One year later, the US Gulf Coast remains held hostage by the President of the United States, Barack H. Obama.
While vacationing with his family in Brazil, POTUS gave Brazil money to develop their oil drilling while also allowing them to have undersea oil storage in the Gulf of Mexico.
What about American oil production? Why does he continue to block drilling by American oil companies in the Gulf Coast? Does it have anything to do with the fact that all the Gulf Coast states are Red States?
Is Mr. Obama practicing reparations to help Brazil while stifling economic development in the US?
America, wake up! Speak up! Ask the tough questions before it's too late!
Saturday, March 26, 2011
Tuesday, May 25, 2010
The Gulf Coast Held Hostage: 37 Days
Apparently the Obama Administration is revealing its very thin skin to any criticism. Does that really surprise anyone? What Narcissist doesn't have thin skin?
Trying to maintain the appearance of being in control is becoming an unraveling facade, and it is FINALLY becoming evident to more Americans that the current President of the United States is a fraud and void in leadership.
37 Days and Counting: the Gulf Coast is held Hostage by its own President who only knows how to play partisan politics. Isn't is strange to anyone that all the Gulf Coast states are governed by Republican governors? Yet the President refuses to respond to pleas to build sand bars and barriers to stop the oil from coming on shore. If these were states governed by Democrats, you better believe the US government would have responded pronto!
Isn't it somewhat appalling that Mr. Obama did not go to Nashville when they experienced the worst flooding in that area in 500 years? Was it because TN did not go for Obama in 2008?
Then there is the immigration issue with Arizona: no cabinet member nor the President has READ the Arizona Immigration Bill--all 12 pages; yet they criticize, impugn, and malign Arizona and ignore requests for talks by the Republican governor of Arizona.
Pretty soon we can start saying: America Held Hostage by its own President!
Trying to maintain the appearance of being in control is becoming an unraveling facade, and it is FINALLY becoming evident to more Americans that the current President of the United States is a fraud and void in leadership.
37 Days and Counting: the Gulf Coast is held Hostage by its own President who only knows how to play partisan politics. Isn't is strange to anyone that all the Gulf Coast states are governed by Republican governors? Yet the President refuses to respond to pleas to build sand bars and barriers to stop the oil from coming on shore. If these were states governed by Democrats, you better believe the US government would have responded pronto!
Isn't it somewhat appalling that Mr. Obama did not go to Nashville when they experienced the worst flooding in that area in 500 years? Was it because TN did not go for Obama in 2008?
Then there is the immigration issue with Arizona: no cabinet member nor the President has READ the Arizona Immigration Bill--all 12 pages; yet they criticize, impugn, and malign Arizona and ignore requests for talks by the Republican governor of Arizona.
Pretty soon we can start saying: America Held Hostage by its own President!
Monday, January 25, 2010
The Shot Heard 'Round the World
Scott Brown's phenominal victory in the Massachusett's senate race was the unbelievable shot heard 'round the world. The only place the resounding message did not seem to resonate was 1600 Pennsylvania Avenue.
Last week the President took to the political stump to defend his failed policies and stubbornly cling to his same old litany as well as his blaming everything on George W. Bush. At some point will the President stand up, man up, and assume responsibility or will we continue to hear this crying and whimpering from Obama through 2012?
Really, it is starting to become so predictable, so pathetic to hear a US President blame everyone else. At some point the duped and drugged media will wake up and realize they've been played like a Stradivarius by a crafty and cunning White House that is transparently loyal to the euphemism of politics of the absurd.
The Republicans have ideas about healthcare, but Obama does NOT want to hear them. Obama is following down the partisan path of destruction of this nation to the point that he is making James Earl Carter look like he did an OK job as President.
Last week the President took to the political stump to defend his failed policies and stubbornly cling to his same old litany as well as his blaming everything on George W. Bush. At some point will the President stand up, man up, and assume responsibility or will we continue to hear this crying and whimpering from Obama through 2012?
Really, it is starting to become so predictable, so pathetic to hear a US President blame everyone else. At some point the duped and drugged media will wake up and realize they've been played like a Stradivarius by a crafty and cunning White House that is transparently loyal to the euphemism of politics of the absurd.
The Republicans have ideas about healthcare, but Obama does NOT want to hear them. Obama is following down the partisan path of destruction of this nation to the point that he is making James Earl Carter look like he did an OK job as President.
Thursday, September 10, 2009
The Silent Synecdoche, Regurgitation, and 'Just Words'
Mr. Obama's 2nd State of the Union proved again his love for rhetoric and caveats. Short on details and substance, contrite with those who oppose his ideological views, Mr. Obama once again left us unconvinced that he is truly concerned with the escalating deficit, which is now exponentially out of control.
The Devil is in the details, and Mr. Obama cleverly left out the agonizing details of how restrictions and limitations on insurance companies and the private sector would reduce their services, cut jobs, and in the short term eliminate private sector healthcare plans. The CBO has estimated that if the private sector healthcare folds and insurance companies fold it would amount to approximately 5 million jobs lost. It's just words, Mr. Obama, just words. But these are extremely important words.
Let's talk about "just words, just words," as you so often and so eloquently state when campaigning, Mr. Obama. You used an operative word in your comments about malpractice reform. You said you would "consider" it. "Consider" it doesn't sound like a ringing endorsement, does it? Or is it 'just words, just words' to pacify a nation so you can ram a healthcare bill through Congress?
Other than that comment, Mr. Obama, you simply regurgitated everything in H.R. 3200.
The phrase "public option" is nothing more than a silent synecdoche for government run healthcare...and look how well they have done with Fannie, Freddie, Cash for Clunkers, the Postal Service, VA services, Social Security, Medicaid, and Medicare. Mr. Obama, when are you going to give us the word that the Congressional Budget Office reported this week that your Government Motors will not be able to pay back the $70 billion the hard working taxes payers gave them? Is $70 Billion 'just words, just words'?
Silly me, those were all the faults of the Bush Adm.
You know, that's like me saying that any student who didn't do well in my class was the fault of Elementary teachers!!
If the American people bought those 'just words' last night, then they bought a lemon.
Let's face it. There are simply some people out there who think the Public Option is going to be free, some who have no peripheral vision, and some who can't make a decision on their own. These are the people who worship at the altar of the Almighty GOVERNMENT as their savior in life.
The Devil is in the details, and Mr. Obama cleverly left out the agonizing details of how restrictions and limitations on insurance companies and the private sector would reduce their services, cut jobs, and in the short term eliminate private sector healthcare plans. The CBO has estimated that if the private sector healthcare folds and insurance companies fold it would amount to approximately 5 million jobs lost. It's just words, Mr. Obama, just words. But these are extremely important words.
Let's talk about "just words, just words," as you so often and so eloquently state when campaigning, Mr. Obama. You used an operative word in your comments about malpractice reform. You said you would "consider" it. "Consider" it doesn't sound like a ringing endorsement, does it? Or is it 'just words, just words' to pacify a nation so you can ram a healthcare bill through Congress?
Other than that comment, Mr. Obama, you simply regurgitated everything in H.R. 3200.
The phrase "public option" is nothing more than a silent synecdoche for government run healthcare...and look how well they have done with Fannie, Freddie, Cash for Clunkers, the Postal Service, VA services, Social Security, Medicaid, and Medicare. Mr. Obama, when are you going to give us the word that the Congressional Budget Office reported this week that your Government Motors will not be able to pay back the $70 billion the hard working taxes payers gave them? Is $70 Billion 'just words, just words'?
Silly me, those were all the faults of the Bush Adm.
You know, that's like me saying that any student who didn't do well in my class was the fault of Elementary teachers!!
If the American people bought those 'just words' last night, then they bought a lemon.
Let's face it. There are simply some people out there who think the Public Option is going to be free, some who have no peripheral vision, and some who can't make a decision on their own. These are the people who worship at the altar of the Almighty GOVERNMENT as their savior in life.
