FULL TEXT: Obama's Health Care Proposal The White House (via Kaiser Health News), 02/22/10
The proposal President Barack Obama will bring to his Thursday health 'summit' with Congressional leaders contains many of the ideas from the bills already passed by the Democratic House and Senate, including a mandate that individuals buy insurance and a promise to "end discrimination" from pre-existing conditions.
Click here to read President Obama's health reform proposal.
CPAC 2010: "Saving Freedom from Obamacare: It Isn't Over Yet" Grace-Marie TurnerConservative Political Action Conference, 02/19/10Galen Institute President Grace-Marie Turner moderated "Saving Freedom from ObamaCare: It Isn’t Over Yet!" at this year's Conservative Political Action Conference (CPAC) in Washington, DC. Below is a video of the panel, as well as Grace-Marie Turner's opening remarks.
Good morning and welcome to our panel on "Saving Freedom from ObamaCare: It Isn’t Over Yet!"
Our panelists are leaders who took action to light the flame that swept across America to set Massachusetts on fire on January 19 and halt ObamaCare from near-certain passage.
“Scott Brown 41!” President Obama and Speaker Pelosi still deny the message that voters sent to Congress by electing Senator Brown to “The People’s Seat.”
Before Massachusetts, we were truly within days or a few weeks at most of ObamaCare being enacted. But even today, if the House were to take a suicide vote and pass the Senate bill, it would be the president’s desk immediately and signed in to law. Their plan is to use the 51-vote reconciliation strategy to “fix it” in the Senate.
Ladies and gentlemen, these bills cannot be fixed. But even today, news reports say that the White House will post a merged bill online on Monday and dare Republicans to oppose it at next Thursday’s health care summit at Blair House.
Leader John Boehner made it very clear yesterday that he’ll insist they, and I quote, “scrap their big government take over of our health care system and start over with a clean sheet of paper and common sense ideas.”
He knows these bills cannot be fixed. The latest Rasmusssen poll shows that 61 percent of Americans agree with him.
Mr. Boehner warned us to stay alert. Just today, we learned that the White House plans to come out of the health care summit next week “with guns a-blazing,” according to one Democrat official. We are not safe from passage of ObamaCare until the gavel falls on the 111th Congress.
One Democratic official said this week if the had any idea that Scott Brown could win, they would have worked through Christmas to finish work before the Massachusetts election.
They are not giving up, and we must not either.
These four outstanding leaders stepped up and found unique ways to have a huge impact in turning the tide away from what seemed like an inevitable path to ObamaCare. And we need them to keep working!
Heather Higgins chairs the board of the Independent Women’s Forum, is president of The Randolph Foundation, and is involved in many other professional and philanthropic endeavors. She will talk with you about her crucial work in educating Massachusetts voters about the dangers of ObamaCare.
Dr. Eric Novack is a full-time orthopedic surgeon and chairman of Arizonans for Health Care Freedom. He will tell you about his work in starting a nationwide movement in state legislatures nationwide to stand up to Washington oppression.
Dr. Hal Scherz is a noted pediatric urologist in Atlanta and took action to create Doctors 4 Patient Care. (What a novel idea!). He started with 20 members last May and now is up to 4,000 members. Look out AMA!
And Jim Martin will talk about his incredible messaging campaign as president of the 60 Plus Association – the conservative alternative to the AARP.
A Primer on Problems with Congress' Health Reform Bills and a Preview of Possibilities with Patient-Centered Reform Grace-Marie TurnerGalen Institute, 02/18/10
Here is a refresher that may be useful to those attending the Blair House summit to answer those who still insist the Democratic leadership's bills must be passed so they can “do something” on health reform. The American people know we need reform, but they simply do not want this legislation, as evidenced in the latest Rasmussen poll showing that 61 percent of those polled saying Congress should start all over on health reform.
Download the full paper here.
