Part of the health care overhaul due to kick in this September could strip more than 1 million people of their insurance coverage, violating a key goal of President Barack Obama’s reforms.
Under the provision, insurance companies will no longer be able to apply broad annual caps on the amount of money they pay out on health policies. Employer groups say the ban could essentially wipe out a niche insurance market that many part-time workers and retail and restaurant employees have come to rely on.
This market’s limited-benefit plans, also called mini-med plans, are priced low because they can, among other things, restrict the number of covered doctor visits or impose a maximum on insurance payouts in a year. The plans are commonly offered by retail or restaurant companies to low-wage workers who cannot afford more expensive, comprehensive coverage.
Depending on how strictly the administration implements the provision, the ban could in effect outlaw the plans or make them so restrictive that insurance companies would raise rates to the point they become unaffordable.
As they whip for the health care bill, Democratic leaders pack a mean one-two punch of populist rhetoric and the hefty financial backing of the drug industry.
In the heated yearlong health fight, President Obama has often accused his opponents of willful misrepresentation, even as he and his allies have endlessly repeated the biggest whopper of all — that the bill would rein in the special interests.
The Obama team regularly dismisses opponents as industry lackeys. The Democratic National Committee blasted out e-mails this week warning that “for every member of Congress, there are eight anti-reform lobbyists swarming Capitol Hill” and “Congress is under attack from insurance lobbyists.”
But drug industry lobbyists, according to Politico, spent the weekend “huddled with Democratic staffers” who needed the drug lobby to “sign off” on proposals before moving ahead. Meanwhile, we learn that the drug lobby is buying millions of dollars of ads in 43 districts where a Democratic candidate stands to suffer for supporting the bill. The doctors’ lobby and the hospitals’ lobby are also on board with the Senate bill.
So the battle at this point is not reformers versus industry, as Obama would have you believe. Rather, it is a battle between most of the health care industry and the insurance companies.
(And the insurers are not opposed to the whole package. On the bill’s central planks — limits on price discrimination, outlawing exclusions for pre-existing conditions, a mandate that employers insure their workers and a mandate that everyone hold insurance — insurers are on board. They object mostly that the penalty is too small for violating the individual mandate.)
Pharmaceuticals are a far more entrenched special interest than the insurers.
Of all the single-industry lobbies in Washington, the largest is the Pharmaceutical Researchers and Manufacturers of America. PhRMA spent $26.2 million on lobbying last year — that’s nearly three times as much as the insurance lobby, America’s Health Insurance Plans, which spent $8.9 million.
If you include individual companies’ lobbying, pharmaceuticals blow away the competition, beating all other industries by 50 percent, according to data at the Center for Responsive Politics.
Given this Big Pharma clout, it’s unsurprising that the bill Obama’s whipping for — Senate bill — has nearly everything the drug companies wanted: prohibiting reimportation of drugs, preserving Medicare’s overpayment for drugs, lengthy exclusivity for biotech drugs, a mandate that states subsidize drugs under Medicaid, hundreds of billions in subsidies for drugs, and more.
PhRMA chief Billy Tauzin, who was vilified by Obama on the campaign trail, worked out much of this sweetheart deal in a West Wing meeting with White House Chief of Staff Rahm Emanuel. Tauzin visited the White House at least 11 times. He left his imprint so deeply on the current bill that it should probably be called BillyCare rather than ObamaCare.
Recall that pharmaceutical executives and political action committees dug deep trying to save the flailing candidacy of Democrat Martha Coakley in Massachusetts — a race that was explicitly a referendum on health care. She took in more than 10 times as much drug company cash as Republican Scott Brown.
This week, PhRMA, through a front group called Americans for Stable Quality Care, is rolling out millions of dollars in advertisements for the Democrats’ jury-rigged package consisting of the BillyCare bill and some as-yet-undetermined “budget reconciliation” measure. The ads reportedly will target wavering Democrats.
