Tuesday, December 29, 2009

British government seizes hospital charity money

It seems to be aiming to treat donations as part of what the government pays to hospitals -- so that it can reduce what it actually pays. So donations to a particular hospital will no longer benefit it and might as well not be made. Very socialist but incredibly stupid

Hundreds of millions of pounds of charity donations to hospitals are to be “nationalised” under an NHS accounting change, which critics say will make it easier to slash health budgets. Ministers are imposing new rules on NHS charities requiring all donations — including those to specialist children and cancer units, local fundraising campaigns, teaching hospitals and local community trusts — to be listed on a hospital’s balance sheet.

The Charities Commission says that this is “wholly inappropriate” because combining the trust and charity accounts will jeopardise the charity’s autonomy and discourage donations. About £330 million was given to 300 NHS charities in the year to June 2008, and they control an estimated £2 billion of assets. A spokeswoman for the Commission said: “The Charity Commission does not agree with the interpretation of the accounting rules in the Department of Health letter to NHS bodies. We are currently engaging with the Department on this matter.”

Charities also fear that the change, due to come into effect in April, will be used as a smokescreen to hide cuts in health spending, with ministers reducing funds for organisations such as children’s hospitals that have successful charitable arms. Jenny Willott, a Cabinet Office spokeswoman for the Liberal Democrats, said: “This could lead to hundreds of millions of pounds of charitable donations being effectively nationalised under the NHS. “The Government has no right to get its hands on any charitable NHS funds. People make donations on the understanding that it is up to charities to decide how to spend it, not ministers.”

A source at a leading hospital said that the rule change appeared entirely unreasonable and risked creating unnecessary budgetary pressures and distorted disparities between hospitals with different levels of fundraising ability.

Ministers were banned from counting charitable donations towards the central NHS budget under the original legislation that created the NHS in 1948. But this looks set to be reversed after the Treasury agreed to implement International Accounting Standard (IAS) 27. Now all NHS Trusts whose trustees have the “power to control” their charitable arm look likely to be forced to consolidate both sets of accounts in one. Estimates of the number of NHS charities affected vary between 30 and 300 organisations.

A Department of Health spokesman said: “The accounting rule does not change the fact that the deployment of all the monies donated remain the responsibility of the trustees.” The spokeswoman denied that the change would stop NHS charities from claiming Gift Aid.


The massive accounting blunder that should sink U.S. healthcare reform

Yesterday, David discussed the CBO's miscalculation regarding the Senate health care bill. Democrats had been insisting that bill somehow cut the deficit and strengthened Medicare, but as it turns out the CBO had to clarify that the savings of the bill were being double counted. The "savings" the bill produces either have to be applied toward the Medicare trust fund or they have to be put toward the cost of the legislation to make it reduce the deficit by $132 billion over the next ten years. (That's assuming you buy into the shady accounting tricks used to score the bill.) Megan McArdle has a typically astute blog post up discussing the implications all of this. Megan even observes that as recently as Saturday, President Obama was trumpeting the bill's twin achievements of deficit reduction and strengthening Medicare. However, Megan didn't quote Obama in full -- fortunately The American Spectator's Phil Klein did. The entirety of Obama's remarks in the immediate aftermath of Senate Democrats securing finally securing 60 votes to pass their health care bill are worth pondering:
"This bill with strengthen Medicare and extend the life of the program. Because it’s paid for and gets rid of waste and inefficiency in our health care system this will be the largest deficit reduction plan in over a decade. In fact, we just learned from the Congressional Budget Office that this bill will reduce our deficit by $132 billion over the first decade of the program, and more than one trillion dollars in the decade after that."

Well, we now know that whether it was an innocent mistake or fiscal prestidigtation, one of these claims is simply not true. Which is all the more reason you don't railroad an unpopular bill through in the middle of the night, as this episode proves conclusively that the Senate can't be trusted not to make mistakes involving literally hundreds of billions of dollars.

But the bottom line is that this is a massive, massive blunder and the President and the Senate Democrats need to come clean about it. They sold the American people, or tried to anyway, on specific promises regarding deficit reduction and preserving Medicare. Now they can't be sure of either of those promises. And Joe Taxpayer should probably be scared has heck about what else they've overlooked regarding the consequences of health care legislation.

If the President and Senate Democrats are serious about their repeated promises to produce health care reform that saves money in the long-term, then they're going to have to scrap what they've got and go back to the drawing board. But nothing in the way that health care legislation has been handled so far suggests that Democrats are hoping for anything other than a short-term, ego-driven legislative victory.


