Posts tagged ‘health care bill’

It's a Tax

Forcing people to pay money or pay a fine on their tax return to buy a product they currently don't buy is a tax.  Particularly when that product will likely be over-priced to the young and healthy not buying it today to subsidize the older folks.

Health Care Budget Games

Bruce McQuain points out something I think has not gotten enough attention in the health care bill.  The new taxes being proposed start in 2010, but the benefits don't begin until 2013 and are phased in through something like 2018.  That means for any 10-year budget look, there are 10 years of taxes but only 6-7 years of benefits.  And even with this trick, the plan STILL adds a trillion dollars to the deficit, even before the certainly more pessimistic CBO numbers come in.

More Union Payback

Mark Mix has an article in the WSJ on various paybacks to unions buried in the current health care bill.  The steps range from forced-unionization of certain health care professions to direct subsidies of union health care funds to exemption of union health care plans from the rules everyone else will have to follow.

Update: The Greg Conko study also looks good, but I am only part way through it.

Congress Is Listening... Sort of

Congress now understands that the majority of the public has deep concerns about their government health care bill.  So, they are responding by ... finding new and creative legislative approaches to a) avoid public scrutiny of what they are actually putting into the bill and b) reduce the number of votes they need for passage.  Kevin Drum explains the game:

The latest trial balloon from the Democratic leadership is that they might split healthcare reform into two bills.  The first would have all the controversial provisions and would go through the reconciliation process, where it needs only 50 votes.  The second would go through the normal process and therefore need 60 votes, but since it includes the stuff that's widely popular it would pass anyway.

I told you weeks ago they were going to pass this pig no matter what it took.  So now the only real floor vote will be on percieved benefits (more coverage, more spending, consumer mandates) while the costs, taxes, and individual restrictions will get done in the back room, where blue dogs can disavow any responsibility.

If this becomes unstoppable, I think the Republicans should make a high profile effort to move the implementation date up from 2013 to well before the next presidential election.   You can always tell whether legislators know in their hearts if something they are passing is really going to suck for a lot of people.  They push the implementation date back  (despite the fierce moral urgency to hurry up on this, as we are told) to after the next election.

Reading the Health Care Bill

Here are some notes on the health care bill from one person who plowed all the way through it.  Some of the interpretations are a bit over the top, but I find it a useful index to help me find relevent sections I want to read in more detail.

Report Dissidents to the White House

Several people have emailed me this: Apparently the White House web site is asking that you report anyone writing things on health care that don't match the Administration position so the White House can "keep track".

There is a lot of disinformation about health insurance reform out there, spanning from control of personal finances to end of life care. These rumors often travel just below the surface via chain emails or through casual conversation. Since we can't keep track of all of them here at the White House, we're asking for your help. If you get an email or see something on the web about health insurance reform that seems fishy, send it to

Wow, "disinformation."  You wonder why people ever listen to those counter-revolutionaries and aren't satisfied with just reading Pravda.

Well, we at the global headquarters of CoyoteBlog Enterprises are certainly happy to help.  I sent them this email today:

Thanks for the opportunity to report disinformation where people write things that don't match what the President is saying on health care.  Please check out this document I found on the web -- a number of parts bear very little relationship, and in fact outright contradict, what the President is promising about health care reform.

The link is to a copy of the House health care reform bill.  If you are so inclined, you might wish to offer similar help.

Postscript: My son, who is a big fan of dystopic novels like George Orwell's "1984" might ask if he would get extra credit for turning in a family member.

Update #1: The White House site in question is really ridiculous.  It responds to critiques of what is actually in the bill with statements like "the President has consistently said that if you like your insurance plan, your doctor, or both, you will be able to keep them."  Well duh, of course he has.  But this President, even more than the average President, will say just about anything.

At this point, since the President is purposely uninvolved in the crafting of the legislation and has admitted at times that he doesn't even know the details of what is in it, talking about his promises or preferences is irrelevant.   In fact, nobody is talking about the President's promises and intentions any more, with actual legislation on the table.   They are talking about what is actually in the written bills in the House and Senate.

So the question is, what is in the actual legislation, and does it match Obama's promises, and the current answer is clearly "no."  And will the President veto a health care bill that doesn't follow through on his promises?  Don't make me laugh.  He is going to sign any bill with "health care" in the title no matter what it says -- his advisers have already made that clear by saying that the entire Presidency is riding on having some kind of bill pass that does something with health care.

By the way, in this we can see the White House strategy for passing such controversial bills.  Their hope is to jump directly from the President's "everyone is a winner and there is no cost" rhetoric directly to signed legislation.  They want people focused on his promises, which are enticing, and not the reality of the actual language of the bills, which is ugly and in many ways bear no relationship to the President's rhetoric.  This worked for the stimulus and almost worked for Waxman-Markey and was tried again for health care.

Be A Better Legislator Than Your Congressman

You can actually read the health care bill.  Here.

The Next Crisis-Emergency-Rush

I have been trying to find a word to describe the legislative style we have seen prominently over the last 9 months (though it was used long before this administration -- the Patriot Act comes to mind).   Unable to think of any other name, an in homage to "murder-death-kill" in "Demolition Man,"  I am going to call it Crisis-Emergency-Rush.

TARP was a Crisis-Emergency-Rush.  As was the Stimulus bill, Waxman-Markey, and now Health Care.  (The last two are particularly hilarious when one needs to evaluate the need to rush.   Waxman-Markey is implemented over decades, and the health care bills as currently written don't really begin to take effect until 2013).