What to expect from the Blair House health talks Grace-Marie TurnerNational Review Online: Critical Condition, 02/17/10
Republican leaders and the White House are publicly sparring over next week’s health-reform summit, with President Obama demanding the GOP bring its own comprehensive health plan and House Republican leader John Boehner asking the White House to “assure the American people that Democratic leadership is not putting together any kind of backroom deal or plotting any kind of legislative trickery” to get its legislation passed.
This does not bode well for an open dialogue at Blair House about a bipartisan agreement on health reform.
If actions speak louder than words, then it is relatively clear the White House is using the meeting as a set-up to make one last, big push to get its huge health-care bill passed before Easter.
Congressional operatives admit they are planning to move from bipartisanship to ultra-partisanship. Aides to Speaker Pelosi have outlined a tortured parliamentary path to enactment, demanding that the Senate use its 51-vote reconciliation process to ram through changes the House wants made to the Senate bill. Only then would the House hold its nose and vote for final passage.
The scheme won’t work, but the first challenge is convincing Democrats to start over. They need to admit that the problem wasn’t the marketing but the fundamental substance of Obamacare.
A parade of independent studies shows that the legislation before Congress fails to achieve its most basic goals and would create an avalanche of unintended consequences throughout the rest of the health sector and economy. The American people simply do not want this legislation, as evidenced in the latest Rasmussen poll showing that 61 percent of those surveyed say Congress should start all over on health reform.
Here is a reminder of what would happen if the Democratic leadership’s health-care legislation passed:
*Health costs would continue to rise. The Congressional Budget Office says health-insurance premiums would continue their steady upward climb under the Reid bill. Families purchasing insurance in the individual market would see an increase of $2,100 in the year 2016, over and above increases they already would be facing as health-insurance premiums continued to rise at about twice the rate of general inflation.
That means those families would be paying $15,200 for health insurance if the Senate bill passed, and $13,100 if it didn’t. Families who get health insurance through small businesses would be paying $19,200 in six years, and those working for large firms, $20,100.
PricewaterhouseCoopers released a study, commissioned by America’s Health Insurance Plans, that showed the cost of a family plan in 2019 would be $4,000 a year higher if reform passed.
*Federal health spending would increase. Chief Medicare actuary Rick Foster estimates that under the Senate bill, “Federal expenditures would increase by a net total of $279 billion” between 2010 and 2019.
*People would lose the coverage they have today. Steep cuts in Medicare Advantage would mean that at least one-third of seniors likely would lose their comprehensive Medicare Advantage coverage as their plans withdrew from the program, cut their benefits, or raised their premiums.
As for people with employer-sponsored insurance, the CBO says that 10 million of them could lose their current coverage. Independent studies by the Lewin Group found that a full “public plan” option would mean 83 million Americans could lose private coverage.
*Taxes would increase . . . on the middle class. The bills call for nearly $500 billion in new taxes, including taxes on insurance companies, Cadillac health plans, medical devices, and “the rich” — taxes that would hit the middle class and increase prices and health-insurance costs for consumers.
And the requirement that all individuals carry health insurance would come with tax penalties for non-compliance. Congressional tax expert Thomas Barthold told the Senate Finance Committee that these penalties would amount to an excise tax that would hit the middle class.
*The bills just wouldn’t work. The American Academy of Actuaries (AAA), in a 21-page letter to Congress, critiqued the House and Senate bills and said major changes must be made to avoid a series of damaging consequences.
For example, the AAA found significant problems with the new long-term-care entitlement program (the CLASS program) that the legislation would create. The AAA said that “given the way the program is structured, severe adverse selection would result in very high premiums that are likely to be unaffordable for much of the intended population, threatening the viability of the program.”
Medicare actuary Rick Foster also concludes that “there is a very serious risk that the problem of adverse selection would make the CLASS program unsustainable.”
*The deficit would increase. Former CBO director Doug Holtz-Eakin concludes that the legislation “can claim to be deficit-neutral only because during its first decade it offers 10 years of taxes compared with six years of subsidies, making it look far cheaper initially than it really is (while still costing more than $800 billion). The Republican staff of the Senate Budget Committee estimates that, fully implemented, Democratic legislation would cost $2.4 trillion over 10 years, nearly three times the cost projected by the Congressional Budget Office.”
