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


To: Magnatizer who wrote (11155)11/8/2009 10:07:42 AM
From: bentway  Read Replies (1) | Respond to of 42652
 
"The Conservative underground is moving full steam ahead."

I'm all for you guys Scozzafavaing (R) candidates nationwide!



To: Magnatizer who wrote (11155)11/8/2009 10:14:35 AM
From: bentway  Read Replies (1) | Respond to of 42652
 
The Night They Drove the Tea Partiers Down

By FRANK RICH

FOR all cable news’s efforts to inflate Election 2009 into a cliffhanger as riveting as Balloon Boy, ratings at MSNBC and CNN were flat Tuesday night. But not at Fox News, where the audience nearly doubled its usual prime-time average. That’s what happens when you have a thrilling story to tell, and what could be more thrilling than a revolution playing out in real time?

As Fox kept insisting, all eyes were glued on Doug Hoffman, the insurgent tea party candidate in New York’s 23rd Congressional District. A “tidal wave” was on its way, said Sean Hannity, and the right would soon “take back the Republican Party.” The race was not “even close,” Bill O’Reilly suggested to the pollster Scott Rasmussen, who didn’t disagree. When returns showed Hoffman trailing, the network’s resident genius, Karl Rove, knowingly reassured viewers that victory was in the bag, even if we’d have to stay up all night waiting for some slacker towns to tally their votes.

Alas, the Dewey-beats-Truman reveries died shortly after midnight, when even Fox had to concede that the Democrat, Bill Owens, had triumphed in what had been Republican country since before Edison introduced the light bulb. For the far right, the thriller in Watertown was over except for the ludicrous morning-after spin that Hoffman’s loss was really a victory. For the Democrats, the excitement was just beginning. New York’s 23rd could be celebrated as a rare bright spot on a night when the party’s gubernatorial candidates lost in Virginia and New Jersey.

The Democrats’ celebration was also premature: Hoffman’s defeat is potentially more harmful to them than to the Republicans. Tuesday’s results may be useless as a predictor of 2010, but they are not without value as cautionary tales. And the most worrisome for Democrats were not in Virginia and New Jersey, but, paradoxically, in the New York contests where they performed relatively well. That includes the idiosyncratic New York City mayor’s race that few viewed as a bellwether of anything. It should be the most troubling of them all for President Obama’s cohort — even though neither Obama nor the national political parties were significant players in it.

But first let’s make a farewell accounting of the farce upstate. The reason why the Democratic victory in New York’s 23rd is a mixed blessing is simple: it increases the odds that the Republicans will not do Democrats the great favor of committing suicide between now and the next Election Day.

This race was a damaging setback for the hard right. Hoffman had the energetic support of Sarah Palin, Glenn Beck, Rush Limbaugh and Fox as well as big bucks from their political auxiliaries. Furthermore, Hoffman was running not only in a district that Rove himself described as “very Republican” but one that fits the demographics of the incredibly shrinking G.O.P. The 23rd is far whiter than America as a whole — 93 percent versus 74 — with tiny sprinklings of blacks, Hispanics and Asians. It has few immigrants. It’s rural. Its income and education levels are below the norm. Only if the district were situated in Dixie — or Utah — could it be a more perfect fit for the narrow American demographic where the McCain-Palin ticket had its sole romps last year.

If the tea party right can’t win there, imagine how it might fare in the nation where most Americans live. Some G.O.P. leaders have started to notice. Mitt Romney didn’t endorse Hoffman despite right-wing badgering to do so. On Wednesday, Michael Steele dismissed the right’s mantra that somehow Hoffman’s loss could be called a victory and instead talked up the newly elected Republican governors who won by appealing to independents and moderates. Chris Christie and Bob McDonnell are plenty conservative, but both had rejected Palin’s offers to campaign for them. They also avoided the tea party zanies, the fear-mongering National Organization for Marriage and the anti-abortion-rights zealots Hoffman embraced. They positioned themselves as respectful Obama critics, not haters likening him to Hitler.

In the aftermath of this clear-cut demonstration of how Republicans can win, the revolutionaries are still pledging to purge the party’s moderates by rallying behind more Hoffmans in G.O.P. primaries from Florida to California. And they may get some scalps. But Tuesday’s loss revealed that they’re better at luring freak-show gawkers into Fox’s tent than voters into the G.O.P.’s. As if to prove the point, protesters hoisted a sign likening health care reform to Dachau at the raucous tea party rally convened by Michele Bachmann on Capitol Hill on Thursday.

Should the G.O.P. avoid self-destruction by containing this fringe, then the president and his party will have to confront their real problem: their identification with the titans who greased the skids for the economic meltdown from which Wall Street has recovered and the country has not. If there’s one general lesson to be gleaned from Christie’s victory over Jon Corzine in New Jersey, it’s surely that in today’s zeitgeist it’s less of a stigma to be fat than a former Goldman Sachs fat cat, even in a blue state.

