The Right Prescription

Committing HarryCare

Harry Reid's government takeover of health care would turn the American Dream into the American Nightmare -- but it can still be stopped.

By 12.2.09

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The Obama Administration and the Congressional Democrat leadership are desperately trying to create the false impression that the government takeover of health care now pending in Congress is rolling towards inevitable victory. But the truth is that the legislation is now hanging by a thread, and can be routed by the growing tide of public opposition. The recent Senate vote on the bill was just to proceed to debate on the measure. No Democrat was going to vote against merely debating the bill.

But even among the 58 Democrats and 2 Independents, there are deep divisions over the legislation. Some have openly stated that they will not vote for a bill that includes a government-operated, "public option," health insurance plan. Others have said they will not vote for a bill that does not include that "public option." We have the same division on the abortion question.

Meanwhile, public opposition grows the more voters hear about the bill. Besides the Rasmussen poll, which shows the public opposing the legislation 56% to 38%, every other poll now shows the public swinging to opposition as well. Both the Fox News poll and the Quinnipiac poll show the public opposing it 51% to 35%. Even CBS News, now openly an arm of the Democrat party, shows the public in opposition 45% to 40%.

Seniors whose health care is looted under the legislation to finance an even greater Welfare State turned against Obamacare 2 to 1 months ago. Now young voters under 30 are turning against it as well, when they find out, as explained below, that their insurance premiums in most of the country will double and triple under the legislation, and that they must pay for such insurance or pay arbitrary income tax penalties. After Dick Morris ran ads explaining this in three key states, Arkansas, North Dakota, and Maine, top pollster John Zogby found that voters under 30 turned from 58% to 30% in favor to 65% to 25% against.

This swelling tide of public opposition has firmed up the 40 Republican Senate votes against the bill. Because of Senate rules, a determined minority can stop legislation. With over half a dozen Senate Democrats having run and won election as supposed conservatives, plus some reasoned Democrat doubters such as Joe Lieberman and Ron Wyden, victory over the socialized medicine crusade is quite possible, if the public stays engaged.

Act Up to Stop the Democrat Welfare State

You have to understand, this is not your father's Democrat party. The reigning Democrat majorities in Washington today are working towards a vision of a Super Welfare State, where the government takes and spends 60% to 80% of all the money earned in the economy. This is an informed estimate based on official government projections of current programs, Democrat "reforms" of welfare and health care, and the expected negative economic effects of these government burdens.

Already, under the income tax increases in the House health bill and in President Obama's budget adopted earlier this year, the top income tax rate in 5 states politically controlled by Democrats, New York, California, New Jersey, Oregon, and Hawaii, the top income tax rate counting Federal and state taxes will be higher than in socialist Sweden! And this is before the Cap-and-Tax bill the Democrats want, and the new European-style Value Added Tax (VAT) already supported by Democrat Congressional leaders, which President Obama may propose in January to counter record shattering federal deficits.

Under this backbreaking burden of overwhelming government, the traditional economic prosperity that has always characterized America, "The American Dream," will be crushed. Working people will no longer enjoy the traditional American economic freedom to decide how to spend the fruits of their own labor. The government will decide that for them. America will then be precisely "just another country," as President Obama has characterized it.

What is surprising a lot of people is that over the past 30 years, while the country was enjoying the American Renaissance under Reagan-dominated leadership, the Democrat party and the formerly "mainstream" media has been taken over by the New Left of the 1960s. Bill Clinton tried leading the Democrats in the opposite direction to more moderation to counter the Reagan tidal wave. But with the passing of Clinton and Gore, 2004 saw the New Left openly rise to the top of the Democrats and their media colonies, and they now rule America with a literally neo-Marxist vision and agenda.

We are now experiencing a defining turning point in American history, like the American Revolution or the Civil War. If you want traditional American freedom and prosperity for you, your children, and your grandchildren, this is no time to be politically idle, totally consumed by personal affairs. If you want to save your country, then you need to become politically active, and reach out and organize your friends, neighbors, and relatives for political action.

