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Gov. Schwarzenegger (R-CA) and Gov. Patterson (D-NY)

Just because every Democrat in the Senate voted to pass their health care bill doesn’t mean that states with a majority of Democratic voters support it. In fact, the Governors of California and New York (the two largest Democratic states) are strongly against the measure, saying it will put their already near-bankrupt economies over the edge (read the full article from Politico.com here). To be specific, Governor David Patterson (D-NY) said, “[I] am deeply troubled that the Senate version of the bill worsens what was already an inequitable situation for New York and I will continue to be an advocate on behalf of New Yorkers to ensure we are treated fairly by this critical federal legislation,” and Gov. Schwarzenegger wrote “When asked for my support, I was assured that federal legislation would not increase costs to California or include new unfunded mandates,…Unfortunately, under nearly every scenario we can predict, the federal health care reform legislation being debated would cost California’s General Fund an additional $3 billion to $4 billion annually.” Wow, these are strong words, and I have to assume that if these two states see further economic problems arising from this new health care legislation (as I predicted in my last article, Our nation must have been naughty this year), that they are not the only ones.

To further complicate the matter, as I’ve been reporting all along, American voters still do not support the new health care legislation that has been proposed. The numbers released from Rasmussen Reports on 12/30/09 show that 58% of U.S. voters are opposed to the bill, while only 39% support it (read the full story here). To underscore this number further, of the 58% that oppose it, 46% strongly oppose it, but of the 39% that favor it, or 19% strongly favor it.

Another interesting component to this health care vote that I brought up in my article Do our Representatives care what we think?, is the fact that Senate Majority Leader Harry Reid was trailing by significant margins in every re-election poll run (regardless of which GOP candidate emerged from the primaries to run against him). Many people believe that his push for this version of health care reform is to blame for his new-found unpopularity in his state, and it looks like this may be the beginning of trend of backlash against representatives who don’t listen to their constituency. Senator Ben Nelson of Nebraska was the last Democrat holdout on the Senate bill until a provision was added to exclude Nebraska from having to contribute funds to the new Medicaid expansion that is included in the bill. You’d think the people of Nebraska would be thanking him for getting them the best deal of any of the 50 states, until you remember one fact. The voters of Nebraska oppose the new legislation at an even higher rate than the nation (64% oppose in Nebraska vs. 58% nationwide, and 53% strongly oppose in Nebraska vs. 46% nationwide), and Sen. Ben Nelson just wasn’t listening. He refused to  break ranks with the rest of his party, even though that’s what the people that elected him wanted, and instead put up a stink for a while, and got them a special concession, and thought that would make everything OK. In other times that might have been true, but voters around the country are “on alert” right now, and the voters of Nebraska saw right through Sen. Nelson’s smokescreen, and the proof is the poll numbers. In a poll released on 12/29/09, if Nebraska Gov. Dave Heineman were to run against Sen. Nelson in 2012 he would receive 61% of the vote and Sen. Nelson would receive 30% (read the full story at Rasmussen Reports). That’s a great example of letting your vote speak for you, and a 31 point deficit in the polls speaks very loudly.

So, just like all of my other health care articles lately, we are left with the same conundrum. The majority of American voters do not support this version of health care reform. As Gov. Patterson and Gov. Schwarzenegger have pointed out, it will not reduce or even maintain costs for states, and as I have tried to repeatedly point out in previous articles, it will not reduce costs for the average American who already has health care (which was one of the original selling points). It will add additional burdens to businesses, and probably lead to increased taxes or insurance premiums for individuals (during a recession). The Senators and Representatives who vote for this bill are in danger of being voted out the very next time they run, according to many polls. Yet, even with all of this on the table, this legislation rolls on, with a seeming inevitability of being passed and signed into law, and the question I keep asking is, why? To this point, I have yet to receive a good answer.

To: All Americans - From: The U.S. Senate

For many Americans Christmas morning is a time of great anticipation, where the giddy excitement of our youth is remembered and sometimes still experienced. I came sprinting down the stairs on this Christmas morning with thoughts of family, gift-giving, and good times on my mind, only to discover a proverbial lump of coal in my political stocking. We all must have been naughty this year because our Senate rewarded us with a Christmas Eve vote (the first since 1895) to pass their version of a health care reform bill. This means that both the House and Senate have now passed versions of a health care bill that now must only be reconciled together, and eventually signed by President Obama. You may think that health care reform sounds like a pretty good gift to the American people, and under the right circumstances I would agree with you, but let’s look at what we’ve really unwrapped this Christmas morning.