Michael Bloomberg’s shocking underperformance in New York was an even more dramatic illustration of this animus. Tuesday’s exit polls found that he had a whopping 70 percent approval rating, as befits a mayor who, whatever his quirks and missteps, is widely regarded as a highly competent, nonideological executive who has run the city well. Yet only 72 percent of those who gave him a thumb’s up voted for him. Though the mayor wildly outspent and out-campaigned his bland opponent, Bill Thompson, he received only 50.6 percent of the vote.

This shortfall has been correctly attributed to Bloomberg’s self-serving, highhanded undoing of the term limits law he had once endorsed. The ferocity of the public reaction to this power grab surprised him, pollsters and the press alike. That it became a bigger deal than anyone anticipated — arguably bigger than it merited — is an indicator of how much antipathy there is toward the masters of the universe in the financial capital. Americans don’t hate rich people, but they do despise those who behave as if the rules don’t apply to them. “Michael Bloomberg is About to Buy Himself a Third Term” was the cover line on New York magazine in October. However unfairly, some voters conflated his air of entitlement with the swaggering Wall Street C.E.O.’s who cashed out before the crash and stuck the rest of us with the bill.

The Obama administration does not seem to understand that this rage, left unaddressed, could consume it. It has pushed aside the entreaties of many — including Paul Volcker, the chairman of the White House’s own Economic Recovery Advisory Board — to break up too-big-to-fail banks. Those behemoths, cushioned by the government’s bailouts, low-interest loans and guarantees, are back making bets that put the entire system at risk. Yet last Sunday, we once again heard the Treasury secretary, Timothy Geithner, on “Meet the Press” dodging questions about the banks in general and Goldman in particular with unpersuasive bromides. “We’re not going to let the system go back to the way it was,” he said.

Surely he jests. On Monday morning, a business-savvy Democratic senator, Maria Cantwell of Washington, publicly questioned Geithner’s fitness for his job, given his support of loopholes in proposed regulations of the derivatives that enabled last year’s collapse. On Tuesday, Congressional Democrats, with the White House’s consent, voted to gut the Sarbanes-Oxley Act, the post Enron-WorldCom law passed in 2002 to prevent corporate accounting tricks and fraud. Arthur Levitt, the former Securities and Exchange Commission chairman, told me on Friday it was “surreal” that Democrats were now achieving the long-held Republican goal of smashing “the golden chalice” of reform. If investors cannot have transparency, Levitt said, “the whole system is worthless.”

The system is going back to the way it was with a vengeance, against a backdrop of despair. As the unemployment rate crossed the 10 percent threshold at week’s end, we learned that bankers were helping themselves not just to bonuses as large as those at the bubble’s peak but to early allotments of H1N1 vaccine. No wonder 62 percent of those polled by Hart Associates in late September felt that “large banks” had been helped “a lot” or “a fair amount” by “government economic policies,” but only 13 percent felt the “average working person” had been. Unemployment ranked ahead of the deficit and health care as the No. 1 pocketbook issue in the survey, with 81 percent saying the Obama administration must take more action.

The tea party Republicans vanquished on Tuesday have no jobs plan. They just want to eliminate all Washington spending — a prescription that didn’t go down too well in New York’s 23rd, where the federal government has the largest payroll. The G.O.P. establishment’s one-size-fits-all panacea is tax cuts — thin gruel for those with little or no taxable income. The administration’s answer is the stimulus, whose iffy results so far, it argues, can’t be judged this early on.

Fair enough. But a year from now the public will register its verdict in any event. Meanwhile, both parties have their own delusions, not the least of which is the Republicans’ conviction that Tuesday was a referendum on what Obama has done so far. If anything, it was a judgment on just how much he has not.

Copyright 2009 The New York Times Company



To: Magnatizer who wrote (11155)11/9/2009 9:05:39 AM
From: Peter Dierks  Read Replies (1) | Respond to of 42652
 
What the Pelosi Health-Care Bill Really Says
Here are some important passages in the 2,000 page legislation.
NOVEMBER 7, 2009, 9:58 A.M. ET.

By BETSY MCCAUGHEY
The health bill that House Speaker Nancy Pelosi is bringing to a vote (H.R. 3962) is 1,990 pages. Here are some of the details you need to know.

What the government will require you to do:

• Sec. 202 (p. 91-92) of the bill requires you to enroll in a "qualified plan." If you get your insurance at work, your employer will have a "grace period" to switch you to a "qualified plan," meaning a plan designed by the Secretary of Health and Human Services. If you buy your own insurance, there's no grace period. You'll have to enroll in a qualified plan as soon as any term in your contract changes, such as the co-pay, deductible or benefit.

• Sec. 224 (p. 118) provides that 18 months after the bill becomes law, the Secretary of Health and Human Services will decide what a "qualified plan" covers and how much you'll be legally required to pay for it. That's like a banker telling you to sign the loan agreement now, then filling in the interest rate and repayment terms 18 months later.



