health care

The President’s Health Care Fables

by Hans Bader on July 16, 2011 · 1 comment

in Healthcare, Politics as Usual, Regulation, Sanctimony, Zeitgeist

The president pushed the health care bill through Congress using a series of fables — health insurance horror stories that turned out to be false. Michelle Malkin chronicles just a few of the false anecdotes told by President Obama in making the case for Obamacare. The most famous was the false claim that his mother’s health insurer tried to avoid paying for his dying mother’s treatment based on a pre-existing condition — when it in fact did no such thing and paid her benefits in full. (As the Washington Post notes, Obama’s misleading stories about his mother’s final months “often spoke as if he had been at his mother’s side,” even though he actually failed to visit her at all in the months leading up to her death from cancer.)

As Malkin notes, Obama’s “sham-ecdote” about his mother “is just the latest entry in an ever-expanding catalogue of Obamacare fables,” which include the following:

– Otto Raddatz. In 2009, Obama publicized the plight of this Illinois cancer patient, who supposedly died after he was dropped from his Fortis/Assurant Health insurance plan when his insurer discovered an unreported gallstone the patient hadn’t known about. The truth? He got the treatment he needed in 2005 and lived for nearly four more years.

– Robin Beaton. Also in 2009, Obama claimed Beaton — a breast cancer patient — lost her insurance after “she forgot to declare a case of acne.” In fact, she failed to disclose a previous heart condition and did not list her weight accurately, but had her insurance restored anyway after intense public lobbying.”

– Natoma Canfield. The White House made the Ohio cancer patient a poster child for Obamacare in 2010 after she wrote a letter complaining about skyrocketing premiums and the prospect of losing her home. After Obama gave Canfield a shout-out at a health care rally in Strongsville, Ohio, and promised to control costs, officials at the renowned Cleveland Clinic, which is treating her, made clear that they would “not put a lien on her home” and that she was eligible for a wide variety of state aid and private charity care.

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Improve Americans’ Physical and Fiscal Health: Cut Out the FDA

by Michelle Minton on June 22, 2011

in Health and Illness, Nanny State, Personal Liberty, Regulation

President Obama made a big show about cutting “red tape” government regulations that kill jobs and hurt the economy. In addition, members of the Obama administration, including his wife, Michelle, claim they want to improve the health and well-being of Americans. If these are genuine policy goals of the current administration then a good place to start would be to stop the FDA from instituting any new policies.

A news story today told the good news that the FDA approved a device for the iPhone that would combine a plug-in blood pressure monitor with an application purchased in the app store to monitor the health of the user. According to a two-year long study conducted by the Brookings Institution and the Kauffman Foundation, remote medical reporting such as blood pressure monitoring could save the nation nearly $200 billion in health care costs over 25 years.

According to remarks by economist Robert E. Litan, the study’s author, who is the Vice President for Research at the Kauffman Foundation and Senior Fellow at Brookings:

Widespread use of remote monitoring over broadband networks, located in both institutions and homes, to track vital signs of patients with chronic diseases such as congestive heart failure and diabetes is a critical and urgent development. “Remote monitoring can spot health problems sooner, reduce hospitalization, improve life quality and save money.”

Litans made his remarks earlier this year at a health forum sponsored by the Better Health Care Together coalition (BHCT). Participants at that forum suggested that the way to achieve wide-spread usage of devices like the cuff is to have larger insurance payouts for hospitals in order to fiscally incentivize their integration.

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Supreme Court Refuses the Speedier Route for Health Care Appeal

by Kathryn Ciano on April 27, 2011

in Economy, Healthcare, Legal, Regulation

Monday morning the Supreme Court rejected Virginia Attorney General Ken Cuccinelli’s request to speed up the process for a ruling on Virginia’s health care appeal.

By rejecting Virginia’s unusual request, the Court denied Cuccinelli’s request that its appeal bypass usual legal procedures to go directly before the nation’s highest court. Instead, the Fourth Circuit Court of Appeals will hear Virginia’s appeal, scheduled for May 10.

So far five federal judges have heard challenges to Obama’s sweeping healthcare overhaul. Judges in Florida and Virginia have declared the law unconstitutional, while Democratic appointees in Michigan, Virginia, and Washington, D.C. have upheld Obamacare.

