If government were a product, selling it would be illegal" PJ O’Rourke
The latest version of health care reform legislation introduced by Speaker Pelosi and passed by a 220 to 215 cliff hanger vote represents a 1990 page mammoth attempt to ‘change’ America. While clearly there is bipartisan recognition of the need for reform, in particular, covering pre-existing health conditions and lower health care costs, Pelosi’s legislation overdoses on busted budgets, punishing taxes, and an omnipresent government power grab.
Budget Busting: Despite the President’s repeated promise that health care reform will not add a single dime to the deficit, the price tag of PelosiCare determined by the non-partisan Congressional Budget Office is $1.05 trillion over 10 years. That’s just for starters as a $250 billion “fix” for Medicare and Medicaid’s chronic underpayment of physicians has been moved to another piece of legislation so supporters can hide this healthcare bill's true costs. With budget chicanery alive and well in Washington, some inconvenient history is in order. When Medicare was implemented in the 1960s it was estimated it would cost $12 billion by 1990. In fact, actual costs were $90 billion --- and today’s unfunded future liabilities are $37 TRILLION. Is Pelosi worried? No!! Here's why:
Punishing Taxes: Tax hikes total $730 billion. Everything from small businesses to medical device manufacturers get hit and Pelosi simply ignores the President’s vow not to raise taxes on those earning less than $250,000. The three most onerous taxes include a 2.5% income tax surcharge for any individual not purchasing government approved insurance with fines up to $250,000 and even five years in jail as a penalty for non-compliance. Further, there’s an 8% surcharge on most businesses that don’t offer coverage, and a 5.4% tax on high income tax returns. It turns out this latter tax will fall most heavily on small business owners who file as limited liability or subchapter S corporations. Historically, small businesses create many of the new jobs our nation depends on -- especially in a recession where unemployment increases are relentless and now exceed 10%. Higher business costs will be a cure worse than the disease as America’s job hemorrhaging to China and India will only accelerate. It will be grim holiday solace indeed when unemployed Americans put Mandated by America stickers on their job applications rather than Made in America certificates on goods and services they produce.
Power Grabs: President Obama said this summer “First of all, if you’ve got health insurance, you like your doctors, you like your plan, you can keep your doctor, you can keep your plan. Nobody is talking about taking that away from you.” Unfortunately these are false promises. By 2013, many individuals will not be able to purchase individual policies unless approved by government bureaucrats and purchased through a “Government Exchange”. Large employers will face similar mandates. Insurance companies have predicted that costs will soar for middle class Americans. WellPoint, which operates Blue Cross plans across the country, has estimated that costs for young and healthy Americans could triple.
Private insurers will face ever more costly mandates and regulations while government exchanges and Medicaid will get even more subsidies. The inevitable result: people will lose the coverage they have today and will be forced onto Government Care!
Pelosi’s legislation subsidizes these “Exchanges” for anyone earning up to 400% of the federal poverty limit -- $88,000 for a family of 4 -- at a cost to taxpayers of $605 billion. Further, Pelosi’s legislation shoves some 15 million more Americans onto Medicaid at a cost of $425 billion. State budget writers should beware -- they will be expected to cover billions of uncompensated Medicaid costs. Former Health and Human Services Commissioner John Stephen has estimated the 10-year cost of PelosiCare will exceed $1.2 Billion for New Hampshire alone – an impending budget train wreck.
Dress PelosiCare up -- call it anything you want – there’s no hiding the complete government takeover of the health care system it doesn’t already control. And as the Wall Street Journal recently editorialized, the inevitable result will be healthcare rationing as “we live in a world of finite resources and infinite wants.”
The first to experience this rationing may well be some 10 million seniors who depend on Medicare Advantage because it provides better wraparound coverage for chronic conditions and disease management. Payments for the very popular Medicare Advantage will be cut --- all because it commits the sin of being administered by insurance companies not the government.
Unfortunately what’s missing from the legislation are the two concepts its supporters blithely tout: choice and competition. By design of the legislation’s authors, private insurance with new mandates and regulations will not be able to compete with government care that will be heavily subsidized -- so choice of insurance plans and health care options will disappear. Had the authors truly wanted to foster choice and competition, the focus of the legislation would have been on controlling healthcare’s high costs.
There was no effort to curb runaway medical liability costs and the associated costs for doctors who must practice defensive medicine. The American Medical Association has estimated these costs could approach $180 billion annually. There was no effort to create a nationwide marketplace for individuals and businesses to purchase health insurance across state lines – that’s competition and choice which would control costs. There was no effort to give individuals the same favorable tax treatment corporations now enjoy relative to deducting health care costs. Changing this tax provision would put individuals more in control of their health care and lead to wiser utilization of services.
While there is an arguable need to reform insurance regulation relative to pre-existing conditions, loss of coverage when ill, and lifetime benefit levels – these reforms must be done in the context of lowering costs unlike the explosion of costs in PelosiCare.
Perhaps Americans shouldn’t worry about soaring deficits, higher taxes, costlier insurance and government control. Why? PelosiCare has created 118 new federal bureaucracies to deal with expected future problems and exempts Members of Congress from obligations to purchase health insurance from the “Government Exchanges” like the rest of us.
-By Jeb Bradley