RUSH: A Duke Professor Explains WHAT THE HEALTH CARE BILL ACTUALLY SAYS

www.rushlimbaugh.com ^ | Wednesday, August 12, 2009 | Rush Limbaugh

[Yosemitest]

RUSH: This is a must-read written by an ordinary citizen.

A Duke Professor Explains What the Health Care Bill Actually Says
August 12, 2009

BEGIN TRANSCRIPT

RUSH: Now, what I have here is very long.
I cannot read the entire thing. But there are summaries that I can read.
This is a piece entitled,
"What the Health Care Bill Actually Says,"
and it was put together by John David Lewis.
It is from the website Classical Ideals.
John David Lewis is a professor of classics at Duke University,
and here is how he introduces his analysis:
"What does the bill, HR 3200, short-titled 'America's Affordable Health Choices Act of 2009,' actually say about major health care issues?
I here pose a few questions in no particular order,
citing relevant passages and offering a brief evaluation after each set of passages.

"This bill is 1017 pages long.
It is knee-deep in legalese and references to other federal regulations and laws.
I have only touched pieces of the bill here.
For instance, I have not considered the establishment of
(1) 'Health Choices Commissioner' (Section 141);
(2) a 'Health Insurance Exchange,' (Section 201), basically a government run insurance scheme to coordinate all insurance activity;
(3) a Public Health Insurance Option (Section 221); and similar provisions.
This is the evaluation of someone who is neither a physician nor a legal professional.
I am citizen, concerned about this bill's effects on my freedom as an American.
I would rather have used my time in other ways
-- but this is too important to ignore.
We may answer one question up front:
How will the government ... pay for all this?

"Higher taxes, more borrowing, printing money, cutting payments, or rationing services
-- there are no other options.
We will all pay for this, enrolled in the government 'option' or not."
So, when we talk about how we're going to pay for it,
"How will the government ... pay for all this?"
it's all of the following:
"Higher taxes, more borrowing, printing money, cutting payments, or rationing services
-- there are no other options" to pay for it.
"We will all pay for this, enrolled in the government 'option' or not."
The first question that he wanted to discover here is:
"Will the plan ration medical care?"
Then he cites the relevant passages from the bill
and then evaluates the passages in real language,
not the legalese that he found.
This section, rationing medical care:


"1. This section amends the Social Security Act.
2. The government has the power to determine what constitutes an 'applicable [medical] condition.'
3. The government has the power to determine who is allowed readmission into a hospital.
4. This determination will be made by statistics:
when enough people have been discharged for the same condition, an individual may be readmitted."
In other words, there's nothing personal about this.
That's why Obama's answer to the woman with the 100-year-old mother,
"Are you gonna take into account the spunk and spirit, the will to live?"
was,
"I don't think we can do that."
It's going to be statistic based.
"5. This is government rationing, pure, simple, and straight up."


There is no other way to analyze this section of the bill.
"6. There can be no judicial review of decisions made here. The Secretary is above the courts."
All this language is in this piece.
The language from the bill is from the piece.
I'm not just going to read that to you.
I'm reading his evaluation, stripping away the legalese, what it all means.
"7. The plan also allows the government to prohibit hospitals from expanding without federal permission:
page 317-318."
The next question that the classics professor at Duke researched is:
"Will the plan punish Americans who try to opt out?"
and then he gives the relevant portions from the bill as it's written
followed by his evaluation.
Number one... Remember the question here is:
"Will the plan punish Americans who try to opt out?
... 1. This section amends the Internal Revenue Code.
"2. Anyone caught without acceptable coverage and not in the government plan will pay a special tax."

Now, this we know.
We've seen this ourselves.
"3. The IRS will be a major enforcement mechanism for the plan,"
as written in this bill.
The IRS will be a major enforcer.
The next section that he analyzed:
"What constitutes 'acceptable' coverage?"
Because, in the previous passage the bill said:
"Anyone caught without acceptable coverage and not in the government plan will pay a special tax"
So, what is "'acceptable' coverage"?
Here are the relevant passages, sentences from the bill.
"Evaluation of the passages.
1. The bill defines 'acceptable coverage' and leaves no room for choice in this regard.
2. By setting a minimum 70% actuarial value of benefits,
the bill makes health plans in which
individuals pay for routine services,
but carry insurance only for catastrophic events,
(such as Health Savings Accounts)
illegal."


