By Julianna Goldman and Nicholas Johnston
President Barack Obama, pushing his plans for revamping the U.S. health-care system, said Americans are being “held hostage” by the risk that insurers may cancel or deny medical coverage when they get sick.
“It’s wrong,” Obama told an audience at a town hall yesterday in Belgrade, Montana, about eight miles northwest of Bozeman. “It’s bankrupting families, it’s bankrupting business, and we are going to fix it when we pass health- insurance reform this year.”
Taking his health-care push on the road for the second time this week, Obama said the health-care system “all too often works better for the insurance companies than it does for the American people.”
Obama flew to Montana yesterday after visiting Portsmouth, New Hampshire, on Aug. 11, where he denounced “scare tactics” by opponents of health-insurance changes. The president will hold another town hall meeting on the issue today in Colorado.
Proposals to overhaul U.S. health care have run into angry protests at forums across the U.S. during Congress’s August recess and face sagging support in public-opinion polls.
Among political independents, 35 percent say the demonstrations at the town hall meetings have made them more sympathetic to the protesters’ views, according to a USA Today/Gallup poll.
Montana Senator Max Baucus, a Democrat who was among politicians joining Obama at yesterday’s meeting, said voters are hearing “outrageous myths.”
‘Plenty of Dishonesty’
“There’s plenty of dishonesty out there,” Baucus said. As chairman of the Senate Finance Committee, Baucus leads a group of three Democratic and three Republican senators trying to piece together bipartisan legislation.
Lawmakers have faced critics charging that the government wants to take over the U.S. health-care system and, as part odf the changes, empower bureaucratic “death panels” to “pull the plug” by withdrawing treatment from ailing senior citizens.
In the effort to calm voter fears that legislation may hurt the quality of their medical care, Obama is stressing ways that his plans may help the 250 million Americans who have health insurance. In New Hampshire earlier this week, Obama talked about individuals who are denied coverage because of medical conditions. Tomorrow, in Grand Junction, Colorado, Obama plans to talk about lowering out-of-pocket costs for patients.
Marc Montgomery, an insurance agent in Helena, Montana, yesterday pressed Obama about whether the White House has a strategy to “vilify” insurance companies.
Obama said he’s not targeting health insurers and wants to “work with the existing system.” Obama said the U.S. needs to change “certain practices that are very tough on people.”
Keeping Coverage
Karen Ignagni, president and chief executive officer of America’s Health Insurance Plans, said the insurance industry has proposed a set of reforms that includes steps to “make sure that no one is denied coverage because of a pre-existing condition.”
At the Montana meeting, a questioner said voters “keep getting the bull” about how the government plans to pay for a health-care bill. Obama said cost savings and higher taxes on wealthy Americans will cover the expense.
“We’ve got to get over this notion that somehow we can have something for nothing,” Obama said. The president repeated his pledge against higher taxes on middle-class Americans.
At his two meetings this week, Obama hasn’t faced loud or angry questions that have disrupted forums by other Democrats. Obama said the televised protests give only a partial picture of the health-care debate.
Television Ruckus
“TV loves a ruckus,” Obama said. “What you haven’t seen on TV” are many meetings where people “are coming together and having a civil, honest and often difficult conversation about how to improve the system.’
Obama’s approval ratings have slid to some of the lowest levels of his presidency. In a daily Gallup Inc. tracking poll, 54 percent of respondents say they approve of Obama’s job performance, down from 60 percent in mid-July.
Before Obama arrived in Montana, state Republican Chairman Will Deschamps said Americans don’t want the government dictating health-care decisions. “People don’t like to be mandated as to how to live their lives,” he said.
Democrats are pushing plans to cover some of the 46 million uninsured Americans while cutting health-care costs that make up about one-sixth of the nation’s economy.
Cost Wariness
Efforts to win voter support have been complicated by polls showing that Americans are wary of estimates that the health-insurance proposals may cost the government $1 trillion over 10 years.
Obama and top congressional Democrats are pushing plans that would offer the option of purchasing health insurance from a government-run program, while requiring all Americans to get coverage and putting new restrictions on insurers. Republicans say the effort will increase costs and limit medical choices.
Obama is on a four-day swing in the West that includes an appearance in Arizona and visits with his family to Yellowstone National Park and Arizona’s Grand Canyon.
To contact the reporters on this story: Julianna Goldman in Belgrade, Montana, at jgoldman6@bloomberg.net; Nicholas Johnston in Washington at njohnston3@bloomberg.net.
Read it more:The Health Care Debate
8/29/09
Cardiologists Crying Foul Over Obama Medicare Cuts
By Alex Nussbaum and Lisa Rapaport
An Obama administration plan to cut Medicare payments to heart and cancer doctors by $1.4 billion next year is generating a backlash that’s undermining the president’s health-care overhaul.
While President Barack Obama and members of Congress have spent August debating health insurance and medical costs at public forums, specialists are waging what one advocate calls a “tooth and nail” fight against a separate initiative to boost the pay of family doctors, and cut fees for cardiologists and oncologists. The specialists, in newspaper columns and meetings with lawmakers, say patients will lose access to life-saving care, from pacemakers to chemotherapy.
The proposal by Medicare, the government insurer for the elderly and disabled, is an effort by Obama to focus U.S. medicine on preventive care. The fight by physicians who work with the most expensive patients is weakening support for Obama’s broader goal, legislation to remake the health system, said Mark B. McClellan, 46, a former Medicare chief.
“If you can make the health-care debate all about moving slices of the pie around, it’s very easy to generate opposition and very easy to get derailed,” said McClellan, a physician and analyst at the Brookings Institution, a policy research center in Washington, in an interview.
Obama and his allies in Congress are pushing to extend coverage to the 46 million Americans without health insurance, at a potential cost of $1 trillion over a decade. The separate Medicare proposal, announced July 1, slashes projected spending for care by cardiologists and oncologists by more than 10 percent each, while paying family doctors 8 percent more and nurses an additional 7 percent.
‘Tooth and Nail’
“Our 37,000 members are fighting tooth and nail on these other issues rather than fighting thoughtfully for expanding access,” said Jack Lewin, 63, chief executive officer of the Washington-based American College of Cardiology.
The cuts could have the unintended consequence of rationing care, especially in rural regions with a large number of Medicare patients, doctors said. In other areas, specialists may decide to pull out of Medicare, or ask patients to make up the difference with higher out-of-pocket payments, said Alfred Bove, president of the American College of Cardiology.
“A fair number of cardiologists are looking at the accounting and saying ‘we can’t afford it,’” Bove said in a telephone interview.
Some oncologists in rural areas may stop offering chemotherapy in the office, forcing patients to travel to more- distant hospitals, said Allen S. Lichter, 63, CEO of the 27,000- member American Society of Clinical Oncology in Alexandria, Virginia.
Cuts ‘Impossible’
The cuts would be “impossible” for some small-town cardiologists who rely on Medicare patients, said Zia Roshandel, a heart doctor in Culpeper, Virginia. The town of 10,000 people is about 60 miles southwest of Washington.
Roshandel and two partners see perhaps 50 patients a day at his practice, the local hospital and a community clinic for the indigent, the 40-year-old said in a telephone interview. Medicare accounts for two-thirds of their clientele, he said.
Already squeezed by government and private insurers, Roshandel said he has cut office hours, forgone paychecks and shifted his 12 workers to a high-deductible insurance plan over the past two years. The latest proposal would push him out of private practice altogether, most likely to a hospital in a larger community less reliant on Medicare, he said.
‘Close the Office’
If the proposal stands, “the bottom line is I’m going to close the office,” he said. “This is impossible for me to survive. If my partners and I don’t get a salary and run it for free, maybe then we can survive.”
Medicare would reduce reimbursements for some of Roshandel’s most common procedures, raising the amount patients will need to pay up front, he said. The government would cut the $251 it pays for an echocardiogram, a sonogram of the heart, by 40 percent, he said. The rate for a cardiac catheterization, another test, would drop by a third to $249.
Those reductions include an additional across-the-board cut of 22 percent for all physicians mandated by federal budget rules. Legislation passed by three committees in the House last month would eliminate that cut, at a cost of $200 billion to U.S. taxpayers. Even so, if Medicare goes ahead with its tilt toward primary care, cardiologists will suffer, Roshandel said.
The Obama administration’s plan to raise payment for primary care doctors is intended to encourage more doctors to enter the field. Some 65 million people already live in areas considered by the U.S. Health and Human Services Department to have too few primary care doctors, with less than one practitioner for every 2,000 people, according to department figures as of March 31.
