The Affordable Care Act. IS it? What IS it?

It's an honest question. Nancy Pelosi said we'd have to pass the Act, to find out what was in it. Now we find out:

Deep Inside The Hot Mess Called Obamacare: It's Time For Honesty.

“Oh what a tangled web we weave when first we practice to deceive,” wrote Walter Scott in Marmion. It begins to appear that the Obama White House, right up to the president, cut class the day that Marmion was being taught. The ensuing breakdown in America’s health insurance system, and the political backlash, shows what happens when integrity is drained from politics.

[...]

“[P]oliticians made a series of short-term fixes that all but guaranteed long-term problems.” Politicians, elected officials, and career civil servants are guided by different incentives than businesses. And follow them. And then are, or act, incredulous when this time officious meddling yet again degrades the quality of goods and services in whose markets they have intervened.

Who would have guessed that tampering with the free market will end, as it always seems to, in tears. Who would have guessed? Not Pyongyang. Not Nation For Change. And, apparently, not freshman Senator turned president Barack Obama. As Abraham Lincoln noted, you can fool all of the people some of the time….

Under the rapidly unraveling deceit what’s really going on?

Is Obamacare really stealth capitalism? Or is it really stealth socialism?

Or is it really something far older and more pitiful? The one thing all seem to agree upon is that it, whatever it is, is stealthy. Is Obamacare simply a badly designed system tangled in a web of lies woven to mask the hubris and the incompetence of those who are, as former U.S. Treasurer Ivy Baker Priest once wittily described herself, “often wrong, but never in doubt”?

In this case progressives have given the American people the hot mess called Obamacare. Who — other than the Republicans, libertarians, conservatives, supply siders, and Tea Partiers vilified by the mainstream media — as well as most Forbes.com columnists — could have guessed that the Affordable Care Act might actually serve to make health care less available and less affordable?

At a certain point spin becomes deception. The promotion of Obamacare crossed that line.

The American people do not appreciate being hoodwinked.

Stealth capitalism? Stealth socialism?

Nobody knows which.

But we mere voters know stealth. And don’t like it. [...]

A shit brick, by any other name...

It's such a mess, I have to wonder if it was ever intended to work, or if it was intended to merely destroy the healthcare system we had, so the government could then try to fix the problem they created by shoving a single payer system down our throats, which is what so many of them wanted right from the start?

I don't think every element of the Affordable Care Act is bad. But as a whole, it is a mess. Republicans should have taken the initiative for healthcare reform when they had the chance. They didn't, so the Democrats did, they did it all THEIR way, and now we have The Shit Brick.

We are just a few days away from January 1st, and I still don't know if we will have insurance by then. Our group policy was cancelled. We were steered toward the state health exchange. We made a choice from there. Half of it went through, half was botched up, and we're still trying to sort it out.

Meanwhile, our old insurance policy was suddenly resurrected for another year and offered to us, with only six days to decide, but by then we'd already committed to the new plan, yet headlines are NOW screaming that the State Exchange is on the verge of running out of money, and our registration with the new plan seems in limbo at the moment.

And what will it do to our taxes? The cost of our previous health insurance was a deduction. The new plan comes with tax credits. Deductions are subtracted from what you owe. Credits are subtracted from what you pay. So our income tax is going to go up as well. So then, how much will we actually save? I guess it's the Nancy Pelosi method: "You have to pay more taxes before you can see how much you will get back".

I want to be optimistic and believe it will all come right in the end. And perhaps it will. But this sure is not encouraging. And it is NOT the way to do business.
     

The Truth: You can't keep the plan you had

Sticker shock often follows cancellation notice for those with individual health care policies

MIAMI — Dean Griffin liked the health insurance he purchased for himself and his wife three years ago and thought he’d be able to keep the plan even after the federal Affordable Care Act took effect.

But the 64-year-old recently received a letter notifying him the plan was being canceled because it didn’t cover certain benefits required under the law.

The Griffins, who live near Philadelphia on the Delaware border, pay $770 monthly for their soon-to-be-terminated health care plan with a $2,500 deductible. The cheapest plan they found on their state insurance exchange was a so-called bronze plan charging a $1,275 monthly premium with deductibles totaling $12,700. It covers only providers in Pennsylvania, so the couple wouldn’t be able to see the doctors in Delaware whom they’ve used for more than a decade.

“We’re buying insurance that we will never use and can’t possibly ever benefit from. We’re basically passing on a benefit to other people who are not otherwise able to buy basic insurance,” said Griffin, who is retired from running an information technology company.

The Griffins are among millions of people nationwide who buy individual insurance policies and are receiving notices that those policies are being discontinued because they don’t meet the higher benefit requirements of the new law.

They can buy different policies directly from insurers for 2014 or sign up for plans on state insurance exchanges. While lower-income people could see lower costs because of government subsidies, many in the middle class may get rude awakenings when they access the websites and realize they’ll have to pay significantly more.

Those not eligible for subsidies generally receive more comprehensive coverage than they had under their soon-to-be-canceled policies, but they’ll have to pay a lot more.

Because of the higher cost, the Griffins are considering paying the federal penalty — about $100 or 1 percent of income next year — rather than buying health insurance. They say they are healthy and don’t typically run up large health care costs. Dean Griffin said that will be cheaper because it’s unlikely they will get past the nearly $13,000 deductible for the coverage to kick in.

Individual health insurance policies are being canceled because the Affordable Care Act requires plans to cover certain benefits, such as maternity care, hospital visits and mental illness. The law also caps annual out-of-pocket costs consumers will pay each year.

In the past, consumers could get relatively inexpensive, bare-bones coverage, but those plans will no longer be available. Many consumers are frustrated by what they call forced upgrades as they’re pushed into plans with coverage options they don’t necessarily want. [...]

The article goes on to give more examples, from people in lower income brackets than the Griffins, who are also loosing the plans they had, and will now have to pay more.

I've been given a 90 day notice that my insurance plan is being canceled.

Health care reform, done properly, should offer us more choices of things we want and need, not choices made by bureaucrats that are shoved down our throats. I want the health care I had, not somebody elses decisions.

