Repeal Obamacare

Healthcare reform is a great idea. Unfortunately, what we got from the liberals in Congress and President Obama is not. The evidence is mounting that the monstrosity from Capitol Hill will result in higher costs, poorer service, and rationed care. For an excellent summary of some of the most recently discovered problems I recommend this opinion piece from the Washington Examiner. The writer notes that Obamacare will have severe negative impacts on business, especially small businesses, healthcare providers, especially doctors, and the patients themselves. He also points to an alternative to Obamacare that is worth considering. Actually, there are many very good alternatives out there--the ERLC offers fifteen principles for successful healthcare reform--but we can't get to any of them until this current fiasco is put out of our misery. Practically every demographic group opposes Obamacare. Repeal of Obamacare starts this fall!

Health Care Reform Goes Political

Happy New Year! I pray the Lord will bless you in amazing ways in 2010. While the calendar has changed, the battles have not. Health care reform is still first on the agenda in DC. For the next several weeks, Democrats in the House and Senate will be working behind the scenes to create a bill they believe can pass both chambers and accomplish their goals. These will be closed-door, invitation-only meetings, far from the press or anyone who might object to their plans.

To get an excellent picture of the political situation the bill creates for the Democrat leadership, I encourage you to read this article by James Capretta and Yuval Levin at the Ethics and Public Policy Center. You can be sure the Democrat leadership is well-aware of these issues and is looking for a way to salvage their mess.

I encourage you to be in continual communication with your congressman and senators. They need to be reminded constantly how their constituents feel about the current state of the health care bills. They also need to hear what you object to that is not currently in play. For example, someone may still try to insert a trigger in the final bill that will trigger a public option if insurance costs do not come down. One thing you can be sure of--they are certainly not going to decline under the current House or Senate versions of health care reform, which means the public option would be triggered. They also need to hear from those who object to the use of federal funds to pay for elective abortions, either directly, through some third party, or through government subsidies. I'm sure you have other concerns as well.

Blessings on you and yours,

Barrett

The Senate Health Care Reform Bill: Some Persistent Problems

By Andy Lewis and Doug Carlson

Edited by Barrett Duke, Ph.D.

The Senate’s proposed health care reform bill is certain to undergo numerous changes as Majority Leader Harry Reid (D-NV) tries to attract enough votes to secure its passage. Some things will not change, though. After performing thorough analyses of current proposals and probable amendments, the Ethics & Religious Liberty Commission concludes that a number of unacceptable problems will persist. Of greatest concern are funding for abortions, high costs, and government-run health care.

Abortion. Recent Senate actions indicate that reform will include government funding of elective abortions. Consider the following:

• The Senate voted 54-45 on Dec. 8 to kill an amendment that would have prohibited federal funding of most abortions under health care reform.
• Federal funds will be used to pay directly for elective abortions in the government’s public option.
• Federal funds will be used to pay indirectly for elective abortions in private health care plans through government-provided premium subsidies for people in low income brackets.

High Cost. The Senate health care reform bill will impose significantly higher costs on everyone.

• Free preventive care, while desirable, will drive up insurance premiums. If it were cheaper to provide this than to only cover illness, the insurance companies would already be doing it.
• Every proposal to date results in higher premiums, higher taxes, mandate penalties, and cuts to Medicare. The Congressional Budget Office (CBO) estimates that the current Senate bill will cost approximately $2.5 trillion once fully implemented in 2014 and will require a nearly $500 billion tax increase.
• The CBO also estimates that, based on the current Senate bill, an average family will pay $2,000 more in health insurance premiums.

Government-run Health Care. The Senate is determined to expand the role of government in health care. Whether the Senate creates a public option or expands Medicaid and Medicare, the following is certain.

• As health care costs increase, the government will resort to rationing.
• Private insurers will be gradually squeezed out as their ability to compete is destroyed.
• Some people will lose their current health care plans.
• Medical services will be less available and quality of care will be diminished as fewer men and women go into the medical profession.

Current Senate proposals signal severe problems for the future of health care in our nation. While we need health care reform, the options currently being presented in Congress are unacceptable solutions.

Opt-outs and Triggers: Government-run Health Care by Stealth

Liberals have nearly achieved their decades-long goal of taking over health care in the United States. The House passed its plan by a vote of 220-215. The vote was close, but close was all the liberals needed.

