By Diana Furchtgott-Roth - For a study in contrasts, look no further than President Obama’s State of the Union Address. The president, in a spasm of fiscal responsibility, asked Congress to freeze discretionary non-defense spending for three years, for $250 billion in savings over the next decade. Then, he proposed student loan write-offs, new middle-class entitlements, and reiterated support for expensive high-speed rail and $1 trillion health “reform.”
Mr. Obama declared, “By the time I’m finished speaking tonight, more Americans will have lost their health insurance. Millions will lose it this year… I will not walk away from these Americans, and neither should the people in this chamber. As temperatures cool, I want everyone to take another look at the plan we’ve proposed. ”
The Democrats’ health proposal featured overarching regulation on insurance companies governing what benefits their policies must offer and what range of prices they could charge; a requirement that individuals buy conforming policies; cuts in Medicare; a panel to determine allowed cost-effective treatments; and taxes on expensive plans, high-income individuals, and on employers who don’t offer the right kind of health insurance.
There has to be a better way to combine fiscal responsibility with health care reform. For better ideas, look no further than the food stamps program, which costs about $56 billion a year, and gives low-income people a debit card to use at stores to buy whatever food they choose. This approach to subsidizing nutrition allows freedom of choice and gets few complaints.
But imagine if, instead of food stamps, the government delivered bags of groceries to people’s front doors. Complaints would soon abound, because people probably would not like the contents. Some might say that they didn’t want Corn Flakes, they wanted granola. Others might reject Velveeta in favor of Kraft Slices, or chicken in favor of beef.
The Democratic health insurance bills take a similar approach, specifying what coverage people must buy. But one size does not fit all well.
Representative Paul Ryan, Republican of Wisconsin has applied the food stamps idea to health reform. In his Road Map for America’s Future, reintroduced this month, Americans would take refundable tax credits – $2,300 for singles and $5,700 for families – and choose private insurance. All insurance plans that are licensed in a particular state would be eligible, and each company would be free to set its own premiums. Low-income individuals would get extra tax credits so they could buy the same kind of health care as other Americans.
Medicare would remain the same for current beneficiaries and for those 55 and older when they reach 65. But when those born in 1955 or later become eligible for Medicare at age 65, their plan would change. They would receive $11,000, adjusted for inflation, to buy a Medicare certified plan. Those with lower incomes or with more serious health conditions would receive more funding.
Under Mr. Ryan’s plan, health insurance companies could offer high-deductible plans carrying lower premiums combined with health savings accounts, or more traditional managed care or fee-for-service plans. Persons with high-cost chronic illnesses, such as hemophilia or diabetes, would be placed in special affordable state high risk pools, with subventions paid by the government.
On Wednesday, Congressional Budget Office Director Douglas Elmendorf wrote to Mr. Ryan to tell him that this plan reduced health care costs and the federal deficit. He said: “Under the proposal, national health expenditures would almost certainly be lower than they would under the alternative fiscal scenario. Federal spending for health care would be substantially lower, relative to the amount in that scenario, for working-age people and the Medicare population.”
Ask yourself this question: What is the one health system characteristic every developed country has, except the United States?
If you answered: Every other country has made health care a right, you’re wrong. Citizens of Canada have no right to any particular health care service. They have no right to a CT scan or open heart surgery. They don’t even have a right to a place in line. The 100th Canadian waiting for heart surgery isn’t entitled to the 100th surgery.
If you answered: Every other country guarantees access to care, regardless of ability to pay, you’re wrong again. In Britain people routinely go to the private sector and pay out-of-pocket for care they cannot get from the state. Canadians come to this country. In both cases, lack of ability to pay is a barrier to care.
Answer: Other countries have nationalized, or collectivized, their health care systems. So far we have not.
In the United States, whether you have insurance at all, what kind of insurance you have, where you get it, what price you pay — these decisions are primarily made by individuals and employers in the private sector. In other countries, they are made by government.