The problem with the ACA right from the beginning was that there was no significant bipartisan input. Reform was needed, but it was too one-sided, and this is the result.

Two interesting comments under the article:

UCanKeepthechange
11/3/2013 10:11 AM PST
The WH is attempting to blame cancelled policies on insurance companies. However, the truth is that it is due to the ACA.

The so called grandfathering in of existing policies was dishonest. If the cost to the consumer of a policy went up a single dollar ($1) since the law passed in 2010, it was DISQUALIFIED from the grandfather clause.

When the law passed in 2010, the administration already knew the following:

80%+ of individual market policies would not conform to ACA and would be eliminated by law
65% of policies for small businesses and their employees would not conform to ACA and would be eliminated by law
45% of policies for large businesses and their employees would not conform to ACA and would be eliminated by law.

So, when you hear the administration's talking heads blaming insurance, understand that it is simply another lie. This one is all on Obamacare.

Salverda
11/2/2013 7:10 PM PDT
Don't be deceived, by the latest straw-man argument, into thinking that insurance companies are some how sabotaging Obamacare. Think for a minute: Who wants the "individual mandate" forcing every American to become a costumer of the insurance industry? And: Why would insurance companies want to infuriate half of their current customers by canceling their existing policies, without having the law on their side? The insurance companies know that they won't loose their clients, they will just be "transferred" or "channeled" into more expensive plans that call for higher premiums and larger deductibles. The complicit insurance companies are in cahoots with Obama on Obamacare; Why aren't they speaking up right now while Obama falsely accuses them of canceling policies, and charges them with selling "inadequate" and "unsatisfactory" "bad-apple insurance" products to their costumers? They keep quiet and just take it, because they are colluding with Obama, open your eyes! Sure there were coverages (no coverage caps, pre-existing conditions, 26 year old "child" dependents) that the insurance industry was reluctant to offer, at first. Their costumers would not have stood for the increased costs of these extravagant, and even unnecessary, services. However, under Obamacare they have found a way to get us to pony up, and now, they view these services in a different light. Their clients will be forced by law, to pay for these things, and they have been "allowed" to charge us for them. To the insurance industry, it is as if all of their costumers have been upgraded into their highest cost Cadillac plans. And they are lapping it up, taking full advantage of the situation.

     

Truely Bipartisan Health Care Reform

Unlike Obamacare, the Wyden-Ryan plan is truely a bipartisan effort, that does not dump any grandma's off a cliff. From Senator Wyden's website:

Bipartisan Health Options

U.S. Senator Ron Wyden (D-OR) and U.S. Representative Paul Ryan (R-WI) introduced a new proposal that represents a major advance in the effort to build a more secure future for the millions of seniors who rely on Medicare.

The new report from Sen. Wyden and Rep. Ryan, titled “Guaranteed Choices to Strengthen Medicare and Health Security for All: Bipartisan Options for the Future,” outlines a detailed proposal to offer expanded health care choices for older Americans while preserving a traditional Medicare plan as an option. The report also proposes to give Americans under 65 more power and freedom to purchase insurance products they can carry with them into retirement.

[...]

Why do you say Wyden-Ryan won’t “end Medicare as we know it?”  Won’t allowing seniors to choose private health plans be a major change?

First of all, the hallmark of Medicare is not its structure but its guarantee that every American will have high quality health benefits as they get older.  And, as has been mentioned before, “Medicare as we know it” will end in 2022 if nothing is done to change its current course.  Wyden-Ryan takes action to ensure the Guarantee is preserved.

Contrary to what many believe, every Medicare beneficiary does not currently get their Medicare from the government-administered Medicare insurance plan.  Many seniors are already getting their Medicare from private health insurance plans.  In Oregon, for example, 56 percent of seniors currently get all or some of their health coverage from a private plan. (15 percent of Oregon seniors purchase private Medigap policies to supplement their traditional Medicare, while 41 percent of Oregon's Medicare beneficiaries are enrolled in private health insurance plans through Medicare Advantage.)Wyden-Ryan would allow seniors to continue to choose between the traditional government-administrated Medicare option and privately administered plans.  But instead of maintaining separate programs, Wyden would make those private plans more robust and accountable by forcing them to – for the first time – compete directly with traditional Medicare.

Every private plan that participates in the program would be required to offer health benefits that are AT LEAST as comprehensive as those offered by traditional Medicare and premium support payments would be pegged to the actual cost of health care in a given area, determined by an annual competitive bidding process.  Therefore, every senior – whether they get their health insurance from a private plan or the government – will be guaranteed to have the high quality health benefits that has long been Medicare’s promise.

How will Wyden-Ryan ensure that private insurance companies don’t take advantage of seniors?

All participating private plans will be required to offer benefits that are at least as comprehensive as traditional Medicare, with such standards enforced by the Centers for Medicare and Medicaid Services.  Any plan that is found taking advantage of seniors or providing inadequate care will be kicked out of the system. Cherry picking healthier seniors will be made unprofitable by robust risk-adjustment, and the Medicare Exchange where plans will seek to offer coverage to seniors, will be policed by the federal government.

It is worth noting that the Medigap law Senator Wyden authored to regulate the private market for Medicare’s supplemental insurance market has been protecting seniors from unscrupulous insurance practices for more than two decades.

How will Wyden-Ryan guarantee that health care will be affordable for all seniors? Isn’t it just a voucher?

A voucher suggests giving seniors a fixed amount of money indexed by a set rate of growth that may/may not have anything to do with the actual growth of health insurance costs.  Vouchers would not guarantee that seniors could afford health coverage.  (This is what the last year’s House Republican Budget did.)

Wyden-Ryan does not give seniors vouchers.  Instead Wyden-Ryan would guarantee that seniors can afford their health insurance premiums by giving seniors premium support payments, the amount of which will be determined by the actual cost of insurance premiums each year.

It would do this through a competitive bidding process in which private insurance plans, wanting to cover Medicare beneficiaries, would submit their benefit packages and the amount they will charge in premiums for the upcoming year.  The amount seniors receive in premium support will be determined by either the cost of traditional Medicare premiums or the second cheapest private plan available on the exchange (whichever is cheaper.)  This process will take place each year, so if health care costs – and therefore insurance premiums -- grow dramatically from one year to the next, so will the premiums support payments that seniors get to pay for them – thus ensuring that every senior can afford their health insurance premiums.

