Senator Reid released the Senate’s version of the healthcare reform bill on Wednesday. It is even bigger than the House version, at 2,074 pages. The CBO estimates that it will cost $849 million over 10 years.
The Reid bill does not protect patients or make medical care more affordable. According to Americans for Tax Reform’s Ryan Ellis, the bill actually makes medical care more expensive by raising various taxes. They inlcude:
Individual Mandate Tax (Page 324/Sec. 1501/$8 bil): Starting in 2014, anyone not buying “qualifying” health insurance must pay an income surtax.
Employer Mandate Tax (Page 348/Sec. 1513/$28 bil): If an employer does not offer health coverage, and at least one employee qualifies for a health tax credit, the employer must pay an additional non-deductible tax of $750 for all full-time employees. Applies to all employers with 50 or more employees
More tax implications can be found at ATR
Facts on the bill from Congressional Budget Office (CBO)
Top-Line Facts:
Spending: The cost of the bill is $2.5 trillion over 10 years of full implementation (2014-2023).
Taxes Increases: Taxes will go up $493.6 billion—nearly half a trillion dollars.
Medicare Cuts: Medicare will be cut $464.6 billion—another half a trillion dollars.
Government Plan: The bill includes a government run plan and provides states with the possibility of opting out of participating in that plan. According to CBO, the government run plan “would typically have premiums that were somewhat higher than the average premiums for the private plans in the exchanges.”
Employer Mandate: The bill will impose $28 billion in new taxes on employers that do not provide government approved health plans. These new taxes will ultimately be paid by American workers in the form of reduced wages and lost jobs.
Above from Michael Ostrolenk:
http://www.takebackmedicine.com/thehillshaveeyes/
Download a copy of the bill here:
http://www.aapsonline.org/senatebill.pdf .
A vote on the motion to proceed with the bill may take place on Saturday. The Senate needs 60 yes votes in order to pass the motion to proceed. Republican Senator Tom Coburn, a physician from Oklahoma, is calling for the entire bill to be read on the Senate floor. More details are available in this AP article:
http://news.yahoo.com/s/ap/20091118/ap_on_go_co/us_health_care_overhaul .
Also, an initial analysis of the differences between the House and Senate healthcare bills can be found here:
http://www.npr.org/templates/story/story.php?storyId=120068329
As of today these Senators are UNDECIDED on how to VOTE on SATURDAY. These Senators can make the difference in whether or not this bill passes. Please take the time to call, fax, and email them immediately. The vote is expected around 8pm Saturday evening. We can stop this with your help. They need to hear from all of us! Thanks for what you are doing!
THE MESSAGE SHOULD BE TO VOTE NO ON CLOTURE! TO VOTE NO ON GOVERNMENT RUN HEALTH CARE AND GOVERNMENT MANDATES!
THESE FOUR SENATORS SHOULD BE YOUR FOCUS:
Senator Bill Nelson (NE)
Chief of Staff: Tim Becker
Washington, DC (202) 224-6551 / (202) 228-0012 fax
Lincoln (402) 441-4600 / (402) 476-8753 fax
Omaha (402) 391-3411 / (402) 391-4725 fax
Senator Blanche Lincoln (AR)
Chief of Staff: Elizabeth Burks (elizabeth_burks@lincoln.senate.gov)
Washington, DC (202) 224-4843 / (202) 228-1371 fax
Little Rock (800) 352-9364 / (501) 375-7064 fax
Senator Mary Landrieu (LA)
Chief of Staff: Jane Campbell (jane_campbell@landrieu.senate.gov)
Washington, DC (202) 224-5824 / (202) 224-9735 fax
New Orleans (504) 589-2427 / (504) 589-4023 fax
Baton Rouge (225) 389-0395 / (225) 389-0660 fax
Shreveport (318) 676-3085 / (318) 676-3100 fax
Lake Charles (337) 436-6650 / (337) 439-3762 fax
Senator Mark Warner (VA)
Chief of Staff: Luke Albee (luke_albee@warner.senate.gov)
Washington, DC (202) 224-2023 / (202) 224-6295 fax
Abingdon (276) 628-8158 / (276) 628-1036 fax
Norfolk (757) 441-3079 / (757) 441-6250 fax
Roanoke (540) 857-2676 / (540) 857-2800 fax
Midlothian (804) 739-0247 / (804) 739-3478 fax
p 27 line 5 and following
Quality of health care is apparently being impeoved with “programs” that are potentially irrelevant to outcome. We need access to good drugs and procedures and assistive devices, not the abstract “quality” that is not explicitly defined and is a rationalization for a boondoggle. If everyone works in health care, then there is no unemployment. Also no food or housing.
p 27 line 22 and following
Who defines “best clinical practices”? The drug companies that want to push untested drugs? The insurance companies that want to proclaim systematic negligence of the elderly “good” and save themselves money? Risky!
