Obamacare Special Report

If there’s one thing the Obama administration knows, it’s how to exploit a good crisis or — if none is handy — to manufacture one to suit the moment. But sometimes, as in the “global-warming crisis” that generated the Waxman-Markey “cap-and-tax” bill for the President — a manufactured crisis can well be the political equivalent of New Coke: The public just doesn’t buy it.

A Gallup Poll released in July found that only 20% of Americans believe that the U.S. healthcare system is in crisis, and even fewer — 16% — think solving that crisis should be the government’s top priority.  

Yet President Obama claims there is a health care crisis in America and has repeatedly asserted that 47 million Americans are uninsured. The U.S. Census Bureau’s just-released annual report “Income, Poverty, and Health Insurance Coverage in the United States: 2008,” does say that just under 47 million people lack health insurance.  

Yet when you examine the data in this report, nearly 18 million of the uninsured Americans earn over $50,000 per year and can afford their own insurance (over 9.7 million earn $75,000 or more). Unless you think taxpayers should buy insurance for 18 million people who can afford to buy their own, Obama’s “crisis” number just slipped to 29 million. But there is more.

Of the remaining 29 million, according to the Census Bureau report (page 21, Table 7), there are 9.5 million uninsured people in the United States listed as “not a citizen.” This is an extremely conservative estimate. Unless you think American taxpayers are responsible for buying health insurance for anyone who can walk across our wide-open borders undetected, the number of uninsured Americans is now roughly 19 million.

Nearly eight million of those are under the age of 18, thus are eligible to participate in the State Children’s Health Insurance Program (SCHIP). Their parents simply need to register them for the service.

Roughly 11 million Americans remain, including over 8 million people between the ages of 18 and 24. A great many of the young men and women in this age group choose not to purchase insurance because they are young and healthy and don’t believe they need insurance.

During his speech to a joint session of Congress on September 9, the President did change his numbers, revising his estimate down from the 47 million Americans he claimed were uninsured in all prior speeches, radio addresses, interviews and town hall meetings. He now says the number is 30 million, which is still wildly overestimated.

Obama’s “New Coke” just isn’t selling because its justification is faked. So, the government’s own data debunk the hyper-inflated numbers put out by the White House intended to give the appearance of a crisis where there is none.

America Has the Best Health Care System in the World

Throwing out the entire American health care system to provide medical insurance for 3% (or less) of the population makes no sense. The reality is that people travel to America from all over the world to get treatments not available in their own countries mainly because of the rationing that is an inevitable part of a government-run healthcare system. America’s private healthcare system offers unequalled technology that is the envy of the world.  

Statists complain that the World Health Organization (WHO) ranks the American system 37th in the world. Look at the measures this internationalist organization uses to rate healthcare quality:

    1. Health Level: 25%
    2. Health Distribution: 25%
    3. Responsiveness: 12.5%
    4. Responsiveness Distribution: 12.5%
    5. Financial Fairness: 25%

But only health level and responsiveness, which make up merely 37.5% of the rating system, have anything to do with health. The remaining 62.5% is weighted heavily by their arbitrary standards of financial fairness and distributive equality.

If that sounds a lot like “wealth redistribution,” it should: All three ideas come from the same Marxian theory of “to each according to his needs, from each according to his ability.”

Other attempts to discredit the American healthcare system include the infant mortality rate. Statists claim that America’s rate of 6.71 deaths per 1,000 live births ranks us inferior to Socialist, government-run systems. But in America we count the death of every child before the age of one year per every 1,000 live births to gauge the infant mortality rate. Other countries — even developed nations such as Japan — have different ways to count infant mortality that falsely reduce their reported rates.

Sen. Tom Coburn (R-Okla.) is a practicing physician specializing in family medicine, obstetrics and the treatment of allergies. He has personally delivered more than 4,000 babies and is a two-time cancer survivor. He is one of only two physicians in the U.S. Senate.

Skewing the Infant Mortality Figures

“If you take neo-natal mortality outside of Medicaid, we rank No. 1 or No. 2,” Coburn says. “What percentage of babies born in this country are born under Medicaid?  It’s getting close to 50%. Now look at neo-natal mortality rates and Medicaid. That’s a government-run program, and neo-natal mortality rates are very high. So if you look at the private sector, we have excellent results.”

