Sunday, December 27, 2009

The Phoniness of Reform

If the 'new' health care bill remains as the final version, we are about to have a private insurance-subsidized behemoth, which will force our population onto the payrolls of Aetna, Blue Cross Blue Shield, et al. To Republicans, this is what constitutes a "government takeover" of health care.

Here is but one example of this libertarian lunacy.

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"Medicine is the keystone in the arch of Socialism"

by EaBo Clipper

"Medicine is the keystone in the arch of socialism" - Vladimir Ilyich Lenin

Lenin knew that in order to control the masses you needed to control their very being, their very body. That is why socialized medicine is so fraught with danger. Socialized medicine is the ability of the state, not private citizens, to control the health and well being of its citizens. The very basis of freedom is freedom of self.

Which brings us to last night. Our mothers always told us that "nothing good happens after midnight". They were never more right than last night. At around 1:00 a.m., when the vast marjority of Americans were in bed, the United States Senate voted 60-40 to end cloture on Health Care legislation. This means that by the end of this week, most probably on Christmas Day the Senate will vote to pass a form of healthcare legislation.

After the Senate passes this legislation it then goes to conference committee. In conference committee the "bill" will again be completely rewritten. The rewritten conference committee bill will then be voted on up or down by both houses of congress sometime in January.

Therein lies the problem.

The conference committee can rewrite a completely new bill. It could have triggers to "universal" coverage in it it. It could enact the law in 2010 and not 2014 as currently written. Anything can, and probably will happen. That was why it was so important to kill that bill last night, and that is why it was so important to Barack Obama that the Massachusetts legislature ignore the rule of law to allow Deval Patrick the ability to appoint Paul Kirk as the 60th vote.

Last nights vote was not about healthcare, it was about "transforming America", to be Barack Obama's America, to be Wayne Rathke, his mentor's, America, to be Bill Ayres' America. The vote last night was to start us on the road to universal healthcare and state control of our lives.

2010 may be our last chance to turn the tide against the ever increasing march of socialism in this country. I can think of no better way to start turning that tide than by electing Scott Brown as the 41st Senator. Have you helped Scott in any way yet? Please do so today, you can start by donating to him now.

http://redmassgroup.com/diary/6211/medicine-is-the-keystone-in-the-arch-of-socialism

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Of course, Congressional Republican leaders like Senator Mitch McConnell thought nothing of voting for the $700 billion Wall Street bailout, which was a pure deficit-spending bill, and supported the Medicare drug benefit law and No Child Left Behind Act, which increased deficit spending by over a trillion dollars in the next decade. Or the stimulus money that Governor Palin took, after claiming to be opposed to its inclusion in the state budget, while supporting the 'bridge to nowhere' project that she exclaimed before a cheering throng at the GOP convention to be originally opposed to, as well. Or the manner in which Rep. Bachmann, who thinks the US is becoming a Stalinist dictatorship, took over a $250,000 of our tax dollars for her farm. That is the beauty of being a Republican. Spending money in the name of Christ and country means never having to hold yourself accountable to your own standards.

To get around the nonsensical language that surrounds this legislation, as I have spent the entire semester reading the House and Senate versions of the bills, to keep up with them for my students (none of whom apparently have read any of them), this is what the bills "accomplish," as they currently stand (courtesy of the Boston Globe).

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* Who is Covered?

The House bill
About 96 percent of legal residents under age 65 – compared with 83 percent now. Government subsidies to help buy coverage start in 2013.

The Senate bill
About 94 percent of legal residents under age 65 – compared with 83 percent now. Government subsidies to help buy coverage start in 2014.

* Cost

The House bill
Coverage provisions cost $1.055 trillion over 10 years. But other provisions, including increased prescription drug coverage for seniors under Medicare, would bring total cost to about $1.2 trillion.

The Senate bill
Coverage provisions cost $871 billion over 10 years.

* How It’s Paid For

The House bill
$460 billion over the next decade from new income taxes on single people making more than $500,000 a year and couples making more than $1 million. More than $400 billion in cuts to Medicare and Medicaid; a new $20 billion fee on medical device makers; $13 billion from limiting contributions to flexible spending accounts; sizable penalties paid by individuals and employers who don't obtain coverage; and a mix of other corporate taxes and fees.

The Senate bill
Fees on insurance companies, drugmakers, medical device manufacturers. Medicare payroll tax increased to 2.35 percent on income over $200,000 a year for individuals, $250,000 for couples. A 10 percent sales tax on tanning salons, to be paid by customer. Cuts to Medicare and Medicaid. Excise tax of 40 percent on insurance companies, keyed to premiums paid on health care plans costing more than $8,500 annually for individuals and $23,000 for families. Fees for employers whose workers receive government subsidies to help them pay premiums. Fines on people who fail to purchase coverage.