I first urge all of you to read this article from U.S. News and World Report about the factual things that this new Senate bill would change, I feel it is unbiased and informative. I’m going to apply as much common sense to the key items as possible, so that we can get a really clear picture of the present we’ve been given.

Item #1: Required Coverage. Americans would be required to purchase health insurance from private companies or pay a fine. The fine would be $750 or 2% of household income (whichever is greater) per person, or $2250/2% (whichever is greater) for families. Required coverage = Your government forcing you to buy a specific product from a private company, which is an utter abomination of the free market system, a disturbing mingling of public and private interests, as well as a violation of your individual liberty.

Item #2: Employer Obligation. All companies with more than 50 employees would be required to provide health insurance or pay a $750 per year fine per employee. Employers of more than 200 would be required to enroll their employees in health insurance without the consent of the employee. Employer obligation = Additional burden to businesses that are already struggling in the current economy. This provision also discourages job-creation, as it adds more cost per employee, and discourages small businesses from growing beyond 50 employees, as they would then incur significant cost increases. Reducing costs to businesses of all sizes is the only thing that will help them grow, thus allowing for more tax revenue, more jobs, and an overall positive effect on the economy. The rules of “employer obligation” as put forth in this bill do the opposite of that.

Item#3: Government Subsidies (the next 4 items are all related, and lead to item#7). The government will help anyone who earns 400% of the poverty level or lower (approx. $43,320 for individuals or $88,200 for families) to pay for their health insurance. Government subsidies = Higher costs for the American taxpayer in one way or another (where is the money going to come from?).

Item #4: Medicaid Expansion. Individuals or families would now be eligible for Medicaid if they earned 133% of the poverty level or lower. Medicaid Expansion = Higher costs for the American taxpayer in one way or another (where is the money going to come from?).

Item #5: Insurance for high-risk patients. Insurance companies would now be unable to refuse individuals with pre-existing medical conditions or charge them substantially higher rates. In fact, under a new “national high-risk pool” their rates would be comparable to those of the average healthy citizen. Insurance for high-risk patients can only be paid for in one of two ways. Either the government subsidizes the “high-risk pool” with taxpayer dollars, or the insurance companies will have to charge higher premiums to the rest of us to compensate for the added cost. In both cases it adds higher costs to the American taxpayer yet again, and could even hurt small businesses further with higher premiums on healthy employees.

Item #6: Lifetime Limits. Insurance companies would not be allowed to cap the amount of lifetime benefits of any one person or cancel coverage on anyone, unless fraud is committed. Lifetime limits = Higher insurance premiums for the average person yet again, as well as businesses who cover their employees, as the insurance companies have to find a way to spread the cost of this new law around.

Item #7: New Taxes (Items 3-6 have to be funded by something, so get ready for this). Many long-standing tax credits and deductions would decline. Taxes on some benefits will increase. The House bill (which we haven’t discussed here) would add an additional 5.4% tax to individuals earning $500,000 per year or families earning $1,000,000 per year or more. The senate bill even adds a new 10% tax on the cost of indoor tanning services. New Taxes = More economic stagnation or decline.

So in review, the Senate would like the average American citizen to lose current tax credits and deductions, have an increased tax on their benefits, buy health insurance or incur a fine, and even tax their tanning habits in order to cover subsidies, expanded Medicaid, and possibly high-risk patients. It would also like every American business (with over 50 employees) to pay for employees health benefits (or pay fines). If you haven’t had time to swallow that gulp yet, you’ll still get an increase in your insurance premiums to help the insurance companies cover the cost of new patients with pre-existing conditions that they’re being forced to take on, and the new ban lifetime coverage limits (businesses would incur similar premium increases). All of these new costs will be generously added to you and businesses around the country during this current recession, which I’m sure will help stifle any economic growth we’ve been able to achieve. I haven’t even brought up the increased financial burden being thrust on the state governments by this bill, which will probably lead to increased state taxes of some kind (income taxes, sales taxes, tolls, etc.), as it is the holidays and I don’t wish to depress anyone. So if that’s the gift of health care reform you’ve been waiting for, I say “Merry Christmas, you got it!”. For the rest of us, don’t blame Santa, I have a feeling he doesn’t want any of the credit for this Yuletide treasure.

