Socialist Vermont Shoots Down Super-Expensive Single-Payer Health Care

Gov. Shumlin of the highly socialist state of Vermont shutdown the necessary request to the legislature for the taxes needed to fund the Green Mountain Care state health plan.  This Vermont single-payer health plan was going to require an 11.5% payroll tax on businesses and a 9.5% income tax in addition to the income tax the state already has on those making four times the poverty level income or more.  Vermont already has a top income tax rate of 8.95%, a 6% sales tax, and a 8.5% corporate income tax.  Shumlin reluctantly admitted that the state could not levy such heavy taxes without putting many businesses out-of-business and without many businesses leaving the state.  He said that given that Vermont was still feeling the effects of the Great Recession, this was a particularly bad time to implement a state-run single-payer health system.

Vermont had initially estimated an annual cost of $2.2 billion for the plan for its 627,000 citizens.  The state had received $45 million to study the implementation of a single-payer system from the Obama's Department of Health and Human Services, which hoped Vermont would pave the path to a national single-payer or totally socialized medical system.  William Hsiao of Harvard and Jonathan Gruber of MIT served as consultants.  A more careful look by Vermont accountants put the increased tax revenue needed at $2.6 billion.  Vermont's total tax revenues now are $2.85 billion, so total state tax revenues would have to almost be doubled.  Projected revenues had to be scaled back by $75 million a year due to the lingering effects of the recession.  The state realized it would get $150 million less in federal cost coverage than they expected to set up the system and that they would get another $150 million less in Medicaid assistance from the federal government than they had earlier thought they would.  Setting up the plan was estimated to cost an additional $500 million.

As I have pointed out many times, it is a fiction that the business paid payroll tax is not paid by employees.  All payroll costs are a cost of employment for employees.  They are all compensation for the labor of all employees.  The greater the payroll tax, whether it is Workman's Compensation, unemployment tax, Medicare, Social Security, a withholding tax, an ObamaCare tax, or a Green Mountain Care tax, the lower the compensation that can be offered an employee.  If an employee's addition to the company revenue is not enough to cover all of these tax costs, all of his take-home pay, and other operational costs incurred to provide him with a job, then the employee is not hired or is let go by any rational employer.  This Green Mountain Care plan in Vermont was going to require a 21% increased cost of employment for a company's most value employees minus whatever the employer might be currently paying into health care plans minus whatever wage decreases ensued.  Employees closer to the poverty level would cost somewhere between 11.5% to 21% more depending upon the progressive explicit tax on their income.

As Gov. Shumlin noted, it was particularly difficult to impose these costs given the failure to recover from the effects of the Great Recession.  What is more, any knowledgeable observer has learned that the cost estimates for new government programs are almost always too low.  They are usually much too low.

Of course, while acknowledging that there was no way to practically implement a single-payer health system in Vermont at this time, Shumlin, as a good Progressive Elitist, continued to maintain that it was the Ideal.  Progressive Elitists never actually consider the costs of their programs to be too high and they never ask what the costs displace in other options individuals might have for their time, effort, property, and money.  Their choices and dreams always take precedent over those of others and they are willing to use force to make sure that every individual accedes to that precedence.

All this for a health care system that is sure to deteriorate into another shabby equivalent of the Veteran's Administration System of an unavailable, highly rationed, low-quality, wait-forever, bureaucratic, vindictive, and dishonest morass that treats its patients like peons.  Of course, individuals who do not retain their individual rights are just that -- peons, serfs, begging servants and dependents of the state.

There must be a few individuals in Vermont who are much relieved by the failure of this Great Socialist Dream.  Indeed, Gov. Shumlin nearly lost his re-election bid to Republican Scott Milne, who ran against the Shumlin-backed Green Mountain Care.  Would Milne have won the election if the newer costs and tax estimates had been made available before the election?  Only 2,095 votes separated the two candidates for Governor.

Socialized Medicine and a Doctor's Moral Obligation

A friend asked this question:

One of the arguments I have heard from proponents of socialized medicine is that it is immoral to stand by while someone dies, and therefore society is obligated to help when someone is facing a life threatening illness but can't afford the treatment. Although there is much to refute in this type of statement, I am wondering about the more difficult refutation. As a personal decision of each doctor, is it rational to make the decision to deny treatment based upon the fact of a patient's inability to pay?

The moral argument against socialized medicine, or ObamaCare in particular, is based on our equal, sovereign individual rights. It is not dependent upon whether a particular doctor decides that he must act to save a life independent of remuneration or not. It is an important moral principle that he is free to either be benevolent or not be benevolent. Now, I do believe benevolence is an important virtue, but benevolence is virtuous in the context that the person helped has value to the doctor.  Benevolence is not about self-sacrifice, since that would hardly be benevolent to oneself. 

If the person has an entitlement mentality, then the doctor generally has no rational reason to help that person without remuneration. It is perfectly moral for him to walk away. In the context of a society of largely productive and benevolent people, a doctor may be rationally inclined to provide help to those who cannot afford to pay for their care, especially if they have become ill or hurt through no great fault of their own. But, even that depends on context, such as the expense the doctor will have in helping him and whether his helping the unfortunate person means that he is not able to help someone else who can pay. He is not obliged to save the poor man, while letting the financially prepared man die! If he gives too much of his time to helping the poor, he may not be able to generate enough income to buy the medical equipment that will enable him to save many lives in the future or he may simply go out of business. The doctor must make difficult moral decisions based on a very complex context. Some may appear to make a greater effort in benevolent acts than others, but still may not be saving the most lives possible.

Rational men are going to balance these difficult decisions differently and we should be careful in our appraisals of their morality.  A doctor may be willing to give his services free in a given case, but he may be unable to convince a nurse and other assistants to give their time free.  Or the hospital may be unwilling to make an operating room available.  Now the proponent of socialized medicine will want to use force to make all of these needed experts and facilities available, but this is a violation of everyone's rights and cannot be tolerated in a civilized society.

My grandfather was a physician in the Great Depression. He was a surgeon who operated in the Mayo Clinic and all of the hospitals of Minneapolis and St. Paul. He did a very unusual number of operations on people who could not pay for them. But, people were different back then. A farmer might not have any money, but he would give Harry Christianson a chicken, which to the farmer was his fortune. Then very likely for 20 years after, when he could, he would stop by grandpa's home and leave a bag of potatoes or a bushel of corn. This was very welcome when rationing was going on in WWII for instance. Harry and his wife Bess always had free food and there was so much that Bess and her daughter Betty organized ways to get it into the hands of those in need in the city. One man decided he would paint grandpa's house in payment for an operation, but while he was painting the upper part of the exterior, union thugs knocked him off the ladder and shattered his leg. The man was not a union painter. He was just a farmer who wanted to pay a debt he believed he had. Harry and Bess put him up in one of their rooms until he was healed. The union later burned down their home because they did this.

So this is another important issue of context. There is value in helping people who put value on the help they receive. There is value in helping people who fundamentally believe that one should trade values for value.

There is little value in helping the ungrateful, however. Any deserving person, any person whose welfare one has reason to care about, will recognize the value they have received and will not presume that they have the rights of a master, while the doctor who worked so hard to develop his healing skills and knowledge is treated as his slave.  A doctor or any other service provider has the right to choose his own values and to pursue his own happiness in terms of his values.

The need of a poor person does not deprive him of this equal individual right to pursue his happiness.  Every man, whether poor or rich, whether a professional or a low-skilled worker, has this magnificent right to pursue his happiness.  No one has the right to dictate the values or the moral code which will define what his happiness will be.  All that can be required of another is that they are not allowed to initiate the use of force as a means to pursue their happiness.

This is very adequate for each of us when we exercise our freedoms and act within the private sector of our society.  In the private sector we have a wealth of potential opportunities to cooperate with others whose values are sufficiently similar to ours or in some way complementary so that each of us can pursue our goals defined by our individually chosen values.  When our values are not approved of by others, they are free to choose not to associate with us.  This is the realm of the voluntary and is relished by those who want rich choices and who abhor being forced to bend to the will of others.

In contrast to this natural realm of freedom, we have the realm of the government.  The principal property of government is its monopoly on the use of force in a society.  Because a wise society seeks to minimize the use of force and seeks to maximize individual freedom of choice and association with others, such a society has a minimal government.  Such a limited and legitimate government uses force only for the purpose of protecting the equal, sovereign rights of the individual to life, liberty, and the pursuit of happiness.

