Polosi's Health Care Bill

Health Reform Cheat Sheet
The House of Representative’s version of health-care reform will cost more than the $894 bn 10-year price tag cited by the Congressional Budget Office.-

That’s because the CBO and Congress do not address human responses to legislation. Tax something more, you ultimately take in less in taxes. Penalize a company, and it finds ways to dodge the penalty.-

And lawmakers have put in this unintended consequence: The individual premium costs in public option to take care of the poor are actually higher than other offerings.-

That’s right, the CBO says the public plan’s premiums are higher than the premiums in the public exchanges, undermining the House’s claim that it will attract 9 mn enrollees by 2019 and result in a two-thirds decrease in the number of uninsured adults in the U.S.-

Use the following as a cheat sheet in coming days as the health-care reform bill wends its way through Congress. The cheat sheet provides an X-ray to this impenetrably dense bill and the CBO’s scoring. The unintended consequences from this bill will be manifold.-

You’ll see the CBO is struggling mightily to score these legislative phantasms, noting its work is not done and that its estimates are “subject to substantial uncertainty.”-

Watch for Congressional statements that, while technically accurate, will also keep you barefoot and clueless on health reform, as the layers upon layers of provisions make the reform bill as transparent as a bucket of tar. And which means the resulting deficit spending from this bill will only add to a U.S. debt load now big enough to block out the sun.-

Keep this in mind when you see the tax revenue the CBO and Congress claim the bill will raise to cover the costs. Both the CBO and Congress tend to not take into account the fact that individuals and companies reorganize their lives to avoid paying taxes.--

Health-care tax, or penalties, or whatever they call it will just mean people will carry on avoidance schemes, which means less revenues. Tax the rich, they’ll shelter it. Tax the Cadillac health insurance plans, insurers won’t offer them.-

Because the CBO and Congress generally do not take into account human behavior when scoring a bill (they use what’s called the “static,” not the “dynamic,” scoring model), the revenue estimates from the CBO and Congress on past tax legislation have been off by a factor of $150 bn or more.-

Also, the reform bill’s taxes are not indexed to inflation, so as more middle-class pay rises into those brackets, more middle- class people will be hurt.-

Here are the details:-

The New Spending-

It includes $1.1 tn in new spending over 10 years: $425 bn increases to Medicaid and SCHIP; $605 bn on subsidies for the poor to buy insurance; $57 bn in spending on primary care increases; and $34 bn in new spending on public health initiatives.-

The New Costs-

The bill’s costs are offset by a new tax surcharge on high-income individuals and other provisions estimated to increase federal revenues by $572 bn; and $168 bn in collections of penalties paid by individuals if they don't buy insurance ($33 bn estimated) and employers ($135 bn) if they don’t buy health insurance for their workers.-

To pay for the bill, the House is also counting on other undefined spending changes. That includes fee cuts for nonphysicians, meaning other health care providers, of $229 bn, and Medicare Advantage cuts of $170 bn ($245 bn in Medicare cuts to doctors over ten years has since been nixed; that cost is now moving into other government budget line items). It’s also counting on wringing tens of billions of dollars in waste and fraud out of the system to pay for the bill.-

The Reality Check That Bounced-

Ok, think this through. Higher taxes on the rich have historially not delivered the revenues promised because the rich shelter their income, IRS data show.-

And the pool of taxpayers that would supposedly toss off all this tax revenue is not that vast and deep--the 5.4% surtax on singles earnings $500,000 in the house bill, married couples earning $1 mn--is only 494,967, based on 2007 IRS data, the last year for which data is available, notes William Ahern of the Tax Foundation.-

Tax cuts can deliver revenues -- the Clinton tax cuts on estates and capital gains delivered more revenues than promised tax revenues from the tax hikes on the rich, according to IRS data.-

And do you really believe that future Congresses over the next 10 years will hang tough and make the $399 bn in total reimbursement cuts to hospitals, other providers, and Medicare Advantage, each year for 10 years straight?-