Wednesday, August 19, 2009
Synopsis of H.R. 3200
Synopsis of HR 3200: “America’s Affordable Health Choice Act of 2009”
By Rebecca K. Wetzel [1]
“Timid men prefer the calm of despotism to the tempestuous sea of liberty.” Thomas Jefferson
Introduction:
H.R. 3200 or “America’s Affordable Health Choice Act of 2009” is a massive proposal for the centralization or nationalization of the US Healthcare system by MANDATING REGULATIONS on individuals, employers, private insurers, hospitals, doctors and states.
In the words of The Congressional Research Services report, “Private Health Insurance Provisions of H.R. 3200”, H.R. 3200 would establish new federal health insurance standards.” [2] The essence of H.R. 3200 is the federalizing of all healthcare in the United States.
H.R. 3200 gives all regulatory authorization over those components to the Secretary of HHS and creates a new Health Benefits Advisory Commission. In examining H.R. 3200, what clearly jumps out is the broad sweeping powers over the healthcare component of the US economy that the US Government is seizing. This authority also extends to the Medicare Program, Medicaid, and SCHIPs.
525 pages of H.R. 3200’s 1018 pages are devoted to reforming, restructuring, and assessing treatment and hospitalization under the Medicare coverage for the elderly.
Another obvious revelation is the ambiguous language that opens the door to significant unintended consequences that will have political and government structure altering outcomes perhaps for the long term future. All economics teachers will tell you everything has a cost, and every economic choice we make has a consequence. [3]
Mr. Obama continues to waffle on whether or not there will be a public option plan in H.R. 3200. On Saturday, August 15 he stated that the public option plan is only a sliver of the bill. It only takes a sliver of an opening for mice to enter your home and cause chaos and disruption.
Even if H.R. 3200 excludes a public option plan, the intent of H.R. 3200 is for the Federal Government to seize control of the nation’s healthcare system, dictate the benefits and treatments of your healthcare coverage, access your financial records to automatically transfer the taxes you would owe if you chose not to have healthcare insurance, and to determine if you qualify for Medicaid.
What is truly missing from H.R. 3200 is the fundamental principle upon which this nation was founded: Freedom of Choice.
What is unclear in this legislation is the estimated cost of initiating the complete overhaul of healthcare system as we know it. The Congressional Budget Office has re-assessed the potential cost of H.R. 3200 at approximately $1.68 Trillion. Although H.R. 3200 does not clearly specify how the entire cost will be covered, provisions are made in the bill for the wealthy citizens to have their income taxes increased by as much as 5%.
There are no checks and balances in the bill for the government overreaching in its power into the lives of the American people as the bill specifically states in Section 223 on page 124 that “There shall be no administrative or judicial review of a payment rate or methodology established under this section or under section 224.” Hence, citizens are denied the right to court review of complaints against the Federal government over the healthcare issue. Does this have a potential unintended consequence of limiting citizens’ rights under the Federal government?
Article IV of the US Constitution guarantees due process of law to citizens.
The 3rd Amendments to the Constitution guarantees individuals the right to privacy and security in their own homes.
The 4th Amendment to the Constitution states, “The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.”
The 9th Amendment to the Constitution guarantees individuals the right of privacy.
The 14th Amendment guarantees individuals and entities equal protection of due process of law.
The purpose of the bill is stated on page 1: “To provide affordable, quality health care for all Americans and reduce the growth in health care spending and for other purposes.” [4] What does “for other purposes” mean? Does this open the door for unintended consequences?
The Congressional Budget Office report describes this particular health care plan in the following way: “federal individual mandate for health insurance would be unique and unprecedented because it would impose a duty on individuals as members of society and it would require people to purchase a specific service that would be heavily regulated by government”. Such a public policy is unprecedented and represents a Federal take-over of 1/6 of our nation’s private sector.
Mandatory Regulation:
What does it mean to be a MANDATED REGULATORY program? In the state of nature animals of prey such as jackals feed on lesser animals. Although we cannot change natural behavior, we can regulate what predators consume. In the marketplace, monopolies feed on smaller competitive businesses and individuals as monopolies, like all businesses and individuals, have a natural appetite to make a profit. After all, it is profit that enables one to meet their needs and wants. [5]
Price is a rationing factor in the marketplace. If the price is too high for some people based on their profits, then they will shop around to find a competitive price that suits their financial standing.
In any economic system, including that of the United States, there are four questions to answer: what to produce, how to produce, for whom to produce, and what is the role of government in production.
The critics of capitalism have obviously not read Adam Smith’s The Wealth of Nations. Smith, the father of capitalism, published The Wealth of Nations in 1776. Capitalism is the economic system that is based on competition, the rationing system is determined by the price mechanism, individuals make the determination what they will purchase from competitive choices, and individuals have the right to own property.
Let’s take the example of an artist, an entertainer, a doctor, a nurse, or a mechanic. All of these produce goods and services. They set the price they are willing to accept for the fruits of their labor.
Consumers, in turn, decide if they are willing to accept the going price for the services of the artist, entertainer, doctor, nurse or mechanic. Government regulates to make sure that the producer of goods and services is not taking advantage of the consumer just as government intervenes if the consumer takes from the producer of goods and services without a fair market compensation for services rendered.
Adam Smith advocated limited government, but the government had the responsibility and obligation to protect consumers from predators such as monopolies. [6] Critics of capitalism reveal their economic and political illiteracy when they maintain that Smith’s theories supported big business over individuals.
Under capitalism, the interaction of supply and demand determines what to produce, how to produce, for whom to produce, and the role of the government is to regulate business and protect the consumer.
Socialism is the economic and political theory that advocates the government ownership of the means of production. In his “Class Struggle of History Theory”, Karl Marx has Socialism as the second phase of his Class Struggle Theory in his work, The Communist Manifesto in 1848. Marx’s three phases are (1) class revolution of the haves v. the have-nots, (2) government ownership to eliminate private property, and (3) the utopian of communism where there will be no government to regulate behavior because people will share out of love for one another. Ironically, in the last section of his book, Karl Marx admitted that the utopian system of Communism was simply that: a Utopia. Marx then concluded that the political economic system he supported was that of Socialism. [7]
Under socialist systems, the government owns the means of what will be produced, dictates how goods and services are produced, determines for whom goods and services are produced, and the government’s role is to control the production of goods and services. In the case of the artist, entertainer, doctor, nurse, or mechanic, a socialist government would determine what prices you set for your services as well as the length and time of effort you put into your work. A socialist government would also be your employer.
There has never been a pure capitalist system. What was created in 1776 with the North American Revolution against England was a system that held the principles of capitalism as its goals. The Declaration of Independence, regrettably never read by but a few Americans, calls for a system where the usurpation of power by the government is limited. In fact, it was the egregious usurpation of power by George III of England that was the ultimate cause for revolution. The battle cry for the revolution was “No Taxation without Representation”.
Socialism, on the other hand, has existed as a political system, and generally, socialist systems are overturned because they place the ultimate focus on government authority over individuals and businesses.
When a government takes over the price mechanism function of an economy, the government has the power and authority to issue mandatory regulations. With such power, the government is close to nationalizing or taking over the ownership of businesses. In the spring of 2009, the United States government took over the ownership of two automotive businesses: General Motors and Chrysler.
Mandates Over Individuals in HR 3200:
•Individual mandates are an unprecedented violation of individual liberties: A Report by the Congressional Budget Office (CBO, which reports directly to the Speaker of the House Nancy Pelosi) issued an assessment in July 2009 stating that the “federal individual mandate for health insurance would be unique and unprecedented because it would impose a duty on individuals as members of society and it would require people to purchase a specific service that would be heavily regulated by government”.
