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.

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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.

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Costs soar for Mass. health care law
By STEVE LeBLANC, Associated Press Writer

BOSTON - Two years after the state's landmark health law was signed, the cracks are starting to show.

Costs are soaring and Massachusetts lawmakers are weighing a dollar-a-pack hike in the state's cigarette tax to help pay for a larger-than-expected enrollment in the law's subsidized insurance plans.

...Anyone earning more is required to get health insurance through their employer, on their own, or by purchasing lower-cost plans through the Health Care Connector, the independent state agency overseeing the law.

Businesses are also on the hook. Those with 11 or more full time employees who refuse to offer insurance face $295 annual penalties per employee. Already, 748 employers have failed to meet that threshold and have paid $6.6 million to the state.

Rick Lord, president of the Associated Industries of Massachusetts, said the state must be "very mindful of placing burdens on businesses that don't exist in other states."

...Michael Tanner, a senior fellow at the libertarian-leaning Cato Institute, said the law has been an unqualified failure.

Tanner was critical of the connector authority, a "super-regulatory agency" which has mandated levels of coverage. He also noted the vast majority of the newly insured are receiving subsidized care.

"They said it would get us universal coverage and reduce costs and it's done neither," Tanner said.

The biggest challenge is rising costs.

In 2006, a legislative committee estimated the law would cost about $725 million in the fiscal year starting in July. In his budget, Patrick set aside $869 million, but those overseeing the law have already acknowledged costs will rise even higher.

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Politicians shouldn’t force grown-ups to buy insurance

In "Health-care reform for grown-ups" (April 6), the Rocky's editorial board says "it can live with" mandatory insurance proposed in Senate Bill 217 if "value benefit plans are indeed viable and available at modest costs." But real grown-ups can't "live with" politicians treating them like children.

Attempting to justify this nanny-state proposal, the editors perpetuate the fallacy that the "cost-shift from the uninsured" makes insurance so expensive: Such "uncompensated care totals $600 million ... according to the blue ribbon commission." Wrong.

In a January 26 Speakout printed here, Commission member Linda Gorman showed that the Commission's figure was much less, and that the maximum annual cost-shift was "about $85 per insured individual." How much will SB 217 cost taxpayers?

Maybe mothers can force their four-year-olds to eat their vegetables, but politicians shouldn't force grown-ups to buy insurance. As grown-ups, we have the individual right to make that choice ourselves.

Brian T. Schwartz, Boulder

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Piling on Poor Coloradans

In football, in order to forestall injury a player is penalized when he piles on to a player who is already down. In politics a government that has repeatedly injured it's citizens with it's past actions is not only not penalized for the harm it has already done, but is encouraged to pile on to it's citizens a little bit more.

Such is the situation we find ourselves in with our legislature about to pass a bill (Senate Bill 217) that will make it a crime for you to not buy health insurance.

Once again the government in addressing a problem which it is solely responsible for; the skyrocketing cost of health care due to its decades-long continuing takeover of the health care market, will make the situation worse by piling on ever more restrictions.

After over a century of evidence that the more you restrict people's free choices in any particular market, the more expensive and less available everything becomes in that market, our socialistic leaders STILL think that the next batch of restrictions is going to make it all wonderful.

It won't, and several years from now when this latest intrusion into our lives has made health care even more costly and less available than it is now, the same people who are ramming this bill through will be demanding ever more power to dictate what your health care choices will be and how much they will cost.

When this cycle will end is when you/we the people decide to go back to the principles of freedom that this country started with. Until then 'enjoy' the consequences of your government’s latest trampling on your rights and intrusion into your lives.

Russell W. Shurts, Centennial

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Rocky off base on health care proposal

Contrary to the April 6 Rocky Mountain News editorial ("Health care reform for grown-ups"), Sen. Bob Hagedorn's proposed mandatory health insurance is the wrong prescription for Colorado. Massachusetts has already imposed a similar system of mandatory insurance for over a year, and it is failing badly. Like Hagedorn's proposal, Massachusetts requires everyone to purchase health insurance, with government subsidies for low-income residents. But rather than creating a health care utopia, the result has been the exact opposite - skyrocketing costs, worsened access, and lower quality health care.

The Massachusetts system violates the rights of individuals to spend their own health-care dollars according to their best judgment. Instead, individuals are forced to choose from plans approved by government bureaucrats. Special interest groups have loaded these plans with costly required benefits that many people might not otherwise voluntarily purchase, such as in vitro fertilization and chiropractor services. Although Colorado politicians promise not to impose similar expensive mandates, how long do we realistically expect this to remain true?

