Here is a copy of our "Open Letter #4: Vote “No” on The Motion to Proceed to The Health Care Reform Bill" faxed today to 21 targeted senators:

Open Letter #4:
Vote “No” on The Motion to Proceed to The Health Care Reform Bill

November 19, 2009


Dear Senator:

In our third letter faxed to you on November 18, 2009, we pointed out that national polls provide a strong political reason for voting against the health care reform bill that may soon come up for a vote on the floor of the Senate.

The data we summarized from recent polls by Gallup, Rasmussen, Pew, CNN, and AP clearly demonstrate:

• The majority of American voters are against this health care reform bill, and
  

• The intensity of voter opposition from Republicans and -- most importantly -- Independents will have significant electoral implications for incumbents in 2010 and, perhaps, even in 2012.

Here is a copy of our "Open Letter #3: Most Americans Oppose Health Care Reform" faxed today to 21 targeted senators:

Open Letter #3:
Most Americans Oppose Health Care Reform

November 18, 2009

Fax (202) 224-6295
Fax (804) 775-2319

Dear Senator:

In our second letter faxed to you on November 16, 2009, we pointed out that the “Individual Mandate” provides you with sufficient reason to vote against the health care reform bill.

Here in our third letter we make another argument for voting against the health care reform bill, namely, that national polls provide a strong political reason for voting against the health care reform bill.

What follows is our summary of recent polls by Gallup, Rasmussen, Pew, CNN, and AP.

1. The majority of Americans (67%) now believe the new health care bill would either make their situation worse or make little difference in their own healthcare.

Gallup (11/9/2009) recently found that, by a 10-point margin, Americans are now more likely to say a new healthcare bill would make their personal healthcare situations worse (36%), rather than better (26%).

Generally, two-thirds of Americans (67%) say the new health care bill would either make little difference in their own health (31%) or make their situation worse (36%).

According to Gallup, these findings ‘reinforce previous research showing some skepticism about the long-term benefits of healthcare legislation, particularly at the personal level.’

2. The majority of Americans (67%) want the Senate to (a) start from scratch on a new bill, (b) change the House bill in major ways, or (c) stop working on health care reform altogether.

A recent CNN/Opinion Research Corporation (11/17/2009) found that 28% of people questioned in the survey feel the Senate should start from scratch and start working on a completely new bill, another 22% want the Senate to pass the House bill only if major changes are made, and another 17% want Congress to stop working on health care reform altogether. Only 30% want the Senate to pass the House bill with only minor changes.

3. The majority of Americans (48%) would advise or are leaning toward advising their member of Congress to vote against a new health care bill this year.

According to Gallup (11/9/2009), Americans have moved in a more negative direction on the issue of whether a new bill should be passed into law. Among those recently polled from November 5 to 8 (see table below), 38% say they would advise their member of Congress to vote against a new healthcare bill this year, while 29% would advise their member to vote for it and 33% have no opinion.

According to Gallup (11/9/2009), ‘The significant majority of Republicans [68%] would want their member of Congress to vote against a new healthcare bill, while a smaller majority of Democrats [55%] would want their member to vote for a bill. Independents are more negative than positive by a 2-to-1 margin [44% vs. 22%]. Notably, Democrats are the most likely to be undecided on the issue.’ (emphasis added; see table below)

Gallup reported that when “leans” are taken into account, 70% of Republicans either initially or after being probed to say which way they lean would want their member to vote against a new bill; 71% of Democrats would want their member to vote for a new bill; and, perhaps most importantly, independents come down more against (53%) than in favor (37%). (emphasis added; see table below)

The bottom line, according to Gallup is this: ‘The debate over new healthcare legislation now shifts to the Senate, at a time when the majority of Americans are not convinced that a new law would benefit either the national healthcare system or their own personal healthcare situations in the long term. The overall advice from the average American to his or her member of Congress at this point tilts negative . . .’ (emphasis added)

5. For the past 2 months, American voters have consistently been more opposed than in favor of the health care plans proposed by President Obama and congressional Democrats.

Pasted Graphic 4Gallup (11/13/09) reported a 29-point gap between Americans who prefer maintaining the current healthcare system based mostly on private health insurance (61%) and those who prefer replacing it with a new government-run healthcare system (32%).