Japan is ranked first in the world according to the 2004 WHO data, the last year the complete international data were available. Yet babies born alive in Japan who do not survive for at least 24 hours are simply not counted, severely skewing the statistics. Babies must be at least 30 centimeters in length — that’s 12 inches long — to be counted as a live birth in Switzerland, which further skews the numbers.

“If a baby is born in the peri-natal period [post-20th week of gestation] and it dies, other countries don’t count it,” Coburn said. “Some countries if they don’t make it through a 24-hour period, they’re not counted. And if you look at the rest of single-payer nations, if they’re born under 30 weeks they don’t count them. We routinely save babies born under 30 weeks. We save babies at 23 weeks now.”

In Canada, if a baby weighs less than 500 grams when it’s born — that’s about 1.1 pounds — and the baby doesn’t survive, it doesn’t count. The Canadian government calls these babies “unsalvageable.”

Yet another frequently cited 2006 WHO report finds the American system inferior, spending $6,719 per person ($3,076 government paid) on medical care while the Brits spend only $2,815 per person ($2,457 government paid). Yet the report fails to note the major reason for the spending differential between America and socialized medicine in other countries such as Great Britain is health care rationing.

“We spend the vast majority of our dollars in the last five years of life,” Coburn said. “We continue to invest in people’s lives because we think the elderly have value. Some other countries don’t. That skews the numbers, as well. But if you compared apples to apples and if we cut off as they do on age-adjusted [spending], our cost would be much lower.”

America’s private medical system is the best in the world. Sure, it can be made better and costs can be reduced. But there’s no ‘crisis,’ just Democrats manufacturing hysteria as a basis to expand the government.  

H.R. 3200: a Summary of Horrors

The 1,017-page House Obamacare bill contains some standout elements that warrant special mention as some may not have gotten as much exposure as others.  

Here’s an excerpt from HUMAN EVENTS’ complete index of the Obama Care Horrors:

Page 16, Section 102(a): mandates that you cannot enroll in a private insurance plan if you don’t have your private plan “on or before the first day” the legislation is enacted. No changes in your plan are allowed. If a new treatment that cures cancer hits the market, you would be forced into the government-run system to obtain the new cancer treatment. If you change jobs, you cannot enroll in private insurance at your new place of employment nor can you take your private insurance with you. At that time you are forced into the government-run health care system. This will kill off private health insurance in a relatively short period of time.

Page 19, Section 102(c): prohibits the sale of private individual health insurance policies beginning in 2013, forcing all individuals to purchase coverage through the federal government. This element alone hands over complete control of access to health care and its content to the federal government.  

Pages 41-47; Division A, Sections 141 and 143: creates a government-run “exchange” through which all insurance must be purchased after 2013. The government decides what insurance qualifies for the exchange and the content of all of the policies in the exchange — in other words, a government takeover.

Page 50, Section 152: Government insurance and taxpayer-funded health care will be provided to all “without regard to personal characteristics extraneous to the provision of high-quality health-care and services.” Translation: The tax-paid health care will be given to all non-US citizens, illegal or otherwise. All amendments that would have specifically barred coverage for illegal aliens were defeated by Democrats in committee. All of them.

Page 58, Section 1173A: Government bureaucrats will have real-time access to an individual’s financial data and bank accounts for auto-debit. This section also refers to a National ID Health Card, which means a national ID card will be created for everyone including illegal immigrants.  

Page 74, Sections 202(c) and (d): protect members of Congress with existing federal employee coverage (as defined in Section 100(c) (6) on page 9) from being forced to join the government-run health plan offered through the government-run health care exchange.  

Page 95, Section 205: The government exchange will use community organizations to enroll individuals and employer groups into government-run health care. Do you really want ACORN or AmeriCorps being paid by taxpayers to visit anyone to “suggest” they sign up for government run health care?

Page 116, Section 221: establishes government-run system that mandates bureaucrats will set benefit levels for all of the plans, including the government plan, creating rules for itself and its “competition.” According to the non-partisan Lewin Group, as many as 114 million Americans will lose their existing coverage because this unfair competition will cause a government takeover.  