But supporters of BillyCare will continue to attack opponents as shills for insurance companies, demonizing, as Obama puts it, “those who profit from the status quo.”
Let’s look at those profits. Drug makers’ combined profit margin last year was 22.2 percent, compared with insurers’ 4.4 percent. Drug maker Merck’s net income, $12.9 billion, exceeds that of the 10 largest insurers combined.
Pfizer, which netted $8.64 billion last year, gave its CEO, Jeff Kindler, a 12.5 percent salary increase, bringing his compensation to $14.9 million. Pfizer, in a federal filing, attributed the raise partly to Kindler’s work “developing and advancing U.S. and global public policies that serve the overall interests of our Company,” including his “constructive participation in the U.S. legislative process.” Kindler contributed the maximum to Obama’s election, and Obama raised more money from the drug industry than any candidate in history.
On this bill, Republicans side with insurers, and Democrats mostly side with the richer and more powerful drug makers. The difference: Republicans didn’t cut a backroom deal with the insurers. Obama will still play the populist card, even as the drug lobby is his ace in the hole.
“The several States composing the United States of America, are not united on the principle of unlimited submission to their General Government.” –Thomas Jefferson
For the past few days, I’ve received loads of emails urging me to get active regarding the healthcare vote – most of which had a subject line similar to: “Last Chance to Stop National Healthcare!”
Well, if you believe the only way to protect your rights is by begging federal politicians to do what you want, then these emails are certainly right. The vote went as expected, and so will the next.
So if you think marching on D.C. or calling your Representatives, or threating to “throw the bums out” in 2010 or 2012 or 20-whatever, is going to further the cause of the Constitution and your liberty – you might as well get your shackles on now. Your last chance has come and gone.
But, those of you who visit this site regularly already know that the Senate’s health care vote is far from the end of things – and you also know that even when it goes into effect (which I assume some version will), it’s still not the end of the road for your freedom.
The real way to resist DC is not by begging politicians and judges in Washington to allow us to exercise our rights…it’s to exercise our rights whether they want to give us “permission” to or not.
Nullification – state-level resistance to unconstitutional federal laws – is the way forward.
When a state ‘nullifies’ a federal law, it is proclaiming that the law in question is void and inoperative, or ‘non-effective,’ within the boundaries of that state; or, in other words, not a law as far as that state is concerned.
It’s peaceful, effective, and has a long history in the American tradition. It’s been invoked in support of free speech, in opposition to war and fugitive slave laws, and more. Read more on this history here.
Regarding nullification and health care, there’s already a growing movement right now. Led by Arizona, voters in a number of states may get a chance to approve State Constitutional Amendments in 2010 that would effectively ban national health care in their states. Our sources here at the Tenth Amendment Center indicate to us that we should expect to see 20-25 states consider such legislation in 2010.
20 States resisting DC can do what calling, marching, yelling, faxing, and emailing has almost never done. Stop the feds dead in their tracks.
For example, 13 states are already defying federal marijuana prohibition, and the federal government is having such a hard time dealing with it that the Obama administration recently announced that they would no longer prioritize enforcement in states that have medical marijuana laws.
While the Obama administration would like to revive it under a different name, the reality is still there – with massive state-level resistance, the federal government can be pushed back inside its constitutional box. Issue by issue, law by law, the best way to change the federal government is by resisting it on a state level.
That’s nullification at work.
Over the years, wise men and women warned us that the Constitution would never enforce itself. The time is long overdue for people to start recognizing this fact, and bring that enforcement closer to home.
The bottom line? If you want to make real change; if you want to really do something for liberty and for the Constitution…focus on local activism and your state governments.
Thomas Jefferson would be proud!
Michael Boldin is the founder of the Tenth Amendment Center
Dr. Benjamin Rush, a signer of the Declaration of Independence, is quoted as warning two centuries ago:
“Unless we put medical freedom into the Constitution, the time will come when medicine will organize into an underground dictatorship. . . . The Constitution of this republic should make special privilege for medical freedom as well as religious freedom.”
