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The Right Prescription

The Health Care Liberation Movement

In the end, patient power will win out over government power. Or we start learning Greek.

In 1992, the Cato Institute published the book Patient Power, by John Goodman. That book proposed sweeping, fundamental reforms to maximize patient power and control over their own health care. Goodman, myself, and many others have worked on implementing such reforms ever since, with some substantial success over the years.

Last weekend, the ultra-left President Obama, the far-left House Speaker Nancy Pelosi, and the easily confused Senate Majority Leader Harry Reid led enactment of just the opposite. We could rightly call it Government Power. Anyone who doesn't understand that it is a complete government takeover of health care is not living in the real world.

Gain Health Coverage, Lose Health Care

The most severe problem in the bill is that while it tries, but fails, to extend health insurance coverage to everyone, in the process it trashes the ability of the health care system to provide the highest quality, most advanced health care to the sickest and most in need of such care. This includes those suffering with cancer or heart disease, senior citizens, highly vulnerable premature babies, the disabled, and others.

Reflecting the thorough government takeover of health care, the bill creates close to 100 new government bureaucracies, boards, commissions and programs with the power together to tell doctors and hospitals what health care they can and should provide, what are supposedly the "best practices" for treating specific illnesses and conditions, what works in health care and what doesn't through the concept of "comparative effectiveness," even who should and shouldn't receive what health care through the concept of "cost effectiveness."

You and your doctors should be making all of these decisions together, based on the medical studies and knowledge of your doctors. A faraway federal bureaucracy in Washington that doesn't even know you doesn't, won't and can't have the information necessary to make these judgments, nor the same interest in your well being as you and your doctor. Medical care must be provided on a case-by-case basis depending on your specific condition and the care you need, not through uniform rules for everyone made by central planning bureaucracies in Washington that will always be behind the latest developments. Moreover, the government should not even be involved in making decisions as to who gets what health care and when, and even who lives and who dies. That is not liberalism, it is fascism.

The government then enforces these central planning dictates under Obamacare through the payment system for doctors, hospitals, specialists, surgeons, drug companies, medical technology manufacturers, and others, through such concepts as "pay for performance," sharply limited "global budgets," and "accountable care." Those who follow the dictates get paid the best, those that don't don't. The enacted legislation even includes a provision that penalizes with lower payments the top 10% of doctors who spend the most in Medicare funds in referring their patients to specialists, giving them a powerful incentive contrary to the interests of their patients. New, advanced, innovative medical technology is also disfavored. All of this again involves still more government takeover and control of health care.

The health care system will then be further trashed by constricting the overall resources flowing into it for payments for health services, treatments, and care. This is reflected in the severe Medicare cuts in the enacted legislation, and whatever is adopted in Medicare will soon be adopted throughout the entire health care system. President Obama crisscrossed the nation proclaiming that his massive new socialized medicine entitlement would actually reduce the deficit as scored by CBO, by close to $100 billion over the first 10 years, and close to a trillion over the second 10 years. But scouring through CBO and House and Senate Budget Committee documents reveals that this ballyhooed CBO score is based first on a 21% cut in payments to doctors and hospitals under Medicare, growing to $2 trillion in Medicare cuts over the second 10 years. The legislation even raids Social Security to reduce the deficit as scored by CBO.

As Dick Morris explains on his website, such Medicare cuts would create havoc and chaos in health care for seniors. Doctors, hospitals, surgeons and specialists providing critical care to the elderly such as surgery for hip and knee replacements, sophisticated diagnostics through MRIs and CT scans, and even treatment for cancer and heart disease will just shut down and disappear in much of the country, and others will just stop serving Medicare patients. If the government is not going to pay, then seniors are not going to get the health services, treatment and care they expect. Yet, there was the spectacle of the President, and fellow Democrats, touting fantasy deficit reductions all across America, without mentioning that they result from assumed Medicare cuts totaling $2.5 trillion over the next 20 years.

If the ruling Democrats back off from these cuts trashing Medicare, then the deficits soar, by at least $500 billion in the first decade, and a trillion in the second decade. In truth, the costs of all the entitlement promises of Obamacare will turn out to be at least 2 to 3 times current estimates, resulting in even higher deficits and debt.