When government attempts to do more, it must necessarily do violence to the rights of the individual as it imposes values and moral codes upon the People.  With this loss of freedom to choose one's values, one loses many of the freedoms to use one's own mind.  One loses the choice of one's own goals.  With the loss of one's own goals, one loses all hope.  It is no accident that unfree societies become depressed societies with large increases in drug use, excessive alcohol use, and increased numbers of suicides.  Big governments do much harm to individuals and are notable in the brutally of their violence against their people should any insist on exercising their sovereign rights.  We see the party of biggest government verging close to a desire to let loose the hounds of hell upon the Tea Party people for just this reason.  Over and over they have tried to label the Tea Party people who simply want to preserve some of their individual rights as terrorists and subversives.  This makes the brutal nature of unlimited government all the more clear in our time.

A Step to Force Medicare Advantage Insurers into Bankruptcy

The 11 million seniors on Medicare Advantage plans administered by private health insurance companies are about to be given new premium and co-pay rates.  Despite medical care costs going up 6% this year, the Obama administration sent letters to Well-Point Inc., Cigna Corp., BlueCross BlueShield Association, and Health Care Service Corp. that they must not increase their premiums and co-pays this year, according to an article in the Wall Street Journal on 7 June 2010.  This is part of the Obama effort to minimize citizen anger at the ObamaCare bill.  These insurers and others had planned to cut back on services offered and to increase payments required.  The bill itself requires government payments to be cut by $136 billion by the end of the decade, but those cuts do not begin until 2012.  The present cost freeze implied by the Kathleen Sibelius letter was not in the bill.

It is appropriate for the government to determine how much of the costs of Medicare Advantage it will pay.  At least it would be if the government had any business being in this business at all.  It is not right for the government to mandate what the costs of such plans offered by private insurers will be or can be, however.  The insurance industry estimates the insurance payment cuts on Medicare Advantage over ten years will be about $200 billion.  They do not see any way to offer these plans without cutting the services offered or raising the payments charged to the Medicare Advantage customers.

The Obama thugs are also planning to announce $250 million in grants to the states to fund their toughening insurance premium regulations.  The grip of state and federal government on our health care insurance industry is tightening.  The plan is to make it impossible for private insurers to make money in the health insurance market, just as the plan is to bankrupt all coal-fired electric power plants.  When insurers have stopped offering health insurance or have gone bankrupt, the socialists will institute the tyrannical plan they have always wanted: a single-payer plan, that is, a government payer plan, that is a taxpayer massive redistribution of income plan.

Deciding Who Lives and Who Dies

Thomas Sowell has just written a column called A 'Duty to Die.'  As is always the case, he makes a good point, in this case about nationalized medical systems.  His main point is that when he grew up in poverty in the Southeast, his family took in an old aunt and cared for her for a while.  The old aunt moved from family to family so no one family was too much burdened, but they all willingly took their turns.  Now, he points out that we live in a culture in which very many of the best educated have learned that the old simply have a duty to die so they will not be a burden on the rest of us.  He points out that this harkens back to primitive societies so strained in resources and so marginal in their survival, that the old had to wander off into the wilderness alone to die.

This issue has long been bothering me.  Those who claim that they are so concerned about their fellow man and his welfare that they believe it is right to use government force to manage scarce medical services resources to provide for the poor or for those who simply do not choose to buy their own health insurance, have taken it upon themselves to make the decisions of who will live and who will die.  In the not too distant past, this decision in the United States was made by a combination of the following filters:

• A lifetime of hard work and savings by an individual provided sufficient money or a substantial part of the money needed for either adequate health insurance or savings for medical care.
• Family members volunteered to help financially or with direct care services.
• Friends did the same.
• Many physicians volunteered their services to those in medical need who could not afford to pay, as my own grandfather did for thousands of patients, especially during the Great Roosevelt Depression.
• Charities provided financial aid and medical services.

As Great Britain  is already doing and we will have to do under ObamaCare, decisions are being made more and more by medical and governmental bureaucracies about who will live or die.  The socialists who favor this approach like to say such things as:  The life and death decisions are now made scientifically by specialized panels on the basis of broad categories of cost, the likelihood of success, and the social worth of the patient based on the patient's age.  These decisions are made in the light of day and reviewed by the democratic vote of the citizens in general elections.  This, they say, is so much better than decisions made by soulless health insurers.  Now, note that they leave out the role of the individual in how he lived his life, the role of his family and his friends, and they assume that doctors do no volunteer work and that taking private charity is somehow demeaning, while taking government charity is not.

In a nationalized health care system, all those who either love the patient or who are voluntarily disposed to help the patient are removed from the decision-making process.  A "scientific" decision of how to spend the limited funds of the government medical program takes the place of all these people who may actually know the patient or who may evaluate the patient as an individual to determine if he or she is worthy of their voluntary help.  The government must make some kind of pretense of providing medical aid equally, so it must do so with no regard to individual character.  One of the easiest ways to do this is with the now inevitable rule of the form:  You are older than 70 years old and you have cancer which is expensive to treat, so you will not be treated.  Is this a more moral system for determining who gets medical treatment and who does not?  To me, it is clear that this system is designed in Hell.  The people who choose this system have no heart and are disloyal to every person of good character that they know.  They are betrayers of those they claim to love.  They are supporters of government-run death panels.

This is our future under ObamaCare

Dr. Smith, a young urologist in Great Britain was misdiagnosed three times for breast cancer by National Health Service General Practitioners and examined once by a Cancer Center in Oxford and told she had a benign cyst. Soon after, it was discovered the pea sized cyst was the size of a golf ball and the cancer had spread into her liver and spine.  Chemotherapy, radiotherapy, and hormone therapy have failed and she has 18 months to live.  She was months from her wedding.

Her condition is now stable and doctors believe she could potentially live for ten to 20 years with the tumours in her spine if they could operate to remove her liver cancer. It must be shrunk first, but normal chemotherapy has failed to do this.

Dr Smith has been told she needs Selective Internal Radiation Therapy (SIRT), a new treatment in which millions of tiny radioactive beads are injected into the artery which supplies the cancer, to deliver targeted radiation.

The treatment was approved in Europe in 2002 and has been used to treat 15,000 patients worldwide, including up to 300 in Britain. But Dr Smith's primary care trust in Ryde has refused to fund it because it has not been fully approved by the rationing body, the National Institute for Clinical Excellence (NICE).

The treatment costs 23,000 pounds and her regional zone in the NHS will not allow it, though other regional zones do.  Each zone has to ration the care provided to stay within their expenditure allotment.  Without the treatment, the NICE and her regional zone of the NHS have condemned her to death.  But, nice people do not talk about death panels.

Given the shortage of doctors in America, perhaps a hospital here should make her an offer.  They could offer to pay for her medical care in exchange for her agreeing to practice with them for a period of time during which she would pay the practice back.  I doubt the monolithic NHS in Great Britain has the flexibility to do the same, however much sense it would make.

Steyn -- The Nationalization of Your Body

Mark Steyn has written an article called The Nationalization of Your Body in which he points out, in total agreement with me, that ObamaCare means the end of our owning our own bodies.  He says ObamaCare will make the citizens dependent upon the state and illustrates this with the example of the United Kingdom.  He says:

When health care is the government’s responsibility, it becomes its principal responsibility. Because the minute you make government the provider of health care, you ensure that, come election time, the electorate identifies “health” as its number one concern. Thus, in a democracy, the very fact of socialized medicine seduces the citizenry away from citizenship. Buying health care is no more onerous than buying a car or buying a house – which, pre-Barney Frank, most Americans seemed able to manage. Indeed, most of the complications are caused by existing government interventions. If you were attempting to devise a “system” from scratch, you might opt for insurance for catastrophic scenarios and, for PAP smears and colonoscopies and whatnot, something similar to the tax breaks for a Simplified Employee Pension: C’mon, how difficult can it be? Back in the day, your grampa managed to go to the doctor without routing the admin through Washington. Matter of fact, the doctor came to grampa. That’s how crazy it was.

But the acceptance of the principle that individual health is so complex its management can only be outsourced to the state is a concession no conservative should make. More than any other factor, it dramatically advances the statist logic for remorseless encroachments on self-determination. It’s incompatible with a republic of self-governing citizens. The state cannot guarantee against every adversity and, if it attempts to, it can only do so at an enormous cost to liberty. A society in which you’re free to choose your cable package, your iTunes downloads and who ululates the best on “American Idol” but in which the government takes care of peripheral stuff like your body is a society no longer truly free.

