Freedom and Liberty
No “gold plated” care for you – unless you’re in a union.
Yes, friends, it’s payback time in the health care legislation world. Bloomberg reports:
The U.S. Senate proposal to impose taxes for the first time on “gold-plated” health plans may bypass generous employee benefits negotiated by unions.
Senate Finance Committee Chairman Max Baucus, the chief congressional advocate of taxing some employer-provided benefits to help pay for an overhaul of the U.S. health system, says any change should exempt perks secured in existing collective- bargaining agreements, which can be in place for as long as five years.
The exception, which could make the proposal more politically palatable to Democrats from heavily unionized states such as Michigan, is adding controversy to an already contentious debate. It would shield the 12.4 percent of American workers who belong to unions from being taxed while exposing some other middle-income workers to the levy.
This is how they manage to get at your health care plan. Baucus wants to tax any health care benefit that is more costly than those provided federal employees. Those costs are about $4,200 for individuals and $13,000 for families. The claim is they again want to go after the “rich” who have “gold plated” plans. And the example in the Bloomberg article is the $40,543 in health benefits paid to Lloyd Blankfein, chief executive of New York-based Goldman Sachs Group Inc., the fifth largest U.S. bank.
Of course that threshold will also affect people much lower on the financial totem pole than Lloyd Blankfein. For example:
It can also affect companies such as Henderson, Nevada- based Zappos.com, where workers’ $11 per hour pay is supplemented by employer-paid health insurance plans worth about $7,500.
So immediately you have an $11 an hour employee liable for $495 at 15% of the difference. But remember, your taxes won’t go up by a dime. Not a single dime.
Why the desire to exempt unions? Well it gets a favored constituency off their back, is a measure of payback for their support and union members can then enjoy their “gold plated” coverage while $11 an hour workers pay the freight. Don’t believe unions have gold plated coverage. Try this example:
Sandra Carter, a retired Pacific Bell Telephone Co. technician from Stockton, California, said her health benefits, worth about $12,000 per year, were negotiated by the Communications Workers of America. She is unmarried with no children, meaning her individual coverage exceeds benefits paid to federal workers by about $7,800. If that amount were taxed at the 15 percent marginal rate, she would owe $1,170.
“I can’t afford the taxes I pay now,” said Carter, who said she suffers from diabetes. “Why should I get taxed on a benefit that keeps me a functioning person?”
Gee Ms Carter, why should anyone? Why is it any business of the government to limit the coverage to $4,200 and tax the rest. Who is Max Baucus, or anyone, to arbitrarily set the insurance limit at $4,200 for individuals and $13,000 for families and punish those who have better plans through taxation?
I would guess, however, Ms Carter is fine with unions being exempted and also fine with others being taxed in her stead.
Most unions, of course, see themselves as the exceptions deserving of such exemptions:
Anna Burger, secretary-treasurer of the Service Employees International Union, said in an interview that workers have often traded salary increases for better benefits in agreements.
Taxes “shouldn’t be taken from the backs of workers who have bargained away wages and other things for their benefits over the years,” Burger said.
But it is ok if others who’ve negotiated the same sort of exchange privately get nailed, eh Ms Burger? It’s not the principle, it’s the exception which is important here apparently.
To their credit, some unions are actually standing on principle:
“Either way, we are against a tax on health-care benefits in whatever form it takes,” said Jacob Hay, spokesman for the Laborers’ International Union of North America. The union represents 500,000 workers, largely in the construction industry.
Special interest democracy – political payback – so blatant now that you don’t even have to wonder if it is being done. Democrats are shameless in their pursuit of it. If you’re in a favored group, your ship has come in.
The vote was 219 to 212.
4 votes on the other side and it goes down to defeat.
So, who are these people:
Mary Bono Mack (Calif.), Mike Castle, Mark Steven Kirk (Ill.), Leonard Lance (NJ), Frank LoBiondo (NJ), John McHugh (NY), Dave Reichert (Washington), Chris Smith (NJ)
They’re the Republicans who voted for the bill and assured its passage.
You may want to find some way to thank them for passing one of the largest and most regressive tax increases in US history.
What were the charges?
Expanded executive power. Trampled on rights. Ruled by executive order. Creeping authoritarianism.
