American Elephants


American Voters Are Very Angry at the Federal Government.

Rasmussen Reports that 71 percent of Americans are Angry at the federal government.  That figure includes 46 percent who are Very Angry.

The latest national telephone survey finds that only 27 percent are Not Angry about the government’s policies, including 10 percent who are Not at All Angry.

Men are angrier than women.  Voters over 40 are more angry than those who are younger.  A majority of those over 40 are Very Angry.  Only 25 percent of under-30 voters share that view.  And the data suggests that the level of anger is growing.  The 46 percent who are Very Angry is up 10 percentage points since September.

Only nine percent of voters trust the judgment of America’s political leaders more than the judgment of the American people.  Americans now view being a member of Congress as the least respected job one can hold.  Ouch!

Well, polls come and go, but if I were a member of Congress debating the health care bills now being considered, these polling results might just make me stop and think — or then again, maybe not.   And that might be the very reason why voters are so very, very angry.



It’s Often the Words of Our Mouth That Trip Us Up.

At National Review Online, Ramesh Ponnuru commented a few days ago in the Corner:

In the primaries, Obama distinguished himself from Clinton on health care by opposing an individual mandate. In the general election, he distinguished himself from McCain by opposing taxes on health benefits. So now he is trying to pass bills with both an individual mandate and taxes on health benefits—and his supporters are saying that Congress should go along because he won the election.



A Tax-and Spend Bill of the Very Highest Order! Affordable Care Indeed!

It looks as if Harry Reid has the 60 votes he needs to pass his health care bill to the floor.  This is a procedural vote, but an important one, and Republicans may not be able to keep the bill from passing.  Senate Majority Leader Harry Reid (D-NV) has used every trick in the book to get the votes he needs. Scheduling the vote for a Saturday night when all the senators were anxious to be off on their Thanksgiving vacation provides an extra bit of urgency.   Bribes for reluctant Blue Dog Democrats ((moderates) like the $100 million for Louisiana Senator Landrieu’s constituents written into the health care bill show how it is done.

I would dearly love to see a quiz ordered, on the senate floor, to see just what the  senators know about the bill that they are voting for.  I suspect not much.  After all it has only been available for a couple of days, and it is 2074 pages long. No one has had time to read the whole thing, understand it and analyze its consequences.

The gimmicks (cheats) used to get a favorable rating from the Congressional Budget Office are quite amazing.  The “Doc-Fix” is a big one.  They cut the Medicare reimbursements to physicians for their services, and right now the payments to doctors are far under the doctors costs.  What happens when you do not reimburse doctors fairly?  They quit accepting Medicare patients.  (Same thing for Medicaid).  Senators know this, so will pass a separate bill putting back the reimbursements they removed.  Since only the cut is part of the bill, the CBO will find that it cuts costs. (Lie, Cheat, Fraud).

The CBO estimates costs over a ten-year period.  So the taxes and fees commence next year, but the bill doesn’t take full effect until 2014 when the costs begin.  That’s how you make it seem cheaper.  Over 20 years, the true costs will be $4.9 trillion, though every health care bill anywhere, Medicare, Medicaid, the States’ plans have all cost far more than estimated — except for the Medicare Drug Plan.  That came in costing less than the estimates because of the “donut hole” provision which encouraged seniors to make wise choices to keep the cost of their prescriptions down. The Democrats, of course, plan to eliminate the “donut hole.”  There is no end to their folly.

How about this bit:  according to Keith Hennessey, 16 million uninsured Americans  pay a penalty tax.  8 million uninsured illegal aliens will not have to pay a penalty tax.

Health Savings Accounts (HSAs) have been increasingly popular. In 2006 only about 1% of adults with private insurance had HSAs, by this year it is up to 4%.

The Blue Cross Blue Shield Association, whose members dominate the HSA market, says that enrollees are more likely than those with traditional insurance to be better consumers. They’re more likely to track expenses (63% to 43%), save for the future (47% to 18%), and search for information on physician quality (20% to 14%). They’re also more likely to participate and see results from wellness programs like weight loss, fitness and smoking cessation. This makes intuitive sense: They’ve got skin directly in the game.

David Goldhill, a media executive, recently wrote in the Atlantic Monthly that if a 22-year-old starts at his company today earning $30,000 and health costs grow at 3%, by the time he retires he’ll have paid out $1.77 million in premiums, lower wages, out-of-pocket costs and both sides of the Medicare payroll tax.

If all that money were instead available via an HSA, including by borrowing against future contributions, “wouldn’t you be able to afford your own care?” Mr. Goldhill asks. “And wouldn’t you consume health care differently if you and your family didn’t have to spend that money only on care?”

About 40% of tax-filers with HSAs earn under $60,000 a year.  Naturally the Democrats eliminate Health Savings Accounts.  And of course, the Reid bill subjects all private health insurance (you didn’t think you would escape this, did you?) to detailed Federal regulation.  Those clever bureaucrats (who can’t even read the bills they vote for) know better than you or your doctor what health care you should be allowed to have.

