A drug for dangerously high blood pressure, normally priced at $25.90 per dose, offered to hospitals for $1,200. Fifteen deaths in 15 months blamed on shortages of life-saving medications.

A growing crisis in the availability of drugs for chemotherapy, infections and other serious ailments is endangering patients and forcing hospitals to buy from secondary suppliers at huge markups because they can’t get the medications any other way.

An Associated Press review of industry reports and interviews with nearly two dozen experts found the shortages — mainly of injected generic drugs that ordinarily are cheap — have delayed surgeries and cancer treatments, left patients in unnecessary pain and caused hospitals to give less effective treatments. That’s resulted in complications and longer hospital stays.

Just over half of the 549 U.S. hospitals responding to a survey this summer by the Institute for Safe Medication Practices, a patient safety group, said they had purchased one or more prescription drugs from so-called “gray market vendors” — companies other than their normal wholesalers.

Most also said they’ve had to do so more often of late, and 7 percent reported side effects or other problems with those drugs.

Hospital pharmacists “are really looking at this as a crisis. They are scrambling to find drugs,” said Joseph Hill of the American Society of Health-System Pharmacists.

At a hearing Friday before the health subcommittee of the House Energy and Commerce Committee, hospital officials and other experts testified that the worsening shortages are preventing them from giving many patients the best care and are driving up costs.

“Considering the nation’s budget crisis and our skyrocketing health care bill, these markups are nothing more than profiteering at the expense of patients and providers who are struggling to afford vital medicines,” said Mike Alkire, chief operating officer of Premier Healthcare Alliance, a group that helps U.S. hospitals and other health providers improve their patient care and finances.

The shortages could cost hospitals at least $415 million a year, he said, citing data from health care providers across the nation. So far, hospitals have been absorbing the extra costs, but they’ll soon have to start passing them on to insurers and patients, according to the American Hospital Association.

The scarcity of mainstay cancer drugs is not only hurting patients but is halting or disrupting clinical studies of potential new treatments, said Dr. Robert S. DiPaola, director of the Cancer Institute of New Jersey.

“The drug shortages of today can have a ripple effect on the availability of new drugs and treatment combinations tomorrow,” he told the committee.

On Monday, the Food and Drug Administration is holding a meeting with medical and consumer groups, researchers and industry representatives to discuss the shortages and strategies to fight them.

The FDA says the primary cause of the shortages is production shutdowns because of manufacturing problems, such as contamination and metal particles that get into medicine.

Other reasons include theft of prescription drugs from warehouses or during shipment, as well as the “gray market” vendors who buy scarce drugs from small regional wholesalers, pharmacies or other sources and then sell them to hospitals at many times the normal price. These sellers may not be licensed, authorized distributors.

In addition, many companies have stopped making generic injected drugs because the profit margins are slim. Producing them is far more expensive than stamping out pills, and it takes about three weeks to produce a batch. Making things worse, companies don’t have to notify customers or the FDA that they’ve stopped making a medicine. That means neither FDA nor competitors can fill the gap in time.

Only a half-dozen companies make the vast majority of injected generics. Even if other companies wanted to begin making a drug in short supply, they’re discouraged by the lengthy, expensive process of setting up new manufacturing lines and getting FDA approval.

The article goes on, but that last paragraph is really the most important point we need to wrap our brains around to understand this terrible tragedy: Drug shortages occur precisely because of the existence of the government’s meddling with the process of researching, manufacturing, selling, and purchasing drugs.

As I explained in Fixing US Health Care Once And For All – 5 Crucial Steps:

On the market, such imbalances are, under free competition, swiftly addressed via a simple process: High prices for certain consumer goods indicate a high demand and an insufficient supply. Thus profit seeking entrepreneurs have an incentive to shift from what they are currently doing to focusing on producing more of such highly demanded goods, by employing more commensurate factors of production that turn out the demanded goods. This leads to a decline in their prices, moving the market closer to equilibrium and thus restoring balance.

But when a group of people which obtains its means of operation via aggression and theft, the government,  imposes decrees that prevent the voluntary market participants to perform such balancing acts, and threaten them with imprisonment and fines should they not oblige, the imbalance will persist. If that group’s actions are such as to bring about even more shortages for the demanded goods, the imbalance will grow, prices will keep rising.

Of course Obamacare has not addressed a single one of the points I put forward in that article, quite the contrary, and so it should not surprise us that this horrific and quite frankly murderous trend continues to aggravate shortages of health care products and services, continues to drive sick people into bankruptcy, and continues to kill people by the thousands, if not millions.

Related posts:

1. WikiLeaks – Cuba Banned ‘Sicko’ Due to Mythical Depiction of its Health Care System
2. The US Health Care Myth
3. US Health Care in Crisis – Where is the Outrage?

A good example in the realm of economics that I just came across is this guy who writes an article that is in large parts predicated upon the following assertion:

The United States has the most privatized health care system in the advanced world; it also has, by far, the most expensive care, without gaining any clear advantage in quality for all that spending.

So he makes the assumption that spending on health care in the US more privatized in the US than in any other industrialized nation. And from that he concludes that there is no clear advantage in quality for “all this spending”.

Now, if “all this spending” was indeed more privatized than anywhere else in the world then he may have indeed supplied a valid argument for more government involvement in the realm of health care.