Due to the skyrocketing costs, the Boston Globe reports, the government will have to "cut payments to doctors and hospitals, reduce choices for patients, and possibly increase how much patients have to pay." Massachusetts is also asking the federal government to make up the shortfall of "hundreds of millions of dollars."

Instead of another massive government program, we should adopt free market reforms, such as eliminating insurance benefit mandates and allowing Colorado residents to purchase health insurance across state lines. These genuine reforms could reduce insurance costs between 20 percent and 50 percent for thousands of Coloradans, without compromising access or quality. The free market is the only moral and practical solution to our current health care crisis.

Paul Hsieh, M.D., is a practicing physician in the south Denver metro area and a co-founder of the Colorado group Freedom and Individual Rights in Medicine (FIRM).

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NO INSURANCE; BREAK THE LAW

It's the grand prize of politics. Fix health care and be a rock star. Unfortunately, some things can't be fixed at the Capitol. But that's a memo state politicians refuse to read.

Both parties in the Colorado General Assembly are gleefully pushing a Senate bill they've called a bipartisan blueprint for universal health insurance, setting a goal of health care for all by 2010. Shockingly, Republicans seem as overjoyed as Democrats regarding the most overreaching and frightening bill to pass through Denver in years.

The bill, a brainchild of Sen. Bob Hagedorn, D-Aurora, is patterned after the Massachusetts health care program, signed into law by former Gov. Mitt Romney, a Republican.

Most notably, the Hagedorn plan would make it a crime for anyone in Colorado to choose against purchasing health insurance. Those who don't buy insurance would be penalized on their taxes, and subjected to other nasty sanctions of the state. It's a bit like addressing the homeless problem with a mandate that every human buy a house, or else suffer financial punishment. Imagine if there were only so many houses to go around, and every living being was required to buy one. It's a supply and demand nightmare scenario, and the health care proposal isn't much different.

In an effort to make the bill sound something less than insane, legislators will direct the Department of Health Care Policy and Financing, along with the Division of Insurance, to develop a new bare-bones health insurance package that offers something less than comprehensive coverage. That's to make us believe the program won't over-burden the health care system.

Mandatory health insurance will be a disaster, just like the program in Massachusetts. The system of Romney & Co. has resulted in higher health care costs, lower quality health care, major rationing, and a looming exodus of doctors from Massachusetts. Patients sometimes wait months to see a doctor, because everyone's entitled to consume health care now. Some residents can't find doctors accepting new patients at all, even though they're forced to pay for insurance.

The problem with health care is one of supply and demand and controls that interfere. There's more demand than supply, and that's why the price goes up. Legislators, by mandating health care coverage, will only increase demand on a system that's already unable to keep up for a variety of reasons, most of them regulatory. Hagedorn knows his bill has problems, but he feels compelled to save the day.

"The alternative to this bill is to do nothing, and I don't find that acceptable," Hagedorn said, as quoted in the Denver Post.

Mr. Hagedorn, please do nothing. It's the best thing you can do. The problems with health care have resulted from too much interference from politicians, not too little. You can't fix the system, and you'll only make it worse.

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Mandating health care coverage is a costly mistake

The March 28, 2008 article, "Health Coverage Gets New Push" quotes State Senator Bob Hagedorn as supporting a plan to force all Coloradans to purchase mandatory health insurance, because it would be "immoral" to "sit on our hands and do nothing."

Unfortunately, the solution proposed by Senator Hagedorn is also deeply immoral and impractical. The state of Massachusetts has already imposed a similar plan of mandatory health insurance on its residents for over a year now, and it is failing badly. Like Senator Hagedorn's proposal, the Massachusetts plan requires all residents to purchase health insurance, with state subsidies for lower income residents.

But rather than creating a utopia of high-quality affordable health care, the result has been the exact opposite — skyrocketing costs, worsened access, and lower quality health care.

Massachusetts' system of government-mandated health insurance is immoral because it violates the rights of individuals to spend their own health care dollars according to their best judgment for their own benefit. Instead, individuals are forced to choose from a limited set of plans approved by the government bureaucrats.