The Republican plan would shrink the deficit by $61 billion at least, without accounting gimmicks. Can’t have that!

ADDENDUM:  The National Federation of Independent Business has come out in full force against the Senate health care bill.  It does not address their number one problem: the unsustainable cost of healthcare.  They oppose it due to the amount of new taxes, the creation of new mandates, and the establishment of new entitlement programs.  The costs far outweigh any benefits that businesses might have reallized.  Why are they speaking up only now?  The bill has just become available — all 2074 pages.



Dan Mitchell Explains the Health Care Train Wreck

The Cato Institute’s Dan Mitchell does an excellent job of explaining the problems and costs of the health care bills before Congress. The Democrats have wanted government-run health care for so long (why I do not understand) that they are willing to resort to all sorts of subterfuges to accomplish it.They are buying votes, reducing the Congressional Budget Office’s cost estimates by raising taxes for five years before the costs start to kick-in in 2014.

They are planning to force a vote on Saturday night when the Senate wants to leave for their Thanksgiving break in order to add urgency.  (Don’t you wish we got all the vacations Congress gives themselves?) The bill just appeared yesterday and they will have to once again vote without reading or understanding what is in the bill.

We have the best health care system in the world.  Their big ideas do nothing to improve it, but only start breaking it down. Do take the time to listen to Daniel Mitchell, you will be glad you did.



How Do You Pass a Bill that The Majority of Americans Don’t Want?

If you desperately want to pass a bill nationalizing one-sixth of the economy, destroying the best health-care system in the world, raising the costs of health insurance for everyone in the country, and raising taxes on everything that moves — and you have some reluctant blue dog Democrats that might not go along — what do you do?

In the case of Mary Landrieu (D-LA),and you need her vote,  if you are Senator Harry Reid (D-NV), you add a little section on page 432 of your health care bill to increase Medicaid subsidies for “certain states recovering from a major disaster.”

The bill takes two pages to define which states would qualify, as those stated during the preceding seven fiscal years have been declared a “major disaster area.” All of which manages to apply to just one state — Louisiana, the home of said blue dog reluctant Democrat Mary Landrieu, and presents Louisiana with a Medicaid subsidy of $100 million taxpayer dollars.

That’s how you buy votes.



A Step Backward in the Fight Against Breast Cancer.

The U.S. Preventative Services Task Force tossed out long-time guidelines for breast cancer screening, and has caused a well-deserved uproar.  This should alert anyone paying attention as a preview of the coming political decisions about cost-control and medical treatment that are central to ObamaCare.

In 1983, the American Cancer Society began recommending that all women get screened beginning at age 40.  Since 1990 mortality from breast cancer has dropped by about 30 percent, after remaining constant for nearly 50 years.

This week, the task force, which includes neither oncologists nor radiologists, recommended that patients under 50 or over 75 without special risk factors no longer needed mammograms, and other screening techniques aren’t worth the money.

Did something change?  The panel decided to review the data with an eye to health care spending as a core concern.

ObamaCare is “predicated on the assumption that the federal government has the knowledge, capacity, and will to drive greater efficiency in American health care,” noted James Capretta.

The health care bills under consideration would hand over to the federal government nearly all power for organizing American health care.  And there is not a shred of evidence that Congress or the administration can handle these tasks well.  Indeed, there is abundant evidence that, in a crunch to control costs, politicians will do what they always do, which is impose across-the-board payment-rate cuts.  …It’s cuts for all providers, no matter how well or badly they treat patients.

The task force admitted that the benefits of early detection are the same for all women, but there are fewer cases of breast cancer in younger women.  So you get into statistical abstractions about how many screenings it takes to save one life, and how many false positives there are in each age group.

At the bureaucracy level, this sort of recommendation is usually adopted by Medicare when it makes coverage decisions for seniors, and Medicare’s decisions usually influence the private insurance market.

The American Cancer Society objects.  They acknowledged the limitations to mammography, but said the task force underestimates its lifesaving value.  You can’t treat a tumor until you find it, and mammography has led to finding tumors when they are smaller and more treatable.

Today, the task force from the U.S. Preventive Services Task Force hastily said — We didn’t mean— we’re not telling your doctor what to do — not issuing rules.  So that is where it stands, with more to come.

What it does is provide an example of political decisions by bureaucrats looking at statistical abstractions and numbers and deciding what treatment your doctor may order for you and your loved ones.



Sometimes a Good Graphic Chart Really Helps to Make Things Clear!

A while back, we posted a chart of the bureaucracy created by the House Democrat’s Health Care bill, which shows the many offices, committees, groups, programs, corps, centers, committees, funds and departments that would insert themselves between you and your doctor and your health care.

It’s pretty horrifying to consider all those bureaucrats with their sticky fingers deciding what you can have and what you shall do. The white parts are the existing bureaus.  The colored parts are what is added by the bill.

