The Hubbub
Listing all Hubbub postings by date. Scrap Health Bill Taxes, Penalties and Mandates and Start Over
Grace-Marie Turner
Galen Institute, 03/01/10
In a new radio ad airing on Sirius XM Satellite Radio, Grace-Marie Turner highlights the taxes, mandates and regulations in the current health reform proposals, and how Congress must start anew to enact meaniful health reform.
Washington-knows-best the wrong approach to health care reform
Grace-Marie Turner
The Daily Caller, 03/01/10
Article available here.
The Washington-knows-best approach to governance embraced by the Obama administration and Democratic leaders was on vivid display at Thursday’s health care summit and helps explain why the American people are rejecting their health reform plans.
The bills that have passed the House and Senate use the levers of government—including mandates, regulations, and taxes—to try to fix problems in our health sector. And to pay for their plan, they plan to increase taxes by $500 billion and cut Medicare by almost $500 billion.
The result: Independent studies by the Congressional Budget Office, Medicare’s chief actuary, and other experts show:
•Health costs will continue to rise
•Federal health spending will increase
•People will lose the coverage they have today
•Taxes will increase, hitting the middle class
•Doctors and hospitals will become insolvent, jeopardizing access to care for seniors
•Job creation will suffer
Not surprisingly, the American people have rebelled against ObamaCare, with 73 percent saying Congress should start over with a new bill or stop working altogether on health reform, according to a new CNN survey.
Americans know our health sector is too big, too complex, and too important to try to change in any one bill written by a few political leaders who don’t know the needs of 300 million individual Americans.
Understanding this, Republican leaders are advocating a step-by-step, targeted approach that doesn’t attempt to do everything all at once. They want to restructure incentives to bring more competition, markets, and individual patients and doctors into the health sector.
Allowing interstate purchasing of health insurance, for instance, could give people more choices than may be offered in states with too much regulation and too little competition. A study by Steve Parente and Roger Feldman at the University of Minnesota estimates allowing people to buy policies across state lines would mean an additional 12 million people would purchase insurance.
Many states are extremely concerned about the health care bills in Congress, and rightfully so: struggling state government budgets will be hit hard by ObamaCare. States could serve as laboratories for health reform. Instead, the congressional bills would impose hundreds of costly mandates upon them.
So where do we go from here?
President Obama could have used the summit as an opportunity to redefine success by agreeing to incremental steps through a targeted, smaller bill. Such an approach would garner bipartisan support and could pass Congress.
But Senate Majority Leader Harry Reid says he is ready to pursue the ultra-partisan path of reconciliation. This route is wrought with political peril for Democrats as they would be betting that their constituents will suddenly share their belief that with health reform, Washington knows best.
The next health fight; summit leaves Dems stymied
Grace-Marie Turner
New York Post, 03/01/10
Article available here and here.
The White House expected a slam-dunk at Thursday's health summit -- another tour-de-force by President Obama that would convince rank-and-file Democrats in Congress that the time's come to push the reform bill through. That didn't happen -- but the push is still on.
The president's advisers seemed to expect the Blair House event to repeat President Obama's triumph at last month's House Republican retreat in Baltimore. But there, he was on stage, flanked by flags and behind a microphone and podium looking down on Republicans who were sitting around tables at lunch.
The staging there put that GOP crowd at a disadvantage, subordinating substance to style. Thursday's gathering was a different story.
With the president and members of Congress all around a table talking with each other as equals, it was clear that Republicans held their own on health care -- an issue they're clearly taking ownership of. They got far less than half the airtime, but still succeeded in making coordinated arguments on behalf of a step-by-step approach to reform.
The summit was not the game-changer the White House hoped it would be. Will the adminstration go to "plan B," and support a smaller (though possibly still bad) bill that can draw GOP votes and command solid majorities in both houses?
Or will it continue to insist on passing a wildly unpopular, comprehensive overhaul of one-sixth of our economy that three out of four Americans reject?
The president opened the summit by saying that Republicans and Democrats aren't far apart on health reform because they share concerns about growing deficits and rising health costs. But the debate showed the two sides have very different approaches to solving those problems.
