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Article posted Mar 22 2010, 12:10 PM Category: Politics/Corruption Source: Investors.com Print

20 Ways ObamaCare Will Take Away Our Freedoms

By David Hogberg

With House Democrats poised to pass the Senate health care bill with some reconciliation changes later today, it is worthwhile to take a comprehensive look at the freedoms we will lose.

Of course, the overhaul is supposed to provide us with security. But it will result in skyrocketing insurance costs and physicians leaving the field in droves, making it harder to afford and find medical care. We may be about to live Benjamin Franklin's adage, "People willing to trade their freedom for temporary security deserve neither and will lose both."

The sections described below are taken from HR 3590 as agreed to by the Senate and from the reconciliation bill as displayed by the Rules Committee.

1. You are young and don't want health insurance? You are starting up a small business and need to minimize expenses, and one way to do that is to forego health insurance? Tough. You have to pay $750 annually for the "privilege." (Section 1501)

2. You are young and healthy and want to pay for insurance that reflects that status? Tough. You'll have to pay for premiums that cover not only you, but also the guy who smokes three packs a day, drink a gallon of whiskey and eats chicken fat off the floor. That's because insurance companies will no longer be able to underwrite on the basis of a person's health status. (Section 2701).

3. You would like to pay less in premiums by buying insurance with lifetime or annual limits on coverage? Tough. Health insurers will no longer be able to offer such policies, even if that is what customers prefer. (Section 2711).

4. Think you'd like a policy that is cheaper because it doesn't cover preventive care or requires cost-sharing for such care? Tough. Health insurers will no longer be able to offer policies that do not cover preventive services or offer them with cost-sharing, even if that's what the customer wants. (Section 2712).

5. You are an employer and you would like to offer coverage that doesn't allow your employers' slacker children to stay on the policy until age 26? Tough. (Section 2714).

6. You must buy a policy that covers ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services; chronic disease management; and pediatric services, including oral and vision care.

You're a single guy without children? Tough, your policy must cover pediatric services. You're a woman who can't have children? Tough, your policy must cover maternity services. You're a teetotaler? Tough, your policy must cover substance abuse treatment. (Add your own violation of personal freedom here.) (Section 1302).

7. Do you want a plan with lots of cost-sharing and low premiums? Well, the best you can do is a "Bronze plan," which has benefits that provide benefits that are actuarially equivalent to 60% of the full actuarial value of the benefits provided under the plan. Anything lower than that, tough. (Section 1302 (d) (1) (A))

8. You are an employer in the small-group insurance market and you'd like to offer policies with deductibles higher than $2,000 for individuals and $4,000 for families? Tough. (Section 1302 (c) (2) (A).

9. If you are a large employer (defined as at least 101 employees) and you do not want to provide health insurance to your employee, then you will pay a $750 fine per employee (It could be $2,000 to $3,000 under the reconciliation changes). Think you know how to better spend that money? Tough. (Section 1513).

10. You are an employer who offers health flexible spending arrangements and your employees want to deduct more than $2,500 from their salaries for it? Sorry, can't do that. (Section 9005 (i)).

11. If you are a physician and you don't want the government looking over your shoulder? Tough. The Secretary of Health and Human Services is authorized to use your claims data to issue you reports that measure the resources you use, provide information on the quality of care you provide, and compare the resources you use to those used by other physicians. Of course, this will all be just for informational purposes. It's not like the government will ever use it to intervene in your practice and patients' care. Of course not. (Section 3003 (i))

12. If you are a physician and you want to own your own hospital, you must be an owner and have a "Medicare provider agreement" by Feb. 1, 2010. (Dec. 31, 2010 in the reconciliation changes.) If you didn't have those by then, you are out of luck. (Section 6001 (i) (1) (A))

13. If you are a physician owner and you want to expand your hospital? Well, you can't (Section 6001 (i) (1) (B). Unless, it is located in a country where, over the last five years, population growth has been 150% of what it has been in the state (Section 6601 (i) (3) ( E)). And then you cannot increase your capacity by more than 200% (Section 6001 (i) (3) (C)).

