.com/instapundit/83648)
Glenn Reynolds (http://pajamasmedia.com/instapundit/83648) doubts that this will get as much attention as the boycott of Glenn Beck. I’m surprised to see CBS covering the story, and doing it this well. Kudos to CBS for a balanced and informative piece.

The thing is, it doesn't matter if it gets media attention or not. Seniors are a very active voting bloc, it's a major reason why AARP has such significant clout in Washington. Democrats and health care reformers have pissed them off, to the degree that tens of thousands have left AARP because it didn't take a clear stand on the issue and allowed Obama to co-opt them.

Seniors probably skew conservative as it is, so it likely requires a concerted effort to court them as a Democrat. Good luck getting them back after this debacle. Maybe a bit more name calling will do the trick!

[Grunthos]

Seniors tend to vote Democratic, as I recall... all for the gimmies. Because many of them survive on the continuation of gimmies.

[Tonus]

Apparently, during the Clinton years they instituted a VA program called "Your Life, Your Choices." The program seems to have been designed to convince aging veterans that their best choice was to die off and stop being such a burden on society. You think I'm being "melodramatic?"

Decide for yourself. (http://hotair.com/archives/2009/08/20/wsj-va-pushes-vets-to-consider-death-as-an-alternative-to-treatment/)

WSJ: VA pushes vets to consider death as an alternative to treatment

The ObamaCare bill may not contain “death panels,” but even Charles Lane (http://hotair.com/archives/2009/08/09/why-bend-the-cost-curve-with-end-of-life-planning/) and Eugene Robinson (http://hotair.com/archives/2009/08/12/eugene-robinson-also-wonders-about-section-1233/) at the Washington Post wonder why the bill incentivizes end-of-life consultations with the elderly and ill as part of its cost-containment strategy. Maybe Lane and Robinson should take a look at the VA, where the Obama administration and former General Eric Shinseki have reinstated a program called “Your Life, Your Choices.” The Wall Street Journal (http://online.wsj.com/article/SB10001424052970204683204574358590107981718.html) reports that this program amounts to a high-pressure sales pitch for refusal of treatment for veterans:
“Your Life, Your Choices” presents end-of-life choices in a way aimed at steering users toward predetermined conclusions, much like a political “push poll.” For example, a worksheet on page 21 lists various scenarios and asks users to then decide whether their own life would be “not worth living.”

The circumstances listed include ones common among the elderly and disabled: living in a nursing home, being in a wheelchair and not being able to “shake the blues.” There is a section which provocatively asks, “Have you ever heard anyone say, ‘If I’m a vegetable, pull the plug’?” There also are guilt-inducing scenarios such as “I can no longer contribute to my family’s well being,” “I am a severe financial burden on my family” and that the vet’s situation “causes severe emotional burden for my family.”

When the government can steer vulnerable individuals to conclude for themselves that life is not worth living, who needs a death panel?

One can only imagine a soldier surviving the war in Iraq and returning without all of his limbs only to encounter a veteran’s health-care system that seems intent on his surrender.

I was not surprised to learn that the VA panel of experts that sought to update “Your Life, Your Choices” between 2007-2008 did not include any representatives of faith groups or disability rights advocates. And as you might guess, only one organization was listed in the new version as a resource on advance directives: the Hemlock Society (now euphemistically known as “Compassion and Choices”).
Of course, the program is entirely voluntary, right? Well, the VA has instructed its physicians to deliver this end-of-life counseling to all of its patients. In effect, the US government is telling every veteran it treats that they may want to die for their country — not to defend it, but to save it a few bucks.

This booklet has been in use since the Clinton administration. When the Bush administration finally reviewed “Your Life, Your Choices,” it suspended its use within the VA system. For some reason, the Obama administration and Shinseki have reinstated the booklet this year. The directive reinstituting the booklet was issued last month.

Perhaps some of the “death panels” rhetoric was overblown, but this is downright disgusting. The Bush administration was correct in suspending the use of these tactics to push vets into refusing treatment, and the government these men and women defended should be ashamed to have put that in their hands in the first place. If Obama wants to argue that he won’t bend the cost curve downward at the expense of treatment, maybe he should start by stopping that very policy at the VA — one of the existing “public plans” that need reform much more than the overall health-care system.
Yeah, let's bash Sarah Palin for her remarks about 'death panels.' Then let's turn around and tell the people who fought for this country that maybe they should stop being such a burden and drop dead already, because we've got a budget to maintain. Yeah, yeah, yeah, we're grateful that you risked death and performed heroic actions for your country, but enough is enough... just drop dead already, these bills are too much!

I really hope this gets some airplay, because it's just ghastly. I want to hear the justifications and rationalizations for this appalling bullshit from the same people who have been slamming any criticism of 'end of life planning' in the health care bills.

[Tonus]

This article (http://www.realclearpolitics.com/horseraceblog/2009/08/amateur_hour_at_the_white_hous_1.html) should make for some interesting reading.

It does leave me wondering something. I am pretty convinced that the inability to see the "Democrat divide" coming is a result of two factors- the Obama administration's hubris, and it's inexperience. Obama promised that he would get away from typical beltway politics, and in this particular area he certainly has.

But I also wonder if part of it is not just from the administration as much as it is from the Democratic leadership. After two years of gloating over the apparent implosion and demise of the Republican party, culminating in the recent elections, it may simply be too painful to admit that their own party is fracturing at the very worst time.

Then again, probably not. Obama has not been alone in trying to ram through an agenda that caters notably to the fringes of the party. It does seem as if the administration and the party leadership figured that they could charm, cajole, and outright bully the more center-leaning members of the party. The mess they've made could kill Obamacare, and regardless of how the health care battle plays out, the political damage means that the rest of his agenda (and possibly his second term) is shot.

I think that at this point, Obama's best hope is to get health care 'reform' passed in some manner, and then have the Democrats routed in 2010. That way, when the rest of his agenda goes nowhere, he can blame the Republicans and start campaigning against the "party of no" early. That might fail only because he's already started blaming Republicans for obstructing his plans, but since Democrats hold solid majorities in both the House and Senate, it comes off as whining from a sore loser.

If I were Obama, I'd be on the phone to Karl Rove right about now...

[Grunthos]

I seem to remember a whole bunch of people pointing to Obama's lack of substantive experience as an executive was the prime reason he should not be president.

I know I was one.

[S Carver Orne]

Apparently, during the Clinton years they instituted a VA program called "Your Life, Your Choices." The program seems to have been designed to convince aging veterans that their best choice was to die off and stop being such a burden on society. You think I'm being "melodramatic?"

Decide for yourself. (http://hotair.com/archives/2009/08/20/wsj-va-pushes-vets-to-consider-death-as-an-alternative-to-treatment/)


Yeah, let's bash Sarah Palin for her remarks about 'death panels.' Then let's turn around and tell the people who fought for this country that maybe they should stop being such a burden and drop dead already, because we've got a budget to maintain. Yeah, yeah, yeah, we're grateful that you risked death and performed heroic actions for your country, but enough is enough... just drop dead already, these bills are too much!

I really hope this gets some airplay, because it's just ghastly. I want to hear the justifications and rationalizations for this appalling bullshit from the same people who have been slamming any criticism of 'end of life planning' in the health care bills.

http://img.photobucket.com/albums/v368/profmgmiller/1250816990828.jpg

[Tonus]

"Pretty soon you're talking real money!"

[Tonus]

Obama gets called a fascist and a liar... ON AIR AMERICA. (http://hotair.com/archives/2009/08/21/oh-my-obama-being-called-a-fascist-now-on-air-america/)

Be sure to listen to this one, it's a liberal host on an ultra-liberal radio station interviewing a liberal guest who is absolutely steamed at Obama's back-room dealings with the pharmaceutical companies in order to salvage health care legislation. They play clips of Obama campaign speeches where he makes promises that he has since broken (hey, I know, this is not news for a lot of us, but having Air America expose him is). The administration has mishandled health care legislation about as badly as they could have, it's breathtaking to be honest.

[Grunthos]

Buyer's remorse is an ugly thing, man...

[Tonus]

As a way of easing us into an understanding of health care reform, we get an example of rationing... via Social Security! (http://hotair.com/archives/2009/08/24/social-security-cancels-colas/)

Social Security cancels COLAs

Barack Obama already has had a tough time with seniors on the health-care reform initiative, and for good reasons (http://hotair.com/archives/2009/08/20/aip-column-aarps-willful-blindness/). The latest news from Social Security won’t make them any happier about it. The Social Security administration has canceled cost-of-living adjustments (COLAs) for the next two years, which means the fixed income on which these seniors rely will freeze at current levels. However, their Medicare premiums will still increase, which means they will get less money over the next two years, the first declines in SSA in more than 30 years:

Millions of older people face shrinking Social Security checks next year, the first time in a generation that payments would not rise. The trustees who oversee Social Security are projecting there won’t be a cost of living adjustment (COLA) for the next two years. That hasn’t happened since automatic increases were adopted in 1975.


By law, Social Security benefits cannot go down. Nevertheless, monthly payments would drop for millions of people in the Medicare prescription drug program because the premiums, which often are deducted from Social Security payments, are scheduled to go up slightly. …


Advocates say older people still face higher prices because they spend a disproportionate amount of their income on health care, where costs rise faster than inflation. Many also have suffered from declining home values and shrinking stock portfolios just as they are relying on those assets for income.


“For many elderly, they don’t feel that inflation is low because their expenses are still going up,” said David Certner, legislative policy director for AARP. “Anyone who has savings and investments has seen some serious losses.”

Inflation has been low enough that the cost of living has remained flat. Canceling COLAs might make sense with that in mind, except that the SSA’s increase in premiums are predicated on inflation in health care costs. If that’s true, then the COLAs should remain in place. Right now, it looks like the government wants to eat its cake and have it, too. Even those who agree with canceling COLAs when inflation stops have to answer for the premium increases.


Why are the premiums going up? Health care costs continue to go up — but SSA’s beneficiaries all use Medicare, which is a single-payer government program. The federal government has never solved the cost problem in Medicare, but now it wants to expand it for all Americans, either now or in the future (http://hotair.com/archives/2009/08/18/video-dem-wants-to-eliminate-private-health-insurance-altogether/). Anyone who has paid attention to the Medicare entitlement crisis understands that the government has no ability to contain costs even within its own existing systems, and the premium increases that will slam SSA recipients will eventually become the norm for everyone in ObamaCare.


Last week, I wrote about the corrosive effect that ObamaCare would have on wage growth, and the impact that would have on solvency for SSA. The AARP has relentlessly ignored the connection between this policy and the hastened bankruptcy of a system on which their entire membership relies. Perhaps this will serve as a wake-up call to the AARP, which finally decided to get off the sidelines for this issue, but apparently only to cheerlead slightly less for the Obama administration. Meanwhile, their members get squeezed in both directions.


This is, effectively, an example of the "95% of working Americans won't get a tax cut" type of charade. SS payments will remain the same for the next two years, and with inflation relatively flat, that doesn't seem so bad. But wait... Medicare premiums will go up, and thus SS recipients will have less income. But inflation, and thus their cost-of-living, isn't going up. *wink*

Seniors are going to go apeshit over this, but they're just a bunch of redneck, racist, nazi, racist, un-American, racist, well-dressed racist Republican stooges. So who cares what they think?

[Tonus]

This just in-- Republicans decide to attack entitlements by... defining a new entitlement. (http://online.wsj.com/article/SB125112553661853921.html) So much for the "health care isn't a right" argument!

Edit to add: here's a priceless quote from an AARP rep:
Mr. Rother said that AARP was frustrated by the lack of concrete proposals being put forward on the Republican side of the debate. "The debate as I see it doesn't even focus on health care," Mr. Rother said. "It is all about the role of government and the importance of the federal deficit."

Yeah, you silly Republicans, how DARE you care about stupid shit like individual liberties and economic responsibility???

The irony is that by using Medicare as a hedge against Obamacare, the Republicans are not really showing the proper concern about the role of government or the federal deficit. They're just positioning themselves as the lesser of two evils. But apparently they're just not evil enough to garner AARP's support.

[Tonus]

PS, about those health care systems in places like the UK, the ones that work really really great? Okay, maybe not so great... (http://www.dailymail.co.uk/news/article-1208663/Test-foreign-doctors-coming-practice-Britain-say-GP-leaders.html)

Foreign GPs who commute to Britain: £100-an-hour Poles and Lithuanians fly in for shifts our doctors won't do

The huge extent to which the NHS needs foreign doctors to treat patients out of hours is revealed today.

A third of primary care trusts are flying in GPs from as far away as Lithuania, Poland, Germany, Hungary, Italy and Switzerland because of a shortage of doctors in Britain willing to work in the evenings and at weekends.

The stand-ins earn up to £100 an hour, and one trust paid Polish and German doctors a total of £267,000 in a year, a Daily Mail investigation has found. It raises fresh concerns that British patients are being treated by exhausted doctors without a perfect command of English.

Yesterday the Royal College of GPs and the General Medical Council called for a 'radical review' of out-of-hours care so that the NHS no longer has to rely on help from abroad.

The figures come months after an investigation was launched into the conduct of a German doctor after two patients died on his first shift in Britain. Daniel Ubani had just three hours sleep after travelling from Germany before he went on duty in Cambridgeshire.

The Nigerian-born doctor injected 70-year-old kidney patient David Gray with ten times the maximum recommended dose of morphine, and an 86-year-old woman died of a heart attack after Ubani failed to send her to hospital.

The NHS is having to rely on doctors from overseas because a lucrative new contract for British GPs has resulted in more than 90 per cent opting out of responsibility for their patients in the evenings and at weekends. Despite doing less, their pay has soared by 50 per cent to an average of almost £108,000.

Responsibility for out-of-hours cover has now passed to primary care trusts. The rules state that foreign doctors need to have basic GP training, but recent experience is not always necessary.

Their qualifications are checked by the General Medical Council and the local PCT, but no checks are in place to ensure that they are not exhausted after working long hours in their home country.

Our investigation revealed that more than a third of the 152 primary care trusts (PCTs) in England have flown in foreign GPs in the last year. Of the 146 trusts who responded, 51 have used overseas GPs in the last 12 months.

There's more at the link. Basically, until now doctors in the UK were being underpaid and overworked, and now they've gotten a bump in pay and figured they'd balance that out by keeping to normal working hours, leaving the UK with a shortage of doctors on evenings and weekends. So providers are essentially "busing in" doctors from overseas. These doctors may or may not have the necessary experience for the job, and they're sent right to work after they arrived, so that they're tired and mistake prone. The example given is of a German doctor whose sloppiness led to two deaths.

I guess we have a new concern over rationing, don't we?

[S Carver Orne]

Well America, here's a glimpse into our future if the Dems & Obama get their way.

Thousands of surgeries may be cut in Metro Vancouver due to government underfunding, leaked paper

VANCOUVER — Vancouver patients needing neurosurgery, treatment for vascular diseases and other medically necessary procedures can expect to wait longer for care, NDP health critic Adrian Dix said Monday.

Dix said a Vancouver Coastal Health Authority document shows it is considering chopping more than 6,000 surgeries in an effort to make up for a dramatic budgetary shortfall that could reach $200 million.

“This hasn’t been announced by the health authority … but these cuts are coming,” Dix said, citing figures gleaned from a leaked executive summary of “proposed VCH surgical reductions.”

The health authority confirmed the document is genuine, but said it represents ideas only.

“It is a planning document. It has not been approved or implemented,” said spokeswoman Anna Marie D’Angelo.

Dr. Brian Brodie, president of the BC Medical Association, called the proposed surgical cuts “a nightmare.”

“Why would you begin your cost-cutting measures on medically necessary surgery? I just can’t think of a worse place,” Brodie said.

According to the leaked document, Vancouver Coastal — which oversees the budget for Vancouver General and St. Paul’s hospitals, among other health-care facilities — is looking to close nearly a quarter of its operating rooms starting in September and to cut 6,250 surgeries, including 24 per cent of cases scheduled from September to March and 10 per cent of all medically necessary elective procedures this fiscal year.

The plan proposes cutbacks to neurosurgery, ophthalmology, vascular surgery, and 11 other specialized areas.

As many of 112 full-time jobs — including 13 anesthesiologist positions — would be affected by the reductions, the document says.

“Clearly this will impact the capacity of the health-care system to provide care, not just now but in the future,” Dix said.

Further reductions in surgeries are scheduled during the Olympics, when the health authority plans to close approximately a third of its operating rooms.

Two weeks ago, Dix released a Fraser Health Authority draft communications plan listing proposed clinical care cuts, including a 10-per-cent cut in elective surgeries and longer waits for MRI scans.

The move comes after the province acknowledged all health authorities together will be forced to cut staff, limit some services and increase fees to find $360 million in savings during the current fiscal year.

In all, Fraser Health is looking at a $160-million funding shortfall.

D’Angelo said Vancouver Coastal’s deficit is closer to $90 million — almost a third of which ($23 million) has already been absorbed through reductions in non-clinical administration efficiencies.

Vancouver Coastal performed 67,000 surgeries last year, an increase of 6,500 surgeries over 2007.

“What has now happened is that now our wait times are about 25 per cent lower than the provincial average,” D’Angelo said. “We have put a dent in that wait list.”

Brodie acknowledged surgical waiting times have dropped significantly in recent years, particularly for patients needing hip and joint replacements.

He said the proposed cuts threaten those advancements.

“It sounds like we are going backwards here,” he said.

Total health spending in British Columbia was $15.7 billion this year, up about four per cent over last year’s total of 15.1 billion, according to figures provided by the ministry of health.

Health Minister Kevin Falcon was unavailable for comment Monday on the proposed health-care cuts. A ministry spokesman said Falcon is away on his honeymoon until the end of August.

Elsewhere in British Columbia, the province will look to replace the head of the Interior Health Authority, Murray Ramsden, after he announced he will step down at the end of the year.

Ramsden has said his decision to retire is not related to financial problems faced by the authority.
http://www.vancouversun.com/story_print.html?id=1878506&sponsor

[S Carver Orne]

YFV5Tx4LxBM

[Tonus]

I can't wait until our health care system is just like the UK's! (http://www.qando.net/?p=4304)

Choice quote:


In the last six years, the Patients Association claims hundreds of thousands have suffered from poor standards of nursing, often with ‘neglectful, demeaning, painful and sometimes downright cruel’ treatment.


