Health Care Reform Becomes Insurance Mandate

After all the hullabaloo about public options, socialized medicine, death panels, and employer mandates, yada yada, it all comes down to this, judging by the bill the U.S. Senate is poised to pass:

You must buy health insurance or go to jail. Or pay a fine. Or get a government subsidy. Or thumb your nose and see what happens (probably nothing).

WINNERS: Insurance companies.

LOSERS: Just about everyone, as this will no doubt raise premiums sky high even as services are reduced to cover new, unserviceable demand.

PREDICTION: If Obama and the Democrats survive in power after 2012, look for the public option to come back in full force as they once again demonize the insurance companies, when in truth it's Medicare and Medicaid that are driving the system bankrupt and unaffordable.

A Cool $10B for Unions in House Health Bill

One of the motivations behind the Employee Free Choice Act (EFCA) and other Obamaic union-ripoff measures is to replete the unions' pension fund coffers, which have been horribly managed and looted for political purpose (e.g., electing Obama).

Now, the House health care bill is rushing to the aid of unions as well, earmarking $10 billion for a "reinsurance fund" to help pay retired union members' health care bills.

On top of that, if a public option passes in the final health care measure (if the package itself passes), it will require that any provider participating in the plan be unionized.

Thus health care reform=more union bailouts (think Chrysler, GM as precursors).

Unlike Her Cohort, Susan Collins Makes Sense

Maine's other Republican Senator, Susan Collins, reacted swiftly to the pro-health reform vote of Olympia Snowe, who calls herself a Republican but says her party has changed for the worse.

Seeing through the Senate Finance Committee reform plan, Senator Collins said the bill not only does not lower costs but actually raises them:

The goal of health care reform must be to rein in costs and provide consumers with more affordable choices. Yet, many individuals and families would be forced to pay more for their health care under the Finance Committee bill, and they would have fewer choices. Our health care reform efforts should give Americans more, not fewer, choices of affordable coverage options.

She also lamented the gutting of Medicare for senior citizens.

It would be laughable if not palpably tragic to listen to Barack Obama and his Demo-cronies hail health reform as "deficit-neutral" and lowering costs for Americans.

Instead of my going on and on, however, read Senator Collins' perceptive comments here.

What the Public Option Will Mean to Your Wallet

If the Democrats succeed in creating their "robust public option" of health insurance for those who currently don't have any insurance, there will be blood. Well, maybe not actual blood, but the color of blood--red--all over the budgets of people and entities from coast to coast.

Consider this:

A study by the actuarial firm Milliman calculated that public programs, such as Medicare and Medicaid, currently shift $88.8 billion in costs onto private payers per year, increasing the typical American family's annual private health insurance premium by $1,512. Can you imagine the cost shift if 103.4 million more Americans were on a government plan?

Pretty frightening, huh? And since the "public option" will be just as underfunded as Medicare/Medicaid, you can chalk up another $37 trillion in unfunded liabilities over the next 50 years or so.

But the Democrats will forever be able to charge at election time that "the Republicans will take away your health care" and thus presumably win votes.

However, since they'll also have to ration and deny health care just to be able to pay 80 percent of what private insurers do (in order to make the public option "affordable"), taking away one's health care won't amount to a whole lot. You won't be able to get any medical services anyway, so what will there be to take away?

Can Reform Help This Kind of Health Care?

I just a chilling article about two nurses in West Texas who anonymously reported to the Texas Medical Board a doctor in their hospital who was peddling his own herbal remedies to patients as well as neglecting his official duties and, basically, practicing bad medicine.

Seems the Good Doc, however, was in cahoots with the local sheriff in the herbal remedy racket. Said sheriff then swooped in, seized computers, found the nurses, charged them with crimes, got them fired, and now they're out on $5,000 baiil awaiting trial.

Herbal remedy sales are still booming throughout the ordeal, evidently.

However sad this sordid little tale is, what is even more shocking is how widespread deliberate malpractice is. Chew over this tidbit:

Medical professionals, especially nurses who are generally lower on the food chain, so to speak, are increasingly reticent to speak out when they see unsound, unethical or corrupt things going on in healthcare. It is hard to do the right thing. They know and see the consequences of following their consciences and the Code of Ethics. This is not an isolated incident. Three California nurses were suspended after they reported a doctor who later admitted giving a lethal injection to a child and another nurse was threatened with firing after refusing to follow a doctor’s verbal order to administer morphine until a patient stopped breathing.

