Paging Dr. Galt

Health Care from the Producer's Perspective
by Robert Tracinski, editor www.TIADaily.com

"Much of the debate over the health-care bill starts and stops in the wrong
place. It dwells on the experiences of health-care consumers—but the story
actually begins with the producers of health care, the doctors, nurses,
hospitals, drug companies. Without these producers, no health care is available
for the consumers to buy—at any price. So we need to begin by looking at the
current legislation from the perspective of the producers.

So far, President Obama's efforts in that direction merely betray the inability
of a lifelong leftist to see private enterprise in any terms other than the
standard Marxist caricatures about "greed" and exploitation. He made that
jarringly clear in his attacks on doctors, whom he has characterized as
unscrupulous hacks who cut off limbs for lucre.

http://www.foxnews.com/opinion/2009/08/25/kevin-mccullough-obama-doctors-health/

"Let's take the example of something like diabetes, one of—a disease that's
sky-rocketing, partly because of obesity. Partly because it is not treated as
effectively as it could be. Right now if we paid a family—if a family care
physician works with his or her patient, to help them lose weight, modify diet,
monitors whether they are taking their medication in a timely fashion, they
might get reimbursed a pittance. But if that same diabetic ends up getting their
foot amputated, that's $30,000, $40,000, $50,000, immediately the surgeon is
reimbursed."

That part about surgeons being paid fabulous sums of money for amputations turns
out to be a total fabrication. The actual reimbursement for such a procedure is
less than $1,000.

Obama also explained for us the workings of the tonsillectomy racket.

So if you come in, and you've got a bad sore throat, or your child has a bad
sore throat, or has repeated sore throats. The doctor may look at the
reimbursement system, and say to himself, "You know what, I make a heck of a lot
more money if I take this kid's tonsils out."

Now that may be the right thing to do, but I'd rather have that doctor making
those decisions, just based on whether you really need your kid's tonsils out,
or whether it might just make more sense just to change—maybe they have
allergies, maybe they have something else that would make a difference.

Thus speaks our national physician-in-chief to his new apprentice, your doctor.

What kind of policies does this outlook lead to? The Obama administration just
announced a plan to reduce already low Medicare reimbursement rates for
cardiologists and oncologists, deliberately starving out these specialists and
decreasing their incomes in order to encourage more doctors to become general
practitioners.

http://www.bloomberg.com/apps/news?pid=20601070&sid=apv3pcTOWVjk

This is a timely reminder of what the current legislation really means. By
deliberately inducing a shortage of physicians in crucial specialties, just as
the "silver tsunami" of baby boomers comes roaring into old age, the
administration has reminded us that their goal isn't just to cut costs. They
seek to impose a kind of central planning on the medical industry through such
measures as adjusting reimbursement schedules to reflect the latest decree from
Washington, DC, about the proper ratio of specialists to general practitioners.

Vilifying physicians is a tactic that has always backfired on advocates of
socialized medicine, because the American people have an enormous and
well-earned respect for their doctors. The average person knows his doctor as a
trusted and respected figure, the person who delivered their babies or cured
grandma's cancer. We know our doctors, and in the current debate we can sit down
and talk to them and ask them what they think—and if you do that, you're likely
to get an earful.

I sat down recently with a local Charlottesville physician, Dr. Gary
Helmbrecht—who also happens to be one of my wife's obstetricians. (I had last
talked to him when he performed the ultrasound I described in a previous
article.)

http://www.intellectualactivist.com/php-bin/news/showArticle.php?id=1123

Dr. Helmbrecht confirmed my sense of what the health-care crisis is not. It is
not a crisis in the availability or quality of care in this country. The actual
experience of patient care, he says, is "exemplary." The process in which a
patient notices a problem, goes to a doctor, undergoes medical tests, gets a
diagnosis, and receives treatment is well-oiled.

He gave an example of a woman he had recently treated, who had reported a
problem with her pregnancy—and was then able to secure appointments that same
day with three different specialists, leaving his office at the end of the day
with medications in hand. (See a similar story about Dr. Helmbrecht here.) When
a patient has a problem and needs to be treated, "It gets done."

http://www.savvyspot.com/rw/Dr+Gary+Helmbrecht+Charlottesville+Virginia+Helped+m\
e+have+a+healthy+baby+b/rw/ReviewID=11792/rw/reviews/viewreview.aspx

But he also pointed out that this is about more than just known treatments for
known problems. The current system also allows for a "free entrepreneurial
spirit." Dr. Helmbrecht's specialty is prenatal diagnosis, and he and his
partner were leaders in the use of nuchal translucency screening—a way of using
a certain physical marker in an early ultrasound to assess the risk of Down
Syndrome and other chromosomal defects. Many of their customers were other
doctors' patients who were referred to them for this special screening.

But now, he says, other physicians are catching up, so his practice is trying to
stay on the "front end of the curve" by purchasing new ultrasound machines that
give them better, clearer pictures and more information. They can do this
because there is no big bureaucracy they have to answer to. A big institution
would have a "capital equipment committee" to make that kind of decision, but in
Dr. Helmbrecht's case, he and his partner can make a major decision just with a
conversation in the hallway between appointments. "We are the capital equipment
committee."

Now compare that to the Medicare story above. That's the direction the "public
option" is taking us: greater control of the entire health-care system from
Washington, DC, which will seek to control physicians' spending and manipulate
their priorities.

Consider, for example, the proposals for a government board that would establish
"guidelines" about which procedures are "cost-effective" and which are not. That
creates a bias in favor of known, established procedures and against any kind of
innovation. New treatments, after all, are often more expensive, and precisely
because they are new, their benefits are less well-established. So under a
government-controlled system, forget about pioneering tests and new ultrasound
machines.

But the biggest threat is that the whole goal of the current legislation is to
control costs by imposing Medicare-like reimbursement rates as standard payment
for physicians. The problem? Medicare cuts its costs by reimbursing physicians
and hospitals at low-ball rates that are generally unprofitable.

The hospitals make up for the shortfall through "cost shifting"—charging higher
rates to the rest of us to make up for the money they're losing on Medicare
patients.

But once the whole system is run by government, there will be nowhere left to
shift the costs to.

Dr. Helmbrecht talked about what that would do to practices like his. At
Medicare-level reimbursement rates, "we can't even cover our expenses." The
result, he says, would be "catastrophic." Large, state-connected institutions
(like the University of Virginia Medical Center) may survive, but community
hospitals (like Martha Jefferson Hospital) and a whole constellation of private
practices associated with them will be wiped out.

And it gets worse. Dr. Helmbrecht pointed to a little-discussed fact. There is
already a shortage of doctors, which will only get worse as the baby boomers
age. So providing free or subsidized health care to millions of new people would
cause a surge of demand for doctors' services, just as unprofitable
reimbursement rates are driving them out of business. It is a prescription for
immediate shortages—a problem that would then have to be solved through
government rationing.

Dr. Helmbrecht had much more to say about the problems with the current system
and what actually should be done about it. But the overall conclusion I took
from our conversation is that the current health-care bill was designed with no
consideration for the way an independent private medical practice works, for the
economics of how doctors are to make a living and be rewarded for their work.
There has been no thought on this subject because the left doesn't care about
the rights of the producers of health care. They focus only on the demands of
the consumers.

Dr. Helmbrecht related a recent case in which he drove down to Charlottesville
from a conference in Northern Virginia to perform an emergency procedure to save
a woman's pregnancy. He interrupted his trip and got on the road late at night
because he is the only doctor in the area who performs that procedure. But you
have to ask, he said: "Where's the motivation?" Under the current system, he
said, "If you work hard for the patient, the funding follows." But what will
happen if that is no longer true?

In Ayn Rand's timeless novel Atlas Shrugged, the mysterious hero John Galt is a
symbol of the man whose productive energy is withdrawn from the world in protest
against living as the despised pawn of the state. But Ayn Rand was aware that
the disappearance of the men of talent did not always happen as a deliberate act
of protest; it is often just the natural outcome of any system that punishes
hard work, ambition, and independent thought, discouraging and demoralizing men
with those life-giving qualities. This is what some people have started
referring to as "going Galt."

If we accept such a system in the medical profession, we could find ourselves
paging Dr. Galt—and getting no answer."

For more articles like this, see TIADaily's HEALTH CARE GUIDE here:

http://www.intellectualactivist.com/php-bin/news/showArticle.php?id=1127

The Health-Care Bureaucracy-Formation Bill

Why the Health-Care Bill Is Unacceptable in Any Form

by Robert Tracinski, editor www.TIADaily.com

Facing a broad public rejection of President Obama's health-care bill, our
Kamikaze Congress is contemplating the political suicide of ramming the bill
through against the people's loudly expressed wishes, using the brute power of a
Democratic majority without even the window dressing of support from moderate
Republicans.

But these congressional leaders are just whistling Dixie—an apt metaphor, since
their real problem is their inability to convince Southern "Blue Dog" Democrats.
The health-care bill was never held up because moderate Republicans refused
their support. It was held up because moderate Democrats refused to support it.

More likely, the Democrats will attempt to water down the bill and offer fake
compromises such as the substitution of government-backed health-insurance
"co-ops" for the "public option"—a distinction without a difference. Over the
weekend, the White House briefly indicated its support for this tactical
retreat, only to backtrack when faced with opposition from far left congressmen
in the House. That reversal actually makes the dropping of the "public option"
more likely. The administration's flip-flop tells every wavering congressman
that the White House is in disarray and cannot be trusted to take a position and
stick to it—so why should anyone in Congress stick their necks out? A lot of
them will say what Florida Democrat Allen Boyd told a town hall meeting over the
weekend: that he is willing to "scrap everything," in the words of one of his
questioners, and start over from scratch on the health-care bill.

But don't be fooled by attempts to compromise and water down this bill, because
the fundamental issue is not any one specific provision in it. The issue is the
very existence of the new government health-care bureaucracy it would create.

An amusing "live-blogging" of the health-care bill—a blogger sharing his
observations as he reads through all 1,017 pages of HR 3200—has been making the
rounds on the Web, and what I found most interesting about it was his
description of the first 100 pages of the bill. (The author writes under the
nome-de-blog "the Czar" and refers to himself in the third person; it's the
blogosphere, so you just have to learn to put up with these literary
eccentricities.)


As you begin reading the actual text of the bill, you begin to notice a pattern.
Roles and responsibilities of the Secretary of Health and Human Services.
Commissioners. Ombudsmen. Auditors. Assistants. Departments. Commissions. You
begin to realize you are reading a verbal description of a corporate
organizational chart, with lengthy discussions of how these people will be
staffed, compensated, replaced, and so on….
43 pages in, the Czar muttered "Holy cow. Still nothing but definitions of terms
and descriptions of people who will have Very Important and Necessary Jobs to do
once this is enacted."…

The Czar began to notice that a lot of the sections, like 2714 and 2754, purport
to discuss ensuring lower premiums. But when he read it, he found nothing that
described specifics. Instead, there were blanket statements that it will be
someone's responsibility to find a way to lower premiums. The Czar cannot
imagine this in the real, corporate world. "My proposal is to save you money."
How? "Hire me first, and then I'll come up with something."…

[T]here's no discussion of how this will save money; but there are concepts
thrown around about how the SecHHS will review a bunch of different options to
find the best ones representative for each type of group member. Same as before:
we will make healthcare affordable for all Americans by finding a way.





The "Czar" is looking at this from the perspective of the Democrats' promise
that the bill will reduce health-care spending. But let's look at this from the
perspective of simply trying to figure out exactly what the bill will do. In
effect, the bill sets up an enormous bureaucracy for the purpose of regulating
health-insurance in a way that will reduce health-care costs—but leaves to that
future bureaucracy all of the actual, specific decisions about how this is to be
done.

In short, the fundamental purpose of this bill is not to establish a "public
option" or "end-of-life planning" or any other specific outcome. Its purpose is
to establish a functioning bureaucracy with the legal authority to regulate all
aspects of health insurance and health-care spending. What that bureaucracy will
actually do is a detail to be worked out later by the Secretary of Health and
Human Services, or the Health Choices Commissioner, or some other
executive-branch functionary.

Is it any wonder we're afraid that our private health-insurance will be taken
away because the Health Choices Commissioner decides to impose regulations that
hound private insurers out of existence? And that's why there are whispered
rumors about "death panels." What do you expect, when you create an unelected
bureaucracy charged with cutting health-care costs—without ever specifying
exactly what they are empowered to cut?

This is why the bill must be defeated in any form. It does not matter much
whether the Democrats strip out one obnoxious provision or another. Once
government takes on this newly expanded role as regulator plenipotentiary of the
health-insurance industry, the power to achieve the left's entire wish list will
be shifted from Congress to a new, unelected health-care bureaucracy.

Historically, this is how Congress has given away its power, and our freedom.
Congress passes a law declaring some vague and laudatory-sounding
goal—"environmental protection," say, or "clean air," or "occupational safety,"
or the relief of troubled assets—then Congress creates a vast new bureaucracy
and leaves it to them to fill the Federal Register with tens of thousands of
pages, year after year, specifying exactly how those goals are to be achieved.

That's why it's impossible to say exactly what any of this legislation actually
does. It is impossible to predict whether the Clean Air Act will be used to
regulate carbon dioxide, or whether the Troubled Asset Relief Program would do
any of the half-dozen things it ended up doing after Hank Paulson decided that
it wouldn't actually buy up any troubled assets.

So it's a mistake to think of the current legislation as a health-care reform
bill. It is actually a bill for the formation of a massive health-care
bureaucracy charged with the task of scheming endlessly to expand its own power.

The only way to prevent this kind of free-floating grant of power to the
bureaucracy is to prevent it from forming in the first place, by keeping
government out of medicine. It's far too late to keep the government out of
medicine altogether; the government has been "reforming" health-care for 60
years, and it has already taken over roughly half of the industry. But we can
stop it from encroaching any further.

If we don't, we can expect that every political battle over health-care from now
on will be a futile rear-guard action to stop the new health-care bureaucracy
from taking on an ever wider role, imposing new regulations and controls that
were never specified—or even dreamed of—when the current legislation was passed.

Advocates of liberty have been winning the current battle over health-care. The
administration is making concessions, Blue Dogs are trying to mollify us, and
some congressmen are so terrified that they can only be found on milk cartons
this August.

It is time to press our advantage, keep up the pressure, and make it clear to
our congressmen that we don't want a modified health-care bill or a watered-down
health-care bill. We want no health-care bill and no new health-care
bureaucracy.

We're Winning

-Robert Tracinski, editor www.TIADaily.com

Excerpt:

"Why are we winning in the battle against socialized medicine? Partly because we
have the facts on our side. Here are a few more of them.

Michael Tanner clearly explains how the entire rationale behind the Obama
health-care plan is based on a myth: the 47 million uninsured. He breaks down
the various people who make up this group and shows how the claim that these
people are cruelly being denied health care is a lie.

http://www.realclearpolitics.com/articles/2009/08/18/who_are_the_uninsured_97934\
.html

(Michael Ramirez also has a good cartoon summarizing this data.)
http://www.ibdeditorials.com/CartoonPopUp.aspx?id=333232530356809

Charles Krauthammer offers a good op-ed on the claim that Obama's health-care
plan will save money by emphasizing "preventive medicine."

http://www.washingtonpost.com/wp-dyn/content/article/2009/08/13/AR2009081302898.\
html

He notes: "In an Aug. 7 letter to Rep. Nathan Deal, [Congressional Budget
Office] Director Doug Elmendorf writes: 'Researchers who have examined the
effects of preventive care generally find that the added costs of widespread use
of preventive services tend to exceed the savings from averted illness.'"

This is what has turned the elderly against Obama's plan, by the way. The Obama
plan calls for cutting hundreds of billions of dollars in Medicare spending.
Those who have been forced to rely on Medicare know that this money isn't going
to be saved through some harmless program like preventive medicine. They know
that it is going to saved by denying care to the elderly.

That's why 60,000 people have quit the AARP in protest of its implicit support
for Obama's plan.


Elaine Guardiani has been with AARP for 14 years, and said, "I'm extremely
disappointed in AARP."… Many are switching to the American Seniors Association,
a group that calls itself the conservative alternative…. Last week alone, they
added more than 5,000 new members. Our camera was there Friday when the mail
came. Letters were filled with cut-up AARP cards.