Remember, the 1997 Balanced Budget Act tried to chase down this exact strategy, but Congress undid those cuts and reimbursed providers anyway.-

And watch out for the promises to cut waste and fraud out of the system that the House is counting on from the American Medical Association and hospitals.-

You really think the AMA can corral the 135,000 active doctors in its membership to deliver on these promises? Or that the nation’s 5,700 hospitals will all fall in line?-

How Employers Will React-

The “play-or-pay” requirement on employers says they would either have to offer “qualifying” insurance to their employees and contribute a substantial share toward the premiums, or pay a fee to the federal government that would generally equal 8% of their payroll.-

It’s an easy choice for employers: Lay off and not hire workers if the insurance costs are too high, or just pay the extra 8% payroll tax and dump workers on the public plan. Which means more costs to the U.S. taxpayer.-

State Taxes May Rise-

Moreover, the federal funding for Medicaid to take care of extra enrollees will only cover 70% of the state’s costs. The rest the states have to pay for. That means state taxes rise.-

Public Option’s Not So Cheap Premiums-

The primary rationale espoused by Democrats for the government-run health care plan is that it would drive down costs by providing a lower cost option than private plans (and thus force the greedy insurance companies to lower their “exorbitant” rates to compete), notes Fox News analyst James Farrell.-

But will the poor really sign up for the public option since its premiums are higher than the average private industry plan in the new proposed insurance exchanges? How would the public option drive down insurance costs through competition if its premiums are higher than the average private industry plan in the exchanges?-

The CBO finds that under the House plan, the government-run plan would actually charge higher premiums:-

"That estimate of enrollment reflects CBO’s assessment that a public plan paying negotiated rates would attract a broad network of providers but would typically have premiums that are somewhat higher than the average premiums for the private plans in the exchanges."-
The Opt Out is Not an Option-

Democratic Senate Majority Leader Harry Reid announced the health-care bill will have a public option and a way for states to opt out of the public option (the House bill does not include an opt-out ).-

It’s a charade — taxpayers in states that opt out will get taxed anyway to pay for the bill. And who in each state gets to decide to trigger the opt out escape hatch? Voters? State legislators? -

The DMV?-

A churlish reaction would be this: couldn't the states turn around and say they want to opt out of the fed’s unfunded mandates —like the expansion of Medicaid to pay for the health reform bill, where they’ll have to pony up 30%?-

The Arizona Legislature already passed the Health Care Freedom Act, which places an initiative on the 2010 ballot allowing citizens to vote to decide whether the state should opt out of the entire health care reform bill, notes Darrell M. West, vice president and director of governance studies at the Brookings Institution. Other states are considering similar legislation, West says.-

And West wonders if unhealthy people will migrate to states with a public option if their own jurisdiction opts out of the national system. States may be tempted to establish residency requirements for health care the way they did for welfare, he says, possibly making it more difficult for the uninsured to get coverage in those areas.-

Also, if states don’t like congressional decisions on gun control, climate change or immigration, will state legislators demand an opt-out? “If this were 1965 and there were a Medicare opt-out, it is conceivable we would have ended up with two-thirds of the country having Medicare, while one-third did not,” West says.-

DEMOCRACY - SOMETHING TO THINK ABOUT

Democracy: A process in which ruling power is given to whoever is most skillful at directing the herd instincts of the largest masses of their most ignorant citizens.

THEY ARE COMING

Hide your money, hide your guns, the US Wrecking Crew will be coming to your town soon.

