Prognosis: It’s a matter of life and death


By Carmen Reynolds —— Bio and Archives January 25, 2010

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Under the guise of assisting Americans in obtaining much-needed health care, Congress is expediting foolhardy legislation fueled by tax increases and draconian Medicare cuts, using every trick in the book to ramrod it through. Despite the many other pressing issues such as unemployment and the lagging economy, Congress maintains its No. 1 priority is healthcare, and this crisis must be resolved now. There is much, much more not meeting the eye, however.

We’re told Democrats came to Washington D.C. last week, convening behind closed doors to avoid the planned Conference Committee designed to merge the House and Senate versions of HR 3590, a bill that has been mishandled first by its lack of bipartisanship, then its promised transparency.

C-SPAN requested coverage of the upcoming House - Senate health-care reform negotiations. However, it appears there won’t be much, with the White House only agreeing to one hour of coverage, despite eight promises by President Obama that the American people could witness the actions of their representatives on C-SPAN. He promised we could see for ourselves if representatives were advocating in the interests of the insurance companies or for us.

Jack Cafferty of CNN-LIVE railed against President Obama and the Administration’s failed promise of more openness and transparency in government by shutting out the public and conducting secret health-care negotiations.  “It was all just another lie that was told in order to get elected,” he said.

Kudos to U.S. Rep. Vern Buchanan (FL-13), sponsor of the “Sunshine Resolution” requiring public access to negotiations on the health care bill, who filed a discharge petition Jan. 13 to force a House vote on his proposal.

“In Florida we have one of the strongest right-to-know laws aimed at ensuring that government leaders conduct the people’s business in public,” said Buchanan in a redcountry.com article.. “No private meeting, no backroom deals, no secrecy. It’s time to shine some Florida Sunshine on the Halls of Congress.”

Buchanan’s resolution demands the meetings to discuss the final details of the health care reform bill are conducted in the open under the watchful eye of the American people.

This bill, like many others, has ceased to be any form of Democrat versus Republican issue.  It’s now about the sheer physical and economic survival of Americans.

When the federal government has the power to determine the level and quality of health care we receive, it also has the power to determine whether we live or die and how and when. Plus, there will be fines for not purchasing insurance which could include jail time, keeping things exciting for the adrenaline-rush crowd.

Consider November’s U.S. Preventive Services Task Force recommendation to forego mammograms until at least age 50 a harbinger of things to come. Expect frequent edicts and medical policy changes to save money.

There is much distrust and rightly so – especially after the special deals U.S. Sens. Bernie Sanders (IND-Vt.), Ben Nelson (D-Neb.), Mary Landrieu (D-La.), and Bill Nelson (D-Fla.) secured. There very well may be more, but we aren’t allowed to witness it for ourselves.

Nelson protected some of Florida’s citizens from cuts in Medicare Advantage - those who live in Broward, Dade and Palm Beach counties, leaving our 64 other counties to fend for themselves.  Why?

These deals are one of three reasons cited for this bill’s unconstitutionality, wrote U.S. Sen. Orin Hatch (R-Utah) in his Jan. 2 Wall Street Journal article where he specifically named the mandate to purchase health insurance, the sweetheart deals and the requirement for the states to set up insurance-benefit exchanges.

“Mandating anyone to purchase a service and requiring states to establish health exchanges reduces them to little more than subdivisions of the federal government and violate the letter, the spirit, and the interpretation of our federal-state form of government,” he wrote.

And if anyone thinks Scott Brown’s victory in the special election for Ted Kennedy’s Massachusetts senate seat could impact the final vote on this bill, think again, despite the protestations by the president, Jim Webb and Barney Frank.  The Boston Herald reported the Democrats plan to stall his seating to negate its possible influence on the outcome of the Senate vote.  Note that U.S. Rep. Bill Owens (D-N.Y.) was seated immediately after his win in District 23, even before the certification of the final votes by its Secretary of State.

There is no question health-care reform is necessary.  But many viable concepts such as malpractice insurance costs, tort reform and lowering premiums through competition aren’t even included in either version of the 2,074-page bill. In fact, premiums are projected to increase. What’s more troubling though, is the real motivation behind this bill and the reason for its quickening advance.

Taxpayers are calling, writing, e-mailing and sensing little sense of urgency in Washington to our concerns. In fact, U.S. Rep. Jeff Miller (R-Fla.) stated at last week’s Town Hall meetings that the bill is a done deal with a small ray of hope if Democrats for the Stupak Amendment hold things up.  If challenged on its constitutionality, other troublesome parts of the bill will still remain.  Ho hum.

That’s an easy pill to swallow if one already possesses a golden health care policy largely funded by taxpayers.  U.S. Rep. Fleming (R-La.) was on the right track when he introduced H. Res. 615 which requires members of Congress who vote to create a government-run health insurance agency to give up their own comprehensive health insurance plans to join the public option they advocate for others. Miller did sign on as a co-sponsor to that bill.

Congress automatically receives an annual Cost of Living Allowance raise, thanks to the Ethics Reform Act of 1989.  Another automatic raise kicked in this month.  Last year’s raise cost taxpayers $2.5 million.

