Health Care Reform: The Senate parliamentarian dims GOP hopes on a reconciliation bill that contains even more onerous taxes and even a financial incentive to lay people off. No wonder Speaker Pelosi is laughing.
We'll acknowledge that the signing of ObamaCare into law is a historic event, but we think the Weather Channel broadcasting the signing ceremony was a bit much. On the other hand, stormy political weather and more dark clouds lay ahead.
The cries of "repeal" and "remember in November" are rising, and state attorneys general are taking the feds to court over the unconstitutional mandates and usurpation of rights contained in reform's first incarnation. The bad news is that things are going to get worse before they get better.
On Monday, as House Speaker Nancy Pelosi had a good laugh celebrating her coup d'etat, Senate Parliamentarian Alan Frumin, who gets paid out of Senate Majority Leader Harry Reid's office, issued informal guidance to Republicans that on at least one issue their plans to use the reconciliation process as a last stand had hit a snag.
According to a spokesman for Senate Minority Leader Mitch McConnell, Frumin sent word that he feels that the so-called "Cadillac tax," a proposed tax on high-end health insurance plans from which union members would be exempt, does not have an impact on the Social Security trust fund and therefore does not violate reconciliation rules under the 1974 budget act by changing contributions to the trust fund.
Republicans had hoped Frumin would be some profile in courage, but the Senate parliamentarian is one of the spoils of victory. The courts hold some hope, but in the end the only way to stop this promised fundamental transformation of America will be at the ballot box starting in November.
Meantime, put down your wallet and back away slowly, especially those of you who put people to work. An analysis of the House Reconciliation Act of 2010 (HR 4872) by the Heritage Foundation shows it to be as much of a job-killer (except for those 17,000 new IRS agents) as the Senate bill President Obama signed into law.
HR 4872, Heritage reports, would "force companies to pay a tax penalty if that business employs 50 or more workers as soon as one worker qualifies for, and opts to accept, a health insurance premium subsidy."
That $3,000 penalty is on top of the $2,000-per-worker penalty for all workers beyond the first 30 for such companies not offering a "qualified" health plan or paying 60% of employee health premiums. Such companies would be faced with a $3,000 penalty for hiring a single parent, the very kind of person desperately in need of employment.
Here's where it gets even more bizarre. According to Heritage, under the reconciliation bill, if Company A lays off an employee with a working spouse, this could generate a $3,000 tax penalty for the other spouse's employer, unless Company B also lays off the other spouse.
We're not making this up. This byzantine legislation is a job-killer that will destroy small business, the major creator of new jobs. Some 77,000 businesses in the U.S. have 50 to 200 workers that could face the $2,000-per-employee tax penalty. An additional 116,000 businesses have 35 to 49 workers.
This nonsense will stunt economic growth and worsen the economic downturn by actually providing financial incentives to not hire people. It's not worth the trouble. Businesses that might have expanded will stop at 49 employees. Those already considered a "large" business will face a minefield of taxes and penalties due in some cases to events beyond their control.
The power to tax is indeed the power to destroy. As we have said, this is not about health care. This is about power and the redistribution of wealth. And the IRS will be making a list and checking it twice to see who's being naughty and who's being nice
Tuesday, March 23, 2010
Enacting A Lie -(really really scarey stuff)
Enacting A Lie
Posted 03/22/2010 06:53 PM ET
Health Overhaul: Sunday's vote exposed the ugly truth that ObamaCare is not really about health care at all. It's all about who pays for it and who controls it — in effect a massive wealth-redistribution scheme.
Those who believe this will lead to some medical nirvana will likely be disappointed. Fact is, this poorly designed monstrosity will lead to lower-quality care, higher costs, fewer practicing physicians, higher taxes and fewer jobs.
We've done more than 150 editorials in the past year or so documenting these problems. Democrats surely understand them. Yet, despite a recent CNN poll showing that 59% of Americans oppose ObamaCare, Congress approved it anyway.
Why? Because it's not really about health care. It's the largest wealth grab in American history, masquerading as health care "reform," another step in the socialization of Americans' income in the name of "fairness" and "spread(ing) the wealth around," as Obama himself has put it.
That's why we call the program a lie.
The idea behind all this, simply put, is control. This is a vast expansion of government that will require as much as $3 trillion in added spending over a decade. All claims of deficit neutrality are a joke.
This is socialization through the tax code. That $3 trillion has to be paid for. As we showed last week, the health care bill levies $569.2 billion in new taxes over the next 10 years alone.
At the same time, as noted by Douglas Holtz-Eakin, former head of the Congressional Budget Office, it will increase U.S. budget deficits by $562 billion.
Who'll pay all these taxes? Those deemed "rich" by Democrats, and businesses. Specifically, the bulk of the money comes from a special 3.8% Medicare tax on 5 million people earning more than $200,000 a year. That tax is imposed on capital gains, dividends, rents, royalties and interest — that is, investment income.
Obama already has proposed boosting these taxes in his budget. So the top tax take on dividends and cap gains will rise to 23.8% from 15%, an increase of nearly 59%, while top rates on interest and rents will soar from 15% to nearly 44%, a 193% jump.
About 50% of this higher-taxed group reports small business or partnership income. So don't be fooled: These aren't taxes on the "rich," but on small businesses and jobs.
In ObamaCare, the taxes will be ruinous. Unlike real insurance, where individuals pay to cover their risks, this program covers everyone — including 32 million uninsured — and pays for it by a "mandate" ( read: "tax" ) and by taking money from other people to subsidize those who can't pay. And this just scratches the surface of the new taxes — we literally don't have room to list them here.
Hmm. Taking money from one group, and giving it to another. That's called welfare — or, perhaps, health-fare. It's not insurance.
Once the new program is finished wrecking what remains of the private health insurance industry — as it ultimately will — we'll be stuck with the government declaring that "the market doesn't work" and forcing all of us into a single-payer government plan.
