The Right Prescription
The Absolutely Worst Bill Ever
The Obama/Pelosi House bill is a cruel perversion.
(Page 2 of 2)
But the Obama Administration has already started the rationing for seniors on Medicare. The recently adopted Medicare payment rules for next year impose an 11% overall cut on cardiology and a 19% cut on radiation oncology (cancer treatment). Payments for basic tools and treatments for heart disease, such as stress tests and catherization, are slashed by 42% and 24% respectively. Payments for diagnostic imaging services like MRIs and CT scans that help identify cancer early are cut by 24%. Payments for antitumor radiation therapy will be cut by 44%.
AARP shamefully provides cover for this attack on the health care of seniors. That is in part because it has always been a liberal/left front group, like ACORN and SEIU, and it is standing up for its left-wing political allies. But it's also because AARP doesn't sell a Medicare Advantage plan, and it wants to drive out the competition to its overly costly Medigap plans.
Soaring Health Costs
The socialized medicine policies adopted in the House health bill will at the same time cause soaring health costs and health insurance premiums. The House bill provides that you or your employer will be forced to buy the health insurance plan specified by the government, regardless of what you want. This will include all of the politically correct benefits no matter how expensive, such as drug rehab, mental health, maternity benefits even if you are over 50, male, or gay. Coverage for abortion too will ultimately be required with politics involved in the decision, no matter what they say now. Many people today are wisely saving a lot of money with high annual deductibles, paying for routine expenses out of pocket. (Does your car insurance pay for oil changes and new tires?) Forget about that under the House bill.
The House bill further adds costly new regulations on health insurance, such as guaranteed issue, which requires coverage for all new applicants regardless of how sick they already are, and community rating, which requires the same premiums for new applicants regardless of health condition. This regulation is like requiring fire insurance companies to insure new applicants whose houses are already on fire, charging them no more than anyone else. Such regulations have caused health insurance premiums to soar even in the context of broader health reform, as we have seen in Massachusetts.
But health insurance premiums will also rise because of increased cost shifting to private insurance from the Medicare cuts, and from the Public Option. The House bill would also radically increase incentives to demand more health care, with the government paying for everything or paying for health insurance to pay for everything. It would also radically reduce the incentives to supply health care by clamping down more and more on payments to doctors, hospitals and other health providers for their services, as discussed above. Increasing demand while reducing supply will produce skyrocketing health costs, which will further increase health insurance premiums.
Readers of this column know I have been saying as much for months. But now comes expert confirmation in a study from WellPoint, which provides transparent insight from its own health insurance files and experience. Their study shows that health insurance premiums for the young and healthy will triple in some states! Average middle class families will see their premiums more than double. A previous study from Price Waterhouse showed quite similar results. These studies didn't even take into account all of the factors above.
Democrats and their allies have responded with name-calling and libel, with no substantive response. If they pass a final bill without a public option, when premiums do rise as a result for all of the above reasons, they will be back arguing this shows the Republicans were wrong about not needing competition from a public plan. You can't argue with religion.
By the way, the profits of the 10 largest health insurance companies last year totaled $8 billion, combined. That is less than one half of one percent of total health costs. It's not an issue, except for socialists.
Soaring Taxes and Deficits
House Speaker Nancy Pelosi claims that the House bill is deficit neutral. But that is based on a 21.5% cut next year in payments to doctors under Medicare included in the bill. That is so ridiculous that even the Democrats don't believe in it. So in a separate bill they propose to restore $250 billion of those cuts, adding that entire amount to the deficit! So how can the House bill really be considered deficit neutral, based on a huge cut so ridiculous the Democrats themselves immediately reverse it in another bill? Has our government ever been this brazenly dishonest?
Over the first full 10 years of operation, CBO estimates that the bill will cost $1.8 trillion, not the $829 billion claimed by Speaker Pelosi, actually misrepresenting the CBO score. The actual costs counting all spending increases, which haven't been scored by CBO yet, will be $2.4 trillion to $3 trillion. The bill costs so much because with an overwhelming entitlement crisis already looming, the House bill insists on massively expanding Medicaid, adding 18 million more people, and adopting a new middle class entitlement providing subsidies to buy health insurance for those making up to $96,000 a year for a family of four in 2016.
The $700 billion in tax increases, plus the Medicare cuts, won't be enough to cover all those costs, adding hundreds of billions to the deficit. In particular, the bill relies on an income tax surcharge adding 5.4% to the top income tax rate. Along with the Obama tax rate increases already planned for 2011, the top marginal federal tax rate will soar to almost 48% from 35% today. Counting state income taxes, the average top income tax rate in America would climb to about 52%. The top U.S. income tax rate would then be higher than in France, Germany, Canada, and 23 other countries in the OECD. In five states dominated by Democrats, California, New York, New Jersey, Hawaii, and Oregon, the total top tax rate would be higher than in socialist Sweden. That top tax rate increase won't raise nearly the $460 billion CBO now projects because of its uncounted, counterproductive economic effects.