Outnumbered by Specialists
The U.S. has 250,000 primary-care doctors and nurses and about three times as many specialists, said Atul Grover, 39, chief advocacy officer for the Association of American Medical Colleges, a Washington group. The number of medical school graduates in the U.S. entering family medicine fell more than a quarter from 2002 to 2007, according to a study last year by the group and the American Medical Association.
With the number of Americans older than 65 soaring, specialists will be in short supply, Grover said. The Census Bureau projects 81.2 million people in the U.S. will be 65 or older in 2040, from 40.2 million in 2010.
‘Silver Tsunami’
“That silver tsunami that represents the baby boomers hitting Medicare age is coming,” Grover said in a telephone interview, referring to the U.S. generation born from 1946 through 1964. “In the next 20 years, we are going to face a physician shortage really across the board.”
Medicare, which covers 45 million people, is expected to spend $503.1 billion this year, accounting for one of every five dollars spent on U.S. health care, the Centers for Medicare and Medicaid Services estimated in February. Spending will reach $931.9 billion in 2018, the agency said.
Without changes, the system is guaranteed “to basically break the federal budget,” Obama said at a White House news conference July 22.
The reimbursements, though, are still a proposal, and may change before a final schedule is adopted Nov. 1, said Ellen Griffith, a spokeswoman for the Centers for Medicare and Medicaid Services, in an e-mail. “All comments that are submitted during the comment period will be given careful consideration,” she said.
Reid Cherlin, an assistant White House press secretary, said the proposal “reflects an effort to pay primary care doctors more appropriately for services to Medicare patients. We have a deep appreciation for the lifesaving work that cardiologists and oncologists do every day, and as part of the rulemaking process CMS has met with groups representing both fields.”
Focus on Results
McClellan, who ran Medicare while George W. Bush was president, said the ultimate solution requires changing how doctors are paid to focus more on results rather than on the number of patient visits.
“My hope is that they’ll resolve it in a way that doesn’t just move the deck chairs around in a Medicare payment system that’s clearly sinking,” he said. “This gets resolved by changing the way that Medicare pays so that both the specialists and the generalists get paid more when they work together and deliver better care.”
McClellan cited Medicare pilot programs in which doctors have formed “accountable care organizations” allowing them to better coordinate patient care. The ACC, the cardiologist group, has pitched another alternative that would use lower co-pays to steer patients to better-performing doctors and give bonuses to physicians and hospitals that cut wasteful spending.
Tensions Rising
Tensions are rising among doctors, said Ted Epperly, 55, president of the American Academy of Family Physicians in Leawood, Kansas, in a telephone interview. Epperly runs a family practice in Boise, Idaho, and teaches at the University of Washington School of Medicine in Seattle.
Specialist colleagues have implied his support for the Medicare changes may cost his students, he said.
While family-care students typically spend parts of their three-year residencies training with specialists, “What I’ve heard is ‘maybe we just won’t have time any longer to teach your residents,’” Epperly said.
The ACC is offering a sample letter to patients, asking them to write Congress. “I am concerned that my physician may no longer be able to treat me or other Medicare patients,” the letter says. The campaign has extended to fliers, posters and even the on-hold message the group plays for callers to its Washington office, which asks the public to fight “drastic pay cuts for cardiology.”
The arguments have a familiar ring, McClellan said.
“The usual way that you try to scuttle a health-care reform proposal is by saying whatever it is going to reduce your access to the care that you need,” he said.
Three Years Earlier
Cancer specialists made similar warnings three years ago when reimbursement was cut for the drugs they used, said Nancy M. Kane, a professor at the Harvard School of Public Health in Boston and member of the Medicare Payment Advisory Commission, a panel of outside advisers to Congress.
“As far as I know we have not seen a drop in the number of oncologists since then,” Kane said. “People are not screaming that they don’t have access to oncologists.”
The pay shift would help right a financial imbalance that keeps young physicians out of family care, said Epperly, of the family doctors’ group.
Average total compensation for family doctors ranged from $150,763 to $204,370 a year, according to a 2008 survey by Modern Healthcare magazine. Cardiologists fetched from $332,900 to $561,875. Radiation oncologists, cancer doctors who specialize in radiation therapy, earned $357,000 to $463,293.
“If we don’t invest more in primary care, we won’t have the resources to offer more access,” Epperly said. “Our system is very good at getting people to do what they’re paid to do. That’s why specialists are doing all the things they do, because they’re paid gobs of money.”
To contact the reporters on this story: Alex Nussbaum in New York anussbaum1@bloomberg.net; Lisa Rapaport in New York at lrapaport1@bloomberg.net.
An Obama administration plan to cut Medicare payments to heart and cancer doctors by $1.4 billion next year is generating a backlash that’s undermining the president’s health-care overhaul.
While President Barack Obama and members of Congress have spent August debating health insurance and medical costs at public forums, specialists are waging what one advocate calls a “tooth and nail” fight against a separate initiative to boost the pay of family doctors, and cut fees for cardiologists and oncologists. The specialists, in newspaper columns and meetings with lawmakers, say patients will lose access to life-saving care, from pacemakers to chemotherapy.
The proposal by Medicare, the government insurer for the elderly and disabled, is an effort by Obama to focus U.S. medicine on preventive care. The fight by physicians who work with the most expensive patients is weakening support for Obama’s broader goal, legislation to remake the health system, said Mark B. McClellan, 46, a former Medicare chief.
“If you can make the health-care debate all about moving slices of the pie around, it’s very easy to generate opposition and very easy to get derailed,” said McClellan, a physician and analyst at the Brookings Institution, a policy research center in Washington, in an interview.
Obama and his allies in Congress are pushing to extend coverage to the 46 million Americans without health insurance, at a potential cost of $1 trillion over a decade. The separate Medicare proposal, announced July 1, slashes projected spending for care by cardiologists and oncologists by more than 10 percent each, while paying family doctors 8 percent more and nurses an additional 7 percent.
‘Tooth and Nail’
“Our 37,000 members are fighting tooth and nail on these other issues rather than fighting thoughtfully for expanding access,” said Jack Lewin, 63, chief executive officer of the Washington-based American College of Cardiology.
The cuts could have the unintended consequence of rationing care, especially in rural regions with a large number of Medicare patients, doctors said. In other areas, specialists may decide to pull out of Medicare, or ask patients to make up the difference with higher out-of-pocket payments, said Alfred Bove, president of the American College of Cardiology.
“A fair number of cardiologists are looking at the accounting and saying ‘we can’t afford it,’” Bove said in a telephone interview.
Some oncologists in rural areas may stop offering chemotherapy in the office, forcing patients to travel to more- distant hospitals, said Allen S. Lichter, 63, CEO of the 27,000- member American Society of Clinical Oncology in Alexandria, Virginia.
Cuts ‘Impossible’
The cuts would be “impossible” for some small-town cardiologists who rely on Medicare patients, said Zia Roshandel, a heart doctor in Culpeper, Virginia. The town of 10,000 people is about 60 miles southwest of Washington.
Roshandel and two partners see perhaps 50 patients a day at his practice, the local hospital and a community clinic for the indigent, the 40-year-old said in a telephone interview. Medicare accounts for two-thirds of their clientele, he said.
Already squeezed by government and private insurers, Roshandel said he has cut office hours, forgone paychecks and shifted his 12 workers to a high-deductible insurance plan over the past two years. The latest proposal would push him out of private practice altogether, most likely to a hospital in a larger community less reliant on Medicare, he said.
‘Close the Office’
If the proposal stands, “the bottom line is I’m going to close the office,” he said. “This is impossible for me to survive. If my partners and I don’t get a salary and run it for free, maybe then we can survive.”
Medicare would reduce reimbursements for some of Roshandel’s most common procedures, raising the amount patients will need to pay up front, he said. The government would cut the $251 it pays for an echocardiogram, a sonogram of the heart, by 40 percent, he said. The rate for a cardiac catheterization, another test, would drop by a third to $249.
Those reductions include an additional across-the-board cut of 22 percent for all physicians mandated by federal budget rules. Legislation passed by three committees in the House last month would eliminate that cut, at a cost of $200 billion to U.S. taxpayers. Even so, if Medicare goes ahead with its tilt toward primary care, cardiologists will suffer, Roshandel said.
The Obama administration’s plan to raise payment for primary care doctors is intended to encourage more doctors to enter the field. Some 65 million people already live in areas considered by the U.S. Health and Human Services Department to have too few primary care doctors, with less than one practitioner for every 2,000 people, according to department figures as of March 31.
