Not That The Overlords In Congress Care About My Opinion On Healthcare Reform

So the Democrats finally unveiled Pres. Obama's vision for healthcare. If this is reform we can believe in, we obviously believe in some really bad things.

Apparently, if you believe everything the Pres. Obama said in the interview he gave to Fox news earlier this week, you must leave a lot of special deals are necessary to protect this only certain parts of the American population. The rest of us, just get the tax portion of that, along with maybe some healthcare but that's questionable he also. Why? That would have to be because there is nothing in this bill which does anything to solve the basic problem of the healthcare crisis: cost.

As you may recall, a couple months ago when this debacle began, a couple of states managed to eke out exceptions the reform package. Most notably, this included Nebraska (which got to keep 100% of its Medicare money unlike the rest of the country) in Florida (where seniors bear got a special deal as well). later, Louisiana got in on the act matched its own bit of graft, claiming that it still had all those problems left over from Hurricane Katrina. And let's not forget that the unions got their own little special deal where they are healthcare would not get taxed because, well,... their unions and they give money to Democrats and Pres. Obama.

Now, can anyone remember what the point of reforming health care in this country was about? Oh yeah, that's right, without making healthcare more affordable for everyone. So we now have a plan, which pretty much everyone agrees is going to allow rates to go up at on all love spending to our budget (and in the process creating a new sacred cow of American politics, because what politician is in a while take a stand and say I want to disestablish the national healthcare system in this country?)

Oh yeah, and with this health care bill which makes health care more expensive, they have still left in the provision they will be financially penalized or not having healthcare insurance. Is below sees people been talking to the Blue Shield people?

Speaker Pelosi, President Obama's point woman in this whole fiasco, has been trumpeting this bill, even though it doesn't seem like she's actually read it as a panacea for healthcare and for the economy in general. She claims, that this proposal will not only solve all the healthcare problem but it will also reduce the federal deficit. As support for this, she points to the CBO's report which was recently issued. According to the Congressional Budget Office, under the proposed healthcare plan the deficit will be cut by $138 billion in the first decade and $1.2 trillion over the next decade. the Democrats also claim that the bill will decrease Medicare expenditures by little more than 1% each year (meaning that instead of going bankrupt in a couple of years Medicare will go bankrupt around 2020). Sounds pretty good, right?

the problem is, the CBO isn't forced to operate under certain rules. This means that if you track your bill correctly and present the input correctly to CBO you're going to get the kind of numbers back from CBO that you want. Now I am not a numbers guy, a more process type guy with, so I would suggest you go over and read this article at the Weekly Standard and read their analysis of the budget. In short, although the numbers look good, like $2 trillion not good, they look good because the time period which the CBO is allowed to analyze does not include the period of time when the real costs of this legislation start to be felt by the system. However, I think this paragraph pretty much sums up this legislation:

And what would we get for all of this? The CBO says that health insurance premiums would rise by 10 to 13 percent in the individual market, in relation to current law. The Medicare Chief Actuary says that the percentage of the gross domestic product spent on health care would also rise in relation to current law, increasing from 17 percent today to 21 percent in 2019. And, as the CBO reports in its latest scoring, as of 2019 there would still be 23 million people in America lacking health insurance.

So what do we get for almost a billion dollars? Apparently 23 million people without insurance. As a point of reference, there are currently approximately 36 million uninsured American citizens and another 9 million or so who are illegal aliens. Apparently, a billion dollars and uncontrolled increases in premiums will get you an additional 13 million people with health insurance. Hardly seems cost-effective.

One thing that this proposal shows, is that this president is impotent. He has promised time and again to deliver a package that will meet the needs of the American people. However, he is unable even within his own party to get legislation drafted that meet those promises which he puts out and proclaimed the American people. It shows that, when it comes to the Democrats in the House of Representatives and Senate, he really has very limited power to get what he believes done. even at this late date, after months of negotiation, Pres. Obama is still the position where he is having to essentially sell the bill to his own party. This has included such things as suddenly putting forth the name of one Representative's brother for a federal judgeship. it just so happens that that representative was one of the 10 who was against the health-care package back in November. How convenient.

