Healthcare - The Myth of Neutrality

Now that the Healthcare bill has become law, we are finally getting some of the transparency we had hoped for during the debates. Unfortunately, this transparency came too late to be of any use during the legislative process and the news is devastating. Despite the promises of budget neutrality made by the President and the Congressional Democrats, this neutrality is turning out to be a shameless and cruel hoax. While the President points to the Congressional Budget Office (CBO) report that claims the bill will provide deficit reduction of just over $100 billion dollars in the first ten years and $1.2 trillion dollars in the second ten years, those numbers were intentionally manipulated by the Democratic leadership.

The CBO can only score what it is before them. It can not extrapolate based on intent and it cannot adjust even when it knows key provisions have been left out of the materials they have been given. The $500 billion that this bill cuts from Medicare was factored in as a savings measure to provide solvency for Medicare through 2019. One would think that if it were a savings measure, that the money would remain in Medicare to restore balance to the program considering the projected rate of expansion. No; instead that $500 billion was also scored as part of the funding for a new entitlement program in the healthcare bill to provide subsidies for the purchase of healthcare insurance for low income families. Counting the same money twice in a business plan or as a proposal to investors would be a crime unless that plan or proposal is being submitted by Congress to the CBO for analysis.

The CBO must also score the bill based upon the language contained in the bill and must assume the cuts proposed in the bill will be law and will take place. Historically, the Congress has already passed cuts to Medicare in many previous years and to date, none of those cuts have ever been enacted. The CBO would love to say “Are you kidding? You guys have never made Medicare cuts before so why should we believe you will now?” The sad truth is they are prohibited from adding anything to their analysis that isn’t part of the actual language before them; including the intent and historical spinelessness of Congress.

Since the $278 billion dollar “doctor fix” was also removed from the legislation and will be considered as part of a spending package separate and apart from the Healthcare Bill, the CBO was prohibited from considering the budget implications from that as well. So far, a cursory look at the fiscal manipulation Democrats used to conceal the true cost of this bill adds up to three-quarters of a trillion dollars and that is just the beginning. It doesn’t sound like that $100 billion dollar savings in the first year is all it’s cracked up to be. As far as the $1.2 trillion dollar savings the CBO estimated for the second ten years is concerned, that is equally as fictional. What the President left out in his speech to the nation was the side note the CBO gave him on their estimates for year eleven through twenty of the program. The CBO made sure they cautioned that the estimates they provided are unreliable beyond ten years and that the projected savings can only be realized if the assumptions made by Congress in the legislation remain valid.

This is only the tip of the iceberg. Large portions of the uninsured are going to be driven into the expanded Medicaid program; a program that bears little consequence for the Federal government but can spell disaster for the individual States. It is very easy for Congressional Democrats to claim budget neutrality when they can shift 70% of this new burden onto the States and let them worry about how to deal with it. Many of these States are already struggling with budget problems of their own because of the recession and loss of tax revenue. In short, while Congressional Democrats try to sell the illusion of budget neutrality and the benefits of the healthcare bill before the November election, the States are going to have to raise your taxes, cut your services or both just to avoid bankruptcy because of the new unfunded mandates in the bill.

Many of the States realize they are already at the tax saturation point and will find it exceedingly difficult to raise taxes to offset the increased Medicaid liability without driving their real tax payers out. States like New York, New Jersey and California have already seen an exodus of the highest earners in recent years and when the affluent in these areas have finally had enough, they aren’t moving to neighboring States for a measly one or two percent decrease in taxes; they are moving to one of the seven US States that have no personal income tax which should be a lesson for us all. As world markets decline, investors are going to look for the safest place to put their money and many would prefer the security and stability of the United States. Unfortunately, the wild spending and outrageous taxes have taken us out of the running and nervous investors would rather take a chance on China’s experiment with limited Capitalism than America’s incredibly stupid experiment with Socialism.

