Feeds:
Posts
Comments

Archive for the ‘healthcare’ Category

Wow. It’s been almost 3 months since I have posted anything on the old bloggeroo. I have been somewhat idle, but not completely so. I have had several pieces published on another blog, The Arkansas Patriot. Here are some links to a few of those thoughts:

Searcy A&P Tax: What are our Rights?

The Beginning of the End of Private Healthcare

Fight to Keep Washington Style Politics Out of Searcy

I am also very active on Twitter; I usually post between 5 and 5,000 short thoughts and links per day. If you are into the Twitter thing, you can follow me by going here. My Twitter feed is also displayed on the bottom right corner of this blog page.

I will try my best to start updating this blog again on a regular basis. We have our 4th baby due in the next couple of weeks, so don’t expect a lot until that big event has transpired, but I fully intend to pick this thing up again. The times are too interesting to abandon commentary.

See you soon…

Read Full Post »

As the House of Representatives and the Senate debate how to governmentalize our health care system, voices of private experts are arguing for a move in the opposite direction. The following 4 videos were put together by the Campaign for Liberty and feature Peter Schiff, Dr. Rand Paul, and Judge Andrew Napolitano.

Read Full Post »

Last night President Barack Obama addressed a joint session of Congress on the topic of healthcare. It was supposed to be a historic speech, but today no one seems to be discussing healthcare much. They’re all too busy talking about what Joe Wilson did.

Wilson, a Republican Congressman from South Carolina, shouted, yes, actually shouted “YOU LIE!” at the President of the United States during the address. Everybody heard it; Nancy Pelosi’s head almost exploded. Immediately the liberals in Congress starting clamoring, but not about what you would think. In fact, if you do an online search on the subject, you will find a multitude of stories about how inappropriate and boorish Joe Wilson is, but only a few stories about the main point that should concern us all: Is Barack Obama telling the truth?

When you come right down to it, I think the Democrats are mad that someone, especially a Congressman, would dare to yell in verbal protest at President Obama during an important speech. They can’t fathom it. This, like most partisan issues, is a double standard. When George Bush discussed Social Security in the 2005 State of the Union Address, the Democrats booed him. For crying out loud, the liberals literally bubbled with glee when an Iraqi reporter threw his shoes at Bush during a press conference. Heckling Presidents is nothing new or unusual. It just wasn’t supposed to happen to Barack Obama.

In the end Joe Wilson succumbed to the pressure of the gutless GOP and the Obama machine and called to grovel out an apology to Rahm Emanuel for his outburst. He said his emotion got the better of him. Too bad it turned out this way. Had Congressman Wilson played his cards right, he might have been able to shut the speech down, or at least make the President find a quieter spot to speak. Kind of like this:

Read Full Post »

HealthcareAlignment01I am a professional healthcare provider. It is natural, therefore, that I be interested in the big changes that will soon be coming to my profession. Barack Obama is proposing a complete overhaul of the U.S. healthcare system, ushering in a new level of government involvement. In response, the irrelevant Republicans offered their own plan to overhaul healthcare, apparently just so they could hear themselves talk, since no one else appears to be listening. Of course, both parties seem to think the way to improve healthcare in this country is to get the federal government more involved in the private medical and insurance markets. As usual, both parties are wrong.

The following article is one of the best I have read about the boneheaded attempts by the Republocrats to overhaul healthcare. It was written by Tom Mullen, author of the book A Return to Common Sense.

Politicians Talking Gibberish About Health Care

Every minute of every day, Americans are subjected to politicians and media pundits talking gibberish. There really is no other word for it, whether the particular subject is economics, foreign policy, or even climatology. However, the gibberish that is getting the most attention right now concerns health care “reform.” President Obama is leading the Democrats with the familiar socialist model that has failed in every industrialized nation in which it has been tried. The Republicans are answering with gibberish of their own. You have to especially admire the Republicans, because they are not only fomenting nonsense from a discredited, minority position, but are actually trying to suck up to voters by selling their version of government-run, loot-funded health care as a “free market solution.” Only the party of George W. Bush could be capable of gibberish like this.

