Republican leaders boycott controversial ObamaCare board

• 

  April 23, 2013: Senate Minority Leader Mitch McConnell listens during a news conference on Capitol Hill.AP

The Republican leaders of the House and Senate announced Thursday that they will boycott the ObamaCare-created committee responsible for holding down Medicare costs, in a challenge to a controversial element of the health care overhaul. 

The Individual Payment Advisory Board, or IPAB, has been described as a "death panel" by some of its fiercest critics. Though that epithet is not often used anymore to describe the panel, Republicans still say it would hurt seniors by forcing doctors to stop seeing patients. 

House Speaker John Boehner and Senate Republican Leader Mitch McConnell, in a letter Thursday to President Obama, said they would refuse to recommend any nominees to the committee, reiterating that they think it should be repealed entirely. 

They revived concerns that the panel would enforce Medicare cuts by reducing payments to providers and/or "eliminating" certain treatments. 

"These reduced payments will force providers to stop seeing Medicare patients, the same way an increased number of doctors have stopped taking Medicaid patients. This will lead to access problems, waiting lists and denied care for seniors," they wrote. 

The 15-member advisory board, known as IPAB, would have the power to force payment cuts on insurers, drug companies and other service providers if Medicare costs rise beyond certain levels. 

The health care law explicitly forbids the board from rationing care, shifting costs to seniors or cutting their benefits. But Boehner, at a news conference Thursday, said the members still "have the authority to deny seniors access to care." 

It's unclear what effect the boycott will have on the panel. The law says the president should consult with Congress on the nominations, but the president is free to make his own appointments. The members of the board, though, are supposed to be from both parties and nominees would be subject to Senate confirmation. 

White House Press Secretary Jay Carney slammed Republicans for the stance and for renewed efforts to repeal the health care law. 

"It just demonstrates again how out of touch with what the American people want the House Republicans have become. Instead of focusing on measures that could help us invest in innovation and manufacturing and job creation, instead of focusing on common-sense efforts to reduce our deficit in a balanced way, House Republicans are voting again to repeal the Affordable Care Act," Carney said. 

Asked why the House was voting a 37th time to repeal all or part of the law, even though GOP leaders know the Democratic-controlled Senate will again ignore the vote, Boehner said there were about 70 new members of the House this year. "Frankly they have been asking for an opportunity to vote on it, and we are going to give it to them." 

He said he supports total repeal of the law rather than efforts to amend it as it goes into effect over the next year. 

Republicans say there have been only two previous votes to eliminate the health care law in its entirety. They say there have been more than 30 votes to partially repeal or defund the law, and several have been signed into law, including one eliminating an unpopular tax-filing requirement that would have affected millions of businesses. 

Economists have predicted that the Medicare board's services might not be needed in the near future because Medicare cost increases appear to be manageable. 

The Associated Press contributed to this report.

View the original article here

South Carolina bill would make it a crime to implement ObamaCare

• 

  July 1, 2003: The South Carolina State House in Columbia is shown.AP

The Supreme Court may have ruled ObamaCare is constitutional, but implementing the controversial federal law would become a crime in South Carolina if a bill passed by the state House becomes law.

The bill, approved Wednesday by a vote of 65-39, declares President Obama's signature legislation "null and void." Whereas the law that Obama pushed and Congress passed is known as the Patient Protection and Affordable Care Act, South Carolina's law would be known as the Freedom of Health Care Protection Act.

It would prohibit state officials and employees from "enforcing or attempting to enforce such unconstitutional laws" and "establish criminal penalties and civil liability" for those who engage in activities that aid the implementation of ObamaCare.

The Supreme Court ruled last year that ObamaCare's underlying provision, requiring all Americans to obtain health insurance, is constitutional, though lawsuits still are pending that argue against certain parts of that mandate -- in particular, contraceptive coverage, which some Christian employers argue violates their religious beliefs.

