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I have updated this report with newer facts and figures to demonstrate that my predictions are already being proven
correct. Linda de Sosa 3/6/2011
Original preface: Assuming many Americans have not had time to do research, I am compiling information from studies
and government sources, adding questions to assess logic and ideas generated from many sources for solutions.
3/18/2010
1) Look at Infant mortality (percentage of infants not living to one year of age)
The US rate is high, relative to other countries (6.8%)
What are the causes?
d. Higher rate of very low birth weight infants in US (12.4%) and rising rapidly
i. Primarily teen mothers and mothers 40+ (Source: CDC study)
ii. For older mothers, directly related to higher multiple births (fertility treatments, not lack of
health care)
iii. Younger mother analysis
1. Mothers younger among American Indian, black, Mexicans, and Puerto Ricans
2. Mothers younger in Alabama, Arizona, Arkansas, DC, Georgia, Louisiana, Mississippi,
Nevada, New Mexico, Oklahoma, South Carolina, Tennessee, Texas.
iv. US infant preterm mortality rate is actually higher than other countries, indicating better health
care
e. Decreases significantly if we could reduce low birth weight – suggests improved access to prenatal care
for teens and improved teen pregnancy prevention programs
f. Small rate variation due to US increased definition of live birth
i. Several countries do not consider a birth live unless it is over a certain weight or gestation week
– Norway, Czech Republic, France, Ireland, Netherlands, Poland
ii. Accounts for some, but not large amount of our lag
g. The top 3 causes of infant mortality (equally 43% of the cases) are congenital malformations, disorders
leading to low birth weight and gestation, and sudden infant death syndrome.
Therefore, infant mortality does not indict health care quality itself.
Rather than bemoan our health care system, we need to increase access
301.4millio
Total people n
Insured 255.1 84.6%
Not Insured 46.3 15.4%
The uninsured are disproportionately in the South and West, American Indian, and Hispanic (30.7%). Even discounting
the illegal proportion of Hispanics, a Hispanic cultural bias against insurance was indicated. In addition, the states with
the highest percentage of involuntary uninsured are Texas, New Mexico, Louisiana, Florida, Arkansas, Arizona,
Oklahoma, Mississippi, and Alabama. Analysis shows that the difference in state income per person was also a large
indicator. In other words, these states have lower incomes per person and so fewer people can afford insurance.
Therefore, these states would need more financial help if they are going to increase their percentage of people insured.
Conclusion: We have a great system, but we must increase access and lower costs.
1) Does it fix the problem or meet the need without injuring other parties?
2) Is it Constitutional?
3) Is it something the nation can afford?
g. [UPDATE -A survey, released in August by the Washington-based National Business Group on Health,
showed a majority of large employers revising health-benefit programs for 2011 in response to the
legislation -- with nearly two-thirds (63 percent) planning to increase premiums for employees and 60
percent considering dropping retiree-health coverage in the future.
h. UPDATE - In late September, Oak Brook, Ill.-based McDonald's informed the U.S. Department of Health
and Human Services that the law's requirements may force it to drop coverage for 29,500 low-wage
employees. Other companies and unions are threatening to drop their coverage as well, including the
United Federation of Teachers (potentially affecting 351,000 people) and San Diego-based Jack in the
Box (with 1,130 workers affected). In response, the Obama administration announced a week later, on
Oct. 7, that 30 employers, including McDonald's, Jack in the Box and the teachers' union, would receive
one-year waivers that would allow them to maintain minimal coverage below the new law's standards. A
total of 115,000 McDonald's plans were excused.
i. UPDATE - Manufacturing conglomerate 3M Co., based in St. Paul, Minn., announced on Oct. 5 that it will
no longer offer health insurance to retirees beginning in 2013.
j. UPDATE - On Oct. 8, the Business Insider website reported that Microsoft told its employees it would
scale back its heretofore-generous employee-healthcare program -- and that workers would have to start
paying for some of their benefits beginning in 2013
It is not constitutional.
1) Making health insurance mandatory is not constitutional
a. There is no power in the Constitution to force this.
d. Not the equivalent of auto insurance since you can choose not to drive
e. Even car insurance only requires liability insurance, not comprehensive
f. Some have said that the Preamble statement, “promote the general welfare” covers this.
i. The preamble does not confer any power to the government, however.
ii. Jacobson v. Massachusetts, 197 U.S. 11, 22 (1905) ("Although th[e] preamble indicates the
general purposes for which the people ordained and established the Constitution, it has never
been regarded as the source of any substantive power conferred on the government of the
United States, or on any of its departments."); United States v. Boyer, 85 F. 425, 430–31 (W.D.
