Democrats see GOP hypocrisy in health care debate

In the December 25, 2009 article "Democrats see GOP hypocrisy in health care debate," Associated Press writer Charles Babington reports on the hypocrisy of Republican criticism of Democratic health care proposals that add to the federal budget deficit when their own proposals from a few years ago are a significant contributor to the public debt.

WASHINGTON – Republican senators attacking the cost of a Democratic health care bill showed far different concerns six years ago, when they approved a major Medicare expansion that has added tens of billions of dollars to federal deficits.

The inconsistency — or hypocrisy, as some call it — has irked Democrats, who claim that their plan will pay for itself with higher taxes and spending cuts and cite the nonpartisan Congressional Budget Office for support.

By contrast, when Republicans controlled the House, Senate and White House in 2003, they overcame Democratic opposition to add a deficit-financed prescription drug benefit to Medicare. The program will cost a half-trillion dollars over 10 years, or more by some estimates.

With no new taxes or spending offsets accompanying the Medicare drug program, the cost has been added to the federal debt.

All current GOP senators, including the 24 who voted for the 2003 Medicare expansion, oppose the health care bill that's backed by President Barack Obama and most congressional Democrats. Some Republicans say they don't believe the CBO's projections that the health care overhaul will pay for itself. As for their newfound worries about big government health expansions, they essentially say: That was then, this is now.

Six years ago, "it was standard practice not to pay for things," said Sen. Orrin Hatch, R-Utah. "We were concerned about it, because it certainly added to the deficit, no question." His 2003 vote has been vindicated, Hatch said, because the prescription drug benefit "has done a lot of good."

Sen. George Voinovich, R-Ohio, said those who see hypocrisy "can legitimately raise that issue." But he defended his positions in 2003 and now, saying the economy is in worse shape and Americans are more anxious.

Sen. Olympia Snowe, R-Maine, said simply: "Dredging up history is not the way to move forward." She noted that she fought unsuccessfully to offset some of President George W. Bush's deep tax cuts at the time.

But for now, she said, "it's a question of what's in this package," which the Senate passed Thursday in a party-line vote. The Senate bill still must be reconciled with a House version.

The political situation is different now, Snowe said, because "we're in a tough climate and people are angry and frustrated."

Some conservatives have no patience for such explanations.

"As far as I am concerned, any Republican who voted for the Medicare drug benefit has no right to criticize anything the Democrats have done in terms of adding to the national debt," said Bruce Bartlett, an official in the administrations of Ronald Reagan and George H.W. Bush. He made his comments in a Forbes article titled "Republican Deficit Hypocrisy."

Bartlett said the 2003 Medicare expansion was "a pure giveaway" that cost more than this year's Senate or House health bills will cost. More important, he said, "the drug benefit had no dedicated financing, no offsets and no revenue-raisers. One hundred percent of the cost simply added to the federal budget deficit."

The pending health care bills in Congress, he noted, are projected to add nothing to the deficit over 10 years.

Other lawmakers who voted for the 2003 Medicare expansion include the Senate's top three Republican leaders, all sharp critics of the Obama-backed health care plans: Mitch McConnell of Kentucky, Jon Kyl of Arizona and Lamar Alexander of Tennessee. Eleven Democratic senators voted with them back then.

The 2003 vote in the House was even more divisive. It resulted in a nearly three-hour roll call in which GOP leaders put extraordinary pressure on colleagues to back the prescription drug addition to Medicare. In the end, 204 Republicans and 16 Democrats voted for the bill.

Democrats certainly have indulged in deficit spending over the years. They say they have been more responsible over the last two decades, however. Bill Clinton's administration was largely constrained by a pay-as-you-go law, requiring most tax cuts or program expansions to be offset elsewhere with tax increases and/or spending cuts.

Clinton ended his presidency with a budget surplus. But it soon was wiped out by a sagging economy, the Iraq war, GOP tax cuts and the lapsing of the pay-as-you-go restrictions.

Obama and many Democrats in Congress have vowed to restore those restrictions. But they waived them this year for programs, including heavy stimulus spending meant to pull the economy from the severe recession of 2008-09.

The 2010 deficit is expected to reach $1.5 trillion, and the accumulated federal debt now exceeds $12 trillion. When the Republican-led Congress passed the Medicare expansion in 2003, the deficit was $374 billion, and was projected to hit $525 billion the following year, in part because of the new prescription drug benefit for seniors.

Some GOP lawmakers cite these numbers in arguing that their current worries about heavy government spending are legitimate, even if they voted for the deficit-financed Medicare bill in 2003.

But Judy Feder, an analyst with the Democratic-leaning Center for American Progress, said these Republicans had their chance and blew it. In the second Bush administration, she said, "there was a total elimination of any kind of pay-for responsibility."

Those responsible should now show some humility, she said.

A Letter from Prominent Economists Outlining How the Political Process is Destroying Benefits of Health Care Reform

Prominent economists sent the following letter to Senate Majority Leader, Harry Reid, to outline how politicians, succumbing to pressure from special interests, have removed important features of health care reform:

December 7, 2009

Senator Harry Reid
Majority Leader, United States Senate
Washington, DC

Dear Senator Reid:

We thank you for your leadership in bringing forward the Patient Protection and Affordable Care Act. This draft bill has four elements that several of us, in a November 17 letter to President Obama, identified as crucial to health reform: 1) deficit neutrality, 2) an excise tax on high-cost insurance plans, 3) an independent Medicare commission, and 4) delivery system reform. The Congressional Budget Office estimates that the proposed legislation will not only achieve deficit neutrality but will reduce the deficit. The draft bill’s tax on high cost insurance plans should encourage efficiency and innovation in health insurance. As you and your colleagues continue to discuss health reform, we urge you to retain these elements. For the fiscal strength of the nation and to ensure Americans receive the best possible care, we also urge the Senate to strengthen both the role of the Independent Medicare Advisory Board and the delivery system reforms.

Independent Medicare Advisory Board

The Independent Medicare Advisory Board can help Congress modernize Medicare. The Board will offer proposals to improve the quality, efficiency, and financial viability of the Medicare program. Yet the Board’s effectiveness will be diminished by restrictions that the draft bill places on the circumstances under which the Board’s recommendations will receive “fast track”
status in Congress. One restriction is on the breadth of recommendations the Board can make. Physician and hospital payments, which account for more than half of Medicare expenditures, are excluded until 2019 – two years after the 2009 Medicare Trustees Report projects that the Hospital Insurance Trust Fund will be exhausted. The Board’s recommendations should encompass diverse aspects of Medicare , including changes to payments affecting physicians and hospitals, and all of its recommendations should be considered for “fast track” action in Congress.

Even after 2019 Congress will only “fast track” the Board’s recommendations if Medicare spending per person rises more than overall health care spending per person. We do not believe that this will be enough to constrain excess growth in health care spending. The Board’s recommendations should receive “fast track” status even if spending thresholds are not exceeded. These changes will enable the Board more effectively to do its part to ensure Medicare’s long- term viability and to improve the quality of care Medicare beneficiaries receive.

Finally, the Senate might consider expanding the authority of the Medicare Commission so it does not only address Medicare policies but can provide recommendations on changes to Medicaid and other Federal health programs.

Delivery System Reform

Some of the most far-reaching effects of health reform will come from changes in the delivery of care. The proposed legislation has many provisions to encourage such change. For example, it will help shift payment for care so that physicians and hospitals will be rewarded for achieving better health outcomes, not simply for delivering more services.

The proposed incentives, however, would be much more effective if they were strengthened and implemented earlier. For example, the draft bill imposes a financial penalty on hospitals that readmit patients for complications of hospitalization, but the penalty applies to just 3 conditions and is too small. It does not start until 2013, and even then the penalty will be limited to 1%, rising to only 3% two years later. The penalties for hospital-acquired infections are even smaller and delayed longer. The Senate Finance Committee recommendations do more to reward doctors and hospitals for providing better health rather than more services.

Furthermore, despite the great interest in bundling payments for medical services, the draft bill calls for bundling only in a limited set of circumstances, mainly concerning hospitalization. The impact of the payment changes would be greater if they allowed bundled payments for chronic conditions such as congestive heart failure and diabetes over an entire year. After all, care for these chronic conditions accounts for more than half of all health care spending and avoidable services. The Secretary should be authorized to implement pilots that improve the quality of care and lower its cost on a national scale unless legislation is specifically enacted that prohibits the Secretary from doing so.

You and your colleagues should be applauded for including the four essential elements of a successful, fiscally responsible reform strategy. Much more could be achieved if the Senate strengthens the Medicare Commission and the delivery system reforms. Doing so would help to ensure that health reform both improves the health care that Americans receive and slows the growth of spending. We are ready to work with you to achieve these goals.

Sincerely,

Dr. Henry Aaron, The Brookings Institution
Dr. Kenneth Arrow, Stanford University, Nobel Laureate in Economics
Dr. Alan Auerbach, University of California, Berkeley
Dr. Martin Bailey, The Brookings Institution
Dr. Gary Burtless, The Brookings Institution
Dr. David Cutler, Harvard University
Dr. Laura D’Andrea Tyson, University of California, Berkeley
Dr. Angus Deaton, Princeton University
Dr. Peter Diamond, Massachusetts Institute of Technology
Dr. Victor Fuchs, Stanford University
Dr. Alan Garber, Stanford University
Dr. Harold Luft, University of California, San Francisco
Dr. Daniel McFadden, Massachusetts Institute of Technology, Nobel Laureate in Economics
Dr. David Meltzer, University of Chicago
Dr. Joseph P. Newhouse, Harvard University
Dr. Uwe Reinhardt, Princeton University
Dr. Robert Reischauer, The Urban Institute
Dr. Alice Rivlin, The Brookings Institution
Dr. Meredith Rosenthhal, Harvard University
Dr. Isabel Sawhill, The Brookings Institution
Dr. Charles Schultze, The Brookings Institution
Dr. William Sharpe, Stanford University, Nobel Laureate in Economics
Dr. John Shoven, Stanford University
Dr. Jonathan Skinner, Dartmouth University
Dr. Robert Solow, Massachusetts Institute of Technology, Nobel Laureate in Economics
Dr. Richard Zeckhauser, Harvard University

Disclaimer:
This letter represents the personal views of the signers, not of the institutions with which they are affiliated. The institutions are listed for identification purposes only.

