Friday, March 09, 2007

Is the Governator's plan illegal?

Post lifted from Democracy Project

Chris Reed, an editorialist of the San Diego Union-Tribune, (here's his bio) has been doing a fantastic and knowledgeable job of exposing the new clothes of the grandiose health care proposal by California Gubernator Schwarzenegger as lacking fiber.

In his online blog at the newspaper, today, Reed cites the court decision striking down the Maryland so-called "Wal-Mart tax" requiring a certain level of health benefits by employers or else pay a tax to a state fund for the benefit of the uninsured:

Because the Fair Share Act effectively mandates that employers structure their employee healthcare plans to provide a certain level of benefits, the Act has an obvious "connection with" employee benefit plans and so is preempted by ERISA.

Reed then phones one of the nations leading ERISA experts, who was general counsel for Wal-Mart, to check up on California governor Schwarzenegger's proposed health care plan that also imposes a "play-or-pay" on employers:

"Frankly, I'm not impressed here. ... They are trying to skirt around these prickly issues and sell the overall idea (of extending health insurance coverage)," he said. "Respectfully speaking, I don't know where they're getting all this."

As Reed sums up:

[T]he governor's staff: Declines to name a single lawyer not in the administration's pay who thinks its health insurance plan is legal..

This would be comic if the stakes weren't so high. We're about to have a bitter fight for months over something that's plainly illegal, a fact that's obvious to every ERISA expert out there, but not to our governor or his high-paid staff. Just great.

Maybe the Gubernator is hoping on a special dispensation from Congress, or in-law Teddy to drive to the rescue (without himself going off a bridge but sending the rest of us there).

Read Reed's comprehensive editorial, "Governor's plan falls apart under scrutiny," from yesterday's San Diego Union-Tribune to get the whole sorry picture of the naked foolishness by Schwarzenegger.

Reed is dogged in revealing the empty rhetoric driving most other newspapers, as they lament the "uninsured." The poor already receive health care, through Medicaid and similar programs for working poor, and even illegals are guaranteed emergency care. Most of the uninsured are, actually, the young and foolish, and most others can afford at least catastrophic insurance if they didn't prioritize lattes and other luxuries over self-responsibility. Here and here, Reed names the newspapers glibly citing that there are 47-million uninsured, when up to 12-million are actually illegal aliens.

The mantra that we must upend the health care arrangements and economics of the 85% of us with insurance, polls usually showing 80% satisfaction, in order to subsidize the inflated, undeserving and irresponsible bulk of the uninsured 15% is public policy insanity, driven by the Left's obsession with enlarging government and bureaucrats' power over us via a government-run, nationalized health care system.

Red tape killing NHS

The National Health Service is groaning under the weight of inspection and regulation, with at least 56 bodies with a right to visit NHS hospitals and trusts, many without an invitation. There are so many bodies that the authors of a new report from the NHS Confederation say that they are not sure they have managed to count them all. Calling for a halt to overbearing bureaucrats, the confederation - which represents NHS managers in 90 per cent of trusts - says something must be done to reduce the burden.

The burden of providing data is even worse than that of playing host to Government inspectors, the report says. Often different bodies call for the same data, but in subtly different forms, so that it must be collated twice at huge cost. "The sheer number of inspections, standards, and volume of information required to demonstrate compliance is making it difficult for NHS organisations to extract value from these various process and use them to drive improvement in services for patients" the report says.

Despite claims by the Healthcare Commission, the principal inspector, that it would adopt a "light touch" and promises by Government to ease the burden of regulation, things are getting worse, not better. The impact of the commission's annual health check is "overwhelming", the report says, and loses its meaning because of its wide-ranging nature. The process requires 500 separate information topics to be addressed, so voluminous that managers told the confederation they doubted they could ever complete them well enough.

There is also huge overlap with data required by the Clinical Negligence Scheme for Trusts and the Healthcare Commission.

There is also criticism of the commission's move to ask trusts to "self declare" compliance with its standards. While the aim was to reduce inspections, the result has been confusion as trusts do not know what documents they need. "This has led to an increased feeling of a burdensome system where the board has to second guess what the Healthcare Commission is looking for," the report says.

Sometimes the demands are absurd. One hospital installed a toilet block and single-sex wards, but the commission refused to accept this as there was no paperwork. Extra work was needed to generate paper that has no function except to satisfy the regulator.

Gill Morgan, chief executive of the confederation, said: "NHS leaders welcome meaningful regulation and inspection, but unsurprisingly they don't like excessive bureaucracy. "Regulation is not an end in itself. It will only fulfil its purpose if it helps NHS organisations assess themselves as a way of driving forward improvement and providing public assurance about quality and safety of the service."

The commission has introduced a concordat between inspection bodies aimed at reducing the burden. But, the conferedation says, it is not working. It recommends the sharing of information between regulators, cuts to inspections and data collections, inspections managed to avoid unnecessary evidence gathering and that the concordat be extended to all organisations



For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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