Originally published on August 1, 2009, this post refers to the “first look” that the public got at the health care proposal. It was only a little more than 1,000 pages and notoriously grew to more than 3,000 as it worked its way through Congress, which told us, via Speaker Nancy Polosi, that they (the Congress) “would have to pass it to find out what was in it.” Read it for yourself, as the link I included is still live.

I should start by admitting I have a bias against BIG: I don’t much care for big cities, big schools, big bureaucratic corporations, big hospitals, and — most of all — big government. My life experience has taught me that big entities beget big problems, and the bigger the problems, the more resistant they are to solutions — especially common-sense solutions.

I like small towns because problems are easier to define, and common-sense solutions seem to be easier to come by because you know whom to call, and volunteers are easier to motivate.

As an Army brat, I attended 12 schools, including 4 high schools — one big one and three small ones. As both a student then and later as a teacher, I concluded that small schools are likely to serve students and parents better than their large, bureaucratic counterparts.

Large corporations become bureaucratic, almost by definition; and bureaucracy helps to obscure bad business practices. Just look at the recent history of financial institutions that did catastrophic damage, then were deemed by government as “too big to fail,” thus necessitating taxpayer bailouts and government takeovers.

When it comes to health care, I prefer to deal with routine issues at a small private practice in the tiny Maryland community where we have a lake house: The doc listens to you and the problem gets resolved. I even made the three-and-a-half-hour trip to that community to have an angry gall bladder removed because they could take me right away, rather than wait for at least two weeks to schedule the surgery at the huge Hershey Medical Center, which is only 7 miles from my Pennsylvania home. I’m glad the med center is there when big medical guns are needed; but it takes way too much energy to get a hangnail diagnosed there.

The remedy or the disease?
And now the Federal government, which has grown at a breathtaking pace since last fall, is poised to nationalize our health care system, according to a plan that, in effect, points to a leak in the national faucet and proposes to fix it by tearing up the entire American plumbing system. And just wait until you see the proposed bureaucratic solution. I’m certain that most Americans want health care reform that would address cost escalation, insurance for pre-existing conditions, portability, and catastrophic care. But this proposal redefines Byzantine complexity. The idea that healthcare, would become less complicated and more affordable by saddling it up this mind-numbing bureaucracy beggars belief. Take a look at how it is organized:



This diagram was created by Rep. Kevin Brady (R-Texas) and Republican staff of the Joint Economic Committee to illustrate the organization of the Democratic health care plan. It interested me because Republicans are being vilified for opposing the bill. I’m a registered Independent because neither party represents enough of my core views to strongly identify with, but on this one, I’m grateful to the Republicans for standing firm and to the Blue Dog Dems who are risking the ire of the White House in repudiating this nightmare.

Democrats have prevented Republican House Members from sending their constituents a mailing that includes this organization chart under House franking privileges, claiming that it is inaccurate. Well, I don’t think so because I’ve read the bill. In fact, I’m not sure it fully includes all of the plan’s complexity. Don’t take my word for it . . . you can read the thing yourself by clicking here.

Read the Bill!
Start by reading the Table of Contents; it is scary unto itself. Next: read pages 22-28, just to get a feel for the kinds of rules and regulations this monstrosity proposes. Lawyers will love it. Here are just a few page-by-page highlights to whet your appetite:

Page 27 covers “Health Insurance Exchanges,” which effectively brings private heath care under government control. See page 84, line 4 to see how sweeping this governmental mandate is and the potential it holds for rationing care.

Page 29, lines 4-16 establishes a cost-for-benefits ceiling (annual limitation) on “essential benefits” for what the government deems to be an acceptable plan.

Page 30, Section 123, line 11 mandates a private/public Health Benefits Advisory Committee government committee that decides what determines eligible treatments/benefits are provided by an acceptable plan.

Page 42 lays out the duties of the Health Choices Commissioner. He gets to choose your benefits, not you.

Page 50, Section 152: I’m pretty sure that the language of this section provides health care to non-US citizens, illegal or otherwise, even though another section of the bill says that it (not the section on page 50) doesn’t provide care to illegals. Consult your legal staff to find out for sure.

Page 65, Section 164 greatly expands subsidized care to retirees (55 years or older) and family members, even if they already have health plans. And wait until you read the red tape required to collect!

Page 143: Read Subtitle B of this section carefully, as it relates to “Employer Responsibility.” In it you will find that in order to “comply” employers must:

• Offer coverage to all employees and their families through the government option or a current employment-based health care plan.
• Be taxed at a rate of 8% of payroll if health care option is not offered to employees and dependents. Small businesses will pay less than 8%, but just imagine the increased costs involved for the private sector.
• Enrollment by employer of employee is automatic unless the employee opts out during a 30-day period. Unless the employee is covered by a family plan elsewhere, he or she will be subject to “Individual Responsibility” provisions, which the government dictates (see page 167, line 18 for “Tax on Individuals Without Acceptable Health Care Coverage.” Hint: They will be taxed at a rate of 2.5% of income.
• Pay special attention on page 150, line 8: “Special Rules for Small Employers, as this would pertain to most photographers (payroll under $400,000). If payroll is between $251,000 and $400,00 payroll tax will be 2-6%.