Well, if you remember, that bill came in far too expensive, so they went behind closed doors and reworked the whole thing , so they got everyone’s favorite give-aways in and figured out new ways to bring the cost down.  That part was hard, but they figured if you started paying the taxes and penalties right away, but put off any of the costs until 2014, that was a good way to make the costs over the next ten years look much, much better.

But just about everybody in the back rooms had things to add, and some had to be added as bribes for people who didn’t want to vote for the bill.  So here is the new chart of the bureaucracy for PelosiCare.  You will be astounded by how much they have added.  I was.  You will recognize the original chart in the center.

The thing is, it doesn’t matter what they have to promise, or what they exclude to get votes. Their plan  is to get the government firmly in control.  Then they can put back in the things that they took out.  They can tinker and ration, refuse treatments that they think are too expensive, or medicines that are too new.  They are already planning to tax wheelchairs, pacemakers, artificial hips, hearing aids and other medical equipment.

We have the world’s best health-care system.  It has some problems that are pretty easily solved.  But when you refuse to indulge any of the proven ways of saving money, as Democrats have, all that is left is rationing, or paying less for everything.  When you pay less, you don’t get the same goods.

The purpose of the American health care system is saving lives.  The purpose of the Democrats’ health care plan is saving money.



Committing National Suicide, Step by Step.

The House passed the bloated, liberty-destroying, job-killing, tax-hiking, deficit-exploding health care bill late Saturday night.  The Democrats are so excited.  They’ve wanted to nationalize health care just forever, and to hell with the majority of Americans who do not want any part of it.

PelosiCare would not go fully into force until 2014, but the bill has to be passed — quickly, without debate or allowing the public to see what is in the bill — because the more Americans awake and find out what it will do, the more they oppose it.

It is hard impossible to understand why they want single-payer, government-run health care so much.  The hard-left passeth all understanding.  They utter condescending bromides about “the people,” but their actions consistently deny their words.

John Dingell (D-MI) has been pushing government-run health care for years. He is so delighted.  “It provides coverage for 96 percent of Americans and affords everyone the peace of mind that comes from knowing they will have access to affordable healthcare when they need it.” What a load of road apples.

For example, the bill moves Medicare patients from a fee for service payment system, in which patients choose which doctors to see, towards what is called a “medical home.” That is the hugely unpopular old HMO restrictions on care — renamed.  The bill specifies that patients may have to settle for a nurse practitioner rather than a physician as the primary-care-provider.  Sec. 1302 (pp.672-692).

This is just a sample of some of the stupidity in the bill, as documented by Betsy McCaughey in the Wall Street Journal.  That’s a must-read article if you care about your own future.

The newest Congressional Budget Office calculation of the costs of PelosiCare comes in at $3 trillion over ten years.  The bill is so filled with poorly thought out mandates and the potential for unintended consequences that it will undoubtedly cost far, far more.  Medicare costs nine times as much as original estimates of cost.

The gyrations that Democrats go through in trying to maintain their fantasies would be amusing if it weren’t so serious and so damaging to our freedom.

 



New Democrat Breaks FOUR Promises in First HOUR!

Pelosi Owens

(Update: Traffic from Drudge appears to have crashed the linked site, if the link doesn’t work, try again later.)

That’s gotta be record-breaking dishonesty, even from the notoriously dishonest Democrat party.  Brand-spanking new Democrat congressman, Bill  Owens (NY-23) has broken at least FOUR campaign promises in his very first hour!

Owens told voters he did not believe a public option was appropriate, he said he was opposed to cuts in Medicare, he said he was opposed to taxing health care benefits, and said he was opposed to increasing taxes on the middle class.

But now that he has been sworn in, this new weasel among weasels has pledged to vote for the Pelosi bill, which:

  1. contains a public option.
  2. cuts Medicare.
  3. taxes benefits, and
  4. increases taxes on the middle class!

That’s four campaign promises broken in his very first hour!  When dealing with a group as reliably dishonest as the Democrat party, it’s hard to plumb new depths of dishonesty, but congratulations NY-23! Your new congressman may have set a new record!

Update: Ace has Owens statement of support for the bill.



Pelosi Lies to America Again
November 6, 2009, 3:44 am
Filed under: Democrat Corruption, Health Care, Socialism | Tags: , ,

pelosi_mad

Nancy Pelosi breaks pledge to put final health care bill online 72 hours before vote.

She doesn’t WANT Americans to be able to read about the vast amount of power she is going to assert over them, the vast amount of money she is going to steal from them, or the vast amounts of liberties this bill will destroy. She is changing America from a nation of people with a government to a government with a people. She is intentionally regulating the private health care industry out of business, so that as then candidate Obama promised, in 5 to 10 years, all Americans will be forced onto government run health care, which Democrats believe people will elect them to control. And that’s what it’s all about. They don’t care about your health. They blocked amendments that would make them have the same care. They care about power and control.