Page 127, Section 225: The government will set wages for physicians for participating plans which will drive some doctors out of the practice of medicine altogether. Further, it will discourage people from going into the medical profession.  

Page 167, Section 401: imposes a 2.5% income tax on all individuals who do not purchase “bureaucrat-approved” health insurance. If the government doesn’t like your plan because it offers you too much or too little (bureaucrats decide, not you), you have to pay this tax if you want to keep your private insurance, regardless of how much or how little money you make.

Page 197, Section 441: imposes additional job-killing taxes on “high income” individuals at rates ranging from 1% of gross income ($350,000-500,000) to 5.4% ($1 million or over). More than half of this half-trillion-dollar “surcharge” will be paid by small businesses. And — according to Obama’s own senior economic advisor — will cost up to 5.5 million jobs.  

Page 272, Section 1145: mandates that government review and “cost adjust” payments made to cancer hospitals. Underpayment — as is done through Medicare and Medicaid — will cause rationing and even closure of cancer hospitals.  

Page 317 (Lines 21-25) and Page 318 (Lines 1-3): Prohibit expansion of hospital facilities without prior government approval.

Page 331, Section 1161: cuts more than $150 billion from Medicare Advantage plans, jeopardizing millions of seniors’ existing coverage without providing a coverage alternative.

Page 425, Section 1233: incentivizes end-of-life care consultations through Medicare reimbursement. This particular section has caused strong concerns that vulnerable seniors will be isolated and targeted for “death counseling.”

Page 501, Section 1401: establishes a new Center for Comparative Effectiveness Research. The bill includes no provisions preventing the government-run health plan from using the results of such research to deny access to life-saving treatments.  

Page 835, Section 1802(b): includes “taxes on certain insurance policies” to fund comparative effectiveness research. These additional taxes levied on any grandfathered private insurance policies are intended to make these policies too expensive for the overwhelming majority of Americans to afford.

Missing from the bill is any mention of federal funding for abortion. The President and Democratic leaders in Congress claim that abortion isn’t covered in the government plan. But — because there is nothing in the legislation that specifically bars it — abortion is included. The courts have been very clear in cases involving other programs that unless you specifically say abortion will not be covered, abortion will be covered.

Government-Run Health Care Will Cost Lives and Money

The taxpayers will pay an enormous price for Obamacare. According to the non-partisan Congressional Budget Office (CBO), H.R. 3200, the House Democrats’ health care proposal, includes over $1 trillion in new spending over the next ten years.  

And the final figure is probably going to be much more than that. According to Congress’s Joint Economic Committee (JEC), historical cost estimates for government health care programs have been extremely unreliable. In 1967, when Congress was first considering passage of Medicare, the estimate cost for the entire Medicare program by the year 1990 was $12 billion. The actual cost was over $111 billion, nearly 10 times the original estimate. In 1987, Congress estimated Medicaid’s share of hospital payments to states to be $1 billion by the year 1992. The actual cost was $17 billion which was a whopping 17 times the original estimate just five years earlier.

What Democrats also won’t tell you is that their government takeover of health care as contained in H.R. 3200 is not fully implemented until the year 2015. The bill intentionally hides the full financial impact on taxpayers through budget maneuvers by pushing implementation to out years.

H.R. 3200 also includes over the next 10 years more than $820 billion in job-killing tax increases on small businesses and on families making as little as $18,700 per year.  Yet even these massive new taxes aren’t enough to pay for the Democrats’ plan.  

In an attempt to get a handle on the size and scope of the Democratic proposal, Rep. Kevin Brady (R.-Texas) and House Republicans on the JEC provided a chart detailing the bureaucratic nightmare of the House Democrats’ health care plan. The chart identifies at least 31 new federal programs, agencies, commissions and mandates that accompany the unprecedented government takeover of health care in America.

The CBO was not given all the details of H.R. 3200 when it was asked to provide the cost estimate for the bill. The odds are that the $1 trillion estimate grossly understates the real costs.

