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Healthcare

A Bureaucratic Nightmare
Posted By:  - 08/03/10

Have you tried counting the number of new agencies, boards and commissions created under Obamacare? Don't waste your time. The Congressional Research Service (CRS) recently released a report that claims such an estimation would be "impossible" and "unknowable." Why? According to Politico (and previously mentioned in multiple NTU blog posts), the provisions of the law vary dramatically and many of its details are yet to be determined, much less released.

Politico writes: "The law says a lot about some of them and a little about many, and merely mentions a few. Some have been authorized without instructions on who is to appoint whom, when that might happen and who will pay." Confusing, I know, but that means a number of agencies are in an interminable waiting period until they receive further instruction, and then there are others that have the authority to spawn new organizations if just one entity is insufficient. CRS says 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." How can a bill that's 900+ pages long possibly be this ambiguous?

Politico goes on to assert that the law's lack of specificity could result in more complicated congressional oversight. I'd venture to say it could result in little to no congressional oversight! One example, as presented in the CRS report, is the Government Accountability Office (GAO). Obamacare requires the GAO to appoint at least 83 new members to six new boards, but how can they be accurately and independently audited when the U.S. comptroller general has appointed their members? For those of you still questioning this potential conflict of interest, remember that the comptroller general is chief leader of the GAO.

The Politico article explains the debate in greater detail, so I encourage you to give it a read. One thing is for certain: we have no real picture of how Obamacare will affect us now and down the road. It could be years before these provisions are fully enumerated…maybe longer.

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Will Missouri voters be the first say “no” to Obamacare?
Posted By:  - 07/29/10

On August 5th, Missouri will hold a special, historic election. On the ballot will be Proposition C, also known as the Missouri Health Care Freedom Act. Referred to the voters by the Missouri Legislature, Proposition C is Missouri's response to President Obama's health care law ("Obamacare') that will substantially enlarge the size of government, raise taxes, limit choice in care, and interfere with the patient-doctor relationship. NTU has urged its members in Missouri to support Proposition C.

As we wrote to our members, "Obamacare represents the federal government's largest-ever intervention in the U.S. economy and personal health care decisions. Obamacare will require all Americans to have health insurance. Those who don't have coverage will be penalized. In the process, Obamacare will increase total federal spending by $2.6 trillion and raise taxes by half a trillion dollars over the next decade. What's more, Obamacare includes a number of hidden taxes we are only just beginning to understand and accounting gimmicks that hide its ominous cost."

But as more Americans learn about the cost of Obamacare and how it will intrude on the doctor-patient relationship, the more they say they don't want politicians in Washington making decisions about their health care. Now, we hear about lawsuits by the states against Obamacare and initiatives like Proposition C in Missouri. A "yes" vote on Proposition C will amend Missouri law to prohibit the government from punishing a citizen who doesn't buy the insurance Washington wants them to, and would uphold every American's right to pay for his or her health care directly. We hope Missouri makes history on Tuesday August 3rd by being the first state to say "no" to Obamacare and "yes" to health care freedom.

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Seeing ObamaCare Through Rose Colored Glasses
Posted By: Kristina Rasmussen - 07/20/10

RS Logo

"How Health Care Reform Affects You." Chances are you've seen an article along these lines pop up in your magazines of choice lately. I certainly have. Chances are the articles gloss over the major problems inherent in ObamaCare -- if they're not a straight out endorsement of the takeover.

Stephen Spruiell takes the latest incarnation of this problem to task in "Real Simpletons: A popular magazine ignores the downside to Obamacare."

My wife subscribes to Real Simple, a women's-interest magazine specializing in articles on how to make life more organized. I often joke that our lives would be more organized if we didn't have eight copies of Real Simple floating around the apartment at any given time. But since they are around, I'll flip through them occasionally to see if there's anything worth reading. And today, in the latest issue, I saw a short feature titled "How Health-Care Reform Affects You."

The article reads like an advertisement for Obamacare. One would be forgiven for thinking it a part of the administration's campaign to improve the legislation's popularity. Here is a complete list of the article's subheads:

  • More services will be paid for in full.
  • Lifetime limits are history.
  • Your children can remain on your policy until age 26.
  • Kids with preexisting conditions cannot be denied coverage.
  • Insurers have to spend more money on care.

That's it: All good, no bad, and the only two sources quoted in the article represent non-profits who supported the legislation. Don't take my word for it: While the article isn't available online, you can hear a podcast of the article (alas, the third of three recorded items) here.

Readers of Real Simple: now would be a good time to send a letter to their editor. Here's a quick highlight of the many, many problems with ObamaCare.

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Massachusetts Leaves Tough Decisions to Local Governments
Posted By:  - 07/07/10

If awards for work shirking existed, Massachusetts would win in a walk. Last week, Governor Deval Patrick signed a budget that severely cuts funding to local governments but prohibits them from reforming one of the most costly aspects of their budget, namely health care plans for public employees.

