Rob’s latest update on the health insurance mandate lawsuit, Democrat attacks on the independence of the Attorney General’s Office.
Update from Rob McKenna from Rob McKenna on Vimeo.
Tuesday, December 7, 2010
Important Health Care Lawsuit Update
Mon, Dec 6, 2010 at 11:50 AM
Rob’s latest update on the health insurance mandate lawsuit, Democrat attacks on the independence of the Attorney General’s Office.
Rob’s latest update on the health insurance mandate lawsuit, Democrat attacks on the independence of the Attorney General’s Office.
Sunday, November 7, 2010
Thursday, August 26, 2010
Some Ideas for Real Health Care Reform?
This is a summary of proposed free market reforms.
Health Insurance USA
This is ³reform²
Government
€ Change tax rules so that no one pays taxes on health insurance
€ Vouchers for Medicaid-eligible persons to purchase health insurance
€ Interstate sales allowed, without State-mandated coverages
€ States license insurers based on ability to pay claims
€ State civil justice reform no non-economic damages
€ Repeal or downscale HIPA
Employers
€ Offer group plans, if desired, or pay employees to purchase individually
Consumers/Patients
€ Voluntary purchase of health insurance;
€ Select from a wide choice of insurers and plans total choice
€ Choose providers and treatments as needed
€ Those without insurance are responsible for paying their bills
Insurers
€ Offer unlimited choice of deductibles, coinsurance, maximums
€ 60 day open enrollment once per year (prior didn¹ts; 2 years, etc.)
€ Insurers establish substandard risk tiers and rates
€ Non-profit uninsurable risk companies funded by insurers
€ Utilize standard claim forms
€ Offer credits for healthy habits on renewal
Providers
€ Publish schedules of all fees
€ Charge each patient the same fee for the same service
€ No special deals for different insurers
€ May discount for individuals
€ Utilize electronic records
John F Brinson, Chairman
Lehigh Valley Tax Limitation Committee
NCPA Consumer's guide to Health Care Reform Bill
Health Reform Costs, Benefits Explained In NCPA Consumer's Guide
The
first detailed and objective consumer's guide on the impact of the
Patient Protection and Affordable Care Act has just been released by the
National Center for Policy Analysis (NCPA), titled, "What Does Health
Care Reform Mean To You? A Detailed Analysis."
"The guide does not ignore the benefits of the Affordable Care Act,
but it also does not deny the costs," says John C. Goodman, President,
CEO and Kellye Wright Fellow of the NCPA. "This is the first unbiased
summary of health care reform costs and benefits, and it's a unique
resource."
"The consumer's guide answers questions about the coming changes and
costs in Medicare, Medicaid, health insurance, employer coverage and
income tax returns," says Goodman.
The research analyzes the costs, benefits and drawbacks of health reform changes, including:
- Health insurance requirements and fines for individuals and employers.
- Expanded health coverage for up to 34 million people.
- Projected shortages of doctors, nurses and hospitals.
- Free health plan preventative services.
- New coverage protections for patients with pre-existing conditions.
Also:
- Reporting family income totals to your employer.
- Benefit and spending cuts for the elderly and disabled on Medicare.
- New taxes on private health insurance, drugs, medical devices.
- Insurance subsidies and changes in coverage options.
To educate patients, doctors and all those affected by the new health
care law, the NCPA has also produced a shorter version of the guide in a
summary pamphlet, also titled, "What Does Health Care Reform Mean To
You?" The pamphlet is a succinct and unbiased overview of the
Affordable Care Act changes, in layman's terms, to help consumers
understand what to expect from health care reform.
Source: Press Release, "Health Reform Costs, Benefits Explained in NCPA Consumer's Guide," PRNewswire, August 25, 2010.
For text:
For Consumer Guide:
http://www.ncpa.org/pdfs/What-Does-Health-Reform-Mean-for-You-A-Consumers-Guide.pdf
For Summary Pamphlet:
http://www.ncpa.org/healthreform/
For more on Health Issues:
Saturday, August 7, 2010
ObamaCare Is in Big Trouble
August 7, 2010
ObamaCare Is in Big Trouble
By Deroy Murdock
ObamaCare faced voters for the first time last Tuesday and was diagnosed as seriously ill.
By a margin of 71 percent to 29 percent, Missouri voters approved a referendum to invalidate any ObamaCare mandate to purchase health insurance or any penalty for not doing so.
Proposition C reflects growing momentum to repeal ObamaCare, an increasingly unpopular federal sinkhole that the American people do not want and numerous state and federal officials are working sedulously to reverse.
ObamaCare’s latest defeat did not occur in some right-wing bastion, but in a swing state in which Barack Obama lost by just 3,903 votes to Sen. John McCain in 2008.
And on Monday, Federal Judge Henry Hudson ruled that Virginia may proceed with its lawsuit to overturn ObamaCare’s individual mandate to acquire medical coverage.
“While this case raises a host of complex constitutional issues,” Hudson wrote, “all seem to distill to the single question of whether or not Congress has the power to regulate - and tax - a citizen’s decision not to participate in interstate commerce.”
As Virginia Attorney General Ken Cuccinelli observed, “The government cannot draft an unwilling citizen into commerce just so it can regulate him under the Commerce Clause.”
ObamaCare’s mandate redefines the individual’s relationship to Washington, D.C. If it can compel Americans to buy health insurance, why can’t it force each American to join a gym or eat bran?
Twenty different state attorneys general are in court battling ObamaCare’s defining ideology, as embodied in the individual mandate.
Meanwhile, on Capitol Hill, 170 of 178 Republicans have signed Rep. Steve King’s (R-Iowa) discharge petition to bring repeal language to the House floor.
Americans increasingly would applaud such a House vote. A July 30-31 Rasmussen survey shows that among 1,000 likely voters, 59 percent want ObamaCare overturned. Despite relentless Democratic preening over ObamaCare, pro-repeal sentiments have risen from 55 percent (42 percent opposed) on March 24, when Obama signed this bill.
