• More than half the cost of health care reform will be paid for by $523 billion of cuts in Medicare spending over the next ten years.
• Although there are some new benefits for seniors (mainly new drug coverage), the costs exceed the benefits by a factor of more than ten to one.
• As many as 8.5 million of the 11 million seniors in Medicare Advantage (MA) plans may lose their coverage, according to Medicare’s Chief Actuary.
• Those lucky enough to retain their MA coverage will face steep cuts in benefits or hefty increases in premiums or both.
• In addition to these direct costs there are indirect costs, including new taxes on drugs and medical devices. Although these taxes don’t single out senior citizens, who do you think are the heaviest users of wheelchairs, crutches, artificial joints, pacemakers, etc.?
• To make matters worse, severe rationing problems lie ahead, as 32 million newly insured people try to double their consumption of medical care under a reform bill that produces not one new doctor or nurse or other paramedical personnel. Because many of the newly insured will be in private plans paying market rates, they will be more attractive to doctors than Medicare enrollees paying about 20% to 30% less.

So how did this happen? Aren’t senior citizens supposed to be the most powerful voting bloc? Aren’t they supposed to be represented by the all-powerful AARP?

Unfortunately for seniors (and indeed all Medicare enrollees), AARP sold out its own members. Just as the AMA sold out the doctors and the labor unions sold out their own members, AARP signed on to legislation that helps AARP but hurts the millions of people who AARP claims to represent.

Continue reading about senior citizens and health care reform on John Goodman‘s blog.

Paul Krugman says the opposition to ObamaCare is conducting a campaign based on “blatant fear-mongering, unconstrained either by the facts or by any sense of decency.” The proponents’ case, by contrast, has been principled.

Hmmm…..Krugman and I must be listening to completely different sound bites. Over the past few weeks I can’t recall a single TV appearance by a proponent that did not involve an anecdotal horror story in which a hapless victim is abused by a mean insurance company. Is the purpose of these anecdotes to make us feel sympathy?… To get our checkbooks and make a contribution?… Or is the purpose to make us fear that we too could be abused?… In other words, to scare us??

[Interestingly, Krugman himself wrote a column only a few days earlier in which he based the entire argument for ObamaCare....on....on....you guessed it....a fear-mongering horror story! I'll let readers decide whether the delivery was "unconstrained by facts or any sense of decency." (David Henderson gives the rest of the story here.) Meanwhile, I predict that abuse of the sick by insurance companies will become more likely, not less likely under ObamaCare -- a subject I'll reserve for another day.]

Just how scared should we be? It’s been illegal to rescind a person’s insurance because of a change in health status since the passage of HIPAA in 1996. It’s also been illegal for any employer to discriminate against employees because of their health condition over the same period of time. So it’s only in the “individual market” (less than 10% of the total) that people get charged premiums which tend to reflect their expected health care costs.

Okay. So how well does the individual market work? Better than you might think. In his new book, Health Reform Without Side Effects (previously reviewed by me at the Health Affairs blog), Mark Pauly shows that the market works better than the health insurance exchanges ObamaCare would replace it with and better than the small group market that Obama would leave largely untouched. Moreover, with a few reasonable reforms, the individual market would work better still.

Continue Reading on John Goodman‘s Blog.

FOR IMMEDIATE RELEASE

March 22, 2010

CONTACT:

David Guenthner
(512) 472-2700
dguenthner@texaspolicy.com

Foundation: State policymakers should take steps to protect Texas from ObamaCare

AUSTIN – The Texas Public Policy Foundation criticizes yesterday’s U.S. House passage of legislation that enables the federal government takeover of America’s health care system.

“The legislation that Congress has sent to the White House will have disastrous consequences on Texans’ access to quality health care,” said The Honorable Arlene Wohlgemuth, executive director of the Texas Public Policy Foundation.  “We will work with Texas policymakers to explore all available options to protect our state from the fiscal damage and other harmful consequences of this law going into effect.”

