The press is singing the praises of Senator Harry Reid as an impresario of political tactics. Sadly, political tactics by the left and the right are what have most Americans most deeply upset these days.  It is clear that back room dealing is going on like never before and millions upon millions of tax payer dollars are being used by these “public servants” as their own personal poker chips.  Witness the pay off to Senator Mary Landrieu of Louisiana, totaling perhaps as much as one half billion dollars. Not that Louisiana does not need help, especially after the twin insults of Katrina and Rita, but Senator Reid is essentially buying votes (anyone recall the word bribe) for his health plan.

The Senate bill in many respects resembles the House version with some nuanced differences. The most notable – and laughable – is the opt out provision for states.  Senator Reid knows full well that states will not be able to opt out of any federal plan of this magnitude, when it includes confiscatory and selective taxation of individuals and industries.  Instead of facing the fact that the tax code needs to be overhauled so that ALL citizens pay taxes, they are offering this fairy tale called the opt out option.  Well it is not an option and Senator Reid and his senatorial cabal know that.  Expansion of Medicaid without a means for states to cover their matching costs is also a ludicrous suggestion.   This provision will place heavy tax burdens on poorer states creating greater flight from those states among the entrepreneurial and business class, who are the job creators.

Additionally, the marriage of the federal government to abortion on demand, continues to fuel the subtle subterfuge of the political operatives in Washington DC as they attempt to find methods to slip tax  payer funding for abortions into the final bill.  This is creating a huge backlash from many religious groups who oppose abortion as a civil rights issue, thus adding an unneeded layer of opposition to any meaningful reform.

It is the belief of many, that the sole focus of both the House and Senate bills is in the end, to create untenable situations that many on the left think will lead to a single payer, federally controlled health insurance system and therefore, by default, a federalized health care system.  Unfortunately, none of this is necessary or needed.  The House and Senate could easily (and by now have done so) pass single focus issue reform to address the most egregious issues facing Americans.  Eliminate the ability of health insurers to deny coverage for pre-existing conditions.  Eliminate the ability of health insurers to drop persons who become ill.  Allow sale of health insurance across state lines to increase competition.  Force health insurers to rate based on ALL subscribers, not on subsets or isolated groups of individuals. Those four items alone would go along way to solving most of the problem faced by the uninsured.  Mandating personal responsibility for coverage would also be helpful with those persons refusing to buy personal coverage, being subscribed into Medicaid, but at a high premium/fee/penalty automatically.

Oh well, simple, common sense solutions are not what the political class is interested in, not when you can hide the pork and your true intentions inside 2,000 + pages of legalese and political doublespeak.  Americans, real health reform is not this complicated.  Wake up . . . obi jo

Now it is Senator Harry Reid’s health care bill.  The majority leader’s deep personal involvement in assembling the overhaul of the health care system — now on the brink of a historic Senate debate — has, for better or worse, conferred ownership of the legislation on Mr. Reid, Democrat of Nevada.  Should Mr. Reid shepherd the measure successfully through the Senate and meld it with the House version into final legislation that President Obama can sign, it would be the biggest accomplishment of his career. Should the bill fall victim to the complex political, procedural and substantive fights raging around health care, it would be a stinging defeat for him, his president and his party — all while he faces a tough re-election fight at home.  Colleagues say Mr. Reid’s extensive knowledge of Senate tactics and well-honed understanding of what drives and divides his Democratic colleagues leave him well positioned to pull off a legislative coup that has eluded seasoned and determined lawmakers for decades.

Reid, as Legislative Tactician, Takes Ownership of Health Care Overhaul - http://www.nytimes.com/2009/11/20/health/20reid.html?ref=us

Democratic leaders in the Senate on Wednesday unveiled their proposal for overhauling the health care system, outlining legislation that they said would cover most of the uninsured while reducing the federal budget deficit.  Senator Harry Reid of Nevada, the majority leader, said at an evening news conference that the legislation, embodying President Obama’s signature domestic initiative, would impose new regulations on insurers, extend coverage to 31 million people who currently do not have any and add new benefits to Medicare.  Mr. Reid said the bill, despite a price tag of $848 billion over 10 years, would reduce projected budget deficits by $130 billion over a decade because the costs would be more than offset by new taxes and fees and by reductions in the growth of Medicare.

Senate Says Health Plan Will Cover Another 31 Million – http://www.nytimes.com/2009/11/19/health/policy/19health.html?bl

The Senate version of sweeping health legislation would cover five million fewer people than a companion bill passed by the House, but it would cost less, in part because Senate Democratic leaders felt they had to win support from fiscally conservative members of their party.   The Senate is expected to vote Saturday on whether to take up the legislation. The majority leader, Harry Reid, Democrat of Nevada, refused to say Thursday whether he had the 60 votes needed to clear that procedural hurdle. While the guts of the Senate and House bills are similar, Mr. Reid came up with a new method of financing coverage, not found in any other major health bill. His proposal would significantly increase the Medicare payroll tax for high-income people. The Senate and House bills would provide coverage to millions of the uninsured by expanding Medicaid and subsidizing private insurance for people with moderate incomes.