The American people can kill this monster in its crib. Handing Republicans the keys to Congress on Nov. 2 could smother this $2.5 trillion extravagance in its infancy. While a GOP repeal vote surely would earn a presidential veto, a Republican Congress could defund this law’s implementation.
Instead, Republicans should administer a pro-market antidote to ObamaCare’s poison: Health-insurance vouchers, medical malpractice reform; universal, tax-free Health Savings Accounts; and individual, portable medical plans - all available across state lines.
ObamaCare’s ultimate demise likely will require a GOP chief executive to sign its death certificate. Until that joyous occasion, Americans should dream of the day when Obama returns to Chicago to break ground on his presidential library.
Deroy Murdock is a columnist with the Scripps Howard News Service and a media fellow with the Hoover Institution on War, Revolution and Peace at Stanford University.
Real Clear Politics
ObamaCare Is in Big Trouble
By Deroy Murdock
ObamaCare faced voters for the first time last Tuesday and was diagnosed as seriously ill.
By a margin of 71 percent to 29 percent, Missouri voters approved a referendum to invalidate any ObamaCare mandate to purchase health insurance or any penalty for not doing so.
Proposition C reflects growing momentum to repeal ObamaCare, an increasingly unpopular federal sinkhole that the American people do not want and numerous state and federal officials are working sedulously to reverse.
ObamaCare’s latest defeat did not occur in some right-wing bastion, but in a swing state in which Barack Obama lost by just 3,903 votes to Sen. John McCain in 2008.
And on Monday, Federal Judge Henry Hudson ruled that Virginia may proceed with its lawsuit to overturn ObamaCare’s individual mandate to acquire medical coverage.
“While this case raises a host of complex constitutional issues,” Hudson wrote, “all seem to distill to the single question of whether or not Congress has the power to regulate - and tax - a citizen’s decision not to participate in interstate commerce.”
As Virginia Attorney General Ken Cuccinelli observed, “The government cannot draft an unwilling citizen into commerce just so it can regulate him under the Commerce Clause.”
ObamaCare’s mandate redefines the individual’s relationship to Washington, D.C. If it can compel Americans to buy health insurance, why can’t it force each American to join a gym or eat bran?
Twenty different state attorneys general are in court battling ObamaCare’s defining ideology, as embodied in the individual mandate.
Meanwhile, on Capitol Hill, 170 of 178 Republicans have signed Rep. Steve King’s (R-Iowa) discharge petition to bring repeal language to the House floor.
Americans increasingly would applaud such a House vote. A July 30-31 Rasmussen survey shows that among 1,000 likely voters, 59 percent want ObamaCare overturned. Despite relentless Democratic preening over ObamaCare, pro-repeal sentiments have risen from 55 percent (42 percent opposed) on March 24, when Obama signed this bill.
The American people can kill this monster in its crib. Handing Republicans the keys to Congress on Nov. 2 could smother this $2.5 trillion extravagance in its infancy. While a GOP repeal vote surely would earn a presidential veto, a Republican Congress could defund this law’s implementation.
Instead, Republicans should administer a pro-market antidote to ObamaCare’s poison: Health-insurance vouchers, medical malpractice reform; universal, tax-free Health Savings Accounts; and individual, portable medical plans - all available across state lines.
ObamaCare’s ultimate demise likely will require a GOP chief executive to sign its death certificate. Until that joyous occasion, Americans should dream of the day when Obama returns to Chicago to break ground on his presidential library.
Deroy Murdock is a columnist with the Scripps Howard News Service and a media fellow with the Hoover Institution on War, Revolution and Peace at Stanford University.
Real Clear Politics
Wednesday, August 4, 2010
Your New Health Care System Chart
Congressman Brady Introduces “Your New Health Care System” Chart
July, 28, 2010 — nicedebLast year, TX Congressman, Kevin Brady’s Health Care Bill Chart was a viral sensation. Today, he unveiled a special visual project highlighting how out of control the expansion of the federal government has become:
“A little sunshine goes a long way”.
Kathryn Jean Lopez asks; Do You Trust Your Government to Be Competent to Run This?
PDF here, for a closer look.
Texas Republican Rep. Kevin Brady says in a release that committee analysts actually couldn’t fit everything in: “This portrays only about one-third of the complexity of the final bill. It’s actually worse than this.”
In a conference call with conservative bloggers, today, Brady made note of the high potential for rationed care, and the 13 different sections in the law that disallow challenges to health care decisions.
He says there will be an explosion of bureaucratic government jobs, and IRS lawyers, while private sector jobs dwindle because the new taxes will cost thousands of jobs, making us uncompetitive with other countries.
Brady also assured us that Republican congressmen are dedicated to repealing the bill and replacing it with common sense reforms.
Look for this chart to make appearances at town halls all across the country, this August.
Plans are in the works for a similar chart on the Financial Reform Bill.
Congressman Brady is the Senior House Republican on the Joint Economic Committee and a ranking subcommittee Member for Ways and Means. You can visit his web site here.
Wednesday, July 28, 2010
Tuesday, July 27, 2010
Refusing Treatment to Infants under 22 Weeks
Infant left to die by socialized medicine
I Would Assume Jayden Capewell Would Have Had A Differing Opinion
The Bad News About ObamaCare Keeps Piling Up
It's now obvious that many millions will lose the coverage they have.
* JUNE 17, 2010 THE WALL STREET JOURNAL/OPINION JOURNAL
In his brilliant exposition of why sweeping policy changes often have unintended consequences, the late sociologist Robert K. Merton wrote that leaders get things wrong when their "paramount concern with the foreseen immediate consequences excludes the consideration of further or other consequences" of their proposals. This leads policy makers to assert things that are false, wishing them to be true.
Which brings us to President Obama's many claims about his health-care reform. Take his oft-expressed statement that if you like the coverage you have, you can keep it. That sounds good—but perverse incentives in his new law will cause most Americans to lose their existing insurance.
