By John Goodman – I’ve been through this three times. You’d think that someone would notice a pattern. Learn lessons. Avoid repeating dumb mistakes. Alas, it was not to be.

First there was the Medicare Catastrophic Care Act of 1988. A drug benefit added to Medicare was passed one year and repealed the next. It was the first repeal of a major federal welfare program in 100 years. Grass-roots negative reaction was so intense that House Ways and Means Chairman, Dan Rostenkowski, was chased down the streets of Chicago by angry senior citizens. Then there was HillaryCare. After working for a year, the designers of this plan met ignoble defeat. There was never a hearing. Not even a vote. And now there is ObamaCare.

In all these cases, politicians and special interests met behind closed doors to carve up huge chunks of the medical marketplace. They then emerged and announced their plan to push everyone around and tell them what to do in the most intimate and personal aspects of their lives. In all three cases, the voters replied “no.” 

The reaction of nonseniors to the latest reform is easy to understand. How many times did Barack Obama say, “If you like the health plan you are in, you can keep it”? Inside the Beltway, I’m sure no one bothered to count. They weren’t listening anyway. That’s because no one in Washington — whether Republican or Democrat, man or woman, old or young, tall or short, fat or thin — no one took this promise seriously from the get-go.

But out in the Hinterland, people did take it seriously. And when it was obvious that the promise was not going to be kept and that no one who voted for ObamaCare could explain why the promise was not being kept, the negative reaction was palpable. Adding to the understandable fear and anxiety was a threat by McDonald’s to abolish health insurance for 30,000 employees and 3M’s announcement that it would end coverage for its retirees.

Folks, this is only the beginning. Over the next two years, many more people will get hit with similar unpleasant surprises. In an earlier Health Alert, I predicted that this election would not go well for people who devised the Affordable Care Act (ACA). If this Rube Goldberg contraption is not opened up and seriously repaired, we will have another election in 2012 just like this one.

As for seniors, this is all a no-brainer. For every $1 of benefits under the new bill, they will bear $10 of cost. As Joe Newhouse explained in Health Affairs, by the end of the decade their access to care will be worse than low-income families on Medicaid. (See the very excellent chart prepared by the Office of the Medicare Actuary.) Not only will seniors have to turn to community health centers and safety net hospitals for their care, they will be the least preferred patients in the waiting lines.

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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.

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The Senate Finance Committee bill written by Chairman Max Baucus (D-Mont.) (the Baucus bill) will drive up the cost of health insurance for all Americans and then force everyone to buy it or face tax penalties or jail time.  While the Baucus bill does cap out-of-pocket costs based on a person’s income, the effect on American families is still staggering, says PricewaterhouseCoopers. 

Other findings:

• For individuals making $34,140 (three times the Federal Poverty Level) the Baucus health care proposal could mandate up to $4,097 in annual premiums, a sum which could have been spent on over nine months of food, almost four months of housing or well over a year of utilities.
• For a family of four making $69,480 (300 percent above poverty) the Baucus bill mandates annual health insurance premiums of $8,338, which would be worth the equivalent of over 10 months of food, four months of housing or almost two years of utilities.
• For individuals earning $45,520 (400 percent above poverty) Baucus mandates $5,462 for health insurance, or over a year of food, four months of rent or a year and a half of utilities.
• For families earning $92,640 (400 percent above poverty) Baucus mandates $11,117 in health premiums, the equivalent of over a year of food, five months of housing or two years of utilities.

Those numbers include the subsidies for health insurance in the Baucus bill.  To pay for all this new health care spending, plus the massive expansion of Medicaid, the Congressional Budget Office (CBO) estimates that the Baucus bill will collect $4 billion in fines from those who do not purchase insurance, $200 billion taxing health insurance companies with generous health plans, and $25 billion in taxes on employers.  Not to mention the billions in cuts to Medicare payments to hospitals which will result in significant cost shifting to consumers.

Instead of reducing the average family’s health insurance premiums by $2,500 per year, as President Obama promised, the Baucus bill would actually raise them by $4,000 more than they would have been without reform.  The Baucus bill spends at least $1 trillion, fails to cover all Americans, taxes employers for creating jobs, and inflicts higher out-of-pocket health care costs on all Americans. 

Source: Report, “Potential Impact of Health Reform on the Cost of Private Health Insurance Coverage,” PricewaterhouseCoopers, October 2009.