In South Carolina, the nullification bill would allow the state attorney general to take action against anyone causing harm by the implementation of ObamaCare. It proceeds to the state Senate for committee review, according to The Washington Times.

Gov. Nikki Haley has rejected the expansion of Medicaid insurance rolls under a joint federal-state program for low-income Americans, which is an anchor of the law Obama signed in 2010.

"Not in South Carolina," Haley declared at the Conservative Political Action Conference in March. "We will not expand Medicaid on President Obama's watch. We will not expand Medicaid ever."

Other parts of ObamaCare have already started to fray, even before full implementation.

The Obama administration now says a special system of exchanges designed to make it easier for small businesses to provide insurance will be delayed an entire year -- to 2015.

"Lots of small businesses struggle with providing insurance for their workers so this was supposed to facilitate it and make it easier for small business to do this," Jim Capretta of the Ethics and Public Policy Center, told Fox News last month. "It was a huge portion of the sale job. When they passed the law in 2010 there were many senators and members of Congress who were saying 'I am doing this because it's going to help small businesses.'"

The Associated Press contributed to this report.

Click here for more from The Washington Times.

View the original article here

ObamaCare vs. neglect --what's better for your health?

• 

• • 

    Lawmakers Trying to Opt Out of ObamaCare?

  • 

    ObamaCare Driving Up Health-Care Costs?

  • 

    How ObamaCare is blocking my business expansion

Most Americans -- even those who are legislators -- know very little about the details of President Obama’s Affordable Care Act, so-called "ObamaCare." Next year, when it goes into effect, we will learn the hard way.

Many people lazily assume that the law will do roughly what it promises: give insurance to the uninsured and lower the cost of health care by limiting spending on dubious procedures.

Don’t count on it.

Consider just the complexity: The act itself is more than 906 pages long, and again and again in those 906 pages are the words, “the Secretary shall promulgate regulations ...”

If only government would neglect the rest of health care! Then we’d have better service and better care at lower cost.

“Secretary” refers to Secretary of Health and Human Services Kathleen Sebelius. Her minions have been busy. They’ve already added 20,000 pages of rules. They form a stack 7 feet high, and more are to come.

Our old health care system was already a bureaucratic and regulatory nightmare. It had 16,000 different codes for different ailments. Under our new, “improved” system, there will be more than a 100,000.

Government likes to think regulations can account for every possibility. Injured at a chicken coop? The code for that will be Y9272. Fall at an art gallery? That means you are a Y92250.

There are three different codes for walking into a lamppost -- depending on how often you’ve walked into lampposts. This is supposed to give government a more precise way to reimburse doctors for treating people and alert us to surges in injuries that might inspire further regulation.

On Government-Planned World, this makes sense. But it will be no more successful than Soviet central planning.

Compare all that to a tiny part of American medicine that is still free-market: Lasik eye surgery.
Its quality has improved, while its costs have dropped 25 percent. Lasik (and cosmetic surgery) are specialties that provide a better consumer experience because they are a market. Patients pay directly, so doctors innovate constantly to please them. Lasik doctors even give patients their cell phone numbers.

President Obama didn’t kill American free-market health care. It began dying during World War II, when government imposed wage and price controls. 

At first, companies said, “Great, stability!” But then they realized that they could not attract better workers without raises. So companies got around the rules, as companies do. They gave “benefits,” like health insurance.

Government then distorted the market further by giving employer-based health insurance better tax treatment than coverage you buy yourself.

But employer-based insurance is nuts. Many workers feel locked into their jobs. Company insurance largely destroyed the health care free market, since employees rarely shop for the best service at the lowest price.

Now ObamaCare may kill what’s left of that market.

Maybe we will soon be like Canada, where some people wait years for treatment. A producer from my TV show went to a Canadian town where the town clerk pulls names out of a box and then phones people to say: “Congratulations! You get to see a doctor this month!”

But there is at least one area where Canada offers cutting-edge, life-saving technologies. Unfortunately, to get this care, you have to meow or bark. Veterinary care is still handled by the market. Providers innovate or go out of business.