The grassroots political event that Washington remembers to this day was in 1988, when seniors protesting enacted "catastrophic health care" legislation for Medicare stormed and stopped the limousine of then House Ways and Means Chairman Dan Rostenkowski in Chicago. That "reform" was repealed the next year by large Democrat Congressional majorities.

Harry Reid's Government Health Care Takeover

Harry Reid is no longer interested in representing the little people of Nevada. He is operating on the grand stage of history now, doing the bidding of the New Left presently running Washington, from House Speaker and San Francisco Democrat Nancy Pelosi, to President Barack Obama, to the New York Times. He is thinking now of going down in history as one of the political fathers of socialized medicine.

That is why there is no denying that the Senate health bill he has put on the floor is a government takeover of health care. What do you think the 2,074 pages of that bill are all about? What else is involved in the bill's creation of almost 100 new bureaucracies, boards, commissions, and programs, like the House health bill?

Under the bill, the government tells insurance companies exactly what benefits they must provide. It tells them exactly who they must cover. It closely regulates how and what they can charge for that coverage. It even redistributes their earnings among them under a new "risk adjustment" system. This can't be viewed as anything but a complete government takeover of health insurance.

The government then tells employers they must buy that insurance for their workers, and tells workers that otherwise they must buy that insurance directly themselves. These requirements are enforced by new tax penalties on both workers and employers.

The new bureaucracies tell doctors and hospitals what health care is "cost effective," and what health care supposedly works and what doesn't, as if Washington bureaucrats know this better than your own doctor. The legislation then sets up new payment rules and regulations for doctors and hospitals with the power to enforce this central planning decision making. The legislation even gets into controlling the health care workforce, and who provides what health care.

Harry Reid's Medicare Cuts and Death Panels

Worst of all, the legislation involves a fundamental assault on the high quality health care that you and your loved ones will need to save their very lives in the future, through government health care rationing. This is the same rationing that is adopted by every other socialized medicine system because, with the government taking over health care, only the government can control costs, by directly rationing care.

This follows as well the political logic of socialized medicine. The vast majority of voters are healthy. Only a small percentage are critically ill and in need of advanced medical care. So a politically run system will be designed to serve the healthy with their free check-ups and regular tests, not the truly sick who need expensive, highly advanced health care to save their lives, from tiny premature babies to seniors with heart disease or cancer. The truly sick are also not very effective political advocates, maybe dead before the next election. They also don't know when the doctor comes to tell them there is nothing that can be done whether that is due to the science of medicine, or to politics and government rationing.

That is why the legislation includes close to $800 billion in Medicare cuts in the first 10 years of full implementation, slashing the payments to doctors and hospitals who provide health services and care to seniors. This is the beginning of the health care rationing for seniors, with the money devoted to expanding Medicaid. But President Obama has already begun that rationing, by adopting new Medicare payment rules for next year that will slash payments to the specialists who treat cancer and heart disease, and for the diagnostic equipment and tests they use.

Those Medicare cuts include over $100 billion in cuts to Medicare Advantage, the private health plans that almost one-fourth of seniors have chosen to provide their coverage under Medicare. The government's own Center for Medicare and Medicaid Services estimates that almost 9 million seniors will lose their Medicare Advantage plans as a result. The Reid Senate bill further includes the Independent Medicare Advisory Commission, a panel of unelected bureaucrats with the power to adopt still more Medicare cuts in the future.

The new bureaucracies, boards, and commissions in the bill are collectively "death panels" with the power to ration and deny you care through "comparative effectiveness" and "cost effectiveness," as enforced through "Pay for Performance" and fixed global budgets for the care doctors and hospitals can provide their patients. Various uninformed liberal commentators and literal clowns serving as comedian/commentators want to ridicule that term because it is so effective in communicating exactly what is going on.

