This post is going to be a bit long, so I’ll hide it behind a cut.

All links are followed with a number to refer to the citation in the endnotes.

So over the weekend Pelosi managed to push the newly merged health care reform bill, H.R. 3962, the Affordable Health Care for America Act, through the House. (1)

There was just one major snafu at the last minute: a jackass from Northern Michigan by the name of Bart Stupak, Congressman and Panty-Sniffer Extraordinaire, and his caucus of pro-coat hanger Dems pushed an (2) amendment (3) into the bill that would ban any money from the Federal Government from going to any health insurance plan that might ever, in some future event, cover any sort of ‘abortion services’ (except for cases of rape, incest or imminent risk of death). He did this at the behest of an organization of Catholic Bishops (4), who helped the House hammer out the precise details of the amendment and determine what would, and would not, be acceptable in our supposedly secular representative democracy.

Sigh.

This has been coming for me for a long time, and not just over abortion, though by itself, sacrificing the ability of millions of American women (whose only crime was being poor) to have an abortion covered with their own money in the Exchange, instead increasing their risk of death and our costs… that was bad enough. The truth is, though, over the last few weeks the reform bill in the House has worsened steadily, until it sank completely under its own weight and became of negative utility sometime around when Bart Stupak earned his Good Catholic Merit Badge from the Vatican.

Here is a list of reasons why I think that no person of decent and fair mind, let alone a Liberal, should support the current Democratic plan for health care, in no particular order:

1: The Public Option Won’t Work.

Sorry, true-believers. It’s time to wake up and smell the coffee.

The Public Option might, if constructed properly, have had an effect, but it’s been watered down so far and restricted so highly that there’s no chance in hell.

First, they firewalled it from 90% of Americans. (5) You can’t opt for the PO, or any other plan on the Insurance Exchange, if you have coverage through your employer, no matter how bad or expensive it is, so long as it meets a poorly-defined minimal level of coverage. (6) Thus the PO is doomed to a very small pool of potential customers, spread over a very wide geographic area.

Second, they refused to tie it to Medicare rates, or Medicare rates plus 5%. (7) Instead, the Public Option will be forced to negotiate with doctors, hospitals, and big Pharma despite having no real purchasing power and very few customers.(8)

Oh, and it has to break even on premiums alone.

Third, the Public Option will not be adequately protected against patient dumping. (9) The other companies on the Insurance Exchange are, technically, punished financially for dumping sicker patients onto the PO. The Congressional Budget Office, however, found in its analysis that the law.. won’t be adequate to stop them from doing so. In fact, the CBO says, the PO will be far more efficient and provide better care, more efficiently, than a private plan. (ibid) It will however have a far sicker client base due to this unethical dumping, so its premiums will end up being higher. (10) Thus costing the government more in subsidies, and the final purchaser more out of their paycheck.

So the Public Option will be of no help to the vast majority of Americans, and little help to those in the Exchange, though it may drive costs down slightly. It will not be cheaper, though it may be the last refuge of the damned.

2: This Bill, and the Senate Bill, Erode Religious Freedom, Not to Mention Sovereignty
The House bill’s Stupak Amendment is a disgusting assault on the right to choose, but we’ll get to that. First, let’s talk about how it, and a similar measure for another group in the Senate, are an assault on our 1st Amendment freedoms.

The Stupak Amendment had only one (political) purpose: to buy off ‘pro-life’, usually Catholic, Democrats. (4) There was a body of about 40 of them who needed their palms crossed with some red meat, and women were put on the altar.

Stiffening the backbone of those who oppose abortion was the bishops’ conference, which circulated a letter late Friday arguing that without such an explicit prohibition in the bill, the legislation could otherwise force individuals who oppose abortion to indirectly subsidize the procedure with their tax dollars.
…
“The Catholic bishops are a very important group, to especially a lot of the Catholic members and people from districts with large Catholic populations,” House Energy and Commerce Chairman Henry A. Waxman (D-Calif.) noted Friday. “The problem is that we have a very fragile situation. You give somebody a vote one way and we lose people on the other side.”