If, however, this assumption were to be proven incorrect, then he would have unwittingly supplied an argument for less government involvement.

Let’s look at the facts on Health care in the United States:

Public spending accounts for between 45% and 56.1% of U.S. health care spending. Per-capita spending on health care by the U.S. government placed it among the top ten highest spenders among United Nations member countries in 2004.

Government health spending in the US in 2005 was at 7.2 percent of US GDP. In a comparison of 188 countries worldwide the US ranks at position 18. If we exclude third world countries, the US ranks at position 9, ahead of such supposed big government health care paradises as Canada or even Cuba!

So if, furthermore, said guy were to ignore or deny the fact that what he put out there is a blatant falsehood and cling on to his preconceived theories no matter what … well then we have ourselves a good old fashioned, bigoted, boring, predictable, laughable, and paid-off pseudo economist, potentially of the Keynesian specimen, who will cowardly defend the notion that his masters need more power, more money, more credit, more taxes for all eternity, no matter how much they have already been given.

People like this guy never talk about hugely important things like the state enforced special privileges and monopolies granted to the AMA that allow its members to keep prices for health care services high and supply of doctors low.

He also seems to avoid the topic of the state imposed restrictions on importing drugs from abroad unless I’m missing something, but even if he had talked about it somewhere for sure he avoids it where it matters, which would be right in this article.

He also didn’t point out that “Medicare Part D” prohibits Medicare to negotiate with drug companies, as any other entity on the free market can do.

He also passes in silence the fact that there is this institution called FDA that makes it almost impossible for innovative entrepreneurs to bring new potentially lifesaving drugs to market at a cheap price. I heard that 80% of the cost of a drug in the US covers expenses for compliance with FDA regulations.

He also avoids the fact that health insurance providers are not allowed to compete across state lines in most if not all US states.

If you ignore the root causes of why prices are so high, namely state intervention from start to finish, then there is little sense in complaining about the high cost of insurance or the supposedly insufficient level of tax extortion & enslavement of the young generation on whose backs all those outrageous expenses will fall in the end.

If on top of all that, after having been supplied all this information, you ask for EVEN MORE state intervention than we ALREADY have, then you are nothing but yet another abhorrent enabler of a system that year after year claims more and more sick people’s happiness and energy and you do indeed deserve nothing but the deepest scorn and contempt from all those who truly care to make this world a healthier and happier place to live for everyone, and not just for a privileged few who can afford the high cost of medicine and insurance in this country!

Related posts:

1. Fixing Health Care in the US
2. Health Care Debate – The Public Option Nonsense
3. The US Health Care Myth

Castro’s government apparently went on to ban the film because, the leaked cable claims, it “knows the film is a myth and does not want to risk a popular backlash by showing to Cubans facilities that are clearly not available to the vast majority of them.”

(…)

The cable describes a visit made by the FSHP to the Hermanos Ameijeiras hospital in October 2007. Built in 1982, the newly renovated hospital was used in Michael Moore’s film as evidence of the high-quality of healthcare available to all Cubans.

But according to the FSHP, the only way a Cuban can get access to the hospital is through a bribe or contacts inside the hospital administration. “Cubans are reportedly very resentful that the best hospital in Havana is ‘off-limits’ to them,” the memo reveals.

According to the FSHP, a more “accurate” view of the healthcare experience of Cubans can be seen at the Calixto Garcia Hospital. “FSHP believes that if Michael Moore really wanted the ’same care as local Cubans’, this is where he should have gone,” the cable states.

A 2007 visit by the FSHP to this “dilapidated” hospital, built in the 1800s, was “reminiscent of a scene from some of the poorest countries in the world,” the cable adds.

The memo points out that even the Cuban ruling elite leave Cuba when they need medical care. Fidel Castro, for example, brought in a Spanish doctor during his health crisis in 2006. The vice-minister of health, Abelardo Ramirez, went to France for gastric cancer surgery. The neurosurgeon whoheads CIMEQ [Centro de Investigaciones Médico-Quirúrgicas] hospital – widely regarded as one of the best in Cuba – came to England for eye surgery, returning periodically for checkups.

“After living in Cuba for two and a half years, treating numerous Cuban employees at USINT, and interacting with many other Cubans, the FSHP believes … preventive medicine in Cuba is a by-gone ideal, rather than the standard practice of care,” the memo concludes.

In a system of central planning with no recognition of property rights where bureaucracy reigns supreme, misallocations always and inevitably lead to shortages. And shortages always necessitate compulsory rationing and bribery.

This is, by the way, exactly the direction that health care in the US has been taking for the past decades and continues to accelerate towards full throttle.

It takes the delusion of bigoted socialist ideology to look past such simple and obvious realities.

Related posts:

1. Health Care & Drug Shortages in the USA
2. Opening Up to Cuba – A Step in the Right Direction
3. Fixing Health Care in the US

Health insurers say they plan to raise premiums for some Americans as a direct result of the health overhaul in coming weeks, complicating Democrats’ efforts to trumpet their signature achievement before the midterm elections.

Aetna Inc., some BlueCross BlueShield plans and other smaller carriers have asked for premium increases of between 1% and 9% to pay for extra benefits required under the law, according to filings with state regulators.

These and other insurers say Congress’s landmark refashioning of U.S. health coverage, which passed in March after a brutal fight, is causing them to pass on more costs to consumers than Democrats predicted.

