Posts Tagged 'medicaid'

Don’t Blink

This Saturday morning, July 23rd, the Senate was originally scheduled to vote on Cut, Cap and Balance, the Republican plan to cut $111 billion out of this year’s deficit, trim $4 trillion over ten years, and present a balanced budget amendment to the states.  Instead, Harry Reid moved the vote up to Friday morning, calling it a waste of time and the worst piece of legislation to ever come to the Senate floor.  It failed to pass on strict partisan lines.

Senator Schumer called the bill “Cut, Cap and Kill” because he insisted that the bill would kill Medicare.  Debbie Wasserman-Schultz declared in the House of Representatives that the bill would kill seniors and that it was the Paul Ryan plan on steroids.   The only problem is that in three different places Cut, Cap and Balance specifically exempted Medicare and Social Security from cuts and caps.  Had Republicans known, some of them might have been a little bit more up in arms about the bill.  It was actually a very good compromise.  It cut and cap wasteful spending on liberal social programs and government bureaucracy, not hot buttons like military, Social Security and Medicare.

Perhaps that is a more reasonable explanation of why Harry Reid went back on his promise to allow debate on Cut, Cap and Balance and instead moved the vote up.  Perhaps someone in the Senate actually read the bill and told Reid what was in it.  And then, as if scripted, suddenly news outlets started declaring a deal between Boehner and Obama that was so close Reid needed to get this bill off the floor and stop “wasting time” on it.  The only problem is there was no such deal.  Somebody was lying to provide the sense of urgency needed to cut off debate on Cut, Cap and Balance before it got out that Democrats were lying about it killing Medicare.

This has become the name of the game in budget talks.  Neither side is willing to give in because both sides know that 2012 elections hang in the balance.  The difference is that Republicans have actually gone so far as to write a good compromise bill.  Democrats can’t vote yes on it, not because it “kills Medicare” or kills seniors.  They can’t vote on it because passing Cut, Cap and Balance would destroy Democrat re-election hopes for 2012.  It would be a huge Republican victory because Republicans came up with it.

On the other hand, Democrats can’t write a plan of their own.  They haven’t submitted a budget in over 800 days, and they can’t submit one now or that will also destroy their chances of getting re-elected in 2012.  Democrats can’t write a bill that says “We want to raise taxes so that we don’t have to cut spending as much” and still win in 2012 because the vast majority of the country doesn’t want Democrats to raise taxes so that they can spend more.  They are spending enough already, and we are taxed enough already.  On the other hand, Democrats can’t write a plan saying “Ok, no higher taxes, just cuts” or they will lose their class warfare base.  The liberal base of the Democrat party does not want a bill that doesn’t raise taxes on the “rich”.  It’s not about raising revenue, it’s about punishing upper classes more.

Republicans submitted a plan and it was a good plan.  Obama has signaled that he is willing to let the country default on its debt rather than compromise with Republicans.  Democrats have proven that they are the party of no on a budget deal.  If Republicans end up caving in order to save our credit rating, I hope Americans get the right message.  It doesn’t mean Republicans are wimps and we need to get rid of them.  It means they can only do so much with just a majority in the House.  We need to give them the Senate and the Presidency in 2012 if we expect anything to get accomplished.

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Obama’s Healthcare Plan vs. My Healthcare Solutions

A few months ago I wrote fifteen Conservative Constitutionalist healthcare solutions that would fix our healthcare system.  Since then, Obama has passed his healthcare reform tax bill.  Let’s see how his solutions measure up.

1. End medicare and medicaid. These open ended guaranteed government payments allow businesses to operate and make millions while justifying poor service because the Government thinks it is paying discounted prices. Any medical assistance programs must be implemented on a state level where it is not unconstitutional.

Instead, Obama cut Medicare payments to doctors and Medicare prescription plans for seniors.  At the same time he expanded Medicaid requirements for states, except for states of Senators whose vote he bought.  And he expanded Medicare to everyone who makes under 133% of the poverty level, starting in 2014.  He also increased Medicare taxes for individuals who make more than $125,000 (if married) and on investment income.

2. Employers should be able to let employees choose their individual plan based on their needs. For example, I am not going to get pregnant, and I don’t anticipate most of the health problems that come with age at this point in my life. Yet I am paying for all of that in my insurance plan.

