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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: TimF who wrote (10446)	10/14/2009 12:49:03 PM
From: Peter Dierks	3 Recommendations Respond to of 42652

The Baucus Bill Is a Tax Bill Middle-class families would get hit with a double-digit increase in their marginal tax rate. OCTOBER 13, 2009, 6:54 P.M. ET. By DOUGLAS HOLTZ-EAKIN Remember when health-care reform was supposed to make life better for the middle class? That dream began to unravel this past summer when Congress proposed a bill that failed to include any competition-based reforms that would actually bend the curve of health-care costs. It fell apart completely when Democrats began papering over the gaping holes their plan would rip in the federal budget. As it now stands, the plan proposed by Democrats and the Obama administration would not only fail to reduce the cost burden on middle-class families, it would make that burden significantly worse. Consider the bill put forward by the Senate Finance Committee. From a budgetary perspective, it is straightforward. The bill creates a new health entitlement program that the Congressional Budget Office (CBO) estimates will grow over the longer term at a rate of 8% annually, which is much faster than the growth rate of the economy or tax revenues. This is the same growth rate as the House bill that Sen. Kent Conrad (D., N.D.) deep-sixed by asking the CBO to tell the truth about its impact on health-care costs. To avoid the fate of the House bill and achieve a veneer of fiscal sensibility, the Senate did three things: It omitted inconvenient truths, it promised that future Congresses will make tough choices to slow entitlement spending, and it dropped the hammer on the middle class. One inconvenient truth is the fact that Congress will not allow doctors to suffer a 24% cut in their Medicare reimbursements. Senate Democrats chose to ignore this reality and rely on the promise of a cut to make their bill add up. Taking note of this fact pushes the total cost of the bill well over $1 trillion and destroys any pretense of budget balance. It is beyond fantastic to promise that future Congresses, for 10 straight years, will allow planned cuts in reimbursements to hospitals, other providers, and Medicare Advantage (thereby reducing the benefits of 25% of seniors in Medicare). The 1997 Balanced Budget Act pursued this strategy and successive Congresses steadily unwound its provisions. The very fact that this Congress is pursuing an expensive new entitlement belies the notion that members would be willing to cut existing ones. Most astounding of all is what this Congress is willing to do to struggling middle-class families. The bill would impose nearly $400 billion in new taxes and fees. Nearly 90% of that burden will be shouldered by those making $200,000 or less. It might not appear that way at first, because the dollars are collected via a 40% tax on sales by insurers of "Cadillac" policies, fees on health insurers, drug companies and device manufacturers, and an assortment of odds and ends. But the economics are clear. These costs will be passed on to consumers by either directly raising insurance premiums, or by fueling higher health-care costs that inevitably lead to higher premiums. Consumers will pay the excise tax on high-cost plans. The Joint Committee on Taxation indicates that 87% of the burden would fall on Americans making less than $200,000, and more than half on those earning under $100,000. Industry fees are even worse because Democrats chose to make these fees nondeductible. This means that insurance companies will have to raise premiums significantly just to break even. American families will bear a burden even greater than the $130 billion in fees that the bill intends to collect. According to my analysis, premiums will rise by as much as $200 billion over the next 10 years—and 90% will again fall on the middle class. Senate Democrats are also erecting new barriers to middle-class ascent. A family of four making $54,000 would pay $4,800 for health insurance, with the remainder coming from subsidies. If they work harder and raise their income to $66,000, their cost of insurance rises by $2,800. In other words, earning another $12,000 raises their bill by $2,800—a marginal tax rate of 23%. Double-digit increases in effective tax rates will have detrimental effects on the incentives of millions of Americans. Why does it make sense to double down on the kinds of entitlements already in crisis, instead of passing medical malpractice reform and allowing greater competition among insurers? Why should middle-class families pay more than $2,000 on average, by my estimate, in taxes in the process? Middle-class families have it tough enough. There is little reason to believe that the pain of the current recession, housing downturn, and financial crisis will quickly fade away—especially with the administration planning to triple the national debt over the next decade. The promise of real reform remains. But the reality of the Democrats' current effort is starkly less benign. It will create a dangerous new entitlement that will be paid for by the middle class and their children. Mr. Holtz-Eakin is a former director of the Congressional Budget Office and a fellow at the Manhattan Institute. online.wsj.com

To: TimF who wrote (10446)	10/19/2009 12:08:20 PM
From: Peter Dierks	1 Recommendation Read Replies (2) \| Respond to of 42652

