Health Care Bill Passes, 219-212

It's here. The worst health care reform possible. Enjoy it, suckers.

A comment from a fellow concerned citizen:

The plan to solve health care is to force everyone under penalty of law to buy health insurance? Really? Then why not solve homelessness by passing a law forcing everyone, under penalty of law, to buy a house? Why not solve poverty by passing a law forcing everyone, under penalty of law, to make $100,000 a year?

Well at least we can stop talking about this now.

Rage Against the Morons

I found this in my travels:

To President Obama and all 535 voting members of the Legislature,
It is now official you are ALL corrupt morons:

1. The U.S. Post Service was established in 1775. You have had 234 years to get it right and it is becoming more unsustainable by the day.

2. Social Security was established in 1935. You have had 74 years to get it right and it is bankrupt.

3. Fannie Mae was established in 1938. You have had 71 years to get it right. It is bankrupt and now has an unlimited line of credit from the Fed.

4. The War on Poverty started in 1964. You have had 45 years to get it right; $1 trillion of our money is confiscated each year and transferred to "the poor" and they only want more.

5. Medicare and Medicaid were established in 1965. You have had 44 years to get it right and they are bankrupt.

6. Freddie Mac was established in 1970. You have had 39 years to get it right. It is bankrupt and now has an unlimited credit line from the Fed.

7. The Department of Energy was created in 1977 to lessen our dependence on foreign oil. It has ballooned to 16,000 employees with a budget of $24 billion a year and we import more oil than ever before. You had 32 years to get it right and it is an abysmal failure.

You have FAILED in every "government service" you have shoved down our throats while overspending our tax dollars AND YOU WANT AMERICANS TO BELIEVE YOU CAN BE TRUSTED WITH A GOVERNMENT-RUN HEALTH CARE SYSTEM??

This about sums up my feelings toward our beloved federal government. Depending on how the vote goes Sunday, we may soon have yet another bureaucracy to waste billions of our tax dollars.

WTF is this Health Care Reform, anyways?

On the eve of the historic House vote on health care reform, we reflect back on the substance of the bill, as well as the problems, as much of this has been lost in the heated debate. The bill as it stands now does many things:

• prohibiting health insurers from refusing coverage based on patients' medical histories[5][6]
• prohibiting health insurers from charging different rates based on patients' medical histories or gender[5][6]
• repeal of insurance companies' exemption from anti-trust laws[6][7]
• establishing minimum standards for qualified health benefit plans[5]
• requiring most employers to provide coverage for their workers or pay a surtax on the worker's wages up to 8%[5][8]
• restrictions on abortion coverage in any insurance plans for which federal funds are used[6][8]
• an expansion of Medicaid to include more low-income Americans by increasing Medicaid eligibility limits to 150% of the Federal Poverty Level and by covering adults without dependents as long as either or any segment doesn't fall under the narrow exceptions outlined by various clauses throughout the proposal.[9][10]
• a subsidy to low- and middle-income Americans to help buy insurance[8]
• a central health insurance exchange where the public can compare policies and rates[8]
• requiring most Americans to carry or obtain qualifying health insurance coverage or possibly face a surtax for non-compliance.[5][12]
• a 5.4% surtax on individuals whose adjusted gross income exceeds $500,000 ($1 million for married couples filing joint returns)[5]
• a 2.5% excise tax on medical devices[5]

Basically it will establish minimum standards for "qualified health benefit plans," which we will all be required to buy, or our employer will be required to buy for us, on new "exchanges" which are mechanisms will theoretically allow people to more easily compare and shop for insurance plans. It also expands Medicaid, and provides subsidies for other low income people to buy insurance on exchanges. To pay for this bill, there are several new taxes and non-compliance penalties, as well as scheduled cuts to Medicare.



There are parts of the bill I agree with, but many more that I am completely opposed to. I have several critiques of this bill, but I will limit myself to my top four.

1. We can't afford it. First of all, the largest expenses don't begin until 2014, so this "$1 trillion over the next decade" price tag is misleading. A more honest price tag would start in 2014, and would be substantially higher, estimated at $2.5 trillion. And that's assuming we DO cut Medicare, which Congress is supposed to have done already on several occasions, but has not.

Also, the tax on "Cadillac" insurance plans does not kick in until 2018, and there is a strong possibility that Congress will avoid this unpopular measure when the time comes.

2. It will hurt small business. Businesses with 50 employees or more will be required to cover all of their employees or face stiff penalties. This will put many people out of work as businesses will be unable to afford the assuredly more expensive health insurance, and those who keep their jobs will likely face stagnant or reduced wages in order to pay for health care.

3. It encourages the employer-based insurance system. This system separates citizens from making health care decisions, and is a large part of why our system today is so terrible. Most people with health insurance do not pick their own plans, but rather take what is offered to them at work. The problem here is two-fold: first, since employees don't pick their insurer, employers are likely to pick the cheapest/easiest plan they can, not necessarily the best plan. Since employers may not face the consequences of picking a crappy plan, the money savings can outweigh any potential downsides of choosing a bad provider. Problem two: when you lose your job, you lose your insurance. I do not know how portability is addressed in this bill, so they may have fixed it, but I couldn't find it.

4. It is unconstitutional. Requiring every American to purchase insurance is plainly unconstitutional. Nowhere in the constitution is the federal government given this power, or anything like it. It's job is to regulate commerce, not require it. Idaho and Virginia's Attorneys General will sue over this issue if the health bill passes.

This bill has been watered down so much that little, in the end, will change. Health costs will continue to rise faster than the economy, and there will still be 20 million uninsured in America. I know we can do better.