"I think that probably the seniors are most upset with cuts in Medicare," said
ASA President Stuart Barton. The American Seniors Association is flat-out
against President Obama's plan, which calls for $313 billion dollars in Medicare
cuts over ten years.

Meanwhile, congressmen continue to hide out from their angry constituents,
prompting Ed Morrissy to dub them "milk carton" politicians.

In full panic mode, the Obama administration signaled that it would back off
from the "public option" of government-run, government-subsidized health
insurance, in favor of health-care co-ops—which would also be managed and funded
by the government. As Investor's Business Daily points out, this is just a
thinly disguised version of the public option

Yet even this concession touched off a revolt from the far left that threatens,
in the words of a Politico article, a "Democratic civil war." So the White House
promptly reversed its signal on the public option.

That kind of flip-flopping is what will do the most damage. It will tell every
wavering congressman that the White House is in disarray and cannot be trusted
to take a position and stick to it—so why should anyone in Congress stick their
necks out to save Obama's bill? More and more conservative Democrats will take
the approach of the one quoted in the article below: they will urge scrapping
the current bill entirely and starting over.

Oh yes, and just when it looked like things couldn't get any worse for Obama,
the incoming president of the Canadian Medical Asssociation has denounced that
country's socialized medicine system as "imploding" and "unsustainable."

Dr. Anne Doig, the incoming president of the Canadian Medical Association, said
her country's health care system is "sick" and "imploding," the Canadian Press
reported…. When her colleagues from across the country gather at the CMA
conference in Saskatoon Sunday, they will discuss changes that need to be made,
she said. "We all agree the system is imploding, we all agree that things are
more precarious than perhaps Canadians realize," she said.

Current president of the CMA, Dr. Robert Ouellet,…has said that "competition
should be welcomed, not feared," meaning private health insurance should have a
role in the public health system.
Doig said…that universal health care, while good in some ways, has not always
been helpful for sick people or their families. "(Canadians) have to understand
that the system that we have right now—if it keeps on going without change—is
not sustainable," Doig said.

So it looks like the Canadians are now considering the "private option"—a
greater role for private health insurance.

"Blue Dog: 'Excellent Idea' to Start Over on Health Care Reform," Kevin Bohn,
CNN, August 17

http://politicalticker.blogs.cnn.com/2009/08/17/blue-dog-excellent-idea-to-start\
-over-on-health-care/

Acknowledging his amazement at the crowds gathered to debate health care at his
town halls, Rep. Allen Boyd, D-Florida, faced three large gatherings on Monday
with many questioners voicing skepticism about the proposals being debated in
Washington…. Boyd, in his seventh term, represents a conservative area in
northern Florida. A fiscal conservative, he is part of the group of House
Democrats known as the Blue Dogs….

When a questioner, Ray Evans, said he believed the President wants to do too
much at once and asked whether Boyd would "be willing to scrap everything" and
start over to do pursue reform more incrementally, the congressman responded: "I
think that is an excellent idea…we may end up there."

In a later interview with CNN, he said the idea had been floated with the
congressional leadership. He said that with the strong emotions and heated
opposition he is seeing, the idea of doing health reform in a more piecemeal
fashion is something he is strongly considering.

A large number of those asked questions at Monday's events said they did not
feel the government should play any bigger role in society.
"Government is supposed to be for the people. [It] already took over banks and
the car industry. We don't want [it] to take over the health industry," said one
questioner, Ann Millard.

Health Care "Ghimmitude"
by Robert Tracinski, editor www.TIADailycom

Excerpt from TIADaily.com:

" My article on Obama's war on health insurance, published at RealClearPolitics
and in a shorter version at Investor's Business Daily, focused on the issue of
individualism versus collectivism.

In thinking about that focus, I realized a notable difference between the 1994
health-care debate and today's. Back then, the administration and its supporters
put much more emphasis on the idea of a "right to health care."

Obama has not emphasized that, partly because he is deliberately doing the
opposite of what Hillary Clinton did, and partly for a more insidious reason.

A "right to health care" emphasizes the individual's prerogative to demand that
a good be delivered to him. It is an attempt to steal the individualistic
language of rights for a collectivist purpose.

But the whole emphasis of Obama's program is cost cutting, which emphasizes, not
what the government is going to provide for you, but what it is going to deny
you. That's why we're all talking about "death panels."

In short, Obama has sold the program in a way that inadvertently emphasizes the
fact that you will be dependent on government for life-or-death needs, making
individualism versus collectivism into the central issue.

I say all of that to introduce a brilliant formulation of this issue from a
legal blogger.

He calls it "ghimmitude"—a combination of "gimme" and "dhimmitude" which
brilliantly captures the way in which the leftist chooses to sell his soul,
giving up his birthright of independence in exchange for a handout from the
state.

"Health Care Ghimmitude," William A. Jacobson, Legal Insurrection, August 4

The fight over nationalized health care is at the heart of a larger societal
battle over the role of the individual. At stake is whether individual health
care choices will be subservient to the state's larger health care interest by
forcing the individual to submit to state control of the most personal aspects
of one's life in exchange for health care security and benefits.

I call this system "Ghimmitude."

Unlike the system of Dhimmitude, this has nothing to do with religion. But the
concept of a recognized alignment of power between two groups (here, the state
and the individual) based on recognized control by one group (here, the state)
is similar….

Rather than focusing on people trying to get something for nothing, which has
taken place since the beginning of time, the system of Ghimmitude requires that
in exchange for getting something for nothing the individual give up some
measure of freedom….

Ghimmitude: "A peaceful surrender to the state in exchange for health care
security and benefits, based on accepting the inferiority of the individual and
individual rights."

****************

What is "The Intellectual Activist"?

This magazine is for those who take ideas seriously — those who realize that
fundamental ideas shape our culture and change the course of the world — those
who believe that the philosophical ideas we accept are a matter of life and
death.

The intellectual Activist is for those who agree that the job of a thinker is
not to play academic word games, but to address the crucial issues of human
life: what kind of government we should live under; what we should seek in art,
in love, in friendship; what standards we should uphold in our thinking; where
our civilization stands in history and in contrast to the rest of the world.

The Intellectual Activist examines and evaluates the ideas that influence the
whole spectrum of human action — from the immediate practical realities of
politics and economics — to the vision of human potential offered by art — to
the vast achievements of science and the threats of ignorance and superstition —
to the grand-scale drama and powerful lessons of history — to the way in which
basic ideas filter down to the smallest details of our lives, to our habits, our
pastimes, our entertainment.

This magazine is for those who want to change the world, not through mindless
street protests, but by changing the ideas that shape our lives. It is for those
who want to be activists, not just in politics, but in the realm of the
intellect.

http://www.intellectualactivist.com/about.html

Real Debate Is Individualism Vs. Collectivism
By ROBERT TRACINSKI

"The goal of the Democrats' plan for health care reform is coming more and more
out into the open: They want to eliminate health insurance.

This is the line of attack the Democrats have chosen as they've gone into the
August recess:

Private health insurance companies are evil, and big government is here to save
us from them.

According to the New York Times, President Obama is planning an "August
offensive against the insurance industry." It is "a campaign of increasingly
harsh rhetoric" that is "intended to drive home the message that revamping the
health care system will protect consumers by ending unpopular insurance industry
practices, like refusing patients with pre-existing conditions."

That part about pre-existing conditions gives the game away. Health insurance
companies refuse to cover pre-existing conditions for the same reason that you
can't insure your automobile after you crash it.

Insurance is a form of financing for the unexpected and unpredictable. It is not
a mechanism to force somebody else to pick up the tab for expenses you have
already incurred.

Do the Democrats even understand what insurance is? Insurance is a form of
financing. It is a contract under which a health insurance company agrees to pay
for medical bills that could run into the tens of thousands of dollars, if you
are hit by a bus or are diagnosed with cancer, so that you don't have to pay for
those bills out of your income or savings.

So let's ask the question the left never asks: How is it possible for an
insurance company to pay for these giant medical bills?

Welfare, Not Insurance

For every person who needs open-heart surgery or chemotherapy, there have to be
a certain number of other people who are paying their premiums but haven't
gotten seriously ill. If the insurance company has gotten its calculations
right, the expenses for any one person's catastrophic care are balanced out by
the premiums other people pay "just in case."

You can see how Obama's demands undermine all of these calculations. To ask
insurance companies to cover a patient after the tumor is diagnosed is to ask
them to take on a known expense. Combine that with another of the president's
demands — that insurance companies can't charge higher rates for those who are
at higher risk of getting sick.

So if insurance companies have to take on a known expense and can't charge a
higher rate for it, how are they going to pay for it? By raising everyone else's
premiums, redistributing their wealth to the new freeloaders.

This isn't insurance, it's welfare. And that's the whole point.

Government regulations and enormous government spending have already distorted
the health care market for decades, but the current legislation is the coup de
grace. Its whole point is to force insurance companies to act as if they are
government welfare agencies.

And when the insurance companies collapse under that artificial burden, the
government will drop the pretense and have the welfare agencies, under the
banner of the "public option," take over.

Don't be fooled by labels. The "public option" is not insurance, because it is
deliberately designed not to balance premiums against risk.

Precious Right

And instead of choosing how much coverage you are willing to pay for, everyone
is forced into a plan designed by an Orwellian "Health Choices Commissioner."
When you get sick, you don't have a contract with a private company that you can
enforce. You are dependent on benefits that are doled out uniformly to everyone
by the government.

There are no independent individuals in this system. It is designed to make
everyone dependent on the collective will of the government — which can decide
to reduce your care or pay less for it when costs spiral.

The Democrats oppose health insurance because it's based on an opposite idea:
that people are independent individuals who should be expected — and have the
right — to pay their own way. It is a system in which people decide what level
of coverage they want and how much they are willing to pay for it, and insurance
companies balance an individual's premiums against his health risks.

Paying your own way is a demanding responsibility, but it is also a precious
right that few people want to give up. He who pays the piper calls the tune, and
when it comes to health care, our lives depend on being able to call the tune.

Will we be independent individuals with some control over our own fate — or will
we be cogs in the collective, forced to be dependent on government for the most
important needs of our lives? "

Tracinski writes daily commentary at TIADaily.com. He is the editor of The
Intellectual Activist and TIADaily.com.

More information about TIADaily.com:

www.TIADaily.com

This magazine is for those who take ideas seriously — those who realize that
fundamental ideas shape our culture and change the course of the world — those
who believe that the philosophical ideas we accept are a matter of life and
death.

This magazine is for those who agree that the job of a thinker is not to play
academic word games, but to address the crucial issues of human life: what kind
of government we should live under; what we should seek in art, in love, in
friendship; what standards we should uphold in our thinking; where our
civilization stands in history and in contrast to the rest of the world.

The Intellectual Activist examines and evaluates the ideas that influence the
whole spectrum of human action — from the immediate practical realities of
politics and economics — to the vision of human potential offered by art — to
the vast achievements of science and the threats of ignorance and superstition —
to the grand-scale drama and powerful lessons of history — to the way in which
basic ideas filter down to the smallest details of our lives, to our habits, our
pastimes, our entertainment.

This magazine is for those who want to change the world, not through mindless
street protests, but by changing the ideas that shape our lives. It is for those
who want to be activists, not just in politics, but in the realm of the
intellect.

We're Winning
by Robert Tracinski, editor www.TIADaily.com

"Here we are, just a few weeks into the August recess, and the results are
already clear: we're winning.

If August is to be the crucial battle over socialized medicine, then it is clear
that the pro-liberty forces are gaining the upper hand and the advocates of
socialism are on the defensive.

The key battleground is "Town Hall Hell"— the legions of angry supporters who
have turned out to confront their Senators and Representatives at town hall
meetings.

Here are a few of the latest media reports.

Representative Anthony Weiner went to a senior citizens' center in Brooklyn and
was confronted by accusations that President Obama's health-care plan is
Communist.

"Are we going to have a say in this or are we becoming a Communist country?"
demanded a 61-year-old man named Bill. "I've never heard of a government program
that doesn't explode in costs. This is a joke." One elderly man yelled out,
"It's a Socialist country!" Others clapped.

Weiner tried to calm them down. "Let's turn down the rhetoric," he pleaded.

One senior wanted to know how the government would pay for a program to cover
some 47 million uninsured Americans. "Where are the doctors and nurses going to
come from to cover all these new people?" he asked.

Sheryl Debling, who declined to give her age, but was not a member of the senior
center, came to the meeting to get some answers. "Where is the money going to
come from?" she asked. "You are bankrupting our country. You guys are crooks."

Pennsylvania Senator Arlen Specter, an early target of harsh treatment at town
hall meetings, seems to be cracking under the withering hostility.

Sen. Arlen Specter deployed a novel countermeasure at his raucous health care
town halls on Wednesday: humor.

"I consider it a compliment that you want to come back," Specter (D-Pa.) cracked
during a round of boos, a reference to the hecklers who derailed his health care
forums Tuesday.

Heck, Specter even booed himself at one point. Not that it did him much good.

And the Wall Street Journal reports on the response of voters in a centrist
"swing" district in Indiana.

At a town-hall meeting here, Rep. Joe Donnelly, a Democrat in a conservative
district, was told by constituents they don't trust the government to be their
doctor.

They just can't, said local physician Mark Crowley: "Given the government's
track record on running various corporations like Amtrak and the Post Office,
how can you guys in good conscience decide to run one-seventh of the national
economy?"…

"I just want to know, when do these entitlements stop?" asked Ron Ammerman, a
35-year-old who has been laid off from his job as a splicer for AT&T Corp. He
was the first to take the microphone and earned applause.

"I'm responsible for myself and I'm not responsible for other people. I should
get the fruits of my labor and I shouldn't have to divvy it up with other
people."

This is what I love about America: an unemployed blue-collar worker lectures his
congressman about being responsible for oneself and keeping the fruits of one's
labors.

Note also that there is real substance to the things said by these constituents
to their congressmen. They aren't just shouting down their opponents, as the
Democratic smears would have you believe.

I happen to think that the people are entitled to occasional outbursts of
inarticulate rage, if only as revenge against all of those smooth, well-spoken
types—the John Kerrys and Barack Obamas—who think their Ivy League diplomas
entitle them to control our lives.

But articulate, ideological opposition to socialism is much more effective and
likely to lead to a better result.

So I am glad to see many readers of TIA Daily—getting involved in this battle.

I haven't yet had a chance to go directly into this fight. My own congressman is
a Republican leader (Minority Whip Eric Cantor), Virginia's two Democratic
senators have so far refused to expose themselves in public, and
Charlottesville's representative, Democrat Tom Perriello, has practically gone
into hiding. So I have had to live vicariously through reports sent by my
readers.

I was particularly gratified to see some of them using my "20 Questions for Your
Congressman," available on the Web at TIA's Health Care Guide.

Chuck Blythe reports:

I was able to ask my Congressman, Pat Tiberi (12th District, Ohio), question #17
this evening. [Question #17 brings up Health Savings Accounts and ends by asking
"Are you open to ideas…for free-market reform of health-care?"]

Even though Pat is a pachyderm, he stumbled on this one, as he falls into the
"compassionate" category and favors amendments that will guarantee [insurance
coverage for] pre-existing conditions.

By the way, I also pushed him on another question, which was: "Do you, or does
anyone in Congress, fundamentally understand the business of insurance?"

My allegory was to tell a tale of the person with a totaled vehicle who demands
that Nationwide/Geico/All State, etc. give him collision coverage with no
deductible, as it was his fundamental right as an American. Again, nothing but
governmental gobbledygook for an answer.

That's a good suggestion for a question, as is this one, from reader Tait
Solberg:

A favored line of President Obama is "If you like your health care, you can keep
it."

The question should be asked, "Who gave you the authority to take it away?" If
this bill passes we will have gone full circle from subject to citizen to
subject in less than 250 years.

Scott Clarke reports:

I attended the town hall with Peter DeFazio at Cottage Grove, OR, earlier today,
first one ever for me, and was all set to ask some of your 20 questions.

The turnout was so large that they moved it from the hall to the parking lot
outside, as more people were outside the doors than in. I was about 15 feet from
Mr. DeFazio and got called on.

I ended up just winging it with my own question, deciding to keep it simple and
fundamental, even though this was not the venue for a thoughtful discussion of
much of anything.

