American Elephants


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



Daniel Mitchell Explains the Value Added Tax, and Why It Should Be Opposed. by The Elephant's Child
October 15, 2009, 2:38 am
Filed under: Capitalism, Economy, Health Care, Taxes | Tags: , ,

Daniel Mitchell of the Cato Institute explains in the video above,  just what a Value Added Tax (VAT) is, and why it should be vigorously opposed.

Democrats believe that government does most things far better than they can be done by the private sector.  As far as that goes, they don’t particularly like the private sector.  They don’t like corporations, they don’t like business, they are opposed to the idea of profit which they feel is unfair.  They especially don’t like business executives, who make far too much money — that is, they make more than congressmen do.  They prefer to have government in charge.  This allows them to control things, and especially to use taxpayer money to finance worthy causes in their own states which will help them to get reelected.

You remember the TARP money, the $787 billion Stimulus Bill, the Auto Bailout, “Cash for Clunkers”,  taking over the car companies, AmeriCorps, and the yet-to-be-enacted Health Care Bill, the Climate Bill, the takeover of the Student Loan Program, the billions for Pakistan, the Smart Grid, the Amnesty Program, the high-speed rail system for the Midwest, the cash for appliances program, the second Stimulus Bill (to be called something else), new CAFE standards, and tax rebates for the folks at the bottom of the income pie who pay no taxes.  I expect I am forgetting some programs.

I’m sure that you realize that the government has no money of its own. (Not everybody does).  That means that all these exciting programs have to be paid for.  Everything starts with getting rid of the evil Bush Tax Cuts, which is a huge tax increase in itself.

The video above explains a Value Added Tax which is very appealing to Democrats. Daniel Mitchell lists some of the other taxes that Democrats have either enacted or are considering enacting, but the video passes by the list so quickly that you may not have time to absorb the enormity of it all.

  • Raise the top income tax rates.
  • Limit itemized deductions.
  • Increase capital-gains taxes and dividend taxes.
  • Raise the social security tax.
  • Tax employer-provided health benefits.
  • Tax drivers on their mileage.
  • Change the rules to raise the gift tax.
  • Restore the estate (death) tax to 45 percent.
  • Raise the cigarette tax by 62¢ a pack.
  • Raise taxes on beer, wine, liquor and soda.
  • Tax employer-provided cell phones.
  • Raise taxes on overseas corporate earnings.

There are a number of taxes proposed in the Baucus Bill (Senate Health Care), like taxing “Cadillac” health insurance plans; taxing medical equipment like wheelchairs, stents, dialysis machines, pacemakers and so on; but since the Baucus Bill exists only as a series of vague concepts, it’s all pretty wispy.  The Congressional Budget Office stuck some numbers on the Baucus Bill, but they are meaningless since there is no legislative language.

PricewaterhouseCooper and Heritage have looked at the CBO estimate and reject the idea that the bill will save money or reduce the deficit.  They say health insurance will cost more and wages will decline.   The Democrats are pulling some pretty sneaky tricks like estimating costs for the decade from 2010 to 2020 although health care doesn’t come into full effect until 2015, which makes it cheaper on paper, but phony. They are also proposing to take some expensive things out of the health care bill and tack them on somewhere else or in a separate bill so it won’t add to the cost of health care. Unethical, and a cheat.

But that is what you get when you start with the idea that things must be done by the government, and then work backwards from that, nipping and tucking and taxing.  It is a sleazy process.



Scare Tactics? No, Real Life Evidence, Scary As It Is. by The Elephant's Child
August 6, 2009, 8:44 pm
Filed under: Capitalism, Freedom, Health Care | Tags: , , ,

In 2006, the State of Massachusetts adopted a health care plan that required every resident to get health insurance and required every business to provide it.  Otherwise, residents and employers would be fined.  This was the nation’s first state universal health insurance program.  It was to be the test ground to see how universal health coverage by the government would work here in the United States.  It was to be the model that could be replicated around the country.

Within weeks of the deadline to have everyone signed up, the state hadn’t accurately budgeted for the program. 95 percent of doctors weren’t accepting new patients.  Many doctors were leaving the state.  Rationing of services, reductions in benefits and growing waits for care began.  To keep the program solvent, Massachusetts cut payments to doctors and hospitals, reduced choices for patients, and was looking at increasing out-of-pocket expenses for patients.

