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Posts Tagged ‘health care’

Mandatory insurance: Yes, it’s a tax

Friday, September 25th, 2009

by Jeff Jacoby

obamacare1It was a perfectly straightforward question. The answer was anything but.

President Obama vows not to raise taxes on any American family earning less than $250,000 a year. Yet he backs legislation that would force every American to carry health insurance or pay a hefty penalty to the IRS. Such an “individual mandate’’ is included in all the major health care bills making their way through Congress, including the legislation unveiled by Senate Finance Committee Chairman Max Baucus last week. So when ABC’s George Stephanopoulos interviewed the president on Sunday, he raised the obvious challenge:

“Under this mandate, the government is forcing people to spend money [to buy insurance], fining you if you don’t. How is that not a tax?’’

Obama replied that the individual mandate “is absolutely not a tax increase,’’ since, in his view, there is good reason to impose it. He stuck to that position even when confronted with Merriam-Webster’s definition of “tax’’ - “a charge, usually of money, imposed by authority on persons or property for public purposes.’’

“George,’’ chided Obama, “the fact that you looked up Merriam’s Dictionary . . . indicates to me that you’re stretching a little bit right now.’’

But the only one “stretching’’ was the president, whose position was at odds with the legislation itself. “The consequence for not maintaining insurance would be an excise tax,’’ notes the committee staff report on the Baucus bill. “The excise tax would be assessed through the tax code and applied as an additional amount of Federal tax owed.’’

obamacare-300x300Obama isn’t the first politician to maintain that a mandate to buy health insurance isn’t just another middle-class tax. Mitt Romney did so as governor of Massachusetts, boasting in 2006 that thanks to his signature health care law, “every uninsured citizen in Massachusetts will soon have affordable health insurance, and the costs of health care will be reduced. And we will need no new taxes . . . to make this happen.’’ But isn’t the penalty that law imposes on the uninsured – a penalty that this year will run as high as $1,068 per person – a tax? Gosh, no, enthused Romney: “It’s a personal responsibility principle.’’

Whatever it’s called, it hasn’t transformed Massachusetts into an Eden of universal coverage. According to the Department of Revenue, nearly 200,000 state taxpayers remained uninsured at the beginning of 2008. And the individual mandate hasn’t made insurance in the Bay State more affordable: Massachusetts has the highest health insurance premiums in the nation.

Far from holding insurance costs down, “reform’’ in Massachusetts seems to have had the opposite effect. “Insurance premiums rose by 7.4 percent in 2007, 8-12 percent in 2008, and are expected to rise 9 percent this year,’’ notes Michael Tanner of the Cato Institute. “By comparison, nationwide insurance costs rose by 6.1 percent in 2007, just 4.7 percent in 2008, and are projected to increase 6.4 percent this year.’’

However tempting it may seem, universal health coverage cannot be achieved by waving a legislative wand and ordering every citizen to buy insurance. Supporters of an individual health-insurance mandate like to compare it to the nearly universal requirement for auto insurance, but far from proving their point, it undermines it. True, auto insurance is mandatory almost everywhere. Yet nearly 15 percent of motorists remain uninsured.

Requiring that drivers be insured, Obama told Stephanopoulos, “is a fair way to make sure that if you hit my car . . . I’m not covering all the costs.’’ Auto insurance is required, however, only if you choose to own a car and drive it on public roads. Under ObamaCare (as with RomneyCare), health insurance would be compulsory no matter what you did or didn’t do.

Obamacare-300x276It is a myth that those who don’t buy health insurance are basically free riders who unload their medical costs onto the backs of more responsible Americans. In truth, most of the uninsured are young, fit, and unlikely to need medical care. Why should they be forced to pay for expensive insurance they don’t need?

The right way to expand coverage is not to scourge the healthy with new taxes, but to win them over with lower premiums. Deregulation is a far better strategy than compulsion. If insurers were free to compete for business across state lines, for example, and if states would repeal the excessive benefit requirements that have driven up the cost of insurance, premiums would shrink and so would the ranks of the uninsured.

Coercive insurance mandates are a prescription for more misery, not less. Massachusetts is learning that lesson the hard way. The rest of America doesn’t have to.