FACT CHECK: Health insurers cherry-pick facts

In the October 14, 2009 article "FACT CHECK: Health insurers cherry-pick facts," Associated Press writer Alan Fram explains health insurance companies are misleading the public in the debate over health insurance reform:

WASHINGTON – In its assaults on a Democratic health care overhaul bill, the insurance industry uses facts selectively and mixes accurate assertions with misleading spin and an embrace of worst-case scenarios.

Take the 30-second TV spot that America's Health Insurance Plans, the industry's trade group, was running this week in six states as the Senate Finance Committee approved overhaul legislation.

With a series of beleaguered-looking elderly people on camera, a soothing female voice says accurately that Congress has proposed cutting more than $100 billion from Medicare Advantage. The program, administered by private companies that provide extra services like eye and dental care, serves about a quarter of Medicare beneficiaries, more than 10 million people.

Then the announcer adds, "The nonpartisan Congressional Budget Office says many seniors will see cuts in benefits." Words flash on the screen for three seconds saying, "50 percent reduction in extra benefits."

The announcer's words are true — but could be easily misunderstood to mean that basic Medicare coverage is at risk.

The budget office's director, Douglas Elmendorf, has said that as a result of the proposed cuts, the extra benefits Medicare Advantage recipients receive would be halved over the next decade. But the ad leaves unspoken the fact that under the Finance bill, Medicare coverage for doctors, hospitals and other basic services would remain fully intact, with no reduction in benefits.

The ad also fails to mention the reason senators targeted Medicare Advantage for savings: The program is expensive for the government to administer, costing about 14 percent more per recipient than regular Medicare.

Robert Zirkelbach, the trade group's spokesman, says the ad does not attack anyone.

"Seniors have a right to know how the current legislation will impact their health security," he said.

Even so, the ad illustrates a favored tactic of Washington interest groups, which is to arouse worry about a bill among a key constituency — in this case, elderly voters.

"Call your senators. Tell them we need health care reform that protects seniors," the announcer concludes.

A study the health insurers released earlier this week takes similar liberties. It concludes that Democrats' health care effort would drive up premiums for insured people, based on cherry-picking convenient facts and perspectives. It's an example of the classic lobbying tactic of commissioning a report that, predictably, reinforces an interest group's views.

The study only examined four parts of the Finance bill that it said would boost consumers' costs. It ignored provisions aimed at making health care more affordable, such as exchanges whereby companies would compete for customers and subsidies to help lower-income people afford policies.

PricewaterhouseCoopers, the financial analysis firm the insurance industry commissioned to write the report, issued a statement this week noting it had been asked to only focus on four aspects of the bill: its weak enforcement mechanisms for the requirement that everyone buys insurance, an excise tax on expensive insurance policies, cuts in overall Medicare spending and fees on health care providers.

Provisions aimed at reducing costs, if successful, "would offset some of the impacts we have estimated," the accounting firm acknowledged.

One conclusion the report draws was mirrored by a fresh study released Wednesday by the Blue Cross and Blue Shield Association: For the health overhaul to work, there must be strong ways to enforce the requirement that people buy insurance.

Before the Finance Committee approved its bill, senators reduced the fines uninsured people would have to pay. The insurers argue that means many young, healthy people would remain uninsured, driving up costs for everyone else who purchases insurance — a conclusion that analysts generally agree is valid.

"Gee golly whiz. I could pay a $400 fine and get insurance when I need it, or pay $8,000 in premiums" per year, said Robert Laszewski, a private health policy analyst. He said the choice many families would make is "blindingly obvious."

The insurers' study concludes that insurance companies, medical device makers and other providers will pass on to consumers all the new taxes and fees the Finance bill imposes. It also assumes that doctors, hospitals and other health care providers would fully pass on the cuts lawmakers would make in Medicare, which total about $500 billion over 10 years.

It's an economic fact of life that businesses generally pass on the costs of taxes by raising prices. It's also fair to assume that when doctors and other providers see a reduction in income from their Medicare patients, they seek to make it up, if possible, from the rest of their patients.

Yet concluding that providers will pass the full cost of these changes to their customers ignores a basic assumption of the health overhaul effort. The goal is to increase competition and reduce the rate of growth currently assumed in medical costs. If the overall legislation succeeds in doing that, there would be less incentive for providers to pass on those costs — and more incentives for them to compete by keeping prices low.

Relax. You'll love healthcare cooperatives! Honest

In the October 12, 2009 Salon editorial "Relax. You'll love healthcare cooperatives! Honest," Steven Hill says "Liberals want a public option, and see co-ops as a sellout. But if Congress passes co-ops, don't fret. They work."

Watching the torturous turns of the healthcare debate in the Senate is mind-numbing, even for the most savvy policy wonks, let alone for members of the public. Each side in this debate has its own set of facts and scare statistics, and the resulting FUD -- fear, uncertainty and doubt -- have led to a colossal misunderstanding about healthcare cooperatives. That is unfortunate, since these co-ops may hold the key to a substantive compromise.

For liberals, and especially for single-payer advocates, their line in the sand has been drawn at the government-run public option, and so healthcare cooperatives represent another degree of sellout. Picking up a whiff of this discontent, some conservatives are supporting co-ops merely as a foil that can siphon support away from the much-demonized public option.

Yet private, nonprofit healthcare cooperatives, properly designed, actually could offer quite a lot to both the left and the right, as well as to anyone who is interested in expanding healthcare coverage, reducing costs and improving care. If the Senate combined nonprofit cooperatives with negotiated fees for each healthcare service -- both components having been offered up individually in various Senate proposals but not yet combined into the same package -- the making of a deal would be in sight. Indeed, nonprofit co-ops might prove to be a gift on the proverbial silver platter, because they could be just as effective as the public option and yet they will be easier to pass because Obama has some of the conservative senators thinking that it was their idea to begin with.

To understand why co-ops can work, it's important to understand how the healthcare market works. Or rather, doesn't work. According to the American Medical Association, insurance markets lack vigorous competition in more than nine out of 10 metropolitan areas. In 16 states, a single insurer writes more than half the policies, and nearly three-fifths of hospitals have little competitive pressure in the markets in which they operate.

That's because dominant insurers in a local market often pay healthcare providers high reimbursement rates to discourage them from participating in rival insurance plans. That discourages other insurers from entering the market, which in turn frees the dominant insurer to raise its premiums charged to its patients to cover the inflated reimbursements. In other words, the insurance companies make out, the doctors make out -- but the patients pay for it all.

The most direct way to break this logjam is to introduce a nonprofit element into the healthcare market. And here's the beauty of it: If designed correctly, it matters little if that nonprofit element is provided by the government or by a private organization, such as a cooperative. The effect on market dynamics is substantially the same, if the nonprofit can produce quality care for less money.

To see how this potentially could work, look to Germany. Germany has more than 200 private, nonprofit healthcare companies, which cover 92 percent of its population. Germany does not use a single-payer system but instead uses a "shared responsibility" system in which individuals and employers each are required to pay a premium of 6-7 percent of the individual's salary to the nonprofit healthcare companies. That percent is much smaller than what U.S. employers pay for their employees' healthcare. Despite spending only about 55 percent per capita of what the United States spends on healthcare, Germany still gets much better results for the 74 million Germans who use these nonprofits.

But while having more nonprofit players is necessary, it is not sufficient. After all, Kaiser and Blue Cross/Blue Shield are nonprofits, but they rake in huge earnings and pay multimillion-dollar CEO salaries. Group Health actually is a nonprofit cooperative, and while premiums at Group Health have increased less compared to those of competitors, the increases still have been fairly significant, averaging 12.3 percent per year since 2000.

So that's why negotiated fees for service are an additional crucial component needed to rein in costs. The impact of negotiations is best illustrated by another German practice, where representatives of the healthcare nonprofits deal with organizations of physicians, nurses, technicians and other healthcare professionals. Patient representatives also are given a seat at the table, and together they determine fees and rate ceilings for every treatment, procedure and doctor visit.

That combination -- of nonprofit companies and negotiated fees for service -- prevents costs from spiraling out of control. This system is better not only for individuals and families but also for businesses, since it not only makes healthcare costs for Germany's employers lower than in the United States but also allows them to better forecast and plan for these costs.

The Senate Finance Committee is scheduled to vote on its final proposal on Tuesday. The Finance bill includes co-ops, instead of a public option, but without enough clout to set rates with doctors and hospitals; the co-ops would have to cut individual deals with each provider, instead of negotiating across-the-board terms. Several Democrats joined all the panel's Republicans to vote down proposals to add a public option to the bill, in part because they think co-ops, not a public option, could get enough support to pass. But a bill that actually married co-ops with real negotiating clout -- the bargaining power of a public option without needing to involve the government -- might be an even better way to get the votes needed.

The good news for both liberals and conservatives is that nonprofit healthcare cooperatives could substantially impact market dynamics, without increasing the size of government. Both sides can have some of their cake, and eat it too. For those liberals who want a robust nonprofit element in the healthcare market, they'll get that. For those conservatives who don't want government playing a bigger role in healthcare, they'll get that.

Senators, what are we waiting for?

How Healthcare Reform Might Reduce Unemployment

In the October 5, 2009 U.S. News & World Report article "How Healthcare Reform Could Get You Hired," Liz Wolgemuth explains how healthcare reform might reduce unemployment:

In the debate over healthcare reform, references to outcomes mostly have to do with patients. But the impending overhaul of the health insurance system may lead to very different outcomes in employment. That's because health insurance coverage seems to guide the career choices of many older workers--and healthcare costs can guide the decisions of many employers.

If healthcare reform makes insurance much more affordable to individuals and businesses, it could result in a greater variety of career options for workers. For one thing, it would reduce barriers to entrepreneurship. Reform also could make it easier for workers to leave employers to whom they are "job-locked," or committed to solely for health benefits--a situation more common to older workers and those with pre-existing conditions.

