The Politics of Health Care

[G M]

We could have gov't get the hell out of healthcare and let the free market price it. I know, just crazy talk.....   

[DougMacG]

We could have gov't get the hell out of healthcare and let the free market price it. I know, just crazy talk.....   

That would solve it, but for some reason we can't.

[G M]

http://danieljmitchell.wordpress.com/2011/04/21/would-you-prefer-privatization-or-a-death-panel/

Choose wisely.

[Crafty_Dog]

Underneath Newt Gingrich's rhetoric last week about Paul Ryan's "right-wing social engineering" was a common anxiety about the politics of Medicare: Is this the right moment for entitlement reform? Did the GOP endanger its House majority by giving Democrats a campaign strategy for 2012, and is Mr. Ryan's proposal really too "radical" after all?

Entitlement reform is the hardest challenge in politics, which is one reason we oppose all new entitlements. But Republicans now tempted to retreat at the first smell of cordite need to understand that they are taking even larger political and policy risks than Mr. Ryan is. The Medicare status quo of even two years ago, much less 20, is irretrievably gone, and anyone pining for its return is merely making President Obama's vision of government-run health care inevitable.

***
This reality is underscored in the just-released annual report of the Medicare trustees. Democrats sold ObamaCare as a way to slow the growth of costs, but the report shows that the program's finances have deteriorated even since last year. Medicare is carrying $24.6 trillion in unfunded liabilities through 2085, and chief actuary Richard Foster says even that does "not represent a reasonable expectation for actual program operations."

As a matter of simple arithmetic, this problem can't be solved with tax increases, because health costs and thus government spending on health care are rising so much faster than the economy as a whole is growing. The U.S. capacity to pay for Medicare on present trend diminishes every year.

With ObamaCare, Democrats offered their vision for Medicare cost control: A 15-member unelected board with vast powers to set prices for doctors, hospitals and other providers, and to regulate how they should be organized and what government will pay for. The liberal conceit is that their technocratic wizardry will make health care more rational, but this is faith-based government. The liberal fallback is political rationing of care, which is why Mr. Obama made it so difficult for Congress to change that 15-member board's decisions.

Republicans have staunchly opposed this agenda, but until Mr. Ryan's budget they hadn't answered the White House with a competing idea. Mr. Ryan's proposal is the most important free-market reform in years because it expands the policy options for rethinking the entitlement state.

View Full Image

Associated Press
 
House Budget Committee Chairman Paul Ryan
."Premium support" is not a new idea, but it has long been dormant, and Republicans will need to continue their effort to reintroduce it to voters. Seniors would receive a fixed-dollar subsidy from the government to choose from private insurance options, with higher payments for the poor and sick. Consumers would make cost-conscious choices at the margin, and insurers and providers would compete on health-care value and quality.

Mr. Gingrich is right that reforms of this magnitude need to be grounded in a social consensus built over time. But that means the task for Republicans is to educate the public about market principles and more consumer choice. Mr. Ryan's model is flexible enough to adjust the level and rate of growth of the premium-support subsidy. The Ryan Medicare plan was never going to be adopted this year, but it is the first credible, detailed alternative to Mr. Obama's approach.

Some GOP critics, like Mr. Gingrich, claim that it would be politically safer to introduce premium support but give seniors a chance to keep traditional Medicare. The problem is that this leaves all of Medicare's distortions in place and does little to stop its explosive costs. As long as the major incentive in health care is Medicare's fee formula, very little will improve.

Republicans have been passing such reform quarter-measures for 20 years, with little to show for it. Medicare Advantage already offers private insurance options to one in four seniors, but this camel's nose hasn't led to a reconstruction of the larger Medicare tent. The same is true of health savings accounts in the 2003 prescription drug benefit, or the current Republican talking point that medical malpractice reform will somehow solve every problem in health care.

All of these are important but don't reach Medicare's core problem of government-controlled prices and regulation, and in any case Democrats always gut the reforms once they return to power. In retrospect, this play-it-safe strategy paved the way for ObamaCare.

The political forces unleashed by ObamaCare will grow unimpeded if Republicans now retreat from offering an alternative. Once the White House's efforts to limit costs by fiat fail—as they inevitably will—liberals will turn to even harsher controls. This future is already emerging in post-Mitt Romney Massachusetts, and also in Vermont, which wants to move to single government payer.

***
We wrote earlier this year that Republicans would get no objection from us if they postponed Medicare reform until they had a GOP President, but the House went ahead anyway. Far be it from us to criticize politicians for having too much courage. But having committed themselves, Republicans will appear (and will be) feckless if they abandon reform only weeks after voting for it. Trying to change entitlements can be agony, but it is fatal to try and fail. The voters will conclude the critics were right.

Mr. Gingrich has done great harm to his party and the cause of reform with his reckless criticism of Mr. Ryan, forfeiting any serious claim to be the GOP nominee. But equally as culpable are the self-styled conservative pundits who derided Republicans for dropping the reform mantle during the Bush years but now tremble that Mr. Ryan has gone too far.

The reality is that Medicare "as we know it" will change because it must. The issue is how it will change, and, leaving aside this or that detail, the only alternatives are Mr. Ryan's proposal to introduce market competition or Mr. Obama's plan for ever-tightening government controls on prices and care. Republicans who think they can dodge this choice are only guaranteeing that Mr. Obama will prevail.

[Crafty_Dog]

http://patriotpost.us/perspective/2011/05/25/paul-ryan-on-medicare/

[Crafty_Dog]

By KARL ROVE
A kerfuffle was stirred up last week by a devastating McKinsey & Company study that concluded up to 78 million Americans would lose their current health coverage as employers stopped offering insurance because of President Obama's Patient Protection and Affordable Care Act.

The report contradicted Mr. Obama's frequent pledge that under his reform, "if you like your health-care plan, you can keep your health-care plan." And McKinsey's was at least the fourth such analysis calling the president's promise into question.

 Pulitzer Prize-winner Joseph Rago tracks the White House effort to prevent the impact of its policies.
.In May 2010, former Congressional Budget Office (CBO) Director Douglas Holtz-Eakin concluded that employers would drop coverage for about 35 million Americans because of ObamaCare. A month later, in June 2010, the National Center for Policy Analysis (NCPA) pegged the number between 87 million to 117 million. And last November, Allisa Meade, a McKinsey analyst, told health-insurance company executives that 80 million to 100 million people might lose their employer-provided health insurance.

Simple economics is the reason. According to the Kaiser Family Foundation's Employer Health Benefits 2010 Annual Survey, the annual premium for an average policy last year was $5,049 for a single worker, with the company picking up roughly $4,150 and the employee the rest. For a family of four, the total cost was $13,770, with the company picking up $9,773.

Yet under ObamaCare, businesses can stop providing health-care coverage, paying a $2,000 per-worker fine instead. For small businesses, the trade-off is even more attractive: They are given a pass on the first 50 workers.

Workers losing coverage will be moved into the "exchange," a government-run marketplace to buy health plans. Those whose insurance costs were more than a specified share of their income (9.5% in 2014) could get subsidies. The exchange starts in 2014 and is fully operational by 2016.

Perversely, ObamaCare both drives up the cost of insurance with mandates and rules while making it attractive for companies to dump the increasingly more expensive coverage and pay a lesser fine. There will be huge ramifications for the country's finances if more workers lose coverage than was estimated.

When Mr. Obama's health-care bill passed in March 2010, the CBO and the congressional Joint Committee on Taxation predicted that 24 million workers would be covered by the exchange. Of these, nine million to 11 million would lose their employer-provided coverage, offset by six million to seven million who would be getting employer-provided insurance, for a net of three million workers losing company-sponsored coverage. The CBO said the exchanges would cost $511 billion over ObamaCare's first decade.

