Guest Editorial: Demand Full Debate | Orthopedics This Week
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Guest Editorial: Demand Full Debate

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Eric Novak, M.D.
The Democratic leadership in the U.S. House and Senate is looking to push a plan to get radical health care reforms passed this year without a full and complete debate.

Former Senator Tom Daschle, who but for tax issues would be spearheading health care reform for President Obama, has been the most open about the real agenda of the administration.

The goal is simple: a government-mandated and run health care system where government determines what care is available and for whom, and get it done FAST.

Clarity can be found in the pages of his [Daschle's] book, Critical: What We Can Do About the Health-Care Crisis. And his co-author, Nancy-Ann DeParle, was just named to the “health care czar” position at the White House.

“The next president should act immediately to capitalize on the goodwill that greets any incoming administration. If that means attaching a health-care plan to the federal budget, so be it. This issue is too important to be stalled by Senate protocol.”[--Daschle]

By using the budget process, the reforms would not be subject to a 60-vote threshold in the Senate. In other words, no filibuster would be possible to stop bad legislation.

Daschle proposes a two-step process to achieve a de facto single-payer system:

  1. Progressive, massive expansion of government-run programs like Medicare and Medicaid, so that they compete with and supplant all private health plans.
  2. Once everyone is captured in the “net” of government-run programs, institute centrally controlled health care rationing.

The details matter as well:

  1. Mandatory participation in health care programs is a central feature in the Daschle/Obama plan.

    By mandating coverage through either an individual mandate (everyone must have insurance or pay a fine or penalty), or an employer mandate (every business must pay a certain amount per employee for health care coverage), or a combination of the two, everyone is “captured” into the system.

  2. Creating new Medicare or Medicaid-like public plans that compete with private plans for the newly mandated coverage.
  3. Subsidizing the public plan option so that private plans progressively cannot compete, or only exist as ‘contractors’ for the public system.
  4. Further handicap the private sector by using health information technology to get people automatically enrolled in public plans.
  5. Create the central, Washington-based rationing board so that it starts merely as a group that meets to "evaluate" the costs of different treatments to society relative to the benefits to individuals. Then use that data to ultimately make coverage decisions. And with no viable private sector, no coverage will mean no care for the people affected.

How far has President Obama gotten with his use of the Daschle plan?

  1. The attempt to get health care reform attached to the budget process will be determined over the next two to three weeks. Democrat leaders in the Senate have not ruled out putting the necessary language into the final 2010 $3.5 trillion budget bill. Unless enough pressure is put on key Democrat Senators, the option to use the budget process very well may pass.
  2. Expansion of government-run health care plans began with the passage of the reauthorization and broadening of the State Children’s Health Insurance Program (SCHIP).
  3. Over 100 pages of the so-called ‘stimulus’ bill, passed in February of this year, were dedicated to health care reform items.
    1. A national health information network that would require a searchable personal health record for every American by 2014.
    2. Those records are to be used for “research” purposes by government agencies and contractors without patient consent.
    3. A government created electronic health record program to compete with private technology companies is to be created and subsidies to use the government system are available.
    4. A "comparative effectiveness research board", analogous to the “Federal Health Board” suggested by Daschle was created and funded.
      1. While the Board cannot implement policy, its recommendations can certainly be used to make coverage and rationing rules by Medicare and Medicaid.
      2. Through the rule making process of Medicare, it would achieve the goal of being, as Daschle put it, “a cost-effectiveness review organization with teeth.”
  4.  Influential lobbying groups, from hospital, nurses, doctors, business, consumer, and insurance groups—all part of the “Health Reform Dialogue”—are on record as recently as March 27, 2009, accepting the need for mandatory health insurance for every American.
  5. Health and Human Services Secretary-designate Kathleen Sebelius said in her Senate hearing testimony: "If the question is do I support a public option side-by-side with private insurers, yes I do.”
  6. Leadership in the House and Senate, as well as the White House, is committed to enacting the "reforms" this year at nearly any price.
    1. U.S. House Speaker Nancy Pelosi (D-CA): “We just want to get a budget passed and we want to get healthcare passed. Whatever the path is to do that is fine.”
    2. Pelosi: “We really have to be fiscally sound, but I also know we have to invest in order to grow the economy.”
    3. Sebelius: “"Inaction is not an option. The status quo is unacceptable, and unsustainable.”
    4. Sebelius: “[h]ealth reform would be my mission."
    5. Senator Max Baucus (D-MT), chair of Senate Finance Committee: “Enacting comprehensive health care my top priority.”
    6. Baucus: “Now it's time to move from first steps to giant steps… There's never been a better moment. The stars are all aligning.”

Health care reform should not be rushed through Congress.

Health care reform is too important for you, your profession, and your family to have RADICAL reforms shoved in a bill that no one reads before it becomes law.

The corruption, deception, and incompetence that characterized the AIG bailout should not be allowed to happen with health care reform.

Congress will decide on rushing health care reform through without full debate when they return from recess next week.

Call your Senators’ offices TODAY and tell them, unequivocally, DO NOT USE THE BUDGET PROCESS FOR HEALTH CARE REFORM.

Eric Novack, M.D., is an orthopedic surgeon in practice in Phoenix, Arizona, and a Senior Fellow in Health Care Policy at the Center for Freedom and Prosperity. He can be reached at Views contained in the editorial are strictly those of the author.


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