I had my recorder running, and this is the transcript:

Me: Is health care a right?
DeFazio: Uh oh... [commotion]

Me: ...And if so, if so, if it is, if I need neurosurgery does that man who's
not there any more [I pointed to where a neurosurgeon had stood who had asked
the first question, about why tort reform is not being addressed] have an
obligation, moral and legal, to provide it to me?

DeFazio: Well, uh, th-that's a, you know, in-in, in the current system, as
George Bush famously said, no one is denied health care in America, they can
always go to the emergency room. But the problem is, if they go to the emergency
room...

Me: ...But is it a right, is it a right?

D: ... We have made it a right, 'cause you can, you know, always go to the
emergency room...

Me: Why? Justify it. What is the moral justification to make it a right?

D: Well sir, I don't want...
Me: True rights do not clash...

D: Sir, sir, you know, could I, you know ... every other...
Me: You asked, "Could I", and you are not. Is it a right or not?

D: ...democracy on earth covers all their citizens with health care, at a lower
cost than health care in America. (Applause) I think we can figure
out...(applause)...something that works here.

Me: You did not answer my question!
D: Yeah, go ahead [to next questioner]....

I didn't intend to be that aggressive but when he started doing the politician's
dance instead of just saying yes or no then elaborating, I was aggravated.

On reflection, perhaps that is the only way to have an impact in a setting like
this. The sides were evenly matched, numbers-wise, which was promising in
liberal Oregon, but no one was going to persuade anybody of anything, that was
abundantly clear.

So maybe the only way we can leave a lasting impression is by leaving a bad
taste in their mouths, which will register as uncommonly irate constituents with
the potential to threaten their power-trip gigs if they get on the wrong side of
public opinion.

In a similar vein, reader Glenn Horrell asks what to do about a far-left
representative in a solidly left-leaning district, who is unlikely to be
dissuaded by a few angry constituents.

What's the answer? Vote them out of office?

Possible at the state level, but in St. Paul the Democrats could nominate a dead
moose to the House of Representatives and it would win in a landslide.

I advocate finding good congressional candidates elsewhere and doing what you
can to support their campaigns—including donations of time and money.

If you can't vote your leftist representative out of office, the next best thing
is to give him the unpleasant experience of being in a powerless congressional
minority.

The same for someone like me who lives in a "safe" Republican district. Next
year, I expect to be active in the next district over, volunteering some time
and money for whoever runs against Tom Perriello.

Perhaps the most active TIA Daily reader is Mark Kalinowski, who is one of the
founders of the Clifton NJ Tea Party Organization.

Mark has put up on YouTube a delightful series of eight video clips from a town
hall meeting last Monday in North Arlington, New Jersey, with Democratic
Representative Steven Rothman. The first video is here, and you can see the
whole series by following the "related videos" that YouTube offers you.

These links and a long write-up of the meeting are also posted on Mark's
Facebook page, and he invites you to "friend" him there.

(Speaking of which, I am on Facebook now, and also on Twitter, which required
overcoming a big psychological barrier: as someone who writes and speaks for a
living, I have tried very hard never to do anything that could be described as
"twittering."

I am not using either of these services very actively yet, but I am at least
dipping a toe into the waters of social media.)

I thought the most interesting part of Mark's write-up was this:
[W]hen I showed up an hour early, Rothman's staff had placed four 2' x 3'
posters (placards) up—each of which made many points in favor of socialized
health insurance, and none of which showed anything having to do with the
pro-liberty side of the argument….

Each poster was labeled at the top "America's Affordable Health Choices Act:
Quality Affordable Health Care." Somebody ought to ask Rothman how so-called
"affordable housing" turned out, and what makes so-called "affordable
healthcare" any different….

The posters which Rothman had up were taken down before the scheduled 1 PM start
of the meeting, once it was pointed out to him and/or his staff how one-sided
they were.

That eloquently indicates the impact of Town Hall Hell: a congressman shows up
with pre-printed placards giving the standard talking points in favor of Obama's
health-care legislation—but takes them down and hides them away when he realizes
how badly they will go over with the hostile crowd outside.

If that's what he does at the Town Hall meeting, what do you think he'll do when
it comes time to cast an actual vote on the Obama plan?

It's not just a few congressmen, and it's not just at town hall meetings. A
cascade of e-mails on the issue has been crashing congressional e-mail servers.

The left has been striking back with its campaign of contempt for the governed,
most recently with Senate Democratic leader Harry Reid branding town-hall
critics of the health-care bill as "evil-mongers."

Remember that.

The people who thought it was morally simplistic to refer to brutal
dictatorships as an "Axis of Evil" think it's just fine to brand defenders of
the free-market as "evil-mongers."

Meanwhile, a black Democratic congressman in Georgia reports having his office
door defaced with a swastika, presumably by critics of the health-care bill.

Don't you think that's a bit too pat, too much in keeping with Nancy Pelosi's
absurd branding of critics as Nazis? The story seems—what's the word—a bit
"fishy." We'll see if anyone comes of it.

There are a number of signs, though, that the Democrats are breaking.
One congressman has been forced to apologize for his condemnation of critics at
town hall meetings.

Rep. Brian Baird (D-Wash.) apologized yesterday for accusing town hall
protesters of "brown shirt tactics" and comparing them to a "lynch mob."

Baird, who originally decided against holding town hall meetings because of
expected protests, now says he'll schedule some forums during the August recess.

"Frankly, I have had concerns about how we can have constructive dialogue and,
unfortunately, in response to some of the things we've been seeing across the
nation I have said some things myself that I regret," Baird said….

"I want to express that regret directly and announce that we will be holding a
series of five town halls so people can express their opinions and ask
questions."

There has been some controversy over whether the passionate expression of
opposition at town halls would backfire against the right—whether the American
people would find this response obnoxious and "un-American."

  Well, the numbers are in. A Gallup poll reveals that most people regard the
raucous debate as a healthy expression of representative government, that they
believe it is a real grass-roots reaction—and that the opposition at town halls
has made them more sympathetic, not less, to the opponents of socialized
medicine.

That's particularly true among independents, which is important because they are
the ones who tend to swing elections to one side or the other.

Meanwhile, there is so similar grassroots upsurge on the other side.

The New York Times reports that Barack Obama's vaunted grass-roots operation
(which was always exaggerated) has not turned backed him up in this contest:

Mr. Obama engendered such passion last year that his allies believed they were
on the verge of creating a movement that could be mobilized again. But if a
week's worth of events are any measure here in Iowa, it may not be so easy to
reignite the machine that overwhelmed Republicans a year ago….

Here in Iowa, the Organizing for America effort resembles the earliest days of a
presidential campaign, a shoestring operation where homemade signs hang from the
walls and only the most diehard of supporters attend events….

Some of the activists Mr. Obama attracted to politics remain involved, but
audiences at the Organizing for America events were largely filled with party
stalwarts….

"People came out of the woodwork for Obama during the campaign, but now they are
hibernating," Ms. Smith said. "Now it is hard to find enough volunteers to fight
the Republicans' fire with more fire."…

Ms. Adkins, who hosted the meeting in her home this week here in Muscatine,
speaks passionately about Mr. Obama. She attended the inauguration and carefully
follows the developments at the White House. But she conceded that when it came
time for door-to-door canvassing a few months ago—a task she has long
disliked—she left town so she would not have to say no.

Support for the health-care measure keeps dropping in the polls, and Larry
Kudlow points out that the market now seems to be betting against it.

It's still tough to know whether this behemoth government takeover of health
care will actually pass. But two key markets are betting against it. First, over
at the Intrade pay-to-play online-betting parlor, the bid for the US government
health-plan contract is only 38 cents.

That's down from 50 cents in late July. Second, the share prices of big private
health insurers have rallied in recent weeks. UnitedHealthcare is up 13 percent,
Humana is up 12.4 percent, and Aetna is up almost 10 percent. These firms will
be decimated if the government insurance plan passes. But investors are now
predicting it won't.

And the bill may have just lost a key ally in Congress. Moderate Republican
Senator Chuck Grassley, who was most likely to give the bill a "bipartisan"
patina, is now hinting that he may drop the whole thing—and he may do so because
of the impact of the town hall rebellion.

Sen. Chuck Grassley (R-Iowa), the ranking member of the Senate Finance Committee
who has been locked in negotiations to craft a bipartisan health bill, suggested
that, as the August recess plays out, the current reform legislation before
Congress may have to be delayed or ditched entirely.

"We won't really know until we get back there the full impact," Grassley said in
a news conference with Iowa reporters. "But it could have the impact of stalling
it. It could have the impact of starting all over again [with a new bill]."

The Politico puts it bluntly: the Democrats are "losing" the August recess.

[I]f the August unrest has spooked a safe, respected senior senator like
Grassley, it can't be good sign for the dozens of much more vulnerable moderates
from both parties, who worry that the wrong vote on health care could cost them
the job next year….

Grassley says that the outraged reaction at town hall events hasn't changed his
message…. But he noted that his town hall meetings on health have drawn three
times as many attendees as past events—a dramatic increase given that Grassley
has held 2,846 town halls over his career.

"The message I got is that people are very definitely opposed to any piece of
legislation that would even lead to a takeover of health care," he said….

The Iowa town hall attendees didn't hide the political price they could exact on
lawmakers over health care reform. "I'm a conservative, and what we expect is
for you to fight for us," shouted a questioner at a town hall in Adel, Iowa.

"Every senator, Democrat or Republican, that votes for this bill—we will vote
you out."

Yes, my friends, we are winning. But we haven't won yet, so keep up the
pressure. Whether or not your congressmen have the guts to show their faces
before their constituents, find any medium you have available to you—and give
'em hell.—RWT

===========================================================
What is The Intellectual Activist?:

http://www.intellectualactivist.com/about.html

This magazine is for those who take ideas seriously — those who realize that
fundamental ideas shape our culture and change the course of the world — those
who believe that the philosophical ideas we accept are a matter of life and
death.

This magazine is for those who agree that the job of a thinker is not to play
academic word games, but to address the crucial issues of human life: what kind
of government we should live under; what we should seek in art, in love, in
friendship; what standards we should uphold in our thinking; where our
civilization stands in history and in contrast to the rest of the world.

The Intellectual Activist examines and evaluates the ideas that influence the
whole spectrum of human action — from the immediate practical realities of
politics and economics — to the vision of human potential offered by art — to
the vast achievements of science and the threats of ignorance and superstition —
to the grand-scale drama and powerful lessons of history — to the way in which
basic ideas filter down to the smallest details of our lives, to our habits, our
pastimes, our entertainment.

This magazine is for those who want to change the world, not through mindless
street protests, but by changing the ideas that shape our lives. It is for those
who want to be activists, not just in politics, but in the realm of the
intellect.

Obama's Death Panels:  Whose Life Is It, Anyway?

The Real "Death Panel" Threat Is the Morality of Collectivism
by Robert Tracinski editor, www.TIADaily.com

"The big story of the past week is the controversy over "death panels"—Sarah
Palin's term for the idea that "my parents or my baby with Down Syndrome will
have to stand in front of Obama's 'death panel' so his bureaucrats can decide,
based on a subjective judgment of their 'level of productivity in society,'
whether they are worthy of health care."

The basis for this claim is two different provisions put forward in various
versions of the (still not completely written) health-care bill.

The first is a proposal to establish a panel of medical experts who would
determine which treatments are supposedly most cost-effective and thus will be
paid for under a government-run system—and which will not.

In a New York Times interview in April, which makes very instructive reading in
the current debate, President Obama explained that "part of what I think
government can do effectively" is to be a "broker" "between patient and
provider"—that is, between you and your doctor—"in assessing and evaluating
treatment options."

He continued: "And certainly that's true when it comes to Medicare and Medicaid,
where the taxpayers are footing the bill and we have an obligation to get those
costs under control."

The example he gives? Whether his ailing grandmother should have been allowed a
hip replacement in the final months of her life.

"End-of-life care" he said, is an area where "you just get into some very
difficult moral issues. But that's also a huge driver of cost, right? I mean,
the chronically ill and those toward the end of their lives are accounting for
potentially 80 percent of the total health care bill out here."

So who is going to make the decisions about grandma's cancer treatment and hip
replacement surgery?

"It is very difficult to imagine the country making those decisions just through
the normal political channels. And that's part of why you have to have some
independent group that can give you guidance."

Just don't call it a "death panel"!

Other countries already have such a system. In Britain, it's known by the
creepy, Orwellian acronym NICE, for National Institute for Health and Clinical
Excellence, and it is the panel charged with deciding, for example, that a
cancer drug that would extend your life by six months is too expensive because
you don't have enough "quality adjusted life years" remaining to justify your
cost to the National Health Service.

This is a rationing board for government-provided medical care, based on a
bureaucratic formula that tells you how much your life is worth to the state.

The second provision in the current health-care reform, covered in more detail
by Palin in a follow-up posting, is a proposal—actually included in a Senate
version of the bill until Palin pointed it out—that would give doctors a
financial incentive to approach their patients about "end-of-life planning."
This would likely have the effect of pushing doctors to discourage additional
treatment in the last years and months of one's life in order to cut costs for
the government.

Obama has dismissed these concerns—somewhat flippantly—as mere "rumors." But
they are totally in keeping with his own statements and with the logical
consequences and overall direction of the bill.

And worse: the fears about "death panels" and rationing of care for the elderly
are validated by the moral justifications offered for the health-care bill in
the first place.

In a recent editorial, the Wall Street Journal does an excellent job of
describing the economic factors that will necessitate rationing of health-care
and denial of care for the elderly. But it is important to grasp that this is
not an accidental or unintended consequence of government control of health
care. It is an intended consequence, following directly from the basic moral
premise behind the health-care bill: the premise that your medical care is the
business of "society."

Thus, when discussing the "difficult moral issues" that are raised by
end-of-life care, President Obama says, "I think that there is going to have to
be a conversation that is guided by doctors, scientists, ethicists. And then
there is going to have to be a very difficult democratic conversation that takes
place," leading to Obama's idea of an "independent group" being put in charge.

Is this how you would naturally think about decisions regarding the end of your
own life? Would you say, "let's have a democratic conversation about it"? Or
would you respond that this is your life and hence your decision, which cannot
morally be made by anyone else?
Jack Wakeland sent me an e-mail yesterday which captured how these "end-of-life"
decisions—let's put it bluntly: decisions about dying—are currently, and
properly, treated.

"When a patient is terminally ill, it is entirely proper and legitimate for
doctors to push for frank discussions between the patient and his family about
whether or not the medical profession can really do anything for him other than
alleviate pain. It is entirely proper and legitimate for the patient to consider
the financial burden he is imposing on his family if they are supporting him, or
the financial loss to his family if he intends to bequeath to them what remains
of his estate after his death.

This kind of end-of-life cost/benefit analysis is a deeply personal issue. It is
so intensely personal that one's own family members—including one's own wife or
husband—may not legitimately involve themselves in the decision unless they're
asked by the one who is to die."

Yet Obama is proposing to turn the subject over to a whole bunch of strangers,
to an "independent group" "guided by doctors, scientists, ethicists."

Under what morality is this acceptable?

Ask one of the "ethicists": Ezekiel Emanuel, a physician, the brother of White
House Chief of Staff Rahm Emanuel, and a "special advisor for health policy" in
the Obama administration. Dr. Emanuel has advocated the denial of care based on
a viciously thorough, consistent version of collectivism: the premise that an
individual's life is only valuable insofar as he is valuable to the collective.

In an article titled "Principles for Allocation of Scarce Medical
Interventions," published in the medical journal The Lancet in January of this
year, Dr. Emanuel and his co-authors advocate "a priority curve on which
individuals aged between roughly 15 and 40 years get the most chance, whereas
the youngest and oldest people get chances that are attenuated."

Get that? We're going to "allocate" "chances that are attenuated." Just don't
call it a "death panel"!

The administration's toadying defenders in the press have leapt to object that
Dr. Emanuel was "only addressing extreme cases like organ donation," but the
examples that lead his article include "beds in intensive care units,"
penicillin, and kidney dialysis (which were once quite scarce). Yet what is
important is not so much the treatments that are to be rationed, but the
principle on which they would be rationed.