And again, every private plan in the Medicare exchange will be required to offer benefits that are at least as comprehensive as those offered by traditional Medicare. [...]

It's not a "Radical Plan to Kill Medicare". It actually builds on the Medicare options that already exist, in a way that will both control costs and offer more choices. And it's a plan we can actually afford!

It's definitely worth reading the whole thing. It's pretty much the same Medicare plan that Paul Ryan is advocating on his website.

In an interview for Human Events, Ryan explains the history of bipartisan support for the reforms he's advocating.

   

Medicare's future, for those under age 55

People like me:

What no one is telling you about Medicare

[...] Cuts are inevitable. The real battle is over who bears the cost.

This spring the House passed a budget resolution designed by Paul Ryan (R-Wis.) that radically overhauls Medicare. The plan is unlikely to become law in its present form, but the ideas behind it will play a pivotal role in shaping Medicare reform.

Here's how the system would work: If you are younger than 55 today, your Medicare insurance would be replaced with a fixed voucher, or what Ryan calls "premium support," which you'd use to buy a private health insurance plan. In 2022 a typical 65-year-old would get about $8,000. Plans would have to take all comers, regardless of their health, and would charge the same price to people of the same age. Your premium support would go up as you got older or sicker. Low-income seniors would get extra cash.

You get skin in the game...

Premium support attempts to fight what economists call the moral hazard problem. If your insurance picks up a lot of your medical bills, you don't have much incentive to be a picky consumer. Your doctor prescribes, you comply. Even if there might be a cheaper way to get better results.

"Medicare has inherent in it inflationary pressures that push costs up very high, very rapidly," says Jim Capretta, a former George W. Bush administration budget official now at a think tank called the Ethics and Public Policy Center.

Ryan's approach would force you to make choices about what to do with your $8,000. You could pay a lot on top of that to get a generous plan or buy a cheap one that lets you see doctors within an HMO network and leaves you with a high deductible.

How much would that system reduce the cost of care? The answer is hotly contested. Some people would spend less but might also forgo care they really needed, says Juliette Cubanski, a Medicare policy analyst at the Kaiser Family Foundation.

Gail Wilensky, who ran the Medicare system during the George H.W. Bush administration, thinks a market dynamic will help a lot, but cautions that much spending is concentrated on the very sick, whose costs have blown past any reasonable deductible. "The serious spenders are always going to be using someone else's money," she says.

Shifting to private plans also has costs: Insurers have to charge enough to pay for administration and marketing while clearing a profit. The CBO, which concedes a lot of uncertainty about how vouchers would change the market, believes total costs would go up. It estimates that private plans will be so expensive that in 2022 a typical 65-year-old would spend twice as much to get the same benefits Medicare provides. That's an extra $6,240 to you.

...but a shrinking benefit.

The voucher is also a tool to cap government spending on health care. In 2022, once the feds send you $8,000, they're done paying for the year. "What we do in Medicare today is say, 'We're going to set in motion an open-ended entitlement, and the government's going to subsidize whatever it takes to provide that package,'" says Capretta. "The Ryan budget says, 'Why don't we build a budget that sets a level of taxation that we can afford, and here's the level of entitlement spending that will fit within that?'"

The idea of imposing a limit isn't inherently conservative or liberal. Most other rich countries, with their universal insurance, set a health care budget; the reform law signed by President Obama last year tries to cap spending too. But Ryan's cap is remarkably austere.

Social Security checks to rise 3.6%

The value of his voucher would grow at the level of inflation, which is almost always less than the growth of the economy. But no industrial country keeps health spending growth below GDP growth.

"It's implausible to think costs would inflate at that level," says Boston University health economist Austin Frakt. If so, then over time premium support would buy you less and less insurance -- and less and less care.

There are countless ways to moderate the severity of the Ryan plan. Wilensky suggests a cap that grows a little faster than GDP, for instance. What's most important about the proposal, though, is not the specific growth target; it's the philosophical stake in the ground planted about how much of the cost of paying for health care should be shared collectively, through taxes, and how much should be a responsibility for you, the individual, to bear. The Ryan plan says clearly: more on you. [...]

Hmmm. I do believe that costs have gotten so far out of control, because once the "government" is paying, instead of an individual, then nobody cares about the costs or questions what is being charged and why. But if it goes too far the other way, then people under 55 might be getting a lot less, even though they payed into Medicare the same as people over 55.

Is there a happy medium, a balance, somewhere? One will have to be found, because it sure can't continue like it is; unsustainable.

It's quite a long article. From PART 2:

Medicare: How much more will they cut?

For all the chatter about how politicians have to buckle down and get serious about reining in Medicare, you might have missed this development: Last year's health reform bill cut $500 billion out of two big Medicare programs over a decade, while increasing the number of high-income retirees who have to pay larger Part B premiums.

"It's as if that never happened," says Jonathan Oberlander, a professor of health policy at the University of North Carolina.

To be sure, health reform wasn't a let's-shrink-the-government project. The reason Democrats got their hands grimy and made cuts to the program was to help pay for a new health care entitlement, making it easier for Americans under 65 to buy their own insurance. Still, the new law shows that liberal lawmakers will slice into Medicare if needed, and offers a glimpse into how they'll try to do it.

The central idea behind the maze of cost-control provisions health reform establishes: Focus on trimming fat before reducing benefits. One approach is to reduce the power of providers to drive spending. When your doctor says you need this test or that surgery, you tend to take his word for it, even if you have hefty out-of-pocket costs. Hospitals, meanwhile, have consolidated in recent decades, giving them considerable price-setting power.

Results: There's substantial evidence that doctors at times over-treat, and you overpay for just about everything. "For a long hospital stay we pay $18,000, vs. $4,000 or $5,000 in Germany or Japan," says Gerard Anderson, director of the Center.

[...]

In coming months one idea you'll hear debated a lot is imposing a numerical cap on future government spending or revenue -- say, 21% of GDP or even 18%.