We already see the beginning of this as well in the U.S. Preventive Services Task Force, which recently abruptly reversed its long-standing recommendations that women over 40 should get mammograms to test for breast cancer every year. Now it recommends no more mammograms for women under 50 or over 74, and only every other year for the ages in between. Under the prior practice, breast cancer death rates fell by 30% over the past 20 years. Dara Richardson Heron, CEO of New York Susan G. Komen for the Cure, recounted in the New York Post on Sunday how her breast cancer was discovered, and her life saved, by a mammogram at age 34. But the panel indicated that it takes 42% more mammogram tests to save a life for women in their 40s compared to those in their 50s, so saving those lives before 50 is apparently not worth the costs of the tests anymore. And what does no more mammograms for women over 74 tell you about breast cancer treatment in the brave new world of Obamacare for women of that age? Under the Senate bill, this same Task Force is empowered to determine your coverage for preventive services.

More fundamentally, considering the Medicare cuts, the restricted payments to doctors and hospitals under the "Public Option," and other changes to the compensation for health providers in the legislation, the incentives for investment in health care across the board will be eviscerated. Gone will be the money for investment in new miracle cure drugs, advanced medical equipment, innovation, and first rate hospital and clinic facilities. While science is blazing new frontiers in human genetics and biotechnology, the realization of that in health care will have to await a New Enlightenment.

Paying More for Less

When Reid, Pelosi, and Obama get done fixing health care, health costs and insurance premiums will soar, for at least 4 reasons. First, the health insurance you will be required to buy will include coverage for all the expensive, politically correct benefits, whether you want them or not, such as drug rehab, mental health, and lower deductibles and co-pays. Second is the new taxes on health insurance, not only on the most expensive plans, but over time on the more ordinary ones as well. Indeed, there is a second tax that applies to all health insurance plans from the start. New taxes on prescription drugs, medical devices and clinical labs will also raise the cost of health care and insurance. Third is the cost shifting to private insurance from reduced compensation paid to doctors and hospitals under Medicare, Medicaid, and the Public Option.

Finally, there is the new regulation requiring guaranteed issue of health insurance to everyone who first applies, regardless of how sick and costly, with only limited variations in how much can be charged for coverage. This is like requiring the sale of fire insurance to those whose houses are already on fire. Studies now confirm what this column has long explained, that this will cause health insurance premiums to double and even triple in most of the country, particularly for those young people under 30 who get charged much less now because of their relative good health.

Altogether, over the first full 10 years, the Senate bill will cost $2.5 trillion, with almost $1 trillion in new taxes along with the almost $1 trillion in Medicare cuts. That is because the bill involves a massive entitlement expansion, on top of all the entitlement promises we have already made that we can't afford. The bill expands Medicaid to another 15 million people, and provides subsidies for the purchase of health insurance for families earning up to $88,000.

None of this is necessary to address our real health care problems. Only about 12 million Americans arguably can't afford health insurance. We can just provide them with some government assistance to help them buy it, at little additional cost. We already spend around $400 billion on Medicaid each year, with that slated to soar in future years. Give each state the authority to redesign its Medicaid program from the ground up to provide a true safety net for the poor. Each state can include in that an uninsurable risk pool where those uninsured who become too sick to get private insurance can get guaranteed coverage, paying what they can given their resources, with the government paying the rest. Since few people actually become uninsurable, this would provide a complete safety net at little in added cost.

We can actually reduce costs by expanding rather than restricting Health Savings Accounts (HSAs), where consumers are covered by catastrophic insurance with a high deductible, which costs far less than traditional low deductible coverage. The difference is saved in the HSA to pay for expenses below the deductible, providing market incentives for patients to avoid overly expensive or unnecessary medical care, as they can keep what they don't spend. With patients concerned about costs, doctors, hospitals and other health providers would have new incentives to compete to reduce costs. Common sense solutions like allowing interstate sales of health insurance and tort reform would also reduce health costs.

No rationing, no government takeover, no trillion dollar programs are necessary to address these problems. Quite the opposite. That reveals that the health care debate is really about government and political power, not health care. Sucker.

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About the Author
Peter Ferrara is Director of Entitlement and Budget Policy at the Heartland Institute, General Counsel of the American Civil Rights Union, Senior Fellow at the National Center for Policy Analysis, and Senior Policy Advisor on Entitlements and Budget Policy at the National Tax Limitation Foundation. He served in the White House Office of Policy Development under President Reagan, and as Associate Deputy Attorney General of the United States under President George H.W. Bush.