El presidente de EEUU, Barack Obama, ha logrado aprobar su reforma sanitaria en el Congreso. Su coste superará el billón de dólares, aumentará los impuestos y prevé reducir el déficit público basándose en meras promesas políticas.
Tras meses de dura campaña política, el discurso oficial sobre la reforma sanitaria impulsada por Obama ha girado en torno a la necesidad de otorgar cobertura médica a unos 32 millones de personas que carecen de seguro privado, así como en la promesa de que su proyecto logrará reducir el déficit público.
Entre otros aspectos, el plan incrementa las subvenciones públicas, prohíbe a las aseguradoras rechazar dar cobertura a personas que ya padezcan alguna enfermedad y hace obligatorio para la mayoría de los residentes el contar con un seguro médico. Entrará en vigor a partir de 2014.
Sin embargo, ambos ejes (cobertura y déficit) se tambalean a la vista de un análisis más profundo de los datos, más allá de los meros mensajes gubernamentales. En primer lugar, el desglose de la población sin seguro médico echa por tierra algunos mitos acerca del modelo sanitario estadounidense. La situación es mucho menos grave de lo que parece, tal y como avanzó Libertad Digital.
Así, el 25% de los no asegurados son inmigrantes sin nacionalidad estadounidense; muchos tan sólo carecen de seguro médico una parte del año (mientras están sin trabajo); unos 15 millones cuentan con unos ingresos superiores a los 50.000 dólares al año; unos 18 millones tienen entre 18 y 34 años, una edad en la que es poco probable enfermar y, por ello, muchos eligen no contratar un seguro médico; además, más de 11 millones tienen acceso a los programas médicos estatales.
El 85% de los estadounidenses cuenta con un seguro médico privado.
Pero más importante si cabe es el análisis económico de la reforma sanitaria. Y es que, Obama ha insistido en los últimos meses que su proyecto logrará reducir el déficit público. La cuestión es… ¿cómo? La Oficina Presupuestaria del Congreso (CBO) señala en su último informe sobre esta materia que, de cumplirse al pie de la letra el proyecto de Obama, la reforma sanitaria reducirá el déficit público en 143.000 millones de dólares entre 2010 y 2019.
La expansión pública de la cobertura médica tiene un coste de 940.000 millones de dólares, pero si se suman la extensión de las subvenciones a las recetas, el aumento de la financiación para los centros médicos comunitarios y las políticas de prevención, la factura total de la reforma ascenderá a 1,072 billones de dólares en la presente década.
Según el CBO, el aumento del gasto público directo en sanidad (382.000 millones de dólares entre 2010 y 2019) se vería compensado por un incremento de los ingresos fiscales (más impuestos) de 525.000 millones. De este modo, la reforma permitirá al Gobierno reducir el déficit público en 143.000 millones hasta 2019.
El problema, sin embargo, consiste en que tales cálculos son meras previsiones basadas en promesas, cuyo cumplimiento dependerá en todo caso de la voluntad política. Así, si bien por el lado de los ingresos, Obama aumentará los impuestos a empresas (aseguradoras) y particulares (con rentas altas), además de obligar a todos los ciudadanos a contar con cobertura médica, por el lado del gasto todo dependerá de que los próximos gobiernos apliquen un ambicioso plan de austeridad, cuyo cumplimiento nadie garantiza.
Así, tal y como recoge el CBO, la reforma de Obama prevé ahorrar 455.000 millones de dólares en el programa público de salud Medicare (para los mayores de 65 años) hasta 2019. De hecho, ésta es la fuente de financiación clave de la reforma. El proyecto aprobado por el Congreso incluye la creación de un consejo gubernamental para aplicar importantes medidas de ahorro en el Medicare, ya sea aumentando la eficiencia o bien reduciendo la cantidad o calidad del servicio público.
Ese recorte presupuestario de 455.000 millones equivale casi a la mitad del coste total estimado de la reforma (algo más de 1 billón de dólares). En líneas generales, el proyecto contempla reducir el precio de los servicios que cobran los proveedores privados de Medicare, así como garantizar que el gasto por beneficiario no crezca más de un 2% anual, frente al avance medio del 4% de los últimos 20 años.
De este modo, la financiación de la reforma se basa en la siguiente hipótesis: ampliar la cobertura médica mediante más gasto público y pagar parte de la factura con más y nuevos impuestos, para luego, en los años venideros, comprometerse a reducir el gasto público sanitario. Las dudas entre los expertos no se han hecho esperar: si la legislación se ejecuta tal y como ha sido aprobada, el déficit futuro se reducirá de forma sustancial; pero si los próximos gobiernos no aplican rigurosamente el citado plan de austeridad el déficit, sin duda, aumentará.
