The Right Prescription
Blue Dog Day Afternoon
The conservative Democrat-Waxman deal should be taken very seriously.
The “All Obama, All the Time” media have gone to great lengths to save his health-care reform crusade from faltering. So you might get the impression from their coverage of the shaky deal established at gunpoint by Obama consigliere Rahm Emanuel between conservative Congressional Democrats and Representative Henry Waxman that “real reform” is at hand.
I am afraid they might be right.
The deal cut with conservative Democrats consists largely of assuring that the hospitals in their districts are not run out of business by a government takeover of health care. Meanwhile Democrats are promising the public, as Charles Krauthammer summarized, “no policy cancellations, no preexisting condition requirements… even a cap on out-of-pocket expenses.”
So how do you provide no-cap coverage for 97 percent of all Americans for everything they want for less than about 10 percent of their post-tax income?
First, it is important to bear in mind that at the end of the day less than 5 percent of all Americans will receive a health insurance subsidy. So you hide the fact that for all the hype the amount of dough Americans will really get isn’t much at all.
Second, you cut what doctors get paid but spread the cuts as widely as possible. And third — and by extension — you make the government run plan a loss leader so you can get a total takeover down the road.
What you will hear instead in the coming weeks is how the new improved Blue Dog-endorsed version protects consumers against insurance companies without creating a government-run health plan.
Indeed, House Democrats have been using a letter from the Congressional Budget Office to claim that a public plan would not hurt private insurers and — by extension — you and me. In that letter the CBO estimates that only 6 million people from large employers would switch to public plans
But CBO’s explanation is a backhanded compliment to private insurance companies:
Although we assumed that the public plan would have somewhat lower administrative cost per enrollee than would private plans in the exchanges, the public plan would probably have to incur much of the same cost in order to attract and retain members…. we estimate that the public plan’s premium would, on average, be about 10 percent lower than that of a typical private plan offered in the insurance exchanges. The most recent analysis of that difference concluded that the costs of the traditional Medicare plan were only 2 percent lower, on average, than the costs of private plans participating in Medicare to provide the same benefits.
In other words, private plans providing more benefits and coordinated care to a group of seniors much sicker than most seniors were only 2 percent more expensive than the vaunted public plan used as the model for government-run health care.
How would a public plan offer lower premiums unless it cut what it paid doctors, hospitals, and others and also rationed care? Indeed, as a recent Lewin analysis (pdf) of the Waxman bill notes: “The (Waxman bill) includes over 80 sections that alter Medicare provider payment policies for virtually all types of providers of health services including physicians, hospitals, home health agencies, skilled nursing facilities, rehabilitation hospitals and other health care practitioners…. Total reductions in payments to providers under the bill would be $361.9 billion.”
In addition, the Lewin study shows that even after scheduled Medicare cuts to a small percentage of AMA members are restored, total physician payments are cut (through Medicaid and other Medicare payment machinations) by $32 billion through 2011.
These cuts will produce lower premiums in public plans. They will allow the public plans to attract nearly 70 million younger and healthier people who hardly use the health care system. And they will be not requiring or receiving a subsidy.
Once the younger, healthier types enroll, the rest of the employees in private plans — the sicker and older folks — will come along or will be dumped as premiums rise. Trapped by the requirement not to adjust premiums or cap benefits, insurers and employers will make the logical choice. A government takeover of health care will be a fait accompli.
And as the number of people in public plans swell, the pressure to control costs will grow. CBO estimates that the cost of single payer care will grow rapidly by 2015 and add greatly to the deficit by 2019 even as Medicare goes bankrupt. The push to ration care and delay treatment will grow.
Who will be hurt, and how, is the subject of my next article.
About the Author
Robert M. Goldberg is vice president of the Center for Medicine in the Public Interest and founder of Hands Off My H ealth, a grass roots health care empowerment network. His is new book, Tabloid Medicine: How the Internet is Being Used To Hijack Medical Science For Fear and Profit, was published last month by Kaplan.
