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Today Drudge reports that Walgreens drugstores in Washington State will no longer accept new patients under Medicaid. Walgreens explains that reimbursement rates under Medicaid are simply too low: the stores are losing money by serving this population.
Welcome to the brave new world of government-run medicine.
As governments try to squeeze savings, providers will exit this system. This won’t just happen with pharmacists. An Investor’s Business Daily survey which was conducted last fall found that 45 percent of doctors say they will consider leaving medicine if this health care legislation passes. Another survey conducted in December had similar findings. Undoubtedly many of these doctors, already sick of spending so much of their time complying with the existing bureaucracy and paperwork, worry that increased government involvement will mean even more red tape. Too low government reimbursement rates are surely also part of the problem.
An exodus of medical professionals will lead to longer wait times; those wait times will be even worse since more widely available health insurance will mean a greater consumption of medical care. So we will have more patients and fewer doctors. It’s no wonder that our recent poll found that a majority of voters from swing states believe that the health care system will be made worse by this legislation.
Members, are you listening?
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Speaker Pelosi is reportedly meeting with female Members of Congress today. No doubt the intent of the meeting is to twist arms and threaten any Member who might be wavering about which way to vote.
Before meeting with the Speaker, those female Members should do a little reading. First, they should check out IWV’s new poll, which shows that despite what the Speaker might say, voters emphatically want them to vote against this health care monstrosity. They also might be surprised to learn that eight in ten women disagree with the statement “It is the responsibility of the federal government to mandate that everyone have government-approved health insurance and to be penalized if they do not.”
Female Members should also be sure to read this article by Grace-Marie Turner in the Wall Street Journal which examines Massachusetts experiment with mandatory health insurance. Here’s some highlights:
While Massachusetts’ uninsured rate has dropped to around 3%, 68% of the newly insured since 2006 receive coverage that is heavily or completely subsidized by taxpayers. While Mr. Romney insisted that everyone should pay something for coverage, that is not the way his plan has turned out. More than half of the 408,000 newly insured residents pay nothing, according to a February 2010 report by the Massachusetts Health Connector, the state’s insurance exchange….
Mr. Romney’s promise that getting everyone covered would force costs down also is far from being realized. One third of state residents polled by Harvard researchers in a study published in “Health Affairs” in 2008 said that their health costs had gone up as a result of the 2006 reforms. A typical family of four today faces total annual health costs of nearly $13,788, the highest in the country. Per capita spending is 27% higher than the national average. …
Further, insurance companies are required to sell “just-in-time” policies even if people wait until they are sick to buy coverage. That’s just like the Obama plan. There is growing evidence that many people are gaming the system by purchasing health insurance when they need surgery or other expensive medical care, then dropping it a few months later. …
The Bay State is also suffering from what the Massachusetts Medical Society calls a “critical shortage” of primary-care physicians. As one would expect, expanded insurance has caused an increase in demand for medical services. But there hasn’t been a corresponding increase in the number of doctors. As a result, many patients are insured in name only: They have health coverage but can’t find a doctor.
Fifty-six percent of Massachusetts internal medicine physicians no longer are accepting new patients, according to a 2009 physician work-force study conducted by the Massachusetts Medical Society. For new patients who do get an appointment with a primary-care doctor, the average waiting time is 44 days, the Medical Society found….
The difficulties in getting primary care have led to an increasing number of patients who rely on emergency rooms for basic medical services. Emergency room visits jumped 7% between 2005 and 2007. Officials have determined that half of those added ER visits didn’t actually require immediate treatment and could have been dealt with at a doctor’s office—if patients could have found one.
Finally, Members should remember that voting against this version of health care reform isn’t a vote for the status quo. There are plenty of ways that Congress can and should change the health care system to make the system work better for everyone—and particularly for women.