When our health care system fires people who want to do good and right while it protects the evil-doing doctors, then we clearly need more than health care reform. We need to stay healthy enough so that we never have to go to a hospital. Here's to dying like Bing Crosby--falling over dead while playing golf on a course in Spain.

HR 3200 in One Illustration and One Page

If you can figure out this illustration, you're a better man than I am, Gungha Din. However, it gives you a pretty good idea of what a monstrosity the House health reform measure (HR 3200) is.

Also, here's a rundown of some of the salient features of the legislation, ranging from home visitations to governmental access to your bank account for payment!

Don't Read His Lips--It's All in HR 3200

The health care bill that emerged last week from the House of Representatives, HR 3200, indeed contains a provision mandating end-of-life planning despite Obama's insistence that no one would visit you to explain that health care ends when you get a terminal illness and you have no quality years left.

(There actually is a formula for figuring out quality life-years, and if you're retired, you're on the short end of that list. Quality in governmentese=productivity, or $$$ in taxes that you can pay.)

I bring this up because Fox TV's Glenn Beck has aired a video of Representative John Conyers, D.-Mich., explaining that congressmen are too busy to read bills before they pass them; besides, they couldn't understand them anyway. (Translation: "So long as my pet earmarks are in the bill, I'm votin' yes!")

Here's what the esteemed gentleman (I use the term quite loosely had to say):

"To get up and say, 'Read the bill.' What good is reading the bill if it's 1,000 pages and you don't have two days and two lawyers to find out what it means after you read the bill?"

Scary, isn't it/he?

Despite What He Says, Home Visits Are Coming

I guess Barack Obama hasn't even bothered to read the Senate's HELP (Health, Education, Labor and Pensions) Committee health plan.

Yesterday, Obama went on the offensive to deny that government stormtroopers, er, employees, would start visiting old people in their homes to ask them how they want to die. While that is not (to my knowledge, anyway) in the HELP bill, there definitely is a provision to allow home visits to make sure children get all their vaccinations.

I can see that now: "Mrs. Smith, is little Johnny home? We see on his electronic health record that he's behind on his vaccinations. We're here with all the necessary syringes and vaccinations to get him up to date. It shouldn't take more than five minutes."

That scenario is very definitely authorized by the Ted Kennedy underlings who wrote the HELP bill.

Here's what the Prez said to a town hall gathering of AARP members (i.e., old people):

"You know, I guarantee you, first of all, we just don't have enough government workers to send to talk to everybody, to find out how they want to die. I just want to be clear: Nobody is going to be knocking on your door; nobody is going to be telling you you've got to fill one out. And certainly nobody is going to be forcing you to make a set of decisions on end-of-life care based on some bureaucratic law in Washington."

Actually, they won't be forcing anyone to make end-of-life decisions. They'll just do it for you, so technically, he's right, and we all lose if we fall for his version of health care reform.

Painting 'The Doctor' Far From Today's Reality

Sir Luke Fildes lost his eldest son Phillip on Christmas Eve 1877 while a doctor spent a compassionate vigil at the child's side. In commemoration, Sir Fildes painted "The Doctor" (above) in 1891 to depict "the physician in our time."

This same painting was used by the American Medical Association (AMA) in 1949 to stop President Harry Truman in his attempt to nationalize health care. The message was "Keep Politics Out of This Picture."

The AMA can't use this picture or tactic this time around. Things have changed too much.

Some of us who've lived long enough can actually recall how doctors once did make house calls and could even be reached on weekends and evenings for emergencies. (Today, you get a voice recording commanding you to "Dial 911.")

To say the least, we've come a long way in our medical care, and in one sense Obama is correct--the system is broken if you're looking for compassion and home visitations.

But it's not really broken, just adapted to a new reality. We're now a nation of 300 million people with nowhere nearly enough doctors to even treat all of us, let alone make house calls (though some still do and swear by it).

Medical care is now like visiting an auto mechanic. "Doc, it hurts here." "Let me take a look." A few small probes and examinations later, and the doctor is ready. "Fortunately, nothing is broken. I'll prescribe you some painkillers. You should be fine in a few days."

Okay, so I've simplified things here a bit (I left out the two sets of x-rays and follow-up MRIs), but the general picture of "sick care" in America is just that. It's like taking your car into the shop, except it's your body--and your life.

Paucity of time and doctors can account for our new reality, but the biggest contributing factor to what Obama calls our "broken" health care system is Medicare and Medicaid.

Since most doctors won't accept the payment structure of Medicaid, leaving that to emergency rooms, your family doctor is modelling his or her practice on the Medicare payment structure--the more procedures he or she can perform, the more the office can bill for your visit. ("I also notice your car's belts are getting worn. We'd better replace those for $125 before you get stuck on the freeway." Get the analogy?)