The Senate vote on government-run health care will also be close. In fact, it is likely that liberals will need some kind of stealth plan in order to gain the 60 votes they need. They are working on so-called compromises right now that will essentially give us a government-run health care system without it looking like it. Two plans are being floated that could very possibly garner the last couple of votes Senate liberals need to pass their own version of a massive government takeover of health care.

The Opt-out Plan

The first plan is known as an Opt-out plan. Under this proposal, each state would get to decide whether or not it wanted to allow a government-run plan to be offered within their borders. While it sounds like a nice nod to states rights principles, the truth of the matter is that it is highly unlikely that any states would opt-out of the plan. For one thing, it is simply a political non-starter. There are several reasons. First, the government-run plan will promise lower health insurance premiums. Citizens will not tolerate the prospect of paying higher premiums for the same coverage available in other states that offer the government-run plan. Second, health insurance subsidies for low income people will likely be tied to the government-run plan rate. So, the subsidies may not cover as much of the gap between the cost of health insurance and what people can afford in opt-out states. This will not be received well by the citizens of those states. It is even possible that subsidies will not even be available to states that opt-out. Third, uninsured/underinsured citizens and businesses in opt-out states will be forced to pay taxes and penalties that will be used to help pay for the government-run plan for people in other states, with no benefit for themselves. They will certainly resent this inequity.

The other problem is purely economic. The states are looking at serious financial shortfalls as soon as the stimulus funds run out. They call this event ominously “the funding cliff.” If the states think they can close their impending gaping budget holes by moving their employees into what they are told is a cheaper government-run plan, they will likely feel compelled to grab any rope thrown their way, and then, so much for states opting out. Of course, all of the currently proposed government-run plans will lead to increased rates for everyone, but this will not be evident until the government-run plan is introduced in the states. Then the states’ health insurance dilemmas will be even more perilous. But it will be too late.

The Trigger Plan

The second plan is called a Trigger option. In this scenario, the government-run health plan would be included in the bill, but would only be activated if insurance companies fail to achieve certain benchmarks set by the health care reform legislation. If this option passes, one thing seems quite certain—the trigger will be pulled. It is easy enough to imagine that liberals, who are determined to create a government-run plan, could simply create a set of goals that are nearly impossible to meet. For example, they could require that health insurance premiums decline by a certain percentage—which is certainly a reasonable gauge—but fail to do anything to help drive down costs.

The stage for higher health care premiums has already been set. Consider these facts. The bills liberals have put forward do not allow for interstate competition among private health insurers, without which it will be hard to drive down costs. The bills require free preventive care, which people will appreciate, but which will make health care costs go up. Everyone knows this. The reform proposals prevent insurance companies from denying coverage based on pre-existing conditions. Again, this is an important reform measure, but it will not make insurance premiums decline. It will cause them to go up. There is no tort reform in any of these bills, which means that doctors will be forced to continue to engage in defensive medicine to protect themselves from lawsuits, once again, driving up the cost of health care and consequently driving up premiums. So, when the lower premium benchmark is not reached, the government-run plan will be triggered.

Government-run Health Care Must Be Stopped

Whether one includes a state opt-out or a trigger in the Senate’s health care reform bill, the same result is assured—government-run health care, which will certainly lead to higher costs, rationed care, and poorer service. The only way to prevent this is to insist that the Senate not pass any bill with a government-run plan in it, regardless of when or how that plan might be implemented. The time to insist on this is now. Every person who cares about their and their children’s health care must contact their senators immediately and often and insist that they vote against any health care reform plan that includes a government-run health care option.

Federal Funds for Abortion in the Reid Health Bill

Senator Harry Reid unveiled his “Patient Protection and Affordable Care Act” this week. It will be a while before we know all that he is proposing to do in the name of health care reform in his 2,000+ page bill. However, it is already clear that he intends to greatly expand the use of federal dollars to help pay for abortion in our nation. Section 1303 (a)(1)(D)(i) of his bill actually requires every health insurance exchange to have at least one plan that pays for abortion-on-demand for any reason.

Direct Funding in the Public Option

Senator Reid’s bill uses federal funds to help pay for abortion in two ways, directly and indirectly. Federal funds will pay directly for abortion through the so-called “Community Health Insurance Option,” which is the Reid bill’s name for the public option, Section 1323 (b). To help achieve this, the bill divides abortion into two categories. The first category consists of abortions related to rape, incest, or threats to the mother’s life. According to Section 1303 (a)(1)(C)(i)(III), federal funds will help pay for abortion in these instances for all people, regardless of their income level. Currently, the Hyde Amendment restricts federal money for abortions in these instances to low-income people on Medicaid.

