healthcare: taking away your right to decide

The more one tries to reconcile the rhetoric and the facts on
healthcare reform, the more disconcerting discrepancies crop up.

Mr. Obama tells us "I don't believe anyone should be in charge of your health
care decisions but you and your doctor - not government bureaucrats, not
insurance companies" [nyt3].

Actually, the reform specifically targets for punishment citizens who choose
to truly be in charge of their health care decisions by making those
decisions between themselves and their doctor without the involvement of a
government bureaucrat or an insurance company [hahca Sec. 59B(a) p167].

The reform takes away the right of a citizen to define what

"acceptable health care coverage" is for them, turning that decision over to
the HHS Secretary and the Health Choices Commissioner, both government
bureaucrats [hahca Sec. 59B(d)(2) p171-3].

The reform creates 53 bureaucracies and/or bureaucrats, dramatically

increasing government intrusion into decisions about health care [rs53].

The reform restricts the right of a citizen to define what an acceptable

practitioner is for them, putting government bureaucrats in charge of that
[hahca Sec. 225(a),(b) p126]. Those who choose to be free of insurance
because they subscribe to unorthodox practitioners and types of healing
not covered by insurance companies will be deprived of their right -
only practitioners approved by either a government bureaucrat or an
insurance bureaucrat would be allowed.
Those who are rich will be able to pay both the fines or mandated insurance
and also their chosen unapproved health care, but those with limited income
will be deprived of their right to choose health care not approved by
government or insurance bureaucrats.

"Reform will finally bring skyrocketing health care costs under

control, which will mean real savings." [nyt3]

Supporters of Massachusetts' reform said it would reduce premiums because

of the money extracted from young healthy people who didn't need medical
care. They were wrong. What actually happened is that government healthcare
costs increased 42% [nyt1], median employee family premium contributions
increased 24.7% from 2005 (before reform) to 2007 (after reform) [mass1] -
more than double the increase nationally [kff1], and Commonwealth Choice Bronze
monthly premiums increased 15% from 2007 to 2009 [mass2] - 1.5 times the
national increase [kff1]. Thus the record of actual experience is that
reform dramatically accelerated the skyrocketing of costs.

Note that premium increases are not accounted for by the Congressional
Budget Office, which does not look at the cost to the public, only the cost
to the federal government, so we can be sure that the true cost to you and me
will be much higher than what the CBO says.

The federal reform takes away citizen control over decisions about costs,
turning that over to one government bureaucrat, the HHS Secretary.
Citizens are not allowed to save costs by getting policies with annual or
lifetime caps, even if they have a living will opposing expensive heroic
measures [hahca Sec. 122(a)(3) p27]. Neither can they save costs knowing
they never want mental health or substance abuse coverage; even single men
can't save the cost of maternity and baby care [hahca Sec. 122(b)(7),(9),(10)
p28].
Changes to these mandates are to come from a Health Benefits Advisory
Committee whose composition is to represent "various sectors of the
health care system" [hahca Sec. 123(a)(5) p32] - in other words we can
be sure the interests of consumers will be drowned out by those who
stand to reap billions of dollars from ratcheting up minimum benefits -
dollars taken out of consumer pockets. Since this money is taken
through premiums, again this cost is not accounted for by the CBO.

"You will not be waiting in any lines." [nyt3]

When Massachusetts passed a similar reform, waiting times to see some

types of doctors almost doubled [nyt2]. Some people found that calling 25
doctors was not enough; it took calling 50 doctors to get one appointment [objs1].

"If you don't have health insurance, you will finally have quality,
affordable options once we pass reform." [nyt3]

43% of the uninsured are uninsured by choice [oneil1 p5], many

of whom already have affordable options that would be taken away by the reform,
which forces individuals making over $14,400 to pay for insurance even if
they never want any of the types of medicine insurance would pay for.
[hahca Sec. 59B(d) p171, Sec. 243(b) p135, Sec. 243(d)(1) p137]
That's barely enough to pay for rent and food in some parts of the country.
Many low-income people will not agree with the label of
"affordable" slapped on by those making over $100,000.
The voluntarily uninsured have a death rate less than the insured
[oneil1 Table 11], demonstrating that ordinary people can
manage their own health without either private or public insurance.

"14,000 Americans lose their health insurance every day." [nyt3]

44.5% of the time someone loses insurance they regain it within

4 months, and 70.7% of the time they regain it within a year [cbo1].
The following statement is true: "300 million americans go without
food and water for some part of every day".
From 1994 to 2006, the ranks of the involuntarily uninsured increased from
11.1% to 11.6% of the total population (ie, it increased each year by 1/25th
of 1%); among married people with childen it increased from 10.0% to 10.1%
(about one-hundredth of 1% per year) - hardly the skyrocketing epidemic the
supporters are trying to scare us with to stampede support for reform.
Most of the 1.8% increase in total uninsured (less than 2 tenths of 1% per
year) was due to those who voluntarily opted out. [oneil1 Table 5]

Americans have been voting with their feet by making more visits to
alternative health practitioners than orthodox physicians. Of the money
they have control over, americans choose to spend more on alternative
medicine than either hospitalization or orthodox physicians [jama1].
Forcing everyone to buy into the orthodox medical system deprives citizens
of the ability to choose alternatives, consolidating the orthodox monopoly
and allowing it to keep prices - and thus health care costs - high.
In other words, the priorities of the public are competely different from
those benefitting from reform.

