Existing Public Health Care "Death Panel" Rebuffed By Federal Court

Interesting that at the same time we were being told Sarah Palin's "Death Panel" comment was over the top, Hawaii attempted to implement that very thing as regards a public health care plan. They held no public hearings and didn't clearly state the ramifications to those most impacted. They just decided to save fifteen million bucks by withholding lifesaving care. Public health care - you're in good hands, oh yeah!

The issue is mildly complex given established public health care obligations as a result of nuclear tests in the Pacific Islands some time back. But the action the government attempted is very clear. When it came time to cut costs because of budget issues, the government attempted to withhold life saving health care under a plan called Basic Health Hawaii.

Funny, I always thought remaining alive was pretty basic when it came to one's health. But then I'm not a politician, so what do I know? Some key excerpts below, the entire AP item here.

HONOLULU (AP) -- A federal judge ruled Tuesday that Hawaii's government must continue providing lifesaving dialysis and chemotherapy treatments to Pacific island migrants suffering from kidney disease and cancer.

U.S. District Judge J. Michael Seabright granted a temporary restraining order preventing the state from instituting a new, limited health insurance program intended to save $15 million. The new health program was scheduled to start Tuesday.

Basic Health Hawaii was announced less than a month ago and without public hearings. Because many of the migrants don't speak English as their first language, they weren't able to understand how their coverage would change when they received notification letters or called an English-speaking automated phone help line.

"It appears the state made a unilateral decision to decrease benefits with little or no notice," Seabright said.

The ruling keeps in place broad health coverage for dialysis,chemotherapy, prescription drugs and doctor visits.

The cash-strapped state, facing a steep budget deficit, wanted to switch about 7,000 legal migrants to the new health insurance program. About 100 of them receive dialysis treatments paid by the state.

The state announced Monday it had found $1.5 million in annual federal Medicaid funding that would continue dialysis coverage for two more years, but chemotherapy and many name-brand prescription drugs were not included.

Migrants from the Federated States of Micronesia, the Republic of the Marshall Islands and the Republic of Palau are beneficiaries of the Compact of Free Association, a deal with the U.S. government providing financial assistance in exchange for defense rights.

Seabright prevented the new plan, called Basic Health Hawaii, from taking effect because its implementation may have violated due process rights guaranteed in the U.S. Constitution.

Seabright didn't decide whether the new plan violated constitutional guarantees of equal rights for all legal U.S. residents.

A hearing on a more permanent injunction will be held Oct. 19.

Comments

[Mark Turner]

Federated States of Micronesia, the Republic of the Marshall Islands and the Republic of Palau were all "Trust Territories" of the US, if I remember correctly. Guam and American Samoa might also fall under this category, and I imagine Puerto Rico, having commonwealth status, might also somehow currently benefit similarly from government-subsidized healthcare. If Hawaii's healthcare system is so strained with regard to financial solvency that they have to worry about a few thousand special cases of coverage, you can imagine what would happen if this gets taken to a national level. At best, it would be just a variant of Medicaid or Medicare (hardly examplary from a cost containment perspective), but the Dems are pushing far beyond that.

[Mark Turner]

Forgot US Virgin Islands also

[crosspatch]

The problem I have with nearly every government program is that they can sell it as one thing initially and then change the rules once it is in place. There has already be discussion on capitol hill, for example, of government taking people's 401K and IRA accounts and rolling them in to social security.

[crosspatch]

Oh, and as some have difficulty believing that Congress has been talking about confiscating IRAs, here is a link to a news article describing Congressional testimony:

http://www.carolinajournal.com/exclusives/dems-target-private-retirement-accounts.html

[WPE]

Hmmm - looks like the cut was done by Republican Governor Lingle, not the legislature.

Hawaii Sen. J. Kalani English, who's also president of the Association of Pacific Island Legislatures, did clarify yesterday that funding for programs that serve "our Pacific neighbors" was cut by the Lingle administration, not the Hawaii Legislature.

"In fact, both the Hawaii Legislature and the U.S. Congress are actively seeking ways to restore that funding and provide these vital services," English stated.