Rationing Health Care

British Prime Minister Margaret Thatcher once said, “The problem with socialism is that you eventually run out of other people’s money.”

England’s National Institute of Health and Clinical Excellence (NICE) makes healthcare rationing decisions for all British subjects. These NICE people calculate what they term a Quality Adjusted Life Years (QALY) measurement using age as the baseline to calculate how much British taxpayer money is spent on an illness before the patient is cut off — the patient is flat out refused medical treatment outright due to age and survivability rates.

Long waiting lines and outright denials of service are routine in even life-threatening situations. It’s all nice, neat and sterile. It’s government-run health care.  

H.R. 3200 implements mechanisms for American rationing: comparative effectiveness research (CER). Section 1401 of the bill authorizes the Center for Comparative Effectiveness Research (CCER).  

According to a non-partisan CBO report released in 2007, “Research on the Comparative Effectiveness of Medical Treatments,” the CBO defines CER “[a]s applied in the healthcare sector, an analysis of comparative effectiveness is simply a rigorous evaluation of the impact of different options that are available for treating a given medical condition for a particular set of patients. Such a study may compare similar treatments, such as competing drugs, or it may analyze very different approaches, such as surgery and drug therapy. The analysis may focus only on the relative medical benefits and risks of each option, or it may also weigh both the costs and the benefits of those options.”

Congress already funded CER in the so-called stimulus bill in the amount of $1 billion through the National Institutes of Health.  

Sen. John Barrasso (R.-Wyo.) is an orthopedic surgeon and one of two physicians in the U.S. Senate.  

“Comparative effectiveness research is actually something that was funded in the stimulus package that was passed and signed into law,” Barrasso said. “While there is some value in saying what is the best medical care and giving that as a recommendation, to then say we’re going to use not just the scientific but also the economic factors in deciding what care the government will permit doctors to provide patients, that’s where you really get into trouble.”

“Advances in medicine are often made by people trying to find new solutions to old problems,” Barrasso added. “Government is going to cut back on that with their comparative effectiveness research, especially when they apply economic control as part of their comparison. As the President said, maybe someone doesn’t need an operation, maybe they should just take a pain pill. People can read the quote and make their own decisions.”

Barrasso is referring to the President’s town hall meeting when a woman asked the President if her mother, who at the time was 100 years old, would have received approval for a pacemaker under his health care proposal. Her mother, under our current health care system, had the surgery five years ago and is still alive and doing very well at 105.  

Obama’s now infamous unscripted moment in response: “Look, the first thing for all of us to understand that is we actually have some—some choices to make about how we want to deal with our own end-of-life care… We as a culture and as a society [can start] to make better decisions within our own families and for ourselves… at least we can let doctors know and your mom know that, you know what? Maybe this isn’t going to help. Maybe you’re better off not having the surgery, but taking the painkiller.”

Grandma gets thrown under the bus in a drug-induced stupor by a panel of bureaucrats. Using CER, your personal health care will become nothing more than an impersonal federal budget item calculated by using one-size-fits-all formulas devised by federal government bureaucrats. H.R. 3200 is 1,017 pages long and is intentionally broadly worded in order to disguise its specific intent. Once you retire and are no longer paying steady income taxes into the system, by simple mathematics you become an aged, expensive, depreciating budget item.

Under H.R. 3200, the government-run system will pay Medicare rates only for services that do not cover the actual cost of treatment. The bill also sets wages for doctors.

“Many physicians I talk to, if they are able to retire from the practice of medicine will retire as soon as this goes into effect,” Barrasso said. “That’s going to make it even harder for patients to find doctors to take care of them. Right now, about 40% of Medicare patients can’t find doctors to take care of them because Medicare pays doctors and hospitals in many ways less than the cost of taking care of the person in the first place.”

“The hospitals in Wyoming receive about 37 cents on the dollar for Medicare patients,” Barrasso continued. “They can’t keep their doors open if everybody is paying Medicare rates. The difference is made up by people who have their entire bill paid for, whether it is being paid out of their own pocket or because they have private insurance. But the government is the biggest deadbeat when it comes to paying for health care.”

Barrasso also pointed out that it’s not just hospitals and doctors that are currently getting shorted.