AARP - ASSOCIATION AGAINST RETIRED PEOPLE

Have you really paid attention to the AARP TV ads. The part that picked up my ears was where AARP states they will even cover your visit to a specialist without prior approval. I have no doubt the will. But have you considered medicare. You go to see a medical specialist. AARP covers say $400.00. You are happy as a bug in the rug, but then bad news hits, medicare is not going to cover the specialist because you didn't get prior approval from them and if you did try they may turned you down and now you are on the hook for a few thousand dollars you have to pay. A little misleading ad don't you think?
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Two points to remember, first AARP is in for the high profits they make selling health insurance to those covered by medicare. So keep that in mind when you watch their ads, what are they really hiding? And secondly, don't just jump into anything until you really understand what it is, what it offers and how much it will cost. This is true for AARP and your friendly health care specialist at Capital Hill.
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People, despite what congress is telling you, in the end you will be stuck with a national health care plan you will not want and one that is going to cost you a lot. Already one part of all the health care plans being offered up by both the house and senate will head to the Supreme Court. A few states are already considering not making it mandatory for people to purchase health care. This flies in the face in what congress will be coming out with. I'll side on states rights on this one. Just remember, the states gave the federal government certain rights via the constitution. Anything not in the constitution is left for the individual states to deal with.

By DAVE COLLINS, Associated Press Writer Dave Collins, Associated Press Writer – Sun Oct 4, 3:14 pm ET
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HARTFORD, Conn. – The nation's nursing homes are perilously close to laying off workers, cutting services — possibly even closing — because of a perfect storm wallop from the recession and deep federal and state government spending cuts, industry experts say.
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A Medicare rate adjustment that cuts an estimated $16 billion in nursing home funding over the next 10 years was enacted at week's end by the federal Centers for Medicare and Medicaid Services — on top of state-level cuts or flat-funding that already had the industry reeling.
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And Congress is debating slashing billions more in Medicare funding as part of health care reform.
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Add it all up, and the nursing home industry is headed for a crisis, industry officials say.
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"We can foresee the possibility of nursing homes having to close their doors," said David Hebert, a senior vice president at the American Health Care Association. "I certainly foresee that we'll have to let staff go."
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The funding crisis comes as the nation's baby boomers age ever closer toward needing nursing home care. The nation's 16,000 nursing homes housed 1.85 million people last year, up from 1.79 million in 2007, U.S. Census Bureau figures show.
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Already this year, 24 states have cut funding for nursing home care and other health services needed by low-income people who are elderly or disabled, according to the Center on Budget and Policy Priorities, a nonprofit research firm based in Washington, D.C.
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Some facilities are now closed because of money problems — including four in Connecticut — and others have laid off workers because of what industry officials say are inadequate Medicaid reimbursement rates. Medicare cuts are troubling, they say, because the higher Medicare reimbursements have been used to compensate for the lower Medicaid rates.
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In Griswold, Conn., the community's only nursing home shut down earlier this year because of rising costs and an inability to pay for $4.9 million in needed renovations for the 90-bed facility.
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"A 92-year-old woman was screaming and crying as she was loaded into the ambulance, saying 'This is my home,'" Griswold First Selectman Philip Anthony said. His 88-year-old mother was a resident of the same home at the time.
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Anthony sought and found a new facility for his mother, but she died of pneumonia before the Griswold Health and Rehabilitation Center closed in the spring.
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"To be hit with a sudden and deliberate closure like this, it just drained the heart right out of you," Anthony said.
