Consumerism in Europe

How extraordinary it was in London and Paris last week to hear broad agreement about the value of consumer choice, competition, portability, and the essential role that private providers play in health care in Europe.

The world has turned upside down.

I was in Paris to speak at the first pan-European conference focusing on the issue of private hospitals, organized by the European Union of Private Hospitals and its president, Dr. Max Ponseille and vice-president, Alberta Sciachi. More than 400 people attended, including members of the EU parliament, former health ministers, and many corporate CEOs.

Throughout Europe, a network of private hospitals is growing. Government officials say private hospitals are essential in serving as a safety valve for public health systems to give people a way out of waiting lines that would be even longer without their services.

There was general agreement among almost everyone at the conference that private hospitals are essential in the mix of care. And many say the private hospitals make public hospitals better by providing competition.

How tragic, then, that the recently passed health overhaul law in the U.S. effectively prohibits new physician-owned private hospitals. Physician Hospitals of America has rightly filed suit challenging the law’s provisions.

John Bowis, former Minister of Health for the United Kingdom, spoke about the importance of allowing “patients to be partners in managing their care” and that “information is key to empowering patients.”

Clearly, Europeans have come to these conclusions based upon long experience with government-controlled, bureaucratically-run health systems. And yet, here we are in the U.S. going head first into “reforms” that will reduce the role of genuine competition and put more and more power and control over health care decisions in the hands of government bureaucrats.

And in London, I spoke at a luncheon briefing organized by the Stockholm Network and its energetic and competent CEO Helen Disney.

Even in Britain with its government-controlled health system, doctors have private practices. Doctors work under contract to treat patients in the National Health Service, but they also see patients who pay privately, often with private insurance they receive through their employers.

There is tremendous interest in the health overhaul law in the U.S. Here is the PowerPoint presentation I used during my opening keynote address in Paris — which was translated in real time into four other languages — to give them an overview.


Casualty: A tragic early casualty of ObamaCare is a terrific new company run by Paul Kitchen in Richmond called nHealth. “The hotly debated healthcare reform bill signed into law in March has killed a local insurance company,” according to a Richmond BizSense news report.

nHealth offered HSA-qualified high deductible insurance combined with wellness and coordinated care programs, but the health overhaul law has made the two-year-old company’s business model unsustainable, denying clients a hugely popular health option and putting 50 employees out of work. Here’s the report:

According to nHealth CEO Paul Kitchen and Paul Nezi, one of the company’s original investors and former board members, regulatory changes the company believes are coming as a result of the legislation will require levels of capital beyond what nHealth’s business model can sustain.

“Despite a product that was gaining increasing acceptance among companies throughout the Commonwealth, the uncertainties in the regulatory climate coupled with new demands imposed by national healthcare reforms have made it challenging to sustain the level of sales required to remain viable over the long run,” Slabaugh said in the letter.

Founded in 2008, nHealth was built around a high deductible insurance plan model that utilized health savings accounts and kept costs down [by] making consumers more involved in their healthcare decisions.

nHealth was recognized in October 2008 by the Venture Forum as a promising company to watch and Nezi said the model was gaining acceptance in the market.

“Our results over the last couple of years prove the product does work,” Nezi said. “I believed and still believe in the product design or I wouldn’t have invested in the company.”

The letter to agent[s] stated nHealth has “ample capital to pay claims” for business on the books through the end of the year. It also said the company will continue to pay commissions on business “as long as it remains on nHealth’s books.”

What a sad day for nHealth, the tireless work of Paul and his team of entrepreneurs, and the clients who loved the product they offered.


HHS to monitor recipes? Galen Institute founding board member John Hoff was a winner in the Politico Pulse contest on the “most overlooked health reform provision.” To quote the Pulse:

John Hoff, of the Galen Institute, found a choice paragraph in Section 4205. The provision, which requires chain restaurants and vending machines to provide nutrition notices, instructs the HHS Secretary to “consider standardization of recipes and methods of preparation, in reasonable variation in serving size and formula of menu items, space on menus and menu boards, inadvertent human error, training of food service workers, variations in ingredients…” Considering recipes? Sounds more like cooking class, less like health reform.


America! On a bright note, I was at Ronald Reagan National Airport yesterday morning where there were an unusual number of uniformed military personnel. Inside security, a crowd had gathered at one of the US Airways gates, clearly awaiting someone special.

It turned out that the festivities were to welcome 40 World War II veterans who were flying to Washington from Kansas City for their first visit to the World War II memorial. Several hundred people — mostly other travelers like me — gathered around the gate for a wonderful and spontaneous welcoming ceremony.

An honor guard of servicemen and women had held a small welcoming ceremony on the tarmac, and back in the terminal, someone was playing patriotic and military tunes as we all clapped and cheered the veterans as they arrived at the gate.

The veterans all were in their 80s and 90s, some in wheelchairs. How moving it was to see the young, uniformed personnel guiding them in. One person held a sign that said: “If you can read this in English, thank a veteran.”

These are truly heroes, every one of them. And the citizens that cheered them knew that and were anxious to say hello and shake their hands.

My father was a veteran of WWII, and here is a link to his diary as a B-17 pilot flying out of North Africa early in the war. I thought about him and how very much this little ceremony would have meant to him. What a great country this is.


