My Congressman on PelosiCare: He's an idiot. Here's how. Can't help you with why.

by: Clyde Middleton   posted: 2009-11-12 22:02:00
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I live in PA-11. Paul E. Kanjorski (D) has repped this district since 1985. He won last cycle by just three points. Although I am slightly out of there, the majority of his district is in NEPA - northeastern Pennsylvania. Scranton, Wilkes-Barre, Hazleton: The region the coal companies trashed and left generations ago. If you think the unions and mafia are not monozygotic twins, then you don't come from here. As a kid, we routinely did our trick-or-treating in bars. More often than not, one of us had to stay outside because our dad was in there. Our jobs are factories, call centers, tourism, and health care. Our priests were pedophiles, and we just removed two trial judges for corruption because they sold juvenile delinquents to detention facilities for a total of $2.8 million. We have "cancer alleys" that remain open secrets lest someone drive away yet another employer. You want to know how bad it is? True story - this past weekend I was in Allentown - 90 minutes south. I met a homeless guy that left here.

So atop all this luster, sits a 13-term congressman, Paul Kanjorski. Good Polish name. I'm Lithuanian and from Scranton, so I can write things like that. Paul has voted for the Stimulus, Waxman-Markey's Cap & Trade, and now PelosiCare. I just got his letter explaining his vote for PelosiCare. Let's dissect it.

Thank you for informing me of your concerns about H.R. 3962, the Affordable Health Care for America Act. I appreciated hearing from you on this important issue.

You're welcome. I sent two letters and called your office. Got the answering service. She was nice.

As you may know, the Congress is currently considering legislation to reform our health care system. The House of Representatives recently considered H.R. 3962, the Affordable Health Care for America Act. After careful consideration, I decided to vote in favor of this legislation and the House passed H.R. 3962 by a vote of 220 to 215.

Tell me about "careful," Paul.

Obtaining health insurance at an affordable price has increasingly become a major concern for many American families. Too many of the estimated 47 million Americans without insurance rely on trips to the emergency room when they are very sick rather than see a doctor routinely to stay well. In addition, many of those who do have insurance have inadequate coverage. More than half of all bankruptcies filed in the United States are a result of medical bills. While this health care legislation is not perfect, action to address these issues is absolutely necessary.

Assertion 1: Obtaining health insurance at an affordable price. All depends on the definition of "affordable." If we presume that the current cost of health care is not affordable, else why do this at all, then one would logically presume that a plan that costs more than current private plans would not be "an affordable price." Sound good? Then try this on for size: "[A] plan paying negotiated rates would attract a broad network of providers but would typically have premiums that are somewhat higher than the average premiums for the private plans in the exchanges." The quote is from CBO chief Doug Elmendorf.

Assertion 1: FALSE

Assertion 2: 47 million Americans without insurance. "Americans," you say. So, illegal aliens are now "Americans"? That's like someone breaking into your home, Paul, and when you scream "What are you doing here?!" they respond with, "I live here." Um, duh?

Let's take apart "47 million Americans." BTW, I can't believe how sloppy you are in a standard letter sent to all constituents. I really hoped you'd be more professional than this. Anyway ...

First, where did your number come from? The US Census Bureau citing 2006 data. That's kinda old, Paul. But here's an interesting fact to start: 9,283 of the 46,995 without insurance earn more than $75,000 a year. Check the Census source yourself, page 21. "No insurance" seems to be a choice.

Now, Dominick T. Armentano is professor emeritus in economics at the University of Hartford (Connecticut) and a research fellow at The Independent Institute in Oakland, CA. He issued an analysis from MONTHS AGO. There's no excuse for not knowing this (op cit. "hoped you'd be more professional"). Even Obama stopped using 47 million, and reduced it to 30 million - still a bad number. Here's the breakdown:

- 10 million illegal aliens
- 17 million people who make more than $50,000 per year and who, for whatever reason, decide not to carry health insurance
- 10 million people are between jobs and will re-acquire health insurance coverage with a new employer in about four months
- [unstated number] millions of adult Americans and children who have nearly free access to medical care benefits through Medicaid and other government programs who don’t really need the direct cost of health insurance and who don’t carry any

Conclusion: "Less than 10 million individuals who are so-called “chronically uninsured.” (The Kaiser Family Foundation says the number could be as low as 8 million). These are individuals who have been unemployed for over 2 years and/or people from households that are too poor to afford non-employer health insurance premiums and who, for whatever reason, have limited access to taxpayer-supported health services."