(ibid)

However, rarely has the actual Church been so involved with writing legislation. The Council of Bishops was intimately involved in the process of writing the amendment, and had to be sought out to approve of the final form of the bill before it could be voted upon.

To quote Rep. Lynn Woolsey:

“The role the bishops played in the pushing the Stupak amendment, which unfairly restricts access for low-income women to insurance coverage for abortions, was more than mere advocacy.

They seemed to dictate the finer points of the amendment, and managed to bully members of Congress to vote for added restrictions on a perfectly legal surgical procedure.

And this political effort was subsidized by taxpayers, since the Council enjoys tax-exempt status.”

(11)

In a very real, and unusually literal sense, dozens of US Congressmen and women took their orders from Rome. More precisely, Vatican City. (12)

All this despite the fact that it will harm millions of people, and make the final bill cost more too. Abortion is both safer (13) and cheaper than pregnancy; the purpose of this bill is to extend coverage and reduce costs (supposedly). So what possible reason could there be to both reduce coverage (of procedures) while increasing costs?

Only one. Religious meddling – from a sovereign foreign power (12) no less!

Meanwhile, in the Senate, the Christian Scientists have been busy.

Reporting from Washington – Backed by some of the most powerful members of the Senate, a little-noticed provision in the healthcare overhaul bill would require insurers to consider covering Christian Science prayer treatments as medical expenses.

The provision was inserted by Sen. Orrin G. Hatch (R-Utah) with the support of Democratic Sens. John F. Kerry and the late Edward M. Kennedy, both of Massachusetts, home to the headquarters of the Church of Christ, Scientist.

(14)

Yes, that’s right. They are trying to sneak in a provision to get the government to pay for their laughable faith healing witchcraft.

The measure would put Christian Science prayer treatments — which substitute for or supplement medical treatments — on the same footing as clinical medicine. While not mentioning the church by name, it would prohibit discrimination against “religious and spiritual healthcare.”

It would have a minor effect on the overall cost of the bill — Christian Science is a small church, and the prayer treatments can cost as little as $20 a day. But it has nevertheless stirred an intense controversy over the constitutional separation of church and state, and the possibility that other churches might seek reimbursements for so-called spiritual healing.

(ibid)

Government sponsored prayer. Amazing, huh?

So in both the House and the Senate the health care reform process has been used as a Trojan Horse to undermine our right to religious freedom, and to our right not to directly subsidize religious practice.

As well in the House we have eroded our sovereignty, when we let agents of a foreign government dictate terms of our domestic policy.

3: Abortion Will Be Dealt A Severe Blow
The Stupak Amendment, contrary to the media’s portrayal, is not simply a continuation of the already-odious Hyde Amendment (15), which says that the Federal Government cannot directly pay for abortion through healthcare money.

It goes much further. Under Stupak, the Federal Government cannot pay for a subsidy for health insurance that *might* help you afford an abortion. (4) See the difference?

It’s akin to banning someone from buying liquor with federal dollars (Hyde), then going further and banning them from buying groceries with a government voucher for part of the cost (Stupak), because they might buy liquor on the way home with the savings.

Wow.

87% of private health insurance plans cover abortion now. (16) In the exchange, the Public Option and the plans that receive government dollars would be forbidden from doing so. Not some of them, not 13% of them, to keep parity with the outside world, not even just ONE of them to give pro-life fanatics an option.

Zero. Zero would cover a legal and cost-effective, often life-saving procedure. In fact, it might lead to a nasty loophole that would allow plans on the exchange to cover abortion, refuse to take subsidy money, and thus exclude poorer, and usually far sicker, patients who can’t afford to go without the subsidies. (17)

It gets better. The Stupak Amendment, covering as it does insurance, bans ‘abortion services’. There are exceptions only for rape, incest, and a threat of death to the mother. Nowhere does it allow for abortion if the pregnancy threatens the mother’s overall health or sanity, or threatens to permanently maim her, or render her sterile. (3)

In fact, it might ban an abortion from coverage, even if the fetus is already dead, and the abortion is the best way to protect the health of the mother. (18) If she’s not already in danger of death, she has to wait her turn, like the dirty slut Bart Stupak assumes she is.

