Email Response to Senator Bill Nelson

Senator Bill Nelson (D-FL) sent an email entitled "Taking Action on Health Care Reform." Before his senate career, Nelson was Florida's Insurance Commissioner; he was fiercely protective of consumers. He brings a great deal of knowledge of the economic realities of and experience working with the insurance industry. He is a moderate Democrat for whom I have voted in the past. Nelson invited constituents to respond with their concerns regarding health care reform. Below is mine:

Dear Sen. Nelson:

Thank you for the email regarding your position on health care reform. I am happy you are on the Senate Finance Committee because I know you will bring your experience as Florida's Insurance Commissioner to this issue.

My biggest concerns are:

1. Adding enforcement procedures to bar illegal aliens from receiving benefits. Without those, the law forbidding it will be a toothless tiger.

2. Assuring that taxpayer funding of abortions will never be allowed under this legislation. Again, without explicit language regarding this, the legislation might be used to undermine or overturn current restrictions.

3. Reliance on Medicare "savings" to fund a large portion of insurance coverage for the uninsured. Even the CBO, along with many other health insurance experts, doubts there is enough "fraud and abuse" in Medicare to add up to the savings estimates. Even if all fraud and abuse in Medicare is eliminated, the reality is Medicare costs will escalate in the next decade. It is unrealistic to expect "cuts" in these expenditures at the same time enrollments will grow by 30% as more baby boomers become eligible. The result can only mean a reduction in benefits or rationing of care or long delays in services. All of these are unacceptable.

Thank you for your continued work on this issue. Please reach across the aisle and help our country solve the problems in our healthcare system without destroying it.

Sincerely,
Susan M. Lamb

Why Are Grandma & Grandpa So Riled?

Seniors across this nation are up in arms over the proposed cuts in Medicare of $50 billion in the healthcare bills before Congress. President Obama and the Democrats are pretending that these cuts will not result in healthcare rationing and accessibility problems. They claim the cuts will all be from cost-savings or the introduction of new efficiencies. They say there will be no change in the healthcare that grandma and grandpa receive. Seniors know better.

Grandma and grandpa have plenty of past experience with the outcomes of previous Medicare cuts. When Medicare reimbursements to doctors are cut, doctors drop out of Medicare. Many seniors have been forced to change doctors who accept Medicare assignment unless they could afford to pay the difference between what the doctor charges and Medicare pays for services. Premier healthcare providers such as Mayo Clinic become inaccessible to all but wealthy seniors because Mayo Clinic no longer accepts Medicare assignment. If grandma and grandpa live in rural areas, they have an especially difficult time finding healthcare, often having to travel long distances to find providers who accept Medicare assignment.

Let’s look at H.R. 3200, the most fully developed healthcare reform bill presented to the American people thus far. For grandma and grandpa, it is a disaster.

“In 2010, 40.2 million seniors 65 years and older will be eligible for Medicare. That number is projected to rise to 54.8 million in 2020 and 88.5 million in 2050, according to the U.S. Census Bureau.” (Source: http://www.foxnews.com/politics/2009/08/06/end-life-counseling-intensifies-health-reform-debate/) Grandma and grandpa are smart enough to know that you cannot cut Medicare expenses by over ten percent at the same time you increase enrollees by thirty percent without drastic impacts on services.

To adequately provide for these new enrollees, you would have major cuts in services even if you had zero reductions in Medicare’s budget. That budget needs to grow in order to provide current benefits to both current and those additional enrollees. The Congressional Budget Office [CBO] warned that the proposed Independent Medicare Advisory Council [IMAC] “to rein in Medicare spending would do little to save the government money over the next 10 years.” The CBO estimated it might save $2 billion between 2010 and 2019, a pittance (less than 0.2%) of the $1 trillion plus cost if H.R. 3200 passes. Furthermore, CBO Director Douglas Elmendorf wrote, "In CBO's judgment, the probability is high that no savings would be realized." (Source: http://thehill.com/leading-the-news/cbo-medicare-council-would-have-little-savings-effect-2009-07-25.html)