Outnumbered by Specialists
The U.S. has 250,000 primary-care doctors and nurses and about three times as many specialists, said Atul Grover, 39, chief advocacy officer for the Association of American Medical Colleges, a Washington group. The number of medical school graduates in the U.S. entering family medicine fell more than a quarter from 2002 to 2007, according to a study last year by the group and the American Medical Association.
With the number of Americans older than 65 soaring, specialists will be in short supply, Grover said. The Census Bureau projects 81.2 million people in the U.S. will be 65 or older in 2040, from 40.2 million in 2010.
‘Silver Tsunami’
“That silver tsunami that represents the baby boomers hitting Medicare age is coming,” Grover said in a telephone interview, referring to the U.S. generation born from 1946 through 1964. “In the next 20 years, we are going to face a physician shortage really across the board.”
Medicare, which covers 45 million people, is expected to spend $503.1 billion this year, accounting for one of every five dollars spent on U.S. health care, the Centers for Medicare and Medicaid Services estimated in February. Spending will reach $931.9 billion in 2018, the agency said.
Without changes, the system is guaranteed “to basically break the federal budget,” Obama said at a White House news conference July 22.
The reimbursements, though, are still a proposal, and may change before a final schedule is adopted Nov. 1, said Ellen Griffith, a spokeswoman for the Centers for Medicare and Medicaid Services, in an e-mail. “All comments that are submitted during the comment period will be given careful consideration,” she said.
Reid Cherlin, an assistant White House press secretary, said the proposal “reflects an effort to pay primary care doctors more appropriately for services to Medicare patients. We have a deep appreciation for the lifesaving work that cardiologists and oncologists do every day, and as part of the rulemaking process CMS has met with groups representing both fields.”
Focus on Results
McClellan, who ran Medicare while George W. Bush was president, said the ultimate solution requires changing how doctors are paid to focus more on results rather than on the number of patient visits.
“My hope is that they’ll resolve it in a way that doesn’t just move the deck chairs around in a Medicare payment system that’s clearly sinking,” he said. “This gets resolved by changing the way that Medicare pays so that both the specialists and the generalists get paid more when they work together and deliver better care.”
McClellan cited Medicare pilot programs in which doctors have formed “accountable care organizations” allowing them to better coordinate patient care. The ACC, the cardiologist group, has pitched another alternative that would use lower co-pays to steer patients to better-performing doctors and give bonuses to physicians and hospitals that cut wasteful spending.
Tensions Rising
Tensions are rising among doctors, said Ted Epperly, 55, president of the American Academy of Family Physicians in Leawood, Kansas, in a telephone interview. Epperly runs a family practice in Boise, Idaho, and teaches at the University of Washington School of Medicine in Seattle.
Specialist colleagues have implied his support for the Medicare changes may cost his students, he said.
While family-care students typically spend parts of their three-year residencies training with specialists, “What I’ve heard is ‘maybe we just won’t have time any longer to teach your residents,’” Epperly said.
The ACC is offering a sample letter to patients, asking them to write Congress. “I am concerned that my physician may no longer be able to treat me or other Medicare patients,” the letter says. The campaign has extended to fliers, posters and even the on-hold message the group plays for callers to its Washington office, which asks the public to fight “drastic pay cuts for cardiology.”
The arguments have a familiar ring, McClellan said.
“The usual way that you try to scuttle a health-care reform proposal is by saying whatever it is going to reduce your access to the care that you need,” he said.
Three Years Earlier
Cancer specialists made similar warnings three years ago when reimbursement was cut for the drugs they used, said Nancy M. Kane, a professor at the Harvard School of Public Health in Boston and member of the Medicare Payment Advisory Commission, a panel of outside advisers to Congress.
“As far as I know we have not seen a drop in the number of oncologists since then,” Kane said. “People are not screaming that they don’t have access to oncologists.”
The pay shift would help right a financial imbalance that keeps young physicians out of family care, said Epperly, of the family doctors’ group.
Average total compensation for family doctors ranged from $150,763 to $204,370 a year, according to a 2008 survey by Modern Healthcare magazine. Cardiologists fetched from $332,900 to $561,875. Radiation oncologists, cancer doctors who specialize in radiation therapy, earned $357,000 to $463,293.
“If we don’t invest more in primary care, we won’t have the resources to offer more access,” Epperly said. “Our system is very good at getting people to do what they’re paid to do. That’s why specialists are doing all the things they do, because they’re paid gobs of money.”
To contact the reporters on this story: Alex Nussbaum in New York anussbaum1@bloomberg.net; Lisa Rapaport in New York at lrapaport1@bloomberg.net.
Democrats Can’t Repeat 1994 Health-Care Failure
Commentary by Albert R. Hunt
Bill Kristol, a powerhouse policy guru for Republicans, often has a tin ear for politics. A week before last year’s presidential election he predicted John McCain would “win huge.” In May, he said President Barack Obama had decided to nominate Michigan Governor Jennifer Granholm to the Supreme Court, and he’s been a cheerleader for Sarah Palin.
Kristol was prescient, though, 16 years ago in advising Republicans that defeating President Bill Clinton’s health-care overhaul would be devastating for the Democrats. He’s making the same case today, imploring Republicans to “go for the kill” on the Obama health-care initiative.
He’s right again. A defeat would be a killer for Democrats. The trademark of Obama’s first year in office would be failure; the reputations of the president and his celebrated White House staff would be decimated. Less evident, though equally true, it would almost certainly cost congressional Democrats seats in next year’s elections, striking especially hard at some of the same centrist Blue Dogs who are resisting a health-care bill.
Now those nervous Democrats are looking at polls showing declining support for Obama on health care, and data heralded by the health-insurance industry showing that most Americans are pleased with their coverage.
Misleading Indicators
Both are misleading.
There is no Obamacare plan. The declining poll numbers reflect the disarray in Congress and among Democrats; this is what happened in 1994. And most Americans are satisfied with their health insurance until they have to use it.
For 30 years my health insurance seemed just fine. Then one of our children was paralyzed and needed to learn to walk again. The insurance company said its “expert” -- dismissing the opinion of Johns Hopkins physicians -- concluded he had no need for a physical therapist.
To contest this expert, we had to put this severely disabled teenage kid through the humiliation of videotaping him while he tried to take steps. Most people who have been deep into health care understand why moviegoers cheered Helen Hunt’s famous denunciation of health insurers in the movie “As Good As It Gets.”
A more relevant number for nervous congressional Democrats to consider is 54 -- the number of seats they lost in 1994 even with a reasonably good economy and no wars; this was after the party disintegrated over health care.
Democrats’ Losses
The big news back then was the defeat of powerful leaders such as House Speaker Tom Foley of Washington. Overall, the losses disproportionately affected middle-of-the-road Democrats -- the Blue Dogs of their day -- from states such as Indiana, North Carolina, Georgia and Ohio.
Some Blue Dogs calculate the best deal for them may be to go on the record as voting against a bill that will become law anyway. The other politically viable option is to help craft the legislation. No one will be defeated in 2010 for voting to overhaul a failing health-care system; it will be several years before the effectiveness of such action is apparent.
Obama and his chief of staff, Rahm Emanuel, need to persuade the Blue Dogs that many of their political futures are at stake, too, while pressuring liberals not to let their notion of the perfect be the enemy of the good. That won’t be easy. “A lot of members are choking,” acknowledges Emanuel. Everybody liked health-care reform, he said “until they got visited by their local self-interest.”
50-50 Chance?
With fractious fights in both chambers, one important advocate says the prospects for success are no better than 50- 50.
That seems a little too pessimistic. Amid the squabbles, there has been considerable progress. In the House, a deal was engineered on the politically sensitive question of regional disparities in Medicare reimbursements.
House Speaker Nancy Pelosi will decide in the next few days whether to bring a bill to the floor before the August recess. Passage would add to a sense of momentum, yet there is a danger in appearing to rush through a measure that affects about one-sixth of the U.S. economy, and she could lose as many as three-dozen of her Democrats in a floor vote. (The White House would prefer the House to stay in session a week beyond the July 31 summer recess date; the problem is many members, with younger kids, have family plans before school starts in mid-August.)
For all the difficulties, the contours of any ultimate measure are clear.
Conditions for a Deal
-- The so-called public option -- some form of government- run plan to compete with private insurers -- will only be a fallback in the event private insurers fail to meet the goals, and will probably be in the form of health cooperatives or another mechanism. Liberals simply will have to accept that they lack the votes for a full-fledged public option.