To truly appreciate how bizarre the arguments are, let’s break down what our ruling class is really saying. Sometimes the music bed, the interruptions by the self-absorbed interviewer, or even the graphics leading into next segment can obscure the gibberishness of some of their assertions.

Let us start by examining the position of the Democrats. They assert that every human being has a right to health care, and that it is the government’s job to provide for those who cannot afford it. There are three key terms here: right, health care, and provide. Let’s define the first two.

Right: that which an individual is entitled to without the consent of or compensation to anyone else. For example, people have a right to life. That is, they do not need anyone’s permission, nor are they obligated to compensate anyone in order to live. It is appropriate for an individual to demand, rather than ask for, their right to life to be respected.

Health care: a service which primarily consists of the labor of health care providers. For example, a physician exerts his mind and body, utilizing his education and experience, to attempt to diagnose and treat a patient’s illness or injury. That physician’s labor is “health care.”

Let us now restate the argument made by the Democrats, using these definitions in place of the terms themselves.

“Every individual is entitled to the labor of health care providers without compensating them or obtaining their consent. It is appropriate for individuals to demand, rather than ask, that health care providers treat them for free.”

Gibberish.

To be fair, although the Democrats repeat their slogan about the “right to healthcare” ad infinitum, they do not actually propose that the government defend this “right” directly. Instead, they use their own peculiar definition of the third term previously cited, “provide.” Americans continue to be bewildered by this parlor trick, whether because they are easily confused or because it is more convenient to be fooled than not. In any case, “provide” to the government means that they will employ the method described by William Graham Sumner where A & B get together to pass a law requiring C to do something for X. So as not to miss the opportunity to describe this plainly, this really means that they are going to use the brute force of government to force some people to pay for health care for others. That is all it is, when you peel away the doubletalk, jingoism, and spin.

Moreover, it is not just your property that the government will take in order to run its program. It will also require another huge portion of your liberty as well. In a recent speech about his health care reform plans, President Obama suggested that “we” must begin encouraging healthier lifestyles, including getting our children away from computer games and back to playing outside. “We” means “the government.” Of course, when it is the government’s responsibility to pay for the health care of other people, the government now claims a right on behalf of taxpayers to see that those people keep themselves as healthy as they can in order to limit the cost. There are already government-imposed exercise programs in Japan. Americans should be aware that the same rules will apply here. One can almost hear the government “instructress” from Orwell’s 1984 screaming from the telescreen.

“Smith W.! Yes, you! Bend lower, please! You can do better than that. You’re not trying. Lower, please! That’s better, comrade.”[1]

Political gibberish often conceals rather horrifying ideas. Thankfully, we have an opposition party that is opposing these heinous proposals, correct? As the people from Hertz say, “Not exactly.”

It is true that Republicans oppose a government-run health care plan. As reported in the Wall Street Journal, the Republican summary of their “Patient’s Choice Act” argues that “ The government would run a health plan “with the compassion of the IRS, the efficiency of the post office, and the incompetence of Katrina.”[2] All true, but of course the so-called party of individual liberty and free markets fails to argue the main point: the government – we the people – do not have the right to forcibly take money from one person and give it to another, not even for the purposes of paying for their health care. Nowhere in any report made public nor in any interview with a spokesperson for this “opposition party” will you hear this argument. There is a good reason for that.

Of course, the Republicans will argue that their plan works through the tax system and actually let’s families “keep more of their own money” to spend on health care, but a careful read of the WSJ article reveals that the same redistribution scheme is hidden within the stale “free market” rhetoric. First, the Republican plan would eliminate the tax exemption for employers when they provide health insurance benefits to their employees. This amounts to a tax increase on employers, whether they continue to provide the benefits or whether they eliminate them and merely pay taxes on the extra net income. What would the government do with this new revenue?

