I'm curious whether Congress, in its wisdom, will enhance federalism by allowing states to (somehow) opt out of mandatory health care. It sounds like a progressive paradox, a little sugar to help swallow a bitter pill. But might Congress unintentionally provide ammo to the 10th amendment believers who wish to construct a wall of separation between the federal and state governments? "I am in favor of the clear, bold step represented by HCR 50, introduced by Representative Creighton, and co-authored by Representative Guillen. It's clear that this is not a partisan issue: it concerns all Americans, and all Texans.

"The Tenth Amendment was enacted by folks who remembered what it was like to be under the thumb of a distant, all-powerful government. Unfortunately, the protections it guarantees have melted away over time."
Office of the Governor Rick Perry - Speeches - Gov. Perry Speaks in Support of States' Rights (http://governor.state.tx.us/news/speech/12228/)

Here's a hint .If Chucky Schumer proposes something instinctively suspect the worse.

The opt out is a bogus trojan horse because the people not on the public option will still be taxed to support it. No Governor in their right mind will tell the people of the state that they should be taxed for a benefit without having the "right" to participate. It's a cute ploy .Tax the people of the state and then give them the option if they want their slice of the pie in return.

Reid said that a tax on "Cadillac" plans has been modified to include family plans worth more than $23,000 . Those taxes would be collected from all states, including those that opt out . Plus there are other across the board funding proposals in various bills that would be collected from all taxpayers.

Pressure from constituents demanding hand outs they are paying for would be too strong for most states. If you need any proof of this just remember the flack some Governors took for suggesting their states don't need porkulus .

Imagine the court challenges as citizens claim they are being denied the right to participate. Or citizens of the state could take it to court to compel their states to opt out. Now you'd have the courts overturning or supporting each states decisions.

Beyond that ;who in the state makes the choice ;the Governor ? The legislature ? A referendum ?It has not been specified to date . Since it is a Federal program each State should decide to opt out or not in the same fashion .

If a state has the right to opt out of a Federal Mandate then why is that not the case for all Federal Mandates ? Maybe they should ;but that isn't the way it works now.

Now ;what happens to us commuters who cross state lines to work ? It probably wouldn't happen here in the North East . But I can see the possibility of bordering states making different decisions regarding this .

What would a business in a state that opts out do ? I see the possibility of them migrating across the border and ending employer provided coverage... in effect compelling their workers to join the public option. Under the pressure of lost businesses it wouldn't take long for states to conclude they HAVE NO CHOICE but to allow the public option in their states.

This is a phony ploy by the Dems to make it appear they are compromising so they can lure some of the queasy jelly fish "moderate" blue dogs ,with a sleight of hand ,to vote for the radical restructuring of the health coverage system.

Edit ; the way this is going to be adopted most likely will mirror the way they conned people onto Medicare Part B . To lure people to participate the initial low ball price was $3 /month. Now it costs $96 /month . When the price goes up do you think the Dems will have added an opt out plan for those states that initially decided to opt in ? NO WAY !

It will most likely be like not requireing them to adopt the Highway Safety rules, they don't have to adopt them, but they mrerely lose billions in highway funds if they don't, Some choice

This is a phony ploy by the Dems Hello:

I don't care about opting out or in.. I want to know about those death panels.. Are they still in there? How come you don't talk about them anymore. Is it cause they're really AREN'T in there?? Cause if they are, and you ain't talking about 'em, I guess you support 'em. And, if they're not, then we got your number...

Then after all that, you wonder why you're not taken seriously in this debate. You opted yourselves right out...

excon

The liberal/progressive/Dems are liars? I wonder if the preamble to the 'health care bill' declares access to affordable health care a 'right'; and then will allow states to deny its citizens that 'right'? Isn't this legislative 'Dred Scott-ism': the Congress deciding the citizens of the US are property and, as such, have no rights?