U.S. Senate

I was looking over some recent poll data this week, and was struck by a very odd pattern that I though was worthy of discussion. In the last 7 days alone I saw 5 polls that showed a disconnect between the views of American voters and the policies being pushed by our elected representatives. I thought I would outline these items here, and see if anyone can tell me who our “representatives” are actually representing.

Item #1: Religious displays being allowed on public lands and the celebration of religious holidays in public schools. ‘Tis the season,…unless your a government bureaucrat. Every news outlet lately seems to be reporting some story about a Fire Department being forced to take down their Christmas tree, or state employees being told that using the greeting “Merry Christmas” is a punishable offense, or a school being banned from singing Christmas carols in their holiday pageant. There was even one school that would not allow students to exchange gifts that had any connection to Santa Claus, Rudolph, christmas trees, candy canes, mistletoe, etc. and banned the use of wrapping paper that had a red and green color scheme (I couldn’t make this stuff up if I tried). Most of these anti-holiday policies and bans are dished out by the elected officials of local municipalities (although State and Federal entities aren’t innocent of it), usually after they receive a complaint from a singular party, and also under the threat of a lawsuit. It’s good to know that our local officials will stand up for us when one misanthrope claims their offended (God forbid). Where do the American voters stand on this? Well, I am happy to report that a Rasmussen poll conducted this week shows that “76% of adults believe religious symbols like Christmas Nativity scenes, Hanukkah menorahs and Muslim crescents should be allowed on public land.” Only 13% disagreed. Even better, “Eighty-three percent (83%) believe public schools should celebrate religious holidays.” Only 14% Disagreed. (read the full Rasmussen report here). I won’t go into all the reasons that I feel the same way, but if you’d like my full opinion on this topic you can read my post “Melting Pot or Empty Pot?“. Why is it that the average American adult can read the statement “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press;”, as written in the 1st Amendment of the Constitution, and clearly see that no law prohibiting people from freely expressing their religion should be made, and that having religiously associated symbols (like Christmas Trees) displayed anywhere on public land, or displayed by a public employee does not constitute a law establishing a religion? Whereas our elected officials and legislators read this and somehow twist it into something that bans any mention of religious holidays in any place owned, operated, or even slightly funded by the government. Those poll numbers are pretty overwhelming, so I hope that our representatives get the message or get replaced.

Item #2: Health Care Reform. I won’t bore you with the details on this one either, as my views are clearly expressed in my articles, “Helath Care of Today vs. Health Care of Tomorrow” and “BS Detector: Urgency of Health Care Reform“. However I think it is worth noting that as of 12/14, “Fifty-six percent (56%) of U.S. voters now oppose the health care plan proposed by President Obama and congressional Democrats.” Only 40% support it, and that is the highest level of opposition found in the last six months of polling. Rasmussen also notes, “Perhaps more significantly, 46% now Strongly Oppose the plan, compared to 19% who Strongly Favor it.” (see the full Rasmussen report here). Doesn’t it seem odd that the more our Federal legislators push this reform, and the closer it gets to passing, the more we as a nation object to it? Shouldn’t the opposite dynamic be in place?

Item #3: A second stimulus package and bailout money for states. Just this week another 446.8 Billion dollar omnibus spending bill passed the senate, and all this spending has Americans heads spinning (read the full story from Politico here). As if that wasn’t bad enough, there has also been a lot of talk on capitol hill about a financial bailout of state and local governments, which seems like the equivalent of some financially irresponsible parents giving a credit card to their even more irresponsible children. Unfortunately, the children in this example probably got their spending habits from watching their parents, if you catch my drift. A Rasmussen poll conducted on 12/08 shows that “Fifty-eight percent (58%) oppose giving bailout money to financially troubled states.” Only 22% favor this initiative (read the full Rasmussen report here). “On top of that, 56% of Americans oppose the passage of another economic stimulus package this year.” Only 33% favor it, yet the parade of spending seemingly has no end.