Letter to the Editor View all comments (84) | Leave a comment
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Sherry| 8.3.09 @ 7:11AM
The government plan is simply paying back the unions for their support.
http://speakmymindblog.com/2009/08/03/why-krogers-grocery-store-obama/
Robert Rosencrans| 8.3.09 @ 7:16AM
The entire health care imbroglio can be summed up as a messy and never ending game of financial musical chairs where someone always gets left standing and someone will get screwed financially so that someone else will feel superior within the system.
Here is the life cycle of socialized medicine.
Think Mozart in the background.
In the beginning the doctors will take less pay, but they will also give less care.
After a period of time the doctors will revolt and refuse to work under such arrangements.
Other health care professionals will demand more and more leading to higher unsustainable costs.
The patients who got suckered into this nightmare will get less and less.
New system called for which will repeat stupid mistakes made by getting into nationalized health care to begin with.
Other side effects will be that private health insurance will be gone with the wind and that the elderly will be asked to be realistic, i.e., you're going to die anyway so why contribute to global warming through your health care?
Etc., etc. Failure.
Louis Jenkins| 8.3.09 @ 10:01AM
"someone will get screwed financially so that someone else will feel superior within the system."
Not only will some get screwed financially, but the death rate will go up, and longevity will go down. Sounds like a good time to get into the funeral business, unless Obama gets into it too. With all the FEMA coffins laying around the nation he may already be there. This is a unique plan to get rid of the "useless eaters".
Pingback| 8.3.09 @ 11:44AM
Obamarama in Healthcare: Let’s enjoy Barack’s gaffes, mistakes, blunders and the othe links to this page. Here’s an excerpt:
Facts| 8.3.09 @ 12:22PM
zenas
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Join Date: Feb 2003
Location: Southern Illinois, USA
Posts: 20,431
Quote:
Originally Posted by zenas
I deal in facts.
Fact: Jews have long been in Mexico.
Fact: Jews have long been involved in illegal drugs.
Fact: Jewish interests control the labs making these flu viruses and vaccines.
Fact: ZOG USrael is under Jewish control.
Fact: The Jewish Wall Street bankers are looting the US and Americans like you are paying for and will pay for it for years to come.
Fact: Attention diverting tactics are a common method to fool the masses.
Fact: International Jewish interests have stated publicly that there are too many people on the planet.
Fact: There are hundreds of thousands of coffin liners ready for use.
Fact: Fact, over a dozen micro-biologists involved with flu and bio weapons have mysterious died in the last few years.
Fact: Fort Detrick has admitted some flu viruses material has "gone missing."
http://edition.cnn.com/2009/US/04/22...ref=newssearch
You can believe that source as it is a Jewish one - CNN.
Fact: Panasonic knew of a "new strain of flu virus" coming soon back in February.
Fact: In December, 2008, a county official in northwestern Indiana revealed that During the legally mandated meetings held with FEMA and the Department of Homeland Security (DHS), different disaster scenarios were reveled to county officials:
They were told if industry were to collapse, for example GM going bankrupt (what a coincidence) resulting in mass unemployment, a depression would soon follow and municipalities could expect to loose 40% of their funds.
Every county in the nation would be required to prepare a "Hazard Mitigation Plan."
The county should prepare a plan to vaccinate the entire populationwithin 48 hours and practice the plan several times. (Gee, now why would they say this last December? Maybe because they knew what was planned.)
FEMA inquired to where mass graves could be placed in the county and would they accept bodies from elsewhere.
The sheriff’s department via the state sheriff association was told that no .223 ammunition rounds would be available as the military would be purchasing all stocks.
The county was asked to make plans for “hardening” of police and fire stations, putting in hardened bunker type buildings around town.
The county was asked to make plans for the possibility of up to 400,000 refugees from Chicago.
Michael Tomlinson| 8.3.09 @ 12:31PM
"The deal cut with conservative Democrats . . ."
Give me a break! When are you people going to learn there are NO conservative Democrats. The so-called blue dogs are nothing more than Obama and Pelosi's bitches. They're liberals who roll over and do what they're told everytime -- this recent debate is a case in point. Pelosi threw them a meager bone and now they're on board to ruin America's great health care to give their master Barack a victory.
Pelosi's lapdogs are blowing smoke up the nation's ass and conservative pundits are eating the BS and spewing out that these liberals are conservatives. How many times do conservatives pundits have to have their nose's rubbed in the blue dog's stink to learn the lesson that blue dogs are two-faced bastards?