Dr. Sherry Glied, an Obama HSS nominee, stated, “Developing a system to promptly identify and penalize scofflaws will take effort and ingenuity, particularly, in our diverse and mobile country. It may require a degree of intrusiveness and bureaucracy that some will find unpalatable.” [8]
•Individual Mandates will not resolve the uninsured problem: Massachusetts was the first state to enact an individual mandate with tax penalties and fines. However, this mandated program has not fulfilled its intended persons because some people are exempted while some people have deliberately chosen to forgo health insurance. The cost of care for those without health insurance is always passed on to the consumer. Government, like businesses, passes its cost of public policy onto to its consumers—the tax payers—in the form of higher taxes.
Currently there are approximately 47 million Americans without healthcare. This number is approximately 15% of the population which means 85% have healthcare coverage. Of that 47 million, 12 million are illegal aliens. Of the remaining 35 million, 12 million are those who have chosen not to purchase healthcare because they are in the upper income bracket and can pay for their healthcare out of pocket. Of the remaining 23 million, 12 million of those who are eligible for already existing federal programs such as Medicaid and SCHIPs but have chosen not to sign up for these programs. This number also includes young people in their 20’s to 30’s who feel they do not need healthcare insurance. The remaining 11 million are the ones who really need help.
Hence, HR 3200 claims to seek healthcare reform when its structure and function clearly indicate it is healthcare overhaul and take over by the US Government. [9]
•Individual Mandates will not solve the Free-Rider Problem: In economics and public policy, the free-rider is the person who benefits from a public policy at the personal expense of others. Even under the proposals of H.R. 3200, the free-rider problem ill exist because the bill has provisions for leveling the cost of covering those who cannot pay on insurers, institutions, and tax payers. The Urban Institute has produced studies showing that people with health insurance account for 30% of the uncompensated care delivered to the non-elderly.
•Individual Mandates are expensive: Dr. Sherry Glied, Obama nominee, states: “Funds diverted from uncompensated care would not be sufficient to pay for the subsidies needed to cover most uninsured people. Eliminating the free-rider problem through universal insurance might make the health care system more fair, but it wouldn’t make it less costly.”
•Individual Mandates are a Special Interest Bonanza: Government mandates that individuals purchase health insurance will define a MINIMUM SET of covered benefits that satisfies that mandate.
Minimum or limited benefits are code words for restrictions and rationing. When something is limited, it is in short supply. When items are in short supply, the cost increases.
Does this limitation then defy the stated purpose of H.R. 3200?
If benefits are limited in supply, there will be competition to have access to the benefits. Thus, health care providers who wish to stay in business will compete or LOBBY the Federal government to make sure their products and services remain in the benefits package.
•Individuals will be required to pay or play: Section 59B on page 167 states that the IRS will be authorized to levy a 2.5% income tax on individuals the Secretary of HHS has determined does not have acceptable health care insurance.
Does this open the door to unintended consequences?
Section 202(d)(3) authorizes the Commissioner of the Health Benefits Commission to automatically enroll those persons eligible for Medicaid into the Medicaid program (regardless of their choice).
•Individuals will automatically have their financial records accessed by the Federal government: Section 163 authorizes the Secretary of HHS to enable automatic electronic transfer of funds from an individual’s financial accounts.
(Note to those critics who say that showing our healthcare cards at medical facilities allows them to access your financial accounts: no, showing your healthcare card at a medical facility provides them with information that you have insurance coverage. Some individuals argue that we already do our banking online and pay bills online. The difference between banks and private sector is you are WILLINGLY ALLOWING them to access your financial accounts. Even if you allow the IRS to access your financial accounts online for a tax payment or refund, the difference is you are WILLINGLY ALLOWING THEM ACCESS. Compulsory access moves the government into the absolute control of your financial accounts. Remember, you will not have any federal judicial review of the healthcare under H.R. 3200, and that includes if the government ‘accidentally’ withdraws too much from your account.”)
Mandates over Private Insurers:
•The Commissioner of the Health Benefits Commission will dictate to private insurers how much and what rate may be charged as determined by the Commissioner (page 17 of H.R. 3200)
•Participation by all insurance plans is mandated. (page 20 of H.R. 3200)
•The Commissioner and Secretary of HHS are authorized to determine the financial solvency and audit all private insurers and employers. (page 22 of H.R. 3200)
•The Commissioner and Secretary of HHS will determine the quality benefits of all healthcare plans of all insurers. (page 25 of H.R. 3200)
•In Section 122, pages 26-30 of H.R. 3200, the following minimum services to be covered as essential benefits includes:
Hospitalization
Outpatient hospital and clinic services
Professional services of physicians and other health professionals
Such services, equipment, and supplies incident to the services of a physician or a health professional’s delivery of care
Prescription drugs
Rehabilitative and habilitative services
Mental health and substance use disorder services
Preventive services
Maternity care
Well baby and well child care
•The National Health Benefits Advisory Committee will make recommendations for benefits and treatments in all insurance plans. No appeals process is specified. (page 30 of H.R. 3200)
•The National Health Benefits Advisory Committee and the Commissioner will design the essential benefits package so that the cost sharing will provide a level of coverage that is designed to provide benefits that are actuarially equivalent to approximately 70% of the full actuarial value of the benefits.
•Under Section 122, the limitations on the amount of benefits and treatments in a fiscal year (FY): $5000 per individual/ $10,000 per family.
•The Commissioner will establish uniform marketing standards which all insurers will be required to meet. (page 37 of H.R. 3200)
•Under section 1173A of the Social Security Act the Health Benefits Board will be authorized to conduct electronic financial and administrative transactions of funds. (page 41 of H.R. 3200)
Mandates on Employers:
Employer healthcare insurance will not face a level playing field. The government does not have to worry about cost, and the government can simply raise taxes or print more money. H.R. 3200 along with increased energy taxes and Card Check, which will force unions in most businesses, will drive up operating costs of business so that employers will opt out of providing health insurance.
The Lewin Group conducted a study of the current healthcare legislation before Congress. Their study shows that the public option plan if adopted will cover approximately 103 million people. The unintended consequences of this legislation will result in 83.4 million people will lose their private insurance. This would represent a 48.4% reduction in the number of people with private coverage.
According to the Lewin Group study, 88.1 million people would see their private, employer sponsored health plan go away, and they would be shifted to the public plan.
Yearly premiums for private coverage will increase as much as $460 per privately insured person as a result of cost shifting to a public plan. [10]
In time, the only plan would be the government’s single payer plan which Mr. Obama stated in 2003 and in the campaign at Ames, Iowa in 2008 was his goal and intention.
Medicare:
525 pages of H.R. 3200 are devoted to Medicare. This alone tells you that Medicare is a significant component of our nation’s healthcare system.
In April 2009, Mr. Obama stated, “The chronically ill and those toward the end of their lives are accounting for potentially 80% of the total health care bills out there. It is very difficult to imagine the country making those decisions just through the normal political channel. This is why you have to have some independent group that can give you guidance.” [11]
Is this the reasoning behind the Advisory Boards and government agencies that will be created by H.R. 3200 to enter the homes, nursing homes, etc. to advise the elderly about the end of life wishes?
16.7% of our annual GDP is health care. (The GDP is the Gross Domestic Product which includes the total dollar value of all goods and services produced in the US. It includes Government spending, Consumer spending, Savings, Investments, and Business spending. IT IS NOT SOLELY GOVERNMENT MONEY.)
52% of our federal budget is spent on welfare and entitlement programs. Included in these are Social Security, Medicare, Medicaid, VA, and SCHIPs.
Mr. Obama is currently seeking a reduction in the Medicare budget for the upcoming Fiscal Year. By 2019, he wants a $313 Billion cut in the Medicare Budget. Currently, Medicare’s annual budget is approximately $413 Billion. Mr. Obama’s slashing of the Medicare Budget is questionable. By 2019 the bulk of America’s ‘Baby-boomer’s will be eligible for Medicare coverage.
If the budget is cut, does this have the unintended consequences of rationing who will get Medicare coverage?