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National Review Online has several good round ups of where the Democrats are in terms of vote counts. Daniel Foster recounts estimates that Democrats are still 10 away:
In a press conference on Capitol Hill today, Rep. David Dreier (R., Calif.), ranking Republican on the House Rules Committee, said the word around the House is that Democrats are still about 10 votes away from securing the 216 they will need to pass changes to the health-care bill. Dreier added that that number might be moving in the wrong direction for Democrats.
And Jeffery Anderson details the hurdles that Democrats face:
If Obamacare’s opponents keep up the pressure on wavering House Democrats, victory is within our grasp. Obamacare faces three major hurdles to passage. You might reasonably assume that these are as follows: It’s a colossally bad bill; it’s an extremely unpopular bill; and members of Congress — despite what President Obama apparently thinks — do care about getting reelected. While you’d be right on all three counts, I’m talking about more specific hurdles related to the concrete numbers in the House.
Things have changed. The Democrats need every member of their caucus who voted “yes” last time to vote “yes” again — or, for every defection, they need to convert a prior “no” vote to their side. They don’t have a single vote to spare…
They need two-thirds of our 40. Andy Wickersham and I have listed the 40 Democrats we think are the most key to passage or defeat. Assuming that all other Democratic members vote the same way as last time — and that all Republicans vote “no” (as they will) — the Democrats need 27 of these 40 to vote “yes” in order to pass the bill. This is a high bar when you consider that 35 of these 40 reside in Republican territory — many of them solidly so — and 24 supported the Stupak Amendment.
Early returns aren’t good for Obamacare supporters….
Other Democrats are more likely to swing against Obamacare than for it. Beyond these 40, the Democrats are far more likely to lose additional members who voted “yes” last time than they are to convert additional members who previously voted “no.”
Hopefully those wavering Democrats have also seen IWV’s new poll that gives them many more reasons to vote against this bad bill.
No one should fool themselves though that the fight is over. Undoubtedly Pelosi and company are trying everything they can to get the numbers they need, so no one in the opposition can afford to let up.
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The Daily Caller
By: Carrie Lukas, Fellow, Independent Women’s Voice
Members undecided about how to vote on health care face intense pressure. The president is calling. Their leadership is badgering. Unions are threatening to back primary challengers and withhold support. Yet wavering Members be warned: Your constituents can’t twist your arm or make creative threats, but they will be voting in November. And if you vote for this health care legislation, chances are they’ll be voting against you.
That’s the message of a recent poll commissioned by the Independent Women’s Voice and conducted by the polling company, inc/ Woman Trend. The poll focused on voters in 35 Congressional districts in which Members are considered critical votes in the health care debate.
Forty percent of those surveyed want Congress to start from scratch on health care legislation, and another 20 percent think Congress should completely give up working on this issue this year. Far from gathering momentum, new information coming out about the legislation is making voters oppose it more strongly. When asked about how the information they’ve heard during the past 10 days affected their opinion, almost twice as many (55 percent) responded that they were less supportive than responded they have become more supportive (29 percent). Forty-two percent said they became much less supportive.
Instead of clamoring for health care reform, the public wants Congress to move on. Nearly 7 in 10 voters feel health care is distracting Congress from bigger priorities, like jobs. By a 2-to-1 margin, those surveyed agreed with the statement that “Even if it means health care reform is not passed this year, I would prefer that my Member of Congress vote against the current legislation.” More people said they would be “relieved” (45 percent) and “pleased” (21 percent) if health care reform didn’t pass this year, than said they would be “disappointed” (20percent), “frustrated” (19 percent), “angry” (14 percent), or “anxious” (10 percent).
People have good reasons for wanting the legislation to fail: more than half (53 percent) believe that they and their loved ones would be worse off under proposed changes. A majority also think the economy (54 percent) and U.S. health care system (55 percent) would suffer. Many see the health care legislation as an inappropriate federal power grab: 76 percent of respondents (and 80 percent of women) reject the statement that “It is the responsibility of the federal government to mandate that everyone have government-approved health insurance and to be penalized if they do not.”