Does that about cover most of what the left tried to hang on the Bush presidency? And who was the answer to all those problems?
The Obama administration, fearing a battle with Congress that could stall plans to close the U.S. prison at Guantanamo Bay, is drafting an executive order that would reassert presidential authority to incarcerate terrorism suspects indefinitely, according to three senior government officials with knowledge of White House deliberations.
Such an order would embrace claims by former president George W. Bush that certain people can be detained without trial for long periods under the laws of war. Obama advisers are concerned that bypassing Congress could place the president on weaker footing before the courts and anger key supporters, the officials said.
So it was never about principle, was it? It was always about politics.
Hope and change.
For new readers the title is that for which the shortened “QandO” stands. This is the second in a series of questions and observations.
- In the “you can’t make this up” department, China will block the sale of Hummer for “environmental concerns”. I guess that’s their nod to the rest of the world after flatly refusing cut CO2 emissions in the future.
- Ezra Klein is suddenly for smaller government, specifically the elimination of the Agriculture Committee. Of course the only reason he’d like to see it given the deep 6 is because it has, in Klein’s opinion, badly weakened cap-and-trade by extracting “a truly mind-boggling array of tax breaks, exemptions, and straight subsidies”. I guess Klein would like to temporarily make government smaller to make it larger.
- Yes, Michael Jackson is dead – but for heaven sake, do we have to devote every minute of the news day to running “Thriller” vid and spreading rumors about the possible cause of his death? Is this what “news” organizations have become?
- Apparently we’re still stalking the North Korean ship enroute to either Singapore or Burma. For those who are waiting for us to confront it and board it, that’s not going to happen. The “tough” UN resolution only provides for boarding if the North Koreans agree. And, while we can demand that they then go to the nearest port for inspection, the North Koreans can refuse that as well. The plan, it seems, is to convince the refueling port the NoKos pull into to refuse to refuel the ship. Then, when the NoKo ship runs out of fuel, put it under tow and then inspect it. As I understand it – they can then inspect it legitimately. Amazing.
- Waxman-Markey, aka cap-and-trade, survived an earlier test vote that moved the bill to the floor for a 5pm vote. As I recall the margin was 5 votes. It is a job destroyer in the middle of a recession. The Center for Data Analysis of the Heritage Foundation figures it will cost 50,000 jobs in the transportation equipment sector alone. Their data for other sectors is available here.
- House liberals have staked out a bit of ground on the health care bill saying they will not vote for it if it doesn’t include a public option – period. That is actually good news as the public option does seem to be in trouble. Any bill showing up without it will most likely not get the 80 members of the Congressional Progressive Caucus to vote for it. Add in the Republicans and the Blue Dogs, and it may be in very serious trouble without just the sticker shock of 1 to 3 trillion dollars of cost.
- Mark Sanford? He should resign. The affair is between he and his family. He should resign because he was derelict in his duty and he misappropriated government funds to pay for his trip to Argentina. Kinda like Bill Clinton should have resigned, not for the affair, but for lying under oath to a grand jury and attempting to obstruct justice.
Literally. The NY Times reports:
The authorities showed little inclination to heed chastisement by outsiders as a senior cleric called for demonstrators to be punished “ruthlessly and savagely.”
At Friday Prayer in Tehran University, the senior cleric, Ayatollah Ahmad Khatami, referred to the demonstrators as rioters and declared, “I want the judiciary to punish leading rioters firmly and without showing any mercy to teach everyone a lesson.”
Reuters quoted him as saying that demonstrators should be tried for waging war against God. The punishment for such offenses under Islamic law is death, Reuters said.
As for the murder of the woman named Neda, now a symbol of Iranian resistance worldwide, Khatami also dismissed that as propaganda ploy:
Khatami said Neda was shot by government opponents for propaganda purposes. “By watching the film, any wise person can understand that rioters killed her,” he said.
Any hope for a new election, or even a recount were dashed by the Guradian Council:
The 12-man Guardian Council’s statement leaves little scope for more legal challenges to the election result, short of an attack on the position of Supreme Leader Ayatollah Ali Khamenei, who has expressed strong support for Ahmadinejad.