14. You are a health insurer and you want to raise premiums to meet costs? Well, if that increase is deemed "unreasonable" by the Secretary of Health and Human Services it will be subject to review and can be denied. (Section 1003)

15. The government will extract a fee of $2.3 billion annually from the pharmaceutical industry. If you are a pharmaceutical company what you will pay depends on the ratio of the number of brand-name drugs you sell to the total number of brand-name drugs sold in the U.S. So, if you sell 10% of the brand-name drugs in the U.S., what you pay will be 10% multiplied by $2.3 billion, or $230,000,000. (Under reconciliation, it starts at $2.55 billion, jumps to $3 billion in 2012, then to $3.5 billion in 2017 and $4.2 billion in 2018, before settling at $2.8 billion in 2019 (Section 1404)). Think you, as a pharmaceutical executive, know how to better use that money, say for research and development? Tough. (Section 9008 (b)).

16. The government will extract a fee of $2 billion annually from medical device makers. If you are a medical device maker what you will pay depends on your share of medical device sales in the U.S. So, if you sell 10% of the medical devices in the U.S., what you pay will be 10% multiplied by $2 billion, or $200,000,000. Think you, as a medical device maker, know how to better use that money, say for R&D? Tough. (Section 9009 (b)).

The reconciliation package turns that into a 2.9% excise tax for medical device makers. Think you, as a medical device maker, know how to better use that money, say for research and development? Tough. (Section 1405).

17. The government will extract a fee of $6.7 billion annually from insurance companies. If you are an insurer, what you will pay depends on your share of net premiums plus 200% of your administrative costs. So, if your net premiums and administrative costs are equal to 10% of the total, you will pay 10% of $6.7 billion, or $670,000,000. In the reconciliation bill, the fee will start at $8 billion in 2014, $11.3 billion in 2015, $1.9 billion in 2017, and $14.3 billion in 2018 (Section 1406).Think you, as an insurance executive, know how to better spend that money? Tough.(Section 9010 (b) (1) (A and B).)

18. If an insurance company board or its stockholders think the CEO is worth more than $500,000 in deferred compensation? Tough.(Section 9014).

19. You will have to pay an additional 0.5% payroll tax on any dollar you make over $250,000 if you file a joint return and $200,000 if you file an individual return. What? You think you know how to spend the money you earned better than the government? Tough. (Section 9015).

That amount will rise to a 3.8% tax if reconciliation passes. It will also apply to investment income, estates, and trusts. You think you know how to spend the money you earned better than the government? Like you need to ask. (Section 1402).

20. If you go for cosmetic surgery, you will pay an additional 5% tax on the cost of the procedure. Think you know how to spend that money you earned better than the government? Tough. (Section 9017).





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Comments 1 - 10 of 10 Add Comment Page 1 of 1
Anonymous

Posted: Mar 22 2010, 7:24 PM

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208253 You are young and don't want health insurance? You are starting up a small business and need to minimize expenses, and one way to do that is to forego health insurance? Tough. You have to pay $750 annually for the "privilege." (Section 1501) -- Forgoing Health Insurance has proven to be too expensive for the country to tolerate, just like riding cars without seatbelts and bikes and motorcycles without helmets (young people get brain injured too), and for exactly the same reason: that catastrophic medical insults end up becoming a strain on public resources. So yes, we are trying as a nation to hold individuals accountable for their own personal and potential burden on society.

You are young and healthy and want to pay for insurance that reflects that status? Tough. You'll have to pay for premiums that cover not only you, but also the guy who smokes three packs a day, drink a gallon of whiskey and eats chicken fat off the floor. That's because insurance companies will no longer be able to underwrite on the basis of a person's health status. (Section 2701). – insurance companies don’t have to issue a policy if they deem someone too great a risk, and there are different insurance products for people with varying attributes / risk profiles. Drinking and eating / smoking / lifestyle habits are neither medical conditions nor pre-existing, and can be used by insurers to determine a prospective customer’s eligibility.