“Instead, it would give an annual tax credit of $2,300 to each individual and $5,700 to each family that they could use to offset the cost of their health insurance. Low-income families would get extra money to buy into private insurance plans.” [emphasis added]

So, in an effort to appear to be protecting the property rights of their more affluent base but at the same time buy the votes of those who cannot afford health care, the Republicans will simply tax those whom they think they can get away with taxing and call their own version of wealth redistribution a “tax cut,” much like George Bush’s “tax refunds” of the past decade. Of course, there is only one word for the suggestion that you can “cut” or “refund” taxes for people who are not paying taxes.

Gibberish.

As usual, the American public is served up a carefully framed debate that attempts to appear to have two sides but doesn’t. In either case, we are getting “reform” of the health care system in the only way that any government can “provide” anything. They are going to forcibly take away the property (taxes) of one group of people and use it to provide property (health care) to another group. Lest anyone mistakes this brutal practice as “the wrong means to a compassionate end,” let us remember the only reason that politicians from either party suggest this: to buy the votes of those who believe that they will benefit from it. Since there are more who would receive benefits in the voting base of the Democratic Party, they are more open about what they are really doing. Since there are more of those who will be forced to pay in the base of the Republican Party, they try to spin their redistribution scheme as a “free market solution.” However, it is dressed up, it amounts to one thing; stealing.

In addition to ignoring the fundamental violation of rights that is part and parcel of any government provided service, both the Republicans and Democrats seem completely unaware of the root cause of the problem: health care is only so expensive because government already provides so much of it. This is the other elephant sitting in the corner whenever politicians from either party start talking about health care reform.

Last year, total health care spending in the United States amounted to roughly $2.4 trillion dollars. Medicare and Medicaid alone accounted for over $800 billion, or 33% of that. Add the Veteran’s Administration and other smaller government health care programs, and government is directly providing almost half of all health care delivered in this country. What does this have to do with the price? Any first-year economics student can tell you.

Price is determined by the intersection of supply and demand. Demand has two components: the desire to buy a good or service and the ability to buy that good or service. Let us assume that the desire for health care services is unlimited, as it is for many other goods or services. In that case, the only factor that can limit demand for health care services is ability to pay. This is the factor that most influences the price of every other good or service provided in the marketplace, including food, clothing, and shelter, which are even more vital to human life than health care. It is the finite amount of money that the buyers have to spend which keeps the price down and makes most goods affordable to those on limited budgets.

However, when government makes something an entitlement, demand suddenly becomes unlimited. Since the government now must provide the benefit and they have the option of taxing or printing what money they need to provide it, there is no longer anything holding down the price. This is the reason that we have seen health care prices skyrocket in recent decades. They will continue to rise until all resources are consumed trying to provide them.

State and local governments have already been experiencing this for years because of the exploding cost of their shares of the Medicaid programs (half of Medicaid benefits are paid by the states, some of which require their local governments to pay a percentage as well). They cannot print their own money, so they have instead cut their police forces and other legitimate functions of government in order to divert money to the insatiable Medicaid beast. In one local county in upstate New York, 100% of the property taxes collected in that county and $40 million dollars of sales tax revenue – the county’s only other revenue source – went to pay that county’s share of the Medicaid bill for their recipients. Now, it has been reported that the majority of the TARP funds that were supposed to go to “shovel-ready infrastructure projects” are instead being earmarked for “existing state social programs.” An audit of these payments would undoubtedly reveal that the bulk will go to Medicaid.

Economic laws are like the forces of nature. They can be held off, as a levy holds off a flood, but they will eventually overwhelm any attempt to violate them. The most fundamental economic law is this: you cannot consume more than you produce without taking the difference from someone else. Government produces nothing. Therefore, any health care benefit that government provides must be funded with money taken by force from someone else. There is no political theory, mathematical equation, or black magic incantation that can change this.

However, even if we are able to put aside the moral repugnancy of this practice, we cannot do so forever. Once voluntary exchange is abolished, market forces are suspended and the price of providing health care will rise until the government is no longer able even to steal enough to pay for it. That day was only a few decades away for the existing government health care programs before the economic crisis we find ourselves in now (which was similarly caused by government for all of the same reasons). If government attempts to provide everyone with health care, the end will come much sooner.

