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And it has brought us to this trainwreck called ObamaCare and we have bankrupted our kids and grandkids!

We are now headed into the 2014 Election Season and common sense and conservatism are on the rise. Please stand-up and be counted!

Reading Collusion: How the Media Stole the 2012 Election is a great place to start!

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And remember the words of Thomas Jefferson "The strongest reason for the people to retain the right to keep and bear arms is, as a last resort, to protect themselves against tyranny in government." See Video of Suzanna Gratia-Hupp’s Congressional Testimony: What the Second Amendment is REALLY For, below (u-tube HERE).

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Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts

Thursday, May 23, 2013

Obamacare Produces Pain and Chaos by Design

EIB/Rush – Cross-posted at True Health Is True Wealth:

BEGIN TRANSCRIPT

RUSH: Here's Denise in Trenton, Michigan, as we head back to the phones.  Welcome to the Rush Limbaugh program.  Hi.

CALLER:  Hey, Rush.  My question is pretty simple, but I also want to ask, you talked to somebody on Tuesday, it was a guy, I know you'll remember him, he worked two part-time jobs and he had a one-year-old and he talked about how he can't get benefits. And you had told him that you had hope to give him, and you talked about a time where there were people in like their fifties and stuff, and they had to go back and they basically lost their jobs, and they did what they really wanted to do.

RUSH:  Right.

CALLER:  And I just hope he's listening today, 'cause I was on the phone with you on hold saying, "Please take my call so I can tell him."  It was true then, and it's true now.  That's what we're doing.  That's what our family is doing, 'cause of course thanks to Obama and his infinite wisdom, I went through the same thing and lost two of my jobs, and I'm back in school and I'm gonna do what I want to do.  And I just want your guy -- I hope he hears this because anybody can do it, and you are who you are not because of who they let you be, but because of you.  He has to do what you said and follow his passion, because --

RUSH:  That's a good point.  It really is.  Just to recap, I remember the guy.  He was working two jobs because he had been downsized because of Obamacare.  He'd been reduced in both jobs to part-time status, so he'd lost his benefits. Even though with two jobs he had the equivalent of a full-time job, he didn't have any benefits, and health care, particularly, was gone.  He didn't know what he was gonna do.  He was from Asheville, North Carolina, and I told him, "You know, even true today, most of the limitations that people face are self-imposed."  And I asked him, "Are you willing to move to pursue your dream?"  He said, "Yeah." 

Okay, well, that's the big one.  Once you're willing to move you're really over a hump, but if you're not gonna leave Asheville, then you have to realize your potential is dictated by what Asheville has, what there is to do there job-wise, career-wise, or what have you.  But the point that I made that you recounted here that's really worth it, all these guys in the nineties laid off in their middle ages, fifties, white-collar guys, could not get rehired at the salaries that they were earning.  So what they did late in life was start businesses with the things they really loved and always wanted to do but had never done.

BREAK TRANSCRIPT

RUSH: Now, one thing from our last caller.  The caller she was talking about was Andy from Asheville, North Carolina.  This is worth repeating.  He was downsized in two jobs, so he had a full-time workweek with two jobs. So he was part time in two jobs, did not have any benefits as a result. He was been downsized in both jobs because of health care. The companies where he worked converted him to part-time status so that they would not have to provide him health care coverage, and that's common and it's happening with greater frequency and will increase its occurrences as more companies realize what they have to do to be complicit with Obamacare. 

If they want to stay in business they're gonna have to let people go.  If they want to stay in business they're gonna have to convert people to part time.  They're gonna have to reduce their hours and they're gonna have to reduce their benefits.  No, that's not the spirit of Obamacare at all.  In fact, Obamacare officials are shocked and stunned that this is happening.  Actual people in the government can't believe this.  They thought that the health care experience in America would be, as they said, enriched because of Obamacare.  They're just a bunch of political lug heads who accept the flawed premise and promises of liberalism.  And because they're good people and because they've put the program together, it's magically gonna work.  Never does.

(interruption)

I was just asked if they just discount all the articles that point out how it's not being implemented as it was designed.  'Cause it isn't a surprise.  It isn't a surprise that business is doing this.  Everybody that paid any attention, had any smarts at all, knew exactly what businesses were gonna have to do in order to stay in business once this thing started to be implemented.  And so the question is, don't these guys in government -- how do they not know this?  Don't they read these stories?  I don't know.  Maybe they don't read them.  But more likely they do and just discount what they're reading.  They do.  They think it's all right-wing propaganda, no matter where it runs.