Hello:

I don't care about opting out or in.. I wanna know about those death panels.. Are they still in there? How come you don't talk about them anymore. Is it cause they're really AREN'T in there???? Cause if they are, and you ain't talking about 'em, I guess you support 'em. ...

excon

Realistically, if Congress and the president can declare access to health care a right, they can just as easily modify that right. Haven't you read the bill, excon?

Excon you make an irrelevant strawman argument(and an ad hominum). We are talking here about the Senate op out proposal by Reid... who by the way has revealed little else about the details .

On the issue of the death panels ;unless the language of HR 2400 has been modified ,then essentially they have not been removed.

George . They know this whole enterprise is unconstitutional . This cover of States Rights is subterfuge ;some pretext they can argue when the whole thing goes before SCOTUS.

Realistically, if Congress and the president can declare access to health care a right, they can just as easily modify that right. Haven't you read the bill, excon?Hello George:

Nahh. I haven't read it. I'm going to wait until there's a final bill.

Congress and the president CAN'T declare a new right. All they can do is recognize a right that the founders assured us - and NO, they can't modify it.

excon

PS> Tom, if the death panels are STILL there are you AREN'T talking about them, then you are doing a this service to your fellow citizens.. You don't think I'D stop talking about them if I were on your side and they were really there.

PS> Tom, if the death panels are STILL there are you AREN'T talking about them, then you are doing a this service to your fellow citizens.. You don't think I'D stop talking about them if I were on your side and they were really there.

I try to avoid redundancy . My position on the House bill has been debated here and I have not changed my position.

Hello:

I don't care about opting out or in.. I want to know about those death panels.. Are they still in there? How come you don't talk about them anymore. Is it cause they're really AREN'T in there?? Cause if they are, and you ain't talking about 'em, I guess you support 'em. And, if they're not, then we got your number...

You be the judge...


Treating seniors as 'clunkers' (http://www.nypost.com/p/news/opinion/opedcolumnists/treating_seniors_as_clunkers_AoV9xo6kjCZHHI4sNh6Zj M)

By BETSY MCCAUGHEY

Everyone knows that if you don't pay to maintain and repair your car, you limit its life. The same is true as human beings age. We need medical care to avoid becoming clunkers -- disabled, worn out, parked in wheelchairs or nursing homes.

For nearly a half century, Medicare has enabled seniors to get that care. But ObamaCare is about to change that, by limiting what doctors can provide their aging patients.

The Senate Finance Committee health bill released last week controls doctors by cutting their pay if they give older patients more care than the government deems appropriate. Section 3003(b) (p. 683) punishes doctors who land in the 90th percentile or above on what they provide for seniors on Medicare by withholding 5 percent of their compensation.

This withhold provision forces doctors to choose between treating their patients and avoiding government penalties. HMOs used the same cost-cutting device in the early '90s until it was deemed dangerous to patients and outlawed. Now, lawmakers want to use it against the most vulnerable patients, the elderly. This bill and four others under negotiation also would slash about $500 billion from future Medicare funding.

President Obama and his budget director, Peter Orszag, have told seniors not to worry, claiming that Medicare spending could be cut by as much as 30 percent without doing harm. They cite the Dartmouth Atlas of Healthcare 2008, which tries to prove patients who get less care -- fewer hospital days, doctors' visits and imaging tests -- have the same medical "outcomes" as patients who get more care. But read the fine print.

The Dartmouth authors arrived at their dubious conclusion by restricting their study to patients who died. They examined what Medicare paid to care for these chronically ill patients in their last two years. By definition, the outcomes were all the same: death. The Dartmouth study didn't consider patients who recovered, left the hospital and even resumed active lives. It would be important to know whether these patients survived because they received more care.

The journal Circulation addresses that question in its latest issue (Oct. 16) and disputes the Dartmouth conclusion. Examining patients with heart failure at six California teaching hospitals, doctors found that hospitals giving more care saved more lives. In hospitals that spent less, patients had a smaller chance of survival. That's the opposite of what Obama is claiming and Congress is proposing. The Senate Finance bill establishes a formula that penalizes hospitals for high "Medicare spending per beneficiary" (Section 2001, p. 643). That may save money, but the California study suggests it will cost lives.

