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Obamacare Only Looks Worse Upon Further Review

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http://www.bloomberg.com/news/2010-0...n-hassett.html

 

Obamacare Only Looks Worse Upon Further Review: Kevin Hassett

By Kevin Hassett - Aug 1, 2010 Bloomberg Opinion

 

One of the more illuminating remarks during the health-care debate in Congress came when House Speaker Nancy Pelosi told an audience that Democrats would "pass the bill so you can find out what's in it, away from the fog of controversy."

 

That remark captured the truth that, while many Americans have a vague sense that something bad is happening to their health care, few if any understand exactly what the law does.

 

To fill this vacuum, Representative Kevin Brady of Texas, the top House Republican on the Joint Economic Committee, asked his staff to prepare a study of the law, including a flow chart that illustrates how the major provisions will work.

 

The result, made public July 28, provides citizens with a preview of the impact the health-care overhaul will have on their lives. It's a terrifying road map that shows Democrats have launched America on the most reckless policy experiment in its history, the economic equivalent of the Bay of Pigs invasion.

 

http://www.house.gov/apps/list/press/tx08_brady/pr_100728_hc_chart.html

 

Before discussing what the law means for you, we have to look at what it does to government. That's where the chart comes in handy. It includes the new fees, bureaucracies and programs and connects them into an organizational chart that accounts for the existing structure. It's so carefully documented that a line connecting two structures cites the legislative language that created the link.

 

Ornate System

 

This clearly is a candidate for most disorganized organizational chart ever. It shows that the health system is complex, yes, but also ornate. The new law creates 68 grant programs, 47 bureaucratic entities, 29 demonstration or pilot programs, six regulatory systems, six compliance standards and two entitlements.

 

Getting that massive enterprise up and running will be next to impossible. So Democrats streamlined the process by granting Health and Human Services Secretary Kathleen Sebelius the authority to make judgments that can't be challenged either administratively or through the courts.

 

This monarchical protection from challenges is extended as well to the development of new patient-care models under Obama's controversial recess appointment, Donald Berwick, whom Republicans are calling the rationer-in-chief. Berwick will run the Centers for Medicare and Medicaid Services, where he can experiment with ways to use administrative fiat to move our system toward the socialized medicine of Europe, which he has at times embraced.

 

Closer to Home

 

A sprawling, complex bureaucracy has been set up that will have almost absolute power to dictate terms for participating in the health-care system. That's what the law does to government. What it does to you is worse.

 

Based on the administration's own numbers, as many as 117 million people might have to change their health plans by 2013 as their employer-provided coverage loses its grandfathered status and becomes subject to the new Obamacare mandates.

 

Those mandates also might make your health care more expensive. The Congressional Budget Office predicts that premiums for a small number of families who buy their insurance privately will rise by as much as $2,100.

 

The central Obamacare mechanism for increasing insurance coverage is an expansion of the Medicaid program. Of the 30 million new people covered, 16 million will be enrolled in Medicaid. And you could end up in the program whether you want it or not. The bill states that people who apply for coverage through the new exchanges or who apply for premium-subsidy credits will automatically be enrolled in Medicaid if they qualify.

 

Hurting the Elderly

 

To pay for this expansion, the bill takes $529 billion from Medicare, with roughly 39 percent of the cut coming from the Medicare Advantage program. This represents a large transfer of resources, sacrificing the care of the elderly in order to increase the Medicaid rolls.

 

For all this supposed reform, you, the American taxpayer, can expect a bill to the tune of $569 billion.

 

Front and center among the new taxes is the 40 percent excise tax on those lucky people with so-called Cadillac health plans. The higher insurance costs that are driven by the government mandates will push many more ordinary plans into Cadillac territory.

 

If the idea of taxing people with coverage deemed too good doesn't bother you, maybe the new 3.8 percent tax on investment income will. That will apply even to a small number of home sales, those that generate $250,000 in profit for an individual or $500,000 for a married couple.