Predictably, the government-mandated plans have been a huge magnet for special interests seeking to have their own favorite benefit included as a state requirement. These state-mandated plans therefore include numerous benefits that many individuals might not otherwise freely choose to purchase, such as in vitro fertilization, chiropractor services, prostate cancer screening, and maternity benefits. Hence, middle-aged Massachusetts women are forced to pay for prostate cancer screening, even though they have no need for that service.

Because the state-mandated health insurance is so expensive, the government must also subsidize the costs for lower income residents, which merely shifts those costs onto the taxpayers. The state has also created a huge new bureaucracy called "The Connector" to enforce these insurance requirements on individuals and businesses.

Overall, the plan is projected to cost as much as three times as originally estimated. According to the Boston Globe, the Massachusetts state government is now asking the federal government to make up the shortfall of "hundreds of millions of dollars."

Nor has the Massachusetts plan improved access or quality. The Boston Globe also reported that due to the skyrocketing costs, the state government will have to "cut payments to doctors and hospitals, reduce choices for patients, and possibly increase how much patients have to pay."

With such poor reimbursements, physicians are increasingly reluctant to take on new patients. Lee Sampson, a 47-year-old unemployed medical transcriptionist had to call 50 doctor's offices before she could find someone who would take her on as a new patient.

The Massachusetts plan has also had a "catastrophic effect" on the Cambridge Health Alliance, which serves most of the poor and uninsured in the Boston area. The high costs have forced the Alliance to fire staff and reduce services in order to stay afloat — harming the very people the plan was supposedly intended to help.

Colorado should not duplicate the failed experiment in Massachusetts. Their system of mandatory health insurance violates the rights of individuals and providers to contract freely for medical services to their mutual benefit. Instead, the government decides how people can spend their own money, and for what.

The predictable result has been skyrocketing costs, worsened access to health care, and a huge new bureaucracy, just like under any system of socialized medicine. As a practicing physician, I can't think of a more immoral "solution."

Instead, we need free market reforms, such as eliminating insurance benefit mandates and allowing Colorado residents to purchase health insurance across state lines.

These genuine reforms could reduce costs up to 20-50%, making health insurance possible to thousands of Coloradans who otherwise could not afford it, without compromising access or quality. The free market is the only moral and practical solution to our current health care crisis.

Paul Hsieh, MD, of Sedalia is a practicing physician in the south Denver metro area and also a co-founder of the Colorado group Freedom and Individual Rights in Medicine (FIRM).

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"I calculated that every time I have a Medicare patient it’s like handing them a $20 bill when they leave,” she said. “I never went into medicine to get rich, but I never expected to feel as disrespected as I feel. Where is the incentive for a practice like ours?”

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Repeal laws raising cost of health insurance

Re: "Health coverage gets new push," March 28 news story.

Democrats like state Sen. Bob Hagedorn, and state Rep. Anne McGihon want to force us all to buy medical insurance - as they define it. But government-mandated insurance does not guarantee actual care. Consider Canada, England and Massachusetts.

The Canadian Broadcasting Corporation reports that "109 people had a heart attack or suffered heart failure while on the waiting list. Fifty of those patients died." The BBC reports that "up to 500 heart patients die each year while they wait for potentially life-saving surgery." The Boston Globe reports that in response to soaring costs, Massachusetts "policymakers could face difficult choices: spend more state money or cut back the two programs by reducing enrollment, cutting subsidies, or eliminating benefits."

Sen. Hagedorn says it's "immoral for us to sit on our hands and do nothing." Hence, instead of passing more laws that kill, politicians should do something that is moral and actually works: repeal laws that make insurance prohibitively expensive.

For example, Colorado House Bill 1327 would allow us to buy insurance plans that meet less damaging regulations of other states. This would make quality, affordable insurance available to thousands of Coloradans.

Brian T. Schwartz, Boulder

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Healthcare cost increases dominate Mass. budget debate
Controlling them said key to keeping universal coverage

When Massachusetts launched its landmark universal health insurance initiative nearly two years ago, the state put off addressing rising costs so it could expand coverage immediately. Now those costs are dominating the discussion as the state faces a recession and pivotal funding decisions that could make or break health reform.

...A larger issue will also come to a head by July 1: the need to secure a new three-year commitment from the federal government to pay for half the soaring cost of insurance subsidies. Massachusetts is seeking up to $1.5 billion, but the Bush administration has been cutting back federal payments to the states.

