More than 100 Canadian women with high-risk pregnancies have been sent to United States hospitals over the past year – in what a doctors' group attributes to the lack of a national birthing plan. The problem has peaked, with British Columbia and Ontario each sending a record number of women to U.S. neonatal intensive care units (NICUs).

..."Neonatologists are very stretched right now," Dr. Lalonde [Andre Lalonde, executive vice-president of the Society of Obstetricians and Gynaecologists of Canada] said in a telephone interview from Ottawa. "We're so stretched, it's kind of dangerous."

..."We're transferring babies across the province, in all directions, to try to find an extra bed for the next potential birth or for any baby already born," Dr. Chessex [Philippe Chessex, division head of neonatology for B.C. Women's Hospital & Health Centre] said in a telephone interview from Vancouver. "We now have babies who have been transferred up to six times after leaving here before reaching home."

This story resonated with me because, as it happens, my eldest daughter was a premie. She was a "thirty-week baby," fifteen inches long and weighing in at a little less than three pounds.

And how did she fare in the evil "profit-driven" U.S. system? Well, there was a bed for her ...about 100 yards away. And a neonatologist was on hand to manage her care from the moment she took her first breath.

What kind of moron would want to exchange a system like that for a pig's breakfast like the Canadian system?

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Wal-Mart expands low-price drug program

Wal-Mart Stores Inc., the world's largest retailer, announced Monday it would expand its discounted prescription drug program to offer 90-day supplies for $10 and add several women's medications at a discount. It also said it would lower the price of more than 1,000 over-the-counter drugs.

The move marks the third phase of a company program that began in 2006 to provide a 30-day supply of generic prescription drugs for $4. The Bentonville-based company said the program has saved customers more than $1 billion.

...While stressing that the expansion was designed to help customers at a time of exorbitant health-care costs and difficult economic times, [senior vice president John] Agwunobi said the program has worked in everyone's favor.

"This is the time for us now to begin building capacity," he said. "It offers (customers') employers potential savings. It offers the customers significant savings. It also offers us the ability to add capacity to our pharmacies without adding people."

Labels: Free Market

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Health-care market dominated by federal government

...Government interference in the health-care marketplace is the elephant-in-the-room that supporters of single-payer health care ignore. The negative unintended consequences caused by massive government involvement in health care should be part of the discussion, but Goodman, like so many other advocates of single-payer, makes no mention of that.

Politicians should take the blame for the health-care mess that they created. Instead, they blame the market and propose that the solution is even more political control of medicine. But more political control is not the solution. Political control is the problem!

...End Medicare and Medicaid. End bans on the importation of drugs from other countries. Abolish the FDA. End health-care mandates and government bureaucratic red tape.

Instead, expand Health Care Savings accounts. Make health care expenses 100% tax deductible. Allow health-care consumers to control all of their health-care dollars and decisions. Consumers will be better off and health care will be more affordable (e.g., there will be Walmarts and Costcos of heath care) when politicians are not in control of health care.

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Insurance headed in wrong direction

Darla Stuart ("Break for the insured," Speakout, April 22) writes that since "Colorado's citizens and businesses deserve to know the real cost of the health-care insurance products they are buying," politicians should force insurance companies to provide "transparency." But we really deserve to know how politicians have inflated insurance costs in the first place.

Tax policy encourages employer-based insurance, which essentially chains us to one insurer. Shielded from competition, insurers need not compete on price very much.

State-level bureaucrats succumb to special interests by burdening small-group policies with many benefits we do not need. The Congressional Budget Office reports that such mandated benefits increase premiums by at least 6 percent, and possibly more than 10 percent. It also reports that community rating laws increase premiums by 9 percent.

What's becoming increasingly transparent is where allegedly well-intentioned controls like House Bill 1389 will lead: politician-controlled health care and insurance where bureaucrats make decisions that rightfully belong to us and our physicians.

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Seven Simple Rules for Health Care Reform
by Richard E. Ralston (April 30, 2008)

The status quo in American health care is indefensible—an expensive regulatory and bureaucratic mess. What that calls for, however, is not more layers of regulation and complicated mandates. Nor should government take over health care completely and run it as part of a political spoils system.

