Clarity, Confidence, and Governing with a Vision

Charles Krauthammer’s piece today is a must read to give much-needed clarity to the debt ceiling battles consuming Washington.

He explains that the battles are a reflection of “the distinctive visions of the two parties — social-democratic versus limited-government” and that these very different visions “have underlain every debate on every issue since Barack Obama’s inauguration: the stimulus, the auto bailouts, health-care reform, financial regulation, deficit spending. Everything. The debt ceiling is but the latest focus of this fundamental divide.

“The sausage-making may be unsightly, but the problem is not that Washington is broken, that ridiculous, ubiquitous cliché. The problem is that these two visions are in competition, and the definitive popular verdict has not yet been rendered… That awaits definitive resolution, the rubber match of November 2012.

“I have every sympathy with the conservative counterrevolutionaries. Their containment of the Obama experiment has been remarkable. But reversal — rollback, in Cold War parlance — is simply not achievable until conservatives receive a mandate to govern from the White House,” Krauthammer writes.

House Republicans will be blamed if a deal isn’t reached, and they will be held responsible for the fallout. The White House is looking for every opportunity to blame someone else for the miserable economy — including today’s economic numbers showing we are dangerously close to another recession.

Speaker Boehner recognizes this risk more than anyone, and he is doing everything he can to put together a bill that will get to 218 votes.

The debt crisis is a health spending crisis, plain and simple, and real change will take much longer. Government spending on health care entitlements will bankrupt this nation unless we reform these programs. And ObamaCare’s new entitlement programs will make the problems much, much worse.

We must take the long view and know that the American people want to have confidence that their leaders can govern. Passing the debt ceiling bill in the House will provide that confidence so that conservatives can continue the real work of scaling back government and providing the climate for a prosperous economic future.

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NFIB shockwave poll: The National Federation of Independent Business caused shockwaves this week with an extensive poll that showed 57% of small businesses were either very or somewhat likely to drop coverage after the health law takes effect. The survey also showed that, since the law passed, 12% of small employers said their health plan has been, or soon will be, terminated.

But the real blockbuster finding, which has not been widely reported, is that 55% of them say it is “not too likely” (18%) or “not at all likely” (37%!) that their business will have an employee health insurance plan a year from now!

This is shocking, indeed. But there is a very positive and optimistic alternative. The survey also found that 57% of small businesses would continue to participate in health coverage if they had a different option — one that involves giving employees a “tax-excluded contribution” they could use to purchase health insurance in an “open market.”

This is the defined contribution model that we believe is the future of 21st century health benefits after ObamaCare falls. A defined contribution (which works like a 401k) would give employees more control over their choices of health insurance coverage, give them ownership so the policy is portable and not dependent upon their job, and provide a greater incentive to shop for the best value — thereby forcing the health insurance marketplace to provide better benefits at better prices.

NFIB can lead the way on this.

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Kaiser shockwave poll: Americans are pessimistic that the new health care law will improve the quality of medicine, do a better job of protecting consumers, or lower costs, according to a new Kaiser poll.

  • 41% said quality would decline under the law
  • 49% say health costs will rise. Many say they already are feeling the impact: six of 10 people with private insurance are seeing higher premiums; half cite increases in their co-pays and deductibles.
  • Only 20% believe that consumer protections will improve under the law.


The law gets more unpopular by the day.

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Feds moving in: During the debt battles, a major story slipped off the radar:

Health and Human Services Secretary Kathleen Sebelius announced this week that the feds are moving into 10 states that she believes are deficient in regulating health insurance rates in individual and small group markets.

Starting Sept. 1, “federal and state officials will begin to scrutinize proposed rate increases of more than 10 percent to determine if they are justified,” according to correspondent Robert Pear’s report in The New York Times.

Seven states — Alabama, Arizona, Idaho, Louisiana, Missouri, Montana, and Wyoming — don’t have effective rate review programs in either market. Virginia, Iowa, and Pennsylvania will be scrutinized for rates offered to small groups.

Sen. John Barrasso, “Wyoming’s Doctor,” is rightfully fighting back. “In Wyoming, state leaders have chosen to let the free market work. The president and his administration have no idea what is best for the people of Wyoming,” he said.

This is a harbinger of what’s coming with ObamaCare as the feds treat the states like subjects rather than the sovereign entities that the Constitution deems them to be.

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Hot and cold: Washington seems to be in the most intense legislative battles when the weather is at its most extreme. And the heated battles over the debt ceiling with heat index temperatures reaching 120° in some parts of the city this month is par for the course.

But I’m right now in Colorado, where there is still snow on the mountains! I’m here to participate in a debate over health reform at the Colorado Health Foundation’s 30th annual meeting. Watch this space for more. Teaser: I won a bushel of delicious Colorado peaches in the debate.