The charity has disclosed a horrifying catalogue of elderly people left in pain, in soiled bed clothes, denied adequate food and drink, and suffering from repeatedly cancelled operations, missed diagnoses and dismissive staff.


The Patients Association said the dossier proves that while the scale of the scandal at Mid-Staffordshire NHS Foundation Trust – where up to 1,200 people died through failings in urgent care – was a one off, there are repeated examples they have uncovered of the same appalling standards throughout the NHS.


There's more at the link.

[Tonus]

What if you had a health care reform and no one showed up?

Will Doctors Opt Out Of Public Option? (http://www.qando.net/?p=4292)

It appears at least some plan to. Dr. Alfred Bonati (http://www.washingtontimes.com/news/2009/aug/25/doctors-ready-to-just-say-no/?source=newsletter_opinion_headlines), who heads the American Society of Medical Doctors, says he plans to say “no” to accepting patients under a government run plan and, according to a poll he cites, so do an awful lot of other physicians:Perhaps this is why a nationwide, nonpartisan poll of physicians this month found that a full 70 percent oppose the health care reform proposals under consideration by Congress. Sixty-six percent feel that a government-run health insurance plan would restrict doctors’ ability to give the best advice and offer the best care possible to their patients. Perhaps most importantly, 60 percent said they would not accept new patients covered by a government insurance plan.
His reasons are based in experience:Nearly all the doctors polled have worked with Medicare. Most have likely been denied Medicare reimbursement, or given minimal reimbursement, for a course of treatment that they prescribed that best fits the needs of a patient and that patient’s family. They know that government coverage does not allow for flexibility, creativity, or, sometimes, even compassion.


[...]


I share the view of the 60 percent in the August poll — those doctors who are planning to “just say no” if government-run health coverage is implemented. Many of us already do not accept patients who are on Medicare or Medicaid because of restrictions those programs put on our decisions as doctors. It pains us to turn away a patient in need, but the narrow rules of government reimbursement programs stymie our ability to follow our oath, so we simply opt out and work with patients who are also in need but have more flexible, private coverage.


If a government option gains the popularity that is expected — after all, who would not choose the most affordable option available, and how could any option compete with one that is subsidized by taxpayers — millions of Americans will face severely limited options in choosing a doctor. As physicians reject working with a system that does not honor our oath, patients will be left opening their own checkbooks, or going into credit card debt, to get the treatment they need and deserve.
The law of unintended consequences again raises its head. The government may indeed put a public option in place – whether or not the citizens of the nation want it or not. And they may, through legislation, force insurance companies to take everyone without exception, but -at least not at this point- they can’t force doctors to accept patients under plans that [they] don’t feel reimburses at a rate commensurate with the care given or doesn’t allow them to treat a patient in accordance with the oath they took.


Of course that then leaves that system with a problem and the government with a dilemma – does it then force MDs to take anyone who applies (as it will insurance companies) regardless of insurance plan? And if so, how do you suppose doctors and other health care providers will react?


It is these sorts of problems, dilemmas and unintended consequences that few are talking about in this great “debate”. What if it is doctors who become the Atlas that shrugs when all is said and done. What options would the government then have – in this land of the “free” and home of the brave?
I suppose this goes to the heart of the "is health care a right" debate. Note that these doctors are not upset with having to do their job. They're upset with not being allowed to do their job by Medicare, and then getting little or no compensation after jumping through government hoops.

Unlike many other groups involved in the debate, the government cannot simply bribe doctors with some goodies (read: CASH) to shut up and sit down, as that would throw the economic equation even farther out of whack than is expected. Which means that doctors are probably getting the short shrift in this whole deal. What happens when the medical field becomes less and less attractive to promising young men and women, who choose another field because the medical profession sounds like a dead end? What happens when doctors are demonized for not wanting to accept certain patients, because they know that their options for care will be restricted and their chances of full reimbursement are low?

As the saying goes, the road to hell is paved with health care reform.

[Tonus]

Is the fear over "death panels" driven by demagoguery, or is there a legit reason to be concerned? It might be the latter. (http://www.telegraph.co.uk/health/healthnews/6127514/Sentenced-to-death-on-the-NHS.html)

[Tonus]

Michelle Malkin has a field day with a New York Times account of a person who, they claim, personifies the problems with the current health care system.

The catch? The person had been receiving treatment, with full government coverage, even before the story went to press... (http://michellemalkin.com/2009/12/02/unbelievable-update-the-crappiest-nytimes-column-on-obamacare-just-got-crappier/)

I'm just going to quote a portion, as the original is long. But it's worth reading, particularly the update where the Times columnist responded in his defense. It's just embarrassing.


Today, I did something that Pulitzer Prize-winning NYTimes columnist Nick Kristof apparently didn’t do: I talked to a spokesman at the Oregon Health Sciences University in Portland, Oregon.

I called them up after OHSU’s Dr. Johnny Delashaw left a comment (http://michellemalkin.com/2009/11/30/a-doctors-message-for-nick-kristof/) about Kristof’s piece spotlighting the horrible plight of John Brodniak (http://michellemalkin.com/2009/11/30/quite-possibly-the-crappiest-nytimes-column-for-obamacare-ever/), an Oregon man with a neurological condition that he says no one would treat.

Kristof used Brodniak’s plight to argue for universal health care, decry Brodniak’s deadly lack of insurance (even though he got Medicaid coverage in August), and lambaste doctors for refusing to treat Brodniak due to low reimbursements.

Well, OHSU confirmed for me two things:

1) OHSU is a safety-net hospital not far from where Brodniak lives. The hospital accepts all Medicaid patients and would not turn Brodniak away.

Okay, are you ready for Number 2?

2) Brodniak is a patient at OHSU — and has been a patient there for the past three weeks.

In other words, at the time Kristof’s article was published this past Sunday, Brodniak was already being treated and cared for by some of the best neurologists in the country!
The Times' columnist claimed that the treatment did not begin until the column ran, implying that the hospital had to be shamed into meeting its obligation. Apart from being shown to be false (read Malkin's follow-up at the end of her blog post) it simply confirms that the system already had coverage for this guy.


Edit to add: Here (http://michellemalkin.com/2009/11/30/a-doctors-message-for-nick-kristof/) is an earlier Malkin column, where she posts comments from the original Times article that shows just how flimsy it was. Shady may find this to be a good link to show to Kelly, as there are some interesting points being made that show just how sloppy the Times story was. If you didn't know better, you'd swear that the article was less a product of sloppy research, and more a product of a columnist willing to write anything* to promote an agenda.

*Except the truth.

[Tonus]

As we've discussed previously, Massachusetts has its own version of Obamacare and its own version of the Public Option. We've read about how poorly it's doing. Back in 2003, Maine went the same route. Guess how that has turned out? Wonder no more! Here are some tidbits from this article in the Bangor Daily News: (http://www.bangordailynews.com/detail/132603.html)


Lawmakers also received sobering news from administrators of the state’s Dirigo health insurance program.

Earlier this year, lawmakers extended Dirigo Health a $25 million loan to help cover costs while the program worked toward self-sufficiency. Karynlee Harrington, executive director at Dirigo Health, told the committee Thursday that the program does not expect to be able to pay back the full $25 million by June 30, as required.

“We are making progress. We have a positive cash balance,” Harrington said. While the program expects to be self-sufficient sometime in fiscal year 2011, which begins July 1, it will not likely happen before then, she said.

“We are moving in the right direction,” she said.
Yes, moving in the right direction. The right direction includes this:


en. Richard Rosen, R-Bucksport, described the program as being “on absolute life support.” Rosen said some of the cost-saving changes discussed Thursday by Dirigo officials — such as requiring those who qualify for Medicare to enroll in the federal program instead of Dirigo — should have been enacted a long time ago.

“These are the types of modifications that should have been made years ago, and they were suggested years ago,” Rosen said.
So... they can't pay back a $25 million loan for at least another year, and they're making changes, such as shuffling people off onto Medicare and off of the state's public plan. Here's what they neglected to mention, from this WSJ story (http://online.wsj.com/article/SB10001424052970204619004574322401816501182.html) published in August:


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.
Whoa, whoa, whoa!!! Hang on a second. This program is running so far in the red that they still cannot pay back a $25 million loan and are looking to offload people onto Medicare, but they're only covering 2.6% of their original target?!?!?!?!

It gets worse. The following is a short analysis of what causes this problems and what sort of solutions have been imposed by the local government:


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.
It's like a perfect storm... high premiums and lower payouts to doctors and hospitals, which will lead (if it has not already) to poorer quality care. Tax increases, including a tax on health insurance in order to fund health insurance (you read that correctly) that was enacted in order to avoid lawsuits. In spite of painfully high premiums, lower payouts for care, tax increases, and borrowing from the general budget, the program covers fewer than 3% of its intended target.

This is what is considered "moving in the right direction."

This is what they want to foist on the entire country.

You don't think that they feel this way?

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.

[Grunthos]

Thatcher: "The problem with socialism is that eventually you run out of other people's money."

[Tonus]

Obama's cousin says: Obamacare SUCKS! (http://www.washingtontimes.com/news/2010/mar/11/obama-family-health-care-fracas/)


WOLF: Obama family health care fracas

A doctor savages his cousin Barack's reform plan

By Dr. Milton R. Wolf

"Primum nil nocere."First, do no harm. This guiding principle is a bedrock of medical care. Sadly, those politicians who would rewrite our health care laws do not live in the same universe as do the doctors and health care professionals who must practice it.

Imagine if, like physicians, politicians were personally held to the incredibly high level of scrutiny that includes civil and financial liability for any unintended consequence of their decisions. Imagine if they were forced to spend tens of thousands of dollars each year on malpractice insurance and still faced the threat of multimillion-dollar lawsuits with every single decision they made. If so, a government takeover of health care would be the furthest thing from their minds.

Obamacare proponents would have us believe that we will add 30 million patients to the system without adding providers, we will see no decline in the quality of care for the millions of Americans currently happy with the system, and -if you act now!- we will save money in the process. But why stop there? Why not promise it will no longer rain on weekends and every day will be a great hair day?

America has the finest health care delivery system in the world. Let's not forget that and put it at risk in the name of reform. Desperate souls across the globe flock to our shores and cross our borders every day to seek our care. Why? Our system provides cures while the government-run systems from which they flee do not. Compare Europe's common cancer mortality rates to America's: breast cancer - 52 percent higher in Germany and 88 percent higher in the United Kingdom; prostate cancer - a staggering 604 percent higher in the United Kingdom and 457 percent higher in Norway; colon cancer - 40 percent higher in the United Kingdom.

Look closer at the United Kingdom. Britain's higher cancer mortality rate results in 25,000 more cancer deaths per year compared to a similar population size in the United States. But because the U.S. population is roughly five times larger than the United Kingdom's, that would translate into 125,000 unnecessary American cancer deaths every year. This is more than all the mothers and fathers, aunts and uncles, cousins and children in Topeka, Kan. And keep in mind, these numbers are for cancer alone. America also has better survival rates for other major killers, such as heart attacks and strokes. Whatever we do, let us not surrender the great gains we have made. First, do no harm. Lives are at stake.

Obamacare: Fixing price at any cost

The justification for Obamacare has been to control costs, but the problem is there is little in Obamacare that will do that. Instead, there are provisions that will ration care and artificially set price. This is a confusion of costs and price.

As one example, consider the implications of Obamacare's financial penalty aimed at your doctor if he seeks the expert care he has determined you need. If your doctor is in the top 10 percent of primary care physicians who refer patients to specialists most frequently - no matter how valid the reasons - he will face a 5 percent penalty on all their Medicare reimbursements for the entire year. This scheme is specifically designed to deny you the chance to see a specialist. Each year, the insidious nature of that arbitrary 10 percent rule will make things even worse as 100 percent of doctors try to stay off that list. Many doctors will try to avoid the sickest patients, and others will simply refuse to accept Medicare. Already, 42 percent of doctors have chosen that route, and it will get worse. Your mother's shiny government-issued Medicare health card is meaningless without doctors who will accept it.

Obamacare will further diminish access to health care by lowering reimbursements for medical care without regard to the costs of that care. Price controls have failed spectacularly wherever they've been tried. They have turned neighborhoods into slums and have caused supply chains to dry up when producers can no longer profit from providing their goods. Remember the Carter-era gas lines? Medical care is not immune from this economic reality. We cannot hope that our best and brightest will pursue a career in medicine, setting aside years of their lives - for me, 13 years of school and training - to enter a field that might not even pay for the student loans it took to get there.

Giving power back to people

I believe there is a better way. The problems in the American health care system are not caused by a shortage of government intrusion. They will not be solved by more government intrusion. In fact, our current problems were precisely, though unintentionally, created by government.
World War II-era wage-control measures - a form of price controls - ushered in a perverted system in which we turn to our employers for insurance and the government penalizes us if we choose to purchase insurance for ourselves. You are not given the opportunity to be a wise consumer of health care and compare prices as well as quality in any meaningful way. Worse still, your insurance company is not answerable to you because you are not its customer. It is answerable to your employer, whose interests differ from your own.

Insurance companies have been vilified for following the perverse rules that government has created for them. But it gets worse. The government, always knowing best, deploys insurance commissioners across the land to dictate what the insurance companies must provide, whether you want it or not, and each time, your premiums increase. Obamacare will make all of this worse, not better.

One of America's founding principles is our trust in the people and their economic freedom to rule their own lives. We should decouple health insurance from employers and empower patients to be consumers once again. Allow them to determine the insurance plan that best meets their families' needs and which company will provide it. This will unleash a wave of competition that will drive costs down in a way that price controls never have. Eliminate the artificial state boundary rules that protect insurance companies from true competition and watch as voters demand that their state insurance commissioners get the heck out of the way. Innovative companies will drive down costs similar to how Geico and Progressive have worked for automobile insurance. And it won't cost taxpayers a trillion dollars in the process.

This free-market approach has worked for everything from high-definition TVs to breakfast cereals, but will it work for medicine? It already is. Take Lasik eye surgery, for example. Because patients are allowed to be informed consumers and can shop anywhere, doctors work hard for their business. Services, availability and expertise have all increased, and costs have decreased. Should consumers demand it, insurance companies - now answerable to you rather than your employer - would cover it.

Between Barack and a hard place

I have personally trained and practiced in both the government-run and free-market segments of American medicine. The difference is vast. Patients see this for themselves, and this may be why, according to a recent CNN poll, they oppose Obamacare nearly 3 to 1. I am with them. It is difficult for me to speak publicly against the president on his central issue, but too much is at stake.

I wish my cousin Barack the greatest of success in office. But I feel duty-bound to rise in opposition to Obamacare. I must take a stand for my patients, my profession and, ultimately, my country. The problems caused by government will not be solved by growing government. Now that this new era of big-government takeovers has spread to our health care system, it's not just our freedoms or our wallets that are at stake. It's our lives.

Dr. Milton R. Wolf is a radiologist in Kansas. He is Barack Obama's second cousin once removed. President Obama's great-great grandfather, Thomas Creekmore McCurry, is Dr. Wolf's great-grandfather. Dr. Wolf's mother, Anna Margaret McCurry, was five years older than Mr. Obama's mother, Stanley Ann Dunham. The two were childhood friends until the Dunhams moved from Kansas to Seattle in 1955.

[Tonus]

President Obama? It's reality, on line 1. (http://www.economics21.org/commentary/hard-choices-still-must-be-made)

I hope it's calling collect...

[Tonus]

I found an interesting blog, run by an economist who targets the New York Times' Paul Krugman. Krugman is an economics PhD and a Pulitzer Nobel Prize winning columnist who writes on matters of the economy. At some point in his life, he decided to put aside anything that he might have learned on his way to earning that PhD, in order to push economics as a purely political tool. The result is that there are many economists who regularly criticize Krugman's columns. And that's putting it mildly.

Anyway, here it is. (http://krugman-in-wonderland.blogspot.com/) It's a pretty entertaining read, considering that it's about politics and economics.

Edit to add: Here's a great way to put the health care issue in perspective (http://krugman-in-wonderland.blogspot.com/2010/02/krugmans-healthcare-howlers.html).

I give you another American institution for which we have seen the same pattern in which third-party payments have forced up costs: higher education.

We have seen tuition and fees for U.S. colleges and universities, both public and private, rise faster than the Consumer Price Index for many years. Why? Much of the payment for college and graduate school is made either through debt (and many people today graduate from all levels of higher education with massive amounts of personal debt) or through direct government payments. Furthermore, government imposes a large number of expensive administrative mandates (Sound familiar?) on colleges and universities. And then we are shocked, SHOCKED that tuition and fees are soaring?

Assume that the government (1) required colleges and universities to admit all applicants, regardless of their academic records (and no place could discriminate, including Krugman's own Princeton University); (2) if someone could not afford the tuition and fees, the government would pay the balance or pay for all of it, and (3) all Americans would be required to go to college.

[Grunthos]

The utopic equality of shared misery....

[Dr. L]

The utopic equality of shared misery....

Aptly decorated as a 'humble collective'.

[Edmaster]

So who's up for Handicapper General this year?

[Dr. L]

So who's up for Handicapper General this year?

Hmmm, but what about freedom of---*buzz*


:mellow:

[Grunthos]

Well, the House today voted itself the authority to circumvent the constitutional requirement that all bills actually be voted on based on identical texts in both houses, and the roll call recorded in the register.

Hasta la vista, Republic.

[KB.]

Smacks of the fall of Rome but I think we all saw that coming.

[Tonus]

It's becoming more likely that health care "reform" will be forced through. So it's a good time to start to understand what we'll be dealing with. Well, we can't quite do that yet, we won't really have a final package until after it is voted on. Shine on, you crazy democracy... shine on.

Anyway, the CBO was asked to 'score' the legislation's cost. The CBO is limited to a ten-year time period from implementation. Since the legislation being considered for passage doesn't begin to spend money until 2013 and doesn't begin to really ramp up until 2014, the 10-year score is decidedly skewed.

