Health Care Reform?

The recently passed health care reform legislation does virtually nothing to control costs in the health care industry and will do nothing to stop the ongoing rise in health insurance premiums. This is contrary to several of the goals the President originally outlined in his proposal - a major one being to make health care affordable again. The article in the link above points out that public anger over rising premiums likely helped to get the bill passed but the bill doesn't even address rising premiums.

Medicare Payment Decreases

It's that time of year again...Medicare payment rates to doctors are scheduled to decline again unless Congress delays them. This kick the can down the road patch to one of medicare's major problems has been going on since about 1997.

The only way the government could seem to wring costs our of medicare was to cut what they pay to doctors for services making medicare patients more costly for doctors to serve than patients with private insurance. The result - as anyone who stayed awake for about 5 minutes in an introductory economics class would know - is that fewer doctors are taking medicare patients on. This drives medicare patients to use ERs and urgent-care facilities which in turn drives up the cost of medicare...anyone see a problem?

FOXNews.com - Verizon to Take $970 Million Charge From Health Care Law

FOXNews.com - Verizon to Take $970 Million Charge From Health Care Law

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The Cost of Modern Medicine

The March 4th edition of Business Week ran a very interesting article entitled: "Lessons of a $618,616 Death." In the article a woman describes her husband's battle with cancer and ultimately his death and uses it to discuss how our health care system works (or doesn't depending on your point of view). While I don't necessarily agree with all her conclusions or points the article is very interesting nonetheless. Please take some time to read it....


http://www.businessweek.com/magazine/content/10_11/b4170032321836.htm?chan=magazine+channel_top+stories

and watch the video below:

Let the Health Care Wars Begin

The House just declared war on states and individual freedom and sovereignty with the passage of the health care reform bill that Obama is certain to sign. The good news is that about 20% of the States are not going to take this lightly:

The CNN article below shows how states are going to fight back.

States Plan to Sue over Health Care

Obama Defends Health Care Reform

Obama defends his health care reform to Republicans at their issues gathering...sounds a little desperate to me! The President is struggling to stem the public wrath over this enormous entitlement program that will almost certainly balloon the national debt. The end of this bill is in sight all we have to do is stick to our convictions.

Obama Care Updated

Democratic Senators may have reached a deal to move the health care bill to the floor for a vote. In order to get the 60 votes necessary to block republican attempts to stall the bill they have made all kinds of deals for the holdouts. This how you elected representatives serve you - making middle of the night deals to give some states huge advantages in exchange for votes, pushing through a bill against clear opposition from the majority of the public, and refusing to properly debate and consider it on the floor. This is the way Obama and the democrats do business - remind anyone of the USSR?

Health Care Debate Moves Forward

The health care debate appears to be moving forward in the Senate. It now appears that Democrats have secured the 60 votes necessary to break Republican efforts to stall the bill prior to open debate in the Senate. The bill is anything but a sure though. Many of the central leaning Democrats while supporting debate have as yet stopped short of actually stating they would vote for the bill. The debate will now center around how much the left leaning Democrats are willing to concede to the centrist Democrats to get the bill through.

House Passes Health Care Bill

The House passed their version of a health care reform bill 220-215. The bill will cost an estimated $1.055 trillion over 10 years and it includes both an individual mandate and a public health care option. This represents perhaps the single largest intrusion of the federal government into the everyday lives of citizens and into our economy. The future of this nation and our economy now rests in the Senate.

The New Health Tax

Taxes are on the rise to cover your health care bill. At least that is the proposed method of paying for the new health care proposals. Congress wants to levy a 5.4% income tax on individuals making over $500,000 a year and couples over $1,000,000. This would raise the effective tax rate on these individuals by nearly 12.5% (a 32% increase) when you factor in other changes Obama wants to make. There are many reasons why taxing the heck out of the wealth is unhealthy for the economy, but this new health care tax has a much more glaring problem. It is not indexed to inflation. This means that each year as inflation slowly erodes the value of the dollar more Americans will be hit with this tax at ever lower income levels in today's dollars. This is not the first tax to suffer this fate - remember the AMT or Alternative Minimum Tax.

Eventually this new health care tax will begin to fall on middle-class Americans as inflation lifts incomes in dollar value but without adding buying power. This will end up being another thing Congress has to "fix" every year before tax time. It seems to me that given our experience with the AMT this is just a covert way to raise taxes year after year.