Massachusetts state and local public employees receive generous health benefits. Currently, local government workers pay only $5 copayments when they visit a doctor. There is no question that such benefits put pressure on local government budgets. But only the state, not the local government, can modify employee health care plans through their Group Insurance Commission. In fact, local governments must get approval for all cost-saving steps by the municipal unions, who have incentives to maintain the benefits for their members rather than find savings for taxpayers. Allowing local government to modify their health benefits could ultimately save $100 million a year and help preserve the health care system, according to the Massachusetts Municipal Association. Geoffrey Beckwith, the Executive Director of the MMA said, "The current [public employee health care benefits] system is unaffordable - it costs taxpayers too much, crowds out important services, and forces the elimination of teachers, firefighters, police officers, and other workers."

Massachusetts' unwillingness to give local governments the ability to address the cost of health care gives the municipalities the mother of all unfunded mandates, namely providing the same health care plan to their employees, but with less money. The state has left the tough decisions to local government but has simultaneously tied their hands. Reforms of public employee health benefits are an important step in reducing government spending. Local governments in Massachusetts should have the same power as the state does to modify health benefits.

 

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Obamacare Strikes Again
Posted By:  - 07/07/10

It looks like retailers and tanning salons are not the only businesses to be adversely affected by Obamacare; restaurants will take a hit as well. Cleveland Plain-Dealer reports that one provision of the new health care law could cost White Castle, a Columbus-based chain specializing in hamburger sliders, roughly 55% of its net yearly income after 2014: "Starting that year, the bill levies a $3,000-per-employee penalty on companies whose workers pay more than 9.5 percent of household income in premiums for company-provided insurance."

White Castle currently pays between 70 and 89 percent of employees' premium costs, so the company anticipates a heavy price tag to comply with the law and says the provision will make it difficult to maintain its 421 restaurants nationwide. Does everyone agree with this prediction? Definitely not. According to the same article, the American Federation of State, County and Municipal Employees union "questions White Castle's calculations." Their spokesperson, Steven Kreisberg, claims White Castle will be saving money while they're paying the penalty since some workers will opt for federal coverage and spare the company from having to pay insurance for those individuals. That may be true, but what happens if there is a mass migration of young, healthy employees out of the company insurance plan and into the federal exchange? Wouldn't that drive up costs for White Castle since they no longer have as many "healthy" people in their plan? It's almost guaranteed to be a no-win situation because they will have to pay a penalty either way: the aforementioned $3,000 fee and/or a $2,000-per-employee fee if workers end up going with federal coverage.

How can the Obama Administration continue to make the argument that this health care "reform" will be good for small businesses and overall job creation? The numbers just don't add up. Will uncertainty surrounding the law diminish as details and timelines are ironed out in the coming months? Maybe, but don't hold your breath.

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See You at the Pool!
Posted By:  - 07/02/10

I have a feeling my neighborhood pool will be a lot more crowded this summer now that individuals are being deterred from signing up for tanning bed memberships. For those of you who have trouble following the gazillion (and I never use that word) provisions of the new health care law, a 10% tanning tax was officially implemented yesterday to bring in $2.7 billion and help pay for the all-too-expensive Obamacare.  

And while employers and customers are frustrated at the tax, they are even more frustrated at its ambiguity. In an article yesterday, The Wall Street Journal (WSJ) talks about how tanning salons will be taxed, but health clubs that offer tanning beds will not. Tanning sessions that include ultra-violet rays will be taxed, but spray tans will not. And let's not forget that there are a number of businesses, aside from specified tanning salons, that offer tanning services on the side, including dry cleaners and video stores. Yes, that came as quite a surprise to me as well, but it's true. The WSJ article highlights Jeanne Chamberlain, a video-rental store owner who will be slapped with the burdensome levy:

"Ms. Chamberlain followed a number of her peers in adding tanning services to smooth out the bumps in her Rice Lake, Wis., business. Today, she wants to offer one free tan for every three rentals. Should that freebie be taxed? Ms. Chamberlain doesn't know, and even if she did, she doesn't yet have the software in place to help with the calculations."

The Internal Revenue Service's answer to Ms. Chamberlain's question? They don't even know! According to the WSJ, an IRS spokesperson said, "Business owners should 'make the best determination they can based on their own facts and circumstances.'" Talk about confusing! I think it's only fair for the appropriate entity (whether the Obama Administration, IRS, or both) to buckle down and solidify some of these new regulations so, at the very least, business owners and consumers know what they are facing. In the meantime, get all that "natural" sunlight you can. It certainly seems to be the more economical choice.

