From National Review Online

The public option isn’t the worst thing about the Senate health-care bill.

By Paul Howard — Joseph Lieberman’s words, “I’m going to be stubborn on this,” must be giving Harry Reid heartburn.

Lieberman may caucus with the Democrats, but he’s more than willing to go his own way — especially when it comes to his staunch opposition to the “public option,” a proposed government-run insurance plan that would compete with private insurers. “Once the government creates an insurance company or plan, the government or the taxpayers are liable for any deficit that government plan runs, really without limit,” Lieberman told the Wall Street Journal.

Other moderate Democrats in the Senate, like Mary Landrieu of Louisiana and Ben Nelson of Nebraska, have made similar criticisms — but none as unequivocally as the junior senator from Connecticut.

So let’s all cheer Senator Lieberman on. There’s a legitimate concern that a public option could eventually use Medicare payment rates to undercut private-insurance premiums, gradually taking over the market. (Democrats insist that the public plan now in play could not work that way — but once it’s in operation, all bets are off. Medicare, after all, was never supposed to set hospital and physician payments — but it didn’t take long before that’s just what it was doing.)

But we should also be wary of a pyrrhic victory. Even if the public option dies, the Senate bill is riddled with fiscal gimmicks and heavy-handed regulations that will increase health-care costs, explode the deficit, and drive up insurance premiums for many people who have private insurance today.

STRIKE ONE
President Obama has promised that he will not sign a health-care bill that would cost more than $900 billion for ten years, and the CBO has scored the Senate bill under that price tag. But according to Jeffrey Anderson, a senior fellow at the Pacific Research Institute, just 1 percent of the ten-year costs of the Senate’s health bill falls in the first four years (2010–2013). Costs escalate rapidly starting in 2014. The minority staff of the Senate Budget Committee estimates the fully implemented cost of the Senate bill for the ten years 2014–2023 at close to $2.5 trillion.

STRIKE TWO
Over the summer, President Obama made a bold promise: “I won’t sign a bill that doesn’t reduce health-care inflation so that families as well as government are saving money.” In that case, the president should tell Harry Reid to head back to the drawing board.

The Congressional Budget Office predicts that, under the Senate bill, coverage costs for individual-insurance subsidies, Medicaid expansion, and tax credits to small businesses will rise at about 8 percent annually. Expansion of eligibility for Medicaid and SCHIP (the State Children’s Health Insurance Program) under the Senate bill would thrust 15 million more Americans into a program that already costs over $300 billion annually.

To add insult to injury, the Senate bill would create another entitlement program on top of Medicaid and Medicare: the Community Living Assistance Services and Supports (CLASS) program, which will offer long-term-care insurance.

CLASS is supposed to be supported entirely through premiums, with no federal subsidies. However, the program is apt to attract sicker enrollees, because their premiums would be higher in the private market than premiums for healthy enrollees. But since these sicker enrollees will cost more to care for, there will eventually be intense political pressure for federal subsidies to keep the program going. The structure of the program would also allow Congress to use premium funds in the early years ($72 billion) to offset coverage costs for the uninsured — making the bill seem deficit-neutral.

Senator Nelson has called CLASS “a Ponzi scheme of the first order, the kind of thing that Bernie Madoff would have been proud of.”

STRIKE THREE
The Senate bill contains a version of insurance regulations currently in force in several states called community rating (charging everyone the same rate) and guaranteed issue (mandating that insurers sell to all applicants, regardless of health status). These policies have driven up insurance costs in every state they’ve been tried in, as younger, healthier applicants drop coverage rather than pay higher costs.

In a recent study for the Manhattan Institute on New York’s individual-insurance market, researchers Stephen Parente and Tarren Bragdon estimated that repealing these regulations could lower insurance premiums by 42 percent.

The Senate bill will drive up other insurance costs as well. Almost everyone would be required to buy expensive policies with limits on out-of-pocket spending, no caps on lifetime spending, and mandatory coverage for services that many consumers would not buy on their own, like orthotics. This is a recipe for health-care inflation.