H.R. 3200 does authorize government Advanced Directive sessions with those persons as they near the final stages of life. Advanced Directive Planning sessions are wonderful ideas for a family to do with their doctors, family members, spiritual directors, and / or ministers. It becomes a different ball game when the persons conducting the Advanced Directive is a government employee sent to discuss this with you as mandated by law.
Mr. Obama is calling for to removal of the Medicare Advantage Plan and Medicare Part D.
H.R. 3200 will have a tremendous impact on Medicare, Medicaid, and SCHIPs. At the present, it does not appear to have an impact on Social Security. However, we cannot forget there are unintended consequences to any public policy.
Medicaid:
H.R. 3200 proposes a major expansion of Medicaid as a primary vehicle to reduce the number of persons who currently do not have health insurance.
Although Medicaid might theoretically cheaper alternative, it would represent a balkanization of families based on income levels, geography, and even history. Not all poor people qualify for Medicaid. Not all people on Medicaid are poor. Criteria such as disability and whether there is a dependent child in the household factor into Medicaid eligibility.
According to CBO studies, H.R. 3200 would increase federal Medicaid spending to $2.2 Trillion in order to keep generally healthy individuals outside the rest of the insurance pool.
Is this and example of the unintended consequences that is counterintuitive and also counterproductive?
What is Missing:
Health Savings Accounts and Flex Savings Accounts will be eliminated.
Specification as to how States who will be mandated to implement parts of H.R. 3200 are going to cover the costs of implementation.
Endnotes:
1.The author holds a B.A. degree from the College of Arts and Sciences at the University of Alabama with a major in History and a minor in Political Science. Although the University only officially recognizes one major and one minor, Mrs. Wetzel’s transcript indicates she took sufficient course work in history, political science and English to qualify for three majors. Her M.A. degree is also from the College of Arts and Sciences at the University of Alabama in history. During her graduate work, Mrs. Wetzel was a Graduate Assistant in historical research of public policy under the tutelage of the late Dr. Charles G. Summersell and the late Dr. Austin L. Venable. Mrs. Wetzel also served as a lecturer in Diplomatic History of the United States and Foreign Relations. She is a retired educator having taught in the public schools in Alabama, Kentucky, and Pennsylvania. The classes she has taught include English literature, English grammar, Alabama History, Kentucky History, U.S. History, World History, World Cultures, Political and Economic Systems, AP History, AP Government, AP Comparative Government, AP Economics: Macroeconomics and Microeconomics, Rights and Responsibilities, and Current Issues. Mrs. Wetzel received her Teacher Certification from Millersville University, and she has taken post graduate courses at Pennsylvania State University. She is a member of Phi Beta Kappa, Phi Alpha Theta, Pi Sigma Alpha, and Alpha Lambda Delta. Mrs. Wetzel’s two Master’s papers were: “James G. Birney’s Role in the American Colonization Society” and “James K. Polk’s Secret War Agent: Juan de la Atocha”.
2.Congressional Research Services Report, “Private health Insurance Provisions of H.R. 3200, page 7.
3.The children’s story of The Three Little Pigs is an excellent introduction to teach the idea of choices having consequences.
4.Page 1 H.R. 3200.
5.Fred Gottheil, Principles of Economics, p. 304.
6.Adam Smith, The Wealth of Nations, 1776.
7.Karl Marx, The Communist Manifesto, 1848.
8.CBO Report July 2009.
9.Dr. Sherry Glied, Obama nominee.
10.Heritage Foundation, www.heritage.org.
11.Barack Obama, April 2009.
By Rebecca K. Wetzel [1]
“Timid men prefer the calm of despotism to the tempestuous sea of liberty.” Thomas Jefferson
Introduction:
H.R. 3200 or “America’s Affordable Health Choice Act of 2009” is a massive proposal for the centralization or nationalization of the US Healthcare system by MANDATING REGULATIONS on individuals, employers, private insurers, hospitals, doctors and states.
In the words of The Congressional Research Services report, “Private Health Insurance Provisions of H.R. 3200”, H.R. 3200 would establish new federal health insurance standards.” [2] The essence of H.R. 3200 is the federalizing of all healthcare in the United States.
H.R. 3200 gives all regulatory authorization over those components to the Secretary of HHS and creates a new Health Benefits Advisory Commission. In examining H.R. 3200, what clearly jumps out is the broad sweeping powers over the healthcare component of the US economy that the US Government is seizing. This authority also extends to the Medicare Program, Medicaid, and SCHIPs.
525 pages of H.R. 3200’s 1018 pages are devoted to reforming, restructuring, and assessing treatment and hospitalization under the Medicare coverage for the elderly.
Another obvious revelation is the ambiguous language that opens the door to significant unintended consequences that will have political and government structure altering outcomes perhaps for the long term future. All economics teachers will tell you everything has a cost, and every economic choice we make has a consequence. [3]
Mr. Obama continues to waffle on whether or not there will be a public option plan in H.R. 3200. On Saturday, August 15 he stated that the public option plan is only a sliver of the bill. It only takes a sliver of an opening for mice to enter your home and cause chaos and disruption.
Even if H.R. 3200 excludes a public option plan, the intent of H.R. 3200 is for the Federal Government to seize control of the nation’s healthcare system, dictate the benefits and treatments of your healthcare coverage, access your financial records to automatically transfer the taxes you would owe if you chose not to have healthcare insurance, and to determine if you qualify for Medicaid.
What is truly missing from H.R. 3200 is the fundamental principle upon which this nation was founded: Freedom of Choice.
What is unclear in this legislation is the estimated cost of initiating the complete overhaul of healthcare system as we know it. The Congressional Budget Office has re-assessed the potential cost of H.R. 3200 at approximately $1.68 Trillion. Although H.R. 3200 does not clearly specify how the entire cost will be covered, provisions are made in the bill for the wealthy citizens to have their income taxes increased by as much as 5%.
There are no checks and balances in the bill for the government overreaching in its power into the lives of the American people as the bill specifically states in Section 223 on page 124 that “There shall be no administrative or judicial review of a payment rate or methodology established under this section or under section 224.” Hence, citizens are denied the right to court review of complaints against the Federal government over the healthcare issue. Does this have a potential unintended consequence of limiting citizens’ rights under the Federal government?
Article IV of the US Constitution guarantees due process of law to citizens.
The 3rd Amendments to the Constitution guarantees individuals the right to privacy and security in their own homes.
The 4th Amendment to the Constitution states, “The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.”
The 9th Amendment to the Constitution guarantees individuals the right of privacy.
The 14th Amendment guarantees individuals and entities equal protection of due process of law.
The purpose of the bill is stated on page 1: “To provide affordable, quality health care for all Americans and reduce the growth in health care spending and for other purposes.” [4] What does “for other purposes” mean? Does this open the door for unintended consequences?
The Congressional Budget Office report describes this particular health care plan in the following way: “federal individual mandate for health insurance would be unique and unprecedented because it would impose a duty on individuals as members of society and it would require people to purchase a specific service that would be heavily regulated by government”. Such a public policy is unprecedented and represents a Federal take-over of 1/6 of our nation’s private sector.
Mandatory Regulation:
What does it mean to be a MANDATED REGULATORY program? In the state of nature animals of prey such as jackals feed on lesser animals. Although we cannot change natural behavior, we can regulate what predators consume. In the marketplace, monopolies feed on smaller competitive businesses and individuals as monopolies, like all businesses and individuals, have a natural appetite to make a profit. After all, it is profit that enables one to meet their needs and wants. [5]
Price is a rationing factor in the marketplace. If the price is too high for some people based on their profits, then they will shop around to find a competitive price that suits their financial standing.
In any economic system, including that of the United States, there are four questions to answer: what to produce, how to produce, for whom to produce, and what is the role of government in production.