Markets find ways to make things better and cheaper. ObamaCare often forbids that. For example, it requires that every insurance policy cover preventive care and “breastfeeding support.” It insists that mammograms and colonoscopies be provided without any deductible.

It’s tempting to believe that such rules prevent illness and save money, but there is little evidence they will. 

Some people will undergo invasive procedures that shorten lives instead of extending them. Some of us want those tests; some don’t. 

Government controlled medicine means we  all get them and pay for them, regardless of whether we want them. Government control kills consumer choice.

Lucky Lasik and cosmetic surgery patients! Their treatments are better in part because government doesn’t consider them important enough to subsidize and regulate. If only government would neglect the rest of health care! Then we’d have better service and better care at lower cost.

And we’d have choices.

John Stossel is host of "Stossel" on the Fox Business Network. He's the author of  "No, They Can't: Why Government Fails-But Individuals Succeed," "Give Me a Break" and of "Myth, Lies, and Downright Stupidity." To find out more about John Stossel, visit his website at johnstossel.com.

View the original article here

ObamaCare in Trouble? Exchange provision delayed, as lawmakers push to repeal another

• 

• • 

    ObamaCare beginning to crumble?

  • 

    ObamaCare's tax surprise

Parts of ObamaCare are starting to fray, even before full implementation. 

The Obama administration now says a special system of exchanges designed to make it easier for small businesses to provide insurance will be delayed an entire year -- to 2015. 

"Lots of small businesses struggle with providing insurance for their workers so this was supposed to facilitate it and make it easier for small business to do this," said Jim Capretta of the Ethics and Public Policy Center. "It was a huge portion of the sale job. When they passed the law in 2010 there were many senators and members of Congress who were saying 'I am doing this because it's going to help small businesses.'" 

The exchanges were designed to give workers a range of choices supported by dollars from their employers. But now they will have only one choice until 2015, which could mean they can't shop for insurance that includes their current providers. Capretta said the administration is "way" behind schedule. 

Since insurance is more expensive for small businesses, many of which have no obligation under the law to provide coverage, analysts now fear many might just stop trying and let workers go on the soon-to-be-launched state exchanges. 

Sara Teppema of the Society of Actuaries -- which did an exhaustive study of ObamaCare -- said that "even if it's just a small change of people who are leaving the employment-based insurance and coming into the individual insurance market, their costs and their numbers will overwhelm those who are currently uninsured." 

That means costs would increase. 

Meanwhile, 79 senators including several liberal lawmakers recently voted to repeal a new tax on medical devices contained in the health care law following a similar vote in the House. 

"The House and the Senate agreeing? This is a harmonic convergence, it doesn't happen," said former Democratic Sen. Evan Bayh. "But on this it's happened because the adverse consequences to our economy and the quality of health care are so apparent." 

The two separate votes have not become law but show widespread opposition to the 2.3 percent sales tax on medical devices. Critics say the law is unfair to the industry since it's a tax on gross sales -- meaning it adds up to a much bigger percentage of a company's profits. 

But supporters such as Paul Van de Water of the Center for American Progress oppose any repeal. 

"I think that repealing the device tax would be irresponsible. We need the revenue and it's not going to be a job killer," he said. 

The theory was that ObamaCare would insure 30 million more people and that device makers, like pharmaceutical companies, would get lots of new customers and a steady stream of new revenue to make up for the tax. Van de Water predicted that would still happen. 

"These device manufacturers are for the most part going to be getting a large increase in business thanks to health reform, thanks to ObamaCare," he said.  

But the CEO of one company said that's not true for the 7,000 small companies with 400,000 employees who make a wide range of devices. 

Christine Jacobs of Theragenics said: "We make widgets -- hips, knees, stents, pacemakers, and implants, even, for prostate cancer. Those widgets tend to be used by people that are elderly. As the body parts wear out, we're needed." 

