Archive for November, 2009
Ed Schultz is a leftist radio personality who recently graduated to MSNBCs barely watched opinion line up. Schultz still hosts his daily radio show and recently had Heritage Foundation fellow Ernest Istook on to discuss Obamacare. The following exchange (audio here) transpired:
SCHULTZ: OK, give us your new information from the Heritage Foundation on health care. Tell us how screwed up the Democrats are on that.
ISTOOK: Well, you know, I think this may be in the category of unintended consequences, although frankly it may be part of the cost control. As we’ve been going through this 2,000 pages that have been brought up for debate in the US Senate, evidently the penalties that they put upon employers if their, the people who work for them go into this public plan, this so-called insurance exchange …
SCHULTZ: Don’t tell me they’re going to jail! Please …
ISTOOK: No, this is not about that.
SCHULTZ: OK. (more…)
The House and Senate health care legislation resembles a game show more than deliberate exercise in public policy. As confusing and confused legislation language is translated into dollars and cents, how much Americans will find themselves paying for health care? It looks more and more like a giant game of chance.
Not only is Congress leaving the current inequities created by the federal tax treatment of health insurance in place, it is busy creating new ones.
Family Premiums. The Congressional Budget Office (CBO) estimates that under the House bill, the average premium in 2016 will be $15,000 and the average cost sharing will be $5,500 for a family policy or a total of $20,500. Under the Senate bill, the average premium will be $14,100 and the average cost sharing will be $5,000 for a family policy or a total of $19,100. Is the higher cost House plan better? How do we know? If the Senate can come in $1,400 lower than the House, could the price tag be lowered by another $1,400? If not, why not?
Under the House bill, a family of four with income of $30,000 will receive the $20,500 value for just $1,100, or less than $100 per month. The family will receive premium and cost sharing subsidies from their neighbors worth $19,400. Under the Senate bill, a family of four with income of $30,000 will receive premium and cost sharing subsidies worth $16,800, still quite generous. These subsidies are so generous in fact, that the House and Senate leaders don’t want millions of Americans to have them to buy private health insurance. (more…)
First Lady Michelle Obama’s video on health care reform raises important issues about female patients who are falling through the cracks of the U.S. health care system. It’s not a perfect system, but Nina Owcharenko explains that ObamaCare would take women and the rest of the country in the wrong direction. Having to depend on politicians or faceless bureaucrats to make decisions about their care doesn’t empower women or improve their health care situations. Plus, the Obama health reform agenda isn’t what women want. A majority of female respondents told the Independent Women’s Forum in a recent survey that they don’t think government-run health care is best for them or their families.
After a sneak-through Saturday night vote to make Senate Majority Leader Harry Reid’s health care bill open for debate, the Senate comes back on Monday to decide how much more involvement the federal government will have over the private health care sector — one-sixth of the nation’s overall economy. With a record-breaking 2,074 pages, there are plenty of provisions in the Senate health care bill that most Americans probably aren’t aware of. Here are some of the highlights that Heritage has noted in the past week:
- The Senate bill breaks President Barack Obama’s promise not to impose new taxes on middle-class Americans.
- The legislation allows feds to micromanage all private health insurance plans.
- The bill creates the health exchange framework that allows for a government-run health plan to overtake the health insurance market. (more…)
No one knows for sure how Senator Reid’s health care bill (HR 3590) will impact any particular person or group, but this much is fairly certain: it will cause health insurance premiums to increase faster—not slower—than they would have otherwise. Even the Congressional Budget Office, Congress’s non-partisan accountants, says that premiums in the “public option” of Sen. Reid’s bill would turn out to be higher than premiums in typical private plans today. Thus, there are ways to “bend the health care cost curve” downward, but this bill does exactly the opposite.
While Reid’s plan, like all of the leading pieces of legislation, clearly seeks to expand coverage, he joins these other plans in failing to contain health care costs. These plans do little to address the issue of rising costs within the system, which is critical to actually ensuring access to healthcare services. Reid’s bill does not take into capacity constraints — and vast inefficiencies– that already exist in the healthcare delivery system, and it is uncertain if legislators understand exactly how these bills will affect physicians and hospitals.