IRS powers are expanded too much by “allow[ing] the IRS to confiscate refunds if there are penalties for not buying health care” in 4+ years from now when that provision takes effect (http://informationliberation.com/?id=29408). This is a penalty for non-compliance with a government requirement, just like when Wesley Snipes went to prison for not filing taxes for 3 years. Criminal charges seems extreme of course, whereas the IRS refund check for overpayment (entirely at the hands and calculators of the individual taxpayer) seems pretty innocuous; I would welcome, and Obama specifically invited, other means of enforcement. For this objection to seem credible (i.e. based in fact and non-partisan) it needs to be accompanied by an alternative means of enforcing the law.

You would like to pay less in premiums by buying insurance with lifetime or annual limits on coverage? Tough. Health insurers will no longer be able to offer such policies, even if that is what customers prefer. (Section 2711). – Why should there be limits on coverage? The industry invented that, not consumers. Why would anyone complain that Insurance Companies have to pay too much for his/her own care? The limits should be on the costs to the individual, which are in fact capped by this Bill, which limits out‐of‐pocket spending requirements. Companies in every sector always ensure that their products comply with legislation, whether toys or lending practices that are toxic.

Health insurers will no longer be able to offer policies that do not cover preventive services or offer them with cost-sharing, even if that's what the customer wants. (Section 2712). – This is very short-sighted. Historically, non-coverage of preventative care does not make premiums lower, it makes them higher, while providing disincentives from people staying fit and well. Any affect on premiums in the first year or two from this is a small price to pay for the reduction in policy prices (and public health costs) that will occur over the ensuing decades.

You must buy a policy that covers ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services; chronic disease management; and pediatric services, including oral and vision care. (Section 1302) -- Yes, any condition or insult that creates symptoms, the treatment for which will ultimately will fall to society to pay, should be covered completely by a private insurer or the public option. Regardless of an individual’s perception of their own risk factors, the fact is that people have underrated their risk and burden to the extent that this legislation was necessary. The whole point of Medical insurance (as opposed to say, Auto, wherein a car can simply be confiscated) is to cover the individual for any eventuality – how could star athlete Lou Gehrig have anticipated ALS, and who would have paid for his rehabilitative and habilitative services and devices today if he ran out of money?

If you are a physician and you don't want the government looking over your shoulder? Tough. The Secretary of Health and Human Services is authorized to use your claims data to issue you reports that measure the resources you use, provide information on the quality of care you provide, and compare the resources you use to those used by other physicians. (Section 3003 (i)). The Government regulates Physicians already – they are licensed by State to write prescriptions and practice medicine. The biggest problem in health care is inefficiencies caused by fragmented institutions with no communication or technology integration among them. It is an appropriate role of government to facilitate access to information, particularly in the effort to reduce fraud (a major 30%+ drain on the system) and promote best practices.

If you are a physician and you want to own your own hospital, you must be an owner and have a "Medicare provider agreement" by Feb. 1, 2010. (Dec. 31, 2010 in the reconciliation changes.) If you didn't have those by then, you are out of luck. (Section 6001 (i) (1) (A)). If you are a physician owner and you want to expand your hospital? Well, you can't (Section 6001 (i) (1) (B). Unless, it is located in a country where, over the last five years, population growth has been 150% of what it has been in the state (Section 6601 (i) (3) ( E)). And then you cannot increase your capacity by more than 200% (Section 6001 (i) (3) (C)).-- If you are a physician and you want to own or expand your own hospital, you are an extremely rare case. The desires of one person are moot compared to the needs of millions and the Nation. This is clearly a complaint for its own sake, or motivated by personal or partisan gain.