Read the rest of the column.

From New York Post

By STEPHEN T. PARENTE & TARREN BRAGDON — New York’s individual health-insurance market is not often held up as a national model, and for good rea son. It’s the most regulated, most expensive and, as a result, one of the smallest in the country, with only a few costly health plans available.

Since New York policymakers inflicted costly regulations on insurers in 1994, enrollment in the individual insurance market has plummeted by 96 percent.

Current prices are staggering. In New York City, the cheapest individual plan costs $9,036 a year for a single person and $26,460 for a family. In contrast, the Congressional Budget Office estimates the average national family premium at $12,000 to $15,000 a year.

Yet both the House and the Senate health-reform bills would make the rest of America look more like New York’s dysfunctional market — and then force New Yorkers to foot a larger share of the trillion-dollar cost.

Only five states now have New York-style insurance regulations, but both bills force those rules on all 50 states and then force people to buy coverage or face tax penalties. Think about it: If 45 states don’t regulate insurance like New York does, there is probably a very good reason. And there is: These regulations drive up costs and limit choices.

Adding insult to expensive injury, Congress also plans to expand Medicaid coverage. Here, too, New York is an example of what not to do. The Empire State has the most expensive Medicaid program in the country — spending as much as Texas, Florida and Illinois combined.

New York’s Medicaid program is the fourth largest among all the states as a percentage of the population enrolled, yet the state’s rate of uninsured ranks 24th highest in the country. Of the 26 states with a lower rate of uninsured than New York, only two have a larger share of residents on Medicaid.

Clearly, doubling down on Medicaid is not the right path to universal coverage — yet Congress wants to push millions of Americans into Medicaid and thrust new costs onto the states.

The Senate bill (which is more likely to become law) envisions Medicaid coverage for adults with no children and no disabilities — many of whom don’t qualify for long-term welfare or food stamps. In fact, only five states now have a traditional Medicaid program that covers such individuals at all and only one state covers adults at income levels as high.

The Senate proposes to pay for this new health-care entitlement through new taxes on the middle class and wealthy, including a new Medicare payroll tax on individuals making more than $200,000 and family incomes over $250,000. Since government programs always cost more than advertised, expect those taxes to go up.

Read the rest of the column.

By Allen Quist

“There is a huge middle class marriage penalty hidden in the House and Senate health care bills. The penalty becomes evident by evaluating questions like the following:

How much would two single people, each making $30,000 per year, pay for private health insurance if the Pelosi bill was in effect now? The answer is $1,320 per year for both individuals combined (based on the premium limits and subsidies outlined on the charts below).

But how much would they pay for the same level of insurance under the Pelosi bill if they were to marry? Their combined cost would then be about $12,000 a year (the estimated cost for private insurance).

Health insurance premium costs for two adults with equal incomes if the Pelosi bill was in effect now

Sources:  The numbers on the chart are based on (a) a chart provided by The Committees on Ways & Means, Energy & Commerce, and Education & Labor, October 29, 2009, see next chart; (b) the current Federal Poverty Levels; see final chart below; and (c) the estimate that two adults would pay $12,000 annually for individual health insurance with average benefits if their income exceeds 400% of the Federal Poverty Level.

“Once the income of Americans exceeds 400% of the Federal Poverty Level, there are no limits on the premiums they can be charged, and their premiums are no longer subsidized. The poverty level is much higher for two people living unmarried as compared to the same two people being married. That is why citizens in many cases will pay far more for insurance if they are married. Why should married people be subjected to financial discrimination?  

“This extraordinary penalty people will pay, should they marry, extends all the way from a two-person combined income of $58,280 to $86,640, a spread of $28,360. A large number of people fall within this spread. As premiums for private insurance escalate, as expected, the marriage penalty will become substantially larger.

“The Senate bill also creates a marriage penalty, in this case by imposing a new tax on individuals who make $200,000 annually but it also applies to married couples making $250,000 each year. This marriage tax on the affluent, however, is just the tip of the marriage penalty iceberg in the Senate bill.