Another very coincidental decision by the administration was announced earlier by the Department of the Interior, which suddenly open the floodgates despite the fact that there is an endangered species, the delta smelt, which the Department of the Interior and the EPA has been protecting from San Joaquin Valley farmers for years. It's just coincidental, that the two representatives for that part of the state of California are both Democrats who were on the fence with regards to Obama's health care reform proposal.

But perhaps my favorite part of this whole fiasco, is that Pres. Obama wasn't content just to screw up one section of the economy while he was trying to reform. He decided he would be better, is that the bitter pill to us by wrapping it in another thing which no politician ever likes voting at. What's the impact? That would be funding for higher education. Knowing that he's got a lousy bill, crafted by the kleptocrats of the Democratic side( the Republicans would've joined in too, but they were invited to this drafting party), is ranked in the sugary goodness of Pell grants and student loans. How nice of him.

Weren't we all up in arms when Bush fired a couple of US attorneys? Weren't we all enraged when VP Cheney held meetings with the energy lobby, excluding environmental groups, and refused to turn over the notes one sunshine requests were made? So why are we letting the present act this way at this time? Or is it because he has a "D" after his name rather than an "R", that we let him have a pass at being responsible representative of the people?

Then there is the administration and speaker policies have it a scheduling significant and important votes for odd hours. This time, it looks like they want to do the vote on Sunday. Kind of convenient, since the day that most major media outlets are covering Capitol Hill or the White House, be quite frankly most of America is probably watching March Madness basketball games on CBS.a reasonable administration tried to do something secret, they did behind closed doors and didn't announce it for all to know. It seems like this administration, which wants to proclaim itself as the most ethical administration in the last hundred years, wants to use the form but not the substance of open government.

But in a way, this all goes back to the basic problem with the Obama administration. What is a problem you may ask? That problem is a lack of realistic goals and proposals. Pres. Obama administration is good for talking about lofty goals and aspirations,but when the rubber hits the road president Obama is always a day behind the rest of the of his party when it comes to outlining concrete and specific or proposals for what you want to see done.

I'd write my congressman and tell them to vote against this debacle. However, my congressman is Speaker Pelosi. So I think she is a pretty firm "yes" on this mess.

Update for the original:

The CBO recently responded to a request for clarification about the total costs of the legislation made by Representative Paul Ryan (R-WI). The CBO confirmed that the bill, if passed along with other legislation that is necessary to make the reform work, will not decrease the deficit. In fact, it will increase the deficit by nearly $59 billion.

Thoughts on Health Care Reform After President Obama's Interview on Fox

So I'm sitting here watching the interview of Pres. Obama by the anchor from Fox news, and a couple of thoughts. First, from the beginning of the interview wanted to be anywhere else but where he was. As a matter of fact, he looked angry and upset that he had to take the time out of his day to explain something to anyone, and in particular to someone from a network that he really really does not like. There is an almost arrogant look about this man eddies across from Fox news person, as if to say I shouldn't have to answer to anyone what I want to do and what I want to implement as my policy as president of the United States.



Second, I understand that to the extent the president has to be loyal to his party. However, at what point does present have to be loyal to his party at the expense of telling people, the people he was elected by, what he truly thinks about something. The first part of the interview, the Fox news reporter asked about the so-called "Slaughterer rule" which the House of Representatives seems determined to use in this situation. Although Pres. Obama said he wanted the vote to happen, he would not say that this parliamentary rule which Speaker of the House Pelosi is enamored with is the wrong way to go about business.

Parliamentary rules exist to allow things to get done, but they are not there to avoid people having to take responsibility for the ultimate votes. The people that we elected to the Congress whether they be Democrat or Republican are ultimately responsible to us and therefore they are unwilling or unable to execute their duty by either voting yes or no on what ever bill there is in front of them, then they need to resign or we need to replace them.