Further, the Congressional Budget Office shows that the Senate bill double-counts Medicare savings. Savings to the Medicare program “would be received by the government only once . . . they cannot be set aside to pay for future Medicare spending and, at the same time, pay for current spending on other parts of the legislation or on other programs.”
Rick Foster makes the same point: A series of accounting maneuvers makes it appear that Medicare’s Part A trust fund would be in better shape under the Reid bill, but that’s not so. “In practice, the improved Part A financing cannot be simultaneously used to finance other Federal outlays (such as the coverage expansion under [the Reid bill]) and to extend the trust fund,” Foster writes. Foster also says that making the cuts to Medicare that Reid’s bill requires would “represent an exceedingly difficult challenge.”
*Doctors and hospitals would become insolvent. Achieving deficit neutrality depends on Congress’s making massive cuts to physician and hospital payments under Medicare — cuts that Congress has virtually no will to implement. But if the cuts were implemented, Foster says that in a decade, one out of five hospitals and nursing homes would become unprofitable, threatening patient access to Medicare services. The 21 percent cut in Medicare payments on March 1 is the next death-defying cliff Congress must figure out how to avoid.
*Job creation would suffer: The new taxes on businesses and individuals would further retard job creation and the economic recovery, and the higher health costs would discourage small businesses — the engine of job creation — from hiring. U.S. Chamber of Commerce president Tom Donohue said: “Congress, the administration and the states must recognize that our weak economy simply could not sustain all the new taxes, regulations and mandates now under consideration. It’s a sure-fire recipe for double-dip recession, or worse.”
WellPoint mined its own actuarial data to model the basics of the plan incorporated in the House bill, using data from 14 states where it runs Blue Cross plans. In all 14, it found that the legislation would drive up premiums for small businesses and individuals — the very people who get economies moving.
This is just a reminder of the damage that the Democratic bills would do. Republicans need to be ready to put their own ideas on the table at next week’s summit.
A Summit Primer Grace-Marie Turner
Galen Institute, February 12, 2010100 votes short? One of the more telling comments about the prospects for final passage of health reform came from a top House Democratic official quoted in a Politico article today entitled, "Family Feud: Nancy Pelosi at Odds with President Obama":
"Though Pelosi and other House Democrats have made it clear that they're angry with the Senate, they're also frustrated with the president, upset that he hasn't come to terms with the problems of getting legislation through the upper chamber -- or done enough to overcome them.
"He wants a jobs bill, we get a jobs bill," the official said. "He wanted health care, we got health care. Then the answer is, 'You just need to twist enough arms to pass the Senate bill.' You can twist arms if you've got a handful of them to twist. You can't twist over 100 arms. There needs to be some reality check there."
So that must mean the House is a long, long way from having enough votes to pass the Senate bill. And the path to reconciling the differences is as difficult as driving the streets of Washington in this week's crippling snowstorms. Clearly the February 25 health care summit is a desperate effort by the White House to save the health overhaul effort.
The leaders should step back and look for the path that is possible. There are things that Congress could do but the changes need to be targeted as part of a step-by-step approach to reform, as I outline in my latest National Reviewcommentary.
********
A summit primer: But the Democratic leadership nonetheless presses forward. The latest tactic is to convince people that health care in America is so broken that the Congress has a duty to pass the Senate bill "to get something done" -- even if it means using a process that would throw any pretense of bipartisanship out the window.
Speaker Pelosi has outlined yet another tortured parliamentary scenario to get the measure passed before Easter, using the 51-vote reconciliation process in the Senate. That would be an admission that they don't even have enough Democratic Senate votes to get a bill passed!
The scheme won't work.
A parade of independent studies shows that the legislation before Congress fails to achieve its most basic goals, and it would create an avalanche of unintended consequences throughout the rest of the health sector and economy.