A margin of nearly 2-to-1 agreed that “the current legislation gives government too big a role in the healthcare system” (63 percent agree [53 percent strongly] vs. 32% disagree). A majority were also very concerned about cost, with 64 percent agreeing (52 percent strongly) that “We as a nation can’t afford to pay for the current healthcare legislation right now.”
Not surprisingly, health care will be a top consideration when voters decide whom to support in November. More than 80 percent of those surveyed said that health care would be among the top three issues they’ll consider. And health care voters overwhelmingly oppose the current legislation.
Overall, 60 percent of voters surveyed said they would vote for the candidate who opposes the proposed health care legislation—that’s nearly twice (32 percent) those who would reward a health care supporter with their vote. Intensity was again on the side of those rejecting current legislation: 38 percent definitely will vote for a candidate opposed to the bill compared to 22 percent who will definitely vote for a health care legislation supporter.
Here’s one finding that’s particularly important for those Members wavering about how to vote this week: if you voted against health care reform in November, your constituents want you to vote against it again. If you voted for it in November, you can help yourself by switching your vote this time around. Sixty-one percent will be less supportive (compared to 29 percent who will be more supportive) of a Member who switched from voting against the bill to voting for the health care bill. In contrast, nearly half (49 percent) will be more supportive (compared to 40 percent who will be less supportive) of a Member who switches from voting for the bill to voting against it.
There are many reasons for Members to vote against this bill: from the policy to the process that has been used to advance it. Yet perhaps the most compelling reason is that Members are elected to represent their constituents—and it is overwhelmingly clear how their constituents would vote on health care if they truly had a voice in Congress.
Carrie Lukas is a fellow at Independent Women’s Voice [1].
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Today Robert Samuelson describes how the recent health care debate hasn’t informed Americans—it’s misinformed them, and the solutions being peddled by the President and Democrats in Congress would exacerbate existing problems with the health care system. He writes:
One job of presidents is to educate Americans about crucial national problems. On health care, Barack Obama has failed. Almost everything you think you know about health care is probably wrong or, at least, half wrong. Great simplicities and distortions have been peddled in the name of achieving “universal health coverage.” The miseducation has worsened as the debate approaches its climax.
There’s a parallel here: housing. Most Americans favor homeownership, but uncritical pro-homeownership policies (lax lending standards, puny down payments, hefty housing subsidies) helped cause the financial crisis. The same thing is happening with health care. The appeal of universal insurance — who, by the way, wants to be uninsured? — justifies half-truths and dubious policies. That the process is repeating itself suggests that our political leaders don’t learn even from proximate calamities.
How often, for example, have you heard the emergency-room argument? The uninsured, it’s said, use emergency rooms for primary care. That’s expensive and ineffective. Once they’re insured, they’ll have regular doctors. Care will improve; costs will decline. Everyone wins. Great argument. Unfortunately, it’s untrue.
A study by the Robert Wood Johnson Foundation found that the insured accounted for 83 percent of emergency room visits, reflecting their share of the population. After Massachusetts adopted universal insurance, emergency room use remained higher than the national average, reports an Urban Institute study. More than two-fifths of visits represented non-emergencies. Adult respondents to a survey said it was “more convenient” to go to the emergency room or they couldn’t “get (a doctor’s) appointment as soon as needed.” If universal coverage makes appointments harder to get, emergency room use may increase. …
Though it seems compelling, covering the uninsured is not the health care system’s major problem. The big problem is uncontrolled spending, which prices people out of the market and burdens government budgets. Obama claims his proposal checks spending. Just the opposite. When people get insurance, they use more health services. Spending rises. By the government’s latest forecast, health spending goes from 17 percent of the economy in 2009 to 19 percent in 2019. Health “reform” would likely increase that.