-- Raising revenue -- in the neighborhood of $300 billion over the next decade -- may be the toughest nut. The House Ways and Means Committee’s millionaire’s surcharge plan is dead; at most, only a much smaller tax on the rich will fly. More likely will be some amalgam, including a tax on the most-generous health-insurance plans or the insurers that offer them, that would be part of the $200 billion in tax measures on the Senate Finance Committee’s table. Fears of a budget-busting bill are misplaced. Neither the politics nor the procedures will permit that.
-- Cost controls, so great in theory, will bite and will require politicians to take on special interests. The Blue Dogs, for all their talk of bills being too expensive, start off demanding more expansive health care for rural areas.It is fantasy to talk about a bipartisan bill; no more than a handful of congressional Republicans are likely to vote for a final bill. They’ve heard Kristol.
The bottom line: Democrats control their own fate; that’s the glory and the agony of governing.
credit byAlbert R. Hunt
Bill Kristol, a powerhouse policy guru for Republicans, often has a tin ear for politics. A week before last year’s presidential election he predicted John McCain would “win huge.” In May, he said President Barack Obama had decided to nominate Michigan Governor Jennifer Granholm to the Supreme Court, and he’s been a cheerleader for Sarah Palin.
Kristol was prescient, though, 16 years ago in advising Republicans that defeating President Bill Clinton’s health-care overhaul would be devastating for the Democrats. He’s making the same case today, imploring Republicans to “go for the kill” on the Obama health-care initiative.
He’s right again. A defeat would be a killer for Democrats. The trademark of Obama’s first year in office would be failure; the reputations of the president and his celebrated White House staff would be decimated. Less evident, though equally true, it would almost certainly cost congressional Democrats seats in next year’s elections, striking especially hard at some of the same centrist Blue Dogs who are resisting a health-care bill.
Now those nervous Democrats are looking at polls showing declining support for Obama on health care, and data heralded by the health-insurance industry showing that most Americans are pleased with their coverage.
Misleading Indicators
Both are misleading.
There is no Obamacare plan. The declining poll numbers reflect the disarray in Congress and among Democrats; this is what happened in 1994. And most Americans are satisfied with their health insurance until they have to use it.
For 30 years my health insurance seemed just fine. Then one of our children was paralyzed and needed to learn to walk again. The insurance company said its “expert” -- dismissing the opinion of Johns Hopkins physicians -- concluded he had no need for a physical therapist.
To contest this expert, we had to put this severely disabled teenage kid through the humiliation of videotaping him while he tried to take steps. Most people who have been deep into health care understand why moviegoers cheered Helen Hunt’s famous denunciation of health insurers in the movie “As Good As It Gets.”
A more relevant number for nervous congressional Democrats to consider is 54 -- the number of seats they lost in 1994 even with a reasonably good economy and no wars; this was after the party disintegrated over health care.
Democrats’ Losses
The big news back then was the defeat of powerful leaders such as House Speaker Tom Foley of Washington. Overall, the losses disproportionately affected middle-of-the-road Democrats -- the Blue Dogs of their day -- from states such as Indiana, North Carolina, Georgia and Ohio.
Some Blue Dogs calculate the best deal for them may be to go on the record as voting against a bill that will become law anyway. The other politically viable option is to help craft the legislation. No one will be defeated in 2010 for voting to overhaul a failing health-care system; it will be several years before the effectiveness of such action is apparent.
Obama and his chief of staff, Rahm Emanuel, need to persuade the Blue Dogs that many of their political futures are at stake, too, while pressuring liberals not to let their notion of the perfect be the enemy of the good. That won’t be easy. “A lot of members are choking,” acknowledges Emanuel. Everybody liked health-care reform, he said “until they got visited by their local self-interest.”
50-50 Chance?
With fractious fights in both chambers, one important advocate says the prospects for success are no better than 50- 50.
That seems a little too pessimistic. Amid the squabbles, there has been considerable progress. In the House, a deal was engineered on the politically sensitive question of regional disparities in Medicare reimbursements.
House Speaker Nancy Pelosi will decide in the next few days whether to bring a bill to the floor before the August recess. Passage would add to a sense of momentum, yet there is a danger in appearing to rush through a measure that affects about one-sixth of the U.S. economy, and she could lose as many as three-dozen of her Democrats in a floor vote. (The White House would prefer the House to stay in session a week beyond the July 31 summer recess date; the problem is many members, with younger kids, have family plans before school starts in mid-August.)
For all the difficulties, the contours of any ultimate measure are clear.
Conditions for a Deal
-- The so-called public option -- some form of government- run plan to compete with private insurers -- will only be a fallback in the event private insurers fail to meet the goals, and will probably be in the form of health cooperatives or another mechanism. Liberals simply will have to accept that they lack the votes for a full-fledged public option.
-- Raising revenue -- in the neighborhood of $300 billion over the next decade -- may be the toughest nut. The House Ways and Means Committee’s millionaire’s surcharge plan is dead; at most, only a much smaller tax on the rich will fly. More likely will be some amalgam, including a tax on the most-generous health-insurance plans or the insurers that offer them, that would be part of the $200 billion in tax measures on the Senate Finance Committee’s table. Fears of a budget-busting bill are misplaced. Neither the politics nor the procedures will permit that.
-- Cost controls, so great in theory, will bite and will require politicians to take on special interests. The Blue Dogs, for all their talk of bills being too expensive, start off demanding more expansive health care for rural areas.It is fantasy to talk about a bipartisan bill; no more than a handful of congressional Republicans are likely to vote for a final bill. They’ve heard Kristol.
The bottom line: Democrats control their own fate; that’s the glory and the agony of governing.
credit byAlbert R. Hunt
8/9/09
Obama-Care is a bad joke?
Obama-Care is a sick joke?
As the New York Post has rightly pointed out ObamaCare is a bad joke. Here are some facts, who refuse to be ignored ...
• In 52 to 40 percent of voters have turned against the health of the Act on 14th July in the Chamber of Deputies.
• Self-employed now against ObamaCare by a ratio of about 2:1.
• The World Health Organization, the U.S. No. 1 over 191 countries to meet the needs of patients, including the provision at the appropriate time in the treatment and the choice of doctors. Among those who are currently 84% are satisfied with their health. But if you're happy, are not at home: ObamaCare forcing the people, their insurance.
• The impartiality Congressional Budget Office (CBO) believes that the draft law by the Chamber of the Democrats would be the Federal Office for $ 239 billion.
• The Obama team has lacked the CBO to the plans to reduce waste and the reduction of services. Unfortunately, the reduction of waste, only about 1% of ObamaCare "savings". Other potential savings from the reduction should be the care of patients.
• In its "keep the system neutral" Maskerade, the Obama administration, he points to reductions in the care of patients in the form of reductions to the health of the Medicare program for the elderly. The American Medical Association, in his controversial letter support for the Democrats' plan with leading repeal $ 230 billion in cuts in health insurance.
• The team Obama is also on the economies of initiatives aimed at prevention. Legislation by the Senate Democrats points to the "prevention" again and again. But as the CBO has pointed out that prevention does not save money in general.
• Obama says he wants one with which the federal government for the health benefits of the Congrès is located. This concept is a farce. The Congress has a cafeteria plan, the choice is from the public, but it is not supported by the government.
• Congress specifically benefits the rest of us can only dream of. There is a doctor on call, only the members of Congress and the Congress has a privileged access and admission of Walter Reed Army Medical Center and Bethesda Naval Medical Center. The Congress is being a VIP for us?
• ObamaCare requires a large bureaucracy in the health sector eye-popping complex Rube Goldberg would be the head.
When Obama was in pre-election campaign mode, some reason he made statements about health care. He wanted to keep your insurance when you are happy with it. He told us that health care by the government with the increase of taxes was a bad idea. And he did not think that anyone should be forced to purchase the insurance. Only those of us naively believe Obama's sweet little promises, but at least they sounded nice.
The kingfisher day of campaign 2008 is long gone. The elections have an impact - promises, for example. But at least we can in the knowledge that Obama and friends have to play by the rules for implementation, is not it?
Wrong!
"Under the current bill Democrats in healthcare, the members of Congress are curiously exempt from the government, the health of the option, the preservation of their health services and on Capitol Hill."
Members of John Fleming, has passed a resolution to the members of Congress, "the possibility of their money where their mouth is and urge their colleagues, the choice for the legislation establishing the government health care plan with an example and in the same audience. "Fleming's Resolution has more than 40 co-sponsors, but not only one of the co-sponsors is a Democrat.
