If one ever doubted that the Obama Administration was all about power and control, they need to consider the following Washington Post story.

The Washington Post is reporting … 

“Obama Eyes The Purse Strings for Medicare:
Lawmakers Now Win Friends at Home by Setting Payout Rates”

How many citizens knew that Congressmen were allowed to assist in Medicare reimbursement rates – possibly on a legal “quid pro quo” basis that saw them altering rates upward in exchange for campaign funding and other support – all under the guise of providing “constituent” services?

“At the same time President Obama is asking members of Congress to take one of the most politically difficult votes of their careers, he is also pressing lawmakers to give up one of their most valued perks of office: boosting Medicare payments to benefit hometown providers.

“Setting reimbursement rates for local hospitals, doctors, home health-care centers and other providers is a legislative ritual that amounts to one of the most effective and lucrative forms of constituent service. Delivering federal money through Medicare, the country's largest insurance program, can be a powerful tool on the campaign trail, allowing lawmakers to argue that they are creating jobs and improving the quality of health care for voters.”

If you are like most people, you may have mistakenly assumed that all providers, nationwide, were subject to the same reimbursement schedule. And that there was little or no political influence involved in setting reimbursement rates which were always characterized by the medical industry and the media as having been “low-balled” and inadequate for sustaining quality medical care.

It’s not their money …

“Longtime members of Congress have become masters at dominating the tug of war between keeping providers flush and trying to rein in the entitlement program's dramatic growth. House Ways and Means Chairman Charles B. Rangel (D-N.Y.) champions New York City's teaching hospitals. Charles E. Grassley (Iowa), the Senate Finance Committee's ranking Republican, makes sure rural health-care services are amply funded. Months before Sen. Ted Stevens (R-Alaska) left office, he secured a permanent 35 percent increase in Medicare payments for Alaska physicians.”

Is Obama admitting  that one of the root causes of the rising costs  associated with the health-care crisis may be political interference?

“Obama administration officials say they are determined to stem soaring Medicare spending, arguing that it is a root cause of the broader health-care crisis that they are trying to address with Congress. Behind the scenes, Obama is pushing for a mechanism that would take Medicare payment authority out of the hands of politicians and invest it in a separate entity, possibly under the executive branch.”

Of course, Obama wants to control healthcare funding in the executive branch; first to consolidate control over one-sixth of the nation’s economy and second, to insure that the healthcare industry is beholden to the Administration.

"Structures that fundamentally alter the long-term costs are a must for real health-care reform," said White House Chief of Staff Rahm Emanuel. He called the Medicare payment debate ‘the least talked-about, most important issue on the table.’"

House Democrats' health-care proposal, released Tuesday, includes no measures aimed at reversing the long-term cost trajectory of Medicare, a fact that spurred a rebellion among conservative Blue Dog Democrats on the Energy and Commerce Committee, which will begin debate on the House bill today. Rep. Mike Ross (Ark.), a Blue Dog leader and panel member, told reporters yesterday that he has the votes to defeat the package unless it is ‘substantially amended’ to address long-term cost concerns.

Something is radically wrong here …

You cannot reduce the total programmatic costs of a healthcare system by dramatically increasing the number of covered individuals without a substantial increase in the number of treatment facilities offering care. Otherwise, the demand on over-strained facilities would mandate prioritization of treatments and individuals which is a polite way of saying “bureaucratic healthcare rationing.” Additionally, the universal laws of supply and demand will drive up prices as supply shrinks and the demands continues to grow. The only resolution for such problems is an increase in tax revenues and/or the curtailment of service levels.

Unfortunately, the Obama plan is more about exerting control over our nation for political purposes than it is true healthcare reform. He wants to raise taxes, enlarge the government bureaucracy and reduce our freedom of choice. In short, he wants European-style socialism that features a governing elite supported by wealthy and powerful oligarchs.