In terms of democratic theory, in other countries people get to vote on what kind of insurance you have and you get to vote on theirs. In the United States the health insurance of most working-age families is based on individual choice, not public choice.
As for day-to-day operations, the U.S. health care system is actually far more similar to the systems of other countries than most people realize. Critics tend to exaggerate the role of out-of-pocket payment in the United States and minimize its role in other countries. In fact, U.S. citizens pay about 13¢ out of pocket every time they spend $1 on health care and this is well below the OECD average (20¢) and even and below that of Canada (15¢)!
Despite all the claims about how different the U.S. system is from the Canadian system, the two systems are far more similar than they are different. Both countries pay doctors the same way; both rely heavily on third-party payment; and both ration by waiting. In Canada, when people see a doctor, the visit is free. In the U.S., it’s almost free. In fact, it’s probably fair to say that there are fewer differences between U.S. and Canadian health care on average than there are among the various types of health plans within the U.S.
The real issue, then, is not about health care at all. It’s about collectivism. It’s about whether we are going to make decisions in one-sixth of our economy privately or publicly. It’s about private sector institutions versus government and ultimately the ballot box.
Highly informed sources on Capitol Hill have revealed to me details of the Democratic plan to sneak Obamacare through Congress, despite collapsing public approval for healthcare “reform” and disintegrating congressional support in the wake of Republican Scott Brown’s victory in Massachusetts.
President Obama, House Speaker Nancy Pelosi, and Senate Majority Leader Harry Reid all have agreed to the basic framework of the plan.
Their plan is clever but can be stopped if opponents of radical healthcare reform act quickly and focus on a core group of 23 Democratic Congressman. If just a few of these 23 Democrats are “flipped” and decide to oppose the bill, the whole Obama-Pelosi-Reid stratagem falls apart.
Here’s what I learned top Democrats are planning to implement.
Senate Democrats will go to the House with a two-part deal.
First, the House will pass the Senate’s Obamacare bill that passed the Senate in December. The House leadership will vote on the Senate bill, and Pelosi will allow no amendments or modifications to the Senate bill.
How will Pelosi’s deal fly with rambunctious liberal members of her majority who don’t like the Senate bill, especially its failure to include a public option, put heavy fines on those who don’t get insurance, and offering no income tax surcharge on the “rich”?
That’s where the second part of the Pelosi-deal comes in.
Behind closed doors, Reid and Pelosi have agreed in principle that changes to the Senate bill will be made to satisfy liberal House members — but only after the Senate bill is passed and signed into law by Obama.
This deal will be secured by a pledge from Reid and the Senate’s Democratic caucus that they will make “fixes” to the Senate bill after it becomes law with Obama’s John Hancock.
But you may ask what about the fact that, without Republican Scott Brown and independent Democrats such as Joe Lieberman, Reid simply doesn’t have the 60 votes in the Senate to overcome a Republican filibuster that typically can stop major legislation?
According to my source, Reid will provide to Pelosi a letter signed by 52 Democratic senators indicating they will pass the major changes, or “fixes,” the House Democrats are demanding. Again, these fixes will be approved by the Senate only after Obama signs the Senate bill into law.
Reid also has agreed to bypass Senate cloture and filibuster rules and claim that these modifications fall under “reconciliation” and don’t require 60 Senate votes.
To pass the fixes, he won’t need one Republican; he won’t even need Joe Lieberman or wavering Democrats such as Jim Webb of Virginia.
His 52 pledged senators give him a simple majority to pass any changes they want, which will later be rubberstamped by Pelosi’s House and signed by Obama.
This plan, of course, is a total subversion of the legislative process.
Typically, the Senate and House pass their own unique legislation and then both bills go to a conference committee. In conference, the leadership of both Democrat-dominated houses wheels and deals and irons out differences.
The final compromise bill is then sent back to the full Senate and full House for a vote and has to pass both to go to the president.
In the House, a simple majority passes the legislation. But under Senate rules, major legislation requires 60 votes to end a filibuster.
