Tuesday, March 23, 2010

Lee Killough on Health Care

I know Lee only through email commentaries, and I happen to agree with much he has to say. Here is what he provides on government interference in health care, copied verbatim from an email he sent out recently. One of the commentaries is provided by Ron Paul.


I spent a few hours going through websites and blogs this morning about
the passage of the health care bill. I collected what I think are the best
commentaries (though some will certainly disagree). I list the URLs below,
and then expand the articles at the end.

One of the criteria I used for selecting articles is that they were
pro-liberty, and not simply anti-Obama or anti-Democrat. So many media
mouthpieces change their tune depending on who's in office or what party
they belong to, and instead of sticking to principles, they worship
parties or personalities.

Links on health care bill:






My own feelings on the issue:

The main problem with health care in this country is that the people
receiving the care, i.e. the patients, are not the ones who have the
final say, or who pass the bucks around.

The only reason I go to a doctor sometimes, is to get a prescription.
Because the laws say that a pharmacy cannot freely sell to me unless a
state-licensed doctor has given me permission. They also say that a
doctor cannot write a prescription for more than 12 months -- that they
must see me at least once a year. In a sense, we're all treated like

Some say that people are not competent to make their own decisions in
medicine. But I think people should be presumed competent, just like
the presumption of innocence. People are afraid of mistakes in
medicine which they don't understand, and so the perceived costs of
actual mistakes on people, and the costs spent to avoid mistakes
(like malpractice insurance), are artificially high. Guess who pays?

If we were responsible for our own care, and if the true costs were
reflected directly at the doctor's office or hospital instead of being
hidden behind an arbitrary price system created by insurance companies
and governments, then people could make rational decisions on their
health care.

If we had ownership of our own health care, and if instead of doctors
and insurance companies making the decisions for us, we made the
decisions, then we could be free, and health care costs would go way
down. But no, we are not free, and are instead controlled by a
pharmacracy of insurance and drug companies in bed with the government.

Single payer is not the way to go -- that only concentrates power even
further into the hands of a few, who will surely be listening to
lobbyists and political donors and drug companies, more than they will
be listening to you and me. Single payer puts too much power in the
hands of one agency, who, no matter how much funding it receives,
cannot omnisciently predict all of the needs out there and allocate
resources accordingly. This is known as the economic calculation
problem ( http://en.wikipedia.org/wiki/Economic_calculation_problem ).

We need to separate medicine and state. Make medical decisions
individual rights.

We lost medical freedom with the passage of prescription drug laws
around the same time the Federal Reserve was created -- coincidence?
Prior to that, you could buy any drugs at the pharmacy without
prescription. People had the freedom and responsibility to make
medical decisions wisely. Going to the doctor wasn't as expensive as
it is now, so an accident or illness wasn't financially life-

Now, with third parties paying directly for our medical care, be it
insurance companies or government, we are not allowed to make the
decisions, nor can we feel the true costs of medicine (they are
artificially inflated or subsidized), nor do service providers compete
for our patronage, because insurance companies or governments pay for
it directly either way, and because the buck doesn't stop with the
patients but goes to third parties.

We're like helpless children, and the government likes it that way, as
do some elites and some people who would rather not be responsible for
their own health care.

The main fallacy is to assume that the costs that exist now, are that
way by necessity, and that any reform must take on these costs head-on.
No, they are that way because the feedback loops which regulate prices in
a free market, are missing. People obviously want health care, but since
they are not the ones paying for it, and since there's not free
competition in medicine where the customer is king, there's nothing to
tell doctors and hospitals what should be the best allocation of their
resources. They just guess, and when they are wrong, pass the costs onto

If a single-payer system were adopted, and government regulated costs by
force, then we would have shortages and angry people on waiting lists
willing to pay more, but unable to receive care, because there would still
be demand, and the state forcing the costs down would prevent communication
of that demand to providers and de-incentivize new providers. If a doctor's
prices are regulated from going up during periods of increased demand
relative to supply, there will be less incentive for doctors to enter
practice and there will be shortages. This is an economic law with the
same force as the law of gravity, yet many people deny it or think that
it can be escaped through man-made laws.