 

In vivid color and detail, Congressman Brady's chart captures the huge expansion of government coming under Obamacare. Harder to show on paper is the pain it will cause.

 

(Kevin Hassett, director of economic-policy studies at the American Enterprise Institute, is a Bloomberg News columnist. He was an adviser to Republican Senator John McCain in the 2008 presidential election. The opinions expressed are his own.)

 

To contact the writer of this column: Kevin Hassett at khassett@bloomberg.net

 

 

http://www.politico.com/news/stories/0810/40561.html

 

Health reform's bureaucratic spawn

By: Gloria Park and Fred Barbash

August 3, 2010 04:31 AM EDT

 

Don't bother trying to count up the number of agencies, boards and commissions created under the new health care law. Estimating the number is "impossible," a recent Congressional Research Service report says, and a true count "unknowable."

 

The reasons for the uncertainty are many, according to CRS's Curtis W. Copeland, the author of the report "New Entities Created Pursuant to the Patient Protection and Affordable Care Act."

 

The provisions of the law that create the new entities vary dramatically in specificity.

 

The law says a lot about some of them and a little about many, and merely mentions a few. Some have been authorized without any instructions on who is to appoint whom, when that might happen and who will pay.

 

Those agencies created without specific appointment or appropriations procedures will have to wait indefinitely for staff and funding before they can function, according to Copeland's report.

 

And others could be just the opposite: One entity might not be enough and could spawn others, resulting in an "indeterminate number of new organizations."

 

The CRS report cites as an example a minority health provision that "requires the heads of six separate agencies within Health and Human Services to each establish their own offices of minority health."

 

Another section, by contrast, says that the Patient-Centered Research Institute "'may appoint permanent or ad hoc expert advisory panels as determined appropriate.' How many such panels will be 'determined appropriate' by the institute is currently unclear."

 

Implicit in the report is a message not to take too seriously the elaborate charts and seemingly precise numbers peddled by Republican critics that are designed to show the law's many bureaucratic tentacles.

 

The Center for Health Transformation, founded by Newt Gingrich, recently estimated that the new law created as many as 159 new offices, agencies and programs. Republican staffers on the Joint Economic Committee determined that there were 47 bureaucratic entities.

 

"Although some observers have asserted that PPACA will result in a precise number of new boards and commissions," the CRS document reads, "the exact number of new organizations and advisory bodies that will ultimately be created ... is currently unknowable."

 

Even in the few cases in which the PPACA set explicit creation dates for organizations, the consequences of missing these deadlines remain unknown.

 

The legislation, for instance, mandated HHS to establish an Interagency Task Force to Assess and Improve Access to Health in Alaska by May 7, as well as an Advisory Committee on Breast Cancer in Young Women by May 22.

 

HHS has yet to appoint members to the breast cancer committee and is currently reviewing nominations, according to HHS spokeswoman Jessica Santillo. The Alaska task force didn't hold its first meeting until July 16.

 

 

The CRS author based his conclusions on a search of the law for any of the following formulations: "there is established," "there is created," "there is hereby created," "shall establish," "shall create," "shall convene," "shall appoint," "purpose of this section to establish," "there is hereby established" and "there is authorized to be established."

 

Beyond the problem of enumeration, the CRS paper expresses concern that the lack of specificity in the bill could complicate congressional oversight. Copeland also raises questions about the number of appointments to boards delegated to the comptroller general of the United States, who heads the Government Accountability Office.

 

"Under the new law, the Government Accountability Office must appoint at least 83 new members to six new boards," he notes. "It is unclear how GAO will be able to independently audit these entities when the CG has appointed their members."

 

Some of these new "entities" have been politically controversial.

 

For instance, prominent Senate Republicans introduced legislation last week to repeal the Independent Payment Advisory Board, which must submit Medicare cost-cutting proposals to Congress and will consist of 15 members, appointed by the president and confirmed by the Senate.