..."If we don't grapple seriously with the cost of healthcare, the support for reform will erode and the perception will become broader that it is unaffordable," said Jon Kingsdale, executive director of the Commonwealth Health Insurance Connector, which oversees much of the reform effort.

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"Universal" Health Care Kills

What good is having medical insurance if you cannot get medical care? Peddlers of "universal health care" — from Hillary, Obama, to Colorado congressional candidate Jared Polis — don't get this.

"Universal health care" is false advertising for politically-controlled medicine, with government as the "single-payer" monopolistic insurer. But having coverage does not guarantee getting medical care.

Since patients prepay through taxes, medical care appears "free." Hence, they have strong incentive to over-consume and providers need not compete on price. To contain costs, governments restrict your access to life-saving treatment. In countries with such "universal coverage," patients die waiting for treatment.

The Canadian Medical Association Journal reports that in one year, 71 Ontario patients died while waiting for coronary bypass surgery and over one hundred more became "medically unfit for surgery." The Canadian Broadcasting Corporation reports that "109 people had a heart attack or suffered heart failure while on the waiting list. Fifty of those patients died."

This week the Globe and Mail reported that:

Inside Sylvia de Vries lurked an enormous tumour and fluid totalling 18 kilograms. But not even that massive weight gain and a diagnosis of ovarian cancer could assure her timely treatment in Canada.

She sought treatment in the United States, as do Canadians in need of intensive care and emergency cardiac care.

"Physicians across Canada are in an advanced stage of burnout due to work conditions" which "causes them to retire early... or simply leave," a former Canadian Medical Association president told the New York Times. He "attributed much of the problem to technological shortages and the powerlessness doctors feel when patients complain about long waits for treatment."

"Access to a waiting list is not access to healthcare," wrote Canadian Chief Justice McLachlin when striking down legislation banning private insurance in 2005. Last year a New York Times headline read: "As Canada's Slow-Motion Public Health System Falters, Private Medical Care Is Surging."

And England? The BBC reports that "up to 500 heart patients die each year while they wait for potentially life-saving surgery." The Times reports that a British woman "will be denied free National Health Service treatment for breast cancer if she seeks to improve her chances by paying privately for an additional drug." A Daily Telegraph headline reads: "Sufferers pull out teeth due to lack of dentists." "Doctors are calling for NHS treatment to be withheld from patients who are too old or who lead unhealthy lives," reports another article.

Consider politically-controlled health care in America: Medicaid and Medicare. Doctors are five times more likely to refuse seeing new Medicaid patients than privately-insured patients. Increasing reimbursement rates won't help much; more than two-thirds of doctors reported being overwhelmed by Medicaid’s billing requirements, paperwork, and delays in payment.

ABC News reports that "Medicare rules bar cancer drugs for patients," including the privately-insured. As the population ages and Medicare costs continue to increase, Medicare may further restrict patients and doctors.

"Single payer" advocates cite international comparisons of life expectancy to support their cause. But life expectancy depends on factors unrelated to healthcare, such as unintentional injury and homicide. Health economist Robert Ohsfeldt found that when accounting for these two factors, life expectancy in America is comparable to that of Canada and England.

What really matters is your chance of surviving a serious illness. The American Cancer Society reported that "U.S. patients have better survival rates than European patients for most types of cancer."

So if politically-controlled medicine isn't the solution, what is?

Not a Massachusetts-style "individual mandate," which forces everyone to buy insurance. This is essentially single-payer in disguise. Insurance regulations severely limit competition, so insurance companies are effectively government contractors for politically-defined insurance.

The Boston Globe reports that to contain costs, Massachusetts authorities will "probably cut payments to doctors and hospitals" and "reduce choices for patients." Sound familiar?

Instead, we must recognize how government policies have crippled free markets.

Because the tax code deeply discounts employer-provided insurance, you're essentially stuck with your employer's non-portable plans. Hence, insurance companies can afford to be stingy and deny you care; they know that losing you as a customer requires that you change jobs. With government as "single-payer" it's even worse: to change insurance providers you must move to a different state or country.

Our current system also encourages thoughtless over-consumption and skyrocketing costs. The tax code punishes paying for medical care out-of-pocket and rewards buying insurance. So "insurance" has become prepaid medicine, and patients over-consume like business travelers dining on their company's expense account.