[crosspatch]

Isn't Obama proposing pretty much the same thing at the federal level for medicare?

http://directorblue.blogspot.com/2009/09/obama-slashes-medicare-in-2010-for.html

[WPE]

No, it isn't.

Please select the current Republican position on Medicare from the options below:

1. Medicare is going to be trillions of dollars in debt and take down the whole country.

2. Any attempt to control Medicare costs means Death Panels for Gramma.

[crosspatch]

Anyone who decides what treatments a person can or can not have based on political "correctness" or "statistics" sits on a "death panel". Oregon is a good example. Would a 75 year-old diabetic get quad bypass surgery? Today they could. Under the Democrats' plan it would be up to a medical commission (i.e. death panel) made up of "green eyeshade" types.

[North Dallas Thirty]

How typical. WPE, instead of dealing with the evidence provided, tries to spin and blame Republicans.

Obama really is a helpless child who can't take responsibility for anything. Every thing that goes wrong is someone else's fault. He's just a poor, helpless victim with no control over anything, no decision-making power, and no capability.

Meanwhile, #1 is correct and #2 is false. If Obama and the Obama Party actually made an honest effort to contain Medicare fraud, as the Republicans want to do, that alone would save over $60 billion a year -- over 10% of the entire Medicare expenditure budget.

But Barack Obama isn't doing that. Furthermore, what Barack Obama is doing is not cutting costs; it's taking money out of Medicare to pay for OTHER programs. Barack Obama is planning to take the money that Gramma has paid into the system for over forty years under the promise that she would receive health coverage after she retired so that snot-nosed welfare brats like WPE who have never contributed a dime, since they don't pay taxes, can get free health insurance.

Why? Because Gramma votes against the welfare Barack and WPE votes for him. Barack is purchasing votes from the young and eliminating the elderly as a consideration in future elections.

[WPE]

Obama is working on cutting fraud.

Sounds like the only answer you have to the Medicare problem is "cut fraud". That ain't gonna do it.

But it's nice of you to defend Socialized Medicine. I love it when conservatives tell us how great Medicare is after telling us how bad socialized medicine is.

"Cabinet officials commenting on this week's trio of Medicare fraud crackdowns in Miami and other cities pushed an emerging two-pronged approach, focusing on fraud prevention as well as prosecutions."

[North Dallas Thirty]

"But it's nice of you to defend Socialized Medicine. I love it when conservatives tell us how great Medicare is after telling us how bad socialized medicine is."

Um, no.

What I recognize at this point is that Gramma has paid into Medicare for forty-plus years, so we're on the hook to deliver at this point for her.

But in my opinion, people my age and younger should be offered an option; you can either continue to have 3% deducted from each paycheck to go to Medicare, or you can choose to have 3% of each paycheck shielded from taxation with the express intent that you will save that money for your future health care. For those who are older than I am, but not yet eligible for Medicare, they can continue on the 3% per paycheck, or they can have 6 - 12%, depending on their age, shielded from taxation -- essentially, the government paying them back for the money they've already contributed -- with the express intent that they will save that money for their future health care.

That does four things; it vastly reduces the government's future indebtedness for Medicare as people opt out, it helps avoid Medicare fraud by requiring people to actually be positively enrolled and trackable in order for Medicare claims to be submitted on them, it completely eliminates the tax burden and expense on employers for Medicare, and it puts more money in the hands of employees to do with as they see fit.

Unfortunately for you and your fellow Obamabots, it also cuts off a major funding stream that you plan to divert to purchase votes instead of providing health care for seniors, which is why you would be screaming like stuck pigs about it.

Fortunately, when you start your usual screaming about how cutting Medicare funding streams is pulling the plug on Gramma, we now have your own statements about how cutting Medicare funding is NOT pulling the plug on Gramma -- which will demonstrate once and for all about how your concern with Medicare is not cutting costs, but in how you can take services away from those who actually contributed but don't vote your way to give kickbacks to those who don't contribute, but do vote your way.

[WPE]

"it vastly reduces the government's future indebtedness for Medicare as people opt out"

Doubtful. Healthy will opt out, the less healthy won't, particularly ones with problematic medical histories. Medicare actually has a higher satisfaction rating than commercial insurers, coverage is for the most part better.