 

"America's seniors deserve the ability to hold elected officials accountable for the decisions that affect their Medicare," Sen. John Cornyn (R-Texas) said in a statement, "but IPAB and many of these other new boards would take that away from seniors and put power in the hands of politically appointed Washington bureaucrats."

 

Cornyn, one of five senators calling for the IPAB repeal, further denounced the number of new boards created by the PPACA. "This avalanche of new boards is arrogantly premised on the idea that Washington has all the answers," he wrote in an e-mail to POLITICO. "In true fashion of Obama-Reid-Pelosi hubris, this is an outrageous growth in government."

 

The political battle over IPAB is especially consequential because its proposals will not be merely advisory. PPACA mandates the secretary of HHS to implement IPAB's proposals unless Congress adopts alternative measures to cut at least as much Medicare spending as the original IPAB recommendations.

 

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The Federal Government has no moral legal or ethical authority to force a citizen to buy a yellow car, a bag of lettuce, a toilet paper roll spring thingie, or an insurance policy. And it would seem that at least most of the people in MO understand that fact.

Nice to see.

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Pelosi was right, we are finding out what is in the bill and it is bad

 

Truth is this bill will not accomplish any of it's stated goals and all of the talking points were lies.

 

None of this comes as a surprise to me.

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I'd be curious to know how all those new agencies and Federal Union employees that get better benefits and pensions than you and I are going to lower the cost to deliver medical care?

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Meanwhile our Republican govenor had no problem accepting a $141 million installment from Obamacare to subsidize the policies required by state law to cover 21,000 uninsured people with pre-existing conditions, resulting in a 30 percent cost reduction. CC is smart enough to be pragmatic about it, at least.

 

I would love to hear his alternative to cover 1+ million other New Jerseyans without health insurance if he decides to join in the fight against Obamacare. Presently, he has none.

 

Now that some of the benefits are starting to show (no cap, dependents up to 26 yo can be covered, etc.), the public lately has warmed up to Obamacare as the flow of disinformation has slowed down a great deal - with 50% in favor and 35% opposed.

 

I hope that ridiculous lawsuit isn't going anywhere - IMO, it only attempts to return to the old health status quo that had been wasteful and inhumane for too many years.

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View PostMeanwhile our Republican govenor had no problem accepting a $141 million installment from Obamacare to subsidize the policies required by state law to cover 21,000 uninsured people with pre-existing conditions, resulting in a 30 percent cost reduction. CC is smart enough to be pragmatic about it, at least.

 

I would love to hear his alternative to cover 1+ million other New Jerseyans without health insurance if he decides to join in the fight against Obamacare. Presently, he has none.

 

Now that some of the benefits are starting to show (no cap, dependents up to 26 yo can be covered, etc.), the public lately has warmed up to Obamacare as the flow of disinformation has slowed down a great deal - with 50% in favor and 35% opposed.

 

I hope that ridiculous lawsuit isn't going anywhere - IMO, it only attempts to return to the old health status quo that had been wasteful and inhumane for too many years.

 

 

How does covering 21,000 uninsured and taking a subsidy reduce healthcare costs by 30%? Is the subsidy the savings? Because that is not a reduction in cost.

 

Where is your poll that states 50% in favor? Every major media outlet has the majority of US citizens not in favor of it.

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View PostHow does covering 21,000 uninsured and taking a subsidy reduce healthcare costs by 30%? Is the subsidy the savings? Because that is not a reduction in cost.

 

Where is your poll that states 50% in favor? Every major media outlet has the majority of US citizens not in favor of it.

 

 

30% reduction in their monthly premiums. Similar to when COBRA was subsidized temporarily for Americans who lost their jobs during the Great Recession but still wanted to keep the health plan offered by their former employer.

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View Post30% reduction in their monthly premiums. Similar to when COBRA was subsidized temporarily for Americans who lost their jobs during the Great Recession but still wanted to keep the health plan offered by their former employer.

 

 

OK that was a 30% reduction on premiums due to subsidies though. Has nothing to do with cost. Someone is still paying for the actual cost.

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