During his presidential campaign in October 2008, Obama accused his rival, Senator John McCain, of supporting “drastic cuts” in Medicare. Obama said, “If you count on Medicare, it would mean fewer places to get care and less freedom to choose your own doctors. You’ll pay more for your drugs. You’ll receive fewer services. You’ll get lower quality care. I don’t think that’s right. In fact, it ain’t right.” (Source: http://online.wsj.com/article/SB10001424052970203517304574303014243807246.html)

What a difference a few months make! Obama and the Democrats have declared war on grandma and grandpa’s health plan. “The federal government is going to decrease Medicare payments to physicians 37% over the next nine years. In that same nine years the cost of treating patients is expected to rise 22%.”

We will need over 124,400 new doctors (a 23.6% increase) by 2025. In-patient hospital care is expected to increase by 36.6%. Currently, medical school enrollments are down, and more doctors are retiring or leaving the profession. The reasons include the high cost of medical education, the long hours, the paperwork required by insurance companies and Medicare, and the ever-present fear of lawsuits. As Dr. David Kahn, D.C., of Fernley Chiropractic wrote, “All this adds up to someone who [is] getting paid less for doing more work, with more obstacles in the way.” (Source: http://www.rgj.com/article/20090729/FERNLEY03/907290353/1306/fernley) Senator Pat Roberts (R-KS), in commenting on government-run health care, said, “It won't matter if 100 percent of Americans have health insurance if they don't have a doctor to see them when they are sick.” (Source: email newsletter from CMPI, July 27, 2009)

Congresswoman Ginny Brown-Waite (R-Florida) was bluntly honest when she said the House healthcare bill essentially tells senior citizens to "drop dead." "Despite their promise to care for our seniors, Democrats have decided that it's too expensive to care for my senior constituents… This bill would cut an additional $156 billion from the Medicare Advantage program in order to pay for the government expansion of healthcare for the young, the healthy, and the wealthy." (Source: http://www.onenewsnow.com/Politics/Default.aspx?id=616402)

Former Senator Tom Daschle, Obama’s first choice for Secretary of Health and Human Services, has been called back to the White House to consult on how to get healthcare legislation through the House and Senate. Grandma and grandpa should be alarmed. Daschle wrote in his book, "... Health-care reform will not be pain free. Seniors should be more accepting of the conditions that come with age instead of treating them." (Source: http://whitehouse.gov/assets/hero/hero_weeklyaddress_7-18-09_CK-0081.JPG)

The fact is old people need more healthcare than young people. Ninety percent of an individual’s healthcare costs will be incurred during the last ten percent of his or her life. That is reality. Unfortunately, too many in Obama’s administration, if not Obama himself, believe that seniors do not have the same Creator-given, inalienable rights to “life, liberty, and the pursuit of happiness” as younger people. The signers of the Declaration of Independence did not discriminate against any age group when they wrote those words.

Many in Obama’s inner circle believe it is moral to discriminate against seniors. They would deny seniors healthcare at the time they most need it. A prime example is Dr. Ezekiel Emanuel, Obama’s special health policy advisor and brother to the President’s Chief of Staff. In the January 2009 issue of the medical journal The Lancet, he wrote that if healthcare has to be rationed, he prefers the "complete lives system," which "discriminates against older people." This system assumes that seniors can be denied health care in the later years because they have lived “complete” lives. Scarce resources should go to younger people who have not yet had the chance to live a “complete” life. Ten years earlier, in an article in the Hastings Center Report, Dr. Emanuel wrote health services should not be guaranteed to "individuals who are irreversibly prevented from being or becoming participating citizens," giving as "an obvious example… patients with dementia." (Source: http://www.onenewsnow.com/Politics/Default.aspx?id=616402)

In case you think grandma and grandpa are being paranoid, just look at the newly released directives from the Center for Disease Control (CDC)regarding swine flu vaccinations. In the past, seniors have always been among the first to receive vaccines because the elderly are considered at great risk for complications from the flu. However, with the swine flu vaccine, seniors are not at the head of the list of recipients. They are not even on the list! Instead, children top the list, then healthcare workers and first responders, then young adults, the middle aged, and finally those 55-64. If you are 65 or older, the C.D.C. evidently does not consider you even worthy of consideration for protection from a potential swine flu pandemic.