By February of 2008, the state was asking the Federal government for help.  Only two years old, and already in trouble.

With the national health care debate now heating up, the obvious question is ‘what can we learn from the Massachusetts experiment?  The state treasurer says “Whatever you do, don’t do what we did.”

State treasurer Tim Cahill offered some startling statistics:

  • The program has so far cost 30 percent more than anticipated.  It already has a $9 billion shortfall projected over the nest two years.
  • Costs have risen 41 percent since the program’s inception, well outpacing the rise in healthcare costs nationwide, which stands at 18 percent.
  • We thought the program would mean that fewer people would go to hospitals, the highest costs that insurance plans have to pay.  That wasn’t true.
  • A Harvard study shows that 60 percent of residents are unhappy with the plan.  The unhappiest are those making $25,000 to $50,000 –those whom it should be helping the most.
  • To cut costs, the program has kicked out 30,000 legal immigrants.

Costs for Commonwealth Care (the subsidized program) soared from $158 million in the first year to $630 million in 2007, then doubled in 2009 to $1.3 billion.  Enrollment is now at 181,000 up from 165,000 in the early spring, and is expected to reach 212,000 next year.

Government managed health care has consistently failed.  The Indian Health Service — jokes say that if you get sick, do it before June, for that’s when they run out of money.  The VA has improved some, but much care is still substandard according to those who rely on it.  Hawaii flirted briefly with universal children’s insurance, and quickly dropped it as it was proving far too expensive. In 1994 Tennessee implemented managed care in its Medicaid program, with a system called TennCare.  They thought they would use the anticipated savings from Medicaid to fund and expand coverage for children and the uninsured.  It nearly bankrupted the state, reduced the quality of care and collapsed from it own deficiencies.

A government cannot promise to insure everyone, offer free care,  increase the quality of care and reduce costs.  It cannot happen.  It is a fantasy.

Fantasies work fine in the movies and in novels, but indulging in fantasy in real life can have real-life consequences.



Once Again, Trying to Understand the Meaning of A Trillion Dollars. by The Elephant's Child
July 28, 2009, 8:52 pm
Filed under: Capitalism, Economy, Taxes | Tags: , ,

If you speak of millions and billions and trillions often enough, the reality of those numbers fades away.  Here is a reminder, for taxpayers, of just what a trillion dollars represents.  It’s worth reviewing.  Maybe you can comprehend it.  I have trouble.



Shona Holmes Warns Us About Canadian-Style Health Care. by The Elephant's Child

The United States Deficit Exceeds $1,000,000,000,000 by The Elephant's Child
July 14, 2009, 8:32 pm
Filed under: Capitalism, Politics, Progressivism | Tags: , , , ,

toon062509

Count all those zeroes! That’s not the National Debt, but the Deficit — what we owe on our national credit card. And of course, just like a credit card, the interest charges pile up.  One trillion dollars.  If you need a picture, go here.

The stimulus isn’t working, and stimulus plans have a long history of not working.  Only 17 percent of Americans think the stimulus has been very effective according to the latest IBD/TIPP  Poll.  53 percent believe it has not been effective in getting the economy going in the right direction.

Since the start of the recession, 7.2 million people have lost their jobs. These are scary numbers, and many companies are asking people to reduce their hours.

Barack Obama has created quite a bunch of jobs with hefty salaries in his assortment of Czars, 28 domestic and 6 international.  No one is quite sure what these Czars are supposed to be doing, since most activities which are of proper concern to the government are represented by a department with a Secretary, an Assistant Secretary, a Deputy Secretary, and an Assistant Deputy Secretary or something like that, with dozens to hundreds of other employees, all of whose generous wages are paid by taxpayers.

The normal way of dealing with a recession is to try to alleviate some of the taxes on business, so that business is more able to create jobs.  And for government to reduce spending as much as they can after providing unemployment help for those who have lost their jobs.

This administration, however, has chosen to “not let a crisis go to waste”, and determined to “act swiftly” to get through a bunch of programs that they would never be able to get through Congress if the people were paying attention.