El coste público casi siempre aumenta
Esto último es, precisamente, lo que sucederá a la vista de experiencias similares. Así, un estudio elaborado por el ala republicana del Senado pone de manifiesto que el coste inicial previsto en los programas públicos de salud aprobados tras la Segunda Guerra Mundial es siempre muy inferior a la realidad.
El coste previsto del Servicio Público de Salud del Reino Unido para su primer año de andadura (1948-49) era de 260 millones de libras. El coste final fue de 359 millones, un 38% más.
En 1967, el Gobierno de EEUU estimó que el coste de Medicare ascendería a 12.000 millones de dólares en 1990, muy lejos de los 110.000 millones que supusieron en realidad (casi 10 veces más de lo previsto). El mismo desfase presupuestario tuvo lugar con el resto de programas que recoge la siguiente tabla:
El Rev. Sharpton ya les saco la careta delcarando que: "cuando el pueblo votó por Obama, votó por el socialismo."
Mientras celebran Obama y sus secuaces la destrucción del mejor sistema de saludo del mundo, después de hacer trizas la constitución de Estados Unidos y de cercenar la libertad de los americanos a decidir el cuidado de su salud y sus relaciones tracionales con sus médico, el pueblo ha expresado en la última encuesta su profundo enojo repudiando el 89% a Pelozi y el 92% a Reid, los verdugos de Herodes Obama encargados de redactar y llevar a cabo esa abominable mostruosidad del OBAMACARE.
Publicado: 03-24-2010 12:39 PM
Dear Ms. Pelosi:
I write to you out of utter disdain! You are as despicable and un-American as the traitor Jane Fonda.
I am a soon to be 65 year-old who has voted in every state and local election since 1966. I have voted for both Republicans and Democrats alike. I have worked on campaigns for both Republicans and Democrats, white and black. I served the country that I love in Vietnam, as my son did in the Middle East. I was awarded two bronze stars. I have been involved in politics since age 6 when my father was campaign manager for a truly great American Congressman, Charles Raper Jonas, who worked for his constituents and his country, and was to be admired, unlike you.
You obviously haven’t read the Constitution recently, if ever, the Federalist Papers, or even David McCullough’s book on John Adams. You ought to take the time while riding around in your government provided luxury executive jet to do just that. You represent Socialistic and even Marxist principals that our founding fathers tried to avoid when setting out the capitalistic republican form of government represented by our Constitution.
I find it interesting that you and your husband are multi-millionaires with much of your fortune being made as a result of your “public service”. You have controlled legislation that has enhanced your husband’s investments both on and off shore. At the same time you redistributed the wealth of others.
Our system of a free market economy is being destroyed by the likes of you, Harry Reid, and now our President. You ride around in a Gulfstream airplane at the tax payer’s expense while criticizing the presidents of companies who produced something for the economy. You add nothing to the economy of the United States; you only subtract therefrom.
I would like to suggest that you return to the city of fruitcakes and nuts and eat your husband’s canned tuna and pineapple produced by illegal immigrants and by workers who have been excluded from the protection that 90% of the legal workers in the United States have.
I await your defeat in the next election with glee.
Don’t ever use the term “un-American” again for protesters who love this country and are exercising their rights upon which this country was founded.
By the way, while I served in the Army, I was spit on by the same type of lunatics who support you and who you probably supported in the 60’s and 70’s. You are an embarrassment to all of us who served so that you would have the protected right of free speech to call us un-American. But at the same time, I have the right to write you to notify you that I consider you to be un-American, as do the majority of the people of this formerly great country. You are a true disgrace to most of the people who served this country by offering themselves for public service in the United States Congress.
I feel certain your aides will not share this letter with you, but I intend to share it with many.
Dennis L. Guthrie
WOW!! What a letter!
Check his credentials. Then read his letter to Pelosi!
Born St. Louis , Missouri , August 21, 1944
North Carolina , 1969
U.S. District Court, Eastern, Middle and Western Districts of North Carolina , 1969
U.S. Tax Court
Fourth Circuit Court of Appeals
Education: Woodford College , 1966 A.B.
Mercer University , 1969 J.D.