At the end of the day, this is a Republic in which our representatives democratically elected. for one party to hijack the process, by allowing bill to be passed and sent to the president for his signature, is a betrayal of our form of government. If this were to happen, whether it be this week next week we're six months ago, I should hope someone would bring case in the federal courts that even the most liberal activist or the most strictly constructionistic conservative judge would be able to look at this and realized that this was not what the Constitution says or means. Because failing that, we would no longer live in a democratic republic but in some sort of weird dictatorship where party leaders act as were the arbiters of what is right for the people and the people have no say in the final outcome, whomever they choose to elect.

when pressed by a reporter, argued back that the raid/conservatives in this country were focused too much on process and not enough on the substance of the bill. However when he was asked about the substance of the bill, he flipped and talked about the process and said how ugly it all was when it came to making laws in this country. What he was either unwilling to a knowledge, or unwilling to say, a double arm court and in our government if the process is corrupt, then no matter what Bill is produced no matter what law is inactive the system is corrupt and loses legitimacy. The fact that our representatives feel that such rule is ever allowable or that such a process can ever be permitted is wrong and if either party had courage there would be not only a rule, a law prohibiting it.

I don't know what is in the bill that speaker policy wants to get past. As a matter of fact, I'm not sure anyone in this country knows the entire contents of the proposed legislation. It's been promised the proposed health care bill will be posted for everyone to read it online. The question is, whether anyone in Congress will read it, or if they're just too desperate to serve their own agendas that one side or the other must win and the other must lose irrespective of what will happen to the American people.

Does this make sense?

Anthem Blue Shield has been in the news a lot lately. Almost none of it good because they have decided that they need to raise their rates on their individual insurance policies. The rates, by the way for individuals, are going up about 39% according to the reports I've been reading.

Today, it was confirmed that for small businesses, the rates are going up at an even higher rate. In some cases, a whopping 76%.

Anthem Blue Shield's press flack tried to justify the rate hikes in a statement where he said,
"We lose membership because fewer people can afford to get it,... It does not help us. We only do it to be able to collect enough money to pay out."

Let's see if this makes sense. The economy has caused people and businesses to cancel their policies. Because they are too expensive. So the solution is... to make them more expensive.

Got to love the insurance industry logic. First you can't buy insurance if you have a health issue (or conversely, you can only buy health insurance if you do not need it). Now, because they are so expensive, they have to raise their rates, to make it even more unaffordable for people.

The Obama plans (because now there is the Senate proposal, the House proposal, and the Administration's proposals) are all flawed. But that does not mean that the GOP has it right either (and the Wall Street Journal's suggestion, that health care costs are not at crisis levels and that it is a phony issue, is ludicrous). Something needs to be done. But it needs to be something that will not break the bank.

Otherwise, even this "regulated" market we have is going to price more and more people out of having health care.

Can You Say Spineless?

I mean seriously, how did we ever elect these bozos. First, we elect President Obama. Simultaneously we give him super-majority in Senate and a more than clear majority in the House of Representatives. The expectation is that they do something to solve the problems that were neglected or caused by eight years of President Bush's administration.

In just over a year, the Democrat controlled congress has managed to accomplish....I think that the term is bubkiss. To say they are failing, in my opinion, is an understatement.

Then comes today's news: the Democrats are pulling back on healthcare reform.

Really? They have two ways to get the bill passed, and with large majorities in both houses of Congress they can't possibly get anything done? Wow, the leadership of the country and Democratic party is truly spineless.

Then again, this is the party that once upon a time put up George B. McClellan as their candidate for president. Apparently, the modern Democratic party has decided to emulate the old master of the slows. They couldn't emulate Harry Truman? Or perhaps FDR? Or perhaps someone who got something done?

The Democratic party is a waste of time and resources. They are just a coalition of special interest which just can't seem to agree to move forward with something in the hopes that something perfect will come tomorrow.

Health Care Reform Is Coming... But Should We Let It?

Ok, let's start with a couple of basics. Health care in America is a bit screwed up right now. We pay a lot. We get alot. But we pay alot. And in having to pay a lot, there are a lot of people who do not have health care covered.

And this is bad. Because if they cannot pay for health care, then we have sick people. Sick people go to the county ER instead of their own physician. The county hospital then has to hope to be reimbursed for all the work that gets done, or to try and recover the money from the person (who is probably too well off to be covered by a government program but not well off enough to afford health insurance). If they can't get paid, then the hospital loses money, has to lay off doctors and nurses and other people do not get treatment.

Sure that is over simplifying things, but its a fair description of the problem.