Also the state's experts, not matter how smart they are and no matter how
much they try to predict, can never reach optimal allocation of resources
for health care because there is always something they will miss and will
assign too few resources to, or something they will over-allocate for. No
system will be perfect, but one in which the decisions are made locally
and freely is more desirable than one where decisions are made far away
by disinterested or conflicted parties. These things are best communicated
through a price system, which can smooth things out, and where private
actors closest to the action feel the costs and take the risks. The
problem is that right now the price system cannot work because people
receiving care are not the ones paying, and people are not allowed to buy
medical goods or services without extensive state regulation, which
imposes rules on the relationship and imposes high startup costs which
are passed on.

Also, the rules imposed by governments and insurance companies are very
black-and-white. Instead of a price being able to communicate a relative
value taking local information into account, prices are fixed by fiat. Or
instead of allowing a price to reflect a relative risk which can be offset
depending on a patient's preferences, a rule is imposed arbitrarily to
control that risk without the patient's consent. When these things happen,
the inevitable economic consequence is that the price is going to be
reflected elsewhere, either in a hidden cost paid somewhere else, or in a
shortage of medical services to society, or in patients who avoid medical
care until it becomes critically necessary.

Prices often convey information which is unarticulated by the parties,
such as relative preferences among alternatives. If prices are not allowed
to work freely, and are replaced with another system like prices set by
insurance companies and governments, then lots of hidden information which
gets communicated through pricing but which isn't articulated or even
known by the respective parties, gets lost.

Separate medicine and state. Abolish prescription drug laws, and all other
drug laws. Teach medical awareness and self-responsibility early in life.
Allow those who are competent, to make their own medical decisions
with or without a doctor. Remove third-party payment providers.
Separate health care from employment -- put ownership of health insurance
back into the hands of the beneficiaries.

Here is my "Imagine" piece from last year:


See also this comparison chart for details on the bill:


And see this recent piece on our country's condition, which I am convinced
is going downhill and must be fixed at the local (not federal) level:





The Individual Mandate: An Unconstitutional Exercise of Congressional Power
Submitted by davidswanson on Sun, 2009-12-20 02:21.
* Healthcare

By Sheldon H. Laskin

It is generally agreed, by both proponents and opponents of the
Administration's health reform bill, that the lynchpin of the
legislation is the individual mandate requiring uninsured Americans to
obtain health insurance, or pay a tax penalty for failing to do so.
Without the mandate, even the Administration's wildly exaggerated cost
savings estimates simply cannot work. The whole plan is predicated on
enlarging the risk pool by bringing in younger, healthier people who
currently lack the means or the incentive - or both - to purchase health

Given the centrality of the mandate, it is somewhat surprising that
little attention has been paid to the critical legal question of whether
Congress has the constitutional authority to require Americans to
purchase a commodity from a private, for-profit corporation. Other than
some limited commentary on the Right -- George Will and Orrin Hatch both
had columns on this topic in the Washington Post and the Heritage
Foundation recently published a detailed legal analysis of the question
- there has been almost no critical discussion of the issue. The silence
on this issue is even more amazing in view of the fact that the
Congressional Budget Office raised a red flag on the question during the
Clinton Administration's abortive effort at health care reform:

A mandate requiring all individuals to purchase health insurance would
be an unprecedented form of federal action. The government has never
required people to buy any good or service as a condition of lawful
residence in the United States.


Unlike the states, Congress cannot enact any law even if doing so would
foster public safety and health. Under our federal system of government,
Congress can only enact laws that are of a type authorized by a
provision of Article I of the Constitution, which sets forth the powers
of Congress. Proponents of the individual mandate typically cite the
Commerce Clause of the Constitution as granting Congress the authority
to require individual Americans to purchase health insurance.

Article I, Section 8 of the Constitution grants Congress the power "[t]o
regulate Commerce with foreign Nations, and among the several States,
and with the Indian tribes." Therefore, in order for Congress to have
the authority to require Americans to purchase health insurance, the
purchase of health insurance must constitute "commerce" within the
meaning of the Commerce Clause. It does not.