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Washington’s Rebate Tax Would Be Paid By Seniors

Grace-Marie Turner
Kaiser Health News, 07/27/11

Leading congressional Democrats have proposed a new tax on prescription drugs for seniors — a tax that would have the effect of increasing Medicare drug plan premiums for some seniors by as much as 40 percent. Lawmakers wouldn’t describe their plan that way, of course, but that would be the effect of their proposal to require drug companies to pay Medicaid-style rebates to Medicare. If the new Medicare rebate tax were imposed, more than 17 million seniors who don’t qualify for low-income subsidies would face drug benefit premiums that would be 20 to 40 percent higher than they are paying now, and they would face an average of $200 a year in higher out-of-pocket costs, according to a study by Doug Holtz-Eakin and Michael Ramlet of American Action Forum. The rebate plan is not a way to cut government spending but is simply a ploy to shift higher costs to seniors. Congress should look elsewhere for real savings rather than resorting to gimmicks that will trick seniors into paying the bill.

Read More »

Jobs Gone to Obamacare

Grace-Marie Turner
National Review Online: Critical Condition, 07/22/11

The conclusion is inescapable that Obamacare is killing job creation and smothering the recovery, and now The Heritage Foundation’s James Sherk has produced a study that clearly shows the correlation. He compared job growth before and after the health overhaul law passed in March of 2010 and finds that it basically flatlined after the law was signed. Before Obamacare passed, the number of new jobs was soaring. Private-sector job creation had improved by an average of nearly 68,000 a month in the 15 months before April 2010. But in the 15 months since then, it has slowed to an average of 6,500 a month, a ten-fold drop. Sherk points out in his paper that “correlation cannot prove causation.” But he says the evidence “does lend strong weight to the voices of business who say that the law is preventing hiring.”

Read More »


Small Business and Health Insurance: One Year After Enactment of PPACA
National Federation of Independent Business, 07/11

Small Businesses and PPACA: If They Like Their Coverage, Can They Keep It?
Douglas Holtz-Eakin, Testimony before the House Small Business Committee Subcommittee on Healthcare and Technology, 07/28/11

National Health Spending Projections Through 2020: Economic Recovery And Reform Drive Faster Spending Growth
Sean P. Keehan, Andrea M. Sisko, Christopher J. Truffer, John A. Poisal, Gigi A. Cuckler, Andrew J. Madison, Joseph M. Lizonitz, and Sheila D. Smith, Health Affairs, 08/11

Nation’s Health Care Bill To Nearly Double By 2020
Phil Galewitz, Kaiser Health News, 07/28/11

If Health Spending Controls Fail, What Are the Options?
Stuart Butler, Ph.D., The Heritage Foundation, 07/26/11

Is Obamacare the Source of Obama’s Approval Woes?
Jeffrey H. Anderson, The Weekly Standard: The Blog, 07/25/11

Poll Finds Americans Gloomy On Some Promises In Health Law
Jordan Rau, Kaiser Health News, 07/28/11

The GOP’s Secret Weapon: Flower Power
Karlyn Bowman and Andrew Rugg, The Wall Street Journal, 07/28/11

Reviving Formal Rulemaking: Openness and Accountability for Obamacare
Gary Lawson, The Heritage Foundation, 07/25/11

‘The Flight to the Exchanges’
The Wall Street Journal, 07/25/11

Federal Auditors Will Soon Review Health Insurance Rates in 10 States
Robert Pear, The New York Times, 07/25/11

Employer Health Reform Survey Results
Lockton, 06/11

82% Say Workers Should Be Allowed To Choose Their Own Insurance
Rasmussen Reports, 07/27/11

The Road to a Downgrade
The Wall Street Journal, 07/28/11


The 7 Things Your Health Insurance Customers Are Not Telling You
Accenture, 07/11


Implementation of Medicare Part D and Nondrug Medical Spending for Elderly Adults With Limited Prior Drug Coverage
J. Michael McWilliams, MD, PhD, Alan M. Zaslavsky, PhD, Haiden A. Huskamp, PhD, The Journal of the American Medical Association, 07/27/11

A Dangerous Medicare Proposal
Tomas J. Philipson, The Wall Street Journal, 07/26/11

Trends in Medigap Coverage and Enrollment, 2010-2011
America’s Health Insurance Plans, 07/11


The High Price of Massachusetts Health Care Reform
David G. Tuerck, PhD, Paul Bachman, MSIE, Michael Head, MSEP, The Beacon Hill Institute, 06/11


Strengthening Medicaid with Health Information Technology: Are Providers & States Up to the Challenge?
Alliance for Health Reform Briefing
Monday, August 1, 2011
12:30pm – 2:15pm
Washington, DC

Doctors Town Hall
National Doctors Tea Party Event
Saturday, August 6, 2011
1:30pm – 5:00pm
Nashville, TN

Third Annual Freedom Conference
Steamboat Institute Event
August 19-20, 2011
Steamboat Springs, CO
Grace-Marie Turner will participate in the “Fixing Medicare and Strengthening America: A Health Care Reform Toolkit” panel at 9:10am on Saturday, August 20.

Martin Luther King, Jr. Health Equity Summit
Institute for the Advancement of Multicultural & Minority Medicine Event
August 22-23, 2011
Washington, DC