So, the next time you hear politicians' bemoaning our "broken" health care system, remember it's only broken because Medicare made it into an assembly-line industry, with each nut, bolt, worker, and procedure along the line being billed for and paid separately.

This is the typical pattern with government: First break it, then blame it on others and come rushing to the rescue to garner votes for the next election, reality be damned.

Politicians just created the housing and credit crises by pushing banks to create "affordable housing." Now they're blaming the bankers and everyone one else in the Fannie Mae/Freddie Mac food chain and claiming to have the solution with "more regulation."

If they really wanted to "fix" health care, all they have to do is fully fund Medicare and come up with a payment structure that rewards healthful results rather than procedures. That'll stop the cost-shifting to private insurers and build some efficiencies into the system.

Instead, they'll give us more regulation (read "rationing") and expand Medicare, the very cause of the crisis in the first place.

Weird Weed Being Smoked in Budget Office

Budget Director Peter Orszag's proclamation over the weekend to CNN that health care reform will not increase the federal deficit must mean the administration plans to create health care collateralized debt obligations (CDOs) and sell them to hedge funds to get the trillions needed and keep the debt off record.

Otherwise, Mr. Orszag has found some kind of noxious weed to smoke while on the job. Clearly, insuring an additional nearly 50 million people ain't gonna be paid for by passing individual mandates or even employer mandates. The fed guv, like Massachusetts' Commonwealth Care, will find itself either subsidizing tons of people or exempting them from the mandate.

Let's get real here, folks. Otherwise, make that weed available to the general public so we can all live in the same unreal world.

Oh, Happy Day: Health Care Deform Pledged

President Obama and the Democrats announced yesterday that absolutely, certifiably and whether we need or like it or not, health care reform will be passed by July 31.

I've begun dubbing it "health care deform," as in deformation, since the consequences are going to be so awful. Read what Labor Law Guy wrote about the consequences of nationalized health care in Great Britain--if your treatment costs too much, you're on your own; the government won't pay for it. Oh, happy day, and this is exactly where we're headed.

Obama said the job must be done because "the stars are aligned." Yeah, and they were for Julius Caesar on the Ides of March.

Peering Through the DoubleSpeak to Clarity

Here's a piece on Senator Jay Rockefeller (D-W.Va.) and his "principles" on health care reform:

Rockefeller's principles. On April 21, 2009, Sen. Jay Rockefeller (D-W.Va.), chairman of the Senate Finance Subcommittee on Health Care, outlined his principles for a 21st century health care delivery system as the Finance Committee unveiled a series of roundtables leading up to health care reform legislation. Sen. Rockefeller’s principles for reforming the health care delivery system are: (1) create a National Director for Health Care Quality; (2) strengthen the Medicare Payment Advisory Commission (MedPAC) and provide expedited implementation of its recommendations; (3) provide the Agency for Healthcare Research and Quality with greater authority to coordinate public and private quality improvement; and (4) require health information technology as a “condition of participation” in Medicare by 2015.

Translation: We're gonna ration it, baby. You'll have access to health care (for an unspecified yearly and per-visit price), but you'll get nothing in return if it's too expensive. However, those of us in government--and our cronies--will have taxpayer-funded, gold plate, everything-is-available-and-free health care. These are my principles, sucka.

Why Not Smart Cards Instead of EHRs?

As the gathering storm of health care reform threatens individual privacy in the form of electronic health records (EHRs) that can be accessed nationwide--and no doubt cleverly hacked into just as everything else is hacked into--a simple solution is to leave the data-keeping to individual patients.

Some countries, notably Taiwan in this comparative study, issue each person a smart card, onto which physicians and other health care providers encode the patient's medical history, medicines being taken, and other pertinent information. Patients carry the cards with them and can present them at any doctor's or specialist's office, and the smart card functions not only as a data center but also as a credit card to bill the government.

Cost for a family of four is just $650 annually and co-pays are low, just $7 for doctors, $1.80 for dentists, and a maximum of $6.50 for prescriptions.

Problem is, like our Medicare, the system is going broke.

Just proves the old adage that you can't have your cake and eat it too.

Deja Vu All Over Again With Health Care Reform

Two admittedly left-leaning columnists, a married couple (he a pollster, she a lawyer), have produced a comparison of polling results then and now. "Then" refers to the Hillarycare hubbub in 1993-1994, and "now" refers to the Obamacare hubbub in 2009-?.

Results are a bit different than you would expect if you listen to or read what our left-leaning media have to say about health care reform.

