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The Family Pecker Should Move Defeated On Saturday

Here's the e-mail I exactly sent my Congressman, freshman "Blue Dog" Frank Kratovil of Maryland:

Please vote no this weekend on the House bill.

This is non wellness tending reform.

This is at to the lowest degree a $1 trillion entitlement expansion paid for one-half amongst only pocket-sized provider cuts in addition to $500 billion inwards taxes.

Real damage containment would curvature the curvature in addition to create the savings needed to achieve universal access.

Being roughly deficit neutral, equally its sponsors claim, is non enough. We are at 17% of gross domestic product today in addition to nosotros would silent live on spending at to the lowest degree 22% of gross domestic product inwards 2018 if this "deficit neutral" nib were to live on passed. Real reform would laid about to convey costs downwards to affordable levels.

The bill's subsidies practise non deliver affordable wellness insurance to the center class. Influenza A virus subtype H5N1 menage unit of measurement of 4 making $65K would silent receive got to pay $6,500 a twelvemonth toward their wellness insurance cyberspace of subsidies. How many such families receive got that variety of coin inwards their checking account?

This is non wellness tending reform. It does non curvature the damage curve. It does non deliver affordable wellness insurance to the center class!

I also telephone outcry upward your attending to an first-class column today at Kaiser Health News yesteryear James Capretta. Influenza A virus subtype H5N1 duo of excerpts:

"Then, in conclusion week, along came the long-awaited revision to the House's July bill. The Speaker asserts that the novel version stays inside the president's $900 billion budget, but that is evidently non the case. The Congressional Budget Office estimates that the Medicaid expansion, the novel subsidies for insurance premiums inwards the exchange, in addition to the taxation credits for little businesses offering coverage volition damage $1.055 trillion over 10 years. In addition, the nib has scores of other spending provisions that would add together to the government's costs. There's an expansion inwards the programme that subsidizes the premiums in addition to cost-sharing for low-income seniors, costing $13.5 billion over a decade. There's also a novel programme to pay primary tending physicians to a greater extent than inwards Medicaid ($57 billion), increment the Medicaid matching rates inwards 2011 ($23.5 billion) in addition to much, much more. All totaled, these other spending provisions add together good over $200 billion to a greater extent than to the bill's total spending.

"The only agency House Democrats tin claim to remain inside the president's stated budget is yesteryear ignoring the non-coverage spending inwards the nib in addition to yesteryear netting the damage of the coverage expansion amongst novel taxes collected from those who refuse insurance in addition to employers who "pay" rather than "play." But this variety of accounting makes no sense. If the spending budget laid yesteryear the president tin live on met yesteryear netting out taxes, it's essentially meaningless, because whatsoever degree of expenditure could live on acceptable if coupled amongst an offsetting taxation increase. That's non what the president meant to convey inwards his speech. And Democrats receive got yet to explicate what could perchance justify all of the other spending inwards the bill.

"Then there's the number of doc fees inwards Medicare. The "sustainable growth rate" formula calls for a 21 per centum cutting inwards doc fees inwards 2010, which no 1 supports. However, the 10-year damage of total repeal is nearly $250 billion. In July, House Democrats proposed to include a total repeal inwards their wellness tending plan, along amongst scores of other Medicare provisions. Now, however, they desire the SGR repeal to top inwards a standalone nib thus they tin claim the costs of wellness tending reform are lower. It doesn't affair to taxpayers if Congress passes all of this inwards 1 nib or two. The total damage is the same either way.

"Overall, then, the House plan, including the SGR fix, is to pass close $1.5 trillion over the menses 2010 to 2019 on wellness care, good inwards excess of the $900 billion budget the president promised to the American people...

"So what does the House nib practise to cutting costs? Orszag touts the inclusion of to a greater extent than bundled payments, incentives for hospitals to cutting dorsum on preventable readmissions, in addition to other similar changes. But these are nipper adjustments that are doomed to larn watered downwards equally fourth dimension passes. In the main, the House nib would only bring down payment rates inwards Medicare in addition to Medicaid to salvage money, including large cuts inwards reimbursement levels for hospitals, nursing homes, in addition to dwelling describe of piece of job solid wellness agencies. These cuts are non calibrated to vantage character or encourage to a greater extent than integrated models of care. They are applied across the board. And they sure practise non institute delivery-system reform. On paper, they seem to bring down Medicare's per capita damage growth rate. But if payment rates were the respond to the damage problem, it would receive got been solved long ago.

"The president built high expectations at the kickoff of this twelvemonth that health-care reform would finally tackle the hard entitlement in addition to damage issues necessary to edifice a sustainable organisation of insurance coverage. But the House innovation has devolved into a large taxation increment (about $725 billion over 10 years) in addition to entitlement expansion, amongst real lilliputian yesteryear agency of "reform." It's non likewise slow for a serious course of written report correction. But if the president in addition to his aides piece of job along to quest that House nib is acceptable, they volition never live on able to deliver the existent reform the president has promised."

Read the residuum of Capretta's column here.

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