It also could ease one of the greatest obstacles to older workers' job searches--even more pressing after nearly two years of recession and rocketing unemployment rates. "One of the long-standing barriers to hiring elderly workers is healthcare costs," says David Autor, an economist at the Massachusetts Institute of Technology. Because rates are higher for smaller employers, "if that concern were taken off the table," it would be easier for more businesses to hire older workers, Autor says.

Some employers worry about the potential for higher healthcare costs when hiring an older worker--although in most cases, a worker who's 50 or older will be more productive than someone younger who has less on-the-job experience, according to a 2005 report by the human resources and financial consulting firm Towers Perrin, prepared for AARP. Although it's unclear what precise shape healthcare reform will take, President Obama has insisted it will reduce the expense of benefits for small businesses. Last year, fewer than half of businesses with between three and nine employees offered health benefits, compared with 99 percent of businesses with 200 or more employees, according to the Kaiser Family Foundation.

A disadvantage. Small businesses pay as much as 18 percent more than large firms for the same health insurance policy, according to the president's Council of Economic Advisers. Employees at small businesses also tend to get leaner benefits packages and pay higher deductibles. "Small firms are likely to be at a competitive disadvantage in the market for hiring workers," according to the council's report. While Obama's goal may be competitive parity, opponents to existing healthcare reform legislation have argued that payroll taxes to pay for more affordable healthcare or mandates for levels of coverage could be prohibitive for small businesses.

Joanna Lahey, an economics professor at Texas A&M University, says there is little empirical evidence that proves insurers charge employers more in premiums for older workers--insurers don't exactly publicize their actuarial algorithms--but older individuals are charged more on individual plans. It would appear that older workers tend to accept lower wages in return for greater health insurance compensation. In New York, for example, after a law was passed prohibiting insurers from charging rates based on age, older workers' wages shot up.

Lahey's research finds that older workers often make new choices in employment when they are covered by insurance that is not provided by an employer. Her study looks at employment changes that occurred after the Department of Veterans Affairs decided to cover all veterans. Less-educated veterans were more likely to drop out of the workforce or work part time, while more-educated veterans were more likely to strike out on their own. Lahey suspects that if a public option in health insurance is good--in quality and price--there might be a similar effect.

This would, in general, be a good thing for the economy. Workers who choose to stay with employers merely to receive health insurance are not ideal for employers, who benefit more from motivated and productive workers. At the same time, workers are not helped by staying in jobs so they can maintain their coverage. There is what Lahey describes as a "loss of well-being" when, say, an older worker is ailing but continues to work until he or she reaches 65 and can be covered by Medicare. Yet many workers, particularly low-income ones, feel that's what they have to do.

U.S. workers' health costs soaring, studies show

In the September 15, 2009 article "U.S. workers' health costs soaring, studies show," Susan Heavey reports there will be dramatic increases in health care costs in the next decade if the U.S. does not reform its health care system:

WASHINGTON (Reuters) – U.S. workers getting health insurance for their families through employers have seen their premiums more than double in the last decade and the trend toward higher health costs is expected to continue, according to two reports released on Tuesday.

The Kaiser Family Foundation said the average premium for a company-provided family health insurance plan rose from $5,791 in 1999 to $13,375, a 131 percent jump.

Separately, the Business Roundtable, an organization that represents large U.S. corporations, said per-employee costs will jump to $28,530 in 2019 from $10,743 currently if nothing is done.

The findings come as Democratic lawmakers push their health reform plan aimed at containing rising costs and covering the millions of Americans currently without insurance.

President Barack Obama has said the changes should build on the current U.S. model, in which most people under the age of 65 with health insurance get it through their employers.

The Kaiser study said the portion of costs born by employees grew from $1,543 on average a decade ago to $3,515 this year. Employer saw their costs shoot up too, from $4,247 in contributions in 1999 to $9,860 in 2009 on average.

"When health care costs continue to rise so much faster than overall inflation in a bad recession, workers and employers really feel the pain. That's why we are having a health reform debate," said Drew Altman, the foundation's president and chief executive.

One Democratic proposal includes a public insurance plan that would rival the insurance industry.
Some critics of a public plan say it could encourage companies to stop providing health benefits, while others say employers would still want to offer benefits to attract employees.

The Business Roundtable says it wants to safeguard the coverage companies already provide while making the system more efficient.

"The (roundtable) report ... paints a very grim picture of what happens if we fail to reform the healthcare system. The cost increases are so large that the employer based system that we have today will be at serious risk," Eastman Kodak Chairman and CEO Antonio Perez told reporters by telephone.

About 60 percent of companies offer health-care coverage in the United States, insuring 159 million non-elderly people, according to Kaiser.

Among those companies still offering health plans, 21 percent said they had reduced benefits or asked workers to pay additional costs while 15 percent said they had increased workers' share of the insurance premium.

For 2010, companies said they also would shift more costs to workers, with 42 percent saying they would increase employees' premiums and 39 percent saying employees would pay more for doctor visits. Thirty-seven percent said workers would have to pay more for prescription medicines.

The survey is based on information that Kaiser, along with the Health Research and Educational Trust, collected earlier this year from more than 2,000 public and private companies with at least three workers.

Kaiser Vice President Gary Claxton concedes the survey misses one big issue -- the number of employees who lost their coverage because they were fired or their company went out of business.

"It's not clear that we got the whole picture," he said in an interview.

Does the Republican Party have a proposal for health insurance reform?

So just exactly what does the Republican Party stand for these days? Health care costs are skyrocketing. Rising premiums for health insurance reduce what employers could otherwise give workers as a pay raise. Corporate profits remain high as health insurers actively deny legitimate claims. Administrative costs for corporate health care are about 20%, compared to 3% for government run Medicare. Even ignoring the millions of people with no health insurance, is there not still a need for reform of the health insurance industry?

Joe Klein argues the Republican Party is focused on acquiring and maintaining power - not doing what is best for the citizens it allegedly represents. So in the health care debate, they are obstructionists. Even when conservatives have helpful contributions, they are silenced by pressure from those who do not want the current administration to accomplish anything of benefit to the American people.

In his August 20, 2009 TIME magazine column "The GOP Has Become a Party of Nihilists," Klein argues:

In one of those awful collisions between public policy and real life, I was in the midst of an awkward conversation about end-of-life issues with my father when Sarah Palin raised the remarkable idea that the Obama Administration's attempt to include such issues in its health-care-reform proposal would lead to "death panels." Let me tell you something about my family situation, a common one these days, in order to illuminate the obscenity of Palin's formulation and the cowardice of those, like Senator Charles Grassley of Iowa, the lead Republican negotiator on the Senate Finance Committee, who have refused to contest her claim.

Both my parents are 89 years old. They have been inseparable, with the exception of my father's service in World War II, since kindergarten. My mother has lost her sight and is quite frail. My father takes care of her and my aunt Rose, lovingly, with some — but not enough — private help at their home in central Pennsylvania. One night in early August, I had a terrible scare. I called home and Aunt Rose was freaking out; she didn't know where my father was. All the worst possibilities crossed my mind — it turned out he was just getting the mail — as well as a very difficult reality: if he'd had a stroke, I would have had no idea about what he'd want me to do. I had lunch with him the next day to discuss this.

It wasn't easy. My dad is very proud and independent. He didn't really want to talk about what came next. He was pretty sure, but not certain, that he'd signed a living will. He was very reluctant to sign an enduring power of attorney to empower me, or my brother, to make decisions about his care and my mom's if he were incapacitated. I tried to convince him that it was important to make some plans, but I didn't have the strategic experience that a professional would have — and, in his eyes, I didn't have the standing. I may be a grandfather myself, but I'm still just a kid in my dad's mind. Clearly, an independent, professional authority figure was needed. And this is what the "death panels" are all about: making end-of-life counseling free and available through Medicare. (I'd make it mandatory, based on recent experience, but hey, I'm not entirely clearheaded on the subject right now.)

Given the heinous dust that's been raised, it seems likely that end-of-life counseling will be dropped from the health-reform legislation. But that's a small point, compared with the larger issue that has clouded this summer: How can you sustain a democracy if one of the two major political parties has been overrun by nihilists? And another question: How can you maintain the illusion of journalistic impartiality when one of the political parties has jumped the shark? [Watch Fonzie jump the shark.]

I'm not going to try. I've written countless "Democrats in Disarray" stories over the years and been critical of the left on numerous issues in the past. This year, the liberal insistence on a marginally relevant public option has been a tactical mistake that has enabled the right's "government takeover" disinformation jihad. There have been times when Democrats have run demagogic scare campaigns on issues like Social Security and Medicare. There are more than a few Democrats who believe, in practice, that government should be run for the benefit of government employees' unions. There are Democrats who are so solicitous of civil liberties that they would undermine legitimate covert intelligence collection. There are others who mistrust the use of military power under almost any circumstances. But these are policy differences, matters of substance. The most liberal members of the Democratic caucus — Senator Russ Feingold in the Senate, Representative Dennis Kucinich in the House, to name two — are honorable public servants who make their arguments based on facts. They don't retail outright lies. Hyperbole and distortion certainly exist on the left, but they are a minor chord in the Democratic Party.

It is a very different story among Republicans. To be sure, there are honorable conservatives, trying to do the right thing. There is a legitimate, if wildly improbable, fear that Obama's plan will start a process that will end with a health-care system entirely controlled by the government. There are conservatives — Senator Lamar Alexander, Representative Mike Pence, among many others — who make their arguments based on facts. But they have been overwhelmed by nihilists and hypocrites more interested in destroying the opposition and gaining power than in the public weal. The philosophically supple party that existed as recently as George H.W. Bush's presidency has been obliterated. The party's putative intellectuals — people like the Weekly Standard's William Kristol — are prosaic tacticians who make precious few substantive arguments but oppose health-care reform mostly because passage would help Barack Obama's political prospects. In 1993, when the Clintons tried health-care reform, the Republican John Chafee offered a creative (in fact, superior) alternative — which Kristol quashed with his famous "Don't Help Clinton" fax to the troops. There is no Republican health-care alternative in 2009. The same people who rail against a government takeover of health care tried to enforce a government takeover of Terri Schiavo's end-of-life decisions. And when Palin floated the "death panel" canard, the number of prominent Republicans who rose up to call her out could be counted on one hand.

