Health Care TEA Party Speech in Plymouth

Fellow Patriots, welcome to our Health Care TEA Party.

Our purpose today is to share information about the proposed government take-over of health care.

P.J. O'Rourke once said, “The Democrats are the party that says government will make you smarter, taller, richer, and remove the crabgrass from your lawn. The Republicans are the party that says government doesn't work and then they get elected and prove it."

That summarizes the dialogue in Washington today about this issue. Those in favor of the government takeover of health care argue that it will do unlikely things like lower cost, improve care, and make the Detroit Lions Super Bowl champions. Those opposed to it argue such goals are unachievable, because government is inherently inefficient, and private citizens will make better choices in their own interest.

Let’s begin with some high level considerations of the government’s proposal.

There’s a book called “Lyndon Johnson and The Great Society.” It describes the reasons for the failures of many government programs. The first reason can be summarized as “We didn’t realize how much funding we really needed”. The second reason can be summarized as “We had no idea how complex the problem really was.”

Those two reasons ring true when we examine various government programs. Let’s face reality. Social Security is bankrupt. Medicare is bankrupt. The post office is bankrupt. Fannie Mae and Freddie Mac are bankrupt. Amtrak is bankrupt. In fact, the entire federal government would be classified as bankrupt, if it was evaluated like a private business. Major sacrifices loom on the horizon for these bankrupt programs, even before the government launches this expensive new program.

This suggests that allowing the government to take over healthcare, which represents 17% of our economy, is simply insane. Despite the rosy promises from Washington today, nationalized healthcare will become just another bankrupt program tomorrow.

Another important consideration is how the government takeover of health care will affect the middle class. Too often, our political discourse is about rich versus poor. Too often, the middle class, the group that is the heart and the soul of this country, is either ignored, or is used as a pawn. Soccer moms and soccer grandmoms: your health, and the health of your children and grandchildren, is far too precious for you to accept the role of pawn in this debate.

Again, let’s face reality. You in the middle class are probably happy with your current health care. Poll after poll bears this out. It makes no sense, then, for our politicians to dismantle the best health care system in the world. I invite you to consider whether you will be better off or worse off when the government takes over healthcare. If you already have insurance and medical care that you are happy with, it’s all downhill from here. Socialists always degrade conditions to the lowest common denominator.

A final high level consideration is the credibility of the politicians proposing this government takeover. Can we trust them to fairly, faithfully, and successfully execute this massive nationalization? Consider the following:

• The very politicians who are pushing this program are not required to participate in it.  Neither are any employees of the federal government. They have their own lucrative health plan, which they can choose to keep forever.  That alone strains credibility.
• They tell us there are 47 million uninsured people. What they don’t tell us is that 16 million are uninsured by choice, and 10 million are illegal aliens. That leaves about 21 million that are involuntarily uninsured. That’s about 7% of our population, which is certainly an issue. But it is not a reason to radically change our entire system and let the government take it over. Why not just address the 7% of uninsured appropriately and humanely? It strains credibility that the government proposal doesn’t even accomplish that simple goal. 11 million people will still be uninsured even after the government ruins the best health care system in the world.
• The President sent out a nice letter describing the wonderful aspects of the proposed program. Strangely, his letter was silent about the negative aspects. A leader interested in a true public debate would have presented a balanced assessment, including future costs, repercussions, and trade-offs, so that we could evaluate the issue honestly and fairly.
• Actually, our leaders are barely telling us anything at all. If you were shopping for insurance, you would ask what procedures are covered, how much will it cost, what are my deductibles and copayments, and which doctors can I use. None of that has been defined. They are asking us to commit a trillion dollars without answering the most basic consumer questions that you would ask before spending your own money.  
• Actually, I’m not convinced any of our leaders have even read the entire legislation. House Judiciary Chairman John Conyers made this confession: {quote} “What good is reading the bill if it’s a thousand pages and you don’t have two days and two lawyers to find out what it means after you read the bill?” {end quote} Such disdain for our democracy is almost too staggering to contemplate.
• Credibility is also strained when our leaders treat average citizens as enemy combatants. A letter was circulated from Washington inviting citizens to rat on their neighbors to a White House website if they say “fishy things” to oppose the bill. That is chillingly Orwellian. The DNC issued a video that mocks protesters at town hall meetings, describing them as mobs and right wing extremists. Pelosi called health care protestors “un-American”. Our leaders are elitists who are ignoring the concerns of middle class citizens. Compare their approach with that of John F. Kennedy, who said, {quote} “No President should fear public scrutiny of his programs, for from that scrutiny comes understanding. And from that understanding comes support or opposition. And both are necessary.” {end quote} JFK’s approach is a far cry from the Chicago Way.