Among the options the Foundation urges state policymakers to consider:

* Litigation challenging the constitutionality of the law. “Prominent legal scholars have identified constitutional defects in at least four major aspects of the legislation,” Wohlgemuth said.  “The provision forcing Americans to purchase health insurance is antithetical to both the U.S. Constitution and the American tradition of individual liberty.”

* State legislation to protect, improve, and lower the cost of Texans’ health care. “Dozens of states are pursuing legislation to protect their residents from the bill’s requirement that individuals purchase health insurance, and the Texas Legislature should do likewise,” Wohlgemuth said.  “The Legislature should also allow Texans to purchase health insurance plans regulated by any other state, create a Health Savings Account option in all state employee and retiree health plans, and allow non-physician medical professionals to provide care to the extent of their medical training.”

* Alternatives to continued participation in the federal Medicaid program. “The runaway costs in Medicaid are at the core of Texas’ current budget problems, and this new federal law will increase Texas’ Medicaid caseload by 50 percent, putting one-fourth of Texas’ population into this government program,” Wohlgemuth said.  “The federal government has no right to co-opt state budgets in the manner that it is with Medicaid.  The Texas Legislature should study fiscally responsible alternatives to the current Medicaid program.”

* A supplementary request that state agencies identify additional budget cuts beyond the 5 percent reductions previously solicited by the state leadership. “Even if Congress provides funding for the first few years of expanded Medicaid eligibility, Texas will eventually bear the full costs of Medicaid expansion, while other provisions of the bill will immediately increase the state’s cost to provide care for our current Medicaid recipients,” Wohlgemuth said.  “The state has estimated the Medicaid provisions will cost at least $24.3 billion in additional general revenue over the first 10 years.  Legislators need to help the public understand how deeply we will need to cut public education, transportation, and public safety to pay for this unfunded federal Medicaid mandate.”

The Honorable Arlene Wohlgemuth is Executive Director and Director of the Center for Health Care Policy at the Texas Public Policy Foundation, a non-profit, free-market research institute based in Austin. She served 10 years in the Texas House of Representatives, specializing in health care issues.

The Texas Public Policy Foundation is a non-profit free-market research institute based in Austin.

Primary website:  www.TexasPolicy.com
Facebook page:  www.Facebook.com/TexasPublicPolicyFoundation
Twitter feed:  www.Twitter.com/TPPF

Dr. John Goodman joined us via taped interview for a segment on health care for the McCuistion 20th Anniversary Program series. Considered one of the key “conservative” experts on health care, he presented his conservative views on health care reform. He had this to say in answer to my [Niki McCuistion] questions on the state of health care today and health cares’ new future, given the changes in the new administration plans. According to Dr. John Goodman, “Health care today is dysfunctional and has perverse incentives… Today, costs are higher, quality is lower and access is more difficult.”

While discussing his conservative views on health care reform, Dr. John Goodman talked about the billions of dollars being spent on health care for the elderly and the young. “It’s too easy now for people to wait to get health insurance till after they are sick and access to health care gets worse. There’s nothing that inspires me to have confidence in what is presently being proposed.”

Yet considering, he still believes there are good things going on relevant to health care; “from 12-13 million people managing their own health costs; to urgent care and walk in clinics and overall a free market for health care”. Dr. Goodman cited the way we can cross the border and get good health care at a fraction of what we pay in the US. And he voiced a concern over boomers and their numbers overwhelming the health care system, “We’re just not ready for them. They think all of these promises were made and there’s not going to be enough money to fulfill them.”

I asked what would you have taxpayers do? His answer,” Liberate the doctor and patient. Let the patient control the money and let doctors compete on price and quality.” For a sobering look at health care today and Dr. Goodman’s conservative views on health care reform, watch and listen to what Dr. John Goodman has to say.