A million march to US Capitol to protest against ‘Obama the socialist’

Tuesday, September 15th, 2009

by David Gardner

As many as one million people flooded into Washington for a massive rally organised by conservatives claiming that President Obama is driving America towards socialism.

The size of the crowd – by far the biggest protest since the president took office in January – shocked the White House.

Demonstrators massed outside Capitol Hill after marching down Pennsylvania Avenue waving placards and chanting ‘Enough, enough’.

Tens of thousands of people converged on Capitol Hill on Saturday to protest against government spending

Tens of thousands of people converged on Capitol Hill on Saturday to protest against government spending

The focus of much of the anger was the president’s so-called ‘Obamacare’ plan to overhaul the U.S. health system.

Demonstrators waved U.S. flags and held signs reading ‘Go Green Recycle Congress’ and ‘I’m Not Your ATM’.’

The protest on Saturday came as Mr Obama took his campaign for health reforms on the road, making his argument to a rally of 15,000 supporters in Minneapolis.

Read more: http://www.dailymail.co.uk/news/worldnews/article-1213056/Up-million-march-US-Capitol-protest-Obamas-spending-tea-party-demonstration.html#ixzz0R8umLuWi

One Sure Way To Profit From Obamacare

Monday, September 14th, 2009

by Don Cooper

medicine-socializedOne sure way to tell which political lobbies stand to benefit from Obamacare is to note who is supporting it with expensive TV and online ads. I’ve seen commercials sponsored by big Pharma, trial lawyers and now today on Abcnews.com I saw a big fold-out banner ad at the top of the website sponsored by the American Association for Retired People (AARP).

Not being a senior citizen, I haven’t had much exposure to AARP, but when I saw and read the ad, I couldn’t help but think how irresponsible for them to use their influence over seniors to try and push something on them like this with big, bright, colorful, intelligent-sounding but misleading advertising.

Their ad consisted of 5 what they call “myths” about Obamacare that they want to clear up for their members and explain why they are false:

Health care reform will be a government takeover

The details of any healthcare bill are irrelevant.  What needs to be considered is only the fact that the government is planning on regulating and hence distorting production and prices, in yet another industry and the historical precedents set by the federal government that never sees a government program die, but rather grow with time. If it won’t be a takeover at first, it will be eventually. Don’t call it a takeover then. Call it taking control, call it regulating, call it whatever you want, it’s government legislation that will force doctors and patients to make decisions about their healthcare that they normally would not make. It introduces the same moral hazard as any and all government regulation.

We can’t afford to fix healthcare in this economic crisis

I agree with AARP on this one. We can do something to address the high costs of healthcare even in hard economic times: get the government out of the healthcare business and address tort reform to prevent frivolous malpractice suites. Both of which would save the government and Americans money.

Healthcare reform will be the end of Medicare

Don’t know much about Medicare except that the U.S. government sold the program in the 1960’s with the lie that by 1990 Medicare would only cost the taxpayers $6 billion. By 1990 it had cost $67 billion in real dollars. If nothing else we can use this as factual historical evidence of government-run healthcare. What more does one need? The government is always wrong with their predictions about anything. Whether it be on purpose, otherwise known as lying, or ignorance. Either way, they need to stop making predictions.

Healthcare reform will lead to rationed health care

All economic goods, which is everything except for air and sunshine, are scarce and need to be rationed somehow. In a market economy that rationing mechanism is price. As an economist who has lived many years in European countries where healthcare is regulated, controlled, provided by the federal government, I can tell you unequivocally that YES, healthcare will end up being rationed not by price but rather by some commission of bureaucrats who will set “guidelines” for who can receive what care. That is in fact the whole purpose of this healthcare reform: to reduce costs, to make costs equitable across social lines. Those artificial costs imposed by government intervention of any kind, will be lower than the true market value and hence we’ll end up with a shortage and of course an excess demand for healthcare. Then healthcare will have to be rationed by other means than price. As with any economic good, as price goes down more of the good is demanded. Of course the cost to people won’t actually go down due to increased taxes, interest on the debt and inflation that will occur so the government can pay for it, but in people’s minds it will be cheaper.  So people will go to the doctor for any and all ailments. Dr. offices will become overcrowded so they’ll start going to the ER which will become overcrowded. So the bureaucrats will ration it.