No matter what the specific numbers proposed are, growing health care costs are on a path to push the size of government well beyond those limits. If that happens, Medicare would go from long-term challenge to immediate crisis. Big changes would have to happen fast. Budget hawks ought to be specific about what those changes will be.

All you can know for sure now: This country, not just the government, but each of us as individuals -- is facing a monster of a doctor's bill, and there's no easy way to get around paying it.

Yikes.
     

Dems want to kill consumer-driven health care

The End of HSAs

About the best that can be said about the Senate health-care bill that Harry Reid revealed this week is that it's marginally less destructive than the House monster. By a hair. Its $1.2 trillion cost (more like $2.5 trillion if you discount the accounting gimmicks), multiple and damaging new taxes, and new regulations will make health insurance more expensive for most Americans while reducing the quality of medical care.

We'll dissect the damage in the days to come. But for today let's focus on the damage the bill would do to consumer-driven health plans—the kind that give individuals more control over their health dollars and insurance choices. The 2,074-page bill crushes them with malice-aforethought. [...]

It goes into detail. I have an HSA, and it's wonderful. It allows me to buy insurance with a high deductible. I can then use the HSA to pay for uncovered costs, and to choose the kind of health care I want.

As the article clearly points out, the Democrats want to eliminate our choices, and force us to take what they choose for us, on their terms, not ours. Congress of course, will have their own insurance, and won't be forced to use what they force on us.

It's time for a revolution, time to get rid of the dictators.

     

The Free Market CAN Fix Health Care

Yes, Mr. President: A Free Market Can Fix Health Care

In March 2009, President Barack Obama said, "If there is a way of getting this done where we're driving down costs and people are getting health insurance at an affordable rate, and have choice of doctor, have flexibility in terms of their plans, and we could do that entirely through the market, I'd be happy to do it that way." This paper explains how letting workers control their health care dollars and tearing down regulatory barriers to competition would control costs, expand choice, improve health care quality, and make health coverage more secure.

First, Congress should give Medicare enrollees a voucher and the freedom to choose any health plan on the market. Vouchers would be means-tested, would contain Medicare spending, and are the only way to protect seniors from government rationing.

Second, to give workers control over their health care dollars, Congress should reform the tax treatment of health care with "large" health savings accounts. Large HSAs would reduce the number of uninsured Americans, would free workers to purchase secure health coverage from any source, and would effectively give workers a $9.7 trillion tax cut without increasing the federal budget deficit.

Third, Congress should break up state monopolies on insurance and clinician licensing. Allowing consumers to purchase health insurance licensed by other states could cover one-third of the uninsured without any new taxes or government subsidies.

Finally, Congress should reform Medicaid and the State Children's Health Insurance Program the way it reformed welfare in 1996. Block-granting those programs would reduce the deficit and encourage states to target resources to the truly needy.

The great advantage of a free market is that innovation and more prudent decisionmaking means that fewer patients will fall through the cracks. [...]

Precisely! The current healthcare system is hamstrug with government regulations that prohibit the free market from working. The free market hasn't failed healthcare; it hasn't had a free hand to work.

The part of the article I've quoted here is just the beginning. If you follow the link, there is a PDF file with the entire policy analysis in detail.

All this could be done without creating TRILLIONS of dollars of debt, and without creating new government programs that can't be sustained.
     

Big Business and Democrats unite for a very profitable Socialist Power-Grab

Pat has already beat me to the things I wanted to post about, so I refer you to his links:

Why Big Pharma and Big Insurance want Obama-style health-care reform:
"No one hates capitalism more than capitalists"

How the Democrats have been steering us towards this for decades:
The Plantation Party has been planning socialized healthcare for over 60 years

More "staged" Town Hall events, with pre-arranged questioners planted in the audience:
Obamugabe's Potemkin townhall

I would love to see the revolt of 1816 repeat itself:
Townhall protesters are not "unAmerican"

The protesters are scoring points, because many people agree with their concerns:
Krauthammer is wrong about the townhall protesters
     

True Health Care Reform: Reduce the "Wedge"

What is the "wedge"? It's one of the crucial things that makes health care costs so high. Read on. From Arthur Laffer at the WSJ:

How to Fix the Health-Care ‘Wedge’

[...] The health-care wedge is an economic term that reflects the difference between what health-care costs the specific provider and what the patient actually pays. When health care is subsidized, no one should be surprised that people demand more of it and that the costs to produce it increase. Mr. Obama’s health-care plan does nothing to address the gap between the price paid and the price received. Instead, it’s like a negative tax: Costs rise and people demand more than they need.

[...]

The bottom line is that when the government spends money on health care, the patient does not. The patient is then separated from the transaction in the sense that costs are no longer his concern. And when the patient doesn’t care about costs, only those who want higher costs—like doctors and drug companies—care.

Thus, health-care reform should be based on policies that diminish the health-care wedge rather than increase it. Mr. Obama’s reform principles—a public health-insurance option, mandated minimum coverage, mandated coverage of pre-existing conditions, and required purchase of health insurance—only increase the size of the wedge and thus health-care costs.

[...]

The president’s camp is quick to claim that his critics have not offered a viable alternative and would prefer to do nothing. But that argument couldn’t be further from the truth.

Rather than expanding the role of government in the health-care market, Congress should implement a patient-centered approach to health-care reform. A patient-centered approach focuses on the patient-doctor relationship and empowers the patient and the doctor to make effective and economical choices.

A patient-centered health-care reform begins with individual ownership of insurance policies and leverages Health Savings Accounts, a low-premium, high-deductible alternative to traditional insurance that includes a tax-advantaged savings account. It allows people to purchase insurance policies across state lines and reduces the number of mandated benefits insurers are required to cover. It reallocates the majority of Medicaid spending into a simple voucher for low-income individuals to purchase their own insurance. And it reduces the cost of medical procedures by reforming tort liability laws.

By empowering patients and doctors to manage health-care decisions, a patient-centered health-care reform will control costs, improve health outcomes, and improve the overall efficiency of the health-care system.

Congress needs to focus on reform that promotes what Americans want most: immediate, measurable ways to make health care more accessible and affordable without jeopardizing quality, individual choice, or personalized care. [...]