The president's plan and the House and Senate bills rely on more regulation and scores of new government programs to control our wayward health sector. Republicans believe in providing incentives for more competition, consumer choice, and price transparency to force changes in the marketplace.
Thursday's dialogue helped the American people see the wide ideological differences -- and made it plain that Republicans simply don't believe it is possible to fix the Democrats' bills, because the specter of government control is woven into their fabric. Democrats, meanwhile, strongly distrust the market and will never agree to the competition-based ideas that are integral to the Republicans' reforms.
Both sides walked out just as they walked in, disagreeing fundamentally on the best approach to health reform.
So what's next? Senate Majority Leader Harry Reid is determined to use the budget-reconciliation process to jam ObamaCare through the Senate -- but that requires huge exertions from House Democrats.
Speaker Nancy Pelosi needs to convince her rank-and-file members to swallow hard and pass the Senate bill so it can then be "fixed" through reconciliation. They have to vote for the Cadillac tax and giveaways like the Cornhusker Kickback -- and trust that the Senate will then go along with removing all those poison pills.
If Pelosi had the votes, the bill would be on the floor in a day. She doesn't.
The summit didn't move the needle. Yet the White House remains absolutely determined to pass this legislation -- so we await the next act.
Democratic leaders realize they may be unable to muster the votes to pass their 2,700-page bill; they're contemplating taking a rifle-shot approach to pass parts of ObamaCare, piece by piece. But that's at least as risky -- because it will take longer, and allow scrutiny on the costs and intrusiveness of each part of their plan.
Summit Standoff
Grace-Marie Turner
Galen Institute, 02/26/10
The consensus among most pundits and reporters was summed up by The Wall Street Journal's Peggy Noonan in her column today: "Boy, that didn't work."
The White House expected a slam dunk, building on what it considered a triumph at the House Republican retreat in Baltimore a month ago, so it could convince rank-and-file Democrats that the time has come to get health reform done.
I was at the retreat in Baltimore, invited to do a session on health reform for members, and was in the room during that remarkable 70-minute exchange.
In the world of cable news, optics are everything. In Baltimore, the president was on stage, flanked by flags and behind a microphone and podium looking down on Republicans who were sitting around tables at lunch. The considerable substance of the dialogue was subordinate to the staging.
Yesterday, with everybody seated around a table at Blair House talking with each other as equals, it was clear that Republicans held their own on health care -- an issue that they clearly are taking ownership of. Even though they received less than half the airtime, they used it to make coordinated arguments on behalf of a step-by-step approach to reform.
The summit was not the game-changer the White House hoped it would be.
The question now will be whether there is the political will to go forward with a smaller bill that very likely could pass this Congress, or whether the White House is going to continue to insist on passing a wildly unpopular, comprehensive overhaul of one-sixth of our economy that three out of four Americans reject.
President Obama opened the summit by saying that Republicans and Democrats are not far apart on health reform because they share concerns about growing deficits and rising health costs.
But the debate showed the two sides have very different approaches to solving those problems. The president's plan and the House and Senate bills rely on more regulation and scores of new government programs to control our wayward health sector; Republicans believe in providing incentives for more competition, consumer choice, and price transparency to force changes in the marketplace.
Politico summed it up well: "So the parties walked out of Blair House almost exactly the way they walked in -- completely at odds over the best way to fix the health insurance system. There were modest efforts around the edges to find common ground -- on reining in waste and fraud and keeping the deficit in check -- but no broad agreements on the shape of reform."
I was actually in Little Rock, Arkansas, yesterday giving a speech so I watched the summit in pieces -- for a while in the Little Rock airport. Late in the afternoon, I saw six or eight traveling businessmen sitting around a bar watching CNN's broadcast of the summit, clearly interested in the debate. The country still is paying attention. The details matter.
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So what's next? While the focus is on Majority Leader Harry Reid's determination to use the budget reconciliation process to jam a health reform bill through the Senate, the real drama is in the House.