A striking example of the prevailing cravenness was Senator Johnny Isakson of Georgia, who has authored end-of-life counseling provisions and told the Washington Post that comparing such counseling to euthanasia was nuts — but then quickly retreated when he realized that he had sided with the reality-based community against his Rush Limbaugh-led party. Mitt Romney, the Republican front-runner for President according to most polls, actually created a universal-health-care plan in Massachusetts that looks very much like the proposed Obamacare, but he spends much of his time trying to fudge the similarities and was AWOL on the "death panels." Why are these men so reluctant to be rational in public?

An argument can be made that this is nothing new. Dwight Eisenhower tiptoed around Joe McCarthy. Obama reminded an audience in Colorado that opponents of Social Security in the 1930s "said that everybody was going to have to wear dog tags and that this was a plot for the government to keep track of everybody ... These struggles have always boiled down to a contest between hope and fear." True enough. There was McCarthyism in the 1950s, the John Birch Society in the 1960s. But there was a difference in those times: the crazies were a faction — often a powerful faction — of the Republican Party, but they didn't run it. The neofascist Father Coughlin had a huge radio audience in the 1930s, but he didn't have the power to control and silence the elected leaders of the party that Limbaugh — who, if not the party's leader, is certainly the most powerful Republican extant — does now. Until recently, the Republican Party contained a strong moderate wing. It was a Republican, the lawyer Joseph Welch, who delivered the coup de grâce to Senator McCarthy when he said, "Have you no sense of decency, sir, at long last?" Where is the Republican who would dare say that to Rush Limbaugh, who has compared the President of the United States to Adolf Hitler?

This is a difficult situation for the President. Cynicism about government is always easy, even if it now seems apparent that it was government action — by both Obama and, yes, George W. Bush — that prevented a reprise of the Great Depression. I watched Obama as he traveled the Rocky Mountain West, holding health-care forums, trying to lance the boil by eliciting questions from the irrational minority that had pulverized the public forums held by lesser pols. He would search the crowds for a first-class nutter who might challenge him on "death panels," but he was constantly disappointed. In Colorado, he locked in on an angry-looking fellow in a teal T shirt — but the guy's fury was directed at the right-wing disinformation campaign. Obama seemed to sag. He had to bring up the "death panels" himself.

This may tell us something about the actual state of play on health care: the nutters are a tiny minority; the Republicans are curling themselves into a tight, white, extremist bubble — but there may be enough of them raising dust to render creative public policy impossible. Some righteous anger seems called for, but that's not Obama's style. He will have to come up with something, though — and he will have to do it without the tiniest scintilla of help from the Republican Party.

FACT CHECK: Health overhaul myths taking root

In the August 19, 2001 article "FACT CHECK: Health overhaul myths taking root" Associated Press writer Calvin Woodward reports that lies and distortions are influencing the debate over health insurance reform:

WASHINGTON – The judgment is harsh in a new poll that finds Americans worried about the government taking over health insurance, cutting off treatment to the elderly and giving coverage to illegal immigrants. Harsh, but not based on facts.

President Barack Obama's lack of a detailed plan for overhauling health care is letting critics fill in the blanks in the public's mind. In reality, Washington is not working on "death panels" or nationalization of health care.

To be sure, presenting Congress and the country with the nuts and bolts of a revamped system of health insurance is no guarantee of success for a president — just ask Bill and Hillary Rodham Clinton. Their famous flop was demonized, too. After all, the devil does lurk in details.

It can also lurk in generalities, it seems.

Obama is promoting his changes in something of a vacuum, laying out principles, goals and broad avenues, some of which he's open to amending. As lawmakers sweat the nitty gritty, he's doing a lot of listening, and he's getting an earful.

A new NBC News poll suggests some of the myths and partial truths about the plans under consideration are taking hold.

Most respondents said the effort is likely to lead to a "government takeover of the health care system" and to public insurance for illegal immigrants. Half said it will probably result in taxpayers paying for abortions and nearly that many expected the government will end up with the power to decide when treatment should stop for old people.

A look at each of those points:

THE POLL: 45 percent said it's likely the government will decide when to stop care for the elderly; 50 percent said it's not likely.

THE FACTS: Nothing being debated in Washington would give the government such authority. Critics have twisted a provision in a House bill that would direct Medicare to pay for counseling sessions about end-of-life care, living wills, hospices and the like if a patient wants such consultations with a doctor. They have said, incorrectly, that the elderly would be required to have these sessions.

House Republican Leader John Boehner of Ohio said such counseling "may start us down a treacherous path toward government-encouraged euthanasia."

The bill would prohibit coverage of counseling that presents suicide or assisted suicide as an option.

Republican Sen. Johnny Isakson of Georgia, who has been a proponent of coverage for end-of-life counseling under Medicare, said such sessions are a voluntary benefit, strictly between doctor and patient, and it was "nuts" to think death panels are looming or euthanasia is part of the equation.

But as fellow conservatives stepped up criticism of the provision, he backed away from his defense of it.
___
THE POLL: 55 percent expect the overhaul will give coverage to illegal immigrants; 34 percent don't.

THE FACTS: The proposals being negotiated do not provide coverage for illegal immigrants.
___
THE POLL: 54 percent said the overhaul will lead to a government takeover of health care; 39 percent disagree.

THE FACTS: Obama is not proposing a single-payer system in which the government covers everyone, like in Canada or some European countries. He says that direction is not right for the U.S. The proposals being negotiated do not go there.

At issue is a proposed "exchange" or "marketplace" in which a new government plan would be one option for people who aren't covered at work or whose job coverage is too expensive. The exchange would offer some private plans as well as the public one, all of them required to offer certain basic benefits.

That's a long way from a government takeover. But when Obama tells people they can just continue with the plans they have now if they are happy with them, that can't be taken at face value, either. Tax provisions could end up making it cheaper for some employers to pay a fee to end their health coverage, nudging some patients into a public plan with different doctors and benefits. Over time, critics fear, the public plan could squeeze private insurers out of business because they would not be able to compete with the federal government.

It's unclear now whether Obama is committed to the public option. He described it recently as "just one sliver" of health reform, suggesting it was expendable if lawmakers could agree on another way to expand affordable coverage. Now the White House is emphasizing his strong support for it.
___
THE POLL: 50 percent expect taxpayer dollars will be used to pay for abortions; 37 percent don't.

THE FACTS: The House version of legislation would allow coverage for abortion in the public plan. But the procedure would be paid for with dollars from beneficiary premiums, not from federal funds. Likewise, private plans in the new insurance exchange could opt to cover abortion, but no federal subsidies would be used to pay for the procedure.

Opponents say the prohibition on federal money for the procedure is merely a bookkeeping trick and what matters is that Washington would allow abortion to be covered under government-subsidized insurance.

Obama has stated that the U.S. should continue its tradition of "not financing abortions as part of government-funded health care." Current laws prohibiting public financing of abortion would stay on the books.

Yet abortion guidelines are not yet clear for the government-supervised insurance exchange. There is strong sentiment in Congress on both sides of the issue.
___
The poll of 805 people was taken Aug. 15-17 and has a margin of sampling error of plus or minus 3.5 percentage points.

Sarah Palin's claims Obama wants a "death panel" as part of his health care reforms.

In an August 7, 2009 posting on her Facebook site, Sarah Palin claimed President Barack Obama wants to implement a "death panel" as part of his health care reforms. (Fact checking groups say her claim is untrue.)

Her posting said:

Statement on the Current Health Care DebateShare
Friday, August 7, 2009 at 4:26pm
As more Americans delve into the disturbing details of the nationalized health care plan that the current administration is rushing through Congress, our collective jaw is dropping, and we’re saying not just no, but hell no!

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

Health care by definition involves life and death decisions. Human rights and human dignity must be at the center of any health care discussion.

Rep. Michele Bachmann highlighted the Orwellian thinking of the president’s health care advisor, Dr. Ezekiel Emanuel, the brother of the White House chief of staff, in a floor speech to the House of Representatives. I commend her for being a voice for the most precious members of our society, our children and our seniors.

We must step up and engage in this most crucial debate. Nationalizing our health care system is a point of no return for government interference in the lives of its citizens. If we go down this path, there will be no turning back. Ronald Reagan once wrote, “Government programs, once launched, never disappear. Actually, a government bureau is the nearest thing to eternal life we’ll ever see on this earth.” Let’s stop and think and make our voices heard before it’s too late.

- Sarah Palin

Rep. Bachmann's speech can be viewed here:
http://www.youtube.com/watch?v=5CHBvKGmevI

Obama wants to kill your grandma: Five right-wing myths about healthcare reform, and the facts

According to Mike Madden's August 6, 2009 article "Obama wants to kill your grandma: Five right-wing myths about healthcare reform, and the facts" on Salon.com:

Turning America socialist apparently wasn't enough for him -- now President Obama is trying to make old people kill themselves, callously deny important medical procedures, funnel tax dollars to abortion clinics and wiggle the government's way into every doctor's office in America.

At least, that's the sense you might have about the healthcare reform proposals Congress is considering from listening to opponents describe them. Already, conservative activists have erupted against the plan, with protesters hanging Democratic lawmakers in effigy and disrupting town hall meetings.

As both the House and the Senate clear out of the Capitol for the month, expect the viral buzz -- and the TV battle -- about what's in the bills to grow louder and louder. The White House finally seems to have realized that the administration can't win the policy debate without addressing some of the attacks from the right. Aides recently released a video rebutting some of the claims about what healthcare reform would and wouldn't do. An administration official told Salon Wednesday that the White House will soon launch a Web site modeled on the "Fight the Smears" site Obama's campaign ran last fall, where voters can find -- and debunk -- some of the rumors about the reform proposals, and the White House is already collecting chain e-mails at "flag@whitehouse.gov," an address Obama aides set up to receive them.

But the administration might already be behind the curve. Over the last few weeks, opponents have managed to get out their spin on the bill through talk radio, blogs, chain e-mails and other channels. And their talking points depend on a notably elastic approach to the truth. Here's a fact check of some of the more alarming claims that the right is making about healthcare reform, claims that are already hardening into myth.