That's what those Democrats who back "Medicare for all" want — to kill what's left of the private market for health care, which has created the best medical system on earth, and use "reform" to expand an already-bankrupt Medicare system.
The math behind this is ugly. Medicare's long-term liabilities now total $89 trillion, according to the Government Accountability Office. Based on projected deficits, the just-passed health reform will take that to $136 trillion.
It will take a lot more than the "rich," as defined today, to make up such unfathomable tax shortfalls. That's when they'll come for the rest of us — poor, middle-class and rich alike — and we all will be paying vastly higher taxes for vastly inferior medical care.
Posted 03/22/2010 06:53 PM ET
Health Overhaul: Sunday's vote exposed the ugly truth that ObamaCare is not really about health care at all. It's all about who pays for it and who controls it — in effect a massive wealth-redistribution scheme.
Those who believe this will lead to some medical nirvana will likely be disappointed. Fact is, this poorly designed monstrosity will lead to lower-quality care, higher costs, fewer practicing physicians, higher taxes and fewer jobs.
We've done more than 150 editorials in the past year or so documenting these problems. Democrats surely understand them. Yet, despite a recent CNN poll showing that 59% of Americans oppose ObamaCare, Congress approved it anyway.
Why? Because it's not really about health care. It's the largest wealth grab in American history, masquerading as health care "reform," another step in the socialization of Americans' income in the name of "fairness" and "spread(ing) the wealth around," as Obama himself has put it.
That's why we call the program a lie.
The idea behind all this, simply put, is control. This is a vast expansion of government that will require as much as $3 trillion in added spending over a decade. All claims of deficit neutrality are a joke.
This is socialization through the tax code. That $3 trillion has to be paid for. As we showed last week, the health care bill levies $569.2 billion in new taxes over the next 10 years alone.
At the same time, as noted by Douglas Holtz-Eakin, former head of the Congressional Budget Office, it will increase U.S. budget deficits by $562 billion.
Who'll pay all these taxes? Those deemed "rich" by Democrats, and businesses. Specifically, the bulk of the money comes from a special 3.8% Medicare tax on 5 million people earning more than $200,000 a year. That tax is imposed on capital gains, dividends, rents, royalties and interest — that is, investment income.
Obama already has proposed boosting these taxes in his budget. So the top tax take on dividends and cap gains will rise to 23.8% from 15%, an increase of nearly 59%, while top rates on interest and rents will soar from 15% to nearly 44%, a 193% jump.
About 50% of this higher-taxed group reports small business or partnership income. So don't be fooled: These aren't taxes on the "rich," but on small businesses and jobs.
In ObamaCare, the taxes will be ruinous. Unlike real insurance, where individuals pay to cover their risks, this program covers everyone — including 32 million uninsured — and pays for it by a "mandate" ( read: "tax" ) and by taking money from other people to subsidize those who can't pay. And this just scratches the surface of the new taxes — we literally don't have room to list them here.
Hmm. Taking money from one group, and giving it to another. That's called welfare — or, perhaps, health-fare. It's not insurance.
Once the new program is finished wrecking what remains of the private health insurance industry — as it ultimately will — we'll be stuck with the government declaring that "the market doesn't work" and forcing all of us into a single-payer government plan.
That's what those Democrats who back "Medicare for all" want — to kill what's left of the private market for health care, which has created the best medical system on earth, and use "reform" to expand an already-bankrupt Medicare system.
The math behind this is ugly. Medicare's long-term liabilities now total $89 trillion, according to the Government Accountability Office. Based on projected deficits, the just-passed health reform will take that to $136 trillion.
It will take a lot more than the "rich," as defined today, to make up such unfathomable tax shortfalls. That's when they'll come for the rest of us — poor, middle-class and rich alike — and we all will be paying vastly higher taxes for vastly inferior medical care.
Monday, March 22, 2010
20 ways Obamacare will take away our freedoms
I thought this article was well worth reposting as I know not too many people get Investors Business Daily in their inbox.
By David Hogberg
Sun., March 21, '10 3:24 PM ET
With House Democrats poised to pass the Senate health care bill with some reconciliation changes later today, it is worthwhile to take a comprehensive look at the freedoms we will lose.
Of course, the overhaul is supposed to provide us with security. But it will result in skyrocketing insurance costs and physicians leaving the field in droves, making it harder to afford and find medical care. We may be about to live Benjamin Franklin’s adage, “People willing to trade their freedom for temporary security deserve neither and will lose both.”
The sections described below are taken from HR 3590 as agreed to by the Senate and from the reconciliation bill as displayed by the Rules Committee.
1. You are young and don’t want health insurance? You are starting up a small business and need to minimize expenses, and one way to do that is to forego health insurance? Tough. You have to pay $750 annually for the “privilege.” (Section 1501)
2. You are young and healthy and want to pay for insurance that reflects that status? Tough. You’ll have to pay for premiums that cover not only you, but also the guy who smokes three packs a day, drink a gallon of whiskey and eats chicken fat off the floor. That’s because insurance companies will no longer be able to underwrite on the basis of a person’s health status. (Section 2701).
3. You would like to pay less in premiums by buying insurance with lifetime or annual limits on coverage? Tough. Health insurers will no longer be able to offer such policies, even if that is what customers prefer. (Section 2711).
4. Think you’d like a policy that is cheaper because it doesn’t cover preventive care or requires cost-sharing for such care? Tough. Health insurers will no longer be able to offer policies that do not cover preventive services or offer them with cost-sharing, even if that’s what the customer wants. (Section 2712).
5. You are an employer and you would like to offer coverage that doesn’t allow your employers’ slacker children to stay on the policy until age 26? Tough. (Section 2714).( This is only one I would disagree with in that my daughter is a struggling college student and is very much dependent on our medical insurance not because she is a slacker however, but because government is killing all the private sector jobs.)