I’ve seen it firsthand. Not a single author of these bills, as far as I know, has ever lived in such a country. They don’t know what they are talking about, pure and simple.

biggovernmentHealthcare reform means the government will make life and death decisions for you

Absolutely, they will. They won’t look at it as such, but that’s what it will be. If someone needs medical care of any kind and they are not free to find a doctor of their choosing from the entire doctor pool but rather are given a list to choose from, and the doctor is forced to only provide a government-influenced schedule of services at set prices then again, the moral hazard issue dominates here. Doctors and patients will make decisions that they otherwise would not make without government intervention. And who’s to say whether they are life or death decisions? Maybe some decisions aren’t, maybe some are. Maybe a doctor would have treated a patient differently which could have prevented or detected early some life-threatening condition, but didn’t due to government regulations. Maybe the patient would have died anyway. Who can say? But one thing for sure, we’ll know that those decisions were not made by the free will of the doctor–patient relationship and so we cannot say that “everything was done to prevent it.”

As with all government intervention, the government assumes the role of being our moral compass. They are in a position to dictate to an entire nation of 300 million plus, what is the “right thing to do.” Of course they’re true objective is to get votes from people at election time while at the same time, getting as much money and power as possible from special interests, campaign donors and political parties.

Circumcision for All; Free Choice for None

Saturday, September 5th, 2009

by Stephanie R. Murphy

I was shocked, surprised, and flabbergasted to hear it. I’m sure that you’ll never believe it, either. The federal government is – get this, readers – butting into your most personal and private business.

circumcisionOK, you’ve caught me in a rare moment of sarcasm. Maybe I wasn’t really that surprised. After all, government bureaucrats attempt to control what types of substances you put into your body, what kind of work you do with your body, and even how you can legally dispose of your body after death; it makes perfect sense that they would also scramble for power over what parts of your body should remain attached. Yes, that’s right. The CDC is now considering a campaign for universal circumcision in the US.

The reason for pushing this one-size-fits-all policy stems from the results of several studies, all done in Africa, which have demonstrated the benefits of male circumcision for reducing the transmission of HIV.

The studies on circumcision and HIV transmission are very interesting. They are large, randomized, controlled trials; the methodology is solid. They show, on average, a 40–60% reduction in the risk of a circumcised, HIV negative man contracting the virus from an HIV positive woman, as compared to an uncircumcised man. The precise mechanism of circumcision’s protective effect is unknown. There are many potential explanations, none of which are mutually exclusive. First, the foreskin has a relatively high population of cells that are receptive to being infected by HIV. Second, it acts as a reservoir which may trap infected secretions. Third, the foreskin has a higher propensity to ulcerate (become scraped) and become infected with other sexually transmitted infections that cause open sores. It seems that removing the foreskin also removes several potential avenues for HIV entry into the body.

However, when considering the benefits of circumcision, there are some significant caveats. For one, circumcision is not a panacea; it does not completely prevent transmission of HIV, it just lowers the probability that a man will contract the virus during any given sexual encounter with an HIV positive woman. It should be noted that these studies only examined the effect of circumcision on transmission of the virus from an HIV positive woman to an HIV negative man. While this is a relatively common scenario in Sub-Saharan Africa, HIV epidemiology in the US is different. Overall rates of infection are lower. Also, HIV in the US is relatively more common among men who have sex with men (MSM). There is no evidence that circumcision protects against HIV acquisition in MSM. Circumcision also does nothing to protect anyone against acquiring HIV via bloodborne routes, such as sharing needles with an HIV positive person. It should go without saying that men can protect themselves from acquiring HIV in other ways besides getting circumcised, such as practicing safe(r) sex and avoiding intravenous drug use. These methods are much more reliable than the 40 – 60% risk reduction conferred by circumcision.