That time seems to have come, but the dictatorship we are facing is not the sort that Dr. Rush was apparently envisioning. It is not a dictatorship by medical doctors, who are as distressed by the proposed legislation as the squeezed middle class is. (For a withering analysis by an outraged M.D. of the nearly 2000 – page House bill, seehere.) The new dictatorship is not by doctors but by Wall Street — the FIRE (finance, insurance, and real estate) sector that now claims 40% of corporate profits.
Economist L. Randall Wray observes that ever since Congress threw out the Glass-Steagall Act separating commercial banking from investment banking, insurance and Wall Street finance have been “two peas in a pod.” He writes:
“[T] here is a huge untapped market of some 50 million people who are not paying insurance premiums—and the number grows every year because employers drop coverage and people can’t afford premiums. Solution? Health insurance ‘reform’ that requires everyone to turn over their pay to Wall Street. . . . This is just another bailout of the financial system, because the tens of trillions of dollars already committed are not nearly enough.”
The health reform bills now coming through Congress are not focused on how to make health care cheaper or more effective, how to eliminate waste and fraud, or how to cut out expensive middlemen. As originally envisioned, the public option would have pursued those goals. But the public option has been dropped from the Senate bill and radically watered down in the House bill.
Rather than focusing on making health care affordable, the bills focus on how to force people either to buy health insurance if they don’t have it, or to pay more for it if they do. If you don’t have insurance and don’t purchase it, you will be subject to a hefty fine. And if you do purchase it, premiums, co-pays, co-insurance payments and deductibles are liable to keep health care cripplingly expensive. Most of the people who don’t have health care can’t afford to pay the deductibles, so they will never use the plans they are forced to buy.
To subsidize those who can’t pay, the Senate bill would make families earning two to four times the poverty level who don’t have employer-sponsored insurance surrender 8% to 12% of their income to insurance payments, or pay a fine. In another effort to make the insurance payments “affordable,” the Senate bill calls for the lowest cost plan to cover only sixty percent of health care costs.
“In other words,” writes Dr. Andrew Coates in a November 23 article, “a guarantee of insurance industry dominance and the continued privatization of health care in every arena.”
Compulsory health insurance is like compulsory selective military service (the draft), except that all of our numbers have come up. The argument has been made that auto insurance is compulsory, so why not health insurance? But the obvious response is that you can choose to drive a car. The only way to escape the vehicle we call a body is to give up the ghost.
The Right to Sovereignty Over Our Own Bodies
And that brings up another issue alluded to by Dr. Rush: the matter of freedom of choice in health care. Some people would equate it with freedom of religion. Not everyone believes in Modern Medicine. If we the people have a right to choose what we believe about life after death, we should have the right to choose what we believe about life before death, by choosing how to maintain our own bodies.
The conventional treatment promoted by the medical/pharmaceutical complex is an aggressive approach that can wind up killing the patient as collateral damage in its war on the disease. Among other researchers questioning the wisdom of this approach is Gary Null, who reported the results of an exhaustive independentreview by the Nutrition Institute of America in 2004. The reviewers concluded that the number one killer is not heart disease or cancer but conventional medicine itself. Conventional medicine was found to be responsible for an estimated 783,936 deaths annually, including 106,000 deaths from adverse drug reactions, 98,000 from medical errors, and 88,000 from infection; and those figures were conservative, since no more than 20 percent of iatrogenic (doctor- or drug-caused) mishaps are ever reported.
There are more natural, less invasive alternatives, but most are not covered by insurance; and even such simple remedies as healthy organic food may be too expensive for people forced to use a major portion of their incomes for medical insurance. A true public option of the Medicare-for-all variety could have solved the problem by keeping health care affordable. If other industrialized countries can find the money for a national health service, we could too. For a model, we could follow the lead of Canada, which originally obtained the funds for its national health service from its own publicly-owned central bank. But that will be the subject of another article. Stay tuned.
