From the Wall Street Journal

And tidings of comfort and joy from Harry Reid too. The Senate Majority Leader has decided that the last few days before Christmas are the opportune moment for a narrow majority of Democrats to stuff ObamaCare through the Senate to meet an arbitrary White House deadline. Barring some extraordinary reversal, it now seems as if they have the 60 votes they need to jump off this cliff, with one-seventh of the economy in tow.

Mr. Obama promised a new era of transparent good government, yet on Saturday morning Mr. Reid threw out the 2,100-page bill that the world’s greatest deliberative body spent just 17 days debating and replaced it with a new “manager’s amendment” that was stapled together in covert partisan negotiations. Democrats are barely even bothering to pretend to care what’s in it, not that any Senator had the chance to digest it in the 38 hours before the first cloture vote at 1 a.m. this morning. After procedural motions that allow for no amendments, the final vote could come at 9 p.m. on December 24.

Even in World War I there was a Christmas truce.

The rushed, secretive way that a bill this destructive and unpopular is being forced on the country shows that “reform” has devolved into the raw exercise of political power for the single purpose of permanently expanding the American entitlement state. An increasing roll of leaders in health care and business are looking on aghast at a bill that is so large and convoluted that no one can truly understand it, as Finance Chairman Max Baucus admitted on the floor last week. The only goal is to ram it into law while the political window is still open, and clean up the mess later.

***

• Health costs. From the outset, the White House’s core claim was that reform would reduce health costs for individuals and businesses, and they’re sticking to that story. “Anyone who says otherwise simply hasn’t read the bills,” Mr. Obama said over the weekend. This is so utterly disingenuous that we doubt the President really believes it.

The best and most rigorous cost analysis was recently released by the insurer WellPoint, which mined its actuarial data in various regional markets to model the Senate bill. WellPoint found that a healthy 25-year-old in Milwaukee buying coverage on the individual market will see his costs rise by 178%. A small business based in Richmond with eight employees in average health will see a 23% increase. Insurance costs for a 40-year-old family with two kids living in Indianapolis will pay 106% more. And on and on.

These increases are solely the result of ObamaCare—above and far beyond the status quo—because its strict restrictions on underwriting and risk-pooling would distort insurance markets. All but a handful of states have rejected regulations like “community rating” because they encourage younger and healthier buyers to wait until they need expensive care, increasing costs for everyone. Benefits and pricing will now be determined by politics.

As for the White House’s line about cutting costs by eliminating supposed “waste,” even Victor Fuchs, an eminent economist generally supportive of ObamaCare, warned last week that these political theories are overly simplistic. “The oft-heard promise ‘we will find out what works and what does not’ scarcely does justice to the complexity of medical practice,” the Stanford professor wrote.

• Steep declines in choice and quality. This is all of a piece with the hubris of an Administration that thinks it can substitute government planning for market forces in determining where the $33 trillion the U.S. will spend on medicine over the next decade should go.

Unnoticed by the press corps, the Congressional Budget Office argued recently that the Senate bill would so “substantially reduce flexibility in terms of the types, prices, and number of private sellers of health insurance” that companies like WellPoint might need to “be considered part of the federal budget.”

With so large a chunk of the economy and medical practice itself in Washington’s hands, quality will decline. Ultimately, “our capacity to innovate and develop new therapies would suffer most of all,” as Harvard Medical School Dean Jeffrey Flier recently wrote in our pages. Take the $2 billion annual tax—rising to $3 billion in 2018—that will be leveled against medical device makers, among the most innovative U.S. industries. Democrats believe that more advanced health technologies like MRI machines and drug-coated stents are driving costs too high, though patients and their physicians might disagree.

“The Senate isn’t hearing those of us who are closest to the patient and work in the system every day,” Brent Eastman, the chairman of the American College of Surgeons, said in a statement for his organization and 18 other speciality societies opposing ObamaCare. For no other reason than ideological animus, doctor-owned hospitals will face harsh new limits on their growth and who they’re allowed to treat. Physician Hospitals of America says that ObamaCare will “destroy over 200 of America’s best and safest hospitals.”