In a 1996 article, Emanuel advocated government guarantees of health care for
those treatments that would make possible the "full and active participation by
citizens in public deliberations," while "services provided to individuals who
are irreversibly prevented from being or becoming participating citizens are not
basic and should not be guaranteed."

Thus, it is "public participation"—a person's usefulness to society—that is the
criterion by which health care is granted or "attenuated."
Of course, this raises the specter of the politicization of health care. After
all, are the tea party protesters good "participating citizens"? Not according
to Nancy Pelosi. So maybe those good "participating citizens" in the Service
Employees International Union should be first in line for the state's allocation
of scarce health-care resources.

Decades after the collapse of the Soviet Union, the left still adheres to the
philosophy of collectivism—the ghostly influence of the twisted moral code that
inspired the murder of millions in the 20th century.

The American people sense this, and that is why they are recoiling in horror
from Obama's plan for a greater government role in health care. Once the
government sets itself up as the allocator of "society's" resources, the
people—and especially the elderly—are afraid that they will be granted or denied
care based on some nebulous criteria that attempts to measure how useful they
have been or will be to society.

Greater government control puts the individual's life at the mercy of
collective—which means the state. And that is what makes people justifiable
terrified of Obama's health-care plan.

The individual is not a mere cog in the collective and cannot be regarded as
such—or discarded when he is no longer useful to the state. That view is a
fundamental rejection of the founding ideal of this nation: that all men are
created equal and endowed with inalienable rights to life, liberty, and the
pursuit of happiness. That means that each individual life is an end in itself,
an irreplaceable value whose fate can only be decided by one person: the
individual himself.

Any legislation that threatens to undermine this code of American individualism
must be thoroughly and immediately rejected. It's time to convene a death panel
to discuss end-of-life planning for Obama's health-care bill.

========================================================================

This magazine is for those who take ideas seriously — those who realize that
fundamental ideas shape our culture and change the course of the world — those
who believe that the philosophical ideas we accept are a matter of life and
death.
This magazine is for those who agree that the job of a thinker is not to play
academic word games, but to address the crucial issues of human life: what kind
of government we should live under; what we should seek in art, in love, in
friendship; what standards we should uphold in our thinking; where our
civilization stands in history and in contrast to the rest of the world.

The Intellectual Activist examines and evaluates the ideas that influence the
whole spectrum of human action — from the immediate practical realities of
politics and economics — to the vision of human potential offered by art — to
the vast achievements of science and the threats of ignorance and superstition —
to the grand-scale drama and powerful lessons of history — to the way in which
basic ideas filter down to the smallest details of our lives, to our habits, our
pastimes, our entertainment.

This magazine is for those who want to change the world, not through mindless
street protests, but by changing the ideas that shape our lives. It is for those
who want to be activists, not just in politics, but in the realm of the
intellect.


http://www.intellectualactivist.com/about.html

Gems from the Health Care Bill

• Page 16: States that if you have insurance at the time of the bill becoming
law and later change it, you will be required to take a similar plan. If that is
not available, you will be required to take the gov option!

• Page 22: Mandates audits of all employers that self-insure!

• Page 29: Admission: your health care will be rationed!

• Page 30: A government committee will decide what treatments and benefits you
get (and, unlike an insurer, there will be no appeals process)

• Page 42: The "Health Choices Commissioner" will decide health benefits for
you. You will have no choice. None.

• Page 50: All non-US citizens, illegal or not, will be provided with free
healthcare services.

• Page 58: Every person will be issued a National ID Healthcard.

• Page 59: The federal government will have direct, real-time access to all
individual bank accounts for electronic funds transfer.

• Page 65: Taxpayers will subsidize all union retiree and community organizer
health plans (example: SEIU, UAW and ACORN)

• Page 72: All private healthcare plans must conform to government rules to
participate in a Healthcare Exchange.

• Page 84: All private healthcare plans must participate in the Healthcare
Exchange (i.e., total government control of private plans)

• Page 91: Government mandates linguistic infrastructure for services;
translation: illegal aliens

• Page 95: The Government will pay ACORN and Americorps to sign up individuals
for Government-run Health Care plan.

• Page 102: Those eligible for Medicaid will be automatically enrolled: you have
no choice in the matter.

• Page 124: No company can sue the government for price-fixing. No "judicial
review" is permitted against the government monopoly. Put simply, private
insurers will be crushed.

• Page 127: The AMA sold doctors out: the government will set wages.

• Page 145: An employer MUST auto-enroll employees into the government-run
public plan. No alternatives.

• Page 126: Employers MUST pay healthcare bills for part-time employees AND
their families.

• Page 149: Any employer with a payroll of $400K or more, who does not offer the
public option, pays an 8% tax on payroll.

• Page 150: Any employer with a payroll of $250K-400K or more, who does not
offer the public option, pays a 2 to 6% tax on payroll.

• Page 167: Any individual who doesn't' have acceptable healthcare (according to
the government) will be taxed 2.5% of income.

• Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans
will pay for them).
• Page 195: Officers and employees of Government Healthcare Bureaucracy will
have access to ALL American financial and personal records.
• Page 203: "The tax imposed under this section shall not be treated as tax."
(Yes, it really says that.)
• Page 239: Bill will reduce physician services for Medicaid. Seniors and the
poor most affected.
• Page 241: Doctors: no matter what speciality you have, you'll all be paid the
same (thanks, AMA!)
• Page 253: Government sets value of doctors' time, their professional judgment,
etc.
• Page 265: Government mandates and controls productivity for private healthcare
industries.
• Page 268: Government regulates rental and purchase of power-driven
wheelchairs.
• Page 272: Cancer patient welcome to the wonderful world of rationing!
• Page 280: Hospitals will be penalized for what the government deems
preventable re-admissions.
• Page 298: Doctors: if you treat a patient during an initial admission that
results in a readmission, you will be penalized by the government.
• Page 317: Doctors: you are now prohibited for owning and investing in
healthcare companies!
• Page 318: Prohibition on hospital expansion. Hospitals cannot expand without
government approval.
• Page 321: Hospital expansion hinges on "community" input: in other words, yet
another payoff for ACORN.
• Page 335: Government mandates establishment of outcome-based measures: i.e.,
rationing.
• Page 341: Government has authority to disqualify Medicare Advantage Plans,
HMOs, etc.
• Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals.
• Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by
phone).
• Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens,
assisted suicide, euthanasia?
• Page 425: Government will instruct and consult regarding living wills, durable
powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of
time.
• Page 425: Government provides approved list of end-of-life resources, "guiding
you in death."
• Page 427: Government mandates program that orders end-of-life treatment;
government dictates how your life ends.
• Page 429: Advance Care Planning Consult will be used to dictate treatment as
patient's health deteriorates. This can include an ORDER for end-of-life plans.
An ORDER from the GOVERNMENT.
• Page 430: Government will decide what level of treatments you may have at
end-of-life.
• Page 469: Community-based Home Medical Services: more payoffs for ACORN.
• Page 472: Payments to Community-based organizations: more payoffs for ACORN.
• Page 489: Government will cover marriage and family therapy. Government
intervenes in your marriage.
• Page 494: Government will cover mental health services: defining, creating and
rationing those services.

20 Questions for Your Congressman
by Robert Tracinski, editor www.TIADaily.com

"The smear against small-government advocates who have confronted their
congressmen at town hall meetings is that they are an "angry mob" who just want
to shout down advocates of Obama's health-care bill. In fact, these protesters
have come to the meetings to ask some tough questions—questions that should have
been asked by the mainstream media.

So when you head off to a local town hall meeting during the August recess,
focus on asking good questions. I don't mean just rhetorical questions intended
to make a point, but also real questions that require a substantive answer.

As a guide to help you prepare for your local town hall meeting, here are my
suggestions for 20 questions you can ask your elected representatives about the
economics, history, politics, and morality of Obama's health-care plan. If your
elected representative will answer these questions, it will tell you a great
deal about his principles (or lack of them) and his goals.

It might also tell you about his method of making decisions: does he just repeat
canned talking points, or does he really think about your questions? And if he
won't answer your questions—if he doesn't have the guts to do anything but
preach to the converted at union-sponsored rallies—well, that gives you all the
answers you need right there, doesn't it?

But don't just ask these questions of your congressmen. Ask them of your friends
and neighbors, of newspaper columnists and reporters, of local doctors and
businessmen and others in positions of influence. These are the kinds of
questions we should all be thinking about and trying to answer, if we are going
to subject this legislation to the scrutiny it needs before Congress votes on
it.

1. The government has been "reforming" health-care for sixty years—tax breaks
for employer-provided health-insurance, Medicare, Medicaid, encouraging HMOs and
managed care, and government health-insurance at the state level in
Massachusetts, Maine, Oregon. Government health-care has expanded until it is
now more than 50% of all health-care spending. Yet after sixty years of
government "reform," the problems with health-care are just getting worse. So
why should we believe that even more government is the solution?

2. President Obama keeps telling us that he's not trying to get rid of private
health insurance. But the bill being debated in Congress would require all new
insurance policies to be offered through a government-run exchange, in which the
rates that can be charged and the coverage that has to be provided will be
dictated by the government's so-called "Health Choices Commissioner."
Employer-provided health-insurance will fall under the same regulations in five
years. How is this insurance going to be "private" if the government controls
everything about it?

3. A video on YouTube shows Barack Obama back in 2003—only six years ago—saying
that he is in favor of a "single payer" system. The "single payer" is
government, so this means he was in favor of socialized medicine. And just a few
weeks ago, Barney Frank—one of the Democratic leaders in the House—said that he
considers the current bill a step toward "single payer." So when Obama and the
Democrats tell us this bill won't lead to a government takeover of health-care,
why should we believe them?

4. Medicare is broke. Social Security is broke. Federal tax receipts are
falling, and Congress has already voted on trillions of dollars of stimulus and
bailouts in the last year. The national credit card is maxed out. So how can you
justify voting for a bill that will require even more money that we don't have?

5. The health-care bill that is being discussed includes huge taxes on
businesses to force them to provide more health insurance for their employees,
as well as a whole set of mandates telling health insurance companies who they
have to cover and what they have to cover them for. This is an enormous increase
of costs for businesses and insurers. Have you considered how they're going to
pay for all of this, or whether they will even be able to pay for it? How many
of these companies will go out of business or lay off more workers after the
government forcibly increases their expenses?

6. One of the main demands of the health-care bill is that insurers are required
to cover people with "pre-existing conditions." That's like getting insurance on
your car after you crash it. It's just a way of getting someone to bail you out
for something that has already happened. This isn't insurance, it's a handout.
So doesn't that mean that the rest of us will have to pay more for our insurance
to absorb the cost of those handouts?

7. The health-care bill will mandate what costs insurance companies have to
cover. For example, they will have to pay for routine check-ups and physicals,
or they will have to provide every woman with maternity coverage. But what if
you don't want to pay for that extra coverage? Right now, if you're young and
healthy and don't need frequent check-ups, you can save money with a
high-deductible insurance that doesn't cover them. Or if you don't want
children, or already have children, you can save money by dropping the maternity
rider on your policy. By taking those choices away from us, won't this bill
actually make our insurance more expensive, not less?

8. A lot of people have been upset about Congress passing bills that they
haven't had time to read—and they haven't even finished writing the health-care
bill yet. But what I want to know is, with a bill this big and complex, have you
taken the time to read it and understand it? Can you really say that anyone has
had the time to figure out how all the parts will work together and what all of
the consequences will be? With a bill this big, is it even possible to figure
out all of that and really know what you're voting for?

9. President Obama and the Democratic leadership are making us a lot of promises
about what we will get and what we won't get from this health-care bill. But
what is or isn't in this one particular bill is not the end of the story. For
example, how many times has Medicare changed over the last forty years? As more
and more of us become dependent on the government for our health-care coverage,
won't we have to worry about what some future Congress or some future bureaucrat
will decide to cover or not cover?

10. The defenders of the health-care bill claim that it's going to lead to all
sorts of savings, not by actually cutting any services or denying care, but just
by finding "inefficiencies" that will save money. Do you think this is remotely
plausible? When has anybody ever said, "This project has to be lean and
efficient—let's get the government do it"?

11. One of the ways that has been proposed for government-provided health
insurance to save money is by substituting Medicare reimbursement rates for
market rates when paying doctors and hospitals. But many private hospitals and
medical practices have said that if they have to accept these lower rates, they
can't cover their expenses, and they will go out of business. So doesn't this
bill guarantee an immediate shortage of doctors and medical services?

12. Medicare cuts costs by paying lower rates to doctors and hospitals, who then
shift these costs to those of us with private health insurance, who get charged
higher rates. But if the government takes over and starts dictating Medicare
reimbursement rates for everyone, who will the costs get shifted to then?

13. When the government starting portraying people in the financial industry as
villains and started limiting their pay and subjecting them to more regulations,
banks reported a "brain drain" as smart and well-educated people left the
industry or went overseas looking for better pay and less stress. But the term
"brain drain" was originally coined in the 1960s when doctors and medical
researchers left Britain to escape socialized medicine. Aren't you afraid we
might see the same kind of brain drain from the medical profession here in
America?

14. Do you know the meaning and significance of the term "quality adjusted life
year"? (For this question, you will need the answer, which you can supply if
your congressman is forced to admit that he doesn't know it—preferable after
some stammering and a long, awkward pause. "Quality adjusted life year" is a
term used under socialized medicine to determine whether elderly patients are
allowed to get expensive drugs or treatments, depending on some bureaucrat's
calculation of how many good years they have left. You should ask your
congressman: Can you assure us that the same thing won't happen here?)

15. One of the proposals for how the government is going to save money is that
it's going to have a panel of medical experts who will dictate from Washington,
DC, what the proper medical practices are that should be paid for, and what
practices are supposedly "wasteful" and "unnecessary." Won't this mean
interfering with decisions that would normally be made by me and my doctor? And
won't this discourage innovation by requiring any new idea to get approved by a
board of establishment "experts" before a doctor can even try it out?

16. Government-run health-care is not some new, untested idea. In Britain, it
has led to a "postcode lottery," where the medical procedures you are allow to
get depend on where you live. In Canada, it has led to a shortage of doctors and
waiting lists for major surgeries. In America, Medicare ended up costing far,
far morethan anyone expected. Massachusetts and Maine spent enormous amounts of
money to extend government coverage to very few people. The Oregon Health Plan
may not cover your cancer treatment—but it will cover assisted suicide. Given
all of this experience, what makes you think that somehow this will be the
exception that will avoid all of the problems that government health-care has
always led to?

17. Why does "reform" always mean more government? Are you aware of proposals
that have been put forward for free-market reforms of health care? Congress has
already approved Health Savings Accounts, where individuals buy their own
high-deductible health insurance and save money tax-free, which they can use for
their out-of-pocket health-care expenses. This gives people more control over
their spending on routine medical treatments while keeping them covered for a
serious illness, and it allows them to keep their health insurance if they
change jobs. But this program has been limited in size. Are you open to ideas
like this, for free-market reform of health-care?

18. A lot of doctors say that medical malpractice insurance is what is really
driving up health-care costs. Doctors have to charge more to cover their
expenses, and they also have to practice "defensive medicine," ordering
unnecessary extra tests just to make sure they can defend themselves in court if
something goes wrong. So why isn't tort reform—for example, limiting excessive
jury awards in malpractice lawsuits—being considered as part of health-care
reform?

19. What part of your decision on this bill, if any, is affected by a
consideration for liberty, individual rights, and the Constitution? Would you
consider opposing this bill for no other reason than because it gives more power
to government at the expense of the freedom and property rights of private
businesses and individuals? Would you consider opposing it simply because it
grants powers to the government that are not authorized anywhere in the
Constitution?

20. Thomas Jefferson said, "A wise and frugal government which shall restrain
men from injuring one another, which shall leave them otherwise free to regulate
their own pursuits of industry and improvement, and shall not take from the
mouth of labor the bread it has earned. This is the sum of good government."

Notice what is not on his list: government-provided housing, or
government-provided food, or government-provided health care. And Jefferson's
views on the role of government were widely shared by America's Founding
Fathers.

So my question is: Please explain where you disagree with the vision of our
Founding Fathers, and why. "

--------------------------------------------------------------------------------\
---------------

Editor's Note: The op-ed above has been added to TIA's new health care page,
which gathers together all of my recent columns on health care. From this page,
you can get printable versions of the article, or you can e-mail them to a
friend.