Virginia’s chief complaint with Obamacare is the individual mandate. Twenty-six states joined Florida’s appeal that Congress grossly overstepped its authority with this unprecedented requirement that individuals buy health insurance or pay a penalty to the government if they do not purchase coverage.

No justices sat out of Monday’s denial of fast-track process. Yet the slow route is new for Obamacare, a highly contested sweeping legislation that passed only when then-speaker of the  House Nancy Pelosi invoked a bizarre, constitutionally-dubious “deem and pass” procedure that unseated civics as we know it and “deemed” the bill popular rather than put it to popular vote the way the American Constitution requires.

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Six Pages of Legislation, 1,000 Pages of Regulation

by Ryan Young on March 30, 2011

in Healthcare, Regulation

HHS is about to issue over 1,000 pages of new regulations stemming from last year’s health care bill. That’s not a huge surprise, considering the bill is about 2,000 pages long.

But these regulations all come from a six-page section covering accountable care organizations, or ACOs.

According to Politico, John Gorman, who runs a health care consulting firm, “expects a 1,000-page rule to come out on Thursday, March 31 — because he doesn’t think HHS will want to deal with releasing the regulations on April Fool’s Day.”

PolitiFact: Obama Made False Claims About Health Care, Taxes, and Court Rulings

by Hans Bader on February 11, 2011 · 1 comment

in Economy, Employment, Healthcare, Legal, Regulation

PolitiFact, which earlier took Obama’s side about whether Obamacare is a government takeover of  health care, now is criticizing President Obama for making false claims about health care and taxes. In a pre–Super Bowl interview with Bill O’Reilly, Obama made the false claim that 12 judges have rejected “the notion that the health care law was unconstitutional.” As PolitiFact notes, only “four judges have ruled on the merits of various cases challenging the health care law. Two ruled in favor of the administration and two against.” (Earlier, we explained why the recent ruling by a Florida judge striking down Obamacare was not judicial activism.)

Obama’s problem with numbers isn’t new; during the 2008 campaign, he claimed that he had been to “57 states.” So he may not have been deliberately lying about this.

But as John Kartch noted earlier, Obama made a far more flagrantly false claim when he insisted to Bill O’Reilly that “I didn’t raise taxes once” while president. It’s hard to view that claim as anything other than a lie. Obama has signed into law a long list of tax increases on consumers and investors, which Kartch lists here. That includes “two dozen new or higher taxes” just in the health care law alone.

Some of the biggest of Obama’s tax increases haven’t gone into effect yet, and won’t go into effect until after the 2012 election, such as the new 3.8 percent tax it levies on many of America’s investors. As PolitiFact noted in debunking Obama’s claim that he hadn’t raised taxes, “starting in 2013,” “Individuals who make more than $200,000 and couples that make more than $250,000 will see additional Medicare taxes of 0.9 percent. They will also, for the first time, have to pay Medicare taxes on their investment income at a 3.8 percent rate.”

By contrast, an excise tax increase Obama signed in 2009 went into effect “soon after” he took “office,” and some of the tax increases in the health-care law that affect middle-class patients and medical-device manufacturers are already in effect.

For the moment, Americans’ taxes are not that high, because many of the tax increases already signed into law have yet to kick in. But appearances are deceiving, for as Kartch notes, “100% of the tax increases Obama signed into law are … permanent,” while “over 90% of the dollar value of the tax cuts Obama signed into law are only temporary.”

I earlier discussed why PolitiFact was wrong to accept the Obama administration’s claim that Obamacare was not a government takeover of the health care system.

While it dramatically increases regulation and red tape, Obamacare has done little to control costs; health insurance premiums have risen substantially in many states as a result of its passage, such as a 47 percent increase for some policyholders in Connecticut. Obamacare contains provisions that are harmful to the economy and medical innovation. Earlier, I discussed some of the bad effects of Obamacare on patients, employers, consumers, and the insurance market.