• Blowing up the federal fisc. Even though Medicare’s unfunded liabilities are already about 2.6 times larger than the entire U.S. economy in 2008, Democrats are crowing that ObamaCare will cost “only” $871 billion over the next decade while fantastically reducing the deficit by $132 billion, according to CBO.

Yet some 98% of the total cost comes after 2014—remind us why there must absolutely be a vote this week—and most of the taxes start in 2010. That includes the payroll tax increase for individuals earning more than $200,000 that rose to 0.9 from 0.5 percentage points in Mr. Reid’s final machinations. Job creation, here we come.

Other deceptions include a new entitlement for long-term care that starts collecting premiums tomorrow but doesn’t start paying benefits until late in the decade. But the worst is not accounting for a formula that automatically slashes Medicare payments to doctors by 21.5% next year and deeper after that. Everyone knows the payment cuts won’t happen but they remain in the bill to make the cost look lower. The American Medical Association’s priority was eliminating this “sustainable growth rate” but all they got in return for their year of ObamaCare cheerleading was a two-month patch snuck into the defense bill that passed over the weekend.

The truth is that no one really knows how much ObamaCare will cost because its assumptions on paper are so unrealistic. To hide the cost increases created by other parts of the bill and transfer them onto the federal balance sheet, the Senate sets up government-run “exchanges” that will subsidize insurance for those earning up to 400% of the poverty level, or $96,000 for a family of four in 2016. Supposedly they would only be offered to those whose employers don’t provide insurance or work for small businesses.

As Eugene Steuerle of the left-leaning Urban Institute points out, this system would treat two workers with the same total compensation—whatever the mix of cash wages and benefits—very differently. Under the Senate bill, someone who earned $42,000 would get $5,749 from the current tax exclusion for employer-sponsored coverage but $12,750 in the exchange. A worker making $60,000 would get $8,310 in the exchanges but only $3,758 in the current system.

For this reason Mr. Steuerle concludes that the Senate bill is not just a new health system but also “a new welfare and tax system” that will warp the labor market. Given the incentives of these two-tier subsidies, employers with large numbers of lower-wage workers like Wal-Mart may well convert them into “contractors” or do more outsourcing. As more and more people flood into “free” health care, taxpayer costs will explode.

• Political intimidation. The experts who have pointed out such complications have been ignored or dismissed as “ideologues” by the White House. Those parts of the health-care industry that couldn’t be bribed outright, like Big Pharma, were coerced into acceding to this agenda. The White House was able to, er, persuade the likes of the AMA and the hospital lobbies because the federal government will control 55% of total U.S. health spending under ObamaCare, according to the Administration’s own Medicare actuaries.

Others got hush money, namely Nebraska’s Ben Nelson. Even liberal Governors have been howling for months about ObamaCare’s unfunded spending mandates: Other budget priorities like education will be crowded out when about 21% of the U.S. population is on Medicaid, the joint state-federal program intended for the poor. Nebraska Governor Dave Heineman calculates that ObamaCare will result in $2.5 billion in new costs for his state that “will be passed on to citizens through direct or indirect taxes and fees,” as he put it in a letter to his state’s junior Senator.

So in addition to abortion restrictions, Mr. Nelson won the concession that Congress will pay for 100% of Nebraska Medicaid expansions into perpetuity. His capitulation ought to cost him his political career, but more to the point, what about the other states that don’t have a Senator who’s the 60th vote for ObamaCare?

Read the rest of the column.

From the Wall Street Journal

Your excellent editorial “The ‘Cost Control’ Bill of Goods” (Dec. 14) doesn’t emphasize a potential stealth cost-control aspect proposed in the bill. It will start pilot programs that would transfer the gatekeeper role to doctors at the bedside, a role currently held by “payers” (HMOs and government-agency insurers, including Medicare and Medicaid).

The transfer will be via capitation fee payments, making clinics “responsible” for the cost of care of “insured lives” for one year. Like the more powerful payers, such clinics must restrict orders for care—or go broke. The clinicians’ other choice is to be left out of the income stream, if they are not incorporated in a comprehensive “provider accountable care organization.” These will bid for capitation fee rates at payer population auctions of the insured lives to be serviced.