But Jacobs notes that most people whose body parts wear out are already on Medicare, so ObamaCare does not provide a new revenue stream for her company -- only financial pain. 

"In the case of a small company, that medical device tax is equal to our R-and-D budget for this year," Jacobs said. 

Bayh said in his own state of Indiana, one company planned to open up to five facilities over the next five years but had to scrap those plans because of the "uncertainty created by this tax." 

Jacobs said the huge multinational device makers might be able to handle the burden but not the small companies. 

"It's just such a disproportionate burden for little guys," she said. "Because we're all being told that it's the little companies that create the jobs. And that's not message that we're getting." 

The tax will even be applied to sutures used on pets that Theragenics developed for the veterinary market. 

She sought FDA approval to demonstrate the quality of her products. But now she said "it's hard for me not to get frosted on this one" -- she explained that whoever wrote the regulations said "if you have FDA approval, you will be taxed."   

President Obama has vowed to veto any repeal of the tax, but Bayh notes that 79 votes in the Senate would be more than enough to override any veto.

View the original article here

Let's hold ObamaCare to this standard: First, do no harm

• 

  FILE - In this March 27, 2012, file photo, Amy Brighton of Medina, Ohio, who opposes health care reform, rallies in front of the Supreme Court in Washington. Health care was the defining political battle of President Barack Obamas first term, and _ after the economy_ it remains his most complicated policy challenge at home, central to his place in history.(AP Photo/Charles Dharapak, File)

Last week, politicians who helped craft the Affordable Care Act celebrated in self-congratulatory style the third anniversary of that monstrosity, which will soon extinguish health care as we've known it.

The president's promises about the ACA saving money and allowing you to keep your existing health plan are proving false, as many predicted.

The Department of Health and Human Services maintains the law will make health care more affordable and accessible. The Wall Street Journal, reminding readers of that claim, reported last week that health insurers are privately warning brokers: "Premiums for many individuals and small businesses could increase sharply next year."

"You will find only systems, ready to suck you up, give you a number, and provide you with federally approved accountable care in a sterile environment populated by highly regulated strangers."

- Dr. John Curry, in an email to Cal Thomas

The 2013 Deloitte Survey of U.S. Physicians, a survey of more than 600 physicians from the Deloitte Center for Health Solutions, found that "six in 10 physicians (62 percent) said it is likely many of their colleagues will retire earlier than planned in the next one to three years."

Based on the survey results, Deloitte found that most U.S. physicians believe that, among other worries, under ObamaCare, "The future of the medical profession may be in jeopardy as it loses clinical autonomy and compensation" and "Medicaid and Medicare reimbursements may be problematic, prompting many physicians to limit or close their practices to these enrollees." Instead of the established doctor-patient relationship of old, "eight in 10 physicians agree "that the wave of the future in medicine ... involves interdisciplinary teams and care coordinators."

One who thinks he's seen the future and doesn't like it, is my physician, Dr. John Curry, of Fairfax, Va. At my request, he sent me the following email:

"Forty years ago, when I began practicing primary care medicine, medical decision-making and its funding were in the hands of patients and their physicians. The only protection patients had lay in the professional ethics of their doctors. In modern terms that sounds pretty skimpy, but think about it for a minute. The first precept was 'Do no harm'. Ask yourself: can you hold your government to that standard?

The underlying principle was that the physician had to put his patients' interests ahead of his own. This was, of course, the Golden Rule, formalized into standards for professional care. It was also the reason I, and many in my class, applied to medical school. It was the reason my wife's older brother, who practiced medicine in a small town in West Texas, prided himself on the fact that much of the time he 'was paid in peas and pies'. Again, ask yourself, is there any health insurance company or government agency that you can count upon to put your health above their interests?