Our Illegitimate, Fascist Socialist Federal Government

The House of Representatives has signed the Senate health insurance takeover bill and Obama will now sign it.  There is an intention to make some amendments to this bill, but in essence it will remain the same.

Americans are now to be forced at the point of a gun to buy health insurance mandated by the federal government.  The government will dictate what services are to be covered and many aspects of what will be charged for those services.  The government will dictate when and to whom these services will be provided, since it must ration health care severely.  Of course, it will bring on the rationing a bit slowly so that We the People will stay in the ever hotter water just as frogs do if the heat is turned up gradually.

What has been accomplished with this health insurance takeover bill?  We have been lied to over and over by the Democrats that our health insurance costs will go down, but they will actually go up greatly for almost all of us.  Companies will have to reduce employees' take-home pay in order to pay still higher health insurance premiums for their employees.  Or, they can drop such coverage and pay the fine, which makes no sense, because it converts something of value to employees as compensation into something of value to neither the company nor the employee.  Still, companies will take this option in some cases rather than to be subject to further hassles from the IRS about whether the employee health plans meet the government specifications.  In fact, the IRS management may mean that if a health care insurance premium payment is a day late, companies will be hit with the fines and interest that they are hit with for late payroll tax payments.  The main reason small companies go out of business relates to cash flow issues and the most rigid cash flow issues of all are payroll taxes.  Adding to this cash flow problem will drive more companies out of business and cause more to go to the lower tax penalty cost on health care insurance since that rigid payment will be easier to make than the larger rigid ever-escalating cost of the government-mandated health insurance plan.

The quality of health care will go down.  I discussed some of the reasons for this in my last post.  There are many other reasons, but some of them I have discussed in earlier posts and others will be discussed in future posts.  Health care rationing must become more severe, as I have discussed in numerous earlier posts, such as this one.

But, the main thing we have lost is a government that protects our individual right to our life itself.  It is now transformed into a fascist socialist government which claims we have no individual right to our own lives.  We have lost government protection of our right to manage our own health to preserve our lives, as an exercise of our liberty, and to allow ourselves a chance to actively pursue our own individual happiness.  We now have a socialist government which plans to heavily interfere with our exercise of this right by putting us under the armed and intrusive surveillance of the IRS and well over 100 government agencies, all of whom are mandated to make many of our health decisions for us.  We can be sure that this tangled web of power-seeking bureaucrats will evolve their role in that decision process to be ever more dominant with time.  Not only will we be enslaved to these many agencies, but we will have no possible way of knowing and complying with the almost innumerable requirements which will be put upon us.  Even if we could know them all, we could not comply, because these agencies will put contradictory requirements on us as surely as the sun will rise tomorrow.  With equal certainty, many of us will die long before we manage to comply with their mandates, because many illnesses will not wait long enough for us to comply.  Implicit in all of our loses, is our loss of the effective ownership of our own bodies.

Socialist governments are always hot to control three aspects of our lives.  They insist on controlling the education of the People, so they can control them and teach them to serve the state.  Obama has made it very clear that he wants even more control of the American education system than government already has.  He wants to control the funding for all student loans for college, the curriculum, and the research money for colleges to control the faculty.  Obama is in tight with the socialist teachers unions on the control of American education as well.

Socialists seek control of commercial activity, so they can control the People's productive work and their jobs.  The redefined interstate commerce clause and the failure to enforce property rights, contract rights, and commercial association rights have long been used to wrest considerable control of the private commercial sector and to extort it.  Obama has shown a socialist commitment to this purpose with his takeover of banks and financial institutions, the takeover of GM and Chrysler, the legislation on credit card use, and Senator Dodd's proposed new regulations on financial institutions and for "consumer protection."  Legislation promoting more unionization of the private sector will be next.  Many administrative rulings have already helped the unions, as has some stimulus bill money.  The effort to gain control of our energy use with the false claims of the catastrophic man-made global warming scare has been followed by the absurd EPA ruling that CO2 is a pollutant.  The socialists claimed the environment justified this further death grip on the private sector and this opened many more avenues for extortion.

Finally, every socialist government lusts for the bodies of it citizens.  It must possess them.  They always pretend to offer medical services as a concern for the welfare of the People in order to take over control of the very continuation of their lives.  By taking over control of their health care, they make the People fundamentally dependent in the most subject way.  The government gains control over how long people live and how much pain and suffering they will be subject to.  This is an immense power.  The power-hungry socialist loves this kind of power and again such power is very useful as a tool of extortion.

The evil of this mindset is beyond recognition to any rational, benevolently joyous individual who thinks that life on Earth should be and can be a wonderful and rich adventure.  We cannot comprehend it, but we can see that it is there.  Evil people do indeed exist and they exist in fairly large numbers.  The Framers of our Constitution were very aware of this and this is why they neither trusted to a democracy nor to any oligarchy of elitists.  They gave us a representative government and insisted that even that government live within the tight constraints of our Constitution.  That Constitution was written to so limit the powers of government that it was not supposed to be able to do anything more that protect our inalienable, sovereign individual right to life, liberty, and the pursuit of happiness.  Our Founding Fathers had already established the principle that no government was legitimate which did not protect these individual rights and do so equally in the Declaration of Independence.  They had already told us that a People have the right, and even the duty, to rebel and throw off the shackles of any government that violates the rights of the individual.

Our present government has made it clear that it has no intention of limiting its powers to those given it by the Constitution.  Obama told us long ago that he does not like the Constitution because it does not allow redistribution of income and forced servitude of individuals.  Indeed, our federal government has not limited its powers to those of the Constitution for a long time.  But, this government has set a new standard as a terrible tyranny.  It could not be more clear that this government intends to respect the individual rights of the People to life, liberty, and the pursuit of happiness not at all.  It clearly has its jackboot squarely on each of our necks and intends to crush any individual who does not meekly and docilely serve the socialist state.  Obama really meant it during the election when he said that service to the state was going to take on new meaning during his presidency.  He is using every trick of demagoguery, misdirection, lying, and extortion he learned as a Saul Alinsky community rabble-rouser to make the federal government a socialist tyranny.

Many of the American People have never put up with tyranny.  But, when the tyranny was Great Britain, there were Tories who were docile.  America today is full of Tories.  They are called Democrats.  The Obama government and the Democrat Tories have declared war on our most fundamental American value that the People, each and everyone, has the inalienable individual right to life, liberty, and the pursuit of happiness.  These are not collective rights.  These are rights each of us holds individually.  I have the right to my life and all aspects of its management.  I have the right to my liberty.  I have the right to choose my values and to manage my own life in accordance with those values.  I have the right to think for myself and to take action based on my own individual judgment.  I own my body, my time, and my labor.  I have the right to act in pursuit of my own happiness.  I have the right to manage my own health choices.  You also have these rights equally.

When the federal government has declared war by using arms and the threat of arms to deprive me of my individual rights, it has performed an act of war on me.  It has done the same to you.  Every individual has the right to defend his rights from those who use violence and extortion to deprive them of those inalienable rights.  Anyone who does not defend his rights is not really an American.  I am an American and I believe completely in the inalienable rights our Founding Fathers believed in and I believe completely in the Constitution which the Framers set up to protect our individual, inalienable rights.  I intend to defend the Constitution against this tyrannical onslaught of fascist socialism.

As the tyranny of Great Britain mounted before the American Revolution, the Founding Fathers and those who joined them, frequently disobeyed the illegitimate laws of Great Britain.  This might mean they did not always put the required stamps on their playing cards, pay the tax on windows, or they might dump tea into Boston Harbor, or they smuggled in goods to avoid tariffs.  Americans today often exceed the speed limit and round a few corners on reporting all of their income, but most of us obey the laws as best we can.  But, some laws, such as those requiring us to report our health care insurance to the IRS, we ought to start massively disobeying.  It is time to start telling this government that we will not bow docilely and place our necks under their hobnailed boot.  It is time to defend our individual rights and our Constitution with some civil disobedience.