6. You must buy a policy that covers ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services; chronic disease management; and pediatric services, including oral and vision care.
You’re a single guy without children? Tough, your policy must cover pediatric services. You’re a woman who can’t have children? Tough, your policy must cover maternity services. You’re a teetotaler? Tough, your policy must cover substance abuse treatment. (Add your own violation of personal freedom here.) (Section 1302).7. Do you want a plan with lots of cost-sharing and low premiums? Well, the best you can do is a “Bronze plan,” which has benefits that provide benefits that are actuarially equivalent to 60% of the full actuarial value of the benefits provided under the plan. Anything lower than that, tough. (Section 1302 (d) (1) (A))
8. You are an employer in the small-group insurance market and you’d like to offer policies with deductibles higher than $2,000 for individuals and $4,000 for families? Tough. (Section 1302 (c) (2) (A).
9. If you are a large employer (defined as at least 101 employees) and you do not want to provide health insurance to your employee, then you will pay a $750 fine per employee (It could be $2,000 to $3,000 under the reconciliation changes). Think you know how to better spend that money? Tough. (Section 1513).
10. You are an employer who offers health flexible spending arrangements and your employees want to deduct more than $2,500 from their salaries for it? Sorry, can’t do that. (Section 9005 (i)).
11. If you are a physician and you don’t want the government looking over your shoulder? Tough. The Secretary of Health and Human Services is authorized to use your claims data to issue you reports that measure the resources you use, provide information on the quality of care you provide, and compare the resources you use to those used by other physicians. Of course, this will all be just for informational purposes. It’s not like the government will ever use it to intervene in your practice and patients’ care. Of course not. (Section 3003 (i))
12. If you are a physician and you want to own your own hospital, you must be an owner and have a “Medicare provider agreement” by Feb. 1, 2010. (Dec. 31, 2010 in the reconciliation changes.) If you didn’t have those by then, you are out of luck. (Section 6001 (i) (1) (A))
13. If you are a physician owner and you want to expand your hospital? Well, you can’t (Section 6001 (i) (1) (B). Unless, it is located in a country where, over the last five years, population growth has been 150% of what it has been in the state (Section 6601 (i) (3) ( E)). And then you cannot increase your capacity by more than 200% (Section 6001 (i) (3) (C)).
14. You are a health insurer and you want to raise premiums to meet costs? Well, if that increase is deemed “unreasonable” by the Secretary of Health and Human Services it will be subject to review and can be denied. (Section 1003)
15. The government will extract a fee of $2.3 billion annually from the pharmaceutical industry. If you are a pharmaceutical company what you will pay depends on the ratio of the number of brand-name drugs you sell to the total number of brand-name drugs sold in the U.S. So, if you sell 10% of the brand-name drugs in the U.S., what you pay will be 10% multiplied by $2.3 billion, or $230,000,000. (Under reconciliation, it starts at $2.55 billion, jumps to $3 billion in 2012, then to $3.5 billion in 2017 and $4.2 billion in 2018, before settling at $2.8 billion in 2019 (Section 1404)). Think you, as a pharmaceutical executive, know how to better use that money, say for research and development? Tough. (Section 9008 (b)).
16. The government will extract a fee of $2 billion annually from medical device makers. If you are a medical device maker what you will pay depends on your share of medical device sales in the U.S. So, if you sell 10% of the medical devices in the U.S., what you pay will be 10% multiplied by $2 billion, or $200,000,000. Think you, as a medical device maker, know how to better use that money, say for R&D? Tough. (Section 9009 (b)).(This particularly scares me)
The reconciliation package turns that into a 2.9% excise tax for medical device makers. Think you, as a medical device maker, know how to better use that money, say for research and development? Tough. (Section 1405).
17. The government will extract a fee of $6.7 billion annually from insurance companies. If you are an insurer, what you will pay depends on your share of net premiums plus 200% of your administrative costs. So, if your net premiums and administrative costs are equal to 10% of the total, you will pay 10% of $6.7 billion, or $670,000,000. In the reconciliation bill, the fee will start at $8 billion in 2014, $11.3 billion in 2015, $1.9 billion in 2017, and $14.3 billion in 2018 (Section 1406).Think you, as an insurance executive, know how to better spend that money? Tough.(Section 9010 (b) (1) (A and B).)
18. If an insurance company board or its stockholders think the CEO is worth more than $500,000 in deferred compensation? Tough.(Section 9014).
19. You will have to pay an additional 0.5% payroll tax on any dollar you make over $250,000 if you file a joint return and $200,000 if you file an individual return. What? You think you know how to spend the money you earned better than the government? Tough. (Section 9015).
That amount will rise to a 3.8% tax if reconciliation passes. It will also apply to investment income, estates, and trusts. You think you know how to spend the money you earned better than the government? Like you need to ask. (Section 1402).
20. If you go for cosmetic surgery, you will pay an additional 5% tax on the cost of the procedure. Think you know how to spend that money you earned better than the government? Tough. (Section 9017).
By David Hogberg
Sun., March 21, '10 3:24 PM ET
With House Democrats poised to pass the Senate health care bill with some reconciliation changes later today, it is worthwhile to take a comprehensive look at the freedoms we will lose.
Of course, the overhaul is supposed to provide us with security. But it will result in skyrocketing insurance costs and physicians leaving the field in droves, making it harder to afford and find medical care. We may be about to live Benjamin Franklin’s adage, “People willing to trade their freedom for temporary security deserve neither and will lose both.”
The sections described below are taken from HR 3590 as agreed to by the Senate and from the reconciliation bill as displayed by the Rules Committee.
