Transparency having become an early casualty in the process of driving through “health care reform” despite rising opposition, the Senate Finance Committee chaired by Max Baucus (D-MT) is marking up a shell bill, a 200+ page outline.
Some think the strategy is to take the product, merge it with the product of the Senate Health, Labor & Pensions (HELP) Committee, and tack it on as an amendment to a bill imposing a tax on certain recipients of bailout funds. Conceivably, the transformational change of one-sixth of the economy could be enacted in two weeks (The Foundry, Heritage Foundation 9/22/09). Then the bureaucrats could set to work on the 100,000+ pages of regulations.
Senator Baucus called the proposal “one of the largest pieces of social legislation since the Depression.”
The individual mandate would force every American to buy approved insurance, or face an IRS-enforced penalty of up to $3,800 per family, writes Linda Halderman, M.D. (American Thinker 9/17/09). Or perhaps it would be only $1,900, since the Committee accepted amendments by Sen. Schumer (D-NY) and Sen. Snowe (R-ME).
Baucus proposed a new payroll tax of $400 per worker not provided with generous health benefits. Along with a 35% tax on too-generous health coverage exceeding $8,000 per year, with the $8,000 limit to include flexible savings accounts (cafeteria plans).
His $856 billion proposal would protect Medicare, Baucus said at a press conference. Then he said that financing would come partly from eliminating Medicare Advantage payments, noted Dr. Halderman.
Baucus had urged the Centers for Medicare and Medicaid Services (CMS) to look into “scare tactics” by Humana, which was informing its beneficiaries that they could lose their Medicare Advantage benefits. The Wall Street Journal called it “bullying tactics,” America’s Health Insurance Plans called the CMS action a “gag order,” and even AARP called it a “selective and inappropriate use of its regulatory powers” (NY Times 9/22/09).
The Humana mailing was “misleading and confusing to beneficiaries, who may believe that it represents official information about the Medicare Advantage program,” said Jonathan Blum, acting director of a CMS regulatory office, and former senior aide to Sen. Baucus. CMS is not investigating AARP for its political advocacy. On its website, AARP states as “fact” that “none of the health care reform proposals being considered by Congress will cut Medicare benefits or increase your out of pocket costs” (Wall St J 9/24/09)
The Baucus bill was stripped of a few of the most contentious elements in an effort to attract Republican support: the “public option,” an employer mandate, and Medicare payments for counseling seniors about “end-of life care.” The Congressional Budget Office (CBO) estimated a 10-year cost of $774 billion, and estimated it would cover 94% of “Americans” by 2019, leaving 25 million people—one-third of them illegal aliens—without coverage., writes John Iglehart (N Engl J Med 9/24/09).
Lacking initial support, it is proceeding along “the sort of winding path often followed by major legislative initiatives,” writes Iglehart.
Initial CBO analysis says the Baucus bill would not add to the deficit because its costs would be covered by a tax on “Cadillac” insurance plans, a slowing of the growth of Medicare and Medicaid payments to nonphysicians, and new fees on clinical laboratories and medical-device manufacturers.
Insurers would be required to cover everyone without discrimination on the basis of health status or caps on annual or lifetime coverage.
John Goodman notes the following effects in an article entitled “Baucus Declares War on the Middle Class”:
- The threshold for the 35% excise tax on “Cadillac” insurance is indexed to the consumer price index (CPI), not the medical price index (MPI), which grows three times as fast. Eventually, all insurance will exceed the cap and be taxed.
- “Credible” employer coverage might cost $13,000 for a family. The maximum the employee can be required to pay is 13% of income, or $6,500 if income is $50,000. The employer must pay the rest (out of reduced wages). The full cost that must be paid by workers, either in premiums or reduced wages, after adjusting for taxes, amounts to 26% of his income.
- If the worker qualifies for Medicaid, the employer faces no increased costs. Thus, there is an incentive to hire the poor, and not to hire the middle class.