Feel free to send them on to as many people as possible, particularly to your
elected representatives

http://www.intellectualactivist.com/php-bin/news/showArticle.php?id=1127

Contempt for the Governed

  by Robert Tracinski, editor www.TIADaily.com

"Faced with a full August of "Town Hall Hell," in which they would be forced to
face constituents angry over six months of bailouts, runaway spending, and an
attempt to socialize medicine, the Democrats have decided on their response: to
denounce their constituents as "angry mobs" and to do their best to avoid them.

Our political system is based on "the consent of the governed." This approach is
the opposite: contempt for the governed.

Some congressmen have decided to cancel their town hall appearances. Others are
filtering out the audiences, packing them with union members and other advocates
of socialized medicine, while keeping out anyone who might show signs of public
dissent.

TIA Daily reader Robert Fudge reports on his experience at an event in Tampa
which has gotten quite a bit of attention:

"I attended the Healthcare Reform Town Hall meeting held in Tampa, and as
predicted the meeting was rigged. This Town Hall meeting was sponsored by
Organizing for America (the successor of Obama for America) and the Service
Employees International Union (SEIU), with both congresswoman Betty Castor and
state representative Betty Reed in attendance.

Knowing there might be a lot of people in attendance, I made sure I was there an
hour before the start. When I arrived, there were approximately 75 people ahead
of me in line. The people around me were being very condescending, arrogant, and
vocal against anybody they identified as being pro-liberty.

"After about 15 minutes from when I arrived, a couple of ladies came out who had
badges that read 'Hillsborough County Democratic Party.' They proceeded to hand
pick people whom they knew, and directed them to a side door.

When I asked one of them if I could go in via this same route, all I got was a
vicious scowl. One lady within the line, who was very nasty, said that they are
letting the handicapped people in early, so I went up to a gentleman who had a
pro-liberty sign, and a cane, and directed him to the same side door.

He was rejected and sent back. Then the same lady told me that they are letting
the 'workers of the event' in.

"When the main doors opened for those of us in line, only about 50 people fit
into the Board Room. Clearly, their strategy was to hand-pick their audience.

They selected a small board room to hold their meeting to ensure they seated a
pro-government-healthcare audience, and made sure the opposition remained
outside to look like an 'angry mob.' But just like the Tea Parties, the crowd
was a well behaved, creative bunch.

"The lady was right when she said that the people let in early were 'working the
event'—they were working the event in their favor! I am sure the photos and
videos from inside will paint a picture of 'total support for Obamacare.' This
was absolutely despicable and adds more evidence of their not wanting any real
debate on the issue."

Backing up this assault on the voters is a vile smear campaign in the mainstream
media, of which the most extravagant example (as usual) comes from Paul Krugman
at the New York Times, who declares that opponents of socialized medicine are
all racists.

What evidence does he cite for this claim? Well, you'd just better read it for
yourself.

For the most part, the protesters appear to be genuinely angry. The question is,
what are they angry about?...

[T]hey're probably reacting less to what Mr. Obama is doing, or even to what
they've heard about what he's doing, than to who he is.
That is, the driving force behind the town hall mobs is probably the same
cultural and racial anxiety that's behind the "birther" movement, which denies
Mr. Obama's citizenship.

Senator Dick Durbin has suggested that the birthers and the health care
protesters are one and the same; we don't know how many of the protesters are
birthers, but it wouldn't be surprising if it's a substantial fraction.

So these are the standards that prevail at the New York Times: it's acceptable
to libel whole swathes of the population without a shred of evidence, based only
on what you feel might "probably" be the case.

If you look at the actual poll numbers, of course, you will discover that the
Democrats and their shills in the partisan press have declared war on a majority
of American voters.

What those polls show—vividly demonstrated in this graph—is a catastrophic loss
of public support for Obama's health-care plan in the last six weeks.

This was the period during which Obama introduced the plan and spoke endlessly
about it. Note that the beginning date on the graph is the day before Obama's
prime-time ABC News special "Prescription for America," in which he launched his
campaign.

In short, the more Obama and the Democrats talked about their health-care bill
and provided specific details, the more the people hated it.

These numbers show how absurd it is for the administration to claim that the
town hall rebellion of the past few weeks is "manufactured."

If that's the case, how come the left couldn't manufacture a similar uprising
two years ago? Before the 2007 August recess, MoveOn.org and other leftist
organizations loudly advertised that they were going to target vulnerable
congressmen at town hall meetings and with rallies in their home districts, in
order to push them to vote for a US withdrawal from Iraq. But the campaign never
materialized: the "surge" was beginning to show results, and there just wasn't a
big enough constituency for defeatism.

Peggy Noonan gets it dead right when she writes that "you can't get people to
leave their homes and go to a meeting with a congressman (of all people) unless
they are engaged to the point of passion…. People are not automatons. They show
up only if they care."

The idea that the health-care protest is "manufactured" is a giant act of
projection. The left is attributing its own motives and methods to its
opponents.

It is the Democrats, after all, who pack their town hall meetings with union
shills. And remember Barack Obama's famous history as a "community organizer"?
His job description was the very definition of "Astroturf."

A Columbia University graduate who grew up in Hawaii, he was hired to "organize"
communities in Chicago. He was an outside agitator brought in to stir up trouble
in neighborhoods where he had never lived and about which he knew nothing.

Noonan also names the essential issue when she says "The Democrats should not be
attacking, they should be attempting to persuade, to argue for their case."

That is the real meaning of "the consent of the governed."

It does not mean that a politician has to slavishly follow the latest poll
numbers. It is sometimes necessary for a leader to do something unpopular
because it is the right thing to do—and to hope that the voters will eventually
agree with him. But when a leader does this, he has to explain clearly why he is
doing it, he has to accept that his constituents are free to complain and
disagree, and he has to accept that they are the ones who are ultimately
entitled to judge his fitness for office.

In short, the principle of "the consent of the governed" means government by
persuasion, not by fiat.

But that's just the problem. Obama and the Democrats tried persuasion—but they
couldn't find any buyers for their arguments.

So now, like French aristocrats sneering at the dirty rabble gathered outside
their palaces, they are raining down contempt and abuse on their own
constituents.

I think this will go down as one of the all-time great political blunders.

There are thousands of people around the country who were never politically
active before—who will spend the time between now and November 2010 volunteering
and donating and actively campaigning to throw these arrogant rascals out of
office.

It is also a fatal mistake in the shorter term. Refusing to engage the public in
defense of their health-care proposal is a confession of weakness, an admission
that they can't win this argument on the merits and are losing the support of
the people.

The Democrats are now about to compound that error by walling themselves off in
their fake town-hall meetings and preaching to the converted.

If they won't talk to their constituents, you can. Talk to your friends, to
acquaintances, to people you meet on the street.

Organize health-care forums examining Obama's legislation. And don't just
organize to storm the newly fortified town halls. Organize to go door to door,
canvassing your neighbors.

Tell them why they shouldn't support Obamacare, answer the questions your
congressman won't answer, and tell them to call and write their congressmen.

Our leaders can ignore some of the people some of the time, but not all of the
people all of the time. Show them what "the consent of the governed" means, and
give them a taste of what will happen to them if they think they don't need it.

--------------------------------------------------

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fundamental ideas shape our culture and change the course of the world — those
who believe that the philosophical ideas we accept are a matter of life and
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This magazine is for those who agree that the job of a thinker is not to play
academic word games, but to address the crucial issues of human life: what kind
of government we should live under; what we should seek in art, in love, in
friendship; what standards we should uphold in our thinking; where our
civilization stands in history and in contrast to the rest of the world.

The Intellectual Activist examines and evaluates the ideas that influence the
whole spectrum of human action — from the immediate practical realities of
politics and economics — to the vision of human potential offered by art — to
the vast achievements of science and the threats of ignorance and superstition —
to the grand-scale drama and powerful lessons of history — to the way in which
basic ideas filter down to the smallest details of our lives, to our habits, our
pastimes, our entertainment.

This magazine is for those who want to change the world, not through mindless
street protests, but by changing the ideas that shape our lives. It is for those
who want to be activists, not just in politics, but in the realm of the
intellect.

The War on Health Insurance
by Robert Tracinski, editor, www.TIADaily.com

"The goal of the Democrats' plan for health-care reform is coming more and more
out into the open: they want to eliminate health insurance.

Barney Frank has been caught on video admitting that the "public option," which
is the centerpiece of the current legislation, is just a step toward what is
called a "single-payer" system—a euphemism meant to hide the fact that the
single payer is the government.

(Frank was prompted into the admission by an advocate of "single payer" who
opposes the current bill because it doesn't socialize medicine fast enough—which
gives you an idea of the contrary pressures on the Democratic leadership.)

It turns out that this is the key kernel of opposition to the Obama health-care
bill among the general public. People do not want to be forced out of their
existing private health insurance. They are terrified of being deprived of any
options other than government-provided health care.

So the Democrats' answer to this has been, not to reassure people that they will
be allowed to keep their existing coverage—since this lie has proven too
transparent to maintain—but instead to vilify the health-insurance companies.

As the article below describes, this is the line of attack the Democrats have
chosen as they go into the August recess: private health-insurance companies are
evil, and the Democrats are here to save us from them.

You can see this reflected among the left's supporters in the press, as in a
sneering hatchet job in the LA Times, in which insurance companies are accused
of—well, it's not all that clear what they're accused of, except maybe being
"functional monopolies."

That's pretty rich when you consider that the left's preferred plan would
mandate a "single payer"— the very definition of a monopoly.

One of the benefits we have, of course, is that the Democrats themselves are in
some degree of internal disarray. They gained a majority in Congress by
recruiting a large number of conservative Democrats from "red state" districts,
and this has set off a clash between the leftists and the "Blue Dogs."

But don't be fooled. Note that most of the proposals preferred by the Blue Dogs
are just less direct attacks on health insurance. For example, two of the main
regulations the Democrats are seeking to impose on insurers are that they will
be forced to cover individuals for pre-existing conditions, and that they will
be banned from charging higher rates for those at a higher risk of illness.

This is an attack on the whole idea of insurance as such. It's like forcing
companies to offer you insurance on your automobile after you've already gotten
into an accident, or requiring them to offer the same auto insurance rate to a
teenage boy as to a middle-aged woman with a spotless driving record. That's a
fast way to make an insurance company go broke.

These provisions also clearly indicate why the Democrats oppose health
insurance. Insurance is a capitalist model based on the idea that people are
independent individuals who should be expected—and allowed—to pay their own way.
The left's model, by contrast, is welfare, in which everyone is taxed to pay for
benefits that are doled out equally by the government, from each according to
his ability and to each according to his need. It is a collectivist model.

The essence of the current legislative crusade is to force insurance companies
to act as if they are government welfare agencies—and then when the insurance
companies collapse, the government will drop the pretense and have the welfare
agencies take over. It is a war on health insurance—and a war on the independent
individual.

"Two Sides Take Health Care Debate Outside Washington," Sheryl Gay Stolberg and
David M. Herszenhorn, New York Times, August 2

With Republicans mobilizing against the proposed health care overhaul, President
Obama, Congressional Democrats and leading advocacy groups are laying the
groundwork for an August offensive against the insurance industry as part of a
coordinated campaign to sell the public on the need for reform.

The effort will feature town-hall-style meetings by lawmakers and the president,
including a swing through Western states by Mr. Obama, grass-roots lobbying
efforts and a blitz of expensive television advertising. It is intended to drive
home the message that revamping the health care system will protect consumers by
ending unpopular insurance industry practices, like refusing patients with
pre-existing conditions.

"I think what we want to communicate is that this is going to give people who
have insurance a degree of security and stability, the protection that they
don't have today against the sort of mercurial judgments of insurance
bureaucrats," said David Axelrod, a senior adviser to Mr. Obama, adding, "Our
job is to help folks understand how this will help them."…

Revamping health care is the president's top legislative priority, and people on
all sides of the debate agree that August, when lawmakers leave Washington to
take the pulse of constituents, will be crucial to shaping public opinion. With
Republicans making headway by casting the legislation as a costly government
takeover, Democrats have decided they must answer the question on the minds of
those now insured: "What's in it for me?"

That has led to a campaign of increasingly harsh rhetoric against the insurance
industry, which says it favors an overhaul but is working to defeat Mr. Obama's
call for a government-run insurance plan to compete against the private sector.
On Friday, Speaker Nancy Pelosi, Democrat of California, promised a "drumbeat
across America" to counter what she termed a "shock and awe, carpet-bombing by
the health insurance industry to perpetuate the status quo."…

The current message is an eight-point list of "Health Insurance Consumer
Protections" the White House Web site promises will "bring you and your family
peace of mind." Mr. Obama picked up on the theme last week, promising members of
AARP that he would "reform the insurance companies so they can't take advantage
of you."…

Polls show that the public is growing uneasy; a New York Times/CBS News survey
last week found that while Mr. Obama still has strong support for revamping
health care, Americans are concerned that an overhaul would reduce the quality
of care, increase out-of-pocket costs and tax bills and limit their options in
choosing doctors.

For more info about TIADaily, go to:

www.TIADaily.com

"Mayo Clinic Calls House Plan Bad Medcine

Obama loses support on reform

Christina Bellantoni and Jennifer Haberkorn, Washington Times, July 21

Minnesota's not-for-profit Mayo Clinic, which Mr. Obama has repeatedly hailed as
offering top quality care at affordable costs, blasted the House Democrats'
version of the health care plan as lawmakers continue to grapple with several
bills from each chamber and multiple committees.

The Mayo Clinic said there are some positive elements of the bill, but overall
"the proposed legislation misses the opportunity to help create higher quality,
more affordable health care for patients."

"In fact, it will do the opposite," clinic officials said, because the proposals
aren't patient-focused or results-oriented. "The real losers will be the
citizens of the United States."…

White House aides did not have a response to the criticism from the Mayo Clinic,
which Republicans exploited. Sen. John McCain, Arizona Republican, used his
Twitter feed to spread the Mayo Clinic statement, adding: "They are right."

An ABC News/Washington Post poll showed that Mr. Obama's approval rate on how
he's handling health care has slipped below 50 percent for the first time. The
president's overall popularity has dipped just slightly.

http://www.washingtontimes.com/news/2009/jul/21/mayo-clinic-calls-house-plan-bad\
-medicine/?feat=home_cube_position1

Obama Frets that Sinking Obamacare Will Destroy His Presidency

Below is an excerpt from www.TIADaily.com:

"You're Going to Destroy My Presidency"

Barack Obama worries that if Republicans and moderate Democrats block his
health-care bill, "You're going to destroy my presidency."

Yes, we can.

********************************************************************

"I linked a few days ago to an Investor's Business Daily editorial revealing
that the House health-care bill would ban new individual private
health-insurance policies. See also the Wall Street Journal on another important
aspect of this issue. If you have employer-provided health insurance, your
coverage is on the chopping block, too.

The Democrats are now trying to claim that this isn't true, and California
Representative Henry Waxman sent a letter to IBD which is unintentionally
revealing. It says that private insurers can write new policies under the
bill—so long as they sell them through a government "exchange" which requires
that those policies meet a whole list of conditions dictated by the government.

My favorite is this one: "Insurers…will be prevented from…charging different
premiums based on an individual's need for health care." Does Rep. Waxman even
know what insurance is?

IBD has a reply which makes the real nature of this "exchange" clear:


But the exchange will not be a private market…. The exchange will be a highly
regulated clearinghouse of providers that meet the government's standards.

Only those providers that follow Washington's stringent guidelines will be
allowed to join this exclusive club.

The government, through an unelected health choices commissioner, will set
premiums, dictate benefits, determine deductibles, and establish coverage.

Exchange participants will be required to insure anyone who asks to be covered
and to accept all renewals. Ryan believes the weight of the mandates will mean
only five or six providers will be able to survive and sell coverage in the
exchange.

In other words, private insurance companies will be offered the privilege of
administering health-insurance policies whose terms are written by government
bureaucrats.

So we get socialized medicine either way. The only "choice" we have is between
two different variations of socialist economics: communism and fascism. The
health insurance plans offered through the exchange are based on the fascist
economic model: they are nominally private, but every aspect of them is actually
dictated by government.

The "public option" is the economics of communism: the pretense of private
ownership has been dropped, and everything is openly owned and run by
government.