1. You are young and don’t want health insurance? You are starting up a small business and need to minimize expenses, and one way to do that is to forego health insurance? Tough. You have to pay $750 annually for the “privilege.” (Section 1501)
2. You are young and healthy and want to pay for insurance that reflects that status? Tough. You’ll have to pay for premiums that cover not only you, but also the guy who smokes three packs a day, drink a gallon of whiskey and eats chicken fat off the floor. That’s because insurance companies will no longer be able to underwrite on the basis of a person’s health status. (Section 2701).
3. You would like to pay less in premiums by buying insurance with lifetime or annual limits on coverage? Tough. Health insurers will no longer be able to offer such policies, even if that is what customers prefer. (Section 2711).
4. Think you’d like a policy that is cheaper because it doesn’t cover preventive care or requires cost-sharing for such care? Tough. Health insurers will no longer be able to offer policies that do not cover preventive services or offer them with cost-sharing, even if that’s what the customer wants. (Section 2712).
5. You are an employer and you would like to offer coverage that doesn’t allow your employers’ slacker children to stay on the policy until age 26? Tough. (Section 2714).( This is only one I would disagree with in that my daughter is a struggling college student and is very much dependent on our medical insurance not because she is a slacker however, but because government is killing all the private sector jobs.)
6. You must buy a policy that covers ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services; chronic disease management; and pediatric services, including oral and vision care.
You’re a single guy without children? Tough, your policy must cover pediatric services. You’re a woman who can’t have children? Tough, your policy must cover maternity services. You’re a teetotaler? Tough, your policy must cover substance abuse treatment. (Add your own violation of personal freedom here.) (Section 1302).7. Do you want a plan with lots of cost-sharing and low premiums? Well, the best you can do is a “Bronze plan,” which has benefits that provide benefits that are actuarially equivalent to 60% of the full actuarial value of the benefits provided under the plan. Anything lower than that, tough. (Section 1302 (d) (1) (A))
8. You are an employer in the small-group insurance market and you’d like to offer policies with deductibles higher than $2,000 for individuals and $4,000 for families? Tough. (Section 1302 (c) (2) (A).
9. If you are a large employer (defined as at least 101 employees) and you do not want to provide health insurance to your employee, then you will pay a $750 fine per employee (It could be $2,000 to $3,000 under the reconciliation changes). Think you know how to better spend that money? Tough. (Section 1513).
10. You are an employer who offers health flexible spending arrangements and your employees want to deduct more than $2,500 from their salaries for it? Sorry, can’t do that. (Section 9005 (i)).
11. If you are a physician and you don’t want the government looking over your shoulder? Tough. The Secretary of Health and Human Services is authorized to use your claims data to issue you reports that measure the resources you use, provide information on the quality of care you provide, and compare the resources you use to those used by other physicians. Of course, this will all be just for informational purposes. It’s not like the government will ever use it to intervene in your practice and patients’ care. Of course not. (Section 3003 (i))
12. If you are a physician and you want to own your own hospital, you must be an owner and have a “Medicare provider agreement” by Feb. 1, 2010. (Dec. 31, 2010 in the reconciliation changes.) If you didn’t have those by then, you are out of luck. (Section 6001 (i) (1) (A))
13. If you are a physician owner and you want to expand your hospital? Well, you can’t (Section 6001 (i) (1) (B). Unless, it is located in a country where, over the last five years, population growth has been 150% of what it has been in the state (Section 6601 (i) (3) ( E)). And then you cannot increase your capacity by more than 200% (Section 6001 (i) (3) (C)).
14. You are a health insurer and you want to raise premiums to meet costs? Well, if that increase is deemed “unreasonable” by the Secretary of Health and Human Services it will be subject to review and can be denied. (Section 1003)
15. The government will extract a fee of $2.3 billion annually from the pharmaceutical industry. If you are a pharmaceutical company what you will pay depends on the ratio of the number of brand-name drugs you sell to the total number of brand-name drugs sold in the U.S. So, if you sell 10% of the brand-name drugs in the U.S., what you pay will be 10% multiplied by $2.3 billion, or $230,000,000. (Under reconciliation, it starts at $2.55 billion, jumps to $3 billion in 2012, then to $3.5 billion in 2017 and $4.2 billion in 2018, before settling at $2.8 billion in 2019 (Section 1404)). Think you, as a pharmaceutical executive, know how to better use that money, say for research and development? Tough. (Section 9008 (b)).
16. The government will extract a fee of $2 billion annually from medical device makers. If you are a medical device maker what you will pay depends on your share of medical device sales in the U.S. So, if you sell 10% of the medical devices in the U.S., what you pay will be 10% multiplied by $2 billion, or $200,000,000. Think you, as a medical device maker, know how to better use that money, say for R&D? Tough. (Section 9009 (b)).(This particularly scares me)
The reconciliation package turns that into a 2.9% excise tax for medical device makers. Think you, as a medical device maker, know how to better use that money, say for research and development? Tough. (Section 1405).
17. The government will extract a fee of $6.7 billion annually from insurance companies. If you are an insurer, what you will pay depends on your share of net premiums plus 200% of your administrative costs. So, if your net premiums and administrative costs are equal to 10% of the total, you will pay 10% of $6.7 billion, or $670,000,000. In the reconciliation bill, the fee will start at $8 billion in 2014, $11.3 billion in 2015, $1.9 billion in 2017, and $14.3 billion in 2018 (Section 1406).Think you, as an insurance executive, know how to better spend that money? Tough.(Section 9010 (b) (1) (A and B).)
18. If an insurance company board or its stockholders think the CEO is worth more than $500,000 in deferred compensation? Tough.(Section 9014).
19. You will have to pay an additional 0.5% payroll tax on any dollar you make over $250,000 if you file a joint return and $200,000 if you file an individual return. What? You think you know how to spend the money you earned better than the government? Tough. (Section 9015).
