If it were to become law, the House bill would put the government in control of over half of all health care spending and would dramatically shift America’s health care system from one that is largely private to one that is subordinated to government control.

The bill engineers a massive expansion of the Medicaid, a welfare program that provides substandard care to lower-income and poor Americans and threatens state budgets. The addition of the public plan, a new federal health care entitlement, would add to the crushing tax burden Americans already face from exiting entitlements. Even worse, millions of Americans would be pushed out of their existing health care coverage, notwithstanding the promises of the President.

The bill would create massive bureaucracy. Under the bill, the new health care commissioner would in fact become a health care czar. This bureaucrat would exercise unprecedented power over the kinds of benefits and medical services available to individuals and families.

The bill also creates new inequities. While it would extent lavish subsidies to certain individuals, it would exclude those with employer-based coverage and would guarantee that others would be confined to substandard care in the Medicaid program.

Contrary to the promises of the President, the House bill would impose new taxes on all Americans regardless of class or income. The employer mandate and the individual mandate would tax the middle class. While the country is trying to recover from a deep and dangerous recession, it is ironic that the day after the jobless rate officially reached 10.2% that Congress would insist on imposing more taxes on individuals and businesses.

The President has insisted that reform should bend the curve on health care spending. This legislation makes a mockery of that goal. The true cost of the bill is in excess of the President’s $900 billion spending target — the full costs will run in the trillions.

The good news is the battle is not over. There is consensus in the U.S. for serious reform of the health care system. But, there is no consensus for a federal government takeover of 1/6th of the US economy.

Read more from Heritage’s “The Foundry” blog

In a victory for President Barack Obama, the Democratic-controlled House narrowly passed landmark health care legislation Saturday night to expand coverage to tens of millions who lack it and place tough new restrictions on the insurance industry. Republican opposition was nearly unanimous.

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As Heritage analysts noted earlier in the week, the Congressional Budget Office released its preliminary score of the bill (H.R. 3962) but too many in the media have not been reporting its true cost. The true cost is not the net spending on only the coverage related provisions ($897 billion) but rather the total gross spending for the coverage provisions ($1.05 trillion) as well as any additional spending in the bill (approximately $217 billion). That would raise the plan’s price tag to about $1.5 trillion when including the roughly $210 billion cost of the “doc fix” is included. The “doc fix” refers to the undoing of the flawed Medicare payment update formula, which Congress created but has routinely stopped from being enforced. Under current law, that formula would result in a 20 percent reduction in doctors’ pay under the Medicare program.

The real story about the true cost is even more dramatic. The bill is front loaded with taxes, and back-loaded with spending in the first ten years. Since most of the spending in the House bill does not fully go into effect until 2014, the 10-year cost estimates based on the preliminary CBO score (for years 2010 through 2019) only account for six years of new spending under the plan. Once it is implemented (over a full 10-year window from years 2014 to 2023), the giant House health bill carries a price tag of $2.4 trillion, or as much as $2.6 trillion with the “doc fix.”

 Read more from Heritage’s “The Foundry” blog

In contrast to H.R. 3962, the Congressional Budget Office (CBO) finds that the Substitute would reduce average health insurance premiums ( by 7 to 10 percent in the small group market and 5 to 8 percent in the individual market) and would reduce the federal deficit by $68 billion over ten years.

A Targeted Approach
In style and substance the “Republican Alternative” is a dramatic contrast to the House Democratic leadership approach to health care. It is incremental as opposed to comprehensive. Instead of pursuing a “Big Bang” solution to the various problems of the health care system, embodied in a bill designed to overhaul the entire health care sector of the economy, it is a targeted, step by step, approach to resolving specific health care issues while minimizing disruption of existing health insurance arrangements.

In a conspicuous contrast to H.R. 3962, the Substitute addresses the medical liability problem, provides for real restrictions on taxpayer funding of abortion, and amends current law to enhance the flexibility of health savings accounts.

Insurance Market Reform
In the course of the national debate, the White House and the congressional leadership evolved their rhetoric, calling for health insurance reform rather than health care reform. In fact, the central problems facing ordinary Americans are often rooted in the discrete problems of state health insurance markets, including access to coverage for those who are sick ( Pre-existing conditions” ) and the need for more rational pooling arrangements to spread health care costs. Under Section 101 of the Substitute, states would be required to address these specific problems, and would be given specialized funding ($25 billion) for the creation of high risk pools or risk reinsurance programs to guarantee access to coverage for those suffering with pre-existing medical conditions. The Substitute would also guarantee portability of insurance coverage and protection for pre-existing conditions, prevent unjust cancellation of insurance, while eliminating annual or lifetime caps on insurance coverage.