All of these forecasts, Obamacare not working, all of these stories of companies downsizing, they just think that's evil business profit-taking.  These people in the government who really thought that Obamacare and even do still think Obamacare is gonna lower costs and expand coverage, and when it doesn't happen, what do they think?  They think that evil CEOs are being greedy and they're just laying people off using the excuse of Obamacare, but all they're doing is hoarding money and building bigger houses for themselves and buying nicer cars while they're firing or laying people off.  That's what they think.  They think that all of this is right wing conspiratorial activity designed to harm Obama.  When they read these stories -- look, try this one.  This is from the Washington Examiner but this is just a repeat of an LA Times story. 

"UnitedHealth, the nation’s largest private insurer, will not participate in California’s Obamacare health exchange, the Los Angeles Times reported Thursday. Health insurance giants Aetna and Cigna will also opt out of Covered California, the state agency charged with implementing Obamacare. All three insurers will still provide health insurance through large employers in the state," but they're not going to participate in the Obamacare exchanges. 

"Kaiser Permanente, the largest health insurer in California, will work with Covered California, as will Anthem Blue Cross and Blue Shield of California. Together, these two companies already control 87 percent of the state’s individual health insurance market. That number will only go up as UnitedHealth, Aetna and Cigna drop out of the individual market entirely. Market consolidation and decreased consumer choice is exactly what some supporters of Obamcare hoped would happen all along."

This is my point.  As UnitedHealth pulls out, as Cigna pulls out, as Aetna pull out, what does that mean?  It means consumers have fewer choices.  That's the design.  The people that really thought about this at the government, the Obamacare people, the people that really put this together with their ultimate aim in mind, intended all of this.  They intended for it to be too big, too unworkable, and too expensive.  They intended for all of these companies, be they businesses or insurance companies, to pull out, to not insure people, they intended this.  That's why the fines for not having insurance in the first couple years are very cheap. 

The fines for not having a policy cost much less than having a policy. They want people to not have the policy. They want people to pay the fine. They want to upset the market and create a mess -- and, then to clean up the mess, they want everybody just to finally say, "You know what? You know what would fix this? Single payer! Just have the government do it. To hell with Aetna, to hell with Cigna, to hell with United Health, to hell with private insurance. Just have the government do it."

That will be the solution.

Video – Obama on Single-Payer Health Insurance

It's not me saying so. Obama said this in 2007 in a speech to the Service Employees International Union. We've played the audio of that speech on this program I don't know how many times where he said to 'em, "I know you want single payer. I want single payer, too. But we can't get there overnight. It's gonna take 10, maybe 15 years. People are going to have  to be slowly conditioned to it and ultimately it's going to have to be the only option available. That's how we'll get it done."

Because people don't want that. Obama knows it. He knew it in 2007; he knows it today. He's governing against the will of the people. People do not want single-payer, government-run health care. They don't want Obamacare. Still, the numbers are 60%. But the people in the regime who believe in this, who think that all of this is the perfect solution to our health care problems, they'll read a story here. They'll read this LA Times story: United Health, Aetna, Cigna pulling out.

They will tell themselves that the people running these companies are just a bunch of greedy Republicans trying to screw Obama. Everything is political to them, and there is no legitimacy in capitalism, and therefore no capitalistic entity is legitimate. They're all cheats, liars. They're all frauds. "Capitalism is unfair. Capitalism is what the 1% use to stay the 1%, and they got to be the 1% by taking everything from everybody else!"

So if you start out from the standpoint that there's nothing legitimate about free markets, if there's nothing legitimate in capitalism, and you read a story like this (and you know how mean and nasty Republicans are), well, you're just gonna assume that the people running these companies are Republicans and hate Obama and they're trying to screw up his grand plan. Then, at some point, they realize what's going on. That's when you get the stories, "Yeah, we really thought it was gonna lower costs!

"We really thought it was going to enrich health care experience for people." The cookie-cutter liberal, the standard operating procedure liberal is really a giant ignoramus. I mean that seriously. They're really ignorant. They are so politically oriented, and they are so arrogant and condescending -- and they have such solid boundaries built around themselves -- that the truth of anything doesn't permeate. The only truth is what they believe and what they think, including all of their biases and all of their prejudices.