Myth 1: Democrats want to kill your grandmother. This claim seems too outlandish on its face to get much traction, but Republicans actually made some headway on it recently. Two House GOP leaders put out a statement warning that the healthcare reform bill "may start us down a treacherous path toward government-encouraged euthanasia." To hear opponents of reform talk about it, the legislation would force seniors to go in for sessions once every five years -- and more frequently if they're sick -- where doctors will encourage them to end their lives. Rep. Virginia Foxx, R-N.C., summarized the scare tactic pretty well on the House floor last week, when she said the bill would "put seniors in a position of being put to death by their government," and therefore, wouldn't be pro-life. The GOP has pushed this line especially hard with some of the conservative groups behind the government's intervention in the Terri Schiavo case a few years ago, hoping to get antiabortion allies on board fighting reform. "Can you imagine the response of the American people when they find this out?" one-time GOP presidential candidate Fred Thompson asked about the alleged euthanasia scheme on his radio show last month. "They're going to counsel you on preparing you to die," Rush Limbaugh pronounced a few weeks ago. Proof of how far this attack has spread came last week, when a caller to an AARP forum asked Obama about it directly. (Probably unwisely, the president tried to make light of the question, saying there weren't enough government employees to go meet with old people to talk about end-of-life care.)

There is a kernel of truth at the root of this attack: The legislation would order Medicare to pay for consultations between patients and doctors on end-of-life decisions, which it currently doesn't cover. But the consultations wouldn't be mandatory; if your grandmother doesn't want to go talk to her doctor about end-of-life care, she won't have to. Because Medicare doesn't pay for this kind of planning now, only 40 percent of seniors who depend on the government insurance say they have an advance directive that tells healthcare providers what measures they do and don't want used to prolong their life, even though 75 percent say they think it's important. The lack of planning actually costs a lot of money. Medicare spends billions and billions of dollars annually on expensive treatment during the last year of a dying patient's life. Without allowing Medicare to pay for end-of-life consultations, it's hard to know whether patients even want to go to such expensive lengths.

Myth 2: The government -- i.e., you -- will have to pay for abortions. This is another way the GOP is stirring up antiabortion activists against healthcare reform -- by warning that your tax dollars will be used to pay for someone else's abortion. An ad by the Family Research Council dramatizes the issue about as creepily as possible. "To think that Planned Parenthood is included in the government-run healthcare plan and spending tax dollars on abortions," a distraught older man tells his wife, sitting at their kitchen table after opening a letter from the government. "They won't pay for my surgery, but we're forced to pay abortions." The narrator lays out what's going on: "Our greatest generation denied care, our future generations denied life." A House Republican aide says the GOP thinks this could be the most potent type of viral attack against reform, since antiabortion Democrats will have trouble voting for the legislation if it includes taxpayer funding for the procedure.

But only the most extreme antiabortion reading of the legislation would say it does that. The words "Planned Parenthood" and "abortion" don't appear anywhere in the text, despite conservative buzz that it would funnel millions of dollars to killing babies. (A proposal in the Senate version of the reform legislation would require insurance plans to cover preventive care and screening visits to community health providers, which could include Planned Parenthood.) Even an AP story that Matt Drudge was hyping on Wednesday as proof that the government would be funding abortions didn't go quite that far -- instead, the story detailed a fight over whether women who buy government-subsidized private insurance through a proposed exchange system should be able to have abortions covered by their plans. Pro-choice lawmakers are trying to craft a compromise that would require insurance companies to pay for abortions out of premiums paid by patients, not out of tax dollars. Pro-choice Rep. Lois Capps, D-Calif., amended the House version of the legislation to state that abortion is not part of an "essential benefits package" that all insurance plans must provide -- meaning someone could offer a special "pro-life health insurance" plan that doesn't cover abortions, even under the reforms.

Myth 3: Obama will ban all private health insurance. Allegedly, the House proposal for healthcare reform bans private insurance. This rumor comes complete with a citation: "Right there on Page 16 is a provision making individual private medical insurance illegal," the unflaggingly pro-business paper Investors Business Daily wrote in an editorial last month. Other right-wing blogs and news outlets picked up on the idea, as well. It fits in with a broader message Republicans have been using: The reform will lead to a total government takeover of healthcare.

The IBD line is literally true -- Section 102 of the House bill says insurance companies can't independently issue any new individual policies after the legislation takes effect (though existing policies are grandfathered in). But it misses the point. Private plans aren't banned, but rather shifted into the new health insurance exchange the legislation would set up. You can still get a private policy, but the way in which you buy it changes. If you wanted to buy your own insurance, you have to do it through the government-run insurance exchange. Your policy becomes part of broader risk pools, which makes the premiums cheaper and keeps insurance companies from dumping them once they get sick. PolitiFact looked into the claim and rated the IBD editorial "pants on fire," its lowest rating -- as in, "Liar, liar, pants on fire."

Myth 4: The government can't possibly run a healthcare program. Opponents of reform trot out comparisons to government services frequently when they try to argue against a public, government-funded healthcare plan. Republicans drew up a chart that purports to show how convoluted the bureaucracy involved in any government plan would be. This message doesn't make Obama the enemy, it makes government inefficiency the enemy. "If you like the Post Office and the Department of Motor Vehicles and you think they're run well, just wait till you see Medicare, Medicaid and healthcare done by the government," conservative economist Arthur Laffer told CNN this week.

If that doesn't quite make sense, there's a reason -- Medicare and Medicaid are, of course, government-run healthcare programs. Medicare in particular is quite popular; polling shows some seniors are anxious that the reform will affect the care they already get from the government. (In fact, Democratic pollster Celinda Lake says she frequently encounters voters who say they want to keep the government out of their Medicare.) The Department of Veterans Administration also runs a healthcare system that experts praise for its well-developed health information technology network, which lets doctors see results of tests and procedures any patient has had anywhere in the network -- eliminating the wasteful duplication that Obama says he wants to cut out of the larger healthcare world, as well.

Myth 5: Unlike private insurance, government bureaucrats will ration care. This line also makes government the enemy. "You may want healthcare that your doctor has prescribed for you," Peter Ferrara, of the anti-tax, anti-government Institute for Policy Innovation, wrote on the National Review last month. "But the rationing bureaucracy in Washington that doesn’t even know you, or your doctor, may decide that your doctor doesn’t know what he’s talking about, or that you are too old for the government to pay for your hip replacement to stop the pain, or to get an expensive triple bypass or a pacemaker operation to save your life." Since the Obama administration keeps talking about encouraging doctors to shift to outcome-based pay scales and evidence-based guidelines for what treatments or procedures to use, opponents don't have much trouble painting a troubling picture of faceless government hacks denying the care you -- or your loved ones -- need.

Of course, there are already plenty of faceless hacks denying people care right now; they just work for private insurance companies, not the government, and they're denying care because that helps keep the insurers' profit margins up. At a recent House hearing, just three insurance companies testified that they had "rescinded" -- or dropped -- coverage for nearly 20,000 patients between 2003 and 2007, often after patients had submitted claims they thought would be covered. Even Republicans seem to know the insurance companies can be bad. "I would always rather the devil I know than the devil I don't know," House GOP boss John Boehner said last week, explaining why going after the government works even though private insurance companies would seem to be just as much of a villain.

Palin says Obama's health care plan is 'evil'

In the August 8, 2009 story "Palin says Obama's health care plan is 'evil'," Associated Press writer Mark Thiessen writes:

ANCHORAGE, Alaska – Former Alaska Gov. Sarah Palin called President Barack Obama's health plan "downright evil" Friday in her first online comments since leaving office, saying in a Facebook posting that he would create a "death panel" that would deny care to the neediest Americans.

"Who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course," the former Republican vice presidential candidate wrote on her Facebook page, which has nearly 700,000 supporters.

"The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care. Such a system is downright evil," Palin wrote.

An e-mail sent to Palin's spokeswoman to confirm authorship was not immediately returned Friday.
Obama, a Democrat, campaigned on a promise of offering affordable health care to all Americans. He has proposed a system that would include government and private insurers.

Republicans say that private insurers would be unable to compete, leaving the country with only a government-run health program. They warn that could leave Americans with little control over their health care.

Republican criticism has included claims that the reform plans will lead to rationing, or the government determining which medical procedures a patient can have. However, millions of Americans already face rationing, as insurance companies rule on procedures they will cover.

Denying coverage for certain procedures might increase under proposals to have a government-appointed agency identify medicines and procedures best suited for various conditions.

In the posting, Palin encouraged her supporters to be engaged in the debate. "Nationalizing our health care system is a point of no return for government interference in the lives of its citizens. If we go down this path, there will be no turning back," Palin wrote.

"Let's stop and think and make our voices heard before it's too late," the posting said.

Palin resigned as Alaska governor on July 26 with nearly 18 months left in her term. She cited not only the numerous ethics complaints that had been filed against her also her wish not to be a lame duck after the first-term governor decided not to seek re-election next year.

Palin, popular with conservatives in the Republican party, has said she wants to build a right-of-center coalition, and there is speculation she will seek the presidency in 2012. In the two weeks since she resigned, Palin has made only one public appearance, giving a Second Amendment rights speech last Saturday before a gun owners group in Anchorage.

Palin or her aides post notes on her Facebook account about once or twice a week, usually to set out policy statements, issue news releases or refute rumors circulating on the Internet.

Palin also has been largely silent before Friday's Facebook post. She was a voracious user of the social networking site Twitter, and promised to keep her supporters updated with a new private account after she left office. But that hasn't happened, leaving some of her fans begging for updates in the past two weeks.

Separating Fact From Fiction In Health Care Debate

According to the August 7, 2009 story "Separating Fact From Fiction In Health Care Debate" on National Public Radio (NPR):

The battle over health care is sparking claims on both sides, but many of the assertions being made twist the facts and others are outright false, says the editor of a Web site that tracks the claims.

Bill Adair, editor of PolitiFact and the Washington bureau chief for the St. Petersburg Times, tells Melissa Block that one group that opposes an overhaul says the health care bill allows illegal immigrants to get free medicine.

"We gave that our lowest rating on our Truth-O-Meter: a pants on fire," he says. "To the contrary, there's language [in the bill] that says that undocumented aliens would not be eligible for the credit under this plan."