That amount will rise to a 3.8% tax if reconciliation passes. It will also apply to investment income, estates, and trusts. You think you know how to spend the money you earned better than the government? Like you need to ask. (Section 1402).
20. If you go for cosmetic surgery, you will pay an additional 5% tax on the cost of the procedure. Think you know how to spend that money you earned better than the government? Tough. (Section 9017).
Saturday, March 20, 2010
Truth Is A Casualty Of The Final Pus
Posted 03/19/2010 07:07 PM ET
Health Reform: Not since the heyday of Bill Clinton have we had a leader play so fast and loose with the facts as President Obama. And as the health care debate reaches a crescendo, he's been especially reckless.
Tired of waiting for the major media to take note, here's a small sampling of whoppers we took from the president's speeches last week in Ohio and Virginia, plus his interview with Fox News' Bret Baier:
• "We have incorporated the best ideas from Democrats and from Republicans." Far from it. Some of the biggest omissions include tort reform, health savings accounts, portable insurance, expanding consumer access to plans across state lines and posting provider prices for services so patients can shop around.Republicans were almost completely shut out from the process and at the early stages last summer, were not even permitted to read the bill. In an atmosphere like this, it's little wonder the bill isn't drawing a single vote of support from Republicans of either house. It's fully a creature of the Democratic Party.
• ("This is not a) government takeover of health care." How is it that government can dictate to private insurance companies what they can offer, to whom, under what circumstances and at what prices, and yet still not own it? Every basic business decision a private company can make has effectively been expropriated.
Even as Obama denied his health care plan was a government takeover, his vice president, Joe Biden, laid out the real deal: "You know we're going to control the insurance companies." We'll take him at his word.
• "If you like your doctor, you can keep your doctor." That's if your doctor chooses to remain in the profession. Unfortunately, our own IBD/TIPP Poll found that up to 45% would consider quitting if they're going to be dictated to by unaccountable bureaucrats who couldn't get into medical school.
Price controls will slash doctor salaries and raise workloads, mandating that doctors make up for losses with volume. Bureaucrats will crack the whip on costs by lowering payments and penalizing doctors who refer patients to specialists. All this, and zero tort reform relief, will drive many doctors out of the profession just as 32 million new patients enter the market.• "Our proposal is paid for ... our cost-cutting measures would reduce most people's premiums and bring down our deficit by more than $1 trillion over the next two decades." Government programs always cost more than projected. Medicare, which has $86 trillion in unfunded liabilities, was supposed to cost $10 billion within 25 years of its implementation. It actually cost $107 billion.
The real cost of the Democrats' reform plan, according to the Cato Institute, which isn't handcuffed in its estimates like the Congressional Budget Office, is $2.5 trillion over the first decade.
• "If this vote fails, then insurance companies will continue to run amok." They're not exactly wildcatting as it is. Health plan providers boast a profit margin of 3.4% — placing them 88th of 215 industries in Morningstar rankings. More than 2,000 state mandates dictate what coverages they provide.
• "By the time the vote has taken place ... you'll know what's in it because it's going to be posted and everybody's going to be able to evaluate it on the merits." The final bill wouldn't available to the public until Saturday morning, the day before the vote, congressional sources told us Friday. So in fact, nobody would have time to digest the 2,500-page leviathan.
• "We're not transforming one-sixth of the economy in one fell swoop." Yes, Obama wants to take over the health care sector, but in pieces. In 2007, he said that "economically it is better for us to start getting a system in place, a universal health care system, signed into law by the end of my first term as president." Canada, he noted, "did not start off immediately with a single-payer system, they had a similar transition step." He's been on record since at least 2003 as a "proponent of single-payer, universal health care."
• "(This will be) the largest middle-class tax cut in the history of the country." Tax cut? New taxes on prescription drug sales, medical devices, tanning services and an annual tax on health insurers for being health insurers will all end up on middle-class shoulders.
Then for families earning $250,000 there are taxes of 0.9% for hospital insurance, 2.9% on "unearned income," plus a tax on high-premium policies. The "middle-class tax cut," in the president's misleading words, amounts to "tax credits to help you afford" the more expensive insurance of the new (also misleadingly named) "competitive marketplace."
• "$3,000 your employer doesn't have to pay ... maybe she can afford to give you a raise." Premiums will not go down, but way, way up. The Associated Press last week found that $3,000 to misrepresent a Business Roundtable analysis last year that "didn't consider specific legislation."
Larry Levitt of the Kaiser Family Foundation told the AP "it would be miraculous" if premiums went down under the legislation set to be passed. Using the HIS/Global Insight U.S. Macroeconomic model, a Heritage Foundation analysis found that with the new government-regulated exchanges "crowding out the employer-sponsored market," there will be "an overall increase in the absolute amount of health spending on premiums."
• "Small business owners ... can purchase more affordable coverage in a competitive marketplace." In fact, small businesses will be slapped with new taxes — including a penalty if they don't provide the level of health coverage Washington dictates. As owners of modest-sized firms cope with the new burdens, their employees may find themselves with substantially reduced coverage — or with pink slips.
As to the promised financial assistance for new employer mandates, it remains unknown what "small business" will mean under ObamaCare. Will the definition apply only to micro-businesses of a couple dozen workers?
• (The reform legislation is) "about the character of our country." Let's hope not. Never in American history have politicians sunk to lower depths than in the push to thrust this massive expansion of government down an unwilling America's throat.
From the unconstitutional "Slaughter solution" that would pass it without a vote of the people's representatives, to the taxpayer-funded bribery of the "Cornhusker kickback" and "Louisiana Purchase," to the pretense of passing it as a budget item bypassing Senate filibusters, Democratic leaders have shown they will stop at nothing to set us on the road to European socialized medicine.
Health Reform: Not since the heyday of Bill Clinton have we had a leader play so fast and loose with the facts as President Obama. And as the health care debate reaches a crescendo, he's been especially reckless.