Mr. Laffer maintains that Obama's solutions won't work, because he has failed to diagnose the problems correctly. Read the whole thing. We need to fix our existing system, not scrap it for an even larger system that suffers from the same systemic problems, and that will also become unsustainable.
     

Obamacare: more government making more problems AND needless, unsustainable expense

Here is a government monster that needs to be killed before it's turned loose:

Inside the monstrous Obamacare bureaucracy



Many people seem to think we just need to get insurance for everyone, but not only is More Health Insurance is Not the Answer, it's actually part of the problem. Too many third parties and bureaucracy actually create administrative costs that are driving up the price of health care. Obamacare would simply expand and feed that problem. We need to simplify insurance and health care billing and bring prices back in touch with reality, using the free market and consumers choice.


Related Links:

Health Care Costs; why the high prices?

Lowering Health Care Costs for Everyone

A National Health Care Preview, and a lesson from Natasha Richardson's experience
     

The Government and Health Care: What's Next?

Where is it all going? What can we expect? This article breaks it down into three areas of consideration; Costs, Mandates, and a Public Plan:

Health care: Deal or no deal? Senators begin work

[...] Sen. Ron Wyden, D-Ore., sees opportunity. "There is a very appealing philosophical truce within the Senate's grasp," he said.

"Democrats are right on the idea that we've got to cover everybody. Republicans have been right on the role of the private sector, not freezing innovation and staying away from price controls," Wyden said. "You meld those philosophical views and you are on your way to 68 to 70 votes."

Consensus is growing on many points: Changes should build on the current system, not scrap it; hospitals and doctors should be paid for quality, not quantity; insurers shouldn't be able to discriminate against people with health problems; small businesses need special attention.

But huge differences remain. Three of the hardest issues are:

Costs:

Obama set aside $634 billion in his budget as a "down payment" for health care over 10 years. Many experts believe that represents less than half the cost. Covering the uninsured could cost $100 billion to $150 billion a year, or more.

Liberal Democrats want to follow Obama's example and get half the money from tax increases and half from spending cuts. Upper-income tax increases and sales tax increases on alcoholic beverages, tobacco products and even sugary sodas are being discussed.

But Republicans and fiscally conservative Democrats want most of the financing to come from spending cuts and from making the health care system less wasteful.

Mandates:

Health insurance is based on pooling risk: premiums from the vast majority of healthy people cover care for the sick. For the system to work, economists say, everyone should have health insurance from the outset so uninsured people don't end up going to the emergency room and driving up costs for everyone else.

Because insurance is expensive, requiring people and businesses to pay for it is politically difficult. Most people now get insurance from their employers, but companies aren't required to offer it and as the economy skids more have cut back.

Obama and Democrats are considering a combination of requirements on individuals, parents and employers, with exemptions for small businesses and sliding-scale subsidies for families making as much as $80,000 a year.

Republicans opposed an employer mandate in the 1990s, but have mixed views on an individual requirement. The insurance industry is supporting an individual mandate. Labor unions are pushing for employer mandates.

Public Plan:

Obama and the Democrats want to give middle-class workers and families the option of joining a government-sponsored insurance plan that would be offered alongside private ones through a new insurance clearinghouse.

Supporters say a public plan could be a testing ground for innovations and a check on private insurers. Republicans see it as a thinly disguised step toward a government-run system. Insurance companies say they wouldn't be able to compete with a government plan.

Efforts are under way to find a compromise, maybe by limiting the scope of the public plan. But Rep. Dave Camp, who is playing a leading role in the House, said he doesn't think a deal is possible. "The public plan is a bright line for us," said Camp, R-Mich. [...]

And so the tug-of-war begins. Who knows what we will end up with. At any rate, we SHALL see.
     

A challenge to four statements that Obama repeats at almost every campaign rally

These statements really do need to be debunked. Neal Boortz has done so, and I'm reprinting them here in their entirety:

AT LEAST KNOW WHO YOU'RE VOTING FOR -- A CHALLENGE

The election is now eight days way. If you've made up your mind for Obama; or if you're trying to noodle through some of the things he's been saying on the campaign trail, this should help. I've taken four statements that The Chosen One repeats at almost every campaign rally. Now these statements are pretty powerful ... if unchallenged ... and we know that the MoveOn Media isn't exactly what we would call "eager" to challenge God's Candidate on any of these issues.

So, here we go again .. this simple talk show host (right wing, hate-filled shock jock, I believe they call us) is going to use some basic logic and the ability to actually read newspapers to catch you up to speed on just what the Big BO is saying here. Now if you're educated in our wonderful government schools you may find this challenging. Stick with it. In spite of what the government has done to you, you can generate some new brain cells that will help you deal with this stuff. It would also help if you got your campaign news from somewhere other than Saturday Night Live.

Here we go, front and center with Barack Obama!

"I'm going to cut taxes for 95% of Americans."

This Obama promise has already been pretty much debunked in the media. The problem is that it hasn't been debunked on the Black Entertainment Television network or on Inside Edition or Entertainment Tonight. Until these television outlets bring forth the facts most of Obama's supporters won't know the truth.

And what is the truth? The truth is that almost one-half of working Americans eligible to vote don't pay federal income taxes in the first place. This brings forth the interesting question of how do you cut taxes for people who don't pay taxes. What Obama has done here is change the definition of "tax cut."

It used to be that when the government walked up to someone who had just received their paycheck and said 'Gimme some of that," and the government then gave that money to someone else who had not earned it; that was called welfare. Now apparently you can't get welfare if you're working ... so we'll just call it income seizure and redistribution. Under Obama a couple earning, for example, $70,000 and owing no federal income taxes at all will get several checks from Obama's federal taxpayer-funded treasury. These checks will be called "tax cuts."

So .. for those who don't pay taxes, here are some of the "tax cut" checks you'll be getting from The Chosen One. I'm taking some literary license here and replacing the words "tax credit" with the word "payment." That literary flourish brings us much closer to the truth. Here are your goodies; come and get 'em:

• A $500 "make work pay" payment.
• A $4,000 payment for college tuition.
• A payment equal to 10% of your mortgage interest
• A payment equal to 50% of the amount of money you put into a savings account up to $1000.
• A payment equal to 50% of the amount of money you pay for child care up to $6000.
• A payment of up to $7,000 if you purchase a "clean car." By that Obama means an environmentally correct car.
• Plus ... an expansion of the earned income tax credit .. increased payments on top of your earnings if the government doesn't feel you are earning enough.