Let me read that again:
"1. The bill defines 'acceptable coverage' and leaves no room for choice in this regard.
2. By setting a minimum 70% actuarial value of benefits,
the bill makes health plans in which individuals pay for routine services"
out of their own pockets,
"but carry insurance only for catastrophic events ... illegal."
That is one of the solutions to the problem we have now.
Pay for what you want
-- a standard checkup, a standard visit to the doctor
-- and catastrophic insurance for when that could break your bank.
Doing that will be illegal in the House bill.
In other words, paying for your own routine day-to-day services
but only having insurance for catastrophic events will be illegal.
The next section that our classics professor, an average citizen, was curious about:
"Will the PLAN destroy private health insurance?"
Here is what it requires, for businesses with payrolls greater than $400,000 per year.
(The bill uses 'contribution' to refer to mandatory payments to the government plan.)


"Pages 149-150, SEC. 313, EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE,"
and then the relevant passages from the bill.
Here is the evaluation of those passages.
Again, what we're talking about here is:
"Will the PLAN destroy private health insurance?"
"1. The bill does not prohibit a person from buying private insurance.
2. Small businesses -- with say 8-10 employees -- will either have to provide insurance to federal standards,
or pay an 8% payroll tax.
Business costs for health care are higher than this, especially considering administrative costs.
Any competitive business that tries to stay with a private plan
will face a payroll disadvantage against competitors who go with the government 'option.'"
Now, let me explain this.
Small businesses, say eight-to-ten employees, will either have to provide insurance up "to federal standards."
If they don't, they will pay an ADDITIONAL 8% payroll tax.

"Business costs for health care are higher than [what will be charged], especially considering administrative costs.
Any competitive business that tries to stay with a private plan
will face a payroll disadvantage against competitors who go with the government 'option.'"
If they go to the government option, they're fine.
If you don't and you stay private, you're going to pay a penalty.
The penalty will make it ridiculous and stupid business-wise to stay with your private plan.
Therefore, you will -- your small business will -- be forced out of private insurance onto the government option.
"3. The pressure for business owners to terminate the private plans will be enormous,"
the financial pressure, the business pressure.
"4. With employers ending plans,
millions of Americans will lose their private coverage,
and fewer companies will offer it."


Now, none of this is anything new.
Everybody showing up at these town halls knows this.
This is nothing that has already been learned when discussing it.
That's why when Obama is saying,
"If you like your plan you can keep it",
it's not true,
because the meat and potatoes of the bill is going to make it impossible.
If your private plan is from an employer,
your employer is going to find it very difficult
to hold onto private insurance and remain competitive with businesses
that opt out and go in the government option.
When Barney Frank or Obama himself says,
"We can't do this immediately.
It's going to take 10 to 15 years,"
this is what they're talking about:
Eventually forcing small businesses and others out of private insurance
because they won't be able to remain competitive with competitors who go the public option.


"5. The Commissioner (meaning, always, the bureaucrats) will determine
whether a particular network of physicians, hospitals and insurance is acceptable"
even if you do stay private.
many people enrolled in the government 'option'
will have no place else to go" if they don't like it.
So all this talk from Obama about adding to competition
is the exact opposite,
which is what everybody who's read this understands
and which is why they know he's lying to them
when he says,
"If you like your plan you can keep it."
Another way to look at that,
"If you like your plan, you can keep it,"
is:
What if everybody decided to do that,
but he says the health care plan, the system we have now is unsustainable.
It's horrible.

Yet if you like your plan you can keep it?
How do those two go together?
The next question that our classics professor at Duke wanted to figure out by reading the bill:
"Does the plan TAX successful Americans more THAN OTHERS?
Here is what the bill says, pages 197-198,
SEC. 441. SURCHARGE ON HIGH INCOME INDIVIDUALS
'SEC. 59C. SURCHARGE ON HIGH INCOME INDIVIDUALS,"
and then it has the legalese.
Here's the evaluation of what it says:
"1. This bill amends the Internal Revenue Code.
2. Tax surcharges are levied on those with the highest incomes.
3. The plan manipulates the tax code to redistribute their wealth.
4. Successful business owners will bear the highest cost of this plan."
Successful small business owners, will bear the HIGHEST cost of this plan.