The illusion of many pundits and policy makers is that mini provider gatekeepers can control costs after the very powerful payer gatekeepers have failed for decades. The problem for patients is the dilemma of all managed-care gatekeepers: cost, quality, access; pick any two. It is not pleasant to think that one’s gatekeeper doctor will have to decide whether to order surgery for your painful hip or only to increase the dose of Ibuprofen—a choice that patients won’t know about, since managed-care corporations and capitated doctors rationing care are carefully hidden behind the Orwellian double-speak of “pay for quality, not quantity,” “well care, not sick care,” “responsibility,” “accountability,” “pay for outcomes,” and other artful illusions.

The economic reality is that no rationing of care supply will ever control costs, when the problem is demand inflation driven by popular insurance tax subsidies too sacred to repeal. Consider that when federal fiscal “necessity” overwhelms empty slogans, scores of new bureaucracies created in ObamaCare would be able to implement Draconian rationing in collusion with subservient insurance and “provider” corporations. The high costs, as well as the rationing powers included in the more than 2,000 pages of the Obama Care Senate legislation are very real.

Robert W Geist, M.D.
St. Paul, Minn.

From Fox News

WASHINGTON – With a self-imposed Christmas deadline at stake, Senate Majority Leader Harry Reid engineered a last-minute compromise in the health care debate that has won the support of the lone Democratic holdout and clinched the required 60 votes to pass a sweeping overhaul of the U.S. health care system.

Marathon negotiations among the White House, Senate Democratic leaders and Sen. Ben Nelson, a conservative Democrat from Nebraska, produced fresh concessions that will mean additional abortion restrictions in the legislation and funding to cover poor people for Nelson’s state and more.

“I know this is hard for some of my colleagues to accept and I appreciate their right to disagree. But I would not have voted for this bill without these provisions,” Nelson said at a news conference in the Capitol.

Democratic leaders offered Nelson a deal similar to the $300 million in Medicaid assistance Sen. Mary Landrieu of Louisiana got for her support, numerous sources told Fox News.

When asked about this, Sen. Kent Conrad, a key Democratic leader involved in the negotiations with Nelson, said, “Oh, it’ll be much more.”

Obama devoted his weekend radio and Internet address to the issue he campaigned on in 2008.

“Now — for the first time — there is a clear majority in the Senate that’s willing to stand up to the insurance lobby and embrace lasting health insurance reforms that have eluded us for generations,” Obama said. “Let’s bring this long and vigorous debate to an end.”

Read the rest of the story.

From the New York Post

By BETSY MCCAUGHEY

Forget the public option, abortion and all the other divisive questions in the health-care debate: The most important issue for patients and their doctors is the transfer of decision-making power from bedside to the federal government.

The bill that Sen. Harry Reid aims to pass in the Senate would mandate that every American enroll in a “qualified” insurance plan. And page 149 states that “qualified” health plans can do business only with a doctor who “implements such mechanisms to improve health-care quality as the secretary [of Health and Human Services] may by regulation require.”

But “mechanisms to improve health-care quality” covers everything in medicine.

Never before has the federal government intruded into medical decisions made by doctors for privately insured patients, except on such narrow issues as drug safety. Now, in the name of quality, the secretary of Health and Human Services would be empowered to regulate your MD’s decisions on everything from cardiac and cancer care to childbirth.

The delegation of power is so broad, it’s conceivable that Washington will be telling your cardiologist when it’s appropriate to use stents or imaging tests — and directing your gynecologist about the use of pelvic sonograms.

What makes this especially troubling is that government will be imposing its regulations with an eye on reducing the cost of your care, even if you’re paying for it yourself: The explicit purpose of “reform” is to reduce what everyone consumes and to discourage some from getting more care than others.

That’s one reason the Senate bill puts a 40 percent tax on “Cadillac” plans — a category that will cover the top 20 percent of plans, according to the Congressional Budget Office. In its Nov. 30 report, the CBO predicts that many employers will downgrade what they provide their workforce to avoid the tax, while others will pass the cost along in the form of lower take-home pay. If you think this bill won’t hurt you because your employer provides a generous health plan, think again.