There you go ... Obama's "tax cuts." Sounds pretty good, doesn't it. Well, I guess it is, if you're not too successful it IS pretty good. Remember, the harder you work the lower these payments get. Barack Obama's tax plans are all about punishing success and rewarding failure. He understands that if it weren't for failures, Democrats would be scrounging in the alleys for votes.

It's rather ironic that the Obama campaign will go to the mat with critics over the definition of "socialist," but feel absolutely free to change the definition of "tax cut" to anything that suits them.

"95% of small businesses won't pay any more taxes."

Once people started hearing that the very people that Obama wanted to raise taxes on are the people we depend on for jobs, The BO campaign had to come up with a line to neuter the "small business" argument. Barack Obama knows he's in trouble if the voters find out that 70% of all extant jobs are in the small business sector and that 80% of all new jobs are coming from small businesses. So, Obama comes up with this line about 95% of small businesses not paying any more taxes under his plan.

Here's the trick. Let me illustrate reality with a simple comparison. Let's say that we have 1000 small businesses. About 950 of them, that would be 95%, employ one or two people each for a total employment figure of 1,200. Now let's assume that the other 50 businesses employ anywhere from 20 people to hundreds of people for a total of about 250,000 workers. If someone comes along and says 95% of small businesses won't be affected by his tax increases, how do you feel? You know that the tax increase is going to slam those businesses that employ 250,000 workers, while leaving the 95% of businesses that employ just 1,200 people alone. Quite a deal, huh. Aren't you impressed?

The point here is that it's not the percentage of small businesses your tax increases hit, it's the percentage of small business employees. Unfortunately that nuance is lost on the majority of voters educated by the government, and the MoveOn Media sure isn't going to take the time to explain it to you. Obama's tax increases are going to hit the small business owners who employ the most people. They are the ones that make the most money. These business owners are going to respond to the tax increases one of two ways. They'll increase prices -- which hit all of us -- or they'll cut expenses. Their number one expense? Personnel. Vote for Obama, say TTFN to your job. Makes perfect sense to me, but then I was government educated too.

"John McCain voted with George Bush 90% of the time."

First of all, George Bush doesn't cast votes in the U.S. Senate, though McCain and Obama do. The best way to judge how they vote is to see how often they vote with their respective parties. You might want to get those nuisance resolutions proclaiming the need for a colonoscopy every once in a while out of the way. That would leave some key votes for you to consider. The Congressional Research Service did the work. They looked at votes for Obama and McCain on KEY issues. The results? Barack Obama voted with Democrats 97% of the time. John McCain voted with the Republicans 79% of the time. Now .. just sit on your hands and wait for the MoveOn Media to report that one. Sit on your hands, but for God's sake don't hold your breath.

"John McCain wants to tax your health insurance benefits."

He's right, but here's the rest of the story. Let's say that you and your brother work for different companies. Your company provides you with health insurance. Your brother has to buy his own. Your boss gets a tax deduction for the cost of your health insurance. Your brother does not get a tax deduction for the cost of his health insurance. In effect, he is paying much more than you are for the same policy. Not fair. There's a reason for this. For decades government has wanted to coerce you into getting insurance through your employer. This gets you acclimated to the idea of someone else -- someone besides yourself -- is responsible for your health care. The end result is that the government, in effect, subsidizes the cost of your health insurance, but not your brother's. Now McCain has this idea of a $5,000 tax credit for every family to pay for their own health insurance policy. To make this work everyone has to start from the same starting line. Remember, you're subsidized, your brother is not. So McCain takes away the tax deduction your employer gets for your health insurance. There ... now we're all of equal standing when the $5,000 tax credits start coming out.

Now that wasn't too hard, was it?

Now .. just in case you've read something here, heard something on my show or gathered some information from some other source that might cause you to switch your vote from Obama to McCain ... just remember. You're a racist. There is only one reason NOT to vote for Barack Obama, and that's if you're a robe-wearing, cross-burning Klansman. Just so you know. You're going to have that on your conscience.

Which will benefit you, and our country, more?

Obama and McCain Tax Proposals
You can follow the link to see a bigger image, and a summary of what the chart's data conveys in practical terms. It's wealth creation VS wealth redistribution.

McCain's tax plan would let us keep more of our own money, and let businesses invest more in creating jobs. The last thing our economy needs right now is a "Jimmy Carter" style tax burden plan. I'm old enough to remember how that worked out; we can do better.

John McCain's Health Care Plan is also something I'm enthusiastic about:

The Strengths of McCain's Health Care Plan
As someone who buys his own health insurance, I appreciate the way it will level the playing field and help me and others make our own, affordable health care choices, without depriving anyone of anything they are already getting. It's a win/win plan.
     

The Strengths of McCain's Health Care Plan

From Yuval Levin: The Cabinet of Dr. Obama

Over the past few weeks, in a series of television ads, in stump speeches, and in the presidential and vice presidential debates, the Obama campaign has sought mightily to attack John McCain's proposal for health care reform. It's vehemence and tenacity have been striking, especially given how little McCain himself has actually had to say about his plan. Ironically, their misleading critiques actually hint at the strengths of McCain's proposal, and point to the serious vulnerabilities in Obama's own approach to health care politics.

At the core of the McCain health care agenda is the most important conservative policy innovation since welfare reform: the transformation of the benefit now given to employer-provided health coverage into a health insurance tax credit made available to all. For almost 70 years now, the federal government has given a significant tax preference to employer-provided health insurance. When your employer takes money out of your wages to purchase coverage on your behalf, the money is not counted as part of your gross income, so you don't pay any taxes on it. But if you purchase insurance yourself, not through an employer, the money you use to do so gets taxed.

This makes employer-provided insurance vastly more appealing and places a serious burden on those to whom it is not available or who prefer coverage other than what their company offers. It has prevented the development of a genuine market in individually purchased health insurance and therefore artificially keeps insurance costs high. [...]

