National Right to Life says new events in Congress further uncover pro-abortion agenda in health care bills

WASHINGTON (September 30, 2009) — Events this week in Congress provide fresh proof that top Democratic leaders in Congress are pushing forward with plans to establish massive new programs that would pay for elective abortions and subsidize insurance coverage of abortions — which, if achieved, would break from decades of federal policy.

“Bills currently advancing in Congress would establish direct federal funding of elective abortion, and tax subsidies for private insurance that covers elective abortions — both drastic breaks from longstanding federal policy,” commented Douglas Johnson, legislative director for the National Right to Life Committee (NRLC), the federation of right-to-life organizations in all 50 states.  ”Ongoing events on Capitol Hill demonstrate the hollowness of President Obama’s public assurances that he does not seek government funding of abortion.”

The Senate Finance Committee today continued a series of meetings to amend the “America’s Healthy Future Act,” a health care restructuring bill proposed by Chairman Max Baucus (D-Mt.).  The bill has a number of major abortion-related problems.  Most of today’s abortion-related debate in the committee focused on a proposed new program that would use tax money to help purchase private health insurance for about 19 million Americans.  The bill specifically authorizes the use of these federal funds to pay premiums on private plans that cover elective abortions — a departure from longstanding federal policy.

Pro-life Senator Orrin Hatch (R-Utah) pointed out that federal subsidies for coverage of elective abortions are not currently allowed under Medicaid, the Federal Employees Health Benefits program, or other federal health programs.  Hatch offered an amendment, backed by NRLC, that would have prohibited federal funds from subsidizing plans that cover elective abortions, but would have allowed insurers to sell abortion coverage through separate supplemental policies not subsidized by federal funds.  The Hatch Amendment failed, 10-13.  Baucus and all other Democrats on the committee opposed the Hatch Amendment, except for Senator Kent Conrad (D-ND), who supported it.  All of the Republicans on the committee supported the Hatch Amendment, except for Senator Olympia Snowe (R-Maine), who opposed it.

By an identical roll call, the committee also rejected another Hatch Amendment that would have codified the Hyde-Weldon Amendment, which is a temporary law prohibiting any level of government from discriminating against health-care providers that do not wish to participate in providing abortions.

On July 15, the Senate Health, Education, Labor, and Pensions (HELP) Committee approved a different health care bill (S. 1679), which also contains provisions that would result in sweeping pro-abortion mandates and government subsidies for elective abortion.  NRLC’s Johnson commented, “Today’s Finance Committee votes mean that the combined bill that will reach the Senate floor in a few weeks surely will contain provisions that would result in both pro-abortion federal mandates and huge federal abortion subsidies.  However, the full Senate must vote on the pro-abortion subsidies, and other pro-abortion components as well.”

Meanwhile, in the House, Reps. Bart Stupak (D-Mi.), Joseph Pitts (R-Pa.), and 181 other members of the U.S. House on September 28 sent a letter to Speaker Nancy Pelosi (D-Ca.), pointing out that the health care bill approved in the House Energy and Commerce Committee (H.R. 3200), including an amendment offered by Rep. Lois Capps (D-Ca.), “radically departs from the current federal government policy of not paying for elective abortion or subsidizing plans that cover abortion.”  The letter notes, among other things, that the Capps language “explicitly authorizes the federal government (the Department of Health and Human Services) to directly fund elective abortions, with federal (public) funds drawn on a federal Treasury account,” through the proposed “public plan.”

The signers — 25 Democrats and 158 Republicans — urged Pelosi to allow a vote on the Stupak-Pitts Amendment to prohibit coverage of elective abortions by the public plan and subsidies for private plans that cover elective abortions.  Seven other House Democrats have sent Pelosi similar letters in recent days, for a total of 32 Democrats.

In response, on September 29 Rep. Capps sent Pelosi a letter in which she argued that the proposed public plan really would not be paying for abortions because “money is transmitted to a private contractor who then reimburses physicians.”  Johnson called Capps’ argument “truly laughable — it is like arguing that it is not the government paying for the abortions if the government sends the payment via the Internet.”

In reality, Johnson said, “The proposed public plan will be entirely a branch of the federal government, all of its funds will be federal funds, and when it pays for abortions, that will be direct government funding of abortion.”

Johnson also noted that the nearly united opposition to the Hatch Amendment by Senate Finance Committee Democrats, and the continued resistance by the House Democratic leadership to allowing a vote on the Stupak-Pitts Amendment, “support our theory that President Obama is misleading the public when he says he does not want federal dollars used for abortion.  In an attempt to keep his 2007 promises to Planned Parenthood, the President is trying to smuggle sweeping pro-abortion policies into law behind smokescreens of contrived language, verbal misdirection, and outright misrepresentation.”

