The health care debate begins again with legislation to repeal ObamaCare.  This Debate will not be settled until politicians from both parties confront the truth.

What if a bunch of politicians tried to make themselves look extraordinarily clever and more compassionate than the rest of us by claiming that health care was “a right” and passing laws to provide medical services to folks who urgently needed them but didn’t have the means to pay?

What if those politicians contrived a way to force most of us to pay for those services, but outside the tax system?

What if those politicians didn’t disclose to us that we were generously providing needed medical services but instead told us the extra money we paid went to excessive corporate profits and unmerited CEO salaries?

What if they then claimed that patients were being denied the medical services we were paying for?

What if they insisted the only way to take care of folks who needed care but were unable to pay was for government to seize control of everyone’s health care and everyone’s health insurance?

Outrageous?  You bet.  But sadly, this is reality in America.

Health insurance used to cost much less because it was available only to people who were reasonably healthy and not in immediate need of expensive medical services.  After all, it was insurance, which is generally understood to be a way to reduce the risk of unexpected future costs.  Every reasonable person understands you can’t buy fire insurance for a house that’s already burning, or life insurance for someone who is terminally ill.

But then the progressive political movement began to prevail with the claim that health care was a right.

So how can that work?  How can I have “a right” to receive valuable services without violating the rights of whoever government forces to fund those services?

Government programs were established to ensure the “right” to health care but were soon swamped by growing numbers of people who had been led to believe they should not have to pay for insurance or set aside part of their income and forgo current consumption in order to be prepared to pay medical costs.  Contributions to charities that had once helped needy people with health care declined because government had assumed control.

Politicians like Barack Obama want credit for taking care of sick people who can’t afford medical care, for implementing a “right to health care,” but they don’t want to be blamed for raising taxes to cover the cost.  So they had to develop alternative funding mechanisms.

One of those mechanisms was requiring health insurance companies to cover people with pre-existing conditions, even if they were in immediate need of expensive treatments.   In the industry this is called “guaranteed issue.” When a health insurance company is required to insure someone who is already sick, it collects one monthly premium and then immediately pays out thousands, or tens of thousands for medical services.  To avoid bankruptcy the company must charge all its customers more -  a lot more.

To a great  extent guaranteed issue is already a reality.  A 1996 federal law, the Health Insurance Portability and Accountability Act (HIPAA), requires guaranteed issue for employee groups, and prohibits charging extra premiums for employees who have pre-existing conditions.  Several states also require insurance companies to comply with guaranteed issue for individual policies.

The recent rapid rise in the cost of health insurance over the past decade coincides with implementation of guaranteed issue requirements.

An additional consequence of guaranteed issue is the incentive for people to delay paying for insurance until they get sick because they can plunk down the first month’s premium to become “covered.”  Again, to remain solvent insurance companies must raise premiums even more, which drives even more healthy customers out, which results in even more premium increases.

The inevitable conclusion of this cycle will be the end of private health insurance.

With its requirement that every person must purchase a government approved health plan the 2,500 page ObamaCare bill is the progressive movement’s grudging acknowledgment that their “right to health care” is an impossibility, and the consequence of their laws and regulations is higher and higher health insurance costs born by fewer and fewer people still able to afford it.  ObamaCare screams the immutable truth that there can be no right to receive value without violating the rights of those against whom force is applied to pay for it.

What should we expect from political leaders now that the right to health care has been swept into the sinkhole of failed progressive ideas?

• An honest politician would openly admit there’s no free lunch, and requiring the insurance company to accept someone who is already sick isn’t about purging greed.
• An honest politician would admit guaranteed issue is simply a political scheme to transfer the cost of the sick person’s medical care to the rest of the company’s customers.
• An honest politician would admit guaranteed issue makes the insurance company the de facto tax collector for a de facto social program created by government decree.
• An honest politician would admit that guaranteed issue laws have caused the continuous premium increases, and the rising number of uninsured.

An genuine leader would admit that when politicians try to meet every need with clever legislation, the advertised benefits are more than offset by undisclosed negative consequences.

Of course those admissions would redirect The People’s anger from insurance companies to the politicians who enacted guaranteed issue laws, took credit for generously helping people who were sick, then lied about the cost.

A real leader would encourage Americans, the most generous and innovative people in human history, to voluntarily help, and to develop financial mechanisms to help those who could not qualify for insurance.  If the insurance industry were not so heavily regulated it could be more innovative.

There are plenty of examples of high quality health care being provided at little or no charge to patients.  One is the Shriners Hospitals for Children.  They accept children who need horrendously expensive treatments at no charge.  Here’s a quote from their website:

Children up to the age of 18 with orthopedic conditions, burns, spinal cord injuries and cleft lip and palate are eligible for admission and receive all care in a family-centered environment at no financial obligation to patients or families.

Liberty does work.  There’s no reason we The People can’t take care of our own without the imposition of command-and-control governmental systems that try to hide the costs and consequences.

Newly released IRS Regulations show the actual value of the ObamaCare Small Business Tax Credit does not measure up to the hype.

Throughout the run-up to passage of ObamaCare in Congress, and in the re-selling campaign since passage, the President has continuously touted its “small business tax credit.”  Here’s a typical Obama quote from a re-selling pep rally in April:

Starting now, small business owners that provide health care to their workers can sit down at the end of the week, look at their expenses, and begin calculating how much money they’re going to save!

