Cost Concerns as Obama Pushes Health Issue

[Herb Schaffler]

Cost Concerns as Obama Pushes Health Issue
Doug Mills/The New York Times
Addressing the American Medical Association, President Obama promised to work with doctors to reduce “defensive medicine.”

[LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. and [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link.
Published: June 15, 2009
WASHINGTON — [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. went before a convention of receptive but wary doctors on Monday to make the economic case for a health care overhaul, both for the nation and for the physicians’ own bottom lines.
But as the president spoke at the annual conference of the [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. in Chicago, it became clear that one of the major health plans on the table would cost at least $1 trillion over 10 years yet leave tens of millions of people uninsured.
Congress is wrestling with how to pay for Mr. Obama’s vision to extend health care to all Americans, and some lawmakers are considering tax increases and spending cuts different from the ones he has proposed. House Democrats, for example, are weighing a tax on soft drinks and a value-added tax, a broad-based consumption tax similar to the sales taxes many states levy.
An analysis released Monday by the nonpartisan [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. raised the hurdles for draft legislation in the Senate just as its Health, Education, Labor and Pensions Committee planned to begin voting on Wednesday. The office concluded that a plan by the committee’s Democratic leaders, Senators [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. of Massachusetts and [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. of Connecticut, would reduce the number of uninsured only by a net 16 million people. Even if the bill became law, the budget office said, 36 million people would remain uninsured in 2017.
That finding came as a surprise. [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. , an economist who headed the budget office when Congress tackled the health care issue in the Clinton administration, said that if so many people remained uninsured, it might not be feasible to cut special federal payments to [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. that serve many low-income people.
Mr. Obama said Saturday that the government could save $106 billion over 10 years by cutting such hospital payments as more people gained coverage.
Senator [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. of Utah, a senior Republican on both committees drafting health legislation, said he found the office’s numbers stunning. He calculated that the Kennedy bill would cost taxpayers $62,500 per uninsured person over the 10 years.
Mr. Obama took the cost issue head on in Chicago. “The cost of inaction is greater,” he told the doctors, because rising health care prices are “an escalating burden on our families and businesses” and “a ticking time bomb for the [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. .”
Opening a week in which health care will dominate attention in Congress, the president’s speech on Monday was the latest example of an oft-used ploy to press his case: appearing before skeptical audiences, confident of his powers of persuasion but willing as well to say what his listeners do not want to hear.
Mr. Obama spoke just days after the A.M.A. had signaled opposition to his proposal for a public [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. plan to compete with private insurers as part of a menu of choices, much like the one for members of Congress.
“The public option is not your enemy,” Mr. Obama said. “It is your friend, I believe.” Saying it would “keep the insurance companies honest,” the president dismissed as “illegitimate” the claims of critics that a public insurance option amounts to “a Trojan horse for a single-payer system” run by the government.
Mr. Obama twice referred to the use of such “fear tactics” about “socialized medicine” in past legislative battles, without pointing out that the A.M.A., a traditionally Republican-leaning group, was among those using the charge, as in the mid-1960s debate over creating [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. for people 65 and older.
Mr. Obama drew repeated applause, and even some standing ovations, when he called for incentives to get more medical students to go into primary care instead of the more lucrative specialty practices, and when he pledged to work with doctors to reduce their often unnecessary “defensive medicine” to avoid malpractice lawsuits. But scattered boos met his follow-up remark that he opposed any cap on malpractice awards.
The president’s emphasis on reducing health care costs over expanding insurance coverage, which dates to his campaign, reverses Democrats’ priorities of recent years. Obama advisers say the focus on cost savings has appeal for all Americans, not just the uninsured. Some advisers, including veterans of the Clinton administration, say President [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. ’s emphasis on covering the uninsured helped doom his health care plan in 1994.
“We have made cost control a coequal objective, just as important as the expansion of insurance coverage, which has traditionally been the dominant goal for Democrats,” said [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. , the White House chief of staff. “The entire discussion has to be centered on controlling or reducing costs.”
That rationale has been Mr. Obama’s answer to those who, after his election, predicted that he would have to shelve his campaign promise to overhaul health care to attend instead to an economy in crisis. “If we fail to act, premiums will climb higher, benefits will erode further, the rolls of the uninsured will swell to include millions more Americans, all of which will affect your practice,” he told the A.M.A. members.
The practical problem for Mr. Obama is that by all accounts, the savings and efficiencies he envisions will not occur quickly, certainly not in the 10-year time frame of budget scorekeeping for purposes of passing legislation.
The budget office estimated that 39 million people would get coverage through new “insurance exchanges.” But at the same time, it said, the number of people with employer-provided health insurance would decline by 15 million, or about 10 percent, and coverage from other sources would fall by 8 million.
In effect, the office said, millions of people would get a better deal if they bought insurance through an exchange because they could qualify for federal subsidies not available if they stayed in their employers’ health plans. Subsidies are expected to average $5,000 to $6,000 a person.
Mr. Obama assured skeptics in the audience: “You did not enter this profession to be bean counters and paper pushers. You entered this profession to be healers. And that’s what our health care system should let you be.”
On Wednesday, leaders of the Senate Finance Committee hope to unveil what will be the one bipartisan measure in Congress.
Democrats on three House panels continue to meet privately to seek consensus on a single plan. Democrats on the House Ways and Means Committee said they were trying to decide whether to finance coverage of the uninsured with one broad-based tax, like the value-added tax, or a combination of smaller taxes.
The value-added tax, common in other countries, is collected in stages from each business that contributes to the production and sale of consumer goods. Economists say a 5 percent VAT could have raised $285 billion last year.
But a VAT could violate Mr. Obama’s campaign pledge not to raise taxes on households with incomes under $250,000 a year.