Like Mushrooms, Health Care 'Reform' Flourishes in the Dark

In a key scene in Frank Capra's 1939 film "Mr. Smith Goes to Washington," appointed senator (and unwitting pawn in a corruption scheme) Jefferson Smith, played by Jimmy Stewart, suggests to a colleague that perhaps it would be a good idea to read bills before voting on them. "The bills?" responds an incredulous Senator Paine, played by Claude Rains. "These bills are put together by legal minds after long study. I can't understand half of them myself, and I used to be a lawyer." Forget it, he tells Smith. "When the time comes, I'll advise you how to vote."

Never has art so closely mirrored life as with the mammoth 2,100-page health care bill passed by the Senate. "The result makes no sense whatsoever -- not to conservatives, not to liberals, not to anyone," accurately concludes the Weekly Standard. "Rather than reform a system that everyone agrees is a failure, it will subsidize that system and compel participation in it."

Many who have long touted health care reform are turning up their noses at the final product. Michael Bloomberg, New York's independent mayor, told "Meet the Press" over the weekend: "I have asked congressperson after congressperson. Not one can explain to me what's in the bill, even in the House version. Certainly not in the other version. And so for them to vote on a bill that they don't understand whatsoever, really, you've got to question how -- what kind of government we have."

Mr. Bloomberg added that his own reading of the Senate bill led him to conclude that it would blow a hole in the New York State budget and force closure of perhaps 100 health clinics.

It's no wonder Congress and the White House are so determined to hide their handiwork from the public while the House and Senate versions are "reconciled." President Obama has said the negotiations will take place in the West Wing and he will be actively involved. But when ABC's Jake Tapper asked White House Press Secretary Robert Gibbs about the president's campaign pledge to "have the [health care] negotiations televised on C-SPAN," Mr. Gibbs dodged the question and took refuge in his talking points, insisting that voters already "have a pretty good sense of who is battling on behalf of thousands of lobbyists that are trying to protect drugs profits and insurance profits, and who's fighting on behalf of middle-class Americans."

In other words, no one in the White House wants the public to be looking on as this Frankenstein monster is finally stitched together.


Democrats on the Health-Care Precipice

Enacting health-care legislation in the face of overwhelming public disapproval may cost the party its chance of forging a sustainable majority

Barack Obama emerged from his meeting with Senate Democrats this week to claim Congress was on the "precipice" of something historic. Believe him. The president is demanding his party unilaterally enact one of the most unpopular and complex pieces of social legislation in history. In the process, he may be sacrificing Democrats' chances at creating a sustainable majority.

Slowly, slowly, the Democratic health agenda is turning into a political suicide pact. Congressional members have been dragged along by momentum, by threat, by bribe, but mostly by the White House's siren song that it would be worse to not pass a bill than it would be to pass one. If that ever were true, it is not today.

Public opinion on ObamaCare is at a low ebb. This week's NBC-WSJ poll: A mere 32% of Americans think it a "good" idea. The Washington Post: Only 35% of independents support it—down 10 points in a month. Resurgent Republic recently queried Americans over the age of 55, aka Those Most Likely to Vote In a Midterm Election. Sixty-one percent believe ObamaCare will increase their health costs; 68% believe it will increase the deficit; 76% believe it will raise their taxes.

Democrats also have managed to alienate the liberal base to which they were catering. The death of the public option and Medicare buy-in this week sent Howard Dean to thundering "kill the bill." A week from now, the current polls might look good.

Yet it is in individual states where the disconnect between the White House's soothing words and the ugly political reality is most stark. While Democrats are under fire for the economy and spending, it is health care that has voters thinking it's time for political change.

Consider North Dakota. A recent Zogby poll showed 28% (you read that right) of state voters support "reform." A full 40% said they'd be less likely to vote for Democratic Sen. Byron Dorgan next year if he supports a bill. In a theoretical matchup with Republican Gov. John Hoeven (who has yet to announce), Mr. Hoeven wins 55% to 36%. Mr. Dorgan has been in the Senate 17 years; he won his last election with 68% of the vote. This should not be happening.

In Arkansas, 32% support this health-care legislation. Sen. Blanche Lincoln, also running next year, trails challengers by more than 50 points among the 56% of voters who strongly disapprove of the health plan. Senate Majority Leader Harry Reid, the public face of health reform, can barely break 38% approval in Nevada. In Colorado, where 55% of voters oppose a health bill, appointed Democratic Sen. Michael Bennet told CNN he'd vote for a bill even if it "cost him his job." Give the freshman credit for honesty.