Finally, all of this trashes the critical incentives for investment in development of new medical innovations, life-saving, miracle-cure drugs, and new technologies based on the latest developments in medical science. With today's latest pacemakers, your doctors can monitor your heart online, and even call to alert you to go for immediate care when a heart attack is imminent. Such modern advances cost a lot of money to develop. But who is going to undertake the necessary investment when adequate compensation is doubtful under Obamacare? Who is going to invest in expanding or even maintaining hospitals, clinics, and other medical facilities under these conditions?

The proof is in the pudding. When the Premier of Newfoundland, Canada needed heart surgery, he said, "This [is] my heart, my choice, and my health. I did not sign away my right to get the best possible health care for myself when I entered politics."

He went to find that best possible health care in Miami, rather than in the Canadian "single payer" health system so beloved by our foggy minded, starry eyed socialists. When their own lives are on the line, suddenly they are clear eyed and understand.

Health Costs in the Age of Aquarius

The thorough government takeover of health care continues with the individual mandate forcing you by law to buy the health insurance plan the government insists you must buy. The penalty for not complying is now a new 2% income tax, with a minimum of $1,000 per couple. If you don't pay the penalty, then you go to jail. During the 2008 campaign, President Obama promised,

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topics:
Obamacare, John Goodman

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.

Letter to the Editor View all comments (142) | Leave a comment

Alexis Frey| 3.24.10 @ 6:59AM

After reading this article, all I can say is, Peter Ferrara, you are the smartest man on earth!

Jon B| 3.24.10 @ 11:48AM

Peter fails to point out that Government run health care costs 1/2 as much as we're paying now, and covers millions more people. This means his premise is based on a lie that Government run health care is "bad."

Pete| 3.24.10 @ 12:31PM

Psssst, Jon. I have a bridge for sale. Interested?

Jon B| 3.24.10 @ 2:36PM

I'd say that you're doing a Dam good job of selling that bridge with your article...

Nick| 3.24.10 @ 3:52PM

Pay no attention to Jon B, folks.

He peddles lies and marxist propaganda. Oops! Redundant.

Like the lie that President Reagan gave the Soviets $425 billion.

After 3 days of trying to belittle those of us who called him out on his lie, he finally admitted his fabrication.

Although, he then claimed it was a mistake That it was actually $425 million, but he offered no source. Just his deeply flawed memories.

He is not worthy of your time.

Jon B| 3.24.10 @ 4:01PM

Mr. Jon B does sound very convincing and factual when he speaks though. But I have to agree with Nick. He should run for congress on the Health Care Bill Victory Wave!

Jon B| 3.24.10 @ 8:53PM

Please just ignore me. I'm really a useless POS, but it's not my fault, I was abused as a kid, mommy won't let me have a puppy, and I still have problems with wetting the bed. I don't have a job, because i'm really a useless piece of crap(but I'm repeating myself again). Gawd, I hate myself, no one loves me, i think i'll slash my wrists

Alan Brooks| 3.24.10 @ 7:57PM

The bottom line is everyone thinks they and theirs' are deserving of eating out of the guvmint trough, but the Other is not.

But you can't go there.

Pingback| 3.24.10 @ 7:50AM

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Melvin| 3.24.10 @ 8:10AM

"Having insurance 'going to be like Christmas'" WRAL Raleigh NC.
This is exactly what Conservatives are up against. During Obama's Campaign a reporter from a media organization that I forgot, asked a young 20 something person about health care. The girl replied, "Yea, we need health care." The media person further went on that it is not necessarily free and that someone eventually has to pay for it.
What the young lady said next will stay with me for the rest of my life. "I don't care about all those details, I just want it to be free."
This is very powerful statement. The underlying message of her words is, I am willing to give up freedom for health care security.
Barrack Obama responded and now he has a voter for life.
What the Conservative movement needs to do is education Americans such as this young girl about the details and maybe she and those who espouse Euro style health care will realize that she and not someone else who will in all eventuality be the one who is going to pay in one way or another, because the IRS isn't the most warm and fuzzy government entity in the world.