Start here, and follow the links for additional information. (http://www.qando.net/?p=7556)

And keep in mind a few things...

1- The costs are minimal at first, then ramp up drastically in 2014-2016, then only begin to level off slightly from 2016-2019.
2- This analysis includes a significant reduction in payments to doctors, a detail which is expected to be stripped from the final bill. Thus, the costs as shown are artificially low.
3- This analysis does not include the impact to individual states, which will have to pay for expanded Medicaid coverage out of their own budgets. Unlike the federal government, states cannot run deficits. These costs are not reflected in the CBO analysis.
4- This analysis does include reductions in spending on Medicare, but they may be understated. And I'm talking about planned reductions, not the ones that will probably happen when Medicare collapses under its own weight.*

This legislation is essentially a time bomb, which is set to go off just as SS, Medicare, and our national debt become too large for us to manage.

*Edit to correct: According to the Heritage Foundation, (http://blog.heritage.org/2010/03/18/morning-bell-what-the-senate-bill-would-do-to-america/?utm_source=Newsletter&utm_medium=Email&utm_campaign=Morning%2BBell) the Medicare reductions will also not be implemented, as the effect would be disastrous to health care providers as well as the elderly. Add $463 billion to the ~$200 billion from the reversal of the "doctor fix." Almost $700 billion in spending that is not being factored in. Hey... do you think that offsets the $138 billion in deficit reduction?

[Tonus]

NHS planning cuts to services and staff (http://www.telegraph.co.uk/health/healthnews/7529454/Hospital-wards-to-shut-in-secret-NHS-cuts.html)

Hospital wards to shut in secret NHS cuts

Tens of thousands of NHS workers would be sacked, hospital units closed and patients denied treatments under secret plans for £20 billion of health cuts.

The sick would be urged to stay at home and email doctors rather than visit surgeries, while procedures such as hip replacements could be scrapped.

The plans have emerged as health chiefs draw up emergency budgets that cast doubt on pledges by Gordon Brown to protect “front line services” in the NHS.

Documents show that health chiefs are considering plans to begin sacking workers, cutting treatments and shutting wards across the country.

The proposals could lead to:

* 10 per cent of NHS staff being sacked in some areas.
* The loss of thousands of hospital beds.
* A reduction in the number of ambulance call-outs.
* Medical professionals being replaced by less qualified assistants.

The plans are contained in a series of internal NHS documents uncovered by The Daily Telegraph.

The final details of the plans are not due to be announced until the autumn, well after the country has gone to the polls for the general election.

The Conservatives and health campaigners said the public deserved to know the true extent of cuts at their local surgeries and hospitals before voting.

Last year all English health authorities were ordered by Sir David Nicholson, the NHS chief executive, to reconsider their plans after the recession forced the Government to freeze health spending from April next year.

This left a ''black hole’’ of up to £20 billion in health budgets up to 2014, prompting the drawing up of new proposals by the 10 strategic health authorities (SHAs).

They had until Friday to submit their plans to Andy Burnham, the Health Secretary. He is under pressure from the Treasury to show how money will be saved to help bring down Britain’s record £167 billion deficit.

In Wednesday’s Budget, Alistair Darling, the Chancellor, repeated that the £20 billion would come through “efficiency savings” and not key services.

Documents produced by several of the SHAs show how the cuts are, in fact, expected to fall on hospital services.

In the South East Coast region, which covers Surrey, Kent and Sussex, up to £1.6 billion must be saved.

A document marked “restricted” and circulated among SHA board members suggests 10,000 of the region’s 100,000 NHS workers may lose their jobs. “The new financial environment demands that the trend in workforce growth must be reversed,” it said, adding bosses must reduce employee numbers by 10 per cent “or further”.

The document said staffing in the acute sector, covering hospitals, “can be expected to decline faster and further” than elsewhere.

Job losses will be “starting in the coming year”, it states. Mr Brown has repeatedly promised Labour will not start making significant cuts to public spending until 2011. A spokesman for the South East Coast SHA said the document was a discussion paper and not a final plan.

In London, which faces £5 billion in cuts, documents show managers believe up to £2 billion can be saved from community care budgets, which cover GPs’ surgeries. This would include “changing how patients get in contact with and receive services, such as through greater use of the internet and email”.

An internal presentation by NHS Yorkshire and the Humber, which spans Sheffield, York, Hull and north Lincolnshire, made similar suggestions. The SHA, which is expected to make about £2 billion in cuts, proposed directing more patients to “teleservices such as NHS Direct”. Meanwhile, £450 million could be saved in London by banning clinical procedures “that have little or no benefit to those receiving them, for example some joint replacements”.

NHS North West, which oversees Greater Manchester and Liverpool, is expected to make about £2 billion savings. It is preparing to close an A&E unit in Rochdale during evenings before scrapping it altogether next year.

In the East region, covering Bedfordshire, Cambridgeshire, Essex, Hertfordshire, Norfolk and Suffolk, up to £2 billion is to be cut. The SHA proposes shifting services out of hospitals and making social workers take over some treatments. It is estimated that savings of about £2.4 billion will need to be made by NHS West Midlands, £2 billion in the South West, £1.3 billion in South Central, £1 billion in the North East and £800 million in the East Midlands.

A Department of Health spokesman said: “We will be clear with trusts that they must not make short-term cuts that harm patient care.” There is a bit of a disconnect here, as plans are made to curtail services, cut jobs, and close hospital wards while spokesmen assure the public that it's okay because they're becoming more efficient and they're doing their best to make sure that essential services are available to all. Well, unless you need a joint replacement that is deemed to be of little or no benefit.

This is a reminder that when push comes to shove, health care becomes just one more budgetary item that gets rationed and cut. See also the "Related Articles" section of the page in order to see the other pressures that the UK's health care service is under.

[Tonus]

New York Times: Congress may have inadvertently taken away health care... from itself. (http://www.nytimes.com/2010/04/13/us/politics/13health.html?partner=rss&emc=rss)


Baffled by Health Plan? So Are Some Lawmakers

WASHINGTON — It is often said that the new health care law will affect almost every American in some way. And, perhaps fittingly if unintentionally, no one may be more affected than members of Congress themselves.

In a new report, the Congressional Research Service says the law may have significant unintended consequences for the “personal health insurance coverage” of senators, representatives and their staff members.

For example, it says, the law may “remove members of Congress and Congressional staff” from their current coverage, in the Federal Employees Health Benefits Program, before any alternatives are available.

The confusion raises the inevitable question: If they did not know exactly what they were doing to themselves, did lawmakers who wrote and passed the bill fully grasp the details of how it would influence the lives of other Americans?

The law promises that people can keep coverage they like, largely unchanged. For members of Congress and their aides, the federal employees health program offers much to like. But, the report says, the men and women who wrote the law may find that the guarantee of stability does not apply to them.

“It is unclear whether members of Congress and Congressional staff who are currently participating in F.E.H.B.P. may be able to retain this coverage,” the research service said in an 8,100-word memorandum.
And even if current members of Congress can stay in the popular program for federal employees, that option will probably not be available to newly elected lawmakers, the report says.

Moreover, it says, the strictures of the new law will apply to staff members who work in the personal office of a member of Congress. But they may or may not apply to people who work on the staff of Congressional committees and in “leadership offices” like those of the House speaker and the Democratic and Republican leaders and whips in the two chambers.

These seemingly technical questions will affect 535 members of Congress and thousands of Congressional employees. But the issue also has immense symbolic and political importance. Lawmakers of both parties have repeatedly said their goal is to provide all Americans with access to health insurance as good as what Congress has.

Congress must now decide what steps, if any, it can take to deal with the problem. It could try for a legislative fix, or it could adopt internal policies to minimize any disruptions.

In its painstaking analysis of the new law, the research service says the impact on Congress itself and the intent of Congress are difficult to ascertain.

The law apparently bars members of Congress from the federal employees health program, on the assumption that lawmakers should join many of their constituents in getting coverage through new state-based markets known as insurance exchanges.

But the research service found that this provision was written in an imprecise, confusing way, so it is not clear when it takes effect.
The new exchanges do not have to be in operation until 2014. But because of a possible “drafting error,” the report says, Congress did not specify an effective date for the section excluding lawmakers from the existing program.

Under well-established canons of statutory interpretation, the report said, “a law takes effect on the date of its enactment” unless Congress clearly specifies otherwise. And Congress did not specify any other effective date for this part of the health care law. The law was enacted when President Obama (http://topics.nytimes.com/top/reference/timestopics/people/o/barack_obama/index.html?inline=nyt-per) signed it three weeks ago.

In addition, the report says, Congress did not designate anyone to resolve these “ambiguities” or to help arrange health insurance for members of Congress in the future.

“This omission, whether intentional or inadvertent, raises questions regarding interpretation and implementation that cannot be definitively resolved by the Congressional Research Service,” the report says. “The statute does not appear to be self-executing, but rather seems to require an administrating or implementing authority that is not specifically provided for by the statutory text.”

The White House said last month that Mr. Obama would voluntarily participate in the health insurance exchange, though the law does not require him or other administration officials to do so. His participation as president may depend on his getting re-elected in 2012.

Representative Jason Chaffetz, Republican of Utah, said lawmakers were in the same boat as many Americans, trying to figure out what the new law meant for them.

“If members of Congress cannot explain how it’s going to work for them and their staff, how will they explain it to the rest of America?” Mr. Chaffetz asked in an interview.

The provision governing members of Congress can be traced to the Senate Finance Committee. When the panel was working on the legislation last September, Senator Charles E. Grassley (http://topics.nytimes.com/top/reference/timestopics/people/g/charles_e_grassley/index.html?inline=nyt-per), Republican of Iowa, proposed an amendment to require that elected federal officials and all federal employees buy coverage through an exchange, “rather than using the traditional Federal Employees Health Benefits Program.”

A scaled-back version of the amendment, applying to members of Congress and their aides, was accepted in the committee without objection.
The federal employees program, created in 1959, now provides coverage to eight million people and, according to the Congressional Research Service, is the largest employer-sponsored health insurance program in the country.


I figure that they'll find a way to patch this up, but it's an embarrassing turn of events. The Times article provides an obvious punch line with the bit about Congress' goal being to provide American citizens with the same level of coverage that they enjoy-- which is to say, due to the sloppily written legislation, NONE AT ALL!

On the other hand, dumping everyone from the health insurance rolls could fulfill one of the promises made regarding Obamacare-- that it would lower the deficit.

[Grunthos]

Would that it would be so... and then the national laryngitis epidemic strikes....

[Edmaster]

Somehow I don't think Congress will mind working overtime to "fix" this particular bit of legislation.

[Tonus]

Nancy Pelosi (http://www.speaker.gov/newsroom/pressreleases?id=1576), March 9 2010: "But we have to pass the bill so that you can find out what is in it, away from the fog of the controversy."

Everyone (http://dailycaller.com/2010/04/19/congress-may-get-fined-by-its-own-health-care-law/), April 19 2010: "Uh, we're still not sure what is in it."


Congress may get fined by its own health-care law

Congress may be fined tens of millions of dollars a year under its own health-care law, in part because the bill dumps members of Congress and their staffs from their current health-care plans.

But no one really knows for sure what the bill does, not even the experts. For instance, exactly who qualifies as an “employer” — and therefore is subject to fines up to $3,000 per employee — is undefined in the bill.

If Congress were subject to a $3,000 fine for each of its employees, it would need to shell out approximately $50 million each year to Uncle Sam. Congress’s research arm, the Congressional Research Service (CRS), informally confirmed the possibility to Republican aides.

Kathleen Sebelius, President Obama’s top health-care cabinet official, will be responsible for establishing most of the details of how the law is implemented. Many Republicans who have raised the issue of Congress’s fining itself believe Sebelius likely will exempt Congress with a regulation narrowly defining “employer,” for instance.

Still, the possibility of the fines, and the uncertainty surrounding them, are drawing heckles from the health-care law’s critics.

“That’s the irony — here we may be the first major employer in the country to be fined for not providing proper health insurance for our employees,” Rep. Dan Lungren, California Republican, told The Daily Caller while laughing. “Isn’t that contrary to the very premise of the bill?”

State and local governments may be on the hook for the fines, but unlike for members of Congress and their staffs, the health-care bill doesn’t specifically dump them from their health-care plans.

Before Congress incurs any fines, a complex series of events would be required to happen under the law. Generally speaking, an lower-tier aide — one not making a six-figure salary like some 2,000 House employees — would have to apply for government subsidies. The way the law works is that employers incur a $2,000 or $3,000 fine for each employee, depending on the circumstances, if only one of their employees obtains the subsidies.

So one lowly staff assistant could think he’s just getting some health-care help, while actually triggering a $50 million annual fine for Congress.

On the issue of the fines, CRS confirmed to Republican aides that the bill does not specify whether Congress would be considered an “employer” under the bill, thus triggering the coverage responsibilities and potential fines.

Previously, CRS explained why it’s “unclear” whether members of Congress and their staff will be able to keep their current health-care plans in an 8,100-word memo.

In that case, CRS argues that under standard lawyerly methods for reading laws, Congress should have been dumped from its current health-care coverage already. Nothing’s changed, though. The CRS memo notes that the law does not designate a government authority to resolve uncertainties, such as whether Congress is on the hook for $50 million a year.

The uncertainties surrounding the health-care law for just Congress’s health-care coverage are driving questions about how the rest of America will fare when its provisions kick into turbo in coming years.

“This is just terribly written legislation,” Lungren said, attributing many of the “drafting errors” and such to the unorthodox process by which the law was passed. “I doubt that when the senators voted on the bill they thought that was going to be the completed project. They needed to get their number of votes and they were going to do it whatever way they could and then anticipated a conference that somehow would have worked out the differences between the House and the Senate version. And because we had so few votes in both the House and the Senate, they did this other thing.”

That “other thing” was passing the Senate bill into law and a “fixes” bill hamstrung by the limitations of the budget reconciliation process which only requires a majority, not super-majority, vote in the Senate.


You wonder just how much bigger the bill would be if they'd bothered to get all of the details straightened out before passing it.

[Tonus]

President Obama, 2009: “Under the reform we’re proposing, if you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan.”

Reality, 2010: "many large companies are examining a course that was heretofore unthinkable, dumping the health care coverage they provide to their workers in exchange for paying penalty fees to the government."

Whoops. (http://money.cnn.com/2010/05/05/news/companies/dropping_benefits.fortune/)


Documents reveal AT&T, Verizon, others, thought about dropping employer-sponsored benefits

(Fortune) -- The great mystery surrounding the historic health care bill is how the corporations that provide coverage for most Americans -- coverage they know and prize -- will react to the new law's radically different regime of subsidies, penalties, and taxes. Now, we're getting a remarkable inside look at the options AT&T, Deere, and other big companies are weighing to deal with the new legislation.

Internal documents recently reviewed by Fortune, originally requested by Congress, show what the bill's critics predicted (http://money.cnn.com/2010/04/02/news/economy/health_care_taxes.fortune/), and what its champions dreaded: many large companies are examining a course that was heretofore unthinkable, dumping the health care coverage they provide to their workers in exchange for paying penalty fees to the government.

That would dismantle the employer-based system that has reigned since World War II. It would also seem to contradict President Obama's statements that Americans who like their current plans could keep them. And as we'll see, it would hugely magnify the projected costs for the bill, which controls deficits only by assuming that America's employers would remain the backbone of the nation's health care system.

Hence, health-care reform risks becoming a victim of unintended consequences. Amazingly, the corporate documents that prove this point became public because of a different set of unintended consequences: they told a story far different than the one the politicians who demanded them expected.

Why the write-downs happened but the hearings didn't

In the days after President Obama signed the bill on March 24, a number of companies announced big write downs due to some fiscal changes it ushered in. The legislation eliminated a company's right to deduct the federal retiree drug-benefit subsidy from their corporate taxes. That reduced projected revenue. As a result, AT&T (T (http://money.cnn.com/quote/quote.html?symb=T&source=story_quote_link), Fortune 500 (http://money.cnn.com/magazines/fortune/fortune500/2010/snapshots/2756.html?source=story_f500_link)) and Verizon (VZ (http://money.cnn.com/quote/quote.html?symb=VZ&source=story_quote_link), Fortune 500 (http://money.cnn.com/magazines/fortune/fortune500/2010/snapshots/2773.html?source=story_f500_link)) took well-publicized charges of around $1 billion (http://money.cnn.com/2010/03/26/news/companies/att/index.htm?postversion=2010032616).

The announcements greatly annoyed Representative Henry Waxman, who accused the companies of using the big numbers to exaggerate health care reform's burden on employers. Waxman, chairman of the House Energy and Commerce Committee, demanded that they turn over their confidential memos, and summoned their top executives for hearings.

But Waxman didn't simply request documents related to the write down issue. He wanted every document the companies created that discussed what the bill would do to their most uncontrollable expense: healthcare costs.

The request yielded 1,100 pages of documents from four major employers: AT&T, Verizon, Caterpillar and Deere (DE (http://money.cnn.com/quote/quote.html?symb=DE&source=story_quote_link), Fortune 500 (http://money.cnn.com/magazines/fortune/fortune500/2010/snapshots/128.html?source=story_f500_link)). No sooner did the Democrats on the Energy Committee read them than they abruptly cancelled the hearings. On April 14, the Committee's majority staff issued a memo stating that the write downs were "proper and in accordance with SEC rules." The committee also stated that the memos took a generally sunny view of the new legislation. The documents, said the Democrats' memo, show that "the overall impact of health reform on large employers could be beneficial."

Nowhere in the five-page report (http://www.scribd.com/doc/30954518/FORTUNE-April-14-Waxman-Memo) did the majority staff mention that not one, but all four companies, were weighing the costs and benefits of dropping their coverage.

AT&T produced a PowerPoint slide (http://www.scribd.com/doc/30954522/FORTUNE-ATT-Power-Point) entitled "Medical Cost Versus No Coverage Penalty." A document prepared for Verizon (http://www.scribd.com/doc/30954710/FORTUNE-Verizon-Doc) by consulting firm Hewitt Resources stated, "Even though the proposed assessments [on companies that do not provide health care] are material, they are modest when compared to the average cost of health care," and that to avoid costs and regulations, "employers may consider exiting the health care market and send employees to the Exchanges." (Under the new bill, employees who lose their coverage will purchase health care through state-run exchanges.)

