How good is Sen. Max Baucus’s health reform bill? So good that Democrats have made sure some of the most costly provisions don’t apply to their own states.
The Senate Finance Committee is gearing up for a final vote next week, and Chairman Baucus now appears to have the Democratic votes to pass his bill. Getting this far has of course meant cutting deals, and those deals, it turns out, are illuminating. The senators are all for imposing “reform” on the nation, so long as it doesn’t disadvantage their constituents.
Getty ImagesSens. Harry Reid (Nevada) and Charles Schumer (New York) are among those inserting goodies for their states.
A central feature of the Baucus bill is the vast expansion of state Medicaid programs. This is necessary, we are told, to cover more of the nation’s uninsured. The provision has angered governors, since the federal government will cover only part of the expansion and stick fiscally strapped states with an additional $37 billion in costs. The “states, with our financial challenges right now, are not in a position to accept additional Medicaid responsibilities,” griped Democratic Ohio Gov. Ted Strickland.
Poor Mr. Strickland. If only he lived in . . . Nevada! Senate Majority Leader Harry Reid, who is worried about losing his seat next year, worked out a deal by which the federal government will pay all of his home state’s additional Medicaid expenses for the next five years. Under the majority leader’s very special formula, only three other states—Oregon, Rhode Island and Michigan—qualify for this perk, on the grounds, as Mr. Reid put it recently on the Senate floor, that they “are suffering more than most.”
Medical-liability reforms such as capping noneconomic damages and tightening the statute of limitation for filing a suit would trim $54 billion from the federal deficit over 10 years, largely by curbing defensive medicine, according to a report released Friday by the Congressional Budget Office (CBO).
Overall, tort reform would reduce the nation’s healthcare spending by 0.5%, the report stated. Forty percent of these savings would stem from lower malpractice insurance premiums for providers. The rest of the savings would result from lower use of healthcare services, as providers would order fewer tests and procedures intended simply to avoid a lawsuit.
The CBO estimate of tort reform’s potential to reduce the deficit is roughly 10 times greater than what it projected last December (a reduction of $54 billion instead of $5.6 billion). At that time, the agency said that evidence about the extent of defensive medicine — and how tort reform could reduce it — was murky. However, more recent research suggests that “lowering the cost of medical malpractice tends to reduce the use of health care services,” according to the latest CBO report.
Now that the Congressional Budget Office has concluded that the health-care bill proposed by Sen. Max Baucus will shrink the federal deficit over the next ten years, its champions are heralding the legislation as a model of fiscal responsibility.
But the CBO’s comforting analysis relies on a big assumption that’s highly questionable, an assumption that virtually no one on either side of the debate — politicians, pundits, even economists — is even challenging.
The assumption is that America’s employers will keep providing coverage for their workers. But, in fact, the Baucus bill severely undermines the employer rationale for offering insurance. Economist Michael Tanner of the conservative Cato Institute points out two main reasons.
First, the Baucus bill would substantially increase the costs of coverage, for example by requiring rich benefits packages and coverage for Americans with pre-existing conditions at far less than their actual expense. At some point, employers will decide that the appeal of offering insurance as a tool for recruiting and retaining employees no longer compensates for its soaring cost.
Second, the bill is based on perverse incentives that no one is even discussing. The subsidies it offers to citizens are so rich that if companies were to drop their plans, the majority of workers would get the same lavish coverage, and extra cash in their paychecks to boot. “Those two factors will change the equilibrium,” says Tanner. “With the government providing huge credits, employers will feel a lot less guilty about dumping their plans.”
Some Members of Congress and pro-abortion groups are claiming that the health care bill will follow current law on government funding of abortions (the Hyde Amendment).
Nancy Pelosi has said about HR 3200, “the bill clearly spells out that no federal funds can be used to pay for abortions.” To the contrary, the legislation, as amended by the Capps Amendment, specifically authorizes the government-run public plan to pay for elective abortions. As the public plan collects funds from various sources those funds become public funds which in turn will pay for abortions.