You are a health insurer and you want to raise premiums to meet costs? Well, if that increase is deemed "unreasonable" by the Secretary of Health and Human Services it will be subject to review and can be denied. (Section 1003) --- LOL! I’m sure that Insurers will prefer the status quo, as they’re making a ton of money at everyone’s expense (like some other Financial companies we’ve seen recently).

The government will extract a fee of $2.3 billion annually from the pharmaceutical industry [on a per-company basis according to market share]. Think you, as a pharma / medical device maker, know how to better use that money, say for R&D? Tough. (Section 9009 (b)). – I do own a company in the Pharmaceutical and Device industry, and it is so rife with waste that I haven’t heard any objections to this among my peers. It seems fair, given our reliance on the FDA approval process and the industry’s extremely high profit margins. We pay many more Billions that that each year in taxes, and view all such regulatory issues as a simpe, expectable cost of doing business. Whoever wrote this is clearly ignorant of how global a business these are, and how much more restrictive and costly the requirements are in other countries.

17. The government will extract a fee of $6.7 billion annually from insurance companies. If you are an insurer, what you will pay depends on your share of net premiums plus 200% of your administrative costs. So, if your net premiums and administrative costs are equal to 10% of the total, you will pay 10% of $6.7 billion, or $670,000,000. In the reconciliation bill, the fee will start at $8 billion in 2014, $11.3 billion in 2015, $1.9 billion in 2017, and $14.3 billion in 2018 (Section 1406).Think you, as an insurance executive, know how to better spend that money? Tough.(Section 9010 (b) (1) (A and B).) – They clearly spend it on employee bonuses…makes me suspicious about the writer’s journalistic integrity and objectivity. Of course Insurance companies won’t like reform – it’s they whom we hope to reform! If that represents a hardship for them, given their contribution to this dilemma, that seems fair, sound and just. Lots of individuals suffered hardships due to their policies and practices. The hope will be that the good ones adapt and improve and the bad ones die out, just as we’ve seen in the Environmental movement (e.g. BP is now “Beyond” Petroleum instead of British). This is exactly how the economy is supposed to work, just as it did after the Meat Packing Act of 1908 – I don’t have to worry about rat hairs in my hot dog, and shouldn’t have to worry that my insurance will be pulled out from under me regardless of payment when I need it most.

You will have to pay an additional 0.5% payroll tax on any dollar you make over $250,000 if you file a joint return and $200,000 if you file an individual return. What? You think you know how to spend the money you earned better than the government? Tough. (Section 9015). That amount will rise to a 3.8% tax if reconciliation passes. It will also apply to investment income, estates, and trusts. You think you know how to spend the money you earned better than the government? Like you need to ask. (Section 1402). – I make well over that threshold and am perfectly happy to pay the slight increase to ensure the long-term survival of my nation’s economy and moral conscience, not to mention my own Industry. Everyone I know who is in or above my tax bracket feels similarly.

If you go for cosmetic surgery, you will pay an additional 5% tax on the cost of the procedure. Think you know how to spend that money you earned better than the government? Tough. (Section 9017). – Sin taxes are a very common fiscal legislative mechanism that date back to the Founding Fathers. When I smoked I paid extra for the privilege, and any who elect for cosmetic surgery will know the costs going in and can make their buying decision accordingly.
Joe 6pack

Posted: Mar 23 2010, 10:22 AM

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9990 Boy, you just have an answer for everything, don't you? You are an useful idiot.
We'll see how smart you are in a year or so, after the economy collapses.
Anonymous 2

Posted: Mar 23 2010, 11:00 AM

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70143 In response to Anonymous...

"So yes, we are trying as a nation to hold individuals accountable for their own personal and potential burden on society."

"trying", "accountable" , "their own personal" and "potential", "burden on society"

Are you frigging kidding me? IT IS NOT YOUR PLACE NOR PRESIDENT OBAMA'S PLACE TO HOLD ME TO HIS STANDARD OF ACCOUNTABLE!!!!

TO TAX ME, TO THREATEN ME, FINE ME AND POSSIBLY IMPRISON ME FOR MY "potential burden on society". YOU HAVE ONE HELL OF A NERVE.