Despite President Obama’s promises, the Senate bill expressly reduces the care under Medicare. Baby boomers retiring soon will get less than seniors get now. Page 1189 gives the secretary of Health and Human Services “authority to modify or eliminate coverage of certain preventive services,” based on what the US Preventive Services Task Force recommends. This is the same group that just called for cutting back on mammograms.

Whatever your age, and whether you’re in a public program or the richest “Cadillac” plan, you’ll also lose out if you need to be hospitalized — you’ll find fewer nurses on the floor, less diagnostic equipment, longer waits for tests and an overall environment of scarcity.

Why? Because the Reid bill forces hospitals into financial distress.

Read the rest of the column.

From the Cato Institute

From the Wall Street Journal

Government guidelines would likely have forbidden the test I used to discover my wife’s cancer.

By SENATOR TOM COBURN – I recently suggested that seniors will die sooner if Congress actually implements the Medicare cuts in the health-care bill put forward by Senate Majority Leader Harry Reid. My colleagues who defend the bill—none of whom have practiced medicine—predictably dismissed my concern as a scare tactic. They are wrong. Every American, not just seniors, should know that the rationing provisions in the Reid bill will not only reduce their quality of life, but their life spans as well.

My 25 years as a practicing physician have shown me what happens when government attempts to practice medicine: Doctors respond to government coercion instead of patient cues, and patients die prematurely. Even if the public option is eliminated from the bill, these onerous rationing provisions will remain intact.

For instance, the Reid bill (in sections 3403 and 2021) explicitly empowers Medicare to deny treatment based on cost. An Independent Medicare Advisory Board created by the bill—composed of permanent, unelected and, therefore, unaccountable members—will greatly expand the rationing practices that already occur in the program. Medicare, for example, has limited cancer patients’ access to Epogen, a costly but vital drug that stimulates red blood cell production. It has limited the use of virtual, and safer, colonoscopies due to cost concerns. And Medicare refuses medical claims at twice the rate of the largest private insurers.

Section 6301 of the Reid bill creates new comparative effectiveness research (CER) programs. CER panels have been used as rationing commissions in other countries such as the U.K., where 15,000 cancer patients die prematurely every year according to the National Cancer Intelligence Network. CER panels here could effectively dictate coverage options and ration care for plans that participate in the state insurance exchanges created by the bill.

Additionally, the Reid bill depends on the recommendations of the U.S. Preventive Services Task Force in no fewer than 14 places. This task force was responsible for advising women under 50 to not undergo annual mammograms. The administration claims the task force recommendations do not carry the force of law, but the Reid bill itself contradicts them in section 2713. The bill explicitly states, on page 17, that health insurance plans “shall provide coverage for” services approved by the task force. This chilling provision represents the government stepping between doctors and patients. When the government asserts the power to provide care, it also asserts the power to deny care.

Read the rest of the column.

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 LifeSiteNews

Take the recent amendment to the Senate health care plan by Senate Finance Committee chairman Max Baucus (D-MT). This language allocates hundreds of millions of dollars of your money toward “Personal Responsibility Education for Adulthood Training.”

What can this possibly mean? According to the amendment’s mostly vague language, $400 million from the years 2010 to 2015 will be spent on “evidence-based effective programs” that will supposedly teach kids “healthy life skills,” including things like “goal-setting, decision making, negotiation, communication and interpersonal skills, and stress management.” This looks like standard Washington-speak: a great pile of words that mean whatever they need to mean.

That is, it looks that way until we get to the part of the amendment that deals with sex. Here we find reference to very specific “activities to educate youth who are sexually active regarding responsible sexual behavior.” The amendment claims to implement “evidence-based effective programs … that have been proven on the basis of rigorous scientific research to change behavior, which means delaying sexual activity, increasing condom or contraceptive use for sexually active youth, or reducing pregnancy among youth.”

Here we come to the nub of the matter. The “personal responsibility education” referred to in the Baucus amendment is actually sex education. The Senate health care plan is going to teach kids about sex. Graphically, and early. With heaps of tax dollars.