These credibility issues alone should cause us great alarm. But, the greater cause for alarm, like the devil, is in the details of the program. I will discuss these details now, in the context of four criteria that any informed consumer would use if they were spending their own money. These criteria are Cost, Privacy, Choice, and Quality.

Let’s talk about Cost first. Here’s a brief video highlighting the cost issue. (Pause for video).

• As the video suggests, costs will necessarily be higher because millions of uninsured will be added to the program, some involuntarily. While the merits of adding the uninsured can be debated, the fact that it will add enormous cost cannot be debated. Simple math tells us that when 15% more people are given coverage, costs will go up correspondingly.
• Costs will necessarily be higher because the bill establishes a huge infrastructure that includes new departments, facilities, laboratories, health information systems, research grants, school-based clinics, and workforce development programs.
• Costs will necessarily be higher because fraud and corruption invariably accompany large government programs. In New York alone, $2 billion per year of Medicaid and Medicare are lost to corruption and fraud. The fraud and corruption that will come with government control of 17% of our economy will dwarf that.
• Costs might be higher because illegal immigrants might participate. The bill is ambiguous about this, and it is still unfinished, but the Hispanic Caucus has reportedly been assured by Nancy Pelosi that illegal immigrants will not be excluded. The government is taking up comprehensive immigration reform after the health care bill, so perhaps that is when this issue will be settled. For now, the anti-discrimination section of the current bill indicates that no service will be denied based on “personal characteristics”, whatever that means.

The President says that he will not add to the deficit to pay for this program, but the current bill is not fully funded. The CBO says it will add $300 billion to the deficit over ten years. The President claims he will save money through efficiencies, which he actually believes will come from a massive government program. But, even his key advisor, Dr. Ezekial Emmanuel, doesn’t believe that. Emmanuel said: {quote} “Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality are merely ‘lipstick’ cost control, more for show and public relations than for true change.” {end quote}

Increased costs must be dealt with somehow. One method will be to reduce services and procedures that are currently available. This will be a serious blow to many people who already have good insurance. Dr. Emmanuel says that Americans are too “enamored with technology”, and he is determined to reduce access to it. So, if you are elderly and you need angioplasty, bypass surgery, or joint replacements, these technologies are likely to be less available, in order to control cost. If you’re over 65, listen carefully: The bill will cut Medicare Advantage by $156 billion over ten years.

Future medical innovations will be less likely. Countries that already have government-run health care have been relying on the U.S. to pay the research and development costs for new technology and medications. The U.S. produces five times as many new drugs as Europe and Asia combined. If we adopt the cost-control policies that have stifled innovation in other countries, the entire world will be worse off. David Blumenthal, another Obama advisor, recommends slowing medical innovation to control health care spending.

The costs that are not offset by reductions in service and technology will have to be covered by increased taxes. Here are some of the taxes being discussed to fund this government takeover:

• The rich will certainly be taxed. Those making over $280,000 per year could face as much as 5.4% in additional surtaxes. This could double by 2013 if the program is still underfunded.
• But, it won’t be just the rich who have to pony up. Everyone will be affected, one way or another. Businesses that don’t provide health care for their employees will be hit with a payroll tax as high as 8%. This could devastate many small businesses, resulting in more unemployment and more outsourcing overseas.
• Conversely, the 8% fee is very cheap compared to what businesses currently pay if they do offer insurance. This will likely tempt many companies to drop their coverage and force millions onto the less attractive government plan.
• If you currently get health care benefits, those benefits might be treated as taxable income.
• A direct tax on certain citizens is being discussed. The bill says that anyone who does not have acceptable insurance will be taxed 2.5% of income.
• A Value Added Tax has been discussed. This will increase the cost of everything that you buy.
• Whichever taxation methods are chosen, the President will be abandoning the pledge he made to the middle class during his campaign, when he said {quote} “you will not see any of your taxes increase one single dime.” {end quote}

Reduced services and increased taxes are not the only threats. Another threat will be to your privacy. Here’s a brief video that touches on the privacy issue. (Pause for video).