I WOULD SUGGEST, THAT YOU HAVE A LITANY OF BEHAVIORS WHICH I WOULD FIND TO BE A POTENTIAL BURDEN ON SOCIETY BEGINNING WITH YOUR RIDICULOUS NOTION THAT YOU ARE ENTITLED TO SIT ON YOUR LAZY ASS WHILE SOMEBODY ELSE MAKES SURE YOU CAN TIE UP A DOCTOR'S OFFICE WITH SOME "potential" malady which you are "trying to be accountable"

So, if you wish to nanny someone, why don't you focus on our fine president's smoking and drinking which a group of doctors has advised him to "continue cessation efforts" and "moderate"

PISS OFF!
Anonymous

Posted: Mar 23 2010, 1:06 PM

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7462 Why would u not want healthcare? What if u have an accident and fall and break your kneecap or something and it requires surgery, u have no healtchare but u need the surgery what u gonna do then? or what if u own a small business and u want to cut expenses but not providing healthcare to your employees, then one of them gets swine flu and is deathly ill, they end up infecting a third of your employees because they didn't go to the doctor because they didn't have insurance. Now u have a third of your employees out sick, your company can't continue to run the way it's supposed to with that many people out. So u end up closing for a few days and you lose money. Where is the sense in that.
Anonymous Supporter

Posted: Mar 23 2010, 1:15 PM

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12922 Thank you, Anonymous. Some of the points on this list are pretty ridiculous. Take #14 for example. Am I supposed to be upset because the Secretary of Health and Human Services can stop insurers from raising premiums if those raises in premiums are deemed unreasonable? Really? I should be up in arms about that?

BTW, great rebuttal, Joe 6pack.
Anonymous

Posted: Mar 23 2010, 2:45 PM

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63147 I think that most of the liberal folks miss the point of what insurance is....insurance mainly does two things,
1. capture dollars today for potential future use tomorrow and/or
2. makes inexpensive people pay for expensive people...
Here is how it works. There are two parts of an insurance plan. The first part is the catastrophic portion. This is truly insurance at its finest, it collects money from me now in case someone in the future has a catastrophic occurence. Let's remember this is a business so the business folks must add additional money to what they think that they will pay out in the future to cover their risk and make more money.
The second part of the insurance is not really insurance. It is simply a mechanism to pay for health care instead of paying the employee enough so that they can afford their health care for the big users for the little users, they get to help pay for the big users. The company and the employee pays for the insurance company to pay the doctors. If the amount the company spent goes up, then the premiums will go up. If the amount the company spent goes down, the premiums will go down. Since the insurance companies have not done a good job to control medical cost, they simply pass the cost back upon the customer, the rates almost always go up. I don't forsee this bill being able to address the amount the customer via the insurance companies are charged for health care. Please remember, when the medicaid cost goes down, the other costs need to go up to support the decreased cost of medicaid. Also, adding tens of millions of people to the insurance rolls does not seem to be a good approach to reduce cost.

Therefore, we are faced with the problem of increasing the total cost of medical care in the US. The thought is that this will be funded by increased taxes to those families who make over $250K. Guess what, those folks are the ones who own the small businesses. If you impact their income, they will figure out a way to maintain their same life style. Therefore, the business might not grow due to the money being used for income rather than reinvestment in the company. They might decide to reduce their staff reducing the number of jobs created. They might just decide to have their employees pay a larger part of their medical benefits.

Items 15 and 16 above plan on extracting money from pharma and medical device makers. Once again people think that they will not raise their rates to cover this money being taken out.

The government will create tables to decide how much of a rate increase an insurance company can raise their rates. This is going to be based upon profitability or these companies or they will go out of business. If the government decides that they want to have insurance companies, they will need to allow them to raise rates else, the government better plan on running health care for all. Quite a few of the insurance companies are publically traded go back to their income statements from their fillings and let me know which ones are making too much money.

