If It Sounds Too Good To Be True – It Probably Is

By Jeb Bradley NH Senate

Listening to the supporters tout the benefits of federal health care reform during the day long debate, I was struck by the saying ‘if it sounds too good to be true – it probably is. For 219 Democrats who voted for passage, it sounds wonderful: access to health care improves, the patient-doctor relationship is strengthened, insurance premiums drop, and deficits decline.

219 Democrats may be true believers or "incentivized" into voting yes, but the American people clearly do not believe this happy talk. Just as noteworthy, Americans witnessed a totally partisan vote for passage, and significant bi-partisan opposition.

Let’s examine the Democratic spin.

Access to health care -- does it deteriorate or improve?  Physicians are already reluctant to accept Medicare and Medicaid patients because of low reimbursement rates. Over $500 billion of Medicare cuts only exacerbates this trend. 32 million people will be newly insured – nearly half covered by Medicaid. How the current medical establishment can absorb 32 million new people without creating long waits is an unanswered question. Ominously, the New England Journal of Medicine recently wrote that one third of physicians “will want to leave medical practice after health reform is implemented.” 

For anyone imbued with the hope that access to healthcare will improve consider this: the Mayo Clinic announced in January it will no longer treat Medicare patients at one of its facilities in Arizona as the Clinic considers whether to drop coverage for 500,000 more Medicare patients it currently serves.  This should not be a surprise as government-run health care in Canada and England has excruciatingly long waits. Where exactly will Americans go when they can’t get life saving treatments at home?

Will medical decisions be made by doctors and patients?  Consider the following: a health czar will determine the parameters of health insurance policies, approve insurance rates, and the extent of reimbursement for medical service. Government mandates and bureaucracy will only lead to fewer patient choices as government controls increase.

Insurance premiums will increase despite the President’s promise that American families would save $2500. The Congressional Budget Office (CBO) has estimated that insurance premiums will be 10% to 13% higher as a result of the bill. The Center for Medicare and Medicaid Services – the people who actually run these programs and the CBO have both estimated that overall health care spending will increase as a result of the reform.

The real world however, is more instructive than any prediction.   Massachusetts mirrors provisions of the federal legislation, in particular the requirement to buy insurance.  They have the highest health insurance costs in the nation, major budget problems, and Governor Patrick has proposed price controls. The rest of the country will learn soon enough. Massachusetts already has – it's no accident that an overwhelmingly Democratic state elected Republican Scott Brown primarily because of his opposition to the national healthcare legislation.

Supporters claim the deficit will drop, accomplished through nearly $600 billion of new taxes and over $500 billion of Medicare cuts and accounting shenanigans. Tax hikes will be immediate while the majority of the new spending does not occur for four years. That’s how Democrats miraculously reduce the deficit.

Congress also deferred over $200 billion for physician reimbursement under Medicare so this legislation appears – for now – to be budget neutral.

The real world is again instructive. When Medicare was first implemented in 1965 the annual projected costs were $9 billion by 1990. Instead its costs were nearly $70 billion and the unfunded future liability for Medicare is now a staggering $37 trillion. With deficits as far as the eye can see—what is really at risk is the health of our nation’s financial system and our children’s future.

Health care reform is necessary. That's why we should develop better high risk pools to resolve coverage denial for pre- existing conditions. We need to allow across state border health insurance purchasing to create competitive markets that will lower costs for business and individuals. We need to change the tax code to give individuals the same preferential treatment as businesses.  Most importantly, we need to let individuals be in charge of their own care so they can make their own choices when utilizing services. Lastly, tort reform could curtail $80 to $150 billion of defensive medicine costs making health insurance much more affordable. All these measures will significantly improve access to affordable health care --- without a government takeover.

If health care reform was everything its supporters claim -- why in the world did they need a second piece of legislation fixing the first legislation an hour after they passed it?  If the legislation is so good – why will the IRS need to hire nearly 17,000 agents to enforce it? And if the legislation was so good then why do its supporters seek to exempt unions from the new tax on so-called "cadillac" health plans the rest of us will pay?

Carol Shea-Porter and Paul Hodes may drop by New Hampshire in April to campaign for their election in November. They should start thinking now about how to explain to constituents that their vote is unfortunately no April Fool's joke.  

