Thanks, Senator Hagan!

Senator Hagan:

Thank you so much for the "Carolina Connection Special Edition: Health Care Facts" newsletter that you sent out earlier this evening.  Since I wrote you several times during the debate over the Health Insurance Reform bill, I appreciate seeing an update from you.  I know that you worked hard to put this together.  Alas, I see that you have called your newsletter "...Health Care Facts" when in fact, it appears to be largely about Health Insurance.  Well, except for the flu shots.

I thought that I would provide you with some additional information that Mssrs. Emanuel and Axelrod may not have provided to you.  In fact, I have reproduced your newsletter below and you will see my responses in blue.

Carolina Connection Special Edition: Health Care Facts newsletter begins:

In March 2010, the Patient Protection and Affordable Care Act

and the Health Care and Education Reconciliation Act

became law. So much information is circulating about health care reform, and sorting through it can be overwhelming and frustrating. This newsletter will help explain what the law does and what it means for you and your family. Other useful information about health care reform can be found atwww.healthreform.gov

.

Starting in the First Six Months...

• Insurers are prohibited from dropping coverage when you get sick.  Sounds great!  How will that affect premium costs? 
• Children with preexisting conditions will not be barred from coverage.  Excellent, I'm OK with this in principle, but again, how will this affect costs?  My expectation is that the insurers will estimate the added cost of a known condition and have no choice but to price it into their policies.
• Young adults up to age 26 can stay on their parents' plans.  As a father, I appreciate the sentiment, but I would prefer that my daughter learn to provide for herself.
• No more lifetime caps on coverage.  Well, this can only drive costs up.  You just invited the whole country to an all-you-can-eat buffet.  I will make a further projection; costs will rise rapidly to extract as much revenue as possible in as short a time as possible.
• Seniors hitting the "donut hole" will receive a $250 check.  Well, OK, the whole donut hole thing was dumb, anyway.  But why a check?  Why not just close the hole?  Why add the administrative cost of cutting a check for several million people?
• Eligible small business owners can receive a tax credit to help pay for health insurance premiums. I have a better idea:  cut taxes permanently in stead of "allowing" business owners to get a credit.  To a small business, cash flow is king and you are forcing small businesses to flow the cash out up to 16 months before they get the credit back.  That's called negative cash flow.  Why not a tax cut, which would create positive cash flow?

Middle Class Families

For middle class families, reform means:

• Tax credits will be available for almost one million North Carolinians to make health insurance more affordable. Again, I would rather have a permanent tax cut, not a deferred tax credit.  Cash flow is important to families, too.
• As many as 2.3 million children in NC will no longer be denied coverage because of a preexisting condition.  Who pays for that?
• Preventive care services, including well-child visits and annual flu shots, will be available at no extra cost.  OK, I'm calling an intentional foul here.  "At no extra cost"?  How do you provide all that for 2.3 million without incurring extra cost?  Will the doctors and vaccine makers simply donate their goods and services?  Somebody, somewhere will have to pay for that.  Who do you think that will be?  I deem this an intentional foul because I think you know that but you are waiving that phrase in front of less-careful readers.  After all, 24% of Americans think that "the government has money on its own without using taxpayer money".  See column here

  for source.  You are playing those people for suckers by saying "no extra cost".

Click here

to read more about the benefits for North Carolina's hardworking families.

Seniors

For NC seniors, the new law means:

• 247,000 NC seniors in the prescription drug "donut hole" will receive a $250 check this year.  See previous.
• The donut hole will be incrementally closed over the next several years until it is completely closed by 2020.  See previous, though this will also increase cost.  Still, the donut hole was silly to begin with.
• 1.4 million NC Medicare beneficiaries will have annual wellness visits and preventive services at no extra cost.  AAARRRGGGHHHH!  There you go again!

Click here

to learn more about the benefits for North Carolina's seniors.

Small Businesses

• Over 120,235 NC small businesses are eligible for tax credits to make premiums more affordable. Businesses won't have to choose between providing insurance and cutting jobs.  Wrong.  We need permanent tax CUTS, not credits, for cash flow reasons.  Worse, these credits phase out with the 26th employee.  The marginal cost for that 26th employee will be so great, that companies will be very hesitant to get much bigger than 20-24 employees.  Here, look at this short paper

  (PDF) for an excellent summary of this effect.

Click here

to read about how the new law will support small business owners.

Health Care Reform and NC Job Growth

• By slowing the health care cost growth rate and allowing businesses to expand employment, researchers anticipate that NC will benefit from as many as 7,100 - 11,400 new jobs per year over the next ten years.  Well, that isn't very many in a state of nearly 10 million.  No less an expert than Fed chairman Ben Bernanke testifying before Congress on April 14 said that job growth will be "slack"

  for years.  And then there is this, from CNN, headlined "Say Goodbye to Full Time Jobs with Benefits"

  .

For more information about how the law improves care and reduces costs, click here

.

Hagan Accomplishments

Senator Hagan included the following provisions in the new law:

• Rural Physicians Pipeline Act to address the shortage of primary care doctors in rural communities.  Good luck, hope it works.  But since I read that many doctors are choosing to get out of the business, I wonder where we will find the doctors we will need to treat the extra 30 million people that will be put on the plan.
• Catalyst to Better Diabetes Care Act to move toward reducing the diabetes epidemic. Exercise and diet.
• Medication Therapy Management Program (MTM) to save money and help seniors better follow their medication regimens.  Sorry, don't know what this one is.  Are we going to have someone visiting people and checking on their medication regimens?  Really?
• An amendment with Republican Senators Mike Enzi (R-WY) and Orrin Hatch (R-UT) to create a regulatory pathway for generic biologics.  Token Republican mention here all the way at the very end of the newsletter.

Senator Hagan, going through this little exercise has really clarified for me something that I knew all along and it is this:  Neither you nor the rest of the Democrats in Washington gave any thought at all on how to pay for this thing.  You have unleashed the law of unintended consequences in a very big way on our country and the effects of this will be with us for decades.  Right now, Canada is looking into ways to move to a more market/consumer driven model.  Britain's health care service is spewing red ink faster than the Deepwater oil well.  The Congressional Budget Office now points out that the bill will NOT hold costs down.  I refer you to the blog of the Director of the CBO, found here.

  It would have been nice to know this before you voted for the bill, don't you think?

See you at the ballot box!

DaveyNC