Until his recent betrayal former RINO Arlen Specter was to the right of the blue dogs. Wake up and smell the stink -- it's the blue dogs dumping on the US and conservative voters.
Sex Sting Catholic Priest| 8.3.09 @ 12:50PM
Sting that caught priest started in Kansas City
BY ROBERT PATRICK, The Southern News Services
Monday, August 3, 2009 4:17 AM CDT
ST. LOUIS -- The FBI pedophile sting that snared a Catholic priest and two other men here marked just the second time nationally that a tough federal sex trafficking charge was used to target demand for child prostitutes, officials said Friday.
The first, “Operation Guardian Angel,” began in March when Independence, Mo., and Kansas City police, FBI and Immigration and Customs Enforcement agents posted Craigslist ads advertising young girls.
Officials eventually arrested and charged seven, including a car dealership finance manager from Mississippi who allegedly intended to pay $60 for sex with a 15-year-old girl. During the e-mail conversations leading up to his visit, prosecutors said the man asked, “Is she willing or do you have to hold her down?”
Another suspect was a Navy recruiter accused of using his government computer and cell phone to arrange sex for $60 with an 11-year-old girl.
Both allegedly paid $20 extra to forgo a condom.
Don Ledford, spokesman for the U.S. attorney’s office in western Missouri, would not say how many people had responded, but he said the ads and ensuing e-mail and phone conversations left no doubt that underage girls were being offered.
The sex trafficking charge is normally used to pursue pimps and carries a mandatory minimum sentence of 10 years in prison, with higher minimums applying to those seeking sex with younger girls.
In St. Louis, a similar operation led to charges Thursday against the Rev. James P. Grady, pastor of St. Raphael the Archangel Church in south St. Louis. It also nabbed a man who works for a landscaping company and another who works for a bank. All posted bail.
Robert Rosencrans| 8.3.09 @ 4:11PM
Here's a video of Obama talking about how his public option will eliminate private insurance. It proves he's a pathological liar if nothing else.
http://www.breitbart.tv/uncovered-video-obama-explains-how-his-health-care-plan-will-eliminate-private-insurance/
XIAO HAI| 8.4.09 @ 2:46AM
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REPUBLICAN! GIVE ME MONEY HONEY.
Steven Bavaria| 8.4.09 @ 2:47PM
Healthcare: Let’s Fix the Real Scandal!
Uninsured people suffer incredible price-gouging by the medical industry, and are routinely charged anywhere from twice as much, to 10 or 12 times as much, for the same services as people covered by insurance. That is the real scandal in health care, and the one we should fix first. Most of us lucky enough to have insurance never bother to ask the cost of our medical services, as long as the doctor accepts our insurance. But if you read your insurance statements, you see the gap between the “sticker price” and the price the insurer pays is huge. In our family’s experience, it is typically 2 or 3 times for doctors’ services, and as much as 10 or 12 times for hospital and lab charges.
It is this huge mark-up on medical bills that is killing the uninsured, much more than the lack of coverage per se. A “quick fix” that Democrats and Republicans should all be able to agree on would be to pass a “Most-Favored-Patient” Act (similar to the most-favored-nation concept in international trade law that guarantees each nation the benefits of tariff concessions granted to other nations) to require health care providers to charge all their patients no more than the lowest price they charge other patients. You could even allow medical providers to gross up prices by some reasonable percentage – 120% perhaps – if you wanted to give large insurers a reasonable “volume discount” that they may feel entitled to.
The impact of this would be huge. First of all, it would remove the primary disadvantage of being uninsured, and be a big win for the lower-income working class, who make up most of the uninsured. It would also introduce transparency and cost-competitiveness to the healthcare industry, since healthcare providers would have to post prices. This would allow all healthcare consumers – insured as well as uninsured – to become smarter and more cost-conscious about how our healthcare dollars are being spent, whether the money is coming directly from our own pockets or from our insurer.
Once we correct the huge inequity that now exists for the uninsured, and introduce price transparency and cost-consciousness across the board, then even if we do move on to a more comprehensive national system it will probably have a smaller price tag because many of the grosser inefficiencies will have already been squeezed out of our current system.
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