Senate Health Care Bill Faces Crucial First Vote – http://www.nytimes.com/2009/11/20/health/policy/20health.html?ref=policy

A coalition of Christian leaders — including the country’s Catholic bishops — put President Obama on notice Friday that it would vigorously fight any health care reform legislation that allows federal funding for abortions.  ”A health care bill can be a great, great blessing to our country,” Philadelphia Archbishop Justin Rigali said during a press conference Friday on Capitol Hill. “But we make a distinction between health care and killing.”  More than 150 Christian leaders, most of them conservative evangelicals and traditionalist Roman Catholics, issued a joint declaration reaffirming their opposition to abortion and gay marriage and pledging to protect religious freedoms. The 4,700-word document, called “The Manhattan Declaration: A Call of Christian Conscience,” was unveiled one day before the Senate is expected to consider it’s sweeping health care bill that includes a measure permitting abortion funding.  ”We’re counting on legislators to make sure that this is not part of what’s going to rule the lives of people,” Rigali said. “Any bill that has abortion in it has to be rejected.” New York Archbishop Timothy Dolan, who is among 15 Roman Catholic bishops who have signed the document, forcefully opposes overturning the decades-long restriction on federal funding of abortions.

Bishops Press Obama to Strike Senate Provision Allowing Federal Abortion Funding – http://www.foxnews.com/politics/2009/11/20/christian-leaders-issue-conscience-pledging-protect-religious-freedoms/

Sen. Reid’s health care legislation would expand Medicaid, but leave states with part of the additional cost. “We all know a sucker play when we see one,” said Republican Gov. Mitch Daniels of Indiana. Digging in for a long struggle, Republican senators and governors assailed the majority Democrats’ newly minted health care legislation Thursday as a collection of tax increases, cuts in services for the elderly and heavy new burdens for deficit-ridden states. Despite the criticism, indications were growing that Democrats would prevail on an initial Senate showdown set for Saturday night, and Majority Leader Harry Reid, the top Democrat, crisply rebutted the Republican charges. He said the bill “will save lives, save money and save Medicare,” the main health program for the elderly. The legislation is designed to answer President Barack Obama’s demand to expand coverage, end insurance industry practices such as denying coverage on the basis of pre-existing medical conditions, and restrain the growth of health care spending. Still, Republicans saw little to like Reid’s legislation awaiting the Saturday night Senate vote. ”It makes no sense at all and affronts common sense,” said Sen. Judd Gregg, one of several Republicans to criticize the measure. He added that a plan to expand Medicaid, the state-federal program for the poor, was a “bait and switch” with states as the victims. Republican governors, meeting in Texas, agreed. “We all know a sucker play when we see one,” said Gov. Mitch Daniels of Indiana. The bill would expand the Medicaid program, which provides health care for the poor, and leave the states with part of the additional cost beginning after three years. Medicaid is administered by the states.

Republicans Blast ‘Bait and Switch’ Health Bill – http://www.foxnews.com/politics/2009/11/20/republicans-blast-bait-switch-health/

Sen. Mary Landrieu, D-La., remained mum Thursday on whether she will deliver a crucial vote Saturday night to enable the Senate to debate health-care reform when it returns from the Thanksgiving holiday.But Landrieu has already succeeded in adding a provision to the 2,074-page Senate version of the health care bill unveiled this week that would provide Louisiana between $100 million and $300 million in Medicaid funding in fiscal 2011. While the Republican National Committee immediately charged that Landrieu has made a “backroom deal with (Senate Majority Leader) Harry Reid for her support of the government takeover of our health care system,” Alan Levine, Louisiana secretary of health and hospitals in the Jindal administration, said that even those who oppose the bill ought to be grateful that Landrieu used her leverage to try to fix the state’s so-called “FMAP” problem. ”Look,” said Levine, who has been lobbying the administration and Congress on the FMAP issue for eight months, “it’s good to have a senator in a position to be able to make demands like that.”
“While I don’t support the bill, she is doing the best she can to help the state, and she should be applauded,” he said.

Sen. Mary Landrieu holds off on taking health care stand, while pressing for aid for Louisiana – http://www.nola.com/politics/index.ssf/2009/11/sen_mary_landrieu_holds_off_on.html

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COMMENTARY:

As the Senate prepares to vote on its version of health reform this week – reform may be a very misused word in this case – we can reflect on what the House accomplished last week.

