Tag Archives: health care bill

New Health Care Law

David Leonhardt Gets It Wrong

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I don’t think I have ever seen so many writers (especially at The New York Times) make so many mistakes about what a bill before Congress is going to do. Here is David’s latest:

At the heart of the health care debate is the question of whether it’s possible to cut medical costs without harming patients.

He goes on to give this example:

Since 1996, the Richmond area has lost more than 600 of its hospital beds, mostly because of state regulations on capacity… [Yet] the quality of care in Richmond is better than in most American metropolitan areas, according to various measures, and it continues to improve.

But that is not what the debate is about. Everyone can point to hundreds of examples of lower-cost, higher-quality care. Just as in education, we can point to hundreds of low-cost, high-quality schools.

The Question Is: Either in health care or in education can the federal government, using the tools of command-and-control, lower costs without reducing quality? The answer would seem to be: “No.”

New Health Care Law

Small Business Rates ObamaCare

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This is from a letter the NFIB sent to Harry Reid:

A new small business tax: The Senate bill includes a new $6.7 billion annual tax ($60.7 billion over 10 years) that falls almost exclusively on small business.

An ineffective subsidy: As structured, the small business tax credit will do little, if nothing, to propel either more firms to take-up coverage or produce greater overall affordability.

Continue reading Small Business Rates ObamaCare →

New Health Care Law

Are Minorities Getting Shafted in the Health Care Bill?

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Minority groups disproportionately use Medicare Advantage (MA), which is slated for a $118 billion cut. One in four MA enrollees is Hispanic/Latino; one in four is African American. Also, more than 80% of Hispanic/Latino Medicare-eligible seniors with incomes of less than $20,000 per year are enrolled in an MA plan.

Individual and employer mandates will disproportionately negatively impact low income, at risk populations. A June 2008 study, put out by the Blue Cross Blue Shield Massachusetts Foundation and Harvard School of Public Health, found that 50% of those impacted by the mandate (meaning they were uninsured in the 12 months prior to the survey at some point) believe people are worse off than they were prior to the reforms.

The employer responsibility component of the bill is fairly complicated, but contains significant disincentives for employers to hire low income workers. The Center on Budget and Policy Priorities (a liberal group) finds that “significant disincentives to hire or retain [workers from low- or moderate-income families] remain” in the bill.

The above is adapted from a report by The San Diego Union-Tribune.

Seniors

A Nasty Surprise for Retirees in the Senate Health Bill

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Current law:

Under the 2003 law that created a prescription-drug benefit known as Medicare Part D, companies that continued to provide such benefits on their own qualified for a 28% tax-free subsidy — worth about $600 a year per retiree. Hundreds of major companies took advantage of the provision.

After health reform takes the subsidy away:

One industry group estimated that as many as one-third of the companies providing the benefits could drop them to avoid the hit to earnings… An analysis by the American Benefits Council, an advocacy group for large employers, found the tax change could result in a one-time 35% reduction in earnings for a typical company now receiving the subsidy.

Full report on cuts to retiree benefits.

Health Care Costs

Cities and States are Preparing to Ration Care

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In case a pandemic makes it necessary, that is. A lot of the planning is being done without public awareness. The U.S. Centers for Disease Control and Prevention is funding many of the planning exercises to develop guidelines on how to ration care. For example:

Utah’s pandemic triage guidelines set out categories of patients — including those with end stage heart failure, incurable cancer and the elderly — who would be denied hospital and intensive care unit admittance during a severe pandemic. The Utah plan also anticipates removing certain patients from life support regardless of their or their families’ permission, to make way for others who are expected to have a better chance of survival.

Seniors

Obama Targets End-of-Life Care: Critics Say Lives are at Stake

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The charge:

According to Dartmouth, Medicare pays about $50,000 during a patient’s last six months of care by U.C.L.A., where patients may be seen by dozens of different specialists and spend weeks in the hospital before they die.

By contrast, the figure is about $25,000 at the Mayo Clinic in Rochester, Minn., where doctors closely coordinate care, are slow to bring in specialists and aim to avoid expensive treatments that offer little or no benefit to a patient.

“One of them costs twice as much as the other, and I can tell you that we have no idea what we’re getting in exchange for the extra $25,000 a year at U.C.L.A. Medical,” Peter R. Orszag, the White House budget director and a disciple of the Dartmouth data.

The defense:

U.C.L.A. and five other big California medical centers recently published their own research results with a striking conclusion: for heart failure patients, the hospitals that spend the most seem to save the most lives.

Full article on end-of-life care in The New York Times.

New Health Care Law

This Would be Funny, if it Were Not So Sad

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New York Times editorial:

Critics of the current bills regularly complain that they do little to…slow the relentless and rapid rise of medical spending.

That is largely true, and for a very good reason: Nobody really knows what reforms would work. All of the pending bills would spend money on various studies, demonstrations and pilot projects in the expectation that some might pan out.