The rate increases largely apply to policies for individuals and small businesses and don’t include people covered by a big employer or Medicare.

About 9% of Americans buy coverage through the individual market, according to the Census Bureau, and roughly one-fifth of people who get coverage through their employer work at companies with 50 or fewer employees, according to the Kaiser Family Foundation. People in both groups are likely to feel the effects of the proposed increases, even as they see new benefits under the law, such as the elimination of lifetime and certain annual coverage caps.

Many carriers also are seeking additional rate increases that they say they need to cover rising medical costs. As a result, some consumers could face total premium increases of more than 20%.

While the increases apply mostly to the new policies insurers write after Oct. 1, consumers could be subject to the higher rates if they modify their existing plans and cause them to lose grandfathered status.

The rate increases are a dose of troubling news for Democrats just weeks before an election in which they are at risk of losing their majority in the House and possibly the Senate.

In addition to pledging that the law would restrain increases in Americans’ insurance premiums, Democrats front-loaded the legislation with early provisions they hoped would boost public support. Those include letting children stay on their parents’ insurance policies until age 26, eliminating co-payments for preventive care and barring insurers from denying policies to children with pre-existing conditions, plus the elimination of the coverage caps.

My comment:

Yes, when you outlaw the denying of policies to people with pre-existing conditions, then costs will go up as a result. That’s not such a tough one to figure out, folks. Did the legislators expect something else to happen? Of course they didn’t. Do they care? Of course they care … about beefing the bill up with things that sound good at first glance, making it appealing to the public to push it through quickly as possible. Do they care about what happens thereafter? Why, of course they do. They care about granting access to positions, offices, projects, and cash to those who invested money in the legislators writing the laws (a.k.a lobbyism).

Now, I can already hear people object: “But Niiiima, health costs were always going up, you are now blaming Obama/Democrats for something that has been happening regardless.” OK, but my point is that these people claimed, and a lot of gullible people listened, that it will be THEY who will make health care more affordable and THEY who will make it universal and bla bla bla.

Republicans and Democrats alike have both been instrumental in socializing the US health care system over the past century. I don’t blame one party more than the other. I blame the idea that a system of organized and centralized aggression can ever be sustained. I support peace and non-aggression as a solution. During abolitionism, people didn’t replace mean slave masters with kinder ones. They abolished the system of slavery, period.

Why will this bill not make real rates drop, at least not lastingly? Because none of the fundamental issues of the health system have been solved while a lot of them have been aggravated through this legislation. As I explained before:

But without addressing the 3 steps I outlined above, all other efforts will be completely and absolutely futile. Without addressing the root of high health care costs, it does not matter whether we let government alone take care of health insurance, or whether we completely liberalize the health insurance market. Nothing would change substantially. We would still be paying high premiums that go into a pool that pays for overly expensive health care products and services. We would still be faced with an inherent shortage of health care goods and services.

Weeks before the election, insurance companies began telling state regulators it is those very provisions that are forcing them to increase their rates.

Aetna, one of the nation’s largest health insurers, said the extra benefits forced it to seek rate increases for new individual plans of 5.4% to 7.4% in California and 5.5% to 6.8% in Nevada after Sept. 23. Similar steps are planned across the country, according to Aetna.

Regence BlueCross BlueShield of Oregon said the cost of providing additional benefits under the health law will account on average for 3.4 percentage points of a 17.1% premium rise for a small-employer health plan. It asked regulators last month to approve the increase.

In Wisconsin and North Carolina, Celtic Insurance Co. says half of the 18% increase it is seeking comes from complying with health-law mandates.

The White House says insurers are using the law as an excuse to raise rates and predicts that state regulators will block some of the large increases.

“I would have real deep concerns that the kinds of rate increases that you’re quoting… are justified,” said Nancy-Ann DeParle, the White House’s top health official. She said that for insurers, raising rates was “already their modus operandi before the bill” passed. “We believe consumers will see through this,” she said.

Previously the administration had calculated that the batch of changes taking effect this fall would raise premiums no more than 1% to 2%, on average.

After Regence mailed a letter notifying plan administrators of its intention to raise group insurance rates in Washington state, the White House contacted company officials and accused them of inaccurately justifying the increase. Kerry Barnett, executive vice president for Regence BlueShield, said the insurer is changing the letter to more precisely explain the causes of the increase.

The industry contends its increases are justified. “Anytime you add a benefit, there are increased costs,” said Karen Ignagni, president of America’s Health Insurance Plans, the industry’s lobbying group.

Massachusetts, which enacted universal insurance coverage several years ago, also has seen steadily rising insurance premiums since then. Proponents of that plan attribute the hikes there to an overall increase in medical costs, while insurers cite it as a cautionary example of what can happen when new mandates to improve benefits aren’t coupled with a strong enough provision to force healthy people to buy coverage.

Republicans, who have sought voter support by opposing the health law, say premium increases could help in November’s congressional races. “People are finding out what’s in [the law], they don’t like it, and I think it’s going to play a big factor in this election,” said Iowa Sen. Charles Grassley, the top Republican on the Senate Finance Committee.

About half of all states have the power to deny rate increases. Ms. DeParle pointed out that the law awards states $250 million to bolster their scrutiny of insurance-rate proposals, saying that will eventually curb premiums for people.