As Federal policy drives the States closer to the brink of disaster, many are beginning to fight back. Several have passed legislation negating the individual mandate that would force citizens to purchase healthcare insurance under the new Healthcare bill and more than twenty more have identical legislation pending. Of course that legislation does not exempt the citizens and businesses in those States from the new tax liabilities so it in fact, allows people the privilege of paying more for absolutely nothing in return.

Congressional Democrats are already kicking back stating that the Supremacy Clause in the Constitution invalidates those measures reminding those States that Federal law supersedes State law. Of course the Supremacy Clause only applies to Federal law that is actually constitutional and that is where several States are applying their attention. Within minutes of the signing of the Healthcare Bill into law, a number of States filed suits challenging the constitutionality of the mandates that force individuals to purchase healthcare insurance and the unfunded mandates the States will face as the number of people enrolled in Medicaid climbs as a result of the bill.

Tomorrow, we will discuss the constitutional questions surrounding the Healthcare Bill and why Congress and the President are secretly concerned about those challenges.

Paul

Kucinich caves - will now support Obamacare

Dennis Kucinich (D-OH) appeared on television this morning to announce his reluctant support for the healthcare bill. Kucinich had originally signed a letter along with 77 other Democrats opposing the healthcare bill because the current bill failed to include a “robust” public option. He maintained that this was not the bill he wanted to support and while he wanted the nation to finally embrace a European style, not-for-profit national healthcare system as opposed to working with for-profit, health insurance companies, he decided to surrender his opposition so that some measure of reform could take place. Dennis Kucinich has made a career out of convincing people that he fights for “the little man”. Well, I suppose that’s true; at 5’7” Kucinich is a little man and there is no doubt that he fights very effectively for his own interests and his interests alone.

There were several areas of Kucinich’s statement that made absolutely no sense and left me wondering if these people even listen to their own words before the cameras are turned on. Kucinich began by recounting storied from his own past and how he survived a youthful brush with poverty that had him living in his car at times. Now I’m not calling the man a liar but I have found very little to substantiate his claims of poverty. His father was a truck driver of Croatian ancestry and his Irish American mother was a homemaker. Since he grew up in the 1950’s, his father was apparently the only truck driver that couldn’t find steady work in the boom times that followed World War II. Curiously contradictory to his story of an impoverished youth is the fact that he somehow managed to attend Cleveland State University from 1967 to 1970 and in 1973, managed to pursue and obtain a Master of Arts Degree in speech and communication from Case Western Reserve University.

Kucinich spoke about how he has been afflicted with Crohn's Disease for much of his adult life which led him to “take charge” of his own healthcare decisions, prompting him to follow the recommendations of traditional physicians and to modify his diet and lifestyle, embracing a more holistic approach of self care. Apparently, Dennis Kucinich doesn’t see the irony of his statements that display the contrasts between his personal life story and his political beliefs. On one hand, he speaks of how he took command of his own healthcare choices in his fight with Crohn’s Disease and then speaks forcefully of his belief that government has to take action to provide a healthcare system that would prevent anyone else from having the ability to exercise that freedom of choice within their own lives.

Kucinich would undoubtedly argue that his belief in a national healthcare system is prompted in part, by his own experience in dealing with Crohn’s Disease and therefore, in trying to make those battles easier for others. I would suggest that his experience not only displays that our current healthcare system worked but when he was faced with the challenge, he found the care he wanted and made the choices that needed to be made to obtain that care. To have government provide health care would relieve people of the responsibility of making beneficial choices for themselves and cheapen the outcome. I submit that is was the absence of a national healthcare system that forced Kucinich to take his participation in his own treatment far more seriously than he would have if some massive government entity relieved him of the responsibility of making his healthcare choices for himself.

While angry Socialists and Progressives may believe that Kucinich has turned his back on the last credible chance to bring about a national healthcare system, I maintain that his opposition is simply window dressing designed to conceal what is hidden deep in the bowels of the Democrat’s 2700 page Progressive manifesto. Kucinich may have wanted to skip a few steps and force a vote for socialized medicine now but the end game will eventually bring that about anyway. You cannot force insurers to provide more coverage, cap the cost and expect that they will stay in business; especially since the health insurance industry only posts a 3.5% profit margin now.