Have you called your representatives yet?

They intend to vote on this biggest-power-grab in American history by Saturday. Make sure you tell your representatives what you think of it. If you are ready to work to defeat anyone who votes for it, be sure you tell them that.

Particularly if your representatives are on this list of targeted, vulnerable Democrats. Call, get your family and friends to call. Blue Dog Democrats are starting to truly worry about their jobs after Tuesday’s election results — tell them they are right to worry. Polls show  that a large majority of Americans do not want this bill, and they feel very strongly about it, much more strongly than the minority of Americans who support it. Call often!

My congressman is already voting against it, so I have called vulnerable Democrats in neighboring districts to tell them that if they vote for this bill I will come volunteer in their districts to make certain they lose their jobs.

This is the last chance to kill the bill in the house. I hope everyone will call!



What is So Wrong With Our Health Care System That it Requires 1,990 Pages of Mandates?

Polls tell us that most Americans who have health insurance are quite satisfied with it.  Most Americans are well satisfied with the health care that they receive, including a lot of people who are uninsured.  So what is so wrong with our health care system that requires reorganizing one sixth of our economy?

  • Some Americans are uninsured and cannot afford health insurance.
    The first number was 46 million uninsured. Then it went down to 30 million when illegal immigrants were excluded from the list.  When you remove those who are already entitled to insurance from an existing program, and remove those who can afford health insurance but choose not to purchase it, you are left with somewhere around 9 to 12 million who need help. The current House bill  still leaves something over 20 million people still uninsured.
  • Some people are uninsured for only fairly short periods between jobs.
    Many of these folks find Cobra Coverage too expensive. Nothing in the bills addresses this problem.
  • There are huge amounts of fraud and waste in Medicare — estimated at $60 billion Completely  unaddressed.  Medicare funding is being sharply cut ($150 billion) to reduce the cost of the legislation.  Medicare is going broke.  That is also unaddressed.
  • Health insurance just costs too much.
    Private insurance premiums could triple under ObamaCare.  Government health insurance premiums could increase by $4,000 per family by 2020. Unaddressed.
  • Health care just costs too much.
    It will cost far more under ObamaCare. Things that are proven to reduce costs like medical liability (defensive medicine) are not only not included in the bills, they are specifically excluded.  Trial lawyers are second only to labor unions in their financial support for Democrats.  Some of the increased costs will come in the form of taxes.  The Senate bill proposes a brand new tax on medical devices like heart valves, pacemakers, stents, artificial hips, insulin pumps; a ten-year $400 billion tax on all implements that retail for $100 or more. It works out to an $11,000 surcharge on every worker employed in that industry. Consequences —massive job losses, squashed innovation.
  • Health insurance can’t follow a person to a new job, it’s not portable.
    This is completely unaddressed.
  • Health insurance cannot be purchased across state lines, and in some states there is little choice among insurers.
    Unaddressed, since the object of ObamaCare is to funnel everyone into single-payer government-run health care.
  • States must bear much of the cost of Medicaid, and they are going broke. ObamaCare funnels many more people into Medicaid, increasing costs to the states without reimbursing the states.  Unaddressed.

What is it that is known to cut costs, improve ways of doing things, increase innovation and preserve and prolong life?  In the vast history of the world, it has always been freedom and the free market. People create when there are potential rewards for their innovations.  Doctors devise new treatments when they are not restricted by 1,990 pages of rules and mandates that punishes them for not following the rules, but interacting with patients.  The word “shall” appears in the House bill 3,425 times — each time a mandate about what one must do.

Democrats believe that 111 new agencies, programs and bureaucracies filled with smart people (like their supporters and friends) can fix all the things that are wrong with health care.

Health care takes place only between doctor and patient — those bureaucrats wandering around the halls of Congress can’t fix your hurts, no matter how much they tinker with legislation.

It took years of study, learning and practice to produce the physicians who can fix our hurts and do their damnedest to cure our diseases and prolong our lives. Each of us is different.  We are not the same — but products of our genetics and our environment and our habits, and we cannot be healed by either Nancy Pelosi’s or Harry Reid’s efforts to control our lives.

Democrats have not learned from evidence.  People who have experienced government health care in countries around the world have urged us: “Don’t do what we did.” Democrats ignore countries who are going broke from their efforts to control health care.  They do not learn from countries that are unnecessarily killing their citizens by rationing care.  And so they are repeating those errors.  The Democrats will ration.  It is inevitable.  It is the only way they have left, because they will not do any of the things that would cut costs.

It was never about health anyway.  It is only about control.



Among The Worst Bills Congress Has Ever Seriously Contemplated!

The Wall Street Journal headline called it “The Worst Bill Ever.”