***

Niki Nicastro McCuistion
Executive Producer/Producer
McCuistion

There have been 8 versions of ObamaCare. The numbers below are estimates made for one or more of them. We believe they are still in the ballpark, and we will update as more information becomes available.

“If you like the plan you are in you can keep it.”

19 million	Number of people predicted to lose their employer plan (Lewin Group)
8 to 9 million	Number of people predicted to lose their employer plan (CBO)
$11,543	Employer incentive to drop coverage for a $30,000 a year worker with family [Tax subsidy in the exchange minus tax subsidy at work minus $2,000 fine] (IRET)
8.5 million	Number of seniors and disabled people at risk of losing their Medicare Advantage plan (Medicare Chief Actuary)
3 million	Additional people who will likely lose Medicare Advantage plan benefits (Medicare Chief Actuary)
$816	Average annual benefit loss for 11 million seniors and disabled in Medicare Advantage plans (CBO)
33 million	Number of people in traditional Medicare at risk of losing access to care because of $523 billion in cuts in Medicare spending (Medicare Chief Actuary)
20%	Fraction of hospitals that would become unprofitable after Medicare spending cuts (Medicare Chief Actuary)

“There will be no tax increases for anyone who earns less than $200,000.”

73 million	Number of people who earn less than $200,000 who will see their tax bill rise (Joint Committee on Taxation)
40%	Tax rate on “Cadillac” plans (Reconciliation Summary)
2.3%	Hidden tax on wheelchairs and other medical supplies (CBO update)
$27 billion	Hidden “medicine cabinet” tax on drugs (Reconciliation Summary)
10%	Tax on tanning salons (Reconciliation Summary)
$60 billion	Hidden health insurance tax (Reconciliation Summary)

“Health insurance reform is…about creating a climate where our entrepreneurs and small businesses can succeed [and] about giving you the chance to prosper and grow.”

$100 million	Cost of ObamaCare mandates for Caterpillar, Inc. in the first year alone (Caterpillar, Inc.)
60%	Implicit marginal tax rate for workers earning as little as $25,000 (IRET)
65%	Implicit marginal tax rate for families earning as little as $50,000 (IRET)
0.9%	New payroll tax on the wages of entrepreneurs and small business owners (Reconciliation Summary)
3.8%	New tax on the capital income of entrepreneurs and small business owners (Reconciliation Summary)

“The average family will save $2,500 in health care costs by the time I complete my first term as President of the United States.”

111%	Premium increase for individual insurance (AHIP)
54%	Premium increase for individual insurance (BlueCross BlueShield)
106%	Premium increase for individual insurance (Wellpoint)
$2,100	Premium increase for the average family (CBO)

“Over the past year the House and the Senate have been working on an effort to provide health insurance reform that lowers costs …”

$220 billion	Rise in national health care spending over the next 10 years(Medicare Chief Actuary)

“… that guarantees access to care …”

15 million	Number of new people added to Medicaid, where care is increasingly rationed and where provider choice is increasingly restricted. (CBO)
0	Number of new doctors and nurses trained and number of new hospitals built to meet the needs of 32 million newly-insured (CBO)

” … and enhances the quality of health care for all Americans.”

24 million	Number of people who will enter a health insurance exchange where health plans will have an incentive to underprovide to the sick. (CBO/NCPA)

19 million	Number of people predicted to lose their employer plan (Lewin Group)
8 to 9 million	Number of people predicted to lose their employer plan (CBO)
$11,543	Employer incentive to drop coverage for a $30,000 a year worker with family [Tax subsidy in the exchange minus tax subsidy at work minus $2,000 fine] (IRET)
8.5 million	Number of seniors and disabled people at risk of losing their Medicare Advantage plan (Medicare Chief Actuary)
3 million	Additional people who will likely lose Medicare Advantage plan benefits (Medicare Chief Actuary)
$816	Average annual benefit loss for 11 million seniors and disabled in Medicare Advantage plans (CBO)
33 million	Number of people in traditional Medicare at risk of losing access to care because of $523 billion in cuts in Medicare spending (Medicare Chief Actuary)
20%	Fraction of hospitals that would become unprofitable after Medicare spending cuts (Medicare Chief Actuary)