The claim came from a chain e-mail that included many other assertions, including one that said a "health choices commissioner" would decide health benefits and that individual consumers would have no choices. This claim, too, got a "pants on fire" from PolitiFact.

"This chain e-mail is very persuasive in many ways because it has specific language, page numbers from the bill, but when you look at what it uses to back up a claim like that, it's just not true," Adair says. "There is a health commissioner that would be responsible for running the exchange under the main bills that have been discussed, but it's not like that person would say you couldn't get coverage or you could. That person would just be responsible to administer what the general standards were for the programs."

Bogus claims aren't just coming from those who oppose an overhaul. Democratic Rep. Russ Carnahan of Missouri recently claimed that the Congressional Budget Office estimated the current plan would create a $6 billion surplus over 10 years. Adair's group has rated that as false.

"That really was a little bit of budget trickery there," he says. "He is wrong that the CBO said this. The CBO said that the health care plan would post a deficit of something like $239 billion, something like that.

"What he's doing is including some other numbers to try to erase that and actually make it look like a $6 billion surplus, but that's not what the CBO says."

Adair says that because much of the action in the health care debate has been on the side of the groups that oppose an overhaul, that side is also responsible for much of the misinformation.

"I think much of the dialogue is being set by the critics who are making some very strong claims about this, and when we check them out, we find that many of them are exaggerated or completely false," he says.

On The Alignment Of Incentives In Healthcare, In Cartoon Form…

http://www.theweek.com/cartoons/index/98581/Congresss_healthcare_plan

On The Alignment Of Incentives In Healthcare, In Cartoon Form…

Five freedoms you would lose in health care reform

Do not misunderstand me. The U.S. needs to reform its health care system. It spends more on health care than any other country, but only ranks 37th in outcomes. Yet, many of the current reform proposals may make things worse, not better. Simply requiring individuals to buy health insurance in the corporate marketplace (with subsidies for some people) is an effective way to shift the costs from the older, wealthier, and more intensive users of health care to the younger, poorer, and healthier members of society. (The rich and powerful win again.)

According to "5 freedoms you'd lose in health care reform":

If you read the fine print in the Congressional plans, you'll find that a lot of cherished aspects of the current system would disappear.

By Shawn Tully, editor at large
July 24, 2009: 10:17 AM ET
NEW YORK (Fortune) -- In promoting his health-care agenda, President Obama has repeatedly reassured Americans that they can keep their existing health plans -- and that the benefits and access they prize will be enhanced through reform.

A close reading of the two main bills, one backed by Democrats in the House and the other issued by Sen. Edward Kennedy's Health committee, contradict the President's assurances. To be sure, it isn't easy to comb through their 2,000 pages of tortured legal language. But page by page, the bills reveal a web of restrictions, fines, and mandates that would radically change your health-care coverage.

If you prize choosing your own cardiologist or urologist under your company's Preferred Provider Organization plan (PPO), if your employer rewards your non-smoking, healthy lifestyle with reduced premiums, if you love the bargain Health Savings Account (HSA) that insures you just for the essentials, or if you simply take comfort in the freedom to spend your own money for a policy that covers the newest drugs and diagnostic tests -- you may be shocked to learn that you could lose all of those good things under the rules proposed in the two bills that herald a health-care revolution.

In short, the Obama platform would mandate extremely full, expensive, and highly subsidized coverage -- including a lot of benefits people would never pay for with their own money -- but deliver it through a highly restrictive, HMO-style plan that will determine what care and tests you can and can't have. It's a revolution, all right, but in the wrong direction.

Let's explore the five freedoms that Americans would lose under Obamacare:

1. Freedom to choose what's in your plan

The bills in both houses require that Americans purchase insurance through "qualified" plans offered by health-care "exchanges" that would be set up in each state. The rub is that the plans can't really compete based on what they offer. The reason: The federal government will impose a minimum list of benefits that each plan is required to offer.

Today, many states require these "standard benefits packages" -- and they're a major cause for the rise in health-care costs. Every group, from chiropractors to alcohol-abuse counselors, do lobbying to get included. Connecticut, for example, requires reimbursement for hair transplants, hearing aids, and in vitro fertilization.

The Senate bill would require coverage for prescription drugs, mental-health benefits, and substance-abuse services. It also requires policies to insure "children" until the age of 26. That's just the starting list. The bills would allow the Department of Health and Human Services to add to the list of required benefits, based on recommendations from a committee of experts. Americans, therefore, wouldn't even know what's in their plans and what they're required to pay for, directly or indirectly, until after the bills become law.

2. Freedom to be rewarded for healthy living, or pay your real costs

As with the previous example, the Obama plan enshrines into federal law one of the worst features of state legislation: community rating. Eleven states, ranging from New York to Oregon, have some form of community rating. In its purest form, community rating requires that all patients pay the same rates for their level of coverage regardless of their age or medical condition.

Americans with pre-existing conditions need subsidies under any plan, but community rating is a dubious way to bring fairness to health care. The reason is twofold: First, it forces young people, who typically have lower incomes than older workers, to pay far more than their actual cost, and gives older workers, who can afford to pay more, a big discount. The state laws gouging the young are a major reason so many of them have joined the ranks of uninsured.

Under the Senate plan, insurers would be barred from charging any more than twice as much for one patient vs. any other patient with the same coverage. So if a 20-year-old who costs just $800 a year to insure is forced to pay $2,500, a 62-year-old who costs $7,500 would pay no more than $5,000.

Second, the bills would ban insurers from charging differing premiums based on the health of their customers. Again, that's understandable for folks with diabetes or cancer. But the bills would bar rewarding people who pursue a healthy lifestyle of exercise or a cholesterol-conscious diet. That's hardly a formula for lower costs. It's as if car insurers had to charge the same rates to safe drivers as to chronic speeders with a history of accidents.

3. Freedom to choose high-deductible coverage

The bills threaten to eliminate the one part of the market truly driven by consumers spending their own money. That's what makes a market, and health care needs more of it, not less.

Hundreds of companies now offer Health Savings Accounts to about 5 million employees. Those workers deposit tax-free money in the accounts and get a matching contribution from their employer. They can use the funds to buy a high-deductible plan -- say for major medical costs over $12,000. Preventive care is reimbursed, but patients pay all other routine doctor visits and tests with their own money from the HSA account. As a result, HSA users are far more cost-conscious than customers who are reimbursed for the majority of their care.

The bills seriously endanger the trend toward consumer-driven care in general. By requiring minimum packages, they would prevent patients from choosing stripped-down plans that cover only major medical expenses. "The government could set extremely low deductibles that would eliminate HSAs," says John Goodman of the National Center for Policy Analysis, a free-market research group. "And they could do it after the bills are passed."

4. Freedom to keep your existing plan

This is the freedom that the President keeps emphasizing. Yet the bills appear to say otherwise. It's worth diving into the weeds -- the territory where most pundits and politicians don't seem to have ventured.

The legislation divides the insured into two main groups, and those two groups are treated differently with respect to their current plans. The first are employees covered by the Employee Retirement Security Act of 1974. ERISA regulates companies that are self-insured, meaning they pay claims out of their cash flow, and don't have real insurance. Those are the GEs (GE, Fortune 500) and Time Warners (TWX, Fortune 500) and most other big companies.

The House bill states that employees covered by ERISA plans are "grandfathered." Under ERISA, the plans can do pretty much what they want -- they're exempt from standard packages and community rating and can reward employees for healthy lifestyles even in restrictive states.

But read on.

The bill gives ERISA employers a five-year grace period when they can keep offering plans free from the restrictions of the "qualified" policies offered on the exchanges. But after five years, they would have to offer only approved plans, with the myriad rules we've already discussed. So for Americans in large corporations, "keeping your own plan" has a strict deadline. In five years, like it or not, you'll get dumped into the exchange. As we'll see, it could happen a lot earlier.

The outlook is worse for the second group. It encompasses employees who aren't under ERISA but get actual insurance either on their own or through small businesses. After the legislation passes, all insurers that offer a wide range of plans to these employees will be forced to offer only "qualified" plans to new customers, via the exchanges.

The employees who got their coverage before the law goes into effect can keep their plans, but once again, there's a catch. If the plan changes in any way -- by altering co-pays, deductibles, or even switching coverage for this or that drug -- the employee must drop out and shop through the exchange. Since these plans generally change their policies every year, it's likely that millions of employees will lose their plans in 12 months.

5. Freedom to choose your doctors

The Senate bill requires that Americans buying through the exchanges -- and as we've seen, that will soon be most Americans -- must get their care through something called "medical home." Medical home is similar to an HMO. You're assigned a primary care doctor, and the doctor controls your access to specialists. The primary care physicians will decide which services, like MRIs and other diagnostic scans, are best for you, and will decide when you really need to see a cardiologists or orthopedists.

Under the proposals, the gatekeepers would theoretically guide patients to tests and treatments that have proved most cost-effective. The danger is that doctors will be financially rewarded for denying care, as were HMO physicians more than a decade ago. It was consumer outrage over despotic gatekeepers that made the HMOs so unpopular, and killed what was billed as the solution to America's health-care cost explosion.

The bills do not specifically rule out fee-for-service plans as options to be offered through the exchanges. But remember, those plans -- if they exist -- would be barred from charging sick or elderly patients more than young and healthy ones. So patients would be inclined to game the system, staying in the HMO while they're healthy and switching to fee-for-service when they become seriously ill. "That would kill fee-for-service in a hurry," says Goodman.

In reality, the flexible, employer-based plans that now dominate the landscape, and that Americans so cherish, could disappear far faster than the 5 year "grace period" that's barely being discussed.

Companies would have the option of paying an 8% payroll tax into a fund that pays for coverage for Americans who aren't covered by their employers. It won't happen right away -- large companies must wait a couple of years before they opt out. But it will happen, since it's likely that the tax will rise a lot more slowly than corporate health-care costs, especially since they'll be lobbying Washington to keep the tax under control in the righteous name of job creation.