- Millions of families will be forced to move from private plans, which provide a broad choice of physicians, to Medicaid and S-CHIP plans with much more limited access.
David McKalip, M.D., notes the following effects on physicians, from the version of the bill available to him:
- Capitation will become the dominant mode of payment.
- Doctors would have to be a “Medicare-enrolled physician” to order services that would result in any cost to the Medicare program.
- Doctors will be penalized for going over budget, and no statistically valid samples will be used. At the same time, the cost of procedures and devices they order will be driven up by taxes.
- Doctors will be made to pay $350 each into a fund to pay for “screening” programs to cover unannounced and random site visits to check for “waste, fraud, and abuse.” Doctors may be prevented from practicing in a “fraud-prone” specialty, or required to put up a $500,000 surety bond.
- Medicare funds are redistributed from specialists to primary-care physicians.
Estimates of the effects of “health care reform” bills ignore the effects of other pending legislation, such as the Waxman “cap and trade” bill. Higher unemployment caused by this bill would increase the number of uninsured. The Kaiser Family Foundation estimates that for every percentage point increase in unemployment (the loss of 1.54 million jobs), the number without health insurance rises by 1.1 million. Using projected job loss figures from Heritage, this could mean more than 820,000 losing their health insurance annually. New health problems are also highly correlated with job loss—including hypertension, heart disease, diabetes, alcohol-related problems, and low birth-weight babies (National Center for Public Policy Research, September 2009).
Although Democrats may be staking everything on passage, Iglehart notes: “The reform effort could be derailed at any point along this treacherous path, and the future of Obama’s presidency could hinge on the outcome.
Additional information:
This Baucus Bill apparently is not going to be available for reading by the American Public, which is a sure sign of its incompetence and immorality.
What do the Senators fear by preventing a read? In short, they fear rejection.
Just as the public, once they read House Bill 3200, rejected that piece of legislation, which was better suited for the National Socialists in the 1930’s than Americans in the 2000’s, so, too, I believe they will reject the Baucus Bill from what I have read about its principles.
For those who believe in Americanism, in the principle of Individual Rights, limited government to protect those rights, and its logical result, capitalism, we should proudly uphold freedom and the free market. Instead we witness attempts to shackle Americans, infringe their rights, and ultimately, in the name of “brother love” and the “poor”, medicine is stifled, limited, and less available for the very persons the government claims to care about.
The Welfare State, whether in matters of housing, food, clothing, or medicine, is a miserable failure, and it is immoral, both in principle and in its practical outcome, resulting in making more people homeless, starving, in rags, and in need of medical care, all the while politicians are skimming the profits from the hides of any productive person in this country to fund a government orgy of altruism.
Any person of self-esteem should say NO to this kind of corruption; what we need is not to replace the Liberal version of the Welfare State with more corruption of the Republican version of the Welfare State; rather, we need to discover that capitalism, when practiced with a proper government in place, is the great benefactor of Mankind and that medical care will take care of itself in such a system by people paying for the services or by using voluntary charity to pay for the services.
We do not need a Welfare State—at all.
Tell this to all of your friends, and even to your Senators and Representatives.
Mark A. Hurt, MD
Another major insult in the Baucus bill is the absence of exemptions for licensed physicians. We are partially self-insured as are our families; for we tend to do all preventive work and some therapeutic work also, without getting paid for it. Despite our self-care, we must buy insurance or pay a penalty. Apparently, our ability to take care of our loved ones is unimportant to these family-hating liberals.
These is a striking absence of direct health-care cost control in these politically oriented cost-control measures. Anyone familar with nutritional medicine can give numerous examples of how to bypass the cost of various drugs with ordinary foods or low-cost supplements. Upset at the loss of access to thyroid extract, I asked a farmer about buying thyroid glands from the slaughterhouse. Vitamin C promotes healing, and it can be added to IV fluids for post-operative patients without much trouble. Finally, there is some old but good research on FDA-banned intravenous hydrogen peroxide, as for infections and respiratory failure. And the list goes on and on.
