A Rebuttal

by

An ordinary citizen who is unwilling to “get out of the way”

To Congressional Representatives and Senators:

I am an ordinary citizen, in fairly good health, and am a fortunate recipient of

Medicare benefits. During my middle years, our family’s health care was provided
through premium-paid private health insurance. This served us well for several decades.
I would like to take this opportunity to write to you regarding the health bills
currently being considered in Congress. There has been such a profusion of information
released regarding the content and status of these bills, that I feel it incumbent upon me,
as a voter and citizen of this country, to address you about my reflections, concerns and
suggestions related to some of the content with which I am familiar, not having read the
one thousand plus page bill in the House, covering (I hope) only healthcare issues –
unlike the expansive stimulus bill that was “stuffed full” of non-stimulus earmarks and
projects for special interests, including inducements for legislators to favor the package.
Several proposals in these bills are devastating to individual liberty, freedom of
choice, and the entrepreneurial spirit.
I rely on your conscience and sense of duty to read my letter, and more
importantly, to read the proposed bill and its amendments in its entirety before voting, so
as to familiarize yourself with its complete contents and be in a more knowledgeable
position to better predict any vital unintended consequences of such a major structural
overhaul to our healthcare system, our financial future and our nation.

Any Government Public Option or Government Sponsored Cooperative, with its

concomitant government regulations, restrictions, stipulations, mandates and major fiscal
changes regarding our health care system is unacceptable because it is designed so that
inevitably all private health insurance will be eliminated, essentially succumbing to a
cumbersome, mired-in-paperwork, bureaucratic, nationalized, socialized, government-run
medical healthcare system. President Obama has already stated his preference for a
government controlled single payer system, i.e. universal healthcare. This will clearly
worsen the quality of healthcare in America and significantly increase our nation’s
deficit.
Following are a few explanations why healthcare will deteriorate with any
government controlled unaffordable program.

1) These proposals are particularly punishing to small business owners and

employee purchasers of private policies through harsh mandates, severe penalties and
additional painful payroll taxes, forcing increasing numbers of lower-wage earners into
government options.
Business owners mandated to pay for health insurance for all their employees,
including part-timers, or be heavily penalized (8% of payroll) would either have to insure
all workers, invariably forcing all into the least expensive, but most restrictive
government option or cooperative where medical decisions are made by government fiat,
or be taxed and penalized to death. But with the demise of small-size businesses with
payrolls over $250,000, jobs disappear! Surviving business owners, suffering from
distressing, exorbitant payroll taxes and/or penalties would likely layoff workers and/or
dramatically scale back hiring, leaving largely lower-wage earners vulnerable and
demoralized.

2) Government-managed options, similar to HMOs and their cost-cutting

features, restrict choice of doctor, restrict specific treatments and use of expensive
medications (as in chemotherapy, for example) particularly for non-productive people
(read: the disabled and the elderly) in order to contain escalating costs.

3) Government public options or federally sponsored cooperatives, generously

subsidized, and competing in the health insurance marketplace, would undercut private
insurers eventually with their lower costs, certainly encouraging large businesses (some
with union members) to thrust their employees from any more costly (or gold-plated)
coverage into the cheaper, but again much more restrictive government option, leaving
only Washington-run health insurance on the playing field with limited medical benefits
and eventual failure to control fraud and waste as evidenced in our Medicare program.

4) Inevitably, government control of our healthcare is crushing to private

initiative and incentive for those involved in our medical economy, including physicians,
ancillary medical personnel, hospitals, extended-care nursing and medical facilities,
private clinics and pharmaceutical companies, all of whose medical, scientific, technical
decisions, fees and salaries would be centrally regulated by government EVENTUALLY!
This is stifling for the medical community, notwithstanding the soft, cynical, self-serving
support of these bills by the AMA, AARP and Big Pharma, not in the best interests of
their members of the first two organizations mentioned. The Obama administration
entered into a verbal, mutual (financial) agreement with the drug companies to win their
support for universal healthcare. They might, however, find themselves duped if the
administration is pushed by their left-wing to disavow an agreed upon arrangement too
“agreeable” to Big Pharma!