As it stands, the House bill and Senate bill have major discrepancies. Reid does not have 60 votes to pass a compromise bill that would no doubt include some of the radical provisions House members have been demanding.
But if the House passes the exact Senate bill that passed by a 60-39 Senate vote last month, there is no need for a conference on the bill. It will go directly to the president’s desk.
There is a rub to all of this.
This secret plan being hatched by Pelosi and Reid requires not only a pledge by 52 Democratic senators to vote later for the House modifications. House liberals must actually believe these Senators will live up to their pledge and pass the fixes at some future date.
Sixty-one percent (61%) of U.S. voters say Congress should drop health care reform and focus on more immediate ways to improve the economy and create jobs.
A new Rasmussen Reports national telephone survey finds that just 30% of voters nationwide disagree and think Congress should press ahead with health care.
Fifty-nine percent (59%) say given the country’s current economic situation, the Obama administration should wait on health care reform until the economy improves. That’s a 10-point increase from March of last year. Thirty-three percent (33%) still say the White House should move forward with health care reform.
Seventy percent (70%) of voters nationwide say the health care issue was important in the special Senate election in Massachusetts. That number includes 49% who say it was very important. Only 15% think the health care issue was not very or not at all important in the Tuesday election.
House Speaker Nancy Pelosi said Thursday she does not have the votes to pass the Senate’s version of a health insurance bill that is now in severe jeopardy of being scrapped.
Just days ago, that was the most viable option for keeping alive President Obama’s top domestic priority, but with the election of Republican Scott Brown to the U.S. Senate in Massachusetts, the fragile coalition of Democrats has broken apart as lawmakers bicker over which portions of the $900 billion, 10-year Senate bill they will and won’t accept.
Emerging from a closed-door meeting with her caucus, the House speaker vented frustration with the massive version of the legislation.
“In its present form without any changes I don’t think it’s possible to pass the Senate bill in the House,” said Pelosi, D-Calif. “I don’t see the votes for it at this time.”
Last week’s cynical deal between the Obama administration and organized labor to exempt unionized workers from the so-called Cadillac health plan tax was portrayed as a victory for organized labor. In truth, the deal was a gift to public-sector unions by a president who is himself a member of what I call the New New Left, that is, the party of Americans who always benefit from a growing government. This New New Left rules the Democratic Party and significant parts of the GOP in some states, and public sector workers are anchor tenants in the New New Left’s mall.
To understand the true nature of the White House deal, look at who actually comprises organized labor in America today. First of all, since both the country’s private sector economy and the portion of private workers who are unionized have slumped in recent years, we have finally reached the point where there are more unionized government workers in America than organized private laborers. Moreover, in the private sector the composition of the union movement has changed dramatically by shifting away from high-wage manufacturing jobs and toward low-wage service jobs in industries like health care and building services. Many of these private service sector workers have only modest health insurance packages whose annual premium costs don’t approach the point at which the health tax kicks in, so exempting them from the tax is meaningless.
By contrast, government unionized workers often have gold-plated health benefits packages that are among the most expensive in America. Several years ago, for instance, the Employee Benefit Research Institute noted in a report the growing gap in both salaries and benefits between the private and public sector, estimating that state and local governments paid on average about 120 percent more on an hourly basis for employee health premiums than private employers. That’s why although the entire notion of a Cadillac tax began as a way to restrain pricey executive health plans in the private sector, Democrats in Washington soon realized that the tax would mainly hit their allies in public sector unions.
In places where government unions have the most influence, like California, New York and New Jersey, the cost of public health plans is well beyond what’s typical in the private sector because public workers in these places make little or no contribution toward premiums, often don’t have co-pays for doctor visits, and have a rich array of supplemental benefits that are rare in the private sector and drive the cost of health coverage skyward (and which the Cadillac tax was supposed to help restrain).
