I subscribe to Sen. George LeMieux’s newsletters and Twitter stream and must say that I’m actually proud to have him representing my ideas and values while (so far) appearing to always take the high road and not compromise his personal values along the way. Had I known about him before his election, I probably would go as far to say that I would have been a campaign volunteer for him – something I can’t believe I’m actually typing. His communication and understanding of his constituents’ wishes is something to behold.
Before I give you his laundry list after reading the bill as it stands now, let’s review what doctors think about the bill and what they say they will do if the bill goes into law:
An IBD/TIPP poll found the following:
– 45% of doctors polled said they would consider leaving their practice or retiring early if the proposed health care bill was to pass
– 65% or 2 out of 3 practicing physicians polled say they oppose the plan
– 72% of doctors polled disagree with the administration’s claim that the government can cover 47 million more Americans with better quality care and at a lower cost
Here is this morning’s release sent out to his newsletter subscribers:
WASHINGTON – U.S. Senator George LeMieux (R-FL) today called attention to a number of myths that have become part of the health care debate as if they were fact. Senator LeMieux made his remarks on the floor of the Senate this evening.
“We know this comprehensive proposal will not reduce costs for Americans, it will not guarantee that you can keep your health care plan if you like it, and it does not truly reduce the deficit,” said LeMieux. “These proposed reforms will take half a trillion dollars from Medicare, they will not reduce the demands on emergency rooms, and they will only go after fraud at the edges.”BACKGROUND ON BUSTED MYTHS:
MYTH 1: YOU CAN KEEP YOUR HEALTH INSURANCE IF YOU LIKE IT
• As recently as today, President Obama has said, “If you have a plan you like, you can keep it.”
A: Employers will drop coverage
• CBO says, “Between 8 million and 9 million other people who would be covered by an employment based plan under current law would not have an offer of such coverage under the proposal.” Because of the employer mandate some businesses would likely drop existing coverage or fail to offer new coverage.
• Rick Foster, the CMS actuary says this number could be even higher. He concluded that 17 million people will lose their employer-sponsored coverage. Many smaller employers would be, “inclined to terminate their existing coverage” so their workers could qualify for “heavily subsidized coverage” through the exchange.
B: Medicare Advantage will be downgraded
• Foster also says, “Lower benchmarks would reduce Medicare Advantage rebates to plans and thereby result in less generous benefit packages. We estimate that in 2015…enrollment in Medicare Advantage plans would decrease by about 33 percent (from a projected level of 13.7 million under current law to 9.2 million under the proposal).”
C: Mandates will usher in era of one-size-fits all health care system
• Mandates eliminate patient choice and force Americans onto certain plans.MYTH 2: YOUR HEALTH INSURANCE PREMIUMS WILL GO DOWN
• One of the President’s earliest stated goals was to control health care costs, including lowering insurance premiums.
• CBO estimates that a majority of Americans who receive their insurance through an employer will notice only a negligible impact on their premiums. Essentially, this is a continuation of the status quo.
• Those who buy their own insurance from the individual market can expect premiums to rise.
• According to CBO, “Average premiums per policy in the non-group market in 2016 would be roughly $5,800 for single policies and $15,200 for family policies under the proposal, compared with roughly $5,500 for single policies and $13,100 for family policies under current law. The weighted average of the differences in those amounts equals the change of 10 percent to 13 percent in the average premium per person summarized above…”MYTH 3: DEMS’ PLAN WILL LOWER COSTS
• In today’s Washington Post, Robert Samuelson takes on the President’s claim that his plan will control costs.
• Samuelson writes: “When people get insurance, they use more health services. Spending rises. By the government’s latest forecast, health spending goes from 17 percent of the economy in 2009 to 19 percent in 2019. Health ‘reform’ would probably increase that.”
• According to the CMS actuary, “We estimate that overall national health expenditures under this bill would increase by an estimated total of $222 billion (0.6 percent) during calendar years 2010-2019.”
• It would also increase the government’s share of health care spending. According to CBO, “Under the legislation, federal outlays for health care would increase…by about $210 billion” during the 2010-2019 period.