“The Senate health committee approved its own bill yesterday on a party-line vote; that package also was silent on the issue of Medicare's growth.”

If the government was truly serious about universal healthcare …

If the government was truly serious about providing healthcare to all citizens, why wouldn’t they simply declare all legal citizens in the United States immediately eligible for Medicare and allow them to simply purchase private Medi-gap insurance policies for those things that are not normally covered under the current Medicare policies? Why would they not subsidize the production of large-scale and costly medical equipment so as to reduce the overall cost of such equipment (achieved by manufacturing economies of scale) and improve availability? Why would they not override the AMA and allow qualified and certified Nurse Practitioners to handle the majority of low-grade health issues and freeing up doctors for the more complex issues? Why would they not severely prosecute systemic Medicare fraud and curtail the costly rules which allow the vendors of durable medical equipment (walkers, wheelchairs, aspirators, etc.) to charge outrageous fees and avoid competing on providing the lowest costs to the patient as well as the government? Why would they not negotiate a master price schedule with the suppliers of costly patented drugs?

The answer to most of these questions is “politics.” They, the politicians on both sides of the aisle, want to continue their vice-grip on issues which generate substantial political influence and campaign funding – as well as feathering their own nests after they are out of office.

Doing the right thing or doing the politically expedient thing?

"We need to make it happen," Senate Finance Committee Chairman Max Baucus (D-Mont.), whose panel has jurisdiction over Medicare, said of payment reform. Baucus is crafting a separate proposal to pay for expanded health-care coverage, but that task is complicated by the fact that he is also attempting to win the backing of lawmakers such as Sen. Olympia Snowe (R-Maine), a crucial swing voter who opposes White House efforts to shift control of the Medicare payment equation.”

You would think that the Congressional Budget Office could produce an analysis which would determine the most beneficial course of action that balances the needs of the citizens needing healthcare and the taxpayer’s who are footing the bill? Without the overlay of political influence, graft, corruption, mismanagement and malfeasance? But that’s not politically expedient – especially if the public becomes aware of past political peccadilloes.

“Snowe said Finance Committee members have debated payment reform at length in recent closed-door meetings, but did not reach a consensus. She said her chief worry is that providers would continue to look to lawmakers to protect their interests but that under a new system, she and others would be unable to respond to their concerns. Congress must retain the ability to ‘shape and influence’ Medicare rates, Snowe said. ‘We're still going to be held accountable.’"

Accountable to whom? Certainly not to the citizens of the United States? And certainly not to the constituents in your individual states and districts? They are worried about not being able to bring home the pork that their political supporters demand as a “quid pro quo” payment in return for campaign support.

Change?

Obama’s mantra of change is both inane and meaningless without knowing the definition of change and the ramifications of implementing the Administration’s wishes. With people like Rahm Emanuel it is all about power, control and money: the perpetuation of a political party dynasty. With the bureaucrats it’s all about building a protected class of workers with ever-expanding benefits, reduced work loads and a cushy retirement. And with the other politicians, it is about staying in office long enough to achieve the power and profits of a CEO, without having to actually work hard enough to become a CEO.

Usurping legislative power …

Many of the Obama Administration’s initiatives involve usurping the legislative power granted to a co-equal branch of the government by our Constitution. By overriding  Cabinet officials, which are subject to Senate confirmation, with so-called czars who require no confirmation and who can serve with known criminal backgrounds and ongoing conflicts of interest. 

“Obama urged House and Senate leaders to action during a White House meeting this week, and at the request of committee chairmen, administration officials yesterday sent two proposals to Capitol Hill aimed at addressing the problem. One would empower the Medicare Payment Advisory Commission (MedPAC), a nonpartisan body of health-care experts that serves Congress in an advisory role, to determine cuts and changes to Medicare, akin to the Federal Reserve Board. ‘It's not perfect, but it does a lot better job than what Congress is doing,’ Rep. Jim Cooper (Tenn.) said of the commission. Cooper, a Blue Dog, co-sponsored the proposal with Sen. John D. Rockefeller IV (D-W.Va.), a senior Finance Committee member.”