This was brought home to me when I asked the CEO of a major restaurant chain about health reform's effect on his company, which now spends $25 million a year on employee health insurance. That will jump to at least $90 million a year once the new law is phased in. It will be cheaper, he told me, for the company to dump its coverage and pay a fine—$2,000 for each full-time worker—and make sure that no part-time employee accidentally worked 31 hours and thereby incurred the fine.
This reality is settling in at businesses across America. A Midwestern contractor told me he pays $588,000 for health insurance for 70 employees, contributing up to $8,400 a year for a family's coverage. If he stops providing health insurance, he'll pay $2,000 per employee in fines, and the first 40 employees are exempt from fines altogether.
It's also dawning on employees that they will lose their coverage. Some will blame management; many more will blame those who wrote this terrible legislation.
Employees who lose coverage get to select a policy from a government-sponsored insurance marketplace called the "exchange." This will be subsidized by taxpayers. Depending on his income, a worker will have to pay between 8% and 9.8% of the cost.
But there are a few hitches. Employers now pay for employee health plans with pre-tax dollars, but workers who buy into one on the exchange pay with after-tax dollars. Families making less than $30,000 and individuals making less than $15,000 a year will be dumped into Medicaid, widely viewed as second-class health care.
Either Mr. Obama was stunningly blind to these perverse effects when he promised people could keep their coverage, or he felt that admitting his plan would collapse employer-provided health coverage could keep it from passing. Either way—self-deception or deliberate deceit—health reform is going to turn out far differently than was promised. And because more workers will be dumped into subsidized coverage, taxpayers are likely to pay much more than the $1 trillion-plus price tag claimed by ObamaCare advocates for its first 10 years.
About Karl Rove
Karl Rove served as Senior Advisor to President George W. Bush from 2000–2007 and Deputy Chief of Staff from 2004–2007. At the White House he oversaw the Offices of Strategic Initiatives, Political Affairs, Public Liaison, and Intergovernmental Affairs and was Deputy Chief of Staff for Policy, coordinating the White House policy-making process.
Before Karl became known as "The Architect" of President Bush's 2000 and 2004 campaigns, he was president of Karl Rove + Company, an Austin-based public affairs firm that worked for Republican candidates, nonpartisan causes, and nonprofit groups. His clients included over 75 Republican U.S. Senate, Congressional and gubernatorial candidates in 24 states, as well as the Moderate Party of Sweden.
Karl writes a weekly op-ed for the Wall Street Journal, is a Newsweek columnist and is the author of the book "Courage and Consequence" (Threshold Editions).
Email the author atKarl@Rove.comor visit him on the web atRove.com. Or, you can send a Tweet to @karlrove.
It doesn't end there. Another way the new health reform will have consequences that are the opposite of what was promised can be found in new draft regulations (its Interim Final Rule) from the Department of Health and Human Services. The proposed rules could cause as many as half of all workers to lose their existing coverage.
Health-care plans that existed before the new law are "grandfathered" with regard to some of its provisions. The rules released Monday spell out how little these plans can change without losing their protected status.
Health plans would no longer be grandfathered if a business changes insurance companies (a common practice when employers shop for lower prices), raises deductibles more than 5%, drops any existing benefits, or even increases co-pays by as little as $5.
* JUNE 17, 2010 THE WALL STREET JOURNAL/OPINION JOURNAL
In his brilliant exposition of why sweeping policy changes often have unintended consequences, the late sociologist Robert K. Merton wrote that leaders get things wrong when their "paramount concern with the foreseen immediate consequences excludes the consideration of further or other consequences" of their proposals. This leads policy makers to assert things that are false, wishing them to be true.
Which brings us to President Obama's many claims about his health-care reform. Take his oft-expressed statement that if you like the coverage you have, you can keep it. That sounds good—but perverse incentives in his new law will cause most Americans to lose their existing insurance.
This was brought home to me when I asked the CEO of a major restaurant chain about health reform's effect on his company, which now spends $25 million a year on employee health insurance. That will jump to at least $90 million a year once the new law is phased in. It will be cheaper, he told me, for the company to dump its coverage and pay a fine—$2,000 for each full-time worker—and make sure that no part-time employee accidentally worked 31 hours and thereby incurred the fine.
This reality is settling in at businesses across America. A Midwestern contractor told me he pays $588,000 for health insurance for 70 employees, contributing up to $8,400 a year for a family's coverage. If he stops providing health insurance, he'll pay $2,000 per employee in fines, and the first 40 employees are exempt from fines altogether.
It's also dawning on employees that they will lose their coverage. Some will blame management; many more will blame those who wrote this terrible legislation.
Employees who lose coverage get to select a policy from a government-sponsored insurance marketplace called the "exchange." This will be subsidized by taxpayers. Depending on his income, a worker will have to pay between 8% and 9.8% of the cost.
But there are a few hitches. Employers now pay for employee health plans with pre-tax dollars, but workers who buy into one on the exchange pay with after-tax dollars. Families making less than $30,000 and individuals making less than $15,000 a year will be dumped into Medicaid, widely viewed as second-class health care.
Either Mr. Obama was stunningly blind to these perverse effects when he promised people could keep their coverage, or he felt that admitting his plan would collapse employer-provided health coverage could keep it from passing. Either way—self-deception or deliberate deceit—health reform is going to turn out far differently than was promised. And because more workers will be dumped into subsidized coverage, taxpayers are likely to pay much more than the $1 trillion-plus price tag claimed by ObamaCare advocates for its first 10 years.
About Karl Rove
Karl Rove served as Senior Advisor to President George W. Bush from 2000–2007 and Deputy Chief of Staff from 2004–2007. At the White House he oversaw the Offices of Strategic Initiatives, Political Affairs, Public Liaison, and Intergovernmental Affairs and was Deputy Chief of Staff for Policy, coordinating the White House policy-making process.
Before Karl became known as "The Architect" of President Bush's 2000 and 2004 campaigns, he was president of Karl Rove + Company, an Austin-based public affairs firm that worked for Republican candidates, nonpartisan causes, and nonprofit groups. His clients included over 75 Republican U.S. Senate, Congressional and gubernatorial candidates in 24 states, as well as the Moderate Party of Sweden.