“The Guardian Council has almost finished reviewing defeated candidates’ election complaints … the reviews showed that the election was the healthiest since the revolution … There were no major violations in the election,” said Kadkhodai.
And while government thugs have been pretty successful in keeping protesters off the street, other signs of resistance are still evident:
There were other signs of continued resistance. A few conservatives have expressed revulsion at the sight of unarmed protesters being beaten, even shot, by government forces. Only 105 out of the 290 members of Parliament took part in a victory celebration for Mr. Ahmadinejad on Tuesday, newspapers reported Thursday. The absence of so many lawmakers, including the speaker, Ali Larijani, a powerful conservative, was striking.
This is by far the most serious challenge to the present regime since the 1979 revolution which put them in power. And I’ll remind you again that it took a year from the initial protests for enough pressure to build (as other elements of the society joined the original dissidents) to the point that millions took to the streets and overthrew the Shah. And at this point, the mullocracy has nothing on the Shah’s regime in terms of brutality, oppression and totalitarian control.
I understand that everywhere else today it is “Michale Jackson is dead” day – I suspect days such as this must be infinitely boring to most news junkies because the news is dominated by a single topic.
Meanwhile Democrats are doing their best to rush cap-and-trade through the House today even while the pseudo-science that supports their effort continues to collapse. The WSJ has an article today which points out:
Among the many reasons President Barack Obama and the Democratic majority are so intent on quickly jamming a cap-and-trade system through Congress is because the global warming tide is again shifting. It turns out Al Gore and the United Nations (with an assist from the media), did a little too vociferous a job smearing anyone who disagreed with them as “deniers.” The backlash has brought the scientific debate roaring back to life in Australia, Europe, Japan and even, if less reported, the U.S.
Interestingly, as the EPA story below points out, it has actually been suppressed here. But that hasn’t stopped the scientific community elsewhere from continuing to destroy the myth of consensus and replace it with a healthy, and might I add peer reviewed, skepticism real science brings to any theory:
In April, the Polish Academy of Sciences published a document challenging man-made global warming. In the Czech Republic, where President Vaclav Klaus remains a leading skeptic, today only 11% of the population believes humans play a role. In France, President Nicolas Sarkozy wants to tap Claude Allegre to lead the country’s new ministry of industry and innovation. Twenty years ago Mr. Allegre was among the first to trill about man-made global warming, but the geochemist has since recanted. New Zealand last year elected a new government, which immediately suspended the country’s weeks-old cap-and-trade program.
The number of skeptics, far from shrinking, is swelling. Oklahoma Sen. Jim Inhofe now counts more than 700 scientists who disagree with the U.N. — 13 times the number who authored the U.N.’s 2007 climate summary for policymakers. Joanne Simpson, the world’s first woman to receive a Ph.D. in meteorology, expressed relief upon her retirement last year that she was finally free to speak “frankly” of her nonbelief. Dr. Kiminori Itoh, a Japanese environmental physical chemist who contributed to a U.N. climate report, dubs man-made warming “the worst scientific scandal in history.” Norway’s Ivar Giaever, Nobel Prize winner for physics, decries it as the “new religion.” A group of 54 noted physicists, led by Princeton’s Will Happer, is demanding the American Physical Society revise its position that the science is settled. (Both Nature and Science magazines have refused to run the physicists’ open letter.)
It is falling apart in big chunks now – not that anyone on the left here is listening. We’ve got the fingers firmly in the ears in Congress and the EPA. Both made up their minds years ago, having bought into the pseudo-science of Al Gore and are now determined to act on their preconceived notions – science be damned.
Economist John M. Keynes once said, “When the facts change, I change my mind. What do you do, sir?”
The answer for the left is ignore them and pass economy killing legislation as fast as they can.
The collapse of the “consensus” has been driven by reality. The inconvenient truth is that the earth’s temperatures have flat-lined since 2001, despite growing concentrations of C02. Peer-reviewed research has debunked doomsday scenarios about the polar ice caps, hurricanes, malaria, extinctions, rising oceans. A global financial crisis has politicians taking a harder look at the science that would require them to hamstring their economies to rein in carbon.
Meanwhile our blinkered ideologues push cap-and-trade while ignoring the new evidence.
Comforting, isn’t it?