Kenneth Huhn, vice president of labor relations at Deere, said (http://www.scribd.com/doc/30954527/FORTUNE-John-Deere-Email) in an internal email that his company should look at the alternatives to providing health benefits, which "would amount to denying coverage and just paying the penalty," and that he felt he already had the ability to make this change under his company's labor agreement. Caterpillar felt (http://www.scribd.com/doc/30954524/FORTUNE-Caterpillar-Serious-Consideration) it would have to give "serious consideration" to the penalty option.

It's these analyses -- which show it's a lot cheaper to "pay" than to "play" -- that threaten to overthrow the traditional architecture of health care.

The cost side

Indeed, companies are far more likely to cease providing coverage if they predict the bill will lift rather than flatten the cost curve. Deere, for example said, "We do expect double digit health care increases as most Americans will now have insurance and providers try to absorb the 15% uninsured into a practice."

Both Caterpillar (CAT (http://money.cnn.com/quote/quote.html?symb=CAT&source=story_quote_link), Fortune 500 (http://money.cnn.com/magazines/fortune/fortune500/2010/snapshots/81.html?source=story_f500_link)) and Verizon believe the requirement to allow dependents to remain on their parents' policies until age 26 will prove costly. Caterpillar puts the added expense at $20 million a year.

How two new taxes and the employer penalty change the health care calculus

First, there is the "Cadillac Tax" on expensive plans. This is a 40% excise tax on policies that cost over $8,500 for an individual or $23,000 for a family. Verizon's document predicts the tax will cost its employees $255 million a year when it starts in 2018, and rise sharply from there. Hewitt also isn't sure that Verizon can pass on the full tax to its employees; so it could impose a heavy weight on the company as well. "Many [have] characterized this tax as a pass-through to the consumer," says the Verizon document. "However, there will be significant legal and bargaining risks to overcome for this to be the case for Verizon."

In a statement to Fortune, Verizon said it is not, "considering or even contemplating" the plans laid out in the report, though records show the company did send the report to its board shortly after the reform plan was passed by Congress.

Second, the bill imposes new taxes on drug manufacturers, medical device-makers, and health insurance providers. Hewitt leaves little doubt Verizon will be paying for them: "These provisions are fees or excise taxes that will be shifted to employers through increased fees and rates."

Caterpillar and AT&T actually spell out the cost differences: Caterpillar did its estimate in November, when the most likely legislation would have imposed an 8% payroll tax on companies that do not provide coverage. Even with that immense penalty, Caterpillar stated that it could shave $25 million a year, or almost 10% from its bill. Now, because the $2,000 is far lower than 8%, it could reduce its bill by over 70%, by Fortune's estimate. Caterpillar did not respond to a request for comment.

AT&T revealed that it spends $2.4 billion a year on coverage for its almost 300,000 active employees, a number that would fall to $600 million if AT&T stopped providing health care coverage and paid the penalty option instead. AT&T declined comment.

So what happens to the employees who get dropped?

And why didn't these big employers drop employee coverage a long time ago? The Congressional Budget Office, in its crucial cost estimates of the bill, projected that company plans will cover more employees ten years from now than today. The reason the bill doesn't add to the deficit, the CBO states, is that fewer than 25 million Americans will be collecting the subsidies the bill mandates in 2020.

Those subsidies are indeed big: families of four earning between $22,000 and $88,000 would pay between 2% and 9.5% of their incomes on premiums; the federal government would pay the rest. So policies for a family making $66,000 would cost them just $5,300 a year with the government picking up the difference: more than $10,000 by most estimates.

As bean counters know, that's not a bad deal for a company's rank-and-file, and it's a great deal for the companies themselves. In a competitive labor market, the employers that shed their plans will need to give their employees a big raise, and those raises could be higher, even after taxes, than the premiums the employees will pay in the exchanges.

What does it mean for health care reform if the employer-sponsored regime collapses? By Fortune's reckoning, each person who's dropped would cost the government an average of around $2,100 after deducting the extra taxes collected on their additional pay. So if 50% of people covered by company plans get dumped, federal health care costs will rise by $160 billion a year in 2016, in addition to the $93 billion in subsidies already forecast by the CBO. Of course, as we've seen throughout the health care reform process, it's impossible to know for certain what the unintended consequences of these actions will be.


This could pave the way to a single-payer system, with blame placed on the evil corporations.

[Edmaster]

The evil greedy corporations are doing what they're designed to do- make money.

I could see this leading to everyone (or a LOT of people) getting dumped into a state-run system, or maybe they'll just go back to steeper penalties?

[Tonus]

The evil greedy corporations are doing what they're designed to do- make money.
Clearly, you are one of those racist teabaggers who wants to see children and old people die.
I could see this leading to everyone (or a LOT of people) getting dumped into a state-run system, or maybe they'll just go back to steeper penalties?I believe that the goal is a state-run system. But they need the narrative that makes it seem as if it is those greedy corporations who are forcing those poor government do-gooders to a single-payer setup. Thus, expect the government to vilify businesses and make token increases in the fines which still make it more attractive to pay the fines and dump workers into the government-run exchanges. The loss of business and crushing government regulation will eventually wipe out private health insurers, at which point the government steps in and "saves" us all from those greedy, heartless bastards.

And if you're one of those greedy and heartless businesses that create and sell medical devices, you'll feel the squeeze soon, too. (http://www.bostonherald.com/jobfind/news/healthcare/view.bg?articleid=1252494)

[Tonus]

One of the arguments in favor of health care reform is that it will result in fewer emergency room visits, thus helping to reduce costs. But it appears as if it will have the opposite effect. (http://thehill.com/business-a-lobbying/98025-health-reform-threatens-to-overwhelm-already-crammed-emergency-rooms)

Health reform threatens to cram already overwhelmed emergency rooms

The new healthcare law will pack 32 million newly insured people into emergency rooms already crammed beyond capacity, according to experts on healthcare facilities.

A chief aim of the new healthcare law was to take the pressure off emergency rooms by mandating that people either have insurance coverage. The idea was that if people have insurance, they will go to a doctor rather than putting off care until they faced an emergency.

People who build hospitals, however, say newly insured people will still go to emergency rooms for primary care because they don’t have a doctor.

“Everybody expected that one of the initial impacts of reform would be less pressure on emergency departments; it’s going to be exactly the opposite over the next four to eight years,” said Rich Dallam, a healthcare partner at the architectural firm NBBJ, which designs healthcare facilities.

“We don’t have the primary care infrastructure in place in America to cover the need. Our clients are looking at and preparing for more emergency department volume, not less,” he said.

Some Democrats agree with this assessment.

Rep. Jim McDermott (D-Wash.) suspects the fallout that occurred in Massachusetts’ emergency rooms could happen nationwide after health reform kicks in.

Massachusetts in 2006 created near-universal coverage for residents, which was supposed to ease the traffic in hospital emergency rooms.

But a recent poll by the American College of Emergency Physicians found that nearly two-thirds of the state’s residents say emergency department wait times have either increased or remained the same.

A February 2010 report by The Council of State Governments found that wait times had not abated since the law took effect.

“That is not an unrealistic question about what’s going to happen in the next four years as you bring all these people on; who are they going to see?” McDermott said.

The Washington congressman tried to include a provision in the healthcare bill he thought would increase the number of doctors.

McDermott’s legislation would have required the government to pay for students’ medical education in return for students serving four years as a primary care physician. The measure did not make it on the final bill that eventually became law.

McDermott stressed that creating a “whole new cadre of doctors” needs to begin now to meet the rising need from patients in the future.

While the measure wouldn’t prevent the infrastructure crunch, it would have provided new doctors for people seeking care.

Richard Foster, Chief Actuary at the Centers for Medicare and Medicaid Services, told The Hill that the current dearth of primary care physicians could lead to greater stress on hospital emergency rooms.

“The supply of doctors can’t be increased very quickly – there’s a time lag,” he said, adding, “Is the last resort to newly covered people the emergency room? I would say that is a possibility, but I wouldn’t say anybody has a very good handle on exactly how much of an infrastructure problem there will be or exactly how it might work out.”

The Academy of Architecture for Health predicts hospitals will need at least $2 trillion over the next 20 years to meet the coming demand.

“As more people have access, you have to deal with the increased capacity,” said Andrew Goldberg, senior director of federal relations at the American Institute of Architects. “At the moment there is not a lot of building going on because of the economy and a lot of health care facilities can’t get the financing. We’ve been working on the Hill to try to address that issue.”

The group has called on Congress to beef-up bonding authorities and expand energy efficient tax breaks for professional buildings. The vehicle targeted is the green energy legislation making its way through the House Ways and Means Committee and Senate Finance.

Dan Noble, a principal at the Dallas-based architecture firm HKS Inc., which also specializes in designing health care facilities, believes the only remedy to meet the coming demand on hospitals is to start projects immediately.

“We would have to get very busy soon,” he said. “It would take a fairly aggressive building campaign for the next decade.”

I'd just like to point out that if we implement plans for building more hospitals and encouraging more students to become doctors, it will add to the cost estimates which continue to grow as we learn more about the health care bill.

This also ignores another likely outcome-- if you are going to force everyone to pay for health insurance, a lot of people who are otherwise healthy and would not have visited a doctor or hospital will do so, because if they are paying for it then by golly they are going to use it. More people will schedule check-ups and doctor's visits if they so much as sneeze. This screws up the system even more, since it relies on healthy people not using it in order to subsidize those who are in need of medical care.

Then again, none of these problems are unexpected. Many of them were already in evidence in other parts of the world, and some were evident in Massachusetts, after it went with a similar program.

[Tonus]

This should come as no surprise, but...

PS- the very first sentence is a doozy. A classic /facepalm moment.


Health law risks turning away sick (http://thehill.com/business-a-lobbying/106887-health-law-risks-turning-away-sick)

The Obama administration has not ruled out turning sick people away from an insurance program created by the new healthcare law to provide coverage for the uninsured.

Critics of the $5 billion high-risk pool program insist it will run out of money before Jan. 1, 2014. That’s when the program sunsets and health plans can no longer discriminate against people with pre-existing conditions.

Administration officials insist they can make changes to the program to ensure it lasts until 2014, and that it may not have to turn away sick people. Officials said the administration could also consider reducing benefits under the program, or redistributing funds between state pools. But they acknowledged turning some people away was also a possibility.

“There’s a certain amount of money authorized in the statute, and we will do our best to make sure that that amount of money insures as many people as possible and does as much good as possible,” said Jay Angoff, director of the Office of Consumer Information and Insurance Oversight at the Department of Health and Human Services (HHS). “I think it’s premature to say [what happens] when it’s gone.”

The administration has not discussed asking Congress for more money down the line if the $5 billion runs out before Jan. 1, 2014. Uninsured sick people could start applying for participation in the high-risk insurance pools on Thursday.

Healthcare experts of all stripes warned during the healthcare debate that $5 billion would likely not last until 2014. Millions of Americans cannot find affordable healthcare because of their pre-existing conditions, and that amount would only cover a couple hundred thousand people, according to a recent study by the chief Medicare actuary.

Republicans continued to hammer that point on Thursday, asking HHS officials to brief them about the program.

We are “deeply concerned that these pools may not provide quality coverage or will limit enrollment,” Reps. Joe Barton (R-Texas), John Shimkus (R-Ill.) and Michael Burgess (R-Texas), the ranking members on the Energy and Commerce panel and its health and oversight subcommittees, wrote in a letter to HHS Secretary Kathleen Sebelius.

The letter requests a briefing on high-risk pools by July 15, particularly on three topics: protections and services in place “to make sure that access is efficient and unimpeded; whether HHS believes the program is financially sustainable through 2013; and details about how each state’s pool will be administered and what options they’ll have available.”

Leading health reform advocate Ron Pollack, founding executive director of Families USA, said the pools were a “very imperfect tool that could be implemented quickly” but were the best option available for the interim period before 2014.

“The pools are going to be helpful for a significant number of people,” he told The Hill, “but nobody thought they’re the ultimate answer for helping people with pre-existing conditions.”

Still, he didn’t rule out that Families USA could press lawmakers to allocate more money in a few years if it looks like the program needs it.

Each state has a certain budget allocation for its pool, and the first step to stay under budget would be to shift money around between states that don’t see a lot of applicants and those that do, said Richard Popper, deputy director of the Office of Consumer Information and Insurance Oversight at HHS.

“If we have that situation where we have strong demand in one state and not as strong demand in another state, the secretary of HHS after a year or two has the authority to reallocate the funding,” said Popper, who used to run Maryland’s high-risk pool.

“Along with that, we can work with the states to adjust their benefit structure, the deductibles, the co-pays, the overall plan structure to address some of those cost drivers, again to help the plan make it to 2014, when it will no longer be needed.”

In addition, Popper said, many people won’t be able to afford to participate in the program since premiums will range between about $140 and $900 a month, depending on applicants’ age and where they live. HHS estimates that at least 200,000 people will be in the program at any one time. To be eligible, applicants have to be citizens or nationals of the United States or be lawfully present; have a pre-existing medical condition; and have been uninsured for at least six months before applying for the high-risk pool plan.

“There are going to be meaningful premiums that are going to be required to stay in this plan — premiums in the hundreds of dollars every month,” Popper said. “There are a significant number of people out there with pre-existing conditions who are uninsured, but a significant number of those people ... also have limited income. And some of them, while they may need this plan, the premiums may not be something they can afford.

“We have that to think about as well,” he added. “But for those who can afford it, this is going to be a great, great plan.”

If it looks like too many people are signing up — states will get monthly updates on how many people they can cover with the money they have left — there’s always the option of turning people down.

The bill “does give the secretary authority to limit enrollment in the plan ... nationally or on a state-by-state basis,” Popper said. “So that is present, but at this point, we’re starting with no one in the plan as of today ... so we don’t see that happening anytime soon.”

The last line is also a doozy. Sure, they admit, we may run out of money and have to turn people away, but since no one has enrolled yet, it's not a problem! You have to wonder what this man is smoking. The concern is not that the program is running out of money now, but that it will run out of money before 2014, when the burden will be foisted upon insurance companies.

One thing that might be missed here-- after all of the criticism we've heard about insurance companies and the way they treat (or mistreat) people just to make an extra buck, the government's program that is designed to cover the highest risk pool is worried that it may run out of money and may need to cut people off or may need to beg for more money. Imagine that!!!

In 2014, insurers will be forced to accept this group of people. You can be sure that government will demand that there be no exceptions and that premiums should not increase. This will increase the likelihood that insurers will go out of business and bring us closer to a single-payer system. A system that will be managed by the same government that is showing it cannot handle even a portion of the responsibility right now.

And this could all happen just as Social Security finally crumbles under its own weight.

[Grunthos]

I've been moving to an all-cash position with my investments for the last couple months, spread across a number of different institutions.

[Tonus]

Is this (http://hotair.com/archives/2010/07/19/surprise-masscare-mandates-incentivize-employers-to-end-health-care-coverage/) another way in which MassCare is a preview of what ObamaCare will cause?


Surprise! MassCare mandates incentivize employers to end health-care coverage

If Massachusetts is the laboratory for ObamaCare, consider this an explosion (http://www.boston.com/news/health/articles/2010/07/18/firms_cancel_health_coverage/). The Boston Globe reports that employers have begun doing precisely what everyone knew they would do when insurance prices spiked: dump health plans. Companies that used to offer health-care coverage are paying the fines and saving money by dumping their employees into state-run coverage (via Newsalert (http://nalert.blogspot.com/2010/07/mass-firms-cancel-health-coveragewith.html)):
The relentlessly rising cost of health insurance is prompting some small Massachusetts companies to drop coverage for their workers and encourage them to sign up for state-subsidized care instead, a trend that, some analysts say, could eventually weigh heavily on the state’s already-stressed budget.

Since April 1, the date many insurance contracts are renewed for small businesses, the owners of about 90 small companies terminated their insurance plans with Braintree-based broker Jeff Rich and indicated in a follow-up survey that they were relying on publicly-funded insurance for their employees. …
The Massachusetts Division of Health Care Finance and Policy annually surveys employers and found no significant drop in coverage as of the end of 2009, when more than three-quarters of companies offered health insurance.

But insurance brokers say the pace of terminations has picked up considerably since then among small companies, of which there are thousands in Massachusetts. Many of these companies — restaurants, day-care centers, hair salons, and retail shops — typically pay such low wages that their workers qualify for state-subsidized health insurance when their employers drop their plans.

“Those employers are trying to keep their doors open, and to the extent they can cut expenses, they will cut health insurance because they know their people can go to Commonwealth Care,’’ said Mark Gaunya, president of the Massachusetts Association of Health Underwriters, a trade group representing more than 1,000 brokers and other insurance professionals.
Actually, in Massachusetts it may be more of a race to see who gets to the ultimate finish line first. Will businesses under extreme economic duress and competitive pressure start dumping employee health insurance coverage before health insurers go out of business? Governor Deval Patrick countermanded rate hikes from major insurers this year, which means they have no way to cover the rising costs created by the must-insure mandate and other legal restrictions in Massachusetts. The question will probably be what will come last — the barbecued chicken or the scrambled egg.

Otherwise, the economics are rather simple. Employers face a fine of less than $300 per employee not covered by health insurance. They have to pay thousands per employee every year for the insurance. In this economy, which option will look best — especially when a company’s competitors dump coverage to keep prices low? Anyone who has run a business can answer that question easily.

The same exact incentives exist in ObamaCare, as CBS belatedly discovered (http://hotair.com/archives/2010/03/24/video-will-obamacare-drive-businesses-out-of-providing-health-insurance/) after its passage. With the Senate and the White House eyeballing price controls (http://hotair.com/archives/2010/04/21/next-up-senate-considers-regulation-of-health-insurance-premiums/) for health insurance, the federal system will have the same perverse incentive structure as Massachusetts, and businesses will eventually respond to them in ways that will create a de facto single-payer system in the US. That appears to be more like a designed outcome than a policy mistake as Barack Obama and Congress follow the Massachusetts playbook.
Aside from the typical concerns about moving to a single-payer system is that we're on a course to become a single-payer nation just as our money runs out.

