20 Ways ObamaCare Will Take Away Our Freedoms
By David Hogberg, Sun., March 21, '10 3:24 PM ET
With House
Democrats poised to pass the Senate health care bill with some reconciliation
changes later today, it is worthwhile to take a comprehensive look at the
freedoms we will lose.
Of course, the overhaul is supposed to provide us with security. But it will
result in skyrocketing insurance costs and physicians leaving the field in
droves, making it harder to afford and find medical care. We may be about to
live Benjamin Franklin’s adage, “People willing to trade their freedom for
temporary security deserve neither and will lose both.”
The sections described below are taken from HR 3590 as agreed to by the Senate
and from the reconciliation bill as displayed by the Rules Committee.
1. You are young and don’t want health insurance? You are starting up a small
business and need to minimize expenses, and one way to do that is to forego
health insurance? Tough. You have to pay $750 annually for the “privilege.”
(Section 1501)
2. You are young and healthy and want to pay for insurance that reflects that
status? Tough. You’ll have to pay for premiums that cover not only you, but also
the guy who smokes three packs a day, drink a gallon of whiskey and eats chicken
fat off the floor. That’s because insurance companies will no longer be able to
underwrite on the basis of a person’s health status. (Section 2701).
3. You would like to pay less in premiums by buying insurance with lifetime or
annual limits on coverage? Tough. Health insurers will no longer be able to
offer such policies, even if that is what customers prefer. (Section 2711).
4. Think you’d like a policy that is cheaper because it doesn’t cover preventive
care or requires cost-sharing for such care? Tough. Health insurers will no
longer be able to offer policies that do not cover preventive services or offer
them with cost-sharing, even if that’s what the customer wants. (Section 2712).
5. You are an employer and you would like to offer coverage that doesn’t allow
your employers’ slacker children to stay on the policy until age 26? Tough.
(Section 2714).
6. You must buy a policy that covers ambulatory patient services, emergency
services, hospitalization, maternity and newborn care, mental health and
substance use disorder services, including behavioral health treatment;
prescription drugs; rehabilitative and habilitative services and devices;
laboratory services; preventive and wellness services; chronic disease
management; and pediatric services, including oral and vision care.
You’re a single guy without children? Tough, your policy must cover pediatric
services. You’re a woman who can’t have children? Tough, your policy must cover
maternity services. You’re a teetotaler? Tough, your policy must cover substance
abuse treatment. (Add your own violation of personal freedom here.) (Section
1302).
7. Do you want a plan with lots of cost-sharing and low premiums? Well, the best
you can do is a “Bronze plan,” which has benefits that provide benefits that are
actuarially equivalent to 60% of the full actuarial value of the benefits
provided under the plan. Anything lower than that, tough. (Section 1302 (d) (1)
(A))
8. You are an employer in the small-group insurance market and you’d like to
offer policies with deductibles higher than $2,000 for individuals and $4,000
for families? Tough. (Section 1302 (c) (2) (A).
9. If you are a large employer (defined as at least 101 employees) and you do
not want to provide health insurance to your employee, then you will pay a $750
fine per employee (It could be $2,000 to $3,000 under the reconciliation
changes). Think you know how to better spend that money? Tough. (Section 1513).
10. You are an employer who offers health flexible spending arrangements and
your employees want to deduct more than $2,500 from their salaries for it?
Sorry, can’t do that. (Section 9005 (i)).
11. If you are a physician and you don’t want the government looking over your
shoulder? Tough. The Secretary of Health and Human Services is authorized to use
your claims data to issue you reports that measure the resources you use,
provide information on the quality of care you provide, and compare the
resources you use to those used by other physicians. Of course, this will all be
just for informational purposes. It’s not like the government will ever use it
to intervene in your practice and patients’ care. Of course not. (Section 3003 (i))
12. If you are a physician and you want to own your own hospital, you must be an
owner and have a “Medicare provider agreement” by Feb. 1, 2010. (Dec. 31, 2010
in the reconciliation changes.) If you didn’t have those by then, you are out of
luck. (Section 6001 (i) (1) (A))
13. If you are a physician owner and you want to expand your hospital? Well, you
can’t (Section 6001 (i) (1) (B). Unless, it is located in a country where, over
the last five years, population growth has been 150% of what it has been in the
state (Section 6601 (i) (3) ( E)). And then you cannot increase your capacity by
more than 200% (Section 6001 (i) (3) (C)).
14. You are a health insurer and you want to raise premiums to meet costs? Well,
if that increase is deemed “unreasonable” by the Secretary of Health and Human
Services it will be subject to review and can be denied. (Section 1003)
15. The government will extract a fee of $2.3 billion annually from the
pharmaceutical industry. If you are a pharmaceutical company what you will pay
depends on the ratio of the number of brand-name drugs you sell to the total
number of brand-name drugs sold in the U.S. So, if you sell 10% of the
brand-name drugs in the U.S., what you pay will be 10% multiplied by $2.3
billion, or $230,000,000. (Under reconciliation, it starts at $2.55 billion,
jumps to $3 billion in 2012, then to $3.5 billion in 2017 and $4.2 billion in
2018, before settling at $2.8 billion in 2019 (Section 1404)). Think you, as a
pharmaceutical executive, know how to better use that money, say for research
and development? Tough. (Section 9008 (b)).
16. The government will extract a fee of $2 billion annually from medical device
makers. If you are a medical device maker what you will pay depends on your
share of medical device sales in the U.S. So, if you sell 10% of the medical
devices in the U.S., what you pay will be 10% multiplied by $2 billion, or
$200,000,000. Think you, as a medical device maker, know how to better use that
money, say for R&D? Tough. (Section 9009 (b)).
The reconciliation package turns that into a 2.9% excise tax for medical device
makers. Think you, as a medical device maker, know how to better use that money,
say for research and development? Tough. (Section 1405).
17. The government will extract a fee of $6.7 billion annually from insurance
companies. If you are an insurer, what you will pay depends on your share of net
premiums plus 200% of your administrative costs. So, if your net premiums and
administrative costs are equal to 10% of the total, you will pay 10% of $6.7
billion, or $670,000,000. In the reconciliation bill, the fee will start at $8
billion in 2014, $11.3 billion in 2015, $1.9 billion in 2017, and $14.3 billion
in 2018 (Section 1406).Think you, as an insurance executive, know how to better
spend that money? Tough.(Section 9010 (b) (1) (A and B).)
18. If an insurance company board or its stockholders think the CEO is worth
more than $500,000 in deferred compensation? Tough.(Section 9014).
19. You will have to pay an additional 0.5% payroll tax on any dollar you make
over $250,000 if you file a joint return and $200,000 if you file an individual
return. What? You think you know how to spend the money you earned better than
the government? Tough. (Section 9015).
That amount will rise to a 3.8% tax if reconciliation passes. It will also apply
to investment income, estates, and trusts. You think you know how to spend the
money you earned better than the government? Like you need to ask. (Section
1402).
20. If you go for cosmetic surgery, you will pay an additional 5% tax on the
cost of the procedure. Think you know how to spend that money you earned better
than the government? Tough. (Section 9017).