Stanley Feld M.D.,FACP,MACE
Democrats are cheerful on this beautiful spring morning. They are happy because congress finally passed this partisan healthcare reform bill. Many are going to try to represent the vote to the traditional media as a great duty to the American people. I also believe they have no idea of the unintended consequence of President Obama’s healthcare reform bill.
The high level goals of the healthcare reform bill are commendable. The bill’s solutions will end in disaster for taxpayers, the government, and patients who need medical care.
I received a comment from a lawyer this morning.
I can’t imagine what is going to happen with this new healthcare bill. Decrease payment to doctors, increase number of patients… hmmm.
Also, can you imagine how happy you are if you are a plaintiff’s lawyer? Less time per patient means more chances of mistake. And just more folks in the system filing bogus claims, too. Total win for the lawyers.
It is also a big win for the healthcare insurance industry, and big pharma . I predict their stock prices will increase in the next weeks.
President Obama’s healthcare reform bill is a big loss for taxpayers and people who are ill and people who are not ill.
The details of the bill are a killer of innovation, jobs creation, and freedom of choice. The bill will increase taxes and decrease quality of medical care. Many of the bill’s benefits will not start until 2014. The increase in taxes will start this year,2010.
President Obama has said: Any one making under $200,000 per year will not pay a penny in increased taxes.
The Joint Committee on Taxation analysis contradicts President Obama’s assertion. Either the congress or the President does not believe the Joint Committee on Taxation or has chosen to ignore it.
The healthcare reform bill will increase Medicaid roles. This will increase burdens on State budgets. Most States have budget deficits. They are required to have balanced budgets.
The Medicaid expansion might be meaningless because of the level of income required for coverage.
“If you're low-income: The law significantly expands Medicaid, the federal-state health program for the poor, making it available to an estimated 16 million more people with incomes up to 133% of the federal poverty level.”
The poverty level was defined in 1955. In Texas poverty is defined as earning less than $950 per month or $11,400 per year. The increase will raise the level to $15,162 per year. How can a person making $20,000 dollars a year afford a $15,000 dollar healthcare policy even if the government subsides 50% of it? A tax credit is meaningless because they do not pay taxes.
This is an example of one of the many non starters in the healthcare reform bill. On the increased taxes side I believe the healthcare reform bill will inhibit investment and economic growth.
A new 3.8% Medicare tax will be levied on investment income including interest, dividends and capital gains that exceed those thresholds.
President Obama’s strategy is to increase taxes. Americans might notice the increased tax burden shortly. The increased taxes could be significant to a moderate earner’s lifestyle and standard of living.
- If you itemize deductions for income tax: Starting in 2013, medical expenses have to reach 10% of your adjusted gross income to qualify for a tax deduction, as opposed to today's 7.5% standard. But seniors age 65 and older would be able to claim an itemized deduction at 7.5% of income through 2016.
There is much talk about the Cadillac tax. There is little understanding of the rules. If the average healthcare insurance policy for an individual is going to rise as the healthcare insurance industry predicts, how is anyone going to be able to afford the insurance much less the excise tax?
This will precipitate the Public Option. What effect will the Public Option have on the bogus deficit reduction calculations?
- If you have high-cost health insurance: A so-called Cadillac tax of 40% on plan administrators offering the richest job-based health benefits will take effect in the next few years and apply to the amount of annual premiums exceeding $10,200 for individuals or $27,500 for families. The thresholds are higher for retirees and workers in certain high-risk jobs.
Willie Sutton’s advice is to go where the money is. President Obama is not going where the money is.
The money is in:
1. Creating a system that puts consumers in control of their healthcare dollars and their health.
2. Rewarding consumers for good health.
3. Promoting self-responsibility for their health and healthcare dollars.
4. Creating a system that decreases defensive medicine.
5. Instituting effective and significant Tort Reform to decrease the need for defensive medicine
6. Creating a system that decreases the cost of adopting functional electronic medical records. An ideal medical record should be available to all at minimal monthly cost based on utilization.
7. Providing effective patient educational tutorials using the internet that is a physician approved extension of his care. Patients with chronic diseases must become professors of their disease. If they do not the complications of the chronic disease will occur and consume 80% of the healthcare dollars.
8. Creating systems of care that will prevent and reduce complications of chronic disease.
President Obama’s healthcare reform bill does not deal with any of these cost saving ideas effectively.
Americans love their country. We also know our government has done some stupid things in the past. The healthcare reform bill’s mistakes have been driven by politics, by ideology, by the influence of vested interests, and by the desire for power and fame .
President Obama’s healthcare reform bill is a stupid bill. America will suffer economically from the unintended consequences in the years to come.