There is strong opposition to Obama Healthcare by physicians, seniors, the

disabled and a majority of Americans who are satisfied by and large with their preferred
current private health coverage.

We can learn from our Medicare Entitlement Program. Firstly, we know that
seniors’ use of medical services is continuously increasing and secondly, neither patient
nor doctor is incentivized to watch costs, each for different reasons.
For patients, long ago, down a “black hole” went a stream of payroll taxes that
were meant to provide for seniors, but like social security, the program is today near
bankruptcy. Patients who have paid Medicare payroll taxes for years feel “entitled,”
rightly so, to quality care. Now, most unfortunately, Medicare medical services will be
greatly reduced if Obamacare is passed!
Proposed in these bills are regulations the ramifications of which would result in
denial of medical care for “non-productive individuals,” particularly the elderly who have
already been taxed for such benefits and continue to pay premiums for Medicare
insurance.
In a cost effective effort, massive cuts will inevitably take place to the tune of
hundreds of billions of dollars over time, RATIONING care on a basis resembling the
British “quality adjusted years remaining.” Our government will offer instead, according
to proposed bills in Congress, end-of-life counseling. This is unconscionable!
Real reform and equitable revisions can include some of the following avenues of
approach to improve medical care and contain escalating costs of quality healthcare for
everyone.

A) Priority should be given to making all private health insurers ACCESSIBLE

and PORTABLE for all Americans. This means legalizing a nationwide marketplace
increasing competition among health insurers. Today policies are restricted by states’
laws and limited to state residence.
Give Americans the opportunity to change health coverage and to transfer
coverage from one insurer to another, or from employer to individuals, giving them tax
benefits only employers currently receive and enjoy.
Give Americans the opportunity to choose among our nation’s wide array of plans
and eliminate government dictates regulating deductibles, services provided and the like
to efficiently match individual ability to pay for the medical benefits provided by the
policy selected. These government regulations stipulating what services policies must
cover – such as holistic medicine, acupuncture, personal trainers, etc. that people
previously paid for out-of-pocket greatly increase premiums.
Introducing these reforms and opening up the private health insurance
marketplace nationwide to increased competition would encourage innovation of
insurance products that would go a long way in reducing premiums overall, increasing
number of people covered, enabling those with specific needs such as pre-existing
conditions to purchase more affordable coverage and inducing the uninsured to purchase
policies.
Federal assistance for Middle America by way of tax credits, and help for the
indigent and many uninsured by way of subsidies would surely be FAR LESS COSTLY
than would a vast, expansive, bureaucratic, government-run (new entitlement) health
option or cooperative eventually resulting in universal health coverage by Washington!

B) Expansion of personal health savings accounts should be encouraged because

those who participate, having a vested interest in keeping costs down, use medical
services with more scrutiny, discretion and care. It’s their own money they’re spending
after all!

C) Health insurers can encourage and control policy holders’ use of medical
services wisely with sliding scales of co-payments, deductibles and premiums. The
insured will not abuse the system if they have a personal financial stake in helping to
control the cost of their own care (similar to the way HSAs work). Any expense to the
privately insured would certainly be far less than the many tax increases imposed on all
to support a government-managed program – as is readily discernable from the Medicare
and Massachusetts experiences for example.

D) Everyone has a special interest in wringing out fraud, waste and abuse from
the medical health industry. We need limited federal oversight and guidelines in
conjunction with private health insurers, but clearly not control over our medical care via
stinging mandates rationing care, particularly for “non-productive” persons, and
subjecting an individual’s medical needs to actuarial statistical analysis decided by
bureaucrats and politicians laboring on the Independent Medical Advisory Council
(IMAC) to contain costs, not save humanity. Physicians should be in charge of medical
decisions – not government.
In addition, if past performance is any window to the future, Washington cannot
be trusted to run yet another public government option. Evidence the abundance of fraud
and waste in Medicare and its near-bankrupt state today.