p 95 line 8 and following
Insurers cannot discriminate based on private accreditations, such as being board-certified or having admitting privileges at a hospital. But they can refuse proviers arbitrarily. This is a setup for the equivalent of expelling “disruptive” physicians from hospitals after a farce of a trial.
p 102 line 1 and following
It looks as if all plans must be ERISA-covered. ERISA itself does not have a protocol for filing forms and being issued an official endorsement of being covered. This is a treasure trove for the lawyers. If the concept is a good one, then the criteria need to be spelled out here, not by reference to something VAGUE.
p 104 line 1 and following
Secretary shall determine the covered services by inquiring of employers, in a survey. It’s easy to pre-survey some employers and use the results of Survey One to choose a sample to do Survey Two, that will be the sample actually used. Results will be biased. Very vulnerable to lobbying and bribery.
p 134 line 3 and following
Rating system, as described, is very subjective and allows official disparagement of disruptive physicians and praise for government flunkies, instead of praise for rule-bending brilliance and hard work with proper demotion of those who follow rules strictly but harm patients in the process.
p 147 lines 22-25 and preceding
Guidelines as to quality to be determined by the Secratary. There is nothing above that suggests other than using resources as with superfluous screening, unnecessarily expensive drugs, etc. I see no effort to remove FDA impediments regarding vitmains and supplements, for example.
p 329 line 24 and following (includes next page)
Religious exemption from insurance. We who do our own preventive care can perhaps join the AAPS Ministry having withstood trial-by-fire f/k/a medical school. Very subject to abuse. No explicit exemption for self-insured preventive services–why not?
p 1278 entire page and following Subtitle B)
We do not need another commission. Activists with all imaginable viewpoints will praise and complain without such expense. A waste of money.
p 659 between lines 5 and 6
A good place to insert wording such as “The Secretary shall be required to arrange for all physicians or similarly qualified examiners to, when performing a medical examination to estblish eligibility for federal funds payable for disability, notify directly or indirectly the driver license registry that has jurisdiction over each examinee who claims or on examination has an impairment that interferes with safe driving. Consent forms that disability claimants sign shall include an explicit provision that driver license registries shall be notified of any relevant impairments and that driver licenses cna be revoked even if disability status is not awarded.” I do disabity examinations and have encountered many disability applicants who claim disability that, if it were real, would make driving dangerous or impossible. Many a malingerer would be deterred, saving millions of dollars annually. Revoking the licenses of genuinely disabled applicants would make our streets safer, too. WHERE IS THIS IN THE BILL? IS EVERY SENATOR STUPID?
p 1001 lines 16-23
As technology improves, expense will increase. What response can there be other than freeze benefits to the technology, drugs, etc. in effect in a specified, base, year and refuse to pay for anything new? Buy a more expensive and more fast car, and the insurable risk goes up and so do the auto insurance premiums. Same for buying a bigger house. Premiums MUST go up as insurable expense goes up due to new and expensive treatments. Only by denying care can premiums be kept steady: the bill needs to specify how.
p 1118 sec 3509 in entirety
Blatant gender discrimination. Men have health problems that women do not: prostate, impotence, etc.
p 1119 lines 4-6
Expert advice will be supplied free of charge by women’s groups, libertarian activists, AAPS, etc. Why pay for someone who might be corrupt?
p 1228 and following, sec 4205
Much ado about calories. No reference to the inefficiecy of digesting and using fat relative to carbohydrate. No reference to conjugated linoleic acid, found in cream and butter (and elsewhere) that helps burn off fat. Same for coconut oil. Counting calories is NOT the whole story regarding weight loss. This section straitjackets the restaurant industry and actually harms the unhappy obese.
p 1240 line 6 and following; entire Subtitle D
Needlessly expensive. Insurers have a motive to reduce cost and can be called on to do the work. This suptitle needs to be replaced with something that rewards insurers for creating a protocol that other insurers use, so as to stimulate research without impoverishing us taxpayers.
p 1786 line 1 and following (entire section 6505)
If health care is less expensive outside the USA, then as we import oil, electronics, etc. we should be able to import health care. If the market speaks and patients are willing to forfeit the possibility of large malpractice awards in exchange for significant savings, then let the market tell its story and make politicians listen. Having a foreign hospital pay for a USA inspector is reasonable; make sure such inspectors are not unjustly expensive.
So what…so a LONG bill is therefore a BAD bill? What kind of ignorance is this?
For the new committees, bureaus, agencies, or whatever, I suggest two names: Welfarites Advocating Stimulating The Economy and Fund Recipients Augmenting Unrepayable Debt. (Watch the acronyms.)
Consider also a reference to the Medically Organized Relying On Nonsense.