“In Kansas, I don’t have a lot of authority to deny a rate increase, if it is justified,” said Kansas Insurance Commissioner Sandy Praeger. She recently approved a 4% increase by Mennonite Mutual Aid Association to pay for the new provisions in the health law.

The process of reviewing rate increases varies by state. For instance, Ms. Praeger said she can deny only rate increases that are unreasonable or discriminatory.

Some regulators say not all insurers have adequately justified their increases. “A lot of it is guesswork for companies,” said Tom Abel, supervisor at the Colorado Division of Insurance. “I was anticipating the carriers to be more uniform.”

Regence BlueCross BlueShield of Oregon, which estimates its increase covers 57,000 members, said its goal is to “anticipate the financial needs of our members as accurately as possible and to collect just enough premiums to cover costs,” said a spokeswoman. Other insurers offered similar explanations or declined to discuss their increases.

A small number of insurers have submitted plans to lower rates and cite the new mandates in the legislation as the reason. HMO Colorado, a Blue Cross Blue Shield plan owned by WellPoint Inc., submitted a letter to state regulators saying small group rates would fall 1.8% starting Oct. 1 because of changes from the law.

Democrats had hoped to sell the bill in the fall elections. But in recent weeks, some Democrats who voted for the bill have shied away from advertising that fact, while the handful of House Democrats who cast “no” votes see it as a potential boost to their re-election bids.

“I think it’s a question of short term versus long term,” said North Carolina Insurance Commissioner Wayne Goodwin, a Democrat up for re-election in 2012. “Thankfully we’re seeing people get more coverage and protections than they’ve ever had before. But until we see the medical-cost inflation affected, you’re likely to see rate increases as long as they are not excessive and in violation of the law.”

… and, dear Mr. Goodwyn, how is this magical “medical-cost inflation” going to be “affected”? Are you going to pray for it? Perform a rain dance? Are you hoping that it’ll just happen somehow somewhere out of the blue? Are you going to will it to happen? Should we maybe write some letters to our health care and pharmaceutical companies asking if they could be a bit nicer and maybe make their goods cheaper?

Haha … you people have got to be kidding !

I am not sure what more I can add than all the things I already wrote, predicted, explained, and reasoned out on the matter of health care. Feel free to explore the links below …

Related posts:

1. We Need Health Care Reform – Now!
2. Fixing Health Care in the US
3. The US Health Care Myth

Related posts:

1. Public Health Care in the US; Comparison of Countries by Public Health Expenditures
2. Health Care Debate – The Public Option Nonsense
3. Health Care Reform Nonsense – Don’t Hurt Your Head About It

The attack on health care by bureaucrats is such a fascinating and instructive example because it is blatantly pursued through numerous different angles, way out in the open and clearly visible, while the public kneels down in awe and, in truly masochistic fashion, asks for more and more abuse, year after year.

I already outlined the economics behind the government’s health care meddling and how the establishment of lasting industry monopolies and the deliberate restriction of supply cements and aggravates high cost of goods and services rendered:

The problem with health care in the US, but in virtually every other country in the world as well, is a simple one: The goods (products and services) offered on the market that address illnesses and and improve our well being are offered at prices that are so high that most consumers are unable to afford a sufficient amount to address their demands.

On top of that, these prices are continuously rising. All other health care issues stem from this simple fact. Health insurance premiums, for example, are charged based on the prices that competing insurers expect to end up paying for health care goods. Thus, naturally, health insurance premiums are on the rise as well, even in the current deflationary environment. The rapid increase in government expenses for its entitlement programs Medicare and Medicaid, too, is simply the result of these ongoing price increases. It is thus not a coincidence that today the US government spends more than any other industrialized nation on health.

On the market, such imbalances are, under free competition, swiftly addressed via a simple process: High prices for certain consumer goods indicate a high demand and an insufficient supply. Thus profit seeking entrepreneurs have an incentive to shift from what they are currently doing to focusing on producing more of such highly demanded goods, by employing more commensurate factors of production that turn out the demanded goods. This leads to a decline in their prices, moving the market closer to equilibrium and thus restoring balance.

But when a group of people which obtains its means of operation via aggression and theft, the government,  imposes decrees that prevent the voluntary market participants to perform such balancing acts, and threaten them with imprisonment and fines should they not oblige, the imbalance will persist. If that group’s actions are such as to bring about even more shortages for the demanded goods, the imbalance will grow, prices will keep rising.

As an outcome of such an interventionist policy, there will always be a small group of entrepreneurs that benefits from the protection awarded against competition and voluntary action on the part of consumers and new entrepreneurs. They naturally reap the benefits from the ability to charge prices that are not being bid down by potentially competing entrepreneurs. It is important to keep this fact in mind when members of such groups utter statements that attempt to justify the policies that have brought about and continue to maintain the imbalance.

It is really an impressive spiderweb of all round government control:

On the drugs side, the FDA decides which drug may or may not enter the market and imposes lifecycles of up to 15 years before a drug is approved. 80% of drug costs can be linked directly to FDA rules that need to be followed.

On the services side, state and federal laws require practitioners to obtain government licenses in order to practice.

Institutions that teach medical practice are naturally also subject to such regulations and medical degree programs thus take an enormous amount of time and capital to complete. Students need to incur debt in order to be able to afford the studies.