Speaker Pelosi needs to convince rank-and-file members that they will have to swallow hard and pass the Senate bill so it can then be "fixed" through reconciliation. If she had the votes, the bill would be on the floor in a day. She doesn't.
The summit didn't move the needle. That said, the White House still is absolutely, positively determined to pass this legislation, so we await the next act.
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Single-payer setback: It didn't help the cause of single-payers who are in love with the Canadian health care system when the premier of Newfoundland secretly traveled to the United States for heart surgery.
Danny Williams, 60, made the situation worse in an interview after the surgery at Mount Sinai Medical Center in Miami, Florida. "This was my heart, my choice, and my health," he said from his condominium in Sarasota. "I did not sign away my right to get the best possible health care for myself when I entered politics."
Yikes! Tell that to the hundreds of thousands of Canadian citizens who can't afford to buy their way out of the Canadian health care system and must wait months and months for care -- care that Premier Williams clearly didn't think made the grade as "the best possible care."
Read more here. Reform Is Best Left To The States Anyway
Grace-Marie Turner
Investor's Business Daily, 02/25/10
Article available here.
The focus of the health reform debate has shifted about a mile down Pennsylvania Avenue, from Capitol Hill to Blair House, where members of Congress and President Obama met Thursday to determine whether bipartisan cooperation on reform legislation is possible.
The political dynamics do not bode well. The White House insists Mr. Obama is "adamant about passing comprehensive reform similar to the bills passed by the House and the Senate."
Democrats in Congress believe the only way to achieve real reform is with an interlocking chain of mandates on individuals and businesses, taxpayer subsidies and new federal programs, regulations and taxes.
Republicans disagree with the size, substance and direction of the legislation that has passed the House and Senate. They would not agree to plug a few of their ideas into bills they believe are seriously flawed.
So what will happen after the standoff at the summit? The focus is likely to shift yet again to the states where they can find examples of state-level health policy experiments that have proven successful in expanding access to coverage and getting costs under control.
States provide a better foundation for viable reform because they are more flexible and can better balance needs with resources.
Consider the Healthy Indiana Plan. Spearheaded by Gov. Mitch Daniels, this program offers coverage to low-income Hoosiers who are uninsured but aren't eligible for traditional Medicaid.
Participants partner with the state in funding an individual health spending account that can be used for medical expenses up to $1,100. Expenses above that are covered by a state program.
Since patients are in charge of spending for routine care, they have a built-in incentive to spend wisely and to take care of themselves. And they also are covered if they need expensive medical care such as hospitalization or surgery.
Healthy Indiana has been enormously successful. So far, it has extended coverage to 50,000 people who were previously uninsured, and it has controlled costs without limiting choice.
Another promising state-level reform experiment is Community Care of North Carolina. This program is an example of a new medical care delivery model known as a patient-centered medical home.
Each patient is connected with a personal physician to coordinate medical care. This connection makes it more likely that medical problems will be detected early and that patients will comply with prescribed treatments.
In 2004, Community Care of North Carolina was responsible for almost $245 million in cost savings, primarily due to reduced emergency room visits and inpatient utilization.
Idaho has devised a novel solution to the problem of insuring people with pre-existing conditions by creating a high-risk reinsurance pool. If a private insurer deems a patient to have chronic health problems or other more costly medical conditions, the insurer can offload some of the financial risk to the pool.
The program is funded by taxes and premiums paid by insurance carriers. More than 1,400 Idaho residents with pre-existing conditions who might otherwise have gone without insurance now have coverage as a result of the program.
Not all state experiments are successful, of course. Three years after Massachusetts enacted its sweeping health-reform legislation, rising health costs continue to bedevil the state and threaten to derail reform efforts.
Indeed, Massachusetts still has the highest health-insurance costs in the nation — the average family policy costs $13,788 annually!
When state lawmakers make mistakes, though, they can learn from their errors and more quickly reverse bad policies.
For example, Kentucky has seen the error of its ways, reversing excessive regulations that drove companies out of the state and sent health insurance prices soaring.
Federal lawmakers can't be nearly as nimble. The 2,500-page Senate health reform bill would alter 17% of the U.S. economy. There is no way that 435 legislators could possibly know how to completely restructure one-sixth of our economy in one bill and get it right.