[Grunthos]

This is what reporters OUGHT to be doing, but it's falling to bloggers and private citizens to try to get answers out of these buffoons:

Blogger Adam Sharp took on pro-Obama liberal Rep. Phil Hare (D-IL) at a town hall in Illinois in April. When asked where in the Constitution it says that Americans can be forced to buy health insurance, Hare responded:

“I don’t care about the Constitution… I believe that is says we have the right to life, liberty and the pursuit of happiness.”

Umm… That’s the Declaration of Independence.

k2iiirr5KI8

To work the math that the congressman could not: 8100 pages at 1 minute per page equals one hundred thirty five (135) hours without breaks, food, rest, researching the thousands of external references in the bill, or stealing candy from babies.

Over three weeks of 8-hour workdays.

[Edmaster]

Diggin' their own hole.

If only we could just follow these people around with cameras all day...

[Tonus]

Saw this one coming... (http://www.telegraph.co.uk/health/7908742/Axe-falls-on-NHS-services.html)

Axe falls on NHS services

NHS bosses have drawn up secret plans for sweeping cuts to services, with restrictions on the most basic treatments for the sick and injured.

Some of the most common operations — including hip replacements and cataract surgery — will be rationed as part of attempts to save billions of pounds, despite government promises that front-line services would be protected.

Patients’ groups have described the measures as “astonishingly brutal”.

An investigation by The Sunday Telegraph has uncovered widespread cuts planned across the NHS, many of which have already been agreed by senior health service officials. They include:

* Restrictions on some of the most basic and common operations, including hip and knee replacements, cataract surgery and orthodontic procedures.

* Plans to cut hundreds of thousands of pounds from budgets for the terminally ill, with dying cancer patients to be told to manage their own symptoms if their condition worsens at evenings or weekends.

* The closure of nursing homes for the elderly.

* A reduction in acute hospital beds, including those for the mentally ill, with targets to discourage GPs from sending patients to hospitals and reduce the number of people using accident and emergency departments.

* Tighter rationing of NHS funding for IVF treatment, and for surgery for obesity.

* Thousands of job losses at NHS hospitals, including 500 staff to go at a trust where cancer patients recently suffered delays in diagnosis and treatment because of staff shortages.

* Cost-cutting programmes in paediatric and maternity services, care of the elderly and services that provide respite breaks to long-term carers.

The Sunday Telegraph found the details of hundreds of cuts buried in obscure appendices to lengthy policy and strategy documents published by trusts. In most cases, local communities appear to be unaware of the plans.

Dr Peter Carter, the head of the Royal College of Nursing, said he was “incredibly worried” about the disclosures.

He urged Andrew Lansley, the Health Secretary, to “get a grip” on the reality of what was going on in the NHS.

The Government has promised to protect the overall budget of the NHS, which will continue to receive above-inflation increases, but said the service must make “efficiency savings” of up to £20 billion by 2014, which would be diverted back to the front line.

Mr Lansley said last month: “This protection for the NHS is protection for patients – to ensure that the sick do not pay for the debt crisis.”

Dr Carter said: “Andrew Lansley keeps saying that the Government will protect the front line from cuts – but the reality appears to be quite the opposite. We are seeing trusts making job cuts even when they have already admitted to being short staffed.

“The statements he makes may be well intentioned – but we would implore him to get a grip on the reality, because these kinds of cuts are incredibly worrying.”

Katherine Murphy, of the Patients Association, said the cuts were “astonishingly brutal” and expressed particular concern at moves to ration operations such as hip and knee operations.

“These are not unusual procedures, this is a really blatant attempt to save money by leaving people in pain,” she said.

“Looking at these kinds of cuts, which trusts have drawn up in such secrecy, it particularly worries me how far they disadvantage the elderly and the vulnerable.

‘‘We cannot return to the days of people waiting in pain for years for a hip operation or having to pay for operations privately.”

She added that it was “incredibly cruel” to draw up savings plans based on denying care to the dying.

On Thursday, the board of Sutton and Merton primary care trust (PCT) in London agreed more than £50 million of savings in two years. The plan included more than £400,000 to be saved by “reducing length of stay” in hospital for the terminally ill.

As well as sending more patients home to die, the paper said the savings would be made by admitting fewer terminally ill cancer patients to hospital because they were struggling to cope with symptoms such as pain. Instead, more patients would be given advice on “self management” of their condition.

Bill Gillespie, the trust’s chief executive, said patients would stay at home, or be discharged from hospital only if that was their choice, and would be given support in their homes.

This week, Hertfordshire PCT plans to discuss attempts to reduce spending by rationing more than 50 common procedures, including hip and knee replacements, cataract surgery and orthodontic treatment.

Doctors across the county have already been told that their patients can have the operations only if they are given “prior approval” by the PCT, with each authorisation made on a “case by case” basis.

Elsewhere, new restrictions have been introduced to limit funding of IVF.

While many infertile couples living in Yorkshire had previously been allowed two cycles of treatment — still short of national guidance to fund three cycles — all the primary care trusts in the county are now restricting treatment to one cycle per couple.

A “turnaround” plan drawn up by Peterborough PCT intends to make almost £100 million of savings by 2013.

Its cuts include closing nursing and residential homes and services for the mentally ill, sending 500 fewer patients to hospital each month, and cutting £17 million from acute and accident and emergency services.

Two weeks ago, Mid Yorkshire Hospitals trust agreed plans to save £55 million in two years, with £20 million coming from about 500 job losses.

Yet, a month before the decision was taken, senior managers at a board meeting described how staff shortages were already causing delays for patients being diagnosed and treated for breast cancer.

Mr Lansley said any trusts that interpreted the Government’s demands for efficiency savings as budget or service cuts were wrong to do so, and were “living in the past”.
Aside from the two obvious alarming parts (that care will be rationed pretty heavily, and the emphasis on reducing care for the elderly and infirm) is the attempt to slip this past the public. The government brazenly insists that they are protecting the NHS, even as they make drastic and severe cuts, in some cases planning to cut back on services that are already suffering from de-facto rationing.

[Grunthos]

"There... is... no... Sanctuary..."

[Azure]

I've been moving to an all-cash position with my investments for the last couple months, spread across a number of different institutions.I may have lost something in context, but why?

[Grunthos]

I may have lost something in context, but why?

Because cash is easier to preserve at this point. It may change tomorrow, but as of right now the government hasn't ever found a (legal, sustainable in court) way to tax cash-in-hand unless you transfer it somehow.

There was talk at one time about illegalizing cash, eliminating it entirely from public possession... but it hasn't been raised for a while.

They did it with gold once, though, so never say never.

[Tonus]

An updated diagram of the new health care system:
http://www.qando.net/wp-content/uploads/obama_chart.jpg

A larger and more detailed view (PDF format): chart (http://www.house.gov/brady/pdf/Obamacare_Chart.pdf)

From Q and O: (http://www.qando.net/?p=9124)


Rep. Kevin Brady (R-TX) had his staff do a study of the ObamaCare bill (http://www.house.gov/apps/list/press/tx08_brady/pr_100728_hc_chart.html) after its passage to assess exactly what Democrats had blindly passed into law. He also asked his staff to put a chart together to represent the health care system under that law.

The result is mind-boggling and troubling. And if you figured the Secretary of Health and Human Services was the new defacto health care czar, backed by the IRS, you’re correct.

Below is a thumbnail of the chart to give you a flavor of its complexity. Brady admits [it] only represents a third of what is in the bill after which it got too crowded. Said Brady, "it’s actually worse than this."

[Tonus]

And in case the chart doesn't tell enough of the story...

Obamacare Only Looks Worse Upon Further Review: Kevin Hassett (http://www.bloomberg.com/news/2010-08-02/obamacare-only-looks-worse-upon-further-review-kevin-hassett.html)

One of the more illuminating remarks during the health-care debate in Congress came when House Speaker Nancy Pelosi told an audience that Democrats would “pass the bill so you can find out what’s in it, away from the fog of controversy.”

That remark captured the truth that, while many Americans have a vague sense that something bad is happening to their health care, few if any understand exactly what the law does.

To fill this vacuum, Representative Kevin Brady of Texas, the top House Republican on the Joint Economic Committee, asked his staff to prepare a study of the law, including a flow chart that illustrates how the major provisions will work.

The result, made public July 28, provides citizens with a preview of the impact the health-care overhaul will have on their lives. It’s a terrifying road map that shows Democrats have launched America on the most reckless policy experiment in its history, the economic equivalent of the Bay of Pigs invasion.

Before discussing what the law means for you, we have to look at what it does to government. That’s where the chart comes in handy. It includes the new fees, bureaucracies and programs and connects them into an organizational chart that accounts for the existing structure. It’s so carefully documented that a line connecting two structures cites the legislative language that created the link.

Ornate System

This clearly is a candidate for most disorganized organizational chart ever. It shows that the health system is complex, yes, but also ornate. The new law creates 68 grant programs, 47 bureaucratic entities, 29 demonstration or pilot programs, six regulatory systems, six compliance standards and two entitlements.

Getting that massive enterprise up and running will be next to impossible. So Democrats streamlined the process by granting Health and Human Services Secretary Kathleen Sebelius the authority to make judgments that can’t be challenged either administratively or through the courts.

This monarchical protection from challenges is extended as well to the development of new patient-care models under Obama’s controversial recess appointment, Donald Berwick, whom Republicans are calling the rationer-in-chief. Berwick will run the Centers for Medicare and Medicaid Services, where he can experiment with ways to use administrative fiat to move our system toward the socialized medicine of Europe, which he has at times embraced.

Closer to Home

A sprawling, complex bureaucracy has been set up that will have almost absolute power to dictate terms for participating in the health-care system. That’s what the law does to government. What it does to you is worse.

Based on the administration’s own numbers, as many as 117 million people might have to change their health plans by 2013 as their employer-provided coverage loses its grandfathered status and becomes subject to the new Obamacare mandates.

Those mandates also might make your health care more expensive. The Congressional Budget Office predicts that premiums for a small number of families who buy their insurance privately will rise by as much as $2,100.

The central Obamacare mechanism for increasing insurance coverage is an expansion of the Medicaid program. Of the 30 million new people covered, 16 million will be enrolled in Medicaid. And you could end up in the program whether you want it or not. The bill states that people who apply for coverage through the new exchanges or who apply for premium-subsidy credits will automatically be enrolled in Medicaid if they qualify.

Hurting the Elderly

To pay for this expansion, the bill takes $529 billion from Medicare, with roughly 39 percent of the cut coming from the Medicare Advantage program. This represents a large transfer of resources, sacrificing the care of the elderly in order to increase the Medicaid rolls.

For all this supposed reform, you, the American taxpayer, can expect a bill to the tune of $569 billion.

Front and center among the new taxes is the 40 percent excise tax on those lucky people with so-called Cadillac health plans. The higher insurance costs that are driven by the government mandates will push many more ordinary plans into Cadillac territory.

If the idea of taxing people with coverage deemed too good doesn’t bother you, maybe the new 3.8 percent tax on investment income will. That will apply even to a small number of home sales, those that generate $250,000 in profit for an individual or $500,000 for a married couple.

In vivid color and detail, Congressman Brady’s chart captures the huge expansion of government coming under Obamacare. Harder to show on paper is the pain it will cause.

Note the part about Cadillac plans. Under Obamacare, they will be taxed heavily, making them less attractive. I expect that the government will use this provision to systematically wipe out the better health insurance plans by simply re-categorizing them as Cadillac plans. Just another step towards a single-payer system.

[Tonus]

Andy Griffith assures Medicare recipients that they won't lose any of their guaranteed benefits. (http://factcheck.org/2010/07/mayberry-misleads-on-medicare/)

The benefits that aren't guaranteed by law? Well...


Mayberry Misleads on Medicare

Would the sheriff of Mayberry mislead you about Medicare? Alas, yes.

In a new TV spot from the Obama administration, actor Andy Griffith, famous for his 1960s portrayal of the top law enforcement official in the fictional town of Mayberry, N.C., touts benefits of the new health care law. Griffith tells his fellow senior citizens, "like always, we’ll have our guaranteed [Medicare] benefits." But the truth is that the new law is guaranteed to result in benefit cuts for one class of Medicare beneficiaries — those in private Medicare Advantage plans.

The White House released the ad on the 45th anniversary of the Medicare program, and said it would run nationally on cable TV networks. Griffith, whose "Andy Griffith Show" was a TV comedy hit at the time Medicare was first enacted in 1965, explains the "good things" that the new health care law will mean for Medicare beneficiaries.

"This year, like always, we’ll have our guaranteed benefits," he says. An announcement of the ad (http://www.whitehouse.gov/blog/2010/07/30/medicare-and-mayberry) on the White House website reinforces that claim, saying: "Under the Affordable Care Act … Seniors guaranteed Medicare benefits will remain the same." But the truth is, for millions of seniors, benefits won’t remain the same.

As we wrote most recently last December (http://www.factcheck.org/2009/12/were-in-the-record/), about 10 million Medicare Advantage recipients could see their extra benefits reduced by an average of $43 per month, according to the Congressional Budget Office. And more recently, a detailed analysis by the Medicare program’s own chief actuary (http://www.cms.gov/ActuarialStudies/Downloads/PPACA_2010-04-22.pdf), Richard Foster, stated in April:
Medicare Actuary Richard Foster: The new provisions will generally reduce MA rebates to plans and thereby result in less generous benefit packages. We estimate that in 2017, when the MA provisions will be fully phased in, enrollment in MA plans will be lower by about 50 percent (from its projected level of 14.8 million under the prior law to 7.4 million under the new law).Even the head of the White House Office of Health Reform, Nancy-Ann DeParle, acknowledges that Medicare Advantage benefits are going to be reduced. "I’m sure that some of those additional benefits have been nice," the Wall Street Journal quoted her (http://online.wsj.com/article/SB10001424052748703340904575285002595068326.html?m od=googlenews_wsj) as saying in a July 25 report. "But I think what we have to look at here is what’s fair and what’s important for the strength of the Medicare program long term."

A Weasel Word

So how can the Obama administration claim that "guaranteed Medicare benefits will remain the same"? The answer is that the term "guaranteed" is a weasel word — a qualifier that sucks the meaning out of a phrase in the way that weasels supposedly suck the contents out of an egg. It may sound to the casual listener as though this ad is saying that the benefits of all Medicare recipients are guaranteed to stay the same — and that may well be the way the ad’s sponsors wish listeners to hear it. But what the administration is really saying is that only those benefits that are guaranteed in law will remain the same.

There’s even a section in the new law (http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_public_laws&docid=f:publ148.111.pdf) (section 3601) that says: "Nothing in the provisions of, or amendments made by, this Act shall result in a reduction of guaranteed benefits under title XVIII of the Social Security Act" (the title that establishes the Medicare program). Section 3602 says even Medicare Advantage recipients won’t suffer any reduction of "any benefits guaranteed by law."

But here’s the catch: The extra benefits generally offered by Medicare Advantage plans aren’t guaranteed by law. They are offered by private insurance companies as inducements. The companies have been able to offer somewhat more generous packages than traditional, fee-for-service Medicare because the system pays them as much as 40 percent more per patient than it pays for traditional Medicare, according to the chief actuary. The average in 2009 was about 14 percent more, according to the most recent analysis by the nonpartisan Kaiser Family Foundation (http://www.kff.org/medicare/upload/8047.pdf), issued in February. But the new law generally eliminates the extra payments in the coming years. Foster, the chief actuary, estimates that federal spending for Medicare Advantage will be reduced by $145 billion over the law’s first decade.

Currently, about 1 in every 4 Medicare beneficiary is enrolled in a Medicare Advantage plan. For many of them, the words in this ad ring hollow, and the promise that "benefits will remain the same" is just as fictional as the town of Mayberry was when Griffith played the local sheriff.


Pay particular attention to DeParle's comment: "But I think what we have to look at here is what’s fair and what’s important for the strength of the Medicare program long term." This is a warning that services and quality of care will suffer if that's what is required to maintain the "strength" of the Medicare program over the long term. Or to use another term... rationing.

[Grunthos]

I'm shocked, shocked, I tell you, to discover deception, fraud, and double-dealing from a Democrat.

[KB.]

What would Aunt Bea think?

[Tonus]

Another article on how MassCare serves as a warning about how Obamacare is likely to work: (http://www.nypost.com/p/news/opinion/opedcolumnists/mass_mess_obamacare_ugly_future_SjLLcYvoUQDMXounlO ljjO)

Mass. mess: ObamaCare's ugly future

Massachusetts' struggle to make "universal health insurance" work continues to be an excellent peek at what the entire nation faces when ObamaCare kicks in -- and the picture remains ugly.

Gov. Deval Patrick has just reached a truce with three of the four top insurers in the state, compromising on this year's rate hikes for the small-business and individual markets. Plus, the state last week passed a law allowing some small businesses to form cooperatives to bargain jointly for health plans. But the numbers still don't add up.

When the Bay State passed its health-reform law in 2006, 9 percent of non-elderly adults lacked insurance; that's now down to 5 percent. The law didn't reduce expensive emergency-room use as predicted. Instead, emergency-room visits have climbed by 9 percent, or about 3 million visits, from 2004 to 2008. But it's bankrupting the state, while the pressures on small businesses and on health-care insurers and providers continue to build toward the breaking point.

Health care now consumes 35 percent of the state budget, up from 22 percent in 2000. Patrick recently asked Washington for $473 million to help make the Massachusetts reform work -- on top of the $1.2 billion in support the feds have already kicked in over three years, more than $3,000 per person in the state.

Whenever the federal help stops coming, the Bay State will have to either hike taxes further to fund its program, or start cutting benefits. Reimbursements are already so low under the state-subsidized plans (most of whose 152,000 enrollees pay nothing) that doctors are already refusing to accept new patients with that "coverage."