State government proposals have proven too expensive in California and have collapsed. In Massachusetts expenses for mandatory insurance after one year are spiraling out of control faster than budgets can be printed. New recommendations in Colorado and elsewhere are being shelved because they are also too expensive to be considered at present. The alternative is one of elegance and simplicity: adopt changes now that require no new government expense, but that remove regulatory complexity and allow freedom of choice. To achieve that end, we need to adopt a few simple rules.

The first simple rule: Make all medical services, insurance and personal savings for such expenses exempt from all federal, state and local income and payroll taxes. Those who complain about the cost of medical care and insurance must be confronted with the fact that if we cannot afford medical care, we surely cannot afford to pay taxes on the money we set aside for it.

The second simple rule: Allow an individual or corporate tax deduction equal to double the value of the service for all charity care by medical care providers. At one time America had a vigorous network of private charity care, which was largely destroyed by the government barging in. We need to restore that environment of private charity, which was more efficient, effective and compassionate.

The third simple rule: Pass legislation now proposed in the U.S. Congress that would give every individual or business the ability to purchase insurance in a national market, from insurance companies in any state. That would allow for ownership of health insurance that is more affordable and can follow individuals from job to job and state to state. The increased competition between insurance companies would restrain the cost of insurance.

The fourth simple rule: Allow the purchase of basic health insurance with high deductibles and low premiums that covers major illness or injury and annual exams, in conjunction with tax-free accounts for out-of-pocket expenses, such as deductibles. That, more than anything, would make insurance premiums more affordable for Americans who fear the financial consequences of health misfortune.

The fifth simple rule: Broaden the availability of optional coverage provided by Medicare Advantage, but allow for additional tax-deductible premiums to be paid by those seniors who elect such options. More choices from more options should be available to retirees—but not paid for by taxpayers. This would allow for expanded and more efficient coverage, and reintroduce an element of competition to those who seek to provide health care to seniors.

The sixth simple rule: Allow Medicare patients to utilize their Health Savings Accounts to pay for services from their Medicare physicians. This could bring thousands of doctors back into the Medicare program overnight and eliminate the ridiculous and unjust prohibition on those who want to spend their own money on their medical care.

The seventh simple rule: Limit non-economic or punitive damages in all malpractice or other litigation against medical providers or drug and medical equipment firms to a maximum of $250,000 (indexed for inflation). This would wring the bonanza for a few law firms out of the current ocean of litigation—and the high cost of "defensive medicine" now practiced by providers as protection against such legal extortion. The effect would be a reduction in the cost of medical care and insurance for everyone.

While these changes would result in more efficient, affordable and uncomplicated health care, achieving them will be no simple matter—thanks to those who oppose any improvements as an obstacle to massive new government controls. But we can stop new regulations, mandates, taxes, government spending and administrative agencies. We can uphold the rational alternative—freedom and personal choice—which can improve the quality and affordability of health care without government spending.

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Yet another bogus Families USA story
Linda Gorman, Director, Health Care Policy Center, Independence Institute, Golden

On April 22, Rocky Mountain News.com carried "Report ties Medicaid cuts to job losses". The story simply repeated the substance of a press release from Families USA.

In fact, the Bush administration has not proposed Medicaid budget cuts. Its FY 2009 budget proposal increases Medicaid spending by $12 billion to $13 billion over expected spending in FY 2008. This is in addition to FY 2005-2007 spending increases of about 10 percent. What the Bush administration is proposing is a slightly smaller budget increase, about 7.1 percent rather than 7.4 percent. The 2009 budget numbers are available on Page 61 at http://www.hhs.gov/budget/ 09budget/2009BudgetInBrief.pdf.

If Families USA were a real family making $50,000 a year, these budget numbers would be the equivalent of having an expected windfall of $53,700 reduced to $53,550.

Families USA is known for approaching health care with a well-defined ideological slant and for producing lousy numbers on all manner of health-care issues. One hopes that, next time, the Rocky will take the Families USA reputation for inaccuracy into account, and that it will check before it unquestioningly reproduces their press releases as news.

Legislature has made health insurance so high
Terry W. Donze, Wheat Ridge

RE: Fair Act, HB-1389, RMN, 04-24 and 25-08 Regarding Colorado’s health insurance, Representative Morgan Carroll asks, "Why are our premiums higher?" All she needs to do is get the plank out of her eye and look in the mirror.