Gallup noted, “Throughout this decade, a plurality of Americans have consistently favored maintaining the current system, although support has fluctuated. In November 2007, the edge for the private system over the government-run system was just 7 points, vs. a 31-point gap in 2004. The current 29-point gap is thus at the high end of the historical range.”

Rasmussen (10/23/2009) found that 86% of Republicans and 73% of unaffiliated voters believe that free market competition will do more than government regulation to reduce health care costs; Democrats are evenly divided.

7. Half of Americans now believe it is not the government’s responsibility to make sure everyone has health insurance.

Pasted Graphic 5Marking a significant shift from attitudes of the past decade, Gallup (11/13/09) found “more Americans now say it is not the federal government's responsibility to make sure all Americans have healthcare coverage (50%) than say it is (47%). This is the first time more Americans said it was not the government's responsibility since Gallup began tracking this question in 2001, and is a significant shift from as recently as three years ago, when two-thirds said ensuring healthcare coverage was the government's responsibility.”

8. The intensity of opposition to health care reform will have electoral implications in 2010.

Pew (11/11/09) reported that 56% of voters who oppose the health legislation in Congress say they are very enthusiastic about voting in the 2010 midterm elections, compared with 43% of voters who support the bills. Among voters who strongly oppose the legislation, 64% say they are very enthusiastic about casting their ballot in 2010; only about half (49%) of those who strongly favor the health care legislation are very enthusiastic about voting.

The takeaway message?

We have argued in previous letters that there are good reasons -- moral, constitutional, economic, pragmatic, and, as emphasized here, political -- to oppose the health care reform bill.
We urge you to listen to the voices of your constituents and our Founding Fathers rather than the misguided and overreaching leadership of the left wing of the party. We expect, of course, that Members of Congress will be responsive to the voice of the majority without ever violating the unalienable rights to life, liberty, and the pursuit of happiness protected by our constitution.
Think about how voting for unpopular health care reform legislation might very well be a career-ending act of political suicide.

Dr. Gregory Garamoni
Founder and Executive Director,
Doctors on Strike for Freedom in Medicine
http://www.doctorsonstrike.com

Here is a copy of our "Open Letter #2: Oppose The Individual Mandate" faxed today to 21 targeted senators:

Open Letter #2:
Oppose The Individual Mandate

November 16, 2009

Fax (202) 224-1193
Fax (701) 250-4484

Dear Senator Tim Johnson:

In our first letter faxed to you on November 11, 2009, we argued that there are good reasons -- moral, constitutional, economic, pragmatic, and political -- to oppose the health care reform bill.

Here we argue that the “Individual Mandate” provides you with sufficient reason to vote against the health care reform bill.

As a matter of principle, many of your constituents resent those Members of Congress who presume -- wrongly -- that they have the moral and constitutional authority to force their constituents to buy health care insurance -- whether they want it or not -- and then to dictate what type of coverage they must “choose” -- and then, by implication, to dictate what they will have to pay for insurance -- and then, by implication, to dictate what health care goods and services they are allowed to receive from physicians, hospitals, and other health care providers.

If you listen to the voices of your constituents -- as we do -- you will hear them resentfully ask variations of the same question:

“Where on earth do Members of Congress think they have the moral right and the constitutional authority to force us to buy a health insurance policy that we do not want, for comprehensive coverage that we do not require, at a price we can’t afford -- all the while taxing us an arm and a leg so everyone will have the same ‘benefit’ from the reform -- all the while threatening us with outrageous fines and jail time if we fail to buy some ‘one-size-fits-all’ insurance policy ‘qualified’ by some out-of-touch bureaucrats in Washington: ‘Section 7203 - misdemeanor willful failure to pay is punishable by a fine of up to $25,000 and/or imprisonment of up to one year; Section 7201 - felony willful evasion is punishable by a fine of up to $250,000 and/or imprisonment of up to five years’?”

Even the CBO in 1994 recognized that the constitutional authority for the “Individual Mandate” is highly questionable:

"A mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action. The government has never required people to buy any good or service as a condition of lawful residence in the United States. An individual mandate would have two features that, in combination, would make it unique. First, it would impose a duty on individuals as members of society. Second, it would require people to purchase a specific service that would be heavily regulated by the federal government."