“The Senate bill stipulates that two unmarried people, 52 years of age, with private insurance and a combined income of $60,000, $30,000 each, will pay a combined cost of $2,483 for medical insurance. Should they marry, however, they will pay a combined cost of $11,666 for insurance—a penalty of $9,183 for getting married (based on tables available here).

“This substantial marriage penalty applies to persons on individual insurance, but, as the Heritage Foundation’s Bob Moffit said: ‘if an employer has a health care benefits package that is 12 to 13 percent of payroll, and they can solve their problem by paying an 8 percent payroll tax [into the Exchange], I think they’re going to do it,’ (New York Times, 9-30-09). And Howard Dean said that, ‘small business won’t need to buy health care for its employees any more’ (Fox News Sunday with Chris Wallace, 11-29-09).

“Businesses will shed their employees and health care dollars into the Exchange, but the dollars that are paid back out will be directed only to those who make less than 400% of the Federal Poverty Level. Those above the Poverty Level will receive none of their previous insurance benefits from businesses. For that reason the new system is income redistribution on steroids.
 
“ ‘Household’ is defined in both bills as including those who can be claimed as dependents for federal income tax purposes thereby clarifying that adults can avoid the marriage penalty by living together unmarried. The new system provides a huge incentive for doing so.

“The bills additionally contain De Facto salary caps. How much would a married couple pay for private insurance under the House bill if their income was $58,000 per year?  The answer is $2,088. But what if their income increased by $1,000? Their annual premium would then be about $12,000. The economic penalty for going off the subsidized system is so severe that it will be difficult for people to increase their earnings beyond 400% of Poverty Level. The Senate bill works essentially the same way.

“Senior citizens and small businesses have already been identified as big losers in the health care bills. Married citizens in the middle class need to be added to the list.”

Official summary of premium limits and subsidy levels in the House bill*

Federal Poverty Levels now in use:

• Single person = $10,830
• Two person household = $14,570
• Three person household = $18,310
• Family of four = $22,050

400% of Federal Poverty Level:

• Single person = $43,320
• Two person household = $58,280
• Three person household = $73,240
• Family of four = $88,200

*  Chart provided by The House Committees on Ways & Means, Energy & Commerce, and Education & Labor, October 29, 2009.

From the Washington Times

As President Obama and Congress craft the largest national health insurance program since the creation of Medicare and Medicaid in 1965, they insist that the final product will add “not one dime” to the federal deficit.

But cost projections are notoriously unreliable, and history is filled with examples of federal programs – especially in health care – that cost far more than originally predicted.

In 1965, the House Ways and Means Committee estimated that the hospital insurance program of Medicare – the federal health care program for the elderly and disabled – would cost $9 billion by 1990. The actual cost that year was $67 billion.

In 1967, the House Ways and Means Committee said the entire Medicare program would cost $12 billion in 1990. The actual cost in 1990 was $98 billion.

In 1987, Congress projected that Medicaid – the joint federal-state health care program for the poor – would make special relief payments to hospitals of less than $1 billion in 1992. Actual cost: $17 billion.

The list goes on. The 1993 cost of Medicare’s home care benefit was projected in 1988 to be $4 billion, but ended up at $10 billion. The State Children’s Health Insurance Program (SCHIP), which was created in 1997 and projected to cost $5 billion per year, has had to be supplemented with hundreds of millions of dollars annually by Congress.

Barely two weeks in office, Mr. Obama signed a $33 billion bill that will add 4 million mostly low-income children to the SCHIP program over the next 4 1/2 years.

All of these numbers were assembled and published in July by the Senate Joint Economic Committee.

The White House and Democratic leaders insist that the proposed health care reform being debated on Capitol Hill will be different. They also note that the costs of some federal health care programs, including the Medicare prescription-drug program, have come in below projections.

But the official arbiter of costs in Congress, the Congressional Budget Office, hints that comprehensive health care reform could go the way of most other health care initiatives from Washington.