For report:

http://media.washingtonpost.com/wp-srv/politics/documents/pwc_report_on_Costs_final_101109.pdf?sid=ST2009101102325

Now that the Congressional Budget Office has concluded that the health-care bill proposed by Sen. Max Baucus will shrink the federal deficit over the next ten years, its champions are heralding the legislation as a model of fiscal responsibility.

But the CBO’s comforting analysis relies on a big assumption that’s highly questionable, an assumption that virtually no one on either side of the debate — politicians, pundits, even economists — is even challenging.

The assumption is that America’s employers will keep providing coverage for their workers. But, in fact, the Baucus bill severely undermines the employer rationale for offering insurance. Economist Michael Tanner of the conservative Cato Institute points out two main reasons.

First, the Baucus bill would substantially increase the costs of coverage, for example by requiring rich benefits packages and coverage for Americans with pre-existing conditions at far less than their actual expense. At some point, employers will decide that the appeal of offering insurance as a tool for recruiting and retaining employees no longer compensates for its soaring cost.

Second, the bill is based on perverse incentives that no one is even discussing. The subsidies it offers to citizens are so rich that if companies were to drop their plans, the majority of workers would get the same lavish coverage, and extra cash in their paychecks to boot. “Those two factors will change the equilibrium,” says Tanner. “With the government providing huge credits, employers will feel a lot less guilty about dumping their plans.”

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Welcome to Obama Care ala Max Baucus.  The specifics of the bill are apparently changing hourly and there are 564 amendments being proposed.  However, the core features are likely to remain intact, says Goodman.  Like other versions of the health reform before Congress, this bill will:

• Require every American to buy a health insurance plan that will be designed in Washington and (through time) be shaped and molded by special interest pressures or pay a hefty tax.
• Subsidize health insurance for young people by taking about $500 billion away from Medicare and Medicaid.
• Cause several million (mostly moderate-income) seniors to lose their coverage under Medicare Advantage.
• Cause millions of families to move from private coverage (which allows them to see a broad array of doctors) to Medicaid and S-CHIP programs (where health care access is much more limited).
• Cause millions of American families to lose their current private coverage and obtain insurance in an artificial market (an Exchange), where insurers will have perverse incentives to underprovide to the sickest patients.
• Nationalize the private health insurance marketplace by effectively outlawing a real market for health care risks.

But unlike the other bills, explains Goodman, this bill has two additional harsh features:

• A 35 percent tax on private health insurance — initially targeting “Cadillac” plans, but eventually reaching all plans.
• An employer play-or-pay mandate that is effectively an implicit tax as high as 26 percent or more on the wages of middle-income workers.

Source: John C. Goodman, “Senator Baucus Declares War on the Middle Class,” John Goodman’s Health Policy Blog, September 23, 2009.

In the most contentious exchange of President Barack Obama’s marathon of five Sunday shows, he said it is “not true” that a requirement for individuals to get health insurance under a key reform plan now being debated amounts to a tax increase. 

But he could look it up — in the bill.

Page 29, sentence one of the bill introduced by Senate Finance Committee Chairman Max Baucus (D-Mont) says: “The consequence for not maintaining insurance would be an excise tax.” 

And the rest of the bill is clear that the Finance Committee does, in fact, consider it a tax: “The excise tax would be assessed through the tax code and applied as an additional amount of Federal tax owed.”

The bill requires every American, with few exceptions, to carry health insurance. To enforce this individual mandate, the Senate Finance Committee created the excise tax as a penalty for people who don’t have insurance – and it can run as much as $3,800 a year per family. 

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Guess who’s behind the “grassroots” movement for health care reform?

A rising chorus of discontent – more a citizens uprising – shows Middle America’s deep suspicion of President Obama’s health care reform proposal. Average citizens have voiced their disapproval at townhall meetings hosted by Sen. Arlen Specter and HHS Director Kathleen Sebelius, Rep. Lloyd Doggett, Rep. Tim Bishop, and staffers of Sen. Claire McCaskill. In a burst of passion-envy, Chris Matthews asked on Monday night’s Hardball, “Where the Hell are the people who want health care, the poor people out there…the union people? Where are they? I haven’t seen one placard, let alone one protest demonstration, for health care.”