The second category consists of abortions that are typically referred to as elective abortions. These are abortions due to other factors, like economic, personal, emotional, etc. These account for the vast majority of all abortions performed in the United States. Most Americans rightly find these abortions unacceptable, and they do not want their tax dollars to be used to pay for them.

The Reid bill allows for the public plan to pay for these abortions as well, so long as the HHS Secretary can certify that no federal dollars are used to pay for them, Section 1303 (a)(1)(C). In order to skirt this limitation, the Reid bill intends to establish a fund that will collect money to pay for elective abortions that will not qualify as federal money. The bill actually sets up a system, Section 1303 (a)(2)(C), that assesses every enrollee in the public option at least $1 per month to pay for elective abortions.

It is clear that Senator Reid intends to pay for elective abortion in the public plan if he can find a way to do it. However, even this sleight of hand does not de-federalize the dollars he collects. Regardless of how the United States Treasury collects the money, it is still federal money. Any funds the government receives to pay for health services in the government-run plan are automatically federal funds. Some people are trying to argue that these funds are segregated insurance premiums and therefore not federal dollars, but there are no non-federal dollars in the United States Treasury. They are all federal dollars.

Just ask these same people if they support using money in the U.S. Treasury for education vouchers to religiously-affiliated schools, and they’ll argue that every penny in the Treasury is federal money, regardless of its source. Even if the federal government funds its health plan through a third party, it is still merely passing along federal dollars for the express purpose of paying for abortion. So, if the government-run health plan pays for abortions, which it certainly will do, it will be using federal funds to pay for them. Other plans in the health insurance exchange will also be allowed to assess their members to pay for elective abortions in their plans.

Direct Funding in All Health Insurance Plans

Federal funds will also help pay directly for abortions in the cases of rape, incest, or threats to the mother’s life for all women in households earning up to 400% of the poverty level, or approximately $88,000 per year for a family of four. Section 402 (c) instructs the government to limit the out-of-pocket expenses people in this range have to pay. The federal government will pay the insurance plan the difference between the actual out-of-pocket expense and the reduced amount the low-income person is required to pay. These federal subsidies for out-of-pocket expenses will apply to any health plan offered through the insurance exchanges.

Indirect Funding in All Health Insurance Plans

In addition, federal funds will pay indirectly for elective abortion through other insurance plans. While Section 1303 (a)(2)(A) of the Reid plan prohibits the direct use of tax credits and federal subsidies for abortions not related to rape, incest, or threats to the mother’s life, these sources of federal funds will still help pay for elective abortions indirectly. This will be accomplished through the premium assistance tax credits and cost-sharing provisions in the bill.

Section 1401 of the Reid bill instructs the federal government to pay for a certain portion of the premiums of low-income individuals. In these instances, federal dollars will be helping to pay peoples’ insurance premiums, including premiums for insurance plans that offer full abortion coverage. According to Section 1402 (c), the federal government will pay the insurance provider part of the out-of-pocket health care expenses lower income individuals incur for their health care. In both of these instances, the insurance provider must simply demonstrate that none of that federal assistance money is being used to pay for elective abortions.

While the government is not paying for elective abortion costs in these situations, it is helping to fund an insurer’s overall expenses. In these instances, federal dollars will help fund the administrative and other costs of the insurer, thereby freeing up other funds available to the insurer to pay for elective abortions.

This relationship between federal dollars and private dollars is referred to as fungibility. Federal funds are being used to offset other costs, thereby freeing up non-government funds for abortion. While technically federal funds are not being used to pay for elective abortion, practically they are supporting the infrastructure so that non-federal dollars can be used to pay for elective abortion.

Essentially, the Reid bill applies the federal government’s arrangement with Planned Parenthood to the entire health care industry. Currently, the federal government gives Planned Parenthood about $300 million a year for their activities. While this money may not be used to pay for abortions except in the cases of rape, incest, or threats to the mother’s life, they are used to help pay for the administrative costs and other activities of Planned Parenthood, thereby freeing up other Planned Parenthood funds to pay for more than 300,000 abortions every year.