When Medicare started in 1965, the law forbade the federal government from interfering in treatment decisions. Doctors decided what patients needed, and Medicare paid for each treatment on a fee-for-service basis. Though this protection from government interference has been whittled away a bit, doctors and patients in Medicare still decide what state-of-the-art medical care they want.

The results are huge improvements in longevity and seniors' quality of life. Life expectancy at age 65 has jumped from 79 years to 84, while disability has steadily declined. Seniors enjoy more active lives than their parents owing to hip and knee replacements, angioplasty and bypass surgery, according to James Lubitz and Ellen Kramarow of the National Center for Health Statistics (Health Affairs, Sept./Oct. 2007). Obama adviser Dr. David Cutler reports that the heart medications and procedures Medicare patients have received over the last 20 years have been a "wise investment" resulting in "excellent value" (Health Affairs, Jan./Feb. 2007).

Cuts in future Medicare funding -- what Obama calls "savings" -- will mean less help in coping with aging and possibly shorter lives. Do we really want to treat our seniors like clunkers?

Betsy McCaughey is chairman of the Committee to Reduce Infection Deaths .

You can call it half assed death panels if you like. One way or another the outcome will be the same.

Steve ;he's trying to divert the discussion of this op because even he can't defend the scam by the Reid Democrats.

Steve ;he's trying to divert the discussion of this op because even he can't defend the scam by the Reid Democrats.

It's obvious he's run out of arguments, maybe he should stick to the Obama as dufus posts. :D

Hello again:

The reason I didn't address the OP, because at this stage in the negotiations, what's IN the bill one minute, is OUT the next...

So, opting in or opting out is just another chip in the negotiations...

You're right about one thing.. I don't see the scam Reid is trying to pass off. I just see him trying to get a bill passed ANY way he can, even if it means watering it down to where it means NOTHING. Letting states opt in or out, means the pubic option LOSES its effect... That should make you happy. But, I can't tell what makes you happy these days.

Yes, I do. If we were talking about WAR, you'd be tickled pink. But, talk about something that might be good for US, no way, Jose.

excon

Yes, I do. If we were talking about WAR, you'd be tickled pink. But, talk about something that might be good for US, no way, Jose.

Do you think forcing American citizens to purchase goods or services under threat of penalty as a requirement for citizenship is a good thing?

Do you think forcing American citizens to purchase goods or services under threat of penalty as a requirement for citizenship is a good thing?Hello again, Steve:

No. That's why these half a$$ed attempts won't work, and single payer would.

excon

Hello again, Steve:

No. That's why these half a$$ed attempts won't work, and single payer would.

So you prefer coercion. I prefer freedom over either.

So you prefer coercion. I prefer freedom over either.Hello again, Steve:

Well, coercion in the sense that I'm coerced into paying my taxes. Kind of like you're not coerced into paying every time you use a public highway or when they drop a bomb on somebody.

Like you, I'd prefer freedom over taxes... But, I'm not going to go to jail over it.

excon

I personally think the death panels are in place now and will continue regardless if we opt in or out of whatever. The present death panels are called "insurance companies". Medicare has them but they're called Medicare.

Hello:
I wanna know about those death panels.. Are they still in there? How come you don't talk about them anymore. Is it cause they're really AREN'T in there???? Cause if they are, and you ain't talking about 'em, I guess you support 'em. And, if they're not, then we got your number...
...

excon

"The Medicare end-of-life planning provision that 2008 Republican vice presidential nominee Sarah Palin said was tantamount to "death panels" for seniors is staying in the latest Democratic health care bill unveiled Thursday." So-Called 'Death Panel' Measure Survives in House Health Bill - Political News - FOXNews.com (http://www.foxnews.com/politics/2009/10/29/called-death-panel-measure-survive-house-health/)

Hello again, George:

Then opting in or out ain't going to matter too much if they're going to knock you off anyway.

excon

The bill exploded to almost 2000 pages. I'm sure all the Reps. Will read it with a fine tooth comb before voting on it.