Surprise, surprise, there was more public support then than now!

You can read through the nitty-gritty polling numbers in "A New Day or Groundhog Day," but let me focus on just one of the results to show you why Obama and the Democrats are going to stuff health care reform down our throats whether we like it or not.

A poll in 1993 when Hillarycare filled the air found 66 percent agreeing with the statement, "I would be willing to pay higher taxes so that everyone can have health insurance." Just 30 percent were opposed. A poll released March 1 of this year found just 49 percent agreeing and 45 percent disagreeing.

But wait--here's where it gets interesting. When those who agreed with the statement in 1993 were asked how much they'd be willing to spend a month so that everyone could have health insurance, just 25 percent said $50, 40 percent said $30, and 61 percent said just $10.

The same breakdown isn't available for 2009, but I bet you'd find few people willing to pay $50 more a month in this economy. I'm not even sure you could get a majority to commit to $10 (unless they thought that they would then get health care for free, an extraordinarily popular delusion in this day and age).

That in a nutshell is why the Dems are rushing to pass "reform" before anyone can sort through the details (which in any case won't be fully available until the thing is published as law). They know the nation can't afford it and taxes will be flying at everyone (and not just the rich) right and left to try to fund so-called reform (to say nothing of the long lines to see doctors, waiting lists to get hospital treatment, and medicines and procedures banned to save money).

Medicare is already on the fast track to go bankrupt in 10 years or less, and somehow our sleight-of-hand artists in D.C. are trying to get us to believe that spending more money actually saves money (in the long run, they add as a disingenuous qualification).

Welcome to life in our Brave New World, where deficits result in savings and less health care is better health care.

Health Care Reform: Denying Services to Cut Costs

I've been warning here all along about the Trojan Horse known as health care reform. In truth, there is no reform, just an expansion of the government option. Already, the State Children's Health Insurance Program (SCHIP) has been reauthorized, replenished and renamed without the state part, so it's now just CHIP.

Dropping that "S" was actually highly significant because, under Obamacare, the feds are taking over, dude. Now, mind you, in some states a family can make up to $106,000 a year and yet qualify for subsidized health care for their children under CHIP.

Senator Jim DeMint, R.-S.C., points out that children growing up with "free" health insurance aren't going to want to have to fend for themselves when they grow up. So the logical thing to do, from a liberal's perspective, is just give everyone "free" health care.

'Cept it ain't free. It's rationed, and that's the word that should be substituted for "reform." What we're going through right now is more appropriately called "health care rationing."

Senator DeMint correctly points out in an opinion piece that $1 billion in the stimulus bill is going for comparative effectiveness research in the field of health care, a code phrase for figuring out how best to ration or eliminate expensive treatments and medicines.

The junior senator tells the chilling tale of a young woman who died at 23 because the rationers in Great Britain wouldn't authorize her to take an expensive test. Read about Claire Everett and her fate at the hands of Britain's cost cutters.

Health Care Reform: How Gurneys Become Beds

To be frank, I share neither the euphoria nor the enthusiasm that seem to surround the rush to "reform" health care. Of course, the optimistic aura surrounding Obama's push for reform is largely media induced, leaving us little hope that we'll see or read anything to detract from what's going on.

My position is that there is no reform of health care going on; there's just a push to get government more involved with an eye toward eventually creating "Medicare for all," for lack of an easier description. Once that happens, then the real, intended reform can take place--bureaucrats will dictate to doctors and hospitals what they can and can't do based on cost effectiveness. In other words, if it's expensive, don't expect to get it once Obamacare takes full effect--unless you want to take a medical vacation to India and pay for it yourself.

Consider this example from Great Britain, which I actually found in a real, live American newspaper (but appearing below and inferior to a more "positive," pro-reform article):

In Britain, for example, politicians were getting pressure from constituents because hospital emergency rooms were so crowded that patients were left on gurneys in hallways awaiting care, sometimes for days. Politicians told the hospitals this had to stop and that they had to admit patients faster.

The response of some hospital administrators: Take the wheels off the gurneys because they then fit the definition of a 'hospital bed.' The patients were no better off, but the statistics looked better to the politicians.

The article was written by someone named Grace-Marie Turner, whom the Atlanta Journal-Constitution quickly described as president and founder of the Galen Institute, which is funded in part by the pharmaceutical and medical industries (my emphasis).

At least the AJC let the article see the light of print before quickly disavowing and discrediting it.

So you see what I mean about how hard it is to find and read the truth.

When It Makes Sense, It Won't Fly in D.C.