The amendment includes the obligatory passing reference to abstinence, (and does reinstate Title V funding for abstinence programs), and claims to provide “age-appropriate information and activities.” However, history shows that these claims are misleading at best. What “age-appropriate information” can the bill possibly have in mind for an 11-year-old boy (included in the bill’s intended target group)? Probably not the same “age-appropriate information” the boy’s parents have in mind.

And what good is “abstinence education” if contraception and abortion are being pushed right alongside it? Kids receive a mixed message. They are told, with a wink and a nod, that maybe they should abstain from sex, but the chances are that they simply can’t – and that no one really can. The past teaches us that “evidence-based” or “comprehensive” sex education is simply code for sexual education that treats sex as unavoidable, rather than a human choice.

In this bleak fantasy, kids are nothing more than farm animals, inevitably and indiscriminately sexual. All that the rest of us can do is simply pick up the pieces.

Read the rest of the column.

From the Washington Examiner

The newest bargain being proposed on health care in the Senate would give liberals a major expansion of Medicare by making more than 30 million Americans between the ages of 55 and 65 eligible for the financially exhausted program, previously just for senior citizens.

But by expanding an existing government-run insurance program (while cutting it by $500 billion?) Senate Majority Leader Harry Reid hopes to avoid defeat of his bill because of moderate member’s concerns over his plan to create a whole new health entitlement.

Writers Greg Hitt and Janet Adamy tell us that what’s being offered as the alternative to the government plan approved in the House is a non-profit, national private plan regulated by the federal government.

Liberals in the Senate are trying hard not to look too happy. The bill would ultimately make the government responsible for the new health plan and would create a genuine public option if the non-profit/private/public lash-up goes bust.

Reid was crowing again last night, but as Examiner colleague Susan Ferrechio points out, there is still no certainty that a bill will pass.

Read the rest of the column.

U.S. Senator Tom Coburn, M.D. (R-OK), a practicing physician and author of one of the first health care reform bills introduced this year – the Patients’ Choice Act – released the following statement tonight after voting against a procedural motion that will help Congress enact a massive, budget-busting government-run health care bill.

“This bill is the most reckless, irresponsible and dishonest piece of legislation I have seen in my time in Congress. I’m disappointed my colleagues voted for a bill that will bust the budget, increase taxes, coerce taxpayers into funding abortion, and grant politicians and bureaucrats the power to ration and deny medically-necessary care,” Dr. Coburn said.

While many Senators who voted for this measure called it a harmless procedural vote, experts disagree. According to the nonpartisan Congressional Research Service, bills that pass procedural tests like the one tonight have a 97.6 percent chance of passing the Senate.

“The accounting tricks in this bill would make Bernie Madoff and Enron executives blush,” Dr. Coburn said. “The bill’s author, Senate Majority Leader Harry Reid (D-NV), makes the outlandish claim that this bill ‘saves’ money over ten years. However, he fails to inform the American people that benefits won’t begin for four years while taxes will increase immediately. This would be like a mortgage banker demanding payments for four years before allowing a family to move into their new home. These gimmicks insult the intelligence of every American.”

“Once implemented, the Reid bill will cost at least $2.5 trillion over ten years. Creating a costly new entitlement while we face the risk of a double-dip recession is the height of irresponsibility. Every major government-run health care program is broke or is headed for bankruptcy. Medicare alone faces a long-term debt of $89.3 trillion, which is about six times the size of our entire economy,” Dr. Coburn said. “History shows that great nations collapse over loose fiscal policy, not external threats. The scope of our debt and our reliance on borrowing from potential adversaries, such a China, is a serious national security threat to the United States. This bill will make us more vulnerable and more dependent on excessive and unsustainable borrowing.”

“The bill’s mandate that all Americans must buy insurance is an unconstitutional and unworkable assault on individual liberty and personal responsibility. If this bill passes millions of younger, healthy Americans will saves thousands of dollars every year by dropping coverage until they get sick. The low penalties of not buying coverage in the bill combined with assurances that no one can be denied coverage will push younger and healthier Americans out of the system, leaving older Americans to endure skyrocketing costs,” Dr. Coburn said, noting that eleven studies from government and private sources show health care premiums will increase faster because of the policies in the Reid bill.

