ObamaCare: More Point and Counterpoint

This article is the second of a point / counterpoint series on Mr. Obama's health care plan. 
  • ObamaCare will not promote abortions.
It is true that there are no provisions in the current plan specifically providing for abortions.  However, there are provisions in the plan for "family planning."  Given his record, many conservatives rightly suspect that to Mr. Obama family-planning means a lot of planning, and fewer people in order to reduce the amount of carbon producing biological units. This health care plan gives the Commissioner of Health Choices the power to determine future benefits within the plan.  The promotion of abortion can be easily added once the bill is passed.   This is another example of liberal incrementalism at its finest.

  • ObamaCare will not lead to less care for the elderly.
Mr. Obama's plan depends upon a $500 billion cut from Medicare.  At the same time, he promises that the elderly will not realize reduced benefits.  If this is the case, what is now being done with that $500 billion?  It is obvious that this brings up a very important conundrum for Mr. Obama.  If the government is able to run medical care so efficiently then how would it be possible for $500 billion in reductions in Medicare to result in no substantial reduction in benefits?  However, if a substantial reduction in funding for Medicare is possible, it is further proof that the government does not run medical care efficiently?

There are other interesting aspects of medical care for the elderly.  Medical care for non-therapy ancillary services will be increased by 10%.  On page 215 we find that payment for therapy will be decreased by 5.5%.  In other words, payment will be increased for the provision of comfort care (think: end of life).  Payment will be decreased for the provision of curative care or care that prolongs life.

  • ObamaCare will not result in the exclusion of private medical insurance.
Nothing could be further from the truth. Private medical insurance must be provided in plans that are approved by the new Commissioner for Health Choices.  If these plans are not approved, they will not exist.  Furthermore, these plans are only given grandfather status.  Over time, private medical insurance will be squeezed out as the government medical plan increases its hold on everyone.

Additionally, the small business employee health coverage credit will phase out over the next several years.  There will be no tax credit for employers ensuring those earning over $80,000 per year. This provision starts immediately.  And, Mr. Obama's health care plan will pit the government plan against private health plans with a distinct legal advantage given to the government plan.

  • ObamaCare will be paid for by increased taxes and savings from cutting Medicare.
The Office of Management and Budget projects that ObamaCare will cost at least double and perhaps triple the amount that Mr. Obama has projected.  We have a history of government subsidized medical care in this country that shows the folly of Mr. Obama's promises.  Medicare has never been able to pay for itself out of payroll taxes.  Medicare required the infusion of general funds from the very beginning, and that infusion from the general fund has increased in proportion ever since the legislation became law.  Medicare receives a larger amount from the general funds than it does from payroll taxes and will be bankrupt by 2018.  Similarly, Obama's plan will never be funded by his proposed tax increases.  Within a very short time, taxes will increase through all strata of income levels and as medical care costs increase the system will implode. Every bit of available evidence shows us that medical care costs will rise more rapidly under a government system.

  • ObamaCare will help small businesses.
Mr. Obama's health care plan will destroy small businesses.  There will be surcharges, otherwise known as taxes, on the private health plans of all employees.  Additionally, businesses with payrolls greater than $250,000 but less than $300,000 yearly will have to pay 2% of that payroll toward the funding of the "Health Insurance Exchange."  Employers with larger payrolls would have to pay more and the percentage increases according to the number of employees in the business. This will cause employers to reduce the number of employees in order to reduce the amount of money they owe to the government.

  • The plan will not result in reduced benefits.
The plan is replete with rationing that is called everything but rationing.  For example, in order to reduce the amount of money spent on readmissions to hospitals, punitive actions will be taken in order to refuse payment to hospitals if patients are readmitted.  It's not the fault of hospitals or physicians when patients are readmitted and often this is necessary because of the severity of the initial illness. However, Mr. Obama's plan relies on punitive measures in order to prevent readmission.

"In order to account for excess readmissions in the hospital, the Secretary shall reduce the payments that would otherwise be made to such hospital under subsection 19 (d) (or section 1814(b)(3)"

These punitive measures are familiar to all of us who have had to work with the constraints of Medicare and Medicaid. Patients who take a turn for the worse will likely not be readmitted because of these penalties. Basically, the government would rather have the patient dead than readmitted.  One must understand that the wording of these provisions is extremely important and will lead to terrible injustices being perpetrated against patients under this plan.

This readmission clause is just one example of the punitive nature of Mr. Obama's health care plan.  I have read every one of the 1017 pages of the legislation and a large number of these pages are devoted to explaining the penalties that will be meted out to those who do not follow the rules of this complex legislation.

  • The government health plan will not cover illegal aliens.
 At first glance this seems to be the case.  On page 142 the plan states:

"Nothing in the subtitle shall allow federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States."

However, it does not state specifically that federal payments for affordability credits will not be allowed and the Health Choices Commissioner has the power to change these regulations at any time without Congressional approval.

The plan also states that persons eligible to receive credits in order to help pay for medical insurance, otherwise known as credit eligible individuals, are defined as those who are lawfully present in the United States (other than as a non-immigrant).  Notice the wording here.  The corollary of this would be that if persons are unlawfully within the United States but are non-immigrants they would be eligible for coverage.  Individuals who fit this description are otherwise known as illegal aliens.