Then there are the solutions that are proposed. Some say its all the fault of the greedy insurance companies. If it was not for their overriding need to make a profit, then costs would be manageable. The insurance industry lashes back by blaming the lawyers. If it wasn't for the lawyers filing all those "frivolous" medical malpractice suits, then things would not cost so much. Some people say its the doctors fault for charging so much. The doctors point out that they have to because, well, hey, they've got bills to pay and medical malpractice premiums to boot.

And then George Bush opens his mouth about the problem and says:



But back to the actual problem.

Today, there was a vote in the Senate. Specifically, it was a vote in the Senate Finance Committee on what has become known as the Baucus Bill. Actually, its called "America’s Healthy Future Act of 2009". The bill is the Democrats answer to the problem. (As a side note, I want to know why, after 8 years in opposition, it took them until September to actually get a bill together?)

Senator Baucus has stated that this proposal is the solution for our problems. He states that the plan will pay for itself. He states that the plan will lower costs and not add to the federal deficit, and that it will encourage competition in the market place.

A lot of hardcore left wingers are not happy with this plan. They see the only solution as being single-payer health care. Now there are advantages to this idea. However, there are perils. And significant costs. Remember, nothing is for free. If we make it another entitlement, then its going to be reflected in our taxes. And once that money gets purposed and set into the federal code, its may never be changed. Don't think so? Remember, we are still paying an emergency tax on our telephone usage. The emergency that the tax was meant to fund? That would be the Spanish-American War, which happened in 1898.

Anyways, the Baucus plan. The Baucus plan has some features that are really good. However, ti also has some really bad things that almost amount to a poison pill.

The good:
Healthcare cooperatives. The Baucus bill will provide that member owned insurance cooperatives can be formed. These will be non-profits which will compete with the insurance companies, hopefully being able to provide comparable services in order to bring the cost down.

The not so good:
Individual mandates. If you do not have healthcare, you will be subject to a fine. Great. So now in addition to being required to have all sorts of other required things (driver's license, car insurance, etc), we will now how have to show proof of insurance. I can see how soon someone will propose a national ID card as cost-cutting means, since it will contain all this information about us that we are required to have anyways. There is also the idea that there might be criminal penalties involved. Sorry, every so often, I get a little paranoid about Big Brother.

Subsidy for those who are deemed to be too poor to afford insurance. Under the Baucus plan, anyone who falls under certain guidelines (an income that it under three times the Federal poverty level) will have access to subsidized plans. Apparently, this means that families of four making less than $661,150 per year will have their health care subsidized. It should probably be noted that the median income for a family of four in the U.S. is about $70,354. In California, the median is $74,801. To me, that seems like an awful lot of people who are going to be getting subsidized health care. Sounds very expensive.

The pre-existing conditions provisions, as I read them, are good and bad. The good part is that those with pre-existing conditions will be able to get coverage. The bad is that it seems to segregate them into a special risk pool. Combined with the individual mandate, this could make things difficult.

The absurd:
According to the Baucus plan, illegal aliens will not be able to participate in this program. That's going to be interesting to enforce, especially in light of the Supreme Court's prior rulings on the subject of what happens when there is a program that the illegal alien would be otherwise entitled.

The bad:
Now some of you may remember that during the election, Senator McCain had a health care reform proposal. (Yes, he had one. Actually fairly fleshed out instead of President Obama's "I'd like to see ...") was to tax health care benefits for employer provided health care plans. Currently, they are not taxed, even though they are a benefit (something that IRS likes to call "income", and income is taxable). Under the McCain plan, the tax was balanced by an equal tax write-off for paying for a personal health care plan. Ideally, under Senator McCain's plan, you would have a net zero effect. At least, that was how it was explained to me.

The problem with Senator McCain's plan was that it did nothing to deal with the issue of pre-existing conditions. As it stands right now, if you have a preexisting condition, it damned near impossible to get individual coverage. Believe me. I have tried (and my "condition" was resolved over 10 years ago. Yet despite the fact that it is resolved, as in will never come back, I still get rejected by insurance companies when I try to buy individual insurance.).

Well now with the Baucus plan, we see that so-called "Cadillac" plans will be taxed. Let's take a step back and look at the absurdity of calling it a "Cadillac". How many people under the age of, say, 55, look at the Cadillac as the pinacle of luxury autos anymore?