Many of these benefits, by the way, don’t merely apply to current government workers but also to retirees because many states and cities now offer public workers attractive retirement packages that start at 50 for public safety workers and 55 for everyone else and which include full-health benefits until retirees reach the age that Medicare kicks in. Even then, government pays for retirees’ supplemental Medicare coverage in many places. That’s one reason why New York City, for instance, is currently paying health premiums for nearly as many retirees as current workers.
The health care deal, then, represents an unprecedented victory for public sector unions, and the deal shows where the next front in the growing battle between taxpayers and those who devour tax revenues will be fought. The burden these outsized public worker salaries and benefits costs have placed on government budgets everywhere has sparked a crisis and a search for new revenues. By exempting public employees from a significant revenue raiser, Washington has pointed the way. Expect more creative deals at the state and local level where government workers will be relieved of paying new taxes or otherwise have their tax obligations subsidized.
As Capitol Hill attempts to overcome the shock over Republican U.S. Senator-elect from Massachusetts Scott Brown’s earth-shattering victory last night, the upset appears to have left supporters of President Obama’s health care bill with few options to save the massive overhaul from defeat.
In his acceptance speech Tuesday night, Brown confirmed a primary theme of his campaign: that he would cast a critical 41st vote against the health care bill, leaving Democrats unable to surmount a Republican filibuster to destroy the measure. Brown defeated Democrat opponent Martha Coakley 52%-47% to overtake the seat held by Democratic icon Sen. Ted Kennedy for nearly 47 years.
“One thing is very, very clear as I traveled across this state. People do not want the trillion dollar health care plan that is being forced on the American people, and this bill is not being debated openly and fairly,” said Brown to cheering crowds. “It will raise taxes, it will hurt Medicare, it will destroy jobs and run our nation deeper in to debt.
“The independent majority has delivered a great victory.”
Many experts project that the Brown win will have catastrophic consequences for the health care overhaul, although Democrats are floating a few options. One of the most talked-about ideas has been to convince the House to pass the whole Senate bill unamended, thus allowing the bill to avoid a second Senate vote.
Leaders would then attempt to accommodate House Democrats’ interests in health care reform with a follow-up, separate budget bill, which would dodge the filibuster by requiring only 51 Senate votes through a process known as reconciliation.
It is unclear, however, how central House Democrat demands for health care reform – such as a more comprehensive public insurance option – could be resolved in a bill restricted purely to federal budget issues.
Patient advocate and health policy expert, Betsy McCaughey explains why some major parts of the Democrats healthcare reform are unconstitutional and how the overhaul puts many patients in peril, particularly the elderly.
In 2006, Massachusetts enacted a sweeping health insurance law that mirrors the legislation currently before Congress. After signing the measure, Gov. Mitt Romney (R) wrote, “Every uninsured citizen in Massachusetts will soon have affordable health insurance and the costs of health care will be reduced.” But did the legislation achieve these goals? And what other effects has it had? This paper is the first to use Current Population Survey data for 2008 to evaluate the Massachusetts law, and the first to examine its effects on the accuracy of the CPS’s uninsured estimates, self-reported health, the extent of “crowd-out” of private insurance for both children and adults, and in-migration of new Massachusetts residents.
We find evidence that Massachusetts’ individual mandate induces uninsured residents to conceal their true insurance status. Even setting that source of bias aside, we find the official estimate reported by the Commonwealth almost certainly overstates the law’s impact on insurance coverage, likely by 45 percent. In contrast to previous studies, we find evidence of substantial crowdout of private coverage among low-income adults and children. The law appears to have compressed self-reported health outcomes, without necessarily improving overall health. Our results suggest that more than 60 percent fewer young adults are relocating to Massachusetts as a result of the law. Finally, we conclude that leading estimates understate the law’s cost by at least one third, and likely more.
Our results hold important lessons for the legislation moving through Congress. As in Massachusetts, there has been no effort to estimate the cost of the private health insurance mandates that legislation would impose on individuals and employers. The costs may therefore be far greater than legislators and voters believe, while the benefits may be smaller than the conventional wisdom about Massachusetts suggests.