Pete| 3.24.10 @ 12:49PM

Education is the key...which is why we are nearing checkmate on the transformation of our country into just another socialist Euro-dump. We have allowed libs to take over the public education system slowly over the last several decades. And they are dutifully churning out dolts who believe there is no right and no wrong, and that government is inherently good. Sure, a handful with responsible parents still make it through with the ability to think for themselves, but essentially what we are facing now is a clone army fabricated by the public education system and reinforced daily by the mainstream media. Even if we prevail now and shoot down this HC takeover, between the public school system and immigration "reform" (read: millions of new dependents), free thinkers will eventually be in the minority, and we won't be able to stop the march towards socialism. It's enough to make you want to give up the fight...but I won't.

Jon B| 3.24.10 @ 2:35PM

Just curious, Pete, how is it that people paying for their own Health Care, and cutting back on Socialized Medicare "socialism" to you?

Jhttp://www.cato.org/pub_display.php?pub_id=4463 "Over the past three years the Republican-controlled Congress...that in 1994 would abolish the Department of Education now brags in response to Clinton's 2000 State of the Union Address that it is outspending the White House when it comes to education."

The Feds pay about 9% of the public school funding. The biggest Federal intrusion into Public Schools came when Bush mandated testing for cash strapped schools w/o providing funding so they could actually do it. Oops, Pete...

Marc Jeric| 3.25.10 @ 7:17PM

Pete is right, unfortunately. I should know, being a refugee from a communist hell. There we had a two-tier medical care system: one for us the slaves (ancient, primitive, long lines waiting, with no medicines, corrupt) and one for the Party elites (modern, no waiting, best doctors, new imported medicines). Now we have 50% of population on the dole of some kind; with this "health care reform" this number will go up to 60%; with immigration amnesty of illegals (all 20 million of them plus their parents, kids, sisters and brothers - say another 20 million) the number of people on the dole will go to 70%. These numbers spell a permanent power for our eco-nazis and communists.

Louis Jenkins| 3.24.10 @ 9:51AM

Melvin:

I heard the comment on Limbaugh the other day. Just like Christmas! Baugh, humm bug. Nothing is free. At least those who work for a living understand that. And who will put those presents under the tree? Certainly not Santa Claus. To further tax the working class and those who have succeeded in life makes nothing free. Ferrara, you have been praised by a post as the smartest man on earth, but there's a problem, the communist elite (no short hand here Old Texican) will not, cannot, and never consider your suggestions. They make too much sense. They actually give us choice and freedom to determine our own course. The communists, being what they are, must have control of our health care and our lives. Slowly and surely we are being choked to death by these pigs.

brett stadler| 3.24.10 @ 10:18AM

Another point about medicaid. The ONLY reason some medicaid patients are still able to find physicians is because the private insurance system allows their doctors to operate a reasonable practice and cover their costs. As it stands now, 30-40% of doctors refuse to see these patients. As a result, the patients fill the ERs seeking care for problems that could be addressed in the physicians office. Care in the emergency room is 2-5X more expensive for the same problem as in the doctor's office. Studies have shown that medicaid patients are far more likely to seek inappropriate ER care (it costs them nothing) than the uninsured and the privately insured. This contributes to the bothersome fact that per patient costs are higher with medicaid than private insurance (along with higher smoking and obesity rates). The democrat bill seeks to dramatically increase the medicaid coverage in this country, and the results will surely be: 1. HIGHER COST 2. FEWER DOCTORS 3. lONGER LINES 4. REDUCTION IN QUALITY
Very well done, Mr. Obama.

Pamela | 3.24.10 @ 10:24AM

And we haven't even yet discovered how this will benefit UNIONS, but we should rest assured, it will.

Pingback| 3.24.10 @ 11:18AM

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DatsunMark| 3.24.10 @ 11:19AM

I believe Teddy Roosevelt said the one way to get rid of a bad law is to" enforce it to the hilt". The IRS should immediately demand *proof of insurance* before anyone gets their tax refund. If you owe taxes and cannot produce proof of insurance then a federal warrant should be issued and you will be picked up next time you get a parking ticket or any contact with a federal agency. How do you like them apples you young Obama supporters?

John Bailo| 3.24.10 @ 12:06PM

What you describe...the patient making all these choices and having patient power and control...it sounds like good self-help, but it's not good business.