That was the promise candidate Barack Obama made. He claimed that wasn’t the case during the Bush administration and under his leadership, science would be ascendent. They’d just let the chips fall where they may.
Well, except maybe in the EPA when a key to an ideological agenda item – declaring CO2 a pollutant – didn’t have the science available to support the desired result. Read the executive summary of this suppressed report. It outlines why the science doesn’t support the desired agenda item of declaring CO2 a pollutant. Of course without such a declaration, legislation for pollution standards for autos as well as this abomination of a cap-and-trade bill before the House today are without basis.
Michelle Malkin is all over this and it’s ironic that what occurred sounds exactly like what the left accused the Bush administration of doing:
The EPA now justifies the suppression of the study because economist Carlin (a 35-year veteran of the agency who also holds a B.S. in physics) “is an individual who is not a scientist.” Neither is Al Gore. Nor is environmental czar Carol Browner. Nor is cap-and-trade shepherd Nancy Pelosi. Carlin’s analysis incorporated peer-reviewed studies and, as he informed his colleagues, “significant new research” related to the proposed endangerment finding. According to those who have seen his study, it spotlights EPA’s reliance on out-of-date research, uncritical recycling of United Nations data, and omission of new developments, including a continued decline in global temperatures and a new consensus that future hurricane behavior won’t be different than in the past.
It appears, at least in this case, that science isn’t of interest to the ideologues on the left any more than it was to the ideologues on the right. That may be an “inconvenient truth”, but there it is. Again we find what was promised by Obama during the campaign, just like transparency and fiscal responsibility, were “just words”.
While I’m sure the specials last night on the deaths of Farrah Fawcett and Michael Jackson vastly outdrew the ABC’s Obama healthcare special the other night (no I didn’t watch it – I was being disappointed by the Yankees/Braves game), there were some very telling moments apparently. And, being the curious type, I found the transcript and read the whole thing.
Let’s say Mr. Eloquent was less than convincing. But he did shed some light on what he’d like to see the final product look like.
Naturally there were some moments that were instantly reported by the media and other bloggers. For instance when he essentially said that if that he’d use his wealth if necessary to go outside any system that denied his family the healthcare he thought they needed. The obvious point is he concedes that his system will do so – i.e. ration care through denial. Of course that’s one of the big complaints he’s had about private healthcare – rationing through denial.
But there were some other things said which only a careful reading of the transcript reveal. Let’s start with this question:
DR. JOHN CORBOY, NEUROLOGIST & MEDICAL PROFESSOR: Well, I think you still have to provide the appropriate care. And I think we all know that there is a significant amount of care that actually is inappropriate and unnecessary.
And the question then is — for you, Mr. President, is, what can you convince — what can you do to convince the American public that there actually are limits to what we can pay for with our American health care system?
And if there are going to be limits, who is going to design the system and who is going to enforce the rules for a system like that?
This question is loaded with key words and phrases. The first is “appropriate”, as in “appropriate care”. Who gets to decide? If you listen to a glib Obama, he constantly says medical decisions should be left to doctors. But this question isn’t being addressed to that point, is it? If there is an “appropriate care” standard, someone is going to have to define it.
And that is precisely what Corboy asks – “who is going to design the system and who is going to enforce the rules?” In fact, who gets to decide what the rules are?
I think you know the answer, but let’s look at the President’s answer:
OBAMA: Well, you’re asking the right question. And let me say, first of all, this is not an easy problem. If it was easy, it would have been solved a long time ago, because we’ve talking about this for decades, since Harry Truman.
We’ve been talking about how do we provide care that is high-quality, gives people choices, and how can we come up with a uniquely American plan? Because one of the ideological debates that I think has prevented us from making progress is some people say this is socialized medicine, others say we need a completely free market system.
We need to come up with something that is uniquely American. Now what I’ve said is that if we are smart, we should be able to design a system in which people still have choices of doctors and choices of plans that makes sure that the necessary treatment is provided but we don’t have a huge amount of waste in the system. That we are providing adequate coverage for all people, and that we are driving down costs over the long term.
OK, let’s stop for the moment right there. We begin with Obama in stump-speech mode. That’s a time buyer. He’s fumbling for an answer and is filling time. By the third paragraph he’s beginning to formulate an answer. Of course, I had to laugh because a uniquely American solution would be to have government back off and let the market take the ball and run with it. But obviously that’s not his plan. I think what he’s saying here is he hopes for a Euro-socialist plan with an American twist.