From the far left in San Francisco: New Obama healthcare plan relies on imaginary savings, costs $2 trillion, explodes budget deficits San Francisco Examiner By: Hans Bader 10.15.2009 San Francisco Examiner, October 15, 2009 -------------------------------------------------------------------------------- Health-care "reform" always costs more than predicted, as ObamaCare provisions have at the state level. So the claim that the new, cheaper version of Obama's healthcare plan will cost only $829 billion, while not increasing the deficit, should be taken with a grain of salt. Senate Majority Leader Harry Reid admitted that the actual cost will be more like $2 trillion, and health-care experts have given it a similar price tag of more than $2 trillion. And the typical family would eventually pay $4,000 more a year. The reason for the lower $829 billion price tag was that the bill's supporters promised to offset its costs by making massive cuts in Medicare that no one actually expects politicians to follow through on, since Medicare cuts infuriate seniors and doctors. Year after year, Congress waives "the annual cut in fees paid by Medicare to physicians" mandated by an earlier law. Yet, now, backers of ObamaCare claim they will cut Medicare by much more to finance coverage of the uninsured. The most recent version of ObamaCare drafted by Senator Max Baucus of Montana claims it will also make "$240 billion in cuts to hospitals, home care providers, nursing facilities and hospices." Based on Congress's past track record, the chance of this happening is zero. As economist and former Congressional Budget Office director Douglas Holtz-Eakin notes in the Wall Street Journal, the promised cuts to pay for ObamaCare will not happen: "Congress will not allow doctors to suffer a 24% cut in their Medicare reimbursements. Senate Democrats chose to ignore this reality and rely on the promise of a cut to make their bill add up. Taking note of this fact . . . destroys any pretense of budget balance." As Holtz-Eakin notes, some "middle-class families would get hit with a double-digit increase in their marginal tax rate" under this version of ObamaCare. Moreover, state budget deficits and state taxes will increase under ObamaCare, which outsources costs to the states by requiring states to expand their Medicaid programs for poor people. Backers of ObamaCare have refused to cut medical costs through tort reform, with Senate Majority Leader Harry Reid saying it will save "only" $54 billion. Yet they justify ObamaCare partly on the alleged need to prevent uninsured people from not paying their medical bills -- even though unpaid medical costs are only 2 percent of all medical costs, a small multiple of the amount Reid admits could be saved from tort reform. (Tort reform would cut the wealth of trial lawyers, who are some of the biggest supporters of the Democratic Party). In reality, tort reform would save far more than $54 billion. The Pacific Research Institute estimates that just one type of cost that could be reduced through malpractice-lawsuit reform -- defensive medicine -- costs around $200 billion annually (which is almost as much as France spends annually on healthcare for all of its citizens; France has no punitive damages, few lawsuits against doctors, and "loser-pays" rules). One reform -- setting up specialized health tribunals to hear malpractice cases -- would be particularly helpful. Replacing uninformed juries with specialized health courts would provide more consistent rulings from case to case, eliminate meritless cases, reduce defensive medicine, and more speedily compensate injured people who truly are victimized by doctors' carelessness. Such tribunals already exist in countries like "Sweden, Denmark, Finland, Iceland and New Zealand." Comprehensive tort reform would also reduce lawyers' wages, resulting in some additional students choosing to go to medical school (where a critical shortage of doctors is projected over the next decade) rather than to law school (there are already too many lawyers, who sometimes can make work for themselves by bringing "creative" lawsuits). At least two of my law school classmates had already gone to medical school before going to law school (one decided to become a medical malpractice lawyer). At least a dozen that I know of had considered going to medical school instead. But life is easier as a lawyer, and you don't get sued as much if you are a lawyer rather than a doctor. As long as professionals like lawyers get paid a lot, doctors will have to be, too -- greater "wage inequality" in the U.S. means that we have to pay doctors more than other countries do to get the same number of people to become doctors. (The looming shortage of doctors is aggravated by arbitrary restrictions placed on highly-qualified immigrant doctors, who have to repeat their residencies all over again in the U.S. even if they manage to immigrate to the U.S.). Another reform opposed by Obama that would make health insurance cheaper would be to let people buy cheaper insurance across state lines, which an antiquated federal law now prevents. Countries with cheaper health insurance permit national competition among insurers. Martin Feldstein, one of Obama's own advisors, has said that Obama’s health-care plan would explode the federal budget deficit and lead to “crippling deficits,” as well as “higher taxes, debt payments, and interest rates” that would cut America’s standard of living. Feldstein also noted that Obama’s health-care plan would harm people with insurance, and predicted that it would lead to massive tax increases. Other analysts have predicted that it will drive up medical costs and inflation. Obama is relying on $2 trillion in imaginary savings to pay for his health care plan. He is also relying on tax increases, which breaks Obama’s campaign promise not to raise taxes on the middle class. Fact-checkers say Obama is lying about health-care. CNN Money says ObamaCare would take away 5 freedoms. liberty.pacificresearch.org