First, we learned that with strong partisan discipline you can get most of your ducks in a row and win a vote, regardless of the damage done to some of your own members.

Second, we learned that at least one Republican can be persuaded to vote with the majority, even if his motives appear very political, despite his comments to the contrary.

Third, we learned that those on the left will have to swallow hard if they want some version of their health reform agenda is to make it out of Congress and to the President’s desk.  They likely will, as the body politik (Democratic that is) has an agenda far more important to them than simply getting some folks health insurance

Fourth, we learned that our Speaker of the House is overly pleased with herself, even though the bill she presided over and ushered in is DOA in the Senate.

Fifth, we learned this past week that Madam Pelosi says she actually read the bill, however her version of “read” is that it was passed to three committees of staffers to review.  Not quite the same Ms. Pelosi, unless we are using Orwellian speech, which you seem to be fluent in.

Sixth, we learned that failure to comply with the individual mandate, could mean jail time.  We favor the individual mandate, but not necessarily with jail time attached.  Sounds like the socialist wing of the party (or is that just the party) is ready to enforce common sense principles with gulag like tactics.

Seventh, we learned, what many have already known, or at least suspected, that the type of health reform being offered by the Democrats has more to do with creating an unending, open ended commitment and entitlement, which will bring the middle class further under government control, enhance “wealth redistribution” and, thus, further the objectives of the central committee of the Democratic Party, which is ultimately to create a vast welfare state.

Eighth, we learned that real health reform remains elusive, as it seems the Democratic majority, and likely many in both parties, do not wish to take on health insurers face to face, but hide behind 2,000 pages of legalese.

In the end real health reform remains unavailable and elusive.  We have offered since day one a step by step approach to consider which would guarantee access, mandate personal responsibility and preserve a market system, which is the cornerstone of our nation.  We wish our Congress persons would take a fresh look and come back with meaningful, step by step reform that is just that, reform, not revolution . . . obi jo

Pelosi says she read the health care bill, Republicans push ideas – http://www.digitaljournal.com/article/282148

Committee Confirms: Comply With Pelosi-Care Or Go To Jail – http://biggovernment.com/2009/11/06/committee-confirms-comply-with-pelosi-care-or-go-to-jail/

Confessions of an ObamaCare Backer: A liberal explains the political calculus – http://online.wsj.com/article/SB10001424052748704795604574522680235765894.html?mod=rss_opinion_main

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Well, supposedly tomorrow will be the day for a vote in the House on HR 3962.  The House bill did receive a boost when it was endorsed by the AMA and AARP.  The AMA represents at best 20% of American physicians.  It is “in bed” with the government at many levels such as its ownership of the CPT coding language and guides.  As the AMA controls which treatments will be accepted for payment and which ones will not be accepted, they and the federal health cabal have a vested interest in supporting each other.  AARP on the other hand is looking to gain millions of new insureds both at the primary level and in the Medicare supplement market and Part D market (drug benefit).  While not all the motives of the AMA and AARP are self-serving, it is interesting that they both chose to support the House bill as is, rather than supporting reform and lobbying for a more perfected bill that is yet to come out of House and Senate conference (if and when the Senate can pass a bill at all, and assuming the House bill does indeed pass).  The House bill is not Real Health Reform, but it is real federal involvement, at the deepest level into the health care system.  Check out these interesting facts about HR 3962:

Speaker Pelosi’s 1990 page Health Care Bill

• $1.055 Trillion total cost
• $ 530+ million per page
• $ 2.5 million per word
• $ 385,504 per letter
• $729 Billion in new taxes
• $500 Billion in cuts to Medicare

The vote should be interesting and to be sure, it appears that the Democratic majority has the numbers to prevail, though this is by no means a sure thing.  Two major issues, access to tax payer funded health care programs by illegal aliens and use of federal funds for abortions are causing some Democrats, particularly the 50 or so who won seats in conservative states on President Obama’s coattails, to think long and hard about their vote.  Republicans, rightly, are concerned about the cost both in terms of real dollars and in cuts to the existing Medicare program.  It will be interesting to see where this ends up.  We have argued for Real Health Reform and sadly, ideologues, this time on the left, have gained control of the process and are pushing a bill that is a Trojan Horse for an eventual drive towards a universal, federal, tax payer funded health system . . . obi jo

Congressman Steve Scalise – http://scalise.congressnewsletter.net/mail/util.cfm?mailaction=clickthru&gpiv=2100049582.10402.378&gen=1&mailing_linkid=5262

The U.S. House of Representatives Committee on Rules – http://rules.house.gov/bills_details.aspx?NewsID=4465

H.R. 3962 – http://docs.house.gov/rules/health/111_ahcaa.pdf

Democrats wary of health-bill defections – http://www.washingtonpost.com/wp-dyn/content/article/2009/11/05/AR2009110505441.html