In pushing a giant step closer to a health care reform deal, Democratic leaders are once again drawing fire from their critics for extending special treatment to an interest group in exchange for its support of the bill.
In pushing a giant step closer to a health care reform deal, Democratic leaders are once again drawing fire from their critics for extending special treatment to an interest group in exchange for its support of the bill.
The latest deal was struck Thursday among the White House, Congress and union leaders over the proposed tax on high-value “Cadillac” health insurance plans.”
Unions had objected strongly to the proposed tax on high-value insurance policies, fearing it would hurt their members, and they won several concessions from the administration. Under the deal, if it becomes law, union workers will be shielded from the 40 percent tax for five years — until 2018. The threshold for the tax also was raised so that it will kick in for plans worth $24,000 instead of $23,000. And dental and vision coverage will not count toward that threshold.
But what about everybody else?
The unions, traditional supporters of the Democratic Party and a major factor in Obama’s political infrastructure, got a deal, but Republicans said that non-union workers will still have to pay the tax from the get-go starting in 2013.
“I guess this bill is only good if it doesn’t apply to you,” GOPAC Chairman Frank Donatelli said.
“Millions of non-union workers … would be forced to pay higher taxes for the same benefits their union counterparts” receive, Republicans on the House Ways and Means Committee said in a written statement.
By BETSY MCCAUGHEY — The health bills in Congress rob you of your constitutional rights. Here are five provisions (of many) that fail the constitutionality test and reveal Congress’s disrespect for the public:
* Section 3403 of the Senate health bill, establishing a commission to cut Medicare spending, says the law can’t be changed or repealed in the future. This whopper shows that Congress thinks its work should be set in stone. Wrong. The people always have the right to elect a new Congress to change or repeal what a previous Congress has done.
* A Senate health-bill amendment mysteriously allocates $100 million to an unnamed facility that “shall be affiliated with an academic health center at a public research university in the United States that contains a state’s sole public academic medical and dental school” (Sec. 10502, p. 328-329). Why not name the facility?
This pork deal was arranged by Sen. Chris Dodd for the University of Connecticut Health Center, although 11 hospitals in the nation technically meet these specifications. If Congress wrote the provision in Polish or Russian to keep the public in the dark, it would be unconstitutional. The language is a deception. The fact that legislators commonly do this makes it more damaging, not less so.
* The bills require you to enroll in a “qualified health plan,” whether you want it or not. Forcing people to buy insurance obviously reduces the number of uninsured. But Congress doesn’t have the authority to force people to buy a product.
Sen. Orin Hatch (R-Nev.) said on the Senate floor, “If Congress may require individuals to purchase a particular good or service . . . We could simply require that Americans buy certain cars . . . for that matter, we could attack the problem of obesity by requiring Americans to buy fruits and vegetables.”
Some Congress members claim the “general welfare clause” of the Constitution empowers them to impose a mandate. But they’re taking the phrase out of context. The Constitution gives Congress power to tax and spend for the general welfare, but not to make other kinds of laws for the general welfare.
The Senate bill (pages 320-324) claims the “interstate commerce” clause of the Constitution gives Congress this authority. But for half a century, states have regulated health insurance. In fact, individuals are barred from buying insurance in any state except where they live, the antithesis of interstate commerce.
Congressional majorities have frequently resorted to the commerce clause to justify their lawmaking. In FDR’s first term, Congress cited it to pass the National Industrial Recovery Act, which gave the federal government power to micromanage local businesses, setting wages and hours and even barring customers from selecting their live chickens at the butcher. Two Brooklyn brothers, owners of Schechter Poultry Corp., a kosher chicken business, challenged that interference. In 1935, the US Supreme Court ruled the NIRA unconstitutional.
In 1995, the high court again admonished Congress against using the commerce clause as a basis for expanded lawmaking, even when the purpose is as worthy as keeping handguns out of a school zone (US v. Lopez). The court ruled that Congress must stick to its enumerated powers and leave states to police school zones (and, perhaps, mandate health insurance).