Grace-Marie Turner on ObamaCare’s Restrictive 1099 Tax Requirement

In this week’s Clip of the Week, Grace-Marie Turner outlines ObamaCare’s 1099 tax provision, which will force businesses to f
ile millions of tax papers and pay billions of dollars to finance President Obama’s costly health overhaul. Watch now >>

GMT on 1099 Requirement




Labor Markets and Health Care Reform: New Results

Doglas Holtz-Eakin and Cameron Smith, American Action Forum
American Action Forum, 05/10

The Patient Protection and Affordable Care Act (PPAC) will have profound implications for U.S. labor markets. The PPAC is fiscally dangerous, raising the risk of higher labor (and other) taxes at a time when the job market is struggling. It provides strong incentives for employers — with the agreement of their employees — to drop employer-sponsored health insurance for as many as 35 million Americans, perhaps leading to widespread turmoil in labor compensation and employee insurance coverage — and raising the gross taxpayer cost of the subsidies to roughly $1.4 trillion in the first 10 years. Finally, the bill exacerbates the already-high effective marginal tax rates on low-income workers. Every worker forced onto the subsidized exchanges will face higher barriers to upward mobility and the pursuit of the American Dream.
Read More »

Republican leaders of the House Energy and Commerce Committee wrote to President Obama this week expressing their concerns about the loss of employer-based health benefits as a result of the health overhaul law.

ObamaCare vs. Small Business

Dan Danner, National Federation of Independent Business
The Wall Street Journal, 05/27/10

For decades small business owners have been telling anyone who would listen that they need health care reforms that lower costs. But President Obama and his allies in Congress pushed through a law that will dramatically raise health care costs and increase the overall cost of doing business. What's more, the federal mandate requiring that nearly all U.S. residents carry health insurance by 2014 seriously threatens our basic constitutional rights and individual freedoms. This is why the National Federation of Independent Business (NFIB), on behalf of small business owners nationwide, has joined the lawsuit with 20 states mounting a constitutional challenge to this devastating new health care law.
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Critics Question Study Cited in Health Debate

Reed Abelson and Gardiner Harris
The New York Times, 06/02/10

In selling the health care overhaul to Congress, the Obama administration cited a once obscure research group at Dartmouth College to claim that it could not only cut billions in wasteful health care spending but make people healthier by doing so…But while the research compiled in the Dartmouth Atlas of Health Care has been widely interpreted as showing the country’s best and worst care, the Dartmouth researchers themselves acknowledged in interviews that in fact it mainly shows the varying costs of care in the government’s Medicare program. Measures of the quality of care are not part of the formula. The Dartmouth researchers responded to The New York Times story with this four-page response. The story also prompted a response from Harvard Professor David Cutler, who claims that his quotes in the story were misconstrued.
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The Debt Commission, Health Care, and Obama’s Budgetary Game Plan

Jim Capretta, Ethics and Public Policy Center
The Heritage Foundation, 06/02/10

When the President’s National Commission on Fiscal Responsibility and Reform (commonly referred to as the “debt commission”) held its first official meeting in April, all of the talk was of getting serious about putting the nation’s fiscal house in order and that everything would be “on the table” for consideration. Unfortunately, the timeline for the United States to take corrective action may have already been shortened. The slow-motion crumble of Greece’s economic house of cards has now quite clearly become the triggering point for full-fledged examination of the risks posed by massive increases in governmental debt combined with aging populations around the developed world. No country is exempt from the scrutiny of the bond markets, including the U.S. The new health care law will only worsen the nation’s fiscal situation, and despite President Obama’s claim that “everything is on the table,” it is clear that the Administration wants to lock in Obamacare and force the commission to look elsewhere.
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White House misses early deadlines in ObamaCare implementation

Jonathan Strong
The Daily Caller, 06/02/10

Critics say missed deadlines and other signs show the Obama administration is stumbling out of the gate on its early steps to implement the president’s health care law. The Department of Health and Human Services (HHS) has already missed as many as four deadlines under the law — not on any major regulations — but still a worrying trend, critics say. Congressional staff and industry representatives have also been asking HHS for a timeline specifying when it will issue the numerous regulations required by the law. They were shocked to find the agency has not produced such a document, one aide said.
Read More »



Moving Forward on Health Reform
Health Affairs Briefing
Tuesday, June 8, 2010
8:30am – 12:30pm
Washington, DC

Policy Forum: Governor Mitch Daniels of Indiana Discusses the Cost of Health Reform
Congressional Health Care Caucus Event
Tuesday, June 8, 2010
12:30pm – 1:30pm
Washington, DC

What's Next? Reporting on Health Reform Between Now and 2014
Alliance for Health Reform Media Briefing
Thursday, June 10, 2010
12:15pm – 1:30pm
Washington, DC

Health Care Reform and Long‐Term Care: A Policy Forum
The SCAN Foundation Event and Webinar
Friday, June 11, 2010
10:00am – 12:00pm
Sacramento, CA

Institute on Business and Government Affairs Evening Forum
The Fund for American Studies Event
Monday, June 14, 2010
7:30pm – 9:00pm
Washington, DC
Grace-Marie Turner will speak to students about current health care legislation and how it will affect the health care industry.

The Role of Health Information Technology in Quality Improvement
National Quality Forum Webinar
Thursday, June 17, 2010
1:00pm – 2:00pm Eastern

How Will ObamaCare Affect Young Adults?
Cato Institute and Galen Institute Student Forum
Thursday, June 24, 2010
4:00pm (Reception to follow)
Washington, DC