Instead, companies will be penalized up to $2,500 per employee who they don’t cover under one of Obama’s qualified plans that covers what Obama thinks should be covered.  If your company doesn’t cover you, you will face fines up to $2,260 for not buying your own health insurance that Obama thinks you should have.

3. Insurance should be portable and easily picked up and dropped. When you buy car insurance, you are covered at that moment. When you buy health insurance, you have to wait a year for some coverage to become applicable. This will create competition.

When Obamacare finally comes online in 2014, your insurance plan still won’t be portable because your company will still be required to cover you.  However, it will supposedly be easier to purchase insurance since you can’t be denied for pre-existing conditions.  It does mean though that insurance will be more expensive.

4. People should be able to buy policies from other states. However, insurance companies should also have the option to not sell to certain states that have strict laws regulating insurance companies.

Buying across state lines is still not allowed.  And many insurance companies will be squeezed out of current state markets through higher taxes on insurance companies and increased regulations.

5. People shouldn’t have to go to doctors with 8 years of college debt to get simple physicals or other simple procedures and diagnosis. They can if they want to, but they shouldn’t have to. I can go to Wal Mart for a $70 eye exam, or I can spend a couple hundred dollars to see a private eye doctor practice.

Actually, Obama’s bill makes you need to go to the doctor for more.  Under the Obama bill, you cannot deduct over the counter medical expenses or pay for them with your HSA or 125 plan without a doctor prescription.

6. Some prescriptions should be de-regulated. Think about it, you can get Plan B over the counter, but for a much lower dose birth control taken daily you have to get annual checkups and pay prescription costs.

Again, not only will there be greater impetus to get doctor prescriptions for drugs, but this bill actually subsidizes name brand prescriptions which will squeeze cheaper generics out of the market.

7. HSA plans are a good idea, but the fees make them not worth it. HSA plans must be made simple like a self-directed IRA to be used for any medical costs no matter what your insurance is. If someone wants full coverage and an HSA, go for it. If they want no insurance and an HSA, go for it.

This bill severely limits what you can contribute to health savings accounts of all kinds, limits what you can spend the funds on, and doubles penalty taxes if you spend the funds on the wrong things, like over the counter drugs. And again, it makes it illegal to not patronize the insurance companies even if you can afford your own healthcare without insurance.  This bill makes insurance companies the permanent middleman which will keep prices for basic medical care high.

8. Doctor/patient confidentiality must apply only to citizens and legal residents. Illegal aliens must be treated and then sent back to their home country where they can obey our immigration laws just like everyone else, however they must pay any medical expenses outstanding as part of the citizenship process.

This bill does nothing to curb use of our healthcare system by illegal aliens.  In fact, this is a better system for them because they don’t have to pay penalty taxes for not paying for insurance.

9. Uninsured individuals must pay for procedures. They can negotiate payment plans and prices with the doctors, but if they use medical services they must pay what the doctor determines they owe. Medical liens should be available to doctors so that they can choose whether or not to treat a delinquent patient before doing an operation.

Now, uninsured individuals can wait until they get sick or injured and then buy insurance that day.  It will increase the price of insurance, which will cause more people to choose to not buy insurance and pay the penalty taxes instead.  The result is a spiral upward of healthcare prices. The mandates don’t bring down health insurance prices, they only fund Obama and the government for more spending.

10. There must be truth in advertising. Doctors must be able to let you know exactly what you will owe for a procedure before you have it and you must be able to easily acquire from your insurance company what they will and will not cover. Except in emergencies, reimbursements must be issued before the procedure takes place. This will ensure limited legal action and no recalculations of what you owe after the fact.

The insurance exchanges are supposed to produce this.  But with insurance companies as the permanent middleman between us and our doctors and the government as the permanent middleman between us and our insurance companies, don’t count on it.

11. We need serious and real tort reform. I would recommend a standardization of what a doctor or insurance company must pay for each situation. I would also recommend a clear understanding between doctor and patient of what creates a legal liability for a doctor. For example, if they amputate the wrong foot, it should be clear what your legal options are. If they are doing a procedure and due to no fault of their own something goes wrong, they should be protected from lawsuits. If a doctor explains an operation to you, listing the risks, and you choose to have the operation, you must be the one responsible for that decision.