Tired of waiting for the major media to take note, here's a small sampling of whoppers we took from the president's speeches last week in Ohio and Virginia, plus his interview with Fox News' Bret Baier:
• "We have incorporated the best ideas from Democrats and from Republicans." Far from it. Some of the biggest omissions include tort reform, health savings accounts, portable insurance, expanding consumer access to plans across state lines and posting provider prices for services so patients can shop around.Republicans were almost completely shut out from the process and at the early stages last summer, were not even permitted to read the bill. In an atmosphere like this, it's little wonder the bill isn't drawing a single vote of support from Republicans of either house. It's fully a creature of the Democratic Party.
• ("This is not a) government takeover of health care." How is it that government can dictate to private insurance companies what they can offer, to whom, under what circumstances and at what prices, and yet still not own it? Every basic business decision a private company can make has effectively been expropriated.
Even as Obama denied his health care plan was a government takeover, his vice president, Joe Biden, laid out the real deal: "You know we're going to control the insurance companies." We'll take him at his word.
• "If you like your doctor, you can keep your doctor." That's if your doctor chooses to remain in the profession. Unfortunately, our own IBD/TIPP Poll found that up to 45% would consider quitting if they're going to be dictated to by unaccountable bureaucrats who couldn't get into medical school.
Price controls will slash doctor salaries and raise workloads, mandating that doctors make up for losses with volume. Bureaucrats will crack the whip on costs by lowering payments and penalizing doctors who refer patients to specialists. All this, and zero tort reform relief, will drive many doctors out of the profession just as 32 million new patients enter the market.• "Our proposal is paid for ... our cost-cutting measures would reduce most people's premiums and bring down our deficit by more than $1 trillion over the next two decades." Government programs always cost more than projected. Medicare, which has $86 trillion in unfunded liabilities, was supposed to cost $10 billion within 25 years of its implementation. It actually cost $107 billion.
The real cost of the Democrats' reform plan, according to the Cato Institute, which isn't handcuffed in its estimates like the Congressional Budget Office, is $2.5 trillion over the first decade.
• "If this vote fails, then insurance companies will continue to run amok." They're not exactly wildcatting as it is. Health plan providers boast a profit margin of 3.4% — placing them 88th of 215 industries in Morningstar rankings. More than 2,000 state mandates dictate what coverages they provide.
• "By the time the vote has taken place ... you'll know what's in it because it's going to be posted and everybody's going to be able to evaluate it on the merits." The final bill wouldn't available to the public until Saturday morning, the day before the vote, congressional sources told us Friday. So in fact, nobody would have time to digest the 2,500-page leviathan.
• "We're not transforming one-sixth of the economy in one fell swoop." Yes, Obama wants to take over the health care sector, but in pieces. In 2007, he said that "economically it is better for us to start getting a system in place, a universal health care system, signed into law by the end of my first term as president." Canada, he noted, "did not start off immediately with a single-payer system, they had a similar transition step." He's been on record since at least 2003 as a "proponent of single-payer, universal health care."
• "(This will be) the largest middle-class tax cut in the history of the country." Tax cut? New taxes on prescription drug sales, medical devices, tanning services and an annual tax on health insurers for being health insurers will all end up on middle-class shoulders.
Then for families earning $250,000 there are taxes of 0.9% for hospital insurance, 2.9% on "unearned income," plus a tax on high-premium policies. The "middle-class tax cut," in the president's misleading words, amounts to "tax credits to help you afford" the more expensive insurance of the new (also misleadingly named) "competitive marketplace."
• "$3,000 your employer doesn't have to pay ... maybe she can afford to give you a raise." Premiums will not go down, but way, way up. The Associated Press last week found that $3,000 to misrepresent a Business Roundtable analysis last year that "didn't consider specific legislation."
Larry Levitt of the Kaiser Family Foundation told the AP "it would be miraculous" if premiums went down under the legislation set to be passed. Using the HIS/Global Insight U.S. Macroeconomic model, a Heritage Foundation analysis found that with the new government-regulated exchanges "crowding out the employer-sponsored market," there will be "an overall increase in the absolute amount of health spending on premiums."
• "Small business owners ... can purchase more affordable coverage in a competitive marketplace." In fact, small businesses will be slapped with new taxes — including a penalty if they don't provide the level of health coverage Washington dictates. As owners of modest-sized firms cope with the new burdens, their employees may find themselves with substantially reduced coverage — or with pink slips.
As to the promised financial assistance for new employer mandates, it remains unknown what "small business" will mean under ObamaCare. Will the definition apply only to micro-businesses of a couple dozen workers?
• (The reform legislation is) "about the character of our country." Let's hope not. Never in American history have politicians sunk to lower depths than in the push to thrust this massive expansion of government down an unwilling America's throat.
From the unconstitutional "Slaughter solution" that would pass it without a vote of the people's representatives, to the taxpayer-funded bribery of the "Cornhusker kickback" and "Louisiana Purchase," to the pretense of passing it as a budget item bypassing Senate filibusters, Democratic leaders have shown they will stop at nothing to set us on the road to European socialized medicine.
Saturday, March 13, 2010
Why Health Bill Makes No Sense
Posted 03/12/2010 07:12 PM ET
Health Reform: So it's come down to this — desperate Democratic leaders strong-arming members on the worst bill ever before they go home to explain to constituents why they decided to commit political suicide.
We've said just about all we've had to say on this issue — actually dating back to 1993-94, when we wrote nearly 100 editorials in opposition to HillaryCare. Since January of last year, we've weighed in 150 more times against the latest version of socialized medicine.