Yet small businesses are clearly finding it necessary to dump their employees on the public health plans. The Boston Globe recently reported on a broker who helps firms do just that; his practice is booming. He's seen about 90 business owners terminate their plans since April.

What's forcing up costs so much? Part of it is simply the increased demand for care, now that more people have insurance. But part of it is the "gaming" of the rules that force insurers to offer coverage to all comers, regardless of health status.

The maximum fine for not buying insurance is $1,116, far below the cost of a private plan. So some people are plainly waiting until they face a major medical expense to buy -- and then dumping the coverage as soon as the problem's resolved.

The state says that the number of short-term insured tripled from 3,508 in 2006 to 17,177 in 2008 -- and that the problem adds up to 1.5 percent to the cost of insurance for everyone else. Patrick and his allies are looking at limiting the periods when anyone can enroll to once or twice a year.

The state is also determined to force insurance companies to eat more costs. But that can't keep happening, either: Most of the big insurers compromised on rates this year after a months-long fight -- but the state Insurance Appeals Board had ruled that the original, higher rates were reasonable, given what insurers must pay to hospitals and doctors.

Tufts Health Plan CEO Jim Roosevelt spoke the obvious: If the state keeps insisting on making health insurance a money-losing business, it "will ultimately force insurers to go out of business or leave the market."

The Bay State is pretty clearly on the road to becoming one giant HMO -- though the new label is Accountable Care Organization. Since this is now supposed to be the whole nation's future, it's not too soon to start asking, "Accountable to whom?"So what are the results so far, after something like eight years? More people are insured, but not nearly everyone. Emergency-room visits have increased. Enough people are gaming the system to add an additional 1.5% in costs (doesn't seem like much? It's a multi-billion dollar program). Insurers, who are currently bearing some of the cost burden, are being squeezed out. Employers are dumping employees into the state health plan, which is already over-burdened as the health care program is swallowing up the state budget, even with large amounts of federal aid to help shore it up.

Once the private insurers are forced out and the feds stop pitching in, the state will bear the full burden of financing the health insurance system. And unlike the federal government, they can't simply run a deficit and leave the excess costs for some future generation to pay for. They have to balance their budget. That means tax increases, rationing, and a gradual decrease in the quality and availability of care. I can't wait until we're all covered by government health care!

[Grunthos]

"The maximum fine for not buying insurance is $1,116, far below the cost of a private plan."

This proves mathematical and sociological idiocy on the parts of those planning the system. Penalty < Compliance = non-compliance.

Of couse, when the plan was put in place, the penalty was probably the higher cost... Then market forces set in.

[Shady]

Health care now consumes 35 percent of the state budget, up from 22 percent in 2000. Patrick recently asked Washington for $473 million to help make the Massachusetts reform work -- on top of the $1.2 billion in support the feds have already kicked in over three years, more than $3,000 per person in the state.

You know, I've been thinking about this tonight for about the last hour. It's just amazing to me how complicated and expensive the government can cause some things to be.

I don't consider the current state of health care in the US to be a "crisis" until the government gets involved and creates one. No, it's not perfect, and yes, it has some problems that could be corrected. But this kind of thing (the MA plan and ObamaCare, even Medicare) is so convoluted I find it difficult to believe that anyone believes it will be a benefit to anyone.

Anyway, here was the thought I had a short while ago: MA could have just given $3,000 to every resident and had less of the state budget consumed (far less than 35%). This could be given in the form of a check that could only be deposited in a flex type of account or an HSA that then could only be used to pay premiums for the insurance plan of the individual's choice, or other health care expenses (doctor bills, Rx, qualifying OTC meds, etc). This could also help to create jobs as it would increase demand for administration of the flex accounts or HSAs. These would be private companies rather than government entities, and people would have a choice of which HSA they chose along with a choice of any of the insurance plans available in the state. Or, they could choose to not have insurance at all and pay for doctor visits themselves with that money, hopefully resulting in more people making more well considered decisions about their care rather than just going to the (expensive) ER to treat routine health problems. And it could still have the same "use it or lose it" policy that HSAs do, and any money left over at the end of the year is refunded to the state by the plan administrator.

It's not that difficult to come up with a more economically viable option for the "health care crisis" than what the government has dreamed up so far.

[KB.]

Edited because I can't articulate what I'm trying to say the way I want to say it.

[S Carver Orne]

20 States Prepare for Day in Court Against Health Care Law

PENSACOLA, Florida -- The Obama administration will try to persuade a federal judge Tuesday to throw out a lawsuit by 20 states that claim the president's health care overhaul is unconstitutional.

The fight will primarily be over sections of the law that will require individuals to have health insurance or face tax penalties and require states to pay additional costs for the Medicaid health insurance program for the indigent that are not covered by the federal government.

Attorneys defending the law will argue that the section requiring health insurance doesn't take effect until 2015 and it's up to an individual taxpayer -- not the states -- to challenge the law then. The government has said it has the right to create the insurance mandate under the commerce and general welfare clauses of the Constitution.

Florida's Republican Attorney General Bill McCollum filed the lawsuit just minutes after President Barack Obama signed the 10-year, $938 billion health care bill into law last March. He chose a court in Pensacola, one of Florida's most conservative cities. The country's most influential small business lobby, the National Federation of Independent Business, has joined McCollum's suit, and a similar case is unfolding in Virginia.

There, the Obama administration also tried to get the lawsuit dismissed, saying Virginia lacked standing to sue, but a federal judge has allowed it to continue, ruling that the overhaul raises complex constitutional issues.

Timothy Jost, a professor at Washington and Lee University law school in Virginia, said it will be difficult for the states to argue that the federal government can't force individuals to have health insurance when the law won't take effect for years.

But more than 30,000 members of the federation are already suffering, said Karen Harned, executive director of its Small Business Legal Center.

Many insurance companies have changed their plans or discontinued their policies in advance of the new law, making it more expensive for small businesses to meet the requirements, she said. Fewer than half of the country's small businesses provide employee health insurance now, she said, and the law would create a financial burden for many of them.

"We would agree with the government that the individual mandate is the key to the entire health care law, but we think the entire health care law is bad," she said.

Attorneys for the states and the Justice Department will each have 45 minutes to present their case to U.S. District Judge Roger Vinson, who is expected to release a written decision later. The lawsuit is likely to wind up before the U.S. Supreme Court, probably before the 2012 presidential election.

The other states that are suing are Alabama, Alaska, Arizona, Colorado, Georgia, Indiana, Idaho, Louisiana, Michigan, Mississippi, Nebraska, Nevada, North Dakota, Pennsylvania, South Carolina, South Dakota, Texas, Utah and Washington.
http://www.foxnews.com/politics/2010/09/13/states-prepare-day-court-health-care-law/

Can't believe the douchebaggery surrounding this administration.

[Grunthos]

You don't see California on that list... but oour state insurance Comissioner allowed Blue Cross and other agencies to raise their rates, in many cases over 30%, to offset the anticipated additional claims load.

[Reserv*ir]

I'm really hoping this lawsuit isn't tossed.
Seems like it'd be another relatively major loss if it was...

[Tonus]

What happens when you promise to add more people to the insurance rolls while expanding coverage and scaling back limitations?

Oh, right. (http://hotair.com/archives/2010/09/18/ct-approves-rate-hikes-to-cover-obamacare-mandates/)


CT approves rate hikes to cover ObamaCare mandates

The big question here will be whether Kathleen Sebelius herself will travel to Connecticut to smite the insurers personally (http://hotair.com/archives/2010/09/13/sebelius-wh-tactics-on-obamacare-dissent-thuggery/), or the state government that approved rate hikes of up to 20% (http://www.courant.com/business/hc-anthem-rate-hike-0918-20100917,0,2399459.story) to cover the new mandates in ObamaCare. These rate hike requests won’t be the last, either:Anthem Blue Cross and Blue Shield in Connecticut requested a wide range of premium increases, which will take effect Oct. 1, to cover the costs of new benefits required by federal health reform. Higher prices mostly affect new members shopping for a health plan on the individual market rather than people who have group plans through an employer or some other organization.

The Connecticut Department of Insurance approved Anthem’s request without changes, including a boost of as much as 22.9 percent just to comply with one provision: eliminating annual spending limits per customer. But it’s unclear how much more customers will pay because of the variety of plans and the complexity of other factors, such as a person’s age.

New provisions mandated by federal law to start Thursday include allowing young adults to stay on their parents’ plan until they turn 26, eliminating annual and lifetime limits on the amount of money an insurer spends per customer and mandating that insurers cover the full cost of preventive services, such as mammograms (http://hotair.com/topic/health/medical-procedures-tests/mammogram-HEPAS000032.topic)and colonoscopies (http://hotair.com/topic/health/medical-procedures-tests/colonoscopy-HEPAS000049.topic).

The looming question is how much those new mandated benefits, along with rising medical costs, will raise prices for health insurance next year. Insurers will submit a new batch of rate requests in October and November to take effect in 2011.
This comes as a great shock to all of those business experts on the Left that kept insisting that additional mandates meant lower costs. To the rest of us, however, who actually understand risk pools (http://hotair.com/archives/2010/03/17/ap-fact-check-premiums-will-rise-under-obamacare/) and the difference between price and costs (http://hotair.com/archives/2010/06/23/obama-administration-eyeing-price-controls-in-health-insurance/), it’s exactly what we predicted for over a year (http://hotair.com/archives/2010/08/05/obamacare-the-sum-of-all-fears/).

Steve McGough at Radio Vice Online (http://radioviceonline.com/health-care-mandates-result-in-18-premium-increase-in-connecticut/) notes that Attorney General and Senate candidate Dick Blumenthal blasted the insurance companies without knowing any of the facts:Connecticut’s attorney general, Richard Blumenthal (D) – who is running for Senate against Republican candidate Linda McMahon – did not exactly blow a gasket, but of course he thinks the rate increases are massive and unjustified. Tell me Blumenthal, did you even attend the meetings where Anthem proved their case to state regulators? Can you even speak to the actual cost increases or did you just pull page 57 out of the play book and read verbatim?
Linda McMahon should jump all over this as an example of just how misguided ObamaCare was, and how clueless its advocates still are.
It seems as if some Democrats have decided to follow the script and insist that this is just a case of greedy insurance companies working to screw the consumer. Because according to The New Math, 2 + 2 = 1, and therefore insurance companies who accept rules that expand coverage should be making more money without modifying their premiums, the same way that if you buy more groceries, you spend less money. I'm starting to understand how it is that liberals believe that we had a budget surplus during the Clinton years.

[Grunthos]

the same way that if you buy more groceries, you spend less money.

Well, look at all the money the stores say you save on discounts! If you buy twice as much, why, you're saving! You can't save money if you don't buy stuff, right?

The same logic that says continuing the same tax policies in effect today will "cost billions more."

Not only that, but insurance compaines faced with being forced to write policies for children with pre-existing conditions (read that as - guaranteed loss for life accounts) are taking the only financially viable path available to them... they are beginning to refuse to insure children at all.

[GuitarFreak]

So some policies went in to effect today.
http://www.huffingtonpost.com/rep-john-b-larson/10-major-new-health-refor_b_736766.html

Looks good to me. I don't really see what the problem is. Better health care? Not having to worry about being dropped or not getting coverage at all because of a pre-existing condition, not denying children health care because of a congenital condition. Most other first world countries provide health care plans, why can't we?

Though I am disappointed that a single payer/public option didn't make it in to the bill, but the republicans are to blame there. I wish Obama had the balls to push it through. Oh well.

[Tonus]

I don't really see what the problem is.
It's what we've been discussing for more than 10 pages now.

In short, health insurance is modeled in such a way as to be unsustainable unless considerable compromises are made. When it's managed by private companies, those compromises consist of strict barriers to entry, high costs, and low limits on critical care allowances. When it's managed by government, the compromises are mostly on the other end-- high costs, reduced access, lower quality of care.

Most of those first world nations who nationalized health coverage have had these problems for a long time, and they're getting worse as their economies suffer. British press have been reporting numerous critical problems, including preventable deaths by the dozens, as the budget crunch has been having an impact on the availability and quality of care.

You are right about one thing- Republican health care policies do nothing to fix the underlying problem. Repealing the recent reforms is good because those reforms are a bad idea, but it leaves us where we are now, with a system that doesn't work as designed. Not here, not anywhere else.

[GuitarFreak]

Insurance companies posted a 26% profit last year. During a recession. There's something wrong with that. Not to mention the hundreds of billions we're spending on the war. There's a lot of money being wasted that could be put towards health care to make it sustainable.

[Tonus]

Insurance companies posted a 26% profit last year. During a recession. There's something wrong with that.
Is that insurance companies as a whole? Because I've read that the profit margins for health insurance companies was around 3.4% in 2009, and that was an increase from the year prior.

Insurance company profits may be 'wrong', but it seems as if government is focusing on the one insurance industry that isn't recording massive profits. And that is because health insurance isn't treated like any other insurance. If it was, most of those horror stories we hear about, both here and abroad, would almost never happen.

And what is really aggravating is that if we did treat health insurance like other insurance, we could provide subsidies for preventive care and basic medical coverage for the poor at a significantly lower cost without sacrificing quality of care. I just don't understand why we insist on choosing the worst possible option, no matter the circumstances.
Not to mention the hundreds of billions we're spending on the war. There's a lot of money being wasted that could be put towards health care to make it sustainable.I've said before, I'd love for this country to announce a significant cutback in overall defense spending, just for the sake of watching most other governments around the world have a mass heart attack. It won't happen, but I can dream.

In any event, there certainly *is* lots of money being wasted by both the federal and local governments. I believe that if we stopped all of the unnecessary waste of federal dollars on pork-barrel and political favors, we could support all (or most) of the desired social spending --including health care-- and actually reduce the debt. But that isn't going to happen because the general attitude in Washington DC is that "this is how it's done." Pork is a very powerful tool for politicians to use in order to keep their office. They will not give it up, period.

Think about it, if we took the 'hundreds of billions' of dollars being spent on the military and returned it to the budget, we'd still be nearly a trillion dollars short of balancing the annual budget. We do not have the luxury of imagining what it would be like if we could shave a few hundred billion from spending so that we could "afford" some other legislation.

[Dr. L]

I understand the thought process behind what they did, but I must clue as to what the path to hell is paved in. The more failures produced, the more I consider Calvin Coolidge's way of managing things.

Imagine that: A president who doesn't rape our minds every day with backwards inconsistencies, a president who has a degree of faith in humanity as to trust us to be able to handle our own shit. That is the one thing the free market and Communism have in common: They both require considerable faith in humanity to try. Socialism, however, places faith in a powerful parental figure who knows best, there is no comradeship even, only a conniving and insufferable collection of assholes telling everybody how foolish they are, and that they should follow blindly the words of a greater authority. At least communism is honest(Even though it's never really happened), and places faith in people working together for a greater good. At least the Free Market gives us the luxury of choice, the ability to have voting power in our very consumerism. We have the power to put terrible businesses out of business. Or at least, we used to.

Socialism though, damn. It has everything wrong with the Free Market and Communism, and enforces it. Maintaining the gap between the rich and the poor, the only possible bridge at all being courtesy of the government's choosing. Communism at least provides the idea that the average person has the heart to work and hold the system up, and the Free Market provides every individual hope of doing so through their own creative means. But THIS is madness. This is utterly, profoundly ridiculous. The Progressives perpetuating this are guilty, and can be found in both parties.

Socialism isn't the gray area. It's the brown area, and filled with nuts.

[Grunthos]

Insurance companies posted a 26% profit last year. During a recession. There's something wrong with that.

How exactly do you suppose the economy will get OUT of the recession, if no business is able to turn a profit?

It amazes me the so few seem to understand that "thriving economy" = "majority of companies (in other words, groups of people) working at something PROFITABLE."

[Tonus]

Consequences. (http://hotair.com/archives/2010/10/05/3m-to-dump-retirees-from-medical-coverage/)


3M to dump retirees from medical coverage

Remember when Barack Obama repeatedly promised that no one’s current coverage would have to change if Congress approved the health-care overhaul he demanded? When the ObamaCare bill passed, the Associated Press suddenly discovered that the change of tax law that would supposedly generate billions of dollars to pay for the costs of the bill would also drive companies to dump retirees from their existing drug coverage (http://hotair.com/archives/2010/03/26/ap-say-guess-what-we-just-found-in-obamacare/) and push them into Medicare. Minnesota-based 3M became one of the first large corporations to do just that — and push retirees off of all their plans as well (http://www.bizjournals.com/twincities/stories/2010/10/04/daily3.html):3M Co. (http://profiles.portfolio.com/company/us/mn/st__paul/3m_co_/2585053/), citing new federal health laws, said Monday it won’t cover retirees with its corporate health-insurance plan starting in 2013.

Instead, the company will direct retirees to Medicare-backed insurance programs, and will provide reimbursement for that coverage. It’ll also reimburse retirees who are too young for Medicare; the company didn’t provide further details.

The company made the changes known in a memo to employees Friday; news of the move was reported (http://online.wsj.com/article/SB10001424052748703859204575526953379583836.html?K EYWORDS=3M+and+insurance) in The Wall Street Journal and confirmed Monday by 3M spokeswoman Jackie Berry.
The ObamaCare bill created a fund to subsidize employers who didn’t dump their retirees, but the WSJ notes that it simply wasn’t enough to change the negative incentives created by the government interventions:The changes won’t start to phase in until 2013. But they show how companies are beginning to respond to the new law, which should make it easier for people in their 50s and early-60s to find affordable policies on their own. While thousands of employers are tapping new funds from the law to keep retiree plans, 3M illustrates that others may not opt to retain such plans over the next few years. …

Democrats that crafted the legislation say they tried to incentivize companies to keep their retiree coverage intact, especially until 2014. The law creates a $5 billion fund for employers and unions to offset the cost of retiree health benefits. More than 2,000 entities, including many large public companies, have already been approved to submit claims for such reimbursement. 3M did not apply.
How did Democrats come up with the $5 billion figure for subsidies to protect retirees from losing their plans? From the looks of it, they simply made it up. They also didn’t do much calculation to determine whether the subsidies would actually incentivize employers into rejecting this strategy for cost savings. To some extent, they may not have been able to make that calculation, because thanks to the massive amount of ambiguity in the bill, no one can really say for sure what the future costs would be. And of course, that’s why 3M chose now to dump the retirees.