Page 57, Section 163 deals with Standardizing Electronic Administration Transactions. This looks scary to me because page 28, line 5 allows “real time determination of an individual’s financial responsibility at the point of service.” Sounds like governmentspeak for “we can get a look at your bank account.” I could be wrong. Hope so, especially since the it also enables electronic fund transfers to allow “automatic reconciliation,” which means the government now has direct access to your bank account. Imagine the outcry if George W. Bush had a bill on the Hill that would allow this level of government intrusion.

What about YOUR doctor?
Are you wondering how your doctor would be affected? Start on page 238, and I dare you to read through page 255. If you do, you’ll wonder why ANYONE would want to become a doctor (especially since the government decides on his or her level of reimbursement on page 127). My personal favorite of all the dictates is on page 253, line 10, under “Validating Relative Value Units” for doctors’ fee schedules: “Work elements to be validated include: time, mental effort and professional judgement, technical skill and physical effort, and stress due to risk.” OMG.

Page 265 covers government mandates on productivity for private health care; Page 489, Section 1308 allows the government to include Marriage and Family Therapy as a health care element; and on and on it goes. Believe me there are HUNDREDS of radical bureaucratic proposals in this bill, but I don’t have enough time to list all the catastrophes. Don’t take my word for it: Read it yourself, or to make it easier, divide it up among your friends and let them take notes, then exchange information.

Over recent months, I’ve watched as Congress and the Administration have severely limit the economic freedom of Americans by quadrupling the deficit, printing money to purchase our own debt, and delivering a pork-laden, non-stimulative “stimulus” bill, all of which are likely to prolong the recession. But in spite of this and a now-stalled cap-and-trade bill that is enough to scare the pajamas off of manufacturers from bread bakers to bomb makers, in the back of my mind I’ve believed there was still room for the private sector to restart the country’s economic engines, something that government cannot do.

An affordable bill? Not so much.
But this so-called health care “affordability” act, which will fundamentally alter one-sixth of our economy, could literally sink the ship of state. The administration says it will be revenue neutral; the Congressional Budget Office (which effectively works for the Democrats), says it will cost $1 trillion or more (think MORE) over 10 years. A growing number of Americans are seeing it for what it is: a naked government power grab based on the assumption that somehow government can do better in “caring for” people than they can do for themselves and through the private sector. This issue is far too serious to stay on the sidelines, so here are some things you can do to stop this national catastrophe:

• Call the local office of your U.S. Congressman and ask for an appointment over the August recess. DO IT NOW!!!
• Get your friends together and crowd into his or her local office. Politicians do pay attention when real live constituents speak to them politely and plainly.
• Bring signs and take pictures outside of his or her office, then send them to your local media, along with a few of your objections to the plan.

Common-sense reform
Yes, health care needs reform badly, but let’s start with a common-sense approach that tackles the issues that drive up costs:

• Separate routine care, catastrophic care, chronic care, and diagnostics to see what % of GDP they take up, and how much each is rising per annum. The costs of routine care are easier to reform; look for best-practice models for chronic care (including end-of-life care) and diagnostics; then let’s see where the cost differentials fall for catastrophic care, which might require a Federal option for uninsurable Americans, rather than unfunded mandates for the states.
• Give the responsibility for routine care (and perhaps diagnostics) back to individuals, allowing individuals to purchase routine health plans or tax-exempt savings plans that include diagnostics and catastrophic care as necessary elements unless and until we find a better way.
• Allow individuals to deduct health care plans to put them on the same par as businesses.
• Allow professional associations to form health care plans. Professional Photographers of America and other trade associations came very close to passing legislation in both houses of Congress several years ago. Estimates at the time were that this plan would cover 70% of uninsured Americans.
• Attack the physician-shortage issue. Does it make sense that there are more than half again as many lawyers in the U.S. than there are doctors? Only to lawyers who love to sue doctors, I suspect.
• President Obama has already said he will not support tort reform, but don’t give up on this.

Get these initiatives moving, then see what a government program for uninsured Americans would look like.
Please understand that I wouldn’t have taken the time to read a 1,000-+-page legislative proposal or to natter on in this post if I didn’t believe that the future of our way of life is at stake. If you agree, please stand up and be counted by passing on this article to your friends. Here’s a live link: http://annmonteith.com/page32/files/category-0022polinomics0022.html