But to review, here are just 15 reasons why a government takeover of the finest medical system in the world makes no sense at all:
1. The people don't want it! This, we would think, should have some bearing on decision-making. Yet the Democrats forge ahead without consent of the governed. In the latest Rasmussen poll, 53% opposed the Democrats' reform while 42% were in favor. More than four in 10 "strongly" opposed; just two in 10 "strongly" favored. This jibes with other surveys, including our own IBD/TIPP Poll, taken since last year.
2. Doctors don't want it! A survey we took last summer of 1,376 practicing physicians found that 45% would consider leaving their practices or taking early retirements if the Democrats' reform became law. In December, the results were validated by a Medicus poll in which 25% of doctors said they'd retire early if a public option is implemented and another 21% would stop practicing even though they were far from their retirement years. Even if the bill doesn't have a "public option," nearly 30% said they'd quit the profession under the plans being considered.
3. Half the Congress doesn't want it! Not a single Republican backed the health care bill that cleared the Senate on Christmas Eve 60-39. House passage was by a slim 220 to 215, and the lone Republican "aye" has since switched to "no." Columnist Michael Barone says other changes would put the House vote today at 216-215 in favor, and he has doubts Democrats can even muster 216.
House Speaker Nancy Pelosi made her job of securing yes votes even more difficult last week when she told a meeting of county officials that "we have to pass the bill so you can find out what is in it." (ARE YOU KIDDING ME? REALLY) Members of Congress aren't waiting: They've already exempted themselves from whatever they inflict on us.
4. People are happy with the health care they've got! Polls show that 84% of Americans have health insurance and that few are displeased with what they've got. Last month, the St. Petersburg Times looked at eight polls and reported that satisfaction rates averaged 87%
5. It doesn't even cover the people they set out to cover! Supporters of government-run health care say there are as many as 47 million Americans — 9 million to 10 million of them illegal aliens — without medical insurance. The Democrats' plans, however, will put only 31 million of the uninsured under coverage.
6. Costs will go up, not down! Democrats say their plans will cost less than $1 trillion over the first decade. But analyst Michael Cannon at the Cato Institute puts the cost at $2.5 trillion over the first 10 years. Even if we go with the government's lower estimates, the cost is already on the rise. A new estimate by the Congressional Budget Office puts the cost of the Senate bill at $875 billion over 10 years, $4 billion more than its original projection. Imagine how fast costs would soar if one of the bills became public policy.
7. Real cost controls are nowhere to be found! The Democrats are offering no meaningful tort reform that will help push down the high malpractice insurance premiums that are a burden to doctors and their patients. Nor are they considering any other cost-saving provisions, such as allowing the sale of individual health plans across state lines or easing health insurance mandates.
8. Insurance premiums will rise, not fall! One goal of nationalizing health care is to lower costs, to bend the spending curve downward. Yet, as Democratic Sen. Dick Durbin acknowledged Wednesday, that won't be the case.
"Anyone who would stand before you and say, 'Well, if you pass health care reform, next year's health care premiums are going down,' I don't think is telling the truth," he said from the Senate floor. "I think it is likely they would go up."
An analysis completed by the CBO at the request of Sen. Evan Bayh confirms Durbin's suspicions. Insurance coverage in the individual market will "be about 10% to 13% higher in 2016 than the average premium for nongroup coverage in that same year under current law," it concluded.
9. Medicare is already bankrupting us! The Medicare trust fund, which has unfunded obligations of $37.8 trillion, will be insolvent in 2017. How can lawmakers justify another entitlement that will cost trillions when they can't pay for existing liabilities?
10. There aren't enough doctors now! Last month, 26% of physicians responding to a Web poll on Sermo.com, which calls itself "the largest online physician community," said they had been forced to close, or were considering closing, their solo practices. Providing coverage for an additional 31 million Americans when the number of doctors is shrinking won't improve our health care.
11. The doctor-patient relationship will be wrecked! The latest IBD/TIPP Poll, taken just last week, found that Americans, by a wide 48%-26% margin, believe the doctor-patient relationship will decline if the Democrats' plan is passed.
12. Medical care will also deteriorate! IBD/TIPP has also found that 51% of Americans believe care would get worse under government control. Only 10.5% said they felt it would improve. In our doctor poll, 72% disagreed with administration claims that the government could cover 47 million more people with better-quality care at lower cost.
13. Rationing of care is inevitable! Health care is not an unlimited resource and must be rationed, either by the individual, providers or government. In Britain and Canada, where the government does the rationing, medical treatment waiting lists are sometimes deadly and quite often excessively long.
For instance, late cancer diagnoses in an overcrowded public health care system cause up to 10,000 needless deaths a year in Britain. The reasons cited for the late diagnoses include doctor delay, delay in primary care, system delay and delay in secondary care.
14. Private health insurers will be destroyed! Added mandates and price controls will force many insurers to simply get out of the health plan business because it will no longer be profitable.
15. It's probably unconstitutional! One way to help bring down the number of uninsured is to demand that those without coverage buy health plans. But the government has never passed a law requiring Americans to buy any good or service. Constitutional scholars say any such mandate would likely draw a legal challenge. (I can hope so)
Tuesday, March 9, 2010
Health Care A Right? More Like A Wish
By WALTER WILLIAMS
Posted 03/08/2010 05:53 PM ET
Most politicians, and probably most Americans, see health care as a right. Thus, whether a person has the means to pay for medical services or not, he is nonetheless entitled to them. Let's ask ourselves a few questions about this vision.
Say a person, let's call him Harry, suffers from diabetes and he has no means to pay a laboratory for blood work, a doctor for treatment and a pharmacy for medication. Does Harry have a right to XYZ lab's and Dr. Jones' services and a prescription from a pharmacist? And, if those services are not provided without charge, should Harry be able to call for criminal sanctions against those persons for violating his rights to health care?
You say, "Williams, that would come very close to slavery if one person had the right to force someone to serve him without pay." You're right.