Temperatures rising on healthcare bill: Pelosi sees win; Republicans demand to see pricetag – http://thehill.com/homenews/house/66659-temperatures-rising-on-healthcare-pelosi-sees-win-gop-demands-pricetag

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It is typically American to wish to be independent in thought and action.  That typical American attitude serves us all well most of the time.  However, that attitude also carries with it a responsibility to accept the consequences of our actions, or inaction.  Too often we want our cake and eat it too.  We do not want to be told by anyone, especially government, what to do.  Yet, when we become ill or injured, we expect the health system (which means people: doctors, nurses, medical staff and medical facilities) to take care of us and never mind the cost please.  Also, don’t ask me to pay the bill . . . didn’t you know, I don’t have any health insurance.

In the case of health insurance, we have argued, against our basic instincts, that it is an individual responsibility to obtain and maintain health insurance.  Businesses and employers are not health insurers and should, we believe, over time be removed from the burden of having to obtain, maintain, oversee and administer health insurance for their employees. As we have long ago posted our plan for Real Health Reform.  The first 5 elements we articulated under “the plan” related in fact to the individual mandate (as it is now called in the on going Congressional debate).

1. All persons must have health insurance from the private sector or government sponsored plans.

2. Proof of insurance would be required to get any type of license, enroll in school, apply for job, yearly confirmation will be required, etc. just as with automobile insurance.

3. Fine of $1,000 if presenting to Doctor, Hospital, etc., for service without insurance, and must pay all expenses for services.

4. The truly financially disadvantaged should be folded into the current Medicaid system with revisions; in that they should pay needs based premiums. As such, Medicaid, Medicare, disability, workers compensation, Government employees, Veterans, Retirement and children’s programs would not be significantly changed.

5. All company-sponsored programs would be phased out over three years (better than a tax break).

Many conservatives and civil libertarians will take offense at our position on this and we acknowledge that this position is in contrast to our natural tendencies in regard to personal freedoms.  Nevertheless, we cannot have real health reform without citizen responsibility being part of the equation along with meaningful health insurance reform and regulation . . . obi jo

“The Plan” Key Features – http://realhealthreform.wordpress.com/the-plan/

As health legislation advances, outrage is building in the blogosphere and elsewhere at the idea that the government would force people to buy a commercial product if they did not want it or could not afford it. Opponents also argue that forcing people to buy one commercial product opens the door to forcing them to buy others. One goal of the legislation has been to expand health insurance to everyone _ including people who do not want it, because only then, proponents argue, would the risk pools be broad enough to make insurance more affordable. Congress is debating how much to penalize people who do not comply, seeking an amount that is high enough so that they do not simply opt for the fine rather than buy insurance.

U.S. Has Right to Require Insurance, White House Says – http://prescriptions.blogs.nytimes.com/2009/10/30/us-has-right-to-require-insurance-white-house-says/

The requirement that everyone buy health insurance moved a step closer to reality last week — and possibly a step closer to being challenged in court.  Conservatives and libertarians, mostly, have been advancing the theory lately that the individual mandate, in which the government would compel everyone to buy insurance or pay a penalty, is unconstitutional. All five committees in the Democratic-led Congress that have taken up a health care plan this year have supported an individual mandate, with the Senate Finance Committee upholding the idea last week. The bills grant exceptions for a variety of reasons, including religious objections and financial hardship; they also exempt American Indians.  Throughout the nation’s history, the federal government has imposed its will in various ways, of course, whether through military drafts, the advent of the federal income tax or the requirement that working people contribute part of their earnings to Social Security.

Still, a health insurance mandate would in many ways be new for the United States. In 1994, during the debate over the Clinton health care plan, the Congressional Budget Office described an individual mandate as ”an unprecedented form of federal action.”Those favoring an overhaul of the health care system say that requiring everyone to carry insurance is essential to making insurance affordable, chiefly by broadening the risk pool to include those who are young and healthy and go without insurance now. The insurance lobby would not support overhauling the system without the individual mandate. President Obama supports it too, although during the presidential campaign last year he supported a mandate for children only.

PRESCRIPTIONS MAKING SENSE OF THE HEALTH CARE DEBATE; Insurance Mandate: The Legal Issues – http://query.nytimes.com/gst/fullpage.html?res=940DE4DD1F3DF934A1575AC0A96F9C8B63&scp=1&sq=Seelye+and+mandate&st=nyt

“Freedom is not created by government, nor is it a gift from those in political power. It is, in fact, secured, more than anything else, by those limitations I mentioned that are placed on those in government. It is the absence of the government censor in our newspapers and broadcast stations and universities. It is the lack of fear by those who gather in religious services. It is the absence of official abuse of those who speak up against the policies of their government…Jefferson, in his first inaugural, spoke for his countrymen when he said, ‘A wise and frugal government, which shall restrain men from injuring one another, which shall leave them otherwise free to regulate their own pursuits of industry and improvement, shall not take from the mouth of labor the bread it has earned, This is the sum of good government…In America, it is the Government that works for the people and not the other way around.”