Further, legislation mandating minimum benefits makes insurance unaffordable for many. Consider: Colorado law compels widowed wives to pay higher premiums for prostate screening, maternity, and marital therapy. Sponsors of Colorado House Bill 08-1327 recognize this injustice. Just as businesses incorporated in other states can operate in Colorado, Coloradans should be able to buy affordable policies from insurance companies that meet less damaging regulations of another state.

So remember, the uninsured aren't the problem, but a symptom of political meddling in our most important personal choices.

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Medical Choice for Arizona
Freedom of Choice in Health Care Act -- A State Constitutional Initiative
March 2008

A MESSAGE TO ANYONE WHO IS, OR MAY SOMEDAY BE A MEDICAL PATIENT

Dear Friend:

My name is Jeff Singer, MD. I am a general surgeon in the greater Phoenix area, and am the Treasurer of a campaign committee called "Medical Choice for Arizona." We are circulating petitions to place on this November's ballot, "The Freedom of Choice in Health Care Act."

As I am sure you are well aware, momentum is building across the nation, by well-intentioned and not-so-well-intentioned people, for comprehensive --even radical-- reform of our health care system. Frustrated with the gridlock in Washington, many states are taking matters in to their own hands, and passing reforms aimed at achieving "universal coverage," but that ultimately will result in rationing of health care and limitations on our freedom of choice of health care options, treatments, and providers.

"The Freedom of Choice in Health Care Act" would amend the Arizona Constitution to insure that, whatever type of health care legislation ultimately emerges from our legislature, it will not be able to restrict our freedom of choice of private health care systems, plans, or options; it will not be able to prevent us from directly paying for lawful medical services; and it will not, in any way, be able to force us to participate in a plan or program if we don't want to.

What's more, our legal counsel, Clint Bolick (co-founder of the Institute for Justice, and currently Director of the Goldwater Institute's Center for Constitutional Litigation, among other things), who designed the language for our initiative, believes this might actually prevent a further FEDERAL intrusion into the healthcare system. He says that there is legal precedent for state constitutional law actually trumping federal law when the federal law trespasses into an area of police power that has been traditionally reserved to the states under the US Constitution. So passage of this amendment in AZ and other states would at least give us a fighting chance against those in DC who want to force us into a one-size-fits-all national health care plan.

Medical Choice for Arizona consists of people from across the political spectrum, all of whom want serious reform to our health care system -- all of whom want to reduce the ranks of the uninsured -- all of whom want to make sure our kids get adequate health care -- but who have differing views regarding what constitutes the best kind of reform. But there is one thing on which we all agree: WE MUST RETAIN THE RIGHT OF PEOPLE TO HAVE CONTROL OVER THEIR OWN HEALTH CARE CHOICES.

Medical Choice for Arizona is not about enacting -- or blocking -- any specific health care legislation. It is about preserving and protecting patients' choice.

WE NEED YOUR HELP TO SUCCEED!

Please visit our website at www.medicalchoiceforaz.com to learn more about "The Freedom of Choice in Health Care Act." The actual ballot language, as well as "Frequently Asked Questions," and a way to donate online can be found at the site. If you have further questions, feel free to phone us at: 623-271-9576.

But most important, please consider making a contribution to our campaign. Arizona law places NO LIMITS on the amount of money that can be contributed to non-partisan citizens initiative campaigns like ours. The donations are not tax deductible. However, Arizona law DOES ALLOW corporate contributions to be made to initiative campaigns.

Please make your check out to: "Medical Choice for Arizona," and mail it to our address at:

3655 W. Anthem Way
Suite A-109--PMB 212
Anthem, AZ 85086

Health care reform is on the front burner in all the political debates this year. No time is more important than NOW to act to protect our right to choice in health care.

Thank you for your consideration.

Sincerely,

Jeff Singer, MD
Treasurer
Our Website: www.medicalchoiceforaz.com

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Maine has recently joined the growing list of failed state reforms. As with other faillures, the Dirigo Care program was shoved down the throats of a bewildered legislature by an egotistical governor who promised Nirvana.

...But look behind the spin and the report is a devastating examination of a program that was poorly conceived and doomed to fail from the beginning – as many of us had predicted. It finds: 1. After 20 months of operation only 11,000 were enrolled in DirigoChoice (out of a total uninsured population of 136,000), and over two-thirds of these were already covered. 2. Of the small companies eligible to participate, only 2.5% actually did. 3. The financing scheme (a “savings offset payment”) is impossible to measure or implement. 4. Almost as many people (3,600) had disenrolled from the program as were newly insured by it.