Here is a refresher with some points that defenders of patient-centered medical care could make at the summit to answer those who insist the Democratic leadership's bills must be passed:
Overall health costs will continue to rise: The Congressional Budget Office says health insurance premiums will continue their steady upward climb under the Reid bill. Families purchasing insurance in the individual market would see an increase of $2,100 in the year 2016, over and above increases they already will be facing as health insurance premiums continue to rise at about twice the rate of general inflation.That means those families would be paying $15,200 for health insurance if the Senate bill passes, and $13,100 if it doesn't. Families who get health insurance through small businesses will be paying $19,200 in six years, and those working for large firms, $20,100.
PricewaterhouseCoopers released a study, commissioned by America's Health Insurance Plans, which showed the cost of a family plan in 2019 would be $4,000 a year higher if reform passes.
Federal health spending will increase: Chief Medicare Actuary Rick Foster estimates that under the Senate bill, "Federal expenditures would increase by a net total of $279 billion" between 2010 and 2019.
People will lose the coverage they have today: Steep cuts in Medicare Advantage would mean that at least one-third of seniors likely would lose their comprehensive Medicare Advantage coverage as their plans withdraw from the program, cut their benefits, or raise their premiums.And as for people with employer-sponsored insurance, CBO says 10 million of them could lose their current coverage. Independent studies by The Lewin Group found that earlier versions of the legislation could mean 83 million Americans would lose private coverage.
Taxes will increase … on the middle class: The bills call for nearly $500 billion in new taxes, including taxes on insurance companies, Cadillac health plans, medical devices, and "the rich" -- taxes that will hit the middle class and increase prices and health insurance costs for consumers.And the mandate that all individuals must carry health insurance comes with tax penalties for non-compliance. And that is indeed a tax, according to top congressional tax expert, Thomas Barthold. He told the Senate Finance Committee that the penalty for not complying with the requirement to buy health insurance is an excise tax that will hit the middle class.
The bills just don't work: The American Academy of Actuaries, in a 21-page letter to Congress, critiqued the House and Senate bills and said major changes must be made to avoid a series of damaging consequences.As just one of many examples, the actuaries described the significant problems with the new long term-care entitlement program the legislation would create, called the CLASS Act. The actuaries said that "given the way the program is structured, severe adverse selection would result in very high premiums that are likely to be unaffordable for much of the intended population, threatening the viability of the program."
Medicare actuary Rick Foster also concludes that "there is a very serious risk that the problem of adverse selection would make the CLASS program unsustainable."
The deficit will increase: Former CBO Director Doug Holtz-Eakin concludes the bills "can claim to be deficit-neutral only because during its first decade it offers 10 years of taxes compared with six years of subsidies, making it look far cheaper initially than it really is (while still costing more than $800 billion)."The Republican staff of the Senate Budget Committee estimates that, fully implemented, Democratic legislation would cost $2.4 trillion over 10 years, nearly three times the cost projected by the Congressional Budget Office."
Further, the Congressional Budget Office shows the Senate bill double-counts Medicare savings. Savings to the Medicare program "would be received by the government only once ... they cannot be set aside to pay for future Medicare spending and, at the same time, pay for current spending on other parts of the legislation or on other programs."
Rick Foster makes the same point: A series of accounting maneuvers makes it appear that Medicare's Part A trust fund would be in better shape under the Reid bill, but that's not so. "In practice, the improved Part A financing cannot be simultaneously used to finance other Federal outlays (such as the coverage expansion under [the Reid bill]) and to extend the trust fund," Foster writes.
Further, Foster says that making the cuts to Medicare that Reid's bill requires would "represent an exceedingly difficult challenge."
Doctors and hospitals will become insolvent: Achieving deficit neutrality depends upon Congress making massive cuts to physician and hospital Medicare payments which Congress has virtually no will to do. But if the cuts are implemented, Foster says that in a decade, one out of five hospitals and nursing homes would become unprofitable, threatening patient access to Medicare services. The 21% cut in Medicare payments on March 1 is the next death-defying cliff the Congress must figure out how to avoid.