People want from health what they want from any product. Ease of use. Convenience. Right now, Health Care is a bad product. It's complex. It's costly. It doesn't work all the time. Too much paperwork, too much fear. I wish Microsoft could buy Health Care so they could transform it into something that 8 year old Kyle could use.

So, telling us that we need more "control" is the wrong answer. We need a better box, one with fewer controls. The Democrat answer is to put a lot of Government "wrappers" around it and smooth the costs with taxation. Much as you have a distaste for such a solution...the end result, being able to walk into a clinic and get a low cost exam or service, is what the Citizen/Customer is looking for.

Republicans are competing with Democrats the way that Google completes with Microsoft, or Barnes and Nobel competes with Amazon. We Republicans have to deliver -- not just shout at the customer about some ideology that he doesn't care about.

Al Adab| 3.24.10 @ 12:18PM

Many weapons still remain in the fight for Liberty. Non-compliance needs be the one of choice by patients and potential enrollees.

Simply put, the public must choose not to participate as over the next couple years the provisions of this bill begin to take effect. Companies will replace existing plans with government programs, employees who up to now have "opted out" of company plans will no longer be able to at risk of their employment. Loss of a job is a high price to pay for Liberty, but not as high as the ultimate cost of submission.

Once again our lives, fortunes and sacred honor are at stake. Whether the citizens of today have the courage of their forefathers remains to be seen. Either our grandchildren will praise us for our defense of Freedom or they will curse our names for delivering them into a new dark age of tyranny.

As John Adams once said, "...there may be unjust and unequal laws obedience to which is incompatible with Liberty." We have arrived at the moment of choice.

David| 3.24.10 @ 12:20PM

Mr. Ferrara, you left out a litte more of the story concerning the Premier's heart surgery in Miami.

First, his story should have been a focal point in the debate since he came here last month. I've talked to several people who never heard about it. The MSM ignored the story, but that does not mean that the repubs should have ignored it in making their case to the American people.

Second, the Premier also said, "I would have been criticized if I had the surgery in Canada because I would have been accused of jumping to the front of the line."

Repubs were idiots to not keep pounding the Premier's story during this debate.

Pete| 3.24.10 @ 12:35PM

"...jumping to the front of the line."

How do you think our new government panels will arrange the line in the future? Contribution size to D candidates? Ethnicity? Tax bracket? Age? Rest assured it will be some algorithm based on the above factors. Or do all worshipers of the Mocha Messiah believe that, just like at a crowded grocery store, the federal government will open up a new line so you can check out at your convenience (without incremental cost)?

Jon B| 3.24.10 @ 2:39PM

You know we already have that system now, Pete. If you wrote articles promoting full CFR reform/full public financing of all political campaigns, I'd think you were more sincere about this.

Nick| 3.24.10 @ 3:53PM

Pay no attention to Jon B, folks.

He peddles lies and marxist propaganda. Oops! Redundant.

Like the lie that President Reagan gave the Soviets $425 billion.

After 3 days of trying to belittle those of us who called him out on his lie, he finally admitted his fabrication.

Although, he then claimed it was a mistake That it was actually $425 million, but he offered no source. Just his deeply flawed memories.

He is not worthy of your time.

Pingback| 3.24.10 @ 12:24PM

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Nyfarmer| 3.24.10 @ 12:30PM

The unfolding debt saturation fiasco may put a crimp on the implementation of any of the schemes planned. All the central planning is moot if the money used is worthless.

David | 3.24.10 @ 1:04PM

Pete, you can bet that racial and ethnic factore will play a significant role in health care decisions.

Blacks and Hispanics have historically had lesser quantity and lower quality of medical care than whites. (It is not due to discrimination). Black salso have higher rates of several serious diseases than whites, such as heart disease and diabetes. Hispanics have the highest rates of diabetes in the world. It is very expensive to treat diabetics.

There is no doubt in my mind that whitey is going to be at the END of the waiting lines and at the BEGINNING of the denial of treatment lines.

Everything the government controls contains affirmative action and racial preferences, and medical care will be no different.