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BAD MEDICINE
Health care proposals will backfire on state

I want to thank The Gazette for its strong editorial against the ill-considered plan by the Colorado Blue Ribbon Commission on Health Care Reform ("Health care reform: It's a joke," Jan. 31). Their proposed system of mandatory health insurance already has been tried in Massachusetts and is failing. Costs there are already more than three times what was originally predicted, and the Boston Globe reports that it is expected to "cut payments to doctors and hospitals, reduce choices for patients, and possibly increase how much patients have to pay." The California state legislature has also just rejected a similar plan because it will cost too much.

These government-imposed plans violate the rights of individuals to freely choose what health insurance plans are best for them, and, as a result, lead only to rising costs and rationing. If Coloradans value their lives and their health, they will also reject this deadly proposal.

For more information on genuine free market health care reform for Colorado, please see www.WeStandFIRM.org.

Paul Hsieh, M.D.
Sedalia

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The subsidized insurance program at the heart of the state's healthcare initiative is expected to roughly double in size and expense over the next three years - an unexpected level of growth that could cost state taxpayers hundreds of millions of dollars or force the state to scale back its ambitions.

If the state doesn't get all of the federal funds it is seeking, policy makers could face difficult choices: spend more state money or cut back the two programs by reducing enrollment, cutting subsidies, or eliminating benefits.

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The Senate Health Committee on Monday rejected Gov. Arnold Schwarzenegger's ambitious effort to reform the state's health care system, voting it down 7-1.

Only one of the committee's seven Democrats supported the bill. All four Republicans opposed it.

Even Senate President Pro Tem Don Perata, a co-author of the bill, came out against it.

The Democrats who voted against the bill or failed to vote said they were afraid the cost of the program would be too great, especially as California faces a $14.5 billion budget shortfall.

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Health care, ho!
State should avoid repeat of Massachusetts
THE GAZETTE January 3, 2008

For Colorado Democrats, a regulatory fix of the state's ailing health care system may seem irresistible during the upcoming 2008 legislative session. Imagine the attention major health care reform, or statewide "universal health care," would garner from the media in August, when the country's Democrats converge in Denver for the Democratic National Convention. Colorado could be held up as the example of how it can and should be done. Democratic leaders could be lauded for aiding 792,000 uninsured men, women and children.

House Speaker Andrew Romanoff, as quoted in The Gazette, says Coloradans are tired of waiting on a federal government that "cannot or won't fix" the health care crisis. The Blue-Ribbon Commission on Health Care Reform, appointed by legislative leaders and the governor, will present its recommendations to the Legislature on Jan. 31. The commission plans to recommend that all Colorado residents be mandated to buy insurance that meets minimum standards, and state subsidies would be extended to more of the state's poor.

Before politicians get too ambitious, however, they should take a closer look at the health care reform led by a leading Republican: Mitt Romney, the former governor of Massachusetts.

"The majority of the commission favors a government-heavy proposal," says Dr. Paul Hsieh, a Denver physician who has studied the new Massachusetts system. "They're crafting it similar to the Massachusetts model."

A year old, the Massachusetts system is resulting in rationing and shortages of care, and higher costs to taxpayers than originally expected. The Patriot Ledger newspaper tells of Lee Sampson, a 47-year-old unemployed medical transcriptionist. Sampson bought into Commonwealth Care, a state-subsidized insurance cooperative. She had to buy insurance by Jan. 1 to avoid tax penalties and fines.

But Sampson, like a growing number of other Massachusetts residents, is learning that mandatory insurance doesn't mean doctors will treat her. To receive benefits from the plan, Sampson must find a primary care physician. She reported calling 50 doctors' offices within a half-hour drive of her home. All rejected her. Most explained they were overwhelmed and accepting no new patients.

Massachusetts, like Canada, will learn that mandating health care as a universal right results in a demand for services that exceeds the supply. The demand for medical services under the new Massachusetts system has become so great, and so expensive, that state officials are cutting back on the compensation doctors receive for services, while raising patient co-pays. The medical community, struggling with high demand and inadequate reimbursement, is cutting costs by rationing services for patients like Sampson.

Ask Americans if they would enjoy free universal health care, like the Canadians have, and many will say yes. Ask the same folks if they'd like to wait several months for an MRI, a heart scan or chemotherapy -- as Canadians often do -- and they'll give a resounding "no way."