Read the rest of the story

From The Hill

By Rep. Michele Bachmann — As unemployment surpasses 10 percent, Congress continues to vow that job creation is a top priority. After the $1.1 trillion stimulus failed to prevent unemployment from rising above 8 percent as its proponents promised, lawmakers are feeling the heat from American families as they struggle to pay for their mortgage, college tuition, and healthcare.

Just last month, 190,000 jobs were lost. All year long, Democrats in Washington have been on a spending spree, claiming that the only way to save the economy from ruin was by spending big. Now House Democrats are using the same excuse to allow the government to take over our nation’s healthcare industry at the steep price tag of $1.3 trillion.

As the House debated the controversial bill late on a Saturday night, Democrats promised that their healthcare reform would help small businesses, lower their premiums, and offer affordable healthcare for all Americans. One of my colleagues on the other side of the aisle said it would “strengthen small businesses so they will be critical engines of growth in our communities.” Another lawmaker even went so far as to promise that the government takeover would reduce insurance costs for 14,800 small businesses in his district.

 

Many supporters of Pelosicare seemed to sympathize with small businesses and the strain that healthcare premiums place on these job creators. This is a noble goal and one that I share. But, it’s exactly why I oppose any legislation that would place the central control of our nation’s healthcare industry into the hands of the federal government. If costs and job growth is their top concern as my colleagues adamantly proclaimed on the House floor, they should also oppose Pelosicare.

Unfortunately, the rhetoric we are hearing does not reflect reality. Research shows that Speaker Nancy Pelosi’s (D-Calif.) healthcare would not decrease costs for American families and small businesses.  How can it when $729.5 billion of new taxes are imposed on the same small businesses and individuals who are already struggling to afford health coverage?

This government takeover of healthcare allows an unprecedented level of government interference. Section 202 of the House bill requires individuals to enroll in a qualified plan.  Meanwhile, Section 303 explains this bill does not design the qualified plan. However, small businesses and American families can be certain this bill does design the new taxes and fines to which they will be subjected. Essentially, the American people are being forced to sign on the dotted line and pay for a product they have not yet seen. 

Section 202 also provides a “grace period” for businesses to meet the qualified plan. Under this bill, businesses will be forced to reevaluate the benefits they are currently providing and adjust them to the standards created by a new bureaucracy that is unfamiliar with the needs of the company’s employees. If these businesses are unable to afford the new government mandates, they will be subject to an 8 percent payroll tax.

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From The Hill

The House-approved healthcare overhaul would raise the costs of healthcare by $289 billion over the next 10 years, according to an analysis by the chief actuary at the Centers for Medicare and Medicaid Services (CMS).

(READ THE FULL REPORT HERE)

The CMS report is a blow to the White House and House Democrats who have vowed that healthcare reform would curb the growth of healthcare spending. CMS’s analysis is not an apples-to-apples comparison to the cost estimate conducted by the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) because CMS did not review tax provisions, which help offset the price tag of the Democrats’ measure.

However, the CMS analysis clearly states that the House bill falls short in attaining a key goal of the Democrats’ effort to reform the nation’s healthcare system: “With the exception of the proposed reduction in Medicare… the provisions of H.R. 3962 would not have a significant impact on future healthcare cost growth rates.”

Republicans immediately seized on CMS’s conclusions.

The long-awaited report should serve as a “stark warning to every Republican, Democrat and Independent worried about the future of this nation,” Ways and Means Committee ranking member Dave Camp (R-Mich.) said in a statement on Saturday. 

Though House Republicans pressed to have this analysis completed before the lower chamber voted on the Democrats’ sweeping healthcare reform bill last week, it was not ready until late Friday. Chief CMS Actuary Richard Foster, who prepared the report, recently told The Hill that he and his staff had only a few days to review the bill before it was voted on.

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From the Wall Street Journal

Meet the unelected body that will dictate future medical decisions.