This sheds light on a fundamental misconception that underlies all of the societal problems that American society faces today: the belief that there is a conflict between individual rights and the “needs of society.” This conflict doesn’t exist. Protecting the rights of every individual serves the needs of society. Violating those rights, for whatever purpose, destroys society. In fact, it is by violating the individual rights of its constituents that government causes nearly every societal problem we face. The high price of health care is just one example.

There is only one moral and practical answer to the high cost of health care: we must get government out of the health care business entirely. That includes rejecting new programs proposed by either major party and figuring out a humane way to get our children out of the existing entitlement system without cutting off those presently dependent upon the benefits. The only lucid argument I’ve heard so far has been put forth by former presidential candidate, Congressman Ron Paul. He suggests that we dismantle our $1 trillion per year overseas military empire and use that money to pay Medicare and Social Security benefits while our children are allowed to enter the workforce without enrolling in the system themselves.

What do you know? A politician moved his lips and something besides gibberish came out.

Check out Tom Mullen’s new book, A Return to Common Sense: Reawakening Liberty in the Inhabitants of America. Right Here!

[1] Orwell, George 1984 Part I Ch. 3
[2] Adamy, Janet “Republicans Offer Health-Care Plan” The Wall Street Journal May 21, 2009

Read Full Post »

tin_cupBarack Obama sent a rough draft of his proposed 2009 budget to Congress last week, giving us a preview of what the government will be doing with our money during the next year. Here are some of the proposed highlights:

* $3.5-4 trillion in government spending
* $750 billion in additional bank bailout funds ($50 billion more than the TARP)
* $634 billion “reserve fund” as a down payment to cover roughly two-thirds of the anticipated 10-year cost of universal health care coverage — projected at $1 trillion
* an additional $300 million to hire additional IRS agents to police and collect a portion of an estimated $350 billion in uncollected taxes
* projects a one-year budget deficit of $1.75 trillion

Glenn Beck has an interesting blog post about the budget here.

This massive expansion in government spending does not come as a surprise considering President Obama’s habits since his inauguration. I am concerned, however, about where Obama plans to get the money for these projects. The $634 billion “reserve fund” for universal health care mentioned above will be funded by limiting the charitable giving tax break for families earning more than $250,000 dollars per year. According to IRS statistics from 2006, families earning more than $250,000, which represent less than 2 percent of all taxpayers, were responsible for about 28 percent of all charitable giving, amounting to more than $81 billion dollars in gifts to charities. According to a study released this week from the Center on Philanthropy, 47 percent of affluent households say they would give less if their tax deductions for charitable giving were reduced. The same study concludes that Obama’s policy will reduce affluent charitable giving by an estimated 4.8%.

I am troubled by this. Why does the Obama administration feel it is necessary to “find money” by reducing the charitable contributions of rich people? Surely there are other ways to trim the budget. Critical thinking about this issue has led me to the following conclusion:

The Obama administration, by attempting to reduce the funding and influence of charities in the United States, is hoping to increase the dependence of the American people on the welfare state. The more people depend on the government, the more control the government has over their lives.

It does not take a huge intellectual leap to reach this conclusion. People who know I am a libertarian ask me, “If we eliminated a large part of the government, who would take care of all the poor people? How would the less fortunate pay for food, or health care, or retirement?” A look at history might help answer these questions.

The United States hasn’t always been a welfare state, you know. There was a time in this country when accepting charity was seen as a character flaw; only the weak and lazy took handouts. Americans were proud to work, and if they couldn’t afford something, they gladly did without. Still, there were certain services in civil society that individuals could not provide on their own, and therefore some assistance was needed. Churches and other religious groups provided many of these needed services, but not the total amount that society required. Thus came the concept of mutual aid to fill the gap.