The critics of capitalism have obviously not read Adam Smith’s The Wealth of Nations. Smith, the father of capitalism, published The Wealth of Nations in 1776. Capitalism is the economic system that is based on competition, the rationing system is determined by the price mechanism, individuals make the determination what they will purchase from competitive choices, and individuals have the right to own property.
Let’s take the example of an artist, an entertainer, a doctor, a nurse, or a mechanic. All of these produce goods and services. They set the price they are willing to accept for the fruits of their labor.
Consumers, in turn, decide if they are willing to accept the going price for the services of the artist, entertainer, doctor, nurse or mechanic. Government regulates to make sure that the producer of goods and services is not taking advantage of the consumer just as government intervenes if the consumer takes from the producer of goods and services without a fair market compensation for services rendered.
Adam Smith advocated limited government, but the government had the responsibility and obligation to protect consumers from predators such as monopolies. [6] Critics of capitalism reveal their economic and political illiteracy when they maintain that Smith’s theories supported big business over individuals.
Under capitalism, the interaction of supply and demand determines what to produce, how to produce, for whom to produce, and the role of the government is to regulate business and protect the consumer.
Socialism is the economic and political theory that advocates the government ownership of the means of production. In his “Class Struggle of History Theory”, Karl Marx has Socialism as the second phase of his Class Struggle Theory in his work, The Communist Manifesto in 1848. Marx’s three phases are (1) class revolution of the haves v. the have-nots, (2) government ownership to eliminate private property, and (3) the utopian of communism where there will be no government to regulate behavior because people will share out of love for one another. Ironically, in the last section of his book, Karl Marx admitted that the utopian system of Communism was simply that: a Utopia. Marx then concluded that the political economic system he supported was that of Socialism. [7]
Under socialist systems, the government owns the means of what will be produced, dictates how goods and services are produced, determines for whom goods and services are produced, and the government’s role is to control the production of goods and services. In the case of the artist, entertainer, doctor, nurse, or mechanic, a socialist government would determine what prices you set for your services as well as the length and time of effort you put into your work. A socialist government would also be your employer.
There has never been a pure capitalist system. What was created in 1776 with the North American Revolution against England was a system that held the principles of capitalism as its goals. The Declaration of Independence, regrettably never read by but a few Americans, calls for a system where the usurpation of power by the government is limited. In fact, it was the egregious usurpation of power by George III of England that was the ultimate cause for revolution. The battle cry for the revolution was “No Taxation without Representation”.
Socialism, on the other hand, has existed as a political system, and generally, socialist systems are overturned because they place the ultimate focus on government authority over individuals and businesses.
When a government takes over the price mechanism function of an economy, the government has the power and authority to issue mandatory regulations. With such power, the government is close to nationalizing or taking over the ownership of businesses. In the spring of 2009, the United States government took over the ownership of two automotive businesses: General Motors and Chrysler.
Mandates Over Individuals in HR 3200:
•Individual mandates are an unprecedented violation of individual liberties: A Report by the Congressional Budget Office (CBO, which reports directly to the Speaker of the House Nancy Pelosi) issued an assessment in July 2009 stating that the “federal individual mandate for health insurance would be unique and unprecedented because it would impose a duty on individuals as members of society and it would require people to purchase a specific service that would be heavily regulated by government”.
Dr. Sherry Glied, an Obama HSS nominee, stated, “Developing a system to promptly identify and penalize scofflaws will take effort and ingenuity, particularly, in our diverse and mobile country. It may require a degree of intrusiveness and bureaucracy that some will find unpalatable.” [8]
•Individual Mandates will not resolve the uninsured problem: Massachusetts was the first state to enact an individual mandate with tax penalties and fines. However, this mandated program has not fulfilled its intended persons because some people are exempted while some people have deliberately chosen to forgo health insurance. The cost of care for those without health insurance is always passed on to the consumer. Government, like businesses, passes its cost of public policy onto to its consumers—the tax payers—in the form of higher taxes.
Currently there are approximately 47 million Americans without healthcare. This number is approximately 15% of the population which means 85% have healthcare coverage. Of that 47 million, 12 million are illegal aliens. Of the remaining 35 million, 12 million are those who have chosen not to purchase healthcare because they are in the upper income bracket and can pay for their healthcare out of pocket. Of the remaining 23 million, 12 million of those who are eligible for already existing federal programs such as Medicaid and SCHIPs but have chosen not to sign up for these programs. This number also includes young people in their 20’s to 30’s who feel they do not need healthcare insurance. The remaining 11 million are the ones who really need help.
Hence, HR 3200 claims to seek healthcare reform when its structure and function clearly indicate it is healthcare overhaul and take over by the US Government. [9]
•Individual Mandates will not solve the Free-Rider Problem: In economics and public policy, the free-rider is the person who benefits from a public policy at the personal expense of others. Even under the proposals of H.R. 3200, the free-rider problem ill exist because the bill has provisions for leveling the cost of covering those who cannot pay on insurers, institutions, and tax payers. The Urban Institute has produced studies showing that people with health insurance account for 30% of the uncompensated care delivered to the non-elderly.
•Individual Mandates are expensive: Dr. Sherry Glied, Obama nominee, states: “Funds diverted from uncompensated care would not be sufficient to pay for the subsidies needed to cover most uninsured people. Eliminating the free-rider problem through universal insurance might make the health care system more fair, but it wouldn’t make it less costly.”
•Individual Mandates are a Special Interest Bonanza: Government mandates that individuals purchase health insurance will define a MINIMUM SET of covered benefits that satisfies that mandate.
Minimum or limited benefits are code words for restrictions and rationing. When something is limited, it is in short supply. When items are in short supply, the cost increases.
Does this limitation then defy the stated purpose of H.R. 3200?
If benefits are limited in supply, there will be competition to have access to the benefits. Thus, health care providers who wish to stay in business will compete or LOBBY the Federal government to make sure their products and services remain in the benefits package.
•Individuals will be required to pay or play: Section 59B on page 167 states that the IRS will be authorized to levy a 2.5% income tax on individuals the Secretary of HHS has determined does not have acceptable health care insurance.
Does this open the door to unintended consequences?
Section 202(d)(3) authorizes the Commissioner of the Health Benefits Commission to automatically enroll those persons eligible for Medicaid into the Medicaid program (regardless of their choice).
•Individuals will automatically have their financial records accessed by the Federal government: Section 163 authorizes the Secretary of HHS to enable automatic electronic transfer of funds from an individual’s financial accounts.
(Note to those critics who say that showing our healthcare cards at medical facilities allows them to access your financial accounts: no, showing your healthcare card at a medical facility provides them with information that you have insurance coverage. Some individuals argue that we already do our banking online and pay bills online. The difference between banks and private sector is you are WILLINGLY ALLOWING them to access your financial accounts. Even if you allow the IRS to access your financial accounts online for a tax payment or refund, the difference is you are WILLINGLY ALLOWING THEM ACCESS. Compulsory access moves the government into the absolute control of your financial accounts. Remember, you will not have any federal judicial review of the healthcare under H.R. 3200, and that includes if the government ‘accidentally’ withdraws too much from your account.”)
Mandates over Private Insurers:
•The Commissioner of the Health Benefits Commission will dictate to private insurers how much and what rate may be charged as determined by the Commissioner (page 17 of H.R. 3200)
•Participation by all insurance plans is mandated. (page 20 of H.R. 3200)
•The Commissioner and Secretary of HHS are authorized to determine the financial solvency and audit all private insurers and employers. (page 22 of H.R. 3200)
•The Commissioner and Secretary of HHS will determine the quality benefits of all healthcare plans of all insurers. (page 25 of H.R. 3200)
•In Section 122, pages 26-30 of H.R. 3200, the following minimum services to be covered as essential benefits includes:
Hospitalization
Outpatient hospital and clinic services
Professional services of physicians and other health professionals
Such services, equipment, and supplies incident to the services of a physician or a health professional’s delivery of care
Prescription drugs
Rehabilitative and habilitative services
Mental health and substance use disorder services
Preventive services
Maternity care
Well baby and well child care
•The National Health Benefits Advisory Committee will make recommendations for benefits and treatments in all insurance plans. No appeals process is specified. (page 30 of H.R. 3200)
•The National Health Benefits Advisory Committee and the Commissioner will design the essential benefits package so that the cost sharing will provide a level of coverage that is designed to provide benefits that are actuarially equivalent to approximately 70% of the full actuarial value of the benefits.