Even Obama has refused to participate in the program, health insurance. I can not blame Obama wants the best care for their family, but I can accuse him, not hypocritical.
The Americans have their appetite hypocritical, reckless spending, and the penetration of the inability of the government in all spheres of life. Obama is trying to address one of these concerns by promising that he "will not sign any health-care bill that adds to the deficit," but apparently it's too little and too late. Support for ObamaCare crumbling. Think of some recent comments:
• The Washington Post: "Month on cooperation between the various stakeholders in the health reform debate seems to come to an end ..."
• Reuters: "The reform of the U.S. $ 2.5 trillion health care is a signature Obama national problem and a test of his presidency, but it's time is short ..."
• CNN: Six key senators - three Democrats, one independent and two moderate Republicans - sent a letter to the leaders of the Senate for a slowing of the pressure for a revision of the health care on the basis of the Congressional Budget Office believes that the democratic currently not would be done, the cost of medical treatment.
• WSB: "Last week was a roller coaster of events that appear to swing in the controversial health reform initiative, then he slowly ..."
• politico: Jim DeMint is apparently the possibility of victory. "If we are in a position to Obama, what is his Waterloo. And they break."
• The Associated Press: "Could it be that the president Barack Obama Midas begins, a little boring, even among members of his own party?"
Obama has a lot of political capital and his credibility to a hard test for the break with the Chicken Little schtick he has the idea to sell. When it comes to health, perhaps the sky is back, but the Americans seemed not to hear.
Obama's popularity is sinking together, the tone changes, and cheerleaders are losing their enthusiasm. "What is right for you? Bread and discipline," they say. "Who knew that we have received, the election of a national mother?"
If Obama has the White House by the Democrats to control in Washington, the government of the health sector seems fate. Well, that's not so clear. The conservatives have many reasons to be optimistic in view of their chances to defeat ObamaCare.
As the New York Post has rightly pointed out ObamaCare is a bad joke. Here are some facts, who refuse to be ignored ...
• In 52 to 40 percent of voters have turned against the health of the Act on 14th July in the Chamber of Deputies.
• Self-employed now against ObamaCare by a ratio of about 2:1.
• The World Health Organization, the U.S. No. 1 over 191 countries to meet the needs of patients, including the provision at the appropriate time in the treatment and the choice of doctors. Among those who are currently 84% are satisfied with their health. But if you're happy, are not at home: ObamaCare forcing the people, their insurance.
• The impartiality Congressional Budget Office (CBO) believes that the draft law by the Chamber of the Democrats would be the Federal Office for $ 239 billion.
• The Obama team has lacked the CBO to the plans to reduce waste and the reduction of services. Unfortunately, the reduction of waste, only about 1% of ObamaCare "savings". Other potential savings from the reduction should be the care of patients.
• In its "keep the system neutral" Maskerade, the Obama administration, he points to reductions in the care of patients in the form of reductions to the health of the Medicare program for the elderly. The American Medical Association, in his controversial letter support for the Democrats' plan with leading repeal $ 230 billion in cuts in health insurance.
• The team Obama is also on the economies of initiatives aimed at prevention. Legislation by the Senate Democrats points to the "prevention" again and again. But as the CBO has pointed out that prevention does not save money in general.
• Obama says he wants one with which the federal government for the health benefits of the Congrès is located. This concept is a farce. The Congress has a cafeteria plan, the choice is from the public, but it is not supported by the government.
• Congress specifically benefits the rest of us can only dream of. There is a doctor on call, only the members of Congress and the Congress has a privileged access and admission of Walter Reed Army Medical Center and Bethesda Naval Medical Center. The Congress is being a VIP for us?
• ObamaCare requires a large bureaucracy in the health sector eye-popping complex Rube Goldberg would be the head.
When Obama was in pre-election campaign mode, some reason he made statements about health care. He wanted to keep your insurance when you are happy with it. He told us that health care by the government with the increase of taxes was a bad idea. And he did not think that anyone should be forced to purchase the insurance. Only those of us naively believe Obama's sweet little promises, but at least they sounded nice.
The kingfisher day of campaign 2008 is long gone. The elections have an impact - promises, for example. But at least we can in the knowledge that Obama and friends have to play by the rules for implementation, is not it?
Wrong!
"Under the current bill Democrats in healthcare, the members of Congress are curiously exempt from the government, the health of the option, the preservation of their health services and on Capitol Hill."
Members of John Fleming, has passed a resolution to the members of Congress, "the possibility of their money where their mouth is and urge their colleagues, the choice for the legislation establishing the government health care plan with an example and in the same audience. "Fleming's Resolution has more than 40 co-sponsors, but not only one of the co-sponsors is a Democrat.
Even Obama has refused to participate in the program, health insurance. I can not blame Obama wants the best care for their family, but I can accuse him, not hypocritical.
The Americans have their appetite hypocritical, reckless spending, and the penetration of the inability of the government in all spheres of life. Obama is trying to address one of these concerns by promising that he "will not sign any health-care bill that adds to the deficit," but apparently it's too little and too late. Support for ObamaCare crumbling. Think of some recent comments:
• The Washington Post: "Month on cooperation between the various stakeholders in the health reform debate seems to come to an end ..."
• Reuters: "The reform of the U.S. $ 2.5 trillion health care is a signature Obama national problem and a test of his presidency, but it's time is short ..."
• CNN: Six key senators - three Democrats, one independent and two moderate Republicans - sent a letter to the leaders of the Senate for a slowing of the pressure for a revision of the health care on the basis of the Congressional Budget Office believes that the democratic currently not would be done, the cost of medical treatment.
• WSB: "Last week was a roller coaster of events that appear to swing in the controversial health reform initiative, then he slowly ..."
• politico: Jim DeMint is apparently the possibility of victory. "If we are in a position to Obama, what is his Waterloo. And they break."
• The Associated Press: "Could it be that the president Barack Obama Midas begins, a little boring, even among members of his own party?"
Obama has a lot of political capital and his credibility to a hard test for the break with the Chicken Little schtick he has the idea to sell. When it comes to health, perhaps the sky is back, but the Americans seemed not to hear.
Obama's popularity is sinking together, the tone changes, and cheerleaders are losing their enthusiasm. "What is right for you? Bread and discipline," they say. "Who knew that we have received, the election of a national mother?"
If Obama has the White House by the Democrats to control in Washington, the government of the health sector seems fate. Well, that's not so clear. The conservatives have many reasons to be optimistic in view of their chances to defeat ObamaCare.
Distortions plague the debate on health care
Distortions plague the debate on health care
Washington - confusing information and distorting final animated the national debate on changes in health.
Opponents of the proposal of Mr. Barack Obama and Democratic Congress wrong to say that government officials, seniors discuss "End-of-life will. Obama has the possibility of a health assessment, a large number of people to change, doctors and insurers.
For all, there is no clear "Obama plan" or "democratic planning." Obama has several goals, but he has few lines in the sand.
The Senate examines two laws is different. The house is still waiting for another act in committee.
A look at some information on the proposals on health:
Request: The home of Bill "can a traitor government encourages euthanasia," House Republican Leader John Boehner of Ohio, said July 23.
Former New York Lt. Gov. Betsy McCaughey said in an article in the July 17th: "A worrying increase in the house of the elderly to the law requires, at a consultation meeting every five years ... on alternatives for the End-of-Life Care. "
Facts: The bill would pay for health advance directive in consultation with health care. But it is not necessary, someone benefits.
Advance directives for a patient wishes aging under different scenarios of a serious illness, brain damage and serious situations. Patients and their families with health professionals, not servants, if they benefit from the proposal.
Request: Health care changes would lead to abortions funded by the state.
Tony Perkins of Family Research Council said in a video, "unless something else congress, under the government of taking care of health, the taxpayer is forced, for the financing of abortion for first time in more than three decades. "
The facts: The proposed bills would not be canceled Hyde Amendment, bars abortion paid by Medicaid, the insurance program for the poor. But a review of health care could be a government run insurance program or insurance "exchange", that is not Medicaid abortion and their guidelines are not clear yet.
Obama recently said CBS, which the States to continue the tradition of the "Financing of abortion that are not part of health care financed by the state."
The trading house energy committee and the House Bill Thursday to health insurance that provides the possibility of abortion, but no public funds can be used to fund abortion. The law says health plans in exchange for a new purchase is not required for abortion, but that each region of the country, must have at least one plan that works.
The action of Congress this fall is whether this language is the final bill.
Demand: Americans are not to change doctors or insurance companies.