Speaker Nancy Pelosi has reportedly told fellow Democrats that she’s prepared to lose seats in 2010 if that’s what it takes to pass ObamaCare, and little wonder.  The health bill she unwrapped last Thursday, which President Obama hailed as a “critical milestone,” may well be the worst piece of post-New Deal legislation ever introduced.

Well, that’s right to the point.  It is a devastating editorial, and worth reading in its entirety. It goes on:

The political incentive will always be for government to expand benefits and reduce cost-sharing, trampling any chance of giving individuals financial incentives to economize on care.  Essentially all insurers will become government contractors, in the business of fulfilling political demands:”There will be no such thing as “private” health insurance.

All of this is intentional, even if it isn’t explicitly acknowledged.  The overriding liberal ambition is to finish the work began decades ago as the Great Society of converting health care into a government responsibility.  Mr. Obama’s own Medicare actuaries estimate that the federal share of U.S. health dollars will quickly climb beyond 60% from 46% today.  One reason Mrs. Pelosi has fought so ferociously against her own Blue Dog colleagues to include at least a scaled-back “public option” entitlement program is so that the architecture is in place for future Congresses to expand this share even further.



Let Your Voice Be Heard
November 3, 2009, 12:45 pm
Filed under: Health Care, Politics, Progressivism., Taxes, The Elephant's Child | Tags: ,


Only massive public opposition has a chance to stop the federal usurpation that the Democrats are planning.

The House Republican Conference has gone to the trouble to list the new commissions, boards, programs, offices, exchanges, councils, administrations, committees, systems, corps, funds, centers, agencies, panels and trusts — one hundred and eleven of them.  Each of them will be manned by dozens to hundreds of bureaucrats and workers.  When it comes to “mandates,” the word “shall” appears 3,425 times.  And they expect us to believe that this will save money and reduce the budget.

Health insurance premiums will be more expensive, wait times for appointments will be longer, innovation will slow, and rationing will increase rapidly.  Your taxes will rise.  Look at this list of bureaucratic entities designed to control your health care and your life.  That is what will stand between you and your doctor.  Try to do what the Democrats in Congress never do — consider the consequences. Let Your Voice Be Heard!