It gets worse yet, if you can believe it. The larger bill, HR 3962, includes provisions to give money out for a couple of other useful programs. One helps small businesses set up Wellness programs, another sets up a big Temporary Reinsurance fund to help old people retire early rather than be terminated, and get their insurance coverage paid until they get into Medicare.(36)

Only, Stupak bans ANY money from HR 3962 from going to ANY fund that covers abortion.

So if your company wants to early-retire Bob in Accounting, you might lose your abortion coverage(36).

If your small employer wants a fitness program, you might lose your abortion coverage(36).

This is an outrageous, disgusting, repugnant assault on Roe v. Wade and the pro-choice community, slipped in at the last moment by an opportunistic jackal. It also is very likely to end up in the final bill. Cheers.

4: The Costs Will Still Be Unbearable
Within the Exchange, the Federal Government is supposed to provide subsidies and guarantees about affordability in the law, so that everyone can afford to buy a plan, whether it be the Public Option or a private competitor. (see HR. 3962, especially section 341)

It does this through a variety of methods. First, it gives subsidies to people, according to their income, to assist them in affording said coverage. (19 or original bill)

Second, it sets caps on out of pocket costs for individuals and families, and provides for assistance with cost-sharing, aka co-payments, aka punishment for getting sick. (ibid)

So what’s the problem? The problem is they didn’t do nearly a good enough job.

The subsidies in question vary according to income, and start at 150% of the poverty level, going up to 400%.

Below 150%, you go on Medicaid instead. It was 133% in earlier versions, but to cut costs they added slightly more people to the government plan (which is much, much cheaper than private insurance).

It also allows low-income adults without kids onto Medicaid for the first time. (19) This expansion is one of the few real improvements found in the bill.

Below is a chart of subsidies provided in the bill, section 341. Note the lower end of the range, which here starts at 133% and not 155%; that is effectively changed in a later provision (1701) dealing with Medicaid (and if you’re in Medicaid or Medicare, you can’t go on the exchange).

Click here to see chart of subsidies for given multiples of the Federal Poverty Level. (This is taken directly from Section 341 of HR. 3962, but this way you don’t have to wade through Thomas to see it.)

Here is a link to the 2009 Federal Poverty Levels. (20) Essentially, 10k per year for an individual is poor, for purposes of this conversation, while it’s 22k for a family of four.

See how the cost goes up to 12% of income at the highest end of the HR 3964 chart? That’s the worst case scenario. Of course, if you make more than that, you’re on your own anyway, subsidy wise.

Ok, so people in the Exchange will be expected to pay up to 12% of their taxable income for insurance they are required by law to have. What about out of pocket?

Out of pocket costs are capped… at 5k per individual, 10k per family, per year, in the highest bracket. Less in lower brackets, obviously (again, see chart)

Ouch. So you could easily be looking at a bill of 12% of your income + 10k per year, if anyone in your family gets more than a few sniffles. (If you’re at the very bottom, you pay much less, on the other hand, about 500 bucks for premiums and 1000 out of pocket for a family of four at 150% FPL… which is still a lot of money for four people living at 150% of poverty level to cut out of their budget in a year. Altogether that makes 1500 bucks out of 33k, or about 4.5% of their pre-tax income.)

Let’s take a hypothetical family of four, whose adult members bring in, say, about 80k per year. They qualify for the subsidies in the Exchange, but at the lowest possible subsidy level. They will be expected to pay between 11 and 12 percent of their annual income in premiums, after subsidies. That amounts to between $8800-9360. If someone falls seriously ill, they will be expected to chip in another $10,000 before they hit their out of pocket cap. This means that this four person family will still be liable for, after ‘health care reform’, up to somewhere between $18,800-$19,360 dollars per year, not counting lost work and wages of course, for their mandatory-by-law government health plan. This is roughly 24% of their pre-tax income.