• For all of its 2,000 pages, the bill does not include ideas to lower costs:
o No transparency;
o No consumer-driven ideas for reducing costs,
o No changes to laws prohibiting purchases across state lines
• Real reform should include medical malpractice reform, which according to CBO, could save as much as $54 billion over the next decade -10 times more than previously estimated.MYTH 4: DEMS’ PLAN WILL REDUCE THE DEFICIT
• The Senate bill relies on budget gimmickry to achieve what appears to be a deficit reduction, but will actually result in another mountain of crushing government spending.
A: Six years of spending/10 years of taxes
• CBO Director Douglas Elmendorf wrote in his December 19, 2009 letter to Senator Reid, “A detailed year-by-year projection for years beyond 2019, like those that CBO prepares for the 10-year budget window, would not be meaningful because the uncertainties involved are simply too great.”
• CBO has also said, “Under the legislation, federal outlays for health care would increase during the 2010-2019 period, as would the federal budgetary commitment to health care.”
B: Budget-buster for states
• The proposal also forces states that cannot afford their current Medicaid programs to contribute tens of billions more to fund new coverage expansions beginning in 2018.
• Tennessee Democratic Gov. Phil Bredesen called it, “the mother of all unfunded mandates.”
• The head of Washington State’s Medicaid program believes that states facing severe financial distress may say, “I have to get out of the Medicaid program altogether.”
• CBO released its first estimate of expected discretionary spending under the Senate-passed bill, confirming the $10-20 billion in discretionary spending over the next decade to implement the legislation – $5-10 billion each for the IRS and HHS.
• CBO also estimates an additional $55.6 billion in discretionary spending on the various grant programs authorized (but not appropriated) in the measure.
C: Will be a trillion-dollar program
• The total to enact health “reform” will easily exceed $1 trillion.
• Government programs rarely cost less than projected.
• The White House has not explained how all this new discretionary spending comports with the President’s plan for a spending “freeze” over the next three years.MYTH 5: MEDICARE CUTS WON’T AFFECT SENIORS
• The bill cuts a half a trillion dollars from Medicare, including nearly $120 billion from Medicare Advantage, which delivers a range of health care options to nearly 11 million seniors, almost one-quarter of those enrolled in the Medicare program.
A: Effect on Medicare
• In his letter to Senator Reid, CBO Director Douglas Elmendorf wrote that the effects of the cuts to Medicare remain unclear, but warned that they could “reduce access to care or diminish the quality of care.”
• These cuts include:
o $135 billion from hospitals
o $120 billion from Medicare Advantage
o Nearly $15 billion from nursing homes
o Nearly $40 billion from home health agencies
o Nearly $7 billion from hospices
• The CMS Actuary says that many of the Medicare cuts are “unrelated to the providers’ costs of furnishing services to beneficiaries.” He concludes that it is “doubtful” that providers could reduce costs to keep up with the cuts.
• The CMS actuary also finds that because of the bill’s severe cuts to Medicare, “providers for whom Medicare constitutes a substantive portion of their business could find it difficult to remain profitable and might end their participation in the program (possibly jeopardizing access to care for beneficiaries).”
• Because of the increased demand for health care, the Actuary says that access to care problems are “plausible and even probable” under the Reid bill.
B: Doctors are turning away patients
• According to a June 2008 Medicare Payment Advisory Commission report, 29 percent of the Medicare beneficiaries it surveyed who were looking for a primary care doctor had a problem finding one to treat them – up from 24 percent in 2007.
C: Florida
• Florida is disproportionately affected since it has the second highest population of seniors and the highest concentration of seniors in the nation at 19 percent.
• Ron Malone, Vice President of Gentiva Health Services expects these cuts to devastate home health care in Florida.