Police Using Facebook to Connect with Community

As I found in a recent news story, the Police Department of Holly Springs, NC has started a Facebook page to better communicate with Holly Springers.

This is a great use of technology to open channels of communication between citizens and the government institutions they support, and it puts a familiar face on what could be a daunting organization.

I hope this idea spreads like wildfire.

Repeating the Mistakes of the Great Depression

This enlightening article on the Great Depression dispels some myths and misunderstandings about the circumstances that led to and compounded the world's greatest economic recession.

Hoover dramatically increased government spending for subsidy and relief schemes. In the space of one year alone, from 1930 to 1931, the federal government’s share of GNP increased by about one-third.

Hoover’s agricultural bureaucracy doled out hundreds of millions of dollars to wheat and cotton farmers even as the new tariffs wiped out their markets. His Reconstruction Finance Corporation ladled out billions more in business subsidies. Commenting decades later on Hoover’s administration, Rexford Guy Tugwell, one of the architects of Franklin Roosevelt’s policies of the 1930s, explained, “We didn’t admit it at the time, but practically the whole New Deal was extrapolated from programs that Hoover started.”[6]

To compound the folly of high tariffs and huge subsidies, Congress then passed and Hoover signed the Revenue Act of 1932. It doubled the income tax for most Americans; the top bracket more than doubled, going from 24 percent to 63 percent. Exemptions were lowered; the earned income credit was abolished; corporate and estate taxes were raised; new gift, gasoline, and auto taxes were imposed; and postal rates were sharply hiked.

My immediate reaction was that we are repeating the same mistakes of Hoover and FDR and expecting different result.

Market Price for Health Care

Why is it that Walmart can post an obvious price for a simple eye exam, yet doctors do not post the price for a simple checkup?

- Posted using BlogPress from my iPhone

Location:Walmart

Mobile Blogging Test

This is a blog test from my iPhone.

I grilled cheese burgers for dinner. It was satisfying on many levels.

Sore thumbed liveblogging here we come.

- Posted using BlogPress from my iPhone

Location:Home

The Price We Pay For Medicare

A new public option idea is brewing, wherein people can buy into Medicare.

Representative Alan Grayson last week introduced a bill which would allow any U.S. citizen the option of buying a health insurance policy from medicare at cost.

Some facts about this proposal:

-It would not cost taxpayers anything. Those opting in would be paying for their own coverage, in addition to the taxes they pay currently.
-It is totally optional. People who like their private insurance are under no obligation to participate.
-It would actually decrease the cost of Medicare by expanding the risk pool to younger, generally healthier people.

-It has no government pork, earmarks, or kickbacks whatsoever. It is a simple, four page bill that anyone can read and understand.

While this idea has some merit, as in the government does not subsidize the cost of the health insurance. However, Medicare itself is in desperate need of an overhaul.

The annual price we pay for Medicare doubles every 4 years. Hardly a success story, and hardly a model we want to expand to everyone in America. Medicare's effects also expand far beyond it as well. Many doctors break even or lose money on Medicare patients, and they must make up this difference by overcharging the uninsured and private insurers. Private insurers then pass this extra cost on to employers. Employers then pass this extra cost on to employees.

In America, roughly 60% of people are covered by employer based health insurance. On top of that, Medicare covers another 15%. That leaves 25% of Americans in the "free" market, including the 15% of Americans who are uninsured. That leaves 10% of people who actually buy unsubsidized insurance on the "free" market. This segment of the population is too small to greatly influence the market, and they bear the full costs of their insurance. This also means that 60% of Americans, those covered through their employer, are thrice removed from the costs of their health care: once by insurers, twice by employers, then three times by the tax exemption.

As you can see in my diagram, institutions like Medicare and private insurers deal most directly with doctors and hospitals, setting coverage and prices. However, these institutions do not have to bear the full cost of these prices, as they are subsidized by tax dollars. Private insurers are further insulated from the market in that they mainly deal with employers, not individual policy holders. As such, a bad decision by a private insurer is not felt by their customer, the employer, but rather by the employee. This is a system ripe for abuse and inflation.

Overall, costs are shifted to the people with the least amount of decision making power, i.e. taxpayers, employees, and individual policy holders. Taxpayers and employees have almost no say in their health insurance choices, and because individual policy holders are such a small group, they are at the mercy of the larger market.

So now you see why it is a misnomer to classify our health insurance system as a "free market," since only 10% of Americans participate in anything that could even come close to being called a free market, as they are the only group who even knows how much their insurance really costs. The rest of the market is the result of a series of subsidies that create a system wherein people with money decide how much to pay other people with money, and the rest of us have to cough up the cash to fund these decisions.

Now, obviously Medicare is not the only problem. The other major problem is the tax exemption employers get when they offer insurance. This encourages the arcane practice of employer based health insurance, which through it's separation from supplier and consumer allows more inflation in this most critical of markets. But Medicare is still part of the problem, and should be reformed before any expansion of government health insurance.

For more information, I highly recommend This American Life's show on how our health care system came to be.

Trip to DC

Took some pictures

It was raining.

Rocket ship

The Best Argument I've Heard For France

It turns out, per hour worked, France produces slightly more than the US.

France has $36,500 GDP/Capita and works 1,453 hours per year. This equates to a GDP/Capita/Hour of $25.10. Americans, on the other hand, have $44,150 GDP/Capita but work 1,792 hours per year. Thus Americans only achieve $24.60 of GDP/Capita/Hour.

They beat us by $0.50 per hour. Not bad, France, not bad.