We got nothing.    Obama would not sell out his lawyer supporters.

12. Doctor education needs to be reformed. The cost of doctor education is unreasonable. But education is a whole other topic that I have dealt with in other places.

Now, when doctors finally get out of school, they will be paying taxes on their services as well.    And when they go to school, there will no longer be competition in regards to their student loans because the Government has taken over the entire school loan sector of our economy.  Apparently that makes us healthier.

13. Patients medical records should be made electronic with every patient being able to access and transfer them from doctor to doctor. GOVERNMENT MUST NOT BE ABLE TO ACCESS THESE RECORDS. You think voter ID cards are a violation of civil rights…

Not only will the government have access to our personal records, but so will the IRS and Social Security administration.  The chief of Health and Human Services will use our medical records to standardize and de-humanize treatments.

14. It’s up to the states, but I would recommend that states do not cover abortions, smoking or drug related illness, sexually transmitted diseases or cosmetic surgery.

Smoking and age are now the only two factors insurance companies can use in determining what you pay.  Apparently you can still drink, eat twinkies for breakfast lunch and dinner, engage in promiscuous sex, do drugs, and whatever else as long as you don’t smoke.  And when you get AIDS, liver disease and diabetes from your unhealthy lifestyle, the insurance companies have to cover you that day and charge you the same as what they charge your health-nut neighbor (unless he smokes in which case they can charge him more).  Philip Morris must not have sent enough lobbyist muscle to Washington.

The government will ensure that everything else is covered.  And if you want an abortion, the government will write you a blank check.  Just don’t tell them what it’s for.  It’s like telling anti-gun advocates that you are going to give $1 million to every gunstore in the country so that they can increase their inventory of safety equipment.  You’re not anti-safety, are you?

15. Businesses and individuals should be allowed and encouraged to pool insurance plans or create healthcare associations to negotiate for lower rates and create pooled risk. Already there are many Christian community organizations who do this and provide medical coverage for less than $100 a month.

The government will allow for government regulated non-profit insurance co-ops, but with taxes on doctors, healthcare equipment, drugs, and increased regulations on health savings accounts and insurance companies, it’s doubtful whether even a non-profit co-op would be affordable.

Halfway States Rights Does Not Equal States Rights

In the political circles where I like to debate, the question commonly comes up about drug policy.  Most Libertarians, many progressive social Democrats and even some Conservatives will argue strongly against our war on illegal drugs.  Many argue that it costs too much, many argue that it is government intrusion into our lives and unconstitutional, and others argue just because they happen to be high at the time.

I have been asked my opinion on the issue and people are sometimes surprised how I answer.  Most conservatives, especially Christian, free-market conservatives who know that illegal drugs ruin lives and turn some people into permanent wards of the state, strongly support Federal intervention and Federal drug laws.  I don’t.

I have read through the Constitution many times and cannot find anything that would justify a Federal ban on putting any sort of substance into your body.  Don’t get me wrong, I have seen what drugs do to people and I would vote in a heartbeat to ban them in my state or city.  But until we amend the Constitution with a new prohibition amendment, we damage the integrity of our national foundation of personal freedom and states rights when the Federal Government assumes the duties that the Constitution clearly delegates to the individual states.    In fact, I think if Thomas Jefferson knew only that Reagan was the one who mandated that states adopt 21 as the drinking age limit, he would certainly have called Reagan an anti-Constitutional tyrant.

So is this high praise of President Obama for instructing his attorney general, Eric Holder, to spend more time on affirmative action violations and less time on prosecuting medical potheads in states where it is legal?  No, and here is why:

Currently there are medical marijuana laws in 13 states.  Washington State is perhaps the most lenient, allowing you to have 24 oz. without getting busted and not charging you for a license to carry (marijuana).  Meanwhile, the other 37 states do not have any medical marijuana freedoms.  Yet, every year all 50 states pay billions in Federal taxes for national drug rehab programs alone.  We are spending nearly $500 billion a year on the state and federal level for rehab, incarceration, child services, dealing with homelessness, and other drug related costs.  States cover much of the bill on their own, but according to Columbia University’s National Center on Addiction and Substance Abuse, if the Federal Government recorded costs for prevention and rehabilitation as a separate budget item, it would rank as the  sixth most expensive Federal program.  It accounts for 9.6% of the Federal budget.