Nationalized healthcare necessarily means government intrusion into the most intimate aspects of your lives. Here are some of the proposed privacy intrusions:

• The government is going to create a national registry and data network containing all of your medical records.  The bill authorizes them to obtain your data from any other department or agency of the U.S. government.
• The bill authorizes the government to access your personal financial information in order to determine ability to pay. It also authorizes the Health Secretary to give the Attorney General access to all of your data.
• The bill authorizes the government to have direct access to your bank account for electronic funds transfers.
• The bill authorizes the government to audit the books of any private company that self-insures.
• The bill will fund grants to groups that will track your behavior, including your weight gain or loss, what you eat, your exercise patterns, tobacco use, or any other behavior that the government chooses. These grantees will be assigned to carry out a “community transformation plan”.

Another key consideration is how the government takeover of health care will limit consumer choices. Here’s a brief video that touches on the issue of choice. (Pause for video).

Here are some examples of how your choices will be limited:

• The bill establishes a government committee and a Health Choices Commissioner to decide what benefits everyone will get. Obviously, everyone can’t get everything. Dr. Emanuel, an advisor to Obama, believes that medical care should not be given to those {quote} “who are irreversibly prevented from being or becoming participating citizens…an obvious example is not guaranteeing health services to patients with Dementia”. {end quote}
• The bill requires everyone to obtain health insurance, at a level specified by the government. You will not be allowed to get more health care by paying for it. Conversely, you cannot buy cheaper insurance if you are young and believe you will not need expensive care.  You cannot just purchase catastrophic coverage and pay for routine costs out of your pocket. If you make no choice at all, you will automatically be enrolled in the government plan.
• The President has claimed that you don’t have to give up your current insurance. While that is technically true in some cases, it is remarkably misleading. For example, after five years, all current policies will be discontinued, and you will be forced into the government program. This could happen even sooner than five years, because if any company makes a change to its current plan, it is automatically disqualified and you will be forced onto the government program. And only employees who work for ERISA-qualified companies (generally big companies) can temporarily keep their insurance. All non-ERISA employees must immediately go to the government plan. This includes people who buy their own insurance or who work for small businesses.
• Whether you like it or not, your tax dollars will pay for abortions. Currently, federal abortion funding is limited to cases involving rape, incest, or danger to the mother. The new public plan will cover all abortions. They will tell you that federal funds will not be directly used to pay for these abortions. That is disingenuous double-talk. You will pay taxes to the government, the government will fund part of the plan, and the plan will cover abortions.
• A critical area that is not clearly defined in the bill is how the government will ration health care as seniors become disabled and approach end of life.
• The bill does have a provision for an advance care planning consultation every five years. This includes setting up living wills, deciding what level of treatment is appropriate at the end of your life, and approving which doctors can write an end-of-life order, if such is deemed necessary.
• The mechanism for defining what treatment you will get at end of life is not defined, though. This determination is likely to be based on Comparative Effectiveness Research, which is funded by the bill. If this approach is eventually used, it will result in a formula where the cost of a treatment is divided by the number of “quality-adjusted life years” that a patient has left to live. In Britain, this formula is already in use, and it results in denying treatments for older patients who have fewer years to benefit from care than younger patients. Perhaps former Colorado Governor Dick Lamm gave us a clue about where we are headed when he bluntly suggested that the elderly have {quote} “a duty to die”. {end quote}

The final key consideration is quality.  Here’s a brief video that touches on this issue. (Pause for video).

Here are some sobering points about health care quality:

• A survey of physicians in various countries found that all except the American physicians reported major shortages of resources important in providing quality health care.
• The most critical resource shortage will be doctors. This is partly because the number of patients demanding service will go up, and partly because pay for doctors will go down. Countries with government-run healthcare save money by paying doctors less. U.S. doctors earn more than twice as much as doctors in Canada and Germany, more than three times as much as in France, and four times as much in the rest of Europe. The bill gives the government power to set compensation levels and to set the value of doctors’ time. When pay for doctors gets limited, our talented young people will choose instead to go into professions where they can earn more money and have more autonomy.
• Critical technology will also be in short supply. For example, today there are 60 CT scanners and MRI machines per million people in the U.S., compared to 18 in Canada and 13 in the U.K. Do we really want to go backward in the availability of technology?
• Results will also suffer. A 2008 study found that the five year survival rate for prostate cancer is 92% in the U.S., versus 57% in Europe. For breast cancer, it is 84% versus 73%, and for colon cancer, it is 60% versus 47%. If we emulate the European system, we will get European results.
• A 2007 study found that the U.S. was number one in preventative care. 85% of U.S women had a Pap test in the past two years, compared to 58% in the U.K. For mammograms, the difference was 84% versus 63%. Again, if we emulate the European system, we will get European results.
• Another way governments reduce health care costs is to require patients to wait for treatment. Dr. Blumenthal, Obama’s advisor, calls it “debatable” whether the timely care Americans get now is worth the cost. For a cancer patient, there is no debate. Delay in treatment is not just inconvenient, it results in suffering and sometimes even death. In Britain, the average patient has to wait 18 weeks from referral to a specialist to treatment. Canadians have to wait an average of 17 weeks. A lot of bad things can happen to a waiting patient in 17 weeks.
• The government will be piloting an HMO-like program that capitates benefits and incentivizes practitioners to keep expenditures under targeted levels in order to receive bonus payments. This will result in either long waits for service while the doctor hopes your problem goes away naturally, or it will result in your doctor being less inclined to authorize more expensive procedures. This is precisely what killed the HMO model.

Clearly, the government is going to be far more involved in your medical care and decisions than ever before. One final point is that the government is going to outsource some of that intrusive involvement in your life to “community groups”. This may include ACORN or Planned Parenthood. Since ACORN has already been contracted to work on the 2010 census for the government, it’s a good bet they will be contracted for this intimate involvement in your life too. When pressed to confirm or deny that ACORN will qualify as one of these “community organizations”, Senator Chris Dodd, who is responsible for shepherding the bill through the senate, disingenuously said, “I’m not saying yes or no”.

Massive changes are being proposed for the way our health care is administered. Unfortunately, as this government takeover of healthcare is being rushed through Congress, we are not getting honest, credible information from our leaders. Instead, we get Orwellian double-talk. The leaders in George Orwell’s “1984” had a slogan: “War is peace; freedom is slavery; ignorance is strength.” Consider the following Orwellian double talk about healthcare coming out of Washington:

· They tell us that health care spending will not go up, yet they are proposing to add $1 trillion dollars to health care spending.

· They tell us that healthcare decisions will not be made by the government, yet they are setting up a new Federal Health Board and a Health Choices Commissioner to tell doctors what treatments they can offer, to whom, and under what circumstances.

· They tell us they are going to get the politics out of healthcare, yet they are putting healthcare under government control. Hopefully, you supported the right party when you need care, or when you run into ACORN.

· They say that they will replace “expensive care” with the “best care”, yet they are substituting the judgment of distant government bureaucrats for the judgment of your personal physician.

· They say that we will stop paying for things that don’t make us healthier, yet they are talking about de-emphasizing the very cutting edge technology and medicines that make us the envy of the world.

· They say that healthcare costs are gobbling up money that employers could use as wages for workers, yet they are proposing an 8% tax on some employers to pay for this program.

· As a final insult to our intelligence, they use the words “government” and “efficiency” in the same sentence.

Ironically, as our government contemplates taking over health care, countries with government-run health care are moving in the opposite direction. Almost every European country has introduced market-based reforms to reduce health costs and increase the availability and quality of care. They have learned what I learned when I lived in Canada for three years. I can say with firsthand knowledge and painful experience that in Canada the doctors are less qualified, the service is bureaucratic and frustrating, the waits are long, and the results are sub-standard. When I returned to America, I wanted to kiss the ground. There were many reasons for that urge, but the American health care system was at the top of the list.

Dr. Ezekial Emmanuel, the brother of presidential chief enforcer Rahm Emmanuel, will be influential in the proposed government takeover of healthcare. As I mentioned earlier, he suggested that it makes no sense to allocate healthcare dollars to those who will never be able to significantly contribute to society.

Soccer moms and soccer grandmoms, I’d like to share with you how Sarah Palin addressed this issue last week. As you know, Sarah has a special child of her own. She said:

{quote} "The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care. Such a system is downright evil." {end quote}

I will close with a reminder from Thomas Jefferson. He said: “We in America do not have government by the majority. We have government by the majority who participate.”

I am going to participate with my heart and soul, and I invite you to also. We need to make sure that our leaders understand that they are treading on middle class voters at their own peril.

Remember, our venom is our vote. 2010 can’t come soon enough.

Thank you.