On Nov. 2, the Congressional Budget Office estimated what the plans will likely cost. An individual earning $44,000 before taxes who purchases his own insurance will have to pay a $5,300 premium and an estimated $2,000 in out-of-pocket expenses, for a total of $7,300 a year, which is 17% of his pre-tax income. A family earning $102,100 a year before taxes will have to pay a $15,000 premium plus an estimated $5,300 out-of-pocket, for a $20,300 total, or 20% of its pre-tax income. Individuals and families earning less than these amounts will be eligible for subsidies paid directly to their insurer.

• Sec. 303 (pp. 167-168) makes it clear that, although the "qualified plan" is not yet designed, it will be of the "one size fits all" variety. The bill claims to offer choice—basic, enhanced and premium levels—but the benefits are the same. Only the co-pays and deductibles differ. You will have to enroll in the same plan, whether the government is paying for it or you and your employer are footing the bill.

• Sec. 59b (pp. 297-299) says that when you file your taxes, you must include proof that you are in a qualified plan. If not, you will be fined thousands of dollars. Illegal immigrants are exempt from this requirement.

• Sec. 412 (p. 272) says that employers must provide a "qualified plan" for their employees and pay 72.5% of the cost, and a smaller share of family coverage, or incur an 8% payroll tax. Small businesses, with payrolls from $500,000 to $750,000, are fined less.

Eviscerating Medicare:

In addition to reducing future Medicare funding by an estimated $500 billion, the bill fundamentally changes how Medicare pays doctors and hospitals, permitting the government to dictate treatment decisions.

• Sec. 1302 (pp. 672-692) moves Medicare from a fee-for-service payment system, in which patients choose which doctors to see and doctors are paid for each service they provide, toward what's called a "medical home."

The medical home is this decade's version of HMO-restrictions on care. A primary-care provider manages access to costly specialists and diagnostic tests for a flat monthly fee. The bill specifies that patients may have to settle for a nurse practitioner rather than a physician as the primary-care provider. Medical homes begin with demonstration projects, but the HHS secretary is authorized to "disseminate this approach rapidly on a national basis."

A December 2008 Congressional Budget Office report noted that "medical homes" were likely to resemble the unpopular gatekeepers of 20 years ago if cost control was a priority.

• Sec. 1114 (pp. 391-393) replaces physicians with physician assistants in overseeing care for hospice patients.

• Secs. 1158-1160 (pp. 499-520) initiates programs to reduce payments for patient care to what it costs in the lowest cost regions of the country. This will reduce payments for care (and by implication the standard of care) for hospital patients in higher cost areas such as New York and Florida.

• Sec. 1161 (pp. 520-545) cuts payments to Medicare Advantage plans (used by 20% of seniors). Advantage plans have warned this will result in reductions in optional benefits such as vision and dental care.

• Sec. 1402 (p. 756) says that the results of comparative effectiveness research conducted by the government will be delivered to doctors electronically to guide their use of "medical items and services."

Questionable Priorities:

While the bill will slash Medicare funding, it will also direct billions of dollars to numerous inner-city social work and diversity programs with vague standards of accountability.

• Sec. 399V (p. 1422) provides for grants to community "entities" with no required qualifications except having "documented community activity and experience with community healthcare workers" to "educate, guide, and provide experiential learning opportunities" aimed at drug abuse, poor nutrition, smoking and obesity. "Each community health worker program receiving funds under the grant will provide services in the cultural context most appropriate for the individual served by the program."

These programs will "enhance the capacity of individuals to utilize health services and health related social services under Federal, State and local programs by assisting individuals in establishing eligibility . . . and in receiving services and other benefits" including transportation and translation services.

• Sec. 222 (p. 617) provides reimbursement for culturally and linguistically appropriate services. This program will train health-care workers to inform Medicare beneficiaries of their "right" to have an interpreter at all times and with no co-pays for language services.

• Secs. 2521 and 2533 (pp. 1379 and 1437) establishes racial and ethnic preferences in awarding grants for training nurses and creating secondary-school health science programs. For example, grants for nursing schools should "give preference to programs that provide for improving the diversity of new nurse graduates to reflect changes in the demographics of the patient population." And secondary-school grants should go to schools "graduating students from disadvantaged backgrounds including racial and ethnic minorities."

• Sec. 305 (p. 189) Provides for automatic Medicaid enrollment of newborns who do not otherwise have insurance.

For the text of the bill with page numbers, see www.defendyourhealthcare.us.

Ms. McCaughey is chairman of the Committee to Reduce Infection Deaths and a former Lt. Governor of New York state.

online.wsj.com



To: Magnatizer who wrote (11155)11/10/2009 1:46:43 PM
From: Peter Dierks  Respond to of 42652
 
Yesterday's vote in the House had a much stronger bipartisan support on the NAY side. There is hope for us who value entrepreneurial ideas and advancement vrs socialization of our healthcare.

...

The Conservative underground is moving full steam ahead. This attack on capitalism will never get through the Senate.


Never is a long time. I am increasingly optimistic that they will not succeed it the attempt to take over the healthcare sector.