In 1982, the Supreme Court declared that, in order for a commodity to be
considered an article in commerce, it must be capable of being sold.
Sporhase v. Nebraska, 458 U.S. 941 at 949 -- 950 (1982). While there is
no doubt that the sale of health insurance by an insurer constitutes
commerce, it does not follow that the purchase - or more precisely, the
failure to purchase - health insurance by a consumer also constitutes
commerce. Health insurance, once purchased by a consumer, is not capable
of being further sold in commerce because there is no market for it; who
would purchase a health insurance policy naming someone else as the

In order to understand the point better, it might be helpful to contrast
health insurance with life insurance. Because paid-up life insurance has
a cash value, an industry has developed in purchasing life insurance
benefits from terminally ill patients. Known as viatical settlement
companies, they will pay a percentage of the value of an insurance
policy to a terminally ill patient if the corporation is named as the
beneficiary of the policy. The patient gets the cash up front, to pay
medical bills or to support his family, and the corporation makes a
profit on its investment when the insured dies. Because there is a
market for life insurance benefits, the purchase of those benefits may
be regulated under the Commerce Clause to make sure that the patient is
not coerced by the Tony Soprano Benevolent Society to name it as
beneficiary. But there is no market for health insurance benefits once
the policy is issued. No one would buy my health insurance, because no
one other than I can derive any benefit from it. Since there is no
market, health insurance is not an article of commerce once issued. If
it is not an article of commerce, Congress lacks authority under the
Commerce Clause to require me to purchase it.

There are two Supreme Court cases that proponents of the individual
mandate often cite in support of their position that Congress may
require individuals to purchase health insurance. The first case
involved government regulation of the amount of acreage used by farmers
to grow wheat. A farmer who was fined for exceeding his acreage
allotment challenged the fine, asserting that since he was using the
excess acreage for personal consumption (he used it either to feed his
chickens or to make bread for his family), Congress lacked authority
under the Commerce Clause to regulate that excess acreage. The Court
rejected this argument, pointing out that even wheat grown for personal
consumption is marketable and that therefore the farmer's excess acreage
affected the supply and demand for wheat in interstate commerce. Wickard
v. Filburn, 317 U.S. 111 at 137 (1942). Using similar reasoning, the
Supreme Court recently affirmed congressional authority under the
Commerce Clause to regulate the production and use of marijuana as
applied to individuals who personally use marijuana for medicinal
purposes under state laws that legalize such use. Gonzales v. Raich, 545
U.S. 1 (2005). Again, Congress had commerce clause authority to regulate
personal consumption in this context because marijuana for home
consumption is "a fungible commodity for which there is an established,
albeit illegal, interstate market." 545 U.S. at 18.

Unlike wheat or marijuana, health insurance is not a fungible commodity
and is therefore not marketable. Again, no one would purchase my health
insurance - it is personal to me and cannot be sold for any price.

Finally, proponents of the mandate often cite the fact that states
require drivers to purchase auto insurance as justifying a federal
individual mandate for health insurance. This is a facile comparison
that ignores the constitutional differences between federal and state
authority to regulate. As noted above, Congress can only legislate when
there is a specific provision of Article I of the Constitution that
authorizes it to enact that type of law. Conversely, the states have
virtually unlimited legislative authority to pass laws that foster the
public welfare, health and safety. Driving is a privilege, and the
states are free to impose any reasonable condition on the exercise of
that privilege that they choose. In any event, the states have limited
the auto insurance requirement to the purchase of liability insurance to
cover injuries sustained by third parties. No state requires drivers to
purchase insurance to cover their own injuries.