Mutual aid societies (also called “fraternal” or “friendly societies”) were extremely prevalent in early 20th century America. They went by names like Masons, Elks, Odd Fellows, and Knights of Pythias. Some were made up of immigrants (the National Slovak Society, the Croatian Fraternal Union, the Polish Falcons of America) or predominantly African Americans (the Prince Hall Masons, the True Reformers, the Grand United Order of Galilean Fishermen). Historian David Beito estimates that in 1920, about 18 million Americans (30% of all adults) belonged to mutual aid societies.

Mutual aid societies were self-governing private mutual-benefit associations which members joined and contributed money to, pledging to help each other in times of trouble. Services provided by the societies included sick pay, medical care, burial expenses, and even survivor’s benefits. Some groups even had lodge doctors that were available to examine and treat its members. Because the members made regular donations to the group, they saw these benefits not as charity, but as entitlements earned by way of their contributions. According to historian David Boaz, people joined mutual aid groups so that they could mutually provide for their own needs in time of misfortune and not be forced to the indignity of taking charity from others. Fraternal codes of ethics, as well as fellowship and solidarity, prevented members from claiming benefits without good cause, and encouraged the development of character and moral discipline.

How different from today’s attitude of unfounded entitlement and shameless government welfare. You may wonder where all of these wonderful fraternal societies have gone. Some of them are still around, to be sure, but these are mere shadows of their former selves. For that we can thank Uncle Sam. Somehow, between then and now, we have been deceived, convinced that we can’t survive without our lifeblood of government handouts. The modern welfare state has all but crushed the last bit of pride and dignity out of us, all in the hope of making us helpless and dependent. Why? Because spineless, helpless, dependent people are easy to control.

So think about this during the next four years:

We are the descendants of a once proud people. There was a time when we held our heads high and took care of one another, without the “charity” of the state. These are the critical days when we must decide what our future will hold; do we succumb to the relentless whine that tells us we are helpless and dependent, or do we listen to that inner voice that tells us to stand up and reclaim our independence? It is time to decide.

Read Full Post »

shhhEver wonder where our legislators get their information? The Congressional Research Service is the official think tank for the Congress; they prepare reports on just about anything any senator or congressman wants to know. Here is their mission statement:

CRS is committed to supporting an informed national legislature — by developing creative approaches to policy analysis, anticipating legislative needs and responding to specific requests from legislators in a timely manner. With a rigorous adherence to our key values, CRS provides analysis that is authoritative, confidential, objective and nonpartisan.

Technically these reports are part of the public domain, but until now they have been mainly available only in written form, and only by special constituent request to one’s representative or senator (and then often “only if politically helpful to said politician”). That means that if you knew there might be a report on a certain subject you could write your congressman and request that he or she send you a written copy. Then they were under no obligation to do so unless it would benefit them politically. Needless to say, these specialized reports were pretty difficult to get. In fact, the CRS reports are listed as #1 in the Center for Democracy and Technology’s 10 Most Wanted Government Documents list.

Multiple attempts have been made to pass legislation that would force the CRS reports to be made public, but each time our Congressmen vote to keep them a secret. The Congressional Research service itself has even lobbied to keep the reports unavailable to ordinary Americans.

Enter Wikileaks, and anonymous web-based service dedicated to freedom of information through the public release of classified material. On February 8, Wikileaks obtained an extensive archive of Congressional Research Service reports dating back to 1990. This massive group of documents (6,780 reports consisting of over 127,000 pages) contains detailed analysis of some of the most explosive concerns of our day, most previously unavailable to the public. In fact, of these 6,780 reports, only 506 of them were previously available online.