Now, do you understand why grandma and grandpa are so upset? Why so many are showing up at Town Halls angry and vocal? Why many of them are resigning from the A.A.R.P.?

The words “ration” and “rationing” of healthcare do not appear anywhere in the 1,800+ pages of H.R. 3200. They don’t have to be spelled out explicitly. Seniors know the only possible outcome of the radical cuts proposed for Medicare can mean one thing and one thing only: rationing of care. And any politician who says otherwise is flat-out lying.

Duty to Die, Redux

Former Colorado Governor Richard Lamm declared in March 1984, "We've got a duty to die and get out of the way with all of our machines and artificial hearts and everything else like that and let the other society, our kids, build a reasonable life." (Source: http://www.nytimes.com/1984/03/29/us/gov-lamm-asserts-elderly-if-very-ill-have-duty-to-die.html) He claimed he was not referring to the elderly only as having this “duty to die,” however his saying that this duty is necessary so “our kids” can “build a reasonable life” puts the lie to that disclaimer. Perhaps Lamm also had in mind younger disabled people in the group with this “duty to die.”

Fast forward twenty-five years to what the Democrats in Congress are proposing in today’s health care reform. H.R. 3200, The American Affordable Health Choices Act of 2009, has over eighty sections altering or reducing Medicare provider reimbursements. Estimated reductions, if this legislation were passed, would be $361.9 billion (Source: http://blog.heritage.org/wp-content/uploads/2009/07/lewin-house-bill-heritage.pdf.This would represent a ten percent reduction over a ten-year period at the same time that Medicare enrollment is expected to increase by thirty percent as baby boomers become eligible.

Specifically, Medicare reimbursements would be reduced by 267.6% to hospitals, 10.8% to physicians, 11.2% to home health agencies, and 37.4% to skilled nursing facilities. Reductions for prescription drugs would equal 34.8% (Source: Congressional Budget Office, July 8, 2009, Preliminary Estimate of the Effects on Direct Spending and Revenues of Division B, Titles I-VII and Section 1872, of the House Tri-Committee Health Reform Discussion Draft. ).

The inevitable result will be reduced supply of Medicare providers at a time of rapidly escalating demand. H.R. 3200 demands seniors bear an inordinate burden to pay for health care for younger and working Americans. Under H.R. 3200, seniors on Medicare can expect longer waits for doctor appointments and procedures or outright denial of services.

President Obama recently echoed Gov. Lamm, telling the aged “to consider hospice care instead of treatment.” Tom Daschle, Obama’s first choice for Secretary of Health and Human Services and an advisor on health care reform, wrote, "... Health-care reform will not be pain free. Seniors should be more accepting of the conditions that come with age instead of treating them" (Source: whitehouse.gov/assets/hero/hero_weeklyaddress_7-18-09_CK-0081.JPG).


Dr. Ezekiel Emanuel is Obama’s special health policy advisor. He openly advocated healthcare rationing to the elderly in a January 2009 article in the medical journal The Lancet. In the Hastings Center Report, he wrote it would be appropriate to deny health care to "individuals who are irreversibly prevented from being or becoming participating citizens." He said an example would be “patients with dementia." Speaking of H.R. 3200, Congresswoman Ginny Brown-Waite (R-Florida) says "Despite their promise to care for our seniors, Democrats have decided that it's too expensive to care for my senior constituents and everyone else's constituents…in order to pay for the government expansion of healthcare for the young, the healthy, and the wealthy" (Source: http://www.onenewsnow.com/Politics/Default.aspx?id=616402).

Clearly, Obama and the Democrats pushing their draconian health care reform think grandma and grandpa should find a nice iceberg and passively float away. No wonder they are so fearful of global warming. They will need all the icebergs they can get for us baby boomers in the next ten years if H.R. 3200 passes.