But what if more people are dumped into the exchange than originally estimated? Costs from the increased subsidies will explode.

If Mr. Holtz-Eakin is correct that there will be 11 million more people in the exchange, then costs could be nearly 40% higher than the $511 billion price tag. If between 78 million and 87 million people are moved into the exchange, the tab could more than triple. And if NCPA's upper-range estimate is right and 117 million people were dumped into the exchange, ObamaCare would cost nearly $2 trillion more than expected in the first decade alone. Much of this extra expense would come from workers losing their employer-sponsored insurance.

Mr. Obama's health-care law has already put the country in bad financial shape. He claimed it reduced the deficit by $143 billion—but that was before the CBO added $115 billion to administer the legislation, including the hiring of bureaucrats and thousands of IRS agents to enforce the new mandates. This reduced Mr. Obama's claimed savings to $28 billion.

The deficit-reduction claim also came before House Budget Committee Chairman Paul Ryan drew attention to the law's Ponzi scheme. It's funded by borrowing $521 billion from the Social Security Trust Fund, Medicare, and new long-term care insurance premiums, and by ignoring the $300 billion cost over 10 years of the annual inflation increases in reimbursements to hospitals and doctors. These gimmicks hide the fact that ObamaCare is really $701 billion in the red in its first decade.

ObamaCare's deficits in its second decade (2020 to 2029) will be even more horrendous as it continues borrowing from Social Security, Medicare and the long-term care insurance program to meet its much larger than anticipated expenses, including a much higher number of people who end up in the exchange.

On March 9, 2010, then-Speaker of the House Nancy Pelosi famously told a meeting of county officials that "we have to pass the bill so that you can find out what is in it, away from the fog of the controversy."

We are now, to our horror, finding out how harmful this measure is. More Americans are realizing that unless repealed, ObamaCare will sink America in a sea of red ink. This helps explain why the nation has turned so hard against it—and against its author whose slippery pledges so misled us.

Mr. Rove is the former senior adviser and deputy chief of staff to President George W. Bush.

[DougMacG]

"devastating McKinsey & Company study that concluded up to 78 million Americans would lose their current health coverage as employers stopped offering insurance because of President Obama's Patient Protection and Affordable Care Act.  The report contradicted Mr. Obama's frequent pledge that under his reform, "if you like your health-care plan, you can keep your health-care plan." "

They lie with such ease, it used to be said of the Clintons.  My health plan is gone and the reasons people like Lawrence Tribe have ascribed to my lack of coverage are false.  Massive over-regulation doesn't lower costs and massive new regulations don't leave existing plans unchanged.  It's not rocket science.

Why was it all or none? Why did they not implement immediately the important reforms Republicans would agree to while we wait for the monstrosity - if the good of the country was the goal.

Why was it delayed implementation? A taste of delayed care?  Why was it 10 years to pay for 6, and then find out it doesn't.

"The deficit-reduction claim also came before House Budget Committee Chairman Paul Ryan drew attention to the law's Ponzi scheme. It's funded by borrowing $521 billion from the Social Security Trust Fund, Medicare, and new long-term care insurance premiums, and by ignoring the $300 billion cost over 10 years of the annual inflation increases in reimbursements to hospitals and doctors. These gimmicks hide the fact that ObamaCare is really $701 billion in the red in its first decade."

Are Ponzi schemes legal in all 50 states?  Would someone please release Bernie Madoff.

I don't get the whole waiver thing.  What basis does the selective waiver process have in equal protection under the law?  What other laws allow for politically-based waivers?  My tax return mandate?  Please grant me a waiver.

The damage done to our economy before its implementation is immeasurable and largely unreported.  See Ryan piece on regulatory uncertainty. 

One reason people buy gold and other non-productive assets is that it is one last places you can put investment money that does not insert yourself into the vicious, highly regulated, ever-changing battle lines of state and federal legislatures and regulators for the crime of ... hiring people.

Some people want to build a better mousetrap.  Other people want to read and study compliance opinions nearly everyday regarding all the changes and administrative ruling updates of highly restraining employment law, payroll law, layoff law, unemployment compensation law, workman comp law, healthcare law...  If you don't want to do all of it, you won't be building a better mousetrap - not in this country.
------
The smartest guy by far in my school district growing up went on to become a lawyer by way of a top Ivy league law school and made his career in the employee benefits section of a major local utility.  That, unfortunately, not inventing amazing new energy sources or curing deadly diseases, is where the action is.

[Crafty_Dog]

The Obama Administration is handing out waivers far and wide for its health-care bill, but behind the scenes the bureaucracy is grinding ahead writing new regulations. The latest example is the rule for Accountable Care Organizations that are supposed to be the crown jewel of cost-saving reform. One problem: The draft rule is so awful that even the models for it say they won't participate.

***
The theory for ACOs, as they're known, is that hospitals, primary-care doctors and specialists will work more efficiently in teams, like at the Mayo Clinic and other top U.S. hospitals. ACOs are meant to fix health care's too-many-cooks predicament. The average senior on Medicare sees two physicians and five specialists, 13 on average for those with chronic illnesses. Most likely, those doctors aren't coordinating patient care.

This fragmentation is largely an artifact of Medicare's price control regime: The classic case study is Duke University Hospital, which cut the costs of treating congestive heart failure by 40% but then dumped the integration program because it lost money under Medicare's fee schedule.

View Full Image

Associated Press
A patient and doctor at Geisinger Medical Center, one of the physician groups that the ACO rule is based on.

Intelligent liberals now concede this reality but claim that the government merely needs to devise better price controls. By changing the way it pays, Medicare under the ACO rule is effectively mandating a new business model for practicing medicine. The vague cost-control hope is that ACOs will run pilot programs like Duke's and the successful ones will become best practices. While the program is voluntary for now, the government's intention is to make it mandatory in the coming years.

But what if they had an ACO revolution and no one showed up? The American Medical Group Association, a trade association of multispeciality practice groups and other integrated providers, calls the rule recently drafted by the Department of Health and Human Services "overly prescriptive, operationally burdensome, and the incentives are too difficult to achieve." In a survey of its members, 93% said they won't enroll.

The Administration wrote its rule based on an ACO pilot program that started in 2005 among 10 high-performing physician groups, including Geisinger Health System and Dartmouth-Hitchcock. All 10 say they have "serious reservations" about the new rule and that without major revisions "we will be unable to participate." In other words, the providers that are already closest to being an ACO have rejected the Administration's handiwork.

And no wonder, since the 429-page rule is a classic of top-down micromanagement. ACOs will need to comply with a kitchen sink of 65 clinical measures that are meant to produce efficiencies, like reducing infections or ensuring that patients take their medications after hospital discharge. If care at an ACO costs less than Medicare predicts it will cost under the status quo, then the ACO will receive a share of the savings as a bonus payment. The rule also includes financial penalties if an ACO misses its targets.

Incredibly, the ACO teams won't know in advance which patients they're supposed to manage. Seniors will be "retrospectively assigned" to an ACO at the end of every year, based on an arbitrary algorithm, for the purposes of calculating costs.

Think about that one: The Geisinger model works because Geisinger patients are treated by Geisinger physicians. Yet this rule is written to ensure that seniors can take "advantage of the full range of benefits to which they are entitled under the Medicare FFS program, including the right to choose between healthcare providers and care settings." So ACOs are going to transform health care, but individual patients don't need to be part of the transformation if they don't feel like it.

Oh, and HHS reserves the right to conduct site visits and audits and "to inspect all books, contracts, records, documents, and other evidence" to ensure that health systems are complying with the ACO rule. The mystery is why even 7% say they'll participate.