"Unfortunately for you and your fellow Obamabots, it also cuts off a major funding stream that you plan to divert to purchase votes instead of providing health care for seniors, which is why you would be screaming like stuck pigs about it."

Not interested in trying to refute your delusions.

They're not taking away any services.

Again, conservatives have continually based Medicare as socialized medicine, tried to frighten people with the terrible spectre of government health care, but here you are, defending it.

Even your Tax-hating Tea-baggers arm themselves with signs warning the government to keep its hands off their Medicare. Hypocrites or just ill-informed. We Report. You Decide.

[North Dallas Thirty]

"Doubtful. Healthy will opt out, the less healthy won't, particularly ones with problematic medical histories."

LOL....and there we get a lesson in liberal "logic".

Currently Medicare pays for both the healthy and the less healthy. For example, let's say Medicare pays $200 per year for a healthy person and $800 a year for a less-healthy person, for a total of $1,000 in government indebtedness.

If the healthy person opts out and goes elsewhere, Medicare is no longer paying for their care; therefore, instead of paying $1,000 total, Medicare is now paying $800 for the less-healthy person and nothing for the healthy person, for a total of $800 in government indebtedness.

But according to the liberal, $800 is the same or greater than $1,000.

Next up:

"They're not taking away any services."

Oopsie.

http://www.bloomberg.com/apps/news?pid=20601070&sid=apv3pcTOWVjk\

"Again, conservatives have continually based Medicare as socialized medicine, tried to frighten people with the terrible spectre of government health care, but here you are, defending it."

What I and those protesters are talking about is the attempt by your Barack Obama to deny care to people who have spent over forty years paying for it so that he can divert it to people like you, who haven't contributed a dime, just because you vote for him and they don't.

If anything, this has done a tremendous job of showing how "socialized medicine" is dangerous. Private insurance companies can be sued. The government can't be. These people have been forced by law to pay you and your fellow leftists a huge chunk of their earnings, and now you are denying them what you promised them. You've actually made the argument even stronger against socialized medicine by showing that the government has no intention of keeping its promises that were made in exchange for payments.

Medicare needs to be gone, but not before it finishes its obligations.

[WPE]

You do realize there's a revenue side as well? So your example is BS.

Since you're so determined to protect Medicare from even the sniff of a possible cut, don't bitch about the Medicare deficit.

Reality check - Medicare's not going anywhere. Seems once they actually use it, people lllooooovvvvveee socialized medicine.

https://www.cahps.ahrq.gov/content/NCBD/Chartbook/HEALTHPLAN08/cahps08chart19.htm

[North Dallas Thirty]

"You do realize there's a revenue side as well? So your example is BS."

Nope, my example makes perfect sense. You simply are incapable of understanding basic logic because you're an Obama Party liberal.

"Since you're so determined to protect Medicare from even the sniff of a possible cut, don't bitch about the Medicare deficit."

What I have proposed doesn't cut Medicare to existing legitimate beneficiaries at all; it simply cuts billions of dollars in fraud to Obama Party voters and supporters. Furthermore, it gives people the option to do without Medicare, reducing the government's overall costs and indebtedness. Obama Party welfare voters like yourself can stay in Medicare all you want; people who can do better with their money have the option to do better elsewhere.

Why does that so terrify liberals?

[WPE]

"Nope, my example makes perfect sense. You simply are incapable of understanding basic logic because you're an Obama Party liberal."

The government collects revenue which is later paid out in Medicare. Some people will require more $$$ of care than they've paid in and will cost the system net dollars. Some people will require less $$$ than they've paid in and be a net $$$ contributor to the system. All you account for is debits.

Again, your example is BS.

Your idea won't work. Commercial insurers aren't going to agree to be locked into providing lifetime care for 3% of your income. Do the math, it doesn't work.

But if you really think it's such a great idea, get one of your conservative legislators to write the bill.

[North Dallas Thirty]

"All you account for is debits."

That's because that's what costs are. You babbled about Medicare costs; I simply pointed out that removing people from Medicare would reduce the total costs. Basic, elementary business logic, but unfortunately beyond the capacity of an Obama Party liberal.

And another example of how Obama Party liberals are not even noticing how contradictory their talking points are.