For small business owners who don’t currently provide health insurance, they’ll be able to factor in this new benefit in deciding whether to do so. And with that savings, employers may be able to cover an additional worker or hire that extra employee they’ve needed.

Even the IRS was used to help promote ObamaCare, sending post cards out to millions of small businesses to tell them they may be eligible for a tax credit equal to 35% of their health insurance costs.

The sales presentation makes it looks quite generous to employers.  But, as with all the promises of ObamaCare, the written details contradict the marketing.  It turns out that the small business tax credit is so limited, so restricted it’s worthless or nearly worthless to most small businesses.

• The tax credit does not apply to the cost of health insurance for Business owners or partners.  It doesn’t apply to relatives of owners or partners who are employees in the business.
• Businesses with 25 or more full time employees are ineligible for the tax credit.
  
• Businesses whose employees are paid, on average, more than $50,000 per year are ineligible.
• If the employer provides a plan that costs more than the government says is the “average” cost of health insurance in the employer’s state, the tax credit is reduced.
  

But even these stern rules make the tax credit appear to be more generous than it is.

It turns out  that the  maximum credit, 35% of the employer’s health care cost, applies only to businesses with fewer than eleven employees who pay average wages under $25,000 per year for full time employees.

For employers who pay more, or hire more the law imposes a ruthless sliding scale, slashing the value of the tax credit.

This table shows the value of the tax credit in a few real world situations. 

Nope.  The term comes from professional actuaries at the Centers for Medicare and Medicaid Services (CMS) a government agency, run by an Obama appointee.  Their publication “Estimated Financial Impacts of the Patient Protection and Affordable Care Act” discloses some of the discrepancies between ObamaCare hype and grim reality.

We all remember when the establishment media reported triumphantly, that the Congressional Budget Office, (CBO) “scored” ObamaCare as reducing the deficit.  President Obama hyped it as “the largest deficit reduction bill in over a decade.”

Not so widely reported were the budgetary gimmicks Congressional leaders contrived with one goal in mind: to trap the CBO into projecting deficit reduction.  Total revenue to the government during the first ten years had to exceed total expenses.  They accomplished this in part by scheduling several tax and revenue functions to begin in the first or second year, while deferring most functions that will cost money to years 4 – 10.

The CMS review scores CLASS as “savings” during the first decade because it begins collecting premiums in 2011 but won’t pay any benefits until 2016.

The CMS review describes CLASS as a voluntary insurance program. People who join the program must pay premiums for at least five years to become eligible for cash benefits in the event they become impaired and need in home living assistance services or long term care in an institution.

CMS estimates that from 2011 to 2015 CLASS will collect $25 Billion in premiums while paying out $0 in benefits. Then, from 2016 – 2019 it will collect $13 Billion more in premiums than it pays out in benefits.

But, CMS warns, in later years CLASS will pay out more than it collects in premiums because:

• For persons earning less than Federal Poverty Level income (FPL) the premium will be only $5 per month.
• The program is subject to what insurance professionals call “adverse selection,” meaning that people with health problems who believe they are at greater risk of eventually needing in-home or institutional care are more likely to participate than people in better-than-average health.
  

In order to overcome the costs of adverse selection and the $5 premium and remain solvent and able to pay benefits, CLASS will have to set high premiums, which will further discourage persons in better health from participating, thereby leading to even more premium increases. Eventually, the premiums will become so high nobody, not even those at greatest risk, will buy it. Quoting from the CMS review:

This effect has been termed the…”insurance death spiral.”

Even though the legislation says CLASS is to support itself, without government subsidy the actuaries at CMS conclude that the program will go broke without subsidies.   Like Social Security, Medicare, and Medicaid, CLASS is a looming financial time bomb whose increasing costs will outpace revenues.

CLASS has served it’s immediate political purpose.  It helped secure a propaganda advantage from the positive CBO score.  Thus, even though very few Americans know anything about CLASS, it was part of the campaign to pass ObamaCare, a giant step toward the progressive vision of government as the sole provider of health care to every citizen.

Obama and the Democrats will deal with all the unsustainable government programs by kicking the painful and inevitable task of unwinding and phasing them out down the road to some future President.

Here’s a quote, directly from the CMS review, dealing with just one of the numerous deceptions within the new health care law:

The Reconciliation Act amendments introduced a new 3.8-percent “unearned income medicare contribution” on income from interest, dividends, annuities and other non-earnings sources for individual taxpayers with incomes above $200,000 and couples filing joint returns with incomes above $250,000.  Despite the title of this tax, this provision is unrelated to Medicare; in particular, the revenues generated by the tax on unearned income are not allocated to the Medicare trust funds.

The political-media establishment often responds to citizen distrust of powerful bureaucracies by citing Medicare as a “popular” example of the wonders of Big Government.  This is a semi-effective emotional appeal because Medicare has been in business, pumping out unchallenged propaganda for so many decades it seems to many, perhaps most Americans, to be an embedded necessity, and core function of government.  Americans have pre-paid for Medicare during their entire working lives, making it impossible to phase it out of existence without denying millions of people part or all of the health care they have been promised in exchange for their tax dollars.

Thus, in the hope of muting opposition the authors of ObamaCare slapped the Medicare label on a new tax that will partially offset the annual cost of myriad new bureaucracies, new programs, and new subsidies, all unrelated to Medicare.

If ObamaCare is such a wonderful idea, if America will be so grateful to the President adn the Democrats for forcing it through Congress, why the deception in labeling? Why not call the new tax what it is?