Let me break that down in simpler terms.  When Californians can get a prescription for marijuana to handle their stress, athlete’s foot, occasional headaches, or whatever else they can get a doctor to write a prescription for; people in Florida, Connecticut, New York, and Texas will be footing the bill to help them clean up their lives.  When someone in Michigan can’t get a job because spend half the day too stoned to get up, someone in Minnesota will be writing their Federal welfare check.

The Federal Government does not have the constitutional authority to rob one state to pay for another’s social ills.  The Federal Government does not have the constitutional authority to provide for certain groups’ specific welfare while harming the welfare of others through redistributive programs.  The Federal Government does have the constitutional duty to regulate interstate commerce and ensure that one state is not ripping off another.

By granting states the individual right to legalize self-destruction, but requiring that all states be mandated to pay for the consequences, Obama has violated the interstate commerce clause and made national social programs such as Federal welfare, Medicaid, Federally funded SCHIP, Federal funding for faith-based organizations, and his dream of universal healthcare and a public option that much more unconstitutional.

Given the choice, I would rather that Obama had ended unconstitutional wealth redistribution programs than lifted the unconstitutional Federal ban on drugs while still making me pay for the consequences.  Either way, this is no victory for states rights advocates.

Other Great Public Options

Have you noticed that talking about the failures of the USSR, China, North Korea, Cuba, Venezuela and other Socialist and Communist states with anti-Constitutionalists is a conversation killer?  There is a disconnect that occurs when you get into international politics.  Most anti-Constitutionalists see the grandeur of tyrants’ palaces but overlook the plight of the workers.  At the same time, they claim to own exclusive rights to the title of the working people’s party.  Just look at China.  In the People’s Republic of China the people’s dictator prints the people’s money in order to grow the power of the people’s government so that the people can be the people’s slaves.

Foreign failures aside, I thought it might be interesting to just look at other public options here in the free United States of America and see how impressed we are with the government’s track record when they delve into the unconstitutional.

Most acknowledge now that Obama put his foot in his mouth when he used the Post Office versus Fedex and UPS as an example of a public option not hurting competition.  Among several points made by the Heritage Foundation, the USPS is facing a $7 billion loss this year even though they are the only entity allowed to deliver first class mail, and there is no “free” postage option.

We have a public option when it comes to school.  Perhaps the greatest testimony to the failure of this public option is that people who can afford it rarely send their children to public schools.  In fact, in studies private school students consistently have higher scores than public school students.  Meanwhile, despite the demand for private schools among the wealthy, the cost of sending a kid to public school is often the same or higher than sending a kid to the best private schools.

Now, I know your 401k hasn’t been looking so hot lately.  But what do you think is more likely to be there in 30 years, your 401k or Social Security?  Right now the public option for retirement is facing complete bankruptcy in 2037.  According to Newsweek, Social Security will face a $45 trillion shortfall over the next 75 years.  That’s more than a trillion dollars a year on average.  That would be a third of last years entire federal budget.  Meanwhile, you are putting probably between 3 and 10% into your 401k every paycheck AND paying a mandatory 12.4% tax to Social Security no matter how much you make each year.  The high school student who pours your coffee in the morning is paying the same 12.4% tax you are.  Imagine if the retirement public option was a choice and you could put that 12.4% into a private account.  Yet at Bush’s state of the union address, Democrats cheered when he said they had failed to fix Social Security.  Apparently the status quo was still in fashion back then.

But healthcare is different, right?  Not so much.  Turns out we already have a public option for health care.  Medicare has been given 8 years to live.  Despite Medicare’s pending financial ruin, Schumer argued over the weekend that the failure of Medicare is the reason we need a public option to be part of Obamacare.  Interesting argument.  By the way, in addition to whatever you pay for your health insurance, you are also paying a mandatory 2.9% in Medicare taxes no matter how much you make.  Even still, in a plan where 140 million Americans pay for the healthcare of about 40 million through mandatory taxes, the system will be completely broke by the time Hillary finishes her third Presidential primary race.