Health Care Proposals In A Nutshell

The table below shows the highlights of the various health care reform bills or click this link for the full web-page:

Features	Senate bill	House Democratic bill	House Republican outline
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Who is covered	The Senate Finance version covered an estimated 94% of Americans. Illegal immigrants would not receive government benefits.	Around 97% of non-elderly residents (those not covered by Medicare, which kicks in at age 65) would be covered. Nearly half the 17 million non-elderly residents who remain uninsured would be illegal immigrants.	Aims to make insurance affordable and accessible to all. There aren't estimates about how many additional people would be covered.
Cost	Senate leaders aim to keep it under $900 billion over 10 years.	The Congressional Budget Office estimates the net cost of the proposal (less payments from employers and uninsured individuals) to be $1.042 trillion over 10 years.	Unknown.
How it's paid for	Fees on insurance companies, drug makers, medical device manufacturers. Tax levied on insurance companies, equal to 40% of total premiums paid on insurance plans costing more than $8,000 annually for individuals and $21,000 for families (that number may rise to $23,000); retirees over age 55 and people in high-risk professions may be allowed to have somewhat more valuable plans before they're taxed. Cuts to Medicare and Medicaid. A fee on employers whose workers receive government subsidies to help them pay premiums. Fines on people who fail to purchase coverage.	Approximately half of the cost of the plan is financed through about $500 billion in cuts to Medicare and Medicaid. The remaining costs are financed through new income taxes on single people making more than $280,000 a year, families making more than $350,000; penalties paid by individuals and employers who don't obtain coverage.	No new taxes are proposed, but Republicans say they want to reduce Medicare and Medicaid fraud.
Requirements for individuals	Almost everyone must get coverage through an employer, on their own or through a government plan. Exemptions for economic hardship. The Senate Finance Committee version required individuals and families to buy coverage as long as it cost no more than 8 percent of their income. Those who are obligated to buy coverage and refuse would face a fine of perhaps $100 in the first year of the program, likely increasing over time.	Individuals must have "acceptable health coverage" requirement enforced through tax penalty with hardship waivers.	No mandates.
Requirements for employers	Not required to offer coverage, but companies with more than 50 full-time workers would pay a fee as high as $750 multiplied by the total size of the work force if the government ends up subsidizing employees' coverage.	Employers must provide insurance to their employees or pay a penalty of up to 8% of payroll. Companies with annual payroll under $500,000 annually are exempt.	No mandates; small business tax credits are offered. Employers are encouraged to move to "opt-out" rather than "opt-in" rules for offering health coverage.
Subsidies	Tax credits for individuals and families likely making up to 400% of the federal poverty level, which computes to $88,200 for a family of four. Tax credits for small employers.	Individuals and families with annual income up to 400% of poverty level ($88,200 for a family of four) would get sliding-scale subsidies to help them buy coverage. The subsidies would begin in 2013.	Tax credits are offered to "low- and modest-income" Americans. People who aren't covered through their employers but buy their own insurance are allowed to take a tax deduction. Low-income retirees younger than 65 (the eligibility age for Medicare) would be offered assistance. Subsidies will not be available for illegal immigrants.
Benefits package	All plans sold to individuals and small businesses would have to cover basic benefits. The government would set four levels of coverage: Under legislation passed by the Senate Finance Committee the least generous would pay an estimated 65% of health care costs per year; the most generous would cover an estimated 90%. Those numbers could change.	Through a new Health Insurance Exchange open to individuals and, initially, small employers; it could be expanded to large employers over time. States could opt to operate their own exchanges in place of the national exchange if they follow federal rules.	Insurers would have to allow children to stay on their parents' plan through age 25.
Government-run plan	Reid proposed a new federal insurance plan this week with payment rates to providers negotiated by the Health and Human Services secretary. Unlike the House bill, states could opt out of the plan. It's not clear the proposal commands enough votes to survive, so it could be replaced by a less sweeping version of a public plan. The bill also would create nonprofit, member-owned co-ops to compete with private insurers.	A committee would recommend an "essential benefits package" including preventive services, mental health services, oral heath and vision for children; out-of pocket costs would be capped. The new benefit package would be the basic benefit package offered in the exchange and over time would become the minimum quality standard for employer plans. The bill is likely to include a compromise version of the public insurance option with rates negotiated with health-care providers, instead of based on Medicare rates.	No public plan.
How you choose your plan	Self-employed people and small businesses could pick a plan offered through new state-based purchasing pools. Employees would be generally allowed to keep their work-provided coverage.	A new public plan available through the insurance exchanges would be set up and run by the secretary of Health and Human Services. Democrats originally designed the plan to pay Medicare rates plus 5% to doctors, but the version that passed the Energy and Commerce Committee instead would let the HHS secretary negotiate rates with providers.	No new purchasing exchange or marketplace is proposed. Health savings accounts and flexible spending plans would be strengthened.
Changes to Medicaid	Income eligibility levels likely to be standardized to 133% of poverty ($30,000 a year for a family of four) for all parents, children and pregnant women. States could negotiate with insurers to arrange coverage for people with incomes slightly higher than the cutoff for Medicaid.	The federal-state insurance program for the poor would be expanded starting in 2013 to cover all non-elderly individuals with incomes up to 133% of federal poverty line.	People eligible for Medicaid would be allowed to use the value of their benefit to purchase a private plan.