Twenty-four fucking percent.

The scariest part isn’t that this is the law that was passed by the House, but that, in America, that’s actually a substantial improvement for some people.

So the plans will discriminate against women, by denying them a vital range of reproductive services, and then if they have the temerity to fall seriously ill, cost the people in them so much money they can kiss the dream of upward mobility or college for the kiddies goodbye. Either that, or they can opt not to get insurance, and pay a 2.5% tax on their income, for absolutely nothing. (19)

There is a hardship provision in the House Bill but it is vague and non-specific. (21) Perhaps if you beg hard enough, they’ll waive the tax. Isn’t that nice? (Most likely, I suppose, if you’re poor enough, the affordability credit will take care of the premium, and you’ll just be left with deductibles that keep you from using it.)

Over in the Senate, the Senate Finance Bill sets a hardship exemption of 8% of income for the premiums. If they exceed that, and as we’ve seen, it’s quite likely, you can opt out. (ibid) There is some fear that this will lead to young, healthy people opting out. I’d be more concerned about all the poor people who will jump ship, if I was them.

But tell me, what do they get in return if they can afford the plan?

5: What You Get Isn’t Worth the Price Tag

Let’s take a look at what the plans in the exchange have to cover, and at what rates.

First, there’s a thing called ‘actuarial value’. (21) Basically, it’s a way to tell the amount of the average health costs of a average adult that a plan will pay, after premiums, versus what the patient will be expected to pay. If you have an actuarial value of 90%, then your plan will pay 90 cents of every dollar, on average.

We already mentioned that if you get seriously ill, you can end up owing 10k per year for a family plan. But the nastiness of these so-called insurance schemes doesn’t stop there. Even for just routine expenses, you’re going to be nickel and dimed, to encourage you to avoid seeing the doctor, or filling prescriptions. Details from plan to plan will vary; some might be more generous with prescriptions while others more generous with doctors. A floor will be set by the law in terms of their overall actuarial value, though; the overall percentage that, on average, a sucker, err, subscriber, will have to shell out after their premiums.

In the House, they’re aiming for an actuarial value of 70%. In the Senate.. as low as 60-65%. To compare, the average HMO nationwide is about 80, while the fatcats in Congress receive plans with 84-87% actuarial value. (ibid)

So, after paying up to 12% of your income in premiums, and taking the risk of huge piles of debt if you dare to fall seriously ill, you still have to shell out up to a third to almost half of your costs just to see a doctor, or fill your kid’s antibiotic script, or set a broken bone.

Isn’t that a fantastic plan?

To be perfectly fair, the House bill does include a measure designed to encourage your employer to offer health insurance or contribute to these premiums. They would have to offer something incredibly lousy as a minimum, along the lines of these basic level, 70% actuarial plans, chip in 72.5%, or they’d be stuck with a tax equivalent to 8% of payroll. (21)

If you think that they’re going to just absorb this without cutting salaries, you’re absolutely insane, of course. Technically offsetting salaries is illegal too (37), but raises? Other benefits? Or just good old fashioned layoffs?

The Senate Finance Bill, with Baucus at the helm, has an astonishingly bad alternative. It charges employers a fee, if and only if they have employees in the Exchange. It does not fine them for not providing coverage. This will provide a very strong incentive to discriminate against poor people when hiring new employees. (19)

Max Baucus really does deserve to burn in hell forever. No citation for that one; it’s a universal truth.

Now, let’s talk about what’s mandated to be covered by the House bill. It’s not just about the expense, after all, it’s about the care.

In general, and this surprised me, it’s pretty good. Inpatient, outpatient, hospitalization, doctor’s visits, etc. That surprised me. There’s a nice touch about baby care and vaccination being immune to cost-sharing, so that vaccination is always free, which, considering the plummeting immunization level thanks to whackos like Jenny McCarthy, is a good thing.

