Archive for April, 2013

Congress exempt from Obamacare

Thursday, April 25th, 2013


Congressional leaders in both parties are engaged in high-level, confidential talks about exempting lawmakers and Capitol Hill aides from the insurance exchanges they are mandated to join as part of President Barack Obama’s health care overhaul, sources in both parties said.
The talks — which involve Senate Majority Leader Harry Reid (D-Nev.), House Speaker John Boehner (R-Ohio), the Obama administration and other top lawmakers — are extraordinarily sensitive, with both sides acutely aware of the potential for political fallout from giving carve-outs from the hugely controversial law to 535 lawmakers and thousands of their aides. Discussions have stretched out for months, sources said.
A source close to the talks says: “Everyone has to hold hands on this and jump, or nothing is going to get done.”

Yet if Capitol Hill leaders move forward with the plan, they risk being dubbed hypocrites by their political rivals and the American public. By removing themselves from a key Obamacare component, lawmakers and aides would be held to a different standard than the people who put them in office.


Democrats, in particular, would take a public hammering as the traditional boosters of Obamacare. Republicans would undoubtedly attempt to shred them over any attempt to escape coverage by it, unless Boehner and Senate Minority Leader Mitch McConnell (R-Ky.) give Democrats cover by backing it.   There is concern in some quarters that the provision requiring lawmakers and staffers to join the exchanges, if it isn’t revised, could lead to a “brain drain” on Capitol Hill, as several sources close to the talks put it.
The problem stems from whether members and aides set to enter the exchanges would have their health insurance premiums subsidized by their employer — in this case, the federal government. If not, aides and lawmakers in both parties fear that staffers — especially low-paid junior aides — could be hit with thousands of dollars in new health care costs, prompting them to seek jobs elsewhere. Older, more senior staffers could also retire or jump to the private sector rather than face a big financial penalty.   Plus, lawmakers — especially those with long careers in public service and smaller bank accounts — are also concerned about the hit to their own wallets.

House Minority Whip Steny Hoyer (D-Md.) is worried about the provision. The No. 2 House Democrat has personally raised the issue with Boehner and other party leaders, sources said.   “Mr. Hoyer is looking at this policy, like all other policies in the Affordable Care Act, to ensure they’re being implemented in a way that’s workable for everyone, including members and staff,” said Katie Grant, Hoyer’s communications director.   Several proposals have been submitted to the Office of Personnel Management, which will administer the benefits. One proposal exempts lawmakers and aides; the other exempts aides alone.

When asked about the high-level bipartisan talks, Michael Steel, a Boehner spokesman, said: “The speaker’s objective is to spare the entire country from the ravages of the president’s health care law. He is approached daily by American citizens, including members of Congress and staff, who want to be freed from its mandates. If the speaker has the opportunity to save anyone from Obamacare, he will.”
Reid’s office declined to comment about the bipartisan talks.

However, the idea of exempting lawmakers and aides from the exchanges has its detractors, including Rep. Henry Waxman (D-Calif.), a key Obamacare architect. Waxman thinks there is confusion about the content of the law. The Affordable Care Act, he said, mandates that the federal government will still subsidize and provide health plans obtained in the exchange. There will be no additional cost to lawmakers and Hill aides, he contends.

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USA world rank slips for freedom & economic liberty

Thursday, April 18th, 2013

According to this poll, 61% rated the current situation in America as decidedly negative, about the same as in 2010, the lowest recorded by Gallup since President Jimmy Carter’s term in 1979, at a time when the economy was in terrible shape with inflation at 14%.   The only other comparable low point came in 1974 during the Watergate scandal and President Nixon’s resignation. Less than half the people, 48%, now have any optimism about improvement in the country within five years, also the lowest since 1979.

Better to Be Born in Estonia

As an example, the Economist Intelligence Unit just published a new “Where To Be Born in 2013” list, the places in the world that they think offer a newborn the chance for a healthy, safe and prosperous life.   The measures used include per capita GDP, life expectancy at birth, quality of life (divorce, political freedoms and job security), climate, personal security (crime, murder rates and terrorism), community life and governance (corruption) and gender equality.

The last time the EIU put together this somewhat lighthearted but unique index was 25 years ago in 1988. The United States of America then ranked first place in the world. Today, the U.S. has fallen to a dismal 16th place, just ahead of the United Arab Republics (UAE) and well behind countries ranging from Switzerland and Norway at the top of the new list, to Germany and Belgium just ahead of the U.S.

So much for the quality of life in America. How about economic freedom?

The 2012 Economic Freedom of the World report released by the Cato Institute and Canada’s Fraser Institute shows that in just a few years, the U.S. ranking has plummeted from No. 2 in 2000 (behind the city-states of Hong Kong and Singapore) to 18th place, trailing such countries as Estonia, Taiwan and Qatar. Finland, Denmark and Canada now also have freer economies than the United States.

The comprehensive index covers the size of government (taxing and spending), legal systems, property rights, sound money, free international trade and regulation (including credit markets, labor and business regulations).  According to the report, in 2005, the U.S. ranked 45th in overall size of government among 144 nations surveyed. Today, government has ballooned in size and the U.S. rank has fallen to 61st place.

Other areas of lost freedom include a substantial increase in stifling business regulations, labor-market restrictions and barriers to trade. The U.S. slipped in all those categories, plus there was a long-term deterioration in ranking on property rights as well.

Madison, de Tocqueville and Reagan

Reagan spoke of the prescient French aristocrat, Alexis de Tocqueville, who, after touring a young America in the 1830s, concluded that democracy in the U.S. was fragile.

