According to Barack Obama, the stated purpose of health care reform is to "provide affordable, quality care for all and reduce growth in spending by 'building' on the current system, retaining what works and fixing what's broken". But, after spending an entire week digesting over 1,000 pages of this garbage, I can confidently say he either hasn't read the legislation, or he's lying through his teeth. Democrats are poised to destroy the private insurance market and stand ready to replace it with yet more tyrannical government. The only things being retained are the doctors and hospitals. Everything else is fair game.
The elements of "reform" that frighten people most are the massive increase in debt, the imposition of yet another bureaucracy, fear of losing existing insurance or ending up with worse coverage, the so-called "public option", and government over-stepping, such as in the case of Sarah Palin's so-called "Death Panels". While Palin's choice of words may be a bit of rhetorical overkill, there is indeed reason to be frightened about what Democrats have in store for your health care.
Have You Read the Bill?
First and most importantly, there are several different versions of health care legislation, all of which must be reconciled into a single bill. So, absolutely no one, not even Barack Obama, can truly say what's "in the bill". In this article, we look at the House version, because that's the most contentious one. And any elements within it could still end up in the final bill.
Secondly, it is so vaguely written in Washington bureaucratic legalese, that the exact legislative outcomes are also in doubt. The bill sets out the administration's mandates and allocates funding, but leaves out all details of how the reforms are implemented. While, no one can truly say what the final outcome would be, the potential for total government control will be introduced with any sort of public option. I challenge anyone to prove otherwise.
One of Obama's biggest selling points is that, if you're happy, you can keep your current insurance. But, that little piece of disinformation assumes that your insurance company will still exist. After reading this legislation, I'm not so sure.
Partial Capitation or Complete Decapitation?
Obama's reform puts far too much un-Constitutional, unchecked power in the clutches of just a handful of people, including a newly-appointed "Health Choices Commissioner". Power such as a new "Special Situation Authority", which is completely undefined, thus open to interpretation. This commissioner is tasked with developing a pilot program to test several different pricing models to impose on insurance providers, with the aim of capping both spending and cost growth. But, what it really does is weaken insurance providers so they can no longer compete.
The pilot utilizes a concept called "partial capitation" for the biggest insurance providers, where the actual provider is at risk for some or all of the costs of a particular procedure. It also imposes rate caps, in the form of "loss ratios", whereby a provider estimates their total yearly expenditures and is then penalized regardless of performance. If the provider spends less than his estimate, he must rebate the difference to the ratepayers. And if he exceeds that estimate, he gets penalized by the government. Loss ratios will be legislatively set at the highest possible level to squeeze every single penny out of providers and is a lose-lose situation for your current insurer.
In conducting this pilot program, the commissioner is omnipotent and can use specious criteria, such as frequency of physician contact, to determine if beneficiaries should be "monitored" by the health care bureaucracy. There is also specific language insulating many aspects of the pilot program and the commissioner's decisions from judicial or administrative review. Areas that cannot be reviewed include the scope of program, whether or not it was successful and its expansion. The architects of this monstrosity also added language exempting the pilot program from USC Title 44, Chapter 35, which governs information security, collection and dissemination.
Further, all electronic medical records will be open for mining to allow the government to collect any data it wishes on your conditions, treatments, frequency of contact or any other aspect of your health care it wishes to monitor. They may also collect what is deemed to be relevant information from any other federal government agency they wish.
And finally, the Federal Acquisition Regulation has been rendered legislatively inapplicable to health care reform. The FAR governs conflicts of interest, competitive bidding, publicizing of contracts and requirements to purchase certain items from the blind and/or disabled, virtually ensuring unfettered government power to pick winners and losers, not just in health insurance, but all aspects of federal health care contracting.
Although he dismisses their concerns as illegitimate, many Americans believe Obama's reforms will lead to rationing. There is language in the legislation to do just that. Under "Shared responsibility" (in other words, socialism), the government is required to cast a very wide net and consider anyone who has not enrolled in a plan as "subsidized", opening up the possibility that, although specifically prohibited in the legislation, illegal aliens may receive benefits. Casting such a wide net could also decrease the number of those in the private insurance pool and lead Democrats even closer to their goal of killing off private insurance.
In order to cover the new crush of people, the Health Choices Commissioner will perform "modification (lowering) of benefits" to provide for cost-sharing (subsidies) to the poor. All Americans will be restricted to a single, generic set of low, medium, high and premium options with exactly the same benefits. And, those being subsidized can qualify for the premium coverage, despite being subsidized. I guess in the #-backwards age of Obama, beggars can be choosers.
There is no justifiable reason to include a public insurance option. This legislation already imposes loss ratios, which will cap the amount that insurance companies charge. Why would we need to further bolster competition? To put them out of business. Barack Obama has previously advocated the public option as the way to single-payer (government-run) health care in five to ten years, and a recent CBO estimate states that 9,000,000 people will be forced off of their private insurance by 2016 under the public option.
I'm beginning to think that Democrats don't like insurance companies very much.
Comparative effectiveness research will eventually lead to rationing. Once again, put this aspect of reform in the proper context: Modern medicine already relies upon hundreds of years of widely accepted research to diagnose and treat patients. With his emphasis on cost cutting, Obama's brand of comparative effectiveness research is specifically designed to balance medical efficacy with cost-effectiveness. Cutting-edge treatments will be put far out of reach. And when medical advances aren't made widely available, their cost remains prohibitively high and the progress of the entire field of medicine suffers. Increasing deficit spending and the national debt to regress backwards technologically, makes no sense at all. This is a hugely negative aspect of Obama's reforms that no one has cared to discuss.
The Final Analysis
No analysis of Barack Obama's health care reform would be complete without putting his legislative efforts in context with his stated beliefs, his past statements, the past statements of other Democrats and the belief systems of the people he has chosen to help implement his vision.
Just because end of life provisions were removed from consideration in the Senate version of the bill doesn't mean they won't find their way back in. Anyone arguing otherwise is either dishonest, or they lack full understanding of the legislative process.
If Obama's aim was to simply provide health insurance to the uninsured, why appoint czars who advocate such monstrous policies as population control and forced sterilizations?
Why would he consult with advisors like Rahm Emanuel's brother Ezekiel, a medical ethicist who openly discusses placing a monetary value on human life in order to impose a corresponding cap on the medical care provided to support that life?
There is no rational explanation for the government to intrude in people's final decisions, other than control. Advance directives and living wills are freely available, they come with instructions and there are already a multitude of resources available to help anyone plan for their final days. It's a simple conversation you can have with your doctor at any time and I'm sure your physician would gladly refer you to the resources you're seeking, if you asked. We're all going to die. We don't need to be reminded.
Most thinking Americans would agree that, while our system is not perfect, it is still the best in the world. The two biggest problems are cost and efficiency. If we began reform by enacting simple measures, such as eliminating Medicare/Medicaid fraud and malpractice and tort reforms, we would immediately save billions, possibly making this whole discussion irrelevant. But, as has been the case with every major legislative issue in the last 20 years, small, sensible measures were ignored in favor of the scorched-Earth policy of liberal Democrats.
This legislation is not a roadmap to health care reform, it is a recipe for total government control.