However, and this is a problem with the entire bill if you look up close, the exact standards aren’t set in the bill; they’re up to the head of the agency that will be put in charge of this whole shebang, and will be made up based on what’s generally true in the industry today.

So, since coverage today is generally shitty… you can expect it to be shitty later. Not so nice after all. (see original bill)

7: You Can Keep What You Have… Unless You’re a Kid

One of the big planks of health insurance reform from the very beginning for the Obama administration has been that, if you like the insurance you get now, you can keep it.

Though as Politifact.com has noted, that promise has, shall we say, moved over the months of this debate. (22)

That’s me being charitable. He either lied, or changed his mind, or never had the control over the process he thought a President would.

We have gone to enormous lengths to keep this pledge, keeping our bloodthirsty private insurers intact, our Frankenstein’s monster of a health care system hobbling along, instead of scrapping it in favor of a far simpler and proven model from another industrialized nation, whether it be single provider (NHS), single payer (Canada), or some model of strict governmental regulation and price setting (Germany/France/Switzerland).

Instead we get this mess. But hey, at least you get to keep what you have, if you like it, right?

Well… not if you’re a sick kid on SCHIP.

See, SCHIP is eliminated by this bill. (23, also, of course, HR 3962)

The way it works is, if you’re below 150% of the poverty level, as a family, you go on Medicaid. Medicaid has a lot of programs for poor kids, because it was designed for that purpose. So it’s not so bad, and generally an improvement.

If your family is above 150%, you go onto the Exchange. The basic Exchange plan is likely to be crappy compared to SCHIP, from the kid’s perspective. Here, from the Center on Budget and Policy Priorities:

On the one hand, for children not shifted into Medicaid, the benefit packages that would be available in the exchange would likely be somewhat less generous than those that CHIP provides today in a number of states, and the premiums and the cost-sharing charges for health services for children likely would be somewhat higher. On the other hand, total out-of-pocket health costs spending for these children’s families as a whole generally would go down, because the parents would now be covered. Moreover, the House bill would require all health plans offered in the exchange — and ultimately, all employer-sponsored plans as well — to provide an “essential benefits package” that has comprehensive benefits, including vision, hearing, and dental care for children and well-baby and well-child care so all children would have access to these important benefits.

(ibid)

So, yes, most children will gain. By being pushed into Medicaid. Other children will see their parents shoved onto the Exchange, where, if they can afford it, they will get decent care. If their parents cannot afford it, however, you know what these SCHIP kids get?

A 2.5% tax on their parents income. Or perhaps they can beg off of it with the hardship provision, depending on what that ends up being in the end after the House and Senate bills are merged in conference.

So once again, in our society, we pick on the sickest and weakest amongst us. Nice.

8: Biologics, or I Hope You Like 200k Dollar Drugs
Never let it be said that Democrats are too idealistic to sell out.

Representative Eshoo of California, along with Rep. Barton, inserted a veritable goldmine of a provision into HR. 3962, (24) one that will make the big pharmaceutical companies billions, prevent many drugs from ever becoming generics, and doom either the taxpayers in general or policyholders specifically to crushing medical debt. (You can find this in the final House bill at Section 2575-2527)

First, a brief word on drugs. There are two kinds of drugs in the wide world of pharmaceuticals. One are plain old-fashioned chemicals; these are drugs that are invented synthetically in the laboratory. The others are made from or synthesized by (or both) living organisms, and are referred to by the fancy name ‘biologics‘. (25)

Currently, biologics never become generics. There are several competing approaches to make them become generic, just like all the other drugs available at your local Walgreen’s (or wherever). (26)

Representative Waxman and Senator Schumer favor an approach like the one for conventional drugs, where they are patentable for 5 years, and then become open to generic competition. Not, however, Rep. Eshoo, or Nancy Pelosi, who put Eshoo’s language in the final bill. (26) (The Senate has a counterpart to Eshoo’s approach from Hatch, Enzi and Hagan)