As usual, the most dangerous parts of ObamaCare aren’t receiving the scrutiny they deserve—and one of the least examined is a new commission to tell Congress how to control health spending. Democrats are quietly attempting to impose a “global budget” on Medicare, with radical implications for U.S. medicine.

Like most of Europe, the various health bills stipulate that Congress will arbitrarily decide how much to spend on health care for seniors every year—and then invest an unelected board with extraordinary powers to dictate what is covered and how it will be paid for. White House budget director Peter Orszag calls this Medicare commission “critical to our fiscal future” and “one of the most potent reforms.”

As envisioned by the Senate Finance Committee, the commission—all 15 members appointed by the President—would have to meet certain budget targets each year. Starting in 2015, Medicare could not grow more rapidly on a per capita basis than by a measure of inflation. After 2019, it could only grow at the same rate as GDP, plus one percentage point.

The theory is to let technocrats set Medicare payments free from political pressure, as with the military base closing commissions. But that process presented recommendations to Congress for an up-or-down vote. Here, the commission’s decisions would go into effect automatically if Congress couldn’t agree within six months on different cuts that met the same target. The board’s decisions would not be subject to ordinary notice-and-comment rule-making, or even judicial review.

Yet if the goal really is political insulation, then the Medicare Commission is off to a bad start. To avoid a senior revolt, Finance Chairman Max Baucus decided to bar his creation from reducing benefits or raising the eligibility age, which meant that it could only cut costs by tightening Medicare price controls on doctors and hospitals. Doctors and hospitals, naturally, were furious.

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From the Orange County Register

It’s too bad the health care overhaul that House Democrats narrowly approved last week isn’t a medical product. If it were, it would have to come with a warning label, Which could read something like this:

WARNINGS:

•This product will increase your health insurance premiums. Millions who are satisfied with their current, low-cost health plans would have to switch to more expensive plans, solely because Congress decided they weren’t buying enough coverage.

The legislation would increase premiums even further over time, as drug companies, chiropractors, acupuncturists, fertility specialists and other special interests lobby Congress to force you to purchase coverage for their services too.

•This product will reduce the quality of your health care. America’s health care sector is often inconvenient, poorly coordinated, and makes less use of information technology than your local supermarket. Research shows that medical errors kill as many as 100,000 Americans per year.

Markets would solve those problems, but government thwarts doctors and entrepreneurs who try to improve quality. Medicare – by far the largest purchaser of medical services in the world – actually penalizes doctors and hospitals that reduce medical errors.

The House bill would cement those deficiencies in place with yet another massive government program, and create new quality problems, like insurers skimping on care and customer service for the sickest patients.

•This product probably won’t make you healthier. The House bill would expand coverage, but at a steep cost and with zero evidence that doing so is a cost-effective way of improving health.

Little research supports the notion that broadly expanding insurance coverage makes people healthier. Medicare established near-universal coverage for the elderly, yet research shows that program didn’t save a single life in its first 10 years of operation. Whether it has had any subsequent impact on mortality rates – positive or negative – remains an open question.

•This product will make you poorer. The House bill contains at least $2 trillion in explicit and implicit taxes. Tax rates for wealthy Americans would rise to 45 percent, with an ever-expanding definition of “wealthy.” For the middle class, effective tax rates would average 60 percent to 70 percent and exceed 100 percent in some cases.

•This product will make your children poorer. Since the bill would actually increase the federal budget deficit, the tax burden would grow over time.

The bill purports to cut Medicare spending, but those cuts are not likely to happen. Want proof? At the same time House Democrats promise future spending cuts, they are gutting $210 billion of spending cuts promised by past Congresses.

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From Cleveland.com

Dr. Toby Cosgrove, the leader of the Obama-praised Cleveland Clinic, predicts that in the next four to five years Americans will demand another health reform bill because the proposals moving through Congress do little to control costs.

The House bill passed last weekend and two Senate proposals fail to make the health system more efficient, and do not do enough to help Americans get healthy, Cosgrove said during a speech at Jones Day law firm in downtown Cleveland Tuesday.