Those things are truth. Anything outside their believability system, outside the cocoon, is a conspiracy designed to undercut them or destroy Obama -- or it's just a bunch of right-wing kooks. That's the challenge. That's why there's no working with these people. There isn't any point in bipartisanship. There is no area of commonality. We don't have anything in common with these people. That's why, in my mind, politically they're to be defeated. The problem is we usually do. They are a minority.

We're just being governed by a minority. It's made to look like the majority because of their never-ending media support. I mentioned yesterday that even the union for the people who are going to enforce Obamacare, the IRS, is begging out of it. It's the National Treasury Employees Union, which runs the IRS. That's the union that all IRS workers are members of. They want to be exempted from it. Their job is to make sure you sign up. Their job is to make sure you are assessed a fine if you don't get insurance under the terms of Obamacare.

They want an exemption. That is liberalism for you. They set up two sets of rules: One set for everybody else, and another set for them. They never have to live by the rules that they set up for everybody else. 'Cause they're special! They're better. They're more important. The rules set up for everybody else are to handle "the masses," the bourgeois -- you know, the slow-witted, dim-witted, mindless people that are incapable of taking care of themselves.

So they set up rules for them, and then another set for themselves, and that's how it works. United Health, Aetna, and Cigna opt out of the California Obamacare exchange -- and they're going to continue to offer insurance policies to employers. Eventually what is designed to happen, and therefore will, is that the policies are going to be so much more expensive than what will be found at the exchanges, private insurance will end.

END TRANSCRIPT

Sunday, September 9, 2012

Biden, Obamas tell health care tall tales at Charlotte convention

Barack Obama's father, also named Barack Obama, and mother, Stanley Ann Dunham. (Photo: AP)

Daily Caller:

Vice President Joe Biden, first lady Michelle Obama and President Barack Obama all told a story during the Democratic National Convention about battles the president’s mother waged with health care companies as she fought a terminal illness in 1995. But the version of events presented Thursday night differs dramatically from others, including those of at least two biographers and Obama’s own previous account.

“Barack had to sit at the end of his mom’s hospital bed and watch her fight cancer and insurance companies at the same time,” Biden said.

The first lady added to the story, observing from the podium that “watching your mother die of something that could have been prevented — that’s a tough thing to deal with.”

“When my mother got cancer,” the president echoed during a video played inside the Time Warner Cable Arena before his entrance, ”she wasn’t a wealthy woman and it pretty much drained all her resources.”

But in 2004, the president told the Chicago Sun-Times that he wasn’t present during his mother’s final days at all.

“The biggest mistake I made was not being at my mother’s bedside when she died,” he said then. ”She was in Hawaii in a hospital, and we didn’t know how fast it was going to take, and I didn’t get there in time.”

David Maraniss, who later authored the best-selling book “Barack Obama: The Story,“ wrote in The Washington Post in 2008 that Obama did not visit her.

“He was into his Chicago phase, reshaping himself for his political future, but now was drawn back to Hawaii to say goodbye to his mother,” Maraniss reported. ”Too late, as it turned out. She died on Nov. 7, 1995, before he could get there.”

The story Democratic convention-goers heard in Charlotte, N.C., however, was not intended as a tragic remembrance, but to convey the tragedy of suffering in a hospital without health insurance.

This narrative, too, is contradicted by history: Stanley Ann Dunham, the president’s late mother, did have health insurance to cover her uterine and ovarian cancer, through her job with Development Alternatives Inc. of Bethesda, Md.

“Ann’s compensation for her job in Jakarta had included health insurance, which covered most of the costs of her medical treatment,” according to Dunham’s biographer, New York Times journalist Janny Scott.

“Once she was back in Hawaii, the hospital billed her insurance company directly, leaving Ann to pay only the deductible and any uncovered expenses, which she said, came to several hundred dollars a month.”

Scott also wrote that Dunham’s compensation package for her work in Indonesia included $82,500 — about $132,000 in today’s dollars — plus a housing allowance and a car, making that amount well within her means.

The story told from the podium Thursday in Charlotte has been a persistent refrain from Obama and his surrogates since his presidential candidacy began in 2007. His campaign produced an ad that year for the Iowa caucuses in which Obama claimed his mother was ”more worried about paying her medical bills than getting well.”