Samuelson argues that the key to reforming health care to control costs is to change incentives. Rep. Paul Ryan makes a similar argument in his oped in the Washington Post. He highlights the many ways the Democrats proposal fell to address the systems most fundamental problems (and would create new problems with new job-killing mandates and by driving costs higher), and makes the case for an alternative approach. He describes alternative legislation that he and other Members have introduced:
The Patients’ Choice Act takes on the discriminatory and inflationary tax exclusion, delinking the tax benefit from employers and attaching it to individuals through universal tax credits. The tax exclusion for employer-provided health coverage subsidizes insurance instead of health care, hides the true cost of coverage and disproportionately favors the wealthy at the expense of the self-employed, the unemployed and small businesses. Health-care economists across the political spectrum and reform-minded Democrats such as Sen. Ron Wyden identify the backward tax treatment of health care as a problem that must be addressed….
This year I re-introduced my own proposals to tackle our entitlement crisis head-on. My plan, “A Roadmap for America’s Future,” fulfills the mission of health and retirement security, lifts our crushing burden of debt, and spurs economic growth and job creation. In stark contrast to the vision being pushed by the majority in Congress, my plan unapologetically seeks to apply our nation’s timeless principles — our Founders’ commitment to individual liberty, limited government and free enterprise — to today’s challenges. It does so in a way that honors our historic commitment to strengthening the social safety net for those who need it most.
If this debate had actually been about health care, we could have worked together to get a grip on costs, make quality care more accessible, address exclusions for preexisting conditions and realign the incentives of insurance companies with those of patients and doctors. Yet this process — including its embarrassing conclusion — demonstrates that the debate has never been about health-care policy but, instead, paternalistic ideology.
This is the debate that Americans need, and deserve, to have about our health care system. Will Members listen to their constituents and scrap this big-government power-grab so they can actual consider ways to make our health system better? We will find out this week.
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A standard backdrop for Presidential health care events is a bunch of people in white coats. The purpose, no doubt, is to make the viewing public think that doctors support proposed health care changes. Yet it’s worth remembering that quite the opposite is true. Most doctors oppose the health care legislation—and some oppose it so much that they’ll consider changing jobs because of it.
Here’s a report on the topic from last fall from Investor’s Business Daily:
Two of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted, a new IBD/TIPP Poll has found.
The poll contradicts the claims of not only the White House, but also doctors’ own lobby — the powerful American Medical Association — both of which suggest the medical profession is behind the proposed overhaul.
It also calls into question whether an overhaul is even doable; 72% of the doctors polled disagree with the administration’s claim that the government can cover 47 million more people with better-quality care at lower cost….
Four of nine doctors, or 45%, said they “would consider leaving their practice or taking an early retirement” if Congress passes the plan the Democratic majority and White House have in mind….
The great concern is that, with increased mandates, lower pay and less freedom to practice, doctors could abandon medicine in droves, as the IBD/TIPP Poll suggests. Under the proposed medical overhaul, an additional 47 million people would have to be cared for — an 18% increase in patient loads, without an equivalent increase in doctors. The actual effect could be somewhat less because a significant share of the uninsured already get care.
Even so, the government vows to cut hundreds of billions of dollars from health care spending to pay for reform, which would encourage a flight from the profession.
Just something to remind your Representatives as they ponder whether to vote for the trillion-dollar government health care take-over.
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In case you need a reminder of just how horrible the Senate bill is, the House Republican Policy Committee has put together this list of all of the “new boards, bureaucracies, and programs” this legislation would create.
It’s worth noting that among this list are FIVE new entities related to women’s health: the Centers for Disease Control Office of Women’s Health, the Agency for Healthcare Research and Quality Office of Women’s Health, the Health Resources and Services Administration Office of Women’s Health, the Food and Drug Administration Office of Women’s Health, and, of course, the Health and Human Services Coordinating Committee on Women’s Health. Yes, the last sounds like another bureaucracy that’s sole purpose is to manage and oversee the many other bureaucracies.
Does anyone seriously think that this kind of massive government expansion is going to help women? It seems much more likely that each entity will create more rules and regulation and protocols that will further gum up the works of our medical system.