Eshoo would have biologics get a 12 year exclusivity period, under a much looser standard than conventional drugs receive. Conventional drugs are patented, whereas biologics would apply for ‘data exclusivity’. With a patent, all you have to do to make a generic is figure out another way to make it; a patent is on a process, and so they are sometimes worked around to get generics out sooner. Data exclusivity is absolute; you can’t find a way to make a copy, or a close copy, and get a cheaper generic out sooner. (26)

It gets better though. Eshoo made sure to put in a provision to allow what is called ‘evergreening’; the company that gets a biologic granted exclusivity can renew the period for another 12 years by making a very minor change to the structure of the original drug. This is commonly done and inexpensive, and it doesn’t just set a new 12 year period on the new variant – it resets the original clock.

In this way, 12 years becomes 24, 24 becomes 36, 36 becomes 48, and with minimal effort, no biologic drug ever becomes a generic. Ever. (ibid)

All this despite the fact that biologics are similar in cost and development time to conventional drugs, which are only patentable for five years. (25 and 26)

Representative Waxman tried to bring this up earlier in the year with Eshoo, but Pelosi went with her approach anyway. (27)

Biologic drugs are the newest and most cutting edge treatments in many fields of medicine, from arthritis care to cancer and HIV treatment. Because they are made with natural proteins they can often alleviate awful side effects of conventional drugs or target illnesses more precisely, and offer great relief from suffering. They are also among the most expensive drugs on the market; a year’s treatment with biologic drugs for cancer can run into the hundreds of thousands of dollars. (25)

Eshoo would have you pay those rates forever. So does this final House Bill.

Update: I forgot to mention another horrible effect of this ‘evergreening’, which is that fewer novel drugs and lifesaving cures will be developed. It costs over a billion dollars and several years to develop an average new drug, biologic or not; it costs a tiny fraction of that to update an old one to get a new data exclusivity period. There’s an enormous perverse incentive in this bill to actually develop fewer drugs and instead gouge forever on the old ones, which will never become generic as long as you keep tweaking. Nice, eh?

9: The Future’s So Bright (for Joe Lieberman)

Everything outlined so far is likely to stay the same, or get worse, as the Senate takes up this issue. The already unacceptable actuarial level of the plans? The Senate wants to go lower, as low as 60%. The subsidies? Lower. In the Baucus version, much lower. The Senate wants to pay for the reform with a tax on actual, GOOD health insurance plans (29), which will disproportionately hit people in high-risk occupations, like firefighters, cops, and first responders. This is because it works based purely on premium costs. For perfectly logical reasons, it costs more to insure a fireman than a schoolteacher. Something about the risk of severe burns and what not.

So instead of doing what the House did, and taxing the very wealthy with a so-called ‘Millionaires’ Tax’ (29), Baucus wants to tax… firemen. Coal miners. Cops. Firefighters. Union workers.

People whose health care is good, or at least likelier to be, now. Senator Rockefeller has made some progress on fighting that (35), but there’s no final Senate bill yet, so who knows what Reid will do in the end.

The Senate is also the home of the lovely money-for-prayer idea the Christian Science loons have going.

So, if you like what you’ve read so far, you’re in luck. It’s going to get much worse under the leadership of ‘Give ‘em Hell’ Harry Reid.

Conclusion:

I cannot fathom how the Democratic Party has managed to screw this up so badly. I sincerely cannot. The fate of the nation is at stake, they have huge majorities in the House and Senate, and a sweeping mandate for change from the last election. We should, by all rights, be getting a unified, coherent, consistent and tested health care system modeled on one of the countries that got it right.

Instead we get a royal mess that screws over women, children, the working poor, young people, old people, emergency responders and cops and unions, all while delaying even the implementation of a weak sauce government insurance plan for 3 more years.

