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Friday, October 30, 2009

Health Bill: 1990 Page Monstrosity

I haven't been blogging too consistently recently-- and honestly it was a bit of a relief to just isolate myself from news and politics for a time. I suppose I might have been charging myself up to tackle this stuff now.

The final House Democratic health restructuring bill was unveiled yesterday-- a 1990 page behemoth. I'm going to slog through it and of course I will post my analysis (for what that's worth). Wish me luck.

Jacobson over at Legal Insurrection has his report on the CBO's scoring of the bill. The bill is shaping up to be pretty much everything I expected it to be-- an expensive travesty.

From Jacobson:

"Here are the highlights (all time periods are through 2019, unless otherwise noted):
  • The scoring 'does not constitute a final and comprehensive cost estimate for the bill.' (page 1)
  • There are $426 billion of cost cuts to Medicare, Medicaid and other federal health programs, and $572 of tax increase revenues projected. (pages 2, 6)
  • The costs of the insurance subsidies will be $894 billion after taking into account certain assumed revenue offsets. (page 3)
  • State spending on Medicaid will increase on net by about $34 billion. (page 4)
  • 18 million non-elderly people will remain uninsured, with the percentage of coverage rising from 83% to 96%. (page 5)
  • 15 million more people will be on Medicaid. (page 6)
  • 6 million people will join the public plan option, which will charge higher rates than private insurance, due to less management of utilization by patients and an unhealthier pool of patients (page 6)
  • It will cost between $5 and $10 billion for the IRS to implement 'the eligibility determination, documentation, and verification processes for subsidies.' These costs are not factored into the overall estimates. (page 9)
  • The deficit will be reduced by $9 billion in 2019. (page 12)
  • The 'bill would put into effect (or leave in effect) a number of procedures [such as leaving physician payment cuts in place] that might be difficult to maintain over a long period of time' and which, if not followed, would require a change in the projections. 'The long-term budgetary impact of H.R. 3962 could be quite different if those provisions generating savings were ultimately changed or not fully implemented.' (page 14)

"In sum, we create massive new federal bureaucracies and regulations, get IRS intrusion into health care, 15 million more people become Medicaid dependents, and we still have 18 million uninsured, and all this after spending over $1 trillion (best case scenario).

"Assuming this best case scenario comes true based upon these unrealistic cost assumptions, we will have achieved very little relative to the costs. And we will have done severe damage to our health care system, something the CBO cannot score because it cannot be expressed in dollars."

Sounds great, doesn't it?

18 million left uninsured (a realistic estimate at how many citizens in the U.S. that cannot afford medical insurance now is 19 million) for $1 trillion. So in other words, those without medical insurance because they are unable to afford it will only be reduced by 1 million people-- for a trillion dollars.

Q: So where does this leave the rest of us?

A: With massive debt, much higher taxes, expanded Medicaid dependants (15 million more) and the medical industry now subservient to Congress and the Executive Branch-- for starters.

This bill is not about getting poor people insurance. It is about something else entirely.

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