Assertion 2: FALSE

Assertion 3: They go to the ER when they get very sick which would not happen is they routinely saw a doctor to stay well. Laughing. Sorry. Kinda. No, not really. This is a strawman, Paul, that any high-school debater can blow through in a second. I am disappointed that you fell for it.

Look, assume some disease has a 2% occurrence rate. That is, 2% of the general population will get that condition over their lifetime. Assume that if the condition is not diagnosed early or treated after diagnosis that it is fatal. Further assume that if screening is done, that the occurrence rate can drop to 0.5%. That is, half a point is going to get it and die anyway.

Now, you are suggesting that if we screen 100% of the population that we can achieve this lower rate of 0.5%. On paper, let's accept that you are right. however, you're all about saving money, Paul. The cost to society of screening 100% of the population for condition exceeds the cost of treating the 2% when they contract it! Don't believe me? Read this:

Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.

That's from the CBO, who you cite so often when their data supports the conclusion you desire.

Assertion 3: TRUE, BUT UTTERLY USELESS STATEMENT

Assertion 4: Half of all bankruptcies in the US are a result of medical bills. Really? Um, no, and you should be ashamed of yourself as an attorney using language so loosely. Your condemner, Paul, is no less than ABC News.

Let me give you an out, first, before I share the rest: Himmelstein today told me that he’s comfortable saying medical costs, as his study defines them, are “a cause” but not “the cause” of bankruptcies. In his view, “It’s accurate to say medical problems cause half of bankruptcies. There may be other conditions as well but medical problems were causal. I wouldn’t be comfortable with it as the ‘only’ cause.”

You see that? It's like me having 50 debts, one of which is a medical debt. With the other 49, I would still file BK, but it is "accurate" to say that the inclusion of medical debt "caused" my BK. Really, Paul, this is weak. Why do go here?

Here's a long quote from the ABC News article. If you go to the source, some of the words are hyperlinks:

The figure comes from a 2005 Harvard University study saying that 54 percent of bankruptcies in 2001 were caused by health expenses. We reviewed it internally and knocked it down at the time; an academic reviewer did the same in 2006. Recalculating Harvard’s own data, he came up with a far lower figure – 17 percent.

A more recent study by another group, approaching it another way, indicates that in 2007 about eight-tenths of one percent of Americans lived in families that filed for bankruptcy as a result of medical costs. That rings a little less loudly than “one every 30 seconds.”

The extrapolation of Harvard’s data to “a bankruptcy every 30 seconds,” which Obama also mentioned in his address to a joint session of Congress last month, comes, per the White House, from a 2005 Washington Post op-ed by Prof. Elizabeth Warren, a co-author of the Harvard paper. Fact-check.org has noted that even using Harvard’s numbers, it’s more like a bankruptcy every minute; indeed if you add up all bankrputcies in a year you barely get one every 30 seconds. (I've e-mailed Warren for comment.) But more to the point is that the Harvard data are clearly inflated, or at best, mischaracterized.

I hope this clarifies things for you. You can issue a retraction anytime.

Assertion 4: FALSE

Assertion 5: This legislation is not perfect. Got that right, cowpoke (I mean that as a verb).

Assertion 5: TRUE BUT POINTLESS

As you may know, H.R. 3962 would make reforms to insurance coverage like requiring insurers to provide coverage for pre-existing conditions; creating a voluntary government-run insurance plan; establishing a health insurance exchange to provide information about plans available in a certain area; and improving the Medicare prescription drug program by reducing drug costs and working to close the donut hole.

Assertion 6: Require insurers to cover pre-existing conditions. Yes, it will. And maybe you can help me here, Paul, with your crack staff. I can't seem to track down a study to support this anecdotal observation.

I was listening to the radio a few months back, and an insurance guy called in to discuss health care. He said that there's a problem with covering pre-existing conditions. After HillaryCare died, co-ops seeded by the government were formed. The cop-ops were intended to be non-profit. The first year, everything was happy. The government money got them going. Pre-existing conditions were covered. The second year, premiums were set to reflect the operating loses the co-ops incurred largely because of the pre-existing conditions coverage. Premiums, in fact, doubled. There was no third year. The co-ops failed.