For single-payer advocates, a very powerful argument is that, while the
individual mandate to purchase private health insurance is
unconstitutional, Congress can lawfully tax to support a government
financed health insurance program. Article I empowers Congress to use
its taxing powers in support of government programs that foster the
public welfare; this is the constitutional authority for Social Security
and Medicare. But to extend that authority to requiring Americans to
purchase a private commodity raises profound civil liberties issues. If
Congress can compel the purchase of insurance from a for profit
insurance company, it can compel the purchase of any commodity if there
is an arguable public policy to support it. The auto industry is
collapsing? Forget Cash for Clunkers, just order Americans to buy cars
or tax them if they don't. Obesity crisis? Order Americans to join
health clubs, or tax them if they don't. If Congress gets away with
this, there is no stopping point and Big Business will have succeeded in
making Americans into involuntary consumers whenever it so chooses.

*Sheldon H. Laskin is an attorney who has appeared in the United
States Supreme Court. He is an Adjunct Professor in the Graduate Tax
Program at the University of Baltimore Law School. Mr. Laskin
specializes in state tax cases under the Commerce Clause of the US



John G. Winder , The Cypress Times
Published 03/21/2010 - 9:47 p.m. CST
America on life support

The shift from personal liberty to federal tyranny is a done deal.

Now that the Health Care Reform bill has passed the House of
Representatives, all that stands in the way of final passage is the
Senate. This bill will pass the Senate. It will then be signed into
law by President Obama and "we the people" will be left to suffer the
consequences for the remainder of days that there exists a place
called the United States of America.

I would love to see universal health care become a reality in this,
and every nation. What Christian wouldn't? I would love to see
universal housing, and universal clothing, and universal assurances
that no one will ever again go hungry.

The problem is that no one in the federal government cares even just a
little bit about providing any of those things to you even if it could
be done.

It's not about you. It's not about me. It's not about health care.
It's not about the sick and dying.

* During the course of this debate, President Obama's approval
rating has dropped to 45%
* The approval rating of the Congress now sits at 18%.
* 46% of our nation's doctors say they'll leave the profession if
this legislation passes.
* 56% of the American people are opposed to this legislation, yet
it powers on toward law.

Politicians, a particularly unique breed of craven coward not known
for bucking the will of the people, are now standing up and voting
against the will of the people which will almost certainly assure them
of losing re-election in just seven months time.


The spin on this transformation is that this smarmy animal (the
Politican) has become a suddenly bold, suddenly brave new breed who
rather than doing as they have always done (living their lives in
double-speak and under the cover of the shadows of relativism) have
now grown spines....because they really really care about you.

In fact, they care so much about you that they're willing to put their
seats, literally and politically, on the line in order to help you.
That's another lie from a bunch of lying liars.

The truth is that this legislation is not about providing health care
for you or me, or for your children or mine. Aside from the taxes you
pay, no one in the federal government cares if you live or die.

This legislation is about power.

The Health Care Reform bill contains such a heady aphrodisiac for
these lying liars that they are even willing to risk their
phony-baloney jobs to dare to reach for power of this magnitude. This
is a kind of power heretofore unimaginable in our once free republic.

To paraphrase a line from Bill Clinton's first presidential race, "It
is about the power, stupid."

It's about the federal government having power over each state.

It's about the federal government having power over the individual.

This legislation is all about power. Your health. Your future. Your
opinion doesn't come into play. This is not a bill about giving to
you - it's a bill about taking from you.

This law is all about tearing your few remaining freedoms from your
tightly clinched fists and putting the federal government in charge of
every aspect of your life. Some of you know this. Others of you are
foolishly handing over your freedom in the blind hope that you can
trust your government. You're placing your hope and faith in the most
leaky of vessels; a politician. Others of you still are selling your
freedom for a misguided belief that you're getting something "Free".

The power transfer is going to happen. The shift from personal
liberty to federal tyranny is a done deal.

So, what now?

Now, those of us who disagree with this legislation can, and will,
look for new candidates to support in order to replace those deaf
Democrats who made this bill the law of the land.

We'll have a litmus test for all candidates, "Will you work to repeal
health care reform?" Those we support will answer, "Yes." In fact,
those wannabe leaders will shout from the roof tops for all to hear,
"I will repeal the health care bill."

We might be successful. Let's assume for a moment that we are successful.