"If you want your plan, and you, as your doctor, you do not do something," said Obama, June 23 "You keep your plan with your doctor."
Fact: The proposed regulations would not require the man to let your doctor or insurer. But some tax provisions, depending on how they are written, have the effect that cheaper for some employers to pay a fee to put an end to preserve their health. Your workers would probably be an audience of insurance, which can not doctors.
Request: democrats lead to rationing plans, or the government to decide what medical procedures a patient may have.
"Strengthening of national health programs accelerate the day that the government rationing medical care of elderly, conservative writer Michael Cannon said in the" Washington Times ".
The facts: millions of Americans before rationing, such as insurance, procedures for insurance.
Denial of coverage for certain procedures increase proposals to a government-appointed agency procedures and identify the most appropriate for different conditions.
Obama said that the goal is effective and efficient medical practices and to monitor patients and providers of services for them. Recently, he told a forum: "We do not want to dictate the diet of someone, 'OK, you know what? We do not think this should be a Senior hip." What we want to do, you can use is to provide information that seniors and their doctors, you know, is the starting point, is very useful for you in managing your condition. "
Request: Revision of health care will not be the deficit of the Confederation in the long term.
Obama has pledged that "the reform of health insurance will not be our deficit over the next ten years, and I am."
The facts: Obama commitment does not apply to proposals for expenditure of approximately $ 245 billion over the next ten years to increase Medicare fees for doctors. The White House said the additional payment, is to ensure that a proposed reduction of over 21% in medical costs, already under the management of the policy.
In addition, the impartial Congressional Budget Office, said House Bill lack of mechanisms to reduce health care costs under control. In response, the White House and Democratic lawmakers on the creation of a powerful new executive board, if the waste in public health programs. But it is difficult to know how they could.
Experts warn of budget accounting tricks, mask the real burden for the deficit. Both sides Committee for a Responsible Federal Budget, says it also back-loading of the most serious at the end of 10 years and beyond.
Then, after the Associated Press, most of what critics say about Mr. Obama 's Health Care is incorrect.
And in most cases, all that Obama says is absolutely true, and is always the case.
The exception is that the AP is to recognize that Mr. Obama may be a little too optimistic, the way the plan does not have the extension of the excessive deficit.
The AP's list of "facts" are all the more surprising that the article itself acknowledges:
[T] is not "Obama plan" or "democratic planning." And: Obama has many goals, but he has few lines in the sand.
And yet, the articles still bold affirmed, "all", like this:
Fact: The proposed regulations would not require the man to let your doctor or insurer.
And it is strange to see the "facts" buttressed by statements like: Obama recently said CBS, which the States to continue the tradition of the "Financing of abortion that are not part of health care financed by the state."
Then we have nothing to fear.
We should now have learned that Mr. Obama will never be on his word. And the future president or Congress or expand the health coverage of abortion.
It is really funny.
Washington - confusing information and distorting final animated the national debate on changes in health.
Opponents of the proposal of Mr. Barack Obama and Democratic Congress wrong to say that government officials, seniors discuss "End-of-life will. Obama has the possibility of a health assessment, a large number of people to change, doctors and insurers.
For all, there is no clear "Obama plan" or "democratic planning." Obama has several goals, but he has few lines in the sand.
The Senate examines two laws is different. The house is still waiting for another act in committee.
A look at some information on the proposals on health:
Request: The home of Bill "can a traitor government encourages euthanasia," House Republican Leader John Boehner of Ohio, said July 23.
Former New York Lt. Gov. Betsy McCaughey said in an article in the July 17th: "A worrying increase in the house of the elderly to the law requires, at a consultation meeting every five years ... on alternatives for the End-of-Life Care. "
Facts: The bill would pay for health advance directive in consultation with health care. But it is not necessary, someone benefits.
Advance directives for a patient wishes aging under different scenarios of a serious illness, brain damage and serious situations. Patients and their families with health professionals, not servants, if they benefit from the proposal.
Request: Health care changes would lead to abortions funded by the state.
Tony Perkins of Family Research Council said in a video, "unless something else congress, under the government of taking care of health, the taxpayer is forced, for the financing of abortion for first time in more than three decades. "
The facts: The proposed bills would not be canceled Hyde Amendment, bars abortion paid by Medicaid, the insurance program for the poor. But a review of health care could be a government run insurance program or insurance "exchange", that is not Medicaid abortion and their guidelines are not clear yet.
Obama recently said CBS, which the States to continue the tradition of the "Financing of abortion that are not part of health care financed by the state."
The trading house energy committee and the House Bill Thursday to health insurance that provides the possibility of abortion, but no public funds can be used to fund abortion. The law says health plans in exchange for a new purchase is not required for abortion, but that each region of the country, must have at least one plan that works.
The action of Congress this fall is whether this language is the final bill.
Demand: Americans are not to change doctors or insurance companies.
"If you want your plan, and you, as your doctor, you do not do something," said Obama, June 23 "You keep your plan with your doctor."
Fact: The proposed regulations would not require the man to let your doctor or insurer. But some tax provisions, depending on how they are written, have the effect that cheaper for some employers to pay a fee to put an end to preserve their health. Your workers would probably be an audience of insurance, which can not doctors.
Request: democrats lead to rationing plans, or the government to decide what medical procedures a patient may have.
"Strengthening of national health programs accelerate the day that the government rationing medical care of elderly, conservative writer Michael Cannon said in the" Washington Times ".
The facts: millions of Americans before rationing, such as insurance, procedures for insurance.
Denial of coverage for certain procedures increase proposals to a government-appointed agency procedures and identify the most appropriate for different conditions.
Obama said that the goal is effective and efficient medical practices and to monitor patients and providers of services for them. Recently, he told a forum: "We do not want to dictate the diet of someone, 'OK, you know what? We do not think this should be a Senior hip." What we want to do, you can use is to provide information that seniors and their doctors, you know, is the starting point, is very useful for you in managing your condition. "
Request: Revision of health care will not be the deficit of the Confederation in the long term.
Obama has pledged that "the reform of health insurance will not be our deficit over the next ten years, and I am."
The facts: Obama commitment does not apply to proposals for expenditure of approximately $ 245 billion over the next ten years to increase Medicare fees for doctors. The White House said the additional payment, is to ensure that a proposed reduction of over 21% in medical costs, already under the management of the policy.
In addition, the impartial Congressional Budget Office, said House Bill lack of mechanisms to reduce health care costs under control. In response, the White House and Democratic lawmakers on the creation of a powerful new executive board, if the waste in public health programs. But it is difficult to know how they could.
Experts warn of budget accounting tricks, mask the real burden for the deficit. Both sides Committee for a Responsible Federal Budget, says it also back-loading of the most serious at the end of 10 years and beyond.
Then, after the Associated Press, most of what critics say about Mr. Obama 's Health Care is incorrect.
And in most cases, all that Obama says is absolutely true, and is always the case.
The exception is that the AP is to recognize that Mr. Obama may be a little too optimistic, the way the plan does not have the extension of the excessive deficit.
The AP's list of "facts" are all the more surprising that the article itself acknowledges:
[T] is not "Obama plan" or "democratic planning." And: Obama has many goals, but he has few lines in the sand.
And yet, the articles still bold affirmed, "all", like this:
Fact: The proposed regulations would not require the man to let your doctor or insurer.
And it is strange to see the "facts" buttressed by statements like: Obama recently said CBS, which the States to continue the tradition of the "Financing of abortion that are not part of health care financed by the state."
Then we have nothing to fear.
We should now have learned that Mr. Obama will never be on his word. And the future president or Congress or expand the health coverage of abortion.
It is really funny.
6 Reasons Obama-Care Is Bad Medicine
6 reasons Obama-Care is Bad Medicine
Nobody denies that in a rich country like ours, where the borders on the tragic that millions are not a form of health care. I believe that Americans really.
I agree that the reform of health care is essential in America, but I do not believe that the draft of the so-called "universal healthcare", which was signed today by our President the solution. Indeed, I believe that medicine is bad for America.
- First of all, universal health care is reflected by carelessness.
Sweeping reform of the health care system to be adopted in record time in the world? Like the promotion and false nonsense rescue, care for Obama is America's Glen (without justification), and propulsion systems, such as a wall by the Congress (without testing). I mention the lightning war Obama: Create a crisis, and the number crunch, CRAM and legislation. The fact is that the president continue to sell the program, but there is still no plan for him or for the Congress is for sale.
- Secondly, the universality of health care is clearly lead our country deep in debt that gradually shift from the experiences of foreign powers, without any doubts in Washington to end.