“She wasn’t thinking about coming to terms with her own mortality,” he told an audience in Santa Barbara, Calif., during a 2007 campaign swing. “She had been diagnosed just as she was transitioning between jobs. And she wasn’t sure whether insurance was going to cover the medical expenses because they might consider this a pre-existing condition.”

“I remember just being heartbroken,” the future president said then, “seeing her struggle through the paperwork and the medical bills and the insurance forms. So I have seen what it’s like when somebody you love is suffering because of a broken health care system. And it’s wrong. It’s not who we are as a people.”

Cross-Posted at True Health Is True Wealth!!

Related:

Fact Check: First Lady's False Fairy Tale of Struggle

DNC-Backed, $100K-Earning Union Member Hits Romney 

Obama’s Speech Was Too Much of a Humblebrag

Eastwood:  Obama ‘Greatest Hoax Ever Perpetuated’

Thursday, May 17, 2012

Myth Busted: Vaccinations Are Not Immunizations

The facts…

Craig Stellpflug  -  Natural News  -  May 16, 2012 – Cr0ss-Posted at True Health Is True Wealth

There is only one kind of immunity and that is natural immunity which is achieved by battling the infectious diseases itself.

Vaccination is merely the artificial triggering of temporary responses to manmade pathogens. Vaccines are both harmful and dangerous and are leading to generations of humans with no natural defenses to disease.

Vaccines do not provide long-term immunity; only temporary at best. In vaccines, an antigen is injected into the body to produce a reaction and the immune system responds in the form of antibodies, but antibody presence does not confer immunity. People still catch the diseases that they are vaccinated against. Vaccines actually skip the normal immune responses to activate killer cells which can trigger an overproduction of cytokines in response to the toxic vaccine adjuvants and can damage tissues and organs and even stop the heart and block air pathways.

Vaccines should never be called immunizations because that is a misnomer. Immunity and vaccinations are two different subjects altogether. In fact, breast milk is so potent with immune energizing effects in the infant that researchers at the CDC recommend women withhold breastfeeding their children in order to boost the “effectiveness” of childhood vaccines. The paper claims that women should stop breastfeeding long enough for the man-made poison to work on artificial/temporary “immunity.”

There is no such thing as a “side effect”

After-effects of vaccines are only followed for a very short time. Effects that are not seen for 30 years will not even be associated with the vaccine. Immunizations are contributing to the lowering of immunity along with the spread of auto-immune diseases such as arthritis and even AIDS throughout the world. Research clearly shows that aluminum mixed into vaccines carries a risk for autoimmunity, long-term brain inflammation, and subsequent neurological complications and may have profound and widespread adverse health complications. Many vaccines contain both aluminum and trace amounts of mercury. When you mix these 2 metals together it causes Extreme Synergistic Toxicity.

The facts:

As vaccinated disease rates go down (but not necessarily as a result of toxic vaccinations), the rate of chronic disease goes up in lock-step. Vaccines, as they are commonly given, destroy the natural immunity process and accelerate the auto-immune disease process.

Deaths from measles in 1900 were 13 per 100,000 people. In 1948: less than one. Measles vaccines introduced in 1963 but took full credit for what they never did – eliminate measles. Japanese health authorities realized that early inoculations were causing crib deaths so they postponed them until the 24th month and SIDS virtually disappeared along with whooping cough (pertussis) during the first two years of babies’ lives. Instead of preventing whooping cough the DPT promotes it as well as SIDS. Reuters recently reports that according to the CDC, the number of pertussis cases is growing – in the fully vaccinated population!

The recent Bachmair vaccine study reveals that the allergy rate in vaccinated children is more than double the rate in unvaccinated ones. Vaccinated children are also nearly eight times more prone to develop asthma or chronic bronchitis than unvaccinated. Furthermore, vaccinated kiddos suffer from more neurodermatitis, herpes, otitis media, hay fever, hyperactivity, scoliosis, epilepsy and seizures, migraine headaches, thyroid disease, and SIDS than unvaccinated children. Vaccinated kids historically also have more measles than unvaccinated kids.

Doctor after doctor will tell you that vaccinations have reduced the incidence of many infectious diseases but they have no real proof. In fact, all the epidemical evidence shows that disease rates rise after vaccines – in the vaccinated population. Should we trust them just on their word? Make an informed decision about you and your child’s health.