"Does THE PLAN ALLOW THE GOVERNMENT TO set FEES FOR SERVICES?
What it says, page 124,
Sec. 223, PAYMENT RATES FOR ITEMS AND SERVICES,"
and then the legalese of the bill.
The analysis or the evaluation:
"1. The government's authority to set payments is basically unlimited.
2. The official" commissioner, bureaucrats "will decide
what constitutes 'excessive,' 'deficient,' and 'efficient' payments and services.
Will THE PLAN increase the power of government officials to SCRUTINIZE our private affairs?
What it says, pages 195-196,
SEC. 431. DISCLOSURES TO CARRY OUT HEALTH INSURANCE EXCHANGE SUBSIDIES,"
then the legalese in the bill.

The evaluation:
"1. This section amends the Internal Revenue Code.
2. The bill OPENS UP income tax return information to federal officials.
3. Any stated 'limits' to such information are circumvented by item (v),
which allows federal officials to decide what information is needed.
4. Employers are required to report whatever information the government says it needs to enforce the plan,"
meaning your medical records, your employment records,
how you're living your life,
what kind of risk that's posing to the health care system.
Next:
"Does the plan automatically enroll Americans in the GOVERNMENT plan?
What it says, page 102,
Section 205, Outreach and enrollment of Exchange-eligible individuals and employers in Exchange-participating health benefits plan,"
then the legalese.
Here's the evaluation:
"1. Do nothing and you are in" the government plan.
"2. Employers are responsible for automatically enrolling people who still work.
Does THE PLAN exempt federal OFFICIALS from COURT REVIEW?

"What it says, page 124,
Section 223, PAYMENT RATES FOR ITEMS AND SERVICES,"
then the legalese and the evaluation.
"1. Sec. 1123 amends the Social Security Act,
to allow the Secretary to identify areas of the country
that underutilize the government's plan 'based on per capita spending.'
2. Parts of the plan are set ABOVE THE REVIEW of the courts."
So the question,
"Does THE PLAN exempt federal officials from court review?"
and parts of the plan do.
This is Mr. Lewis again.
His name is John David Lewis, professor of classics at Duke University.
He's a common, average citizen.
He's not a lawyer, not a doctor.
What this goes to show is,
just about anybody can figure out what's in this bill
if they just take the time to read it.
And a lot of people have,
and the people showing up at these town hall meetings saying "NO,"
already know what this bill says and the elements to it, or of it,
that I just shared with you.

END TRANSCRIPT

Read the Background Material...


Classical Ideals: The Health Care Bill: What HR 3200, 'America's Affordable Health Choices Act of 2009'- John David Lewis

Sweetness & Light: What The Health Care Bill Actually Says


*Note: Links to content outside RushLimbaugh.com usually become inactive over time.

[Yosemitest]

Thank you very much, Rush.
And thank you too, Ph.D. John Lewis.

Here's some more from Professor Lewis.



John Lewis: The Boston Tea Party Speech, July 4, 2009 (Part 1)


John Lewis: The Boston Tea Party Speech, July 4, 2009 (Part 2)

[Rummyfan]

Marking.

[Yosemitest]

Here are two laughs to put this into perspective.

EIB Parody: Obama Sings "Old People"

and this (click to play).

[freekitty]

OMG, Your whole life will be owned by the government. This bill must not pass and Obama needs to go.

[theKid51]

ping
for later

[Islander7]

Book marked:

Sarah Palin's FaceBook response to 0bama mocking her concerns about 'death panels'.

--------------------------------------------------

Yesterday President Obama responded to my statement that Democratic health care proposals would lead to rationed care; that the sick, the elderly, and the disabled would suffer the most under such rationing; and that under such a system these “unproductive” members of society could face the prospect of government bureaucrats determining whether they deserve health care.