Pelosi also says that “the bill preserves the status quo in abortion policy.” Again this is not the case. First, the status quo is that federal government programs do not pay for abortions, yet under the Capps amendment the public plan is authorized to issue checks to abortionists to pay for abortion on demand. Second, the current policy with regard to abortion funding is that the government does not subsidize health insurance plans that includes abortion coverage as evidenced by section 507. (b). The Capps amendment breaks with the status quo and establishes an accounting mechanism by which government subsidies (affordability credits) will be allowed to fund insurance policies that cover elective abortions.
So if someone tries to tell you that the Hyde Amendment applies to health care, tell them to “Stop Hyding!”
By Newt Gingrich – With the Senate Finance Committee poised to pass health care legislation, the final contours of the bill that could come out of Congress are starting to come into focus. The bill will contain new taxes on the middle class. It will add to the deficit. And it will put government bureaucrats between Americans and their doctors, among other things.
So it’s not too early to ask the obvious question: Will President Obama veto health care reform?
It’s worth asking because so many of the costs to taxpayers the President has repeatedly promised won’t be in the legislation are, and so many of the benefits are not.
What follows is a list, in no particular order, of the contradictions between the President’s promises and the reality of Democratic health care reform. Add them up and it’s hard to see how President Obama doesn’t reject the bill Congress seems likely to send him.
Contradiction #1: From a Promise Not to Raise Taxes on the Middle Class to $2 Billion in “Penalties”
As far back as the campaign, President Obama promised he wouldn’t raise taxes on Americans making less than $250,000.
But an analysis by the Congressional Budget Office (CBO) found that at least 71 percent of the individual mandate penalties in Senate Finance Committee Chairman Max Baucus’s (D-MT) bill would be paid by Americans earning less than $250,000. In fact, the nonpartisan analysis found that, of the $2.8 billion in penalties the bill imposes on those who do not purchase health insurance, a full $2 billion will be paid by taxpayers earning less than $120,000 for a family of four.
The Senate Finance bill also levies $215 billion in new taxes on employers and health insurers for offering high-value insurance benefits, which will surely be passed onto all consumers.
Republicans tried to ensure that President Obama’s words would not ring hollow by offering an amendment that said: “This amendment provides that no tax, fee or penalty imposed by this legislation shall be applied to any individual earning less than $200,000 per year or any couple earning less than $250,000 per year.” Democrats defeated it.
Contradiction #2: From a Promise to Reject a Bill That “Adds One Dime to the Deficit” to $239 Billion Added to the Deficit
In his speech to the Joint Session of Congress, the President was adamant: “I will not sign [a bill] if it adds one dime to the deficit, now or in the future, period.”
And yet House bill H.R. 3200 will increase the deficit by an amazing $239 billion over the next decade.
The Baucus bill pretends to be deficit neutral but it’s an accounting gimmick. “It pays for itself” by forcing a new $250-300 billion unfunded mandate on the states. And it doesn’t include nearly $300 billion that will be spent to adjust physician payments in Medicare.
Contradiction #3: From a Promise That “If You Like Your Current Plan You Can Keep It” to Half of Medicare Advantage Benefits Being Cut
In his speech to the Joint Session of Congress last month and elsewhere, the President has reassured nervous Americans that if they like their current coverage, his reform will let them keep it.
Unless you happen to have Medicare Advantage, that is.
Or employer provided insurance.
The director of the nonpartisan CBO testified before the Senate that, under the Senate bill, the benefits of seniors under Medicare Advantage would be cut in half.
And an analysis of the House bill found that 88 million people will lose their current insurance under government health care.
What’s more, both bills would disrupt vision care for more than 100 million Americans.
According to AMA’s National Health Insurance Report Card, Medicare denies 6.85 percent of its claims, higher than any private insurer (Aetna was second, denying 6.80 percent of its claims), and more than double any private insurer’s average.
The Obama administration repeats ad nauseum that we need a government option to “keep insurance companies honest” and to make sure they don’t deny anyone coverage. Well what does one say about the fact that Medicare denies more claims than private insurers?
President Obama has promised that if we like our health insurance we can keep it. But will those who are forced into the public option–which has been estimated to be minimum of tens of millions of currently insured Americans in addition to those “46 million” currently uninsured–be satisfied with their care given that the government program Medicare’s denial of claims outranks any private insurer’s?