If the politicians who are bent on redesigning the medical and medical-insurance industries really wanted only to curb rising prices and help the uninsured get coverage, they would have zeroed in on the previous government interventions that created those problems. Instead, they are pushing grand schemes to turn our medical decision-making over to bureaucrats. That indicates that the so-called reform campaign is about power.
Medical care is too expensive. Prices for services rise faster than other prices, and there’s reason to believe much of the money is wasted. Expensive medical care equates to expensive insurance, which prices some people out of the market.
This has been called a failure of the free market, but that can’t be: Thereisno free market. I defy the advocates of government control to name one aspect of medicine or insurance that government doesn’t dominate.
The anti-market system politicians have put in place — as pleasing as it is for the insurance and pharmaceutical industries and organized medicine — harms the public. Yet it would be easy for them to remove the harmful interventions.
For example, they could end the adverse tax treatment of people who buy their own insurance. If your employer buys insurance for you, it’s paid for with pretax dollars. If you buy your own, you pay with after-tax dollars. That’s a hefty penalty. But the price of avoiding that penalty is high: You must cede control over thousands of dollars in cash wages as well as your medical coverage to your employer. You can’t tailor coverage to your own needs. To get a better plan you have to change jobs. That’s just stupid.
The system creates the incentive to overspend on medical services. Since insurance premiums appear to be paid by your employer and since the policy covers routine elective services and tests, you have no reason to shop wisely in the medical marketplace. That’s one reason for the price inflation. Why ask about the price or the necessity of a test if someone else seems to be footing the bill? Doctors know that and will err on the side of more rather than fewer services.
If the politicians really cared about high prices and lack of choice, they would remove the tax penalty. Do those in power even talk about it? No.
State governments make a bad system worse by mandating that “basic” policies cover many services for which most people would not buy insurance if they were explicitly paying the bill, such as acupuncture, hair transplants, contraceptives, and more. These mandates are state-granted privileges for the providers, who would rather lobby for their profits than have to attract willing customers. Every mandate raises the price of insurance and pushes young and low-income people out of the market. Without those mandates, many people would buy low-priced, high-deductible catastrophic insurance. Government creates many of those uninsured the politicians cry their crocodile tears over.
If politicians really cared about high costs and lack of choice, they would neutralize coverage mandates by removing the federal ban on interstate insurance sales. Then a resident of a high-mandate state, such as California, could buy a policy offered in a low-mandate, such as Arizona.
The government forces prices higher in many other ways. Medicare, for example, gives a virtual blank check to its beneficiaries, who have no reason to be cost-conscious about the services they buy. Retirees have gotten far more in benefits than they ever paid in taxes while working. As long as Medicare exists, everyone’s medical services will be artificially expensive. Medicare is doubly offensive: The money is taken from current workers, and when it is spent it bids up the price of medical services for those workers. Considering its $37 trillion unfunded liability, Medicare is the disaster some people predicted when it was set up in 1965. As long as it exists the medical system will be awry and government will exert control.
Government also raises medical prices by sponsoring a protectionist medical guild in each state, keeping the number of doctors low and prices and incomes high. Occupational licensing is a conspiracy against the public masquerading as consumer protection.
Yes, we suffer from monopoly and high prices. Government is the reason.
Part of the health care overhaul due to kick in this September could strip more than 1 million people of their insurance coverage, violating a key goal of President Barack Obama’s reforms.![Reblog this post [with Zemanta]](http://img.zemanta.com/reblog_e.png?x-id=6785ef43-988c-4c28-8ba2-c7abea1369f9)
If the politicians who are bent on redesigning the medical and medical-insurance industries really wanted only to curb rising prices and help the uninsured get coverage, they would have zeroed in on the previous government interventions that created those problems. Instead, they are pushing grand schemes to turn our medical decision-making over to bureaucrats. That indicates that the so-called reform campaign is about power.
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