There is no such thing as a nonpartisan body of health-care experts. Especially when they are all members of the medical industries chief lobbyists, the American Medical Association. The appointments to the board are certainly of political interest and make the claim of “non-partisanship” an utter sham.

Damned if you do, damned if you don’t: the choice between two equally inappropriate choices is not a choice at all …

“The second proposal would create a similar entity, called the Independent Medicare Advisory Council, to make Medicare recommendations to the president. Lawmakers could vote to overturn decisions with which they disagreed but could no longer tailor Medicare spending to address local concerns.”

George Orwell would be so proud. The use of the word “Independent” which is the farthest thing from the truth. The reality is that such an advisory council would be independent of the transparency of their decision-making and independent of being accountable to the public which it purports to serve. They would be totally dependent on the Administration, the last place one might find non-partisan and independent responsibility.

Are you ready to cede 1/5 of our national economy directly to the politicians who have already taken over the financial industry, energy production and much of heavy industry?

“Medicare and Medicaid spending now accounts for 5 percent of gross domestic product, and if both programs grow at the same rate over the next 40 years as they have for the past four decades, they will eventually hit 20 percent of GDP, according to estimates.”

Non-existent and nonsensical “cost savings” …

“Congress is attempting to extract as much as $500 billion in Medicare cost savings to pay for health-care reform, but Obama administration officials are concerned that those savings would not result in the transformative fixes the system needs to be stabilized for the long term. White House officials say their own proposals for payment reform would make the system more flexible, allowing it to respond to developments such as breakthroughs in treatment.”

Historically, the government has never realized the projected cost savings on any project – the cost savings being translated into increased vendor profits, cost-overruns, unanticipated events, costly delays and open-ended “change orders.” Million dollar projects wind up costing the taxpayers tens of millions. Multi-million dollar projects wind up costing the taxpayers hundreds of millions of dollars. And how can one achieve cost savings when the most expensive part of any government or private run operation is labor and the labor unions keep demanding more money for less work. No real competitive bidding is possible under a union system where labor costs are comparable. And make no mistake about it – the majority of healthcare costs involve labor rather than medical equipment!

Peter Orszag is a simple-minded political hack …

"’We're trying to create a structure where that would be easier to reorient the system towards higher value and lower cost in the future,’ said White House budget director Peter Orszag.

This is nothing more than an Obama-style political sound bite. It sounds good, appears to be rational – and means absolutely NOTHING! Notice they said “create a structure” instead of saying “fix” the current structure in place." A duplicative bureaucracy which is surely going to be vigorously resisted by the older, entrenched bureacracy – with the resultant political compromise being a larger, costlier and more inefficient organization.

Acknowledging the possibility of catastrophic disaster … 

“The long-term cost challenge has emerged as a major point of contention as new health-care legislation creeps closer to becoming a reality. White House officials and Democratic fiscal hawks worry that Congress could provide coverage to millions of uninsured people, expand the government's role in health care, and yet fail to ‘bend the cost curve,’ creating a fiscal disaster for the nation and a political disaster for their party. Republicans are warning that Democrats are charting a ruinous path, and those criticisms are beginning to resonate.”

Perhaps they want to create a fiscal disaster to push their ideological agenda further down the path of socialism – where the government is the “be all – end all” answer?

Where are MedPAC’s successful achievements?

“MedPAC was created in 1997 to address Medicare's grim prospects as health-care costs outpaced inflation and retiring baby boomers caused the program's ranks to swell. As the country's largest health-insurance program, covering nearly 40 million of the most expensive patients, the entitlement program also holds extraordinary influence over the health-care marketplace.”