Karl writes a weekly op-ed for the Wall Street Journal, is a Newsweek columnist and is the author of the book "Courage and Consequence" (Threshold Editions).
Email the author atKarl@Rove.comor visit him on the web atRove.com. Or, you can send a Tweet to @karlrove.
It doesn't end there. Another way the new health reform will have consequences that are the opposite of what was promised can be found in new draft regulations (its Interim Final Rule) from the Department of Health and Human Services. The proposed rules could cause as many as half of all workers to lose their existing coverage.
Health-care plans that existed before the new law are "grandfathered" with regard to some of its provisions. The rules released Monday spell out how little these plans can change without losing their protected status.
Health plans would no longer be grandfathered if a business changes insurance companies (a common practice when employers shop for lower prices), raises deductibles more than 5%, drops any existing benefits, or even increases co-pays by as little as $5.
Monday, July 26, 2010
How America Health Care Stacks Up
What's Really Going On In This Country?
http://i588.photobucket.com/albums/ss324/Civilradiant/PDFSS.jpg
http://i588.photobucket.com/albums/ss324/Civilradiant/PDFSS.jpg
Wednesday, July 21, 2010
Health Care Reform: 13 Tax Changes on the Way
Business Tax
It's just the beginning!!!
Aren't those people that thought this would be "FREE" going to be surprised?
You really need to read this. It starts next year. This is part of the new Health Care Bill.
I contacted my Congressman about House Bill HR3590 the health care bill that just passed. I asked for a summary of changes. The aid directed me to go to http://www.thomas.gov/> , enter HR3590 in the search box and look for CRS Summaries. Then scroll down to:
TITLE IX REVENUE PROVISIONS- SUBTITLE A: REVENUE OFFSET PROVISIONS-(Sec.9001, (as modified by sec.10901) Sec.9002. Starting in 2011 (next year folks) your W2 tax form sent by your employer will be increased to show the value of whatever health insurance you are given by the company. It does not matter if that's a private company or government body of some sort. If you're retired….So what, your gross will go up by the amount of insurance you get.
The dollar value (cost of what the company pays for your insurance) will be considered income and added to your gross pay. You will be taxed on the total.
You will be required to pay taxes on a larger sum of money that you have never seen.
Take your tax form you just finished and see what $15,000 or $20,000 of additional gross income does to your tax debt. That's what you'll pay next year. For many it also puts you into a higher tax bracket so it's even worse.
This is how the government is going to buy insurance for 15% of the populace that doesn't have insurance and it's only part of the tax increases.
Not believing this, I researched the summaries and here's what I'm reading:
On page 25 of 29 :
TITLE IX REVENUE PROVISIONS- SUBTITLE A: REVENUE OFFSET PROVISIONS-(Sec.9001, (as modified by sec.10901) Sec.9002. "requires employers to include in the W2 form of each employee the aggregate cost of applicable employer sponsored group health coverage that is excusable from the employees gross income."
Joan Pryde is the senior tax editor for the Kiplinger letters. Go to Kiplingers and read about 13 tax changes that could affect you. Number 3 is what I just told you about.
Why am I sending you this? I hope you forward this to every single person in your address book. People have the right to know the truth because an election is coming in November.
Kiplinger letters: http://www.kiplinger.com/businessresource/forecast/archive/health-care-reform-tax-hikes-on-the-way.html
THOMAS (library of congress) In the spirit of Thomas Jefferson, legislative information from the Library of Congress http://www.thomas.gov/
Bill Summary & Status- 111th Congress (2009 - 2010)
H.R.3590
CRS Summary http://www.thomas.gov/cgi-bin/bdquery/D?d111:1:./temp/~bdi6AE:@@@D&summ2=m&|/home/LegislativeData.php|
It's just the beginning!!!
Aren't those people that thought this would be "FREE" going to be surprised?
You really need to read this. It starts next year. This is part of the new Health Care Bill.
I contacted my Congressman about House Bill HR3590 the health care bill that just passed. I asked for a summary of changes. The aid directed me to go to http://www.thomas.gov/> , enter HR3590 in the search box and look for CRS Summaries. Then scroll down to:
TITLE IX REVENUE PROVISIONS- SUBTITLE A: REVENUE OFFSET PROVISIONS-(Sec.9001, (as modified by sec.10901) Sec.9002. Starting in 2011 (next year folks) your W2 tax form sent by your employer will be increased to show the value of whatever health insurance you are given by the company. It does not matter if that's a private company or government body of some sort. If you're retired….So what, your gross will go up by the amount of insurance you get.
The dollar value (cost of what the company pays for your insurance) will be considered income and added to your gross pay. You will be taxed on the total.
You will be required to pay taxes on a larger sum of money that you have never seen.
Take your tax form you just finished and see what $15,000 or $20,000 of additional gross income does to your tax debt. That's what you'll pay next year. For many it also puts you into a higher tax bracket so it's even worse.
This is how the government is going to buy insurance for 15% of the populace that doesn't have insurance and it's only part of the tax increases.
Not believing this, I researched the summaries and here's what I'm reading:
On page 25 of 29 :
TITLE IX REVENUE PROVISIONS- SUBTITLE A: REVENUE OFFSET PROVISIONS-(Sec.9001, (as modified by sec.10901) Sec.9002. "requires employers to include in the W2 form of each employee the aggregate cost of applicable employer sponsored group health coverage that is excusable from the employees gross income."
Joan Pryde is the senior tax editor for the Kiplinger letters. Go to Kiplingers and read about 13 tax changes that could affect you. Number 3 is what I just told you about.
Why am I sending you this? I hope you forward this to every single person in your address book. People have the right to know the truth because an election is coming in November.