Nor is this a red state/swing state phenomenon. In deep-blue Delaware, 46% oppose the health plan. Democrats pounded Delaware GOP Rep. Mike Castle, running for Senate, for voting against the House bill. That vote has in fact kept Mr. Castle leading his expected opponent, Beau Biden, the vice president's son. Chris Dodd helped author the Senate health bill and is up for re-election next year. He is arguably the Senate's most politically vulnerable Democrat.

Don't trust the polls? In the past weeks, four well known House Democrats announced they will not run for re-election. All are longtime incumbents; one, Tennessee's respected John Tanner, co-founded the Blue Dog coalition. These folks have seen the political handwriting on the wall.

Democrats have also been pulled by another White House promise: That once Americans witness reform, they will turn around. Yet even supporters know this ugly bill will not "fix" health care. The problems will remain—with more in addition—and Democrats will own them. Meanwhile, the backlash against the pending health-care legislation is seeping out to hamper Democrats' broader agenda. Pew this week published a poll in which it marveled (fretted?) over the "extent to which the public has moved in a conservative direction on a range of issues" since President Obama took office.

So why the stubborn insistence on passing health reform? Think big. The liberal wing of the party—the Barney Franks, the David Obeys—are focused beyond November 2010, to the long-term political prize. They want a health-care program that inevitably leads to a value-added tax and a permanent welfare state. Big government then becomes fact, and another Ronald Reagan becomes impossible. See Continental Europe.

The entitlement crazes of the 1930s and 1960s also caused a backlash, but liberal Democrats know the programs of those periods survived. They are more than happy to sacrifice a few Blue Dogs, a Blanche Lincoln, a Michael Bennet, if they can expand government so that in the long run it benefits the party of government.

What's extraordinary is that more Democrats have not wised up to the fact that they are being used as pawns in this larger liberal game. Maybe Mr. Obama will see a bump in the polls if health care passes; maybe not. What is certain is that this vote is becoming one that many in his party will not survive.


House backers of public insurance option may yield

Two House Democrats who favor a government insurance plan, a central element of health care legislation passed in their chamber, acknowledged Sunday it might have to be sacrificed as negotiators work out a final agreement with the Senate. Rep. James Clyburn of South Carolina, the No. 3 Democrat in the House and one who had appealed to President Barack Obama not to yield on the public plan, set out conditions for yielding himself. Asked during rounds on the Sunday news shows whether he could vote for a final bill that does not embrace a public plan, Clyburn said: "Yes, sir, I can."

Clyburn added: "We want a public option to do basically three things: Create more choice for insurers, create more competition for insurance companies, and to contain costs. So if we can come up with a process by which these three things can be done, then I'm all for it. Whether or not we label it a public option or not is of no consequence."

While insisting "it's not dead," Rep. Chris Van Hollen of Maryland said he recognizes realities in the Senate, where Democrats had to scrape up every vote from their side even to pass a bill without a government plan to compete in the private insurance marketplace. "Before the House was to give up the public option, we would want to be persuaded that there are other mechanisms in whatever bill comes out that will keep down premiums," said Van Hollen, appearing to sketch out a bottom line without a government plan necessarily included. "We've got to make sure that the final product is affordable."

Sen. Robert Menendez, D-N.J., underscored the divisions Democrats will need to bridge when negotiators from the House and Senate meet next month to reconcile the two bills. He said there will need to be more give on the House side than the Senate, which took weeks to find the 60 votes needed for passage. "If we are going to have a final law, it will look a lot more like the Senate version than the House version," Menendez asserted.

The Senate's Christmas Eve achievement brought the nation closer than it's been for generations to a new order in health insurance, one that would eventually require nearly all Americans to get coverage, help many pay for it and restrict onerous insurance company practices such as denying coverage to people with pre-existing sickness. But nothing will change for anyone until the House and Senate can settle on common legislation, pass it and send it to Obama to sign.

The high stakes have both parties hoping they can find a few converts from the other side. Nearly every Republican in Congress has opposed the measures. "If some of the Republicans would come forward with suggestions - offer a vote or two, or three or four - to take away the need to have every last one of the 60 Democrats, you'd have a much better bill in accordance with the tradition of the Congress, especially the Senate, on bipartisanship," said Democratic Sen. Arlen Specter of Pennsylvania, himself a party switcher.

Republican Sen. Jim DeMint of South Carolina voiced similar hope, to opposite ends - "a few Democrats to stand up in the House that maybe didn't before and help us stop this thing." DeMint, Van Hollen, Menendez and Specter spoke on "Fox News Sunday." Clyburn was on CBS'"Face the Nation" and CNN's "State of the Union."


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