The New Year's Resolution New Hampshire Needs: Spending Cuts

By NH Senator Jeb Bradley (Released by Bradley For Senate Campaign)

Thanksgiving has come and gone and Christmas is just around the corner. The Holidays come quickly and there's so much to do to get ready, but is New Hampshire ready for the budget problems awaiting the Legislature’s return to Concord in January?

Through the first five months of the budget that began July 1, 2009, revenue is $31 million below projections the budget was based upon. When December’s figures are known, the first quarter of the two year budget cycle will provide a more complete picture, but it's alarming to be already averaging $8 million under estimates per month. There’s no sugarcoating that!

Additionally, all eyes are on the NH Supreme Court’s pending decision regarding the lawsuit filed by the Joint Underwriters Association (JUA). To refresh memories, the JUA administers a fund that provides medical liability insurance for a large number of NH physicians. Budget writers, desperate for any possible revenue, simply decided to raid that fund of $110 million. Naturally the JUA filed suit. The State lost the initial round in Superior Court. Should the State lose in the Supreme Court as most observers expect, there will be an immediate $110 million budget hole combined with the growing monthly revenue shortfall.

Thus, the stage is set for the Legislature to engage in a profound debate in 2010 – more taxes versus spending reductions.

Perhaps some have already forgotten, in 2009 the Democratically controlled Legislature enacted or raised 38 taxes and fees including extending the interest and dividend tax to limited liability corporations, raising the rooms and meals tax, the cigarette tax, and auto registration fees while slapping a new tax on campers. On top of that, the Legislature raised property taxes across the state by eliminating or reducing aid to cities and towns creating another pending lawsuit that 150 communities will join.

As if that were not a full-course tax menu, the House passed both a capital gains and estate tax that the Senate rejected. The Senate passed increased business taxes that were rejected in a committee of conference. Also floated but rejected, were taxes on entertainment and mortgage refinancing, and of course the specter of an income or sales tax always lurks in the shadow of this Democratic-controlled Legislature.

And this is why we need spending cuts - now! 

Several pieces of legislation designed to reduce spending have been filed, starting with a line-item veto for the Governor. New Hampshire is one of only eight states whose governor does not have this common sense authority. Regardless of whether New Hampshire’s chief executive is an Independent, Democrat or Republican, he or she should have the ability to eliminate wasteful spending subject to a legislative override.

Another piece of legislation would require New Hampshire department heads to submit budget proposals that include 5% spending reductions. Currently, department heads must propose a maintenance budget that upholds previous levels of services. State law does not require department heads to anticipate programs that are no longer necessary, have outlived their usefulness or could be reformed to achieve savings. The proposed legislation would require a department head to propose a maintenance budget that includes a 5% reduction. This type of information would help legislators to set priorities and make responsible spending decisions. If this legislation passes in 2010, it will be extremely useful as the next budget is developed and federal stimulus monies disappear.

Another piece of legislation would move the delivery of Medicaid (health care for needy individuals and families) to a managed care model that better coordinates and manages both the clinical as well as financial implications of health care services. Medicaid is one of the largest expenditures within state government costing $1.3 billion and requiring nearly 30% of NH’s annual ‘General Fund’. Moving to a managed care model could save significant sums while attaining program goals.

A group of lawmakers are meeting to develop a course correction budget that could reduce spending levels by $80 million. Another piece of legislation would reduce the fleet of automobiles used by state employees by 20% over four years. Other bills would eliminate the rooms and meals tax hike, the camping tax, and the extension of the interest and dividends tax to LLCs.  This legislation would give Governor Lynch corresponding responsibility to enact spending reductions equivalent to the anticipated revenue from the tax hikes --- the exact procedure he used recently to trim personnel and save $25 million. Another bill would require super majorities in the Legislature to increase spending over and above a formula that accounts for inflation and population growth.

Additionally, legislation has been filed to allow cities and towns to enact property tax caps if they do not have existing authority or if that authority is subject to legal challenge. Lastly, two bills would enhance transparency and openness in state government by giving whistle blower protection to state employees and provide on-line access to all state spending records.