Kiplinger letters: http://www.kiplinger.com/businessresource/forecast/archive/health-care-reform-tax-hikes-on-the-way.html
THOMAS (library of congress) In the spirit of Thomas Jefferson, legislative information from the Library of Congress http://www.thomas.gov/
Bill Summary & Status- 111th Congress (2009 - 2010)
H.R.3590
CRS Summary http://www.thomas.gov/cgi-bin/bdquery/D?d111:1:./temp/~bdi6AE:@@@D&summ2=m&|/home/LegislativeData.php|
Tuesday, July 13, 2010
EDITORIAL: Robbing Peter to pay Paul's health care
Sen. Kent Conrad
Obamacare is a socialist law designed to take money from some Americans and use it to benefit others. The health care bill signed into law by President Obama is full of hidden time bombs. One costly provision buried in the lengthy reconciliation bill at the last minute has taxpayers covering long-term at-home care for the elderly. Through the so-called Community Living Assistance Services and Support Act (CLASS Act), Americans will find between $150 and $250 taken out of their paychecks each month to cover this program nobody knew about.
Democrats claim this isn't a controversial program, but if they really believed that, they wouldn't have had to sneak the provision into the reconciliation bill. But it was snuck in the reconciliation bill only two days before the House vote.
Even some Democrats warned about the financial impact of the home-care program. Before the idea was dropped last year because of stiff opposition, Sen. Kent Conrad, a North Dakota Democrat who is chairman of the Senate Budget Committee, called the program a Ponzi scheme that would produce massive deficits in the future. A letter released at that time by Mr. Conrad and Democratic Sens. Mary L. Landrieu of Louisiana, Evan Bayh of Indiana, Blanche Lincoln of Arkansas, Ben Nelson of Nebraska and Mark Warner of Virginia warned: "While the goals of the CLASS Act are laudable - finding a way to provide long-term care insurance to individuals - the effects of including this legislation in the merged Senate bill would not be fiscally responsible for several reasons."
The senators were particularly concerned that the Congressional Budget Office numbers missed the real costs of the program. The CBO is instructed only to consider the fiscal impact over the next 10 years, but the way the scheme is set up, people must pay the additional taxes for at least five years to become eligible. So for the first five years we only see revenue. After that, the taxpayers are eligible only gradually. They must then become old enough to require home health care, so expenditures will occur in the distant future. In other words, we see taxes with no expenditures upfront, but huge expenditures picking up after the CBO's 10-year evaluation window passes.
The budget concerns of a handful of Democratic senators kept the program out of the earlier version of the health care bill, which passed the Senate before Christmas. If the provision hadn't been removed, Democrats wouldn't have obtained the 60 votes needed to break the filibuster. Only by jamming it into the Senate reconciliation bill in March were they able to get it passed with the bare minimum 51 votes.
Ironically, the reconciliation procedure, requiring only a simple majority, was originally designed to help reduce the deficit. It certainly was not meant for circumventing normal procedures and throwing in last-minute budgetary land mines.
Democrats might not consider $109 billion in taxes over the program's first 10 years to be controversial. But taking $150 to $250 out of each monthly paycheck will cause problems for millions of Americans. This is yet another example of Mr. Obama breaking his promise not to raise taxes on those making less than $250,000 per year. It's not what we consider a very classy act.
Tuesday, June 15, 2010
Farewell, Medicare Advantage
THE WALL STREET JOURNAL
REVIEW & OUTLOOK | JUNE 11, 2010
Farewell, Medicare Advantage
Democrats strike up the funeral parade for private insurance options.
The White House is launching its latest Willy Loman campaign to resell ObamaCare, helped by $125 million that unions and other interest groups say they'll spend to make Americans love their new entitlement. Seniors in particular should curb their enthusiasm.
"First and foremost," President Obama told seniors on Tuesday in Wheaton, Maryland, "what you need to know is that the guaranteed Medicare benefits that you've earned will not change, regardless of whether you receive them through Medicare or Medicare Advantage." First and foremost, nothing about that sentence is true.
Advantage gives almost one of four seniors private insurance options, and Democrats are about to cut its funding by some $136 billion over the next decade even as health costs rise. The Congressional Budget Office says these cuts will cause enrollment to drop by 35%, the Administration's own Medicare actuaries predict 50%, and both outfits take for granted that benefits will also decline.
The President knows this, so he and his fellow Democrats are gearing up to blame these cuts on . . . insurers, rather than on their own policies. In a letter last week, Democratic Congressional leaders Henry Waxman, Pete Stark, Max Baucus and Jay Rockefeller demanded that the Health and Human Services Department reject "any effort" by insurers to "reduce benefits next year."
Secretary Kathleen Sebelius followed up by warning insurers to "focus on price and quality rather than asking seniors who need health care the most to pay more for it." The Medicare regulator, CMS, is also reshuffling staff so Advantage is run by actively hostile bureaucrats.
The politics here is that Democrats loathe Medicare Advantage because it sanctions the private choices that might eventually liberate the U.S. health market from government price controls. They also wanted to raid Advantage to finance their new subsidies. But now they desperately want to dodge any near-term blame when seniors who use Advantage start to lose its benefits. Ergo, blame insurers first.
All of this is a replay of what Democrats did in the 1990s to a similar program called Medicare+Choice, which was created in 1997 but starved of funds by the Clinton Administration. "Dozens of HMOs Quit Medicare, Patients Face Upheaval," ran one Washington Post headline in 1998. The insurers served as political spear-catchers then too.
The larger debate is about how best to organize the health-care market. In an important new paper for the National Bureau of Economic Research, David Cutler explores entrepreneurial spirits in health care, or rather their peculiar absence in a $2.6 trillion industry. The Harvard economist notes annual productivity growth of minus-0.2 in the official data—"almost surely an underestimate"—and asks why there has been so little organizational innovation akin to Wal-Mart's supply-chain or Toyota's quality control.