But the total spending and resulting deficits will be far higher than even this. CBO assumes that only 30 million will qualify for the middle class entitlement subsidies, with 162 million in employer provided coverage not eligible for the subsidies as a result. But with employers who drop their coverage subject to an 8% payroll tax, and less for small businesses, many will have an incentive to do precisely that, especially since the workers can then get the government subsidies. If your payroll averages $40,000, then 8% is only $3200 per worker, likely much less than the cost of current coverage. This could more than double the projected cost over the first full 10 years, as millions more lose their employer coverage and become eligible for the subsidies.
Finally, remember President Obama's ironclad election year promise not to raise taxes on anyone making less than $250,000 per year, in any form, which won him election? Under the House bill, which President Obama has now endorsed, workers who don't buy insurance will have to pay an income tax penalty equal to 2.5% of income, including those in the bottom 50% of income earners who don't pay any income tax now. If they do buy the mandated insurance, then they will bear costs for the premiums of 1.5% to 12% of income for those making less than $250,000. That is effectively a whole new payroll tax on workers.
President Obama, however, says this is not a tax. But, then, President Obama says lots of things we've learned we cannot believe in.
Mr. Ferrara is the author of "The Obama Health Plan: Rationing, Higher Taxes, and Lower Quality Care," published by the Heartland Institute.
About the Author
Peter Ferrara is Senior Fellow at the Carleson Center for Public Policy, Director of Entitlement and Budget Policy for the Heartland Institute, and General Counsel of the American Civil Rights Union. He served in the White House Office of Policy Development under President Reagan, and as Associate Deputy Attorney General of the United States under the first President Bush. He is the author of America’s Ticking Bankruptcy Bomb, now available from HarperCollins.
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Pingback| 11.11.09 @ 7:00AM
Twitter Trackbacks for The American Spectator : The Absolutely Worst Bill Ever [spec links to this page. Here’s an excerpt:
Viktorich| 11.11.09 @ 7:21AM
For what you so don't like Obama?
ggoblue| 11.11.09 @ 8:09AM
the worst part of it all is this: all treatments no matter how expensive will be provided to comrade party members...if you arent a good little democrat you will be allowed to die. thats the monstrosity being created.
alyeska| 11.13.09 @ 1:10AM
hmmmm, apparently the republicans don't mind curtailing womens' health care options, while being very generous with their own female comrade party members....
GOP bigwigs’ health insurance covers elective abortions:
"We believe in the sanctity of life, and the Stupak-Pitts Amendment addresses a moral issue of the utmost concern," House GOP leaders John Boehner (R-Ohio), Eric Cantor (R-Va.) and Mike Pence (R-Ind.) said in a statement after the vote. "It will limit abortion in the United States. Because of this, while we strongly and deeply oppose the underlying bill, we decided to stand with Life and support Stupak-Pitts."
Still, the RNC chose not to opt out of abortion coverage, Cigna representatives told Politico.
RNC spokeswoman Gail Gitcho reportedly said the policy pre-dates the tenure of current RNC Chairman Michael Steele.
"The current policy has been in effect since 1991," she said, "and we are taking steps to address the issue."
they've had since 1991 to address this issue? i sense a soupcon of hypocrisy here :)
Old Soldier| 11.11.09 @ 8:18AM
Wait until some committee of bureaucrats tells a father that his kids don’t rate treatment and should just die. When he (justifiably) murders the lot of them, the program will include armed guards, secret committees, and gun seizures. These are inevitable consequences.
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Ned| 11.11.09 @ 10:40AM
Old Soldier, you are correct, except the state run media will never report the story, but at least the father will get mental health counseling, so long as he belongs to a registered victims group.
tj| 11.11.09 @ 11:03AM
REPARATIONS ANYONE!!! Healthcare for me, but not for thee....if is not good enough for this administration it is not good enough for me. I will not let you take over my healthcare or my freedom Vote em out 2010/2012. People wake up! Stand up and fight this evil!!
Walter| 11.11.09 @ 12:56PM
I put a lot of blame for this on the Republican politicians who controlled Congress and the White House for so long and who determined who will run under the "R" banner.
It was they who opened the door to a Democratic takeover of government when they abused the power that they had been given and totally dispensed with the mandates that they had been given to steer the country in a conservative direction. They've put us all at risk with their foolish beliefs in politics over principles. They became Democrat-lites (except they were worse at it), were thrown out of office and left the door open for whatever despotism would follow.
I hope that history will record that it was their dereliction of duty and lack of honor that bordered on the treasonous in exposing the country to the dangers that it now faces.
Rmm| 11.11.09 @ 10:15PM
My wife and I have had this same conversation, months ago. You are absolutely correct about Bush & Co. opening this up for the radical Left to pour into the vacuum. It is enough to piss-off the Good Humor man.