It could not exist as a permanent form of government he suggested. It would end when a majority discovered they could vote themselves largess from the public treasury. From that time forward the majority would vote for candidates promising the most benefits, with the result that the democracy would collapse over loose fiscal policy, to be followed by dictatorship.

Citing Gibbon’s Decline and Fall of the Roman Empire, Reagan added: “The average age of the world’s great civilizations has been 200 years.” The evening I heard Reagan utter those words, America was yet to celebrate its 200th birthday – now we are in the 236th Year of Our Independence.

James Madison of Virginia, the fourth U.S. president, a Founding Father and the leading proponent of the Bill of Rights, anticipated, better than most, the processes that destroy liberty when he warned: “I believe there are more instances of the abridgment of the freedom of the people by gradual and silent encroachments of those in power than by violent and sudden usurpations.”

Considering the many “gradual and silent encroachments” by government under which Americans now must live – and many more talked about by President Obama, Americans have a right to be pessimistic.

Break Away

In Jonathan Swift’s Gulliver’s Travels, the shipwrecked hero awakens to find himself a prisoner, tied down by hundreds of tiny pegs, ropes and strings. But Gulliver had an advantage over modern Americans trying to preserve their wealth. He awoke to discover and face his predicament all at once, whereas Americans are only now beginning to realize the thousands of irrational government restraints on our liberties.

Now it’s time for Americans to awake, to arise. The politicians and bureaucrats in control are doing all they can to keep us – and our money – tied up here.   The long arm of government has placed many roadblocks, detour and dead ends in our path. And who knows what and when new “emergency” presidential decrees may be imposed by Obama?

With America’s future darkened by massive budget deficits, increased taxes and more regulations, ObamaCare, the radical Foreign Account Tax Compliance Act (FATCA) and an ever creeping loss of liberty, now is the imperative time to go offshore. Act now.

Bob Bauman
Chairman, Freedom Alliance

Doctors driven to bankruptcy

Tuesday, April 9th, 2013

NEW YORK (CNNMoney) 4-8-13 by Parija Kavilanz
As many doctors struggle to keep their practices financially sound, some are buckling under money woes and being pushed into bankruptcy.
It’s a trend that’s accelerated in recent years, industry experts say, with potentially serious consequences for doctors and patients. Some physicians are still able to keep practicing after bankruptcy, but for others, it’s a career-ending event. And when a practice shuts its doors, patients can find it harder to get the health care they need nearby.

Chapter 11 bankruptcy filings by physician practices have spiked recently, noted Bobby Guy, co-chair of the American Bankruptcy Institute’s health care committee, who tracks bankruptcy trends tied to distressed businesses. Guy said there were at least eight filings in recent weeks, which he said was “very unusual.”

Five years ago, Plantation, Fla.-based bankruptcy attorney David Langley didn’t have a single doctor as a client. Since then he’s handled at least six bankruptcy cases involving doctors. Two current clients — an orthopedic surgeon and an OB/GYN — also are in bankruptcy.
None of his physician clients had malpractice lawsuits that landed them in dire financial straits. All are “top-notch doctors,” he said.
The weak economy has taken a toll on doctors’ revenue, as consumers cut back on office visits and lucrative elective procedures, said Guy, a bankruptcy attorney in Nashville with Frost Brown Todd LLC.  Doctors also blame shrinking insurance reimbursements, changing regulations, and the rising costs of malpractice insurance, drugs and other business necessities for making it harder to keep their practices afloat.

Related Story: Doctors going broke
Oncologist Dr. Dennis Morgan had a profitable solo practice in Enfield, Conn., for years. Revenues began to fall, he said, when reimbursements for treatment and drugs to oncologists started shrinking. He made cutbacks, but he began having trouble meeting expenses, and his business debt grew. Critical chemotherapy drug and medical supplies providers “eventually cut me off,” Morgan said.
In June 2011, his practice, in a medically underserved area, filed for bankruptcy. It had hundreds of chemotherapy patients at the time.
For the next two years, his role became “that of a captain of a sinking ship managing the allocation of life boats until rescue arrived,” he said. He redirected patients to other doctors and area hospitals. Early last year, he stopped practicing medicine.
Having a cancer practice close can be “debilitating” to a community, said Morgan. “If you have to travel one or two hours to get treatment and you have no one to go with you, it becomes a matter of getting care or not getting care,” he said.

Related Story: Doctors: Why we can’t stay afloat
Primary care doctors face similar challenges. Langley recounts one client, a solo practitioner in an underserved area of Broward County, Fla., whose patients were mostly on Medicare or lacked insurance.
As the economy worsened in the wake of the recession, fewer patients could afford to come in. Cash payments and reimbursements dropped. To come up with money to keep the practice going, she took a second job at a hospital. Still, her debt ballooned. She fell behind on state tax payments.

Two years ago, Florida tax officials showed up at her door to shut the clinic down. She quickly called Langley and he was able to file an emergency bankruptcy for her online while the officials were still in the waiting room. He gave them the bankruptcy case number, and they left without closing the clinic. Langley eventually helped the doctor restructure her debt and the clinic is still open, he said.
Dr. Morgan Moor was on the brink of bankruptcy in 2011. An internist with a solo practice in Brentwood, Tenn., Moor said the recession badly hurt her once-thriving practice. By 2010, she had lost almost half of her active patients, her annual revenue had dropped nearly 30%, and she had to lay off half her employees.

“We were told that bankruptcy was our only option,” she said. So she hired Guy. Luckily, Moor said, she was able to restructure her debt and her business without filing.   Every day since has been a struggle, though. “Every payroll, I wonder if we will be able to keep doing this,” she said. “I try not to think about it because it paralyzes me with fear.”
–Join the discussion: #bankruptdoctors.