Medicare Rip Off

Medicare fraud is quickly becoming one of the largest crimes in America. Totaling nearly $60 billion a year in fraud. This is an excellent video segment that shows just how big the problem is. We should think about this long and hard before we hand over another trillion dollars in health care spending to these folks!



Watch CBS News Videos Online

More Obama Care Maddness

More news on the health care front! How can we possibly pay for all this health care "improvement?" One idea is just to force everyone to buy insurance and to make it all fair the old and young should pay the same price, which of course means young adults will pay much more for one-size-fits-all policies with coverage they don't need. Read all about it....

Health Care Continued...

The Day Obama Care Died

Individual Mandate Exposed

One of the more controversial aspects of Obama's health care plan is the so called individual mandate. If such a mandate passed the federal government would basically make you buy health insurance or pay a fine of some sort. This would be one the greatest encroachments on individual liberty since prohibition. Interestingly enough pretty much all of Congresses power under the Constitution comes from either an amendment (like prohibition) or from article one where Congress is granted to power to regulate interstate commerce. This clause has been interpreted very differently over the years - with the trend toward an ever broader definition. As a recent Fox News article points out an individual mandate would be imposed simply for being on this Earth and not because of any commercial or economic activity - which may make such a law unconstitutional. I'll be reading more on this topic!

Health Care Maze

The diagram below is supposed to help you navigate through the government health care system:
Go to Diagram

Health Care Update

There is so much going in the health care debate it is almost impossible to keep track of it all....

President Obama is facing strong headwinds for his vision of health care reform. Americans are overwhelmingly against a public option and in many other ways against other portions of Obama's proposal like an individual mandate. The President has been addressing Congress and the American people trying to sell his ideas. He has even signaled a willingness to consider other proposals as becomes clearer that the public option may lack the votes to pass. For more on Obama's willingness to deal click here.

Recently Representative Joe Wilson shouted out to President Obama "You lie!" during an address to a joint session of Congress. The remark has been decried by both sides of the aisle as unprofessional and inappropriate prompting Representative Wilson to apologize. While I admit it was somewhat rude I am glad that someone is willing to tell the truth in the open. I think it's high time we put some of the political etiquette away and just got down to business.

One of the biggest reasons the democrats claim we need a pubic health care option is to infuse competition into the health care system and drive down prices. If only it were that simple! Our current system is a hodgepodge of government regulation and private industry that will distort any free market policies or approaches. Also, health care is not a traditional type of service, as an economist would say it is not exactly a normal good. What this means in practice is that purchasing decisions and supply decisions are not as straightforward for health care as say for oil changes, hair cuts, clothes, and the like. Why because health care is complicated and most consumers have very limited information upon which to base their decisions because they are not - well doctors. This means that simply adding more competition doesn't always result in lower prices. Take the Dallas area as an example. The Dallas Morning News recently ran an article that shows how health care in Dallas is very expensive when compared to the rest of the country despite the fact that there is a lot of competition. The article touches on some of the reasons behind this. The simple fact of the matter is that we cannot solve a problem as complex as health care by simply adding more insurance options.

Here's a good one...Under one version of the health care package working its way through Congress all individuals would be required to buy health care or pay a fine through higher income taxes. If you don't well they'll just throw you in jail where the health care is free! Anyone see a flaw here?

Obama Care Cont....