“So what?” you say. Well, so far there have been no smoking guns, but here are a few of the reports I found very interesting nonetheless:

On terrorism and civil liberties-

Response to Terrorism: Legal Aspects of the Use of Military Force, September 13, 2001
Terrorism at Home: A Quick Look at Applicable Federal and State Criminal Laws, October 3, 2001
Terrorism Legislation: Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism (USA PATRIOT) Act of 2001, October 26, 2001
The USA PATRIOT Act: A Legal Analysis, April 15, 2002
Privacy and Civil Liberties Oversight Board: New Independent Agency Status, November 26, 2008
Privacy: An Overview of Federal Statutes Governing Wiretapping and Electronic Eavesdropping, September 2, 2008
National Identification Cards: Legal Issues, January 7, 2003

On economic issues-

Soft Money, Allegations of Political Corruption, and Enron, February 12, 2002
Gold: Uses of U.S. Official Holdings, April 22, 2002
Proposals to Allow Federal Reserve Banks to Pay Interest on Reserve Balances: The Issues Behind the Legislation, March 5, 2002

On health issues-

Environmental Exposure to Endocrine Disruptors: What Are the Human Health Risks?, February 4, 2002
Dietary Supplements: Legislative and Regulatory Status, July 11, 2002

On gun control-

The United Nations and “Gun Control”, April 7, 2005
Long-Range Fifty Caliber Rifles: Should They Be More Strictly Regulated?, July 25, 2005
Gun Control: Statutory Disclosure Limitations on ATF Firearms Trace Data and Multiple Handgun Sales Reports, February 1, 2008

On the current financial crisis-

Federal Loans to the Auto Industry Under the Energy Independence and Security Act, November 13, 2008
Containing Financial Crisis, November 24, 2008
China and the Global Financial Crisis: Implications for the United States, November 24, 2008
Fannie Mae’s and Freddie Mac’s Financial Problems: Frequently Asked Questions, September 12, 2008

And that’s just from a 5 minute scan. There is a year’s worth of reading here.

Ever since September 11, 2001, our government has made it it’s business to know what we are up to. Well I say it’s time we learned what it is up to. There is no better way to predict what our legislators will do than to know what information they are being fed. Information is power. Happy reading.

Read Full Post »

for-dummies-guyOK. a few people were upset about the writeup of the healthcare provisions in H.R. 1 that I posted yesterday, claiming that I left out important details like actual quotes from the bill, page numbers, etc. They seem to ignore the fact that I prominently linked the following article:

Ruin Your Health With the Obama Stimulus Plan: Betsy McCaughey

which clearly provides these page numbers and that I linked the following PDF of H.R. 1:

American Recovery and Reinvestment Act of 2009

to which these page numbers can easily be referenced by anyone who happens to be literate.

I guess I took for granted that some of you were energetic and curious enough to look at the bill for yourselves, instead of taking my word for it. However, because I want you all to be fully informed, and because I know laziness is extremely prevalent in our society today, I offer the following revisions to yesterday’s post.

1. H.R. 1 sets up a federal system by which all medical treatments will be electronically tracked.
-“The National Coordinator shall, in consultation with other appropriate Federal agencies (including the National Institute of Standards and Technology), update the Federal Health IT Strategic Plan (developed as of June 3, 2008 ) to include specific objectives, milestones, and metrics with respect to the following:
(i) The electronic exchange and use of health information and the enterprise integration of such information.
(ii) The utilization of an electronic health record for each person in the United States by 2014.”
–H.R.1, pg 444-445, lines 13-24, 1-3
-“AREAS REQUIRED FOR CONSIDERATION.—For purposes of subparagraph (A), the HIT Policy Committee shall make recommendations for at least the following areas: (ii) A nationwide health information technology infrastructure that allows for the electronic use and accurate exchange of health information. (iii) The utilization of a certified electronic health record for each person in the United States by 2014.” –H.R.1, pg 453-454, lines 21-24, 1-3
-“Subtitle B—Incentives for the Use of Health Information Technology SEC. 3011. IMMEDIATE FUNDING TO STRENGTHEN THE HEALTH INFORMATION TECHNOLOGY INFRASTRUCTURE. (a) IN GENERAL.—The Secretary shall, using amounts appropriated under section 3018, invest in the infrastructure necessary to allow for and promote the electronic exchange and use of health information for each individual in the United States consistent with the goals outlined in the strategic plan developed by the National Coordinator (and as available) under section 3001. To the greatest extent practicable, the Secretary shall ensure that any funds so appropriated shall be used for the acquisition of health information technology that meets standards and certification criteria adopted before the date of the enactment of this title until such date as the standards are adopted under section 3004. The Secretary shall invest funds through the different agencies with expertise in such goals, such as the Office of the National Coordinator for Health Information Technology, the Health Resources and Services Administration, the Agency for Healthcare Research and Quality, the Centers of Medicare & Medicaid Services, the Centers for Disease Control and Prevention, and the Indian Health Service to support the following: (1) Health information technology architecture that will support the nationwide electronic exchange and use of health information in a secure, private, and accurate manner, including connecting health information exchanges, and which may include updating and implementing the infrastructure necessary within different agencies of the Department of Health and Human Services to support the electronic use and exchange of health information. (2) Development and adoption of appropriate certified electronic health records for categories of providers, as defined in section 3000, not eligible for support under title XVIII or XIX of the Social Security Act for the adoption of such records.” –H.R.1, pg 479-480, lines 9-25, 1-23