In fact, tens of thousands of people have rallied in the nation’s capital supporting the president’s health care reform plan, including the controversial public option. However, national momentum is not with them, because they are, to use Nancy Pelosi’s phrase, “Astroturf.” These demonstrations were organized by Health Care for America Now! (HCAN), a new “national grassroots campaign of more than 1,000 organizations in 46 states representing 30 million people dedicated to winning quality, affordable health care.” Most of its component organizations have two things in common: they have no experience or expertise in health care, and virtually all received large, tax-exempt grants from far-Left billionaires like George Soros and Teresa Heinz Kerry. Like the “grassroots” movement for campaign finance reform a decade ago, the public demonstrations for health care reform are largely a Soros-financed operation.

Former Governor Howard Dean announced HCAN’s mission on the first night of the annual “America’s Future Now!” conference (formerly the “Take Back America” conference), hosted by the Campaign for America’s Future in June. Dean pledged to spend up to $82 million to advance socialized medicine. HCAN rallied 15,000 people in D.C. in April, 10,000 more in June, and with state affiliates like the Maine People’s Alliance, hundreds more in state capitals in July. A searchable database of upcoming spontaneous demonstrations can be found here.

However, a closer look at its members shows it is less a “grassroots” organization than a series of interconnected left-wing pressure groups united by a collectivist ideology and, for most, a common donor.

Among the 21 members of its steering committee are ACORN, MoveOn.org, and the Center for American Progress. CAP, headed by former Clinton chief of staff John Podesta, was created with Soros’ money as a counterweight to the Heritage Foundation. In 2007 alone, Soros’ charity, the Open Society Institute (OSI), gave CAP $1.75 million in 2007 and approved additional grants totaling $1.25 million. Soros personally gave millions to MoveOn.org before the 2004 elections, and he has funded ACORN, the most notorious practitioner of election fraud in the nation.

Dean announced HCAN’s mobilization before the Campaign for America’s Future, another institution that has received funding from George Soros and the Rockefeller Family Fund. CAF, an HCAN steering committee member, pushes for national health care as one means to transform the United States into a European social welfare state. Co-founder Robert Borosage previously served as director of the overtly Marxist Institute for Policy Studies, while co-founder Roger Hickey also co-founded the Economic Policy Institute. Other CAF co-founders include socialist columnist Harold Meyerson, Sixties radical Tom Hayden, socialist feminist Barbara Ehrenreich, Service Employees International Union president Andrew Stern, AFL-CIO president John J. Sweeney, Jesse Jackson, and Julian Bond. CAF is best known for hosting its annual “Take Back America” conferences, a gathering of D.C. “progressives” and far-Left community organizers. Code Pink activists famously booed Hillary Clinton after a tour-de-force leftist speech in 2006. An up-and-comer named Barack Obama also spoke at the ’06 event.

Advancing the welfare state by ruse is old hat to the Children’s Defense Fund (CDF). The CDF Action Council is a member of the HCAN steering committee. CDF founder Marian Wright Edelman once admitted she got nowhere pushing a left-wing message until “I got the idea that children might be a very effective way to broaden the base for change.” Hiding behind “the children,” her undisguised Sixties radicalism still shines through. In her 1987 book Families in Peril, she wrote, “We must curb the fanatical military weasel.” At the time, the CDF was chaired by one Hillary Rodham Clinton. In addition to Hillary’s patronage, the CDF received a grant of more than $700,000 from the Carnegie Corporation of New York while Teresa Heinz Kerry sat on its board of trustees, and Edelman received the Heinz Award for the “Human Condition” in 1995.

Labor unions are heavily represented on the HCAN steering committee. Members include the SEIU, AFL-CIO, AFSCME, Change to Win (James Hoffa’s breakaway group of seven powerful unions, which includes the SEIU’s Andrew Stern), UAW, the National Education Association, the American Federation of Teachers, Communication Workers of America, and the United Food and Commercial Workers union. Even with the power of compulsory union dues, SEIU received $75,000 from the Open Society Institute in 2007, and AFT was approved for a $150,000 OSI grant.

Other members, such as USAction, are more overtly radical. Its profile on DiscoverTheNetworks.org notes, “The President of USAction is longtime radical activist William McNary, who has written for and supported the official newspaper of the Communist Party USA (CPUSA), the People’s Weekly World.” McNary spoke at the June 25^th HCAN rally. USAction receives also funding from Soros’ Open Society Institute.