Suppose instead of Harry being able to force a lab, doctor and pharmacy to provide services without pay, Congress uses its taxing power to take a couple of hundred dollars out of the paycheck of some American to give to Harry so that he could pay the lab, doctor and pharmacist. Would there be any difference in principle, namely forcibly using one person to serve the purposes of another?
There would be one important strategic difference, that of concealment. Most Americans, I would hope, would be offended by the notion of directly and visibly forcing one person to serve the purposes of another. Congress' use of the tax system to invisibly accomplish the same end is more palatable to the average American.
True rights, such as those in our Constitution, or those considered to be natural or human rights, exist simultaneously among people. That means exercise of a right by one person does not diminish those held by another. In other words, my rights to speech or travel impose no obligations on another except those of noninterference.
If we apply ideas behind rights to health care to my rights to speech or travel, my free speech rights would require government-imposed obligations on others to provide me with an auditorium, television studio or radio station. My right to travel freely would require government-imposed obligations on others to provide me with airfare and hotel accommodations.
For Congress to guarantee a right to health care, or any other good or service, whether a person can afford it or not, it must diminish someone else's rights, namely their rights to their earnings. The reason is that Congress has no resources of its very own.But Texas seems to be delivering superior services. Its teachers are paid less than California's. But its test scores — and with a demographically similar school population — are higher. California's once fabled freeways are crumbling and crowded. Texas has built gleaming new highways in metro Houston and Dallas-Fort Worth.
In the meantime, Texas' economy has been booming. Unemployment rates have been below the national average for more than a decade, as companies small and large generate new jobs.
And Americans have been voting for Texas with their feet. From 2000 to 2009, some 848,000 people moved from other parts of the United States to Texas, about the same number as moved in from abroad. That inflow has continued in 2008-09, in which 143,000 Americans moved into Texas, more than double the number in any other state, at the same time as 98,000 were moving out of California.
Texas is on the way to gaining four additional House seats and electoral votes in the 2010 reapportionment.
This was not always so. In the two decades after World War II, California, with its pleasant weather, was the Golden State, a promised land for most Americans, while Texas seemed a provincial rural backwater. Many saw postwar California's expansion of universities, freeways and water systems as a model for the nation. Few experts praised Texas' low-tax, low-services government.
Now it is California's ruinously expensive and increasingly incompetent government that seems dysfunctional, while Texas' approach has generated more creativity and opportunity. So it's not surprising that Texas voters preferred Perry over an opponent who has spent 16 years in Washington.
What's surprising is that Democrats in Washington are still trying to impose policies like those that have ravaged California rather than those which have proved so successful in Texas.
Posted 03/08/2010 05:53 PM ET
Most politicians, and probably most Americans, see health care as a right. Thus, whether a person has the means to pay for medical services or not, he is nonetheless entitled to them. Let's ask ourselves a few questions about this vision.
Say a person, let's call him Harry, suffers from diabetes and he has no means to pay a laboratory for blood work, a doctor for treatment and a pharmacy for medication. Does Harry have a right to XYZ lab's and Dr. Jones' services and a prescription from a pharmacist? And, if those services are not provided without charge, should Harry be able to call for criminal sanctions against those persons for violating his rights to health care?
You say, "Williams, that would come very close to slavery if one person had the right to force someone to serve him without pay." You're right.
Suppose instead of Harry being able to force a lab, doctor and pharmacy to provide services without pay, Congress uses its taxing power to take a couple of hundred dollars out of the paycheck of some American to give to Harry so that he could pay the lab, doctor and pharmacist. Would there be any difference in principle, namely forcibly using one person to serve the purposes of another?
There would be one important strategic difference, that of concealment. Most Americans, I would hope, would be offended by the notion of directly and visibly forcing one person to serve the purposes of another. Congress' use of the tax system to invisibly accomplish the same end is more palatable to the average American.
True rights, such as those in our Constitution, or those considered to be natural or human rights, exist simultaneously among people. That means exercise of a right by one person does not diminish those held by another. In other words, my rights to speech or travel impose no obligations on another except those of noninterference.
If we apply ideas behind rights to health care to my rights to speech or travel, my free speech rights would require government-imposed obligations on others to provide me with an auditorium, television studio or radio station. My right to travel freely would require government-imposed obligations on others to provide me with airfare and hotel accommodations.
For Congress to guarantee a right to health care, or any other good or service, whether a person can afford it or not, it must diminish someone else's rights, namely their rights to their earnings. The reason is that Congress has no resources of its very own.But Texas seems to be delivering superior services. Its teachers are paid less than California's. But its test scores — and with a demographically similar school population — are higher. California's once fabled freeways are crumbling and crowded. Texas has built gleaming new highways in metro Houston and Dallas-Fort Worth.
In the meantime, Texas' economy has been booming. Unemployment rates have been below the national average for more than a decade, as companies small and large generate new jobs.
And Americans have been voting for Texas with their feet. From 2000 to 2009, some 848,000 people moved from other parts of the United States to Texas, about the same number as moved in from abroad. That inflow has continued in 2008-09, in which 143,000 Americans moved into Texas, more than double the number in any other state, at the same time as 98,000 were moving out of California.
Texas is on the way to gaining four additional House seats and electoral votes in the 2010 reapportionment.
This was not always so. In the two decades after World War II, California, with its pleasant weather, was the Golden State, a promised land for most Americans, while Texas seemed a provincial rural backwater. Many saw postwar California's expansion of universities, freeways and water systems as a model for the nation. Few experts praised Texas' low-tax, low-services government.
Now it is California's ruinously expensive and increasingly incompetent government that seems dysfunctional, while Texas' approach has generated more creativity and opportunity. So it's not surprising that Texas voters preferred Perry over an opponent who has spent 16 years in Washington.
What's surprising is that Democrats in Washington are still trying to impose policies like those that have ravaged California rather than those which have proved so successful in Texas.
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