1. Retiree Reserve Trust Fund (Section 111(d), p. 61)
2. Grant program for wellness programs to small employers (Section 112, p. 62)
3. Grant program for State health access programs (Section 114, p. 72)
4. Program of administrative simplification (Section 115, p. 76)
5. Health Benefits Advisory Committee (Section 223, p. 111)
6. Health Choices Administration (Section 241, p. 131)
7. Qualified Health Benefits Plan Ombudsman (Section 244, p. 138)
8. Health Insurance Exchange (Section 201, p. 155)
9. Program for technical assistance to employees of small businesses buying Exchange coverage (Section 305(h), p. 191)
10. Mechanism for insurance risk pooling to be established by Health Choices Commissioner (Section 306(b), p. 194)
11. Health Insurance Exchange Trust Fund (Section 307, p. 195)
12. State-based Health Insurance Exchanges (Section 308, p. 197)
13. Grant program for health insurance cooperatives (Section 310, p. 206)
14. “Public Health Insurance Option” (Section 321, p. 211)
15. Ombudsman for “Public Health Insurance Option” (Section 321(d), p. 213)
16. Account for receipts and disbursements for “Public Health Insurance Option” (Section 322(b), p. 215)
17. Telehealth Advisory Committee (Section 1191 (b), p. 589)
18. Demonstration program providing reimbursement for “culturally and linguistically appropriate services” (Section 1222, p. 617)
19. Demonstration program for shared decision-making using patient decision aids (Section 1236, p. 648)
20. Accountable Care Organization pilot program under Medicare (Section 1301, p. 653)
21. Independent patient-centered medical home pilot program under Medicare (Section 1302, p. 672)
22. Community-based medical home pilot program under Medicare (Section 1302(d), p. 681)
23. Independence at home demonstration program (Section 1312, p. 718)
24. Center for Comparative Effectiveness Research (Section 1401(a), p. 734)
25. Comparative Effectiveness Research Commission (Section 1401(a), p. 738)
26. Patient ombudsman for comparative effectiveness research (Section 1401(a), p. 753)
27. Quality assurance and performance improvement program for skilled nursing facilities (Section 1412(b)(1), p. 784)
28. Quality assurance and performance improvement program for nursing facilities (Section 1412 (b)(2), p. 786)
29. Special focus facility program for skilled nursing facilities (Section 1413(a)(3), p. 796)
30. Special focus facility program for nursing facilities (Section 1413(b)(3), p. 804)
31. National independent monitor pilot program for skilled nursing facilities and nursing facilities (Section 1422, p. 859)
32. Demonstration program for approved teaching health centers with respect to Medicare GME (Section 1502(d), p. 933)
33. Pilot program to develop anti-fraud compliance systems for Medicare providers (Section 1635, p. 978)
34. Special Inspector General for the Health Insurance Exchange (Section 1647, p. 1000)
35. Medical home pilot program under Medicaid (Section 1722, p. 1058)
36. Accountable Care Organization pilot program under Medicaid (Section 1730A, p. 1073)
37. Nursing facility supplemental payment program (Section 1745, p. 1106)
38. Demonstration program for Medicaid coverage to stabilize emergency medical conditions in institutions for mental diseases (Section 1787, p. 1149)
39. Comparative Effectiveness Research Trust Fund (Section 1802, p. 1162)
40. “Identifiable office or program” within CMS to “provide for improved coordination between Medicare and Medicaid in the case of dual eligibles” (Section 1905, p. 1191)
41. Center for Medicare and Medicaid Innovation (Section 1907, p. 1198)
42. Public Health Investment Fund (Section 2002, p. 1214)
43. Scholarships for service in health professional needs areas (Section 2211, p. 1224)
44. Program for training medical residents in community-based settings (Section 2214, p. 1236)
45. Grant program for training in dentistry programs (Section 2215, p. 1240)
46. Public Health Workforce Corps (Section 2231, p. 1253)
47. Public health workforce scholarship program (Section 2231, p. 1254)
48. Public health workforce loan forgiveness program (Section 2231, p. 1258)
49. Grant program for innovations in interdisciplinary care (Section 2252, p. 1272)
50. Advisory Committee on Health Workforce Evaluation and Assessment (Section 2261, p. 1275)
51. Prevention and Wellness Trust (Section 2301, p. 1286)
52. Clinical Prevention Stakeholders Board (Section 2301, p. 1295)
53. Community Prevention Stakeholders Board (Section 2301, p. 1301)
54. Grant program for community prevention and wellness research (Section 2301, p. 1305)
55. Grant program for research and demonstration projects related to wellness incentives (Section 2301, p. 1305)
56. Grant program for community prevention and wellness services (Section 2301, p. 1308)
57. Grant program for public health infrastructure (Section 2301, p. 1313)
58. Center for Quality Improvement (Section 2401, p. 1322)
59. Assistant Secretary for Health Information (Section 2402, p. 1330)
60. Grant program to support the operation of school-based health clinics (Section 2511, p. 1352)
61. Grant program for nurse-managed health centers (Section 2512, p. 1361)
62. Grants for labor-management programs for nursing training (Section 2521, p. 1372)
63. Grant program for interdisciplinary mental and behavioral health training (Section 2522, p. 1382)
64. “No Child Left Unimmunized Against Influenza” demonstration grant program (Section 2524, p. 1391)
65. Healthy Teen Initiative grant program regarding teen pregnancy (Section 2526, p. 1398)
66. Grant program for interdisciplinary training, education, and services for individuals with autism (Section 2527(a), p. 1402)
67. University centers for excellence in developmental disabilities education (Section 2527(b), p. 1410)
68. Grant program to implement medication therapy management services (Section 2528, p. 1412)
69. Grant program to promote positive health behaviors in underserved communities (Section 2530, p. 1422)
70. Grant program for State alternative medical liability laws (Section 2531, p. 1431)
71. Grant program to develop infant mortality programs (Section 2532, p. 1433)
72. Grant program to prepare secondary school students for careers in health professions (Section 2533, p. 1437)
73. Grant program for community-based collaborative care (Section 2534, p. 1440)
74. Grant program for community-based overweight and obesity prevention (Section 2535, p. 1457)
75. Grant program for reducing the student-to-school nurse ratio in primary and secondary schools (Section 2536, p. 1462)
76. Demonstration project of grants to medical-legal partnerships (Section 2537, p. 1464)
77. Center for Emergency Care under the Assistant Secretary for Preparedness and Response (Section 2552, p. 1478)
78. Council for Emergency Care (Section 2552, p 1479)
79. Grant program to support demonstration programs that design and implement regionalized emergency care systems (Section 2553, p. 1480)
80. Grant program to assist veterans who wish to become emergency medical technicians upon discharge (Section 2554, p. 1487)
81. Interagency Pain Research Coordinating Committee (Section 2562, p. 1494)
82. National Medical Device Registry (Section 2571, p. 1501)
83. CLASS Independence Fund (Section 2581, p. 1597)
84. CLASS Independence Fund Board of Trustees (Section 2581, p. 1598)
85. CLASS Independence Advisory Council (Section 2581, p. 1602)
86. Health and Human Services Coordinating Committee on Women’s Health (Section 2588, p. 1610)
87. National Women’s Health Information Center (Section 2588, p. 1611)
88. Centers for Disease Control Office of Women’s Health (Section 2588, p. 1614)
89. Agency for Healthcare Research and Quality Office of Women’s Health and Gender-Based Research (Section 2588, p. 1617)
90. Health Resources and Services Administration Office of Women’s Health (Section 2588, p. 1618)
91. Food and Drug Administration Office of Women’s Health (Section 2588, p. 1621)
92. Personal Care Attendant Workforce Advisory Panel (Section 2589(a)(2), p. 1624)
93. Grant program for national health workforce online training (Section 2591, p. 1629)
94. Grant program to disseminate best practices on implementing health workforce investment programs (Section 2591, p. 1632)
95. Demonstration program for chronic shortages of health professionals (Section 3101, p. 1717)
96. Demonstration program for substance abuse counselor educational curricula (Section 3101, p. 1719)49. Grant program for innovations in interdisciplinary care (Section 2252, p. 1272)
97. Program of Indian community education on mental illness (Section 3101, p. 1722)
98. Intergovernmental Task Force on Indian environmental and nuclear hazards (Section 3101, p. 1754)
99. Office of Indian Men’s Health (Section 3101, p. 1765)
100. Indian Health facilities appropriation advisory board (Section 3101, p. 1774)
101. Indian Health facilities needs assessment workgroup (Section 3101, p. 1775)
102. Indian Health Service tribal facilities joint venture demonstration projects (Section 3101, p. 1809)
103. Urban youth treatment center demonstration project (Section 3101, p. 1873)
104. Grants to Urban Indian Organizations for diabetes prevention (Section 3101, p. 1874)
105. Grants to Urban Indian Organizations for health IT adoption (Section 3101, p. 1877)
106. Mental health technician training program (Section 3101, p. 1898)
107. Indian youth telemental health demonstration project (Section 3101, p. 1909)
108. Program for treatment of child sexual abuse victims and perpetrators (Section 3101, p. 1925)
109. Program for treatment of domestic violence and sexual abuse (Section 3101, p. 1927)
110. Native American Health and Wellness Foundation (Section 3103, p. 1966)
111. Committee for the Establishment of the Native American Health and Wellness Foundation (Section 3103, p. 1968)