Well, at least the market for those student loans is free and unhampered with by the government … right? Well, wrong! This is what I mean when I say what a beautiful, flawless, and fascinating example of all round government meddling and control we have here. The feds of course heavily subsidize student loans through the government sponsored, and now outright nationalized corporation Fannie Mae.

On the fiscal side, through the programs of Medicare and Medicaid, the federal government alone is responsible for 50% of all medical expenditures made in the country.

If health products and services weren’t so expensive, the need for health insurance would be virtually non existent, except for truly catastrophic events, which is what insurance is all about in pretty much any other sector. But since government intervention has created the problems outlined above, it also deems it necessary, as always, to regulate the effects of its meddling, an iron law of interventionism. Thus the government also heavily regulates the business of health insurance, making it illegal to purchase health insurance across state lines and legislating premiums and insurance policy requirements wherever they see fit.

In light of all this it is rather funny that people would act surprised about constantly rising health costs and insurance premiums and on top of that demand that of all people the government step in and “solve” the problem by grabbing more power. The most recent legislation that aims at regulating health insurance more tightly is just another example for this. Soon we will once again see the good old, so often tried, and so consistently failing measures of price control and rationing as the “solution” to health premiums.

A predictable side effect and yet another reason for rising cost that I would like to touch on here is the phenomenon of enormous debts owed by medical students after they graduate, incurred during their long and expensive studies at government accredited institutions. In order to pay off these debts, medical doctors are practically required to charge higher prices for their services.

The AMA provides background information on medical student debt:

Student debt statistics

* $156,456 – According to the Association of American Medical Colleges (AAMC), the average educational debt of indebted graduates of the class of 2009.
* 79 percent of graduates have debt of at least $100,000.
* 58 precent of graduates have debt of at least $150,000.
* 87 percent of graduating medical students carry outstanding loans.

Source: AAMC 2009 Graduation Questionnaire
Why medical education debt has increased

Medical education debt is driven by rising tuition. AAMC data show that median private medical school tuition and fees increased by 50 percent (in real dollars) in the 20 years between 1984 and 2004. Median public medical school tuition and fees increased by 133 percent over the same time period. Other recent 20-year periods show similar trends.

Tuition is just one source of increasing debt burdens. Other causes include:

* Interest accrued on loans over time significantly adds to the total cost of student debt.
* Students are now entering medical school with more education debt from undergraduate education.
* Increasing numbers of “non-traditional” students who have children to support.

Debt crisis harms both students and patients

The increase in debt not only burdens medical students, but can have effects on the entire health care system. Some of correlations found include:

Decrease in primary care physicians

* Students with high debt may be less likely to pursue family practice and primary care specialties and instead seek specialties with higher income or more leisure time.

Decreased diversity of physician workforce

* The cost of tuition can prevent students from low-income/minority and those with other financial responsibilities from attending medical school.
* Physician diversity is necessary to address the needs of heterogeneous, multicultural patient populations.

Promoting unsafe physician behaviors

* Residents with high debt are more likely to moonlight.
* Increasing debt leads to more cynicism and depression among residents.

How can we reduce debt?

The MSS has come up with recommendations for legislative and administrative remedies to resolve the medical education debt crisis. These recommendations focus on controlling tuition, the principal component of education costs, but include a number of relatively simple administrative measures that could be taken immediately and at a low cost to individual medical schools.

And again: the AMA concludes that the solution to the problems created by government legislation and intervention is to “come up with recommendations for legislative and administrative remedies to resolve the medical education debt crisis.”

The best comedian couldn’t make such a farce up :))

The real solution is a lot more simple, intuitive, and measurable than such nonsense: Stop using guns against people who have done you no harm, get the government out of the way, and society will flourish. For guns are not the answer to complex and structural problems, voluntaryism is.

Related posts:

1. Fixing Health Care in the US
2. Health Care Debate – The Public Option Nonsense
3. The US Health Care Myth

Walker states the simple fact that …

… “government is bigger, entitlement programs have expanded, spending has increased and taxes are higher” as a result of the law.

… those points should be listed in the default template header for any bill brought forth in Congress.

In addition to that, multiply any expense number presented by 10 and you’ll usually have a rough approximation of where a government program is headed.

Government always grows, it’s inevitable so long as people cling on to this mad fantasy.

Related posts:

1. Health Care Reform Nonsense – Don’t Hurt Your Head About It
2. Geithner Preps Nation for Higher Taxes
3. US Taxes, Spending & Debts – Historical Charts