3m has 23,000 retirees, many of them likely to be living in Minnesota. They’re also likely to vote in the upcoming midterms, perhaps even more likely now than ever. That won’t be good news for House Democrats in the Minnesota delegation hoping to win a new term in four weeks.



I'm wondering how the government will report that subsidy. Will it be included in the cost calculations for Obamacare? If it turns out to be more than anticipated, will they simply blame those mean and heartless corporations? That's a tricky explanation, I guess, because we'd have to believe that the corporations which paid for health care for their workers (including those who are retired) suddenly decided not to do so when the cost of doing so went down.

[Tonus]

And perhaps a glimpse into the future? (http://www.prnewswire.com/news-releases/nvhr-blasts-arizona-medicaids-inhumane-policy-depriving-hepatitis-c-patients-liver-transplant-coverage-104300943.html)

(Note: bold text is from the original)


NVHR Blasts Arizona Medicaid's 'Inhumane' Policy Depriving Hepatitis C Patients Liver Transplant Coverage

WASHINGTON, Oct. 4 /PRNewswire-USNewswire/ -- A controversial new policy by the Arizona Health Care Cost Containment System depriving hepatitis C patients coverage for liver transplants is effectively a death sentence that, left unchecked, could have far-reaching consequences for millions of Americans afflicted with chronic viral hepatitis, the National Viral Hepatitis Roundtable (NVHR) said today. The new coverage exclusion governing liver transplants took effect Friday as part of broader Medicaid coverage changes made by the state of Arizona in response to budgetary pressures.

"The Arizona Medicaid program's decision to deprive hepatitis C patients coverage for liver transplants is inhumane and will have devastating consequences for Arizona's Medicaid beneficiaries," said Ms. Lorren Sandt, NVHR Chair and Executive Director of Caring Ambassadors Program, based in Portland, Oregon. "NVHR recognizes that both public and private health care programs are struggling with the burden of rising costs and a challenging economic environment. However, the cruel costs associated with Arizona's Medicaid coverage changes do not appear to be based on sound science and far exceed any supposed benefit."


"The standard of care for centers and practitioners is to offer liver transplants to patients with hepatitis C. All insurance providers – including state Medicaid programs – need to provide coverage for what is the standard of care. With new curative therapies on the horizon, it is imperative not to discriminate against patients with hepatitis C when selecting patients for a liver transplant," said Robert G. Gish, M.D., Co-Director Center for Hepatobiliary Disease and Abdominal Transplantation (CHAT), University of California, San Diego School of Medicine.


Arizona Medicaid's transplant coverage exclusion is the first of its kind in the nation for hepatitis C patients. NVHR is deeply troubled that the new Medicaid coverage exclusion inflicts catastrophic consequences that go far beyond any supposed savings. According to news reports, Arizona faces a budgetary shortfall this year of as much as $825 million. The entire package of Medicaid benefit changes, including the hepatitis C liver transplant exclusion, is expected to yield about $5 million in savings – or about 1/2 of one percent of the projected budgetary shortfall.


An estimated 5.3 million Americans have been infected with chronic viral hepatitis B or C – and with most unaware of their infection, millions are at risk of developing life-threatening complications, especially African Americans and Asian Americans. Without detection and prompt treatment, chronic viral hepatitis leads to liver cancer, cirrhosis, or liver failure.
One thing to remember about Obamacare-- states will have additional expenditures under the new laws, and unlike the federal government, states must balance their budgets. That means cuts in services. And the easiest way to cut into large deficits while affecting the fewest people directly is to cut high-cost services that only affect a relative few. The more PR-friendly method is to cut or under-fund standard services that affect a large number of people. In this example Arizona appears to have taken the former path and might pay a big PR price for it.

More people and fewer restrictions means more demand and higher costs, and individual states will not be able to hide that the way the federal government can. They can hide it in other ways (cuts to non-health care related services, for example) but the pain will still be felt as quality of life continues to decline for the general population.

[S Carver Orne]

I have Medicare, and received a notice out of the blue that I am being dropped. For no reason. So now I have to go through a ridiculously long appeals process.

[Tonus]

And here's the latest facepalm moment. (http://www.msnbc.msn.com/id/39548132/ns/health-the_new_york_times)

White House allows big firms to dodge health reforms
McDonald's, insurers get waivers to maintain coverage far below the new law's standards

As Obama administration officials put into place the first major wave of changes under the health care legislation, they have tried to defuse stiffening resistance — from companies like McDonald’s and some insurers — by granting dozens of waivers to maintain even minimal coverage far below the new law’s standards.

The waivers have been issued in the last several weeks as part of a broader strategic effort to stave off threats by some health insurers to abandon markets, drop out of the business altogether or refuse to sell certain policies.

Among those that administration officials hoped to mollify with waivers were some big insurers, some smaller employers and McDonald’s, which went so far as to warn that the regulations could force it to strip workers of existing coverage.

At a time when the midterm elections are looming and Republicans have been vocal in campaigning against the law, reaction to the rollout has been closely watched.

To date, the administration has given about 30 insurers, employers and union plans, responsible for covering about one million people, one-year waivers on the new rules that phase out annual limits on coverage for limited-benefit plans, also known as “mini-meds.” Applicants said their premiums would increase significantly, in some cases doubling or more.

Tackling resistance

These early exemptions offer the first signs of how the administration may tackle an even more difficult hurdle: the resistance from insurers and others against proposed regulations that will determine how much insurers spend on consumers’ health care versus administrative overhead, a major cornerstone of the law.

Several leading insurers, including WellPoint, Aetna and Cigna, have also objected to new rules requiring them to cover even those children who are seriously ill, warning that they will stop selling new policies in some states because the rules do not protect them from having to cover too many sick children.

“The hardest part of health reform is always going to be the transition,” said Peter T. Harbage, a former state health official who is a policy consultant in Sacramento. He predicts more insurers and employers will lean on the government to delay or weaken the new regulations. “I think this pressure just increases until we get to 2014,” he said, referring to the year that the law will fully go into effect.

How much the administration can, or should, compromise in ways that could dilute the effect of the new law in the next few years is a subject of much debate, depending on the politics from state to state or the economic dynamics in a particular market.

Policy experts say much of the authority to enforce the new law rests with the states, and they say the federal government may have little ultimate control over whether insurers will keep offering coverage in specific markets.

'Balancing act'

Nancy-Ann DeParle, the director of the Office of Health Reform at the White House, acknowledged that the concessions given to companies and insurers reflected attempts to avoid having people lose their current coverage before the full law goes into effect while meeting the aim of improving that coverage.

“It is a balancing act,” Ms. DeParle said. “The president wants to have a smooth glide path to 2014.”

The waivers issued so far include the policies offered by McDonald’s to its fast-food workers, typically capped at just a few thousand dollars, sold by a profit-making company owned by Blue Cross and Blue Shield plans. As a result of the administration’s efforts, McDonald’s says it is “confident that we’ll continue to provide health care coverage for our 30,000 hourly restaurant employees.”

Aetna and Cigna have also received waivers to continue selling limited-benefit policies, according to the list released by the Department of Health and Human Services, as have small employers like Sanderson Plumbing Products and Guy C. Lee Manufacturing. HealthMarkets, which offers policies through MEGA Life and Health and other insurers, says it also plans to apply for a waiver for some of its plans.

Some states, like Iowa and Maine, have already said they might seek additional authority from federal officials to exempt some insurers, at least for a time, because of the potential disruption if carriers leave the market over the new standards on medical spending.

“We have some very small carriers in the state,” said Susan E. Voss, the Iowa insurance commissioner, who said she favored letting state regulators decide whether some carriers should be given more leeway. The state has already lost some carriers, including the Principal Financial Group, which announced its decision last week.

The new standards may prove a challenge to the administration in its attempt to protect the limited-benefit plans. Under the legislation, insurers are required to spend at least 85 cents of every dollar in premiums on the welfare of their customers, and many of these plans spend far less.

Special treatment

The administration says it has the authority to change the way medical spending is calculated. But the National Association of Insurance Commissioners, which has been charged with drafting the regulations that will go to the Health Department for approval, has so far rejected the notion that these plans deserve special treatment.

A committee looking at the issue concluded that there was no reason to calculate spending differently for these plans, saying state regulators could always request exemptions later if they foresaw too much market turmoil.

Some consumer advocates argue that Congress did not intend for these mini-plans to be unaffected by the new standards. “If they wanted to exclude mini-meds, they would have excluded mini-meds,” said Timothy S. Jost, a law professor at Washington & Lee University who has been working with state regulators on these issues.

And even some state regulators, like Ms. Voss, whose state has formally requested a federal waiver to allow Iowa to decide case by case what considerations to give individual carriers, acknowledges that some plans should be allowed to leave the market. “I don’t think my job as a commissioner is to make sure every company is viable forever,” Ms. Voss said.

The struggle to stop insurers from dropping child-only coverage illustrates the limited power that the administration, and some states, may have to pressure companies to participate. While federal officials have tried to address the concerns by insurers that the rules allow parents to wait until their children are sick to sign up, some insurers have remained reluctant to commit to the market.

While states like California can force their hands by passing legislation requiring any insurer who plans to sell policies in the new exchanges to also sell child-only policies, other states have little recourse other than to try to persuade insurers to stay.

In Washington State, for example, Regence BlueShield, a major insurer, has announced it plans to no longer sell child-only policies, and Mike Kreidler, the insurance commissioner, is trying to persuade the other major insurers to stay. He cannot force them, he said, under current state law. “I couldn’t do anything other than use the bully pulpit,” said Mr. Kreidler, who was optimistic that he had succeeded.

And politics surrounding the health care law may intrude. In Minnesota, Gov. Tim Pawlenty, a Republican and a potential 2012 presidential candidate who has long opposed the law, has become the target of accusations that he is stonewalling discussions over certain types of coverage. (He has already refused federal money for rate reviews and to set up the 2014 exchanges.)

“We are seriously disappointed that we appear to have hit a wall,” said Julie Brunner, executive director of the Minnesota Council of Health Plans, which represents the state’s insurers. The insurers had been meeting with regulators to hash out the child-only coverage policies.

Mr. Pawlenty’s office, however, said it had no knowledge that negotiations over children’s insurance had been halted, and a spokesman, Bruce Gordon, denied that the governor had played any role in ending the talks. He said, however, the request by the insurers for a standardized period in which parents can buy coverage was unwarranted: “The insurance companies’ request for an exemption is yet another example of the failings of Obamacare."

The bit that is highlighted in red is particularly rich, and perhaps indicative of the administration's attitude. After crafting legislation that might force some insurers (small insurers, at that) out of business, the attitude is that it isn't government's job to make sure that they survive. In other words, the government is making clear that it reserves the right to create an environment that may harm or even wipe out your business, while assuming no liability for that harm.

And they wonder why businesses are not hiring or expanding? :clown2:

[Grunthos]

See? Nobody's rates are going up, nobody's losing insurance... (becausewedecidednottoenforcethelawjustyet...)

Liberal 'honesty...' not for the faint of heart.

[Shady]

I have Medicare, and received a notice out of the blue that I am being dropped. For no reason. So now I have to go through a ridiculously long appeals process.

I might be able to help. Msg me.

[Tonus]

I guess we can scratch Greece (http://dailycaller.com/2010/10/11/greek-health-system-opts-for-amputation-as-money-saver/) off of the list of countries that we can point to as models of national health care management.

Greek Health System Opts for Amputation as Money-Saver

This Saturday, one of Greece’s most respected newspapers, To Vima, reported that the nation’s largest government health insurance provider would no longer pay for special footwear for diabetes patients. Amputation is cheaper, says the Benefits Division of the state insurance provider.

The new policy was announced in a letter to the Pan-Hellenic Federation of People with Diabetes. The Federation disputes the science behind the decision of the Benefits Division. In a statement, the group argues that the decision is contrary to evidence as presented in the international scientific literature.

Greece’s National Healthcare System was created in the early 1980s, during the tenure of Prime Minister Andreas Papandreou. Papandreou, an academic, won election under the slogan, Αλλαγή, which is the Greek word for Change.


The PHFPD argues that the decision flies in the face of medical evidence. As Ed at HotAir points out: (http://hotair.com/archives/2010/10/11/foot-bandits-strike-in-greece/)

So what? The government, er, foots the bill. They get to make the call on what they want to spend money.

In other words, the government isn't doing this because they believe that amputation is better for the patient. They're doing it because it costs less.

[Grunthos]

Letting them just die is even cheaper. Plus it gets rid of a dissatisfied customer.

Wow, never saw THIS coming... (rolleyes)

Eugenics is only about three more steps down this path, you know.

[Tonus]

Today's facepalm moment comes courtesy of AARP: (http://reason.com/blog/2010/11/05/aarp-blames-obamacare-for-hike)


AARP Blames ObamaCare for Hike in Employee Health Insurance Costs (http://reason.com/blog/2010/11/05/aarp-blames-obamacare-for-hike)

In 2009, the AARP argued that the health care law was a good deal for seniors. That remains to be seen, and a large number of seniors seem to disagree (http://voices.washingtonpost.com/behind-the-numbers/2010/07/seniors_see_negatives_for_medi.html). Regardless, it appears it’s less of a good deal for employees (http://news.yahoo.com/s/ap/20101104/ap_on_bi_ge/us_aarp_health_plan/print). AARP's endorsement helped secure passage of President Barack Obama's health care overhaul. Now the seniors' lobby is telling its employees their insurance costs will rise partly as a result of the law.

In an e-mail to employees, AARP says health care premiums will increase by 8 percent to 13 percent next year because of rapidly rising medical costs.

And AARP adds that it's changing copayments and deductibles to avoid a 40 percent tax on high-cost health plans that takes effect in 2018 under the law. Aerospace giant Boeing also has cited the tax in asking its workers to pay more. Shifting costs to employees lowers the value of a health care plan and acts like an escape hatch from the tax.
A spokesman for the organization says that the law accounts for only a small percentage of the hike. It’s probably true that the group’s insurance premiums would have risen even without the law, though not as much. And there's a case to be made that the Cadillac tax, if it actually goes into effect, could be a first step—an awkward, imperfect first step—towards breaking the U.S. the employer-sponsored insurance system. But neither AARP leadership nor its rank-and-file employees can be enjoying this.

Indeed, the health care law has proven something of a headache for the organization from the very beginning. Leadership liked it, but membership wasn’t as pleased. Last year, the AARP reportedly lost 60,000 members (http://www.cbsnews.com/stories/2009/08/17/eveningnews/main5247916.shtml) angered over the group’s support of the health care overhaul. When CBS reported the loss in September, the AARP responded that they hadn’t officially endorsed any plan. They also got touchy when the president said the group was on board, calling his statement “inaccurate.” That was technically true at the time. But it wasn’t inaccurate for long. In December of 2009, the group announced (http://www.whitehouse.gov/blog/2009/12/15/aarp-announces-support-senate-health-reform-bill) official support for the law. A letter (http://thehill.com/blogs/blog-briefing-room/news/72343-aarp-endorses-senate-health-bill) from AARP CEO A. Barry Rand to Senate Majority Leader Harry Reid gave increased “access to quality affordable plans” for individuals and small businesses as one reason for the group’s support. A representative for the group said (http://www.washingtonpost.com/wp-dyn/content/discussion/2009/08/18/DI2009081802851.html) in an August 2009 Washington Post live chat that its support was predicated on the fact that “health care costs are growing too fast for everyone.” The law passed, but judging by its own employee insurance premiums, that doesn’t appear to have changed.

[S Carver Orne]

facepalm

This.

[Tonus]

Apparently, Obamacare is so darned good that no one can afford it. (http://hotair.com/archives/2010/12/07/obamacare-waivers-now-up-to-222/)


ObamaCare waivers now up to 222


If the US passes a law that then requires the government to issue over two hundred waivers in the first few months to avoid disastrous consequences for enforcement, doesn’t that indicate a problem in the law itself? That question should be foremost on voters’ minds as the number of waivers to ObamaCare issued by the Obama administration soars to 222 (http://blogs.ajc.com/jamie-dupree-washington-insider/2010/12/07/more-health-waivers/):The Obama Administration has quietly granted even more waivers to the new federal health reform law, doubling the number in just the last three weeks to a new total of 222.

One of the more recognizable business names included on the newly-expanded list of waivers issued by the feds is that of Waffle House, which received a waiver on November 23 for health coverage that covers 3,947 enrollees.

Another familiar name was that of Universal Orlando, which runs a variety of very popular resorts in the Orlando, Florida area. Universal was given a waiver for plans that cover 668 workers.

These waivers deal with limited health benefit plans, sometimes referred to as “mini-med” policies, which companies as large as McDonald’s use for some its employees.
Waffle House. How appropriate! The Obama White House demanded a series of federal mandates that it claimed would protect Americans without damaging business, and now the administration is waffling on its own mandates.

The Boss Emeritus (http://michellemalkin.com/2010/12/07/obamacare-waiver-mania-continues-list-tops-222/) has been on the case of the waivers for weeks, and now calls this Waiver-Mania. Why has this fever struck the administration? Its own mandates would force these companies to drop coverage entirely for part-time and low-wage workers under full enforcement — hurting the very people Obama claimed to be helping with his takeover of the health-care industry. The use of “mini-med” coverage allowed employers to offer limited benefits to low-wage employees that they couldn’t afford on their own, and for which taxpayers didn’t provide subsidies. ObamaCare and its coverage mandates would eliminate that coverage by design and force those employees onto Medicaid, greatly increasing the cost of ObamaCare and reducing their ability to get private coverage instead.

This is basically a finger-in-the-dyke approach to oncoming disaster. Any such waivers means that the government is no longer enforcing the rule of law but the rule of whim, choosing winners and losers in a totally inappropriate manner. Issuing 222 waivers (for now!) demonstrates that the law is unworkable and needs to be repealed.So to summarize, the government decides to reform the health insurance system and comes up with a law that they have to exempt companies from. There's a reason that most of the provisions don't even start to go into effect until 2014. If the law is so poorly drafted that government must provide waivers almost four years before it goes into full effect, you have to wonder what will happen in 2014.