“This is not about big government …”

16,500	Additional IRS auditors needed to enforce the legislation (Ways and Means Minority Report)

“This legislation will protect families …”

$6,000 to $10,000	Marriage penalty if two $32,000-a-year workers say “I do.” (Ways and Means Minority Report)

“We are going to get rid of the special deals …”

$7,300	Extra exemption from the Cadillac premium tax for members of labor unions. (Ways and Means Minority Report)

“This bill will reduce the federal deficit …”

$562 billion

Increase in the deficit after removing budget gimmicks and unrealistic tax increases and budget cuts relegated to future Congresses (CBO former director)

Democrats hail landmark US healthcare bill

Democrats have hailed the approval of legislation extending healthcare to an additional 32 million Americans as a historic advance in social justice.

The speaker of the House of Representatives, Nancy Pelosi said it was comparable to the establishment of Medicare and Social Security.

The bill was passed in the House on Sunday evening by just seven votes.

Sebelius: Americans Will Embrace Health Reform

Secretary of Health and Human Services Kathleen Sebelius says that, despite a new CBS News poll showing widespread skepticism and confusion, Americans will be “enthusiastic” about the health reform bill passed by the House of Representatives once they understand it.

“I think what’s been going on for the better part of a year is a lot of attempts to confuse and scare Americans,” Sebelius told “Early Show” co-anchor Maggie Rodriguez.

Sebelius said she was “absolutely convinced” that “once people understand what’s in the bill and the fact that a lot of what they’ve been hearing has never been contemplated, has never been in the bill, that they’ll be very enthusiastic about what congress did last night.”

Health care bills change game for states

The package of health care legislation passed by the U.S. House Sunday night (March 21) would bring major changes to patients and the medical system that treats them, but it also could shake up state government in ways felt in the courtroom, on the campaign trail and in regulatory offices.

Three Republican state attorneys general — from Florida, South Carolina and Virginia — are chomping at the bit to challenge the planned changes in court. In Virginia, Attorney General Ken Cuccinelli vowed to file suit “as soon as the ink is dry” from President Obama’s signature on the bills, the Washington Post reports.Cuccinelli’s legal reasoning for attacking the scheme hinges on a mandate that would require individuals to buy health insurance. He says the requirement goes beyond Congress’ authority to regulate interstate commerce, the rationale for federal action.

Will Obama now blame GOP for faults in his health care plan?

After Democrats finish dancing in the streets to celebrate narrow passage of new health care laws Sunday night, they’re likely to switch to another favorite pastime: shifting blame.

Why? Because there are two bills, with one being enacted into law but the other still hung up in the process, very possibly indefinitely.

That will likely lead to a classic game of political spin and propaganda. President Obama’s has admitted that the first bill—which passed and he is signing into law—is deeply flawed. But the second bill—the supposed clean-up-and-fix-the-first bill—may never become law.

Key Democrats Still in Play as Health Vote Approaches

WASHINGTON — House Democrats, entering the final 48-hour countdown on their yearlong effort to overhaul the health care system, emerged from a caucus meeting on Friday morning amid signs that crucial votes remained in play in both directions.

Full text of President Obama’s speech on health reform

The link above will forward you to the text from President Obama’s speech at Georgetown University.

Caterpillar Opposes Health Care Bill, AARP and AMA Support It

As Congress prepares for a final vote on health care reform legislation, an executive from Caterpillar, Inc., notified the Democratic and Republican leaders of the House that the company is asking legislators to vote against the health care reform bill because it will drive up the company’s health care costs “by more than 20 percent (over $100 million) in the first year alone and put at risk the coverage our current employees and retirees receive.”