For anyone who cares to read the Bill, it is HR 3962. Here's a link to the PDF. 1990 pages long. Have fun...

http://docs.house.gov/rules/health/111_ahcaa.pdf

Elliot

Hello again, George:

Then opting in or out ain't gonna matter too much if they're gonna knock you off anyway.

excon

As we are finding out, the IRS will be monitoring the usage of health care. It will be a simple interface for the IRS to perform a cursory cost/benefit analysis to see whether the patient/taxpayer is costing more than he is worth (anyone who thinks this is 'insurance' is on weed or just plain stupid). How efficient and fascistic things will be; and the multitudes will sing: Glory, glory to Obama; Glory, glory to Obama,. (to the tune of... oh, you know).

As we are finding out, the IRS will be monitoring the usage of health care. It will be a simple interface for the IRS to perform a cursory cost/benefit analysis to see whether the patient/taxpayer is costing more than he is worth (anyone who thinks this is 'insurance' is on weed or just plain stupid). Hello again, George:

Here's the good news. I'M certainly NOT going to be one of those who are worthy, so they'll knock me, and the other stupid ones off straight away. When the government has taken care of that, you can change it back, cause there won't be anyone left to oppose it.

excon

No, man. The 'good news' will be the American folks aren't going to stand for it. Hopefully, these bridges will never be crossed. I'm betting on the pursuit of happiness rather than the prospect of security.

Meanwhile there is good news for Canadians .They average waiting list has dropped to only 4 months(six months in Newfoundland)!!

Waiting Your Turn: Hospital Waiting Lists in Canada, 19th Edition (http://www.fraserinstitute.org/researchandpublications/publications/6992.aspx)

That's a drop of a critical 1 week!!

For anyone who cares to read the Bill, it is HR 3962. Here's a link to the PDF. 1990 pages long. Have fun...

http://docs.house.gov/rules/health/111_ahcaa.pdf

Elliot

Big Government Blog Archive Pelosi Health Care Bill Blows a Kiss to Trial Lawyers (http://biggovernment.com/2009/10/30/pelosi-health-care-bill-blows-a-kiss-to-trial-lawyers/#more-23042)





Section 2531, entitled “Medical Liability Alternatives,” establishes an incentive program for states to adopt and implement alternatives to medical liability litigation. [But]…… a state is not eligible for the incentive payments if that state puts a law on the books that limits attorneys’ fees or imposes caps on damages.





American Thinker Blog: Health care reform targets...vending machines? (http://www.americanthinker.com/blog/2009/10/health_care_reform_targetsvend.html)



BREAKING: Comprehensive List of Taxes<br> In House Democrat Health Bill (http://www.atr.org/breaking-comprehensive-list-taxesbr-house-democrat-a4113#)


This gargantuan beast contains thirteen new tax hikes.


I'm sure there are plenty of more gems like these. :rolleyes:


G&P

To answer the question ;yes the death panels remain in HR3962
Pelosi Bill Keeps End-of-Life Planning - CBS News (http://www.cbsnews.com/stories/2009/10/30/politics/main5460587.shtml)

To answer the question ;yes the death panels remain in HR3962
Pelosi Bill Keeps End-of-Life Planning - CBS News (http://www.cbsnews.com/stories/2009/10/30/politics/main5460587.shtml)

FTA:

The provision allows Medicare to pay for voluntary counseling to help beneficiaries deal with the complex and painful decisions families face when a loved one is approaching death. Yea, that's death panel. :rolleyes:
Please spread more FUD tom.