You were around then, Paul. Remember?

In PelosiCare, every insurer will be required to accept every applicant regardless of health. Do I also recall that no premium for pre-existing conditions could be charged?

Covering pre-existing conditions should be done, but by the government. Every time you guys get your hands on manipulating private industry the Rule of Unintended Consequences arises, and economic chaos ensues.

Assertion 6: TRUE, UNFORTUNATELY

Assertion 7: Creates a voluntary government-run insurance plan. Voluntary? After 2013, private insurance companies can no longer write private policies. Will states be able to opt out? Not yet, but when they can you will burden the opt out just like you have the education system making it economic suicide to do so. Further, what will employers do in response to the mandate to buy insurance? Transit from employees to independent contractors, who, in turn, will not be able to buy private insurance. Voluntary? Ever hear of cause and effect?

Assertion 7: TRUE BUT MISLEADING

Assertion 8: Creates a health-insurance exchange. Sigh ... so what? See above.

Assertion 8: TRUE BUT MISLEADING

Assertion 9: Reduces drug costs. Reduce revenue to drug companies, and you will reduce research investment. Reduce research investment, and you stagnant progress. Is that what you want? Try regulating the FDA.

"Finding one successful new drug means investigating roughly 67 to 100 possible compounds. The following table shows the stages of drug research and how they winnow the candidates down."

Stage	Time	Remaining compounds
Concept/discovery	1-2 years	100
Screening	1 years	20-30
Testing with animals and human cells in test tubes	2-3 years	12-15
Testing for safety in healthy people (clinical phase I)	1-2 years	4-5
Testing for effectiveness (clinical phase II)	1-2 years	2-3
Wider testing for effectiveness (clinical phase III) and FDA approval	2-3 years	1.0-1.5

[Adapted from Millennium Pharmaceuticals, 1999.]

"Cost estimates for developing a single new drug range from a minimum of $250M to as much as $900M. The most-often cited cost is $500M."

Tell me, what drug on the market today would you give up?

Assertion 9: TRUE, UNFORTUNATELY

Many opponents of this bill have raised concerns about increased government spending. While these concerns have considerable merit, if we do nothing to reform health care, health care costs are expected to double over the next ten years, just as they have over the last ten years. H.R. 3962 attempts to reduce the costs of insurance to employers and employees by providing greater competition among insurers. In addition, this legislation works to provide subsidies to lower income individuals to purchase health insurance. It is estimated that 96% of all Americans will have access to affordable health insurance under this bill.

Assertion 10: Increased government spending is a concern. Concern to who? Us taxpayers? Yes. But you wrote this letter. Is it a concern to you? Obviously not. Headline:

Federal Deficit Hits October Record of $176 Billion. I'm not going to bother listing the trillions of dollars you have approved - deficit spending all.

Assertion 10: FALSE

Assertion 11: If we do nothing, health-care costs will double in ten years. Using the Rule of 72, that means that the health-care inflation rate is estimated to be 7.2% without this monstrosity of a bill. Is that an absurdly high number? Dunno. Let's go to the American Thinker for some information:

The HMO Act of 1973 provided grants and loans to provide, start, or expand a Health Maintenance Organization (HMO); removed certain state restrictions for federally qualified HMOs; and required employers with 25 or more employees to offer federally certified HMO options. The Act gave HMOs greater access to the employer-based market, providing for the rapid expansion of HMOs and was synergistic with Medicare and Medicaid in decreasing out-of-pocket expenses.

In addition, state regulations have increased and now require health insurance companies to cover a ridiculous range of health care services including but not limited to: acupuncture, breast reduction, contraceptives, dieticians, drug abuse treatment, hair prosthesis, in vitro fertilization, massage therapy, etc. and this has had a profound effect on health care inflation. All these policies have had the net effect of changing the way Americans pay for health care services, by precipitating the change from catastrophic medical insurance to "comprehensive" health care coverage.

When a third party pays the cost of routine health care services, consumers become insensitive to prices, quality, and choice of care setting. Individuals respond to lower cost-sharing (more comprehensive coverage) by utilizing more care, as well as more expensive care because they do not face the full price of their decisions at the point of utilization.