(bold emphasis mine) Exactly. As a self employed person, I have to purchase my own insurance. I have to pay taxes on it, as income. People with employer provided insurance don't and it's grossly unfair. We need more freedom and more choices in buying our health insurance and making our own health care decisions.

Some folks who get their insurance from their employer are satisfied with the status quo, and don't want to rock the boat. But what if we could have the best of all the options?

[...] How can the problems of the current system be addressed without displacing the millions of Americans who are satisfied with it?

The McCain solution is to change the incentives for consumers, but not for employers, so that people find themselves with more options, but are not forced out of their current insurance arrangement. Rather than exempt from taxation all the money used by employers to buy insurance, he would treat it as income but then provide individual taxpayers (regardless of how they obtain their coverage) with a credit that more than covers the taxes. The effect of this, from the point of view of individuals and families, would be to make employer-provided coverage just one option among many.

All American taxpayers, regardless of whether they now have health insurance or where they get it, would receive a $2,500 health care tax credit ($5,000 per family) under McCain's plan. If you now have health insurance through your employer and would like to keep it, you can do that and the economics of the arrangements would change only slightly, and (for all but the top 5 percent of taxpayers) for the better. The money your employer takes out of your wages for your insurance would be taxed, but the new credit would more than cover the additional taxes, leaving you with the insurance you have now, and with a little more money in your pocket at tax time (between $700 and $1,600, according to the estimates of the Tax Policy Center). Things don't change for your employer, and they get a little better for you. [...]

Under this plan we would all have more choices, and more people would be covered too. Read the whole article, it's very detailed and also shows how and why Obama's arguments against it are baseless, and the weaknesses inherent in Obama's own plan.


Related Links:

[The truth about] Mac's health insurance plan

There's No Place Like Home:
What I learned from my wife's month in the British medical system.
     

McCain and Health Care

From the Boston Herald Editorial Staff:
McCain gets it right on health care
Examines the strengths and weaknesses of McCain's proposals thus far.

From the Dallas Morning News, Op/Ed:
Nancy Kruh: Rating McCain's plan
Excerpts of commentary from various political pundits.

From Star Parker at Townhall:
McCain is right on health care
While acknowledging there are still details to be worked out, she says he's moving in the right direction for the right reasons, and explains why.
     

Health care solutions without Socialism

If you listen to the MSM, you would think that socialism is the only solution available for fixing health care in the USA. It's a ridiculous assumption, when you consider how many people DIE while waiting for treatment in countries where the government controls health care. If America embraces socialist medicine, where will the Canadians go for their health care? We need to fix what we have, not copy an inferior system.

During World War II, wage controls in the US prohibited cash raises, so employers started giving non cash benefits, like health insurance, to attract workers. After the war, the practice continued. Now decades later, many Americans have unfortunately gotten the idea into their heads that their employer is responsible for providing their health care. There is an assumption that it's someone else's responsibility to provide it for us, instead of providing it for ourselves.

If employers stopped providing health insurance, and we were allowed to shop around and buy our own insurance across state lines from whoever we chose, the free market would sort it out, competition would drive prices down making insurance rates much more affordable. Why should it be forbidden to us to buy health insurance from an insurer in another state? Restricting competition is keeping prices so high; the free market isn't given a chance.

The Democrats keep advocating "Socialized" Medicine, more government, as the answer, despite it's abysmal record elsewhere. What are conservatives offering? Not enough, it would seem. I think that is why we are seeing Socialist "Republicans" like Mike Huckabee gaining popularity. People want affordable health care. Conservatives have ideas for achieving that, but are they doing enough to bring it about? Unless costs are brought down, the answer from most people would probably be "no".

Yet there are non-socialist solutions to be found. Republican Mitt Romney, while Governor of Massachusetts, tackled the problem by creating universal health insurance without new taxes or government agencies:

Romney to the Rescue

[...] As the new governor, Romney consolidated state agencies, cut employees, and closed what he called loopholes in the corporate tax code. He also tackled the most difficult public policy issue of all, health insurance.

With input from the Heritage Foundation, Romney came up with a way to provide universal health insurance by requiring that everyone buy coverage, just as drivers are required to buy car insurance. If they don't, they lose their personal exemption on their state income taxes and part of their state tax refund. The idea was that in a reformed marketplace, everyone has the responsibility to have health insurance - no more free riders.

For those who cannot afford coverage, Romney cobbled together funds from Medicaid and the state's free-care pool to make sure everyone is covered.

By merging individual and group plans, Romney covered more healthy individuals, lowering prices.

[...]

Romney likes to contrast his health-care plan with the one proposed by Sen. Hillary Rodham Clinton, D-N.Y. "My plan is based on personal responsibility and allowing the free market to work in a more effective manner," he says. "Her approach was to build a large government bureaucracy and provide more controls to help the health-care system work."

He adds with a smile: "Perhaps the biggest difference between our two plans was that mine got passed, and hers didn't."

States such as Iowa, California, and New Jersey are looking into adopting the Massachusetts approach, and Bush is pushing other states to look into it. To conservatives who bristle at the idea of an imposed plan, Romney says, "The key factor that some of my libertarian friends forget is that today, everybody who doesn't have insurance is getting free coverage from government." [... ]

I'd like to see more ideas like this from Republicans, more private sector and free-market solutions. That is an arena in which Romney excels, and hopefully we will be hearing more from him on this important issue. Here is another solution without government involvement. From Nealz Nuze:

PRIVATE HEALTHCARE ... SAY IT AIN'T SO!

Somewhere across the country, a Hillary staffer is having a breakdown ... private healthcare offered directly from doctors? This is going backwards for the universal healthcare nuts. We need more government, not less! But now we have this program in Rhode Island called HealthAccessRI. You pay $30 for a "membership" in a primary care doctor's practice and you get 24-hour telephone access, sick visits, well child care, check-ups, school and sports physicals, family planning and yearly physicals. Each office visit is just $10. Thirty dollars! That's less than a cell phone bill or one tank of gas. Now this is not an insurance program – and politicians are already quick to point that out – but it offers an affordable solution for primary care. And it didn't take government to do it! All it took was a group of doctors. The private sector! There are now 21 participating doctors, brought together by Michael D. Fine who is taking the program statewide. [...]