Wait a minute! I thought those evil insurance companies were making billions of dollars? The President said so. Yeah, well that was a cute little trick designed to anger people and create some false support for the bill. If you take all of the insurance companies in the industry and pool all of their profits together, it is billions of dollars but those billions still only represent a measly profit of just 3.5%. The Federal number crunchers know very well when to use dollars and when to use percentages to make their point. In the end, private insurance cannot survive this healthcare plan and that will “force” the government to step in and take their place. It’s a neat little trick to get socialized medicine in through the back door but we know what they are doing and we will blame them when they do it.

The Progressives in Congress know their numbers don’t add up so most have abandoned using them altogether and have resorted to one sob story after another in an attempt to soften the opposition to the bill by appealing to our humanity. Too bad all of the stories they have used are full of lies and half truths. The President spoke of Natoma Canfield during his visit to Ohio. Natoma Canfield is a cancer patient who could no longer afford her healthcare premiums for fear of losing her home. The President made an impassioned plea for his healthcare plan, challenging people to “remember Natoma” and support this plan. Of course what he didn’t tell you is that Natoma was being treated at the state of the art, Cleveland Clinic. Spokesmen for the Clinic said that Natoma is not only eligible for Medicare but that the Clinic itself, has a large charitable endowment of more than one-hundred million dollars with which they can provide free care for people like Natoma, who have no other options.

In another shameless display, Senate Democrats paraded 11 year-old Marcelas Owens before a press conference on Thursday. Coached by his activist grandmother, Gina Owens, Marcelas told a packed room of reporters that he wanted the president and Congress to come together and pass health insurance reform. “I am here because of my mom,” said Owens. “My mom was diagnosed with pulmonary hypertension in 2006. She missed so much work she lost her job. And when my mom lost her job, she lost her health care. And losing her health care ended up costing her her life.” As it turns out, Marcelas grandmother is an activist with the Washington Community Action Network, which is another misguided group of community activists that espouse a platform of socialist ideals. If fact, Gina Owens is now preparing Marcelas 7 year-old sister to play her part in this disgusting display of emotional manipulation. Grandma….have you no shame? Of course not…Socialists have no shame because the ends justify the means.
The truth is that it is the existing government healthcare programs that failed Tiffany Owens. If a sick, single mother of three cannot get Medicaid….who can? Where was the activist grandmother during this travesty of justice? Where is her outrage at the social programs that should have saved her daughter’s life? Better still…why wasn’t the activist grandmother actively involved in helping her navigate the Medicaid application process? After all, isn’t that what activism is all about?

There is no doubt that Tiffany Owens succumbed to her illness (pulmonary hypertension) but there are so many pieces of the puzzle still missing. Tiffany had already received care, including an 8 day hospital stay, but when she began vomiting blood, she failed to seek additional care which eventually contributed to her death. Was she too weak to get to a doctor and where was her activist mother at the moment when her needs were greater than anytime before? Where was the Medicaid system that was specifically created to provide care for people just like Tiffany? Most importantly, why should we trust a government with our care when they failed so miserably in the case of Tiffany Owens?

One would think that if seventy people a day are dying because of the lack of affordable healthcare insurance as Progressive Democrats claim, that the President could easily pick case after case where the death of an individual can be solidly linked to the lack of health care but instead, they choose ones that fall completely apart under the slightest scrutiny. The reason they don’t is because they can’t. This nation has had a long standing practice of providing care for anyone that needs it and while there are stories of financial difficulties, those come after the care has already been given and the money is sorted out later. No one in America dies because of a lack of care. Kucinich can claim that insurance companies, from time to time, may unfairly deny paying for a procedure, leaving the patient with the bill but that truth is also a hard indictment of government care. What Kucinich and his President never told you is that the insurance companies that lead the nation in claim denial are the Federal government programs of Medicare and Medicaid. Imagine that!