“The Reid bill also takes a historic step toward forcing every American taxpayer to finance abortion. The bill gives the Secretary of Health and Human Services the authority to include elective abortions in the government-run and taxpayer-funded ‘public option,’ which is a radical departure from the federal government’s current policy of not funding abortion with public funds,” Dr. Coburn said.

“Sadly, this bill’s lack of respect for life doesn’t end with coercing public funding for abortion. The bill gives bureaucrats the ability to deny coverage on the basis of cost, not care. For instance, the bill specifically authorizes the Secretary of HHS to deny payments for prevention services the U.S. Preventive Services Task Force has recommended against. This is the same task force that recently suggested women under 50 should not receive annual mammograms. As a practicing physician, such decisions should be made by a doctor and her physician, not a politician or bureaucrat in Washington,” Dr. Coburn said.

From LifeSiteNews

The statistics are scary when it comes to the percentage of unborn children born with special needs who become victims of abortion. One fiscal conservative group says the task for parents raising such children is made more difficult by extra taxes found in Harry Reid’s new Senate health care bill.

The measure has already been condemned by pro-life groups and the Catholic bishops for its abortion funding and this latest analysis won’t make it any more endearing.

Ryan Ellis of Americans for Tax Reform notes that the bill contains 18 separate tax increases — one of them targeting parents of disabled children.

“One of them caps the amount that can be deferred in Flexible Spending Accounts (FSAs) at $2500 per year (a similar provision was included in the Pelosi-Obama health bill),” Ellis notes.

“There is currently no limit to how much can be saved, though all monies must be used by the end of the year. Employers may put a cap in place for their employees, but this would put a cap in federal tax law for the first time. According to the Employee Benefit Research Institute (EBRI), 30 million American families use an FSA,” he explained.

Most Americans won’t notice a $2,500 cap as FSAs tend to be used for things like small deductibles, co-payments, eyeglasses, over-the-counter medicines, and laser eye surgery.

But parents of special needs children will, he says.

Read the rest of the story

From DefendYourHealthCare.us

The House of Representatives squeaked through a health bill on November 7th by a mere  five votes, but our biggest battle is still looming – our battle to hold back the Senate.  A win in the Senate will prevent the dismantling of American healthcare and the threat to our liberty. Your hard work has helped turn the tide against passage of these dangerous  bills.  I call upon you now to redouble your efforts and take action as we approach our final fight.  
 
The content of the House bill (H.R. 3962) reveals why this call to action is necessary. 
 
Here’s what the government will require you to do if the bill is enacted:

 

· Sec. 202 (p. 91-92) of the bill requires you to enroll in a “qualified plan.” If you get your insurance at work, your employer will have a “grace period” to switch you to a “qualified plan,” meaning a plan designed by the Secretary of Health and Human Services. If you buy your own insurance, there’s no grace period. You’ll have to enroll in a qualified plan as soon as any term in your contract changes, such as the co-pay, deductible or benefit.
 
· Sec. 224 (p. 118) provides that 18 months after the bill becomes law, the Secretary of Health and Human Services will decide what a “qualified plan” covers and how much you’ll be legally required to pay for it. That’s like a banker telling you to sign the loan agreement now, then filling in the interest rate and repayment terms 18 months later.
 
On November 2, the Congressional Budget Office estimated what the plans will likely cost. An individual earning $44,000 before taxes who purchases his own insurance will have to pay a $5,300 premium and an estimated $2,000 in out-of-pocket expenses, for a total of $7,300 a year, which is 17% of his pre-tax income. A family earning $102,100 a year before taxes will have to pay a $15,000 premium plus an estimated $5,300 out-of-pocket, for a $20,300 total, or 20% of its pre-tax income. Individuals and families earning less than these amounts will be eligible for subsidies paid directly to their insurer.
 
· Sec. 303 (pp. 167-168) makes it clear that, although the “qualified plan” is not yet designed, it will be of the “one size fits all” variety. The bill claims to offer choice-basic, enhanced and premium levels-but the benefits are the same.  Only the co-pays and deductibles differ. You will have to enroll in the same plan, whether the government is paying for it or you and your employer are footing the bill.
 
· Sec. 59b (pp. 297-299) says that when you file your taxes, you must include proof that you are in a qualified plan or risk paying fines.  
 