If a federal bill does not include dismantling the FDA or otherwise encouraging, or at least permitting worry-free, the prescription and adminstration of such remedies, then we should infer that those who write it and vote for it are more interested in our destruction than in the citizens’ good health at low cost.
Once again the government is meddling with individual rights. Forcing people to buy health insurance is unconstitutional. Of course, the people in Washington are pushing this health care package through for your own good. And those whose sense of self reliance has been damaged will rush to embrace it. There are other much more practical and sensible reforms that could be passed but here they go again with their freedom peddling. As Goethe once said: ” What’s the hardest thing of all? That which seems the easiest. For your eyes to see that which lies before your eyes”
The fact that governments force citizens (and those who are not but within their jurisdiction, or the reach of it) to do all sorts of things is nothing new. Being compelled to “buy insurance” is done by various (if not all) US states when it comes to automobiles. The choice is not to drive at all on the public (government) roads or risk fine/vehicle confiscation/imprisonment if caught by law enforcement agencies. So the recent move to enact legislation that requires the purchase of “health insurance” is along the same government “reasoning”.
While very many USers will claim that this compelling of citizens is “unconstitutional”, and therefore should not happen, the problem is that the US Constitution is full of holes, inconsistencies and inadequacies. Probably the most common justification for regulations that are used to compel an individual to act against his/her (hir) own judgment of what is in hir best interest, is in the Preamble itself:
“We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.”
“[P]romot[ing] the general welfare” leaves the door open for government to do almost anything – and that is just what has happened from almost before the ink was dry on the last state ratification for the US Constitution. In actuality there is no such thing as “the general welfare” since each person is an individual with hir own values; humans are not hive animals like bees and ants. But that fact has not stopped the US federal government, nor other governments – even those without such phrasings in their laws.
Therefore “upholding the Constitution”, as is often the claim for solution, is actually problematic – because the Constitution itself contains within it the seeds of its own deterioration and destruction, the results of which are all around us. Do not get me wrong. The US Constitution was a remarkable document when it was created and the best that the learned (and they were) men of that time could produce to organize an orderly society. They did not have the knowledge and technology that has become available mostly in the past 25 to 30 years. The Internet itself by which these exchanges of information and views are taking place is one of the major ones. Understanding of human neurophysiology is another. I wrote on this very subject of returning to the Constitution over 6 years ago, “Return To The Constitution??!” – http://selfsip.org/focus/returntoconstitution.html
Thomas Jefferson explained this phrase as follows:
“They are not to do anything they please to provide for the general welfare, but only to lay taxes for that purpose. To consider the latter phrase not as describing the purpose of the first, but as giving a distinct and independent power to do any act they please which might be for the good of the Union, would render all the preceding and subsequent enumerations of power completely useless. It would reduce the whole instrument to a single phrase, that of instituting a Congress with power to do whatever would be for the good of the United States; and, as they would be the sole judges of the good or evil, it would be also a power to do whatever evil they please… Certainly no such universal power was meant to be given them. It was intended to lace them up straitly within the enumerated powers and those without which, as means, these powers could not be carried into effect.” –Thomas Jefferson: Opinion on National Bank, 1791. ME 3:148
and
“Our tenet ever was… that Congress had not unlimited powers to provide for the general welfare, but were restrained to those specifically enumerated, and that, as it was never meant that they should provide for that welfare but by the exercise of the enumerated powers, so it could not have been meant they should raise money for purposes which the enumeration did not place under their action; consequently, that the specification of powers is a limitation of the purposes for which they may raise money.” –Thomas Jefferson to Albert Gallatin, 1817. ME 15:133
The fact is that EVIL MEN can take ANY written document and distort it for their own selfish gain. The Constitution provided for checks and balances to prevent distortions of it’s words. However, we have a majority of evil men “in power” such as the United States has never had in its history. Wake up America – because we are being “taken over without a shot being fired!”