Pingback| 3.24.10 @ 1:09PM

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WM| 3.24.10 @ 1:34PM

I cannot condone any solution which is designed to preserve Medicaid and Medicare. If we are going to do vouchers, it should have a phase-out built in.

The idea that we MUST provide a public safety net is wrong. If we do not repudiate that notion, then we are doomed. Do you not see that it was the reflexive, anxious, cowardly guilt over the supposed poor and downtrodden that inexorably led to big government conservatism? There is no way to separate them.

The notion of a public safety net must be formally and firmly replaced in our hearts and minds with the concept of private charity. Anything less is evil, and a betrayal of the spirit of our Founding Fathers.

We are at a historic fork in the road, whether we wish to see it or not. We must make a choice: Either we move toward full decontrol, or we accept the leftist notion of public safety nets and move further to the left. A refusal to make that choice will be choosing further statism by default.

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John3| 3.24.10 @ 4:09PM

All politics is local. The health care bill mandate is poised to destroy the initiatives of the state of Indiana to insure those with significant medical problems. Because of the present tax glut in Indiana (and elsewhere), there will be no money left for anything and if President Obama thinks that the different states can support the medicaid mandates in this bill, I'll be darned. I know many middle class people who have used the HIP Indiana plans with much success. Now, Gov. Daniels has stopped enrollment in preparation for federal mandates from the health care bill--in case Indiana is unable to prevent the implementation of it in the state.

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Jim O'Brien| 3.24.10 @ 5:45PM

I've been checking El Al online for one-way ticket prices to Israel. Other suggestions? Australia?

Pete| 3.24.10 @ 6:26PM

Jim,

Let me know what you find out. Maybe Switzerland? Samoa?

Jim O'Brien| 3.25.10 @ 8:02AM

I thought of Tahiti, although there could be a tsunami risk there. Switzerland would make the short list. Looking for a country that appreciates capitalism, is not afraid to kill terrorists, and recognizes Islamism as evil.

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batman| 3.24.10 @ 6:38PM

Sen. Baucus today said people earning below 200K will see a tax increase. The big lie exposed once again.

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philfl63| 3.24.10 @ 7:59PM

Christ people, it is not that complicated. We do not need health savings accounts, flex accounts or any other such nonsense. No one " deserves" health insurance or health care. It is a service subject to purchase just like food and clothing. The only people who are deserving of special assistance are those born with birth defects, the mentally ill, and those truly mentally or physically incompetent. Everyone else can get a job (hello minorities) and pay for their healthcare. I do not want to pay for anyone's healthcare but my own and my family (again hellow low-life welfare minorities). Our healthcare is the most private of our life's concerns. Government has no business being involved in it whatsoever. None whatsoever, got it?

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Consumers seek short term loans for medical expenses | loan finder links to this page. Here’s an excerpt:

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David | 3.25.10 @ 12:38PM

Philfl63, why criticize health savings accounts? You said everyone should pay for their own medical care. That is what the savings account is for - it allows individuals to take dollars from the gross (not the net) on their paychecks and put them in an account. If you were paying a deductible or co-pay under a regular plan you would spend more because you pay those amounts out of the net dollars from your paycheck. In other words, depending on your income tax bracket say (example 25% bracket), you would have $400 in a health savings account to spend on med expenses, instead of $300 with a traditional health insurance plan because you have not received the tax break that HSA's provide.

philfl63| 3.31.10 @ 8:18PM

Sorry for the late reply. The reason we do not want Health Savings Accounts is because the gov't is involved in the process. The gov't has no right to tell me what to do with my money regards paying for my healthcare. I do not need nor want another government regulated / intrusive program controlling my money. It is mine not theirs. I am perfectly capable of paying a doc in cash if needs be. I do not need a corrupt bureaucrat to think for me or regulate me. Nuff said.

MTB| 3.25.10 @ 12:40PM

"If you don't pay the penalty, then you go to jail."

Several years ago, I was hit broadside by a lady who ran a red light. She didn't have a driver's license or insurance. I had to file a claim with my insurance company (obviously). My car was totaled, but I owed $1,000 more than I got from the insurance company. So, I had to pay the car off out-of-pocket, and then come up with the money to buy a replacement car. The lady got two tickets, one for not having a license, one for not having insurance. She did NOT go to jail for not having car insurance. But, under Obama's law, if we don't have health insurance and don't pay the tax penalty, we go to jail?!! We now live in an oppressive, dictatorial, fascist country. How the hell did we let this happen?