The Swine-Flu Mess, and Why It Is a Mess.

You will have to admit that it is handy for the administration — when the nation is embroiled in a debate about government efforts to reform our health care system — to have the public concerned about getting swine-flu, and looking to the government for succor.

President Obama first declared the swine flu to be a Public Health Emergency back in April, and then on Friday, October 23, he declared it a National Emergency.  The first declaration allowed the shipment of flu-fighting medications from the federal stockpile. (There was no vaccine at the time).  The second declaration modifies hospital regulations so they can put treatment tents in parking lots and addresses financial questions for hospitals.

The Centers for Disease Control (CDC) estimates that on average through the 1990s about 36.000 people died of seasonal flu-related causes each year.  Flu-related means things like the flu turning into pneumonia, or the flu affecting someone whose underlying cause of death was a respiratory or circulatory disease.

The CDC estimates that only about a third of the samples that doctors or scared patients suspect may show swine flu (H1N1) actually test positive.  Some people may have swine flu, but with symptoms so mild that in previous years they would just have stayed home.  But panic has flooded doctors offices with the mildly ill or the worried well.  “Government,” Michael Fumento quotes H.L Menken,”ever seeks to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary.”

The administration estimated that 40,000 doses of H1N1 flu vaccine would be ready by November. So far only about half that many doses are available. What happened? Dr. Scott Gottlieb explains in the Wall Street Journal:

The first fateful decision, way last spring, was to forgo vaccine additives — called adjuvants— that activate the immune system and make shots more potent. Adjuvants allow a smaller supply of vaccine stock to be stretched across more doses.  These adjuvants  are included in H1N1 vaccines world-wide, but not in the U.S.

Why do adjuvants matter? An adjuvanted H1N1 vaccine being used in Europe contains 3.75 micrograms of vaccine stock.  The same vaccine in the U.S. , without the adjuvant, requires 15 micrograms of vaccine for equal potency.  If we used adjuvants, we could have had four times the number of shots with the same raw material.

The second cautious decision was to require that the H1N1 vaccine be a single shot. (…)

The third policy decision was to stick for too long with a proven, but slow process for making flu shots that uses chicken eggs to grow the raw vaccine material.

Dr. Gottlieb, a practicing physician who was deputy commissioner of the FDA from 2005 to 2007,  has some suggestions for improving our regulatory process to prevent such shortages.  Read the whole article here.

Nine weeks ago, the President’s Council of Advisors on Science and Technology issued its report with a “plausible scenario” of 30,000 to 90,000 deaths  peaking in “mid-October.  Best counts so far (CDC no longer releases specific swine flu case death numbers) is about 1.100.

Pregnant women and children under 4 are the most vulnerable, along with children 5 to 18 with chronic medical problems such as asthma and diseases of the heart and liver.  But swine-flu problems are clearly much less than with the regular seasonal flu.  Vaccine production is being stepped up.

The Defense Department has announced that detainees at Guantanamo Bay, Cuba, are considered to be at higher risk, and will thus be offered the H1N1 vaccine.  It would obviously be politically incorrect to chance any of the detained terrorists at Gitmo contracting the swine flu.