Enlisting the Creativity of Federalism
Under Section 111 of the Substitute, states would get special funding ( $50 billion) to adopt reforms to expand coverage and reduce the numbers of the uninsured, as well as control health care costs. States could pursue a variety of market reforms and adopt new information systems that would facilitate an ease of access to coverage (allowing auto enrollment in employer coverage with a right to op out) and providing comparative information on health plan choices. As a condition for getting federal funding, the states would have to agree to meet federals goals to reduce the numbers of the uninsured and to slow the growth in health care costs within the private sector. In sharp contrast to the House leadership bill, for example, the Substitute does not crowd-out existing private health insurance through an expansion of public programs, including welfare programs like Medicaid. In the main House bill (H.R. 3962) Medicaid expansion would impose an unfunded mandate on the states, and eligibility for Medicaid would be increased up the income scale to 150 percent of the federal poverty line ($33,000 for a family of four), a provision that would guarantee a crowd out of private health coverage.

Promoting Competition
There are 1300 health insurance companies in the United States, but there is often little competition within the states. State health insurance markets are often artificially high priced, driven by special interest and provider driven mandates and excessive regulations. The result: millions of Americans are price out of the health insurance markets, and choice and competition are undercut by state policy. Under Section 221 of the Substitute, Americans will henceforth be able to buy health insurance anywhere in the United States. Health insurance, like most other goods and services, will be available through interstate commerce, but the Substitute provides that policyholders will still enjoy the consumer protection and anti-fraud and abuse laws of the state in which the policyholder resides. This is a large and consequential change. According to researchers at the University of Minnesota, millions of Americans could secure affordable coverage as a result of the intensity of such competition. In every other sector of the economy, Americans can get what they want, and pay what they want to pay, for goods and services anywhere in the country. They should be able to do the same in health care.

Next Steps
While the Substitute makes significant and consequential changes in the health insurance market- focusing on the persistent problem of pre-existing condition exclusions and portability issues- it falls short in dealing with the most significant problem in health care policy: the federal tax treatment of health insurance. Major legislation to effect such tax changes, expanding coverage for millions of Americans, has already been introduced by Rep. Tom Price (R-GA), Rep. Paul Ryan (R-WI), Rep. Devin Nunez (R-CA) and Rep. John Shadegg(R-AZ).

If there is one area where there is an overwhelming consensus among economists, liberals and conservatives alike, it is that complete reform of private health insurance markets requires reform of the federal tax treatment of health insurance. If Americans cannot get health coverage through the job, then they get no tax break at all on the purchase of their health insurance, forcing them to pay as much as 50 percent more for the same package of benefits they would have paid for if they had gotten their health insurance at the place of work. This unfair tax policy not only undermines the access of millions of Americans to affordable health care, but it also fuels higher health care costs. By reforming the tax treatment of health insurance and providing for individual tax relief, Congress would take a huge step toward expanding private health coverage for millions of Americans, giving individuals choice of coverage, leveling the playing field, promoting personal ownership and portability of health insurance policies, while reducing the burden on taxpayers who today provide free care to the uninsured in the most expense place on the planet: the hospital emergency room.

Read more from Heritage’s “The Foundry” blog

Get everyone out tomorrow to the Capitol!

WASHINGTON, D.C. — Congressman Steve King today made the following statement calling on American citizens to come to Washington this weekend to stop a government takeover of health care.

“Nancy Pelosi and Washington liberals cannot ignore what transpired yesterday in Washington. Americans from every state stormed Capitol Hill. They took over the Hill. And they loudly chanted ‘Kill this bill!’

When:   Saturday, November 7, 2009 at 1:00 p.m.

Where:  U.S. Capitol
Read more from NetRightNation

Cap-and-trade means a declining “cap” on total emissions, while allowing trading of pollution permits. Confidence in the certainty of declining caps is based on the mistaken assumption that cap-and trade was proven in the EPA’s acid rain program. In fact, addressing acid rain required relatively minor modifications to coal-fired power plants. Reductions were accomplished primarily by a fuel switch to readily available, affordable, low-sulfur coal, along with some additional scrubbing. In contrast, the issues presented by climate change cannot be solved by tweaks to facilities; it requires an energy revolution through investments in building clean-energy facilities.”

The authors explain, however, that these minor modifications and cheap alternatives aren’t available when it comes to America’s energy use:

The biggest obstacle to this revolution is that uncontrolled fossil fuel energy remains much cheaper than clean energy. Cap-and-trade alone will not create confidence that clean energy will become profitable within a known time frame and so will not ignite the huge shift in investment needed to begin the clean-energy revolution. In recent interviews, even the economists who thought up cap-and-trade have said they don’t believe it’s an appropriate tool for climate change.”