OK

Here are some hidden tax increases in the bill compiled by Americans for Tax Reform :
Employer Mandate Excise Tax (Page 275): If an employer does not pay 72.5 percent of a single employee's health premium (65 percent of a family employee), the employer must pay an excise tax equal to 8 percent of average wages. Small employers (measured by payroll size) have smaller payroll tax rates of 0 percent (<$500,000), 2 percent ($500,000-$585,000), 4 percent ($585,000-$670,000), and 6 percent ($670,000-$750,000).

Individual Mandate Surtax (Page 296): If an individual fails to obtain qualifying coverage, he must pay an income surtax equal to the lesser of 2.5 percent of modified adjusted gross income (MAGI) or the average premium. MAGI adds back in the foreign earned income exclusion and municipal bond interest.

Medicine Cabinet Tax (Page 324): Non-prescription medications would no longer be able to be purchased from health savings accounts (HSAs), flexible spending accounts (FSAs), or health reimbursement arrangements (HRAs). Insulin excepted.

Cap on FSAs (Page 325): FSAs would face an annual cap of $2500 (currently uncapped).

Increased Additional Tax on Non-Qualified HSA Distributions (Page 326): Non-qualified distributions from HSAs would face an additional tax of 20 percent (current law is 10 percent). This disadvantages HSAs relative to other tax-free accounts (e.g. IRAs, 401(k)s, 529 plans, etc.)

Denial of Tax Deduction for Employer Health Plans Coordinating with Medicare Part D (Page 327): This would further erode private sector participation in delivery of Medicare services.

Surtax on Individuals and Small Businesses (Page 336): Imposes an income surtax of 5.4 percent on MAGI over $500,000 ($1 million married filing jointly). MAGI adds back in the itemized deduction for margin loan interest. This would raise the top marginal tax rate in 2011 from 39.6 percent under current law to 45 percent—a new effective top rate.

Excise Tax on Medical Devices (Page 339): Imposes a new excise tax on medical device manufacturers equal to 2.5 percent of the wholesale price. It excludes retail sales and unspecified medical devices sold to the general public.

Corporate 1099-MISC Information Reporting (Page 344): Requires that 1099-MISC forms be issued to corporations as well as persons for trade or business payments. Current law limits to just persons for small business compliance complexity reasons. Also expands reporting to exchanges of property.

Delay in Worldwide Allocation of Interest (Page 345): Delays for nine years the worldwide allocation of interest, a corporate tax relief provision from the American Jobs Creation Act

Limitation on Tax Treaty Benefits for Certain Payments (Page 346): Increases taxes on U.S. employers with overseas operations looking to avoid double taxation of earnings.

Codification of the “Economic Substance Doctrine” (Page 349): Empowers the IRS to disallow a perfectly legal tax deduction or other tax relief merely because the IRS deems that the motive of the taxpayer was not primarily business-related.

Application of “More Likely Than Not” Rule (Page 357): Publicly-traded partnerships and corporations with annual gross receipts in excess of $100 million have raised standards on penalties. If there is a tax underpayment by these taxpayers, they must be able to prove that the estimated tax paid would have more likely than not been sufficient to cover final tax liability.
BREAKING: Comprehensive List of Taxes<br> In House Democrat Health Bill (http://www.atr.org/breaking-comprehensive-list-taxesbr-house-democrat-a4113)#

One other thing... Pelosi et al claim this is defecit neutral . The only way that is true is if you take into account the hundreds of billions of dollars in Medicare cuts. Yup ,Pelosi and the Democrats will be able to campaign next year as the party that cut Medicare benefits!

One other thing ..... Pelosi et al claim this is defecit neutral . The only way that is true is if you take into account the hundreds of billions of dollars in Medicare cuts. Yup ,Pelosi and the Democrats will be able to campaign next year as the party that cut Medicare benefits !!No it's about cutting Medicare fraud and waste. That was widely reported but you chose to post more misinformation.