•Under Section 122, the limitations on the amount of benefits and treatments in a fiscal year (FY): $5000 per individual/ $10,000 per family.
•The Commissioner will establish uniform marketing standards which all insurers will be required to meet. (page 37 of H.R. 3200)
•Under section 1173A of the Social Security Act the Health Benefits Board will be authorized to conduct electronic financial and administrative transactions of funds. (page 41 of H.R. 3200)
Mandates on Employers:
Employer healthcare insurance will not face a level playing field. The government does not have to worry about cost, and the government can simply raise taxes or print more money. H.R. 3200 along with increased energy taxes and Card Check, which will force unions in most businesses, will drive up operating costs of business so that employers will opt out of providing health insurance.
The Lewin Group conducted a study of the current healthcare legislation before Congress. Their study shows that the public option plan if adopted will cover approximately 103 million people. The unintended consequences of this legislation will result in 83.4 million people will lose their private insurance. This would represent a 48.4% reduction in the number of people with private coverage.
According to the Lewin Group study, 88.1 million people would see their private, employer sponsored health plan go away, and they would be shifted to the public plan.
Yearly premiums for private coverage will increase as much as $460 per privately insured person as a result of cost shifting to a public plan. [10]
In time, the only plan would be the government’s single payer plan which Mr. Obama stated in 2003 and in the campaign at Ames, Iowa in 2008 was his goal and intention.
Medicare:
525 pages of H.R. 3200 are devoted to Medicare. This alone tells you that Medicare is a significant component of our nation’s healthcare system.
In April 2009, Mr. Obama stated, “The chronically ill and those toward the end of their lives are accounting for potentially 80% of the total health care bills out there. It is very difficult to imagine the country making those decisions just through the normal political channel. This is why you have to have some independent group that can give you guidance.” [11]
Is this the reasoning behind the Advisory Boards and government agencies that will be created by H.R. 3200 to enter the homes, nursing homes, etc. to advise the elderly about the end of life wishes?
16.7% of our annual GDP is health care. (The GDP is the Gross Domestic Product which includes the total dollar value of all goods and services produced in the US. It includes Government spending, Consumer spending, Savings, Investments, and Business spending. IT IS NOT SOLELY GOVERNMENT MONEY.)
52% of our federal budget is spent on welfare and entitlement programs. Included in these are Social Security, Medicare, Medicaid, VA, and SCHIPs.
Mr. Obama is currently seeking a reduction in the Medicare budget for the upcoming Fiscal Year. By 2019, he wants a $313 Billion cut in the Medicare Budget. Currently, Medicare’s annual budget is approximately $413 Billion. Mr. Obama’s slashing of the Medicare Budget is questionable. By 2019 the bulk of America’s ‘Baby-boomer’s will be eligible for Medicare coverage.
If the budget is cut, does this have the unintended consequences of rationing who will get Medicare coverage?
H.R. 3200 does authorize government Advanced Directive sessions with those persons as they near the final stages of life. Advanced Directive Planning sessions are wonderful ideas for a family to do with their doctors, family members, spiritual directors, and / or ministers. It becomes a different ball game when the persons conducting the Advanced Directive is a government employee sent to discuss this with you as mandated by law.
Mr. Obama is calling for to removal of the Medicare Advantage Plan and Medicare Part D.
H.R. 3200 will have a tremendous impact on Medicare, Medicaid, and SCHIPs. At the present, it does not appear to have an impact on Social Security. However, we cannot forget there are unintended consequences to any public policy.
Medicaid:
H.R. 3200 proposes a major expansion of Medicaid as a primary vehicle to reduce the number of persons who currently do not have health insurance.
Although Medicaid might theoretically cheaper alternative, it would represent a balkanization of families based on income levels, geography, and even history. Not all poor people qualify for Medicaid. Not all people on Medicaid are poor. Criteria such as disability and whether there is a dependent child in the household factor into Medicaid eligibility.
According to CBO studies, H.R. 3200 would increase federal Medicaid spending to $2.2 Trillion in order to keep generally healthy individuals outside the rest of the insurance pool.
Is this and example of the unintended consequences that is counterintuitive and also counterproductive?
What is Missing:
Health Savings Accounts and Flex Savings Accounts will be eliminated.
Specification as to how States who will be mandated to implement parts of H.R. 3200 are going to cover the costs of implementation.
Endnotes:
1.The author holds a B.A. degree from the College of Arts and Sciences at the University of Alabama with a major in History and a minor in Political Science. Although the University only officially recognizes one major and one minor, Mrs. Wetzel’s transcript indicates she took sufficient course work in history, political science and English to qualify for three majors. Her M.A. degree is also from the College of Arts and Sciences at the University of Alabama in history. During her graduate work, Mrs. Wetzel was a Graduate Assistant in historical research of public policy under the tutelage of the late Dr. Charles G. Summersell and the late Dr. Austin L. Venable. Mrs. Wetzel also served as a lecturer in Diplomatic History of the United States and Foreign Relations. She is a retired educator having taught in the public schools in Alabama, Kentucky, and Pennsylvania. The classes she has taught include English literature, English grammar, Alabama History, Kentucky History, U.S. History, World History, World Cultures, Political and Economic Systems, AP History, AP Government, AP Comparative Government, AP Economics: Macroeconomics and Microeconomics, Rights and Responsibilities, and Current Issues. Mrs. Wetzel received her Teacher Certification from Millersville University, and she has taken post graduate courses at Pennsylvania State University. She is a member of Phi Beta Kappa, Phi Alpha Theta, Pi Sigma Alpha, and Alpha Lambda Delta. Mrs. Wetzel’s two Master’s papers were: “James G. Birney’s Role in the American Colonization Society” and “James K. Polk’s Secret War Agent: Juan de la Atocha”.
2.Congressional Research Services Report, “Private health Insurance Provisions of H.R. 3200, page 7.
3.The children’s story of The Three Little Pigs is an excellent introduction to teach the idea of choices having consequences.
4.Page 1 H.R. 3200.
5.Fred Gottheil, Principles of Economics, p. 304.
6.Adam Smith, The Wealth of Nations, 1776.
7.Karl Marx, The Communist Manifesto, 1848.
8.CBO Report July 2009.
9.Dr. Sherry Glied, Obama nominee.
10.Heritage Foundation, www.heritage.org.
11.Barack Obama, April 2009.
Tuesday, August 11, 2009
Analytical Breakdown of HR 3200
Analytical Breakdown of HR 3200: “America’s Affordable Health Choice Act of 2009” Pages 1-167
Page 1: “To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.” (What does the prepositional phrase “for other purposes” mean?)
Page 17:Dictates to private insurers how and what rates may be charged as determined by the Commissioner
Page 19:No pre-existing conditions exclusions may be imposed ( A Positive)
Page 20: HIE: Health Insurance Exchange Program—network of all insurance plans including the Public Option; Participation for all insurances plans is mandated;
Page 22:Commissioner and Sec. of HHS will have the authority to determine the financial solvency and AUDIT of private insurers and all employers that self-insure.
Page 25:Commissioner and Sec. of HHS will determine QBHP (qualified benefits health plan) that comprises a plans essential benefits plan
Page 26-29:lists the general benefits a plan in the private sector market must provide;Specifies all plans will be co-pay not co-insurance;
Page 29:Limitations will be placed on the amount of benefits permitted in a fiscal year (FY). $5000 per individual/$10,000 per family;
Page 30:A national Health Benefits Advisory Committee will make recommendations for benefits and treatments in the essential, enhanced and premium plans; No appeals process is specified.