Limiting Language Solution

Explicit restricting language is necessary to prevent the use of federal funds from paying for the massive expansion of abortion in the Reid bill. Some very good language is available in the Stupak-Pitts Amendment. The amendment states, “No funds authorized or appropriated by this act may be used to pay for any abortion or to cover any part of the costs of any health plan that includes coverage of abortion” except in cases of rape, incest, or threats to the physical life of the mother. We should even be concerned about the breadth of this language since it allows for abortion in the cases of rape and incest, but it is only repeating the current exceptions in the Hyde Amendment, and is probably as good of a restriction as can be obtained. Certainly, this must be the limit. Anything less would undoubtedly be too weak to protect most innocent human life.

Until the Reid bill includes the Stupak-Pitts Amendment, at the very least, all pro-life people should oppose its passage for the sake of millions of unborn children in our nation. The Senate should not even proceed to debate on this disastrous bill until it includes the language of the Stupak-Pitts Amendment or language even more protective of innocent, unborn human life.


Blessings,

Barrett

EPA Moves to Regulate CO2, Afghanistan Becomes Political

Dear Friends,

Here are a couple items I thought you would want to follow.

Blessings,

Barrett

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EPA Moves to Regulate CO2

The EPA has announced it is moving forward with plans to regulate CO2 emissions. This threat has been held over our heads to put pressure on Congress to pass a CO2 control bill. Now that it looks like that isn’t going to happen any time soon, the EPA is starting to move forward with its Supreme Court-granted authority to regulate so-called greenhouse gases (GHG) through the Clean Air Act.

They announced their first move last week. They are requiring the auto industry to implement changes that will reduce GHG emissions in future cars and light trucks. They state:

“The standards proposed would apply to passenger cars, light-duty trucks, and medium-duty passenger vehicles, covering model years 2012 through 2016. They require these vehicles to meet an estimated combined average emissions level of 250 grams of carbon dioxide (CO2) per mile in model year 2016, equivalent to 35.5 miles per gallon (mpg) if the automotive industry were to meet this CO2 level all through fuel economy improvements.”

And yes, this is going to cost everyone some money. The EPA claims that their rules will add about $1,100 to the cost of a 2016 year vehicle. They say this is negligible compared to their estimate that a consumer will save $3,000 a year in fuel costs over the lifetime of the vehicle. Somewhere in one of their files one could probably find how they arrived at their calculation, but you can be sure they based it in part on their expectation that gasoline is going to be more expensive and that using less of it will result in savings for the driver. If we just drilled for our own oil, this would never be the case, but of course such thinking is not even part of the process in these circles.

Furthermore, this average cost/benefit calculation is an average. Those who drive less will not experience the same benefit, but their cars are still going to cost $1,100 more. So, who gets hit the worst? The poor, who will have to pay more for their cars, but who will drive less, and senior citizens, who no longer must commute to work and tend to use their cars less. In other words, the very people with the least disposable income will bear more of the cost and experience less of the benefit.

Also, you can be sure that the EPA didn’t calculate other costs that will result. For example, we already know that municipalities are feeling the effects of lower gasoline prices and less gas consumption. Their tax revenue on gas sales is down so badly that they are looking for alternative ways to raise money off of car drivers. One of the more popular ideas is to start taxing people for the miles they drive. Such a proposal will hit people who use their cars the most, which will reduce the benefit they are supposed to be getting through the EPA’s calculation, but they will still be paying $1,100 more for their cars. It will also add costs to the poor and senior citizens. While they are likely to drive fewer miles, they will still have to pay for the miles they will drive, adding more costs against the supposed savings.

Afghanistan Becomes Political

This week, President Obama decided to hold off on any decision to send more U.S. troops to Afghanistan. Why? Liberal members on the Hill are questioning the wisdom of sending more troops.

Our commanders aren’t questioning it. The Chairman of the Joint Chiefs of Staff Admiral Mike Mullen has called for more troops. General Stanley McChrystal, the top U.S. commander in Afghanistan, is reportedly asking for 30,000 to 40,000 more troops.

Of course, there are a lot of factors to consider. Afghanistan has a history of bringing nations to their knees, but the crowd now fighting the call to send more troops to Afghanistan also fought the surge in Iraq. They can hardly be considered objective counselors in this issue.