On today's headline: "Flex spending accounts face hit in health overhaul"
Further: "Those tax-free spending accounts that you and your co-workers use to help pay for dental work, insurance copayments or over-the-counter drugs face a hit under the health overhaul bills in Congress — unless a coalition that includes a powerful union, insurers and others can stop it."
Flex spending accounts face hit in health overhaul - Yahoo! News (http://news.yahoo.com/s/ap/20091101/ap_on_bi_ge/us_health_overhaul_flexible_spending)
Why destroy a program that is working?

No it's about cutting Medicare fraud and waste. That was widely reported but you chose to post more misinformation.

NK, here's a clue:

When you cut Medicare fraud, it results in lower spending.

However, when you cut the Medicare BUDGET, it does not result in lower spending, just less money available, and more cost overruns.

Pelosi isn't doing anything to cut Medicare fraud. She's just cutting their budget and telling us that they will therefore have to cut fraud themselves.

She's cutting Medicare. Deal with it.

What government agency, anywhere, has ever accurately forcast its revenues? Or, its expenses?

Hello:

My understanding is that there will be cuts in the subsidies the insurance companies got to write Medicare Supplemental insurance... The only way the dufus could get them to write these policies in the first place, was if he gave 'em the ranch - and he did.

This is just taking some of YOUR money back from them. These subsidies are going to be cut. I suppose that means the insurance companies will cut services and raise premiums. But, that's on them.

Now, it's hard for me to say that the cuts in subsidies is a cut in service. It isn't. It's exactly what it portends to be - saving more of YOUR money.

Now, if the insurance companies want to cut services as a result, then they will. But, let's not suggest that the BILL is doing that. It's clearly the insurance companies who are going to do it as a RESULT of the bill.

excon

Hello:

My understanding is that there will be cuts in the subsidies the insurance companies got to write Medicare Supplemental insurance...

excon

Your understanding is way off base, according to my understanding.

There are no subsidies flowing to insurance companies with repect to medicare supplemental policies; those policies are purchased by the insured and they cost real money.

What you may understand correctly is that Medicare Advantage plans will be cut. Progressive/liberals hate this program because they (P/L's) are "out" of the loop and not able to dictate results.

excon, you are living in a very sick world if this is what you believe. You are way too smart to buy-in to that crap.

No it's about cutting Medicare fraud and waste. That was widely reported but you chose to post more misinformation.

The Wall Street Journal (rightfully) calls Pelosicare The Worst Bill Ever (http://online.wsj.com/article/SB10001424052748703399204574505423751140690.html?m od=rss_opinion_main). If it's about cutting waste and fraud they can begin by starting from scratch and using a little common and fiscal sense. And by the way, Pelosicare only made Americans like it less (http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/september_2009/health_care_reform).

Steve ;not sure you are citing an NK approved source.

Hello George:

You're right. I misspoke. The supplemental plans I spoke of ARE correctly called Medicare Advantage. They cost real money, too. I own one.

I don't know what plans you might be talking about. There ARE no other plans that a senior would buy. These are the ones, whose subsidy's will be cut... Subsidy's that the dufus gave them.

excon

Hello George:

You're right. I misspoke. The supplemental plans I spoke of ARE correctly called Medicare Advantage. They cost real money, too. I own one.

I don't know what plans you might be talking about. There ARE no other plans that a senior would buy. These are the ones, whose subsidy's will be cut... Subsidy's that the dufus gave them.

excon

A Medicare Advantage plan or policy is not a medicare supplemental policy. If you are with a Medicare Advantage plan, then you should know the difference. Let me know if you want assistance with this. By the way, some medicare advantage plans are offered for a zero (0) monthly cost to the plan holder.

No it's about cutting Medicare fraud and waste. That was widely reported but you chose to post more misinformation.

They need an entire healthcare overhaul to cut out fraud?
Why is that not currently being done?
Fraud and waste is a smoke screen. There is no need for a thousands of pages of a bill to fight fraud and waste - This should already be an ongoing process.


G&P