The federal government's main job should be to get the incentives straight so private-sector solutions and state initiatives can emerge to make health care and coverage more affordable and accessible. The right answer is to take a step-by-step approach to reform and engage the states as active partners in the process.
Summit or Political Suicide?
Grace-Marie Turner
National Review Online: Critical Condition, 02/25/10
Article available here and here.
The American people have rebelled against Obamacare because they know our health sector is too big, too complex, and too important to try to change in any one bill written by a few political leaders who don’t know the needs of 300 million individual Americans.
The Senate’s 2,500-page bill will lead to tens of thousands of pages of regulation that will paralyze progress in our health-care system for a generation.
Yes, we need health-sector reform, but Obamacare gets it so wrong that enacting it would be worse than doing nothing.
Independent studies by the Congressional Budget Office, Medicare’s chief actuary, and other experts show that, under the Senate bill upon which Obamacare is based:
· Health costs will continue to rise
· Federal health spending will increase
· People will lose the coverage they have today
· Taxes will increase, hitting the middle class
· Doctors and hospitals will become insolvent
· Job creation will suffer
The American people know this would be harmful, and the latest Rasmussen poll shows that 61 percent say Congress should start over. A poll by Harvard’s Robert Blendon highlights Americans’ views about health reform:
· 45 percent say overall health costs will increase
· 34 percent say their medical care will get worse
· 34 percent say their own health costs will increase
· 79 percent say their taxes will go up
Republicans have two missions at the health-reform summit: 1) explain why the bills the Democrats propose would be so damaging to our health sector and to our economy, and 2) explain that Republicans want to start a process of targeted reforms that build on the strengths of our health-care system.
Our latest paper, “A Primer on Problems with Congress' Health Reform Bills and a Preview of Possibilities with Patient-Centered Reform,” provides details on how to accomplish these goals.
President Obama could use the summit as an opportunity to redefine success by agreeing to incremental steps through a targeted, smaller bill. Such an approach would garner bipartisan support and pass Congress. That is the only way that Democrats can avoid turning health reform and the Blair House summit into a political-suicide mission.
HAPPENING NOW: Free-Market Health Care Leaders Live Blogging the Health Summit
Center for Health Transformation is live blogging today's health summit, featuring commentary from free-market health reform leaders, including Newt Gingrich, Congressman Michael Burgess, John Goodman, Grace-Marie Turner, Andrew von Eschenbach and John Zogby. The live blogging starts at 10 AM Eastern, and can be found at:
http://www.healthtransformation.net/
RESPONSES TO THE PRESIDENT'S HEALTH REFORM PROPOSAL
The latest responses from leading health care and tax policy think tanks on the president's health reform plan:
http://healthreformhub.org/statements.html
Opinion: Obama's Health Plan -- A Missed Chance
Grace-Marie Turner
AOL Sphere, 02/22/10
Article available here and here.
Instead of offering a genuinely fresh approach, President Barack Obama has unveiled a health plan that essentially splits the difference between two bad partisan bills that are hugely unpopular with the American people. The dubious hallmarks of the House and Senate bills -- hundreds of billions in tax hikes, trillions in new health care spending, job-killing mandates on individuals and businesses, and onerous Washington regulations on one-sixth of the U.S. economy -- are all in the president's plan.
The American public has seen this movie before and has rejected it, yet Obama decided to release it once more, hoping for a better review.
He would continue to require both individuals and employers to pay for health insurance or face fines and penalties. Rather than reform Medicaid, the president would expand it, the most dysfunctional health program in the country and one that politicians would not want to be their health plan. And Obama would increase fees on insurers and other health companies -- fees that will be passed along to consumers in the form of higher premiums.
The big new idea in the president's plan is to federalize regulation of health insurance, creating a Health Insurance Rate Authority to conduct "reviews of unreasonable rate increases and other unfair practices of insurance plans." This might sound appealing, but do we really want to give Washington -- with its trillion-plus-dollar deficits -- more control over the health sector? This new "rate authority" would be a first step toward imposing price controls on private insurance.