Let's assume that come November, the GOP sweeps back to power in the
Congress. Let's assume that every single Democrat who voted for
Health Care Reform gets booted out. Let's assume that every
Democratic Senator who voted for this bill, and stands for re-election
in 2010, gets booted out.

What then?

Once they're elected and sitting in that federal office behind that
federal desk feeling the surge of federal power race through their
beings, they will NEVER repeal health care reform.

You'll elect each of them based on their promise to repeal the bill.
But when they get into office, they'll immediately realize that they
now control all of the power. That power is the most enticing,
addictive drug of all to those lying liars who want to ?lead? our

Do you remember how the Democrats railed against "The Patriot Act" and
the irresponsible powers that it provided the President of the United
States? What happened to "The Patriot Act" when the Dems took
office? Did they repeal it? Did they still feel that this act gave
the Prez too much power? No, no, it was no longer an issue.


Those who covet power only get upset when the other guy has the power.
Dems don't like power grabs when it's the Republicans doing the
grabbing. Republicans don't like power grabs when it's the Dems doing
the grabbing. The real problem is all of that power is coming from
you and me. It belongs to us, not them.

We call that power our freedoms, or rights, and they are quickly
becoming endangered species.

With both the Republicans and the Democrats grabbing as much power as
they can, while never relinquishing any of their ill-gotten gains, it
is "we the people" who suffer.

We will suffer the consequences of the passage of Health Care Reform
for the remainder of days that there exists a United States of
America. As of now our once great nation lies in critical condition,
on life support. Our nation's lifeblood is that unique belief that
man has certain unalienable rights, granted by God, and that all power
in the United States government resides in the people.

That lifeblood is now draining away before our eyes.



The Revolution is Not Coming -- Today

Even if Congress passes its "health-care reform" bill today -- and
President Obama signs it into law -- this is not going to lead to a
Tea-Party-led general revolt.

In my very first article for this column on October 31, 2009,
"ObamaCare Doesn't Bring Socialized Medicine to U.S.," I wrote:

To listen to Glenn Beck and other right-wing pundits, President
Obama's proposals for health care reform are the first step in turning
America into Cuba or Venezuela.

But the truth is that the health-care system favored by
conservatives is only marginally less government-run than the public
option and must-buy health insurance favored by progressives.

All medical practitioners -- physicians, surgeons, dentists,
nurses, etc. -- must be licensed by state and local governments, and
approved by the federal government if they are to receive
reimbursement for their services from Medicare.

All hospitals and clinics must also be government licensed, with
additional licenses for teaching hospitals.

All degrees awarded by medical schools are only valid if they're
issued by medical schools approved by state-sanctioned medical boards.

Doctors may only prescribe pharmaceuticals or medical devices
approved by the FDA -- that is if they're not on lists of substances
prohibited by law from being prescribed at all, and providing them
gets one a visit from the DEA.

Flu epidemics exist or not by a decision made by the Federal
Centers for Disease Control and Prevention, which also approves or
disapproves of the vaccines to treat them.

An entire department of the Federal government is devoted to
regulating "Health and Human Services."

Finally, fifteen percent of the U.S. population -- those 65 or
older or declared disabled -- are already enrolled in fully-socialized
"public option" government health insurance through Medicare and
Medicaid -- and as high as a third of the U.S. population have at times
been eligible for 100% U.S.-government-run health care provided
through the Veterans Administration.

So Fox News and right-wing radio pundits ranting that President
Obama and the Democratic Party want to bring socialized medicine to
America is not only hypocritical and ignorant of history. It's just
obliviously silly.

I'm 56 years old, and I have never drawn a breath when my health
care wasn't fully regulated by -- often paid for by, and sometimes
directly operated by -- the government, at one level or another.

It's undeniable that expanding government health insurance to
those under 65 who aren't veterans or disabled -- and forcing healthy
people to buy healthcare policies to lower premiums for those with
preexisting illnesses -- is indeed moving in the direction of universal
single-payer health care.

But to argue that President Obama and the Democrats want to bring
us socialized medicine ignores the obvious.