In 2010, we must turn out of office every Democrat possible in the House of Representatives and the Senate.  We must replace these members of the socialist party with someone who has at least some commitment to our Constitution and to our inalienable individual rights.  I am sure we will not always get a really good choice, but we must still teach tyrants the important lesson that we will turn them out.  If we work with the Tea Party enthusiasts, we will be able to find many candidates who are at least a marked improvement over the present socialists of the Democrat party.  We must not let up, since we must turn out even more socialists in the election of 2012 and then we must become very serious about rolling back the socialist state.  We must return government to the role of protecting, not violating, our inalienable individual right to life, liberty, and the pursuit of happiness.

Doctors and the ObamaCare Shortage

The Medicus Firm, a national physician search firm based in Dallas and Atlanta, polled physicians about ObamaCare and its effects on them.  They reported the results in the New England Journal of Medicine.  Key results include:

• 62.7% of doctors believe health reform is needed, but want targeted and gradual legislation, not the massive ObamaCare bill.
• 46.3% of primary care physicians (family and internal medicine disciplines) believe ObamaCare will either force them out of practice or make them want to leave medicine.
• 72% of doctors believe a public option will have a negative impact on medical care.

According to the Health Resources and Services Administration of the Dept. of Health and Human Services, there were 306,100 primary care physicians in 2005 and there were 511,400 Non-Primary Care specialist physicians in 2005, for a total of 817,500.  ObamaCare will depend upon these physicians to deliver the increased medical care that ObamaCare is supposed to provide to 32,000,000 more people.  About 15,000,000 of these people are expected to be added to Medicaid, which is a program a great many physicians will not participate in now or will not accept new patients from that program.  Who does this tyrannical Democrat government think will provide these services?  Many physicians are already also declining Medicare patients, though that program has paid somewhat better than has the Medicaid program.  However, the scheduled cuts in Medicare payments even as more and more Baby Boomers will soon enter it and need more medical care must surely cause the Medicare program to shift even deeper into underpaying doctors for their services.  The huge deficit growth of the federal government must further push it to making still lower Medicare and Medicaid payments to doctors.  The terrible condition of many state governments will also decrease their ability to make their expected and required Medicaid payments.

The net result is obvious, unless you are a pig-headed, pie-in-the-sky, other-worldly Democrat!  Doctors are going to be very unhappy.  Probably more than they now think even, as the reality of these much lower payments set in, as the tangle of myriad federal agencies start giving the doctors incredible increases in paperwork and contradictory requirements, as the number of unhappy patients pile up in their waiting rooms, and as the reality of having even less time per patient than the already inadequate time now causes them to lose all confidence that they are able to do their work in a manner consistent with professional standards, they will become seriously depressed.

When their work comes to be the source of depression, many will leave the profession.  The claim that 46.3% primary care physicians will do so or will be unhappy should be taken very seriously.  Many physicians will retire early.  In fact, there is clear evidence that many have already been unhappy enough with the pre-Obama
Care medical profession that they have been retiring early already.  We can learn more by looking at the age distribution of physicians according to the Health Resources and Services Administration.

First, note that despite the growing population of the U.S. from 2000 to 2010, the number of physicians in the three younger of the five categories dropped.  This trend is expected to be the case in 2020 also.  The only age group of doctors with an increase from 2000 to 2010 is the 55 to 64 year old group.  These doctors are close enough to retirement age and probably largely well enough off, that they can readily retire if ObamaCare is passed later today, as it now appears it likely will be.  Many of these doctors will indeed retire early and that means they will not be practicing in the 65+ age category either in the near future.  Many of the doctors already in the 65+ age group will quite immediately.


Now let us look into the future to the 2010 projection.  Note that the projection is rather optimistically expecting the future number of physicians in the 55 - 64 age group to remain as high as it is now.  This would mean a larger fraction of those in the 45 - 54 age group will continue on into the next age group than did in the 2010 case.  Given the effects of ObamaCare, this will surely not be the case.  This number will drop considerably relative to the prediction here.  It will also be insane to believe that a larger fraction of doctors will continue to practice after age 65 than did in 2000 and 2010 after ObamaCare comes into play.

The bad news does not end here.  There is another contribution to decreasing services which we are facing even without ObamaCare, which is going to make ObamaCare much less supportable.  To quote the Health Resources and Services Administration:

Currently, one in four physicians is female, but two factors are contributing to a rise in female representation. First, during the past three decades the proportion of new medical graduates who are female has risen from 10 percent to close to 50 percent. Second, the growth in female representation is a relatively recent phenomenon, and it is predominantly male physicians who are nearing retirement age. Although one in three active male physicians is age 55 or older, only one in eight active female physicians is age 55 or older. Because work and retirement patterns differ systematically for male and female physicians, the increasing proportion of physicians who are female has profound implications for the overall supply of physician services. Female physicians are more likely than their male counterparts to choose non-surgical specialties and to spend fewer hours per year providing patient care. They are also less likely to work in rural areas, and they tend to retire slightly earlier.

So, the increasing shift to more female physicians was going to lead to a smaller supply of medical services in any case.  Now, ObamaCare will chase more doctors out of the profession on top of the smaller numbers of younger physicians already and the larger fraction of female physicians who will work shorter hours and retire earlier.  This smaller pool of available physician manhours will be deluged by much more demand from aging Baby Boomers and from the greater demand brought on by ObamaCare.  The consequence will be that the quality of health care must degrade rapidly.  It will also become much more expensive, or degrade still more rapidly.  The law of supply and demand can never be denied.

We were already staring severe problems in the face.  ObamaCare is clearly going to make those severe problems catastrophic problems.  It will not be long before we really will have to be pulling the plug on granny much earlier than we have in the past.  Obama lied about this again just yesterday.  A lot of Baby Boomers are soon going to be very expendable.  Severe health care rationing is coming.  It probably was coming to some extent anyway due to the Medicare and Medicaid programs and the Baby Boomer demand increase, but ObamaCare will have to make this much more severe.  This will not be because anyone really wants this, except Obama and the Emanuel brothers, but because the Democrats do not think anything through and do not care about the constraints of reality.  They are simply other-worldly people.

The Right to Health Care Insurance

The legislation before Congress at this time, often called ObamaCare, does not provide Americans with a right to health insurance, though its supporters and some of its enemies often say it does.  We all have a right to life, liberty, and the pursuit of happiness.  This right is a sovereign right which we each hold whether we have a legitimate government or not and it is a right we all hold equally.  Illegitimate government is that government which does not simply defend and protect our individual rights, just as our Declaration of Independence properly observed.  When government acts to provide services beyond the protection of our individual rights, it is impossible for it to do so without violating the rights of some of us and usually of all of us.  Any redistribution of income or any requirement that one of us must serve others of us, must necessarily be a violation of the individual right of some of us and then a violation of the principle that each of us is equal in that we have equal standing in our individual rights.  My freedom of speech is equal to your freedom of speech.  My freedom to take action to preserve my life, such as to make arrangements for the care of my health, is equal to your freedom to do the same.  My freedom to own my own body is matched by your freedom to own your own body.  My freedom to pursue my happiness by preventing pain, is matched by your freedom to do the same.

Obama and most of the Democrats in Congress are working very hard to violate many of our most fundamental freedoms at this very moment.  They claim they are trying to give more Americans a right to health care insurance.  This is transparent nonsense.  They claim that they are giving more Americans the right to medical care.  This is also nonsense.  They are in fact proposing a severe violation of our right to health care insurance and medical care.

Health insurance is a fundamental human right in the same sense that freedom of speech is a fundamental human right.  I have the right to speak or not to speak.  I have the right to speak what I want to speak.  I do not have a right to force someone else to write a speech for me.  I do not have a right to force others to gather around me and listen to me talk.  I do not have the right to take a bullhorn from someone else and use it without their freely given permission.  I do not have the right to force someone to build me an auditorium to give a speech in, or to rent it to me, or to allow me to use it on terms that disregard their interest.  Not only do I not have the right to use force personally to do these things, but neither does any government have that right on my behalf.

I have the right to insure my health care or not, providing I can find someone who will willing come to mutual terms with me on the cost and services to be paid for.  Note that Obama and the Democrat majority in Congress intend to mandate that I must buy health insurance or go to jail.  Note that the government intends, if this monstrous bill is passed, to dictate which health insurance plans are acceptable to it, with complete disregard to my individual right to make that determination.  I have the right to seek out medical care, but not the right to force someone to provide it on my terms.  But note that the government, claiming to act on my behalf, will dictate which medical procedures will be paid for by an acceptable health insurance plan and you can be sure, how much will be paid for it.  What has happened to my right to find a doctor to provide me with the medical care I need, as determined by me, and my right to ensure that he will do the work well because I have adequately paid him to do so?