The naïve may shug their shoulders and say well surely the President’s revised legislation with pare down all of this unnecessary bureaucracy. Be warned: once the Senate bill is passed, it very well could become law of the land. Promised amendments and changes may very well not make it through Congress. And don’t count on the President’s proposal to improve the bill anyway. One of his chief contributions was to propose another major federal regulatory entity.
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The Financial Times reports that the President has given the House of Representatives a deadline of March 18 to pass the health care bill.
Who knows how seriously to take this new deadline (I believe the first presidential health care deadline was last August?), but it suggests that some Democrats recognize that this issue is doing them no favors in terms of their electoral prospects in November, and want it over with, one way or the other. It also means that many House Members will be facing intense pressure to switch their votes from no to yes… Opponents of this legislation should be looking at a 10 day push to keep this bad bill from becoming law.
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National Review Online
It’s counterproductive to worry about why an organization opposes the president’s latest iteration of health-care reform. At least for now, anyone working to defeat this monstrosity is an ally.
The National Organization for Women (NOW), for example, has just released a new statement by their president, Terry O’Neill, which says that the White House reform bill “denies women’s basic rights” and is “a giant leap backward for women.” NOW supports a single-payer, Canadian-style health-care system. They’re disappointed current proposals don’t contain strong enough “public options,” and worry the bill restricts coverage for abortion. They also believe current proposals don’t go far enough in eliminating insurance companies’ ability to consider risk factors like gender and age in setting premiums.
I’d argue NOW has it exactly backwards. A single-payer system would be far worse for women because it would result in rationed care, lower quality care, and greater government control of what procedures are allowed. And that’s just a few of the “fundamental differences” the president has referred to.
Yet there’s another reason to reject this legislation that should unite NOW and free marketers: It would discourage companies from hiring lower-income workers, particularly those with dependents, which especially would disadvantage single moms.
Section 4980H (under Title 1, Subtitle F, Part II, Section 1513) of the Senate’s bill stipulates large employers that fail to provide employees and their dependents access to insurance meeting the government’s “minimum essential coverage” definition face penalties if at least one full-time employee obtains insurance using a government subsidy. As the Washington Post’s Ezra Klein explains (while calling the provision “the worst policy in the bill, and possibly in the world”), the penalties could be considerable, and will create disincentives for hiring poor parents.
Rather than a simple employer mandate that forces every employer over a certain size to provide health-care insurance or pay a small fee, the free rider approach penalizes employers for hiring low-income workers who are eligible for subsidies. That will create an incentive to do one of two things: Don’t hire low-income workers (hire a teenager looking for a job rather than a single mother, or hire a housewife looking for a second job rather than an unemployed breadwinner), or hire illegal immigrants.
And it actually gets worse. The employer pays more if the low-income worker needs subsidies for his family as opposed to just himself. So it not only discriminates against low-income workers, but it particularly discriminates against low-income parents. Single mothers will get the worst deal, as they have lower incomes, and as you might expect, children who need health care.
Surely legislation penalizing the hiring of single moms meets NOW’s definition of “anti-woman.” Defenders could argue the intent is not to penalize hiring, but to encourage companies to provide benefits to employees. Yet these are the kinds of unintended consequences inevitable in a bill that tries to micromanage so many aspects of a very complicated system. Mandates are supposed to ensure adequate coverage, but inevitably drive up costs. Cost-cutting measures are supposed to encourage efficiency, but will inevitably reduce the quality and quantity of care that’s available. Expanding health-insurance coverage helps the uninsured, but means that as a nation we’ll be consuming more health care and paying more for it.
NOW has its own reasons for opposing the health-care bill, and that’s fine. A little more digging, though, and it might uncover other ways this legislation would — and big government regularly does — fail the women NOW claims to represent.
— Carrie Lukas is the vice president for policy and economics at the Independent Women’s Voice and a contributor to National Review Online.
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What will happen if the health care reform bill becomes law? It will be a first step in the push toward a single-payer system. That’s what President Obama is suggesting to Progressives when trying to get their support for this bill, and I think we should take him at his word on this one…