E) Tort reform is crucial to reducing costs endemic in our medical system.

Doctors tend to overuse the system due to the daily practice of “defensive medicine”.
Physicians order every test available in their arsenal to avoid potential threatening and
costly lawsuits. Astronomical malpractice premiums are passed onto the consumer,
increasing costs for everyone.
Why is President Obama adamantly opposed to tort reform? Is it possible that
some special interest groups like lawyers and unions are being protected? Is it possible
that exorbitant awards “redistribute wealth,” a concept supported by President Obama?
Unfortunately, the President does not see fit to reform this systematic abuse that drains
untold sums from the medical system. Sadly, it is ignored by our politicians in Congress
as well.

F) Major contributors to our escalating healthcare costs are new, expensive

technology, treatments, and drugs, all of which absorb enormous funds for research,
development and studies, reflecting our innovative creativity in treating disease.
In the name of “cost-effectiveness” we must not destroy the most advanced
medical system in the world that brought into our hospitals and body of knowledge new
technologies that we all acknowledge raise the cost of care, but from which all
Americans, to our good fortune, benefit tremendously. We must not squelch innovation
by squeezing our physicians and scientists of their dedicated service.
These brilliant introductions to the advancement of medical care, recognized
worldwide, contribute to higher healthcare costs, particularly as it pertains to the elderly
who need and utilize more medical services than the younger population, but it is
unethical to deprive seniors of these benefits which enrich their lives and extend their
lifespan. Health insurers in conjunction with Government-in-Medicare should exert
influence and realistic guidelines solely against abuse of expensive care rather than deny
human beings the fruits of our high quality medical and scientific knowledge.

G) Of utmost importance, we must not increase our huge and ghastly deficit by
introducing yet another permanent government-managed healthcare option centralized in
Washington, with perhaps another Czar accountable to NO electorate population
whatsoever and accompanied by the excessive cost of additional, onerous layers of
bureaucracy. The greater the number of people in the “business of government,” the
greater the opportunity for power plays, waste and corruption.
Recently disclosed New Jersey scandals and alleged sweetheart deals, special
favors and the like by some of our Representatives, Senators and appointed individuals
make voters reluctant to cede more power, control and decision-making to government.
The broken promises of our politicians contribute mightily to our cynicism, disgust and
distrust of government.

H) To contain skyrocketing medical costs is a major focus of the current proposals

in Congress. If passed, these bills, instead will explode our current excessive debt by at
least a trillion dollars as assessed by the CBO (a neutral body), incur the wrath of
Medicare recipients (on whose shoulders a third of that sum would be carried) and the
disabled, eventually imposing on the entire population an expensive, nationalized,
federally controlled healthcare system, beggaring ourselves, our children, and
grandchildren encumbered with debilitating tax schemes, repressing future economic
growth, crippling Americans universally and eventually impoverishing our nation.

I) The bills in Congress undoubtedly would require raising taxes to pay for any
government healthcare program. All sorts of taxes are currently being considered, but
raising taxes on every tax-paying American family, on businesses, corporations, on every
stage of production (with a value added tax, known in Europe as a VAT tax), on incomes,
dividends, energy use of gasoline, oil, electricity (through intrusive monitoring), on
HSAs, on private health insurers to pay for another stultifying layer of bureaucracy in a
government-run healthcare program in addition to a mind boggling deficit from
government bailouts, stimulus packages of pork and earmarks geared to special interests
and Congressional votes, and budget-busting giveaways and handouts to favored
businesses endangers America’s future and is, at best, fiscally irresponsible!
Most pernicious is the continual expansion of government and government
encroachment into the most intimate aspects of our lives, our preferences, our daily habits
and behavior.