The very wording of Mr. Obama's health care plan is meant to be confusing.  It is complex, nearly incomprehensible, expands the power of the federal government and the Internal Revenue Service, even making tax preparation more complex. I have spent weeks reading and studying this plan and I am still confused.  I am not, however, confused about the intent of this plan: the complete subjugation of the American people. In my opinion, ObamaCare would be the final nail in the coffin of this republic.
This article is the second of a point / counterpoint series on Mr. Obama's health care plan. 
  • ObamaCare will not promote abortions.
It is true that there are no provisions in the current plan specifically providing for abortions.  However, there are provisions in the plan for "family planning."  Given his record, many conservatives rightly suspect that to Mr. Obama family-planning means a lot of planning, and fewer people in order to reduce the amount of carbon producing biological units. This health care plan gives the Commissioner of Health Choices the power to determine future benefits within the plan.  The promotion of abortion can be easily added once the bill is passed.   This is another example of liberal incrementalism at its finest.

  • ObamaCare will not lead to less care for the elderly.
Mr. Obama's plan depends upon a $500 billion cut from Medicare.  At the same time, he promises that the elderly will not realize reduced benefits.  If this is the case, what is now being done with that $500 billion?  It is obvious that this brings up a very important conundrum for Mr. Obama.  If the government is able to run medical care so efficiently then how would it be possible for $500 billion in reductions in Medicare to result in no substantial reduction in benefits?  However, if a substantial reduction in funding for Medicare is possible, it is further proof that the government does not run medical care efficiently?

There are other interesting aspects of medical care for the elderly.  Medical care for non-therapy ancillary services will be increased by 10%.  On page 215 we find that payment for therapy will be decreased by 5.5%.  In other words, payment will be increased for the provision of comfort care (think: end of life).  Payment will be decreased for the provision of curative care or care that prolongs life.

  • ObamaCare will not result in the exclusion of private medical insurance.
Nothing could be further from the truth. Private medical insurance must be provided in plans that are approved by the new Commissioner for Health Choices.  If these plans are not approved, they will not exist.  Furthermore, these plans are only given grandfather status.  Over time, private medical insurance will be squeezed out as the government medical plan increases its hold on everyone.

Additionally, the small business employee health coverage credit will phase out over the next several years.  There will be no tax credit for employers ensuring those earning over $80,000 per year. This provision starts immediately.  And, Mr. Obama's health care plan will pit the government plan against private health plans with a distinct legal advantage given to the government plan.

  • ObamaCare will be paid for by increased taxes and savings from cutting Medicare.
The Office of Management and Budget projects that ObamaCare will cost at least double and perhaps triple the amount that Mr. Obama has projected.  We have a history of government subsidized medical care in this country that shows the folly of Mr. Obama's promises.  Medicare has never been able to pay for itself out of payroll taxes.  Medicare required the infusion of general funds from the very beginning, and that infusion from the general fund has increased in proportion ever since the legislation became law.  Medicare receives a larger amount from the general funds than it does from payroll taxes and will be bankrupt by 2018.  Similarly, Obama's plan will never be funded by his proposed tax increases.  Within a very short time, taxes will increase through all strata of income levels and as medical care costs increase the system will implode. Every bit of available evidence shows us that medical care costs will rise more rapidly under a government system.

  • ObamaCare will help small businesses.
Mr. Obama's health care plan will destroy small businesses.  There will be surcharges, otherwise known as taxes, on the private health plans of all employees.  Additionally, businesses with payrolls greater than $250,000 but less than $300,000 yearly will have to pay 2% of that payroll toward the funding of the "Health Insurance Exchange."  Employers with larger payrolls would have to pay more and the percentage increases according to the number of employees in the business. This will cause employers to reduce the number of employees in order to reduce the amount of money they owe to the government.

  • The plan will not result in reduced benefits.
The plan is replete with rationing that is called everything but rationing.  For example, in order to reduce the amount of money spent on readmissions to hospitals, punitive actions will be taken in order to refuse payment to hospitals if patients are readmitted.  It's not the fault of hospitals or physicians when patients are readmitted and often this is necessary because of the severity of the initial illness. However, Mr. Obama's plan relies on punitive measures in order to prevent readmission.

"In order to account for excess readmissions in the hospital, the Secretary shall reduce the payments that would otherwise be made to such hospital under subsection 19 (d) (or section 1814(b)(3)"

These punitive measures are familiar to all of us who have had to work with the constraints of Medicare and Medicaid. Patients who take a turn for the worse will likely not be readmitted because of these penalties. Basically, the government would rather have the patient dead than readmitted.  One must understand that the wording of these provisions is extremely important and will lead to terrible injustices being perpetrated against patients under this plan.

This readmission clause is just one example of the punitive nature of Mr. Obama's health care plan.  I have read every one of the 1017 pages of the legislation and a large number of these pages are devoted to explaining the penalties that will be meted out to those who do not follow the rules of this complex legislation.

  • The government health plan will not cover illegal aliens.
 At first glance this seems to be the case.  On page 142 the plan states:

"Nothing in the subtitle shall allow federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States."

However, it does not state specifically that federal payments for affordability credits will not be allowed and the Health Choices Commissioner has the power to change these regulations at any time without Congressional approval.

The plan also states that persons eligible to receive credits in order to help pay for medical insurance, otherwise known as credit eligible individuals, are defined as those who are lawfully present in the United States (other than as a non-immigrant).  Notice the wording here.  The corollary of this would be that if persons are unlawfully within the United States but are non-immigrants they would be eligible for coverage.  Individuals who fit this description are otherwise known as illegal aliens.

The very wording of Mr. Obama's health care plan is meant to be confusing.  It is complex, nearly incomprehensible, expands the power of the federal government and the Internal Revenue Service, even making tax preparation more complex. I have spent weeks reading and studying this plan and I am still confused.  I am not, however, confused about the intent of this plan: the complete subjugation of the American people. In my opinion, ObamaCare would be the final nail in the coffin of this republic.