How about Medicaid?  According to the Wall Street Journal, it’s no bargain if you have any interest in quality.  In fact, people who have coronary bypass surgeries under medicaid were found to be 50% more likely to die. This is blamed on poor followup by greedy doctors who don’t like working for free.  In fact, according to the same article only half of doctors will take on new Medicaid patients due to the required discounts in services and Government failures in making timely payments and reimbursements.

Democrats say that the problems with Medicare and Medicaid are proof that we need a public option for healthcare.  On second thought, maybe expensive private schools aren’t all they’re cracked up to be.

Healthcare Solutions

There are alternatives to paying trillions for the Government to look at what their computer tells about the most intimate details of your life and then decide what treatment you should get from their underpaid doctors.

1. End medicare and medicaid. These open ended guaranteed government payments allow businesses to operate and make millions while justifying poor service because the Government thinks it is paying discounted prices. Any medical assistance programs must be implemented on a state level where it is not unconstitutional.

2. Employers should be able to let employees choose their individual plan based on their needs. For example, I am not going to get pregnant, and I don’t anticipate most of the health problems that come with age at this point in my life. Yet I am paying for all of that in my insurance plan.

3. Insurance should be portable and easily picked up and dropped. When you buy car insurance, you are covered at that moment. When you buy health insurance, you have to wait a year for some coverage to become applicable. This will create competition.

4. People should be able to buy policies from other states. However, insurance companies should also have the option to not sell to certain states that have strict laws regulating insurance companies.

5. People shouldn’t have to go to doctors with 8 years of college debt to get simple physicals or other simple procedures and diagnosis. They can if they want to, but they shouldn’t have to. I can go to Wal Mart for a $70 eye exam, or I can spend a couple hundred dollars to see a private eye doctor practice.

6. Some prescriptions should be de-regulated. Think about it, you can get Plan B over the counter, but for a much lower dose birth control taken daily you have to get annual checkups and pay prescription costs.

7. HSA plans are a good idea, but the fees make them not worth it. HSA plans must be made simple like a self-directed IRA to be used for any medical costs no matter what your insurance is. If someone wants full coverage and an HSA, go for it. If they want no insurance and an HSA, go for it.

8. Doctor/patient confidentiality must apply only to citizens and legal residents. Illegal aliens must be treated and then sent back to their home country where they can obey our immigration laws just like everyone else, however they must pay any medical expenses outstanding as part of the citizenship process.

9. Uninsured individuals must pay for procedures. They can negotiate payment plans and prices with the doctors, but if they use medical services they must pay what the doctor determines they owe. Medical liens should be available to doctors so that they can choose whether or not to treat a delinquent patient before doing an operation.

10. There must be truth in advertising. Doctors must be able to let you know exactly what you will owe for a procedure before you have it and you must be able to easily acquire from your insurance company what they will and will not cover. Except in emergencies, reimbursements must be issued before the procedure takes place. This will ensure limited legal action and no recalculations of what you owe after the fact.

11. We need serious and real tort reform. I would recommend a standardization of what a doctor or insurance company must pay for each situation. I would also recommend a clear understanding between doctor and patient of what creates a legal liability for a doctor. For example, if they amputate the wrong foot, it should be clear what your legal options are. If they are doing a procedure and due to no fault of their own something goes wrong, they should be protected from lawsuits. If a doctor explains an operation to you, listing the risks, and you choose to have the operation, you must be the one responsible for that decision.

12. Doctor education needs to be reformed. The cost of doctor education is unreasonable. But education is a whole other topic that I have dealt with in other places.

13. Patients medical records should be made electronic with every patient being able to access and transfer them from doctor to doctor. GOVERNMENT MUST NOT BE ABLE TO ACCESS THESE RECORDS. You think voter ID cards are a violation of civil rights…

14. It’s up to the states, but I would recommend that states do not cover abortions, smoking or drug related illness, sexually transmitted diseases or cosmetic surgery.

15. Businesses and individuals should be allowed and encouraged to pool insurance plans or create healthcare associations to negotiate for lower rates and create pooled risk. Already there are many Christian community organizations who do this and provide medical coverage for less than $100 a month.


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