Paul

The President's Healthcare Plan - Just More Things to Despise

To make good on his promise, or threat depending on how you look at it, the President released a summary of his healthcare proposal on Monday morning. I haven’t been able to find a full copy of the text as of yet and if all he intends to post to the internet is a summary / infomercial, then I am truly concerned. Considering what is in the summary, I can only imagine what horrors the full text of the proposal has in store for us. Bear in mind, this is not a full proposal designed to replace the bill that a majority of Americans would like to see tossed; this is yet another addition to the more than two thousand pages that already exist.

In essence, the President’s proposal has taken a bill Americans already hate and gave us even more to despise. There are more tax increases, higher penalties for not purchasing health insurance, a clever renaming of the medical device fee to an excise tax and a “millionaire’s tax” of 5.25% levied on people earning a quarter of what it takes to be a millionaire. Incidentally, the millionaire’s tax also contains a marriage penalty where tax is levied against single people earning more than $200,000 and couples earning more than $250,000.

The President’s plan still punishes health insurance companies, extorting $67 billion dollars in fees to help the enrollment process on the assumption that insurance companies are going to make so much money from all the new people that will be forced to purchase insurance. Well, if this plan is meant to allow access to health insurance for the 30 million Americans that are reportedly without insurance, then what are we talking about, a ten percent increase in business? But wait, the income assessment used to force people to purchase insurance doesn’t kick in until you earn more than $18,700 per year so you can hack off a healthy portion of that 10%. This does not take into consideration that once the exemptions for pre-existing conditions are removed from the equation, some will simply prefer to pay the penalty knowing that they can always get insurance later when it is an absolute necessity saving themselves thousands in premium costs.

The President couldn’t eliminate the additional tax on “Cadillac” healthcare plans to make his union friends happy without an uproar so he did the next best thing. He postponed that tax until 2018 and by then, private insurance should be a thing of the past. Oh yes, private insurance will be decimated by the President’s plan. His proposal includes capping premium costs knowing that the industry only has a 3.4% profit margin now; a margin that will not be able to keep up with rising health provider costs as more people are absorbed into Medicaid and Medicare. You see, it is the paltry amount that the Federal government reimburses doctors and hospitals for Medicare and Medicaid services that created the problem in the first place. Hospitals and doctors are forced to increase their charges to private insurance to make up the shortages and private insurance must pass that on to you in what is really, the largest hidden tax to fund those programs ever perpetrated on the American people.

The President’s plan has a “grandfather” clause that will allow people that like their current insurance to keep that plan. Hmmm? Why would we need a grandfather clause if their intention wasn’t to force people to accept certain plans that the government will choose for you? In fact, the grandfather clause isn’t worth much since the government will force changes to these plans that will no longer make them profitable. You see, you can’t get to the single payer system the President really wants if you get to keep a plan that will not go away. The changes that the providers of these plans will have to make will ensure they cannot remain competitive.

The President’s summary states: “Within months of legislation being enacted, it requires plans to cover adult dependents up to age 26, prohibits rescissions, mandates that plans have a stronger appeals process, and requires State insurance authorities to conduct annual rate review, backed up by the oversight of the HHS Secretary. When the exchanges begin in 2014, the President’s Proposal adds new protections that prohibit all annual and lifetime limits, ban pre-existing condition exclusions, and prohibit discrimination in favor of highly compensated individuals. Beginning in 2018, the President’s Proposal requires “grandfathered” plans to cover proven preventive services with no cost sharing.” In short, by 2018, these plans will either be eliminated by the provider or will be too expensive to purchase to all but a few.

Pharmaceutical companies will also be hit hard as official preference is given to generic drugs. Ignoring the companies that actually pioneered the creation of new drugs and had to fund the expense of clinical trials and Federal approval will create a stagnant climate within the pharmaceutical industry. This short sighted approach will have a detrimental limiting effect on research and development of new drugs and treatments. The President’s plan also increases the government theft of pharmaceutical company profits $10 billion dollars more than the Senate plan proposed for a total of $33 billion over ten years.