The best solution is to move to a let-freedom-ring regime of high deductibles, no community rating, no standard benefits, and cross-state shopping for bargains (another market-based reform that's strictly taboo in the bills). I'll propose my own solution in another piece soon on Fortune.com. For now, we suffer with a flawed health-care system, but we still have our Five Freedoms. Call them the Five Endangered Freedoms.

Find this article at:
http://money.cnn.com/2009/07/24/news/economy/health_care_reform_obama.fortune

The Obama Experiment

A Republican National Committee (RNC) website designed to "battle against President Obama's and Congressional Democrats' government-run health care plan" contains the following transcript:

WASHINGTON - Remarks of Chairman Michael Steele, National Press Club, July 20, 2009:

President Barack Obama is a good man who cares deeply about this country - but, he is determined—with an unprecedented single-mindedness—to transform it into something none of us would recognize.

Candidate Obama promised change. President Obama is conducting an experiment.

He's conducting a dangerous experiment with our health care. He's conducting a reckless experiment with our economy.

And he's conducting an unnecessary experiment with our tax dollars—experiments that will transform the very way of life of our country and its citizens.

The president is rushing this experiment through Congress so fast, so soon, that we haven't had a moment to think if it would work -- or worse, to think about the consequences to our nation, our economy and our families' economic future if it doesn't.

The Barack Obama experiment with America is a risk our country cannot afford. It's too much, too fast, too soon.

Surveys show that a solid majority of Americans are concerned that President Obama has no strategy to reduce the deficit. Perhaps that is because President Obama's strategy is to increase the deficit.

In only his first six months, this president's first budget has sought to take on nearly as much debt as we have taken upon ourselves in the entire history of our country. The deficit for this year alone will be the highest in U.S. History, nearly 5 times as much as it was just two years ago.

His economic experiments have left all of us, and generations to come, with a staggering bill. And the Obama experiments are not working.

So far, his experiments in that economic laboratory called Congress have simply failed or blown up.

President Obama told us that his stimulus package would keep unemployment under eight percent. It's now at 9.5% and now he tells us that unemployment will go over ten percent anyway.



That experiment cost us 787 billion dollars. To try to understand the enormity of that number, consider this: the interest on the stimulus package—the interest alone—costs us nearly 100 million dollars every day.

President Obama has committed to borrowing trillions from foreign creditors.

In return, they get the lion's share of our nation's future economic output. In short, our children will be working to build productive capacity and improve standards of living--but not here in America, but for our foreign creditors.

Let me quantify that a bit. In a typical year, the total profits for all American businesses amount to six or seven percent of GDP. President Obama's own budget projections acknowledge that our country's debt will exceed 100 percent of our GDP in the next decade. That means that—even assuming relatively benign interest rates, which is no safe assumption with all the inflationary policies he has pursued—roughly five to six percent of our GDP will go to paying interest on our federal debt.

That means, in short, capital roughly equal to all the business profits in the country—capital that historically has funded the expansion of our economy and enabled us to improve our standard of living—will go instead to our creditors, largely China and OPEC, to expand their economy and improve their standard of living.

Mr. President, you are putting your party's entire big-government wish list on America's credit card - but that card comes with a bill.

It is more debt our children will have to pay—because this reckless administration has an unrestrainable urge to splurge.

When President Obama faced a credit crisis, a struggling economy, a housing bust, bankrupt auto companies, wall-street failures, whatever the problem was, he responded by spending, spending and more spending. And now our president is proposing more debt, more risk, more experimentation.

His next big ticket item is a risky multi-trillion dollar experiment with our health care, including a government-run health care plan. It not only risks our economy, it risks every American's health, too.

President Obama says he wants to reduce health care costs. Republicans agree—health care costs too much.

Health insurance premiums have risen three times faster than wages. Health insurance is costing families and businesses too much and we have to fix that.

But here is my question: how come the Democrat's plan to save money will cost us more money? How come their plan to reduce health care costs ... will cost us trillions more in tax dollars? Democrats boast that their plans cost “only” about one trillion dollars—consider the absurdity of that for a moment—but that assertion is based on a deliberate misreading of the data.

The non-partisan Congressional Budget Office (CBO) projections to which they refer are for the next 10 years, but the Democrat plans are only fully implemented towards the end of that window.

According to CBO's best guess, once the plan is fully implemented, it will cost hundreds of billions each year—in the case of the house bill, $202 billion in 2019 alone. And note that I said “best guess”. The thousand-plus page house bill was not released until less than 48 hours before markup, and CBO said that it still had not completed its revenue analysis.

For example, CBO stated: quote—“we have not yet estimated the administrative costs to the federal government of implementing the specified policies.” In other words, the staggering cost estimated by CBO does not even include one of the biggest expenses in the bill.

Only Washington could make saving money more expensive. It doesn't matter if your insurance charges you more through the front door in higher premiums or President Obama charges you more through the back door in higher taxes. It's the same thing. Under the Obama-Pelosi plan, costs are going up. And you are going to pay more money.

Let's just use common-sense here: when has Washington ever made anything cost less?

If you are a small business owner, you will see a tax hike on your income, your payroll, and your investments … all of which won't help you to grow and create more jobs.

If you are a senior, you face 400 billion in Medicare, Medicaid cuts. If you are working, you face 600 billion in new taxes.

And they are just getting started. Some Democrats are even complaining that they are not raising taxes enough: if you get health coverage at work, they actually want to tax your health insurance!

But they are not finished. If you are thirsty, they're considering a 10 percent tax on a can of soda. And if you need stronger drink after hearing this bad news, I've got more bad news: they are thinking about raising the alcohol tax, too.

In addition, they are considering a new tax on employers equal to 3 percent of payroll. Also under consideration is a value added tax, a sort of national sales tax, of up to 1.5 percent or more.

Foolish me, and all this time I didn't know raising taxes on things made them cost less! That's like those commercials that promise you can eat more deserts and lose weight. Who knew?

The point is this: a good doctor makes a thorough diagnosis and prescribes a remedy that is specifically targeted at what ails the patient. If you come in with a sore knee but are otherwise healthy, the doctor doesn't remove your kidney, put your arm in a sling, and perform quadruple bypass surgery. And above all, for thousands of years, physicians have pledged to adhere to one principal above all others—first, do no harm.

We should approach health care reform in the same way. We must specifically target reforms at what ails our system, do no harm to what is right about it. In fact, much about our health care system is in very good shape, and we should make sure those aspects are strengthened, not eliminated.

First, 267 million Americans currently have health insurance coverage, the great majority through private insurers. And polls consistently show that they are overwhelmingly pleased with their current coverage.

Second, America is home to the highest quality and most innovative health care in the world. Don't take my word for it—ask the Saudis receiving care at Johns Hopkins, the Canadians at the Mayo clinic, or the British at Mass General. Or ask the committee that awards the Nobel Prize for medicine—over the past 25 years, the vast majority of honored researchers have been Americans.

So what is the diagnosis for what ails our health care system, the problem for which we must provide a remedy? In a word? Cost.

We spent a colossal amount on health care—over 15 percent of our GDP. The next highest industrialized nations spend about ten percent. And for that amount, in the aggregate, we have similar health outcomes as country's spending less when measured by such key metrics as life expectancy.

Our uninsured are a symptom of that cost problem, a problem Senator Daniel Patrick Moynihan once characterized as health care “cost disease”.

It is true, some of our uninsured have the means to purchase health insurance, but unwisely choose not to in the hopes that they will stay healthy and save the money. Others qualify for government assistance but for various reasons, do not receive it. But for most of the uninsured, the problem is easy to diagnose—they just can't afford health insurance. Yet President Obama's response is to make health care insurance even more expensive.

Let me throw another statistic at you—one that, remarkably, received little or no coverage from the media as far as I know.

According to the latest CBO estimates, under the house Democrat version of the health plan, after it is implemented, the cost of insuring each additional individual would be nearly $30,000, an amount far greater than the average annual cost of insuring an entire family today. (According to the Henry J. Kaiser foundation, the average cost of an employer health plan for a family of four is about $12,800.)

What's more, to add insult to injury, CBO tells us that every version of the Democrat health plan, even after spending trillions of dollars, would leave millions still uninsured.

The Democrat plan does not contain costs; it shifts them—to the taxpayer, to our children and to future generations that will have to cope with this crushing debt—by implementing huge premium subsidies and establishing a government controlled health care plan. In fact, the president's plan prescribes short-term pain relief instead of trying to fix the source of the pain. If he was a doctor, that would be malpractice.

And his plan is likely to be worse than the plans those Americans have now.

Don't believe me? Then believe President Obama.

On his ABC health care town hall a few weeks back, President Obama refused to pledge he'd limit his family to getting the same cures and treatments his public plan would give the rest of us.

If the president doesn't have faith in his plan for his own family, how can we trust his plan for ours?

The American health care system should not be more like the European health care system, where patients who are over 70 are told, “no you are too old for cancer screenings.” Where sick people are told, “you have to wait in line for this test or that medicine.” No thank you, Mr. President.

The president tells us that he just wants the government run health care plan as another choice to compete with the health care insurance you have now. He says you won't be forced to join. But his plan does the opposite.

In fact, the president's proposal creates yet another government czar—what are we up to now, 20?—who will push government run health care while dictating to your private insurance company how they should operate, the insurance coverage they should provide and which health care services you should receive.

We all remember Harry and Louise. Harry and Louise helped save us from Hillary Clinton's health care experiment in 1994. This year, Harry and Louise have been replaced by another couple -- Harry Reid and Nancy Pelosi.

Harry and Nancy aren't really doctors...but they are playing doctor in Washington, experimenting with health care, insisting on a big government takeover

Say you have a job in the grocery business, office supply store, or a hardware store. Imagine if the us government knocked on your door and said, “Hi, we are opening up a government-run store across the street to compete with you.

And we are going to have lower prices than yours because we are the government and we don't have to pay our own bills! We'll just leave them for your children to pay later.” How long do you think the store where you work would stay in business? How long would you have your job? When big government competes, one Congressman said, it's a like an alligator competing for a chicken. And the health care you have now is the chicken.

Simply put, experts tell us President Obama and the Congressional Democrat's government run plan option could lead to 119 million Americans being dumped out of their private coverage into a cheaper, government run health care program.