The Democrat politicians in control of the government are making claims that ObamaCare will reduce the cost of health insurance and of medical care.  First, these costs will in fact increase more rapidly with their plan.  But even worse than that, the response of the government will be that of nationalized health care systems everywhere else.  They will push harder and harder to limit and ration the medical care allowed to moderate the rate of increased costs.  Innovations will be stamped out by the government refusal to allow payments for initially expensive experimental procedures.  Doctors will be paid less than they want to work for as ObamaCare works the inevitable through the dense thickets of government agencies involved in its operations, just as Medicaid and Medicare already pay them so little for many procedures and specialties that many doctors will not take patients with those government programs.  Fewer and fewer doctors will soon be working to handle a much heavier load of work as 30,000,000 Americans start gobbling up more and more health care.  Health care will be rationed by allowing waits in doctor's offices to become so long and waits for appointments to become so long that those of us who lead busy lives will be culled out of the population.  We will not go for checkups and minor pains and will wait until it is too late to save us.  We will be allowed to see a doctor, but no longer on terms acceptable to us.  This is a violation of our rights.

This last week, a serviceman was on Fox News and he claimed that marijuana use helped him greatly to cope with his post-traumatic stress syndrome.  A doctor kept insisting that marijuana had not been proven effective as a treatment for this purpose.  This is a clear clash of the nanny state and progressive viewpoint on medical care and our individual rights.  The fact that marijuana has not been proven effective generally for the treatment of post-traumatic stress syndrome is completely irrelevant.  If it is effective for this one, single individual, then the state has no business interfering with his right to act in the best interest of his health, his right to his own body, and his right to pursue his own happiness.  We already have a health care system which has seriously infringed upon our individual rights and ObamaCare is simply going to provide more power to people such as the doctor in the Fox interview who want to further restrict our individual needs for health care.  We see the federal government also taking the wrong stance on marijuana use to ease pain for cancer patients and others.  We see the federal government adding greatly to the cost of medical devices and drug development and slowing down their introduction to the market.  We see them denying the use of drugs which are critically helpful to some patients, because they are deemed not helpful to enough patients.  We also see them telling doctors that they must try drugs in a certain order and overriding the doctor's knowledge that some of the drugs he must try will not work.  He has to use them anyway and prove they do not work, before he can use the drug that he thinks will work.  These are all examples of the government already badly violating individual rights in the name of some collectivist justification.

The major problems in the health care industry presently are caused by government interference.  Medicaid and Medicare are largely subsidized by people who have to pay higher premiums on their private health insurance.  Young people are especially charged more for private health insurance to cover the costs that get shifted to the privately insured.  This is one of the chief reasons why so many young people choose not to buy health insurance.  Health insurance costs are driven sky-high by the requirements of a great many states that insurance policies offered in that state must cover large numbers of procedures and services which many people in the state do not need.  Sometimes, no one needs them, but those who provide the service as a business want to use the state to drum up business for them.  This is why health insurance in New Jersey costs about twice what it does in Pennsylvania.  Another problem is that the federal government allows insurance provided through a business to be tax deductible, but not when a private individual buys it.  Also, the many small businesses cannot deduct health insurance for employees who own more than 2% of the stock of the company.  For most small businesses, this means that someone with very little wealth is treated as though he is the same as someone who owns 2% of GE.  In fact, a very large fraction of the uninsured are small business owners and this discrimination against them hardly helps.  Then there is the problem of excessive medical care awards and litigation for the special interest group of trial lawyers who have their grips deep into Obama and the Democrat Congress by virtue of buying them with huge election campaign donations.  This leads to excessive clinical testing and more expenses aimed to minimize lawsuits and their losses.  Finally, there are many government restrictions on competition in the medical services.  There are many restrictions on the number of doctors and the number of hospitals.  Government acts to increase the demand for medical services, while at the same time greatly restricting the supply side of medical services.  It is no wonder that medical costs have long been going up in a world where most goods and services go down or go up very slowly.
 
If each individual has the right to life, liberty, and the pursuit of happiness, then many, many more rights are implied than those enumerated in the Constitution.  But one thing these rights all have in common is the fact that they never make anyone else serve us.  They only leave us free to manage the many aspects of our own life and to seek associations with others on mutually agreed terms to fulfill our many wants.  The way we do this is through the free markets of a Capitalist society.  This free market allows us consistently many more individual choices and much more room for our individual differences than government control can ever allow.  We cannot exercise our individual rights by means of government-provided services, income redistribution, and mandates that some must serve others.  We cannot do this if we want "to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the General Welfare, and secure the Blessings of Liberty to ourselves and our Posterity."  The framers of the Constitution had a very sound vision of the proper reach of government consistent with our individual rights and the consent of the governed.

Representative Paul Ryan's Comments on ObamaCare Costs

Representative Paul Ryan is a Libertarian-oriented Republican Congressman of the 1st Congressional District of Wisconsin, which is bordered by Illinois, Lake Michigan, the southern suburbs of Milwaukee, and reaches out to Janesville in the west.  Racine and Kenosha are in his district.  Paul Ryan has read Ayn Rand's works and thinks highly of them.  I have heard him speak a number of times at events which the Atlas Society or the Competitive Enterprise Institute were participating in or sponsoring and he has always been a rational voice.  On 25 February, he spoke up at the Health Care Summit called for by Obama to discuss budgetary issues.  While I believe the primary, and completely sufficient, reason to oppose ObamaCare is the personal mandate and the idea that government has the power to decide what is and what is not acceptable health insurance and health care, the budgetary issues are also important.

Congressman Ryan said:

• Medicare has a $38 trillion unfunded liability already, but half a trillion dollars is to be taken from it, so 20% of present Medicare providers will either go out of business or stop serving people on Medicare.
• The cost of Medicaid is growing at a 21% annual rate and is about to bankrupt a number of states.
• The Majority Leader of the Senate claims the Senate bill will reduce the deficit by $131 billion over the next 10 years, which is nonsense.
• The bill collects half a trillion dollars of new taxes for 10 years and cuts Medicare for 10 years, in order to provide revenues for 6 years of ObamaCare spending.
• The first 10 years of ObamaCare will cost $2.3 trillion.
• The Senate bill takes $52 billion from Social Security, which has huge unfunded liabilities already.
• It takes $72 billion from the long-term care insurance program called the CLASS Act.
• The real 10-year cost of ObamaCare will cause a $460 billion deficit, despite the four-year delay in the program and counting taxes in that 4-year period.
• The second 10-year cost of the program is $1.4 trillion.
• For the last 7 years, Congress has not made the kind of 21% doctors payment cuts that are supposed to be part of the savings from Medicare according to the Senate bill.  The savings which will not occur from this cut is $371 billion.
• Far from reducing Medicare's costs as claimed by Obama, the chief actuary at Medicare says medical costs are going up $222 billion.

The Obama camp response to being in deep, deep debt and running deep, deep deficits, is to close your eyes and plow ahead with huge new spending plans.  After all, tomorrow we will all be dead.

The Government Poisons Alcohol -- Lessons for Socialized Medicine

Prohibition began on 1 January 1920 and was intended as an act of the Nanny State to bring on an improvement of the human race.  But, Americans were not willing to give up their drinking.  Insurance companies believed that alcoholism increased three-fold during the Prohibition!  By 1930, there were about 30,000 speakeasies in New York City.  The federal government became desperate to force the People to stop drinking.  They had greatly decreased the smuggling trade from Canada and other countries, but by the mid-1920s, the U.S. Treasury estimated that about 60 million gallons of industrial alcohol was stolen each year to be converted into drinking alcohol.  This industrial alcohol became the primary source of drinking alcohol.

Beginning back in 1906, the government had required that industry must denature alcohol or pay the drinking alcohol taxes on it.  But, during Prohibition, the well-paid chemists of the bootleggers became very skilled in removing the poisons from denatured industrial alcohol so they could make it potable.  The federal response in 1926 was to force the addition of still worse poisons into industrial alcohol so that they would be much harder to remove.  They frankly knew that many people would die, but they expected that those deaths would finally force most drinkers to stop drinking.  The social engineering objective of these progressives justified the means.  It always starts with the use of force and to make that force credible, it must be brutally applied whenever anyone gets out of line.