The President made light of these concerns. He said:

“Let me just be specific about some things that I’ve been hearing lately that we just need to dispose of here. The rumor that’s been circulating a lot lately is this idea that somehow the House of Representatives voted for death panels that will basically pull the plug on grandma because we’ve decided that we don’t, it’s too expensive to let her live anymore....It turns out that I guess this arose out of a provision in one of the House bills that allowed Medicare to reimburse people for consultations about end-of-life care, setting up living wills, the availability of hospice, etc. So the intention of the members of Congress was to give people more information so that they could handle issues of end-of-life care when they’re ready on their own terms. It wasn’t forcing anybody to do anything.” [1]

The provision that President Obama refers to is Section 1233 of HR 3200, entitled “Advance Care Planning Consultation.” [2] With all due respect, it’s misleading for the President to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients. The issue is the context in which that information is provided and the coercive effect these consultations will have in that context.

Section 1233 authorizes advanced care planning consultations for senior citizens on Medicare every five years, and more often “if there is a significant change in the health condition of the individual ... or upon admission to a skilled nursing facility, a long-term care facility... or a hospice program." [3] During those consultations, practitioners must explain “the continuum of end-of-life services and supports available, including palliative care and hospice,” and the government benefits available to pay for such services. [4]

Now put this in context. These consultations are authorized whenever a Medicare recipient’s health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is “to reduce the growth in health care spending.” [5] Is it any wonder that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care? As Charles Lane notes in the Washington Post, Section 1233 “addresses compassionate goals in disconcerting proximity to fiscal ones.... If it’s all about alleviating suffering, emotional or physical, what’s it doing in a measure to “bend the curve” on health-care costs?” [6]

As Lane also points out:

Though not mandatory, as some on the right have claimed, the consultations envisioned in Section 1233 aren’t quite “purely voluntary,” as Rep. Sander M. Levin (D-Mich.) asserts. To me, “purely voluntary” means “not unless the patient requests one.” Section 1233, however, lets doctors initiate the chat and gives them an incentive -- money -- to do so. Indeed, that’s an incentive to insist.

Patients may refuse without penalty, but many will bow to white-coated authority. Once they’re in the meeting, the bill does permit “formulation” of a plug-pulling order right then and there. So when Rep. Earl Blumenauer (D-Ore.) denies that Section 1233 would “place senior citizens in situations where they feel pressured to sign end-of-life directives that they would not otherwise sign,” I don’t think he’s being realistic. [7]

Even columnist Eugene Robinson, a self-described “true believer” who “will almost certainly support” “whatever reform package finally emerges”, agrees that “If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending.” [8]

So are these usually friendly pundits wrong? Is this all just a “rumor” to be “disposed of”, as President Obama says? Not according to Democratic New York State Senator Ruben Diaz, Chairman of the New York State Senate Aging Committee, who writes:

Section 1233 of House Resolution 3200 puts our senior citizens on a slippery slope and may diminish respect for the inherent dignity of each of their lives.... It is egregious to consider that any senior citizen ... should be placed in a situation where he or she would feel pressured to save the government money by dying a little sooner than he or she otherwise would, be required to be counseled about the supposed benefits of killing oneself, or be encouraged to sign any end of life directives that they would not otherwise sign. [9]

Of course, it’s not just this one provision that presents a problem. My original comments concerned statements made by Dr. Ezekiel Emanuel, a health policy advisor to President Obama and the brother of the President’s chief of staff. Dr. Emanuel has written that some medical services should not be guaranteed to those “who are irreversibly prevented from being or becoming participating citizens....An obvious example is not guaranteeing health services to patients with dementia.” [10] Dr. Emanuel has also advocated basing medical decisions on a system which “produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated.” [11]

President Obama can try to gloss over the effects of government authorized end-of-life consultations, but the views of one of his top health care advisors are clear enough. It’s all just more evidence that the Democratic legislative proposals will lead to health care rationing, and more evidence that the top-down plans of government bureaucrats will never result in real health care reform.