1. Grant program for consumer assistance offices (Section 1002, p. 37)
2. Grant program for states to monitor premium increases (Section 1003, p. 42)
3. Committee to review administrative simplification standards (Section 1104, p. 71)
4. Demonstration program for state wellness programs (Section 1201, p. 93)
5. Grant program to establish state Exchanges (Section 1311(a), p. 130)
6. State American Health Benefit Exchanges (Section 1311(b), p. 131)
7. Exchange grants to establish consumer navigator programs (Section 1311(i), p. 150)
8. Grant program for state cooperatives (Section 1322, p. 169)
9. Advisory board for state cooperatives (Section 1322(b)(3), p. 173)
10. Private purchasing council for state cooperatives (Section 1322(d), p. 177)
11. State basic health plan programs (Section 1331, p. 201)
12. State-based reinsurance program (Section 1341, p. 226)
13. Program of risk corridors for individual and small group markets (Section 1342, p. 233)
14. Program to determine eligibility for Exchange participation (Section 1411, p. 267)
15. Program for advance determination of tax credit eligibility (Section 1412, p. 288)
16. Grant program to implement health IT enrollment standards (Section 1561, p. 370)
17. Federal Coordinated Health Care Office for dual eligible beneficiaries (Section 2602, p. 512)
18. Medicaid quality measurement program (Section 2701, p. 518)
19. Medicaid health home program for people with chronic conditions, and grants for planning same (Section 2703, p. 524)
20. Medicaid demonstration project to evaluate bundled payments (Section 2704, p. 532)
21. Medicaid demonstration project for global payment system (Section 2705, p. 536)
22. Medicaid demonstration project for accountable care organizations (Section 2706, p. 538)
23. Medicaid demonstration project for emergency psychiatric care (Section 2707, p. 540)
24. Grant program for delivery of services to individuals with postpartum depression (Section 2952(b), p. 591)
25. State allotments for grants to promote personal responsibility education programs (Section 2953, p. 596)
26. Medicare value-based purchasing program (Section 3001(a), p. 613)
27. Medicare value-based purchasing demonstration program for critical access hospitals (Section 3001(b), p. 637)
28. Medicare value-based purchasing program for skilled nursing facilities (Section 3006(a), p. 666)
29. Medicare value-based purchasing program for home health agencies (Section 3006(b), p. 668)
30. Interagency Working Group on Health Care Quality (Section 3012, p. 688)
31. Grant program to develop health care quality measures (Section 3013, p. 693)
32. Center for Medicare and Medicaid Innovation (Section 3021, p. 712)
33. Medicare shared savings program (Section 3022, p. 728)
34. Medicare pilot program on payment bundling (Section 3023, p. 739)
35. Independence at home medical practice demonstration program (Section 3024, p. 752)
36. Program for use of patient safety organizations to reduce hospital readmission rates (Section 3025(b), p. 775)
37. Community-based care transitions program (Section 3026, p. 776)
38. Demonstration project for payment of complex diagnostic laboratory tests (Section 3113, p. 800)
39. Medicare hospice concurrent care demonstration project (Section 3140, p. 850)
40. Independent Payment Advisory Board (Section 3403, p. 982)
41. Consumer Advisory Council for Independent Payment Advisory Board (Section 3403, p. 1027)
42. Grant program for technical assistance to providers implementing health quality practices (Section 3501, p. 1043)
43. Grant program to establish interdisciplinary health teams (Section 3502, p. 1048)
44. Grant program to implement medication therapy management (Section 3503, p. 1055)
45. Grant program to support emergency care pilot programs (Section 3504, p. 1061)
46. Grant program to promote universal access to trauma services (Section 3505(b), p. 1081)
47. Grant program to develop and promote shared decision-making aids (Section 3506, p. 1088)
48. Grant program to support implementation of shared decision-making (Section 3506, p. 1091)
49. Grant program to integrate quality improvement in clinical education (Section 3508, p. 1095)
50. Health and Human Services Coordinating Committee on Women’s Health (Section 3509(a), p. 1098)
51. Centers for Disease Control Office of Women’s Health (Section 3509(b), p. 1102)
52. Agency for Healthcare Research and Quality Office of Women’s Health (Section 3509(e), p. 1105)
53. Health Resources and Services Administration Office of Women’s Health (Section 3509(f), p. 1106)
54. Food and Drug Administration Office of Women’s Health (Section 3509(g), p. 1109)
55. National Prevention, Health Promotion, and Public Health Council (Section 4001, p. 1114)
56. Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (Section 4001(f), p. 1117)
57. Prevention and Public Health Fund (Section 4002, p. 1121)
58. Community Preventive Services Task Force (Section 4003(b), p. 1126)
59. Grant program to support school-based health centers (Section 4101, p. 1135)
60. Grant program to promote research-based dental caries disease management (Section 4102, p. 1147)
61. Grant program for States to prevent chronic disease in Medicaid beneficiaries (Section 4108, p. 1174)
62. Community transformation grants (Section 4201, p. 1182)
63. Grant program to provide public health interventions (Section 4202, p. 1188)
64. Demonstration program of grants to improve child immunization rates (Section 4204(b), p. 1200)
65. Pilot program for risk-factor assessments provided through community health centers (Section 4206, p. 1215)
66. Grant program to increase epidemiology and laboratory capacity (Section 4304, p. 1233)
67. Interagency Pain Research Coordinating Committee (Section 4305, p. 1238)
68. National Health Care Workforce Commission (Section 5101, p. 1256)
69. Grant program to plan health care workforce development activities (Section 5102(c), p. 1275)
70. Grant program to implement health care workforce development activities (Section 5102(d), p. 1279)
71. Pediatric specialty loan repayment program (Section 5203, p. 1295)
72. Public Health Workforce Loan Repayment Program (Section 5204, p. 1300)
73. Allied Health Loan Forgiveness Program (Section 5205, p. 1305)
74. Grant program to provide mid-career training for health professionals (Section 5206, p. 1307)
75. Grant program to fund nurse-managed health clinics (Section 5208, p. 1310)
76. Grant program to support primary care training programs (Section 5301, p. 1315)
77. Grant program to fund training for direct care workers (Section 5302, p. 1322)
78. Grant program to develop dental training programs (Section 5303, p. 1325)
79. Demonstration program to increase access to dental health care in underserved communities (Section 5304, p. 1331)
80. Grant program to promote geriatric education centers (Section 5305, p. 1334)
81. Grant program to promote health professionals entering geriatrics (Section 5305, p. 1339)
82. Grant program to promote training in mental and behavioral health (Section 5306, p. 1344)