Sources for this article include:
http://www.ncbi.nlm.nih.gov/pubmed/20442687
Tomljenovic L and Shaw CA. Aluminum vaccine adjuvants: Are they Safe? Current Medicinal Chemistry. 2011; 18: 2630-2637.
http://www.flcv.com/hgsynerg.html

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Tuesday, June 9, 2009

Understanding the House Democrats’ health care bill

Posted Tuesday, June 9th, 2009, at 10:30 am

Yesterday I posted and described the draft Kennedy-Dodd health care bill. Today I would like to do the same for an outline produced by House Democrats.

Here is a three-page outline of “Key Features of the Tri-Committee Health Reform Draft Proposal in the House of Representatives,” dated yesterday (June 8, 2009).

The three committees are:

  • The House Ways & Means Committee, chaired by Rep. Charlie Rangel (D-NY). The Health Subcommittee is chaired by Rep. Pete Stark (D-CA).
  • The House Energy & Commerce Committee, chaired by Rep. Henry Waxman (D-CA). The Health Subcommittee is chaired by Rep. Frank Pallone, Jr. (D-NJ).
  • The House Committee on Education & Labor, chaired by Rep. George Miller (D-CA). The Health, Employment, Labor and Pensions Subcommittee is chaired by Rep. Robert Andrews (D-NJ).

The document suggests this is a joint product of the three committees and/or their subcommittees. My sense, however, is that it is Speaker Pelosi who is driving the bus. This is in contrast to the Senate, where the committee chairmen (Kennedy/Dodd and Baucus) appear to have the pen, in less well-coordinated efforts.

Kennedy-Dodd and the House bill outline are remarkably similar. Whether this represents House-Senate coordination or parallel thought processes is unclear.

I think the easiest way for me to present the House bill outline is in comparison with the Kennedy-Dodd bill. So here my description from yesterday of the Kennedy-Dodd bill, with today’s comparison to the House bill outline in red. I hope it’s comprehensible and useful this way. If you read yesterday’s post, you can skim the text in black and focus on the new text in blue.

Here are 15 things to know about the draft Kennedy-Dodd health bill and the House bill outline.

  1. The Kennedy-Dodd bill would create an individual mandate requiring you to buy a “qualified” health insurance plan, as defined by the government. If you don’t have “qualified” health insurance for a given month, you will pay a new Federal tax. Incredibly, the amount and structure of this new tax is left to the discretion of the Secretaries of Treasury and Health and Human Services (HHS), whose only guidance is “to establish the minimum practicable amount that can accomplish the goal of enhancing participation in qualifying coverage (as so defined).” The new Medical Advisory Council (see #3D) could exempt classes of people from this new tax. To avoid this tax, you would have to report your health insurance information for each month of the prior year to the Secretary of HHS, along with “any such other information as the Secretary may prescribe.”

    The House bill also contains an individual mandate. The outline is less specific but parallel: “Once market reforms and affordability credits are in effect to ensure access and affordability, individuals are responsible for having health insurance with an exception in cases of hardship.”

  2. The Kennedy-Dodd bill would also create an employer mandate. Employers would have to offer insurance to their employees. Employers would have to pay at least a certain percentage (TBD) of the premium, and at least a certain dollar amount (TBD). Any employer that did not would pay a new tax. Again, the amount and structure of the tax is left to the discretion of the Secretaries of Treasury and HHS. Small employers (TBD) would be exempt.

    The House bill outline also contains an employer mandate that appears to parallel that in Kennedy-Dodd: “Employers choose between providing coverage for their workers or contributing funds on behalf of their uncovered workers.”

  3. In the Kennedy-Dodd bill, the government would define a qualified plan:
    1. All health insurance would be required to have guaranteed issue and renewal, modified community rating, no exclusions for pre-existing conditions, no lifetime or annual limits on benefits, and family policies would have to cover “children” up to age 26.

      The House bill outline is consistent with but less specific than the Kennedy-Dodd legislative language. The House bill outline would “prohibit insurers from excluding pre-existing conditions or engaging in other discriminatory practices.” I will keep my eye on what “other discriminatory practices” means in the legislative language. Does that mean that a health plan cannot charge higher premiums to smokers?

      Like the Kennedy/Dodd bill, the House bill outline would preclude health plans from imposing lifetime or annual limits on benefits: “Caps total out-of-pocket spending in all new policies to prevent bankruptcies from medical expenses.” This would raise premiums for new policies.

      The House bill outline “introduces administrative simplification and standardization to reduce administrative costs across all plans and providers.” I don’t know what this means, but suggest keeping an eye on it.