The debate over health care has not slowed down at all. The democrats are pushing to get something through Congress as fast as possible, so is the President, while the republicans are doing everything they can to slow down the process. I for one think that we should take some more time and think about what we are doing. The huge cost of the suggested programs should dictate careful consideration. Unfortunately what has happened is that the debate has shifted to the sharing of anecdotes, which often are not even accurate. Just ask Obama....

Health Care Reform Update

It appears that the efforts of Americans to get out to town hall meetings and tell their elected officials what they think of health care reform were not in vain. The article below is from Fox News, you can find the complete article here, and it shows some of the ways in which the public outcry might be changing the legislation. There is a chance that the public health care option may no longer be on the table! There are still lots of other terrible ideas in the proposed bill, but let's take a moment and celebrate this small (though still tenuous) victory. See below:

WASHINGTON -- The Obama administration's bottom line on a government health insurance option blurred Sunday as White House officials stressed support but stopped of short of calling it a must-have part of an overhaul.

As President Barack Obama prepares for a Wednesday night speech to Congress in a risky bid to salvage his top domestic priority, no other issue is so highly charged. Obama's liberal supporters consider the proposal for a public plan to compete with private insurers do-or-die.

Republicans say it's unacceptable. It's doubtful the public plan can pass the Senate.

White House political adviser David Axelrod said Obama is "not walking away" from a public plan. But asked if the president would veto a bill that came to him without the option, Axelrod declined to answer.

The president "believes it should be in the plan, and he expects to be in the plan, and that's our position," Axelrod told The Associated Press.

Asked if that means a public plan has to be in the bill for Obama to sign it, Axelrod responded: "I'm not going to deal in hypotheticals. ... He believes it's important."

The biggest challenge Obama faces in his prime-time address is to take ownership of health care legislation that until now has been shaped by political conflicts in Congress. Lawmakers return this week from a summer break that saw eroding public support for an overhaul and contentious town hall meetings in their districts.

The idea of a public plan has become a symbol for the reach of government in a revamped health care system. Supporters say it would give workers and their families similarly secure benefits as older people now get through Medicare, while leaving medical decisions up to doctors and patients. The plan would be offered alongside private coverage through a new kind of purchasing pool called an insurance exchange. At least initially, the exchange would be open to small employers and people buying coverage on their own.

Insurers say they could never compete against the price-setting power of government. Employer groups warn it would undermine the system of job-based coverage.

A public option -- or government plan -- has come to mean different things to different people. Some say it could be a public trust and independent of the government: nonprofit co-ops could serve as a check on insurance companies. In its original form, supporters envisioned a Medicare-like plan in which the government pays the bills. But it would be financed through premiums paid by beneficiaries, not taxpayer dollars.

While there's strong support for a public plan among House Democrats, the votes appear to be lacking in the Senate.

Democratic Sen. Ben Nelson of Nebraska, a swing vote on health care legislation, said the only way a public plan should be included is as a last resort. The government option would only be rolled out if after a few years, private insurers have failed to increase competition and restrain costs.

"If somehow the private market doesn't respond the way it's supposed to, then it would trigger a public option, or a government-run option," Nelson said on "State of the Union" on CNN. "But only as a fail-safe backstop."

White House spokesman Robert Gibbs, who joined Axelrod in a one-two administration punch on the Sunday talk shows, said the president believes a government plan would be "a valuable tool." But Gibbs danced around the question of whether it has to be in the final legislation.

"We're not going to prejudge what the process will be when we sign a bill, which the president expects to do this year," he said on ABC's "This Week."

The uncertainty over the administration's position isn't new. Health and Human Services Secretary Kathleen Sebelius said last month that a government alternative to private insurance is "not the essential element" in revamping the system to guarantee coverage for all and try to curb unsustainable costs.

On Friday, during a call with prominent liberal House members, Obama refused to be pinned down on the public plan, a participant told The Associated Press. "It was unclear as to whether the public option is on or off the table," said the official, who spoke on condition of anonymity because of the sensitivity of the issue.

Independents who helped propel Obama to the presidency are increasingly skeptical about his direction on health care. Unsubstantiated allegations that the legislation would promote euthanasia grabbed headlines last month. But beneath such controversies, voters appear most concerned about the scope and costs of the bill -- around $1 trillion over 10 years. Obama has said he won't sign a bill unless it is fully paid for and doesn't add to the deficit.