To the “general welfare” clause in the Constitution, one can make an argument foolproof, but one cannot make it damn-foolproof. The damn-fools in the Congress have proven me right, once again.
Mark A. Hurt, MD
Thomas Jefferson’s understanding and explanations of the US Constitution “general welfare” clause (reasonable as they may appear) are not part of that document. In fact disagreements on what that clause means – on what Congress is allowed to do – dates at least back to Hamilton and Madison, both writing in the Federalist Papers. While the latter was much like Jefferson in his contentions that the powers of appropriation and taxation of the (still) proposed government should be regarded merely as self-support for its defined powers, Hamilton took a much broader view. From the very early date of 1792, appropriations for subsidies and “internal improvements” have been a part of Congressional legislation; only the pace has quickened, the purposes broadened and the amounts spent (via taxes of course) vastly increased.
Contrary to the view of some (possibly many) opposed to government control of the health industry, I do not think that the vast majority of US citizens who want government provided health “insurance” are “evil”. These ordinary citizens simply and very wrongly have concluded that everyone should have the same level of medical/health care as everyone else *and* that the only way for medical/health care to be equally accessible to everyone is for government to make and enforce regulations (using tax money of course) to ensure that this comes about. These individuals are quite willing to be taxed at some level (?how high?) and maybe even have some of their choices limited (?which ones? to what degree?) in order that everyone have this “health coverage”. These are people who sincerely think that government is necessary to produce not only an orderly society but one that will ensure “safety nets” for those “less fortunate”, whether on an emergency or long-term basis.
As for politicians, I concluded some time ago that the vast majority of them are power-seekers, though many of them likely did not start out that way, if their introduction to politics was at the very local level. In that case they likely viewed themselves as just better at “seeing what needs to be done” and fond of socializing. However, within one term in office at the county or state level they likely found it pleasurable when large numbers of people sought them out for favors (lobbied for desired legislation/regulations) and enjoyed the lavish praise (with favors returned) for “taking care” of their constituents. Definitely at the federal level the intoxication of power backed by physical force – the operational necessity of government – is an enormous driver for more of the same. The system attracts those who want power and rewards them with countless opportunities to use it; just getting on the ballot as a federal candidate for either of the two main parties calls for a lot of power playing – for this reason a starry-eyed well-intentioned, honest candidate rarely will make it. In turn, politicians encourage the notion among their constituents that government is the solution to problems (even if originated by previous government actions) is just one step from the idea held by most that having an orderly society necessitates a government.
The essence of the problem is not that “evil men” (or even “damn-fools”) have distorted and subverted a fine document into a tool for their own aggrandizement. Rather the US Constitution, which has been used to promote and carry out large amounts of harm during its 220+ years of existence, and any government produced by it, is fatally flawed because of its internal contradictions and lack of a correct philosophical basis derived from the essential nature of humans in reality. For a detailed critique of the Constitution Preamble and Bill of Rights – http://selfsip.org/critiques/billofrights.html
Bottom line: it is the system – government, whether here in the US or elsewhere (at least in the industrialized world) – that is the problem and this is what needs to be understood.
Kitty’s critique points out a glaring fault of the constitution, maybe a couple (and this is just something that occurred to me while reading said critique). First, it occurred to me that the framers of the constitution assumed that Common Sence would always be with us and would always prevail. We in the 21st century know that, especially on Capitol Hill and in the main stream media, Common Sence is Dead. Second, Term Limits for members of Congress would do a world of good towards stopping the power trip that these people have. A side note: we are so free today that we cannot even recognize treason against the United States: or is it that we have to be “politically correct” and ignore the elephant in the room?
I am afraid we might be too late. But my husband and I have organized a Health Care Forum at the Sacramento Doubletree ballroom seats 700 from 7-9 on monday October 12th. Confirmed 6 Physician speakers and several policy experts. Theme: What’s right? What’s wrong? Dispel the myths. Encouraging healthcare professionals and concerned citizens to attend.
Jamie Skaff
(916) 941-1740
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