The deaths started showing up at Christmas time in 1926.  Bellevue Hospital in New York City treated 60 people on Christmas day who were desperately ill from alcohol poisoning.  But this was not the usual alcohol poisoning that had become common in the earlier 1920s.  Eight of those people died.  Over the next two days, another 23 people died of alcohol poisoning in NYC.  The doctors came to learn that these deaths were caused by the U.S. government and its new and deadlier denaturing requirements for industrial alcohol.

Deborah Blum tells this story in The Poisoner's Handbook and here.  She describes the new poisons:

By mid-1927, the new denaturing formulas included some notable poisons—kerosene and brucine (a plant alkaloid closely related to strychnine), gasoline, benzene, cadmium, iodine, zinc, mercury salts, nicotine, ether, formaldehyde, chloroform, camphor, carbolic acid, quinine, and acetone. The Treasury Department also demanded more methyl alcohol be added—up to 10 percent of total product. It was the last that proved most deadly.

Charles Norris, the New York City medical examiner, blamed the federal government for the deaths and did everything he could to publicize them.  In 1926 in NYC, 1200 people were made sick by poisoned alcohol and 400 died.  In 1927, 700 people died in NYC of alcohol poisoning.  Many people were also blinded by the poisons.  The Prohibition Amendment was finally repealed in December 1933 and this evil experiment upon the American People ended.  The death toll due to government-required alcohol poisoning has been estimated to be greater than 10,000 Americans.

At this point, this is an interesting American history note.  But we are supposed to learn from history.  In this case, we ought to relate this Prohibition experience in social engineering and the Nanny State to the present day proposals of the socialist, progressive leaders of the Democrat Party who so badly want to take over all medical services.  There are clearly movements afoot among these elitist progressives to force the People to change their eating habits, exercise habits, and drinking habits.  If they take over medical services entirely, this will lead to promotion of even more social engineering in the name of reducing costs to the government due to the higher health care costs of obese and sedentary people.

If the government was once willing to add ever more deadly poisons to alcohol it knew people would drink as an inducement to get them to drink less, can we be sure that there really will be no panels of bureaucrats and doctors in their grip who will be forced to identify obese and sedentary people as being unworthy of medical effort when they have a medical crisis?  Might the government even resort to poisoning products they do not want people to eat or drink again?  During the Prohibition, the progressives were very cavalier about the deaths of those who bought spirits from those who broke the 18th Amendment.  This despite the fact that the 18th Amendment did not actually make drinking alcohol unconstitutional.  That amendment only prohibited its manufacture, sale, and transportation.

For instance, diabetes is a disease which mostly afflicts people who are overweight and sedentary.  Will a government-run medical services industry in time decide that anyone who has diabetes asked for it and is not worthy of the expenditure of federal tax monies?  Might this not lead to under-treatment of diabetes?  You may think your mother who has diabetes is worthy of treatment, but will the panel of government bureaucrats and their captive doctors who decide how much money will be spent on her treatment and how much limited doctor time and limited equipment time?  Will the government say of those who have stress-related illnesses, "You worked too hard and/or you tolerated a stressful family life, so you do not deserve much of our limited funds for treating your stress-induced illness."?   Of course, we already know that the progressives believe less money should be spent on saving the lives of babies and young children and also on the elderly, both of whom they believe to have less social value and to be of less human capital.

The very fact that the progressives will not let their very unpopular health services takeover plan go and they keep desperately trying to revive it, makes it clear they do not care what the People think of it.  They want badly to force the People to give up control over their own health care and cede that control to the government.  He who controls the money, dictates the terms of the transaction.  With the government controlling the flow of money to pay for all medical services, the government will soon dictate what those services will be and who will get them.  This is a certain fact.

The government will have no pressure to behave reasonably, once the private sector health care and insurance industries are prostrate at its feet and begging for every dollar of their income.  We the People will be nothing more significant than our Social Security number.  Mao wanted to change every Chinese person into a number.  The Democrat socialized health care system will turn every American into just a body with a number identifying it.  That body will be expected to toe the line, or the government just will not offer it any medical services and may even put it out of any resulting pain and misery with drugs.  This is what is already widely being done in the socialized medical system in Great Britain.

Our most fundamental individual right is that to the ownership of our own body.  If government will not respect that right, then it will not respect any individual right.  If we give up this one right, then we have given up all of our rights.  We must fight against the Democrat health care takeover as a life and death issue on which we will make no compromise.  The progressive (fascist) Democrats will not give up on their socialized medicine plan because they have a bloodthirsty hunger for this supreme power over each and every American.  I can see the future.  The amount of medical care provided will be dependent upon the same criteria now used to get into most graduate schools, namely, how much of your life was invested in activities the progressives approve of, such as what they consider to be social services.  How much of your life did you dedicate to sacrificing your interests to others?  The more you sacrificed, the more value they see in your life and the more worthy you are of rationed medical services.  Heaven forbid, you dedicated your time to your private sector profession for income and to your own family!

A Mayo Clinic in Arizonia Stops Treating Most Medicare Patients

The Mayo Clinic facility in Glendale, Arizona has stopped treating many Medicare patients as part of a two-year trial program.  The Mayo Clinic is known as a high quality, relatively low cost provider of health care and was praised by Obama in June as a model for efficient health care.  Yet, the Mayo Clinic, based in Rochester, Minnesota, with a staff of 3,700 physicians and scientists, treated 526,000 patients in 2008 and lost $840 million on Medicare patients.  The average loss per patient was $1600 and many of their patients were not on Medicare, so the loss per Medicare patient was higher.

According to the March report of the Medicare Payment Advisory Commission (MPAC), doctors made 20% less treating Medicare patients than they did caring for privately insured patients in 2007.  Of course, this is like getting an estimate of future costs for a government medical program from the CBO.  As is well-established historically, the CBO estimates are always many times less than the future costs actually turn out to be.  The underpayment estimates of the MPAC are just as surely underestimates.

Socialists like to claim that Medicare is a huge success.  It would in fact be an obvious total failure, except that many of its costs have been transferred to patients on private insurance and the fact that demographics have allowed it to operate successfully as a giant Ponzi scheme so far.  As the Baby Boomers reach the age of 65, the program will rapidly incur costs which will exceed the current income from the Medicare payroll tax.  This will happen by 2017 or even earlier by 2013 in some estimates.  Some combination of higher taxes, lower medical services payments, and rationed medical care will have to make up the shortfall in the program's ability to pay for medical services.  The day of reckoning is very near and the present socialist Democrat health insurance reform bills are not addressing any of the real problems, except perhaps on the pathway of rationing future health care.  In many ways, the present ObamaCare bills actually add to expenses directly with taxes on medical services and will add further with an incredible overload of bureaucracy and innovation restrictions.

The Glendale Mayo Clinic facility has more than 3,000 patients eligible for Medicare.  They will have to pay cash to continue to see their doctors there.  This facility lost $120 million in 2008 on their treatment.  Only about 50% of the cost of treating elderly primary care patients at this facility was paid by Medicare.  There are a few areas in which Medicare payments will still be accepted there.  Specialist cardiology and neurology services and laboratory services payments will still be accepted.

Medicare covered about 45 million Americans at the end of 2008.  About 92% of family doctors participate in Medicare, but only 73% of them or about 2/3 of all family doctors are accepting new patients under the program.  The increased numbers of patients over 65 in the next few years will result in a further reduction in the percentage of family doctors accepting new Medicare patients.  If payments are cut back, as they likely will have to be due to the coming funding crisis for Medicare, then the percentage of doctors accepting Medicare patients will drop still further.  There is already a severe shortage of family doctors at the present time, so the situation will deteriorate catastrophically.  Congress, just about a week ago, postponed a 21.5% cut in Medicare payments to doctors for two months.

Yes, this is the farce the socialists are telling us is a great and successful program.  In fact, it is as bad as the post office, Amtrak, the ethanol from corn subsidy program, and subsidies for wind and solar power generation.  Well, except that the failure of this program will have fairly immediate deadly consequences for very large numbers of elderly Americans.  At the same time, it will most likely add still more backbreaking taxes upon younger generations, who will also be struggling under the huge increases in health care insurance premiums which ObamaCare will require them to buy for themselves.  Some very nasty intergenerational warfare is going to result.