The government is going to limit the CEOs pay. This always works out well to find the best person to do the job.
Anonymous2

Posted: Mar 23 2010, 2:46 PM

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70143 You have zero credibility when you do not acknowledge the fact that it is NOT your decision or government's decision to tax me based on being a potential burden. Those are your words, not mine. I do not acknowledge your idiotic premise of not wanting healthcare. Your "what if" scenarios are childish. The fact is careful, considerate people made the best decisions for themselves and their families. They make decisions based on facts and their situation. Deliberate, prudent people do not make decisions based on hysteria, or while they're sucking down a pint of coffee what makes them "feel" like they're doing something by trying to mandate other people's actions. It is not for government to pretend to create a right for me, mandate I pay for it and then deny me the right of choice in how I choose to take care of myself and family. Maybe it's to be insured, maybe it's to not be insured for a time, maybe it's through my employer, maybe it's through private insurance, maybe if I am on hard times it's through a government safety net specifically for people who are suffering financially, but NO WHERE IN THIS COUNTRY IS ANYONE TURNED AWAY FROM AN ER DUE TO NOT BEING INSURED. And it is not the position of the government to decide that for me, for any period of time. Read the bill, go ahead take a week and read it, read about how you can trade "volunteering" for some of your school being paid for, read how you'll be joining a union, read how you're daughter will have the benfit of a birthing center, not a hospital, read how there will be technicians trained for certain procedures, Learn to add a f**king column of numbers and realize, there's nothing free Jack!

I do not have the right to demand from someone else they pay for me to have "healthcare", food, a house, a car or a trip to France. I do not have that right - and neither do you.

And to you Anonymous Supporter -- No you don't have to be "upset" you still have the right not to be upset about #14, and some day when you get a grown up job, I don't have to be upset that somebody decides you gave them crappy service and it would be unfair for them to bother to pay you.
GiGi

Posted: Mar 25 2010, 1:15 AM

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68212 Does anyone who has commented so realize what is happening here? This is not about everyone having "healthcare". This is about CONTROL. Has anyone ever heard of COMMUNISM? I suggest each of you read the Communist Manifesto. This is the definition I got when I googled the word communism. Definition - a system of social organization in which all economic and social activity is controlled by a totalitarian state dominated by a single and self-perpetuating political party.

Is this what is happening to the United States of America?

The current administration took CONTROL of 1/6 of our economy on Sunday. They already tell banks and the auto industry how much their CEO's can make, what is next?
AnonymousG

Posted: Apr 10 2010, 9:12 PM

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24216 What annoys me is how everyone complains about how "my government doesn't take care of me! By the way, got a light?"

How about people start taking care of their damned selves for once? I am young and I keep myself perfectly healthy, and when one of those stops being true, I will probably look into getting health insurance. Before that, I can promise you that I have FAR better things to spend my money on than the ludicrously expensive hospital visit of some "public service" freeloader who went to the ER for a goddamned bloody nose.

This is not health care reform, it is health insurance reform and, as GiGi pointed out, it has nothing to do with helping the people of this country get or stay healthier. On top of this fact is that we are now being required to shell out more money for ZERO, and possibly negative, improvement in the service.

If we're going to have "Health Care Reform," let's have REAL health care reform and develop a treatment system that focuses on fixing the causes of our health issues rather than this obnoxious epidemic of masking symptoms and causing side-effects. Let's develop a system where lobbyists have less power and all synthesized chemicals have to be tested for their effects on health. Let's develop a system where an oppressive public insurance option is not uproariously demanded because it is not necessary!

Health care in this country shouldn't be about requiring responsibly healthy people to pay for the care of irresponsibly unhealthy people; it should be about finding better ways to treat serious conditions and creating a system where one doesn't HAVE to be extra responsible in order to be healthy.
Anonymous

Posted: Apr 21 2010, 6:21 AM

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198189 Want a news site that's neither liberal nor conservative and hasn't been hijacked by tea-baggers? Tough.
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