[1] See http://blogs.abcnews.com/politicalpunch/2009/08/president-obama-addresses-sarah-palin-death-panels-wild-representations.html.
[2] See http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf
[3] See HR 3200 sec. 1233 (hhh)(1); Sec. 1233 (hhh)(3)(B)(1), above.
[4] See HR 3200 sec. 1233 (hhh)(1)(E), above.
[5] See http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf
[6] See http://www.washingtonpost.com/wp-dyn/content/article/2009/08/07/AR2009080703043.html].
[7] Id.
[8] See http://www.washingtonpost.com/wp-dyn/content/article/2009/08/10/AR2009081002455.html].
[9] See http://www.nysenate.gov/press-release/letter-congressman-henry-waxman-re-section-1233-hr-3200.
[10] See http://www.ncpa.org/pdfs/Where_Civic_Republicanism_and_Deliberative_Democracy_Meet.pdf
[11] See http://www.scribd.com/doc/18280675/Principles-for-Allocation-of-Scarce-Medical-Interventions.

[HiTech RedNeck]

I hope Dr. Lewis referenced the correct plan du jour, because they’re juggling a handful of them in the shell game on Capitol Hill.

[screaminsunshine]

You got it. I am retired from the health ins. biz. I was a large group rating and marketing rep. The advent of managed care was when it started going downhill. HMO plans were started and at first were cheaper but soon the cost could not be controlled and the people HATED it. The government option is flawed. First the option is not “optional”. It will turn several of the largest insurers in to administrative services companies only. Smaller companies will get out of the business. The Federal government will become the “gatekeeper”. Deciding who can recieve what services. Every election will be about health insurance and the benefits. The Federal Government will “manage”. Every aspect of life. I hope the people rise up and stop Obama.

[freekitty]

I remember in the 80s I saw my first HMO. We hated it. Back then we couldn’t get in to see a doctor from the very first. The reason from the doctor they are not taking any new patients. Unbelievable. Two weeks later we had a meeting and got rid of the plan.

People should know how our parents and grandparents thought. They would never allow government including local and state to interfer. They knew by allowing the government to help; they would become slaves.

[driftdiver]

“Your whole life will be owned by the government.”

And thats their goal.

[kindred]

[How will the government ... pay for all this?
“Higher taxes, more borrowing, printing money, cutting payments, or rationing services]

The US government is destroying America and resists all attempts to fix any problem but does the worst job for all peoples.
It is corrupt and stinks to high heaven and may the Lord judge those people who support the legislation and never allow them to hold public office anymore.

[wastoute]

The libtards can continue to pretend that if they feed the unicorn the right kind of stuff they can get the skittles. Rality is that unless we do specific things the mess the politicians have made will just get messier. Social Security and Medicare are unsustainable. Period. They both have to end.

What takes their place? Free market. It is the only solution. This is why Medical Savings Accounts will ultimately be the only answer. Let people decide for themselves what services they will pay for. There will continue to be terrible stories about 5 year olds with menningitis and such and the answer to these needs to be charity. Good old fashioned charity. The libtards have successfully brainwashed most of the U.S. into accepting their premise that your tax dollars relieve you of your obligation to be charitable. This kind of thinking has led the recipients of this charity to consider it a right. This is unacceptable. You can never use gummint to take what is someone else's and consider it your right. Period. This has to stop. It also is unsustainable.

Until actions that actually fix problems are taken, the problems will just get worse.

Μολὼν λάβε

[freekitty]

Exactly and they have convinced their voters that is Utopia; which is so far from the truth as it can get.

[uncbob]

Why isn’t this video clip getting more publicity especially from the talk show hosts

http://hotairpundit.blogspot.com/2009/08/new-video-from-nakedemperornews-mother.html

[screaminsunshine]

Right. They were popular at first. But then the Doctors, Patients and providers got very angry when the insurance company got in between and tried to make decisions. Obama has a plan to turn the whole USA in to one huge HMO of very low quality with 200,000 buerocrats and 50 new government agencys between a doctor and a patient. It will be a total catastrophe. He is lying from start to finish.

[SES1066]

BTT for later read.

[freekitty]

Watch out now, Obama and Co have started to bring people on tv to pretend to be mad at the conservatives. They are, of course, lying big time and they want to make you mad for whatever.

[screaminsunshine]

Well you need to watch MSNBC and whatever they do not like...Do a lot more of it.

[MeekOneGOP]

RUSH: A Duke Professor Explains WHAT THE HEALTH CARE BILL ACTUALLY SAYS

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Pingin' my General Interest AND Texas Lists here cuz I thought you'd wanna know!

Thanks for posting this, Yosemitest!! :)

Ping! Ping! Ping!

[EdReform]

BTTT