Suppose an Injured Patient Lives in Canada

Suppose an injured patient lives in Canada.  The patient needs a CT scan to assess the damage and to schedule an operation, if necessary.  The time the patient will have to wait for the CT scan is either the next day or more than a month.  If an operation is needed, the further wait is a day or more than 3 months.

If the patient waits for 4 months rather than a couple of days to have the injury operated on, is the patient human or not?

By the logic of socialism, if the patient has to wait 4 months for medical help, it is human.  For those patients fortunate enough to receive medical treatment under the private enterprise system in Canada, the medical service is great.  As John Stossel notes, you just have to bark or meow.  Talking is not allowed.  Talkers are prosecuted to the fullest extent of the law if they go to a veterinarian for faster and higher tech treatment.

Obama Calls Me a "Tea-bag, Anti-government" Person

When exhorting the numerous reluctant Democrats in the House of Socialist Representatives to vote for the unread Obama-Pelosi 1990-page socialized medicine bill, this tyrant and usurper called those of us who have protested against this socialist government and its many infringements of our sovereign, individual rights, those "tea-bag, anti-government people."

OK, I am opposed to this socialist government.  I am all in favor of a constitutional federal government, which is to say a government of highly limited powers.  I am not an anarchist.

As for tea-bag, that is his idea of being Presidential.  It is clearly meant to invoke the crude sexual put-down so popular among the socialists in which they call Tea Party Protesters, Tea-Baggers or say they are tea-bagging.  Well, such tea-bags as I have, I am just trying to protect from the hungry lips and devouring mouths of Obama and Pelosi.

After all, we the People have a sovereign right to defend and protect our bodies and our property from those who would force themselves upon us, even if they have all the power of government behind them.

Fines for Refusing to Document Acceptable Health Insurance to IRS

Apparently, the socialist Democrat Congress is terrified that many Americans are going to refuse to document having an acceptable health insurance plan to the IRS.  Let us take a look at the 1990 page HR 3962 just passed in the House of Socialist Representatives.

If you do not buy one of the very expensive acceptable government health insurance plans, you will be fined $1900.  If you do not pay this fine and you do not prove that you have acceptable insurance, you will be fined $25,000.  If you do not pay this fine, you will be subject to imprisonment for five years and a fine of $250,000.  These penalties are so severe that it appears clear that the socialists are very afraid that many Americans will refuse to go along with this unconstitutional law.  Many will feel they are obliged to stand up for our Constitution, even if they will be fined or sent to jail.  If many do this, this already unpopular plan will crumble.  So, the penalties have to be so severe that all of the Constitution and individual rights defenders will be cowed.  These penalties are indeed so severe that it opens a new chapter in American history.

It is as if King George III had said he was going to draw and quarter any American colonist who rebelled.  Our Socialist Democrats say they will send any rebel to the Gulag and confiscate everything he owns.  This is a strong and blatant statement that they care not a whit for the value of individual lives.  This attitude that many American individualists are expendable, is very close to that of Mao, who is so much admired by so many close to Obama.

Apparently, I will be in the Gulag or dead in 2013, unless the Senate refuses to go along with this draconian tyranny or unless it is repealed subsequent to the elections of 2010 and 2012.  The socialist Democrats must be thrown out of both the House and Senate and the presidency by 2013, or this blog will end and I will be in the Gulag or dead.  That is a bit of a tall order.  I hope the American People are still American enough to be up to it.

Robert Bidinotto on ObamaCare

My friend Robert Bidinotto has written a very good evaluation of ObamaCare which he has invited everyone to copy and make available to others.  Here it is:

How ObamaCare Will Hurt YOU -- and How to Defeat it NOW

Now that the House and Senate finally have drafted their enormous health-care bills, we can see what the final provisions will be. Their differences are far less important than their similarities. Either bill will be a disaster for our economy—for our personal well-being, both financial and medical—for our precious rights and freedoms—and for the futures of our children and grandchildren.

If “ObamaCare” becomes law, we will never again have the same America that was given to us by our nation’s Founders—that was defended by the blood of our ancestors—and that we have enjoyed as the greatest nation in the history of the world.

Both bills are coming up for crucial floor votes as early as this week. Many in Congress are very nervous about what their votes will mean for their political careers.

This coming week is thus critical in either passing or defeating this legislation, once and for all. Now is the time that you can weigh in and make a real difference with your congressman and senators.

Here is what you need to know. Rather than overwhelm you with arcane details of each bill, it is more important that you understand in principle what ObamaCare will mean for you and your family.

ObamaCare will mean:

Outrageous Costs. At a time of exploding federal spending and budget deficits, both the House and Senate bills would add far more than a trillion dollars to the mind-boggling financial liabilities we taxpayers already face. Even the stated price tags of these bills are fraudulent products of statistical manipulations. One way they pretend reduce costs is to remove a quarter-trillion dollars in doctor Medicare reimbursements from the bills, but instead add that gargantuan spending into separate legislation. Another way they pretend to balance the books (“deficit neutrality”) is to impose years of tax increases to fund these bills, before the outrageous spending actually kicks in. When it does, the “cost curve” in later decades will soar upward, and deficits will pile up by the billions. In addition, the bills would vastly expand the already-bankrupt Medicaid program; this would impose on state governments, which already face crushing budget crises, tens of billions of dollars in new taxing and spending commitments. You will ultimately pick up that tab, too.

Soaring Taxes. ObamaCare is not “insurance,” but a gigantic new entitlement scheme meant to “spread the wealth around.” To pay for this spending spree, both bills will drain our ailing private economy of hundreds of billions of dollars in higher taxes. These taxes will fall disproportionately upon the young and healthy: They will be forced to buy costly policies, thus expanding the “pool” of payers who will subsidize those older and sicker. Higher taxes also will fall heavily upon “the rich.” But these include the same entrepreneurs and employers whom we expect to create businesses and jobs to lift us out of the recession—and also the very doctors whom we expect to provide the medical services to the millions of new patients. The legislation also proposes hefty taxes on better private-insurance plans, which would penalize and undermine existing employer-employee benefits packages. These are just a few of the many new taxes and fees the bills would impose on us.

Perverse Incentives. ObamaCare would subsidize and greatly expand the demand for health care, while discouraging the supply of health care. It would create a gigantic new federal entitlement program that would add millions of new, taxpayer-subsidized claimants for health-insurance coverage. Then it would force insurers to accept all comers—regardless of any actuarial risk factors—and to provide them coverage that is far beyond what many people actually require. On the other side of the equation, ObamaCare will increase taxes on those private insurers (who now average only 2-3% profit margins), while expecting them somehow to pay all the new benefits. It will also increase taxes and fees on hospitals, doctors, pharmaceutical manufacturers, and the inventors of new medical devices—thus punishing those who create and provide medical treatments. Inevitably, this will deter many of them from developing or offering vital new medical treatments for patients, and it will even force some of them out of business.

Government rationing. When soaring demand for medical care overwhelms shrinking supply of providers, the only outcome would be government rationing of medical care—which has occurred in all socialized-medicine regimes—and which is the intended outcome.

Lost Individual Choice. All talk of adding “choice and competition” to the health-insurance market is a complete fraud. The bills do not free individuals to buy insurance across state lines—“choice and competition” that would actually reduce the cost of insurance. Instead, the bills propose a host of new mandates on private individuals, employers, and private insurers. Under penalty of fines or jail, individuals will be forced to buy costly coverage; employers will be forced to provide it and to comply with countless petty regulations; and doctors, hospitals, and private insurers will be forced to comply with a mountain of new government orders, requirements, restrictions, demands, and regulations. Compliance with all these ever-expanding governmental edicts will drive up the costs for physicians, hospitals, medicines, treatments, and private insurance premiums. Skyrocketing costs will force more and more people into the “public option.” Meanwhile, the bills would slash reimbursements to Medicare Advantage plans, killing a private-insurance option now exercised and enjoyed by one-fourth of all seniors.

Broken promises. The pending legislation will not cover all the uninsured; it will not add to freedom of choice for consumers; it will not be “deficit-neutral”; it will not “bend the cost curve downward”; it will not prevent illegal aliens from receiving taxpayer-subsidized medical care; it will not prevent government payments from funding controversial procedures such as abortions; and it will not allow people to “keep their current coverage.” All of these are the loud promises of ObamaCare’s advocates; all are demonstrable falsehoods.

