The healthcare bill currently being debated in the United States Senate is a nightmare in the making. Three results are certain: 1) costs will skyrocket over time, 2) care will be rationed, 3) America will be pushed to the financial brink or beyond. Betsy McCaughey, writing for The New York Post, has penned the following expose. Be sure to scroll down to see the incredible number of new programs and government bureaucracies created by the “revenue neutral” monstrosity. Here’s Ms. McCaughey:
“ObamaCare’s winners and losers”
“After the Senate voted Saturday night to proceed with debate on health reform, Majority Leader Harry Reid declared the public the winner. In truth, more Americans will be losers than winners.
Both Senate and House bills strip nearly half a trillion dollars from Medicare, robbing seniors to expand Medicaid. The Senate bill also spends billions on drug treatment, sex education, translators and romance and relationship lessons (p. 612) that could be used to treat heart disease, cancer and stroke — the diseases that kill most of us.
Losers
The middle class: The bills require nearly everyone to enroll in a ‘qualified’ plan, either by getting it at work or purchasing it. The government will decide what benefits are covered and how much you’ll be legally required to pay. There will be no subsidies for a single person earning more than $44,000. A family of four earning $96,000 can expect to pay 19 percent of pretax income on premiums, copays and deductibles, according to the Congressional Budget Office. Medicare’s chief actuary, Richard Foster, predicts that even though penalties can be as high as thousands of dollars per adult in the House bill, 18 million people will choose the penalty over paying the costlier premiums. In the Senate version, where penalties are lower ($750 per adult), even more families are likely to pay the penalty and end up with no insurance.
People with high-deductible plans: Unless you’re under age 30, you’ll be legally required to switch from your catastrophic plan to the government-designed comprehensive plan (Senate bill, p. 114).
People with ‘Cadillac’ plans: Generous health plans get slapped with a 40 percent excise tax (Senate, p. 1,980), similar to the “sin taxes” government uses to discourage smoking and boozing. This is pushing equality to an extreme. Since when is good health care a sin?
And the ‘Cadillac’ tax is designed to hit far less generous plans after a few years.
Women — and men: Last week, the US Preventive Services Task Force recommended that women forego mammograms between the age of 40 and 50, settle for mammograms every two years thereafter and stop altogether after 74 — a huge departure from current practice. The Task Force says its guideline will be 81 percent as effective in saving lives and should be good enough. This is the same task force empowered by the Senate bill to determine preventive care in your benefit package (p. 17). James Thrall, a Harvard Medical School professor, says, ‘I fear we are entering an era of deliberate decisions where we choose to trade people’s lives for money.’
Seniors and baby boomers: Both Senate and House bills slash funding for Medicare, mainly by reducing payments to hospitals and other institutions to care for patients.
Foster, the Medicare actuary, warns that institutions ‘for whom Medicare constitutes a substantive portion of their business could find it difficult to remain profitable and might end their participation in the program (possibly jeopardizing access to care for beneficiaries).’ Where will they go when their local hospital, home-health agency or nursing home stops taking Medicare?
Despite many claims by the president that Medicare benefits won’t be reduced, Sec. 4105 empowers the government to modify or eliminate preventive-care services for seniors based on what the stingy US Preventive Services Task Force recommends (p. 1,189).
Literally half a page later, the bill expands access to preventive care for adults in Medicaid, including diagnostic and screening tests. The agenda couldn’t be clearer.
Winners
Those newly eligible for Medicaid: Both the Senate and House bills reduce the number of uninsured primarily by enrolling them in Medicaid. That’s different from making private health insurance affordable.
The bills ease Medicaid income restrictions, make uninsured newborns automatically eligible and add groups previously ineligible, such as homeless adults without children (Senate, p. 396-455). The House bill adds 21 million people to Medicaid, about 60 percent of all those newly insured. The Senate bill adds 15 million and includes enrollment-simplification and outreach provisions (p.445-51).
Patients with pre-existing conditions: The bills require insurers to take all comers, regardless of their health. That makes it necessary to force everyone to buy insurance, because otherwise the healthy would refuse to share the cost of treating the sick. The wiser alternative is what the Senate bill does temporarily: create high-risk pools, with government funding, to make health insurance accessible and affordable for people with pre-existing conditions (p. 41-47).
Community groups seeking government money: Slipped into the Senate bill’s 2,074 pages are programs that transfer taxpayer money to ‘community-based organizations.’
For example, ‘community transformation grants’ can fund infrastructure improvements as well as activities that promote wellness or ‘reduce racial and ethnic disparities, including social, economic and geographic determinants of health.’ Almost anything qualifies, and there’s only one prohibition: ‘A grantee shall not use funds . . . to create video games or to carry out any other activities that may lead to higher rates of obesity or inactivity’ (p. 1209).
Adding to the dishonesty, these programs aren’t included in the current CBO estimates of the bill’s cost (CBO letter to Sen. Harry Reid, Nov. 18, p. 13).