You would think that they would have produced more than reports … 

A flood of carefully researched MedPAC reports set forth specific ideas for addressing Medicare's many deficiencies. In testimony before the House in late June, MedPAC Chairman Glenn M. Hackbarth summed up his view of the problems. ‘The health-care delivery system we see today is not a true system: Care coordination is rare, specialist care is favored over primary care, quality of care is often poor, and costs are high and increasing at an unsustainable rate,’ Hackbarth told Energy and Commerce Committee members.”

And whose fault is this? If not for government intervention into healthcare and some of the ridiculous requirements to achieve reimbursements, the system would be tighter, more well-controlled, more cost-effective and more beneficial to the patient.  

Subverting the program by fielding special interest lobbyists …

The ordinary citizen and consumer of healthcare does not stand a change of influencing politicians as they cannot deliver campaign funding that will fuel the 2010 and 2012 election cycle. Each segment of the medical industry will attempt to warp and subvert the system to enlarge their own niche monopolies and preferential practices.

We need to take back our government – to make the politicians more afraid of the citizens they purport to represent than the lobbyists with their pockets full of cash …

“But for most lawmakers, resisting the armies of health-care lobbyists who are deployed to protect industry interests has proved difficult. ‘Basically, the cards are stacked against the member who has to confront these groups,’ said George F. Grob, who conducted numerous Medicare reviews through the Department of Health and Human Services' inspector general's office. "Look at who they're confronting -- the cancer doctors. Drug companies saying, 'We're the ones saving lives out there.' Hospitals saying, 'We're going to have to shut down.' "

The revolving door …

No matter how many Congressional initiatives have attempted to close the revolving door between lobbying by former legislators and the current legislative staffs, it simply is too self-serving to actually close the door.

“Such concerns are often conveyed to politicians by former colleagues or aides who have joined industry ranks. ‘They're talking to their friends,’ Grob said. But also, he said, the lobbyists ‘make really good arguments. They really know their stuff, and they understand the process. They know what the life cycle of a bill is, they know who to talk to, they know what they're talking about -- and they reach everybody.’"

Lazy, incompetent bastards with their hands out …

Truth be told, most legislators lack the type of technical expertise to craft a legislative initiative and are quite willing to allow lobbyists and their “staff” to write the bill. All overlaid with lawyerly loopholes, exceptions and ambiguous language which benefits the special interests over the citizens.

Bottom line …

The Obama Administration is hell-bent on making everything an emergency which requires legislation to be ramroded through the legislative process. Their current mantra could be simply summarized as:

Ready, fire, aim!

The only solution is …

-- steve

_______________________________________________

OneCitizenSpeaking: Saying out loud what you may be thinking …

Reference Links …

Obama Wants Medicare Reimbursement Rates Out of Congressional Hands|Washington Post

the democrat health plan: your doctor is nowhere to be found ...|OneCitizenSpeaking

OBAMA HEALTHCARE: BE PREPARED TO DIE | OneCitizenSpeaking

Chilling words on healthcare: "so we don't continue to pay for things that don't work ..."|OneCitizenSpeaking

IS OBAMA PLANNING TO DESTROY A FUNCTIONING HEALTHCARE SYSTEM WHICH SERVES 85% AND REPLACE IT WITH AN UNKNOWN SYSTEM TO COVER AN ADDITIONAL 15%? (Updated)|OneCitizenSpeaking

Obamanomics & Healthcare: Manufactured Misery?|OneCitizenSpeaking

OBAMA STIMULUS: COMPROMISING YOUR HEALTH RECORDS FOR POLITICS AND PROFITS |OneCitizenSpeaking

Another conspiracy theory: How Obama can use healthcare to grow the unions ...|OneCitizenSpeaking

Taxing YOUR healthcare plan, but exempting the unions … democrats void Constitution – again? |OneCitizenSpeaking

OBAMA BREAKS FAITH WITH TROOPS -- WANTS TO CHARGE THEIR PRIVATE INSURANCE CARRIERS FOR VA TREATMENT (Updated)|OneCitizenSpeaking