The legislature has mandated so many items (40+ and counting) for the health insurance industry to cover, what does she expect? They have run several health insurance providers out of Colorado over the past several years, such that it is extremely difficult to find affordable individual coverage because of limited competition.

Yet more regulation as proposed by her will only add to the costs, not only in higher premiums but also in higher taxes to pay for yet more government.

If she is really interested in bringing costs down, instead of more regulation Carroll should be demanding rescission of the mandates already on the books.

Labels: Insurance, LTE, Medicaid

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For Better Health, Repeal Political Controls

My wife and I pay $132 per month total for high-deductible health insurance, hundreds of dollars less than we would pay for comprehensive insurance. Our goal is to never need to make an insurance claim. We pay for all of our routine medical care -- doctor visits, eye glasses, dental work, prescriptions -- out of pocket, and we like it that way.

Our medical expenses come out of our Health Savings Account (HSA), which means that it's all pre-tax money. Unfortunately for us, various enemies of HSAs have been trying to undermine them at the national level.

By paying less for high-deductible insurance, we've been able to pay off debts faster and prepare for a family, something that has been difficult given our high tax burdens.

If Colorado wants to keep and attract young working families, the legislature ought not further muck up health insurance by loading in a bunch of new expensive mandates, Nor should the legislature require such couples to further subsidize others through higher taxes and/or insurance premiums.

If the legislature wants to make health insurance more affordable for more people, it should repeal existing political controls that have driven up insurance costs and priced some people out of the market.

However, we should realize that the broader problem with health insurance is that, because of federal tax policy, most insurance is tied to one's job. Lose your job, lose your insurance. Because of the tax benefits of "paying" people with insurance coverage, such insurance is really pre-paid medical care that discourages economic provision and consumption of health care.

Our society has largely forgotten the proper purpose of insurance when it comes to health. Most people remain healthy into middle age, when risks for various diseases start to increase. Through insurance, we voluntarily pool our resources to pay for the care of the few who get unlucky. If federal policy had not driven health insurance off track, we'd buy insurance when we're young at a low rate and keep the same policy long-term, and we'd also pay for routine and expected expenses directly, which would encourage healthy competition.

All of the commonly cited problems with medicine have been caused by decades of political intervention in medicine. For details, see "Moral Health Care vs. 'Universal Health Care'," by Lin Zinser and Paul Hsieh, MD, at WeStandFirm.org.

Yet, rather than act to repeal the controls that are the cause of the problems, many of today's politicians want to impose still more controls. If they succeed, the result will be worse health care that costs even more.

Here in Colorado, the legislature has considered everything but repealing the controls that are the cause of the problems. In 2006, then-Governor Bill Owens signed into law Senate Bill 208 to create the Blue Ribbon Commission for Healthcare Reform. That commission rejected the only free-market proposal and recommended such measures as massively expanded taxes and forcing everybody to buy insurance. The Commission's recommendations basically went nowhere.

But apparently one failed commission deserves another, so State Senator Bob Hagedorn is currently pushing Bill 217. If the bill passes, later this year Governor Bill Ritter will appoint "a panel of expert advisors" to come up with a bunch of new political controls for the legislature to consider in the future.

Originally, the bill encouraged the "panel of experts" to assume that all Coloradans would be forced to purchase politician-approved health insurance. The amended bill lists that only as an option.

Forcing people to buy insurance would cause two basic problems. First, you can't force somebody to buy something they can't afford, so any such plan must accompany massive tax hikes and subsidies. Second, once politicians force you to buy something, special-interest groups will constantly fight to include their pet service as part of the forced package, whether you want it or not. The result will be continual pressure to expand the scope of the forced insurance and make it ever more costly.

Much of the bill describes the creation of politician-approved "value benefit plans" for health insurance that would be subject to a variety of restrictions and substantially subsidized through taxes.

Yet consumers and providers have the right to decide through voluntary exchange what plans constitute a value to them. We don't need a new bureaucratic commission; we need liberty.

Ari Armstrong, a guest writer for the Independence Institute, blogs at FreeColorado.com.