"Your idea won't work. Commercial insurers aren't going to agree to be locked into providing lifetime care for 3% of your income. Do the math, it doesn't work."

FYI, 3% of your lifetime income is the approximate contribution that you and your employer make in total to Medicare for "lifetime care".

And what did you state happens with Medicare?

"Some people will require less $$$ than they've paid in and be a net $$$ contributor to the system."

You have already admitted that 3% is actually MORE than is needed to cover many peoples' "lifetime care". Why would a commercial insurer not agree to a situation in which they could charge MORE than it would cost?

Meanwhile, as for "doing the math", I certainly will. Let's take 3% of an average annual income of $50,000 over an entire working life, which equals $1,500 per year, invest it at a piddling 3% interest per year, and run that over the 43 years from a person entering the workforce at age 22 and exiting at 65.

http://www.moneychimp.com/calculator/compound_interest_calculator.htm

That totals out to be roughly $132k set aside by the time you get to be 65. 4% interest would be $171k and 5% would be $225k -- all rates obtainable by making good, simple investments, and way below the average return in the equity markets.

Now, given the average lifespan of Americans to be 78 years, that would be 13 years of health insurance to cover with that $132k, or a little over $10,000 per year in premiums. Heck, if you were a smart investor, you'd have over $17k per year to spend on premiums.

The reason you're not taught to do this in your talking points, WPE, is because Barack Obama and the Obama Party don't want you to make another calculation -- like what the total amount of 12.5% of an annual income of $50k, or $6,250, is when invested at 3% for the same 43 year period and divided by the average 13 years between eligibility at age 65 and death at age 78.

I'll give you a hint why; the maximum Social Security benefit per year is a lot, lot lower than that.

[WPE]

Medicare is underfunded - that's why they predict trillions in deficits for it. Or don't you admit that either? Again, you're not going to find a private insurer that will provide the quality or quantify of service Medicare does for 3% a year.

Privatization is a bad, bad idea. http://www.socsec.org/publications.asp?pubid=503

[North Dallas Thirty]

"Medicare is underfunded - that's why they predict trillions in deficits for it. Or don't you admit that either?"

Impossible. How can something that allegedly funds itself and, as the Obama Party claims, only has "3% administrative costs", run a deficit? Your Obama Party talking points are contradictory yet again.

"Again, you're not going to find a private insurer that will provide the quality or quantify of service Medicare does for 3% a year."

I repeat what you said previously.

"Some people will require less $$$ than they've paid in and be a net $$$ contributor to the system."

Again, you have already admitted that 3% is actually MORE than is needed to cover many peoples' "lifetime care" for Medicare-level coverage.

What you're doing is exposing the lies of socialized medicine. You and your fellow leftists claim socialized medicine reduces costs, then blabber about Medicare deficits. If socialized medicine were cheaper and more efficient than private insurance, there would BE no Medicare deficits.

[WPE]

What a moron. Ya think Medicare might have some other expenses than just administrative costs. Like the few trillion in drug benefits the Republicans tacked on?

Yes, it's true. Some people won't use all the dollars they pay in. Some will die early, some are so healthy then won't need much care. But there ain't many of them. far fewer than the number that will use MORE than they pay in. And no one can predict who they'll be.

Any system is cheaper than ours - including socialized medicine. US per capita costs for health care is over $7000. Highest, by far, in the world.

*****
http://www.oecd.org/dataoecd/46/2/38980580.pdf

Total health spending accounted for 16.0% of GDP in the United States in 2007, by far the highest share
in the OECD. Following the United States were France, Switzerland and Germany, which allocated
respectively 11.0%, 10.8% and 10.4% of their GDP to health. The OECD average was 8.9% in 2007.

The United States also ranks far ahead of other OECD countries in terms of total health spending per
capita, with spending of 7,290 USD (adjusted for purchasing power parity), almost two-and-a-half times
greater than the OECD average of 2,964 USD in 2007. Norway follows, with spending of 4,763 USD per
capita, then Switzerland with spending of 4,417 USD per capita. Differences in health spending across
countries may reflect differences in price, volume and quality of medical goods and services consumed.

[North Dallas Thirty]

"What a moron. Ya think Medicare might have some other expenses than just administrative costs."