“Without controlling obesity, and without controlling smoking, and without dealing with wellness, it’s going to be very difficult for us to ever control the cost of health care in the United States, and the current bills do very little along those lines,” Cosgrove said.

President Barack Obama has made controlling health care costs a focus in his health reform efforts. He visited the Clinic in July before stopping for a rally at Shaker Heights High School as part of day-long effort to reinvigorate the national health care discussion .

The president has praised the Clinic, as well as the Mayo Clinic, as models of low-cost and high-quality care. The reference comes from statistics in the Dartmouth Atlas of Health Care 2008, a report from the Dartmouth Institute for Health Policy and Clinical Policy, a research and educational institution in New Hampshire.

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From Heritage.org

Nancy Pelosi has unveiled the new health care bill in the House after merging together three different versions of legislation. To appease moderate Blue Dog Democrats and to meet President Obama’s oft-stated promise that reform wouldn’t cost more than $900 billion in the first ten years, Speaker Pelosi sought to reduce the $1.5 trillion total cost of the bill. Newsflash: she failed.

The Congressional Budget Office released its preliminary score of the bill and while some in the media have been reporting its net cost of $894 billion, the total cost of health reform legislation is more like $1.5 trillion. So, Speaker Pelosi is essentially right back where she started—with a huge 2,000 page plan that carries a hefty price tag.

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From the Wall Street Journal

Washington is captivated by the Senate melodrama over the so-called public option, salivating at the ring of Harry Reid’s political bell (see below). But the most important health-care questions continue to be about the policy substance—particularly those that Democrats don’t want asked.

Foremost among them is: How will ObamaCare affect insurance premiums in the private health-care markets? Despite indignant Democratic denials, the near-certainty is that their plan will cause costs to rise across the board. The latest data on this score come from a series of state-level studies from the insurance company WellPoint Inc.

At the request of Congressional delegations worried about their constituents—call it a public service—WellPoint mined its own actuarial data to model ObamaCare in the 14 states where it runs Blue Cross plans. The study therefore takes into account market and demographic differences that other industry studies have not, such as the one from the trade group America’s Health Insurance Plans, which looked at aggregate national trends.

In all of the 14 states WellPoint scrutinized, ObamaCare would drive up premiums for the small businesses and individuals who are most of WellPoint’s customers. (Other big insurers, like Aetna, focus on the market among large businesses.) Young and healthy consumers will see the largest increases—their premiums would more than triple in some states—though average middle-class buyers will pay more too.

Not even two hours after Wellpoint had presented its materials on the Hill, Democrats were already trashing it—which, considering that it runs to some 238 pages and took weeks to prepare, must have required remarkable powers of digestion and analysis.

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From the New York Times

WASHINGTON (AP) — Quick quiz: What do these enterprises have in common? Farm and construction machinery, Tupperware, the railroads, Hershey sweets, Yum food brands and Yahoo? Answer: They’re all more profitable than the health insurance industry.

In the health care debate, Democrats and their allies have gone after insurance companies as rapacious profiteers making ”immoral” and ”obscene” returns while ”the bodies pile up.”

Ledgers tell a different reality. Health insurance profit margins typically run about 6 percent, give or take a point or two. That’s anemic compared with other forms of insurance and a broad array of industries, even some beleaguered ones.

Profits barely exceeded 2 percent of revenues in the latest annual measure. This partly explains why the credit ratings of some of the largest insurers were downgraded to negative from stable heading into this year, as investors were warned of a stagnant if not shrinking market for private plans.

Insurers are an expedient target for leaders who want a government-run plan in the marketplace. Such a public option would force private insurers to trim profits and restrain premiums to compete, the argument goes. This would ”keep insurance companies honest,” says President Barack Obama.

The debate is loaded with intimations that insurers are less than straight, when they are not flatly accused of malfeasance.