Seniors will see no increase in their Social Security, and military retirees will not get a COLA increase, however.  Since Americans’ withholding tax will be increased, the federal government receives a loan with everyone experiencing a pay cut – while expenses for everything from bread to toilet paper rise.

Scott Brown stated during his campaign that the potential impact on Tricare and Tricare for Life, the military medical insurance program for military, retires and those retirees older than 65, has not yet been determined.

It’s no wonder a recent Gallup poll reflects a 14-percent approval rate for Congress and movements such as Firecongress.com and kickthemallout.com support the firing of all incumbents during the 2010 and subsequent elections.

A recall effort is underway in Louisiana against U.S. Sen. Mary Landrieu, and Louisiana’s state Sen. A.G. Crowe (R-Slidell) is introducing a bill that would make Obamacare illegal if it violates state laws. Crowe says Obamacare violates Article I, Section 8 of the Constitution and feels that it violates the 10th Amendment among others.

Florida Attorney General Bill McCollum this week announced that he finds the individual mandate currently included in the federal health care legislation unconstitutional.

“Congress’s unprecedented mandate on every citizen to purchase health insurance coverage or to face a penalty raises serious constitutional concerns,” wrote the Attorney General. “The health care individual mandate provisions as currently drafted violate constitutional principles and lack constitutional authority for Congress to enact.”

If the mandate appears in the final version of the bill signed by the president, the States and citizens should pursue legal action to challenge it. He noted that several Attorneys General had expressed interest in joining Florida if legal action becomes necessary.

Many wonder why representatives in Washington aren’t mounting more resistance when there is so much at stake - when our country is already bankrupt. This bill cuts needed programs to add millions of eligibles to the rolls, and there is no guarantee it won’t pay for abortions or illegal aliens.
In fact, U.S. Rep. Luis Gutierrez (D-Ill.) last month introduced the Comprehensive Immigration Reform ASAP Bill which the National Association of Evangelicals and the Catholic Bishops have been strongly pushing – to include Amnesty.  The clear intent then is, one way or the other, to have this health-care bill cover illegal aliens and that it be taxpayer-funded.

Robert Creamer’s new book “Stand up Straight: How Progressives Can Win,” lays out this strategy, commencing with socialized healthcare and ending with amnesty to add voters dependent on entitlement programs – providing a guaranteed repository of “interested” voters. Even some Democrats aren’t enthused about this bill, but for different reasons.

Former chairman of the Democratic National Committee and former Vermont Gov. Howard Dean advocated killing the bill. He told Vermont Public Radio this isn’t health care reform or even insurance reform.  “Because of the expense, it will more likely make the crisis worse,” he commented.

Dean felt the nail in the coffin was the failure of the Dorgan amendment which would have allowed for re-importation of cheaper drugs from Canada.  Dean said this was a bigger bailout to the insurance companies than AIG. Talk about large companies…

This health-care bill creates at least 32 new bureaucracies (johnboehner.house.gov), robs seniors of the care they will so desperately need at the exact time they will need it, undercuts Medicare payments to doctors, and devastates financially struggling family units and physician practices at times they can least afford it.

Specifically, to pay for the expansion of insurance coverage, the bill increases taxes by $493.6 billion, and reduces Medicare spending by $464.6 billion. The bill would cut $134.9 billion from hospitals, $120 billion from Medicare Advantage (MA), $14.6 billion from nursing homes, $42.1 billion from home health agencies, and $7.7 billion from hospices.

Take hikes include a 40-percent tax on high cost health-care plans.  And we know that this week the unions were able to decrease this amount for their Cadillac plans.  That difference must be made up somewhere…

Medicare payroll taxes will be increased by $53.8 billion. That translates into an increase in our Medicare taxes on our pay. Health insurers will be taxed $60.4 billion, drug manufacturers $22.2 billion and medical devices will be taxed $19.3 billion.  Translation?  All of these taxes will be passed directly to the consumer via increased reductions from our pay, increased health-care premiums, drug costs and prices for any medical devices.

Taxpayers will no longer be able to deduct medical expenses greater than 7.5 percent of their income. This figure now rises to 10 percent, unless the individual is 65 years or older. This means less of our medical expenses will be deductible.

Home health agencies and hospices should be the last areas cut.  Home health agencies assist families with the endless financial and emotional burdens of caring for sick and elderly family members.  Without them, some spouses and family members aren’t even able to work because of these constant demands.

In fact, ask any family member how irreplaceable hospice assistance was during his relative’s final months, weeks or days of life, and you will hear how palliative care was a godsend to alleviate the pain and suffering kept the patient comfortable.

The Administration initially identified the Medicare cuts would be used to eliminate fraud and redundancy – not reducing current levels of care. In the final application, the above cuts will directly affect those agencies and patients receiving or destined to receive Medicare and Hospice services.

Medicare reimbursement is already so minimal that some physicians don’t accept it and medical equipment companies are cutting back on staff and services. Hospitals and nursing homes faced with these cuts will also be forced to reduce staff, reduce ratios, refuse patients, and some will ultimately shut down – exactly the opposite of what’s needed with our burgeoning aging baby boom generation.