To Congressmen representing voters:

Please read the bills in their entirety before voting because these lengthy
proposals, the innumerable amendments, mandates and acquiescence to special interest
groups are so complicated, confusing and obfuscating (perhaps deliberately so) that
legislators are reluctant to read them. Some cynically retort that it would require “two
lawyers and a staff” to understand them!
Buried in this thousand-plus page House bill and unread (as acknowledged by
President Obama himself) are regulations and mandates, the ramifications of which the
authors don’t want any of us to understand.
The government proposals (and tax hikes sure to be made), if passed, are slated to
begin after, well after, elections are held, in 2013, presumably to avoid deepening the
current recession, only to be put into effect when the downturn eases, but President
Obama wants some version of a bill (hopefully reflecting his preference for a government
option) on his desk before the end of the year, insisting on urgency when there is none,
possibly via the RECONCILIATION process (if the Democratic partisans deem it
necessary), bypassing the genuine will of the people. This stealthy, devious option is, as
Senator Schumer has recently stated, still “on the table”. It is a travesty of justice to ram
a bill through congress that will affect all of us so profoundly!
Unexamined, imbedded mandates give rise to UNINTENDED
CONSEQUENCES EVENTUALLY such as:

- Any public option or cooperative will develop eventually into a large,

unwieldy, expensive bureaucracy and a single-payer healthcare system
controlled by the Washington establishment.

- A severe shortage, eventually of physicians, qualified healthcare

personnel, hospitals and extended medical facilities (including cancer
care centers) as a direct result of mandated health insurance for all
(including what is said to be 45 million additional people), many of
whom voluntarily do not purchase health insurance, 10 million said to be
illegal immigrants, and probably millions who can’t afford health
insurance with current restrictions on accessibility to more affordable
policies, and many who, negligently, did not sign up for Medicaid.
Finally, people should be responsible for their healthcare, not
government.

- Long waits to see primary care physicians as gatekeepers, interminable

waits for specialists, and even longer waits to receive treatments for
serious health conditions, eventually.

- Inevitable and eventual rationing of medical care due to cost-effective

mandates, falling hardest on Medicare recipients, but not exclusively so.

- A demoralization of healthcare providers whose compensation

eventually will be dictated by government attempts to control costs.

- A demotivated, highly unemployed youth and young adult population

due to slackened hiring by eventually tax-burdened businesses.

- Wealth redistribution eventually via oppressive tax structures,

disheartening to the hard-working Americans, half of whom would
eventually be taxed to provide for the 50% of Americans who pay no
taxes at all.

- A stupefying shrouding of personal liberties, lifestyles and freedoms,

eventually.

- And the outrage of Americans who will be reported to the Administration

at the request of President Obama by other citizens roaming the internet
to find “misinformation disseminated regarding the health proposals or
anything that seems ‘FISHY’”!!

It is this very tactic itself that smells “FISHY”! We are still free to speak our
minds and voice dissenting, adversarial opinions without being obnoxiously labeled
extremists, racists, right-wingers, and having the Speaker of the House insinuate that
loud, strong objectors to the House bill display Nazi-like behavior – even calling it un-
American to protest!
And now, to have fellow citizens encouraged to inform on other citizens for
distributing on the internet anything that sounds “FISHY”? Should I fear signing my
name to this document if posted on the internet? Should I fear reprisal for opposing
proposed drastic changes to our healthcare system or health insurance this year?
This indeed is an outrageous consequence fueled by these bills currently being
considered in Congress.

The House bill is deeply Socialist in its goals and design, Statist in its intent, and
painstakingly out-of-sync with American values.
Washington has developed into a culture of cronyism, lobbyists with outsized
influence, and corruption that has continued unabated in this Administration in spite of
the promises of transparency and honesty.
Government spending has run amok! Instead of curtailing federal extravagance,
government bureaucracy is profligate, ever-expanding, and increasingly intrusive, in near
total disregard for American industry, business and consumer.
I implore you to scrutinize the bill, debate, discuss and consult with constituents
about reforming our healthcare system with integrity and respect for ourselves, our
children and our country’s future.
There will be many ideas and recommendations from the people whom you
represent. Just ask them!

Sincerely,

Barbara Stephens