“Ambulance services are not even reimbursed the cost of sending out the ambulance to pick up the person and take him to the hospital,” Barrasso said. “We have 100,000 square miles in Wyoming and only about 23 hospitals. The distances are great and what Medicare pays isn’t enough sometimes to put gas in the ambulances that are run by volunteers. So they can’t even afford to provide the service because the Medicare values are so little.”

Republican Alternatives

When Democrats say “bi-partisan” they mean when they can force Republicans to agree with them. The dog-and-pony White House health care meeting with the President was merely another staged media event. Republicans have been literally shut out of all health care planning and negotiations in Congress. All of them.

Despite media reports and Democratic claims, Republicans have offered alternative bills, two of which are outlined below.

The first healthc are bill offered in this Congress was introduced back in May, sponsored by Senators Tom Coburn, M.D. (R.-Okla.) and Richard Burr (R.-N.C.), and Representatives Paul Ryan (R.-Wis.) and Devin Nunes (R.-Calif.). The bill offers universal access to quality, affordable healthcare without adding billions of dollars in new debt or taxes and without a government takeover of America’s healthcare system.

“We had a bill out there before anybody else had a bill out there, and it addresses every problem we have,” Coburn told HUMAN EVENTS. “It’s also constitutional.”

“The Patients’ Choice Act of 2009” uses choice and real competition rather than rationing and restrictions to contain costs. Initially focusing on prevention, the bill singles out the five chronic diseases (heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes) that cause two-thirds of American deaths and make up 75% of total health care expenditures. The bill incentivizes treatment for these largely preventable diseases and uses innovative measures such as targeting the use of food stamps to healthy food choices.

Through advanceable and refundable tax credits and deductions, the bill provides $2,300 per individual or $5,700 per family to purchase health insurance and expands Health Savings Accounts (HSAs) allowing increased annual contributions and the purchase of insurance with pre-tax dollars.

The bill also addresses tort reform.

“Texas passed meaningful tort reform and they’ve had a 36% drop in the cost of malpractice insurance,” Coburn said. “They’ve had an influx of doctors that has lowered cost not raised cost.”

“The smarter states are going to open up their barriers to allow cross-state purchase of health insurance and then they’re going to do risk readjustment and they’re going to tell insurers that if you come in here and you cherry pick [exclude those with pre-existing conditions] you’re going to pay part of your capital at the end of the year to the other insurance companies,” Coburn added. “And they can all do that. And that’s what we do in our bill. We allow states to risk readjust at the end of the year based on experience. That eliminates pre-existing conditions.”

You can find summaries and the full text of “The Patients’ Choice Act of 2009” bill on Sen. Coburn’s website:

Empowering Patients First Act

Rep. Tom Price, M.D. (R.-Ga.) is the chairman of the conservative Republican Study Committee (RSC) and a former orthopedic surgeon. The RSC’s “Empowering Patients First Act” focuses on four main principles: universal coverage affordability, individual insurance policy ownership, improvements in health care delivery structure and reining in cost.

Again, this alternative bill offers real solutions without a government takeover of health care.
Through tax credits and tax refunds, the bill makes the purchase of health care financially feasible for all Americans. Expansion of risk pools offers coverage of pre-existing conditions. It protects employer-sponsored insurance so if you like your current health insurance plan, you really can keep it and, even better, take it with you wherever you go because you own it.  

This bill requires that employers offer discounts on insurance for healthy habits through wellness and prevention programs and tackles cost reduction through reforming the medical liability system. The cost of the plan is completely offset through decreasing defensive medicine, savings from healthcare efficiencies, sifting out waste, fraud and abuse, plus an annual one percent non-defense discretionary spending stepdown.

You can find more information, bill summaries and the bill’s full text on the RSC website.

Make no mistake: This is not about a health care crisis in America. The government takeover of healthcare is about control — statist control over who will and who will not have access to healthcare which means the state decides who lives and who dies in this country.  

Freedom and liberty are reduced to mere slogans chiseled into marble to mock the remnants of a country once founded to protect and defend individual inalienable rights.

Obamacare should be rejected utterly by Congress.  Let your members hear from you on this today.