Mr. Cutler, a close White House ally, cites many dysfunctional incentives, though one he singles out is "the stagnant compensation system of public insurance plans." In most markets, he observes, "higher quality is associated with higher prices. That is not true in medical care, however, largely because of the public sector." Original Medicare—about 25% of hospital and physician income—pays fixed fees to any provider a patient visits, regardless of the quality of the services rendered. "A less good job earns as much as a better job," Mr. Cutler writes.
Mr. Cutler is convinced that Medicare's dysfunctions will end with ObamaCare's multiple pilot programs—even though the current system was designed by the last generation of technocrats to solve the problems created by the previous generation. Such people have faith in ObamaCare on the theory that they are the ones they've been waiting for.
Yet no planner had to tell Wal-Mart how to revolutionize the retail industry. In the same way, Advantage offers the flexibility necessary for decentralized innovation, market pricing and competition that might rationalize the entitlement state. The program isn't a miracle worker, and some plans are far better than others. According to the Medicare Payment Advisory Commission, the Advantage HMOs that serve 15% of all seniors in Medicare cost on average two percentage points less for the same benefits than the traditional program, without fiat pricing.
Using government data, the insurer trade group AHIP estimates that Advantage beneficiaries in California spend 30% fewer days in the hospital than fee for service, 23% fewer days in Nevada. These successes and others have come about because Advantage allowed insurers and providers to collaborate, pay for value and coordinate care.
These successes are threatening to politicians because they are a model for true Medicare reform, which would reduce the health-care powers that Congress has exercised for nearly a half-century and let patients decide. This terror explains why Democrats are so intent on killing Medicare Advantage, and on blaming someone else for destroying a program that millions of seniors prefer.
----------------End of Article
REVIEW & OUTLOOK | JUNE 11, 2010
Farewell, Medicare Advantage
Democrats strike up the funeral parade for private insurance options.
The White House is launching its latest Willy Loman campaign to resell ObamaCare, helped by $125 million that unions and other interest groups say they'll spend to make Americans love their new entitlement. Seniors in particular should curb their enthusiasm.
"First and foremost," President Obama told seniors on Tuesday in Wheaton, Maryland, "what you need to know is that the guaranteed Medicare benefits that you've earned will not change, regardless of whether you receive them through Medicare or Medicare Advantage." First and foremost, nothing about that sentence is true.
Advantage gives almost one of four seniors private insurance options, and Democrats are about to cut its funding by some $136 billion over the next decade even as health costs rise. The Congressional Budget Office says these cuts will cause enrollment to drop by 35%, the Administration's own Medicare actuaries predict 50%, and both outfits take for granted that benefits will also decline.
The President knows this, so he and his fellow Democrats are gearing up to blame these cuts on . . . insurers, rather than on their own policies. In a letter last week, Democratic Congressional leaders Henry Waxman, Pete Stark, Max Baucus and Jay Rockefeller demanded that the Health and Human Services Department reject "any effort" by insurers to "reduce benefits next year."
Secretary Kathleen Sebelius followed up by warning insurers to "focus on price and quality rather than asking seniors who need health care the most to pay more for it." The Medicare regulator, CMS, is also reshuffling staff so Advantage is run by actively hostile bureaucrats.
The politics here is that Democrats loathe Medicare Advantage because it sanctions the private choices that might eventually liberate the U.S. health market from government price controls. They also wanted to raid Advantage to finance their new subsidies. But now they desperately want to dodge any near-term blame when seniors who use Advantage start to lose its benefits. Ergo, blame insurers first.
All of this is a replay of what Democrats did in the 1990s to a similar program called Medicare+Choice, which was created in 1997 but starved of funds by the Clinton Administration. "Dozens of HMOs Quit Medicare, Patients Face Upheaval," ran one Washington Post headline in 1998. The insurers served as political spear-catchers then too.
The larger debate is about how best to organize the health-care market. In an important new paper for the National Bureau of Economic Research, David Cutler explores entrepreneurial spirits in health care, or rather their peculiar absence in a $2.6 trillion industry. The Harvard economist notes annual productivity growth of minus-0.2 in the official data—"almost surely an underestimate"—and asks why there has been so little organizational innovation akin to Wal-Mart's supply-chain or Toyota's quality control.
Mr. Cutler, a close White House ally, cites many dysfunctional incentives, though one he singles out is "the stagnant compensation system of public insurance plans." In most markets, he observes, "higher quality is associated with higher prices. That is not true in medical care, however, largely because of the public sector." Original Medicare—about 25% of hospital and physician income—pays fixed fees to any provider a patient visits, regardless of the quality of the services rendered. "A less good job earns as much as a better job," Mr. Cutler writes.
Mr. Cutler is convinced that Medicare's dysfunctions will end with ObamaCare's multiple pilot programs—even though the current system was designed by the last generation of technocrats to solve the problems created by the previous generation. Such people have faith in ObamaCare on the theory that they are the ones they've been waiting for.
Yet no planner had to tell Wal-Mart how to revolutionize the retail industry. In the same way, Advantage offers the flexibility necessary for decentralized innovation, market pricing and competition that might rationalize the entitlement state. The program isn't a miracle worker, and some plans are far better than others. According to the Medicare Payment Advisory Commission, the Advantage HMOs that serve 15% of all seniors in Medicare cost on average two percentage points less for the same benefits than the traditional program, without fiat pricing.
Using government data, the insurer trade group AHIP estimates that Advantage beneficiaries in California spend 30% fewer days in the hospital than fee for service, 23% fewer days in Nevada. These successes and others have come about because Advantage allowed insurers and providers to collaborate, pay for value and coordinate care.
These successes are threatening to politicians because they are a model for true Medicare reform, which would reduce the health-care powers that Congress has exercised for nearly a half-century and let patients decide. This terror explains why Democrats are so intent on killing Medicare Advantage, and on blaming someone else for destroying a program that millions of seniors prefer.
----------------End of Article
Wednesday, June 9, 2010
Impact of Health Care Bill
Why six residents of assisted-living centers will be evicted -- Port Angeles Port Townsend Sequim Forks Jefferson County Clallam County Olympic Peninsula Daily NEWS
By June's end, Prairie Springs in Sequim and Laurel Park in Port Angeles will have evicted six of their elderly residents because they are on Medicaid.