The GOP and the Health Insurance Mandate

by Greg Conko on February 2, 2011 · 2 comments

in Health and Illness, Healthcare, Insurance, Personal Liberty, Regulation, Zeitgeist

With the health insurance individual purchase mandate looking more vulnerable than ever, Democrats are trying desperately to get some mileage out of the fact that it was Republicans who first proposed the idea. Washington Post blogger Ezra Klein posted an interview yesterday afternoon with University of Pennsylvania economist Mark Pauly, who is sometimes identified as the “father of the individual mandate.” Klein writes:

“Pauly was the lead author of a Health Affairs paper attempting to persuade President George H.W. Bush and his administration to adopt a universal health-care proposal that would keep the government from eventually taking over the sector. … At the heart of that strategy was the individual mandate, which would go on to be promoted by congressional Republicans, the Heritage Foundation, and Massachusetts Gov. Mitt Romney before being adopted by Democrats and becoming a bete noire of conservatives.”

It’s true, of course, that Republicans seized on the purchase mandate idea, as Pauly suggests, “because we were concerned about the specter of single payer insurance, which isn’t market-oriented, and we didn’t think was a good idea. One feature was the individual mandate. The purpose of it was to round up the stragglers who wouldn’t be brought in by subsidies.” In a 1991 paper published in the journal Health Affairs (pdf), Pauly and his co-authors wrote that, “Our view is that excessive government intervention will make matters worse. … Our strategy, therefore, is to design a scheme that limits governmental rules and incentives to the extent necessary to achieve the objectives.”

The GOP bit into it hook, line, and sinker. But a little context is necessary.

In November 1991, Democrat Harris Wofford beat expected favorite Dick Thornburg in a special election to replace deceased Pennsylvania Senator John Heinz in 1991, running primarily on a platform centered around universal health care. And the following year, Bill Clinton won the presidency after making universal health care a central feature of his campaign. There was genuine fear among Republicans that First Lady Hillary Clinton’s Health Care Task Force would propose legislation that included a single payer plan, so Republicans scrambled to design their own proposals that would be “less bad.”

Republican Senator John Chaffee introduced the Health Equity and Access Reform Today Act, and Republican Senator Don Nickles and Rep. Cliff Stearns introduced the Consumer Choice Health Security Act, both of which contained an individual health insurance purchase mandate and attracted dozens of Republican co-sponsors. (As an aside, Democrats have seized on liberal Republican Chaffee’s bill as an example of conservative hypocrisy while ignoring the bill introduced by actual conservatives Nickles and Stearns. It’s not clear why this is. Perhaps just laziness, but maybe I’m just reading into things?) And, as has been pointed out repeatedly, the conservative Heritage Foundation entertained a similar feature, and then Massachusetts Governor Mitt Romney also included a purchase mandate in his state’s health care overhaul, for which both should be roundly condemned.

It’s worth noting, though, that most of us in the free market movement have never embraced the health insurance purchase mandate. And I’m proud to dig out of the archives an old Cato Institute paper (pdf) written by my former CEI colleague Tom Miller (now at the American Enterprise Institute), which roundly criticizes the 1993-94 Republican compromise legislation. Tom found a lot of faults in those bills, and he singled out the individual purchase mandate as being especially egregious.  While acknowledging that, from a political perspective, “any legislative alternative to the Clinton plan must guarantee universal coverage,” he wrote:

The most troubling aspect of the Nickles-Stearns legislation, as introduced on November 20 [1993], is the mandate that it imposes on all Americans to purchase a standard package of health insurance benefits. By endorsing the concept of compulsory universal insurance coverage, Nickles-Stearns undermines the traditional principles of personal liberty and individual responsibility that provide essential bulwarks against all-intrusive governmental control of health care.

Tom concluded that, “By failing to provide a clear alternative based on market principles, Nickles-Stearns blurs opposition to Clinton-style health care legislation. By focusing the political debate on the wrong issues, it opens the door to extensive political interference in private health care decisions.” Indeed.

Obamacare Makes State Budget Problems Worse

by Hans Bader on December 21, 2010 · 1 comment

in Healthcare, Legal, Regulation

Obamacare is making state budget problems much worse, as governors now lament. Earlier, CEI filed an amicus brief in Florida v. HHS on behalf of two governors explaining how the radical changes to state Medicaid programs resulting from Obamacare violated limits on congressional power under the Constitution’s spending clause. Some of the fiscal burdens Obamacare imposes on states are obviously huge, while many others are ambiguous, unpredictable, and contingent on bureaucratic caprice, and uncertain future events.