More Bad News:  Porkers Live Off Fat of the Land & Seniors Lose Out

 

Shockingly, more than half of the House bill has nothing to do with making insurance better or more affordable.  Instead, in these pages, billions of dollars are diverted to the creation of new urban welfare and diversity programs with vague standards of accountability.  Here are just a few of those pork programs:
 
· Sec. 399V (p. 1422) provides for grants to community “entities” with no required qualifications except having “documented community activity and experience with community healthcare workers” to “educate, guide, and provide experiential learning opportunities” aimed at drug abuse, poor nutrition, smoking and obesity. “Each community health worker program receiving funds under the grant will provide services in the cultural context most appropriate for the individual served by the program.”
These programs will “enhance the capacity of individuals to utilize health services and health related social services under Federal, State and local programs by assisting individuals in establishing eligibility . . . and in receiving services and other benefits” including transportation and translation services.
 
· Sec. 222 (p. 617) provides reimbursement for culturally and linguistically appropriate services. This program will train health-care workers to inform Medicare beneficiaries of their “right” to have an interpreter at all times and with no co-pays for language services.
 
· Secs. 2521 and 2533 (pp. 1379 and 1437) establishes racial and ethnic preferences in awarding grants for training nurses and creating secondary-school health science programs.  For example, grants for nursing schools should “give preference to programs that provide for improving the diversity of new nurse graduates to reflect changes in the demographics of the patient population.” And secondary-school grants should go to schools “graduating students from disadvantaged backgrounds including racial and ethnic minorities.”
 
· Sec. 305 (p. 189) Provides for automatic Medicaid enrollment of newborns who do not otherwise have insurance.  This provision is separate from the one that makes Medicaid available to all adults with incomes at or below 150% of the federal poverty line – which means about 21% of the entire U.S. population would be eligible for this welfare program. 
 
While pork programs make it possible for more people to live off taxpayer dollars, an estimated $571 billion will be cut in future Medicare funding to offset the tab for the health bill.  That’s about a 10% reduction over the next decade, when almost 18 million baby boomers will be turning 65 and entering Medicare!  The President insists these cuts won’t affect senior care, but the House bill fundamentally changes how Medicare pays doctors and hospitals, permitting the government to dictate treatment decisions.  Here’s how:
 
· Sec. 1302 (pp. 672-692) moves Medicare from a fee-for-service payment system, in which patients choose which doctors to see and doctors are paid for each service they provide, toward what’s called a “medical home.”
 
The medical home is this decade’s version of HMO-restrictions on care. A primary-care provider manages access to costly specialists and diagnostic tests for a flat monthly fee. The bill specifies that patients may have to settle for a nurse practitioner rather than a physician as the primary-care provider. Medical homes begin with demonstration projects, but the HHS secretary is authorized to “disseminate this approach rapidly on a national basis.”
 
A December 2008 Congressional Budget Office report noted that “medical homes” were likely to resemble the unpopular gatekeepers of 20 years ago if cost control was a priority.
 
· Sec. 1114 (pp. 391-393) replaces physicians with physician assistants in overseeing care for hospice patients.
 
· Secs. 1158-1160 (pp. 499-520) initiates programs to reduce payments for patient care to what it costs in the lowest cost regions of the country. This will reduce payments for care (and by implication the standard of care) for hospital patients in higher cost areas such as New York and Florida.
 
· Sec. 1161 (pp. 520-545) cuts payments to Medicare Advantage plans (used by 20% of seniors). Advantage plans have warned this will result in reductions in optional benefits such as vision and dental care.
 
· Sec. 1402 (p. 756) says that the results of comparative effectiveness research conducted by the government will be delivered to doctors electronically to guide their use of “medical items and services.”
 
We must take a stand against these outrages.

TAKE ACTION NOW

From the Wall Street Journal

By Dr. Jeffrey Flier — As the dean of Harvard Medical School I am frequently asked to comment on the health-reform debate. I’d give it a failing grade.