2. The bill creates a new bureaucracy, the National Coordinator of Health Information Technology, which will monitor your doctor’s prescribed treatments and make sure they are in line with what the federal government thinks they should be.
-“SEC. 3001. OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY. (a) ESTABLISHMENT.—There is established within the Department of Health and Human Services an Office of the National Coordinator for Health Information Technology (referred to in this section as the ‘Office’). The Office shall be headed by a National Coordinator who shall be appointed by the Secretary and shall report directly to the Secretary. (b) PURPOSE.—The National Coordinator shall perform the duties under subsection (c) in a manner consistent with the development of a nationwide health information technology infrastructure that allows for the electronic use and exchange of information and that—(4) provides appropriate information to help guide medical decisions at the time and place of care.” –H.R.1, pg 441-442, lines 10-23, 10-12
-“IN GENERAL.—The National Coordinator shall, in consultation with other appropriate Federal agencies (including the National Institute of Standards and Technology), update the Federal Health IT Strategic Plan (developed as of June 3, 2008 ) to include specific objectives, milestones, and metrics with respect to the following: (vii) Strategies to enhance the use of health information technology in improving the quality of health care, reducing medical errors, reducing health disparities, improving public health, and improving the continuity of care among health care settings.” –H.R.1, pg 444-446, lines 14-21, 24-25, 1-4

3. The bill outlines strict penalties for doctors and hospitals who are not willing to be “assisted and guided” by the federal government.
-“(1)INCENTIVE PAYMENTS — IN GENERAL.—Subject to the succeeding subparagraphs of this paragraph, with respect to covered professional services furnished by an eligible professional during a payment year (as defined in subparagraph (E)), if the eligible professional is a meaningful user (as determined under paragraph (2)) for the reporting period with respect to such year, in addition to the amount otherwise paid under this part, there also shall be paid to the eligible professional (or to an employer or facility in the cases described in clause (A) of section 1842(b)(6)), from the Federal Supplementary Medical Insurance Trust Fund established under section 1841 an amount equal to 75 percent of the Secretary’s estimate (based on claims submitted not later than 2 months after the end of the payment year) of the allowed charges under this part for all such covered professional services furnished by the eligible professional during such year.” –H.R.1, pg 5-11-512, lines 16-25, 1-12
Notice that only “meaningful users” of the new system will receive incentive payment, effectively strangling the income of physicians and hospitals that decide not to use the new system.
-“The Secretary shall seek to improve the use of electronic health records and health care quality over time by requiring more stringent measures of meaningful use selected under this paragraph.” –H.R.1, pg 518, lines 6-15
-“(3) MEANINGFUL EHR USER.— (A) IN GENERAL.—For purposes of paragraph (1), an eligible hospital shall be treated as a meaningful EHR user for a reporting period for a payment year (or, for purposes of subsection (b)(3)(B)(ix), for a reporting period under such subsection for a fiscal year) if each of the following requirements are met: (i) MEANINGFUL USE OF CERTIFIED EHR TECHNOLOGY.—The eligible hospital demonstrates to the satisfaction of the Secretary, in accordance with subparagraph (C)(i), that during such period the hospital is using certified EHR technology in a meaningful manner. (ii) INFORMATION EXCHANGE.—The eligible hospital demonstrates to the satisfaction of the Secretary, in accordance with subparagraph (C)(i), that during such period such certified EHR technology is connected in a manner that provides, in accordance with law and standards applicable to the exchange of information, for the electronic exchange of health information to improve the quality of health care, such as promoting care coordination. (iii) REPORTING ON MEASURES USING EHR.—Subject to subparagraph(B)(ii) and using such certified EHR technology, the eligible hospital submits information for such period, in a form and manner specified by the Secretary, on such clinical quality measures and such other measures as selected by the Secretary under subparagraph (B)(i). The Secretary shall seek to improve the use of electronic health records and health care quality over time by requiring more stringent measures of meaningful use selected under this paragraph.” -H.R.1, pg 540-541, lines 6-25, 1-20