The RAND Health Insurance Experiment provides a case study on how "comprehensive" health insurance leads to the over utilization of health care services and thus, health care inflation. In the RAND study, health insurance coverage was randomly assigned to individuals and subsequent health outcomes were compared across experimental groups. These groups were assigned health insurance with varying levels of coverage or cost-sharing. The RAND experiment found NO significant effect of the level of benefit coverage on various measures of health status for the average adult however, total health care spending increased significantly as benefit coverage increased.

The lesson from the RAND experiment is that providing "comprehensive" care leads to the over utilization of health care services without providing any real health benefits.

Let me distill for you the above paragraphs, Paul: When government got involved in health care by requiring more and more basic coverage, the cost of providing that coverage increased. When costs of providing coverage goes up, it is called "health-care inflation." You clowns stay out of our health care and HC inflation will moderate. Instead, what do you do? March in like a herd of elephants. You create a problem, and then complain about it? Have you no ethical center at all?

Assertion 11: TRUE BUT MISLEADING

Assertion 12: This bill creates more competition. If by competition, you mean a public option that unfairly can compete across state lines when the insurance companies cannot, then that is not true competition. If by competition you mean a higher priced policy (see Assertion 1) offered by the government, then you don't understand capitalism.

Assertion 12: FALSE.

Assertion 13: This bill will provide subsidies to lower-income individuals. "Lower-income" is set as a function of the Federal Poverty Level. Here's a schedule of your subsidies:

	Individual		Family of Four
% of FPL	Median Income	Subsidy	Median Income	Subsidy
100-150%	$ 14,700	96%	$ 30,000	97%
150-200%	$ 20,600	83%	$ 42,000	87%
200-250%	$ 26,500	64%	$ 54,000	74%
250-300%	$ 32,400	42%	$ 66,000	58%
300-350%	$ 38,300	19%	$ 78,000	41%
350-400%	$ 50,100	0%	$ 90,100	26%

Are you going to subsidize? Absolutely. A family making $90 grand a year will get a kickback from the government. How nice.

Perhaps here is where it is appropriate to mention who is paying this kickback: Employer Mandate Excise Tax (Page 275), Individual Mandate Surtax (Page 296), Medicine Cabinet Tax (Page 324), Cap on FSAs (Page 325), Increased Additional Tax on Non-Qualified HSA Distributions (Page 326), Denial of Tax Deduction for Employer Health Plans Coordinating with Medicare Part D (Page 327), Surtax on Individuals and Small Businesses (Page 336), Excise Tax on Medical Devices (Page 339), Corporate 1099-MISC Information Reporting (Page 344), Delay in Worldwide Allocation of Interest (Page 345), Limitation on Tax Treaty Benefits for Certain Payments (Page 346), Codification of the “Economic Substance Doctrine” (Page 349), Application of “More Likely Than Not” Rule (Page 357).

And if we don't play along? Pelosi think jail is "very fair." What the hell is wrong with you, Paul? how you lost your soul?

Assertion 13: TRUE, INSULTINGLY SO.

Assertion 14: 96% of all Americans will have access to affordable health insurance. You write above that 47 million are without insurance. Well, we trashed that number, but let's work with it for a moment. There's 304 million people in the country. Forty-seven million is 15%. You're going to cover 96% of all Americans. The remaining 4% is 13 million. So you are offering a 72% solution at a cost of a trillion dollars. Really? Is that the best you can do?

Let's work with Obama's statement (which we all know is false because there is already Constitutional precedent to the contrary) that this bill not cover illegals. That brings 47 million down to 37 million. You are therefore presenting a 65% solution. For a trillion dollars? Whew, you guys suck at this.

Tell me this: Which 13 million won't have access?

Assertion 14: TRUE, BUT I CAN'T BELIEVE YOU ADMITTED IT.

While there are many detailed provisions in this complex legislation, it is important to note what the bill does not do. The only effect it will have on senior citizens who rely on Medicare is it will reduce their out-of-pocket costs for prescription drugs. The bill does not use tax dollars to pay for abortions. It does not require our smallest businesses to pay for insurance coverage for their employees. It will not result in the federal government controlling the delivery of health care; in fact, the non-partisan Congressional Budget Office (CBO) estimates that only six million Americans will choose to enroll in the government-sponsored insurance plan, the so-called "public option." It will not add to the federal deficit. CBO estimates that the bill will reduce the deficit by $109 billion over the first ten years.