Mo. 1898) ("The preamble never can be resorted to, to enlarge the powers confided to the
general government, or any of its departments. It cannot confer any power per se. It can never
amount, by implication, to an enlargement of any power expressly given. It can never be the
legitimate source of any implied power, when otherwise withdrawn from the constitution. Its
true office is to expound the nature and extent and application of the powers actually conferred
by the constitution, and not substantively to create them."
g. Some say the interstate commerce clause gives the federal government the right to regulate it.
However, that was to make sure there were no tariffs for goods going between states. When you go to
the doctor, it has nothing to do with commercial purposes.
2) The bill orders the states to make payments for health care. When the Constitution was created, it gave only 17
specific authorities and the rest was given to the states or the individual. Health care is not one of them. And the
“It is difficult to imagine that a nation which began, at least in part, as the result of opposition to a
British mandate giving the East India Company a monopoly and imposing a nominal tax on all tea sold
in America would have set out to create a government with the power to force people to buy tea in the
first place,” the ruling says.
“It would be a radical departure from existing case law to hold that Congress can regulate inactivity
under the Commerce Clause. If it has the power to compel an otherwise passive individual into a
commercial transaction with a third party merely by asserting — as was done in the act — that
compelling the actual transaction is itself “commercial and economic in nature, and substantially affects
interstate commerce,” it is not hyperbolizing to suggest that Congress could do almost anything it
wanted,” the ruling says.
“The mere status of being without health insurance, in and of itself, has absolutely no impact whatsoever
on interstate commerce (not ’slight,’ ‘trivial,’ or ‘indirect,’ but no impact whatsoever) — at least not any
more so than the status of being without any particular good or service,” the ruling says.
Read more: http://dailycaller.com/2011/01/31/2nd-federal-judge-rules-obamacare-
unconstitutional/#ixzz1Ed5S1jnF
In his report, sent to Congress Thursday night, Mr. Foster said that some provisions of the law, including cutbacks in
Medicare payments to health care providers and a tax on high-cost employer-sponsored coverage, would slow the growth
of health costs. But he said the savings “would be more than offset through 2019 by the higher health expenditures
resulting from the coverage expansions.”
http://www.cms.gov/ActuarialStudies/Downloads/PPACA_2010-04-22.pdf ]
- New Long term care insurance (CLASS) plan faces a significant risk of failure
CONCLUSION:
This bill should not be passed. We have issues with health care costs and access that must be
addressed. This bill, however, has so many negatives, it could dangerously hurt our excellent
health care system and damage our struggling economy. Instead, we should directly address
the cost and access issues with the suggestions on the following pages.
Educate and enroll those who are already eligible for Medicaid – streamline procedure
For younger, make it easier to enroll so increase the age where they are eligible to be on their
parents’ plan to 26
Educate the Native Americans and Hispanics on the benefits of insurance
Focus subsidy dollars for insurance in states with lower income per person.
Those who are involuntarily uninsured have fewer checkups, blood pressure checks, flu shots,
and preventive tests like mammograms and pap smears. Low cost clinics could provide these.
Consider increasing the minimum eligibility income for Medicaid
Current eligibility is set by each state, but the minimum requirements are
1) Meet Aid to Families with Dependent Children eligibility
2) Pregnant women and children under 6 with income at or below 133% poverty
a. Poverty level currently $10, 830 for a single person and $22,050 for a family of 4
3) Children 6-19 with family income to poverty level
4) Caretakers for those with children 18 and under
5) SSI recipients (disabled)
6) Those living in medical institutions with monthly income up to 300% of SSI income
7) Medically needy (pregnant, children, blind) with too much money to meet the requirements above
Increased access for those with medical issues
3) Simplify administration
a. Standardize electronic exchange formats and sharing for information between patients, providers,
and insurance companies
b. Enhance information sharing between healthcare providers on patients
1) Increase competition
a. Compete across state lines.
i. University of Minnesota Steve Parente additional 12 million enrolled
b. Web portal to ease comparisons between policies for individuals and employers
2) Spread Risk
1) Small businesses pool together to purchase insurance to spread risk
3) Study possible tax credit enhancements to help reduce the cost of insurance
i. Tax Credits for insurance costs for employers and individuals
1) Also improves portability
ii. Promote use of Health Savings Account
iii. Look for tax favored status
iv. Change the self-employed health insurance deduction to adjusted gross income into
a fully deductible business expense
4) Improved payment innovations
a. Payable semi annually for Medicaid
5) Study the efficacy of reinsurance programs