But do you know what's in it? If you think you do, then read on:
Where are the self-styled consumer champions when you need them? The
ones who comb out every nit lurking in the fine print of mortgages, car
loans and leases. The ones who want to list every ingredient on cereal
boxes and restaurant menus.
The American public is about to be
dealt the largest-ever package of consumer products and services whose
fine print runs on for hundreds of pages, but consumers are being given
little time to comprehend the particulars. I guess it doesn't matter
because consumers will have little choice but to agree to the terms
dictated to them.
You'll recall that Obama had insisted that the law be ready for his
signature in early August, a request so outrageous -- considering the
volume of the detail that had to be considered -- that now it seems
Even with an extra two months to consider the
various forms of the legislation, the president and Democrats still are
hotfooting it to foist something on a public that has little chance of
vetting thousands of pages of legalese. The House bill is more than
1,000 pages. In the Senate, a committee vote could come Tuesday on a
bill that isn't in writing yet, so there isn't any fine print to
The Senate legislation is embodied in something called
the "chairman's mark," which is a synopsis of the bill. It originally
was a 220-page document, drawn up under the auspices of the Senate Finance Committee chairman, Max Baucus, D-Mont. Detailed language will come later.
all the haste? Why not a full debate on the fine print? Because Obama
and the Democrats don't really want Americans to fully comprehend
what's in the bill. Obama and the Democrats are pulling a hustle every
bit as gigantic as the most greedy, unconscionable scam ever pulled by
Still, Democrats can't hide everything. Go to
pages 80 and 81 of the chairman's mark and you'll find in a weed patch
choked with "PQUIs," "CMSs" and other incomprehensible initials some
obfuscation that its critics call the "death spiral."
It reads: "Beginning in 2015, (Medicare)
payment (to physicians) would be reduced by 5 percent if an aggregation
of the physician's resource use is at or above the 90th percentile of
national utilization. After five years, the (health and human services)
secretary would have the authority to convert the 90th percentile
threshold for payment reductions to a standard measure of utilization,
such as deviations from the national mean."
Let's see if I can put this verbiage into English. If you're an oncologist with a heavy load of breast cancer
patients requiring expensive tests and treatments, the cost of what you
are authorizing could far exceed what the average general practitioner
authorized for his healthier Medicare patient caseload. If what you
prescribe is in the upper 10 percentile of per capita Medicare costs,
you'll automatically lose 5 percent of your Medicare reimbursements.
there's no consideration made for quality of care or results. You may
be prescribing the most effective and efficient care, but that doesn't
count. Notice also that, since some physicians always will end up in
the top 10 percentile (it's like teachers who grade on the curve, thus
ensuring that someone always fails) the pressure on doctors to reduce
costs would be constant. Thus, the death spiral.
O'Steen, executive director of National Right to Life Committee, which
opposes the provision, said it shifts the bad guy role from government
bureaucrats to physicians. "Instead of bureaucrats directly specifying
the treatment denials that will mean death and poorer health for older
people, it compels individual doctors to do the dirty work."
may or may not agree with this assessment, but it's unlikely you know
about this provision since it has received so little media attention.
In a private-sector hustle you can read the fine print and, more
important, you don't have to buy. When the snake oil salesman pulls
into town, you can ignore him. Not so with the Obama and Democratic
health care schemes. Whether you like it or not, you'll be signed up.
This column also appeared on The Chicago Tribune op-ed page.
From Reuters, here are are further details of the legislation.