President Ronald Reagan’s words articulated in a major address on America’s Economic Bill of Rights on July 3, 1987

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If health reform is to be meaningful then all must contribute.  Currently, the bottom 75% of those filing tax returns pay only about 3% of all federal income tax.  That does not figure in the tens of millions who do not file returns under current tax law.  The Democratic bill in the House aims to transfer almost $500 billion dollars of personal wealth over the next 10 years to subsidize health insurance for some 35 million + Americans, and in the end, despite protests to the contrary, quite possibly another 12-20 million illegal aliens.  The proposed 5.4% “surtax” will be on top of the 39.6% rate increase on marginal income to become effective in 2011.  This will bring the top marginal rates to 45% at the federal level, before taking into account state income taxes, local income taxes, sales taxes, property taxes, capital gains taxes and other incidental taxes and fees.  The House bill, at nearly 2,000 pages, is a bureaucrats wish list come true.  It involves, fees, committees, panels, reviews, and more red tape than we have seen in many years.

Health reform does not require this amount of federal taxation.  Congress has been for too long simply unwilling to regulate health insurers in a meaningful way.  Some believe this is because Congress is heavily “in bed” with the insurance industry via lobbying as well as political contributions.  All in all, this is a bad bill.  The House likely cannot do better, given their ideological viewpoint.  The most simple reforms seem unable to be addressed in a straightforward manner. Such as removal of all pre-existing condition exclusions.  Maybe Congress could try that one in a one page bill.  And then vote on that one up or down.  Is that too hard? . . . obi jo

Who Pays Income Taxes?  – http://www.ntu.org/main/page.php?PageID=6

The typical family would be spared higher taxes from the House Democratic plan to overhaul health care, and their low-income neighbors could come out ahead. Their wealthy counterparts, however, face big tax increases that could eventually hit future generations of taxpayers who are less wealthy. The bill is funded largely from a 5.4 % tax on individuals making more than $500,000 a year and couples making more than $1 million, starting in 2011. The tax increase would hit only 0.3 % of tax filers, raising $460.5 billion over the next 10 years, according to congressional estimates. But unlike other income tax rates, the new tax would not be indexed for inflation. As incomes rise over time because of inflation, more families — and more small business owners — would be hit by the tax.

These are very big numbers and very high effective tax rates. The new health care tax would come on top of other tax increases for the wealthy proposed by Obama. The top marginal income tax rate now is 35%, on income above $372,950. Obama wants to boost the top rate to 39.6% in 2011 by allowing some of the tax cuts enacted under former President George W. Bush to expire. House Democrats said they are proud that they found a way to finance the health care package largely from a tax on the wealthy. There is, however, little appetite for a millionaire’s tax in the Senate, and some tax experts think it is a mistake to tap only rich people to pay for services used by all. “If health care is a benefit that is worth having, then it’s worth paying for,” said William Gale, who was an adviser to President George H. W. Bush’s Council of Economic Advisers and is now co-director of the Tax Policy Center. “This gives the impression that it’s only worth having if someone else pays for it.”

Under the bill, individuals are required to obtain health insurance coverage or pay penalties, which are described as taxes in the legislation. The penalty would be equal to the cost of an average insurance plan or a 2.5% tax on incomes above the standard threshold for filing a tax return, whichever is less. There would be waivers for financial hardships. To help afford insurance, families with incomes up to four times the federal poverty level would qualify for subsidies. The poverty level for a family of four is $22,050 this year. Republicans argue that the penalties violate Obama’s tax pledge, and they liken the millionaire’s tax to the Alternative Minimum Tax, which Congress enacted in 1969 to ensure that wealthy Americans cannot use loopholes to avoid paying any income taxes. The AMT was never indexed for inflation, so Congress must enact a fix each year to spare about 25 million middle-income families from being hit with big tax increases.

Health care plan hits rich with big tax increases -
http://www.neworleanscitybusiness.com/uptotheminute.cfm?recid=27670&userID=0&referer=dailyUpdate

More and more, the Great Health Care Debate of 2009 is a numbers game. And the longer the debate goes on, the squishier the numbers seem to get. For months, many leading Democrats, including President Obama, have pushed for the creation of a government-run insurance plan to compete with private insurers. A main argument was that a public plan would save people money. It would not be under pressure to earn profits, pay high private-sector salaries or deny needed care. But after House Democratic leaders unveiled their health care bill on Thursday, the Congressional Budget Office said the public plan would cost more than private plans and only six million people would sign up. One reason the public plan would not save customers money is that it would have to negotiate payment rates with doctors and hospitals just like private plans.