Instead, ObamaCare will do only one thing, which was the overt objective of its proponents from the outset: put the federal government in charge of the delivery of all health care in America.

A single-payer, government-run program of socialized medicine is the stated objective of those who designed this legislative monstrosity—from President Obama, to the vast coalition of unions and advocacy groups, to the congressional leaders who drafted these bills. They explicitly intend to bankrupt the private-insurance marketplace, so that only the government option remains. Far from adding “choice and competion,” then, ObamaCare aims at imposing on us a government health-care monopoly.

But only if we allow it to happen. Because this power-grab still can be stopped.

Congress remains deeply divided over many provisions of this legislation. If it passes, it only will be by a handful of votes. That means we can defeat this monstrosity by changing just a few minds. Now—this week—is the time for you to raise your voice and put on the pressure.

To contact your congressman, by phone, mail, or email, go here:

http://www.house.gov/house/MemberWWW_by_State.shtml

and contact your two senators by going here:

http://www.senate.gov/general/contact_information/senators_cfm.cfm


Tell them the following, preferably putting the ideas into your own words:

The House and Senate bills will not create “universal, affordable insurance.” They instead would create a gargantuan, unaffordable new federal entitlement program. They would further explode our soaring deficits; hugely increase tax burdens on our ailing economy; create perverse incentives that would expand the demand for medical services, while discouraging and punishing the suppliers of medical care; and deprive Americans of true choice and competition, by imposing an endless stream of new “mandates” on individuals and employers. This legislation would destroy existing private health-insurance plans, and ultimately destroy the quality and affordability of health care in America.

This legislation is so flawed and destructive in principle that it cannot be “fixed” or amended; it must be scrapped in its entirety. True health-care reform is necessary, but it must be based on our free-market system—such as:

• allowing individuals to purchase insurance from companies across state lines, and letting them take that coverage with them when they change jobs;
• letting individuals buy high-deductible, low-cost catastrophic coverage, by freeing insurers from laws that force them to offer only costly, state-mandated provisions in their policies;
• enacting tort reform, to eliminate the costly practice of “defensive medicine.”

Such reforms would expand coverage to millions of the uninsured, while actually reducing costs to employers, policy-holders, and individual taxpayers.

I feel so strongly about this, that I cannot consider you for re-election unless you vote against this legislation, in any shape or form.

* * *

Whether or not you have ever contacted a congressman or senator, now is the time to do it. This week may be the last time we can influence the outcome on this issue.

Your health, your financial well-being, and your nation’s future hang in the balance.

Please act today—then copy and/or direct this message to your family, friends, and associates.

Changes for Doctors and Patients Under ObamaCare

The House bill 3200HR is one of the bills being folded together in some mysterious way in Congress.  The Senate has some Democrat Senators and Rahm Emanuel huddled behind closed and locked doors meshing together the Health Committee bill and the Finance Committee bill, which seems to have become 1500 pages long suddenly after the Finance Committee voted on a conceptual plan a bit under 300 pages long.  We do not know precisely what the ill-chosen provisions of the final passed bill will be, but the way everything is being rushed and so much is being hidden, we have to evaluate as much as we can from the available information, or we will be caught flat-footed when the final version is rushed blindly through Congress.

Here are a few provisions of HR 3200 we had best take note of:

• Doctors are in the public option unless they opt out.  There is no mechanism for opting out.  The Secretary of Health and Human Services will set up a mechanism someday and it may include penalties, fines, taxes, and who knows what other disincentives.  In effect, the plan is to make doctors slaves who may then have some onerous option to buy their freedom, their manumission.
• The paperwork required of doctors has been increasing rapidly over the last 15 years.  This bill will increase it much more, cutting down on patient time, attendance at seminars and on post-graduate education.  They will have to document all interactions with the many new federal bureaucracies to be set up, as well as the greatly expanded ones.  They will have to document all referrals, determine if there are fraud risks, and continually update quality assessments.  They will be bored to death!
  
• The expanded patient records will include copious financial records, medical data, mental health evaluations, and such things as any sexually transmitted infectious diseases.  This data will be available to huge numbers of medical people and to many bureaucrats.  Imagine what the Democrats will do with this information on a Republican running for public office?  Apparently, they will use such information on that Republican's entire family, if we can extrapolate from Sarah Palin's case.
• If patient's must be readmitted to a hospital after being released, there are fines.  Those with chronic diseases, the disabled, and the elderly are most likely to be readmitted.  Doctors and hospitals will become reluctant to treat such people because they inherently bring with them an increased likelihood of fines due to readmission.  There will be attempts to transfer such patients to other facilities.
• End-of-life counseling will be required as part of the regular medical practice.  The government will train and approve the counselors.  It will provide the films, brochures, and the data to be given to the patients.  It is expected that this advice will be for them to forgo more than ordinary medical treatments and play upon their guilt in being a burden.  The health czar, Ezekiel Emanuel, believes doctors are obsessed with the Hippocratic Oath.  He serves on an advisory panel for the Hastings Center which states that patients should reject ordinary and extraordinary care and accept death.
  

ObamaCare is Meant to Increase Private Health Insurance and Medical Costs

ObamaCare was initially sold as a means to reverse or slow down the rate at which health care costs have been rising in the U.S.  It was always nonsense that this would be achieved, since the federal government has never had much success in managing the costs of any rather complex operation. It has a long history of managing medical programs specifically, whose costs have not only skyrocketed, but have caused the costs of the private health care sector to go up far more than they otherwise would have.  The claim that ObamaCare would bring down costs was simply a political lie told to ease its passage.  The intent, the purpose, of ObamaCare is to increase the costs of private health insurance to the point that most people cannot afford it.  Then, the People will demand that the government rescue them by providing a totally nationalized health care system.  This is the socialists ideal:  create the desperation and then appear as the champion of the suffering little guy.  To do this, socialism aims to pull us all down into economic poverty so that we will all feel we are little guys and helpless without the socialist state.

The initial ObamaCare bill will do a number of things at the minimum, which are designed to force costs upward.  The direct taxes on the health industry discussed are those from the Baucus conceptual plan and are likely to be worse in the final bill.  Among the forces designed to increase the cost of private health insurance are:

• The individual mandate will force more people to have health insurance, which will increase demand on the limited supply of health care workers, so prices will go up.  That old law of supply and demand cannot be denied.
• The government qualified plans will require many services to be covered which many people do not need, so they will have to pay more for services they will not use.
• More young people will have to subsidize older people in larger pools, which will help lower the costs for older people, but will leave younger people, who are usually lower earners, in more strained financial circumstances and prevent them from building wealth.
• Relatively affordable high-deductible plans will not be allowed.  Co-pays are also to be set at very low values.  Health Savings Accounts will no longer serve a purpose.  Those people who only need insurance for major medical expenses will have to pay more expensive insurance costs to cover almost every penny of their medical costs.
• Health insurance companies are being taxed $20 billion between 2013 and 2015 to be allowed to issue health insurance and to manage benefit plans for major medical coverage in those years.  This cost has to be passed on in the form of higher insurance premiums.
• Insurance companies will have to contribute $5 billion to a high-risk insurance pool which will exist until 2013 to cover uninsured individuals who have been denied health care coverage due to a pre-existing condition.  This cost will have to passed on to others these companies insure.
• Anyone manufacturing or importing prescription pharmaceuticals will have to pay in a share to create a contribution of $2.3 billion annually from 2010 for the Medicare SMI trust fund.  This cost will be passed on to the privately insured.
• Medical device manufacturer's and importers will have to pay fees totaling $4 billion annually.  Necessarily, medical devices will cost more for the privately insured.
• U.S. health insurance companies will have to pay fees totaling $6 billion annually.
• Clinical laboratories will have to pay fees totaling $750 million annually, thereby increasing the costs of medical tests for the privately insured.

It is clear that ObamaCare is trying to drive up our private health insurance costs well beyond the already high rates that Medicaid, Medicare, the regulatory costs of the FDA and NIH, the limitations on the numbers of doctors educated in medical schools, the already high costs imposed by state qualification requirements on health insurance, and the costs of excessive medical malpractice awards have done.

The People should be furious about the Obama and Democrat Congress lies that they are trying to reduce health care costs.  They are not.  They are only interested in causing the private sector of the health care system to fail, so they can force all Americans into medical dependency upon a socialist government.  Forcing the once proud American individual into submission before the ruling state is their purpose! This is clear and undeniable.