Remember that government today spends $0.57 of every health care dollar on its own programs, Medicaid or Medicare. Medicaid and Medicare already have huge rate-setting power in health care, and determine to a large degree the delivery of healthcare—including, in many respects, adding to the inefficient delivery of healthcare. So, it is highly questionable whether Reid’s bill will move the US in a direction of addressing the problems in the inefficient delivery (and financing) of health care. (more…)
Earlier this week, The Foundry’s Conn Carroll wrote that under the Senate’s version of Obamacare, insurers and employers would have justification to refuse coverage for annual mammograms as a cost-cutting rationing measure, pursuant to the recommendations of the U.S. Preventive Services Task Force.
On Sunday’s “This Week with George Stephanopoulos,” the debate on mammogram rationing grew heated when Rep. Marsha Blackburn (R-TN) explained that the Task Force’s guidelines on mammograms “become the law” under the Senate bill, meaning that rationing would occur. In response, Rep. Debbie Wasserman Schultz (D-FL) accused Republicans of politicizing the issue of breast cancer.
Senator Tom Coburn (R-OK) noted that while a “cost” argument for the guidelines could be made, “from a patient standpoint, they’re atrocious. And that’s the problem with a bureaucracy stepping between a physician and their patient.” (more…)
Health Care News
A growing number of state medical societies and groups are opposing Senate Majority Leader Harry Reid’s 2,074-page health care bill and the 1,990-page bill that passed in the House.
Just in the past week, the Florida Medical Association and the Texas Medical Association have separately said they would not support H.R. 3590, citing concerns that the legislation would increase government interference in health care decisions, expand the amount of red tape doctors face and raise health care costs for patients.
“The proposed Senate legislation contains many provisions that would undermine the patient/physician relationship and create even more access obstacles for Floridians,” the Florida medical group said in a statement.
In addition to state medical coalitions, larger physician groups like the American Association of Neurological Surgeons and the Congress of Neurological Surgeons have voiced their opposition to ObamaCare.
Health Care News
It is a well known economic policy rule that if you want less of something you tax it, and if you want more of something you subsidize it. Policymakers frequently follow this rule to influence behavior. This is why there are “sin taxes” on things like alcohol and cigarettes, and also why “cap and trade” taxes carbon. This is why there are subsidies for education and for “green” technologies. If taxes and subsidies make any sense at all, they make sense when used to tax “bad” things and subsidize “good” things.
Given this basic rule, can you guess which of these are being subsidized and which taxed in the Reid Health Bill currently in the Senate?
- Innovative Medical Companies
- Medical Devices, such as prosthetic limbs, wheelchairs and pacemakers
- Over-the-counter medicines
- Privately funded medical care – including private health insurance plans, private medical expenses paid out-of-pocket, and employer-provided care
(answers below the fold) (more…)
Health Care News
Last week, the United States Preventive Services Task Force issued new guidelines recommending that women in their 40s no longer have annual mammograms and that women ages 50 to 74 have them only every other year, instead of annually. The recommendations were highly controversial, and by week’s end most health insurers and the federal Medicare program said they would ignore the panel’s recommendation and continue covering annual mammograms. This is at it should be: the federal government collects information and makes recommendations, and Americans are then free to consult their health care providers and ignore the government if they so choose. The problem is that Obamacare would forever change this relationship.
Both the House and Senate versions of Obamacare create detailed new federal regulations that micromanage all health insurance decisions. Specifically, Section 2713 of the Senate Health Bill would give the recommendations of the U.S. Preventive Services Task Force the force of law by requiring all health insurance plans to provide coverage (with no patient co-pays) for “items or services that have in effect a rating of “A” or “B” [recommended] in the current recommendations of the United States Preventive Services Task Force.” (more…)
Health Care News
After noting that Social Security, Medicare and Medicaid spending totaled $1.3 trillion, 43 percent of federal spending and more than twice military spending, in 2008, the Washington Post‘s Robert Samuelson turns to Obamacare:
Now comes the House-passed health-care “reform” bill that, amazingly, would extract more subsidies from the young. It mandates that health insurance premiums for older Americans be no more than twice the level of that for younger Americans. That’s much less than the actual health spending gap between young and old. Spending for those age 60 to 64 is four to five times greater than those 18 to 24. So, the young would overpay for insurance that — under the House bill — people must buy: Twenty- and thirtysomethings would subsidize premiums for fifty-and sixtysomethings. (Those 65 and over receive Medicare.) (more…)
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