The irony, and maybe the tragedy, is that Paul Ryan's Medicare reform plan is far more likely to drive more accountable care. Under his proposed premium support payments, seniors would be responsible for the marginal costs of their care, and we suspect most will choose more efficient providers. As these incentives start to change patient behavior and spread throughout the delivery system, the doctors and hospitals that offer a better value for the health dollar will succeed.

This market approach respects the complexity and uncertainty of modern medicine, allowing for local flexibility and gradual change. Government doesn't know "what works and what doesn't," and it can't. What works will be different for different people and places.

***
The Obama Administration's attempt at omniscience delayed the ACO rule for months amid bitter interagency combat. The White House budget office favored more flexibility, but the HHS bureaucracy prevailed in its belief that it can run this brave new world via the Federal Register. ACOs are gaining traction among private health plans in concert with providers, but the regulatory uncertainty is inhibiting the investments and long-term practice decisions required to bring off an ACO—in effect, a Gresham's regulatory law that is crowding out innovation.

The ACO concept is well-meaning, and we hope it works, but we suspect it will go the way of diagnostic-related groups, HMOs, the sustainable growth rate, and every other top-down government plan to cut health spending since the 1970s. We also hope ACOs work because if they don't, the liberal fallback to cut costs are harsher price controls and the political rationing of care. Seniors will wish they had Paul Ryan's choices.

[G M]

If you think health care is expensive now, wait until you see what it costs when it's free. – P.J. O'Rourke

[Body-by-Guinness]

A Hospital Drug Shortage Made In Washington

Posted by Walter Olson

As readers may know, I’ve been beating the drum for a while on the increasingly dangerous shortages that doctors are encountering in the availability of common, off-patent drugs used in hospital and clinical settings, including drugs that are important in chemotherapy, anesthesia, and infection control. Among the reasons for the shortages: the Food and Drug Administration has toughened its regulation of pharmaceutical makers in ways that lead to manufacturing line shutdowns and withdrawals from production.

John Goodman has a must-read blog post at Health Affairs Blog on the mounting crisis, amplified by a post by George Mason economist Alex Tabarrok at Marginal Revolution, getting into further specifics. In particular:

• 246 drugs are now considered to be in shortage, a record high, and the number has been rising for years. Rationing of scarce chemotherapy drugs is now making a difference in which patients have a chance at survival. In the absence of familiar compounds, doctors are falling back on inexact substitutes, sometimes more dangerous and less effective.

• After “tainted drugs” scares a few years ago, the FDA stepped up its Good Manufacturing Practice regulations, which control the production of pharmaceuticals. In particular, it now proclaims zero tolerance, barbed by tough fines, for many technical infractions whose actual impact on patient risk is at best doubtful, and it is unafraid of shutting down production lines again and again for retooling until its regulations are satisfied to the letter. It also changes its formulation and manufacturing requirements often, with scant forgiveness for makers who have trouble retooling to the new specifications quickly.

• Remarkably, the feds have inserted themselves into the role of central planners of drug output. Goodman:

For example, a drug manufacturer must get approval for how much of a drug it plans to produce, as well as the timeframe. If a shortage develops (because, say, the FDA shuts down a competitor’s plant), a drug manufacturer cannot increase its output of that drug without another round of approvals. Nor can it alter its timetable production (producing a shortage drug earlier than planned) without FDA approval.

That the results might include many unpleasant surprises will surprise only those unfamiliar with the record of a century of central planning failure.

• Pre-1938 drugs are suffering particular disruptions because of a separate FDA program, long demanded by consumer groups, to subject these “grandfathered” compounds to regulatory oversight just as tough as newer drugs. The dictates of the Drug Enforcement Administration also contribute to problems with some controlled substances.

• Several leading professional organizations, including the American Society of Anesthesiologists and the American Society of Clinical Oncology, collaborated on a meeting last November to raise the visibility of the issue and seek possible solutions. You can read its summary report here. Objectively, it’s a damning indictment, but be warned that — rather typically in a field where many key players live in fear of offending the FDA — the report refrains from outspoken criticism of the agency and in fact proposes widening the agency’s funding and powers.

Wouldn’t this make a good subject for hearings at the newly Waxman-liberated House Commerce Committee?

http://www.cato-at-liberty.org/a-hospital-drug-shortage-made-in-washington/

[Body-by-Guinness]

2nd post:

http://reason.com/blog/2011/06/15/gao-report-obamacare-waivers-i
Reason Magazine

GAO Report: ObamaCare Waivers Issued to Prevent Premium Increases Caused By Health Law’s Mandates

Peter Suderman | June 15, 2011

For months, it’s been unclear how the Obama administration’s Center for Consumer Information and Insurance Oversight (CCIIO)—the new bureaucracy set up to regulate health insurance under ObamaCare—was deciding whether to hand out waivers to businesses and unions seeking exemptions from some of the law’s requirements. Now, thanks to a new report from the Government Accountability Office (GAO), we have a somewhat better idea: The administration was handing out waivers in order to prevent large health insurance premium hikes that last year’s health care would have otherwise caused.

According to the GAO, which prepared its report with the help and guidance of CCIIO, the Obama administration’s new insurance regulators “granted waivers on the basis of an application’s projected significant increase in premiums or significant reduction in access to health care benefits.” It’s not a bright-line test, however; there’s still a discretionary element. As the report’s authors explain, “officials told us that they could not exclusively rely on specific numerical criteria to define a significant increase in premiums or a significant decrease in access to benefits, because applicant characteristics and circumstances varied widely.” So the process is still not fully transparent.

But what’s most important about the report is how it reveals, yet again, that the folks running the ObamaCare show are aware of the effects the law will have on the price of insurance. Like the Obama administration’s decision to grant the state of Maine a waiver from ObamaCare’s medical loss ratio requirement, the GAO’s description of the waiver process is about as straightforward an admission as anyone is likely to get fulfilling ObamaCare’s new insurance requirements does indeed drive up premium prices and/or reduce health insurance benefits.

Now, the administration would likely contest that argument as unfair. After all, they did issue waivers to businesses and union groups where the premium hikes or benefit losses were expected to be largest. But if anything, the waiver process simply shows that the Obama administration knows that, despite all of the president’s claims about bringing down the cost of both care and insurance premiums, the legislation, as passed, will make health insurance more expensive for a very large number of individuals—hence the issuance of 1,347 waivers covering more than 3 million people.

The result is an inherently unfair system in which some businesses and unions have to obey the rules and some don't, and the regulators get to decide who falls into which category. I've said it before, and I'll probably say it again: If it's so clear that the provisions in question aren't working for so many people, why not just grant everyone waivers by ditching those requirements entirely?

[Crafty_Dog]

The point seems simple and obvious to me:  How can this be Constitutional under the Equal Protection clause? 

Even worse, if I have my facts correct here, my understanding is that there is no provision for waivers in the statute; the waivers are a bureaucratic creation 

Baraq's America is a Kafkaesque nightmare.

[G M]

http://news.yahoo.com/s/ap/20110621/ap_on_go_ca_st_pe/us_health_overhaul_glitch

Hooray! Other people's money!

[ccp]

Apparantly the AMA is more interested their members get paid then in individual freedom.  It is almost always about the money.

I got this in my email.  I am not and never have been an AMA member but I got this from the ACP American College of Physicians who are generally rather liberal but to some degree follow the trends in a politically realistic fashion.  Unlike years ago where medical groups had enormous political sway in Washington they hold almost NO sway now.  So they just jump on board and play both sides as best they can and go with the political winds.  Right or wrong that is the way it is.  Not like the legal lobby which controls the country like a vice.