83. Grant program to promote nurse retention programs (Section 5309, p. 1354)
84. Student loan forgiveness for nursing school faculty (Section 5311(b), p. 1360)
85. Grant program to promote positive health behaviors and outcomes (Section 5313, p. 1364)
86. Public Health Sciences Track for medical students (Section 5315, p. 1372)
87. Primary Care Extension Program to educate providers (Section 5405, p. 1404)
88. Grant program for demonstration projects to address health workforce shortage needs (Section 5507, p. 1442)
89. Grant program for demonstration projects to develop training programs for home health aides (Section 5507, p. 1447)
90. Grant program to establish new primary care residency programs (Section 5508(a), p. 1458)
91. Program of payments to teaching health centers that sponsor medical residency training (Section 5508(c), p. 1462)
92. Graduate nurse education demonstration program (Section 5509, p. 1472)
93. Grant program to establish demonstration projects for community-based mental health settings (Section 5604, p. 1486)
94. Commission on Key National Indicators (Section 5605, p. 1489)
95. Quality assurance and performance improvement program for skilled nursing facilities (Section 6102, p. 1554)
96. Special focus facility program for skilled nursing facilities (Section 6103(a)(3), p. 1561)
97. Special focus facility program for nursing facilities (Section 6103(b)(3), p. 1568)
98. National independent monitor pilot program for skilled nursing facilities and nursing facilities (Section 6112, p. 1589)
99. Demonstration projects for nursing facilities involved in the culture change movement (Section 6114, p. 1597)
100. Patient-Centered Outcomes Research Institute (Section 6301, p. 1619)
101. Standing methodology committee for Patient-Centered Outcomes Research Institute (Section 6301, p. 1629)
102. Board of Governors for Patient-Centered Outcomes Research Institute (Section 6301, p. 1638)
103. Patient-Centered Outcomes Research Trust Fund (Section 6301(e), p. 1656)
104. Elder Justice Coordinating Council (Section 6703, p. 1773)
105. Advisory Board on Elder Abuse, Neglect, and Exploitation (Section 6703, p. 1776)
106. Grant program to create elder abuse forensic centers (Section 6703, p. 1783)
107. Grant program to promote continuing education for long-term care staffers (Section 6703, p. 1787)
108. Grant program to improve management practices and training (Section 6703, p. 1788)
109. Grant program to subsidize costs of electronic health records (Section 6703, p. 1791)
110. Grant program to promote adult protective services (Section 6703, p. 1796)
111. Grant program to conduct elder abuse detection and prevention (Section 6703, p. 1798)
112. Grant program to support long-term care ombudsmen (Section 6703, p. 1800)
113. National Training Institute for long-term care surveyors (Section 6703, p. 1806)
114. Grant program to fund State surveys of long-term care residences (Section 6703, p. 1809)
115. CLASS Independence Fund (Section 8002, p. 1926)
116. CLASS Independence Fund Board of Trustees (Section 8002, p. 1927)
117. CLASS Independence Advisory Council (Section 8002, p. 1931)
118. Personal Care Attendants Workforce Advisory Panel (Section 8002(c), p. 1938)
119. Multi-state health plans offered by Office of Personnel Management (Section 10104(p), p. 2086)
120. Advisory board for multi-state health plans (Section 10104(p), p. 2094)
121. Pregnancy Assistance Fund (Section 10212, p. 2164)
122. Value-based purchasing program for ambulatory surgical centers (Section 10301, p. 2176)
123. Demonstration project for payment adjustments to home health services (Section 10315, p. 2200)
124. Pilot program for care of individuals in environmental emergency declaration areas (Section 10323, p. 2223)
125. Grant program to screen at-risk individuals for environmental health conditions (Section 10323(b), p. 2231)
126. Pilot programs to implement value-based purchasing (Section 10326, p. 2242)
127. Grant program to support community-based collaborative care networks (Section 10333, p. 2265)
128. Centers for Disease Control Office of Minority Health (Section 10334, p. 2272)
129. Health Resources and Services Administration Office of Minority Health (Section 10334, p. 2272)
130. Substance Abuse and Mental Health Services Administration Office of Minority Health (Section 10334, p. 2272)
131. Agency for Healthcare Research and Quality Office of Minority Health (Section 10334, p. 2272)
132. Food and Drug Administration Office of Minority Health (Section 10334, p. 2272)
133. Centers for Medicare and Medicaid Services Office of Minority Health (Section 10334, p. 2272)
134. Grant program to promote small business wellness programs (Section 10408, p. 2285)
135. Cures Acceleration Network (Section 10409, p. 2289)
136. Cures Acceleration Network Review Board (Section 10409, p. 2291)
137. Grant program for Cures Acceleration Network (Section 10409, p. 2297)
138. Grant program to promote centers of excellence for depression (Section 10410, p. 2304)
139. Advisory committee for young women’s breast health awareness education campaign (Section 10413, p. 2322)
140. Grant program to provide assistance to provide information to young women with breast cancer (Section 10413, p. 2326)
141. Interagency Access to Health Care in Alaska Task Force (Section 10501, p. 2329)
142. Grant program to train nurse practitioners as primary care providers (Section 10501(e), p. 2332)
143. Grant program for community-based diabetes prevention (Section 10501(g), p. 2337)
144. Grant program for providers who treat a high percentage of medically underserved populations (Section 10501(k), p. 2343)
145. Grant program to recruit students to practice in underserved communities (Section 10501(l), p. 2344)
146. Community Health Center Fund (Section 10503, p. 2355)
147. Demonstration project to provide access to health care for the uninsured at reduced fees (Section 10504, p. 2357)
148. Demonstration program to explore alternatives to tort litigation (Section 10607, p. 2369)
149. Indian Health demonstration program for chronic shortages of health professionals (S. 1790, Section 112, p. 24)*
150. Office of Indian Men’s Health (S. 1790, Section 136, p. 71)*
151. Indian Country modular component facilities demonstration program (S. 1790, Section 146, p. 108)*
152. Indian mobile health stations demonstration program (S. 1790, Section 147, p. 111)*
153. Office of Direct Service Tribes (S. 1790, Section 172, p. 151)*
154. Indian Health Service mental health technician training program (S. 1790, Section 181, p. 173)*
155. Indian Health Service program for treatment of child sexual abuse victims (S. 1790, Section 181, p. 192)*
156. Indian Health Service program for treatment of domestic violence and sexual abuse (S. 1790, Section 181, p. 194)*
157. Indian youth telemental health demonstration project (S. 1790, Section 181, p. 204)*
158. Indian youth life skills demonstration project (S. 1790, Section 181, p. 220)*
159. Indian Health Service Director of HIV/AIDS Prevention and Treatment (S. 1790, Section 199B, p. 258)*