* Never before has the federal government intruded into decisions made by doctors for privately insured patients, except on narrow issues such as drug safety. Nothing in the Constitution permits it. But the Senate bill makes you enroll in a plan and then says that only doctors who do what the government dictates can be paid by your plan.
“Qualified plans” can contract only with a doctor who “implements such mechanisms to improve health-care quality as the [current or future] secretary [of Health and Human Services] may by regulation require” (Sec. 1311, p. 148-49). That covers all of medicine, from heart care to child birth, stents to mammograms.
* Finally, the “takings clause” of the Fifth Amendment bars government from taking your property without compensation. It should protect everyone, no matter how unpopular — even insurance companies, but Congress ignored it in writing the health bill. The Senate version goes beyond reining in insurance-company abuses, a just cause, and actually caps insurance-company profit margins at well below current levels, robbing shareholders.
President Obama repeatedly promised the American people that he planned to televise the health care reform negotiations on CSPAN. But the reality is that most of the most important negotiations that have taken place to date and are currently taking place in reconciling the House and Senate versions of the bills are occurring behind closed doors.
The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little.
More than 3,000 patients eligible for Medicare, the government’s largest health-insurance program, will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic in Glendale, northwest of Phoenix, said Michael Yardley, a Mayo spokesman. The decision, which Yardley called a two-year pilot project, won’t affect other Mayo facilities in Arizona, Florida and Minnesota.
Obama in June cited the nonprofit Rochester, Minnesota-based Mayo Clinic and the Cleveland Clinic in Ohio for offering “the highest quality care at costs well below the national norm.” Mayo’s move to drop Medicare patients may be copied by family doctors, some of whom have stopped accepting new patients from the program, said Lori Heim, president of the American Academy of Family Physicians, in a telephone interview yesterday.
“Many physicians have said, ‘I simply cannot afford to keep taking care of Medicare patients,’” said Heim, a family doctor who practices in Laurinburg, North Carolina. “If you truly know your business costs and you are losing money, it doesn’t make sense to do more of it.”
A constitutional historian says American courts would have to overturn their last 80 years of jurisprudence to uphold the constitutionality of the healthcare bill in Congress.
Thirteen Republican attorneys general are threatening to file a lawsuit against the Democrats’ healthcare bill if Senate Majority Leader Harry Reid (D-Nevada) and House Speaker Nancy Pelosi (D-California) refuse to remove a provision being called the “Cornhusker Kickback” — the nearly $100 million Medicaid deal Democratic Senator Ben Nelson secured for his home state of Nebraska. Ostensibly, the deal was in exchange for Nelson’s vote — the 60th of 60 needed — favoring the legislation. As reported earlier, the senator’s decision has angered many Nebraskans.
In a letter sent last week, the 13 attorneys general argue the provision is “constitutionally flawed” and violates the U.S. Constitution’s protection against “arbitrary” legislation. Constitutional historian David Barton, the president of WallBuilders, also believes the provision is unconstitutional.
“I think there’s huge constitutional problems with this thing,” exclaims Barton, “and it may be that we see the power of Congress limited constitutionally through a number of different venues by these various lawsuits that are out there.”
Barton notes that court challenges are looming over the bill’s individual mandate, as well as its anti-trust provision that forces a government monopoly. Texas Governor Rick Perry has also threatened to file a lawsuit, arguing the bill violates states’ rights outlined in the Tenth Amendment.
Just before Christmas, The Heritage Foundation also questioned the constitutional legality of the healthcare legislation, publishing a legal memorandum charging that the individual mandate “takes congressional power and control to a striking new level.”
The letter to Senator Reid and Congresswoman Pelosi was signed by top prosecutors in Alabama, Colorado, Florida, Idaho, Michigan, North Dakota, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Virginia, and Washington state. Four of the Republican attorneys general are running for governor in their respective states.