• The Florida Medical Association – the largest physician’s association in Florida with nearly 20,000 members says, “…this legislation does not adequately fix what’s wrong with our current system. It contains many provisions that would allow government bureaucrats to interfere with patient care decisions and actually raises the cost of health insurance unnecessarily.”MYTH 6: EMERGENCY ROOMS WILL BE LESS BURDENED
• According to the Urban Institute, after Massachusetts adopted a somewhat similar plan, emergency-room use remained higher than the national average.
• More than two-fifths of these visits were for non-emergencies. And of these, a majority of the adult respondents said it was “more convenient” to check into the E.R. because they were not able to get in to see a doctor.
• Massachusetts’ plan has worsened the state’s doctor shortage. The Massachusetts Hospital Association found that two thirds of hospitals say their community has too few primary care clinicians.
• The 2008 Massachusetts Medical Society Report found that 12 of the 18 physician specialties had, “critical or severe shortages.” The problems were particularly acute in the family and internal medicine fields.
• The percentage of family medicine physicians no longer accepting new patients rose from 25 percent in 2006 to 35 percent in 2008.
• Waiting times increased from an average of 15 days in 2008 to 18 in 2009.
• With a shortage of doctors in rural communities nationwide, such a plan on a national scale will only make matters worse.MYTH 7: THE DEMS’ PLAN TAKES ON INSURANCE COMPANIES
• Contains tax credit for insurance companies. According to the Senate Finance Committee’s report, “The premium tax credit, which is refundable and payable in advance directly to the insurer, subsidizes the purchase of certain health insurance plans through the state exchanges.”
MYTH 8: BILL TAKES UNPRESCEDENTED STEPS IN FIGHTING HEALTH CARE FRAUD, WASTE, AND ABUSE
• The bill only continues the pay-and-chase method of fighting Medicare fraud, waste, and abuse.
• I believe more money can be saved on the front end. There is a more efficient way of fighting the estimated $60 billion lost through waste, fraud, and abuse each year.
• We can look no further than the private sector for innovative ways to save money and stop wasting Americans’ hard-earned dollars.
A: S.2128
• Under my plan, we adopt the predictive modeling used by the credit card industry.
• Predictive modeling has realized as much as a 30 to 1 return on investment in the financial services industry.
• Using predictive modeling, the credit card industry loses about 7 cents for every 100 dollars transacted due to fraud, a fraction of 1 percent of total transactions. Medicare, on the other hand, loses 1 out of every 7 dollars or approximately 14 percent of the entire payouts.
B: Background checks
• My plan will stop fraud before the checks are sent out – ensuring the people rendering medical services or selling medical devices are not criminals.
• According to independent estimates, once the system is fully operational, my plan would result in the savings of $22 to $35 billion per year.
• Predictive modeling is not limited to the financial services industry. In fact, private health care companies have saved millions of dollars after implementing this technology. The Federal government can, too.MYTH 9: DEMS’ HEALTH CARE REFORM WILL NOT IMPACT PATIENT-DOCTOR RELATIONSHIP
• I agree with my colleague, Dr. Barasso, who supports a patient-centered approach.
• Real health care reform should ensure a doctor and a patient can work together toward the best health for that patient.
• This bill will increase costs for patients, create more bureaucratic headaches for doctors, and result in an America where the health of our people is only as good as the health of our nation’s balance sheet.MYTH 10: TAXES WILL NOT GO UP
• This bill is a jobs bill for the tax collector.
• National Federation of Independent Businesses – I talked with the Florida NFIB members and they have great concern about this bill and the impact the taxes will have.
• The NFIB released a statement on their Web site on December 8 expressing their opposition to the Reid bill: “When evaluating health care reform options, small business owners ask themselves two specific questions. First, will the bill lower insurance costs? Second, will the bill increase the overall cost of doing business? In both cases, the Patient Protection and Affordable Care Act fails the small business test and, therefore, fails small business.”
• If you have insurance…you get taxed.
• If you DON’T have insurance…you get taxed.
• If you need prescription drugs…you get taxed.
• If you need a medical device…you get taxed.
• If you have high out-of-pocket health expenses…you get taxed.
• Some of these taxes go into effect right away, while the majority of the benefits do not kick in for 4 years.