So now Barack Obama has flip-flopped on his talking points and started whining that Medicare has more than 3% expenses. Got it.

"Like the few trillion in drug benefits the Republicans tacked on?"

Which Obama Party members completely and totally opposed, right?

As usual, Barack Obama whines and cries and refuses to take responsibility, instead trying to blame everyone else. How typical. People are realizing how childish he and his party puppets like you are.

"Any system is cheaper than ours - including socialized medicine. US per capita costs for health care is over $7000. Highest, by far, in the world."

And of course, by that logic, Mexico and Turkey have the best health care in the world because they're the cheapest.

Perhaps if you had read your own source, you wouldn't look so foolish.

"Differences in health spending across countries may reflect differences in price, volume and quality of medical goods and services consumed."

We pay more because we consume more services and of higher quality. You don't have to wait months here, you don't have to take a number because we have far more in the way of facilities, and you have the flexibility to choose your own health care. Those things all cost money, and we choose to pay that.

But you wouldn't know about that, because you're a welfare addict. Your only concern is increasing the size of your welfare check, and that's why you come up with all these elaborate rationalizations for why you should be allowed to steal from people who actually work and who pay their own way.

[WPE]

By the numbers, not your delusions, our health care isn't better than France's, Germany's, Japan's, Taiwan's, Canada's, etc. Our life expectancy isn't higher.

[WPE]

I thought conservatives were supposed to be hard-headed business men - run government like a business, cost-benefit analyze everything, get the most bank for your buck. Apparently doesn't apply to health care.

We spend way more than anyone but all that money doesn't buy us better health:

33rd on the Infant Mortality List

http://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate

35th in Life Expectancy

http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

"Despite spending lots more per capita on health care, the U.S. is often as bad or worse than other industrialized nations in wait times"

http://www.businessweek.com/technology/content/jun2007/tc20070621_716260.htm

Then there's preventable deaths. The US ranks last:

http://www.reuters.com/article/latestCrisis/idUSN07651650

[North Dallas Thirty]

"I thought conservatives were supposed to be hard-headed business men - run government like a business, cost-benefit analyze everything, get the most bank for your buck. Apparently doesn't apply to health care."

Oh, it very much does. That's why, for example, I support eliminating government-run health care, because it has consistently demonstrated a complete inability to control fraud and it runs massive, massive deficits.

Meanwhile, the market is already creating its own solutions to issues, as ironically one of your own sources points out.

"But the health-care market itself is beginning to address the issue, with the rise of walk-in medical clinics situated in retail stores. Hundreds of these clinics have sprung up in stores like CVS/Caremark (CVS), Wal-Mart Stores (WMT), and Pathmark Stores (PTMK), and they are rapidly growing. Usually staffed by nurse practitioners, they promise rapid care for minor medical problems, usually getting patients in and out in 30 minutes. The slogan for CVS's Minute Clinics says it all: "You're sick, we're quick.""

"We spend way more than anyone but all that money doesn't buy us better health"

Ah yes, the old leftist liberal talking points.

Here's a graph that is much more meaningful.

http://www.nationmaster.com/graph/hea_obe-health-obesity

Given the positive and strong linkage between obesity and premature and/or preventable death, the measure of the US health system is that we are nearly the same as France when it comes to preventable deaths and life expectancy -- despite having three times the obesity rate. That's like two countries having the same lung cancer rate despite having one having three times the smokers.

And what makes this pretty hilarious is that you know what most positively correlates for obesity in the United States? How poor and likely to be on welfare that you are.

http://www.sciencedaily.com/releases/2008/02/080207163807.htm

If you and your fellow leftists want to cut health care costs, maybe you should stop rewarding people for not working and being lazy. But that's not your point; your Barack Obama, for example, wants to smoke, but instead of accepting that he should pay more because he takes that deliberate risk, he babbles and whines that other people who don't smoke should be forced to pay more. He doesn't want to take responsibility for his behavior -- which is so typical of liberalism.

[WPE]

Still waiting for an explanation why we spend so much more than anyone else for so much less.

Over half the bankruptcies are due to health care costs and 80% of those people had health insurance.

Nice system.