Barack Obama Wins the Nobel Peace Prize

LONDON — The surprise choice of President Barack Obama for the Nobel Peace Prize drew praise from much of the world Friday even as many pointed out the youthful leader has not yet accomplished much on the world stage.

The new president was hailed for his willingness to reach out to the Islamic world, his commitment to curtailing the spread of nuclear weapons and his goal of bringing the Israelis and Palestinians into serious, fruitful negotiations.

Health Industry Concerned about Health Care Reform

The industry heavyweights President Obama neutralized through the summer are agitating that the health-care bills in Congress violate agreements they made with the White House, leave 25 million Americans uninsured and have the potential to increase medical costs.

GM Expected to Seal Hummer Sale

BEIJING – General Motors Co. is expected to seal a deal as early as Friday to sell its Hummer unit to China’s Tengzhong Heavy Industrial Machinery Co. for $150 million, according to people close to the talks

China’s central government could still balk at the acquisition because of Hummer’s reputation for gas-guzzling excess, although the people said Chinese regulators have been briefed on the talks frequently, and that support may be building for the deal.

The Senate Panel Rejects a Public Option in the Health Plan

WASHINGTON — After a half-day of animated debate, the Senate Finance Committee on Tuesday rejected efforts by liberal Democrats to add a government-run health insurance plan to major health care legislation, dealing the first official setback to an idea that many Democrats, including President Obama, say they support.

All of the other versions of the health care legislation advancing in Congress — a bill approved by the Senate health committee and a trio of bills in the House — include some version of the government-run plan, or public option.

But the Finance Committee chairman, Senator Max Baucus, Democrat of Montana, long ago removed it from his proposal because of stiff opposition from Republicans who call the public plan a step toward “socialized medicine.”

The committee on Tuesday afternoon voted, 15 to 8, to reject an amendment proposed by Senator John D. Rockefeller IV, Democrat of West Virginia, to add a public option called the Community Choice Health Plan, an outcome that underscored the lack of support for a government plan among many Democrats.

Report: More troops needed for Afghan war success

“WASHINGTON — The top U.S. and NATO commander in Afghanistan has reported to President Barack Obama that without more troops the U.S. risks failure in a war it’s been waging since September 2001.

“Resources will not win this war, but under-resourcing could lose it,” Gen. Stanley McChrystal wrote in a five-page Commander’s Summary. His 66-page report, sent to Defense Secretary Robert Gates on Aug. 30, is now under review by Obama.”

Dollar Gains on Rivals

“NEW YORK — The dollar is stronger Monday as the yen and higher-yielding currencies give back some of their recent gains versus the greenback while investors consolidate their positions.

With markets in Japan, Singapore and several other Asian countries closed Monday for holidays, the dollar took advantage of thin conditions to push to an almost two-week high against the yen, although remaining in range.”

Oil Prices Slide Below $70

“NEW YORK – Crude futures fell Monday as the market’s two biggest cues in recent months, the dollar and equities, both pointed to sharply lower oil prices.

Light, sweet crude for October delivery recently traded $2.63, or 3.7%, lower at $69.41 a barrel on the New York Mercantile Exchange. Brent crude on the ICE futures exchange traded $2.85, or 4%, lower at $68.47 a barrel.

The dollar stretched a correction into a second day after hitting its weakest point against the euro this year on Thursday, raising the relative cost of commodities priced in the U.S. currency. Oil prices came close to a 2009 high as the dollar weakened steadily earlier this month.”

Obama to focus on innovation in New York speech

“WASHINGTON (Reuters) – President Barack Obama travels to New York on Monday to promote his strategy to improve the U.S. economy by spending on education and innovation, as he shifts his focus from healthcare reform to a week of diplomacy and international economic issues.

Obama will talk about his strategy, building on more than $100 billion in economic stimulus funds, as well as regulatory and other initiatives, in a speech at Hudson Valley Community College in Troy, a city in eastern New York 140 miles north of New York City, the White House said in a statement.”