I'm guessing that in 2014, this health care reform package will not magically create a more efficient and cost-effective market for health care that covers more people while reducing its impact on the budget.

[Da Big W]

Well, I'm selfish, I'll be insured, good for me.

[Grunthos]

Well, I'm selfish, I'll be insured, good for me.
Not for long, you won't. When it goes boom, it'll take all affordable coverage with it.

[Tonus]

Well, I'm selfish, I'll be insured, good for me.
Healthcare, as structured (both government-run and corporate) works out very well for those who are generally healthy. It's worked just fine for me, as someone who has had almost no need of medical care until recently, and whose current health care needs are fairly simple and not costly. However, it's terrible for the people who need it the most- those whose situations call for expensive treatment and care.

The irony is that when people are arguing in favor of nationalized health care, they always show you the examples of people with terminal or extremely painful conditions who wind up being "turned away" by insurance companies. Yet, these same people will suffer just as badly, or worse, under nationalized health care because the basic economic flaw isn't being addressed. And when government decides not to cover you, or to deny you care, you no longer have anyone else to turn to. And good luck filing that lawsuit!

[Shady]

And when government decides not to cover you, or to deny you care, you no longer have anyone else to turn to. And good luck filing that lawsuit!

This is (and always has been) my issue with government healthcare. Who is held accountable for poor care plans, or absent care plans? The government? The government can not be held accountable for civil or criminal infractions against any plaintiff. Those who act on behalf of the government can, but it still takes an act of congress, literally.

The new healthcare law places the power in the hands of a selected (not elected) individual who is head of an entity who is beyond reproach.

It's just bad. Bad Bad Bad.

[Tonus]

This (http://www.washingtonpost.com/wp-dyn/content/article/2010/12/27/AR2010122702343.html) strikes me as a bit ironic, as it's one of the 'features' of Obamacare that I expected people to take advantage of very quickly, for obvious reasons. It's the part that allows those with an existing health care issue to get insurance, thus providing potentially significant subsidies for the care they need. And yet...

PS- Pay close attention to some of the parts I bolded. I think that it may be a good time to read between the lines and get an idea as to where we may be headed with health care reform.

Health plans for high-risk patients attracting fewer, costing more than expected

An early feature of the new health-care law that allows people who are already sick to get insurance to cover their medical costs isn't attracting as many customers as expected.

In the meantime, in at least a few states, claims for medical care covered by the "high-risk pools" are proving very costly, and it is an open question whether the $5 billion allotted by Congress to start up the plans will be sufficient.

Federal health officials contend the new insurance plans, designed solely for people who already are sick, are merely experiencing growing pains. It will take time to spread the word that they exist and to adjust prices and benefits so that the plans are as attractive as possible, the officials say.

State-level directors of the plans agree, in part. But in interviews, they also said that the insurance premiums are unaffordable for some who need the coverage - and that some would-be customers are skittish about the plans because federal lawsuits and congressional Republicans are trying to overturn the entire law.

The Pre-Existing Condition Insurance Plan, the program's official name, is an early test of President Obama's argument that people will embrace the politically divisive health-care overhaul once they see its advantages firsthand. According to some health-policy researchers, the success or failure of the pools also could foreshadow the complexities of making broader changes in health insurance by 2014, when states are to open new marketplaces - or exchanges - for Americans to buy coverage individually or in small groups.

Under the sprawling health-care legislation that Democrats pushed through Congress in March, the special health plans were designed as a temporary coping mechanism for a small but important niche among the nation's 50 million uninsured: people who have been rejected by insurance companies because they already are sick.

Twenty-seven states have created their own high-risk pools. The rest used an option in the law to let their residents buy coverage through a new federal health plan.

In the spring, the Medicare program's chief actuary predicted that 375,000 people would sign up for the pool plans by the end of the year. Early last month, the Health and Human Services Department reported that just 8,000 people had enrolled. HHS officials declined to provide an update, although they collect such figures monthly, because they have decided to report them on a quarterly basis.

"Like the rest of the country, we thought we'd have pretty much a stampede. That obviously hasn't materialized," said Michael Keough, executive director of North Carolina's plan. With nearly 700 participants, it is among the nation's largest so far, but it has one-third of the people expected by now.

According to interviews with administrators of nine of the state-run plans, only one - Colorado's - is close to its forecast enrollment. Maryland, the only jurisdiction in the Washington area that has created a plan, has 97 participants, compared with 19,000 in an older state high-risk pool, according to Kent McKinney, who directs both. HHS's November report said that Virginia had 75 participants in the federal plan. The District had none.

Potential lifesaver

The plans have been a boon and a heartbreak.

"I don't mean to be gushy about it, but they potentially saved my life," said Maureen Murray, 50, of Arlington County, who had dropped her individual insurance policy in July 2009, after her work as a freelance video producer dried up. Murray was getting ready for a gym class in October when she "felt something go down my left side." It was a stroke. She was still at Alexandria's Mount Vernon Hospital when a CAT-scan detected an aneurysm on the left side of her brain.

She was discharged two days before Halloween with a $25,000 hospital bill.

A friend recommended the new high-risk pool. Four days after Thanksgiving, she was approved. It will cover her surgery in January to repair the aneurysm. The plan's premiums, Murray said, are steep - $358 a month even after a rate reduction in January. "I'm in rough financial position, but . . . I can get another job," she said. Without the insurance, "I might not have that opportunity."

Expensive coverage

On the other hand, Will Wilson, 57, of Chicago said he is "really, really, really, really discouraged." After he received an AIDS diagnosis in 2002, he discovered that his insurance at the time paid only $1,500 for medicine each year. His AIDS drugs cost $3,000 a month. He ended up in bankruptcy.

Wilson, a tourist trolley guide, now gets help from the federal AIDS Drug Assistance Program, but he has no coverage for other kinds of care.

Wilson remembers tears streaming down his face in February 2009, the night that he watched Obama vow to Congress, "Health-care reform cannot wait, it must not wait, and it will not wait another year!"

Wilson became an activist for health reform, circulating petitions, going to demonstrations. And the day after the president signed the bill into law, a Chicago Sun-Times column quoted him as saying, "I've had a grin on my face all day" at the prospect of the high-risk pool he could join. That was before the rates were announced in July and Wilson discovered that the premium - nearly $600 a month - "was almost as much as my rent. It was like, no way! I was floored."

The law contains rules to make the high-risk pools more affordable than older ones that many states have run; the new ones cannot charge more in premiums than the average premium for other individual insurance in a given state. But "the individual market is expensive," said Jean P. Hall, a University of Kansas researcher studying the new plans. "From my perspective, it is not a good match for people who have expensive conditions."

HHS has made some changes for 2011 in the federal plan on which 23 states and the District are relying. It will have somewhat lower premiums and two new options with varying deductibles, according to Richard Popper, HHS's deputy director for insurance programs.

The agency also is launching a more aggressive marketing campaign, Popper said, focused on states, including Virginia, whose residents have not had any kind of high-risk pool in the past. And the Social Security Administration has agreed to tell everyone it approves for disability benefits about the new health plans.

Among the 27 states with their own plans, 17 have submitted changes for HHS to approve so they can lower premiums, adjust other costs or alter who is allowed to join.

And they are doing more marketing. Michigan is running Internet ads through Google. North Carolina is advertising on billboards across the state and on cable television.

Fretting about challenges

Whether the marketing and plan adjustments will translate into more customers remains unclear. Cecil Bykerk, the executive director for the new plans in Montana, Iowa and Alaska, said some people are wary over whether the health-care law - and the high-risk pools it has created - will last. "I think there is a lot of concern in the public with all the [federal court] challenges and all the political rhetoric about appeal," he said.

Montana is one of a few states in which the medical bills from those who have joined are huge. New Hampshire's plan has only about 80 members, but they already have spent nearly double the $650,000 the state was allotted in federal money to help run the program, said J. Michael Degnan, its director.

The spending, Degnan speculated, might slow down if it turns out that the early bills reflected a burst of pent-up need for care. HHS agreed to give New Hampshire more money, he added.

When the law was passed, proponents of the special health plans feared the $5 billion would run out before 2014. Today, HHS's Popper says of that financial help: "We want to use it - make it last but also use it to effectively to get people covered."

The Washington Post wants to put a pretty face on Obamacare, and so they trot out a couple of heartfelt anecdotes. But you will notice that in both cases, the person in question (who benefits from the plan to the tune of thousands, and possibly tens of thousands of dollars in savings) is shocked at the "high" cost of the insurance. They don't seem to realize that they are automatically a NET LOSS for the system, which is why traditional insurers won't cover them.

And note how hard the Post works to try and sneak past the implication that there may be "adjustments" coming in the future. The UK recently applied an "adjustment" to their health care when they exempted hip replacement surgery from coverage. Similar "adjustments" are becoming the hallmark of tax-supported health care around the world. There is no magic to it. If you reduce the premiums for the highest-risk pool, you either have to make it up by increasing premiums on others, or you simply cut back on available coverage and services, and perhaps even trade some quality for quantity.

[Shady]

I am shocked, shocked to find that ObamaCare is not working! Oh, thank you for my free voucher, Obama.

/Captain Renault off

[Tonus]

This is not quite as earth shaking as it seems, but it will definitely get people talking. A lower court just threw out Obamacare... in its entirety: (http://www.washingtonpost.com/wp-dyn/content/article/2011/01/31/AR2011013103800.html)

Obama Health-Care Reform Act Ruled Unconstitutional

Jan. 31 (Bloomberg) -- President Barack Obama's health care reform legislation, assailed as an abuse of federal power in a 26-state lawsuit, was ruled unconstitutional by a U.S. judge.

U.S. District Judge Roger Vinson in Pensacola, Florida, declared the law unconstitutional in a ruling today. Then- Florida Attorney General Bill McCollum filed suit on behalf of 13 states on March 23, the same day Obama signed into law the legislation intended to provide the U.S. with almost universal health-care coverage. Seven states joined the litigation last year, and six signed on this year. Virginia Attorney General Kenneth Cuccinelli sued separately on March 23 and Oklahoma Attorney General Scott Pruitt filed his own suit on Jan. 21.

Vinson's ruling may be appealed to the U.S. Court of Appeals in Atlanta. A federal appeals court in Richmond, Virginia, is already slated in May to hear challenges to two conflicting federal court rulings in that state, one of which upheld the legislation while the other invalidated part of it. The U.S. Supreme Court may ultimately be asked to consider the issue.

The 955-page law bars insurers from denying coverage to people who are sick and from imposing lifetime limits on costs. It also includes pilot projects to test ideas like incentives for better results and bundled payments to medical teams for patient care.

In an Oct. 14 decision letting the case to proceed, Vinson narrowed the issues to whether the act exceeded the constitutional powers of Congress by requiring all Americans over the age of 18 to obtain coverage and expanding eligibility for Medicaid, the federal-state program offering care for the indigent.

The case is State of Florida v. U.S. Department of Health and Human Services, 10-cv-00091, U.S. District Court, Northern District of Florida (Pensacola). This is an early ruling that will, obviously, be appealed. And as the lower portion notes, it is based on whether the mandate that will help fund the bill is constitutional. I doubt that anyone expected any different regardless of the ruling, but the ruling against the law will make for a pretty busy next few days for pundits.

The GOP may be hoping to work that angle (whether citizens can be forced to buy health care) as it is a critical linchpin for the law. Without being able to depend on young and healthy Americans to provide at least some of the funding for ObamaCare, the costs would be significantly higher. Not only because those people wouldn't be paying in, but because they'd still be able to apply for coverage (and get it) if they happened to fall ill.

I mean, it's their right, after all.

[Reserv*ir]

Hell, it's the best news coming out of the Judicial branch since Rahm Emanuel was almost taken off the ballot.

[Tonus]

Heh... (http://hotair.com/archives/2011/02/01/video-guess-who-predicted-the-obamacare-ruling/) in 2008, when he was battling Hillary Clinton for the Democratic nomination, Obama criticized HillaryCare because it would include a mandate forcing people to purchase health insurance. Something that he assured the audience wouldn't happen under ObamaCare. Now the fate of ObamaCare may depend on whether the Supreme Court agrees with the 2008 Obama.

[Grunthos]

Job killer, confirmed...

CBO: Yes, ObamaCare is a job killer

To the tune of 800,000 jobs. That’s the word of Doug Elmendorf, head of the Congressional Budget Office, in testimony before Congress today.

Campbell: You just mentioned that you believe—or that in your estimate, that the health-care law would reduce the labor used in the economy by about one half of one percent. Given that, I believe you say, there’s 160 million full-time people working in 2021, that means that, in your estimation, the health-care law would reduce employment by 800,000 in 2021. Is that correct?

Elmendorf: Yes. The way I would put it is that we do estimate, as you said, that household employment will be about 160 million by the end of the decade. Half a percent of that is 800,000.

Never mind “If you like your coverage, you can keep your coverage.” By passing ObamaCare, the genius Democrats threaten our very livelihoods.


http://pajamasmedia.com/tatler/2011/02/10/cbo-yes-obamacare-is-a-job-killer/

[Tonus]

Bending the cost curve... kinda:

Latest beneficiary of ObamaCare waiver: AARP (http://hotair.com/archives/2011/05/20/latest-beneficiary-of-obamacare-waiver-aarp/)

No one seems to know what criteria HHS uses to grant or deny waivers to insurers from provisions in ObamaCare. The White House won’t release the names of those insurers and employers refused waivers or discuss denials at all. But maybe, just maybe, we could all agree that organizations that publicly pushed ObamaCare to approval should be ineligible to escape its consequences (http://dailycaller.com/2011/05/19/aarp-latest-to-receive-obamacare-break/)?
The Daily Caller has learned that the Department of Health and Human Services (HHS) rate review (http://dailycaller.com/2011/05/19/aarp-latest-to-receive-obamacare-break/#) rules, which it finalized on Thursday, exempt “Medigap” policy providers, like the American Association of Retired Persons (AARP), from oversight when such providers increase payment rates for their supplemental insurance plans.


Insurance providers who aren’t exempt from Obamacare’s rate review rules are required to publicly release and explain some health care payment rate increases.
Let’s not forget that AARP had a distinct interest in seeing ObamaCare pass, because it helped eliminate competition for AARP’s supplemental insurance program:
The AARP is the nation’s biggest seller of Medigap policies, or supplemental healthcare (http://dailycaller.com/2011/05/19/aarp-latest-to-receive-obamacare-break/#) plans that add onto what Medicare won’t cover for seniors. The senior citizens interest group advocated for Obamacare to include an attack on Medigap policies’ biggest competitor, Medicare Advantage.


Though the White House and HHS dismiss allegations of political favoritism when it comes to who’s getting exceptions from the new health care regulations – such as in the recent uproar over the disproportionate number of Obamacare waivers (http://dailycaller.com/2011/05/17/nearly-20-percent-of-new-obamacare-waivers-are-gourmet-restaurants-nightclubs-fancy-hotels-in-nancy-pelosi%E2%80%99s-district/) that went to companies (http://dailycaller.com/2011/05/19/aarp-latest-to-receive-obamacare-break/#) in House Minority Leader Nancy Pelosi’s district — Obamacare critics say the mere appearance (http://dailycaller.com/2011/05/19/obamacare-transparency-fail-who%E2%80%99s-still-waiting-for-waivers-and-who-got-denied-obama-won%E2%80%99t-tell-us/) of the administration helping friends is disturbing.
The attack on Medicare Advantage plans was a crucial part of ObamaCare. Democrats insisted that the public-private partnership was driving the cost curve upward and needed to be drastically curtailed, and the bill sliced $500 billion out of Medicare, largely at the expense of Medicare Advantage. Fortunately for the AARP, which was conducting a public-relations campaign to drum up support for ObamaCare, those changes didn’t impact their own Medigap plans.


Thanks to the passage of ObamaCare, Medicare Advantage plans began disappearing, and the choices are much fewer for seniors and the disabled who want supplemental insurance. That puts AARP in perfect position to take advantage (pun intended) of the lack of choice. And now they don’t even have to deal with the few consequences that their favorite bill created for them.


How coincidentally fortunate for them!


We’re way beyond “mere appearance” here. If the AARP and the labor unions that backed ObamaCare need waivers from its consequences, then we all do.

The Obama administration has provided almost 1,400 waivers to date.

[Grunthos]

20% of which go to businesses in Nancy Pelosi's district.

Quite the corrupt little racket.

[Tonus]

Mark Steyn makes an important point: how far out of control have we become when we create laws that are 2,700 pages long (http://www.nationalreview.com/blogs/print/294947)? The money quote:

A 2,700-page law is not a “law” by any civilized understanding of the term. Law rests on the principle of equality before it. When a bill is 2,700 pages, there’s no equality: Instead, there’s a hierarchy of privilege micro-regulated by an unelected, unaccountable, unconstrained, unknown, and unnumbered bureaucracy. It’s not just that the legislators who legislate it don’t know what’s in it, nor that the citizens on the receiving end can never hope to understand it, but that even the nation’s most eminent judges acknowledge that it is beyond individual human comprehension. A 2,700-page law is, by definition, an affront to self-government.

The Patient Protection and Affordable Care Act is pure heaven for government bureaucrats and for lawyers. Not surprisingly, it was drafted and passed by those very same groups. The justices of the Supreme Court of the United States of America seem to cringe at the thought of reading the law, and they're currently deciding whether it's constitutional or not! This is the point where it should be clear just how far the government has separated itself from the people it claims give it its power.

[Grunthos]

"Cruel and unusual punishment", indeed.

This bill is going to get shitcanned in it's entirety.

The incomprehensible is by definition unconstitutional.

[Tonus]

Heh, back on August of 2009:
I think that at this point, Obama's best hope is to get health care 'reform' passed in some manner, and then have the Democrats routed in 2010. That way, when the rest of his agenda goes nowhere, he can blame the Republicans and start campaigning against the "party of no" early.
Granted, it didn't take a genius to see it...

[Grunthos]

But then, a genius wouldn't have managed to piss off the entire judicial branch while his signature-legislation's case is under USC review.