Job creation will suffer: The new taxes on businesses and individuals will further retard jobs creation and the recovery, and the higher health costs will discourage small businesses -- the engine of job creation -- from hiring. US Chamber of Commerce President Tom Donohue said: "Congress, the administration and the states must recognize that our weak economy simply could not sustain all the new taxes, regulations and mandates now under consideration. It's a sure-fire recipe for double-dip recession, or worse."WellPoint mined its own actuarial data to model the basics of the plan incorporated in the House bill, using data from 14 states where it runs Blue Cross plans. In all 14, it found that the legislation would drive up premiums for small businesses and individuals -- the very people who get economies moving.
Just a reminder of the damage these bills would do. The problem is not the marketing. The problem is the substance of these bills, Mr. President. This is the wrong prescription.
Starting Over Grace-Marie Turner
Galen Institute, February 5, 2010Frustration: The Democrats seem to be in the anger phase of grief over the collapse of their health overhaul, with a sharp and heated meeting between top White House advisers and Senate Democrats on Wednesday. Politicoreports:
"Sen. Al Franken ripped into White House senior adviser David Axelrod this week during a tense, closed-door session with Senate Democrats. Five sources who were in the room tell Politico that Franken criticized Axelrod for the administration's failure to provide clarity or direction on health care and the other big bills it wants Congress to enact...
"But they also said the Minnesotan wasn't the only angry Democrat in the room. 'There was a lot of frustration in there,' said a Democratic senator who declined to be identified."
According to grieving expert Elisabeth Kubler-Ross, after anger, comes the bargaining stage. Now this also from Politico:
"Months after Congress abandoned any hopes of a broad bipartisan deal on health care reform, President Barack Obama said Thursday the 'next step' on health care reform involves going back to the negotiating table with Republicans.
"Obama told supporters at a Democratic National Committee fundraiser that he wants to have a meeting with Republicans, Democrats and health care experts to go through the bills 'in a methodical way.' 'And then, I think that we've got to go ahead and move forward on a vote,' he said."
Starting over? During the House GOP retreat in Baltimore last week, Mr. Obama said that many Republican proposals were incorporated into legislation by the Democratic leadership, including:
Allowing inter-state purchase of health insurance
Catastrophic health insurance for young people
High-risk pools for uninsured people with pre-existing conditions
Small business health plans
Incentives for wellness
Allowing young adults to stay on their parents' policies
While not every Republican or Democrat would agree with every item on the list, it is a start for a bipartisan discussion.
And to that list, I would add several others that were in the health policy platforms of both Sens. McCain and Obama during the campaign, including agreement on the importance of:
Targeted financial help for the uninsured
Incentives for prevention and early treatment
Coordination of care and disease management
Greater use of information technology and electronic medical records
New approaches to "best practices" in treatment
There are serious differences about how to structure the underlying policy on any of these items and whether more power and control go to government or to doctors and patients. But these lists nonetheless could be a start for a bipartisan conversation.
Targeting Ryan: The White House has declared war on Rep. Paul Ryan, R-WI, over his Roadmap for America's Future. The legislation creates a 21st century plan for reforming tax policy, Medicare, Medicaid and Social Security. It has been scored by the Congressional Budget Office as putting entitlement programs and the federal budget on a sustainable path, reversing the tsunami of red ink facing the next generations and creating dramatic economic growth.
But White House Budget Director Peter Orszag laid into the plan this week, saying in part:
"[Ryan] introduces individual accounts, privatization into Social Security. He has significant changes to the tax code … He eliminates the tax preference that currently exists for employer-sponsored insurance… He has put forward an interesting plan. There are many aspects of that that are worthy of further discussion and debate, but it is a dramatically different approach in which much more risk is loaded onto individuals and in which the Medicare program in particular is dramatically changed from its current structure."
"There are few paths forward more destructive, more painful, and more irresponsible than the one advanced by those clinging to the unsustainable status quo. There is consensus that entitlement reform is urgently needed, and I welcome constructive criticism of my plan -- a CBO-certified plan that actually solves the long-term fiscal crisis.
"What is unaffordable and unacceptable, however, are political attacks unaccompanied by alternative plans. Those who would rather kick the can down the road are consigning the next generation of Americans to not only a broken social safety net, an inferior standard of living, and bankruptcy -- but a future in which America's best days are behind it.