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Connecticut Gov. M. Jodi Rell and state lawmakers gave no Medicaid rate increases to nursing homes in the state last fiscal year and kept the funding flat for the next two years.
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The Griswold home was one of four nursing homes in the state that have closed since December because of financial problems, a higher rate than usual, said Deborah Chernoff, a spokeswoman for District 1199 of the New England Health Care Employees Union in Connecticut, which represents more than 20,000 health care workers in the state.
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"We're really teetering on the edge of what we see as the collapse of the long-term care system," she said.
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Chernoff said many of Connecticut's 240 or so nursing homes have been reducing workers' hours to deal with money problems, while two are in bankruptcy now.
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Also this year across the country:
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• The Motion Picture & Television Fund said in January it would close a hospital and nursing home in Woodland Hills, Calif., founded to care for actors and other entertainment industry workers, because of financial losses.
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• The Westchester Medical Center in suburban New York said it would close a nursing home and cut 400 jobs to deal with Medicaid and other fund cuts.
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• The Dove Health Care nursing home in Glendale, Wis., near Milwaukee, closed this summer because of heavy debt.
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• Medicaid reimbursement rates to nursing homes were cut this year by Rhode Island (5 percent); Michigan (4 percent) and Florida (3 percent).
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• Washington state legislators whacked nursing home funding by $93 million for the next two fiscal years.
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Gary Weeks, executive director of the Washington Health Care Association, said some of the organization's 400 assisted living and nursing homes have laid off workers. Some will not survive, he said.
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At the request of Weeks' association, a federal judge in July issued a temporary restraining order blocking the cuts because state officials didn't do a required analysis of how the reductions would affect care quality and access.
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"There's a lot of pain going on everywhere, but it's clearly a crisis in long-term care," Weeks said.
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"You're going to find that some folks go out of business," he said. "Some will look for more Medicare patients — Medicare pays more than Medicaid."
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In Washington, D.C., health care interests are resisting President Barack Obama's plan to pay for his health care overhaul by slowing Medicaid and Medicare spending. Obama wants to trim $313 billion from the two programs over 10 years.
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It's not clear exactly how all the health spending cuts will affect nursing homes.
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A University of Pittsburgh study earlier this year found nearly 1,800 nursing homes nationwide closed from 1999 to 2005, about 2 percent each year.
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One of the study's authors, health policy and management professor Nick Castle, said the annual closure rate is rising, for reasons that include inadequate Medicaid reimbursement rates and the push for more home and community care.
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"It's come to a head recently with state budgets being in such jeopardy that they're cutting in all areas," Castle said.
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The federal stimulus package approved in February includes $87 billion in Medicaid funding to help states. But Connecticut and several other states are using a loophole in the legislation to divert the money to budget items unrelated to health care, according to a congressional study.
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On average, Medicaid payments by states to nursing homes fell short by $12 per patient, per day last year — nearly $4.2 billion in unreimbursed costs for Medicaid-allowed expenses, according to the AHCA.
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In New York City, the Metropolitan Jewish Health System laid off about 200 of its 1,000 employees at three nursing homes in Brooklyn because the state cut Medicaid funding by 10 percent to 14 percent, said President and Chief Executive Eli Feldman.