Meanwhile, the insurgency is growing every day, and American and NATO troops are dying at higher rates. General David Petraeus recently called for patience in dealing with Afghanistan, which included a call for increased security, which I interpret, in part, to mean, more troops. He said,

“In Afghanistan, security is the principal concern, although there are numerous other challenges as well, with governmental legitimacy prominent among them. Clearly, the security trend in Afghanistan has been a downward spiral, with levels of violence at record highs in recent weeks.”

General Petraeus has proven he knows what he is doing. As far as I am concerned, his voice outweighs all the negative attitudes on Capitol Hill. We will soon find out if Afghanistan is going to be a political issue, or if President Obama will follow President Bush’s strategy of letting the experts fight our wars, and win them.

Where Is the President’s Health Care Reform Bill?

In his speech Wednesday night President Obama delivered a broad outline of key components he says are in his health care reform package. The President declared, “The plan I’m announcing tonight would meet three basic goals.” He went on to give some “details that every American needs to know about this plan.” He called it “my plan” and “my health care proposal.” He said “the plan that I’m proposing will cost around $900 billion over ten years.” Evidently, President Obama has a health care reform plan.

The main problem with what I heard Wednesday night is that I don’t know what plan the President is talking about. Many of the features the President described do not exist in any of the bills Congress is working on. They aren’t in the liberal Democrats’ bills. They aren’t in any bill from the Blue Dog Democrats. They haven’t written one. They aren’t in the Republicans’ bills, and they have at least five they are trying to get people to notice.

For example, I found myself wondering what insurance exchange the President was talking about. Is it like Henry Waxman’s bill, H.R. 3200, which mandates what coverages must be in every policy in the exchange? And does it follow H.R. 3200 in preventing insurance companies from selling new policies that don’t offer the government-mandated coverages? Does he have something entirely different in mind? I’d like to know.

I also wonder about the President’s not-for-profit option. None of the bills under consideration include this. But since it’s in the President’s plan, I wonder how this option will “keep pressure on private insurers to keep their policies affordable.” He says the public option will be able to eliminate some overhead that “gets eaten up at private companies by profits, excessive administrative costs and executive salaries.” Are we looking at something like Fannie Mae or the Post Office? If so, I am skeptical. Neither of these government-supported programs has managed to operate efficiently or responsibly. And we certainly can’t look to them as models of restraint when it comes to executive salaries and benefits. The Postmaster General of the Post Office received $800,000 in salary and benefits in 2008. The former CEO of Fannie Mae received over $90 million in pay and bonuses during his six years at Fannie Mae. Lower level employees have also been paid very well in these organizations.

The President also said “under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.” I haven’t seen this in any of the bills the Democrats are working on. In fact, most of them have resisted every effort to put language in their bills guaranteeing that no federal funds would be spent on abortion. I was more surprised by the President’s affirmation that conscience laws will remain in place since he has already ordered the HHS to start weakening conscience protections for health care practitioners. I would really like to see this language in the President’s plan.

And then there is material that the President is still thinking about whether or not to add to his plan, like tort reform. He can’t possibly be talking about any of the bills currently under consideration. None of the Democrat bills even come close to addressing the problems caused by predatory lawsuits and the defensive medicine doctors must practice to protect themselves from lawsuits. Yet, the President admitted that “defensive medicine may be contributing to unnecessary costs.” He said he was ordering the HHS to develop demonstration projects to help develop some data on it. If the president will not back tort reform until he has some numbers to look at, then health care reform should be delayed until we know what conclusion he reaches and whether or not that will be included in his health care reform bill.

The President’s target date for implementing his exchange interested me as well. He plans to wait four years, which he says will “give us time to do it right.” Surely, if the plan will not even help a single person for the next four years, Congress can take more than the next couple of weeks or months to arrive at a compromise bill that the American people will support. In fact, if the President actually has his own plan, we should give him the time to write it, including those pesky “significant details” that need “to be ironed out,” and send it over to Congress so they don’t have to keep trying to guess at what the President wants.

Obviously, the President has a health care reform plan, but where is it? Much of what he said Wednesday night doesn't square with anything I've seen in Congress so far. Senator Tom Coburn made the same observation. He remarked, “It was a good speech, the problem is that what he wants and what they've written are two totally different things.” I agree. So, I am looking for a bill to come from the White House that we can read. And here’s hoping that it doesn’t arrive DOA, just like all the current Democrat proposals.