In a poll separately asking about reform policy components, one had the
strongest consensus: by a 68% to 26% margin the public opposes compelling
anyone to buy insurance [quin1]. Such a mandate benefits the insurance
industry by $195 billion per year [uprem] or almost $2 trillion over 10 years,
much of it not accounted for by the CBO because it's taken from citizens
through premiums not taxes. Note that unlike the one-time bank bailouts,
this amounts to an ongoing bailout of trillions more in future decades.

The medical and insurance industries contributed over $213 million to

Washington politicians in the 2008 election cycle [crp1]. If reform passes,
the trillions they stand to make in additional revenue comes out to over
100,000% return on investment.

If reform is not about pushing insurance companies and government bureaucrats

into areas of our lives that are intensely personal and involve
fundamental differences in beliefs and values about life and death, then the
mandate to buy insurance will be removed.
If reform really benefits ordinary citizens then they will voluntarily sign up.
So long as the reform continues to contain devices to disempower citizens and
force itself on everyone such as requiring purchase of government-approved
insurance, then we know the advocates themselves do not believe it is really in
the interest of the general public, and the credibility gaps and suspicions
about whose interests this reform is really serving will grow.

If you believe citizens should be in control of their healthcare decisions

without interference from bureaucrats, tell Congress and the White House to
remove things like the requirement to buy insurance and the minimum benefits
and coverage mandates.

references:

[cbo1] How Many People Lack Health Insurance and For How Long?, Congressional
Budget Office 2003 page 9, http://www.cbo.gov/ftpdocs/42xx/doc4210/05-12-
Uninsured.pdf

[crp1] Center for Responsive Politics,

http://www.opensecrets.org/industries/indus.php?ind=H
http://www.opensecrets.org/industries/indus.php?ind=F09

[hahca] House Affordable Health Choices Act,

http://waysandmeans.house.gov/media/pdf/111/AAHCA09001xml.pdf

[jama1] Trends in alternative medicine use in the United States, Eisenberg etal,
Journal of the American Medical Association 280(18):1569 1998,
http://www.ncbi.nlm.nih.gov/pubmed/9820257

[kff1] Kaiser Family Foundation Employee Health Benefits 2008 Annual Survey,
Exhibit 1.9, http://ehbs.kff.org/images/abstract/7790.pdf

[mass1] Massachusetts Employer Survey 2007,

Massachusetts Division of Health Care Finance and Policy,
http://www.mass.gov/Eeohhs2/docs/dhcfp/r/pubs/08/employer_report_2007.doc

[mass2] Health Care in Massachusetts: Key Indicators May 2009,

Massachusetts Division of Health Care Finance and Policy, page 16,
http://www.mass.gov/?pageID=eohhs2terminal&L=4&L0=Home&L1=Researcher&L2=Physical+
Health+and+Treatment&L3=Health+Care+Delivery+System&sid=Eeohhs2&b=terminalcontent&
f=dhcfp_researcher_all_dhcfp_publications&csid=Eeohhs2#key_indicators

[nyt1] "Massachusetts Faces Costs of Big Health Plan" NY Times 16 March 2009
http://www.nytimes.com/2009/03/16/health/policy/16mass.html?_r=1
[nyt2] "In Massachusetts Universal Care Strains Coverage" NY Times 5 April 2008
http://www.nytimes.com/2008/04/05/us/05doctors.html?pagewanted=2

[nyt3] Why We Need Health Care Reform, Barack Obama, NY Times 16 Aug 2009,
http://www.nytimes.com/2009/08/16/opinion/16obama.html?pagewanted=all

[objs1] Mandatory Health Insurance, Paul Hsieh, The Objective Standard Fall 2008,
http://www.theobjectivestandard.com/issues/2008-fall/mandatory-health-
insurance.asp

[oneil1] Who are the Uninsured? An Analysis of America's Uninsured Population,

Their Characteristics and Their Health, June O'Neill, Dave O'Neill,
Baruch College, City University of New York, June 2009,
http://www.epionline.org/studies/oneil_09-1993.pdf

[quin1] Quinnipiac University National Poll, 5 Aug 2009

http://www.quinnipiac.edu/x1295.xml?ReleaseID=1357

[rs53] HR 3200 - Obamacare Creates 53 New Federal Bureaucracies,

http://rightsoup.com/hr-3200-obamacare-creates-53-new-federal-bureaucracies/

[uprem] $195 billion = nu x ( spercent x spremium + fpercent x fpremium )

nu = 47 million uninsured
x = multiplied by
spercent = 63.3% uninsured without children [oneil1 Table 7]
fpercent = 36.7% uninsured with children [oneil1 Table 7]
spremium = $4,704 single premium [kff1]
fpremium = $12,680 family premium / 4 = $3,170/person [kff1]

-- health american way

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