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"We understand there's a recession/depression," Feldman said. "But this is not health reform ... and the victims are basically the people who live in the facilities. The Legislature basically says, 'Too sick, too old, too bad."

OBAMACARE

Now that the various healthcare plans are being reduced to print, the financial details are emerging and with them a fundamental conclusion is becoming evident: The Obama plan is a giant tax increase for much of the American people (not just the rich).
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Start with the mandate that falls on those whose welfare is the supposed object of the entire program — the uninsured. According to the Congressional Budget Office, the average uninsured person or family will have to pay between 15 and 20 percent of his or their total income on health insurance (counting premiums, deductibles and co-payments) before any of the subsidy in the Baucus bill kicks in. Even in the more generous House bill, the tab that the uninsured must pay is very, very high.
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Most uninsured would likely be quite happy to avoid paying this much of their income for health insurance. But they will be forced to shell out the money under the program. Others would want catastrophic coverage (which for the young would likely not be too costly) but the Obama program requires comprehensive insurance that is costly to satisfy the government requirement.
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Having spent the entire campaign speaking about “affordable” coverage, it turns out the program is not at all affordable, but a massive new tax on the average uninsured American.
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Then there is the tax on health insurance premiums that is to finance about a quarter of the subsidy for the uninsured. This tax, billed as only to be levied on “gold-plated” policies, will, in fact, reach down to the average American. The Baucus bill specifies that the tax of 35 percent would be put on all premiums over $8,000 for an individual and on proportionately higher premiums for families. Current estimates are that about one-tenth of the current health insurance policies would be taxable. But the $8,000 premium level that will trigger coverage is not indexed for inflation, let alone for medical inflation, which typically runs twice as high. ObamaCare will take effect in 2013. By then, the percentage of Americans subject to the tax will doubtless expand dramatically. Indeed, this trigger is a new Alternative Minimum Tax waiting to happen. As inflation pushes more and more Americans into tax eligibility, it will become a universal health insurance excise tax of 35 percent. While the tax will be imposed on health insurers and employers, it will, obviously, be passed along to the policyholders.
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So if you are insured, you will increasingly have to pay 35 percent more for the privilege. And if you are uninsured, you will have to pay one-fifth of your income in premiums, deductibles and co-payments before any subsidy kicks in.
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And then there is the final piece of the puzzle — the $500 billion cut in Medicare that will pay for the bulk of the subsidy under the bill. We are literally slicing services to the elderly in order to transfer healthcare to others. Obama’s claim that only “waste and inefficiency” in Medicare will be cut is, at best, disingenuous. Most of the cuts will be in reimbursement for doctors and hospitals. That will lead to less care, shorter office visits, fewer tests, fewer surgeries and less care. And it will lead to fewer doctors. As a result, a survey by the Investor’s Business Daily indicates that 45 percent of all doctors would “consider retiring or closing their practices” if the Obama bill passes. The result will be a greater scarcity of medical services, even as the patient load expands by at least 30 million people.
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Each of these fiscal pieces is movable. The left will pressure Obama to increase the subsidy to the uninsured. But that will necessitate raising the Medicare cut borne by the elderly or increasing the tax on health insurance policies — or adding to the deficit. Any of these options will alienate moderate senators. Balancing these competing priorities only works if the taxpayers don’t know what is going on.
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If the average middle-income American family realizes that it will have to pay one-third more for health insurance or the uninsured learn that they will have to pay a fifth of their income to get insurance, they will make their dissatisfaction felt by their Democratic senators.
-All of which begs the fundamental question: How willing are Democratic congressmen to commit political suicide? Are they willing to lose the elderly and to antagonize the uninsured as the health insurance cops chase them around the block? When does JFK’s comment kick in: “Sometimes party loyalty asks too much”?

HEDY LAMARR THE ACTRESS, THE SCIENTIST

The following is from www.originaloldradio.com
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Hedy Lamarr (November 9 1913 – January 19 2000) was an Austrian-born American actress and scientist. Though known primarily for her acting (she was a major MGM contract star), she also co-invented an early form of spread spectrum communications technology, a key to modern wireless communication.
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Frequency-hopped spread spectrum invention
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Avant garde composer George Antheil, a son of German immigrants and neighbor of Lamarr, had experimented with automated control of instruments. Together, he and Lamarr submitted the idea of a Secret Communication System in June 1941. On 11 August 1942, U.S. Patent 2,292,387 was granted to Antheil and "Hedy Kiesler Markey", Lamarr's married name at the time. This early version of frequency hopping used a piano roll to change between 88 frequencies and was intended to make radio-guided torpedoes harder for enemies to detect or jam.
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The idea was ahead of its time, and not feasible owing to the state of mechanical technology in 1942. It was not implemented in the USA until 1962, when it was used by U.S. military ships during a blockade of Cuba, after the patent had expired. Neither Lamarr nor Antheil (who died in 1959) made any money from the patent. Perhaps owing to this lag in development, the patent was little-known until 1997, when the Electronic Frontier Foundation gave Lamarr an award for this contribution.
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Lamarr's and Antheil's frequency-hopping idea serves as a basis for modern spread-spectrum communication technology, such as COFDM used in WiFi network connections and CDMA used in some cordless and wireless telephones. Similar patents had been granted to others earlier, like in Germany in 1935 to Telefunken engineers Paul Kotowski and Kurt Dannehl who also received U.S. Patent 2,158,662 and U.S. Patent 2,211,132 in 1939 and 1940. Blackwell, Martin and Vernam's Secrecy Communication System patent from 1920 (1598673) does seem to lay the communications groundwork for Kiesler and Antheil's patent which employed the techniques in the autonomous control of torpedoes.
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Lamarr wanted to join the National Inventors Council, but she was told that she could better help the war effort by using her celebrity status to sell War Bonds. She once raised $7,000,000 at just one event.