Instead of forthrightly dealing with the fundamental problems, discussion is dominated by rival factions struggling to enact or defeat President Barack Obama’s agenda. The rhetoric on both sides is exaggerated and often deceptive. Those of us for whom the central issue is health—not politics—have been left in the lurch. And as controversy heads toward a conclusion in Washington, it appears that the people who favor the legislation are engaged in collective denial.

Our health-care system suffers from problems of cost, access and quality, and needs major reform. Tax policy drives employment-based insurance; this begets overinsurance and drives costs upward while creating inequities for the unemployed and self-employed. A regulatory morass limits innovation. And deep flaws in Medicare and Medicaid drive spending without optimizing care.

Speeches and news reports can lead you to believe that proposed congressional legislation would tackle the problems of cost, access and quality. But that’s not true. The various bills do deal with access by expanding Medicaid and mandating subsidized insurance at substantial cost—and thus addresses an important social goal. However, there are no provisions to substantively control the growth of costs or raise the quality of care. So the overall effort will fail to qualify as reform.

Worse, currently proposed federal legislation would undermine any potential for real innovation in insurance and the provision of care. It would do so by overregulating the health-care system in the service of special interests such as insurance companies, hospitals, professional organizations and pharmaceutical companies, rather than the patients who should be our primary concern.

In effect, while the legislation would enhance access to insurance, the trade-off would be an accelerated crisis of health-care costs and perpetuation of the current dysfunctional system—now with many more participants. This will make an eventual solution even more difficult. Ultimately, our capacity to innovate and develop new therapies would suffer most of all.

Read the rest of the story

From Fox News

Last Saturday, House Speaker Nancy Pelosi begged, cajoled, and threatened health care legislation to a successful vote in her chamber, albeit by a razor thin margin of 220-215. The administration and House leadership touted this as a landmark vote, which it is, but only if you ignore the fact that the bill achieves almost none of President Obama’s promised health reform goals. In fact, it is very likely to explode the deficit, drive up health care costs, and inflict massive new taxes on middle-class Americans.

Watching events unfold in Washington at first hand, it’s become clear that health reform has become the Democrats version of “Moby Dick,” as party leaders embrace the premise that they must pass something this year and declare victory, no matter how flawed the final product is. Unfortunately, they may sink the economy along the way.

If clearer heads prevailed, Congress would scrap these partisan bills and start over:

Both the House and Senate bills will cost well over $1 trillion over the next ten years. The CBO scores the Senate bill at $829 billion and the House bill at $1.055 trillion, but only because of the most transparent budget gimmicks. The Senate Budget Committee puts the fully-implemented price tag at roughly $2.5 trillion for the first decade – demolishing the president’s promise that reforms would not cost more than $900 billion.

The cost curve for spending gets bent…up. The CBO says spending in both bills rises at 8 percent annually as far as the eye can see and CMS actuary Richard Foster says that national health spending gets worse, not better. So much for the president’s repeated assurances that reform would slow the rate of health care inflation.

New entitlements plus cost growth equals taxes, and debt, debt, debt. The CBO only scores the bills as reducing the deficit because Democrats pretend that Medicare docs will get slashed by over 20 percent in two years. Reality says Congress will borrow about $240 billion for the “doc fix”. Democrats pretend they will cut over $400 billion out of Medicare through more vigorous price controls – cuts that will never live to see the light of day. Get ready for a bubble in health entitlement debt.

What isn’t borrowed in these plans is inflicted on drug companies, diagnostic companies, private health insurance companies, “Cadillac” health plans, and individuals and businesses that don’t buy government mandated coverage. These taxes and fees, roughly 90 percent of which fall on families making under $200,000 a year, must grow even faster (10 percent annually) to keep up with the new spending spree.

Private insurance: expensive or off-limits. Taxes, fees and ill-conceived insurance reforms raise the specter of double-digit premium inflation for the majority of Americans with insurance. Millions will find their policies don’t pass muster with the bill’s insurance czar, driving them to more costly policies. The rest? Fifteen million will be thrust into Medicaid as eligibility rises to 150 percent of poverty.

It’s not too late for moderates and conservatives in Congress to force Nancy Pelosi and Harry Reid to chart a safer, bipartisan course. Here are five fundamental, commonsense reforms that will cost less, improve health care quality, and expand coverage:

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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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