Page 37:Commissioner shall establish uniform marketing standards that all insured QBHP (benefits plans) offering entities shall meet. Commissioner will establish the grievance and claims mechanisms
Page 38:(apparently the program is going to be run through States as there is reference to the State Judicial Review process concerning grievances and claims; there is no Judical Review permitted under HR 3200 at the Federal level)
Page 39-40:Commissioner will oversee transparency of QBHPs through mandated audits
Page 40-41: Commissioner will standardize benefits and reimbursement of payments
Page 41:A QHBP offering entity is required to comply with
standards for electronic financial and administrative
transactions under section 1173A of the Social Security
6 Act, added by section 163(a).
Page 41-43:Governance will be by the Health Choices Administration headed by the Health Choices Commissioner;(new government agency in the Executive Branch)Commissioner will be appointed by the President and confirmed by the Senate (a political appointment);
DUTIES.—The Commissioner is responsible forcarrying out the following functions under this division:
(1) QUALIFIED PLAN STANDARDS.—The establishment of qualified health benefits plan standards under this title, including the enforcement of such standards in coordination with State insurance regulators and the Secretaries of Labor and the Treasury.
(2) HEALTH INSURANCE EXCHANGE.—The establishment and operation of a Health Insurance Exchange under subtitle A of title II.
Commissioner will have the authority to audit QBHPs and recoup payment from QBHPs for the audit.
Plans that fail to meet the standards established by the Commissioner will be subjected to fines and suspension of of enrollment of individuals;
Commissioner is responsible for development of standards for the definitions of terms used in health insurance coverage, including insurance-related terms.
Commissioner is responsible for determining regulations and standards of efficient and effective administration in the HIE.
Page 42:Commissioner will determine all health benefits for all persons and all insurance plans.
Page 46:Commissioner will appoint QBHP Ombudsman
Page 50:Sec. 152 prohibits any discrimination in healthcare coverage;
Page 51: Whistleblower Protection
Page 57:Standardized Electronic Administrative Transactions
Page 58:“authoritative, permitting no additions or constraints for electronic transactions, including companion guides; be comprehensive, efficient and robust, requiring minimal augmentation by paper transactions or clarification by further communications; enable the real-time (or near realtime) determination of an individual’s financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility, which may include utilization of a machine-readable health plan beneficiary identification card;”
‘‘ enable, where feasible, near real-time adjudication of claims; provide for timely acknowledgment, response, and status reporting applicable to any electronic transaction deemed appropriate by the Secretary;
“The goals for Financial and Administrative Transactions call for eanbling the real-time (or near real time) determination of an individual’s financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility, which may include utilization of a machine-readable health plan beneficiary identification card;… and enable, where feasible, near real-time adjudication of claims.”
Every individual will be required to have a National ID Health card.
Page 59:“enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment and remittance advice;
(The Congressional Budget Office: CBO has stated this power will be the greatest concentration of an individual’s financial records in the hands of the US Government’s computer systems.)
Page 65:Reinsurance Program for Retirees who do not fall under Social Security
Page 72:All private healthcare plans must conform to government rules and to participate in the Healthcare Insurance Exchange
Page 84:All private healthcare plans benefits must conform to the Healthcare Insurance Exchange benefits
Page 91:Mandated requirement of linguistic infrastructure for services
Page 102:Mandates automatic enrollment of individuals who are eligible for Medicaid. Individuals will have no choice in the matter.
Page 124:No healthcare insurance company can sue the government for price-fixing; No ‘judicial review’ is permitted against the government monopoly of nationalized healthcare.
Page 127:The government will determine how much physicians will be paid for treatments;
Page 145:Employers must automatically enroll employees into the government public plan.
Page 146:Employers must pay healthcare bills for part-time employees and their families.
Page 149:An employer with a payroll of $400,000 + and does not offer the public option plan must pay an 8% payroll tax on each employee
Page 150:Employers with a $250,000-$400,000 payroll who do not offer the public option must pay 2-6% payroll tax on each employee
Page 167:Individuals who do not have acceptable healthcare as determined by the Sec. of HHS will be taxed 2.5% on their income.
Page 1: “To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.” (What does the prepositional phrase “for other purposes” mean?)
Page 17:Dictates to private insurers how and what rates may be charged as determined by the Commissioner
Page 19:No pre-existing conditions exclusions may be imposed ( A Positive)
Page 20: HIE: Health Insurance Exchange Program—network of all insurance plans including the Public Option; Participation for all insurances plans is mandated;
Page 22:Commissioner and Sec. of HHS will have the authority to determine the financial solvency and AUDIT of private insurers and all employers that self-insure.
Page 25:Commissioner and Sec. of HHS will determine QBHP (qualified benefits health plan) that comprises a plans essential benefits plan
Page 26-29:lists the general benefits a plan in the private sector market must provide;Specifies all plans will be co-pay not co-insurance;
Page 29:Limitations will be placed on the amount of benefits permitted in a fiscal year (FY). $5000 per individual/$10,000 per family;
Page 30:A national Health Benefits Advisory Committee will make recommendations for benefits and treatments in the essential, enhanced and premium plans; No appeals process is specified.
Page 37:Commissioner shall establish uniform marketing standards that all insured QBHP (benefits plans) offering entities shall meet. Commissioner will establish the grievance and claims mechanisms
Page 38:(apparently the program is going to be run through States as there is reference to the State Judicial Review process concerning grievances and claims; there is no Judical Review permitted under HR 3200 at the Federal level)
Page 39-40:Commissioner will oversee transparency of QBHPs through mandated audits
Page 40-41: Commissioner will standardize benefits and reimbursement of payments
Page 41:A QHBP offering entity is required to comply with
standards for electronic financial and administrative
transactions under section 1173A of the Social Security
6 Act, added by section 163(a).
Page 41-43:Governance will be by the Health Choices Administration headed by the Health Choices Commissioner;(new government agency in the Executive Branch)Commissioner will be appointed by the President and confirmed by the Senate (a political appointment);
DUTIES.—The Commissioner is responsible forcarrying out the following functions under this division:
(1) QUALIFIED PLAN STANDARDS.—The establishment of qualified health benefits plan standards under this title, including the enforcement of such standards in coordination with State insurance regulators and the Secretaries of Labor and the Treasury.
(2) HEALTH INSURANCE EXCHANGE.—The establishment and operation of a Health Insurance Exchange under subtitle A of title II.
Commissioner will have the authority to audit QBHPs and recoup payment from QBHPs for the audit.
Plans that fail to meet the standards established by the Commissioner will be subjected to fines and suspension of of enrollment of individuals;
Commissioner is responsible for development of standards for the definitions of terms used in health insurance coverage, including insurance-related terms.
Commissioner is responsible for determining regulations and standards of efficient and effective administration in the HIE.
Page 42:Commissioner will determine all health benefits for all persons and all insurance plans.
Page 46:Commissioner will appoint QBHP Ombudsman
Page 50:Sec. 152 prohibits any discrimination in healthcare coverage;
Page 51: Whistleblower Protection
Page 57:Standardized Electronic Administrative Transactions
Page 58:“authoritative, permitting no additions or constraints for electronic transactions, including companion guides; be comprehensive, efficient and robust, requiring minimal augmentation by paper transactions or clarification by further communications; enable the real-time (or near realtime) determination of an individual’s financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility, which may include utilization of a machine-readable health plan beneficiary identification card;”
‘‘ enable, where feasible, near real-time adjudication of claims; provide for timely acknowledgment, response, and status reporting applicable to any electronic transaction deemed appropriate by the Secretary;
“The goals for Financial and Administrative Transactions call for eanbling the real-time (or near real time) determination of an individual’s financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility, which may include utilization of a machine-readable health plan beneficiary identification card;… and enable, where feasible, near real-time adjudication of claims.”