* Requirements for Individuals

The House bill
Individuals must have insurance, enforced through a tax penalty of 2.5 percent of income. People can apply for hardship waivers if coverage is unaffordable.

The Senate bill
Almost everyone must get coverage through an employer, on their own or through a government plan. Exemptions for economic hardship. Those who are obligated to buy coverage and refuse to do so would pay a fine starting at $95 in 2014 and rising to $750.

* Requirements for Employers

The House bill
Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll, with companies with payrolls under $500,000 annually exempt. Small businesses – those with 10 or fewer workers – get tax credits to help them provide coverage.

The Senate bill
Not required to offer coverage, but companies with more than 50 employees would pay a fee of $750 per employee if the government ends up subsidizing employees' coverage.

* Subsidies

The House bill
Individuals and families with annual income up to 400 percent of poverty level, or $88,000 for a family of four, would get sliding-scale subsidies to help them buy coverage. The subsidies would begin in 2013.

The Senate bill
Tax credits for individuals and families likely making up to 400 percent of the federal poverty level, or $88,200 for a family of four. Tax credits for small employers.

* Benefits package

The House bill
A committee would recommend a so-called essential benefits package including preventive services. Out-of-pocket costs would be capped.

The Senate bill
All plans sold to individuals and small businesses would have to cover basic benefits. The government would set four levels of coverage with the least generous paying 60 percent of costs per year and the most generous covering 90 percent.

* Restrictions on Insurers

The House bill
Starting in 2013, no denial of coverage based on pre-existing conditions. No higher premiums allowed for pre-existing conditions or gender. Limits on higher premiums based on age.

The Senate bill
Starting in 2014: no denial of coverage based on pre-existing conditions. No higher premiums allowed for pre-existing conditions or gender. Limits on higher premiums based on age and family size. Starting upon enactment of legislation: children up to age 26 can stay on parents insurance; no lifetime limits on coverage.

* Government-run plan

The House bill
A new public plan available through the insurance exchanges would be set up and run by the health and human services secretary.

The Senate bill
In place of "public option," the estimated 26 million Americans purchasing coverage through new insurance exchanges would have the option of signing up for national plans overseen by the same office that manages health coverage for federal employees and members of Congress. Those plans would be privately owned, but one of them would have to be operated on a nonprofit basis, as many Blue Cross Blue Shield plans are now.

* Prescription Drugs

The House bill
Grants 12 years of market protection to high-tech drugs used to combat cancer, Parkinson's, and other deadly diseases. Phases out the gap in Medicare prescription drug coverage by 2019.

The Senate bill
Grants 12 years of market protection to high-tech drugs used to combat cancer, Parkinson's, and other deadly diseases. Drug companies contribute $80 billion over 10 years with the majority of the money used to limit the prescription coverage gap in Medicare.

* Long-Term care

The House bill
New voluntary long-term care insurance program would provide a basic benefit designed to help seniors and disabled people avoid going into nursing homes.

The Senate bill
Same as House bill.

* Anti-Trust Provision

The House bill
Would strip the health insurance industry of a long-standing exemption from antitrust laws covering market allocation, price-fixing, and bid rigging.

The Senate bill
Maintains the health insurance industry's decades-old antitrust exemption.

* Illegal Immigrants

The House bill
Would be barred from receiving government subsidies but permitted to use their own money to buy coverage offered by private companies in the exchange.

The Senate bill
Would be barred from receiving government subsidies or using their own money to buy coverage offered by private companies in the exchanges.

* Abortion Coverage

The House bill
Private companies in the exchange could not offer plans covering abortion if those plans received federal subsidy money. Most plans in the exchange would be affected, because most consumers in the exchange would be using federal subsidy money to buy coverage. The new government plan could not offer abortion coverage. Insurance companies would be permitted to offer supplemental abortion coverage in separate plans that people could buy with their own money. Use of federal money for abortion coverage would be limited to cases of rape, incest, or danger to the woman's life.