This is why Obama has to push through his bills so quickly. If he lets us read
them and examine them, we might have time to figure out what the bill actually
does.

And we also might find out that even he hasn't read the bill and doesn't know
what's in it.

The other reason Obama needs to move fast is to prevent the political opposition
from discovering effective counterarguments and building up political momentum
against his legislation.

But he may already be too late.

One of the lines of argument the right has been using is to point out that
smaller versions of Obama's plan have already been tried on the state level—in
Maine, in Massachusetts, and elsewhere—and have failed to meet any of the
promises made for them.

--------------------------------------------------------------------

For an important analysis of the causes and consequences of the failed
Massachusetss "universal health care experiment" - which set up state-regulated
insurance purchasing exchange identical to the one Obama proposes on a
*national* level-  see this important article:

Mandatory Health Insurance: Wrong for Massachusetts, Wrong for America

http://www.theobjectivestandard.com/issues/2008-fall/mandatory-health-insurance.\
asp

-----------------------------------------------------------------

See for example an op-ed on Tennessee's attempt to overhaul Medicaid along the
lines envisioned by Obama:

In 1994 Tennessee implemented managed care in its Medicaid program, creating a
system known as TennCare. The objective was to use the anticipated savings from
Medicaid to fund and expand coverage for children and the uninsured. The result
was a program that nearly bankrupted the state, reduced the quality of care, and
collapsed under its own weight.

And it turns out that the revered Mayo Clinic has even turned against Obama's
health-care plan. See the article linked to and excerpted below, and also this
one.

The result is that Obama's poll numbers are beginning to slide—quickly. ABC News
has an overview of the latest numbers:


Barely over half, 52 percent, now approve of [Obama's] work on the economy, down
8 points from its peak. Just under half, 49 percent, approve of his handling of
health care, also down 8. And fewer, 43 percent, approve of his handling of the
deficit, with 49 percent disapproving—only the second issue on which more have
disapproved than approved of Obama's work. (The first was the automaker
bailout.)
Intensity is running against the president on these issues as well.

For the first time more people "strongly" disapprove of his work on the economy
than strongly approve, 35 percent vs. 29 percent.

Ditto on health care, 33 percent vs. 25 percent. And on the deficit, strong
disapprovers now outnumber strong approvers by 2-1, 38 percent vs. 19 percent.

The only issues on which Obama still shows strong approval ratings are in
foreign policy—that is, issues that neither the public nor the administration is
paying much attention to.

Gallup reports that in their poll, Obama's approval is moving below 50% on
health care specifically, with more people disapproving than approving.


[T]he latest USA Today/Gallup poll finds that more Americans disapprove (50%)
than approve (44%) of the way US President Barack Obama is handling healthcare
policy…. Obama's marks on healthcare are among the lowest of seven issues tested
in the July 17-19 poll, better than only his rating for handling the federal
budget deficit.

Notice how the budget deficit keeps popping up as the real disaster in Obama's
poll numbers? And what caused the deficit to yawn open and swallow the economy?
Obama's "stimulus" plan, a piece of legislation so unpopular that Republicans
are now trying to exploit the issue by calling for a rollback of unspent
stimulus money.

I have pointed for a while to the paradox that Obama has enjoyed high approval
ratings even though the public generally does not support his policies.

I think the reason is obvious. Americans voted for Obama because they wanted to
put racism behind them by voting the first black president into office. But as
for socialized medicine—they're not so enthusiastic. So the gap between Obama's
popularity and the unpopularity of his agenda is about to come crashing down.

This will have cascading political effects.

If Obama doesn't cram the legislation through before the August recess, it will
probably fail.

Someone from a local pro-free-market group e-mailed me a link to a YouTube video
of a Democratic congressman being booed and heckled when he claimed that the
health-care bill would actually save money. The subject line: "Note to Congress:
Here's a preview of your August recess!"

And there's another factor lurking in the background. According to a recent
article in the New York Times, Washington lobbyists have so far been kowtowing
to the administration on the principle (or anti-principle) that "if you're not
at the table, you're on the menu."


Industry groups and lobbyists typically hostile to intrusive government programs
have been professing solidarity with Mr. Obama and his agenda on matters like
health care, energy and financial regulation.

Industry has calculated that it stands a better chance of achieving its ends by
negotiating with the White House than by fighting it—at least publicly, and at
least until the various proposals get down to the final details.

This means that when Obama no longer seems untouchable and his agenda no longer
seems inevitable, the lobbyists will begin to turn against him.

It's no wonder Obama is beginning to panic. The National Journal reports on a
rumored admission by the president of the do-or-die stakes involved.


A telling episode recounted by Senate Finance ranking member Charles Grassley
reveals the Obama administration might be more worried than they are letting on
that a Republican senator's comparison of the healthcare overhaul to Waterloo
might be dangerously close to the truth.

Grassley said he spoke with a Democratic House member last week who shared
Obama's bleak reaction during a private meeting to reports that some factions of
House Democrats were lining up to stall or even take down the overhaul unless
leaders made major changes.

"Let's just lay everything on the table," Grassley said. "A Democrat congressman
last week told me after a conversation with the president that the president had
trouble in the House of Representatives, and it wasn't going to pass if there
weren't some changes made...and the president says, 'You're going to destroy my
presidency.'"

To which our answer should be: yes, we can.

********************************************************************

"Mayo Clinic Calls House Plan Bad Medicine," Christina Bellantoni and Jennifer
Haberkorn, Washington Times, July 21

Minnesota's not-for-profit Mayo Clinic, which Mr. Obama has repeatedly hailed as
offering top quality care at affordable costs, blasted the House Democrats'
version of the health care plan as lawmakers continue to grapple with several
bills from each chamber and multiple committees.

The Mayo Clinic said there are some positive elements of the bill, but overall
"the proposed legislation misses the opportunity to help create higher quality,
more affordable health care for patients."

"In fact, it will do the opposite," clinic officials said, because the proposals
aren't patient-focused or results-oriented. "The real losers will be the
citizens of the United States."…

White House aides did not have a response to the criticism from the Mayo Clinic,
which Republicans exploited. Sen. John McCain, Arizona Republican, used his
Twitter feed to spread the Mayo Clinic statement, adding: "They are right."

An ABC News/Washington Post poll showed that Mr. Obama's approval rate on how
he's handling health care has slipped below 50 percent for the first time. The
president's overall popularity has dipped just slightly.

*****************************************************************

What is TIADaily.com?

http://www.intellectualactivist.com/about.html

"This magazine is for those who take ideas seriously — those who realize that
fundamental ideas shape our culture and change the course of the world — those
who believe that the philosophical ideas we accept are a matter of life and
death.

This magazine is for those who agree that the job of a thinker is not to play
academic word games, but to address the crucial issues of human life: what kind
of government we should live under; what we should seek in art, in love, in
friendship; what standards we should uphold in our thinking; where our
civilization stands in history and in contrast to the rest of the world.

The Intellectual Activist examines and evaluates the ideas that influence the
whole spectrum of human action — from the immediate practical realities of
politics and economics — to the vision of human potential offered by art — to
the vast achievements of science and the threats of ignorance and superstition —
to the grand-scale drama and powerful lessons of history — to the way in which
basic ideas filter down to the smallest details of our lives, to our habits, our
pastimes, our entertainment.

This magazine is for those who want to change the world, not through mindless
street protests, but by changing the ideas that shape our lives. It is for those
who want to be activists, not just in politics, but in the realm of the
intellect."

Subscription information:
http://www.intellectualactivist.com/php-bin/ecomm4/categories.php

The New Third Rail:  They Touch it- We Die

Save Individual Private Health Insurance

by Robert Tracinski, editor www.TIADaily.com

"President Obama is pushing hard to get his health care bill up for a vote in
the next few weeks. The trademark tactic of this administration is speed.

They try to achieve their agenda by ramming legislation through Congress as fast
as possible—too fast for opponents to subject the bills to scrutiny, search for
objectionable provisions, or develop effective counter-arguments in a public
debate.

Heck, Obama and his allies in Congress push through the bills so fast that
congressmen and administration officials themselves don't even have time to read
the damned things.

If we're able to block his health care bill, it will be because we actually got
a little bit of time to read it. The folks at Investor's Business Daily did just
that, and what they found right away is that Obama's bill would outlaw
individual private health insurance.

It was already known that the so-called "public option" for health insurance was
an attempt to "crowd out" private health insurance by luring people into
government-subsidized insurance, but the plan to kill private health insurance
is actually much more direct: the bill bans insurance companies from writing new
individual policies.

Government-provided health insurance turns out not to be an "option": it's
mandatory.

Killing private health insurance is the only way the left can achieve its dream
of a government-run health-care system. They have to do it, because
government-provided health coverage, even if it is subsidized, cannot actually
compete with private insurance.

Government-provided care always leads to cost-cutting—isn't that the whole
stated purpose of health-care reform, to cut costs?—which always means rationing
the amount and kind of care we will be provided.

Given that risk, many people would refuse to go onto the government program and
cling to their individual private plans instead. And this makes it harder for
the bureaucrats to impose rationing on government-funded care, because they know
patients in the government program will compare the quality of their care to
what is available from private plans.

Private health insurance sets a kind of gold standard for the quality of care
people expect—and that's a standard government-run health care has never met and
can never meet.

All of the relentless propaganda about how "our health care system is broken" is
an attempt to blind us to this fact. It is supposed to make us think that we are
not getting the best care in the world, when we are.

I know, because my family has been a pretty significant user of medical care in
the past few years. Two years ago, our first child was born, and we now have a
second child on the way. In between, my wife was in a semi-serious car accident.
So we've spent our share of time in hospitals and examination rooms recently,
and I cannot adequately express my gratitude for the quality of care we have
received.

Three experiences stand out.

When my first son, Walter, was born, one of the pediatricians noticed that his
heart was making a slight noise, so he sent us up for a consultation with a
pediatric cardiologist. I have a decent knowledge of science, and I have a few
friends who are doctors and engineers, so I consider myself a decent judge of
experts.

It's not too difficult to tell when you're dealing with a physician who really
knows what he's talking about and is able to answer your questions clearly and
thoroughly.

I was very impressed with this cardiologist, who performed an echocardiogram (a
high-precision ultrasound imaging of the heart) and explained that what the
pediatrician heard was actually a normal sound—what he called the singing of the
"heart strings" that connect opposite walls of the ventricles.

It was a thorough cardiac workup that relieved all of our anxieties—with no need
to get on a waiting list or ask anyone's permission or go through some arcane
cost-benefit analysis.

After Sherri's car accident, she experienced some vision problems. Since she is
very near-sighted, she is at heightened risk for retinal detachment, and she was
afraid that the impact of the collision—she was rear-ended by a truck going
about 60 miles per hour—could have broken her retina loose. So again we searched
around for the best expert we could find, a very impressive retina specialist,
who did a very thorough check.

More recently, we went in for an ultrasound on the new baby. If you think an
ultrasound is just about getting a grainy image of the fetus, you haven't seen
one lately.

In this ultrasound, our physician looked at the development of the baby's
internal organs and the brain (I could clearly see the cerebellum). Using
Doppler ultrasound, which is able to track the direction and rate of motion, he
looked at the blood flow through the baby's heart. And he performed a whole
other series of measurements (the length of the femur, the circumference of the
skull, etc.) which are markers for potential birth defects. It was a thorough
physical check-up—way more thorough than anything I've ever had—performed long
before the baby is born.

All of this offered us the reassurance that we have another healthy child on the
way. This is not something we take for granted. My wife and I waited a long time
to have children, and with age, the risk of complications increases. So it is an
enormous benefit for us to be able to check thoroughly and be sure.

Now notice that all of these examples are, fortunately, about medical problems
that did not exist. Which makes them precisely the kind of tests that would be
very easy for bean-counting bureaucrats to deny on the grounds that they are not
cost-effective. Not cost-effective, that is, for the government.

But I didn't have to worry about what was cost-effective for the government. I
only had to think about what was cost-effective for me.

I was able to make the choice based on what my insurance would cover and—since I
have a Health Savings Account, one of the few pro-free-market health-care
reforms Congress has managed to pass—what I could afford to pay in deductibles
and premiums.

My experience with the "health care system"—i.e., with my own doctors and
nurses—has been a dream. I am not wealthy by any means (I am a self-employed
writer, which should say just about everything right there), and I have no
special connections or "pull." Yet I have had no difficulty making sure that my
family receives top-quality care.

The key is that we are in control.

We are able to shop around for the best doctors and the best insurance coverage,
and we are able to decide if we want to spend, say, $1500 on an ultrasound or
amniocentesis in order to avoid greater costs (or more tragic consequences)
later on.

This system works at allowing me to protect myself and my loved ones. And that's
why I am terrified that Barack Obama wants to smash it all to pieces.

A few days ago, I got an e-mail from Vern Hodgins, a long-time subscriber in
Canada, who recounted a very opposite experience with Canada's health-care
system.

Read this carefully, because if Obama gets his way, the happy story I told above
is not the future.

This is:

"My wife and I relocated to a new community. For my wife, that meant finding a
new doctor, which became a six-year wait. During that time, she had to do with a
local outpatient clinic, which rotates its medical staff.

It is rare to see the same doctor twice, which renders continuity feeble at
best. As well, the rules do not allow rotation doctors to provide full physical
examinations; only a family physician may do that.

"While waiting in line for a family doctor, my wife became ill. Typically, a
patient gets about ten minutes with a community clinic doctor, which for my wife
meant cursory examinations and referrals to physiotherapists and chiropractors.

"My wife's condition worsened and we could not do anything about it. Finally,
the government granted her a family doctor. That doctor also gave her a cursory
exam, diagnosed her ailment as a sports injury, and referred her to more physio
and chiropractic treatment. Her condition worsened still, and still her doctor
insisted it was a sports injury.

"Fed up with my dear wife whimpering her nights away in pain, I visited her
doctor. The doctor's receptionist rudely rebuffed me, saying my wife had to wait
in line just like everyone else because despite what I thought, she was no more
or less special than anyone else.

"The next morning I described my wife's condition to a work colleague who is a
doctor. Having never met my wife, and with only my description, that doctor told
me to get my wife into a hospital immediately because she was certain it was a
metastasized cancer.

"Sure enough, as soon as the hospital emergency staff saw my wife, they knew; it
was advanced non-Hodgkin lymphoma, which had dissolved some of her collarbone.
My wife had to be told her prognosis was not good, that she had to prepare for
the worst.

Fortunately for me, my doctor colleague, a high profile media individual, used
her influence to get my wife the best specialists in the country—which, yes,
meant that my wife is somewhat more special after all.

She survived. She endured the most aggressive treatment regimen there is, and
though she's left with considerable damage from the radiation, she's alive.

"The incompetent family doctor, who misdiagnosed, suffered no consequence. As
well, my wife must keep the same family doctor unless she wishes to wait another
six years or so.

"That's socialized medicine. Worse still, one may not openly criticize our
system without being told to move to America if we don't like the world's finest
socialized medical system.

Criticizing our system is tantamount to being a global warming 'denier.' The
propaganda is that effective."

Anyone can have a family doctor who makes a wrong diagnosis—but in America,
you're not stuck with him.

I'm a fan of the TV show "Mystery Diagnosis," which tells the real stories of
people with very rare medical conditions who spend years trying to get a proper
diagnosis and treatment.

One of the things these patients talk about is how you have to "be your own
advocate," and most of the cases are solved when the patient himself searches
for information on the Internet, finds a specialist who is an expert in the
disease, and seeks out that physician's advice.

But how can you be your own advocate under socialized medicine?

It is outlawed, because you are no longer in control of your own health care.

You have no freedom to choose a physician, or to seek out a specialist on your
own, or to decide what medical tests you will pay for.

Mr. Hodgins concludes his story by saying, "In Canada, the patient is not a
client; deference goes to the doctor." I don't think that's quite accurate,
because I've known a few doctors who had to work under the Canadian system, and
it's no treat for them, either—not for the decent ones.

In Canada's system, deference doesn't go to the doctor. It goes to the state.
Care is denied in order to cut costs and save trouble for the government.

The Democrats' attempt to eliminate individual private health insurance,
combined with the enormous, multi-trillion-dollar price tag of their health-care
bill, tells us that this is what they want for America, too.