Every individual will be required to have a National ID Health card.
Page 59:“enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment and remittance advice;
(The Congressional Budget Office: CBO has stated this power will be the greatest concentration of an individual’s financial records in the hands of the US Government’s computer systems.)
Page 65:Reinsurance Program for Retirees who do not fall under Social Security
Page 72:All private healthcare plans must conform to government rules and to participate in the Healthcare Insurance Exchange
Page 84:All private healthcare plans benefits must conform to the Healthcare Insurance Exchange benefits
Page 91:Mandated requirement of linguistic infrastructure for services
Page 102:Mandates automatic enrollment of individuals who are eligible for Medicaid. Individuals will have no choice in the matter.
Page 124:No healthcare insurance company can sue the government for price-fixing; No ‘judicial review’ is permitted against the government monopoly of nationalized healthcare.
Page 127:The government will determine how much physicians will be paid for treatments;
Page 145:Employers must automatically enroll employees into the government public plan.
Page 146:Employers must pay healthcare bills for part-time employees and their families.
Page 149:An employer with a payroll of $400,000 + and does not offer the public option plan must pay an 8% payroll tax on each employee
Page 150:Employers with a $250,000-$400,000 payroll who do not offer the public option must pay 2-6% payroll tax on each employee
Page 167:Individuals who do not have acceptable healthcare as determined by the Sec. of HHS will be taxed 2.5% on their income.
Monday, August 10, 2009
HR 3200 and Reading
HR 3200 (National Healthcare Plan): 485 pages read. Only 633 to go.
The following is an overview of the first 100 pages of the House of Representatives Healthcare Bill in addition to some possible questions one needs to keep in mind.
First lesson in Economics 101 is nothing is free. Everything has a cost. By cost we mean that you have to give up something.
The US healthcare system is not perfect. It has its flaws. There needs to be some type of reforms without question.
Every year the US Government spends $2.1 TN on the following components of healthcare/entitlement programs: Social Security, Medicare, Medicaid, SCHIPS, Veterans benefits, State and Local healthcare programs. (GAO)
The $2.1 TN the Federal Government spends on healthcare/entitlement programs is 1/6 or 16.7% of the nation’s GDP (total dollar value of all goods and services produced within the nation in a fiscal year). (GAO)
Any and all government programs result in government agencies having the sole power to determine the rules and regulations pertaining to these healthcare/entitlement programs. [Hence, there is great ambiguity in Congressional legislation because Congress relegates the detailed rule making to Bureaucratic agencies. Examples: Food Stamps are regulated by the Agriculture Department. Tax policies, as we all know, are written by the IRS.]
Thus, healthcare/entitlement programs are one of the most highly regulated sectors of the US economy. The result of this massive regulation is a loss of personal freedom known as the right to make a choice.
1.HR 3200 will not go into effect until 2013. (HR 3200 itself)
Why the rush to ram in through Congress?
Why not get states to run trial healthcare systems to tweak the system before mandating it in all 50?
2. If the Federal Mandated Healthcare System is adopted, and should it fail, can we get rid of it?
Probably not because once Congress has created a Federal Bureaucratic agency, it tends to grow, feed on itself in a self-perpetuating manner.
Example: When FDR signed the Social Security Act into law in 1935, he stated it would only be in use for 5 years. 74 years later we still have it, and Social Security is the largest component of the healthcare/entitlement programs.
If it’s voted in, we’re stuck with it---flaws and all---forever.
3.Single Payer (Public Option) v. Private Sector Plans
Will you be able to retain your current healthcare plan? Yes, as long as the current plan is offered by your employer. Businesses may (and probably will) opt to pay the 8% fee (tax) not to offer their healthcare plans. Why? The cost of healthcare already consumes a large % of operating costs for businesses. Competing against the government in offering healthcare plans is not feasible since the government has the capacity to print more money (inflationary) and / or raise taxes (inflationary) to generate revenue to pay for the public option –government healthcare.
Private enterprises simply are unable to compete with government subsidies.
Members of Congress have their own healthcare plan, and they have stated they will not have to participate in the public option because they are very satisfied with their plans. (They also have the power to make that decision unlike average citizens.)
4. Freedom of Choice in Plans
As long as there are private healthcare plans available.
5. Doctors
Will you be able to keep your own doctors?
Maybe. Maybe not.
When you add more people to a healthcare system, but you do not increase the numbers of doctors the result is a shortage. Whenever there is a shortage of goods, the price goes up. Price is a rationing system in economics.
Hence, a shortage of doctors will result in a rationing of healthcare.
6.Costs
The cost of government healthcare has not been forthcoming from the White House nor the Congress according to the CBO.
The CBO--Congressional Budget Office (which reports directly to the Speaker of the House, currently Nancy Pelosi)-- has stated in reports that the projected plan has failed to provide the following:
“The current plan has not detailed evidence of and cost of disease management, comparative treatment effectiveness, health information technology projections, prescription drug re-importation in reducing costs quickly, appreciably, and effectively.” (CBO)
The CBO’s best estimates and disregarding inflation for the annual cost of the current House of Representatives Plan is $1 TN a year on top of the current $2.1 TN spent on the healthcare/entitlement programs in the Federal budget.
7.Privacy of Health Records
Thus far, the bill is not clear on whether the health records will be kept private. The language is vague and ambiguous. Such policies will be determined by whatever government agency Congress creates.
8.Federal Health Regulatory Board will have the power to deliver, determine, and resolve conflicts over what constitutes ‘quality care’.
HR 3200 calls for an expansion of Medicaid and SCHIPs by the Federal Health Regulatory Board.
This board, according to HR 3200, will have watchdog power over Private Sector Plans (micromanaging) --the competitor of the government healthcare plan.
The Federal Government will have control overall all healthcare---public or private.
Is this an invasion of privacy?
Is this an egregious intrusion of government power into the lives of individuals?
9.Secretary of Health and Human Services
The HHS Secretary will be authorized to establish the standards and goals for the financial and administration transactions.
The Secretary will have access to determine an individual’s responsibilities at point of service (POS), the power to determine if the individual is eligible for specific services.
The HHS Secretary will have power to “enable electronic funds transfers, in order to allow automatic reconciliation with the related healthcare payment and remittance.” (pages 52-59 HR 3200)
Note the ambiguity of the language. Transfers of whose funds? Automatic payment from whom to whom? How extensive is this power to access one’s financial records and funds?
Would you have wanted the Nixon Administration to have had such a power?
10. What role will states have in the government healthcare?
Although he is a proponent of a public option plan, Governor Ed Rendell on the Mike Huckabee show on Sunday, August 9 made some interesting points.
Gov. Rendell raised these questions that remain unanswered by the Congress and White House:
If this is a Federally Mandated Program, will the Feds pay the cost or will there be a split cost such as 90/10?
Will this be an unfunded mandate and the states expected to pay the cost as well as run the program?
Will there be a Claw-back as there currently is with Medicare Part D?
What happens to the funding (if the Feds provide any) in the Outyears (5 years after the program begins)?
Obviously, there are more questions than answers.
The bill is a typical Congressional piece of legislation: oblique, obtuse, and full of enough holes to drive a mack truck through it. In other words, enough room for the creation of more government RED TAPE.
11.Are there 50 million who are uninsured?
We know there are at least 250 million in the US with healthcare plans. Of the 50 million remaining, 12 million are illegals leaving us with 38 million uninsured. From that number, about 20 million fall under government healthcare/entitlement programs. Now we’re down to 18 million. Approximately 10 million young adults have chosen not to purchase healthcare, leaving us with approximately 8 million uninsured.
Is it absolutely necessary to restructure/destroy the entire private healthcare system in order to reform a system? There have to be some alternative means to achieve the goal of offering the 8 million uninsured persons healthcare coverage.
Do we not have the ability and leadership in Congress to think creatively without furthering the economic recession?
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