Obama clearly is not trying to bridge the divide between Republicans and Democrats as a starting point for a dialogue at Thursday's summit. If he were, he would have included medical liability reform, meaningful interstate purchasing of health insurance and other ideas Republicans support that would provide more competition in the health insurance market and help reduce rising health insurance premiums.
In fact, the Obama plan snubs the GOP by calling for increased taxes on companies inside and outside the health sector, and for a payroll tax on the non-wage interest and dividend income of wealthier Americans. These higher taxes will drive up the cost of health insurance, depress innovation and delay the economic recovery.
Rather than eliminating special interest deals like "the Cornhusker Kickback," "the Louisiana Purchase" and the labor-union exemption, the president's plan basically extends the sweetheart deals to others. All states get more favored treatment for expanding Medicaid, and the threshold for taxing high-cost health plans is raised, while the tax will not take effect until 2018.
All of these deals will cost money. While the Congressional Budget Office won't be able to estimate the bill's costs until it gets actual legislative language, we know that the proposal outlined by the president will cost even more than the Senate bill's staggering $2.4 trillion price tag over 10 years.
Health spending will continue to rise, premium costs will increase, at least 24 million people will remain uninsured and the system of subsidies to individuals and businesses will continue to allow politicians to pick winners and losers. Moreover, because the president's plan is built upon the Senate bill, it would include cuts to Medicare that will jeopardize care for seniors.
It's unfortunate that Obama shunned the bipartisan path to a health reform compromise in favor of this split-the-difference partisan plan modeled after the House and Senate bills. It offers Republicans little upon which to build a conversation that could lead to genuine compromise at Thursday's summit.
Obama’s Health Reform: Tax. Spend. Regulate. Mandate.
Grace-Marie Turner
National Review Online: Critical Condition, 02/22/10
Article available here and here.
The much-awaited health-care reform plan the White House released this morning is little more than an amalgamation of the taxing, spending, mandating, and regulating policies of the bills that passed the House and Senate last year.
Instead of offering a genuinely fresh approach, Mr. Obama split the difference between two bad bills that are hugely unpopular with the American people. He would continue to mandate that both individuals and employers pay for health insurance or face fines and penalties. He would expand Medicaid, the most dysfunctional health program in the country. And he would increase fees on insurers and other health companies — fees that will be passed along to consumers in the form of higher premiums.
The big new idea in the president’s plan is to federalize regulation of health insurance, creating a Health Insurance Rate Authority to conduct “reviews of unreasonable rate increases and other unfair practices of insurance plans.” This reflects the overall strategy to give more and more control over the health sector to Washington.
Mr. Obama clearly is not trying to bridge the divide between Republicans and Democrats as a starting point for a dialogue at the summit on Thursday. A separate document listing Republican ideas he would include focuses almost exclusively on policies to crack down on waste, fraud, and abuse — good ideas, but not enough.
In fact, the Obama plan snubs the GOP by calling for increased taxes on companies inside and outside the health sector, and for slapping a payroll tax on the non-wage interest and dividend income of wealthier Americans. These higher taxes will drive up the cost of health insurance, depress innovation, and delay the economic recovery.
The way the president has dealt with the Cornhusker Kickback, the Louisiana Purchase, and the labor-union exemption is to basically extend the sweetheart deals to others. All states get more favored treatment for expanding Medicaid, and the threshold for taxing high-cost health plans is raised, while the tax will not take effect until 2018.
The proposal that the president has outlined will cost even more than the Senate bill. It will lead to exploding costs that will surely top the Senate bill’s $2.5 trillion over 10 years. Health spending will continue to rise, premium costs will increase, at least 24 million people will remain uninsured, and the system of subsidies to individuals and businesses will continue to allow politicians to pick winners and losers. Moreover, because the president’s plan is built upon the Senate bill, it would include cuts to Medicare that will jeopardize care for seniors.
The Obama plan is not an improvement, and it offers Republicans little upon which to build a conversation that could lead to genuine compromise at Thursday’s summit.
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