Item #4: Free market economy. This one shouldn’t even be up for debate, as a free market economy is what this nation was founded on, but increased government regulation on businesses, the banning or over-taxation of particular products or services that the public desires, the creation of more and more public sector jobs at the expense of private sector jobs, government-run health care, and tax-funded government bailouts of private industry are just a few examples of items that have begun to undermine our free market system. However, “A new Rasmussen Reports national telephone survey finds that 76% of voters now say a free market economy is better than one managed by the government. Only 10% prefer an economy managed by the government” (read the full Rasmussen report here). This really doesn’t come as a huge surprise to me, but the folks on Capitol Hill seem to be marching to a different drummer, and that drummer is playing a song called “Oh what a glorious day, when the free market becomes a little less free” (or something along those lines).

Item #5: The culmination of these factors. When you add together all four of the items above, what do you get? According to Rasmussen Reports, “For the second straight week, just 30% of U.S. voters say the country is heading in the right direction”. 65% believe it is headed in the wrong direction, and that’s the highest level that number has reached during all of 2009 (read the full Rasmussen report here). So why do our politicians continue down this track? Who are they truly representing? The only logical conclusion is that they’re not representing us, but representing themselves (or the special interest groups/high-powered organizations that fund their elections). Either that, or they think they are that much smarter than the people that elected them, and no what is best for us when we don’t. Would you rather be treated like an idiot, or have someone sell out your interests for personal gain?

So what can we do about it? Well let me assure you that our democracy is not dead yet, and we, as a people, still have the power to remove individuals from office if they don’t do the job we elected them to, and our weapon is a simple vote. Vote them right on out the door. I know it seems as though these corrupt politicians are in there for life, but hope is springing up around the nation, and we need to maintain and strengthen the momentum that has begun. If you don’t believe me, let me leave you with one last Rasmussen poll that I thought was telling this week. Senate Majority Leader Harry Reid, who is the primary architect of the Senate health care reform bill and has been at the forefront of the health care reform debate since day one is up for re-election in 2010. Reid is seeking a fifth term, holds the prestigious “Majority Leader” status and has already served for 24 years as a Nevada Senator, so he’s a shoe-in, right? Not at all. Rasmussen has been polling him against 3 different possible Republican opponents, and no matter who they pit him against, he is losing (read the full Rasmussen report here). In each race he trails by 4-7 percentage points, with only 2-3% undecided. This shows a great deal of fortitude on the part of the people of Nevada, and an even greater sign of what’s to come nationwide in the 2010 midterm elections, because if his seat is at stake, every incumbent’s seat is at stake. It would sure be a poor time to let your voter registration lapse…

We are currently on the brink of a sort-of “health care revolution”, with the House and Senate inevitably passing some version of health care reform in the near future. If they can reconcile the two bills into one, President Obama won’t be able to grab a pen quick enough to sign it into law, and our health care system will change in significant ways. The question we all should be asking (and I’m sure many of us are) is, “Is this health care reform good for me and my family?”. I personally believe that health care reform is necessary, and creative solutions need to be implemented to drive down insurance costs and get affordable coverage available to more people. However, I am firmly against the current legislation that is being proposed for three main reasons.

Reason #1 (and clearly the most important reason): On principle. One of the main tenets of all the legislation that has been proposed is that it requires almost all Americans to purchase health insurance coverage of some kind, or be subject to a penalty (in most proposals the penalty is a tax penalty, but some fringe proposals even offered a provision for prison time). This means that the Government would be forcing us to purchase a product by law, which is a direct violation of my individual liberty (and is questionably a Constitutional violation). Their argument that if everyone purchases health insurance it will drive down costs and make it more available to everyone is a “sacrifice individual rights for the greater good” argument, and goes directly against the spirit of the founding fathers and the Constitution. The Bill of Rights is evidence enough that the founding fathers were deeply concerned with preserving individual rights at the cost of governmental power. I heard a ridiculous but apt analogy of this situation, and I find it more appropriate with each passing day. If the federal government passed a law tomorrow that required every U.S. citizen to purchase a gym membership, how would you react to that? What if you said “No, I don’t want a gym membership”, and they told you that it would be better for everybody because it would drive down the costs of gym memberships, provide more people with the ability to get gym memberships, and help make Americans healthier? Seems silly doesn’t it, but how far off is that? I’m being forced to purchase a product, so that other people can have that product, and if I choose to violate that law I will have more money taken from me, and that money will be used to help other people get that product. If they want to raise my taxes to start a new social program that pays for other people’s health  care, I won’t like it, but I can’t stop them. However, making a law that I have to buy a specific product goes against the principles that our country was founded on.