Lucile Cole, who'll turn 99 on June 13, and Edith Bateman, 93, are among the women and men who received a letter this spring from Assisted Living Concepts, the Wisconsin-based corporation that owns Prairie Springs and Laurel Park.
"The last day of Medicaid participation . . . will be June 30," the letter stated. "Thank you for the opportunity to be of service to you."
The evicted residents paid their way with Medicaid, the Social Security Act program designed to provide quality health care to low-income Americans. It is a joint federal-state program, with each state having its own plan.
Cole, at 98 one of the oldest Prairie Springs residents, moved in five years ago.
She spent much of her adult life moving around California and Oregon with her late husband, Duane, who worked in shipyards and construction.
Cole chose Prairie Springs because of its congenial staff and country setting.
"I've been happy here," she said. "I'm too old to move. I've moved enough times."
But she must -- like many others at Assisted Living Concepts facilities around the state.
The company's Victoria House in Port Townsend told nine residents they had to move out in 2007, since their dementia or other needs weren't adequately covered by Medicaid.
And at Franklin House in Sumner, Pierce County, seniors on Medicaid have also gotten eviction notices.
The Medicaid contracts are up for renewal at Laurel Park and Prairie Springs, and Assisted Living Concepts is opting out, said CEO Laurie Bebo.
"It costs us more to take care of people than what Medicaid pays," Bebo added.
Assisted Living Concepts, whose slogan is "Life just got easier," is a publicly traded company that owns 215 assisted living facilities across the United States, including 40 in Oregon and Washington.
Judy Lawson, whose mother Alice Hellerud, 85, moved to Laurel Park six years ago, was shocked by what she called a form letter from the corporate headquarters in Menomonee Falls, Wis.
"I can see that this is a business, and that they can't take any more Medicaid [patients]. But who knows how long Mom has? I don't understand why they can't be grandfathered in."
Bebo said that once Assisted Living Concepts ends its Medicaid contract, it's no longer legal for it to house anyone on Medicaid.
The state Legislature passed a law in 2008 prohibiting the eviction of residents with Medicaid; under the statute, those residents may stay as long as they choose.
If a facility has no Medicaid contract, it isn't subject to the state requirement.
Finding new housing for the six evicted residents of Laurel Park and Prairie Springs was a maze of a task, since many assisted living houses don't take Medicaid.
St. Andrew's Place in Port Angeles is one of a scant few on the North Olympic Peninsula that do, but it has a long waiting list.
Thanks to a cadre of social workers at the Department of Social and Health Services, at the Olympic Area Agency on Aging and the resident directors of Prairie Springs and Laurel Park, each evicted resident has found a place to go.
Two women are going into subsidized senior apartments; one woman moved to California to live with family and one man from Prairie Springs is being moved to Seaport Landing in Port Townsend, said Jane Meyer, the regional long-term care ombudswoman for Clallam and Jefferson counties.
"Two others are going to nursing homes, which they're not happy about," she added.
"I do have to say the administrators made an effort," to help, Meyer said, referring to Laurel Park resident administrator Benjamin Barkofsky and Prairie Springs' Dan Burke.
Some residents and their families are happy to move out, however, and say quality of life at the assisted living facilities has fallen off steeply in recent years.
Prairie Springs' staffers have been kind -- but too often, they don't stay long, said Grace Wheeler, Cole's daughter-in-law.
"She just gets to know somebody, and they're gone," Wheeler said.
"That's not atypical for health care generally," Bebo said.
She attributed high turnover to the fact that workers have so many choices of employers.
"It's real easy for an employee to transition," to another facility in the same community or nearby, she said.
"We work as a company to try to reduce turnover for the people we want to keep."
No longer accepting Medicaid and requiring residents to pay full price, Bebo added, enables Assisted Living Concepts to pay its workers better wages.
Meyer, for her part, feels for the facilities' local staff people, but questions Assisted Living Concepts' plan to sever its Medicaid contracts.
Both Laurel Park and Prairie Springs are seeing their numbers dwindle, Meyer said; she wonders why the company won't continue taking Medicaid payments -- which bring at least some income -- instead of ending the relationship entirely and letting rooms go vacant.
In response, Bebo said again that Medicaid payments are too low, and declined to say how many private-pay residents live at both facilities.
For those who had to leave, "the concern is transfer trauma," Meyer said.
Moving at any stage of life can be fraught with stress, but being forced to leave one's home is especially risky for people in their 80s and 90s.
"Research has borne out that if an elderly person moves involuntarily, there's a reduction in life span," she said.
"Sometimes they get into a new environment, and they just thrive. But sometimes the stress of being relocated is too much. I've seen cases where they just give up."
These are people who worked hard for many decades and then, as they grew frail, wanted a place they could stay until the end of their lives, Meyer added.
Bateman, for example, lived in San Francisco and walked up and down its hills into her late 80s. Since moving to Prairie Springs, her Social Security benefits, a small pension and Medicaid have sustained her.
But without Medicaid in the picture, seniors such as Bateman can't afford the $2,000 to $8,000 per month cost of an assisted-living facility.
"This is indicative of a looming problem that we're going to have to deal with," Meyer said.
It's a catch-22, with long-term care costs rising and facilities backing away from Medicaid.
"It's going to be scary in the next 10 to 20 years if nobody wants to accept Medicaid," she said, "while more people may need to go on Medicaid because they can't afford long-term care."
People are outliving their savings, or losing large portions of what they had invested for long-term care, Meyer added.
Many counted on pensions and investment accounts to supplement Social Security, "but then a kid loses a job, a husband has a heart attack," or some other crisis guts what was set aside for old age.
"These people have done everything right. They've saved their money," Meyer said. "But that doesn't always work."
________
Sequim-Dungeness Valley Reporter Diane Urbani de la Paz can be reached at 360-681-2391 or at diane.urbani@peninsuladailynews.com.