    2. A qualified plan would have to meet one of three levels of standardized cost-sharing defined by the government, “gold, silver, and bronze.” Details TBD.

      Same: “… by creating various levels of standardized benefits and cost-sharing arrangements…”. It also contains this addition relative to Kennedy-Dodd: “… with additional benefits available in higher-cost plans.”

      But note the “various levels of standardized benefits.” This appears to be more expansive government control of health plan design than in the Kennedy-Dodd draft.

    3. Plans would be required to cover a list of preventive services approved by the Federal government.

      This is unspecified in the House bill outline. We’ll have to wait to see legislative language. The House bill would require plans to “waive cost-sharing for preventive services in benefit packages.”

    4. A qualified plan would have to cover “essential health benefits,” as defined by a new Medical Advisory Council (MAC), appointed by the Secretary of Health and Human Services. The MAC would determine what items and services are “essential benefits.” The MAC would have to include items and services in at least the following categories: ambulatory patient services, emergency services, hospitalization, maternity and new born care, medical and surgical, mental health, prescription drugs, rehab and lab services, preventive/wellness services, pediatric services, and anything else the MAC thought appropriate.

      This appears parallel but is less specific for now: “Independent public/private advisory committee recommends benefit packages based on standards set in statute.” I find the “standards set in statute” interesting. It suggests that provider and disease interest groups will have two fora in which to lobby for their benefits to be mandated: Congress, and the advisory committee.

    5. The MAC would also define what “affordable and available coverage” is for different income levels, affecting who has to pay the tax if they don’t buy health insurance. The MAC’s rules would go into effect unless Congress passed a joint resolution (under a fast-track process) to turn them off.

      The House bill outline is silent on this.

  4. Health insurance plans could not charge higher premiums for risky behaviors: “Such rate shall not vary by health status-related factors, … or any other factor not described in paragraph (1).” Smokers, drinkers, drug users, and those in terrible physical shape would all have their premiums subsidized by the healthy.

    The House bill outline says it would “prohibit plans [from] rating (charging higher premiums) based on gender, health status, or occupation and strictly limits premium variation based on age.” If the bill were to provide nothing more, this would appear to parallel the Senate bill and preclude plans from charging higher premiums for risky behaviors.

  5. Guaranteed issue and renewal combined with modified community rating would dramatically increase premiums for the overwhelming majority of those Americans who now have private health insurance. New Jersey is the best example of health insurance mandates gone wild. In the name of protecting their citizens, premiums are extremely high to cover the cross-subsidization of those who are uninsurable.

    The House bill outline is silent on guaranteed issue and renewal. I’m going to make an educated guess that the bill includes these provisions as part of “other discriminatory practices,” and they have just left them out of the outline. Given the philosophy behind this outline (with which I disagree), it would be a striking omission. But for now, the outline says nothing specific on these topics.

  6. The bill would expand Medicaid to cover everyone up to 150% of poverty, with the Federal government paying all incremental costs (no State share). This means adding childless adults with income below 150% of the poverty line.

    The House bill outline “expands Medicaid for the most vulnerable, low-income populations,” so we have no specifics other than that there’s an expansion. I cannot tell if this is expanding eligibility or benefits. The outline also “improves payment rates to enhance access to primary care under Medicaid.” I assume this means the bill would expand the Federal share paid of each dollar spent by a State Medicaid program on primary care, rather than the Federal government actually mandating specific payment rates to be implemented by States. Federal micromanagement of specific Medicaid provider payment rates was eliminated in the mid 1990’s.

  7. People from 150% of poverty up to 500% (!!) would get their health insurance subsidized (on a sliding scale). If this were in effect in 2009, a family of four with income of $110,000 would get a small subsidy. The bill does not indicate the source of funds to finance these subsidies.

    The House bill outline has a sliding scale up to 400% of poverty. If this were in effect in 2009, a family of four with income of $88,000 would get small subsidy.

  8. People in high cost areas (e.g., New York City, Boston, South Florida, Chicago, Los Angeles) would get much bigger subsidies than those in low cost areas (e.g., much of the rest of the country, especially in rural areas). The subsidies are calculated as a percentage of the “reference premium,” which is determined based on the cost of plans sold in that particular geographic area.

    The House bill outline is not specific on this point. I would not expect it to be – this is something you can tell only from legislative language.