Yet one can't argue that our nation's health care system is well. As reported by The New York Times, health care costs are going up at twice the rate of inflation. With soaring costs come rising insurance rates, which fewer employers and individuals are willing or able to pay. Based on U.S. Census data, 10 million Americans were uninsured 15 years ago. Today, more than 46 million live uninsured.

While it's expedient for politicians to promise a solution in the form of a program, Massachusetts will continue showing us why it doesn't work. Government intervention, in fact, explains the failures of our current system. The IRS code drives most Americans to buy health insurance through employers. That means insurers don't have to compete for consumers, because for most Americans, shopping around for a better deal involves a career change. And because health insurance has been packaged as a "free" benefit from employers, patients have spent the past half-century consuming health care without challenging the price. For those with health plans, "insurance" has morphed into pre-paid service, seemingly paid for by someone else. Imagine a system in which large employers provided auto insurance. Would employees balk at the cost of this "free" benefit, demanding a better price? If the insurance covered routine oil and lube jobs, the way health insurance covers physicals, would consumers demand lower prices from Grease Monkey? Doubtful.

State legislators can't change the morass of federal regulation that has led to a health care system unrestrained by the conventional market forces that control other services and goods. But legislators can improve access to health care by eliminating most of the state controls that prohibit affordable coverage. State law, for example, requires that health insurance plans include coverage for childhood autism -- even for consumers with no prospect of children. Regardless of a consumer's personal needs, any policy he or she buys in Colorado must cover alcohol rehab, mental health and maternity treatments -- to name a few. Why not a law that says all cell phone plans must come with 80-channel cable TV?

Brian Schwartz, an Arvada-based optical engineer, proposed to the Blue Ribbon Commission a market-based health care reform package that mostly involved deregulation. Commission member Linda Gorman fought for it, but others scoffed.

"One commissioner said we already have a free market in health care, and it has failed," Schwartz told The Gazette. "But we don't have a free market. If you're a widow, you have to buy a policy that covers marital therapy, maternity and prostate cancer. You have no need for this, but if you want insurance you're required to buy it. Mandates raise your premium by 20 to 50 percent."

Government, as we're seeing in Massachusetts, can't make health care affordable and abundant. Market forces can and will -- if politicians ever allow them to.

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Mass. panel approves changes to subsidized residents health plan
By Alice Dembner

Striving to hold down costs to taxpayers, a state panel yesterday approved a range of changes for next year for the rapidly growing subsidized health insurance program. The changes will probably cut payments to doctors and hospitals, reduce choices for patients, and possibly increase how much patients have to pay.

The program is the centerpiece of the state's landmark effort to insure nearly every resident, and there is widespread concern about long-term funding of the initiative because of growing healthcare costs.

Mass. To Cut Payments to Docs & Hospitals
Posted by Jacob Goldstein

Massachusetts’s universal health-care plan is turning out to be more expensive than predicted. Now the state is looking at cutting payments to docs and hospitals next year to make ends meet.

That fiscal reaction, which some critics of the plan warned about, sends a stark message to those of us in the other 49 states. Massachusetts has become something of a model for the national plans proposed by Hillary Clinton and John Edwards, among others.

The state requires everybody to buy health insurance. A subsidized health plan offered to the poor as part of the program has proved more popular than expected, and that’s helping to push costs 20% over what the state had budgeted. The tab could run $619 million for the current fiscal year, $147 million over budget, the Boston Globe reports.

Now the board that oversees the plans has approved cuts of 3% to 5% in reimbursements for to health-care providers caring for those in the subsidized plan. The article suggests the cuts will bring reimbursement in line with Medicaid.

Labels: Insurance, MA, States

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Success could put health plan in the red

Enrollment in the state's new subsidized health plan is growing so quickly that the state could face a funding gap as large as $147 million by the end of the fiscal year, according to a state projection.

...But the state would have to find ways to pay the insurance bills for so many more people. Options include appropriating more money, using funds allocated to care for those without insurance, or cutting extra payments to certain hospitals that were included in the law mandating insurance.

Thousands balk at health law sign-up mandate

With just seven weeks left until 2008, tens of thousands of Massachusetts residents -- up to 100,000 or more by some estimates -- have yet to sign up for insurance plans created as part of the state's historic health care reform law.

This has left insurers falling far short of expectations for signing up new customers, as countless people -- intentionally or otherwise -- come perilously close to risking fines and escalating penalties if they don't obtain insurance by the end of the year...

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