***Welcome to The ACP Advocate.

I’m pleased to start off this issue by reporting to you the news in our first story.  At its June meeting, the American Medical Association's House of Delegates passed a resolution to reaffirm the necessity of a personal responsibility requirement (the individual mandate) as part of health reform.  Continuing to emphasize the importance of the requirement is crucial.  Without requiring everyone (including the young and healthy among us) to have health insurance, the system simply won’t be able to provide coverage to all at rates that are affordable.  This sort of requirement is necessary in order to continue to have a viable private payer system.

[G M]

Apparantly the AMA is more interested their members get paid then in individual freedom.  It is almost always about the money.

I got this in my email.  I am not and never have been an AMA member but I got this from the ACP American College of Physicians who are generally rather liberal but to some degree follow the trends in a politically realistic fashion.  Unlike years ago where medical groups had enormous political sway in Washington they hold almost NO sway now.  So they just jump on board and play both sides as best they can and go with the political winds.  Right or wrong that is the way it is.  Not like the legal lobby which controls the country like a vice.

***Welcome to The ACP Advocate.

I’m pleased to start off this issue by reporting to you the news in our first story.  At its June meeting, the American Medical Association's House of Delegates passed a resolution to reaffirm the necessity of a personal responsibility requirement (the individual mandate) as part of health reform.  Continuing to emphasize the importance of the requirement is crucial.  Without requiring everyone (including the young and healthy among us) to have health insurance, the system simply won’t be able to provide coverage to all at rates that are affordable.  This sort of requirement is necessary in order to continue to have a viable private payer system.

How Orwellian! I hope it's starting to sink in to all the young and stupid Obama voters how they've suckered. You've got crushing student loans, no jobs and you must buy health insurance to subsidize everyone else. Tweet that!

[ccp]

"You've got crushing student loans, no jobs and you must buy health insurance to subsidize everyone else."

Don't forget we ought to pay for the education of illegals too.

If one is born here to a family that works to pay for their children's education good.

If your illegal and cannot afford an education the above group will be forced to subsidize you out of the good heartedness of the ruling Democrat party itching for a vote.

For a long time people have clamored that health care is a "right".

When did retirement often before 60 and even 50 become a "right"?

[Crafty_Dog]

 
 
 
 
 
A friend writes:
==========
 
Dhimmitude -- What  does it mean?
 
 
Obama used it in the health  care bill.

Now isn't this  interesting? It is used in the health care law.



Dhimmitude -- I had never heard the  word until now.  Type it into Google
and start reading.   Pretty interesting. It's on page 107 of the healthcare
bill.  I  looked this up on Google and yep, it exists..  It is a REAL  word.



Word  of the Day: Dhimmitude

Dhimmitude is the Muslim  system of controlling non-Muslim populations 
conquered through jihad. Specifically, it is the TAXING of  non-Muslims in
exchange for tolerating their presence AND as a  coercive means of converting
conquered remnants to Islam.



ObamaCare  allows the establishment of Dhimmitude and Sharia Muslim diktat
in  the United States .  Muslims are specifically  exempted from the
government mandate to purchase insurance, and also  from the penalty tax for being
uninsured.  Islam considers  insurance to be "gambling", "risk-taking", and
"usury" and is thus  banned. Muslims are specifically granted exemption
based on  this.

How  convenient.  So I, as a Christian, will have crippling IRS  liens
placed against all of my assets, including real estate,  cattle, and even
accounts receivables, and will face hard prison  time because I refuse to buy
insurance or pay the penalty tax.  Meanwhile, Louis Farrakhan will have no such
penalty and will have  100% of his health needs paid for by the de facto
government  insurance.  Non-Muslims will be paying a tax to subsidize  Muslims.
  This is Dhimmitude.

I recommend  sending this onto your contacts.   American citizens need  to
know about it --

=====

Another friend replies:

Click here to see what Snopes says.......it appears that there is a
"general exemption" for religious groups, but actual specifics have not
yet been determined.

http://www.snopes.com/politics/medical/exemptions.asp

[JDN]

Better to be Amish. 

Reading the article, no offense, I question your "friend". 

So he is really worried about "crippling IRS  liens
placed against all of my assets, including real estate,  cattle, and even
accounts receivables, and will face hard prison  time"  Wow!

Even cattle huh?   

It seems Muslims get blames for anything and everything. Or Obama. 

Yet these or similar laws have been in place for years....

Kudo's to you for also referencing Snopes.com which makes mockery of the previous friend.

[G M]

"It seems Muslims get blames for anything and everything."

I know, wage jihad against the rest of humanity for centuries and it's funny how you develop a bad reputation.

[Crafty_Dog]

JDN:

I take my friend's meaning to be that the exemption was written with Islam in mind.  Thus the issue presented is not really Muslims or Islam, but the pre-emptive dhimmitude of the authors of the bill (including Baraq as intellectual author?).

[JDN]

Let me tell you a long personal story; don't worry there is a Health Cost Care point at the end.   

This last week I was riding my motorcycle up Angeles Crest in Angeles National Forest; for those of you who don't know the area,
it's a beautiful long mountain ride full of twists and turns in my hometown just above LA.  A biker's heaven,
if you like going fast in canyons.  My brother hates the ride on his Harley.   

Anyway, I was going fast, too fast; on a narrow straightaway I blew by a Forest Ranger Truck.  Two turns later, deep in the turn I hit gravel.
Oh oh.  Tried to straighten up, did ok, then hit one of those new stupid deep reflector holes and lost it (pilot error).  Flipped, hit my head and slid,
according to the CHP who investigated the scene, over 120 yards over rocks, pavement, etc.  I then sat up and said Whew, that was close.  (3 have died on bikes on this road in the last 3 weeks).  But everything on my body seemed to move and I could focus.

The Forest Ranger truck stopped; two very polite and gorgeous girls got out who are Botanists from Boston.  Not bad for a rescue
team.      Cell phones don't work up Angeles Crest, but they had radios. While I admit I felt like I had gone too many rounds with a heavyweight,
I basically checked myself; everything moved, albeit slowly.   So I said could they please call my Father or Wife
to come get me.  I'll have AAA tow the bike.

For Health Insurance I have a great plan, but it's a $5000.00 Deductible.  I'm usually healthy.  Still, it's expensive.  The theory of high
deductible plans is that you avoid going to the doctor unless it's really necessary.  I decided to save money.

But, then the fire trucks showed up; 5 of them.  I guess it was a boring day.  The paramedic checked me out; found
"nothing" seriously wrong, but...   Then they said they are taking me to ER down the hill.  I saw dollar signs going
off and said pass.  Time will heal everything.

They said just lay down on this gurney.  I did.  They strapped me in 10 different ways.  I rested.  Then the Fire Captain
said they are taking me to ER.  I said "No Thanks".  Didn't matter, literally he got in my face and said I'm going. 
They put me in the Ambulance took me to the ER.

I'm blessed living near an excellent Hospital.  The ER doc was great; he checked me out, mumbled about how lucky
i was and how truly sore I will be (I am), but nothing permanent/serious seems to be going on.  He gave me some good drugs,
the nurse patched up areas that were bleeding, and my wife picked me up. I had good equipment; good leathers (top only).
So my knees are messed up, my back is really sore, and I have bruises all over, but in the end, I will be fine.

Now here is the question, for all you anti national health insurance plan people.  I can afford, although times aren't great,
the $5000.00 deductible.  And the 20% co-pay thereafter.  I'm sure the bill will be close to 10K.  It could have been much much worse.

I know the Fire Captain had my best interest at heart.  Also, that is just how he does it and I don't think he's used to hearing
"No" very often, although I didn't like being kidnapped.
But he is not going to pay the bill.  Easy for him to say go to the ER.