The radicalism and overlapping nature of the “coalition” is perhaps best illustrated by the Center for Community Change (CCC), an organization founded in 1968 to advance Saul Alinsky-style confrontational politics. The CCC board includes a founder of Students for a Democratic Society; former Congressman and current mayor of Oakland, California, Ron Dellums, an admirer of Fidel Castro; Marian Wright Edelman’s husband, Peter Edelman; La Raza Vice President Cecelia Munoz; and Heather Booth, who founded the Midwest Academy, where the SEIU’s Andrew Stern learned about union organizing. The CCC is financed in part by George Soros’ Open Society Institute, with OSI awarding the group $2.9 million in grants in 2007 alone. Other funding sources include the Carnegie Corporation of New York, the Fannie Mae Foundation, the Ford Foundation, and the Rockefeller Foundation.

 

Other members of the HCAN “grassroots” include:

* Democracy for America, the organization Howard Dean founded to drive the Democratic Party to the Left following his 2004 primary loss to John Kerry. Dean was heavily favored by MoveOn.org;

* Leadership Conference on Civil Rights (LCCR). In 2007 alone, OSI approved 11 grants to LCCR totaling nearly $1.8 million;

* Progressive States Network was awarded $800,000 in OSI grants in 2007;

* The Gamaliel Foundation pocketed $150,000 from OSI in 2007;

* National Congress of American Indians, received $125,000 from OSI in 2007;

* True Majority, a far-Left organization founded by Ben Cohen of Ben & Jerry’s Ice Cream fame;

* USPIRG, the group of former “Nader’s Raiders” funded by OSI, Ben & Jerry’s Foundation, and the Carnegie Corporation of New York under Teresa Heinz’s board tenure. Its new study asserts health care reform “could allow the creation of 2.5 million jobs over a five year period.”

Aside from socialist radicals, HCAN’s membership includes two odd constituencies: clergy and abortionists.

Soros-funded clergy have been in the forefront of the universal health care mobilization, often in consultation with Senate Democrats. Mark D. Tooley reported a group of religious leftists met with Senator Ted Kennedy’s chief advisor on health care reform in April, which culminated in the June 24 “Interfaith Service of Witness and Prayer for Health Care Reform.” Among the event’s organizers is Jim Wallis’ Sojourners, which George Soros gave $100,000 in 2007. Concurrently, People Improving Communities Through Organizing (PICO) (which is funded by Citigroup Foundation and William Randolph Hearst Foundation among others) is rallying the Religious Left for ObamaCare alongside Sojourners and the National Council of Churches (NCC). The NCC, seeing mainline church membership dwindle over the last 40 years, is increasingly funded by an array of leftist “charities,” including the Open Society Institute, ACORN, MoveOn.org, TrueMajority, People For the American Way, the Carnegie Corporation of New York, the Tides Foundation, and the Ford Foundation. Soros is nothing if not ecumenical; his Open Society Institute blessed Catholics in Alliance for the Common Good, an HCAN member, with a $300,000 in 2007. The Catholics are joined by a Protestant counterpart, Clergy Strategic Allegiances, LLC, and the National Council of Jewish Women.

These religious figures march alongside HCAN’s abortion advocates. Chief among these are the Planned Parenthood Federation of America, the National Abortion Federation, Physicians for Reproductive Choice and Health, and the Religious Coalition for Reproductive Choice. Planned Parenthood already gets one-third of its billion dollar annual budget from the government, and the Capps Amendment in the current health care bill opens the spigots of federal funding for abortion through fungible payments and accounting transfers. The Alan Guttmacher Institute concluded public funding of abortion increases the number of abortions – and thus, pads Planned Parenthood’s bottom line.

Soros-funded feminists are a constituency in the new “grassroots” coalition. The National Women’s Law Center (NWLC) pushes for enhanced welfare state funding and abortion on demand. DTN notes NWLC’s “major benefactors” include AFSCME, the NEA; the Fannie Mae Foundation; the Ford Foundation; the Rockefeller Family Fund; and the Open Society Institute, which approved $400,000 in grants for NWLC in 2007. HCAN also includes the more overtly political Women’s Voices, Women’s Vote. WVWV was awarded $400,000 in grants from OSI in 2007 and has long been supported by Teresa Heinz Kerry, who steered a $50,000 grant through the Teresa & John H. Heinz III Fund of Heinz Family Foundation. The WVWV website insists its constituents, which consist almost entirely of unmarried women, “take a more progressive viewpoint than their male counterparts and see a larger role for government in helping to solve the challenges they face.” Similarly, Nine to Five, National Association of Working Women is funded by the Ben and Jerry’s Foundation and the Rockefeller and Ford Foundations.

