As reports come in from the workings of our new federal team I am beginning to get concerned. This completely affects how a new federal health care sytem will run. Here are some of them:

1. Obama promised the federal deficit would not increase if a national heathcare system were implemented, and in fact, that he would cut in half our federal deficit by the end of his first term. Here's the link where this is (go to page two):

http://www.whitehouse.gov/blog/pg2/?CategoryId=3

The OMB has now issued two reports stating that the federal deficit can only increase with a national health plan, that there will be no "savings" if the plan is implemented. The number thrown out was over 1.5trillion dollars over ten years, and that did not count "administrative expenses"-did anyone know the proposal calls for THIRTY ONE brand-new federal agencies to "administer" the plan? See point below on administrative costs...

2. Administrative costs of the proposal: here is a smattering of them:

First, the OMB's comment in their report: “We have not yet estimated the administrative costs to the federal government of implementing the specified policies, nor have we accounted for all of the proposal’s likely effects on spending for other federal programs.” ...so as I understand it, the 1.5 trillion does not incluse these costs, and they are huge.

The plan adds a new “Health Choices Commissioner” who would helm the new “Health Choices Administration” (Section 141 of the bill) – separate from the already existing Department of Health and Human Services, Centers for Medicare and Medicaid Services (formerly the Health Care Financing Administration), the Veterans Health Administration, and the Indian Health Service.

Also proposed is the creation of a “Public Health Investment Fund” and a “Health Insurance Exchange Trust Fund.” The latter would create a “transparent and functional marketplace for individuals and small employers to comparison shop among private and public insurers.”

No matter that state insurance departments already operate such systems. This is simply federal redundancy.

The plan also creates a new “Bureau of Health Information” (not to be confused with the already existing National Center for Health Statistics) within the department of Health and Human Services. The BHI will be led by a new “Assistant Secretary for Health Information.” The new assistant secretary will coordinate with the recently-created “National Coordinator for Health Information Technology” – who is responsible for monitoring the $19.5 billion in the stimulus law to implement “a nationwide interoperable, privacy-protected health information technology infrastructure.” The federal government is so good at protecting its information that several of its own databases were recently hacked into, so this is worrisome.

The new Bureau of Health Information will house its own “Office of Civil Rights” and “Office of Minority Health.” The information czar will be required to collect health statistics in the “primary language” of ethnic minorities – and thus, the need for a new “language demonstration program” to showcase their efforts. The plan includes provisions to ensure “cultural and linguistics competence training” and establish “a youth public health program to expose and recruit high school students into public health careers.”

How does this improve core health care? Good question.

And there's more, if you can stomach it. The bill would add a new “Senior Advisor for Health Care Fraud” and require the Attorney General to appoint a “Senior Counsel for Health Care Fraud Enforcement.” There’s already a national Health Care Fraud and Abuse Control Program, but who’s counting?

To coordinate all the new bureaucrats, there would also be created a new “Health Care Program Integrity Coordinating Council” to “to coordinate strategic planning among federal agencies involved in health care integrity and oversight.”

Not too sure why it's in there, but hell, everything else is so why not, a new “Coordinated Environmental Public Health Network” to “build upon and coordinate among existing nvironmental and health data collection systems and create state environmental public health networks.”

Also new, a “National Health Care Workforce Commission” will be “tasked with reviewing health care workforce and projected workforce needs.” New funding will be available for a “demonstration program to improve immunization coverage”, I am not too sure what that means but sure hope it won't take away my current right to refuse the flu shot or any other vaccine for me or mine.

Who’ll be looking out for you? The House bill creates a “public plan ombudsman” and a “special health insurance exchange inspector general” to police spending and guard against waste, fraud, and abuse. Thank heavens, I was beginning to be worried, but with this ombudsman in place, I feel so much better.

3. Tax increase. We were also told income taxes would not be increased, yet Congress has come up with a plan to hit "wealthy" taxpayers with a surtax...now, you may not make the 280K a year to qualify as "wealthy" now, but just wait until "wealthy" gets redefined to be 200K, then 150K, then 100K, then 75K...you see where this is going....soon anyone making a decent salary will be classified as "wealthy" and subject to the additional tax. Truly wealthy people have options, like moving, and if enough of our big taxpayers change their residence, we are in deep doo-doo, regardless of whether we have national healthcare or not (they already have tons of money offshore, it would be easy for some of these folks to simply live outside the US for the requisit number of days in order to qualify for nonresident/domicile status). Something like 1% of the top filers are paying close to 40% of the income taxes already, if only a few of these folks leave, that's a big problem.

4. Option to keep existing plan. We have been told we will be able to keep our existing policies if we want them, yet a recent article in the Wall Street Journal - "Idea to Tax Insurers" "Gaining Traction" indicates otherwise...if insurance companies are taxed, my coverage is going to either be reduced or made more expensive, and thus my health care costs are now higher than they were...that's not what we were told this reform would do! Or worse, my insurance company eliminates my plan altogether, forcing me to choose the federal option, which I am pretty sure we will not want.

See my other post on the Tenth Amendment, where states are opting out of the federal plan.