Phi Alpha Delta
Vice-Justice, District XIV, 1968 - 1969
Professional Associations and Memberships:
North Carolina and American Bar Associations (Member, Sections on: Administrative Law; General Practice; Litigation)
26th Judicial District and North Carolina State Bar
Mecklenburg County Bar Association
American Association of Justice
North Carolina Trial Lawyers Association
Captain, U..S. Army, 1969-1971, Vietnam
National Defense Medal, 1969
Republic of Viet Nam Service Medal, 1970
Bronze Star Medals (2), 1971
Assistant District Attorney, Mecklenburg County , 1971 - 1974
Charlotte Chamber of Commerce
Chairman, Board of Trustees Providence United Methodist Church
Board of Directors, Alexander Children's Home
Board of Directors, Charlotte Culinary Institute
Wofford Alumni Executive Council
Scoutmaster, Boy Scouts of America
Board of Directors, Boy Scouts of America of Mecklenburg County
Board of Directors, Girl Scout Council
Life Member, National Eagle Scout Association
Life Member, Girl Scouts of America
Publicado: 03-25-2010 01:24 PM
AP: Say, guess what we just found in ObamaCare!
by Ed Morrissey
Congress passed the bill without knowing what was in it. Barack Obama signed it without reading it. Now it looks as though the Associated Press reported on ObamaCare without comprehending its content. Readers will have to scroll far down to discover that the elimination of a key tax break that kept retirees on company prescription-medication plans will mean dumping millions of seniors onto Medicare — and that the AP ignored it until now:
The health care overhaul will cost U.S. companies billions and make them more likely to drop prescription drug coverage for retirees because of a change in how the government subsidizes those benefits.
In the first two days after the law was signed, three major companies — Deere & Co., Caterpillar Inc. and Valero Energy — said they expect to take a total hit of $265 million to account for smaller tax deductions in the future.
With more than 3,500 companies now getting the tax break as an incentive to keep providing coverage, others are almost certain to announce similar cost increases in the weeks ahead as they sort out the impact of the change.
Figuring out what it will mean for retirees will take longer, but analysts said as many as 2 million could lose the prescription drug coverage provided by their former employers, leaving them to enroll in Medicare’s program.
Over the past year, I’ve repeatedly warned about the dangers of static tax analysis. That process considers changes in tax policy without considering its impact on behavior. The closure of this “loophole,” as Robert Gibbs called it yesterday, is a perfect example of this stunted thinking.
The Democrats in Congress argued that they would gain $5.4 billion in revenue by eliminating the tax break enacted in the 2003 Medicare Part D program as an incentive for businesses to keep their retirees out of the Medicare system.
Instead, they have given businesses a reason to dump their retirees out of the private networks and into the Part D system now. Not only will the expected tax revenues never appear, but now we will have to spend a lot more money covering those prescriptions out of public funds. The seniors in these programs will suffer most of all, as the Part D coverage is vastly inferior to the private plans offered by businesses in the private sector.
Who could have foreseen this? Well, businesses have been trying to get attention to this problem for months, as the AP somewhat belatedly reports:
Industry groups say they lobbied hard against the change in the tax rules before it was added to the health care law over the winter.
“It was in all of our letters and communications that went up to the Hill, and the companies were heavily involved in that,” said Dena Battle, a tax specialist with the National Association of Manufacturers.
Nationwide, companies would take a $14 billion hit on their financial statements if all of the roughly 3,500 companies receiving the subsidies continued to do so, according to a study by Towers Watson, a human resources consulting firm.
For months, businesses have warned about the problem, and for months, Democrats have claimed this clause as a $5.4 billion revenue source. One might think that the media would be interested in puncturing some bad assumptions. Apparently not.
Publicado: 03-26-2010 01:48 PM
VIN SUPRYNOWICZ: Please don't call it 'state socialism'
The modern Prussian police state was built by Bismarck and others in the 19th century on a Spartan model, giving the central government vastly greater control over the individual than had ever been considered possible before.
Bismarck's program centered squarely on insurance programs designed to increase support for the ever larger and more powerful government. The program included health insurance, workman's compensation, disability insurance and old-age retirement pensions, all innovations at the time.
Starting with the model of Prussian compulsary schooling, American "educators," starting with John Dewey and Edward Thorndike eagerly imported this Prussian model to America.
Trained to accept such state control (and now the new "green" religion) in the schools for most of the past century, then made dependent on government insurance programs (Social Security, Medicare) as surely as the pimp makes sure his young ladies are dependent on the needle and the fix only he can provide, slavery to the state soon appears inescapable, even ordained by God and nature.