Anyway, in the third paragraph we’re again into some key words – this time “necessary” and “adequate”. Again, who will decide what is “necessary” and what form of coverage is “adequate”? Well, trust me, it won’t be you or your doctor, because his priority is what? That’s right – “driving down costs over the long term”. So “necessary” treatment will be considered in the context of “driving down costs”. I’m sure you figure out what that means.
Then there’s the “we should be able to design a system”. He’s not talking about you or the market here. He’s talking about government. He’s a part of the ‘we’ – you’re not.
Last, of course, is the overriding priority – drive costs down. He claims health care is the reason for the current deficit. So the obvious first priority for this so-called reform is to cut costs.
But let’s add 47 million new insured while driving costs down. Make sense to you? And if it does, then you have to admit that lesser cost, if possible, will have to come from some part of the current health care system. He has his ideas, and we’ll cover that in a different post.
Moving on with the answer:
If we don’t drive down costs, then we’re not going to be able to achieve all of those other things. And I think that on the issue that has already been raised by the two doctors, the issue of evidence-based care, I have great confidence that doctors are going to always want to do the right thing for their patients, if they’ve got good information, and if their payment incentives are not such that it actually costs them money to provide the appropriate care.
Here we find a very critical clue to the plan for your health care – the term “evidence-based care”. This is the new way of saying “we’ll decide for you”. Evidence based medicine claims to use the scientific method to determine optimum treatment decisions. The Centre for Evidence Based Medicine says it is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.”
Said another way, a group somewhere doing research decides that certain diseases or conditions should be treated in certain ways. Those treatments are then applied to individual cases without any caveat for unique situations. The cost savings comes with uniform procedures and uniform care – no deviations. In other words, for the most part, decisions on how to treat individual cases will most likely have to conform to EBM guidelines or be considered outside the system. So what Obama said with that simple term is “we’ll decide how you will be treated, not your doctor”.
Of course critics of EBM are many and claim that it has some utility in outlining suggested treatment for populations as a whole, but has limited utility when taken down to the individual situation since each is unique.
And then there’s the inference that medicine to this point hasn’t been based on science. As Abraham Verghese said:
“Evidence Based Medicine” is a term which makes about as much sense as “Sex-based intercourse”–Were we practicing based on zodiac signs before EBM came along?
That brings us to the bit about “doctors always want to do the right thing for their patients”. Yes, of course. But what he says next hints that “the right thing” may be what the technocrats think is right, not necessarily what the doctors might think is right. He says doctors will do that “if they’ve got good information, and if their payment incentives are not such that it actually costs them money to provide the appropriate care.”
Anyone know right now instances when “appropriate care” costs a doctor “money to provide”? Yup, Medicare and Medicaid. It’s the reason so many opt out of treating Medi patients.
How then does he plan on changing their payment incentives so it doesn’t cost them money? Well to do that you either change the reimbursement rate or you change what is “appropriate”, don’t you? EBM promises the latter.
That brings us to the final part of his answer:
And right now, what we have is a situation, because doctors are paid fee-for-service, and there are all sorts of rules governing how they operate, as a consequence often times it is harder for them, more expensive for them, to do what is appropriate.
And we should change those incentive structures.
Now this is simply a load of road apples.
Litigation is part of the problem. Obama refuses to address that as a basic health care cost problem. It drives up costs and it also induces doctors to use unnecessary tests in a CYA gambit. Want to “change incentives?” Here’s a great place to start.
The second problem is chronic underpayment by the government through Medicare and Medicaid – something Obama and Congress want to again reduce by up to 20%. That causes cost shifting to the private side of things. But insurance companies have gotten smart and now refuse, in many cases, to pay more than the Medis. That is an artificial distortion of the market introduced by government arbitrarily deciding what a medical procedure is worth.
And the rules under which doctors operate are no less stringent under the Medis than under any private insurance plan.
That’s one question from the staged ABC “town hall meeting”. There was an amazing amount of info in that one question and answer. Enough information that you should be absolutely shaking in your boots, because what he said is he plans on doing precisely what he has been telling you he wouldn’t do – design a system which will decide how your doctor will treat you. It is all there, and no one has even bothered to take the close look it deserves.