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No, Really, You Can't Keep It
Posted By:  - 06/16/10

Last week, I wrote about President Obama's oft-repeated (and now broken) promise to allow people to keep their current health plans if they were happy. Because, yes, Mr. President, a lot of people are! I referred you to a Politico article that highlighted mini-med plans, which offer low-cost benefits to low-wage employees who may not be able to afford more comprehensive health care. Unfortunately, Obamacare's diagnosis keeps getting worse...

According to the Daily Caller, the Obama Administration just released a new regulation setting rules for who can keep their current insurance plans under the health care law. In an article entitled "Five more ways Obama's health-care law boosts unions," writer Jonathan Strong claims this regulation gives "special consideration" to unions. He goes on to say, "For the rule regarding whether people can keep their health plans – known as "grandfathering" in bureacratise – the Department of Health and Human Services ruled that for union-negotiated health plans, companies can change insurance providers but keep their essential plan  details intact, or grandfathered. For non-union-negotiated plans, companies can't change providers – they must stay with their same insurance provider."

I certainly can't say I'm surprised. What else do you expect from a bill crafted behind closed doors and a law that remains virtually undefined? That's right. We're still waiting on the Administration to release details on how various provisions will be implemented, so I think it's safe to say that more bad news is yet to come.

Furthermore, the Daily Caller reports numerous other ways in which Obamacare boosts unions. The so-called "Cadillac" tax will be imposed on health care plans that cost at least $10,200, except where unions are concerned. For union-negotiated plans, the tax begins at $27,500, an adjustment that Strong says could save union members $60 billion. There is also a $5 billion subsidy for health care for early retirees, many of whom are unionized employees, a condition that gives union members premature access to exchange markets, and the exemption of very large groups from various regulations.

Again, I reiterate the uncertainty of this complex law. It's not just the issue of officials failing to make important information available to the public, it's the fact that many of these details have not yet been crafted! Expect to see even more "special consideration" for organized labor. It's almost inevitable.  

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Freakonomist Agrees with NTU
Posted By:  - 06/16/10

This week Money Magazine released a Q&A session with Steven Levitt.  After two best selling books, Freakonomics and Superfreakonomics, Levitt (Phd University of Chicago) is in the running for the rights to be called America's most famous economist.  In the interview, Money Magazine asked for his thoughts on both Health Care Reform and the Financial Bailouts.

It's always great getting Levitt's take on issues and lending a little more credibility to what should be common sense.  On Health Care reform, "It seems like we did everything wrong with the health care bill" and on Bailouts, "the government should not bail out companies" we couldn't agree more!

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Get the (Real) Facts!
Posted By:  - 06/11/10

In light of the President's new taxpayer-subsidized campaign to sell the American people on Obamacare, economics21 has launched an excellent new resource – ObamaCareWatch.org – to help you get the facts straight.

The website will provide, in one convenient and searchable website, all of the most important research, analysis, news, and commentary related to the new health law. You can also sign up for their weekly "ebrief" for all the latest news and developments.

I encourage you to check it out! In the midst of 2010 election mayhem, it's a great way to stay in the health care loop and keep your leaders accountable for their vote.

Additionally, here is an Op-Ed by Senator Tom Coburn in response to the Obamacare PR campaign mentioned above.

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If You Like It, You CAN'T Keep It
Posted By:  - 06/08/10

Who am I?

"If you like your current plan you will be able to keep it. Let me repeat that: If you like your plan, you'll be able to keep it." That was a direct quote from our President at the White House on July 21, 2009. You may remember… the Administration was desperate to obtain public support for the (still) controversial health care plan, and thought that "promise" would appease the American people. Did it? Well, there were certainly some who bought into the faulty claim, but many of us remained skeptical of the details and ultimate ramifications of such a large, complicated bill. Now, those details are starting to emerge…

Politico published a piece today entitled "Health law could ban low-cost plans." The leading paragraph reads, "Part of the health care overhaul due to kick in this September could strip more than 1 million people of their insurance coverage, violating a key goal of President Barack Obama's reforms."

Here's why:

The "Affordable" Health Care Act would ban the caps currently in place for the amount of insurance company payouts. While, on the surface, this sounds like a positive reform to improve the quality of care, it is problematic for a couple of reasons. There is a niche insurance market, called mini-med plans, which many employees (retail, restaurant workers, etc.) have come to depend on. While these plans do offer limited benefits, they are priced low for low-wage workers who may not be able to afford more comprehensive health care. If caps are eliminated, it could force insurance companies to significantly raise costs or eliminate the plans altogether. That would be detrimental to many of these low-wage workers since insurance exchanges and tax credits will not be available until 2014. According to Politico, a number of employer groups sent a letter to Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis and asserted, "this population would likely be left with no coverage until 2014" – again, when tax credits, etc. begin to kick in.

We are still waiting on the Administration to release particulars on how this provision will be implemented, but I'd recommend getting that job at Nordstrom NOW…before it's too late.  

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