AMA is effectively endorsing a public plan that is the largest denier of claims. How the public option would provide health care to patients is hard to understand.
The major provisions of ObamaCare already have been tried. They’ve led to increased costs and reduced access to care.
By Peter Suderman – Supreme Court Justice Louis Brandeis famously envisioned the states serving as laboratories, trying “novel social and economic experiments without risk to the rest of the country.” And on health care, that’s just what they’ve done.
Like participants in a national science fair, state governments have tested variants on most of the major components of the health-care reform plans currently being considered in Congress. The results have been dramatically increased premiums in the individual market, spiraling public health-care costs, and reduced access to care. In other words: The reforms have failed.
New York is exhibit A. In 1993, the state prohibited insurers from declining to cover individuals with pre-existing health conditions (”guaranteed issue”). New York also required insurers to charge those enrolled in their plans the same premium, regardless of health status, age or sex (”community rating”). The goal was to reduce the number of uninsured by making health insurance more accessible, particularly to those who don’t have employer-provided insurance.
It hasn’t worked out very well, according to a Manhattan Institute study released last month by Stephen T. Parente, a professor of finance at the University of Minnesota and Tarren Bragdon, CEO of the Maine Heritage Policy Center. In 1994, there were just under 752,000 individuals enrolled in individual insurance plans, or about 4.7% of the nonelderly population. This put New York roughly in line with the rest of the U.S. Today, that percentage has dropped to just 0.2% of the state’s nonelderly. In contrast, between 1994 and 2007, the total number of people insured in the individual market across the U.S. rose to 5.5% from 4.5%.
A prominent article in the Washington Post earlier this week suggests that the US medical system is loosing ground when compared to those of other countries with nationalized health care systems. The article cites a study by the Commonwealth Fund which ranks the US dead-last in terms of preventable deaths.
But a recent article from the New York Times says we must look past the health care system to understand the apparent longevity gap. A prominent researcher by the name of Samuel H. Preston has taken a closer look at the data and has found no evidence that America’s health care system is to blame. Instead, his research shows the gap can be explained by lifestyle factors, such as obesity and smoking.
Proponents of ObamaCare are attempting to use the Commonwealth Fund study to justify a government takeover of our health care system. But the reality is that this study is based upon faulty assumptions with lead people to the wrong conclusions. The truth of he matter is that the US health care system is as good or better than that of other nations.
By John Goodman — It’s such a simple idea. Yet powerful. Compelling. Alluring. Irresistible.
And it’s scaring the bejeebies out of the health reform crowd on Capitol Hill.
Here it is: Before Congress votes on a final health reform bill, the full text goes up on the Internet for everyone in the nation to read, along with the Congressional Budget Office (CBO) score — giving the expected price tag and the expected impact on seniors, small business, employer-based coverage, etc.
Think about it. For three days and three nights, everybody in the country can read, debate, discuss and give last-minute “up” or “down” input to their congressional representatives.
What’s so terrifying about that?
Here’s a summary of where the idea stands in the House, prepared by the NCPA’s Brian Williams:
Congress has rushed through several pieces of legislation this year, allowing little or no time to read the actual text of the legislation before voting. This is a common abuse of power when one party controls the legislative process (in other words, Republicans were not immune either).
When she was elected as Speaker, Nancy Pelosi promised that members would have at least 24 hours to examine bills prior to floor consideration. See page 24 of the Speaker’s New Direction for America.
However, the Speaker has broken her own 24-hour rule multiple times by rushing through dozens of major bills. Recent examples on the list include several bills that were more than 1,000 pages in length, such as economic stimulus legislation, cap-and-trade legislation and S-CHIP expansion.
A House rules change has been introduced (H. Res. 554) that would require legislation to be available on the Internet for 72 hours before consideration. The resolution was introduced by Rep. Brian Baird (D-WA) and currently has 164 cosponsors.
Because the Democratic leadership won’t consider H. Res. 554, a motion to discharge (a “discharge petition”) was introduced on September 23 and is currently collecting signatures.
A discharge petition bypasses the Speaker and Democrat-controlled committees to bring the measure directly to the House of Representatives for consideration.