To Bend the Health Care Debate, Curve the Numbers – http://prescriptions.blogs.nytimes.com/2009/11/01/changing-numbers-make-meaning-even-more-elusive/

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Two bills recently advanced in the House will be coming up for debate in the near future.  The first is the already infamous 1990 page “monster” bill, HR 3962, which is the House version of health reform.  At almost 2,000 pages, it would have to be deemed a entire body makeover, not reform.  However, when one begins to read the bill, one finds that large sections, perhaps as much as 40% is devoted to the Indian Health Service and penalties for various failures at obtaining or implementing reform.  In fact, there remains too much legalese and double speak about the most simple reform issues, such as elimination of pre-existing conditions exclusions.   The second bill, HR 3961, has to do with physician Medicare payment reform, repealing the despised SGR (sustainable growth rate) with a new, less complex it is hoped, formula.  To be sure, SGR reform will continue to garner support of organized medicine groups and it is likely to help obtain some of that support for HR 3962.  Still, this is sad politics, as the SGR issue should have been addressed a decade ago, and seems to be getting attention now only for political reasons.

Real health reform does not require 2000 pages of text. It requires simple steps, such as we have outlined in “the plan” to address the basic needs of the system.  We remain hopeful that in conference committee and upon final vote, that sanity will prevail and a more streamlined, meaningful final bill will emerge out of all this posturing . . . obi jo and jomaxx

H.R. 3962 – http://docs.house.gov/rules/health/111_ahcaa.pdf

H.R. 3961 – http://docs.house.gov/rules/health/111_sgr1.pdf

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Emboldened by polls suggesting that a majority of Americans favor inclusion of a public option, Senator Reid has “forced” a public option into the Senate combined bill.  He has tried to take the “sting” out by including a so called opt out for the states.  He knows full well that this is a straw dog.  A fully federally funded program of this magnitude – it will impact 1/6th of the US economy – cannot be opted out of by any state, certainly not for long.  Knowing this, he and the new version of Silent Cal, Silent Barrack (at least when it comes to committing on the health care reform debate, as we all know the President does love to talk), have put together the opt out to give the appearance of fairness.  Sadly, this is classic Washington DC politics at its worst.  It remains unclear and subject to speculation as to why the Congress and President will simply not endorse regulatory reform and oversight of the health insurance industry as the most economical and logical method to solve most of the real health reform issues at hand.  Clearly, a broader agenda must be in mind, one that will in the end have the federal government controlling, or at the very least determining, the direction of health care in the United States.  Real Health Reform does not need slight of hand and political tactics, just leadership and courage . . . obi jo

straw dog – http://www.urbandictionary.com/define.php?term=straw%20dog

SILENT CAL COOLIDGE – http://www.suite101.com/article.cfm/presidents_and_first_ladies/25803

While the headline news from Harry Reid was about the public option, which is firm and in stone, on several other fronts, the deal has not completely been made. A Senate leadership aide close to the negotiations emailed me that on issues of affordability and coverage subsidies, among others, Reid is sending 2-3 versions to the CBO, and then will choose the option which covers the most people and saves the most money for the federal government. So we’ll have to wait a while longer for a public bill. I’m working on some of the other details of the most defined measure in the bill thus far, that public option with an opt-out.

Senate Health Care Bill Still Unsettled On A Host Of Issues – http://news.firedoglake.com/2009/10/26/senate-health-care-bill-still-unsettled-on-a-host-of-issues/

In a dramatic sign of Democrats’ growing confidence that they have the votes to pass a far-reaching health care overhaul, Majority Leader Harry Reid, D-Nev., said Monday that the bill he sends to the Senate floor next month will include a nationwide “public option” plan.  The provision would allow the federal government to create a medical insurance plan to be offered to Americans who do not get coverage at work as an aternative to private policies — with the proviso that individual states could opt out. “While the public option is not a silver bullet, I believe it’s an important way to ensure competition and to level the playing field for patients with the insurance industry,” Reid told reporters at the Capitol.
“Under this concept, states will be able to determine whether the public option works well for them and will have the ability to opt out, if they so choose.”

Reid includes `opt-out’ public option in latest health-care bill – http://dailyme.com/story/2009102600004422/reid-includes-opt-out-public-option-latest.html

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It would seem that heath insurers are following the lead of credit card issuers in “adjusting” rates, deductibles and co-pays ahead of anticipated federal health legislation.  Sadly, when Congress did pass credit card reform legislation, they allowed a window before it became law resulting in massive increases in credit card interest rates, balance allowances, fees and penalties.  Any school age child could have anticipated that, but Congress nevertheless seemed oblivious – or is it complicit – in allowing financial institutions to take advantage of that window.