The purpose of this bill is not to save money or provide better care or—try not
to laugh—provide "health choices." Its purpose is to make us dependent on the
government for the most important needs of our lives.

For the political leaders on the left, the purpose of socialized medicine is
control: they want us to turn to them as the saviors we have to supplicate for
every need in life.

<< An example of government breaking your legs, giving you a crutch and
announcing:  " See? You would't be able to walk without the government!" >>

For the political supporters on the left, the motive for socialized medicine is
envy: the want everyone held to the same equal standard, even if it is an
equally low standard, so that no one will be allowed to think that he is
"special" and has a right to seek out better care.

What we need, and we need it urgently, is a political rebellion in favor of
independence, which is the only real guarantee of our security and happiness.

And to preserve our independence from government, we need to send the message
that any legislation that even remotely threatens individual private health
insurance is a red line that politicians dare not cross.

President Obama is already frightened of this issue. Late last week he tried to
defuse it by responding that "If we don't get health care reform done now, then
no one's health insurance is going to be secure."

In effect, he's telling us that he has to destroy our health insurance in order
to save it. I don't think anyone's going to find that very convincing.

For years, Social Security has been the "third rail of American politics"— an
analogy to the electrified extra rail on commuter train lines.

The rule has been "touch it and you die": any reform that even threatens to
scale back Social Security has (supposedly) caused the political demise of the
person who attempts it.

I think we should create a new third rail in American politics: individual
private health insurance.

If we can block Obama's health-care bill— causing Barack Obama to fail on one of
the central goals of his presidency— then we will send the message: leave our
health insurance alone. Touch it and you die.

That's a harsh rule for politicians, but it reflects the harsh fact that if they
touch it, we die.

www.TIADaily.com

"The Forgotten Man of Socialized Medicine"-and us
by Debi Ghate

During a meeting today, my colleagues and I were discussing the frightening
prospect that socialied medicine is right around the corner:

http://tinyurl.com/kvtrvv

Obama-care is not being opposed on any principled grounds - the only real
dispute appears to be over the details, such as its projected cost.

So if you are counting on somebody, like the Republicans, stepping in to rescue
us from this impending disaster, think again.

I emigrated from Canada some time ago and at that point, one of the significant
differences between the two countries was their respective approaches to health
care.

A relatively free market in health insurance and health care rather than a
monolithic government-managed system? Terrific! You mean I'm not stuck on a long
waiting list in order to see whichever doctors the government allows people in
my geographic area to see?  Wonderful!

Should President Obama succeed in implementing "health care reforms," those last
remaining advantages of the American health care system will disappear. That
would be disastrous for all of us, but it would be especially devastating for
the medical profession.

In Ayn Rand's Atlas Shrugged, there's a minor character, a brain surgeon named
Dr. Hendricks, who refused to practice under a socialized medicine. This excerpt
(reprinted in " For the New Intellectual") explains why Dr. Hendricks decided to
shrug:

"I quit when medicine was placed under State control some years ago," said Dr.
Hendricks.

"Do you know what it takes to perform a brain operation? Do you know the kind of
skill it demands, and the years of passionate, merciless, excruciating devotion
that go to acquire that skill?

That was what I could not place at the disposal of men whose sole qualification
to rule me was their capacity to spout the fraudulent generalities that got them
elected to the privilege of enforcing their wishes at the point of a gun.

I would not let them dictate the purpose for which my years of study had been
spent, or the conditions of my work, or my choice of patients, or the amount of
my reward. I observed that in all the discussions that preceded the enslavement
of medicine, men discussed everything-except the desires of the doctors.

Men considered only the 'welfare' of the patients, with no thought for those who
were to provide it. That a doctor should have any right, desire or choice in the
matter, was regarded as irrelevant selfishness; his is not to choose, they said,
but 'to serve.'

That a man's willing to work under compulsion is too dangerous a brute to
entrust with a job in the stockyards-never occurred to those who proposed to
help the sick by making life impossible for the healthy.

I have often wondered at the smugness at which people assert their right to
enslave me, to control my work, to force my will, to violate my conscience, to
stifle my mind-yet what is it they expect to depend on, when they lie on an
operating table under my hands?

Their moral code has taught them to believe that it is safe to rely on the
virtue of their victims. Well, that is the virtue I have withdrawn.

Let them discover the kind of doctors that their system will now produce.

Let them discover, in the operating rooms and hospital wards, that it is not
safe to place their lives in the hands of a man they have throttled. It is not
safe, if he is the sort of man who resents it-and still less safe, if he is the
sort who doesn't."

Instead of bickering about the price tag of Obama-care, it's time to fight the
battle against socialized medicine on moral grounds:

http://tinyurl.com/cvf8za

It's time for doctors to defend their moral right to practice medicine free from
government interference. And it's time for their patients to defend their moral
right to purchase health-care on a free market.

http://tinyurl.com/mc7376

1,000 Pages and a Whole Lot of Money

A Look at the House's "America's Affordable Health Choice Act"

The below video parses the Orwellian double-speak in Obama's health care
promises and the disasterous economic and personal consequences of  the
*massive*  government power-grab being proposed in the form of   "America's
Affordable Health Choice Act".

Tune in to see what  our "freedom-loving"  politicians are gearing up to ram
down your thoat.

http://www.pjtv.com/v/2168

Quality Adjusted Life Year

by Rober Tracinski, editor www.TIADaily.com

"When the government takes over health care and bans private health insurance,
what can we expect? We can expect rationing of medical care.

In fact, in the New York Times article below, leftist utilitarian philosopher
Peter Singer openly advocates rationing. He does it by arguing that health care
is already "rationed" in the free market, it is just "rationing by price."

This is an inexcusable abuse of the language. "Rationing by price" is a
contradiction in terms, because prices are the opposite of rationing.

The essence of a price is voluntary exchange. A price is the result of a
negotiation between a willing buyer and a willing seller, with each party acting
on his own judgment about his best interests.

So if you decide to pay lower premiums for less extensive insurance coverage, or
to forgo an extremely expensive treatment that will only extend your life by a
few months, so that you can leave more of your savings to your loved ones, these
vital decisions are under your control and are directed according to your
judgment of the risks and of the relative values involved.

You are never denied care-if you are actually willing to do what is necessary to
obtain it.

Prices are implicitly based on an ethics of individualism-the idea that it is
the individual's right to make his own decisions and his responsibility to
support himself.

Rationing, by contrast, is an artificial shortage created by coercion.

It consists of the government telling you that you cannot have certain kinds of
medical care because some board of bureaucrats has decided that it is not
"cost-effective."

Rationing is implicitly-and explicitly-based on an ethics of collectivism.

I don't recommend reading the whole article below, because reading a
contemporary philosopher is like sticking your head in a cotton candy machine.
But if you do choose to read it, you may notice that it never looks at medical
care from the perspective of the individual making rational decisions about
costs and benefits for his own life.

It always implicitly looks at health care from a collectivist perspective: the
perspective of bureaucrats making decisions about the cost of your medical care
"to society."

The term that sums up this collectivist outlook is the "quality adjusted life
year"-the pseudo-mathematical term for a government bureaucrat's decision
concerning whether your life is worth continuing or not, based upon your age,
your prognosis, and some bureaucratic formula that quantifies your "quality of
life."

"Quality adjusted life year" is the term that tells you that the most profound
decisions concerning your own life have been taken out of your hands. Get ready
to hear it a lot- and to live and die by it- if Obama and the Democratic leaders
in Congress get their way.


"Why We Must Ration Health Care," Peter Singer, New York Times, July 15

http://tinyurl.com/ox7g6k

"You have advanced kidney cancer. It will kill you, probably in the next year or
two. A drug called Sutent slows the spread of the cancer and may give you an
extra six months, but at a cost of $54,000. Is a few more months worth that
much?
If you can afford it, you probably would pay that much, or more, to live longer,
even if your quality of life wasn't going to be good. But suppose it's not you
with the cancer but a stranger covered by your health-insurance fund. If the
insurer provides this man-and everyone else like him-with Sutent, your premiums
will increase.

Do you still think the drug is a good value? Suppose the treatment cost a
million dollars. Would it be worth it then? Ten million? Is there any limit to
how much you would want your insurer to pay for a drug that adds six months to
someone's life?

If there is any point at which you say, "No, an extra six months isn't worth
that much," then you think that health care should be rationed.

In the current US debate over health care reform, "rationing" has become a dirty
word….

Health care is a scarce resource, and all scarce resources are rationed in one
way or another. In the United States, most health care is privately financed,
and so most rationing is by price: you get what you, or your employer, can
afford to insure you for.

But our current system of employer-financed health insurance exists only because
the federal government encouraged it by making the premiums tax deductible. That
is, in effect, a more than $200 billion government subsidy for health care. In
the public sector, primarily Medicare, Medicaid and hospital emergency rooms,
health care is rationed by long waits, high patient copayment requirements, low
payments to doctors that discourage some from serving public patients and limits
on payments to hospitals.

The case for explicit health care rationing in the United States starts with the
difficulty of thinking of any other way in which we can continue to provide
adequate health care to people on Medicaid and Medicare, let alone extend
coverage to those who do not now have it. Health-insurance premiums have more
than doubled in a decade, rising four times faster than wages.

In May, Medicare's trustees warned that the program's biggest fund is heading
for insolvency in just eight years. Health care now absorbs about one dollar in
every six the nation spends, a figure that far exceeds the share spent by any
other nation….

Rationing health care means getting value for the billions we are spending by
setting limits on which treatments should be paid for from the public purse. If
we ration we won't be writing blank checks to pharmaceutical companies for their
patented drugs, nor paying for whatever procedures doctors choose to recommend.
When public funds subsidize health care or provide it directly, it is crazy not
to try to get value for money.

The debate over health care reform in the United States should start from the
premise that some form of health care rationing is both inescapable and
desirable. Then we can ask, What is the best way to do it?...

This is the basis of the quality-adjusted life-year, or QALY, a unit designed to
enable us to compare the benefits achieved by different forms of health care.

The QALY has been used by economists working in health care for more than 30
years to compare the cost-effectiveness of a wide variety of medical procedures
and, in some countries, as part of the process of deciding which medical
treatments will be paid for with public money.

If a reformed US health care system explicitly accepted rationing, as I have
argued it should, QALYs could play a similar role in the US...

www.TIADaily.com

Private Medical Insurance  Is  "NOT"  An Option

....at least according to the House bill.....

It didn't take long to run into an "uh-oh" moment when reading the House's
"health care for all Americans" bill. Right there on Page 16 is a provision
making individual private medical insurance illegal.

http://www.ibdeditorials.com/IBDArticles.aspx?id=332548165656854

------------------------------------------------------------------

This latest bill includes:

* A new government health insurance plan.

* An individual mandate that every one of us must purchase government-defined
health insurance or face new taxes and fines. This is a clear breaking of the
president's pledge not to raise taxes on Americans earning less than $250,000
per year – at least 8 million Americans and their families will see their taxes
go up.

* An employer mandate that will make businesses either provide
government-defined insurance coverage or pay a penalty tax.

* Another income tax on households and many small businesses with an annual
income of $350,000 to help pay for all this. This is another broken campaign
promise.  The president had pledged not to increase any American's taxes above
the level of the 1990s – and that is just what would happen.

* The government will decide what is an "adequate" health insurance package A
new bureaucracy – the Benefits Advisory Committee – and the Secretary of Health
and Human Services will decide what coverage you have to pay for and what
diseases and treatments will be covered.

* Another bailout that will cost taxpayers tens of billions of dollars – this
time to unions to bail out their retiree health care plans.

More Comparative Effectiveness Research that could lead to government
bureaucrats denying you health care treatment options.

Click here to read the latest Democrat House Bill (Released on 7/14)

http://americansforprosperity.org/examine-the-bill

Informative Links on Health Care Reform
By Paul Hsieh, MD

As health care takes center stage in the political debate, some good articles
have been published recently analyzing different facets of the issue. Here are a
few informative links:

"How Not to Reform Health Care"
by Michael Tanner
(Massaschusetts is a model of failure that we should not emulate at the national
level.)

"Canada's ObamaCare Precedent"
by David Gratzer
(Canada is a model of failure that we should not emulate in the US.)

"4 reasons why Obama's health plan is no bargain"
by Shawn Tully
(Why Obama's plan will fail if implemented.

All links found at:

http://www.westandfirm.org/blog/2009/06/informative-links.html

Healthcare shouldn't be linked to employment
By Jeff Jacoby / Boston Globe

Excerpt:

"...An end to employer-based health insurance is exactly what the American
healthcare market needs. Far from being a calamity, it would represent a giant
step toward ending the current system's worst distortions: skyrocketing
premiums, lack of insurance portability, widespread ignorance of medical prices,
and overconsumption of health services.

With more than 90 percent of private healthcare plans in the United States
obtained through employers, it might seem unnatural to get health insurance any
other way. But what's unnatural is the link between healthcare and employment.

After all, we don't rely on employers for auto, homeowners, or life insurance.
Those policies we buy in an open market, where numerous insurers and agents
compete for our business.

Health insurance is different only because of an idiosyncrasy in the tax code
dating back 60 years - a good example, to quote Milton Friedman, of how one bad
government policy leads to another.

During World War II, federal wage controls barred employers from raising their
workers' salaries, but said nothing about fringe benefits. So firms competing
for employees at government-restricted wages began offering medical insurance to
sweeten employment offers.

Even sweeter was that employers could deduct those benefits as business
expenses, yet employees didn't have to report them as taxable income. For a
while the IRS resisted that interpretation, but Congress eventually enshrined
the tax-exempt status of employer-based medical insurance in law.

Result: a radical shift in the way Americans paid for medical care. With health
benefits tax-free if they were employer-supplied, tens of millions of Americans
were soon signing up for medical insurance through work. As tax rates rose, so
did the incentive to keep expanding health benefits.

No longer was medical insurance reserved for major expenditures like surgery or
hospitalization. Americans who would never think of using auto insurance to
cover tune-ups and oil changes grew accustomed to having their medical insurer
pay for yearly physicals, prescriptions, and other routine expenses.

We thus ended up with a healthcare system in which the vast majority of bills
are covered by a third party. With someone else picking up the tab, Americans
got used to consuming medical care without regard to price or value.

After all, if it was covered by insurance, why not go to the emergency room for
a simple sore throat? Why not get the name-brand drug instead of a generic?

Unconstrained by consumer cost-consciousness, healthcare spending has soared,
even as overall inflation has remained fairly low. Nevertheless, Americans know
almost nothing about the costs of their medical care....

De-linking medical insurance from employment is the key to reforming healthcare
in the United States. ...

For 60-plus years, a misguided tax preference for employer-sponsored health
insurance has distorted America's healthcare market. The price of that
distortion has been paid in higher costs, fewer choices, and mounting anxiety.

The solution is to restore market forces by fixing the tax code, and liberating
Americans from an employer-based system that has made everything worse.

Full article:

http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2008/10/19/hea\
lthcare_shouldnt_be_linked_to_employment/

A Frog Slowly Boiling in Water: The Recent History of Medicaid Physician
Payments

Doctors bear much of the cost of Big Government health care.
By John R. Graham

"To keep doing the same thing over and over again and expect a different result
is insane.  Nevertheless, physicians still think that by lobbying the government
for higher fees, they will succeed in improving the government's unwillingness
to pay them adequately.

One would think that the history of Government health programs would lead
physicians to conclude that they should be wound down, not ramped up.  This is
not the case.  The American Medical Association, for example, calls upon
Government to increase "outreach and enrolment" for Medicaid.

A new article in Health Affairs quantifies what we have known for a long time:
Medicaid's payments to physicians are falling behind.  They didn't even keep up
with inflation during the period, increasing by 15% over the five years to 2008,
versus inflation of 20%.

And yet doctors keep cheering when politicians fragment and hinder our access to
coverage by expanding government-run health programs.  It's remarkably
self-destructive."

http://www.statehousecall.org/a-frog-slowly-boiling-in-water-the-recent-history-\
of-medicaid-physician-payments

A Frog Slowly Boiling in Water: The Recent History of Medicaid Physician
Payments

Doctors bear much of the cost of Big Government health care.
By John R. Graham

"To keep doing the same thing over and over again and expect a different result
is insane.  Nevertheless, physicians still think that by lobbying the government
for higher fees, they will succeed in improving the government's unwillingness
to pay them adequately.

One would think that the history of Government health programs would lead
physicians to conclude that they should be wound down, not ramped up.  This is
not the case.  The American Medical Association, for example, calls upon
Government to increase "outreach and enrolment" for Medicaid.

A new article in Health Affairs quantifies what we have known for a long time:
Medicaid's payments to physicians are falling behind.  They didn't even keep up
with inflation during the period, increasing by 15% over the five years to 2008,
versus inflation of 20%.

And yet doctors keep cheering when politicians fragment and hinder our access to
coverage by expanding government-run health programs.  It's remarkably
self-destructive."

http://www.statehousecall.org/a-frog-slowly-boiling-in-water-the-recent-history-\
of-medicaid-physician-payments

From today's post at the Freedom and Individual Rights in Medicine (FIRM) blog

http://www.westandfirm.org/blog/index.html

Slowing The Push Towards Fast-Tracking
By Paul Hsieh, MD

Democrats in Congress are getting close to a deal which would allow them to
"fast track" their plans for government-run "universal health care".

As former US Senator John Sununu notes in the April 27, 2009 Wall Street
Journal, this would allow a bare miniumum of senators to impose "National Health
Care With 51 Votes".

Part of the Congress' apparent urgency on this issue is that they may believe
that momentum is slipping away from them unless they strike quickly. The Tea
Party protests have galvanized many Americans against further government
takeovers of the economy. And David Catron notes that public support is
shrinking for "universal health care".

And as we've noted, most Americans are pretty happy with their current health
care. But they are legitimately concerned about rising costs. And they've also
been led (or misled) to believe that everyone else is having problems (thus
justifying more government intervention).

All of these signs indicate that free market reforms might receive a fair
hearing -- if Congress decides that it wants to take a deep breath, not rush
headlong into creating any new massive government programs, and have a open
honest discussion about the kinds of reforms we actually need to correct our
current problems.

Americans have already been burnt by the Congressional rush to pass the
"stimulus" bill -- which many legislators now acknowledge that they didn't even
read before voting for it. Congress should not make the same mistake by rushing
to pass "universal health care" legislation.

More here:

http://www.westandfirm.org/blog/2009/04/slowing-push-towards-fast-tracking.html

What's Really at Stake in the Health Care Debate
by Jeffrey H. Anderson

The last remnants of limited government and the free market hang in the balance.

Excerpt:

"Times are tough for most Americans, but it's a boom time for government-run
health care.

Between the $86 billion worth of "economic stimulus" going to Medicaid, the
fresh $32 billion for the State Children's Health Insurance Program (SCHIP), and
the proposed $634 billion "down payment" on a massive expansion of federal
health care, the Obama administration and the Democratic Congress are determined
to make 2009 a year of prosperity and abundance for at least one element of
American society.

While this timing may seem strange — giving out raises with taxpayer money,
while taxpayers brace for layoffs — it is not surprising. The health care debate
is not just about health care anymore. It's a surrogate debate over the
centralization of power in Washington.

Take SCHIP. Ostensibly a program to cover poor children, it will now cover
nearly half of all American kids. This begs the question: do you want to be
among the half of all Americans whose kids receive public assistance health
coverage or among the half who gets to pay for it?

In addition to being an end in itself, health care has become a means to the end
of repudiating the vision of the American Founders and of most Americans. The
Founders believed foremost in liberty and they set up a government to protect it
by decentralizing and separating powers.

Today's "progressive" movement rejects that vision and calls for the
centralization and consolidation of power, with the aim of providing for people
by orchestrating the coercive authority of the administrative state.

Thus, the issue of health care will determine a great deal about our fate as a
nation. Through it, we will embrace our founding principles of limited
government and liberty or we will embrace an alternate vision that seeks to
triumph over these..."

Full article:

http://tinyurl.com/dgvzfg

Those who are gathering in grass roots Tea party protests need to realize that
the issue they are fighting for is bigger than rising taxes.The growing power
and scope of government  is repudiating  and threatening the freedom and
individual rights this country was founded on :


"On April 15, thousands of Americans will gather for modern day tea parties,
proudly named after the Boston Tea Party of 1773. Like our revolutionary
ancestors, we are protesting against growing government power, a government that
increasingly oppresses its citizens instead of protecting them.

But what are we fighting for?

Have we earned the right to call our protests by the same name the Founding
Fathers used? Believe me, they understood exactly what they were fighting for.

When those Bostonians boarded the cargo ship, Dartmouth, and hurled chests of
tea into the ocean, they were not just mad about high taxes. In fact, the Tea
Act that inspired the protest had actually lowered the tea tax on the colonies.

No, the colonists were driven by a certain view of the proper purpose of
government, which the Tea Act repudiated. That view, which would reach its full
expression in the Declaration of Independence, was that the role of government
is to protect individual rights-- to protect the sovereign individual's right to
life, liberty, property, and the pursuit of happiness.

But over the past two centuries, the ideal of individual rights has all but
disappeared from public discourse.

In its absence has emerged today's massive regulatory-welfare state, which taxes
away nearly half our income, tells us what medicines we can take, what kind of
light bulbs to buy, and is rapidly consolidating control over America's banks,
insurance companies, and industrial giants like General Motors.

What happened? Why did we abandon the American ideal? Above all, because the
ideal lacked a moral defense.

To uphold the individual's political right to pursue his own happiness, we must
recognize the individual's moral right to pursue his own happiness. But just try
and say such a thing, and the voices will come from all sides-- that's selfish.

"It's selfish to want to plan for your own retirement--what about those who
aren't responsible enough to save? It's selfish to oppose bailouts for
struggling homebuyers-- why should they have to move? It's selfish to earn and
keep a lot of money for yourself--what about those struggling to make ends
meet?"

And it's all true: the pursuit of happiness is selfish.

That's why you need the individual freedom of a capitalist system--to pursue
your own interests, to act on your own judgment, to make your own life the best
it can be.

That's why you need to crusade for individual rights, not just against the
latest Washington power grab.

To mount such a crusade requires more than protest slogans and picket signs. You
must resolve to morally defend the individual's right to live for his own sake,
not as a servant of society.

So long as you are willing to concede that self-interest and the profit motive
are immoral, and that self-sacrifice for the "common good" is a moral ideal, you
will continue to see freedom diminish and prosperity decline.

In my judgment the only philosopher to provide such a moral defense of
capitalism is Ayn Rand, the author of Atlas Shrugged and Capitalism: The Unknown
Ideal. So I'll close with her words:

"The world crisis of today is a moral crisis--and nothing less than a moral
revolution can resolve it: a moral revolution to sanction and complete the
political achievement of the American revolution. . . .

[You] must fight for capitalism, not as a 'practical' issue, not as an economic
issue, but, with the most righteous pride, as a moral issue. That is what
capitalism deserves, and nothing less will save it."

http://www.aynrand.org/site/PageServer?pagename=media_topic_tea_party

Obama's Gov.Health Plan: Death Warrant for Private Health Insurance

Excerpt:

"...President Obama and Congress' plan to offer a government health plan would
ultimately be a death warrant for private health insurance. The public must be
alerted.

The findings this week of the respected Lewin Group health care consulting firm
should be chilling to all Americans. "The private insurance industry might just
fizzle out altogether," warned John Sheils, chief author of the study, which
looked at the effects of setting up federally managed insurance.

Its premiums could be 30% below the average offered by the private market,
assuming Medicare payment levels. If eligibility were only extended to small
businesses, individuals and the self-employed, as the president promised in last
year's campaign, enrollment in that cheaper public option would reach nearly 43
million. Insurance companies would lose 32 million customers...

It is not a failure of the market, but the ways the market has been distorted
largely due to government policies and programs," the House GOP plan states.

"They have undermined the doctor-patient relationship and removed the individual
patient from the decision-making process...

Layering on more government control, regulation, and 'management' cannot address
the problem; it will only reduce the alternatives available to individuals and
families."

Full article:

http://tinyurl.com/c38l76

Warnings about Obamacare
By Paul Hsieh, MD

The Health Policy Consensus Group has been tracking the trends in various
proposals for "universal health care" and has issued an important warning about
the following elements (PDF version)) which have been floated repeatedly:

• A new government health insurance plan
• An employer "play-or-pay" mandate
• A uniform, government-defined package of benefits
• A mandate that individuals must purchase insurance
• A National Health Insurance Exchange extending federal regulatory powers over
private insurance
• Federal interference in the practice of medicine through a federal health
board, comparative effectiveness review, and other government intrusions into
medical decision-making

Their paper discusses each point in greater detail here:

http://www.galen.org/component,8/action,show_content/id,13/category_id,0/blog_id\
,1187/type,33/

I believe their economic analysis is essentially correct. The American people
should know these facts.

If you're opposed to these ideas and wish to support free market health care
instead, please sign the Galen petition:

http://donoharmpetition.org/home.html

For additional information go here:
http://www.westandfirm.org/blog/2009/04/warnings-about-obamacare.html

PETITION: _DO_ NO_ HARM_ TO U.S.  HEALTH  CARE  SYSTEM

The Hippocratic Oath Taken by All Doctors: "First, do no harm"

Politicians, policymakers and public officials should take the same oath:

DO NO HARM TO AMERICA'S HEALTH CARE SYSTEM.

Many of the proposals and ideas will make America's health care system worse,
not better!
Our freedom to make basic decisions about life, liberty, and health care is at
stake.

Tell the politicians in Washington to adopt the following principles for judging
any health reform proposal, policy, or legislation:

* NO new government-run health insurance plan

* NO one-size government-dictated package of health benefits

* NO new jobs-killing mandates on employers

* NO requirement on individuals to buy this expensive coverage

* NO federal institution that controls private health insurance

* NO government intrusion into our medical privacy

* NO federal government control over the practice of medicine through a federal
health board, comparative effectiveness review, and other government intrusions
into doctor-patient medical decision-making

Please sign this petition to let elected officials know you believe that any
proposal that includes any of the Do No Harm guidelines should be rejected.

Tell them you don't want centralized Washington control over our health sector
but that you want a system that puts patients first.

http://donoharmpetition.org/home.html

Would the Health Reform Prescriptions Offered by President Obama and
Congressional Leaders Help Patients?
April 1, 2009

STATEMENT ON HEALTH REFORM
From the Health Policy Consensus Group

President Obama repeatedly has reassured the American people, "If you've got
health care already, and probably the majority of you do, then you can keep your
plan if you are satisfied with it. You can keep your choice of doctor."  
Research shows 82 percent of Americans rate the health care they receive as good
to excellent.

At the same time, there are serious problems of cost, value, and access
throughout our health sector.  It is vital to address these problems.  But any
health reform proposal to change what needs fixing also must preserve the
freedom, innovation, and quality of American medical care that people value.

We believe a better functioning, more competitive, and transparent marketplace
would cover more people and deliver the higher-value care we seek.

We are gravely concerned that several of the proposals offered by the President
and the Congressional leadership would make matters worse, not better.  These
flawed prescriptions for radical change should not be accepted as part of any
serious and sustainable health reform proposal:

* A new government health insurance plan

* An employer "play-or-pay" mandate

  * A uniform, government-defined package of benefits.

* A mandate that individuals must purchase insurance.

* A National Health Insurance Exchange extending federal regulatory powers over
private insurance.

  * Federal interference in the practice of medicine through a federal health
board, comparative effectiveness review, and other government intrusions into
medical decision-making.

We explain below why we believe these ideas would diminish individual Americans'
freedom and control over their personal health decisions.

A new government health insurance plan:

A new national health plan, to be operated by the federal government, is being
proposed with the claim that it would give Americans a choice between public or
private health plans.  While there may be initial assurances that the plans
would operate on a level playing field, the government inevitably will use its
regulatory, pricing, and taxing authority to favor its plan.

Congress would give the government plan the power to dictate prices so it can
artificially under-price private plans and drive them out of this one-sided
"marketplace."

Many people then would be left with little or no choice, as employers would drop
their current coverage and send their workers into the public plan.  Research by
The Lewin Group shows that as many as 118.5 million Americans would lose or be
switched out of private health coverage.

This massive crowding out of private health insurance would undermine the
employment-based coverage that most Americans under age 65 have today.

Once private plans have been driven out of the market, people will realize that
the government plan will not be able to sustain the quality and quantity of
benefits they were promised.

Government instead will begin to ration care and services, driving out
innovation, competition, and patient-centered quality.

A "play-or-pay" mandate that employers must provide or pay for health coverage
for their workers:

Employers would be required to pay an unspecified "meaningful contribution"
toward their workers' health insurance or pay a new tax to fund the government
plan.

If they are not "playing" in the new system by directly providing health
insurance, then they will be "paying" to fund the government plan.

It is a political certainty that the option to "pay" this new health insurance
tax will be set lower than the current levels at which employers now "play" by
providing their own coverage, enticing many of them to transfer their employees'
insurance coverage to the mercies of the new government plan.

Whether they choose to pay or to play, small employers will be hit especially
hard by a new mandate to finance all or part of the health insurance premiums
for their employees, directly or through new taxes.  Any initial subsidies to
them will quickly be overtaken by higher mandated costs.  As they absorb new tax
burdens they cannot control, the result will be more lost jobs and lower wages
for workers.

A uniform, government-defined package of benefits:  Decades of experience in the
states confirm that whenever benefit packages are determined politically rather
than by the marketplace, legislators find it very difficult to say no to anyone
asking that their services and products be included.

People would have a "choice" of only the expensive one-size-fits-all plan
mandated by government, significantly increasing the cost of health coverage. 
Workers would pay for this more expensive coverage through lower wages, lost
jobs, higher taxes, and lower-value health care.

A mandate that individuals must purchase insurance: If the federal government
requires everyone to purchase health insurance, it must define what qualifies as
insurance.  All signals indicate this would be a very expensive benefits
package, designed as one-size-fits-all in theory but delivered as
one-size-fits-none in practice.

  Sweeping government mandates create a conflict between escalating costs,
limited resources, and the false guarantee of rich coverage – triggering price
and supply controls.

Many individuals will need subsidies to receive coverage that otherwise would be
unaffordable to them, but taxpayers will resist filling an abyss.

As a result, political leaders will try to cover rising costs indirectly and
invisibly – through general revenue subsidies, tax increases, deficit spending,
and escalating fees, fines, and taxes imposed on employers.  And to make the
mandate work, the government also must establish and enforce binding penalties
for individuals who do not comply.

A National Health Insurance Exchange extending vast federal regulatory powers
over private insurance:  A new National Health Insurance Exchange is being
proposed to "streamline the purchase of health insurance."

It actually would steamroll over private choice and patient preferences by
providing a vehicle to extend sweeping federal regulation into virtually every
corner of our health sector.  This would reduce choice for patients and
discourage or prohibit innovation and flexibility in health insurance offerings
that today are helping many companies and families balance their health costs
with other needs.

Federal interference in the practice of medicine through a federal health board,
comparative effectiveness review, and other government intrusions into medical
decision-making:

Congress appropriated $1.1 billion in taxpayer funding for comparative
effectiveness research in the economic stimulus bill, establishing the Federal
Coordinating Council for Comparative Effectiveness Research, which will assess
medical treatments available to Americans.

This provides an irresistible temptation for politicians to go beyond providing
better information and start restricting the treatment choices available to
patients.  House Appropriations Chairman David Obey (D-Wis.) said the intent was
that drugs and treatments "that are found to be less effective and in some
cases, more expensive, will no longer be prescribed."

The clear and present danger is that any centralized health board will use the
cover of comparative effectiveness findings to meet budgetary bottom lines, at
the expense of patients' medical needs and personal preferences.

This is a particular danger to the health of people who suffer from rare
conditions or who need access to specific medicines and treatments but who may
lack the political power to influence the reviewers' decisions.

There are many problems that need to be addressed in the health sector, and the
signatories to this statement have written extensively about our ideas for
reform.

Because the reform agenda is moving rapidly through Congress, we believe the
American public should be aware of the likely impact of the policies described
in this statement which are under active consideration by elected leaders.

We believe that the proposals put forth by the Administration and Congressional
leaders would harm, not help, patients and would not fulfill the goals and
promises made to the American people.

http://www.galen.org/component,8/action,show_content/id,13/category_id,0/blog_id\
,1187/type,33/