To succeed, a discharge petition needs at least 218 signatures.
As of 10/5, the discharge petition has 182 signatures.
The day after the discharge petition was introduced, Speaker Pelosi was asked whether she supports the requirement for legislation to be available for 72 hours before consideration. She responded, “Absolutely.” But if Speaker Pelosi “absolutely” supported the 72-hour rule, there wouldn’t be any need for a discharge petition (the purpose of which is to bypass the Speaker).
In President Obama’s Washington, medical specialists are slightly more popular than the H1N1 virus. Compared to bread-and-butter primary care doctors, specialists cost more to train and make more use of expensive procedures and technology—and therefore cost the government more money. Even so, the quiet war Democrats are waging on specialists is astonishing.
From Senate Finance Chairman Max Baucus’s health-care bill to changes the Administration is pushing in Medicare, Democrats are systematically attacking specific medical fields like cardiology and oncology. With almost no scrutiny, they’re trying to engineer a “cheaper” system so that government can afford to buy health care for all—even if the price is fewer and less innovative ways of extending and improving lives.
Take a provision in the Baucus bill that would punish any physician whose “resource use” is considered too high. Beginning in 2015, Medicare would rank doctors against their peers based on how much they cost the program—and then automatically cut all payments by 5% to anyone who falls into the 90th percentile or above. In practice, this rule will only apply to specialists.
As the health-reform bills move through Congress, the prognosis for Medicare pa tients gets worse and worse.
The Senate Finance Committee bill (generally called the Baucus bill, after Chairman Max Baucus) robs the elderly to cover the uninsured — like snatching purses from little old ladies. The House bills already cut future funding for Medicare by $500 billion over the next decade. The Baucus bill would slash a similar amount, just when 30 percent more people enter the program as baby boomers turn 65.
The Baucus bill also puts new limits on what doctors can do for patients in Medicare:
* A “race to the bottom” provision (p. 102 of the revised chairman’s mark) would take effect each year for the next five years. The provision penalizes doctors who end up in the 90th percentile or above on the cost of what they use to treat their patients, compared with national averages. The intent is to force down the cost of care, year by year. Yet this blunt instrument can’t determine which care is actually wasteful – it will punish doctors for treating high cost patients with complex conditions. Inevitably, it will lower the quality of care.
* Even more devastating is the amendment Sen. Maria Cantwell (D-Wash.) got inserted into the bill (revised chairman’s mark, pp. 102-3). It gives the Secretary of Health and Human Services the power to define quality, cost-effective care for each medical condition and penalize doctors who spend more on their patients.
The law establishing Medicare in 1965 barred the federal government from interfering in doctors’ treatment decisions. Slowly, Medicare regulations have begun unraveling that protection. Now the Cantwell amendment finishes the job.
This is the most extreme change to Medicare ever. Dr. David McKalip, a Florida neurosurgeon and a board member of the Florida Medical Association, predicts: “The only doctors left in Medicare will be those willing to ration care and practice cookbook medicine.”
How good is Sen. Max Baucus’s health reform bill? So good that Democrats have made sure some of the most costly provisions don’t apply to their own states.
Medical-liability reforms such as capping noneconomic damages and tightening the statute of limitation for filing a suit would trim $54 billion from the federal deficit over 10 years, largely by curbing defensive medicine, according to a report released Friday by the Congressional Budget Office (CBO).
Now that the Congressional Budget Office has concluded that the health-care bill proposed by Sen. Max Baucus will shrink the federal deficit over the next ten years, its champions are heralding the legislation as a model of fiscal responsibility.
According to AMA’s National Health Insurance 
The major provisions of ObamaCare already have been tried. They’ve led to increased costs and reduced access to care.
A 
By John Goodman — It’s such a simple idea. Yet powerful. Compelling. Alluring. Irresistible.
In President Obama’s Washington, medical specialists are slightly more popular than the H1N1 virus. Compared to bread-and-butter primary care doctors, specialists cost more to train and make more use of expensive procedures and technology—and therefore cost the government more money. Even so, the quiet war Democrats are waging on specialists is astonishing.
As the health-reform bills move through Congress, the prognosis for Medicare pa tients gets worse and worse.
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