Health Care

The post below is a guest post by my brother, Nathan. He worked on capital hill over ten years, spending several years working for Congresswoman Chenoweth (during which time he obtained his law degree) and then later as a lobbyist. Nathan is our source to the inner workings of congress.

_________

Having come to the realization that this health bill was going to pass, I spent much of the day undergoing the grueling task of reading the bill and watching the debate. In fact, my whole family watched the final two hours of the debate, quite a civics lesson that they will never forget.

I was quietly hoping that at least some of the opposition to this legislation was political "hype" or "hysteria." Sadly, my own personal view after studying the bill and its true implications is that there is no question in my mind that most of the concerns are very legitimate and real. The public has a valid reason to be up in arms.

In short, the new law results in an incredible shift of power and control in health care -- the largest sector of our economy -- to the federal government. We will now be entrusting virtually all of the health care decisions into the hands of federal bureaucrats. I could spend several pages going over the provisions of the bill to show this, but one need only to search a few key words to demonstrate that point. For instance, nearly each reference to "secretary," "commissioner," "director" or other agency head references usually represents a new rule, mandate or change in the law. Here's how those terms stack up in the legislation (just in the Senate bill alone which is now law. The house "corrections" bill contains many more such references):

"Secretary." 2798 instances
"Commissioner" 754 instances
"Committee" 419 instances
New health care “Ombudsman” 74 instances
"Inspector general" 85 instances
"Director" 83 instances

This means that there are likely over 4,000 new rules and regulations touching every aspect of health care that will be issued as a result of this legislation. There will be no discretion left to insurers and providers. What can and cannot be done will be dictated by the feds, not market forces.

And this is only the beginning. It is evident that the drafters could not get all of the powers they wanted in the bill, so many new "commissions" and "studies" have been established that will likely lead to future laws and regulations. There are 962 instances of “commission” in the bill and 167 instances of “study.”

Just the bureaucracy that is created to implement the bill will be staggering. There are major new powers given to the IRS to enforce the new insurance and tax mandates. There's a newly formed bureaucracy between the Secretary of Labor, the Secretary of the Treasury, the Secretary of Health and Human Services, and the newly created Health Choices Commissioner.

Some of you have expressed to me your confidence in the government to carry out the administration of health care in a fair and efficient manner. I'm sorry, but I do not share the same faith -- mainly because I witnessed first hand what the government is truly capable of. For instance, after the "Department of Homeland Security" was established, it was nearly a year before the phones to the new department were up and running. The department then became an enclave for members and lobbyists pet projects and programs. I can only imagine how this health care bill will be dealt with, which is on a much broader scale. I could give you many other such examples. It is a system ripe for unchecked abuse.

What's also interesting is what will happen to insurance companies, who in reality do not have much to complain about in this legislation (and actually helped to write it). They will be well taken care of. Their profits will be institutionalized. However, they will essentially become "utilities" under the direction and control of the government. One might argue that the feds will be able to curtail the profits or costs of insurance companies. However, I think the reverse will be true. First, there are no real cost controls in the bill! No real restrictions on the rate of premium increases. Second, who will be the ones the feds ultimately rely upon to implement the rules? The current and former insurance company employees of course. (And you think that the "military industrial complex" is bad.)

In fact, all of the "special interests" make out like a bandit. There are no real cost controls for hospitals, physicians, pharmaceuticals etc.... There's nothing in the legislation that will require them to charge any less for their services or products. There's nothing to stop the over utilization of health services. Their profits will be "institutionalized" as well. They will remain a powerful lobby to ensure that is the case.

The only group not taken care of in the bill are the taxpayers and consumers. They (we) will bear the burden of both the costs and the type of health care the government will grant us.

Of course, we can't forget about the states -- who notwithstanding their strapped budgets will be faced with a major unfunded expansion of the medicaid requirements. Good luck with that one.