While each and every one of these pieces of legislation faces uncertain prospects, taken together they represent a long overdue initiative to reduce state spending that grew 11% in the previous budget and 10.5% in the current budget. This has happened at a time when other states across the nation were actually reducing expenditures.

The unappetizing smorgasbord of tax options New Hampshire confronts – income, sales, entertainment, business, mortgage re-financing, capital gains, estate taxes —are set against the backdrop of our state struggling to free itself of the clutches of a persistent recession that has left more than 50,000 of our friends and neighbors unemployed. If expanded gaming is approved next year, these revenues may provide some assistance, but will not be a panacea for today’s deficits or future deficits when federal dollars dry-up.

Thus, while spending cuts are difficult, they are absolutely necessary to ensure that our Live Free or Die State thrives into the future.

PAID FOR BY FRIENDS OF JEB BRADLEY FOR STATE SENATE, EUGENE LEONE TREASURER

Jeb Bradley for State Senate 645 SOUTH MAIN STREET WOLFEBORO, NH 03894

Healthcare - My prospective

By Richard ”Dick” Olson

The Monadnock Ledger Transcript’s June 2 editorial “A sane policy on health-care needed now” appears to have been written with the editor’s heads in the sand to borrow their quote.

First of all, our purported representatives in Washington have not had first hand experience dealing with Medicare or health-care insurance companies so they do not have a clue. They do not pay for any of their care because we pay for it.

I have had the fortunate (or unfortunate) experience with Medicare since 2006 and with Government run health-care (Veteran’s Administration) since 2006.

When I retired in 2005, my “COBRA” health-care premiums were almost $900 per month so I studied various plans for a year to look for the best value. Somewhat to my surprise, I found out that my government would deduct monthly premiums from my well earned Social Security benefits.

In 2006, I enrolled in Medicare Parts A & B and also applied for health-care benefits from the VA because I earned those benefits by serving my country for four years during the Vietnam conflict. Of course, I found out that my benefits would be limited because I was not disabled. I signed up for prescription drug coverage under Medicare Part D and found that I would pay a private insurer a monthly premium and that if I used medications that cost over $2,000 to $3,000 annually, I would not be covered if I went beyond those amounts until I spent about $2,000 of my own money. (Called the donut hole).

Here are some of the wonderful things I have learned since 2006.

● No one except yourself will manage your healthcare and its costs.

● Trust no one with health-care and its costs! I trusted AARP because I have been a member since 1991 only to find out that their sponsored health-care provider charged me $660 more per year than Anthem Blues or others. AARP receives a “kick-back” from anyone they endorse

● The health-care I receive from the Veteran’s Administration (Manchester) is good, however, I have received medications without having them discussed with me and making me pay a co-pay that is not competitive with Wal-Mart. (Annual costs for generics are $96.00 vs. Wal-Mart’s $40.00)

● I must maintain a medical relationship with my Doctor at Dartmouth-Hitchcock Clinic in Keene so that if I need emergency care I can get in locally. 

● Wal-Mart is a very “Big Business” as derided by the Ledger, however it is helping us retirees more than Washington has.

I also find it interesting that all health-care providers, including hospitals advertise their services. I would estimate that the Ledger, get more that 30% of their advertising revenue from MCH and others.

Washington and Concord (Democrats, Republicans, Libertarians, etc.) should stop tinkering with citizen’s rights and start major reforms that are needed to fix the system.

To name a few:

· Institute Tort reform to limit abusive law suits and encourage people to become medical professionals.

· Stop the NH legislature for stealing $110 million in surplus from the medical malpractice insurance fund run by the Joint Underwriting Association.

· Restrict lobbyists in the Health-care industries from access to and “bribing” our elected representatives. (This was a campaign promise Mr. President!)

· Give equal access and benefits to elected officials and have them become part of the system. (Another campaign promise Mr. President!)

· Take legal action against “bi-partisan non-profit” organizations that use their organizations to profit from healthcare.

· Establish / strengthen grants, endowments, scholarships for students willing to enter the medical professional field (Nurses, technicians, surgeons, Doctors) and encourage General practitioners.

· Establish a reward system to encourage cost control, control of infection, innovative healthcare, and better generic medications.

Much of this is the “same-old, same-old but our elected officials are not listening to their constituents but are working their own self-serving agendas.