Obama said in a press conference on television at the national level, "The reforms in the health sector will not be given to this deficit, is for a reduction." How can you tell if you do not have problems with a plan for health care? If it is not the impact of supply on a large scale in all communities across the nation?
The President is the struggle against the base of the tax on the rhetoric into reality. According to the Congressional Budget Office, the Senate version of the legislation in the health sector is a significant increase in the federal deficit by around 1.0 trillion U.S. dollars for fiscal year 2010 from the 2019th "And what makes a good financial responsibility in the economy and the government, already facing bankruptcy?
- Thirdly, the universal health care impersonalize would ration health care and medical services.
The government takeover of health care in Washington would also include the use of "Exploring the effectiveness of comparison" to the doctors before the treatment, and how much it cost. This would lead to rationing in health care.
Canada and Europe have already shown that the quality of medical nightmares, with a plethora of new rules and new medical rationing. In the services provided by the government, the staff in health care, the more impersonal harassment. More public transport threaten MINUCI runs in our lives.
- Fourthly, health, generally, the competition in the market for health services.
And with regard to the taxpayers the cost of the program? It would be universal health care, the productivity of their future? Other members of taxes in the class (and that would be even more disadvantaged, their productivity), is certainly not for the creation of incentives for Americans to the American dream. And of course they have added impact of the fees for the consumer. Now we can assume that he would be willing to pay 47 million Americans are "universal health care for their surplus?
You can use competitive markets through the creation of monopolies, but it is exactly what the first government universal health care would be the distortion of competition. If the government must do something, you have to hard against the monopolies of health insurance. If the government wants to regulate something, it would be better to regulate health insurance, and not the American people.
- Fifth, universal health care in the future of health professionals in the vicinity of legislators.
With the government-sanctioned Health Care in general, the Legislative Assembly is almost as medical officer and head of the government of a medical report, the staff and the political oversight of the program. This does not, and the end of life, counseling and services. The policy of the Federal based on a relatively small number of medical director (as in most of them), which in turn is responsible for designing and implementing the political and medical procedures which they consider best for the country.
- Sixth, the Universal Health Care increases and the U.S. government continues to slope to socialism.
The nanny is not the solution to our health. Our government has two programs for health care coverage: Medicare (for elderly) and Medicaid (for low-income citizens). The President mentioned in his speech in the last week that the two programs are the largest contributions to the rise of our deficit. So why not a reform, improvement and expansion of these programs, rather than a third (or fourth or fifth), the government bureaucracy medically as "primary health care?
What is needed is a group in Washington Bipartisan is a long time to work and a health program for compromise, not increase taxes (for everyone), the regulation of medical personnel or election of cooperation in healthcare.
Why wait for Washington? Go to http://patientsunitednow.com/ to find out more about your community and you will be able to reform the health care and options for physicians and medical care. Especially on the website of Dr. Betsy McCaughey to http://www.defendyourhealthcare.us./ You are an expert in the field of health and the former Governor of New York and, in fact, read the entire Senate on the bill for universal healthcare. E 'will show many details hidden in the interior, which do not participate in the discussion with the public in the United States.
Nobody denies that in a rich country like ours, where the borders on the tragic that millions are not a form of health care. I believe that Americans really.
I agree that the reform of health care is essential in America, but I do not believe that the draft of the so-called "universal healthcare", which was signed today by our President the solution. Indeed, I believe that medicine is bad for America.
- First of all, universal health care is reflected by carelessness.
Sweeping reform of the health care system to be adopted in record time in the world? Like the promotion and false nonsense rescue, care for Obama is America's Glen (without justification), and propulsion systems, such as a wall by the Congress (without testing). I mention the lightning war Obama: Create a crisis, and the number crunch, CRAM and legislation. The fact is that the president continue to sell the program, but there is still no plan for him or for the Congress is for sale.
- Secondly, the universality of health care is clearly lead our country deep in debt that gradually shift from the experiences of foreign powers, without any doubts in Washington to end.
Obama said in a press conference on television at the national level, "The reforms in the health sector will not be given to this deficit, is for a reduction." How can you tell if you do not have problems with a plan for health care? If it is not the impact of supply on a large scale in all communities across the nation?
The President is the struggle against the base of the tax on the rhetoric into reality. According to the Congressional Budget Office, the Senate version of the legislation in the health sector is a significant increase in the federal deficit by around 1.0 trillion U.S. dollars for fiscal year 2010 from the 2019th "And what makes a good financial responsibility in the economy and the government, already facing bankruptcy?
- Thirdly, the universal health care impersonalize would ration health care and medical services.
The government takeover of health care in Washington would also include the use of "Exploring the effectiveness of comparison" to the doctors before the treatment, and how much it cost. This would lead to rationing in health care.
Canada and Europe have already shown that the quality of medical nightmares, with a plethora of new rules and new medical rationing. In the services provided by the government, the staff in health care, the more impersonal harassment. More public transport threaten MINUCI runs in our lives.
- Fourthly, health, generally, the competition in the market for health services.
And with regard to the taxpayers the cost of the program? It would be universal health care, the productivity of their future? Other members of taxes in the class (and that would be even more disadvantaged, their productivity), is certainly not for the creation of incentives for Americans to the American dream. And of course they have added impact of the fees for the consumer. Now we can assume that he would be willing to pay 47 million Americans are "universal health care for their surplus?
You can use competitive markets through the creation of monopolies, but it is exactly what the first government universal health care would be the distortion of competition. If the government must do something, you have to hard against the monopolies of health insurance. If the government wants to regulate something, it would be better to regulate health insurance, and not the American people.
- Fifth, universal health care in the future of health professionals in the vicinity of legislators.
With the government-sanctioned Health Care in general, the Legislative Assembly is almost as medical officer and head of the government of a medical report, the staff and the political oversight of the program. This does not, and the end of life, counseling and services. The policy of the Federal based on a relatively small number of medical director (as in most of them), which in turn is responsible for designing and implementing the political and medical procedures which they consider best for the country.
- Sixth, the Universal Health Care increases and the U.S. government continues to slope to socialism.
The nanny is not the solution to our health. Our government has two programs for health care coverage: Medicare (for elderly) and Medicaid (for low-income citizens). The President mentioned in his speech in the last week that the two programs are the largest contributions to the rise of our deficit. So why not a reform, improvement and expansion of these programs, rather than a third (or fourth or fifth), the government bureaucracy medically as "primary health care?
What is needed is a group in Washington Bipartisan is a long time to work and a health program for compromise, not increase taxes (for everyone), the regulation of medical personnel or election of cooperation in healthcare.
Why wait for Washington? Go to http://patientsunitednow.com/ to find out more about your community and you will be able to reform the health care and options for physicians and medical care. Especially on the website of Dr. Betsy McCaughey to http://www.defendyourhealthcare.us./ You are an expert in the field of health and the former Governor of New York and, in fact, read the entire Senate on the bill for universal healthcare. E 'will show many details hidden in the interior, which do not participate in the discussion with the public in the United States.
8/8/09
Obama-care 101: The president's 8 principles
Obama-Care 101: The President'8 principles President Obama said in
The budget released Thursday that he wants Congress to follow a set of eight principles "for the" transform and modernize health care in the United States "as the White House and the Capitol in drafting legislation for health care reform "in the coming years:
1. Protecting the financial health of families. The plan should reduce the growth of premiums and other costs of U.S. citizens and businesses pay for health care. People must be protected because of the catastrophic failure of the disease.
2. To cover health care affordable. The plan should reduce the high administrative costs, unnecessary tests and services, waste and other inefficiencies that consume money without the addition of health.
3. Case of universality. The plan is to put the United States on a clear path for all Americans.
4.cover portability. People should not be locked up in their work to ensure health coverage, and non-American should be denied coverage because of previous reports.
5.Guarantee Choice. The plan would give Americans a choice of health and medical care. They should be able to keep their employer's health care plan.
6. Focus on prevention and wellness. The plan is to invest in public health measures can reduce the cost of our system, such as obesity, physical inactivity and smoking - and to ensure access to preventive treatments.
7.Improving patient safety and quality of care. The plan must ensure the implementation of proven patient safety and provide incentives for changes in the system to reduce variations in patient care. It must support the widespread use of information technologies on health and development of data on the effectiveness of medical interventions to improve the quality of care.
8.Maintaining long-term sustainability of public finances. The health care plan should pay for itself by reducing the rate of growth in costs, improve productivity and provide new sources of income.