Low-income recent immigrants: The Senate bill appears to make legal immigrants who’ve not been in the United States long enough to qualify for Medicaid immediately eligible for subsidies for private plans (p. 246). How fair is it to make seniors, who have paid into the system all their lives, sacrifice so anyone can come to America and get a health plan on the taxpayers’ tab?
Though bill proponents claim the legislation will make insurance affordable, in fact it shifts billions of dollars from caring for the elderly to funding a new social agenda.”
Betsy McCaughey is chairman of the Committee to Reduce Infection Deaths and a former New York lieutenant governor. The Senate and House bills with page numbers can be found at www.defendyourhealthcare.us.
The House Republican Conference has compiled a list of all the new boards, bureaucracies, commissions, and programs created in H.R. 3962, Speaker Pelosi’s government takeover of health care:
1. Retiree Reserve Trust Fund (Section 111(d), p. 61)
2. Grant program for wellness programs to small employers (Section 112, p. 62)
3. Grant program for State health access programs (Section 114, p. 72)
4. Program of administrative simplification (Section 115, p. 76)
5. Health Benefits Advisory Committee (Section 223, p. 111)
6. Health Choices Administration (Section 241, p. 131)
7. Qualified Health Benefits Plan Ombudsman (Section 244, p. 138)
8. Health Insurance Exchange (Section 201, p. 155)
9. Program for technical assistance to employees of small businesses buying Exchange coverage (Section 305(h), p. 191)
10. Mechanism for insurance risk pooling to be established by Health Choices Commissioner (Section 306(b), p. 194)
11. Health Insurance Exchange Trust Fund (Section 307, p. 195)
12. State-based Health Insurance Exchanges (Section 308, p. 197)
13. Grant program for health insurance cooperatives (Section 310, p. 206)
14. “Public Health Insurance Option” (Section 321, p. 211)
15. Ombudsman for “Public Health Insurance Option” (Section 321(d), p. 213)
16. Account for receipts and disbursements for “Public Health Insurance Option” (Section 322(b), p. 215)
17. Telehealth Advisory Committee (Section 1191 (b), p. 589)
18. Demonstration program providing reimbursement for “culturally and linguistically appropriate services” (Section 1222, p. 617)
19. Demonstration program for shared decision making using patient decision aids (Section 1236, p. 648)
20. Accountable Care Organization pilot program under Medicare (Section 1301, p. 653)
21. Independent patient-centered medical home pilot program under Medicare (Section 1302, p. 672)
22. Community-based medical home pilot program under Medicare (Section 1302(d), p. 681)
23. Independence at home demonstration program (Section 1312, p. 718)
24. Center for Comparative Effectiveness Research (Section 1401(a), p. 734)
25. Comparative Effectiveness Research Commission (Section 1401(a), p. 738)
26. Patient ombudsman for comparative effectiveness research (Section 1401(a), p. 753)
27. Quality assurance and performance improvement program for skilled nursing facilities (Section 1412(b)(1), p. 784)
28. Quality assurance and performance improvement program for nursing facilities (Section 1412 (b)(2), p. 786)
29. Special focus facility program for skilled nursing facilities (Section 1413(a)(3), p. 796)
30. Special focus facility program for nursing facilities (Section 1413(b)(3), p. 804)
31. National independent monitor pilot program for skilled nursing facilities and nursing facilities (Section 1422, p. 859)
32. Demonstration program for approved teaching health centers with respect to Medicare GME (Section 1502(d), p. 933)
33. Pilot program to develop anti-fraud compliance systems for Medicare providers (Section 1635, p. 978)
34. Special Inspector General for the Health Insurance Exchange (Section 1647, p. 1000)
35. Medical home pilot program under Medicaid (Section 1722, p. 1058)
36. Accountable Care Organization pilot program under Medicaid (Section 1730A, p. 1073)
37. Nursing facility supplemental payment program (Section 1745, p. 1106)
38. Demonstration program for Medicaid coverage to stabilize emergency medical conditions in institutions for mental diseases (Section 1787, p. 1149)
39. Comparative Effectiveness Research Trust Fund (Section 1802, p. 1162)
40. “Identifiable office or program” within CMS to “provide for improved coordination between Medicare and Medicaid in the case of dual eligibles” (Section 1905, p. 1191)
41. Center for Medicare and Medicaid Innovation (Section 1907, p. 1198)
42. Public Health Investment Fund (Section 2002, p. 1214)
43. Scholarships for service in health professional needs areas (Section 2211, p. 1224)
44. Program for training medical residents in community-based settings (Section 2214, p. 1236)
45. Grant program for training in dentistry programs (Section 2215, p. 1240)
46. Public Health Workforce Corps (Section 2231, p. 1253)
47. Public health workforce scholarship program (Section 2231, p. 1254)
48. Public health workforce loan forgiveness program (Section 2231, p. 1258)
49. Grant program for innovations in interdisciplinary care (Section 2252, p. 1272)
50. Advisory Committee on Health Workforce Evaluation and Assessment (Section 2261, p. 1275)
51. Prevention and Wellness Trust (Section 2301, p. 1286)
52. Clinical Prevention Stakeholders Board (Section 2301, p. 1295)