More recently (July 2009), the CBO raised serious questions about the use of the Commerce Clause (which gives Congress the power to regulate commerce “among the several states”) to justify a mandate that people buy health insurance:

“Whether such a requirement would be constitutional under the Commerce Clause is perhaps the most challenging question posed by such a proposal, as it is a novel issue whether Congress may use this clause to require an individual to purchase a good or a service.”

Then there is the politically undesirable fact that the “Individual Mandate” would be a family budget disaster:

It would force your constituents who currently have high deductible/low premium health insurance policies with catastrophic coverage to buy low deductible/high premium health insurance policies with comprehensive coverage.

Your constituents would be seriously hurt by this quite foreseeable, highly undesirable consequence of the “Individual Mandate”:

Those currently enrolled in an affordable catastrophic coverage plan would be forced to pay significantly higher premiums for a “qualified” comprehensive coverage plan.

They would understandably blame and quite likely vote against the reelection of any Member of Congress who recklessly and willfully voted with full knowledge that doing so would destroy their family’s household budgets.

The takeaway message?

Stop and think about how any health care reform bill with a provision for an “Individual Mandate” would be morally objectionable, constitutionally dubious, economically harmful, practically difficult, and politically unpopular.

Stop and think about how -- for these reasons -- voting for a health care reform bill with an “Individual Mandate” could very well be a career-ending act of political suicide.



Sincerely,
Dr. Gregory L. Garamoni
Founder and Executive Director,
Doctors on Strike for Freedom in Medicine
http://www.doctorsonstrike.com

• Public option, with or without triggers or opt-out options for the states,

• Mandates that force individuals to buy insurance coverage,

• Mandates that force employers to provide and subsidize insurance coverage,

• Surcharges that force some groups to pay for the healthcare of other groups,

• Provisions that might allow HHS to force doctors to act against their professional judgment concerning what diagnostic procedures or treatments to recommend to their patients, and

• Provisions that might allow HHS to force doctors to participate in a public plans.  

November 11, 2009
Dear Senator:
I represent a rapidly growing, national coalition of patients, doctors, and small business owners -- many of whom live in your state -- who are urging you to vote against any health care reform legislation that includes any of the following five provisions:

• Public option, with or without triggers or opt-out options for the states,

• Mandates that force individuals to buy insurance coverage,

• Mandates that force employers to provide and subsidize insurance coverage,

• Surcharges that force some groups to pay for the healthcare of other groups,

• Provisions that might allow HHS to force doctors to act against their professional judgment concerning what diagnostic procedures or treatments to recommend to their patients, and

• Provisions that might allow HHS to force doctors to participate in a public plans.    

• Medicare voters would be angry about cuts in Medicare and the loss of Medicare Advantage,

• Young and healthy voters would be angry about being coerced to buy insurance coverage required under the Individual Mandate;

• Physicians and other health care providers would resent meddlesome government intrusion into their professional decision-making as well as proposed reductions in Medicare payments;

• Business owners would be angry about being forced to provide and subsidize insurance for their employees;

• Wealthy voters -- many of whom are small business owners -- would resent having to pay a surcharge on top of the scheduled increase in income taxes, which would put them in a 45% income tax bracket;

• Other groups of voters (e.g., medical device manufacturers) targeted for tax surcharges to fund health care reform would resent these taxes; and

• Millions of health care policy holders would resent (a) paying significantly higher premiums for their present coverage -- or worse -- for coverage they do not want or need, (b) losing insurance coverage provided by their employers, or (c) losing access to their doctors -- all of these effects being unintended but foreseeable consequences of taxing “Cadillac” insurance policies, mandating coverage for preexisting conditions, mandating coverage for specified services, and shrinking the risk pools for private insurers.

• Public option, with or without triggers or opt-out options for the states,

• Mandates that force individuals to buy insurance coverage,

• Mandates that force employers to provide and subsidize insurance coverage,

• Surcharges that force some groups to pay for the healthcare of other groups,

• Provisions that might allow HHS to force doctors to act against their professional judgment concerning what diagnostic procedures or treatments to recommend to their patients, and

• Provisions that might allow HHS to force doctors to participate in a public plans.  