Could the same scenario be playing out again in regard to health insurance?  It some respects it would seem so.  Health insurers, just as their financial brethren did, are adjusting their financial underpinnings to guard as best they can against any major reduction in profits.   The public needs to be aware of this and take what measures they can to offset the increases in premiums, co pays and deductibles.  Sadly, Congress is looking to limit rather than expand Health Savings Accounts and Flexible Spending Accounts, which if adopted by more in the middle and upper class could go a long way to easing the hikes being imposed on businesses and individuals by health insurers.  Expansion, not reduction of HSA and FSA accounts should be part of real health reform.  Sadly this Congress and President are not about limiting costs to tax payers, but increasing those costs unnecessarily . . . obi jo

Health savings account – http://en.wikipedia.org/wiki/Health_savings_account

Health Savings Accounts (HSAs) – http://www.ustreas.gov/offices/public-affairs/hsa/

Whatever you do with your health benefits during the current open enrollment season for 2010, there’s a good chance it won’t be what you did last year. The time-honored “evergreen” option — defaulting to your current plan — may simply no longer be an option. Either your employer no longer even offers that plan, or the terms may be so radically different that you may no longer want it.  With so much in flux, this may be the year you will need to switch health plans.

Scrutinizing 2010 Insurance Options – http://www.nytimes.com/2009/10/24/health/24patient.html?emc=tnt&tntemail0=y

Most people choose more insurance than they really need.  Such overstuffed choices may have been fine back when premiums were low. But in the last 10 years, the contributions of workers for family health insurance coverage have risen 128 percent — from just $1,543 a year in 1999, to $3,515 in 2009, according to the Kaiser Family Foundation.  So whatever rules of thumb you might have used in the past, here are some general guidelines to help you select the right plan for right now.

Picking the Right Health Insurance Plan for Right Now – http://www.nytimes.com/2009/10/24/health/24patientbar.html?emc=tnt&tntemail0=y

AND now comes the pitch: What can you do to reduce health care costs? During the open enrollment season for employee benefits, now under way for next year, you are likely to hear a whole lot about Consumer-Directed Health Plans. You, of course, are the consumer. And you’re being directed to save your employer a lot of money — so much so that many employers are offering workers lucrative incentives to make the switch into a consumer-directed plan.

Making Sense of High-Deductible Health Plans – http://www.nytimes.com/2009/10/17/health/17patient.html

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Well, it seems we are down to a “tale of two bills”.  The Senate version and the House version.  Both are now packaged and ready to go to conference committee.  It appears that Democrats have gotten their way on most all matters of contention, most specifically the inclusion of a public option in both bills.  The Senate version contains an “opt-out” provisions for individual states.  This is verbal tokenism as its worst, as no state will be able financially to opt-out of a federally financed program of this magnitude.  Certain members of Congress continue to insist that the public option will not cost taxpayers money.  Yet when questioned, and force to actually answer a question, they admit that tax payer monies will need to be used to start up the public plan and insurance exchanges – but it will all be paid back they insist.  Coming from the biggest deficit spenders in the world, that is hardly reassuring.  The House bill unveiled today has now grown into a morbidly obese 1990 pages.  Can health reform really require 2,000 pages? Is this really necessary?  Isn’t this supposed to be reform, not restructuring?  Many members of Congress, those on the left, are thrilled at the possibility of shoving their view of the world down the throats of the American people.  Real Health Reform should be about insurance reform mainly.  We have outlined options to do that.  It is not even clear that the combined House bill even fully addresses the main issues of pre-existing conditions fully.  Read the text of that area and see if you agree – there still appears to be ample wiggle room for insurers to deny coverage.  Real Health Reform does not require this, just common sense reform which can be written out on a single page,  as we have done . . . obi jo

‘‘Affordable Health Care for America Act’’ – http://docs.house.gov/rules/health/111_ahcaa.pdf

Speaker Nancy Pelosi stepped up the pressure on House Democrats on Friday to support her preferred version of legislation that would require the federal government to sell health insurance in competition with private insurers. Her action came amid indications that Ms. Pelosi had not locked down the votes for the proposal, the most contentious element in a bill that would provide health insurance to more than 35 million people, at cost of nearly $900 billion over 10 years.  Other provisions of the bill, including enhanced Medicare benefits, could take the total cost over $1 trillion, Democrats said. But they promised to offset the cost and avoid any increase in federal budget deficits.