MEMO

September 23, 2009

To: All Interested Parties

From: Derrick Jones, Communications Director

Re: Interesting Reading

I wanted to draw your attention to the latest from syndicated columnist Nat Hentoff addressing the Baucus bill, and in particular, the death spiral provisions.  Please forward to appropriate lists.

derrick jones| communications director

national right to life

http://www.wnd.com/index.php?fa=PAGE.view&pageId=110710

World Net Daily

Posted: September 23, 2009
1:00 am Eastern
Sweet Land of Liberty

Nat Hentoff
Health bill’s deadly fine print
I am postponing my second column on the direct complicity of doctors and psychologists during the CIA’s torturing of terrorism suspects because of the sudden disclosure that, in the influential Senate Finance Committee’s health-care bill, there is a dangerous provision that could deny crucial health treatments for Medicare patients.

This is the much-publicized and debated Baucus bill, named for Senate Finance Committee Chairman Max Baucus. In its news section, the Wall Street Journal reported (Sept. 17) that this bill “breaks a logjam and is likely to form the core of a bill in the full Senate.”

During the continuous, extensive coverage of this proposed legislation, there has been only very limited mention – and none I’ve seen in the mainstream press – of a section that penalizes doctors for Medicare patients who, for at least five years (from 2015 to 2020), authorize total treatments that wind up in the top 10 percent of national annual Medicare costs per patient.

The 1 in 10 Medicare doctors who spend beyond this limit will themselves lose 5 percent of their own total Medicare reimbursements. Considering the already low rates Medicare doctors get – and the president pledges they will get lower – this could be a heavy penalty.

As Burke Balch, director of the National Right to Life’s Center for Medical Ethics, says: “This (part of the Baucus bill) means that all doctors treating older people will constantly be driven to try to order the least-expensive tests and treatments for fear they will be caught in that top 10 percent. Note that this feature operates independently of any considerations of quality, efficiency or waste. If you authorize enough treatment for your patients, however necessary and appropriate it may be, you are in danger of being one of the 1 in 10 doctors who will be penalized each year.”

There is, however, in the Baucus bill what seems to be an exception to this iron mandate for reducing medical-care costs that indeed is not related to quality of care, while aiming solely at reducing the national debt. There is a section (page 80, the Chairman’s Mark) that gives Kathleen Sebelius, secretary of health and human services, permission to adjust these strictures for “those physicians who tend to serve less healthy individuals who may require more intensive interventions.”

But what is submerged in here is the cold fact that even if a Medicare doctor does apply this permission in treating certain patients, as he considers necessary, the pressures will continue – with regard to his entire cumulative roster of other Medicare patients – to keep very much in mind that he or she may still be in peril of winding up at the end of a year in the punishable top 10 percent of annual Medicare costs per patient.

To bring Balch back into the conversation concerning the actual effects of the 10

percent health penalty on real-life patients, as well as doctors, he points out that this penalty for Medicare doctors “creates a moving target.”

“By definition,” Balch said, “there will always be a top 10 percent, no matter how far down the total amount of money spent on Medicare is driven.” Say that 2015, the top 10 percent is anything over $10,000 per patient. In 2016, most doctors will scramble to hold down the treatments they authorize to avoid breaking that limit.”

But the real possibility, as a result, is that the total annual amount of that limit will drop. So next year, doctors will try to avoid being in the penalty box for anything they authorize over $9,500. Burke Balch adds:

“As the process repeats, the next year might be anything over $9,000. The year after that anything over $8,000, and so on. It’s a game of musical chairs, in which there is always one chair less than the number of players. No matter how fast the contestants run, someone will always be the loser when the music stops.”

But Medicare doctors will not be the only losers. As the doctors struggle to keep abreast of the continually falling limit of the money they can authorize for their contingent of patients, consider what those patients will lose in the quality of their treatment.

The bluntest assessment of this approach to health-care “reform” is by National Right to Life executive director David N. O’Steen:

“It takes the telltale fingerprints from the government: Instead of bureaucrats directly specifying the treatment denials that will mean death and poorer health for older people, it compels individual doctors to do the dirty work.”

Even if this insidious provision does not survive in the eventual Senate bill, or is excluded from the subsequent House-Senate Conference Committee report on what President Obama will eventually enact into law, its actual existence is a further warning to all of us to pay very close attention to all the health-care “reform” bills before any of them becomes law. For some of us, our very lives may depend on the ultimate statute – not only because of the quality of care we will get, but rather for the nature of our final exit.

An adage that took me many years to understand is that “what the government gives, it can take away.” That’s why an essential individual responsibility of American citizenship is to keep a close eye on your government at all times.
Nat Hentoff is a nationally renowned authority on the First Amendment and the Bill of Rights and author of many books, including “The War on the Bill of Rights and the Gathering Resistance.”