53. Community Prevention Stakeholders Board (Section 2301, p. 1301)
54. Grant program for community prevention and wellness research (Section 2301, p. 1305)
55. Grant program for research and demonstration projects related to wellness incentives (Section 2301, p. 1305)
56. Grant program for community prevention and wellness services (Section 2301, p. 1308)
57. Grant program for public health infrastructure (Section 2301, p. 1313)
58. Center for Quality Improvement (Section 2401, p. 1322)
59. Assistant Secretary for Health Information (Section 2402, p. 1330)
60. Grant program to support the operation of school-based health clinics (Section 2511, p. 1352)
61. Grant program for nurse-managed health centers (Section 2512, p. 1361)
62. Grants for labor-management programs for nursing training (Section 2521, p. 1372)
63. Grant program for interdisciplinary mental and behavioral health training (Section 2522, p. 1382)
64. “No Child Left Unimmunized Against Influenza” demonstration grant program (Section 2524, p. 1391)
65. Healthy Teen Initiative grant program regarding teen pregnancy (Section 2526, p. 1398)
66. Grant program for interdisciplinary training, education, and services for individuals with autism (Section 2527(a), p. 1402)
67. University centers for excellence in developmental disabilities education (Section 2527(b), p. 1410)
68. Grant program to implement medication therapy management services (Section 2528, p. 1412)
69. Grant program to promote positive health behaviors in underserved communities (Section 2530, p. 1422)
70. Grant program for State alternative medical liability laws (Section 2531, p. 1431)
71. Grant program to develop infant mortality programs (Section 2532, p. 1433)
72. Grant program to prepare secondary school students for careers in health professions (Section 2533, p. 1437)
73. Grant program for community-based collaborative care (Section 2534, p. 1440)
74. Grant program for community-based overweight and obesity prevention (Section 2535, p. 1457)
75. Grant program for reducing the student-to-school nurse ratio in primary and secondary schools (Section 2536, p. 1462)
76. Demonstration project of grants to medical-legal partnerships (Section 2537, p. 1464)
77. Center for Emergency Care under the Assistant Secretary for Preparedness and Response (Section 2552, p. 1478)
78. Council for Emergency Care (Section 2552, p 1479)
79. Grant program to support demonstration programs that design and implement regionalized emergency care systems (Section 2553, p. 1480)
80. Grant program to assist veterans who wish to become emergency medical technicians upon discharge (Section 2554, p. 1487)
81. Interagency Pain Research Coordinating Committee (Section 2562, p. 1494)
82. National Medical Device Registry (Section 2571, p. 1501)
83. CLASS Independence Fund (Section 2581, p. 1597)
84. CLASS Independence Fund Board of Trustees (Section 2581, p. 1598)
85. CLASS Independence Advisory Council (Section 2581, p. 1602)
86. Health and Human Services Coordinating Committee on Women’s Health (Section 2588, p. 1610)
87. National Women’s Health Information Center (Section 2588, p. 1611)
88. Centers for Disease Control Office of Women’s Health (Section 2588, p. 1614)
89. Agency for Healthcare Research and Quality Office of Women’s Health and Gender-Based Research (Section 2588, p. 1617)
90. Health Resources and Services Administration Office of Women’s Health (Section 2588, p. 1618)
91. Food and Drug Administration Office of Women’s Health (Section 2588, p. 1621)
92. Personal Care Attendant Workforce Advisory Panel (Section 2589(a)(2), p. 1624)
93. Grant program for national health workforce online training (Section 2591, p. 1629)
94. Grant program to disseminate best practices on implementing health workforce investment programs (Section 2591, p. 1632)
95. Demonstration program for chronic shortages of health professionals (Section 3101, p. 1717)
96. Demonstration program for substance abuse counselor educational curricula (Section 3101, p. 1719)
97. Program of Indian community education on mental illness (Section 3101, p. 1722)
98. Intergovernmental Task Force on Indian environmental and nuclear hazards (Section 3101, p. 1754)
99. Office of Indian Men’s Health (Section 3101, p. 1765)
100.Indian Health facilities appropriation advisory board (Section 3101, p. 1774)
101.Indian Health facilities needs assessment workgroup (Section 3101, p. 1775)
102.Indian Health Service tribal facilities joint venture demonstration projects (Section 3101, p. 1809)
103.Urban youth treatment center demonstration project (Section 3101, p. 1873)
104.Grants to Urban Indian Organizations for diabetes prevention (Section 3101, p. 1874)
105.Grants to Urban Indian Organizations for health IT adoption (Section 3101, p. 1877)
106.Mental health technician training program (Section 3101, p. 1898)
107.Indian youth telemental health demonstration project (Section 3101, p. 1909)
108.Program for treatment of child sexual abuse victims and perpetrators (Section 3101, p. 1925)
109.Program for treatment of domestic violence and sexual abuse (Section 3101, p. 1927)
110.Native American Health and Wellness Foundation (Section 3103, p. 1966)
111.Committee for the Establishment of the Native American Health and Wellness Foundation (Section 3103, p. 1968)
Posted by Jerry Pomeroy in Best Of the Web, Health Insurance Debate