A Web site called Business Insider offers up a thoughtful analysis called "Our Health Care Wish List."

Now, mind you, probably none of the changes suggested in the article will ever be implemented, let alone even seriously discussed in Congress or the White House, but there are some good ideas in the piece.

Let me focus on a couple:

One is to let pharmacists write prescriptions, as is done in Europe (in Mexico, you just walk up to the pharmacy and buy what you want, I hear). What a time- and cost-saving idea. When I had a sore throat last year and knew I needed antibiotics, I had to trudge to the doctor's anyway and let her ring up a $200 office visit. What a waste of time and money. In Europe, I could've gone to the pharmacy and just asked for amoxicillin.

The other proposal is to create mini-doctors, which the article defines as "someone with minimal training," to examine sore throats and infections and treat them at $20 a pop. (Why not just train the pharmacists to do these basic functions?) I've always felt that most doctors' visits could just as easily be handled by nurse practitioners, but as I reconsider the situation, creating a new category like a corpsman in the Navy would be perfect.

I guess I should mention one other proposal--get rid of insurance entirely for the routine stuff and just use insurance for the big-ticket items that require specialized procedures and/or hospital stays--catastrophic insurance, in other words.

Personally, I would have no problem paying for the routine stuff if I could get a catastrophic policy for the price of a small car a month, say a couple of c-bills or so. Of course, bringing down the cost of medicine would help immensely too, but already WalMart and Target have huge lists of drugs they'll sell you for $4 a month or $10 for 90 days. If you can stick to the list, it's cheaper than using your insurance and its co-pay.

But, as I said, none of this will matter once the politicians debate health care reform. Then it will be all about creating government bureaucracies and so-called initiatives. And no one will take on the American Medical Association, so look for high-cost, physician-based insurance to reign from cradle to grave (except for the politicians who will feed off the taxpayers' largesse for free).

When government reforms something, we all end up paying.

Analysis Correct, But What Aren't They Telling Us?

A group calling itself Physicians for National Health Program (PNHP) has issued a press release revealing the failure of Hillarycare as it was resurrected in Massachusetts by former Governor Mitt Romney (who somehow has now seen the light of his transgressions from Republican orthodoxy).

Costs are up, services are hard to get, the state is going broke, and what was once free for the indigent now costs them money--that's the Massachusetts health care plan implemented in 2006.

So far, so good--these are the inevitable results of government interference in the free market. (Watch for higher costs and more rationing coming down the pike soon.)

However, PNHP then advocates the adoption of a single-payer national health care system "while maintaining the private delivery system." This plan is embodied in H.R. 676, the so-called United States National Health Care Act.

The group claims implementation of H.R. 676 would save Massachusetts alone "about $8 billion to $10 billion a year in reduced administrative costs," but it fails to say how except that it would eliminate (now, really?) the 31-percent administrative fees built into private insurance plans. Eliminate some admin costs, yes, but all, no, but PNHP never goes into detail.

Also, how does this differ from just putting everyone on Medicare? No clue in the press release.

What H.R. 676 really amounts to is a massive "fee-for-service" cash grab by the physicians of America who, once they got their hands on an "unlimited" federal money spigot, would open the valve as wide as possible with a) more patients and b) more services for every patient they see.

Unless they can provide better details than this crappy press release does, these physicians need to go back to the drawing board--and figure out how they can see more patients for the same, or less, than they do now.

Otherwise, it's just more greedy pigs lining up at the federal trough (see banks, the Big Three, the states, housing, unions, etc.).

A Compassionate People We Ain't, Maybe...

Or it could be that the spirit of Howard Jarvis (California's infamous Proposition 13 tax measure author) lives on in most Americans.

I came across a great survey done this past October about health care reform in the U.S., conducted by Deloitte LLC, which showed that only 25 percent of the public favors higher taxes to provide health insurance for the uninsured while 43 percent are outright opposed. The rest are labeled "mixed" or "lukewarm."

The survey also found that 63 percent oppose an individual mandate forcing all people to have health insurance either through work or on their own, while 53 percent favor an employer mandate. Finally (there's more but you can hit the link above to read it), two out of three said health care would be a prime factor in their presidential vote.

(Two-thirds also opposed evidence-based medicine, which means they didn't understand the concept or they saw right through it and realized it's just a code term for rationing. I hope the latter is the case.)

Reading through the results, I concluded (but I had this opinion before reading the survey, to be honest) that the American public still believes that somehow Obama et al. can create a health care system that is free while offering freedom of choice and quick access.

If pipes can dream, then that's what they'll get, but show me that pipe dreaming first.