Reason #2: There’s no evidence that the assumptions made in the current health care reform legislation are accurate. The financial footing of these proposals is shaky at best, and relies on people making certain decisions. There is one piece of circular reasoning that I find particularly troubling. The Congressional Budget Office estimated that the Government would bring in 33 billion dollars over 10 years from people who pay the penalty for not purchasing health insurance, and this money will be used to support the reform (read the CBO estimates here). Why is this a problem? If this estimate is correct than it means that people are electing to pay a tax penalty and get nothing in return rather than paying for health insurance under the new plan. The only reason that people would do this is because health insurance was still too expensive, and it is more affordable for these people to just pay the tax penalty, which defeats the whole purpose of the reform, does it not? If health insurance does become more affordable, and everyone signs up for it, than no one pays the penalty, and the budget is now short 33 Billion dollars, either way the plan is flawed. I believe that an even worse issue will eventually arise as a result of this inequity. Another provision in the plan is that health insurers can no longer reject new patients based on pre-existing medical conditions. Once people realize this, it won’t take them long to put 2 and 2 together. They can go without health insurance and only pay the tax penalty, which would be significantly less expensive, and then if they do get sick, they can start purchasing health insurance at that time. They’ll save tons of money and still have access to coverage as soon as they need it. When this happens it will cause health care reform to completely backfire, because if people aren’t paying insurance premiums when they’re healthy, and sign up only when they’re sick it will bankrupt private insurance companies and drive premiums through the roof, and insurance companies won’t be able to stop it because the law won’t let them refuse anyone. The extra money generated from more people paying the tax penalty won’t be nearly enough to compensate for this dynamic. People will always put their personal interests before that of the population as a whole (regardless of what they say in public), and to assume otherwise is legislative suicide.

Reason #3: The Future. There are really only two kinds of people in this world. The kind of people that believe that this health care reform is a one-time thing, or an isolated piece of much needed legislation, and after it is passed that will be the end of it. Then there are the people who think that this first piece of health care reform is just the beginning, and that within 20-40 years time the government will be the only ones providing health insurance for all of us, better known as socialized medicine. I am the latter, and if I’m right I’m going to have a lot of allies in fighting such developments. A recent Rasmussen poll shows that only 27% of voters nationwide support a single payer health care system where the federal government provides health care for everyone (see the Rasmussen poll here). So why would I support a bill that has the precursors for such a system, like a publicly run government health care option, or forced purchase of health insurance by the government, or an increase in some people’s taxes to help pay for other people’s insurance (which would happen to all of us under socialized health care). If we don’t let them take the first steps, they’ll never reach the end of the road.

When the daily news brings with it the faint but distinct odor of “BS” that only a hound dog’s nose could detect, Harley Quinn reports on it.

Yesterday the U.S. Preventive Services Task Force (which is federally funded) published new guidelines for the screening of breast cancer in women. These guidelines have become instantly controversial, as they are far less stringent than currently accepted practices. They say women don’t need to start getting mammograms at age 40 and that women between 50 and 74 only need them every two years and not annually. They also discourage women from doing self-examinations, saying that the data indicates that “they don’t work” (read the full story from the Wall Street Journal here). Whatever happened to “early detection is the key”?

What makes these new guidelines a point of political interest, and not just a disagreement among medical professionals? It’s because these new guidelines don’t pass the “logic test”, which means we’re being fed a shovel-full of “BS”. First we must expose the flaws in their findings and then ask ourselves why they would put these guidelines out there. Let’s start with their claim that women between 40-49 don’t need get regular mammograms until they reach age 50. Their research indicated that only 1 in 1900 women between 40-49 test positive during a mammogram, and truly have breast cancer. They say this ratio doesn’t justify the “risks” to these younger women, such as “false positives” which can lead to “anxiety” and “unnecessary additional tests”. Maybe I’m missing something, but our country currently has 307 million residents, and even if only 10 million of these are women between 40-49 (and the number is probably higher than that), than that means that having mammograms starting at age 40 would have saved the lives of 5,263 women. Ask those women if finding out about their cancer justifies the “risks”, which cause no permanent harm to anyone.