Why, it's a good thing! In exchange for the possibility of ever becoming truly exceptional, of growing rich based on our own efforts, it rewards us with ... "security."
"It is possible that all our politics will come to nothing when I am dead, but state socialism ("Der Staatssozialismus") will push itself through," Bismarck said in 1881.
"State socialism," he called it.
We're told that for some reason we're not allowed to call the Obama-Reid-Pelosi agenda "socialism," "communism," "Marxism," "state socialism" "fascism," or anything else that might sound unpleasant.
Much as I hate to cite the tyrant Lincoln, if we call a dog's tail a leg, does it have five legs? Telling us we're not "allowed" to use an accurate label for something doesn't change what it is.
Instead of allowing General Motors and Chrysler to go through normal bankruptcies, through which new and more efficient private operators could have purchased their worthwhile assets while shedding their crippling union contracts, the two giant auto makers have now been effectively nationalized.
Meantime, an unelected federal "pay czar" decides on the compensation of executives, even at supposedly private banks that have paid back all their "bailout" loans. Does that sound like the normal function of the American free market, as understood in 1910, 1960 or even 1990?
Thanks to thoroughly unconstitutional "bailouts," the federal government now de facto manages our major banks and/or credit card companies, along with our airlines and airports.
The health care bill was "sweetened" with a federal takeover of college loans. Why? You don't imagine the federal government will ever try to manipulate the behavior of college graduates, offering to "forgive their college loans" if they agree to behave in ways favored by the fedgov, do you?
"Federalizing" all these programs shifts money and employment from the private to the government-bureaucrat sector. Unionized government bureaucrats tend to belong to outfits like the SEIU, which actively back Democrat/socialists, while dispatching purple-shirted thugs to beat up black freedom-fighters handing out "Don't tread on me" Gadsden flags outside rigged Democratic "town hall" meetings.
The so-called "health reform" bill authorizes $10 billion to field 16,500 more IRS agents to collect and enforce mandatory "premiums," which we're assured are not a "tax." Providing you're a "normal" citizen with a job and house, of course. (Illegal aliens Get Out of Jail Free, as usual.)
Last week the Review-Journal mentioned in passing, in an editorial about socialist Congresscritter Dina Titus' move to facilitate the takeover of Nevada Occupational Safety and Health enforcement by the federal government, that the Constitution grants the federals no authority to regulate workplace safety within the states.
One letter writer couldn't wait to write in that the newspaper was wrong: turns out the preamble to the federal OSHA law as adopted specifies that it's all constitutional, since the federal government is empowered to regulate interstate commerce, and "workplace health and safety can impact interstate commerce."
It would be more justifiable to hold that an IRS man can climb the fence into my back yard and smash the watermelons I'm growing there, since by growing my own watermelons I reduce the demand for supermarket watermelons grown in another state, and this "impacts interstate commerce."
So we're right back to "If you call a dog's tail a leg, does it have five legs?" If Washington can do anything it likes because everything somehow "impacts interstate commerce," why do we have a Constitution with that two-page list of specifically delegated powers? Why not just one sentence: "Congress shall have power to do anything it figures might promote the general welfare and/or impact interstate commerce"?
On the radio this week I heard Congresscritter Titus asked whether she's concerned about state lawsuits challenging the new federal mandate that everyone will have to buy "suitable" health insurance. "Oh, no," she said, "The Constitution has been interpreted all kinds of ways, so I'm not concerned about that."
This from a woman -- a supposedly well-educated college professor -- who swore a solemn oath to "protect and defend the Constitution" 14 months ago.
You're still waiting for the American economy to "come back"? You may wait a long while. Once the investment capital is scared offshore, and the foreigners stop buying our bonds, who's going to pay for even the "entitlement" programs already in place, let alone this Obama-Reid-Pelosi "State-socialism on steroids"?
The biggest buyer of U.S. government bonds will soon be the Federal Reserve. Where does the Federal Reserve get its dollars? It orders the Bureau of Engraving to print them -- or just taps them into existence on its computer screens. As ever more dollars bid for a fixed pile of goods, the value of each dollar -- including the paltry few you still have saved in the bank -- shrinks.
This is like saying, "I won't starve; I can always eat my own foot." By the time you've eaten both legs up to the knees, it may start to dawn on you that this is a recourse with a limited future.
Vin Suprynowicz is assistant editorial page editor of the Review-Journal, and author of "Send in the Waco Killers" and the novel "The Black Arrow." See www.vinsuprynowicz.com/.
Publicado: 03-28-2010 11:35 PM