David | 3.25.10 @ 1:58PM

It happened because the democrats are fighting a war and repubs just don't understand that.

When dems want something, they go for the whole ball of wax. When repubs fight back and keep them to only 10% of what the dems wanted, we celebrate as though we were victorious. Repubs don't seem to understand that they didn't win sh_t - that they just lost 10% to the liberal way of doing things. 10% here, 15% percent there, and that is how we ended up in this situation.

That is why it is importanta to repeal the ENTIRE health plan. Not simply say there are some good things in it, etc.

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Lazy Jack| 3.25.10 @ 7:53PM

With all deference to Mr. Ferrara, it is no longer the Age of Aquarious, it is:

The Age of Dependency (To the tune of that great song from the 5th Dimension)

When Rahm is in the Lincoln Bedroom
And Harry Reid aligns with Mars
Then Barak will guide the masses
And Dodd will steal the stars

This is the dawning of the age of dependency,
The age of dependency,
Dependency, dependency.

Taxation and confiscation
Stimulus and hope abounding
No more freedom and dissention
Golden free healthcare delusions
Mystic Nobel ordination
And your income redistribution
Dependency, dependency

When Rahm is in the Lincoln Bedroom,
And Pelosi aligns with Mars,
Then Barak will guide the masses
And Rangel will steal the stars.

This is the dawning of the age of dependency,
The age of dependency,
Dependency, dependency.

Pay more taxes….., pay more taxes now
More taxes….now
Give your savings……give your savings now
Your savings…..now
They deserve it…….they deserve it more
Yes more…..than you

Pay more taxes….., pay more taxes now
More taxes….now
Give your savings……give your savings now
Your savings…..now
They deserve it…….they deserve it more
Yes more…..than you

Pay more taxes….., pay more taxes now
More taxes….now
Give your savings……give your savings now
Your savings…..now
They deserve it…….they deserve it more
Yes more…..than you

Lay Jack

http://thanksforthelaughs.word.....-aquarius/

www.thanksforthelaughs.wordpress.com

Lazy Jack| 3.25.10 @ 7:53PM

With all deference to Mr. Ferrara, it is no longer the Age of Aquarious, it is:

The Age of Dependency (To the tune of that great song from the 5th Dimension)

When Rahm is in the Lincoln Bedroom
And Harry Reid aligns with Mars
Then Barak will guide the masses
And Dodd will steal the stars

This is the dawning of the age of dependency,
The age of dependency,
Dependency, dependency.

Taxation and confiscation
Stimulus and hope abounding
No more freedom and dissention
Golden free healthcare delusions
Mystic Nobel ordination
And your income redistribution
Dependency, dependency

When Rahm is in the Lincoln Bedroom,
And Pelosi aligns with Mars,
Then Barak will guide the masses
And Rangel will steal the stars.

This is the dawning of the age of dependency,
The age of dependency,
Dependency, dependency.

Pay more taxes….., pay more taxes now
More taxes….now
Give your savings……give your savings now
Your savings…..now
They deserve it…….they deserve it more
Yes more…..than you

Pay more taxes….., pay more taxes now
More taxes….now
Give your savings……give your savings now
Your savings…..now
They deserve it…….they deserve it more
Yes more…..than you

Pay more taxes….., pay more taxes now
More taxes….now
Give your savings……give your savings now
Your savings…..now
They deserve it…….they deserve it more
Yes more…..than you

Lay Jack

http://thanksforthelaughs.word.....-aquarius/

www.thanksforthelaughs.wordpress.com

Explosion Proof Light| 11.2.10 @ 9:21AM

What do you want to say, Jack. Where are you live? I am just wonder that is the all countrytake the taxes like us.

Austin| 3.26.10 @ 6:05AM

It is a start in the right direction, but it is not universal enough. Should be single payer public option with a right to Private insurance if so wished. It works elsewhere and we should adapt a simular style for our own.
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How will Obama play with the health care issue in the next campaign?

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