4. Another goal of the bill is to reduce the use of new medications and treatments, as these tend to cost more. Quoting Betsy McCaughey:

“What penalties will deter your doctor from going beyond the electronically delivered protocols when your condition is atypical or you need an experimental treatment? The vagueness is intentional. In his book, Tom Daschle proposed an appointed body with vast powers to make the “tough” decisions elected politicians won’t make.
The stimulus bill does that, and calls it the Federal Coordinating Council for Comparative Effectiveness Research. The goal, Daschle’s book explained, is to slow the development and use of new medications and technologies because they are driving up costs. He praises Europeans for being more willing to accept “hopeless diagnoses” and “forgo experimental treatments,” and he chastises Americans for expecting too much from the health-care system.”

-“(a) ESTABLISHMENT.—There is hereby established a Federal Coordinating Council for Comparative Effectiveness Research (in this section referred to as the ‘‘Council’’). (b) PURPOSE; DUTIES.—The Council shall— (1) assist the office and agencies of the Federal Government, including the Departments of Health and Human Services, Veterans Affairs, and Defense, and other Federal departments or agencies, to coordinate the conduct or support of comparative effectiveness and related health services research; and (2) advise the President and Congress on— (A) strategies with respect to the infrastructure needs of comparative effectiveness research within the Federal Government; (B) appropriate organizational expenditures for comparative effectiveness research by relevant Federal departments and agencies; and (C) opportunities to assure optimum coordination of comparative effectiveness and related health services research conducted or supported by relevant Federal departments and agencies, with the goal of reducing duplicative efforts and encouraging coordinated and complementary use of resources.” –H.R.1, pg 190-191, lines 14-24, 1-10

5. The bill authorizes more treatments for younger patients, who theoretically have more of their useful lifespan remaining, and less medical care for elderly patients. This would be accomplished by changing the Medicare system, which now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost-effectiveness standard set by the Federal Council.
-“ADOPTION OF INITIAL SET OF STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA.—(1) IN GENERAL.—Not later than December 31, 2009, the Secretary shall, through the rulemaking process described in section 3004(a), adopt an initial set of standards, implementation specifications, and certification criteria for the areas required for consideration under section 3002(b)(2)(B). (2) APPLICATION OF CURRENT STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA.—The standards, implementation specifications, and certification criteria adopted before the date of the enactment of this title through the process existing through the Office of the National Coordinator for Health Information Technology may be applied towards meeting the requirement of paragraph (1).” –H.R.1, pg 463-464, lines 14-25, 1-6.
For more information on this point, go here and here.

Incidentally, you should always look at all sides of an issue. For a view of this topic from the left, go here.

There you have it. It was a lot more work for me, but it saved you a couple of mouse clicks. By the way, thanks to all of you who actually made an effort to learn something.

Read Full Post »

Older Posts »