The brunt of the authors’ objection to a cap and trade system has to with the offset provision. If a coal plant believes it’s cheaper not to reduce its carbon footprint, it can pay someone else to do so. For instance, a company could pay a logger not to cut down trees, or they could pay someone to grow trees since trees absorb carbon. Or a developing country can build a cleaner coal plant saying they were going to build a dirtier one while cashing a check from a developed country for the alleged carbon offset. Williams and Zabel make the same case with the forest owner:

[I]f the landowner wasn’t planning to cut his forest, he just received a bonus for doing what he would have done anyway. Even if he was planning to cut his forest and doesn’t, demand for wood isn’t reduced. A different forest will be cut. Either way, there is no net reduction in production of greenhouse gases. The result of this carbon “offset” is not a decrease but an increase — coal burning above the cap at the power plant.”

And the offset program creates perverse incentives and unintended consequences:

[C]onsider the refrigerant HCFC-22, the manufacture of which creates an extremely powerful greenhouse gas as a byproduct. This byproduct is relatively easy and cheap to destroy, and governments could require refrigerant manufacturers to do just that. But offset investors have persuaded regulators to approve destruction of the byproduct as a carbon offset, making it twice as profitable to sell byproduct destruction as it was to sell the refrigerant.”

Designed to be a cost containment measure, experience with offsets have led to nothing but fraud with no reduction in carbon dioxide. The architects of cap and trade legislation claim that farmers and landowners with forestland to be the big winners from the offset program. But the economic pain they suffer, along with everyone else, will be much greater than any offset check they collect.

Read more from The Heritage Foundation’s blog, “The Foundry” here.

We can’t speak to the view of those overseas, but we can certainly talk about the immigrants who are already here. In our survey of immigrants, A Place to Call Home, we found a powerful endorsement of life in America. More than seven in 10 say that if they could do it all over again, they’d still come to the United States. Just as many say they intend to make the United States their permanent home.

The reasons are simple enough: immigrants buy into American society. Three-quarters say the United States is “a unique country that stands for something special.” Strong majorities also rate the U.S. as better than their birth country on a range of dimensions, including making a good living, having a trustworthy legal system and providing education and health care.

With all the ups and downs of our international reputation, with all the challenges we face, people still want to come to America. And the ones who have already come here, want to stay. That’s a powerful endorsement – and in fact, you couldn’t ask for a better one.

Scott Bittle is the executive vice-president of Public Agenda, a non-partisan non-profit.

When—as in will Obama ever turn off the campaign rhetoric? Every time you hear him, he still sounds like he is still campaigning. Americans understand it is basically all he has ever done, and he is comfortable in that arena, but after ten months on the job he needs to understand he is no longer campaigning. He is the president now, and while it was probably forgivable at first to blame the prior administration, he no longer has the luxury of blaming George Bush for all of his failures and indecisiveness of major issues facing this great nation. It is time for him to step up to the plate and start acting like the commander in chief, and that begins with him taking responsibility for decisions he and his people are making, and to stop saying what he is going to do, and start doing something positive for this country.

When— as in his failure to keep numerous campaign promises, such as his promise of transparency in his government. This is evident with the appointment of czars to several key positions in his administration. The people of this country do not have the benefit of these czars having to have senate confirmation, thus very little is known about them. Without people like Glenn Beck and others who have the resources to investigate the credentials of these key people, those like Van Jones and others like him, would never have been discovered.

When—as in the shell game he is playing with health care reform. The American people spoke loud and clear about their discontent of this hot button issue this past summer with tea parties and town halls that took place all across this country. It was hoped that those representatives, understanding they work for their constituents, would listen to the wishes and concerns of their people. How did they listen and address those concerns? By changing the locks on doors to keep out republicans and re-drafting the health care reform bill to the extent it nearly doubled in size with its verbose and rambling content. Content which is riddled with inequities and vagueness that leaves its interpretations wide open to whoever is reading it at the time. How does this benefit the American people, who legitimately need health care?

The American people are saying WHEN! They put their faith and trust in a man who promised change and took him at his word. The change he is proposing, and yes, has even instituted, is not what the people of this country had in mind, thus it diminishes the respect for him, as well as respect for the highest position in the country. Obama needs to start taking responsibility for his actions, and come clean with the people on his true intent. He needs to stop apologizing for this country, and start apologizing for his own failures in getting this country back on track. Blaming George W. is immature, ill-conceived and unbecoming of a man who knows better.

©Julie Spears 2009