And of course the IRS will be given more powers of enforcement, because, you know, when you tack on government programs you kinda wanna get the guys with the guns involved, it’s completely inevitable:

A report on the New York Post website yesterday reports the IRS may hire as many as 16,000 new agents.This is estimated to add another $1 billion dollars to the federal budget. This is alleged by Republicans on The House Ways and Means committee. Under the Obama plan the IRS would be given new powers of enforcement. The IRS will be given the charge to see every American has “acceptable” health insurance. If your plan is not acceptable the IRS may be able to withhold your income tax return and or levy fines due to your non compliance. Everyone under the Obama plan will be required to purchase insurance. If you can’t pay for the insurance the subsidy to purchase will come through the IRS in the form of a tax credit. Under one version of the plan the money will come from a Health Choices Administration. Do we really want the IRS involved in assessing our health care and possibly releasing our tax information to other agencies?

He also aptly points us to this passage from this old and forgotten piece of paper:

“He has erected a multitude of New Offices, and sent hither swarms of Officers to harass our people and eat out their substance.” – Declaration of Independence

This, me friends, is the shape of things to come …

Related posts:

1. Former CBO Head on Healthcare Reform – “government is bigger, entitlement programs have expanded, spending has increased and taxes are higher”
2. Healthcare – Monopoly, Cost, Sustainability, and the Final Convulsions of an Imploding Government
3. Healthcare Debate – Pseudo Solutions from Academia

Health care monopoly, high health costs, unsustainability & people opting for the $695 fine:

Health care mess in the UK, government bureaucracy, medical students’ debt, mandated charges & the last convulsions of an imploding system:

Cheaper health care, unions, subsidies, special interest groups & fighting tooth and nail:

Related posts:

1. Former CBO Head on Healthcare Reform – “government is bigger, entitlement programs have expanded, spending has increased and taxes are higher”
2. Healthcare Debate – Pseudo Solutions from Academia
3. The Government’s Healthcare Takeover in Numbers

Every single one debates this bill with such amazing certainty, it’s really quite amusing. Because nobody, not one single person, knows the full content of this 2400+ page monster.

I don’t know what specifically is in it because I have not taken the time to read through the entire bill, just as no single Senator or Congressman has, but one thing is for sure: it satisfies all the different lobbyists who needed to get their pork in order for their representatives in Congress to vote for the bill.

I wrote before what would need to happen in a hypothetical world where politicians really care about fixing health care in the US. (*chuckle*) Of course none of this is going to happen.

Politicians will do everything in their power to loot the public purse at an accelerating speed and government will continue its long lasting and inevitable growth.

There is no use in hurting your head about it or shouting at them on Capitol Hill. Talk to your friends and family about the truth behind what’s going on, try to enlighten those who are interested. Like I said before:

This train wreck is headed for a cliff and the public is cheering on its acceleration. The system will have to play itself out, and in the very process it is going to destroy itself.

All we can do is remain calm and collected, don’t stress over this madness. Educate yourself and your friends and family about the truth about Freedom, Peace and Happiness. Act upon it. Understand the concepts of Ethics, Human Nature, Government, and Liberty. Act upon it.

Once people understand the truth, society will be transformed into a viable, peaceful, and prosperous system.

Related posts:

1. We Need Health Care Reform – Now!
2. Health Care Debate – The Public Option Nonsense
3. Former CBO Head on Healthcare Reform – “government is bigger, entitlement programs have expanded, spending has increased and taxes are higher”