  9. There would be a “public plan option” of health insurance offered by the federal government. In this new government health plan, the federal government would pay health care providers Medicare rates + 10%. The +10% is clearly intended to attract short-term legislative support from medical providers. I hope they are not so naive that they think that differential would last.

    The House bill outline “creates a new public health insurance within the Exchange … the public health insurance option competes on ‘level field’ with private insurers in the Exchange.” There are no specifics on how the public plan would work, or on provider payment rates.

  10. Group health plans with 250 or fewer members would be prohibited from self-insuring. ERISA would only be for big businesses.

    The House bill outline is silent on this point.

  11. States would have to set up “gateways” (health insurance exchanges) to market only qualified health insurance plans. If they don’t, the Feds will set up a gateway for them.

    The House calls it an Exchange rather than a Gateway. While the Senate bill would tell each State, “Create a Gateway or we’ll create one for you,” the House bill outline says to each State, “We’re creating a single new national Exchange. You’re in it unless you develop your own State or Regional Exchange.”

  12. Health insurance plans in existence before the law would not have to meet the new insurance standards. This creates a weird bifurcated system and means you would (probably) be subject to a different set of rules when you change jobs.

    The House bill outline appears to parallel the Kennedy-Dodd draft: “Phases-in requirements to benefit and quality standards for employer plans.” This means that new plans will be more expensive than old plans. It also means they’re creating a bifurcated system with all sorts of perverse unintended consequences for employment flexibility.

  13. The bill does not specify what spending will be cut or what taxes will be raised to pay for the increased spending. That is presumably for the Finance Committee to determine, since it’s their jurisdiction.

    The House bill outline lists specific topics for changes to Medicare reimbursement:

    • Changing (how?) the Medicare reimbursement for doctors, called the “Sustainable Growth Rate” (SGR).
    • “Increasing reimbursement for primary care providers”
    • “Improving” the Medicare drug program. I won’t be surprised if, when I see the specifics, I disagree that their changes are “improvements.” In the past this has meant having the federal government mandate specific prices for drugs.
    • Cutting payments to Medicare Advantage plans.
    • Expanding low-income subsidies for seniors and eliminating cost-sharing for all preventive services in Medicare.

    The House bill outline also uses positive language to describe things that might generate budgetary savings from Medicare and/or Medicaid. The hospital readmissions point is specific. The first two points could increase or decrease federal spending, depending on the specifics.

    • “Use federal health programs … to reward high quality, efficient care, and reduce disparities.”
    • “Adopt innovative payment approaches and promote[s] better coordinated care in Medicare and the new public option through programs such as accountable care organizations.”
    • “Attack the high rate of cost growth to generate savings for reform and fiscal sustainability, including a program in Medicare to reduce preventable hospital readmissions.”
  14. The bill defines an “eligible individual” as “a citizen or national of the United States or an alien lawfully admitted to the United States for permanent residence or an alien lawfully present in the United States.”

    The House bill outline is silent on this point.

  15. The bill would create a new pot of money for state gateways to pay “navigators” to educate people about the new bill, distribute information about health plans, and help people enroll. Navigators receiving federal funds “may include … unions, …”

    The House bill outline is silent on this point.

This would have severe effects on the more than 100 million Americans who have private health insurance today:

  • The government would mandate not only that you must buy health insurance, but what health insurance counts as “qualifying.”
  • Health insurance premiums would rise as a result of the law, meaning lower wages.
  • A government-appointed board would determine what items and services are “essential benefits” that your qualifying plan must cover.
  • You would find a tremendous new disincentive to switch jobs, because your new health insurance may be subject to the new rules and would therefore be significantly more expensive.
  • Those who keep themselves healthy would be subsidizing premiums for those with risky or unhealthy behaviors.
  • Far more than half of all Americans would be eligible for subsidies, but we have not yet been told who would pay the bill.
  • The Secretaries of Treasury and HHS would have unlimited discretion to impose new taxes on individuals and employers who do not comply with the new mandates. (The House bill outline is not specific on this point.)
  • The Secretary of HHS could mandate that you provide him or her with “any such other information as [he/she] may prescribe.” (The House bill outline is not specific on this point.)

I strongly oppose the Kennedy-Dodd bill and the House Tri-Committee bill.

If this topic interests you, I highly recommend Jim Capretta’s blog Diagnosis.

Source: Keith Hennessey.com /Daily Thought Pad

Posted: Knowledge Creates Power

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