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From the Wall Street Journal

Washington has just run a $1.4 trillion budget deficit for fiscal 2009, even as we are told a new health-care entitlement will reduce red ink by $81 billion over 10 years. To believe that fantastic claim, you have to ignore everything we know about Washington and the history of government health-care programs. For the record, we decided to take a look at how previous federal forecasts matched what later happened. It isn’t pretty.

Let’s start with the claim that a more pervasive federal role will restrain costs and thus make health care more affordable. We know that over the past four decades precisely the opposite has occurred. Prior to the creation of Medicare and Medicaid in 1965, health-care inflation ran slightly faster than overall inflation. In the years since, medical inflation has climbed 2.3 times faster than cost increases elsewhere in the economy. Much of this reflects advances in technology and expensive treatments, but the contrast does contradict the claim of government as a benign cost saver.

Next let’s examine the record of Congressional forecasters in predicting costs. Start with Medicaid, the joint state-federal program for the poor. The House Ways and Means Committee estimated that its first-year costs would be $238 million. Instead it hit more than $1 billion, and costs have kept climbing.

Thanks in part to expansions promoted by California’s Henry Waxman, a principal author of the current House bill, Medicaid now costs 37 times more than it did when it was launched—after adjusting for inflation. Its current cost is $251 billion, up 24.7% or $50 billion in fiscal 2009 alone, and that’s before the health-care bill covers millions of new beneficiaries.

Medicare has a similar record. In 1965, Congressional budgeters said that it would cost $12 billion in 1990. Its actual cost that year was $90 billion. Whoops. The hospitalization program alone was supposed to cost $9 billion but wound up costing $67 billion. These aren’t small forecasting errors. The rate of increase in Medicare spending has outpaced overall inflation in nearly every year (up 9.8% in 2009), so a program that began at $4 billion now costs $428 billion.

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On Monday, October 19, Senator Jon Kyl of Arizona shared with his colleagues in the Senate what he has been hearing from his constituents on Health Care Reform. Senator Kyl gave a 20-minute presentation in which he aptly articulated the concerns most Americans are expressing about the Health Care Reform bill.  Although it is a bit long, this is a “must-see” speech for everyone who cares about the future of health care in America.

From the Wall Street Journal

By Douglas Holtz-Eakin — Remember when health-care reform was supposed to make life better for the middle class? That dream began to unravel this past summer when Congress proposed a bill that failed to include any competition-based reforms that would actually bend the curve of health-care costs. It fell apart completely when Democrats began papering over the gaping holes their plan would rip in the federal budget.

As it now stands, the plan proposed by Democrats and the Obama administration would not only fail to reduce the cost burden on middle-class families, it would make that burden significantly worse.

Consider the bill put forward by the Senate Finance Committee. From a budgetary perspective, it is straightforward. The bill creates a new health entitlement program that the Congressional Budget Office (CBO) estimates will grow over the longer term at a rate of 8% annually, which is much faster than the growth rate of the economy or tax revenues. This is the same growth rate as the House bill that Sen. Kent Conrad (D., N.D.) deep-sixed by asking the CBO to tell the truth about its impact on health-care costs.

To avoid the fate of the House bill and achieve a veneer of fiscal sensibility, the Senate did three things: It omitted inconvenient truths, it promised that future Congresses will make tough choices to slow entitlement spending, and it dropped the hammer on the middle class.

One inconvenient truth is the fact that Congress will not allow doctors to suffer a 24% cut in their Medicare reimbursements. Senate Democrats chose to ignore this reality and rely on the promise of a cut to make their bill add up. Taking note of this fact pushes the total cost of the bill well over $1 trillion and destroys any pretense of budget balance.

It is beyond fantastic to promise that future Congresses, for 10 straight years, will allow planned cuts in reimbursements to hospitals, other providers, and Medicare Advantage (thereby reducing the benefits of 25% of seniors in Medicare). The 1997 Balanced Budget Act pursued this strategy and successive Congresses steadily unwound its provisions. The very fact that this Congress is pursuing an expensive new entitlement belies the notion that members would be willing to cut existing ones.

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