If I didn't have the 5K who would?  Well first they come after me.  Take my house, garnish my wages, etc.  If the well
is dry, they send it to a collection agency.  If all else fails the government (that's you all) will pay. 

Why not have a base government plan covering everyone like Medicare and then supplemental private plans for the bells
and whistles?  My father has Medicare; he loves it.  He also has a great, albeit expensive supplemental plan ($800.00 month) that covers
everything else in the world that Medicare doesn't that Dad pays for himself.  He's happy.  I just want the same choice. 

I think that makes sense for everyone. 

As a side note, as I have mentioned, my wife was quite sick, but miraculously is doing much better.  Still, no guarantees.
She has kept her job and her insurance (great boss) but now they are thinking of laying her off as well as other employees.  It's the times.
I don't care about her earnings so much, but we need the insurance.  No job, no insurance.  Sure, you can have COBRA.
But that runs out fast.  Then what?  With her pre-existing condition no one will offer coverage at any price.  I understand
the actuarial math, but....  So what's a person to do?  Go without coverage?  Again, a base national health plan might be the answer.

Just a thought. 

[ccp]

"Why not have a base government plan covering everyone like Medicare and then supplemental private plans for the bells
and whistles?"

One problem is the government is already broke and with the population getting older we cannot afford it as it is.

(In case you haven't noticed?)

Perhaps we could cover you but then tax you for riding your motorcylce which is a very high risk endeavor.
We tax cigarettes, Michelle wants a calorie tax, so why not cylces?

[Crafty_Dog]

IMHO the matter of people getting kicked out of their insurance due e.g. to a job loss and while having what then becomes a pre-existing condition is a genuine problem. 

If we could REPLACE what we have now with a simple base plan that would then put this whole matter to rest, off the top of my head that would be a reasonable compromise.  The problem is that with progressives if you give an inch they come back looking for a mile see e.g. "Don't ask, don't tell" or "civil unions".

[ccp]

"The problem is that with progressives if you give an inch they come back looking for a mile see e.g. "Don't ask, don't tell" or "civil unions".

Exactly.  We cannot compromise any more because there is no compromise.

They never stop demanding for more.  Goal:

One world government that controls and monitors everything around the world.

Government distribution of all wealth and conjointly all poverty.

Everything we do or not do is monitored.  For example one eats a french fry you get taxed.  You flush one too many times it is recorded and automatically deducted from one's account as is every other tax, fee, fine, and charge.

You don't exericse you are taxed.

The Ivy league universities guide everything - they kind of already do.

and on and on.

[DougMacG]

"She has kept her job and her insurance (great boss) but now they are thinking of laying her off as well as other employees.  It's the times."

She has coverage because she of the job (private sector inferred).  They are laying off employees because of the economy.  Number one cause of the continued bad economy with almost no new hiring: healthcare reform with non-existent cost savings, along with two dozen new tax increases, new regulations, penalties and heavy burdens on employers.

JDN: "With her pre-existing condition no one will offer coverage at any price."
Crafty: "IMHO the matter of people getting kicked out of their insurance due e.g. to a job loss and while having what then becomes a pre-existing condition is a genuine problem."

Pre-existing condition - instantly - was one of the planks offered in the Republican alternatives and turned down by the ObamaPelosi-ites.  It is a feature of Obamacare but implementation was delayed I believe to 2014.  IT DID NOT HAVE TO BE THAT WAY.  That was solvable in 2009 but they wanted the whole enchilada, not compromise or even a single Republican vote.  If Obamacare did not utilize financial deception to pass, the good features would be law now.

JDN, I'm glad you are okay.  That said...

By your own description, you were a) on a motorcycle, and b) going too fast. (Did I read that right?) Those are two risks that someone else might not want to pay for, and will be likely be freedoms you would lose as we shift the financial consequences to others... or it could void your warranty.

You were burning fossil fuels for the enjoyment. (?)  I'm surprised that freedom wasn't already taken the day Al Franken took the 60th vote in the Senate.  So many potential prohibitions.  So little time.

'Base plan' means disparity and arguing the unfairness to eternity.  Probably a better way than Obamacare to get to full coverage, single payer.

Base plan will however include everything controversial, abortion, birth control, sex change operations, smoker, motorcycle, sky dive coverage.  Anything less will be unfair.  French fries and stick fighting might be the only exclusions?

We already, at least in our state, have full coverage for the financially challenged.  We are talking about a middle class entitlement.  Paid for by whom?

You were going to be treated, like it or not, in this case.  We are only talking about who pays for it.

"My father has Medicare; he loves it.  He also has a great, albeit expensive supplemental plan ($800.00 month) that covers everything else in the world that Medicare doesn't that Dad pays for himself.  He's happy.  I just want the same choice."

a) You will be there soon.  
b) Medicare is bankrupt.  Let's expand it.  

"Why not have a base government plan covering everyone"

Third party pay for millions is already the reason why costs for the rest of us are OUTRAGEOUS.

Healthcare was mostly affordable back when most service was fee for service.  That was when prices had to match affordability.

"then the fire trucks showed up; 5 of them.  I guess it was a boring day."

Would that happen in the private sector?

"Flipped, hit my head and slid"

Hope you mean - hit my helmet.

"3 have died on bikes on this road in the last 3 weeks"

Sounds like fun ...  

[DougMacG]

We drifted to govt healthcare on libertarian issues http://dogbrothers.com/phpBB2/index.php?topic=1565.msg52640#msg52640 where it also belongs and I wanted to answer part of it here.

GM wrote: Yeah, it's funny how a free market can make products and services cheaper for everyone to access but somehow that can't be used for healthcare.

Yes, that was a point a tried to make with a highly educated liberal relative recently.  She was arguing that single payer is the most efficient system and I kept answering with the question: "for everything?"  No, only healthcare because that was all she had looked into, but has someone looked into the most efficient and effective ways to allocate scarce resources if they look at one failed example.  What about housing?  I see areas here where the average price has adjusted from $3 million to $2 million.  At either level, the price is astronomical and the product exceedingly complex and extravagant because that is exactly what people are wanting and able to afford.  Those prices in a free market continuously adjust so that is true under changing cicumstances and the product built adjusts too - if left alone to adjust.  In healthcare, not so.

JDN wrote: "Do you know what cancer costs?  Or a heart attack?  Even just a "routine" visit to the emergency room is $1000's of dollars, Etc.

Yes.  Do you know why??

I put it in a previous reply: "If we paid our own medical bills (for the most part), the cost levels set by providers would be limited to what people could generally afford and were willing to pay (imagine that!), not what an entity with the power to print money could possibly spend."

That does not mean there won't be a safety net for the needy, there already is.  It means as you expand that to include routine care for ordinary income Americans, the entire system with the only known, effective force for cost control is gone.  That can't happen!  Look at Europe! Yeah, look at Europe.

The welfare state like Scandinavia or even Japan relied on a culture of homogeneous people all possessing an unending work ethic and not interested in taking advantage of the system, where the safety net goes only to the truly needy no matter what are the rules.  Hardly a description of Europe today, or the US.

[G M]

"Yes, that was a point a tried to make with a highly educated liberal relative recently.  She was arguing that single payer is the most efficient system and I kept answering with the question: "for everything?"  No, only healthcare because that was all she had looked into, but has someone looked into the most efficient and effective ways to allocate scarce resources if they look at one failed example.  What about housing?  I see areas here where the average price has adjusted from $3 million to $2 million.  At either level, the price is astronomical and the product exceedingly complex and extravagant because that is exactly what people are wanting and able to afford.  Those prices in a free market continuously adjust so that is true under changing cicumstances and the product built adjusts too - if left alone to adjust"

Single payer for food? Who needs supermarkets and restaurants? We could have "nutrition panels" to decide give you the food you need. It would be amazingly efficient!