WASHINGTON – Two amendments are being offered to the healthcare restructuring bill proposed by Senate Finance Committee Chairman Max Baucus(D-Mt) to eliminate a provision that penalizes Medicare doctors who provide higher levels of medical treatment to senior citizens.

“This provision creates a cruel death spiral. By financially penalizing Medicare providers, the Baucus bill sets up the cruelest and most effective way to ensure that doctors are forced to ration care for their senior citizen patients,” said David N. O’Steen, Ph.D, executive director of the National Right to Life Committee.  “Instead of bureaucrats directly specifying the treatment denials that will mean death and poorer health care for older people, it compels individual doctors to do the dirty work.”

Two amendments, supported by the National Right to Life Committee – one offered by Senator Jon Kyl (R-Az.) and one by Senator Pat Roberts (R-Ks.) – would remove the provision that establishes that for at least five years, Medicare physicians who authorize treatments for their patients that wind up in the top 10% of per capita cost for a year will lose 5% of their total Medicare reimbursements for that year [see footnote 1 at bottom of release].

This means that all doctors treating older people will constantly be driven to try to order the least expensive tests and treatments for fear that they will be caught in that top 10%. It is noteworthy that this feature operates independently of any considerations of quality, efficiency, or waste – if you authorize enough treatment for your patients, however necessary and appropriate it may be, you are in danger of being one of the 1 in 10 doctors who will be penalized each year. Moreover, it creates a moving target – by definition, there will ALWAYS be a top 10%, no matter how far down the total amount of money spent on Medicare is driven.

“It’s like a game of musical chairs, in which there is always one chair less than the number of players – so no matter how fast the contestants run, someone will always be the loser when the music stops,” O’Steen added.

The incentive this creates is purely cost-driven, without any balancing of benefit. It will create a constant sense of uncertainty in doctors, since none can know in advance precisely what the cutoff for a given year will be – resulting in still more pressure to limit treatment and diagnostic tests to the bare minimum.

“Creating a financial penalty for doctors who seek to provide their patients with the best, and therefore more costly, treatment available, is a scary way to cut costs,” added Burke J. Balch, J.D., director of NRLC’s Powell Center for Medical Ethics.

The Kyl Amendment #D2 is amendment 125 and the Roberts Amendment #D1 is amendment 137 in the Senate Finance Committee’s markup of the Baucus bill.

For more information:  http://powellcenterformedicalethics.blogspot.com

Notes:

1. On pages 80-81 of the 8.16.2009 Chairman’s Mark, in the “Expansion of Physician Feedback Program” in Title III, Subtitle A, Part I; specifically, at the top of page 81: “Beginning in 2015, payment would be reduced by five percent if an aggregation of the physician’s resource use is at or above the 90th percentile of national utilization. After five years, the Secretary would have the authority to convert the 90th percentile threshold for payment reductions to a standard measure of utilization, such as deviations from the national mean.”

The Congressional Budget Office (CBO) rates this as taking $1 billion from Medicare payments over a period of 6 years. See CBO 9/16/09 letter to Chairman Baucus, Table, page 3 of 7.

The National Right to Life Committee, the nation’s largest pro-life group is a federation of affiliates in all 50 states and 3,000 local chapters nationwide. National Right to Life works through legislation and education to protect those threatened by abortion, infanticide, euthanasia and assisted suicide.

PolitiFact adopts odd premises to dispute one NRLC statement about the abortion-related effects of the Baucus health care bill, while approving of another NRLC statement

On September 21, 2009, PolitiFact released two “Truth-O-Meter” ratings on two statements made by the National Right to Life Committee (NRLC) about the new health care restructuring bill, the “America’s Healthy Future Act,” proposed by Senator Max Baucus (D-Mt.).   Both statements appeared in the same September 16 NRLC press release.  This is the NRLC statement that PolitiFact rated as “true”:

“The Baucus bill “contains provisions that would send massive federal subsidies directly to both private insurance plans and government-chartered cooperatives that pay for elective abortion.”

And this is the NRLC statement that PolitiFact rated as “false”:

“Under the Baucus bill…federal funds would subsidize coverage of elective abortions.”

PolitiFact reached these seemingly contradictory conclusions by buying into the fiction that the federal government can use federal funds to help purchase private health insurance plans that cover elective abortions, and yet not “subsidize coverage of elective abortions.”  This is the kind of argument that most journalists and policymakers would not accept for one minute if it was advanced by a private entity that wished to receive a federal subsidy while continuing to engage in activities that are contrary to federal public policy with respect to, for example, race discrimination (e.g., the federal tax exemption at stake in the famous Bob Jones University case) or sex discrimination (e.g., Grove City College, in another famous case in which the federal subsidy consisted of individual students who had received Pell grants).

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