We've had socialized medicine for generations.

The incremental usurpation of the people's rights and powers has been
going on, now, at least for close to a century. It goes back at least
to 1913, when both the Federal Reserve System and the federal income
tax went into effect.

But the first federal income tax -- and the first military draft --
date back to the Civil War.

The usurpation will continue even if the Democratic Party is forced
back into being the minority in the next two election cycles, and is
replaced in the White House and Congressional majorities by the
Republican Party.

One can name a number of flash points in American history when one
could have expected popular revolts.

I've already suggested why 1913 would have been one.

The beginning of alcohol prohibition in 1920 would have been another.

The prohibition of private ownership of gold in 1933 would have been a
possible flash point.

People don't stage revolutions over entitlements. Entitlements are
shell games designed to hide where the money's coming from.

The closest the United States has come to a modern tax revolt is over
property taxes (which are localized) and the federal income tax.

But the politicians got cagier and used deficit financing monetized by
the Fed instead of raising visible taxation which would have caused
popular opposition.

Ron Paul's efforts aside, the bulk of the American people do not
understand how the Fed loots them, so they can't revolt against what
they do not see.

More limited groups rebel in more focused ways -- like truck drivers
buying radar detectors and CB's when 55 was the national speed limit.

Most special interest groups simply hire lobbyists.

The closest the federal government came to real trouble with a large
popular segment of the American people was in the mid-1990's when the
Clintons and the Democrats started passing major new federal
gun-control laws. Unlike the Gun Control Act of 1968, there had been
time to organize opposition.

It cost the Democrats their majorities in both the United States
Senate and the House of Representatives, and they learned a lesson.

But there's not going to be any real revolt on the basis of
health-care legislation that, in effect, takes a casino approach to
distributing the spoils of new compulsory health-insurance purchases
by people too healthy to need it much. There are too many people who
will see it as a benefit they "have coming to them," just like they
went along with Social Security and Medicare.

So what's going to happen is that American government will continue to
aggrandize power until its liabilities are more than can be passed
along by devaluing the money supply.

Only then will there be a general systemic collapse.

What happens after that collapse depends entirely on the preparations
of the people who understand this -- the people who have secured things
to trade, and rebuild, and defend themselves.

You don't have to go off to Ayn Rand's hidden gulch to do it. That's
why Atlas Shrugged wasn't enough and why I had to write Alongside
Night -- a dramatized show-and-tell portraying how this might work.

Which will resume here with Chapter VI, tomorrow.



Texas Straight Talk

A weekly column
Healthcare Reform Passes

Following months of heated public debate and aggressive closed-door
negotiations, Congress finally cast a historic vote on healthcare late
Sunday evening. It was truly a sad weekend on the House floor as we
witnessed further dismantling of the Constitution, disregard of the
will of the people, explosive expansion of the reach of government,
unprecedented corporate favoritism, and the impending end of quality
healthcare as we know it.

Those in favor of this bill touted their good intentions of ensuring
quality healthcare for all Americans, as if those of us against the
bill are against good medical care. They cite fanciful statistics of
deficit reduction, while simultaneously planning to expand the already
struggling medical welfare programs we currently have. They somehow
think that healthcare in this country will be improved by swelling our
welfare rolls and cutting reimbursement payments to doctors who are
already losing money. It is estimated that thousands of doctors will
be economically forced out of the profession should this government
fuzzy math actually try to become healthcare reality. No one has
thought to ask what good mandatory health insurance will be if people
can't find a doctor.

Legislative hopes and dreams don't always stand up well against
economic realities.