By June's end, Prairie Springs in Sequim and Laurel Park in Port Angeles will have evicted six of their elderly residents because they are on Medicaid.
Lucile Cole, who'll turn 99 on June 13, and Edith Bateman, 93, are among the women and men who received a letter this spring from Assisted Living Concepts, the Wisconsin-based corporation that owns Prairie Springs and Laurel Park.
"The last day of Medicaid participation . . . will be June 30," the letter stated. "Thank you for the opportunity to be of service to you."
The evicted residents paid their way with Medicaid, the Social Security Act program designed to provide quality health care to low-income Americans. It is a joint federal-state program, with each state having its own plan.
Cole, at 98 one of the oldest Prairie Springs residents, moved in five years ago.
She spent much of her adult life moving around California and Oregon with her late husband, Duane, who worked in shipyards and construction.
Cole chose Prairie Springs because of its congenial staff and country setting.
"I've been happy here," she said. "I'm too old to move. I've moved enough times."
But she must -- like many others at Assisted Living Concepts facilities around the state.
The company's Victoria House in Port Townsend told nine residents they had to move out in 2007, since their dementia or other needs weren't adequately covered by Medicaid.
And at Franklin House in Sumner, Pierce County, seniors on Medicaid have also gotten eviction notices.
The Medicaid contracts are up for renewal at Laurel Park and Prairie Springs, and Assisted Living Concepts is opting out, said CEO Laurie Bebo.
"It costs us more to take care of people than what Medicaid pays," Bebo added.
Assisted Living Concepts, whose slogan is "Life just got easier," is a publicly traded company that owns 215 assisted living facilities across the United States, including 40 in Oregon and Washington.
Judy Lawson, whose mother Alice Hellerud, 85, moved to Laurel Park six years ago, was shocked by what she called a form letter from the corporate headquarters in Menomonee Falls, Wis.
"I can see that this is a business, and that they can't take any more Medicaid [patients]. But who knows how long Mom has? I don't understand why they can't be grandfathered in."
Bebo said that once Assisted Living Concepts ends its Medicaid contract, it's no longer legal for it to house anyone on Medicaid.
The state Legislature passed a law in 2008 prohibiting the eviction of residents with Medicaid; under the statute, those residents may stay as long as they choose.
If a facility has no Medicaid contract, it isn't subject to the state requirement.
Finding new housing for the six evicted residents of Laurel Park and Prairie Springs was a maze of a task, since many assisted living houses don't take Medicaid.
St. Andrew's Place in Port Angeles is one of a scant few on the North Olympic Peninsula that do, but it has a long waiting list.
Thanks to a cadre of social workers at the Department of Social and Health Services, at the Olympic Area Agency on Aging and the resident directors of Prairie Springs and Laurel Park, each evicted resident has found a place to go.
Two women are going into subsidized senior apartments; one woman moved to California to live with family and one man from Prairie Springs is being moved to Seaport Landing in Port Townsend, said Jane Meyer, the regional long-term care ombudswoman for Clallam and Jefferson counties.
"Two others are going to nursing homes, which they're not happy about," she added.
"I do have to say the administrators made an effort," to help, Meyer said, referring to Laurel Park resident administrator Benjamin Barkofsky and Prairie Springs' Dan Burke.
Some residents and their families are happy to move out, however, and say quality of life at the assisted living facilities has fallen off steeply in recent years.
Prairie Springs' staffers have been kind -- but too often, they don't stay long, said Grace Wheeler, Cole's daughter-in-law.
"She just gets to know somebody, and they're gone," Wheeler said.
"That's not atypical for health care generally," Bebo said.
She attributed high turnover to the fact that workers have so many choices of employers.
"It's real easy for an employee to transition," to another facility in the same community or nearby, she said.
"We work as a company to try to reduce turnover for the people we want to keep."
No longer accepting Medicaid and requiring residents to pay full price, Bebo added, enables Assisted Living Concepts to pay its workers better wages.
Meyer, for her part, feels for the facilities' local staff people, but questions Assisted Living Concepts' plan to sever its Medicaid contracts.
Both Laurel Park and Prairie Springs are seeing their numbers dwindle, Meyer said; she wonders why the company won't continue taking Medicaid payments -- which bring at least some income -- instead of ending the relationship entirely and letting rooms go vacant.
In response, Bebo said again that Medicaid payments are too low, and declined to say how many private-pay residents live at both facilities.
For those who had to leave, "the concern is transfer trauma," Meyer said.
Moving at any stage of life can be fraught with stress, but being forced to leave one's home is especially risky for people in their 80s and 90s.
"Research has borne out that if an elderly person moves involuntarily, there's a reduction in life span," she said.
"Sometimes they get into a new environment, and they just thrive. But sometimes the stress of being relocated is too much. I've seen cases where they just give up."
These are people who worked hard for many decades and then, as they grew frail, wanted a place they could stay until the end of their lives, Meyer added.
Bateman, for example, lived in San Francisco and walked up and down its hills into her late 80s. Since moving to Prairie Springs, her Social Security benefits, a small pension and Medicaid have sustained her.
But without Medicaid in the picture, seniors such as Bateman can't afford the $2,000 to $8,000 per month cost of an assisted-living facility.
"This is indicative of a looming problem that we're going to have to deal with," Meyer said.
It's a catch-22, with long-term care costs rising and facilities backing away from Medicaid.
"It's going to be scary in the next 10 to 20 years if nobody wants to accept Medicaid," she said, "while more people may need to go on Medicaid because they can't afford long-term care."
People are outliving their savings, or losing large portions of what they had invested for long-term care, Meyer added.
Many counted on pensions and investment accounts to supplement Social Security, "but then a kid loses a job, a husband has a heart attack," or some other crisis guts what was set aside for old age.
"These people have done everything right. They've saved their money," Meyer said. "But that doesn't always work."
________
Sequim-Dungeness Valley Reporter Diane Urbani de la Paz can be reached at 360-681-2391 or at diane.urbani@peninsuladailynews.com.
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