• Go here to find their contact information:
• http://www.doctorsonstrike.com/US_Senate_Contact_Information.html  

As the suicidal Democratic congressmen proceed to rubber-stamp the Obama healthcare reform despite the drubbing their party took in the '09 elections, the president trotted out the endorsements of the AMA and the AARP to stimulate support. But these and the other endorsements his package has received are all bought and paid for.
Here are the deals:
The American Medical Association (AMA) was facing a 21 percent cut in physicians' reimbursements under the current law. Obama promised to kill the cut if they backed his bill. The cuts are the fruit of a law requiring annual 5 percent to 6 percent reductions in doctor reimbursements for treating Medicare patients. Bravely, each year Congress has rolled the cuts over, suspending them but not repealing them. So each year, the accumulated cuts threaten doctors. By now, they have risen to 21 percent. With this blackmail leverage, Obama compelled the AMA to support his bill...or else!

The AARP got a financial windfall in return for its support of the healthcare bill. Over the past decade, the AARP has morphed from an advocacy group to an insurance company (through its subsidiary company). It is one of the main suppliers of Medi-gap insurance, a high-cost, privately purchased coverage that picks up where Medicare leaves off. But President Bush-43 passed the Medicare Advantage program, which offered a subsidized, lower-cost alternative to Medi-gap. Under Medicare Advantage, the elderly get all the extra coverage they need plus coordinated, well-managed care, usually by the same physician. So more than 10 million seniors went with Medicare Advantage, cutting into AARP Medi-gap revenues.

Presto! Obama solved their problem. He eliminates subsidies for Medicare Advantage. The elderly will have to pay more for coverage under Medigap, but the AARP -- which supposedly represents them -- will make more money. (If this galls you, join the American Seniors Association, the alternative group; contact sbarton@americanseniors.org. (read more)

• • Monday, November 9, 2009

FINAL VOTE RESULTS FOR ROLL CALL 887
(Democrats in roman; Republicans in italic; Independents underlined)

      H R 3962      RECORDED VOTE      7-Nov-2009      11:16 PM
      QUESTION:  On Passage
      BILL TITLE: Affordable Health Care for America Act

---- AYES    220 ---

---- NOES    215 ---

Today, Ranking Member of the House Ways and Means Committee Dave Camp (R-MI) released a letter from the non-partisan Joint Committee on Taxation (JCT) confirming that the failure to comply with the individual mandate to buy health insurance contained in the Pelosi health care bill (H.R. 3962, as amended) could land people in jail.  The JCT letter  makes clear that Americans who do not maintain “acceptable health insurance coverage” and who choose not to pay the bill’s new individual mandate tax (generally 2.5% of income), are subject to numerous civil and criminal penalties, including criminal fines of up to $250,000 and imprisonment of up to five years.
In response to the JCT letter, Camp said:  “This is the ultimate example of the Democrats’ command-and-control style of governing – buy what we tell you or go to jail.  It is outrageous and it should be stopped immediately.”
Key excerpts from the JCT letter appear below:
“H.R. 3962 provides that an individual (or a husband and wife in the case of a joint return) who does not, at any time during the taxable year, maintain acceptable health insurance coverage for himself or herself and each of his or her qualifying children is subject to an additional tax.” [page 1]                                                          - - - - - - - - - -                                                   
“If the government determines that the taxpayer’s unpaid tax liability results from willful behavior, the following penalties could apply…” [page 2]                                                          - - - - - - - - - -                                                     
“Criminal penalties
Prosecution is authorized under the Code for a variety of offenses.  Depending on the level of the noncompliance, the following penalties could apply to an individual:
• Section 7203 – misdemeanor willful failure to pay is punishable by a fine of up to $25,000 and/or imprisonment of up to one year.
• Section 7201 – felony willful evasion is punishable by a fine of up to $250,000 and/or imprisonment of up to five years.” [page 3]
When confronted with this same issue during its consideration of a similar individual mandate tax, the Senate Finance Committee worked on a bipartisan basis to include language in its bill that shielded Americans from civil and criminal penalties.  The Pelosi bill, however, contains no similar language protecting American citizens from civil and criminal tax penalties that could include a $250,000 fine and five years in jail.
“The Senate Finance Committee had the good sense to eliminate the extreme penalty of incarceration.  Speaker Pelosi’s decision to leave in the jail time provision is a threat to every family who cannot afford the $15,000 premium her plan creates.  Fortunately, Republicans have an alternative that will lower health insurance costs without raising taxes or cutting Medicare,” said Camp.
According to the Congressional Budget Office the lowest cost family non-group plan under the Speaker’s bill would cost $15,000 in 2016.