The Senate bill
No health plan would be required to offer coverage. In those that do, beneficiaries would have to pay for it separately, and those funds would have to be kept in a separate account from taxpayer money. Moreover, individual states would be able to prohibit abortion coverage in plans offered through the exchange, after passing specific legislation to that effect. Exceptions would be made for cases of rape, incest, and danger to the life of the mother.

http://www.boston.com/news/health/graphics/healthcare_bills_compared/#
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Naturally, those differences must be worked out in joint committee, so the final version of the bill is going to look slightly different, but there are some commonalities in the legislation. One, neither the House nor Senate bill obtain universal coverage. Both have percentage coverage of 90-plus percent, but that is not universal. Both the House and Senate bill extends pharmaceutical companies' monopoly on new drugs from 7 to 12 years, meaning higher costs for consumers with five more years of gauging you without competition from generic drugs (the drug money donated from the industry to reduce costs is a pittance to the amount of money they will make from the extension of this monopoly). Both the House and Senate versions of the bill extend anti-trust exemption to the health care industry, meaning insurance companies that operate as near monopolies in certain state and/or regional markets will not have to worry about any pesky regulations getting in their way, like the Sherman Anti-Trust Act, which was written with these companies in mind.

Both the House and Senate bills also target pregnant women and immigrants, prohibiting abortion coverage, as well as coverage for illegal immigrants. Notice, after the fetus fetishists and Mexican haters won those battles, they still mostly opposed the bill. They knew good and well they opposed the bill anyway, but for that we can thank the Quislings from the Blue Dog coalition, particularly Rep. Stupak and Senator Nelson for those exclusions. Of course, neither of these men have to worry about getting impregnated anytime soon.

And the good ole public option. It is dead. The Senate version puts the uninsured in a private plan, the same one given to federal employees. It is very unlikely that the House version of the bill will survive. That ended when Senate Majority Leader Reid refused to keep the public option by re-inserting on committee and passing the legislation through budget reconciliation (obviating the 5-6 condoms for the insurance lobby), but the senator of Nevada decided to instead drag the process to the new year and give Senator Lieberman, Nelson, et al., and their sponsors from America's Health Insurance Plans a victory.

A Real Reform Plan

If we were truly looking for a reform plan, there has been one in Congress from the beginning of this session, H.R. 676, the U.S. Health Care Act, which would among other things.

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  • Expands the Medicare program to provide all individuals residing in the United States and U.S. territories with free health care that includes all medically necessary care, such as primary care and prevention, prescription drugs, emergency care, long-term care, mental health services, dental services, and vision care.
  • Prohibits an institution from participating unless it is a public or nonprofit institution. Allows nonprofit health maintenance organizations (HMOs) that deliver care in their own facilities to participate. Private insurance would be replaced via the Medicare expansion.
  • Gives patients the freedom to choose from participating physicians and institutions.
  • Prohibits a private health insurer from selling health insurance coverage that duplicates the benefits provided under this Act. Allows such insurers to sell benefits that are not medically necessary, such as cosmetic surgery benefits.
  • Sets forth methods to pay institutional providers of care and health professionals for services. Prohibits financial incentives between HMOs and physicians based on utilization.
  • Establishes the USNHC Trust Fund to finance the Program with amounts deposited: (1) from existing sources of government revenues for health care; (2) by increasing personal income taxes on the top 5% of income earners; (3) by instituting a progressive excise tax on payroll and self-employment income; and (4) by instituting a small tax on stock and bond transactions. Transfers and appropriates amounts that would have been appropriated for federal public health care programs, including Medicare, Medicaid, and the State Children's Health Insurance Program.
  • These taxes would be paid instead of insurance premiums, as the government (instead of private insurance companies) would be paying for the care under this single-payer system.
  • Establishes a program to assist individuals whose jobs are eliminated (e.g., within insurance companies) due to the simplified single-payer administrative process.
  • Requires creation of a confidential electronic patient record system.
  • Establishes a National Board of Universal Quality and Access to provide advice on quality, access, and affordability.
  • Provides for: (1) the eventual integration of the Indian Health Service into the Program; and (2) evaluation of the continued independence of Department of Veterans Affairs (VA) health programs.
  • The bill covers treatments on or after the first day of the year that begins one full year after passage (January 1, 2011 if the bill is passed in 2009). Compensation continues for 15 years to owners of converting for-profit providers for reasonable financial losses.

http://thomas.loc.gov/cgi-bin/bdquery/z?d111:H.R.676:
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This is what President Obama, the Kenyan Muslim socialist to the Fox 'news' watchers out in Red Stateland and our corporate boardrooms, find to be "unreasonable." A bill that makes health care a fundamental right of citizenship, covers everyone, at minimum cost for working people (much cheaper than they are currently paying), and banishes insurance companies, HMOs, and the pharmaceutical industry from parasitically using the profit motive for their stockholders (who they legally are bound to as their first fiduciary responsibility) at the expense of the people whose health needs is to them a cost. That is the kind of reform and socialism that would give Glenn Beck his big one and do in Rush's oxycontin providers. And it is one we will not see, thanks to our president, the Blue Dog Coalition, and the current Congressional leadership.

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