The decades have rolled by, and the sea-changes have come. Costs have risen, and personalized care has faded. The monstrosity has been birthed, and soon you will look in vain if you are seeking a personal physician who knows you, cares about you, and to whom you have ready access. You will find only systems, ready to suck you up, give you a number, and provide you with federally approved accountable care in a sterile environment populated by highly regulated strangers. And it will cost you a lot! (Whatever anyone says, prepare for a future where your health costs will be higher and your choices fewer!)

I am in my mid-70s and have both the capacity and willingness to care for patients for another decade. But I am retiring. I cannot stand it anymore. More than half of my time in the office is spent filling out forms, writing letters, responding to inquiries, and attending to 'urgent' matters that did not exist 10 years ago. And every year my income is less. At this point I would rather be paid nothing and have the freedom to decide what is right for my patients. ACA is only another straw, but for this tired camel, it will break my back."

Neither I, nor the country, can afford to lose doctors like John Curry, but we are losing them, and we will lose them. Take two aspirin, but don't call in the morning, because Dr. Curry and many like him won't be there to answer the phone.

Cal Thomas is America's most widely syndicated newspaper columnist and a Fox News contributor. Follow him on Twitter@CalThomas. Readers may e-mail Cal Thomas at tmseditors@tribune.com.

View the original article here

ObamaCare turns three -- rhetoric vs. reality

• 

• • 

    What have we learned three years into ObamaCare?

  • 

    ObamaCare turns 3-years-old

  • 

    ObamaCare vs. health care

Saturday marks ObamaCare’s third anniversary, and President Obama and Democrats across the country will surely celebrate its greatest achievement to date: survival.  The health care law narrowly survived a Supreme Court challenge, repeated attempts by House Republicans to repeal it and, with President Obama’s reelection, seems to be set for implementation next year.

But survival is a pretty low bar for the law, and far from the lofty claims made on its behalf.

In 2009, President Obama said that “it’s important for us to make sure that 46 million people who don’t have health insurance get it.  And I think it’s important for us to bend the curve, separate and apart from coverage issues, just because the system we have right now is unsustainable and hugely inefficient and uncompetitive.”  

On net, we found evidence that ObamaCare will do very little to slow U.S. health care spending, and may actually increase it.

The Obama administration’s claim that the law would rein in spending undoubtedly persuaded wavering Congressional Democrats to push it across the finish line.

In a new report from the Manhattan Institute, Rhetoric and Reality, my colleague Yevgeniy Feyman and I try to summarize the best evidence to date on the impact that the law is having on health care costs today – and whether or not it is likely to contain costs in the future.

Based on the best currently available data, we project that ObamaCare will increase, not decrease, U.S. health care spending.    

Certainly, the near term trends aren’t favorable for the law.  Since the passage of the law, household premiums for private insurance have increased by 11.3 percent, outpacing even the growth of medical inflation (6.8 percent). Last year, Congressional analysts also projected that employer-based family coverage will cost $20,000 by 2016, an increase of 27 percent over 2012 rates.  Looking a little further ahead, premiums are expected to rise steadily through 2021, except for a brief dip in 2014.

(The “dip” kicks in when ObamaCare’s exchange subsidies begin, transferring costs from individuals and families to taxpayers.  But shifting costs is not the same thing as containing costs.) 

In fact, a recent survey of insurance companies by the American Action Forum, a think tank, found that market reforms included in ObamaCare will spike health insurance premiums, particularly for younger and healthier people.  ObamaCare requires insurers to sell richer benefit packages, but the main cost increases come from new rules like rating bands, that limit the discounts insurers can offer to younger policyholders compared to older ones, and prohibit premium variations based on gender and health status. 

ObamaCare also includes new taxes on everything from insurance companies to prescription drugs, costs likely to be passed along to families and small businesses shopping for coverage.

ObamaCare didn’t invent America’s health care woes, and shouldn’t be blamed for the ones we already have. The U.S. already spends over $2 trillion on health care, approaching 18 percent of U.S. GDP.  And health care costs were rising much faster than income or GDP growth for decades before ObamaCare came along. 