Medicare Advantage is also targeted by the President’s plan and while the summary makes a base assessment that Medicare overpays private plans by an average of 14% to provide the same services as the regular Medicare programs, his summary refuses to actually say what is going to be cut and where. His plan creates a set of benchmark payments at different percentages based on the current average fee-for-service costs in an area. Of course while his summary calls this section “Improving Medicare Advantage Payments” it could just as easily be called “good luck finding a doctor that will accept Medicare Advantage now”. The only reason people go through the expense of paying for Medicare Advantage is that many doctors simply do not take “traditional” Medicare because of the their miserable payment rates. Adjusting the rate structure to something more like Medicare will only make Medicare Advantage as unpopular with doctors as Medicare is currently.

There is the creation of what the President himself calls an “unprecedented array of aggressive new authorities to fight waste, fraud and abuse.” Ok, so we are expected to believe that the savings from the “waste, fraud and abuse” uncovered by this “array” of new authorities will not be consumed entirely by the “array” of new authorities. Call me silly but couldn’t fraud and abuse be adequately pursued and prosecuted by an already bloated and underutilized Justice Department? As far as fraud is concerned, that simply sounds like there needs to be a little house cleaning over at the existing Medicare and Medicaid administrations so that these people actually perform their jobs.

Of course nothing is more devastating than the employer mandates. The President insists that there are no employer mandates in his plans but there are fees that start with companies of 50 or more employees. A fee of $750 would be assessed for every one of that company’s employees even if only one of those employees should purchase insurance with taxpayer assistance; that my friends, is known as a job killer. The carrot of a tax credit is meaningless because the requirements outlive the credits and leave businesses holding the bag for all time. Companies with 55 or 60 employees will find a way to get the job done with 54 and many larger companies will just close their American plants and outsource to foreign companies in countries that were smart enough not to elect a socialist President. There is also an additional tax for employers that offer no insurance or insurance that does not meet “government standards”. The tax would roughly be an 8% payroll tax phased in for employers with annual payrolls from $500,000 to $750,000 which really doesn’t take that much to reach these days now does it?

Of course no plan ever crafted by a Progressive Democrat would be complete without a little bait and switch. The President’s proposal gives billions to Community based health centers and that just sounds like a big “Thank You” from the President to all of the Community organizations that helped him get elected. While the Nebraska deal is tossed out in the President’s plan, the Senate’s “working girl” from Louisiana, Mary Landrieu, gets to keep her $300 million bribe and other States will get a kickback of one degree or another to buy their silence. The President also plans on using this bill to close what he calls a tax loophole in an entirely unrelated clean energy tax credit bill and clearly states that some of the money you good people will be paying for the Healthcare reform bill will be diverted, if needed, to shore up Social Security.

This is nothing less than a nail gun to seal the coffin of private healthcare insurance in this country. Why would the President and Progressive Democrats want to cripple the healthcare system? Because they need to redirect all of the money spent on healthcare in this country into one massive entitlement program just to keep the failed programs of Medicare, Medicaid and Social Security on life support for the next ten or twelve years. This is a shameless attempt to trick the American people into believing that this about healthcare when it is just another attempt to funnel more power and money into the corrupt abyss of Washington.

Paul

Reid pushes for early passage of healthcare bill

Here we go again! Harry Reid is waiting for the CBO score on the new, new, new healthcare bill so he can force this matter to the floor before the Christmas break. I know, Congress calls it the Holiday break but here on the Vigilance Project, Christmas is still Christmas. Mr. Reid’s fear is that not proceeding with the bill now would allow the Senators to face their constituents in a repeat of the summer town hall meetings and that is something he cannot allow.

If this healthcare bill is so damaging to the nation, why then would Reid and Pelosi want it to pass so badly that they would risk what little of their political capital that have left to move it forward? It is still a matter of power. As it stands now, 47% of Americans pay no taxes and some of that 47% actually receive tax money in the form of earned income credits and other public assistance programs. We are dangerously close to tipping that balance and once a minor majority of Americans move from the taxpayer column to the recipient column, there will never be another fair election in this country.