Frustratingly, this legislation does not deal at all with the real
reasons access to healthcare is a struggle for so many -- the
astronomical costs. If tort reform was seriously discussed, if the
massive regulatory burden on healthcare was reduced and reformed, if
the free market was allowed to function and apply downward pressure on
healthcare costs as it does with everything else, perhaps people
wouldn't be so beholden to insurance companies in the first place. If
costs were lowered, more people could simply pay for what they need
out of pocket, as they were able to do before government got so
involved. Instead, in the name of going after greedy insurance
companies, the federal government is going to make people even more
beholden to them by mandating that everyone buy their product! Hefty
fines are due from anyone found to have committed the heinous crime of
not being a customer of a health insurance company. We will need to
hire some 16,500 new IRS agents to police compliance with all these
new mandates and administer various fines. So in government terms,
this is also a jobs bill. Never mind that this program is also likely
to cost the private sector some 5 million jobs.

Of course, the most troubling aspect of this bill is that it is so
blatantly unconstitutional and contrary to the ideals of liberty.
Nowhere in the constitution is there anything approaching authority
for the Federal government to do any of this. The founders would have
been horrified at the idea of government forcing citizens to become
consumers of a particular product from certain government approved
companies. 38 states are said to already be preparing legal and
constitutional challenges to this legislation, and if the courts stand
by their oaths, they will win. Protecting the right to life, liberty
and pursuit of happiness, should be the court's responsibility.
Citizens have a responsibility over their own life, but they also have
the liberty to choose how they will live and protect their lives.
Healthcare choices are a part of liberty, another part that is being
stripped away. Government interference in healthcare has already
infringed on choices available to people, but rather than getting out
of the way, it is entrenching itself, and its corporatist cronies,
even more deeply.

Posted by Ron Paul (03-22-2010, 10:27 AM) filed under Healthcare



Posted on 22nd March 2010 by Administrator in Economy

The healthcare bill will cover 32 million more people and reduce
future deficits. With 2,700 pages of rules, regulations, payoffs,
corporate handouts, and outright bribes, the law of unintended
consequences will work its wonders in the coming decades. Would you
encourage your bright student son or daughter to become a doctor? How
many older doctors will throw in the towel and retire? Why try to make
more than $250,000 when it will all be taken by the Federal
government? Why would a small business with 49 employees expand beyond
that many employees if the Federal government will come down on them
like a ton of bricks?

Do you really think this bill will cut costs and future deficits?
Really? The Democrats crow about the historic passage as being on par
with the great programs of Medicare & Medicaid. Please read the FACTS
below regarding what Congress said they would cost versus what they
actually did cost.

If you are stupid enough to think there is a free lunch, then believe
this bill will reduce costs. Just like the $787 billion job stimulus
bill would create 3.5 million jobs. Remember that one?

Medicare (hospital insurance). In 1965, as Congress considered
legislation to establish a national Medicare program, the House Ways
and Means Committee estimated that the hospital insurance portion of
the program, Part A, would cost about $9 billion annually by 1990.v
Actual Part A spending in 1990 was $67 billion. The actuary who
provided the original cost estimates acknowledged in 1994 that, even
after conservatively discounting for the unexpectedly high inflation
rates of the early '70s and other factors, "the actual [Part A]
experience was 165% higher than the estimate."

Medicare (entire program). In 1967, the House Ways and Means
Committee predicted that the new Medicare program, launched the
previous year, would cost about $12 billion in 1990. Actual Medicare
spending in 1990 was $110 billion -- off by nearly a factor of 10.

Medicaid DSH program. In 1987, Congress estimated that Medicaid's
disproportionate share hospital (DSH) payments -- which states use to
provide relief to hospitals that serve especially large numbers of
Medicaid and uninsured patients -- would cost less than $1 billion in
1992. The actual cost that year was a staggering $17 billion. Among
other things, federal lawmakers had failed to detect loopholes in the
legislation that enabled states to draw significantly more money from
the federal treasury than they would otherwise have been entitled to
claim under the program's traditional 50-50 funding scheme.

Medicare home care benefit. When Congress debated changes to
Medicare's home care benefit in 1988, the projected 1993 cost of the
benefit was $4 billion. The actual 1993 cost was more than twice that
amount, $10 billion.