But the point of the law was to fix the system – not add to its burdens.  The Centers for Medicare and Medicaid Services (CMS) predicts that the law will add about $500 billion to U.S. spending between 2012 and 2021. 

To be fair, ObamaCare does contain several small pilot projects, all of them well meaning, designed to reform the supply or delivery of health care.  But existing pilot programs thus far have had mixed or disappointing results.  And some projects, like the widespread implementation of electronic health records, seem to have increased costs in some cases, by making it easier for providers to bill for additional services. 

Other experiments, like Medicare’s Accountable Care Organization (ACO) program, may also be cost increasing, by encouraging hospital consolidation that allows them to increase prices. 

One area where ObamaCare devotes far too little attention is reforming the demand for health care services.  For all of our talk about the crushing cost of American health care, on average, consumers only spend about 11 cents out of pocket for health care – the fifth lowest average among OECD countries.  And research suggests that when out of pocket spending is lower, health care spending increases because consumers are only paying a tiny fraction of the total bill.

By 2021, ObamaCare will push U.S. out of pocket spending even lower than it is today, to just over 9 percent. This may accelerate price increases by insulating the newly insured largely from the costs of the care they consume. 

Defenders of the law like to point out that CBO scores the law as reducing the deficit. But this is only because the law brings in more revenues (through taxes and penalties) than it spends over a ten year period. And recently, health care cost growth has slowed somewhat. But there is no reason to attribute the slowdown to ObamaCare, since its main provisions haven’t even kicked in.  And lower Medicare spending is largely (75 percent) attributable to lower drug spending in Medicare’s Part D benefit, which started in 2006.

On net, we found evidence that ObamaCare will do very little to slow U.S. health care spending, and may actually increase it.

While the Congressional debate has focused on repealing ObamaCare, a more politically palatable option may be reforming it by focusing on demand side reforms – like moving most non-poor Americans into higher deductible health plans paired with savings accounts and lowering subsidies on the exchanges (currently subsidies extend to families making up to $94,000 annually) to focus on low-income families, and building effective systems that allow consumers to easily compare the price and quality of health care options.

An anniversary is supposed to be the time for celebration. For ObamaCare, its third anniversary signifies how little the law has accomplished, and the enormous health care challenges still facing the country.

Paul Howard is Director and Senior Fellow at the Center for Medical Progress at the Manhattan Institute for Policy Research.

Related Stories

Health Care Reform on Life Support

ObamaCare weighs in: CVS tells employees to reveal personal health info -- or pay up

Fox News Poll: Voters say debt is immediate problem, nervous about economy

Related Opinion

Stop ObamaCare's massive 'HIT' tax before it puts more Americans out of work

View the original article here

Ryan: New House Republican budget includes ObamaCare repeal

Wisconsin Rep. Paul Ryan, chairman of the House Budget Committee, said Sunday that his new budget includes the repeal of President Obama’s health-care reform law known as ObamaCare.

Ryan told “Fox News Sunday” that the new proposal will make enough cuts to balance the federal budget in 10 years, compared to his previous one that tried to achieve that goal in 25 years.

“We think we owe the American people a balanced budget,” the Republican congressman said.

Ryan said the focus of the ObamaCare repeal would be to stop the expansion of Medicaid, the federal program that provides medical services to low-income U.S. families.

“Our budget does promote repealing ObamaCare,” said Ryan, who was not clear whether he intended to call for a full repeal.

Ryan, the Republican 2012 vice presidential nominee, said he wants states to run Medicaid through federal block grants.

Ryan said his proposal attempts to reach a balanced budget, in part, by slowing the rate of federal spending from 4.9 percent to 3.4 percent. Other parts include consolidating federal job-training programs and reforming the federal Food Stamp program to ensure only qualified applicants receive the benefits.

“I’ve very confident this is the way to go,” said Ryan, whose budget would have a better chance of passing the Republican-controlled House than the Democrat-controlled Senate.

View the original article here