Congress has postponed for two months a 21.5 percent cut in Medicare reimbursements. When this occurs seniors already less able and mobile will be forced to travel longer distances for care.  Physicians are already voicing their plans to retire early, move their practices out of the country or change careers. This doesn’t take into consideration the disincentive to young students who might have once thought about a career in medicine.

For example, the Mayo Clinic which operates a hospital and four clinics in Arizona have stopped taking Medicare patients, according to biggovernment.com. Last year it lost $120 million on Medicare patients as the program’s payments cover about 50 percent of actual costs.  According to the Medicare Payment Advisory Commission, which advises Congress on Medicare issues, nationwide, doctors in 2007 made 20 percent less for Medicare patients than others privately insured.

The bill expands Medicaid to cover all individuals up to 133 percent of the Federal Poverty Level, which would increase the number of individuals covered under the program by more than 40 percent, placing extraordinary burdens on states. The FPL for a single person is $29, 330 and $88,000 for a family of four.

This spells a financial death knell for Florida and other states. According to the St. Petersburg Times, Florida is already predicting an unprecedented $2.6 billion deficit, whittled down from the $6 billion as a result of tax increases, spending cuts, raids on savings accounts and the addition of stimulus money.

The main reason for this deficit is Medicaid. This subsidized health care program for the poor is growing as the economy shrinks and will skyrocket in 2014 when Medicaid is expanded by this bill. The federal stimulus money that helped the state avoid deep budget cuts will be running out this year.

Many physicians say the idea the public was sold that the American Medical Association endorses this bill was misrepresented – that the AMA doesn’t speak for the majority of doctors.

One local physician said that his seven calls to Sen. Bill Nelson’s (D-FL) office were a waste of time because he didn’t get to talk to anyone in a position of authority to express his opposition to this bill. Asked by another doctor to place his name on a list of those against Obamacare, he declined for fear of reprisals or an IRS audit.

When Dr. Ezekiel Emanuel, the Special Health Care Advisor to OMB Peter Orszag, says there’s a need to end the “traditional Hippocratic health-care approach” and bring in a population-based system to cut costs, red flags should go up and sirens should blare.

Those with chronic diseases, disorders, dementia, disabilities or elderly are destined to become further pariahs in this system – even the average American.  Rationing care to cut costs is the true objective. Ethics be damned.

In an article for the Hastings Center from 1996, “Where Civic Republicanism and Deliberative Democracy Meet,” he writes, “…the reason the United States has failed to enact universal health coverage is not primarily political or economic; the real reason is ethical - it is a failure to provide a philosophically defensible and practical mechanism to distinguish basic from discretionary health care services.

It should be no mystery then that the perpetuity clause found before Christmas recess by U.S. Sen. Jim DeMint (R-S.C.) in Section 3403 of the bill, makes the Independent Medical Advisory Board provision non-repealable by any subsequent House or Senate actions – a clause that is clearly unconstitutional.  According to historian Anton Chaitkin, this same clause was buried in the Lisbon Treaty until it was discovered and deleted. This is the entity which will make the decisions whether taxpayers are eligible for care based on age, recovery ability and ultimately - cost.

Of grave concern are the thought processes behind an article Emanuel co-wrote with Margaret Pabst Battin of the Hastings Center: “What are the Potential Cost Savings from Legalizing Physician-Assisted Suicide?” Remember, these are the advisors to the Administration implementing this bill.

Others she has written include:  “Should Medical Care be Rationed by Age?”; “Choosing the Time to Die: The Ethics and Economics of Suicide in Old Age;” “Can we Copy the Dutch? Can Holland’s Practice of Voluntary Euthanasia Be a Model for the United States?”; “Is there a Place for Euthanasia in America’s Care for the Elderly?”; “Age-Rationing and the Just Distribution of Health Care; Is There a Duty to Die?”; “The Least Worst Death: Selective Refusal of Treatment;” and “Physician-Assisted Suicide – Yes, But in the V.A.?”

The emphasis on death and cost-cutting in these articles is blatant and chilling.

This should give every reader pause and a renewed determination to continue the calls, letter, e-mails and faxes to representatives in Washington D.C., as well as an incentive to become actively involved in changing those Washington representatives to ensure they listen and make the right choices for us - rather than for big businesses with big interests who stand to make huge profits.

We need statesmen and leaders who won’t give up, who are capable of vociferously fighting the universalists who wish to change the quality and duration of our lives by advocating for the termination of the “traditional Hippocratic health-care approach.”

Why aren’t our representatives sitting down and protesting in the hallways about not being included in the negotiations or screaming from the rooftops to save us from what is coming?

Those legislators against this bill should walk out, returning to their districts to work with state Legislatures to shore up 10th Amendment resolutions with teeth and other important state legislation to protect us from the overreach of a federal government out of control.

Prognosis: It’s a matter of life and death.

Carmen Reynolds, Lt Col (Ret), USAF is an investigative journalist, copy editor and researcher. Carmen can be reached at: .(JavaScript must be enabled to view this email address)


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