Labels: CO, Insurance, OpEd, States

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Mandate repeats mistakes of other states

With Senate Bill 217, which has passed the Colorado Senate and awaits House action, state lawmakers who believe that higher taxes and more spending constitute health care reform have sunk to new depths of legislative trickery.

If SB217 passes, the basic laws that created the failing Massachusetts health care plan could take effect in Colorado in as little as 24 months. Sponsored by Sen. Bob Hagedorn, D-Aurora, and Rep. Anne McGihon, D-Denver, the bill creates a politically appointed panel to create a set of recommendations for rules governing Colorado health care. The rules prepare the way for the panel to recommend that every individual in Colorado purchase state-defined "credible" health insurance. State tax law would "enforce the requirement."

Because even legislators know they cannot force people who have no money to buy health insurance, the panel likely will move to create a subsidy program to "assist low-income individuals and families in paying the premium costs for health insurance."

Judging from the recommendations of the Colorado Blue Ribbon Commission on Health Care Reform, this is an expensive proposition.

The commission recommended that families of four making up to $84,800 be eligible for low-income subsidies that would increase state spending by an estimated $2.3 billion. In a blow to those who peddle individual mandates as a way for the insured to save money, it estimated the subsidies would save about $777 million in spending on the uninsured.

SB217 creates a Connector program, "health marts" "through which an individual eligible for the state subsidy may select" one of the state designed "Value Benefit Plans (VBP)." The health insurance offered through VBPs would be designed by a government committee.

People who would buy "Value Benefit Plans" insurance would have to pay with their premium dollars for some odd things, like "educational materials" that show people how to use the Internet to get health information.

The Hagedorn-McGihon bill envisions prohibiting these plans from helping people to save money on health insurance premiums by paying cash for routine preventive care. It seeks to mandate preventive care and an unspecified grab-bag of wellness programs. The plans also would "encourage" insurers to use a "pay-for-performance system for reimbursing health care providers" and "evidence-based medicine."

Pay-for-performance measures may not be safe for patients.

Experts at a 2001 American Society of Transplantation conference were so concerned about the effects of forced switching from brand name to generic immunosuppressive drugs that they called for patients to be taught to inform their physicians of any switch to or among generic alternatives.

Meanwhile, the pay-for-performance program at Blue Cross Blue Shield of Michigan paid physicians $100 to switch patients from brand name drugs to generics.

SB217 contemplates the Colorado panel finding "a dedicated source of revenue" to support the new programs. But it also says the new revenues may be spent on "the premium subsidy program or other new state costs," so this dedication is a smoke screen. In practice, the new revenues will fund whatever the Legislature fancies. If the governor agrees with the expert recommendations, and he will, SB217 would require that they be submitted to the Legislature on the "third legislative day" of the 2010 session. They then would pass through the Legislature like grass through a goose. People in favor of tax and spend health care reform know that the more voters know the less they like tax and spend reform. Speedy passage limits public debate.

Speedy passage reduces the possibility that people might find out that individual mandates are failing in Massachusetts, where about 20 percent of the uninsured already have been exempted because buying insurance costs them too much. They might be reminded that insurance is not health care, especially when Massachusetts controls costs by cutting payments to doctors, creating a shortage of doctors in the program and ridiculously long waits for care.

They might also be reminded that government officials routinely understate program costs. When campaigning for the Massachusetts plan, then-Gov. Mitt Romney said it would cost $125 million. After it passed in April 2006, his administration issued bonding documents estimating costs at $276 million. As of January 2008, Massachusetts Gov. Deval Patrick was requesting $869 million to cover estimated 2009 costs. (Seven times the original estimate!)

Like Gov. Romney on costs, Colorado politicians mislead the public by saying there will be no mandates this year. In February, Sen. Hagedorn reportedly told the Rocky Mountain News, "There's no mandates coming down this session, pure and simple."

Sen. Hagedorn must have changed his mind in the last two months. He undoubtedly knows his bill contains a program that will impose a health insurance mandate in 2010.

By hiding under an expert panel subject to gubernatorial approval two years from now, he gets to have his mandate and deny it, too.

Linda Gorman is director of the Health Care Policy Center for the Independence Institute, a free-market think tank in Golden. She co-authored the minority report of Colorado's 208 Commission on Health Care Reform.

Labels: CO, Insurance, OpEd, States

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