Of course when the President just turns over stimulus creation to Congress with only the stipulation of getting a lot of money into the economy quickly — then congressmen get lots of goodies to take home to their constituents.

Nancy Pelosi, for example, gets a $30 million program for renovating the salt marshes in San Francisco Bay to save the salt marsh harvest mouse.  A  cute little fellow that may be endangered.  There are probably  jobs involved, but they may not be those most needed by unemployed San Franciscans.

The usual rule is to avoid raising taxes during a recession.  Once you have done what can be done with unemployment benefits and food stamps, then you do everything you can to favor the small businesses that are always the source of new jobs.  Instead, this time Democrats plan to raise taxes on small business.  First, Obama has promised to let the Bush tax cuts expire.  That will raise the top personal rate from 35% to 39.6%.  If those taxes expire, so will various tax deductions and exemptions bringing the top marginal rate as high as 41%.

Chairman Rangel wants to impose a “surtax” on individuals with an adjusted gross income of more than $280,000 — “the rich.”  But more than six of every 10 who earn that much are small business owners, sole proprietors or subchapter S corporations who pay the individual rate.  Then phasing out various deductions and exemptions would bring the tax rate up to around 46% — a level that hasn’t been seen since 1986.

If that weren’t enough to discourage businesses from hiring or expanding; government has shown a willingness to take over private business, tell business how much they may earn, change regulations and add new ones, and impose economy-destroying mandates like the Waxman-Markey climate bill which would raise costs throughout the economy.

“Capital,” the late Walter Wriston said, “will go where it is wanted, and stay where it is well treated. It will flee from onerous regulation of its value or use and no government power can restrain it for long.”  Must be true.  Steven Ballmer has threatened to move Microsoft overseas, and businesses are leaving California in droves.

________________
The cartoon is by Michael Ramirez at IBD Editorials



Just How Gullible Are You? Just Wondering. by The Elephant's Child
June 29, 2009, 10:12 pm
Filed under: Capitalism, Economy, Freedom, Progressivism | Tags: , ,


“Since when do we call it a “town hall” meeting when a bunch of pre-screened experts ask the president a bunch of pre-approved questions in the East Wing of the White House?
” Michael Cannon asked in the Corner at National Review Online.   Good question!

The president held a so-called “town hall” meeting with a pre-selected audience last Wednesday under the benevolent auspices of ABC.  Critics, other opinions, and disagreement were not included.  Republicans formally requested a chance to participate or time to respond, but those who were not fully in the Obama tank were not invited.

Health Care experts from the Cato Institute respond, in the video above, with some of the information you need.  Much of the ObamaCare plan is based on the idea that there is a best treatment for any situation, and with a modern Internet technology approach, and with all your health records online, the government can choose the best care for everyone, and by “incentivising” [fining the doctors who don’t follow the rules] best care, they think they will improve care and reduce costs.  “One size fits all” says Michael Cannon.

But it doesn’t work that way.  My next-door neighbor can take only very small amounts of medicine. A full dose knocks her out.  I need the full dose and then some.  And as far as government management is concerned, a couple of notes.  When the car czar and his czarettes made the decision to close a large number of Chrysler dealerships [a very odd decision, since the dealerships were not owned by Chrysler, but were independent businesses privately owned, who bought their stock of vehicles from Chrysler], Representative Barney Frank (D-MA) immediately went to Chrysler to make sure that the dealer in his district, who was on the closure list, stayed in business.  This is only a tiny sample of how government control works.

These people are politicians and bureaucrats. What do they know about running the health care of 300 million people?  Canada has 33 million people and cannot manage their health care.  Great Britain has 66 million people, and theirs is a mess.  Even Massachusetts, population about 6.5 million, has a new health care plan that is a flop.  But the Great and Wonderful Obama —who has never run as much as a candy store — is perfectly sure that he can manage the whole system, cover the uninsured, reduce costs and insure a healthier, happier America.

The one thing that you most need to know about the “Kennedy Health Care Bill” working its way through the Senate, is that members of Congress, and the Administration and whoever else is currently on the admirable health care plan that they all love are excused from ever participating in the Health Care Plan they stick the rest of us with. And Obama has excused his friends in the Unions from any tax on their benefits.




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