Then they assert that women 50-74 only need to get exams every 2 years instead of every year, even though the likelihood of someone having cancer skyrockets to 1 in 377 for women between 60-69. Any doctor you ask will tell you that early detection of this disease is crucial to the patient, because if you catch it too late (once symptoms become more obvious), the cancer has usually spread beyond the breast and the chances of fatality from the cancer rise significantly. Logic would tell you that having mammograms half as often will certainly hinder early detection.

Their last recommendation, and possibly the most outrageous, is asking physicians to stop teaching women to examine their breasts for signs of cancer, as there is a lack of evidence that it has any benefit. Again, I’m sure there are thousands of women who found a lump during a self-examination and had their lives saved that would like to argue the benefits of such a self-examination. So after reading these new guidelines and realizing something is up, we must ask ourselves what the true motivation is behind them.

Considering the furor with which the current administration is trying to pass health-care reform, could there be a connection, or is the timing simply coincidental? Is this the first shoe to drop in a government effort to cut health-care costs, knowing that at some point they will be the ones providing health care or at least subsidising it? Let’s look at the facts of each controversial point in their new guidelines. First off, discouraging women ages 40-49 from getting mammograms even though by their own statistical admission it would save thousands of lives, can have no other explanation besides cost cutting, since their explanation is ludicrous. They say the “risks” of false positives, such as “anxiety” and “unnecessary additional tests” outweigh the benefit of the testing. Since when is “anxiety” a reason not to undergo a potentially life-saving medical test? Won’t a woman have much more anxiety once she is diagnosed with late-stage breast cancer, and given a low chance of survival? These so-called “risks” are more like inconveniences that will eventually give you piece-of-mind. You have to wonder how stupid they think we are. In terms of dollars, 3.3 billion was spent on mammograms in the last 12 months, most of which was covered by health insurers.

As for women between 50-74 getting mammograms half as often as they do now, that obviously saves on mammogram costs as well, but will also inevitably lead to a higher fatality rate amongst the women who get diagnosed, as the cancer will not be caught as early. I know it’s morbid to even consider that having a patient die sooner, rather than battle their disease for a long period of time and win, cuts health-care costs as well. It would also lead to fewer people that would be collecting medicare, medicaid, social security and other programs for the elderly that are currently on the brink of financial ruin. I’m not saying that this factor was openly discussed by this task force, but I felt it should be mentioned.

What about women not doing self-examinations? What possible reason could the government give for discouraging this practice, since it poses no cost, and no harm to the person, and has nothing but potential upside? They say that a study of 200,000 women in China and 100,000 women in Russia showed no benefits from breast self-examination. What?!? China and Russia? The living conditions/medical culture of these countries is so far removed from our own, I have to ask, what does that study have to do fate of women in America? The word “smokescreen” comes to mind. When women perform a self-examination they might find something that they think is abnormal, and whether it is cancer or not, what do you think a woman will do when she finds something abnormal with one of her breasts? She will go to her doctor for tests, and tests cost money. Most of the time women who find something odd during a self examination don’t have cancer, and the cost of these “unnecessary tests” is something this Task Force would like to discourage. The problem is you only know if the test is “unnecessary” after you get the results back. Women who find real cancer during self-examinations will tell you how necessary those tests are.

The truly scary thing about this story is that mammograms for women age 40-up are currently covered by most forms of health insurance, but now that these new guidelines are out, that could change. John Ayanian, a Harvard Professor of Medicine and Health-Care Policy says that the Task Force guidelines do influence public and private insurers’ coverage decisions, and I’ve got to wonder if that’s the true purpose of putting out these guidelines in the first place. They certainly weren’t created for the benefit of the patients, and logic seems to eliminate most other reasons from contention.

The final question we must ask is, “Is breast cancer the first disease in a list of many that will have revised guidelines for screening/treatment in the coming months”? Is the Task force going to address diseases like lung cancer, prostate cancer, heart disease, diabetes, etc.? Only time will tell, but this is not a good first sign of what our lives might be like in a post-healthcare-reform world (at least the way health-care reform is currently being proposed). The country is in need of health-care reform that makes sense, and if I see any of that, I’ll be sure to let you know right here at The Unmutual Grizzly.