Minority groups also have a seat at this table. The NAACP and the National Council of La Raza, which supports giving drivers licenses, voting rights, and in-state tuition to illegal immigrants, are HCAN members. OSI also doled out more than half-a-million dollars to La Raza in 2007. Illegal aliens make up one of the largest blocks of uninsured, nearly one-sixth of all uninsured by some estimates – and no reform legislation can change their status.

Some endorsers are less obviously connected to the issue of health care yet chose to take to the streets. Brave New Films, a “progressive” movie organization run by Robert Greenwald, is often in the vanguard of leftist groups. BNF’s current productions include MoveOn: The Movie and Rethinking Afghanistan, which assures Americans that Afghanistan “is not a military problem and cannot be resolved by military means.” The International Federation of Black Prides, Inc., a black homosexual organization, is an HCAN member. The National Association to Advance Fat Acceptance seems particularly at odds with the president’s focus on “preventative” medicine.

Any organizations that show promise, however, can expect George Soros to use his money to do what the Left does best: create a permanent infrastructure for radical activism. ACORN, CAP, and MoveOn.org are living testaments to this proclivity. It appears Soros has found another promising start-up:the Roosevelt Institution, which names the Open Society Institute as a benefactor. Part of Soros’s grant, $47, 100 according to documents filed in 2007, facilitated “the transition from a student organization to a professional and sustain [sic.] corp.” This institutionalization of radicalism is perhaps best embodied by League of United Latin American Citizens (LULAC), which Ford Foundation grants transformed from a local, moderate advocacy organization for Hispanics to a full-throated supporter of balkanization. George Soros turned MoveOn.org from a moribund website dedicated to averting the Clinton impeachment into the driving force of the 2004 Democratic elections. MoveOn, in turn, elevated little-known Vermont Governor Howard Dean to frontrunner status. Dean consolidated his campaign by forming Democracy for America and ultimately chairing the Democratic National Committee. And he is now leading the charge for socialized medicine with a band of fellow Soros-funded leftists.

Despite its financial heft, HCAN has tried to amplify its numbers by double-counting many of its organizations. For instance, the historically left-wing Americans for Democratic Action sits on its board alongside Working Families Win, “a project of Americans for Democratic Action and the ADA Education Fund.” So, too, does USAction with True Majority, “a project of USAction.” HCAN’s membership list includes both the AFL-CIO and Working America, which describes itself as a “community affiliate of the AFL-CIO.” CAP and its campus affiliate, Campus Progress Action, are both listed. Other organizations’ membership is largely interchangeable, e.g., MoveOn and Democracy for America. One can see how double- or triple-counting its overlapping memberships can quickly add up to “more than 30 million people.”

It is right, though, that the whole organization be considered one entity, given the constituent members’ long-standing history of coordinating their actions. In 2004, the Democratic Party admitted it was working with CAF, MoveOn.org, People for the American Way, and “dozens” of other groups “to organize a massive public mobilization” against the ’04 Bush tax cuts. (One left-wing poster on Democratic Underground asked if the 527 arrangement was “Our Dirty Little Secret?”) The Campaign for America’s Future partnered with MoveOn.org, Rock the Vote, ACORN, La Raza, the Women’s Voices Women Vote Action Fund, and the AFL-CIO in a voter drive effort in 2008 to help elect Barack Obama. Just this April, SEIU, MoveOn.org, the CCC, True Majority, USAction, WVWV, Brave New Films, and the Working Families Party conducted a mass protest against the Bank of America.

If these coalition members are largely interchangeable, they overlap with the Obama White House and the Democratic Party with increasing frequency, as well. The HCAN Steering Committee includes Americans United for Change. DTN notes, “In 2009, AUFC President Brad Woodhouse became the communications director for the Democratic National Committee under President Obama.” This summer, Obama nominated SEIU general counsel Craig Becker for a seat on the five-member National Labor Relations Board, the highest court of appeals in labor disputes. Becker’s appointment is but one measure of Andy Stern’s tremendous influence with Obama. Another HCAN member, Clergy Strategic Allegiances, LLC, records on its website that its “Services have been provided to…Democratic National Committee…North Carolina Democratic Party, Sojourners and Call to Renewal, Maryland Democratic Party.”

Promoting his new book, former DNC chair Howard Dean has told audiences, “America has had ‘socialized’ medicine since 1964. It’s called Medicare; it covers every American over 65, and they are very happy with the program.” However, as common men and women are proving at Congressional townhall meetings, on radio talk shows, and in diners across the country, those not on George Soros’s payroll are distinctly unhappy with this proposal.