I’ll parse a few more questions from the interview as I have the time, but suffice it to say, if you look hard enough you can figure out exactly where this guy wants to take us.
Apparently it will according to some who have actually beaten their way through the entire bill and read the contents:
The Ways and Means Committee’s proposed bill language (pdf) would virtually require that the president impose an import tariff on any country that fails to clamp down on greenhouse gas emissions.
Of course in this full bore onslaught of major life changing legislation which the Democrats seem determined to push through the Congress as quickly as they can (citing the imminent crisis it will foment if they don’t), this issue seems to be lost in the shuffle:
“This is a sleeper issue that lawmakers have not been paying enough attention to,” said Jake Colvin, vice president for global trade issues at the National Foreign Trade Council, which represents multinational corporations like Boeing Co. and Microsoft Corp. advocating for an open international trading system.
“The danger is, you focus so much on leveling the playing field for U.S. firms, that you neglect the potentially serious consequences that this could have on the international trading system,” Colvin said.
Nancy Peolosi is aiming for a vote in the House this Friday, before the July 4th recess. That obviously will mean very, very limited debate, if any. As NRO notes:
Not content to tempt political fate by imposing huge carbon taxes on the American middle class, Democrats have added a provision which imposes stiff tariffs on our trading partners if they don’t adopt aggressive carbon restrictions of their own.
You heard correctly: progressives have authored a bill that earns the mortal enmity of domestic energy consumers and our most crucial trading partners at the same time. Economy-killing climate policies and a trade war — together at last!
The devil is in the details:
Leaks from Hill offices indicate that the president would now be forced to impose the carbon tariffs — and could only opt out of doing so with permission from both chambers of Congress. Carbon-intensive imports would be subject to penalties at the border unless the country of origin requires emission reduction measures at least 80 percent as costly as ours. (The original Waxman-Markey bill had a threshold of 60 percent.)
Brilliant. Of course, some are going to argue that such measures surely will not be in the Senate version and not survive the reconciliation process when the two versions are merged. With this Congress I wouldn’t bet the farm on that.
There’s some talk that the blue dogs are going to oppose this bill. Obviously you would expect the GOP to oppose it as well. Are there enough other Dems to oppose so as to defeat it? Pelosi may not be the sharpest knife in the drawer when it comes to many things, but over the years she has learned to count votes I’m sure.
Bottom line: this bill is an economy killer, plain and simple. But it is also a progressive wet-dream shared by Pelosi. She is going to do everything in her power to push it through the House.
It took almost two weeks of brutalizing their own people, but the invitation for Iranian diplomats to attend Fourth of July parties at U.S. Embassies around the world has finally been rescinded. Of course this was done about a day after President Obama gave this mealy-mouthed answer to a question on the subject:
Q: Are Iranian diplomats still welcome at the embassy on the Fourth of July, sir?
THE PRESIDENT: Well, I think as you’re aware, Major, we don’t have formal diplomatic relations with — we don’t have formal diplomatic relations with Iran. I think that we have said that if Iran chooses a path that abides by international norms and principles, then we are interested in healing some of the wounds of 30 years, in terms of U.S.-Iranian relations. But that is a choice that the Iranians are going to have to make.
For those of you who need a translator, the answer was “yes”. Today the answer is “no”.
I’m glad they’ve awakened up there to the reality of what is happening in Iran and finally made some sort of move, no matter how trivial or symbolic, to show their disapproval. But it has taken unrelenting pressure to get them to move off of their “engagement at any cost” policy. In the case of 4th of July celebrations, it would have been a travesty to have representatives of the present brutal regime present. Ed Morrissey asks what they’d have been present for anyway:
Besides, what Independence Day values would the Iranian regime want to celebrate with us? Freedom of speech? Freedom of religion? The freedom to peaceably assemble or petition government for a redress of grievances?
Obama rather arrogantly reminded us that “only I am President of the United States”. But as former Secretary of State Lawrence Eagleburger reminded Obama, that means he represents the people of the United States when he speaks and in the case of the Iranian violence, he hasn’t represented them very well at all.