### 

By BETSY MCCAUGHEY
The health bill that House Speaker Nancy Pelosi is bringing to a vote (H.R. 3962) is 1,990 pages. Here are some of the details you need to know.
What the government will require you to do:
• Sec. 202 (p. 91-92) of the bill requires you to enroll in a "qualified plan." If you get your insurance at work, your employer will have a "grace period" to switch you to a "qualified plan," meaning a plan designed by the Secretary of Health and Human Services. If you buy your own insurance, there's no grace period. You'll have to enroll in a qualified plan as soon as any term in your contract changes, such as the co-pay, deductible or benefit.
• Sec. 224 (p. 118) provides that 18 months after the bill becomes law, the Secretary of Health and Human Services will decide what a "qualified plan" covers and how much you'll be legally required to pay for it. That's like a banker telling you to sign the loan agreement now, then filling in the interest rate and repayment terms 18 months later.

Associated Press

Protestors wave signs in front of the Capitol on Thursday.


On Nov. 2, the Congressional Budget Office estimated what the plans will likely cost. An individual earning $44,000 before taxes who purchases his own insurance will have to pay a $5,300 premium and an estimated $2,000 in out-of-pocket expenses, for a total of $7,300 a year, which is 17% of his pre-tax income. A family earning $102,100 a year before taxes will have to pay a $15,000 premium plus an estimated $5,300 out-of-pocket, for a $20,300 total, or 20% of its pre-tax income. Individuals and families earning less than these amounts will be eligible for subsidies paid directly to their insurer.
• Sec. 303 (pp. 167-168) makes it clear that, although the "qualified plan" is not yet designed, it will be of the "one size fits all" variety. The bill claims to offer choice—basic, enhanced and premium levels—but the benefits are the same. Only the co-pays and deductibles differ. You will have to enroll in the same plan, whether the government is paying for it or you and your employer are footing the bill.
• Sec. 59b (pp. 297-299) says that when you file your taxes, you must include proof that you are in a qualified plan. If not, you will be fined thousands of dollars. Illegal immigrants are exempt from this requirement.
• Sec. 412 (p. 272) says that employers must provide a "qualified plan" for their employees and pay 72.5% of the cost, and a smaller share of family coverage, or incur an 8% payroll tax. Small businesses, with payrolls from $500,000 to $750,000, are fined less.
Eviscerating Medicare:
In addition to reducing future Medicare funding by an estimated $500 billion, the bill fundamentally changes how Medicare pays doctors and hospitals, permitting the government to dictate treatment decisions.
• Sec. 1302 (pp. 672-692) moves Medicare from a fee-for-service payment system, in which patients choose which doctors to see and doctors are paid for each service they provide, toward what's called a "medical home."
The medical home is this decade's version of HMO-restrictions on care. A primary-care provider manages access to costly specialists and diagnostic tests for a flat monthly fee. The bill specifies that patients may have to settle for a nurse practitioner rather than a physician as the primary-care provider. Medical homes begin with demonstration projects, but the HHS secretary is authorized to "disseminate this approach rapidly on a national basis."
A December 2008 Congressional Budget Office report noted that "medical homes" were likely to resemble the unpopular gatekeepers of 20 years ago if cost control was a priority. (read more)

• Public option,
• Mandates that force individuals to buy insurance coverage,
• Mandates that force employers to provide insurance coverage,
• Surcharges that force some groups to pay for the healthcare of other groups, and
• Provisions that might allow HHS to force doctors to participate in public plans.

• Voters on Medicare will be hurt by and angry about cuts in Medicare,
• Young and healthy voters will be hurt by and angry about individual mandates,
• Physicians and other health care providers will resent government intrusion into their decision-making and reduced Medicare payments,
• Business owners will be hurt by and angry about the mandate to provide insurance for employees and the surcharge on wealthy business owners,
• Wealthy voters will resent the surcharge on their income taxes,
• Groups of voters targeted for increased taxes to fund HR 3962 will resent these taxes, and
• Millions of health care policy holders will resent having to pay significantly higher premiums, losing the insurance coverage provided by their employers, or losing access to their doctors as a result of taxes on insurance policies, costly mandated coverage by HHS, and shrinking risk pools.