[nohil-billy]

The government-funded $10 tomato

By [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link.


How could we end up with a $10 tomato? The prices of tomatoes, potatoes, breakfast cereal and other commodities are generally kept fairly low because consumers control what they buy. No matter what we do in our current system of shopping, we will not see a $10 tomato until Obamanomics causes hyperinflation and we begin using tomatoes as currency.


However, there is one other way that we could see a $10 tomato. That is if we get government involved in the food industry. For starters, the government could start a grocery insurance system for retired people to ensure sure that all retired people could afford groceries. This system would also be utilized by wealthy retired people, even by those who owned grocery stores and tomato farms. It could also be used by persons who were disabled; and a similar but separate system could be initiated for people who fall below a certain income level. One benefit of this system is that confused [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. (such as me) would have fewer products from which to choose. The government would have lists of groceries that were acceptable, others that were off-limits. Perhaps there would be only about five breakfast cereals and only one type of our hapless tomato offered to individuals on the Government grocery plan.


Of course, we have to get much more complicated than this. Let's continue by making it impossible for retired people to purchase food outside this system. Then, the shoppers in this new system would pay a monthly premium for the privilege of using grocery stores. All of us would pay a federal grocery tax, the government telling us that we are paying for our future groceries. The groceries we will use in the future are not even seeds yet, but we've heard this before.


Complex paperwork would be required to enroll in these plans and even more would be needed any time someone went shopping, with a pre-authorization before placing any groceries into the shopping cart. Retired or poor shoppers would not pay for their tomatoes at the time of purchase. The grocery store would instead have to bill a government agency, "Foodicare", for the products that the shopper "purchased". In many instances a month or two later the grocery store would receive a statement, called an "explanation of grocery benefits". This document would explain why particular tomatoes taken home by a [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. did not fit the size requirements for government-subsidized tomatoes and payment would be denied. Of course, the customer has already eaten their tomatoes and the grocery store would be left holding the (grocery) bag. The same thing would happen with other groceries and pretty soon the grocery stores would end up with fairly large accounts receivable, inappropriately named because they would never receive the money. These would become government grocery write-offs.


The stores would have to offset their losses. What better way than to have private insurance companies offer larger amounts of [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. as insurance for payment of groceries? The government would be all for this, as it would not only substantiate the tactics that the government was using regarding payment for tomatoes but ensure that other people who previously actually paid for their tomatoes were primed and ready for government sponsored tomatoes once they hit the age of 65.


That, my friends is how you would see a $10 tomato. But, even the government has not been so stupid as to become involved in the grocery [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. -- yet. The same argument for becoming involved in tomatoes can be used as that for the government becoming involved in health care. Retired folk have lower income, food is a right and the government is here to help. Everybody should seriously watch out for the Obama tomato.


I have suggested a plan by which we could save [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. over the next five years in health care. For those who can't afford food the government provides food stamps, it does not get involved in the management, control and distribution of food. For those who can't afford medical care and medical insurance, any government (read taxpayer) assistance should take the form of health-care stamps. These would assist in the private purchase of basic health care, as well as help in the purchase of a good basic medical insurance plan, preferably an [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. . However, just as purchases over and above allotted food stamps today have to be made with personal [LINK POSTED BY MEMBER] Only Members Can View This No Hillary For President Forum Link. , purchases over and above allotted health stamps would also have to be purchased with personal funds and all health care would entail at least some personal financial stake.


Certainly, health care cannot be considered a right where food is not. I guarantee that a person can live a lot longer without health care than without food. Therefore, if we give Mr. Obama and his minions a chance, that is where his convoluted logic will take us, straight to the government subsidized $10 tomato.


So unless we want $10 tomatoes in our future and if we really want to reduce the cost of health care while maintaining the best health care quality in the world, it's time to put government in its place. Government intervention is the reason for exorbitant health care costs just as it would be the reason for the $10 tomato. And however you say tomato the whole thing would be pretty stupid.

[nohil-billy]

I just noticed that in the picture above, Obama's picture is captured while in a Messianic pose and on the podium to his right is the name Lazarus. I'm assuming that the Dr. before Lazarus was cut off by the photographer, but one would have to wonder if it was on purpose.

Obama, Messiah, Health Care, Raising Lazarus from the dead.... It's all too convenient to have been coincidental.