Circumcision also has risks and demerits. My personal philosophy on medicine leads me to look skeptically at any procedure that removes a part of the body which is not causing harm, pain, or annoyance to the patient; in other words, don’t mess with success. As with any surgical procedure, infections and pain after circumcision are both possibilities that should not be ignored. Medical errors should be considered as a legitimate risk during circumcision, too. There are rare case reports of penile amputation that have occurred during botched circumcisions. There are also many more reports of less extreme, but still real, consequences resulting from circumcision mishaps.

Of course, the question on the minds of many who are considering circumcision is that of whether the procedure circumcision-procedureimpacts sexual enjoyment and satisfaction. That question is, in my opinion, impossible to answer accurately. To distill the immense debate surrounding this issue to its barest essence, choice seems to play a significant role in how men view their foreskins (or lack thereof). Men who choose to get circumcised tend to be happy that they did so; those who did not have a choice in the matter because they were circumcised at birth are more likely to lament it.

That brings me to my main point in writing about the prospect of universal circumcision: the issue of choice. If my patient asked me about circumcision, I would discuss with him the information above. I would also encourage him to do his own research about the procedure if he felt interested. He would make his own decision about whether he wanted to have the surgery.

By contrast, the CDC’s attitude demonstrates a lack of consideration for patient autonomy and consent, two essential elements in all medical decisions. The CDC would like every baby boy born in America to be circumcised, no matter the opinion of his parents and, more importantly, without the boy’s consent. If circumcision were a medically necessary and life-saving procedure with no possible ill effects, things might be different. In reality, it is a surgical procedure that is not essential for the health of a normal man; furthermore, it has both risks and benefits. The relative importance of those risks and benefits is subjective. Every man may value them differently. For that reason, it’s essential that each individual be afforded the choice about what to do with his own foreskin.

To be perfectly blunt, I do not see any justification for removing a part of a baby boy’s body without his consent. Men can always get circumcised as adults if they wish; by contrast, once the foreskin is gone, it’s gone forever. Most people will concede that the procedure is painful even for babies, but they insist that the pain is justified because the baby will not remember it. I wince at the thought of causing pain to a newborn boy. I say that even if he does not remember the physical pain as an adult, he may still suffer from the psychological sting of having had a body part removed without his permission.

Another argument from the advocates of universal circumcision is that it makes good hygiene easier. This is a typical government one-size-fits-all solution: parents are too stupid, in the minds of government agents, to teach their sons good hygiene, so instead we should just circumcise everyone. People are also too stupid to practice safe sex, so we should circumcise them all because they will gain a marginal reduction in the overall risk of contracting HIV. I’ve also heard arguments for circumcision based in religious tradition and cultural norms. Sure, circumcision is common – and a very old tradition in some religions and cultures. But does that make it right? I don’t think that’s for us to decide. I think that each individual, the owner of his own body, should make the call about whether or not circumcision is appropriate for him.

It’s difficult for me to assume the mindset of statists who advocate for this kind of thing, so I raised the issue of universal circumcision in conversation with a few people whose opinions I thought would be unencumbered by that pesky philosophy of leaving others alone and CircumcisionToolsletting them make their own decisions. In addition to the religious and culturally based arguments that several people trotted out, one colleague had an interesting comment. He thought that universal circumcision was a good idea, envisioning a world where no more would awkward teens have to worry about getting teased in the locker room, because “everyone would look the same.” Oh really? The last time I checked, people came in all shapes, colors, and sizes, and that was a good thing! I guess that if everyone looked alike, wore the same clothes, and had the same hairstyles, nobody would ever have to worry about not fitting in. Would this egalitarian also propose to redistribute the wealth from the best-endowed men to those who are not quite as blessed by Mother Nature? Ridiculous.

I certainly cannot agree with the CDC’s move toward making a blanket recommendation that all boys should undergo a medical procedure at birth, without their consent. I want each man to have the opportunity to make his own decision about what to do with his foreskin when he reaches an age at which he is capable of doing so, based on his understanding of the risks and benefits, and how much he personally values each. The bloated, overreaching federal government apparently does not want the same.

All About Health Care from True News

Saturday, September 5th, 2009

Excellent explanation of health care costs, why they are high, and who’s really to blame for that.  Very, very well done and worth the 23 minutes to watch.

The Free West Radio Show

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