Stan Redmond| 11.11.09 @ 4:45PM
Imagine how good the care you will get as a white male? After budgets are made for popular medical care like women's medical issues, minority medical issues, gay medical issues, transgender medical issues, children's medical issues, and political club medical issues, there's nothing left for you white males. The British NHS spends more money on women than men. Do you think democrats are going to allow equal funding for regular middle American folks and inner city minority groups? HECK NO!!!
alyeska| 11.13.09 @ 1:34AM
oh no, they're going to cut off your viagra -- cold!
jri500| 11.14.09 @ 6:06AM
Oh crawl back in your hole and stop wasting everyone's time with your brainless, moronic posts. You are obviously a mental-defective, liberal democrat loser and a gutless, America-hating Obamist coward.
hunter| 11.11.09 @ 6:22PM
call, phone,write often, and ask your relatives friends and neighbors to do the same. I agree wholeheartly with Walter and Stan, previous comments. This country is under attack, by foreign enemies, from within.
Michael Lee| 11.11.09 @ 8:39PM
I've been a resident of British Columbia for 9 years and the medical system here has treated me very well. But I am very concerned about Obamacare. One of the best things about living in southern BC is the short trip to the US if I get unhappy with waiting in line here. That option would be in serious jeopardy when NICE comes to the US.
alyeska| 11.13.09 @ 1:37AM
well, have you ever had to cross the border to avoid waiting in line?
you need to move back to the us -- canada doesn't need people like you, using their health care services while trashing them at the same time.
go home!
jri500| 11.14.09 @ 6:08AM
Why don't YOU to live with your daddy Fidel in Cuba. Then you can enjoy "the finest heathcare system in the world", you scumbag.
Jennifer Scott ARNP, FNP-BC| 11.11.09 @ 10:50PM
I find it a little insulting that you think that patients "settle" for a NP. My patients prefer me to other physicians and will tell you so. I am a great health care provider with patients who actually come back and do the necessary maintenance to remain as healthy as they can be. I serve in a rural community who is having a very hard time attracting physicians. I find it appalling that you would think that any health care provider would keep a patient from appropriate testing in order to line their own pockets. If they are doing so, they need to be run out of health care. I take care of patients because it's a calling and not just because it pays well. I am curious to see if you have ever seen a nurse practitioner in action before you make snap judgments about the quality of our care.
Walter| 11.12.09 @ 11:09AM
Jennifer,
Thank you for being the type of NP that we all hope will be caring for us when we need you to once a lot of our doctors have wised up and left medicine in disgust with low reimbursements (their reward for 25 years of expensive and grueling medical training) and bureaucratic bungling.
I hope that you can keep your heart in your calling and not become hard and cynical as the work load increases, your face time with patients decreases and you see your compensation and quality of life falling based on what some bureaucrat (not your patient) thinks you deserve to be paid. I hope that you will keep your motivation (after all, we are all depending on it) when you discover that the money to be made in health care has shifted from the providers to the deciders.
I have seen NPs and they are wonderful, as I’m sure that you are. However, in a changed health care environment, with increasing stress on our medical providers, it may be a totally different work environment.
Jennifer Scott ARNP, FNP-BC| 11.22.09 @ 12:32AM
Walter,
Unfortunately, I already am seeing the problems with lower reimbursements by the health insurance policies. They are the real reason why health care is in shambles. I don't like the idea that they decide how health care providers do their jobs and make the premiums so high that regular people cannot afford coverage. Most of my patients do not have insurance and cannot have the testing they need in order to properly confirm what I already suspect is going on so that I can get them treated. It's frustrating watching patients wither away because they have to choose between food or proper treatments.
Roy| 11.13.09 @ 1:56AM
I agree with this. NP's can probably do 90% of what a physician does and in many cases better. Similarly, in a hospital setting, nurses are overworked because they are used for all kinds of tasks that do not require three years of nursing school to learn.
I don't know the exact reason, but I'm guessing it is John Edwards. If anything happens to a patient and they find out that an NP and not a physician made some decision, or a nurse tech and not a nurse brought them their food, then John Edwards, Johnnie Cochrane, John Grisham, and a million other baying leftist demagogues will sue the hospital out of existence.
So, since the government has created the problem the government will now "solve" it through rationing and the exemption of itself from lawsuits. And freedom loses once again.
Jennifer Scott ARNP, FNP-BC| 11.22.09 @ 12:36AM
Roy,
Thanks for the vote of confidence in regards to NP care. The reason nurses are overworked in the hospital is because of litigation issues with lawsuits. Too often we have to take care of the paperwork instead of the patient. (As a provider, it's true too.)
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marianne| 11.13.09 @ 10:55PM
So they are going to deny medicine and certain tests to Seniors and give healthcare to illegal immigrants. I guess George Soros will open up his 'Project on Death in America' again when this health plan is voted in.
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