So here is my prediction for the next Crisis-Emergency-Rush:  Raising taxes.  Obama already has his boys out sending trial balloons about new taxes, even beyond those required in Waxman-Markey and to fund the health care bill.  Having spent over a trillion dollars on useless spending to support favored political constituencies, Obama will now declare a fiscal crisis that can only be solved by increased taxes on his non-favored constituencies.

Thought for the Day

Soon, you may be on the hook for paying for a limitless supply of health care for these people.  (via TJIC)

Update: Good update on issues in the health care bill.

Tort Lawyer Full Employment Act

From Walter Olson, on the House health care bill:

Contacts on Capitol Hill inform me that Republicans yesterday managed to block a remarkable provision that had been slipped into the House leadership's 794-page health care bill just before it went to a House Ways & Means markup session. If their description of the provision is accurate "” and my initial reading of the language gives me no reason to think it isn't "” it sounds as if they managed to (for the moment) hold off one of the more audacious and far-reaching trial lawyer power grabs seen on Capitol Hill in a while.

For some time now the federal government has been intensifying its pursuit of what are sometimes known as "Medicare liens" against third party defendants (more)....

The newly added language in the Thursday morning version of the health bill (for those following along, it's Section 1620 on pp. 713-721) would greatly expand the scope of these suits against third parties, while doing something entirely new: allow freelance lawyers to file them on behalf of the government "” without asking permission "” and collect rich bounties if they manage thereby to extract money from the defendants. Lawyers will recognize this as a qui tam procedure, of the sort that has led to a growing body of litigation filed by freelance bounty-hunters against universities, defense contractors and others alleged to have overcharged the government.

It gets worse. Language on p. 714 of the bill would permit the lawyers to file at least some sorts of Medicare recovery actions based on "any relevant evidence, including but not limited to relevant statistical or epidemiological evidence, or by other similarly reliable means". This reads very much as if an attempt is being made to lay the groundwork for claims against new classes of defendants who might not be proved liable in an individual case but are responsible in a "statistical" sense. The best known such controversies are over whether suppliers of products such as alcohol, calorie-laden foods, or guns should be compelled to pay compensation for society-wide patterns of illness or injury.

He has a lot more detail.  Ask anyone in a public contact business in California how similar laws for ADA violations have worked out.  Just one more horrible, failed law from California that has driven the state into the ground now being emulated at the national level.

Is This Constitutional?

From the House health care bill:

"There shall be no administrative or judicial review of a payment rate or methodology established under this section or any other section."

On Congressional Bribery

Normally, if I were to contemplate resorting to bribery to change someone's decision, I would have to face two hurdles.  First, of course, I would face legal consequences because in many contexts., bribery is illegal.  Second, I would have to consider the cost -- is the price being demanded worth it.  After all, it makes little sense to spend a million dollars to bribe someone to make a decision worth a hundred thousand dollars to me.

But, unfortunately, neither of these problems exist when Congressional leadership seeks to bribe recalcitrant lawmakers to vote their way.  Bribery in this context is not illegal, its just "horsetrading."   And the cost is meaningless, because folks like Nancy Pelosi do not bear the cost of the bribe, taxpayers do.

It is totally clear to me that Obama and Pelosi will spend any amount of money to pass their key legislative initiatives.  In the case of Waxman-Markey, the marginal price per vote turned out to be about $3.5 billion.  But they didn't even blink at paying this.  That is why I fear that some horrible form of health care "reform" may actually pass.  If it does, the marginal cost per vote may be higher, but I don't think our leaders care.

Well, I Am Down To Two Health Insurance Choices

Apparently in the future I will have two health plan choices -- my current plan or the government plan.  And the only reason I will be able to keep my current plan is that is will be grandfathered in.  A few years ago I switched plans, to get one with a better price and mix of benefits for my family.  I will never be allowed to do this again under the new health care bill:

It didn't take long to run into an "uh-oh" moment when reading the House's "health care for all Americans" bill. Right there on Page 16 is a provision making individual private medical insurance illegal.

When we first saw the paragraph Tuesday, just after the 1,018-page document was released, we thought we surely must be misreading it. So we sought help from the House Ways and Means Committee.

It turns out we were right: The provision would indeed outlaw individual private coverage. Under the Orwellian header of "Protecting The Choice To Keep Current Coverage," the "Limitation On New Enrollment" section of the bill clearly states:

"Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day" of the year the legislation becomes law.

So we can all keep our coverage, just as promised "” with, of course, exceptions: Those who currently have private individual coverage won't be able to change it. Nor will those who leave a company to work for themselves be free to buy individual plans from private carriers....

Wow, even for this cynical libertarian, this is a new low of technically complying with a promise while in substance completely violating the spirit of that promise.

By the way, how long will my current insurer even be able to offer me my plan given that it cannot generate any new business  (I use Assurant, who specializes in individual policies for self-employed people like myself).

This is a great example of what I have been saying all along - regulation always helps large companies more than small.   Everything in this legislation is tailor-made to help large companies who already have health plans and pound small companies and the self-employed.  This is in part because the large companies have the lobbying muscle to get themselves a seat at the table as the bill is crafted.   But it is more than just neglect, it is an outright attack.  Large companies most fear competition from smaller, lower cost competitors.  Anything to make the life of small business more expensive and difficult helps cement the big guys market position.

Update: Here is a scary thought -- what will it do to entrepeneurship in this country when a decision to leave a large company and go into business for oneself bascially means giving up private health insurance and going on Medicare?

Update #2: For readers, as well as a place for me to find it in the future, here is a link to all 1000+ pages of the bill.  Enjoy.