This Is What They’re After. Why Do They Feel The Need To Lie About It?

National Review featured a symposium today, with the question “Can ObamaCare Be Stopped?” The consensus was, yes it can, if Congress starts listening to the American people. The American people are worried about the economy, not health care, which is pretty low on their list of priorities.  They think health care should be reformed, but they are deeply concerned about the cost.

Democrats make it clear that their aim is single-payer, government-run health care, but they never explain why.  They have wanted single-payer, government-run health care practically forever, but most of the people we see in the video above are members of Congress, and they have not the slightest intention of participating in such a plan themselves.  That should tell you a whole lot about the plan.

The experience of other countries should lead to a lot more serious reflection and careful planning that have been evident in anything we have heard about the Democrat plans. And despite all the promises of transparency, we haven’t seen any plan at all.

Above all, consider the tendency of everyone involved to lie about the contents of legislation, write the bills in closed back rooms and refuse to allow anyone to see them.

The impression in Washington is that there was a lot of push back this summer with the Tea Parties and Town Hall Meetings, but that interest has declined.

Congress needs to know what people’s concerns are.  They don’t, I am told pay attention to emails, but they do pay attention to phone calls, especially when the volume is high.  Call your congressional representatives in both the House and  the Senate, not just once but daily.  Let them know how you feel.

For your congressman’s phone number, check your phone book under U.S. Government, or go to http://www.house.gov or http://www.senate.gov. and follow directions.  The bill will be harder to pass in the Senate, so your senators are more important.  While you’re at it, call some of the blue dog Democrats, especially those in first year seats. Call over and over again, tell your friends and relatives to do so as well.



And You Were Saying About the Outrageous Profits of the Health Insurance Companies?

60 Minutes did a fine report on Medicare fraud this past Sunday.  Medicare fraud is now estimated to total about $60 billion a year. The government insurance program that provides health care to 46 million elderly and disabled Americans provides a rich income stream for criminals who are constantly finding new ways to steal much of the half-trillion dollars that are paid out in Medicare benefits.

In South Florida, the only visible evidence of the crime are thousands of tiny clinics and pharmacies that occupy low-rent strip malls.  $60 billion is a lot of money.  Medicare loses seven times as much money to fraud than the combined profits of the 14 health insurance companies listed on the Fortune 500.

The reason that the “public option” is supposedly better than private insurance is the government’s low administrative costs.  The major reason why private insurance has higher administrative costs is that unlike the federal government, the private insurance companies make a serious effort to combat fraud. (emphasis added)



A Little History of Health Care Cost Estimates and Actual Results.

Let’s start with the fact that the Democrats want single-payer, government-run health care.  I cannot fathom why they think this would be a good idea, since it has proved so damaging everywhere else.  Damaging to the economy, damaging to the patients who depend on it, and damaging to the medical system itself, and damaging to the society.

But Democrats (Liberals/ Progressives) believe in their good intentions, are uninterested in studies, experience or history, and don’t care much about consequences.  That’s why when they are in pursuit of their enlightened aims, their claims get more and more preposterous.

Washington has just run a $1.4 trillion budget deficit for fiscal 2009three times the deficit in 2008 under the evil George W. Bush.  And we have just been told that a new health-care entitlement will reduce the red ink by $81 billion over ten years.

The theory is that a more involved federal role by those brilliant folks in Congress will restrain costs and thus make health care more affordable.  Stop laughing, it isn’t funny.

Before the creation of Medicare and Medicaid in 1965, health care inflation ran only slightly faster than overall inflation.  In the years since, medical inflation has increased 2.3 times faster than inflation in the regular economy.  Much of this represents advances in technology and new treatments, but the idea of government as thrifty is plain silly.

The Wall Street Journal examined the record of Congressional forecasters in predicting costs.

ED-AK368_1healt_D_20091019182913The record is not good.  Most government programs cost far more than they were estimated to cost, and of course Congress usually cannot keep their hands off and continually tinkers.

The $81 billion “reduction” in cost came from the CBO estimate applied to the Baucus bill which existed only as a bunch of concepts.  We need a good  CBO estimate of whatever they have added in the back room, behind closed doors.  Whatever the estimate, history tells us that it will cost far more.

You will notice that only George Bush’s Prescription Drug benefit came in under predicted cost, but I have read that the Democrats are anxious to fill in the “donut hole” which was the device that brought the program in under estimates, along with greater use of generics, and lower participation by seniors.

Peter Orzag , now White House Budget Director, told Congress when he ran the Congressional Budget Office that the “primary cause” of the cost savings is that “the pricing is coming in better than anticipated, and that is likely a reflection of the competition that’s occurring in the private market.” Competition?  Who knew! The Centers for Medicare and Medicaid Services agreed, adding that when given choices “beneficiaries have overwhelmingly selected less costly drug plans.”

There is a lesson there, but apparently no one is paying attention.