Assertion 15: The only impact on senior citizens will be to reduce their out-of-pocket prescription costs. You lie! You are cutting $426 billion out of Medicare. And with a straight face you write that seniors will actually get MORE coverage?

Fraud is estimated at $60 billion a year. You going to waive a magic wand, greatly increase the size of government insurance, and somehow make all the fraud go away? You going to keep the $250 billion in doc cuts in place? Seniors have a hard time now finding docs to take Medicare (and others to take Medicaid). You're going to just wave something magical and all this goes away?

How in the Good Lord's name do you sleep at night?

Assertion 15: FALSE

Assertion 16: No taxpayer funds will be used to pay for abortions. Laughing. We both know the Conference Committee, if this ever gets that far, will re-insert it. You also know that some compromise will happen for the "health of the mother." And you probably also know that "health of the mother" includes depression and anxiety brought on by the concern of another mouth to feed. Don't play stupid, Paul. It hurts my feelings.

Assertion 16: TRUE, BUT ONLY TEMPORARILY

Assertion 17: Will not result in the federal government controlling delivery of health care. ROFL. Really? You devote 2,000 pages to regulating an industry, and that does not control delivery of health care? My, how finely you split hairs. True, the government won't tell the doctor how to do things, but it will tell him what he can and cannot do. The government will ration care - and you know that, Paul.

Assertion 17: TRUE BUT MISLEADING

Assertion 18: CBO estimates only six million Americans will choose to enroll in the public option. The CBO did not estimate the impact of the economy's adjustment to health-care mandates. The shift to independent contractors will be profound. That will result in at least 20 million enrollees. Funny thing is, they won't "choose" to enroll - that will have no choice. They enroll or get fined thousands of dollars.

Assertion 18: TRUE BUT MISLEADING

Assertion 19: CBO estimates deficit reduction of $109 billion over the first ten years. Have you actually read the CBO? All the qualifiers. They didn't see the actual bill in its final form. Seven years of expenses versus ten years of revenue. C'mon, Paul, really? Do you think we are this stupid?

Assertion 19: TRUE BUT MISLEADING

As you may know, the Senate will now consider its version of health care reform legislation. Any differences between the House-passed bill and a Senate-passed bill will be resolved through a conference committee made up of members from each chamber of the Congress, and the House and Senate will have to vote again on the legislation recommended by the conference committee. I expect that any bill which reaches the President's desk for signature will be significantly different from the House-passed version.

Assertion 20: He expects the final bill to be significantly different from the House-passed version. So now you can read the future? You mean Reid won't try to sneak in the House bill to control the Conference Committee? Is this some "I was against it before I was for it" Kerryesque education for us ... you know, where you Capital Hill people say in your own way that you're special and us commonfolk just can't understand the complexities of all that big-time stuff?

Assertion 20: TRUE BUT POINTLESS

Finally, this bill generated a great deal of interest among the people I represent and I have heard from many people with a variety of perspectives on the legislation. Please know that I gave these concerns serious consideration when making my decision to support H.R. 3962. As this bill continues to move through the legislative process, I encourage you to contact me with any additional thoughts you may have on this matter.

Assertion 21: He encourages me to contact him with additional thoughts on this matter. Why, Paul, so you can send me another generic response like the one above? If I can rip this to shreds, it makes me wonder about the veracity of your "careful consideration." Surely, a top-notch Congressional staff can do better. Right? After all, Paul, you're spending A TRILLION DOLLARS!

Assertion 21: TRUE BUT POINTLESS

Summary of Assertions:

3 TRUE BUT POINTLESS

1 TRUE BUT UTTERLY USELESS STATEMENT

6 TRUE BUT MISLEADING

2 TRUE, UNFORTUNATELY

1 TRUE BUT ONLY TEMPORARILY

1 TRUE, BUT I CAN'T BELIEVE YOU ADMITTED IT

1 TRUE, INSULTINGLY SO

6 FALSE

Not a very good score, Paul. You fail.

Tags: Pelosi, 

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