Why can't we have more solutions like this from the private sector, that cut out insurance completely? Affordable pay-as-you-go treatment?


Related Links:

How to fix healthcare

Lowering Health Care Costs for Everyone

Health Insurance and Medical Expenses

There's No Place Like Home:
What I learned from my wife's month in the British medical system.

Lowering Health Care Costs for Everyone

From In order to bring health care costs down, it's important to understand what makes them so artificially high. John Stossel at Real Clear Politics sheds some light on this important issue:

Control Your Own Health Care

Candidates for president have plans to get more people health insurance. Some would compel us to buy it; others would use the tax code to encourage that. Regardless, insurance is the magic that will solve our health-care problems.

But contrary to conventional wisdom, it's not those without health insurance who are the problem, but rather those with it. They make medical care more expensive for everyone.

We'd each be better off if we paid all but the biggest medical bills out of pocket and saved insurance for catastrophic events. Truly needy people would rely on charity, not government, because once government gets involved, unintended bad consequences abound.

If people paid their own bills, they would likely buy high-deductible insurance (roughly $1,000 for individuals, $2,100 for families) because on average, the premium is $1,300 cheaper. But people are so conditioned to expect others to pay their medical bills that they hate high deductibles: They feel ripped off if they must pay a thousand dollars before the insurance company starts paying.

But high deductibles may be the key to lowering costs and putting you in charge of your health care.

Five years ago, the Whole Foods grocery chain switched to a high-deductible plan. If an employee has a sore throat or a sprained ankle, he pays. But if he gets cancer or heart disease, his insurance covers it.

Whole Foods puts around $1,500 a year into an account for each employee. It's not charity but part of the employee's compensation. It's money Whole Foods would have otherwise spent on more-expensive insurance. Here's the good part for employees: If they don't spend the money on medical care this year, they keep it, and the company adds more next year.

It's called a health savings account, or HSA.

CEO John Mackey told me that when he went to the new system, "Our costs went way down." [...]

(bold emphasis mine) The article goes on to describe the many ways this plan has worked out to benefit both the employer and the employees. I have high deductible health insurance, and a Health Savings Account. All my deductible medical expenses can be paid out of that account; Dentist, Optometrist, Doctor, Chiropractor, even Acupuncture if I want it. With insurance, I'd have to have separate Dental insurance. Eyeglasses or contacts are not always covered. Alternative medicine like Chiropractic and Acupuncture are often not covered by insurance. The HSA account allows ME to choose the kind of care I want, and how much I want to spend on it.

Last year I had a severe gall bladder attack; before the year was over, I had surgery to have it removed.

I used up all the money in my HSA account, but not long after that, my high deductible insurance kicked in, so I didn't end up spending a lot out of pocket. But I was also in charge; I wasn't sure I wanted the surgery, and was able to explore options and have addition tests, because I was paying for them, not the insurance company. That experience has made me a BIG believer in HSA accounts.

Read the rest of Stossel's article to see the affect this freedom has had on Whole Foods Employees. The freedom to choose works out best for everyone.


Related Link:

The Democrats corrupt use of children; lying to promote government sponsored health care:

Graeme Frost and the perils of Democrat poster child abuse
I feel sorry for the kids; it's not their fault that their parents couldn't be bothered to buy health insurance, but spent their money instead on things like business real estate and private school tuition for their kids, among other thingsWhat a sham. It would seem the parents feel entitled to spend their money on luxuries, while the rest of us pay for their insurance.

This isn't the first time Democrats have used children falsely to promote government health care. Remember what Hillary Clinton did in 1994:

Hillary's poisoned poster child

The Media was there while Hillary was using this child as a prop, but where were they when the real sordid story broke out?
     

Health Insurance and Medical Expenses

Have you ever considered that health care costs are so out of control because of insurance? How could that be? John Stossel shows us how:

Our Crazy Health-Insurance System

[...] You have to understand something right from the start. We Americans got hooked on health insurance because the government did the insurance companies a favor during World War II. Wartime wage controls prohibited cash raises, so employers started giving noncash benefits, like health insurance, to attract workers. The tax code helped this along by treating employer-based health insurance more favorably than coverage you buy yourself. And state governments have made things worse by mandating coverage many people would never buy for themselves.

Competition also pushed companies to offer ever-more attractive policies, such as first-dollar coverage for routine ailments, like ear infections and colds, and coverage for things that are not even illnesses, like pregnancy. We came to expect insurance to cover everything.

[...]

But insurance is a lousy way to pay for things. Your premiums go not just to pay for medical care but also for fraud, paperwork and insurance-company employee salaries. This is bad for you and bad for doctors.

The average American doctor now spends 14 percent of his income on insurance paperwork. A North Carolina doctor we interviewed had to hire four people just to fill out forms. He wishes he could spend that money on caring for patients.

The paperwork is part of insurance companies' attempt to protect themselves against fraud. That's understandable. Many people do cheat. They lie about their history or demand money for unnecessary care or care that never even happened.

So there is a lot of waste in insurance -- lost money and time.

Imagine if your car insurance covered oil changes and gasoline. You wouldn't care how much gas you used, and you wouldn't care what it cost. Mechanics would sell you $100 oil changes. Prices would skyrocket.

That's how it works in health care. Patients don't ask how much a test or treatment will cost. They ask if their insurance covers it. [...]

(bold emphasis mine) That is why insurance should be for catastrophes and accidents, not every little thing people need. It's trying to use insurance to pay for EVERYTHING that has made costs go completely out of control. Paying for your health insurance is getting as costly as making mortgage payments, and it needn't be so.

I made a simple visit to my doctor in June. I've only just recently received the bill for that visit. In the interim, I've gotten several statements from the insurance company, each covering some small aspect of the visit. I don't see doctors often, yet I've got files filled with such things. The paperwork generated, and the labor costs associated with it, are ridiculous. I could have paid him right then and there, but it's not ALLOWED. Clearly, changes are needed to reduce the bureaucracy created by insurance companies and third party billing.

Stossel makes some good suggestions in that regard. It's worth reading the whole thing, it's a short article and gets right to the point.