Outspoken Congressional progressives have already admitted that they intend to use the public option to move healthcare from the private sector into a universal government run system much like we see in Canada and England. A victory for the healthcare bill would be a devastating blow to personal freedoms and to the health of the Republic. Universal care will, for the first time in our history, make a majority of Americans dependents of the State and insure the electability of those candidates that promise to keep public money flowing into the Federal entitlement machine.

Medicare was suppose to provide basic health services for those senior citizens that found themselves without care and without the means to pay for care after retirement. Who could argue with that? It was a reasonable plan supported by a compassionate nation. Over the years it became an entitlement program available to anyone over the age of 65, whether you actually needed it or not. Estimates at the time of passage were that Medicare would cost the taxpayers $9 billion dollars a year by 1990 when the actual figure would swell to $65 billion dollars, a 700% miscalculation. Now Medicare has become a sacred cow and any discussion of cuts or means testing the recipients is met with angry mobs of seniors and their advocacy groups.

Social Security was enacted during FDR’s early years in office and promised to offer a safety net to seniors that never had the opportunity to provide for their own retirement. When Social Security was enacted, it was a trust fund. People would contribute to the fund and be able to withdraw an annuity upon retirement. A great idea right? Well, after only three years, Medicare and Medicaid were in serous trouble and the Federal government raided that trust fund to offset the shortages in those programs. Social Security was added as a new line to the Federal budget as another liability for the American taxpayer. In the biggest “double dip” in history, we now have the privilege of continuing our mandatory “contributions” to the Social Security system as well as paying ever-increasing taxes to cover the government’s budget problems wrought by exploding entitlement disbursements.

Social Security has changed too. 40% of recipients are not of retirement age and recent disclosures have shown that even illegal immigrants are drawing from this fund through one abuse or another. The entitlement programs of Medicare, Medicaid and Social Security are rife with fraud and abuse, so much so that even organized crime has found it much easier to defraud the federal government than it is to defraud banks and credit card companies. In fact, the President claims that he can pay for a large part of the healthcare bill by eliminating fraud and abuse. Unfortunately, President Clinton said the same thing back in 1993 during his push for universal healthcare.

In the sixteen years since President Clinton made his healthcare speech identifying the fraud and abuse in the healthcare system, not one bill has passed through Congress to attempt to eliminate the billions of taxpayer dollars lost to Medicare and Medicaid fraud. That leaves two possibilities. Either the Federal government is incapable of combating the fraud in which case, the cost of this legislation is going to balloon the federal deficit and explode the National Debt or the proponents of universal care needed that fraud as a tool to pass a healthcare bill when the power in congress had shifted in which case, those that willingly turned a blind eye to allow the fraud to continue for political purposes should be charged as co-conspirators. No matter what the truth is…are these the people you want to trust with your healthcare?

Curiously enough, members of Congress have no skin in the game. They have the best healthcare plan in history of man. It is free to them and they get to keep it for as long as they live no matter how long they have served in Congress. They will not add language to any of the bills going through Congress that would force them to participate in the same plan that they will force you to take and since their care is provided for them at no charge, they will not be subject to that nasty little 40% tax on “Cadillac” plans proposed in the Baucus bill. If that doesn’t insult you, I don’t know what will.

The bill that is currently under consideration does not lower your healthcare costs. In fact, independent estimates say that premiums for private healthcare insurance will triple under this bill. The same studies say that more than five million jobs will be lost as small business attempts to cope with the new taxes and mandates. Medicare will be cut by five-hundred billion dollars and even though the CBO scored the bill at $1.2 trillion dollars, their past cost evaluations of other spending bills has been historically wrong and has cost taxpayers seven to ten times that amount.

This bill doesn’t do any of the things that experts say would actually result in the healthcare cost savings that is one of the President’s highest goals. Even his primary goal of providing care for the uninsured is not met as this bill still leaves twenty five million people uninsured and they will continue to test the financial stability of our hospitals and clinics.

Over all, this is not a bad bill; it is a rotten bill and the notion that it might not be great but “we have to do something” is an idiotic statement worthy of ridicule. Throwing buckets if gasoline at a burning building is “doing something”…it just doesn’t help the goal of putting the fire out.

Paul