Pelosi Intensifies Pressure for Public Health Plan – http://www.nytimes.com/2009/10/24/health/policy/24health.html?_r=1&emc=tnt&tntemail0=y

The House speaker, Nancy Pelosi of California, on Thursday unveiled an $894 billion health care package that would provide insurance to up to 36 million people by broadly expanding Medicaid, the state-federal insurance program for the poor, and by offering subsidies to moderate-income Americans to buy insurance either from private carriers or a new government-run plan. House Democratic leaders, citing cost analysis by the Congressional Budget Office, said the bill would reduce future federal deficits by about $30 billion over the next 10 years, meeting President Obama’s demand that the health legislation not add “one dime” to the nation’s indebtedness. Ms. Pelosi and House Democratic leaders have been working on the legislation for months, and the 1,990-page measure they rolled out on Thursday is a combination of bills approved by three separate House committees over the summer.

Pelosi Unveils House Health Care Bill – http://prescriptions.blogs.nytimes.com/2009/10/29/pelosi-unveils-house-health-care-bill/?emc=na

In pushing to include a government-run health insurance plan in the health care bill, the Senate majority leader, Harry Reid, is taking a calculated gamble that the 60 members of his caucus could support the plan if it included a way for states to opt out.  Mr. Reid met with President Obama at the White House Thursday to inform him of his inclination to add the public option to the bill, but did not specifically ask the president to endorse that approach, a Democratic aide said. Mr. Obama asked questions, but did not express a preference at the meeting, a White House official said.  Mr. Reid’s outlook was shaped, in part, by opinion polls showing public support for a government insurance plan, which would compete with private insurers. Speaker Nancy Pelosi said again Thursday that the House would definitely include a public option in its version of the legislation.

Senate Leader Takes Risk Pushing Public Insurance Plan – http://www.nytimes.com/2009/10/23/health/policy/23health.html?emc=tnt&tntemail0=y

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It is clear that the final vote on health reform is far from certain.  The recent setback demonstrated that Democrats are not lock step on reform ideas. To be sure, the vote in question affected a vocal, important minority – physicians and other health providers.  A minority that votes, but whose numbers seem to fail to move most elected officials to any distinct action on their behalf.  It is also clear that the American people as a whole have lost a great deal of confidence in the administrations health reform plans.  A wide variety of polls, such as Gallop and Rasmussen indicate that more and more, Americans feel that their own costs will increase with the current reform plan and that they really cannot understand it without details.

Given that the current drafts being reported by the senate conference committee range between 1,500 and 2,000 pages, actually longer than the House version of almost 1,100 pages, is it any wonder that responsible citizens are skeptical.  The Congress has shown itself to be anything but responsible when it comes to spending and it appears to lack the leadership to accomplish anything meaningful for the country.  Real Health Reform as we have argued from day one, can be accomplished simply, easily and with minimal costs.  However, radical elements from the left in the Democratic party, exemplified by Speaker Pelosi, are determined to move to a nationalized system of health care, while being sure to exempt themselves the the Executive Branch from having to participate.  Ms. Pelosi is the modern day Marie Antoinette, spouting “let them eat cake” while she and her political cronies opt out of any participation in the potentially noxious stew they are brewing on health reform.

We know that all may not agree, but our “plan” has outlined meaningful steps, even a few of which if adopted would make a dramatic change in the health insurance picture for most Americans. Yet, out Congress and President are hell bent on a radical makeover, when simple, common sense, regulatory reform would accomplish most of what is needed.  We can only hope that someone will stand up and lead us to Real Health Reform  . . . obi jo

Democrats lost a big test vote on health care legislation on Wednesday as the Senate blocked action on a bill to increase Medicare payments to doctors at a cost of $247 billion over 10 years. The Senate majority leader, Harry Reid, Democrat of Nevada, needed 60 votes to proceed. He won only 47. And he could not blame Republicans. A dozen Democrats and one independent crossed party lines and voted with Republicans on the 53 to 47 roll call. The Medicare bill has become a proxy for larger issues in the debate over legislation to overhaul the health care system. Mr. Reid said the bill, by averting big cuts in physician fees, guaranteed that doctors would continue accepting Medicare patients. But since none of the costs were offset or paid for, Republicans said it was fiscally irresponsible, and some Democrats said they shared that concern.

Democrats Lose Big Test Vote on Health Legislation - http://www.nytimes.com/2009/10/22/health/policy/22health.html?_r=1&emc=tnt&tntemail0=y

Senate Democrats Hit Snag With Doctor Payment Bill – http://www.nytimes.com/2009/10/21/health/policy/21health.html?emc=tnt&tntemail0=y

Trust on Issues:Voters Trust Republicans More On 10 Top Issues – http://www.rasmussenreports.com/public_content/politics/mood_of_america/trust_on_issues

49% Say No Health Care Reform Better Than Current Plan – http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/october_2009/49_say_no_health_care_reform_better_than_current_plan

In U.S., Half See Own Costs Worsening Under Healthcare Bill – http://www.gallup.com/tag/Healthcare.aspx

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