Change is essential. Paul Ryan has a plan that deserves to be taken seriously that offers a vision for reform and that would take years to pass and implement. He and the next generation of political leaders can prevail in advancing real change if they engage a much more informed electorate in a serious debate about policy challenges and alternatives.
People want to be involved, and they want the truth. Helen Darling of the National Business Group on Health told The Wall Street Journal that the legislation the House and Senate passed wouldn't have accomplished much to slow costs, and thus its death won't matter much.
There are serious and very real problems in our health sector that must be fixed -- relentlessly rising health costs, an explosion of entitlement spending, and financial pressures on businesses among them. Americans figured out that the legislation that both the House and Senate have passed does not help and will in fact make these problems worse.
We are entering a new era in the political and policy debate with tens of millions of people having access to information to allow them to focus on the details of policymaking. Engaging the power of the Information Age could lead to the transformative change that our country desperately needs to create a new century of growth and prosperity.
Bracing: Washington is bracing for a record snowstorm that already has started. We may get as much as 24 inches before it's done tomorrow evening. Maybe all of Washington can calm down, tone down the rhetoric, and take the long view of what's right for our country.
Stalemate Grace-Marie Turner
Galen Institute, January 28, 2010
President Obama failed to offer any path to break the congressional stalemate over health reform in his address last night, simply offering another rallying cry for his signature domestic policy initiative and repeating talking points he's made in countless speeches all year.
The president insists people would like his plan if only they understood it. But the American people do understand it, and they don't like it. The latest CNN/Opinion Research Corporation poll taken last week found 69 percent of Americans want Congress to either draft a new bill or drop the issue altogether.
Congress is at war with itself over the best way to proceed after Massachusetts transformed the political landscape, and Mr. Obama needed to do a lot more than restate the problems in our health sector which virtually everyone agrees must be fixed in order to move Congress off dead center.
Rep. Anthony Weiner (D-NY) crystallized the dilemma, telling reporters yesterday: "The Republicans are our opposition. The Senate is our enemy."
The president and Hill leaders spent the weekend desperately trying to convince House Democrats to pass the Senate health overhaul bill, promising the Senate would use the 51-vote reconciliation process to fix their concerns.
But that means asking House Democrats to vote for the Cornhusker Kickback, a tax on high-cost health plans without labor union exemptions, and dozens of other provisions they hate.
Yesterday, the House came up with a package of the fixes it wants the Senate to make. But the price tag was a whopping $300 billion, pushing the full cost toward $1.2 trillion even in the most conservative estimates. Senators were aghast and felt the House was preparing to target them as the reason health reform fails.
In his speech last night, the president challenged anyone to come up with a better plan, basically dissing Democratic committee chairmen who have spent countless hours trying to advance his agenda.
Virginia Gov. Bob McDonnell answered the president's request during his response last night, calling for cross-state purchasing of health insurance, a reform that University of Minnesota economists Stephen Parente and Roger Feldman found would not cost the federal government a penny but would mean 12 million more people would be insured. And he encouraged Congress to tackle lawsuit abuse as a first order of business.
Finally, if the president were a practiced politician and genuinely wanted bipartisan action, he would have done two things. He would have thanked the five Democratic committee chairmen who have worked incredibly hard over the last year to deliver on health reform. A thank you from the president in front of a national audience would have motivated them to keep working.
And if he really wanted to bring Republicans to the table, he might have thrown an olive branch to Sen. Olympia Snowe (R-ME) and a few others to try to get them to the negotiating table. None of that was to be found, only more partisan blame games.
Clearly the president is looking for another miracle that will get the Senate back to 60 Democrats to pull health reform out of the fire. Anything can happen, but that's a pretty risky strategy.
Leadership, anyone?
An abbreviated version of this post appears today on The New York Times' Room for Debate blog.
Starting over? During the House GOP retreat in Baltimore last week, Mr. Obama said that many Republican proposals were incorporated into legislation by the Democratic leadership, including:
