Note to the GOP

Dear GOP,

Last night you won some resounding victories in the election. Four years ago you got your clocks cleaned, and now have made up that ground and more in the House. However, you only control one branch of government, not 3, and will have to do some compromising.

As much as the Tea Party folks want you to repeal anything President Obama has signed in the last couple of years, you can't. What you can do is modify some of it. Some folks in the party might cringe, but you'll have to find some common ground with Obama and Reid if you want to do anything.

Secondly, if you haven't noticed, this is the 3rd election cycle in a row where America has voted for "change". So, doing nothing, or worse; obstructing everything; will probably have you leading the charge out of town again in 2012.

The truth is you have about 16 months to actually accomplish anything. After that we start hitting early caucus' and primary elections for 2012, and as this year proved, nothing happens from the start of the primary season until after the election. No one wants to cast a vote that might kill them come November.

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Just Ten Thousand Jobs

AT&T is the latest company to let shareholders know that it will have to take a huge charge; in their case ONE BILLION DOLLARS; because of the passage of ObamaCare.

For AT&T this is probably going to be an annual charges until 2012, that's when the union contract most of their retirees are covered under expires. At that point expect a pretty ugly negotiation. The current employees will be demanding they keep everything, and the retirees are going to be screaming about how much they are going to lose. Sorry retirees, you'll come out on the short end of the stick.

Until 2010 how does a company make up a billion dollars that suddenly vanished? Well, if you have no seniority at AT&T I'd be polishing up that resume. With consumers still not spending increasing prices on their products probably isn't going to happen. That means that cutting staff is the likely way to get that money back.

But don't worry, it's only about 10,000 jobs that they'd have to pare back for the next couple of years. But really, they'll start rehiring. Really, they will. Okay, maybe not, many states have already started calculating the jobs losses that are going to be caused by the ObamaCare bill, and it isn't pretty. Marathon Pundit has a nice list up of the jobs being lost by Sallie Mae, since the health care reform bill also federalized all guaranteed student loans.

One good thing, the bill has $10 billion in it for expansion of the IRS since they will be handling the compliance issues with the individual mandate. So those displaced workers might be able to find jobs as auditors with the IRS.

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Change the Subject!

So, now we hear of the poor Democratic members of Congress, complaining people are harassing them, and maybe even threatening violence.

Here's my guess folks, they are getting the same number of those e-mails and crank calls today as they did last Friday. The difference, today they are good fodder to change the subject from the Health Care Takeover Act to anything else.

Why? Well, the facts are getting out, and the heat is getting turned up. No one told the folks who work at Caterpillar, John Deere and Verizon that their companies would take a hundred million dollar tax hit this year, and have to lay off thousands to compensate. Those thousands are probably going to be mad as hell.

Why are they taking that tax hit this year? Well, they did the right thing a few years back and provided their retirees with prescription drug coverage. For that, they get about $665 per year from the feds; which trims the government cost for drugs by over $550 per retiree. So it's a win -win the government saves money by giving the subsidy, and the retirees end up with better prescription drug coverage.

Now, though, under the new law, that subsidy is considered business income, and taxed at 35%. So the companies will take a huge hit, and be required to restate earnings because of it. But; to them; there is an easy way out. They are going to drop the drug coverage for the retirees, quit taking the subsidy, and not have the tax burden of it. Instead, the tax payers get the full hit for the retiree drug coverage, and the retirees have to enroll in the Medicare plan now.

This will of course increase the cost of the Health Care bill by billions, and everyone in DC will say "Never saw that coming".

So much for keeping what you've got if you like it. Just another example of how Congress understands no law it passes; and no lawyer can litigate the law of unintended consequences.

So remember, when you hear Congressman Dorkus D-Wherever whine about threats, it's not really about a new threat, it's to get folks to quit talking about the piece of crap bill he or she voted for.

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Health Care Reform Facts

The first big sticker shock of the new ObamaCare era will happen later this year, when the community rating guidelines become final and binding. Suddenly, a whole lot of people under age 62 are going to see higher healthcare premiums and wonder why that is.

They shouldn't worry though, they will be getting subsidies to help with those premiums; ooops, not until 2013 or 2014; sorry to make it looks like this thing saves money they will only collect taxes for four years, not give you the subsidy you were promised.

As for all of you folks that are cheering because pre-existing conditions are now covered, that doesn't happen until 2014. Until then you can (and will) still be rejected unless they are willing to pay big.

Hey, like your current plan, aren't you glad you get to keep it. Maybe... Well if it has a flexible spending account or an HSA as part of it, you don't really get to keep it. Those don't fit the new guildelines for proper insurance, so you'll have to find something else. Sorry if it costs more.

Do you work for a small business, that treats you really well with insurance. Sorry to say that you have about a 1 in 3 chance of having your policy cancelled and being told to buy from the "exchange". Why? Easy, the fine for most businesses to not cover you is much cheaper than buying you insurance. Sorry, you don't get to keep what you have either.

Sorry to piss on your parade, just thought a few facts might be good to have. But look on the bright side, at least McDonalds will be required to post the nutritional info on their drive through board. That's worth the trade-offs, right.

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Whats Next?

So, now that the Democrats can either crow that they got their landmark legislative accomplishment passed, or cry because they'll be losing their jobs come November, what's next?

Here's a few guesses. First, huge parts of this law are going to get gutted by the courts before most of it goes into effect.

There are probably three things that will be subjected to a lot of legal challenges.

1) The Individual Mandate. This will probably get thousands of individual court challenges, in every district of the Federal system. That's going to make it the funnest part of the whole thing. The 9th is going to find some reason that it's constitutional, the 4th is going to laugh and put a stay on enforcement, and DC is going to spin like a top trying to figure out what to do.

My guess is that it will be fast tracked and in the next 18 months end up in Robert's hands at the Supreme Court, where it will die a 5-4 death.

That decision, though, will doom private insurance. The mandate is the only reason they are behind this bill. Without it there is no chance they can make money with the other insurance restrictions on the bill.

2) Individual "Sweetheart deals" that some states got to get votes. While the reconciliation bill killed the Cornhusker Kickback, Louisiana is still getting $100 billion to 300 billion in extra cash, Florida seniors keep Medicare Advantage while everyone else loses it, one town in Montana gets it's Medicare paid for.

Many state AG's threatened to sue over those provisions in December when the Senate passed the bill. Expect it to happen shortly after the signing. The Florida medicare advantage clause may well be the one that dooms a bunch of the bill.

3)While many states are going to scream about the hundreds of billions in unfunded mandates, they don't have much standing to do anything about the bill. Unfortunately for them (and us) the courts have upheld the federal government's ability to pass costs to the states many times.

My guess is that at least one state will be able to say the new Medicaid costs will bankrupt them, and threaten to file a Chapter 9 petition for bankruptcy unless the Feds pick up more of the cost. By the way, Illinois, my state, would be a perfect fit. Unfortunately, our lackeys in Springfield think this is a good idea.

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Failing Me

My personal version of Nationalized Health Care, the VA, has failed me; surprise.

I noted on the 8th that they'd be testing me quite a bit. I had a cardiac stress test that week, which I failed, and a pulmonary function which was good, and an echo test, which was also good. So, the following Monday an imaging stress test was done. Radioactive isotopes were pumped into my blood, I ran a treadmill, and then had pictures of my heart taken.

This is where the system failed. I failed the test; bad enough to cause a couple of doctors a lot of concern; but not enough to get anyone to pick up a phone and call me. I was scheduled for a visit on Thursday, so they planned on telling me then, evidently.

The problem is, I had a heart attack (luckily mild) Wednesday night. Thursday I was feeling well enough to call the VA, and notify them I'd be unable to attend my appointment, I was in the hospital due to the above mentioned heart attack, and was going to be taken for a catheterization shortly.

Six hours later (the same person) called back and asked my wife why I missed my appointment, and told her it was really important I see a the cardiologist, there were problems with my stress test. While I know the Internet isn't censored, I'll avoid posting the wife's response out of respect for any nuns who might read this.

Friday, shortly before the cardiologist who performed part of my procedure came to see me; the attending physician who treated me 2 weeks earlier at the VA called. She'd been doing follow up reviews, saw my stress test, and realized I hadn't been to cardiology (there). So she wanted to let me know it was urgent I saw a the cardiologist. I explained what had transpired over the last 36 hours, and assured her, I'd seen one, just not on my terms.

Here's why the VA failed in this episode, and why my government run health care has failed so often in 30 years. The Bureaucracy of the system is the issue. Most doctors other than GP's don't make decisions on their own.

As was my case a cardiology fellow did the (2nd) stress test, and dicated it. But he didn't call me, instead, he sent the dication to a secretary for transcription. It's not her job (nor should it be) to call patients back, so she didn't. The head of cardiology has to review the transcript in a record, and approve of any recommendations. He did, but he didn't notify me, why bother, I'd be in the next day for an appointment. Unless of course I had a heart attack.

Contrast that to how most "regular health care works". The cardiologist orders a stress test, in the case of my first one I failed. At that point most civilian cardiologists immediately admit you, and order the follow up imaging stress test. This is especially true in cases like mine with a family history and basically every bad marker for heart disease.

Then they run the next test and keep you until they have read the images and decide what it says. In my case, it would have dictated an immediate catheterization, so at that point a number of meds would have been started, and I'd have been doing nothing that could cause any stress on my heart until I was on the table getting fixed.

So instead of going from the 5th, when I was first admitted to the hospital for observation, to the 18th when I had the procedure, I probably would have been completely through the test battery and "fixed" by the 10th or 12th. Six days and 1 heart attack sooner.

This isn't to say there is nothing right with either the VA, or the Military Treatment Facility I go to for my primary care. For general care, and preventive medicine they are pretty good. My annual physical this year found that my blood pressure was getting back out of control, and that my cholesterol had jumped back up too high. It actually started the ball rolling on some of this stuff.

But once they get out of that area to specialty care, the wheels fall off. The same physical couldn't find the problem with one of my hands, so off I go to a specialist. Except there's exactly one in a hundred mile radius that will accept the government reimbursement rate to treat it. He's booked until late April. I guess another 2 months (my physical was late February) isn't long to wait.

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Testing, Testing, They'll be Testing Me!

I know I haven't been posting much, but might change this week, since I'm not at work at all.

I wish it were a vacation, but instead it's a week of sick leave. I started some new medication week back, and had some less than wonderful reactions to it. I called the doctor, he called the ER, and I got to spend a night in the critical care ward at the VA hospital, trying to figure out if I had a heart attack, an asthma attack, or just a weird, and rare, reaction to the medication.

Now, for safety's sake, I'm sidelined for a week, and waiting for a new battery of tests to (hopefully) determine exactly what the hell happened.

Luckily, the Prez hasn't gotten his way with health care yet, so they don't have to go with the "best guess" method of treatment, they can actually do all the tests.

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Biting Dogs?

So, after last nights earthquake in Massachusetts, one has to start wondering if the block of "Blue Dog Democrats" will finally find their teeth.

The Blue Dogs are supposed to be the fiscally conservative wing of the Democrats, especially in the House. However, what they've proven to be is an easily bought off group who has let every spending bill go through in exchange for some kibbles and bits.

Last night, however, might have provided the impetus for them to actually grow some teeth and stand up to Nancy Pelosi. Unlike Martha Coakley, who lost in a state that has been solidly Democratic since 1972, the Blue Dogs mostly come from conservative districts and got their jobs promising the fiscal conservatism that Republicans forgot about from 2002-2006. So for them, last night has to be a shocker, and a wake up call. If they want to keep their seats, they may well have to dump Pelosi's ideas on health care and demand a true bipartisan effort.

The idea of "ping ponging" an unabridged Senate health care bill through the House to get it to Obama's desk is something that the Blue Dogs should resist, if they want to stay in office come November. Since Pelosi will have no ability to bribe for votes offer amendments to gain favor with them, they are now in control of the health care debate, if they wish to be.

As the leadership in their party spends the next few days to a week deciding what to do with ObamaCare, it will become evident to the rest of us what is more important to that leadership, maintaining their majorities in 2011, or getting an unpopular bill passed.

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What's the Plan?

So, the President is now going to make a speech to a joint session of congress to try and get health care reform; or is it insurance reform this week; back on track.

According to the New York Times the idea is to simplify things so that folks will better understand what he wants.

Reading into the Times article it's clear that he really doesn't want to scale back as much as some claim. And the things that will lead to a government take over are still there, and items that could really lead to lower costs are missing.

For example, he'd like to keep the public option, as a form of "competition", but still rejects the idea of selling policies across state lines, which would be a market way of reducing prices.

He'd still like to force insurers to charge the same rate to anyone in an age group, regardless of health, fully knowing that rates then go up for the majority of healthy individuals to cover the added expense of those who aren't.

While he likes the idea of a coverage mandate for individuals, he really hasn't talked about an enforcement mechanism. The problem with this has been seen in Massachusetts, where people get insurance so they have a policy number when they file taxes (when it's checked). Then they dump the policy a month later. They don't pick coverage up again until they are either sick, or have to file again.

He'd like a "no wait, no restriction" guarantee on insurance policies. What does that mean, well, if you call 1-800-insure-me at 8 am to get a policy, at 9:00 you can deliver a baby by Cesarean, and be fully covered. Then, you can drop your policy a few week later when the bills are paid.

What does all this really do? It makes it nearly impossible for an insurance company that isn't underwritten by the federal treasury to break even, much less be profitable. This is an important thing to the President and the folks on the left. They know that the companies will stop writing insurance (ask New Yorkers, and folks in Maine) and then they can claim that "evil insurance companies" don't care about you, and you'd be better off with the public option.

Don't be fooled by the smooth talk next Thursday. The truth is the only goal of this reform idea is to make it impossible for anyone but the government to compete in the insurance business.

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Why We Don't Trust Congress

Need a(nother) reason not to trust Congress on health care reform? We've all heard about HR 3200, the House version. Well Chris Dodd's Senate committee also has a 1,000 page bill that they've voted on.

No one on the committee has even seen the full bill, much less the whole Senate getting a chance to read it. The only thing up on their site is 790 pages before amendments. According to this Wall Street Journal article, committee staffers have said it probably won't be posted by October.

We were promised a new era of tranparency in government not long ago. Evidently the only thing transparent is that promise, not the process of health care reform.

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The Next Angry Mob

If you are looking for the next angry mob in the health care debate they are easy to find, head over to BenGoshi's page at DailyKos. With word coming out that Team Obama might be ready to dump the public option, the netroots are moving back to nutroots mode rather quickly.

Folks from Obama's team were all over the Sunday talk shows doing damage control on the President's signature domestic program. Since I've had a lot of damage control training in my life, I could tell by the efforts that they are at the stage of either save the ship soon, or abandon it. Right now I'd still give abandonment a 50/50 chance.

The folks at Kos are livid, taking the public option off the table and having them replaced by the Co-Ops the Senate has suggested makes getting to single payer a longer road. In fact, the Co-Ops might be the death knell for single payer.

Once the public see's that Co-Ops, operating under the rules the administration would like, are lead zeppelins that can't stay aloft they'll wonder how the government would make single payer work and not bankrupt us.

So what is the Co-Op that the left fears so much? It's basically an insurance pool, where groups or individuals can buy insurance, but with their combined buying power. They work great in many other areas of the economy, like agriculture, where farmers combine to buy seed, fuel and other commodities with group buying power. You can even look at Wal-Mart as a co-op, since the combined buying power of their thousands of stores gets the company lower prices than if they negotiated prices for each store.

Co-Ops can work, and the idea of funding them with a few billion to get them off the ground is a good idea. The problem will come if they are hamstrung with the pre-existing rules, instant coverage rules, etc. that Democrats would like to impose on all insurers. Under those rules they won't be able to break even, and keep premiums lower than buying individual policies.

The plus side to them is they do become a large insurance pool, helping to offset some of those loses by giving smaller employers and individuals the option of being in a group. But they can't offset all of the loses if they use the New York and Massachusetts rules.

How can they help the uninsured? Easy, use a refundable tax credit, based on adjusted gross income level, to help people pay their premium to the co-op if they don't get employer based insurance. Or, if employers wish to provide coverage to their employees through the co-op they would get the same tax write off that other employers do for what they pay for insurance.

Watch the blogs in the next few days, and get your laughs watching the left have fits over the idea of co-ops,

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Good Reading on Insurance Reform

The Wall Street Journal does what most local papers and other national media outlet's haven't been concerning President Obama's newest phrase "Health Insurance Reform"; they point out the facts, in two different editorials.

The first "The Truth About Health Insurance" points out something I did a few days ago, the reforms wanted by the administration won't save you money, they'll just drive your insurer out of business and cost you MORE!

They point out that New York, New Jersey and Massachusetts all have both guaranteed issue insurance laws (you have to sell a policy to anyone, even with pre-existing conditions) and Community Based Ratings (can't use a pre-existing condition to set premiums). Not surprisingly, those are the three most expensive states to by individual health insurance in. In fact, rates are two to three times higher than the rest of the country.

Evidently "fairness" only works one way in those states. It's more fair to require no wait insurance for the folks who get sick and need it now. Unfortunately the rest of the insured end up paying for them to be covered.

The second piece you should read is by John Mackey, CEO and co-founder of Whole Foods. They've reformed their insurance program, and save both the company and employees money. "The Whole Foods Alternative to ObamaCare" lays out how they've done it, and why even their Canadian and British employees, with goverment provided health care want into the system.

The biggest reform they enacted? They turned employees into true consumers of health care. They actually shop around for services and treatments instead of just going to whatever doctor or clinic someone recommends.

They use a high deductible ($2500) policy paid for by the company and a Health Savings Acount, with another $1800 from company. The HSA rolls over each year, so if it's not spent, they don't lose the cash, and can save for a catastrophic event.

What they've found is the employees don't use the HSA money up every year to cover the deductibles, they instead do spend out of pocket for smaller expenses, and end up shopping and saving themselves money.

Mackey has some other great ideas on how to actually bend the curve down, as the President would like to do, but the CBO has pointed out, ObamaCare won't. Check out his ideas.

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Krauthammer's Idea

Charles Krauthammer has a couple of brilliant ideas for the start of health care reform. Neither have a snowballs chance in hell, which is too bad because they make sense.

The first is extreme tort reform, get rid of jury trials for malpractice suits and have them settled by a medical panel of experts. Why do this? Because doctors admit we waste $200 billion a year on "defensive medicine"; tests designed not to necessarily cure you, or find your ailment, but keep them out of court.

You can see this has no chance with Democrats in power. Trial lawyers are some of their biggest donors, and telling them that the jury jackpot system could go away isn't going to keep that cash flowing into election warchests.

The second is eliminating the tax benefit to employers for your insurance, and instead having the money go to YOU to purchase coverage yourself. That would immediately make your coverage portable, which is supposedly one of the things ObamaCare is supposed to bring us.

Unfortunately, as Charles points out, this won't happen either. Obama spent so much time berating John McCain for the idea of taxing that benefit that he can't do it. Just ask Max Baucus.

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