Governors like Phil Bredesen (D-Tenn.) and Donald Carcieri (R-R.I.) warned earlier about the crippling costs of Obamacare to state budgets, but they were ignored by Obama and Congressional Democrats in their headlong rush to pass the health care bill. An adviser to Gov. Bredesen, James Blumstein (a professor of constitutional and health care law at Vanderbilt), argues that Obamacare is a violation of constitutional limits on Congress’s power under the spending clause.

Obamacare: More Broken Promises, More Premium Hikes, More Lost Health Insurance

by Hans Bader on October 22, 2010

in Deregulate to Stimulate, Economy, Healthcare, Legal, Regulation

In The Washington Times, Dr. Milton R. Wolf debunks six “unkeepable Obamacare promises” that have already been shown to be false.  For example, President Obama promised that his health care overhaul would not raise taxes on anyone earning less than $250,000 a year: “I can make a firm pledge. Under my plan, no family making less than $250,000 a year will see any form of tax increase. Not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes.”

But as Wolf notes, Obamacare’s “new excise taxes on pharmaceuticals and medical products will, of course, by necessity be passed on to the patients who depend on these lifesaving medicines, pacemakers, MRI machines or even tongue depressors.”  And Nancy Pelosi promised that Obamacare would create 4 million new jobs, 400,000 almost immediately, none of which ever materialized.

A political commentator notes that her family’s insurance premiums just went up by 45 percent, while the coverage became worse. One of her readers lost her insurance, after her family’s policy was canceled by the insurer due to Obamacare’s legal prohibitions.

We earlier discussed how Obamacare will create pointless red tape and busywork for doctors, and how it has already led to big premium increases, and the elimination of some popular health plans.  It also includes a $60 billion insurance excise tax that will be passed on to patients, and tax increases on some investors and homeowners starting in 2013.

Medical Trial and Error

by Greg Conko on October 21, 2010

in Culture, Health and Illness, Healthcare, Precaution & Risk, Regulation, Zeitgeist

The Atlantic has an interesting profile of medical researcher John Ioannidis, who famously concluded in a groundbreaking 2005 study (a different version of which can be found here) that the scientific conclusions of most of the articles published in medical journals are wrong.  I’m not sure what took The Atlantic so long to write the review.  After all, The New York Times Magazine covered the same ground way back in 2006, and the Times excerpted a lengthy section of Ioannidis’s new book on the subject in June of this year.  Still, the conclusions are worth taking into consideration.  After all, science is merely an organized search for the truth, and every scientist worth his salt knows that any one study can generate incorrect or incomplete results.  It is only once a given observation is tested repeatedly and reproduced that we should come to view the findings as anything more than provisional.

What’s troubling is the reception that Ioannadis’s work has gotten from quacks and cranks — exemplified by a handful of the comments following The Atlantic article, and elsewhere.  If science can’t be trusted, then science must be useless, according to some.  Others lay the blame at the feet of pharmaceutical companies peddling junk science in order to sell more drugs.  But, as pharma researcher and blogger Derek Lowe points out, “drug research probably comes out of [Ioannadis's] analysis looking as good as anything can. A large confirmatory Phase III study is, as you’d hope, the sort of thing most likely to be correct, even given the financial considerations involved. Even then, though, you can’t be completely sure – but contrast that with a lot of the headline-grabbing studies in nutrition or genomics, whose results are actually more likely to be false than true.”

In the end, the cumulative weight of a body of science, as opposed to any single study, still is right more often than not.  To quote science blogger Orac, “in many ways, the present system of randomized clinical trials and peer-review is, to paraphrase Winston Churchill regarding democracy, the worst system for finding the best treatments–except for all the rest. … Despite all that, it is a big mistake to take Ioannidis’ findings as “proof” that science is not the best methodology we have for answering fundamental questions about how the universe works, the pathogenesis of disease, or for identifying the most efficacious treatments. Certainly, it far surpasses any alternatives.”

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