Medicare catastrophic coverage benefit. In 1988, Congress added a
catastrophic coverage benefit to Medicare, to take effect in 1990. In
July 1989, the Congressional Budget Office (CBO) doubled its cost
estimate for the program, for the four-year period 1990-1993, from
$5.7 billion to $11.8 billion. CBO explained that it had received
newer data showing it had significantly under-estimated prescription
drug cost growth, and it warned Congress that even this revised
estimate might be too low. This was a principal reason Congress
repealed the program before it could take effect.

SCHIP. In 1997, Congress established the State Children's Health
Insurance Program as a capped grant program to states, and
appropriated $40 billion to be doled out to states over 10 years at a
rate of roughly $5 billion per year, once implemented. In each year,
some states exceeded their allotments, requiring shifts of funds from
other states that had not done so. By 2006, unspent reserves from
prior years were nearly exhausted. To avert mass disenrollments,
Congress decided to appropriate an additional $283 million in FY 2006
and an additional $650 million in FY 2007.

It's NOT a Health Bill, NOT a Medicare Tax and It Can't Possibly Cost
Only $940 Billion
Posted by Alan Reynolds

* The "reconciliation bill" is not a "health bill" but an
anti-health bill. It relies heavily on price controls, taxes and
fines to punish doctors, hospitals and formerly innovative companies
the produce prescription drugs and medical devices. If we treated
farmers, food companies and grocery stores the way Congress threatens
to treat the health industries would anybody expect food to become
better or cheaper?
* The 3.8% tax on both labor and investment income is not a
"Medicare tax." It's surtax on income that goes into the slush fund,
not the Medicare trust.
* The bill could not possibly cost "only" $940 billion unless it
contained a sunset provision -- repealing the law after 2019.

In fact, new spending is negligible for four years. At that point the
government would start luring sixteen million more people into
Medicaid's leaky gravy train, and start handing out subsidies to
families earning up to $88,000. Spending then jumps from $54 billion
in 2014 to $216 billion in 2019. That's just the beginning.

To be unduly optimistic (more so than the CBO), assume that the new
entitlement schemes only increased by 7% a year. At that rate
spending would double every ten years -- to $432 billion a year in
2029, $864 billion a year in 2039, and more than $1.72 trillion by
2049. That $1.72 trillion is a conservative projection of extra
spending in one year, not ten. How could that possibly not add to
future deficits?

Could anyone really imagine that the bill's new taxes and fines could
possibly grow by 7% a year? On the contrary, most of the claimed
revenues are either a timing fraud (such as treating $70 billion for
long-term care premiums as newly found treasure) or self-defeating.

The hypothetical tax on Cadillac plans (suspiciously postponed until
2018), for example, is designed to discourage such plans from being
offered by employers or wanted by employees -- that is, it's designed
to yield less and less over time.

Moreover, the accumulating penalties on reporting joint incomes above
$250,000 -- a 39.6% tax, a 3.8 % income surtax, a 0.9% Medicare surtax,
rapid phasing-out of deductions and exemptions -- would greatly
discourage any activity that would push income above $250,000. Most
obviously, no sensible family whose income is normally below that pain
threshold would be so foolish as to sell enough assets to let capital
gains to push them over the line.

(If even half of the punitive tax plans are enacted, I plan to launch
a "249 Club" whose members pledge to never again report more than

ObamaCare's Actual Price Tag
Posted by Michael F. Cannon

My oped at FoxNews.com explains just how well Democrats have hidden
the full cost of the Obama health plan:

To hear Democrats tell it, the CBO projects the legislation would
cost a mere $940 billion over the next 10 years.... the actual cost of
the bill is nearly $3 trillion....

Yet this legislation would set in motion political forces that
would make additional spending inevitable. It would create new
constituencies for government spending, hook existing constituencies
on even more government spending, and promise implausible cuts in
existing subsidies to constituencies that are highly organized and

When Congress inevitably fails to implement the Obama plan's
spending cuts, and expands its subsidies to more and more people, the
cost of this legislation will grow beyond $3 trillion.

The CBO did an admirable job of projecting the cost of this
legislation as written. But the text of the legislation does not
reflect the reality it would create.

Giving the Obama health plan the effect of law will not make those
costs disappear.


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