Now a Cadillac plan, under the Baucus plan it is defined in Title VI "Excise Tax on High Cost Insurance", is defined as any plan that goes over $8,000 per year per person or $21,000 per year for a family. The tax would be 35 percent on anything over that. That's a pretty heft tax, one that the Senate committee is hoping will bring in a whopping $215 billion.

To me, this seems a little on the insane side of things. It is actually penalizing people for getting good health care plans. It also has no corresponding reward, other than not being taxed, for getting mediocre ones.

There is also the argument that the excise tax is going to become an AMT. The AMT, or Alternative Minimum Tax, was a tax originally designed to correct a loophole in the law which allowed extraordinarily wealthy people to escape paying income tax. In the beginning, it worked fine. However, with neglect, it has become a tax that is becoming increasingly burdensome on people are not extraordinarily wealthy, and are in fact, really just upper middle class.

In the same way, as the cost of the low end Baucus plan packages rise, middle class income families could find themselves on the receiving end of the excise tax. Seems like there is a flaw in the plan.

Then there is the idea that Medicare will come down, and that those savings will be used to fund the plan. That seems, to me, the least likely since it requires that an entitlement be cut.

Bottom line is this: this is an expensive plan. It requires that the health care exchanges get up and running in order to keep the consumer costs down. If they don't, and instead end up as not for profits, then there is not going to be any real savings in all of this. I am really uncomfortable with taxing people for getting good health care plans. I'm also a little upset with how many people we will end up subsidizing.

Then again, its not like the Republican party has offered anything other than "let the market run free" and "its all the lawyers fault".

At the bottom of it all, this bill is clearly a compromise. It is going to cost a lot of money. Under the Congressional Budget Office's scoring, which is a precise rule driven evaluation, thinks that the bill will help to reduce the federal deficit and cut the number of uninsured. However, others have criticized the CBO's numbers because of what they are not allowed to consider when doing the report on the bill. First, there is the problem that the bill will put the onus on the states to come up with some of the money. This in turn could lead to higher state taxes. It allows President Obama to keep his word not to personally raise taxes, instead leaving that bit to the legislatures of the states. Second, there is no accounting for the actual administrative cost of the plan. Third, there is little thought as to what the cost will be once people actually have health insurance, as in how much will the subsidies need to be increased in order to keep pace with a potential upswing in medical procedures.

Some Random Thoughts On Health Care Reform As I Print Out Stuff

So I have been reading here and there, from the left to the right, about the proposed health care reform. And here is what I am sure about: I am really, really confused.

And I'm an educated person. As far as I can tell, there is no true proposal by President Obama. It seems like there are lots of wishes and desires, but no set of proposals down on paper currently being debated (or scheduled to be debated) by Congress. And no, his campaign plan does not count. The Obama Administration has not gotten someone to submit that as a bill to Congress.

I am pretty sure that no final plan is ready right now. And that is particularly worrisome. How am I supposed to know what I should support if the target keeps moving. Is the plan to go single payer? That's what everyone was saying when this mess began. Is it a a government plan which will compete with private plans? I know that the insurance companies fear this one. Is it a healthcare co-op plan? And if so, what the hell is a government sponsored co-op plan other than a single payer health care plan?

See why I'm confused.

The one thing I am sure about is that under any of the guises currently being bandied about, it will cover illegal immigrants. This is an anathema to the conservatives on the right (just like the specter that the a health care reform will mean that women have their abortions covered just like men get their viagra covered). However, absent a constitutional amendment, I am not sure how any plan would not include coverage for illegal immigrants.

Now, how many of you out there have actually read the Constitution of the United States? All of it. Seriously, you should. Its not that long. We have in it an amendment called the 14th Amendment. It states:

Section 1. All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the state wherein they reside. No state shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any state deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.
Section 2. Representatives shall be apportioned among the several states according to their respective numbers, counting the whole number of persons in each state, excluding Indians not taxed. But when the right to vote at any election for the choice of electors for President and Vice President of the United States, Representatives in Congress, the executive and judicial officers of a state, or the members of the legislature thereof, is denied to any of the male inhabitants of such state, being twenty-one years of age, and citizens of the United States, or in any way abridged, except for participation in rebellion, or other crime, the basis of representation therein shall be reduced in the proportion which the number of such male citizens shall bear to the whole number of male citizens twenty-one years of age in such state.
Section 3. No person shall be a Senator or Representative in Congress, or elector of President and Vice President, or hold any office, civil or military, under the United States, or under any state, who, having previously taken an oath, as a member of Congress, or as an officer of the United States, or as a member of any state legislature, or as an executive or judicial officer of any state, to support the Constitution of the United States, shall have engaged in insurrection or rebellion against the same, or given aid or comfort to the enemies thereof. But Congress may by a vote of two-thirds of each House, remove such disability.
Section 4. The validity of the public debt of the United States, authorized by law, including debts incurred for payment of pensions and bounties for services in suppressing insurrection or rebellion, shall not be questioned. But neither the United States nor any state shall assume or pay any debt or obligation incurred in aid of insurrection or rebellion against the United States, or any claim for the loss or emancipation of any slave; but all such debts, obligations and claims shall be held illegal and void.
Section 5. The Congress shall have power to enforce, by appropriate legislation, the provisions of this article.

Now take a look at Section 1. It's interesting to note that at first it specifically talks about groups of people who are considered citizens. But in the second half, it talks only about persons. Not citizens. Big distinction. Was it intended? Arguably yes. In fact, the Supreme Court has read it that way in the past.

In 1886, Justice Matthews wrote, in the opinion for Yick Wo v. Hopkins,

The fourteenth amendment to the constitution is not confined to the protection of citizens. It says: "Nor shall any state deprive any person of life, liberty, or property without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws." These provisions are universal in their application, to all persons within the territorial jurisdiction, without regard to any differences of race, of color, or of nationality.

Justice Matthews puts it very plainly there. And this interpretation has been upheld in later cases. This includes the Plyler v. Doe case, decided in 1982, which held that public schools would educate illegal aliens just as they would other citizens. Although the court was split 5-4 in deciding for Doe, the court was unanimous in deciding that the 14th Amendment applied. The split was over the level of scrutiny.

It appears established in the law (both black letter and by stare decisis) pretty much that the 14th Amendment means that all person cannot be discriminated against. Illegal aliens are people. Therefore, if health care reform is passed, its applicable to all persons, citizens and non-citizens alike.

So can we please argue about something else when it comes to health-care reform? Unless someone wants to amend the 14th Amendment that is.

Alot of this was sparked by reading James Taranto's daily Best of the Web column a few weeks ago in the Opinionjournal.com.

Everyone gets to be a pharmacist

Apparently, its to increase their own profit margin and not to pool resources of many to make medical costs cheaper. Or at least that is what I am getting from this article in today's Chronicle where UnitedHealth Group, the nation's second largest health insurer, is urging some of its insurees to buy large doses of medicines and cut them in half.

Basically, they are telling people that medicines are too expensive and the co-pays are not going to come down. Therefore, they want people to buy dosages that are double what they are supposed to take and then cut the pill in half.

Now, I have done this in the past, but that was usually because the doctor was taking me down in my medication to a point where they do not make a pill in the amount he or she wanted me to take. And this is done at a doctor's instruction, not an insurance company's. However, in this instance, the insurance companies are saying to their insurees "too bad that costs are so high, we need to keep our profits, so instead of finding some other way to ease the burden, we want you to to play pharmacist."

And that is essentially what they want. Pills do not always split nicely down the center. This means that people could end up getting under dosages and over dosages. With some medications, this will harm the effect the drug is supposed to have on the person. And what is the upside to the patient? By UnitedHealth's estimate a 1 to 2 percent savings. So rather than not be as profitable as possible, they would rather pass it on to the insured. To me, this does not seem like the best way to keep clients healthy.

But never fear, guess who is against this? That's right the drug companies. However, they are claiming to be against it because of the risk to the patients who use their products. Somehow, what I think they are really worried about is that this will eat into their profits as well.

So what is the real problem here? Drug costs are too high. Why is that? Well, I'm sure that the drug companies would say that it is the lawyers that are driving up the costs with their "frivolous litigation". They would probably say that they need to have the high prices in order to recoup the costs of developing the drugs. However, it would seem that the cost is artificially inflated because of the monopoly the companies have over the formulation because of their patent rights. This allows the drug company, and not the market, to set the price for the drug.