[ccp]

If this doesn't beat it all - now politicallyt correct health care in our medical journals. 

I get this journal for free in the mail and it often has some good medical reviews.  This month it comes out with articles on global warming for doctors and patients.  I have a feeling this is a sign of what is to come.  Quality measurements of primary care will include politically correct indoctrination orders from the Federal payer - Department of Health and Human Services - Medicare.

For goodness sakes now it is my job to discuss the health ramifications of "global warming" with patients?  And how we can all help to work towards fixing this?   Can we ever stop being told what to do?

****Slowing Global Warming: Benefits for Patients and the Planet
Parker C L
August 1 2011 Vol. 84 No. 3
View Abstract

Global warming will cause significant harm to the health of persons and their communities by compromising food and water supplies; increasing risks of morbidity and mortality from infectious diseases and heat stress; changing social determinants of health resulting from extreme weather events, rising sea levels, and expanding flood plains; and worsening air quality, resulting in additional morbidity and mortality from respiratory and cardiovascular diseases. Vulnerable populations such as children, older persons, persons living at or below the poverty level, and minorities will be affected earliest and greatest, but everyone likely will be affected at some point. Family physicians can help reduce greenhouse gas emissions, stabilize the climate, and reduce the risks of climate change while also directly improving the health of their patients. Health interventions that have a beneficial effect on climate change include encouraging patients to reduce the amount of red meat in their diets and to replace some vehicular transportation with walking or bicycling. Patients are more likely to make such lifestyle changes if their physician asks them to and leads by example. Medical offices and hospitals can become more energy efficient by recycling, purchasing wind-generated electricity, and turning off appliances, computers, and lights when not in use. Moreover, physicians can play an important role in improving air quality and reducing greenhouse gas emissions by advocating for enforcement of existing air quality regulations and working with local and national policy makers to further improve air quality standards, thereby improving the health of their patients and slowing global climate change.
Full Article - Access restricted to AAFP members and AFP paid subscribers.
Please log-in below to view.
If you are looking for patient information, you may also wish to visit the AAFP patient information Web site, www.familydoctor.org.

Here is a handout we can give to patients:

http://www.aafp.org/afp/2011/0801/p282.html

[JDN]

CCP - I think you should have put this in the Humor section!      
This is a joke, right?

I have cracked ribs from my accident; I don't won't to hear about "global warming".  Just Vicadin.   

As a side note, the head of ER that I went to is Jewish.  What a fabulous Doctor.  I got lucky; he was on duty.  VERY knowledgeable, (I know, my ex wife is a Board Certified Neurologist) he was professionally caring, efficient, practical about my dollars, I was in love with him.  I find it interesting that Jews in general are brilliant. My compliments!

Interesting different discussion, but why?

[Crafty_Dog]

JDN:  Search on the SCH forum for an interesting and controversial article by Charles Murray on that very question.

[ccp]

"CCP - I think you should have put this in the Humor section!     
This is a joke, right?"

JDN, no I am afraid it is not a joke.

Just more "progressism creep" in our society.

It really is a cancer.

"I find it interesting that Jews in general are brilliant. My compliments!"

Thank you I will include myself in that group! 

Unfortunately some Jews (liberals) are misguided and have used their brains inadvertantly to destroy the United States as they think they are making the world a better place.  There appears some signs at least a few of them are learning the foolishness of there ways.  The rest are stubborn to the death and will narcissitically think they know better then the rest of us.

[prentice crawford]

WASHINGTON (Reuters) - An appeals court ruled Friday that President Barack Obama's healthcare law requiring Americans to buy healthcare insurance or face a penalty was unconstitutional, a blow to the White House.
 
The Appeals Court for the 11th Circuit, based in Atlanta, found that Congress exceeded its authority by requiring Americans to buy coverage, but also ruled that the rest of the wide-ranging law could remain in effect.
 
The legality of the so-called individual mandate, a cornerstone of the 2010 healthcare law, is widely expected to be decided by the Supreme Court. The Obama administration has defended the provision as constitutional.
 
The case stems from a challenge by 26 U.S. states which had argued the individual mandate, set to go into effect in 2014, was unconstitutional because Congress could not force Americans to buy health insurance or face the prospect of a penalty.
 
"This economic mandate represents a wholly novel and potentially unbounded assertion of congressional authority: the ability to compel Americans to purchase an expensive health insurance product they have elected not to buy, and to make them re-purchase that insurance product every month for their entire lives," a divided three-judge panel said.
 
Obama and his administration had pressed for the law to help halt the steep increases in healthcare costs and expand insurance coverage to the more than 30 million Americans who are without it.
 
It argued that the requirement was legal under the Commerce Clause of the Constitution. One of the three judges of the appeals court panel, Stanley Marcus, agreed with the administration in dissenting from the majority opinion.
 
The majority "has ignored the undeniable fact that Congress' commerce power has grown exponentially over the past two centuries and is now generally accepted as having afforded Congress the authority to create rules regulating large areas of our national economy," Marcus wrote.
 
Many other provisions of the healthcare law are already being implemented.
 
The decision contrasts with one by the U.S. Appeals Court for the 6th Circuit, based in Cincinnati, which had upheld the individual mandate as constitutional. That case has already been appealed to the Supreme Court.
 
The Court of Appeals for the 4th Circuit, based in Richmond, has yet to rule on a separate challenge by the state of Virginia.
 
(Reporting by Jeremy Pelofsky and James Vicini; Editing by Eric Beech)

http://news.yahoo.com/appeals-court-rules-against-obama-healthcare-law-171829777.html
                           
                                                 P.C.

[DougMacG]

"The case stems from a challenge by 26 U.S. states which had argued the individual mandate, set to go into effect in 2014, was unconstitutional..."

Just the fact that 26 states oppose it should be enough to get what's left of the Obamacare coalition to BACK OFF.  We shouldn't need the court system to know that the constitution never authorized this kind of power.

[JDN]

By no means am I a constitutional scholar, but what is the difference between the established constitutionality of an individual mandate to participate in Social Security and Medicare, and a mandate to participate in a National Health Care system?

[prentice crawford]

Woof,
 Who said it has been established?
                 P.C.

[JDN]

Woof,
 Who said it has been established?
                 P.C.

The Supreme Court.


On May 24, 1937 the Supreme Court handed down its decision in the three cases. Justice Cardozo wrote the majority opinion in the first two cases and he announced them on what was, coincidentally, his 67th birthday. (See sidebar on Justice Cardozo.)

Mirroring the situation in Congress when the legislation was considered, the old-age insurance program met relatively little disagreement. The Court ruled 7 to 2 in support of the old-age insurance program. And even though two Justices disagreed with the decision, no separate dissents were authored. The unemployment compensation provisions, by contrast, were hotly disputed within the Court, just as they had been the focus of most of the debate in Congress. The Court ruled 5 to 4 in support of the unemployment compensation provisions, and three of the Justices felt compelled to author separate dissents in the Steward Machine case and one Justice did so in the Southern Coal & Coke case.

Justice Cardozo wrote the opinions in Helvering vs. Davis and Steward Machine. After giving the 1788 dictionary the consideration he thought it deserved, he made clear the Court's view on the scope of the government's spending authority: "There have been statesman in our history who have stood for other views. . .We will not resurrect the contest. It is now settled by decision. The conception of the spending power advocated by Hamilton . . .has prevailed over that of Madison. . ." Arguing that the unemployment compensation program provided for the general welfare, Cardozo observed: ". . .there is need to remind ourselves of facts as to the problem of unemployment that are now matters of common knowledge. . .the roll of the unemployed, itself formidable enough, was only a partial roll of the destitute or needy. The fact developed quickly that the states were unable to give the requisite relief. The problem had become national in area and dimensions. There was need of help from the nation if the people were not to starve. It is too late today for the argument to be heard with tolerance that in a crisis so extreme the use of the moneys of the nation to relieve the unemployed and their dependents is a use for any purpose [other] than the promotion of the general welfare."