That's why they are forcing members of Congress to vote on legislation to reshape the economy in a fundamental way before a single member of Congress has even read the bill. I don't know you read, let alone understand, over a thousand pages of legislative text in a few hours.

Democrats are determined to shove this bill through without permitting any meaningful scrutiny. That's why they are cutting Republicans out of the process. The Democrats have no intention to have a bipartisan bill. They never have. The president has taken care to arrange for some nice photo ops with republicans, but that's it.

It doesn't have to be that way.

Back in 1994, when Hillary Clinton tried to jam a massive health care bill down Congress's throat, Senator Bob Kerrey of Nebraska, a highly respected Democrat, gave a speech on the Senate floor in which he flatly stated that he would not vote for a bill, which did not have Republican support.

I am waiting for a Democrat—any Democrat—to show that sort of courage today. And please do not mention the Blue Dogs to me. Their press releases may talk about fiscal responsibility, but, in the end, they have been Nancy Pelosi's most reliable voting bloc.

And don't tell me that Republicans are unwilling to support a responsible health care reform proposal from a Democrat. The very first major health care reform bill introduced this year was written by Senator Ron Wyden, not just a Democrat but a pretty darn liberal Democrat. But his bill had some good ideas and has drawn almost as many Republican cosponsors as democrats.

Let me be clear—Republicans support health care reform that addresses the biggest problem in our system—runaway costs. We don't need to spend more on health care—we already spend far more than the rest of the industrialized world.

We need to spend it better, starting by reforming a third party payment system that promotes waste, limits choice, and misallocates resources.

We want the 267 million Americans who have health insurance coverage to keep that coverage.

We want people to choose their own doctors, and make their own choices regarding their treatment options. We want to focus on health outcomes; keeping people healthy through preventive care and promoting good fitness and nutrition.

Under the Obama plan, the vast majority of Americans will pay more to get less. It's that simple.

We will spend trillions more—trillions—and the 267 million Americans who now have insurance will have fewer options and worse care. And we still won't cover all the uninsured.

This is one-sixth of our economy. If we screw this up, it could last for generations. And Congress is trying to do this in the next two weeks?! Two weeks? This reckless approach to an ill-conceived experiment should scare the living daylights out of all of us.

So, slow down, Mr. President. We can't afford to get health care wrong. Your experiment proposes too much, too soon, too fast. Your experiment with our health could change everything we like about our health care -- and our economy, as well.

So, it is time to stop the experiment with our economy and our health care and our future! Mr. President if you will only slow down and stop long enough to see a better way of helping our families and businesses get hold of and bring down health care costs.

Republicans stand with the growing number of Americans supporting the patient-centered health care reform movement. We believe the patient-centered health care reform movement offers the best way to reduce health care costs, bottom-up, with patients and doctors in control.

The old, top-down Washington-centered system the Democrats propose is designed to grow Washington's power to restrict the cures and treatments your doctor can prescribe for you.

The president wants to make health care more affordable. So do we. But Republicans have a completely different vision of how to do it. Republicans support simple common-sense fixes without the big Washington experiment.

Obama-Pelosi want to start building a colossal closed health care system where Washington decides. Republicans want and support an open health care system where patients and doctors make the decisions.

Reforms

So, Mr. President, let's talk about some common sense reforms the American people and their doctors can trust:

Lets' have doctors and hospitals post pricing and outcomes. In this day and age, why aren't the cost of all tests, treatments, procedures and office visits -- as well as effectiveness of treatments posted openly on the internet. That'll bring down costs.

And how about if we make health insurance companies compete with each other with simple, understandable contracts and minimum benefit packages so insurance is simpler, cheaper, and fairer, just like many banks are doing with car or home loans. And simple, one page re-imbursement forms, too. That'll bring down costs.

And let's protect doctors from frivolous, expensive lawsuits so they can work together with other doctors and patients in their communities to reduce unnecessary and expensive tests, procedures and costs. That'll bring down costs.

Then we change the law so you can take your health insurance with you if you have to change jobs, eliminating expensive and unnecessary insurance turnover. That'll bring down costs.

And we cut out the "Washington health care middle-man", reducing expensive bureaucracy to produce big health care savings. That'll bring costs down.

Let's support new paperless, computer-age health care IT systems to reduce the cost of health care management as well as reduce medical mistakes. That'll really bring down costs.

And let's make sure every American has equal opportunity to get the best value and buy the cheapest insurance no matter where he lives or who he works for. Let's change the law so any American can buy the lowest cost insurance available nationwide, not just in their states -- whether from insurance companies, businesses, church groups, college alumni associations, or groups like AARP, who often provide it less expensively. That'll bring costs down too!

And don't you agree that companies like Target are best suited to bring costs down than any politician in Washington? So let's use consumer-buying power and group buying power, not Washington price-controls, to bring health care costs down.

And by the way, let's support a bi-partisan idea, effective prevention, wellness, and disease management programs because they will improve our health. And that'll bring costs down.

Let's support bold new incentives for companies to develop new treatments and cures because that is smarter than paying for chronic long-term illnesses we can't cure today. That'll bring costs down.

Every American should get a tax credit for their health insurance premiums. That'll bring down your costs. Further, under current law, employees not covered by a health care plan—a group which disproportionately includes the working poor—cannot deduct the cost of insurance premiums. Incredibly, rather than remedying that injustice, the Democrats make it illegal for anyone to purchase a new individual plan.

We believe in bottom up health care savings for the middle class and the working poor.

And here is another idea: how about we give small businesses the same cost-saving breaks big businesses get by helping them form small business health plans and small business health co-ops. That'll bring costs down.

Then let's support tough new penalties against anybody who rips off the health care system, whether they are corrupt big insurance company executives, un-ethical physicians or patients, or government pen pushers. That'll bring costs down.

And one more thing: no life-time health care benefits and insurance for Congressmen who leave their jobs...unless and until everybody else in America has the same. That's the right thing to do… and it will bring down costs, too.

I know President Obama has some tough challenges. We get it. And the president tells us, he doesn't want to spend more than we have, he doesn't want the deficit to go up, he doesn't want to live off borrowed money. But he also told us he didn't want to run an auto company.

The president has insisted at every step of the way that his health plan will not add to the deficit. But just last Friday, CBO concluded that the Obama-Pelosi plan will add $239 billion to the deficit by 2019, and hundreds of billions thereafter. That means—according to CBO, not Michael Steele—the Obama-Pelosi plan does not do either of the two things the president swore that they would do: contain costs and not add to the deficit.

President Obama justifies this spending by saying the devil made him do it. He doesn't want to spend trillions we can't afford, but he says he just can't help it. Even though he says believes in less spending, he says has no choice -- but to spend even more.

Even though Washington is on fire with spending, he says he is compelled to conduct this experiment with reckless spending and pour more gasoline on the flames.

Mr. President, the time to stand by your principles isn't just when it is easy. You need to stand by your principles when it is not easy. The time your character is tested is when doing the right thing is tough.

Mr. President, in your press conference Wednesday night, I challenge you to be honest with us. Tell us the truth. Don't tell us it is going to cost less when it's going to cost more. Don't insult our intelligence by telling us Washington has to spend more money to spend less or save more.

And I challenge the American people, when you see the president's press conference tomorrow night, let this president and this Congress know how you feel. If you think his experiment with our health care is too much, too fast, too soon, pick up your phone, flood Congress with calls, faxes, and emails.

Yes, you can! Show Washington who is really in control of America's economy and our health.

In America we do not allow one man to roll the dice with our entire nation. We do not allow one political leader to risk our health care system and our entire economy. We do not allow one political group, to gamble with the fate of generations. We have never allowed one political party to experiment with the future of this country. That is until today.

It is time to hit the pause button on this administration's reckless experiment with America's economy and our health care. This type of experimentation is not what America voted for: it is time to put this experiment on the shelf.

Today, the Republican National Committee is unveiling a multi-platform campaign aimed at informing Americans about the risky experiments that the president is conducting on our economy and our country. We are taking our message directly to voters—through grassroots mobilization, through our new website — www.barackobamaexperiment.com — and through advertising such as the TV ad that we are launching today—so that they understand what is at stake. We're then going to mobilize voters to oppose further experimentation on the economy--especially health care.

Voters may want health care reform, however we're certain that they don't want the kind of reform that will stymie the economy with excessive taxes on small business owners, force tens of millions off of their current plans and away from their doctors, and cost trillions of dollars that the president himself has said we don't have to spend.

Many Democrats outside of the Obama-Pelosi-Reid-Waxman cabal know that voters won't stand for these kinds of foolish prescriptions for our health care. We do too. That's why Republicans will do everything humanly possible to remind voters about the risky experimentation going on in Washington and what we all must do to keep members of the house and senate out of the laboratory.

There is already plenty of change in this world. Keeping what we like about America is just as important as changing what we must to achieve success and to grow. President Obama has his priorities backwards: our job now is to grow this economy not bury it under a mountain of debt.

This is a time of great economic uncertainty. This is a moment when the very structure of the global economy, which depends on our economic might, is being challenged.

We will get through this global economic storm. But, then we will have to compete and win in a new global economy that is going to grow dramatically, in size and complexity, in the next few decades.

Who's going to get all that prosperity? America? Or someone else?

Who is going to own the new economy, with more women and minorities succeeding, the middle class expanding, and the entire workforce earning bigger paychecks, as we build a wealthier world? Who is going to own the future, the coming era promising the most powerful economic and technological growth the world has ever known?

Who is going to lead a world where health care is transformed and people lead longer, healthier lives, building upon the most valuable resource on the planet, the human resource, to transform nations and continents?

Who is going to settle a new global frontier of peace, prosperity and progress?

I say we are. We, the American people.

And I'm telling you there isn't anything before us we can't achieve, any challenge we can't overcome.

Be optimistic, for the opportunities before you now dwarf the opportunities our parents had.

There are new miracles of science to be found and Americans will find them. There are new jobs we cannot imagine and Americans will create them. There are new economic frontiers to be settled and, yes, Americans will compete and win them.

The greatest time to be an American is before us.

All of us here today have a great and noble purpose as our country calls upon each of us to rise to this critical moment and keep America the greatest—and healthiest—country in the world.

Thank-you and God bless America.