Then there is the issue with regard to cost, with the audacious claim that this will somehow be "budget neutral" or even "reduce" the deficit. Setting aside the manipulative math in that the cost projections were based on 10 years of revenue and 6 years of benefits, at the end of the day, this bill will cost no less than one trillion dollars over 10 years (not taking into account the many unknowns and the overly rosy scenarios, which in effect make the trillion dollar figure a baseline.) The trillion bucks must come from somewhere! There's nothing "neutral" about it. As the bill is written now, $500 billion or so is siphoned from medicare, another few hundred billion will come from tax increases in the form of the hefty excise tax placed on the wealthy (more class warfare) and the insurance mandate and/or penalties that businesses and individuals will have to pay if they don't get health insurance. (Oh, and by the way a $100 billion or so will come from interest earnings of the government's take over of the student loan industry.) Of course, the rosy CBO numbers did not include the latest house "corrections" or "buy-offs," i.e. the additional cash thrown to the docs and rural health care providers which push the bill into the red.
That is no less than a trillion dollars usurped from a suffering economy, taken out of the hands of the private sector and put under control of the government. Ultimately, I think it will cost a lot more, which of course we will have to borrow, increasing the deficit further threatening our bond status.

If you look at what is about to come, i.e. the retirement of the baby boomer population and their increased health care needs, I think this bill has sent us on an unsustainable track. We have essentially created a massive new entitlement program, while the ones we have in place now (i.e., social security and medicare) are by all accounts not sustainable themselves. At some point, these programs will become bankrupt. How can we possibly take on this new expansion of entitlement? I fear for my generation and the ones to follow. (Somehow, I think the baby boomers with its major voting block will ensure that their interests are well taken care of.) We are bound for a total collapse. (Maybe that's the real intention behind it all!?)

It's important to consider the immediate practical effect. Notwithstanding the relatively small "subsidies" that small businesses, and/or individuals will be paid to help pay for insurance (hmmm, wonder how we'll pay for that too), at the end of the day for many businesses and individuals it will be more economic NOT to obtain insurance and pay the penalty. Families will then hope to remain healthy. But in the event there is a health problem, they will then obtain insurance (with no ban on pre-existing conditions.) This is certainly an option we will immediately consider. There is a sensible study out there that suggests this will lead to a spike in insurance premiums for everyone.

While I do recognize that there are problems that need addressing in the health care system, and the federal government can play a role in that, this has to be one of the most irresponsible pieces of legislation ever. We are in an economic crisis, $1.5 trillion annual deficits for many years to come -- and this unprecedented expansion of government control is how we respond?

In that regard, I do finally have to say something about the unbelievable process that lead to the vote tonight. The only possible term I can think to describe it is "cult of personality." President Obama made it clear last year that he was going to stake his entire presidency on "health care reform." At some point, sometime after the Virginia, New Jersey and Massachusetts elections, this became much more about politics and personality over substance. If you review the news coverage this last week, the vast majority of it was with regard to what the bill meant to Mr. Obama, not what was actually in the bill, or more importantly, what the majority of the country felt about the legislation. Poll after poll, as well as the overwhelming feedback coming into Washington demonstrated that in large part the public did not want Congress and the President to move forward with this legislation. There are other priorities (e.g., the economy and the deficit) that are more on the minds of Americans.

The arrogant assumption is that the majority of Americans are simply buying into the "unfounded" rhetoric of "right wing nuts" (such as me I suppose) and are not capable of making an informed opinion based on the substance of the legislation and where our true priorities should be. (In other words, we are just a bunch of morons who can't think for ourselves.) Compounded with that elitist and condescending attitude was this bunker mentality that this bill had to be passed for the sake of the Obama presidency if nothing else. That became more important than both the substance of the bill and the will of the American people.

The other tack is that Republicans were simply going to oppose anything Obama and the dems offered for political expediency. Having been a Republican all my life, I find this hard to believe as well. Republicans have never been all that good with "strong arm" tactics with their own. The Dems have always done this much more effectively (see this week's vote.) Had there been anything "moderate" whatsoever, or any true bi-partisan participation, there would have certainly been Republican defections.

In essence, this was astonishing defiance and disregard demonstrated by 219 members of the House and Mr. Obama. It has really been unbelievable to witness. Unfortunately, it will affect more than the political fortunes of a few politicians, but every single American now and in the future. I doubt this will be completely reversible.

Anyway, to those who thought this bill was a great thing for America, I congratulate you. Keep drinking that cool aid (which hopefully isn't full of poison.)

Will try to catch a little sleep. Tomorrow is a new day in America.