And finally, he extended the reasoning to the old-age insurance program: "The purge of nation-wide calamity that began in 1929 has taught us many lessons. . . Spreading from state to state, unemployment is an ill not particular but general, which may be checked, if Congress so determines, by the resources of the nation. . . But the ill is all one or at least not greatly different whether men are thrown out of work because there is no longer work to do or because the disabilities of age make them incapable of doing it. Rescue becomes necessary irrespective of the cause. The hope behind this statute is to save men and women from the rigors of the poor house as well as from the haunting fear that such a lot awaits them when journey's end is near."

With these cases decided, Justice Stone could then dispose of the third case in short order. "Together the two statutes now before us embody a cooperative legislative effort by state and national governments, for carrying out a public purpose common to both, which neither could fully achieve without the cooperation of the other. The Constitution does not prohibit such cooperation." 6

[DougMacG]

(I disagree with that ruling.)

The Court, in the past, reaffirming the power of congresses of the past to go far beyond any concept of limited government laid out in the constitution, even if it happened more than a thousand times, is not precedent to go miles further.

Where is the individual mandate in social security or Medicare except to be taxed on income, which was a power previously lacking but specifically added to the constitution.

[DougMacG]

IIRC, Obamacare was allowed to be deemed passed as a reconciliation item because it was at zero net cost as a budget item.

Besides funny math, 10 years of taxes matched against 6 years for benefits and plenty of other tricks, the reason it was rated at zero net cost was because of the individual mandate.

The individual mandate was struck down.

The deemed passed procedure is now null and void.

Obamacare is thus repealed effective August 12, 2011.   (?)

  - Doug

[JDN]

The individual mandate was struck down.

The deemed passed procedure is now null and void.

Obamacare is thus repealed effective August 12, 2011.   (?)

  - Doug

Until the next court ruling.   

[G M]

The individual mandate was struck down.

The deemed passed procedure is now null and void.

Obamacare is thus repealed effective August 12, 2011.   (?)

  - Doug

Until the next court ruling.   

Or the economy crashes from our massive debt. One way or another, it's doomed.

[DougMacG]

I had a very short conversation yesterday with an old friend who runs a very large healthcare organization, and what he said startled me.  In reply to 'how's work going' he said we're busy implementing Obamacare.  I said I thought it was getting repealed.  His politics isn't any different than mine, but they believe with certainty that some version of Obamacare is coming.
-----
When Obamacare was passed (deemed), Republicans were open to many reforms to avoid national care: end pre-conditions, open up competition across state lines, limit liability, etc.  After passage the conversation turned to repeal AND replace, pretending the opposition R's will have their own healthcare proposal by election time.  Now the candidates all just (naively) say repeal and go on to the next topic.

All that ignores the fact the it took the perfect storm of winning 59 senate seats plus stealing the 60th, deeming passed what wasn't, budget tricks like taxing gold, lying about costs and using 10 years of revenues to pay for 6 years of costs to get it passed.  Now Republican candidates think they can just promise repeal and if they win election it all goes away?

The perfect storm for Republicans in 2012 does not include either taking 60 senate seats or having the Democratic party apologize and fold.  With the worst economy in memory we only have about a 50-50 chance right now of even beating Obama and the anti-incumbent mood could actually hurt Republicans in the House.  The Senate seats Dems will lose (best case) are the moderate ones, not the furthest left from blue states.  Even in the storm of 2010 people like Barbara Boxer and Harry Reid held their seats.

The Supreme Court will likely do something to the individual mandate similar to what the Appeals court just did.  Best case, Republicans may take the Presidency, House and a 53-54 vote majority, but not close to 60. This legislation already doesn't stand on its own but will be left largely in place, lacking the votes to repeal.  The deadlock will make the debt ceiling stalemate look like a walk in the park.  Any deadlock is victory for national healthcare advocates.  Getting repeal votes or even cloture votes from the remaining liberals is a hell freezing over scenario.  No Republican candidate or anyone else is talking at all about how to solve and settle this either politically or operationally.  Meanwhile we will be 3 years into its implementation.

[Crafty_Dog]

I gotta say my initial impression here is that conceptually that this is not much different from requiring companes to say what is in the box and how much there is of it.
===========================================

Anyone who has ever tried to read a health insurance policy knows how hard it is to find out what the plan actually covers and how much it will cost. The Obama administration proposed welcome new rules this month that would make it a lot easier for consumers to compare one policy with another — on cost and coverage — before signing up.

Health policies are notorious for their confusing legalese. When confronted with a big medical bill, enrollees are often shocked to find that there are limits or exclusions they never heard of, leaving them owing a lot more than they can afford to pay.

The new rules, which carry out provisions of the health care reform law, would require insurers and employers, starting next year, to provide a brief summary in plain English listing such items as premiums, deductibles, services not covered, and the costs of using a provider in the network as compared with one outside the network.

There will also be “coverage examples” showing how much the insurer would pay and what a typical enrollee would pay for three common types of health expenses: having a baby, treating breast cancer and managing diabetes. The summaries would be provided in a document or, if consumer safeguards are met, on the insurer’s Web site, on a government site or by e-mail.

Each insurer would have to display the information in the same format and the same order, making it easy to compare policies side by side before buying. Although some private and government sites already offer some of the same information, the new formats are expected to provide the most comprehensive, unbiased information available.

Insurers are complaining that compiling and disseminating the benefits information will drive up their costs. That is a ridiculous objection. The administration estimates that the proposal would cost some $50 million a year to carry out. That seems a small burden on a multibillion-dollar industry. The investment would provide a huge benefit to confused consumers and help spur competition to bring down health insurance costs.

[JDN]

But a difficult choice......

http://www.latimes.com/business/la-fi-lazarus-20110902,0,2080851.column

"Every day was a good day," Karen said. "We were a family, and the kids got to be with their father. You can't put a price on that."

Well, you can, obviously. And it can be argued that you should. The United States already spends about twice per person on healthcare compared with most other developed nations — $7,538 a year on average, according to the Organization for Economic Cooperation and Development.

That translates to healthcare accounting for about 16% of the overall U.S. economy. That compares with 11.2% in France, 10.5% in Germany, 9.4% in Sweden and 8.7% in Britain.

In the harsh light of pure statistics, it's clear that we have to do more to bring down healthcare costs and expenditures. One way to do that would be through the efficiencies of extending Medicare to all Americans and more strictly regulating how much can be charged for medical procedures and insurance.

Another would be to limit how much of our healthcare resources should be devoted to, for lack of a more artful term, lost causes.

[ccp]

From a public health point of view it is clear this vaccine should be given to all.  Yet I tend to agree with Bachmann that people should have  choice.  That said I doubt this is a big issue in the race for the President and was over dramatic on Bachmann's part - with we are attacking little girls and risking them for drug company profit logic:

****Michele Bachmann attacks Rick Perry on HPV
210 Email Print
By ALEXANDER BURNS | 9/12/11 9:16 PM EDT Updated: 9/12/11 10:05 PM EDT

Michele Bachmann accused Rick Perry of using sixth-grade girls as profit engines for a drug company at the CNN/Tea Party Express debate, lacing into the Texas governor for having attempted to mandate the HPV vaccine for young teenagers.

“To have innocent little 12-year-old girls be forced to have a government injection through an executive order is just wrong,” Bachmann said. “Little girls who have a negative reaction to this potentially dangerous drug don’t get a mulligan.”

Continue Reading

The Minnesota congresswoman went even further, accusing Perry of handing out favors to a company, Merck, represented by his former top aide, Mike Toomey.

“There was a big drug company that made millions of dollars because of this mandate,” Bachmann said. “The governor’s former chief of staff was the chief lobbyist for this drug company.”

Perry pushed back hard against Bachmann, but seemed flustered as the attacks on HPV intensified.

“At the end of the day, this was about trying to stop a cancer,” Perry said. “At the end of the day, I am always going to err on the side of life.”

When Bachmann suggested he mandated the vaccine as a favor to a campaign contributor, Perry responded: “I raised $30 million and if you’re saying I can be bought for $5,000, I’m offended”

Bachmann shot back: “I’m offended for all the little girls and parents who didn’t have a choice.”****

[DougMacG]

Thank you CCP for weighing in on this: "From a public health point of view it is clear this vaccine should be given to all."

I thought Perry already admitting his mistake.  It was a freedom-based error made in the interest of saving lives.  It is too late to wait and see if you need a vaccine.  If he had a friend tied closely to the vaccine, then he had someone he trusted telling him what you just said (repeating): "From a public health point of view it is clear this vaccine should be given to all."

When it is not a mandate, it is thrust strongly on you from what perhaps should be your most trusted person, your Pediatrician.  That happened to me with my daughter.  I had very strong reservations about it and said yes.  To say no meant to research it endlessly to know enough to prove him and the whole profession wrong.  Based on my comments on other subjects, in the back of my mind that is possible.  It feels much better to have you agree with Perry adviser and our doctor and the association of pediatricians etc. because I know that in this forum you would freely speak up against them if you felt that way.   

It's far more invasive than seat belts, booster seats, motorcycle helmets, smoke and CO detectors, and all the other things we do in the name of public health.  We deserve the freedom to make our own decisions.  Parents deserve that when the subject is their kids.  But it is common place in America to be legislating public health mandates from government.  Those of us who assume people will make the responsible decision on their own will be offended, but most people accept most of this, especially if they are getting the science right.
----
Sounds like Bachmann's comment of it causing mental retardation in a specific family she spoke to is another glimpse at over the top leaps that she is willing to make.  Another example of shooting (without looking) in the wrong direction.  Her political causes I think would do very well with Perry as President; the person she should be trying to defeat is in the White House.

[ccp]

Doug,

I agree with your thoughts but also sympathize understand the rights of parents to have a say.

So much of communicable disease is political.  Look at the Aids epidemic.   The pols protected the gay community more than the health of the general public.

I don't want to bash the legal profession but clearly the class action law suit industry also helps drive this.  Blame anything and everything one can when going after deep pockets.

There are clearly some ethical attorneys like their are unethical physicians yet the legal system is in view out of control.

[ccp]

While Prof. (emeritus in her own mind) Ann Coulter, Phd, MD. MSc was on Hannity radio yesterday "teaching" us cervical cancer is a rare disease she neglected to note the vector that causes it is truly epidemic:

http://www.cdc.gov/std/stats09/figures/48.htm

[ccp]

I don't have any children but if I did I would resoundingly encourage him and her to get vaccinated.  I strongly recommend it to all adult women I see under age 26.  Most are sexually active.  Asking them to use condoms is nice but not effective.  They all have boyfriends and are convinced their boyfriends have or would never cheat.  I had one girl age 17 who admitted to being sexually active with her "boyfriend"  get totally indignant when I strongly suggested she get vaccinated and read up about gardisal on the net.  She glared at me knowing full well her boyfriend was, is, and always will be her only love - forever!  
Doug, without a doubt you did the exact right thing in portecting your children.  I do agree with Bachman that parents and young adults should have a choice but otherwise she is nuts to put it bluntly.

http://www.ottawacitizen.com/health/Half+have+infections+Study/4365276/story.html

[G M]

I think this was a "not ready for prime time" moment for Bachmann. Most likely a campaign killing move. It just demonstrates how they have so little to go after Perry with.

[Crafty_Dog]

By SALLY C. PIPES
The U.S. Census Bureau has released its latest estimates on poverty, income and health-insurance coverage. Strikingly, the official poverty rate is the highest it's been in 50 years.

As one might expect, the number of Americans without health insurance also rose—to 49.9 million, an increase of 919,000 since 2009.

But that large number hides more than it reveals. And diving into it shows that the uninsured rate won't fall unless the economy starts humming again. Unfortunately, ObamaCare's billions of dollars in new taxes and regulations won't allow that to happen.

Let's take a closer look at the 49.9 million uninsured. The Census reports that 9.5 million of them, about 19%, have household incomes over $75,000. In other words, a fifth of the uninsured make at least 50% more than the median American. They can afford to purchase a plan but have chosen not to.

Another 8.8 million uninsured make between $50,000 and $75,000. Paying for coverage might be more of a stretch for these folks, but they still have incomes higher than the majority of Americans.

For these two subsets of the uninsured population, an insurance plan might not be worth the money, particularly if they're young and healthy. And with ObamaCare set to drive up the cost of a basic individual insurance plan by 10% to 13%, according to the Congressional Budget Office, the number of voluntarily uninsured is certain to grow.

Another 9.7 million of the uninsured are noncitizens, both legal and illegal immigrants. Illegal immigrants will not be able to participate in ObamaCare's exchanges, so they'll continue to seek care in expensive emergency rooms and community hospitals, thereby adding to the cost of care for everyone else. Add these three groups up, and more than half of the people the Census Bureau counts as uninsured could be considered questionably so.

The uninsured truly in need of help are those with household incomes below $25,000. They represent roughly a third of the uninsured, or 16.1 million.

Now, 16 million uninsured is nothing to sneeze at. But they represent only 5% of the American population. Finding coverage for them doesn't require remaking one-sixth of the U.S. economy, as ObamaCare does. Many of these 16 million people are already eligible for public insurance, chiefly Medicaid and the State Children's Health Insurance Program. They just haven't signed up.

The Census figures also show that the number of people with private insurance dropped by 300,000 last year. About 1.5 million people lost their employer-sponsored insurance, most likely because of the economic downturn. But that loss in coverage was partially offset by the fact that over a million people bought coverage for themselves or their families on the private market.

What are we to make of all these numbers? For starters, increasing the employment rate offers the fastest way to reduce the number of uninsured.

The Census pegs the uninsured rate at 16.3%. Not-so-coincidentally, the percentage of the population that is unemployed, has temporarily given up searching for a job, or is working part-time but would like full-time employment is 16.2%.

In America's employer-dominated insurance system, those two figures are closely linked. Without job growth, the percentage of Americans without insurance will stagnate or increase.

The president and his team have cited the Census figures as proof of the need for ObamaCare. But any coverage gains delivered by the law will undoubtedly be undermined by the law's $800 billion in tax increases, which will further slow economic growth and prevent employers from hiring, and thus from furnishing the previously unemployed with coverage.

Because of ObamaCare's mandates and regulations, many employers are also set to drop the coverage they offer and let their employees buy insurance in the exchanges. In June, a study by the consulting firm McKinsey & Co. estimated that about a third of employers will do so. In a report last year published by his American Action Forum, former Congressional Budget Office Director Douglas Holtz-Eakin estimated that 35 million of the 160 million people who currently have employer-based coverage will lose it.

The Census Bureau's latest report confirms that insurance coverage can be hard to come by. But there's more to the Census figures than meets the eye. Until the American economy resumes growing, the uninsured rate will stay right where it is.

Ms. Pipes is president and CEO of the Pacific Research Institute in San Francisco. Her latest book is "The Truth About Obamacare" (Regnery 2010).