The budget released Thursday that he wants Congress to follow a set of eight principles "for the" transform and modernize health care in the United States "as the White House and the Capitol in drafting legislation for health care reform "in the coming years:
1. Protecting the financial health of families. The plan should reduce the growth of premiums and other costs of U.S. citizens and businesses pay for health care. People must be protected because of the catastrophic failure of the disease.
2. To cover health care affordable. The plan should reduce the high administrative costs, unnecessary tests and services, waste and other inefficiencies that consume money without the addition of health.
3. Case of universality. The plan is to put the United States on a clear path for all Americans.
4.cover portability. People should not be locked up in their work to ensure health coverage, and non-American should be denied coverage because of previous reports.
5.Guarantee Choice. The plan would give Americans a choice of health and medical care. They should be able to keep their employer's health care plan.
6. Focus on prevention and wellness. The plan is to invest in public health measures can reduce the cost of our system, such as obesity, physical inactivity and smoking - and to ensure access to preventive treatments.
7.Improving patient safety and quality of care. The plan must ensure the implementation of proven patient safety and provide incentives for changes in the system to reduce variations in patient care. It must support the widespread use of information technologies on health and development of data on the effectiveness of medical interventions to improve the quality of care.
8.Maintaining long-term sustainability of public finances. The health care plan should pay for itself by reducing the rate of growth in costs, improve productivity and provide new sources of income.
Does Obama Care? Part 2
The girl was a very simple question of the President: All the news health itself and the Congress could devise, it is a state in the types of medical decisions, which are stored in the life of his mother - idiosyncratic decisions based on the "spirit" and the vitality and Decisions of the heart and form, which in this case would have meant his his mother was "too old" to deal with?
Sensing his political bind he tap danced around in a few minutes and then blurted something, sometimes people just abandon the procedure, the doctor and take pills instead of pain - and all for the "best" is assumed.
You can imagine the joy of radio was. But I have looked at the video and I watched President Obama, and honestly I do not think it was in this room, when the woman's mother cases have decided that it opposes. In other words, the president - a man, not a politician, not a bureaucrat - was placed in the role that doctors should - that work only as a person, not a bureaucrat, and that such decisions on idiosyncratic, if the situation requires it - is also likely to be thrown all the rules, the heart and the criteria for a comparative cost-effectiveness through the window and give the pacemaker.
But there is a problem of bureaucratic medicine, what happens when the hospital changed to the DMV, which is precisely what the president tries to make the American public the name of cost control and equal access to equal care for all. When the government makes medical science and gave it to the bureaucrats to implement, there is no humanity, only bureaucrats. There is no room for "gut decisions based on the experience and knowledge of intuition is not the width of the assessments, which can not be fully in line with the formula or algorithm, and justifies review boxes, boxes with the format. When bureaucrats practice medicine, they are not in sympathy with the agent or the IRS, DMV drone.
The concepts of male and vitality to mind is precisely the opposite of bureaucratic thinking. For the bureaucrat is simply a statistical compilation, speculation and medium-sized enterprises in the forecasts. And yes, there are budgets, which means that the whole must respond to all. And finally, it means that rationing, delay, denial and the deterioration of the treatment.
There is a debate so that voters do not like Barack Obama are fighting each political battle with him at the individual level, as if he - a man - is the problem rather than the policies she promotes. These voters will be constantly frustrated by their inability to win against him, and they lose the fight against health care managed by the government, if they do not change their strategies.
It is simply not enough to overcome Obama political enemies. In order to protect U.S. citizens against the insane policies managed by the government, the bureaucracy of medicine, it is necessary to raise the discourse, not heavy of fair play, but a strategic necessity. Obama wins is crazy policy, the fight is a high-friendly, popular man. This means that it is necessary to inform and reassure people that if Obama guy could be a great and friendly boy, his ideas and policies are wrong, badly designed and dangerous, especially in elderly patients.
As the 105-year-old, mother of the President of the question, it does not corrupt politicians, who are the worst, but the politicians who have good intentions, ladies, men with too many bad ideas too, and the power to force all who put us all in danger. The good intentions of good men who have too much power and too little information about how the world works, which is how "politics" is just one of the word "abuse". The health care is handled by the government to kill Grandma. That is why the American common sense and good will to demand the withdrawal of Obama Health Care.
Does Obama care?
Obama care?
Barack Obama's off and ambivalent reaction to the events in Iran, the question arises whether it is concerned about the fate of freedom in Iran, and what his attitude to the Iranian regime. When he identified with the regime and its opponents? He care?
Ronald Reagan, the response to the imposition of martial law in Poland, provides an instructive contrast Obama muted reaction. Once in office, John O'Sullivan wrote the President, the Pope and the Prime Minister, Reagan took his staff, he always wanted to know about the development of Poland. "Less than two weeks after its establishment," relates O'Sullivan, "Reagan met with his advisor to discuss foreign policy, as the erosion of communist power in Poland and the intervention of the Soviet Union. "
When the communist government in Poland declared war to crush Solidarity legislative December 12-13, 1981, more than 4,000 Solidarity activists were arrested, was interned Lech Walesa and Solidarity was banned. Steven Hayward reminds us in his forthcoming The Age of Reagan: The Conservatives against revolution: 1980-1989 ", the fact that the Soviets, the Poles are fed up with dirty work, a fig leaf for Western leaders to solve the problem .
Western Chief said to express their understanding by the government against solidarity. They have all their support.
Not Ronald Reagan: "Ronald Reagan," says Hayward, "Poland was furious." Ed Morrissey notes that Reagan reacted immediately the imposition of the law of war by the publication of his interview with Pope John Paul II the next day :
President. "His Holiness, I would like you to know how we feel the situation at home."
"I look forward to the times we meet in person."
"Our sympathies are with people, not the government."
Reagan in his view, three days later a press conference:
All information that we have confirmation that the imposition of martial law in Poland led to the arrest and confinement in prisons and camps, thousands of Polish intellectuals and union leaders. Plants are seized by the security forces and workers affected.
These acts clearly, there was a sharp drop in the movement toward a free society, which in Poland for a year and a half. Coercion and the violation of human rights are widespread in the place of negotiation and compromise. This is clearly a violation of the Helsinki pact, Poland is a signatory.
It would be naive to think and go, without the knowledge and support of the Soviet Union. We are not naive. We see the current situation in Poland in the circumstances, including the increased use of violence against an unarmed population and violations of fundamental rights of the Polish population.
Invite violence and Poland threat of violence in the chaos. We invite all free men, which the Government of Poland in the conditions, negotiations and constructive as possible.
Of course, it will be impossible for us to continue to try to help solve Poland's economic problems, while the law of war is to man in Poland, thousands are in prison, and the rights of Free Trade Unions -- earlier by the government - now denied. We were always ready to assume our role in support of Poland to overcome their economic difficulties, but only if the Polish people can solve their internal problems without coercion and outside.
Our nation was born in the resistance against arbitrary power, and has been constantly enriched by immigrants from Poland and other major nations of Europe. Thus, we feel a special affinity with the Polish people in its struggle against its opposition to the Soviet reform.
The Polish nation, spoke of solidarity is one of the most brilliant, courageous moments in modern history. People in Poland imperishable give us an example of courage and commitment to the values of freedom from the relentless opposition. From left to man from Poland, a new birth of freedom. But there are also those who oppose the idea of freedom, intolerance to national independence and opposition to the European Parliament and the values of democracy and the rule of law.
Two months of December, lost liberty in Afghanistan, and Christmas, what is at stake, Poland. But the torch of freedom is hot. He heats it keep high. It burns those who remove it.
During the two weeks following the imposition of the law of war Reagan meetings of the National Security Council on the Polish crisis almost daily. Richard Pipes Hayward cites the description of an "emotionally charged atmosphere, inspired largely by the mounting anger Reagan." Reagan mocked the "Chicken Little" in Europe.
Regarding the storage of sources, 22nd December Hayward Reagan NSC meeting that it is "the last chance of life, against the filth of the place." Reagan expressed his anger in a submission to Brezhnev free s'indigne December 23: "[N] othing has outraged public opinion, as the pressures and threats that the government of Poland to stifle freedom of movement." On 23 December Reagan had his eloquent condemnation of the repression in Poland. Reagan said:
I must emphasize the belief that if tonight, the atrocities committed in Poland either, we can not, not "business as usual''con authors and those who support and help. Do not get confused the crimes of their costs are costly to their future relations with America and free peoples throughout the world. I have no easy explanation and without serious reflection.
What prevents that Barack Obama, such a statement? He care?
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