To top it all off, it won’t work. Any of it. The Commonwealth Fund did an analysis of various healthcare reform proposals, assuming various efficiency improvements and health information technology upgrades, programs to reduce obesity and smoking, etc, along with three variants of the Insurance Exchange, one with a robust Public Option (medicare rates), a weak one (negotiated, what’s in the House Bill), and purely private plans (what Baucus wants, more or less). (28)

None stopped healthcare costs from soaring at an annual rate of 5% a year, give or take.

The United States already spends vastly more as a percentage of its GDP for healthcare than any other post-industrial nation, as well as vastly more per capita. From the Kaiser Family Foundation, way back in 2007:

Health spending is rising faster than incomes in most developed countries, which raises questions about how these countries will pay for future health care needs. The issue may be particularly acute in the United States, which not only spends much more per capita on health care than any other country, but which also has had one of the fastest growth rates in health spending among developed countries. Despite this higher level of spending, the United States does not achieve better outcomes on many important health measures.

(30)

The US spends at least 15% of our GDP on healthcare, and millions go without. Under the House bill, more people get care, but the cost continues to spiral out of control. For comparison, not ONE European country pays more than 12% of GDP, and most pay a lot less, around 10%(30)

We are being supplanted by countries with a better standard of living, healthier, more productive workers, and voters smart enough to do simple math and realize that they could get universal health coverage for a fraction of what WE pay now.

But they choose not to, because of bugaboos and scary words like ‘socialism’.

Here, I want to emphasize this point a bit more. I’m tired and my eyes are sore, but I don’t think we’ve quite drilled this one into the ground yet, because some halfwit arch-conservative might read this and still be unconvinced.

The US spends more per capita than any other nation, and more as a chunk of our national wealth as well.

Want to see some examples of how we waste it? Ok, let’s!

In other countries in the civilized world, the government sets prices for health care procedures and medicine. Not here of course. That’d be socialism, or fascism, or whatever the voices in Glenn Beck’s head say today.

Ezra Klein of the Washington Post got some figures on how much a variety of medical treatments cost here in the US, versus other developed countries. From, of all places, an Insurance industry CEO, because this isn’t the cost to an end consumer, this is the cost in a fee, that, here in the US, a private insurer generally passes on to you.

Care to look at how badly you’re being screwed, through them?

CT Scan for your abdomen. US Average fee: $750 Canada: $530 France: $248 United Kingdom: $179
CT Scan for your head. US Average fee: $950 Canada: $530 France: $212 United Kingdom: $179
MRI: US Average fee: $1200 Canada: $824 France: $436 United Kingdom: $179
Routine Office Visit:
US Low-end fee: $59, High-end: $151 Canada: $30 France: $31
Average Cost Per Hospital Day:
US Average fee: $3,181 Canada: $837 France: $1,050

This is a small sample, there are 36 pages of this.

Get the whole pdf here. Go ahead, read it and weep.

You want to know what we get for it? In 2000, the World Health Organization ranked us 37th in health system performance, and 72nd in overall health (31)

We are 50th in Life Expectancy, so 49 other countries live longer than we do. (32)
We are 45th in Infant Mortality, so 44 other countries see fewer of their infants die. (33)

Those last two figures are from the pinko commies at the Central Intelligence Agency, who clearly hate your freedom to die young.

This is what the end of an empire looks like from the inside, folks. This is how it ends, when the people have become so willfully, amazingly ignorant and complacent that they slit their own throats.

Jesus Fucking Christ. We are so fucking stupid.

We are just so fucking stupid.

Works Cited/Endnotes

The bill itself, H.R. 3962, from The Library of Congress : http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3962:

1) “House passes health care reform bill“, CNN.com November 8th 2009, Retrieved November 11th 2009
2) “Stupak Amendment Passes; 64 Dems Ask for Primary Opponents“, Firedoglake November 7th, 2009, Retrieved November 11th, 2009
3) “The Stupak Amendment“, The New York Times, Retrieved November 11th, 2009
4) “Democrats to resolve abortion impasse on the House floor“, The Washington Post, November 7th, 2009, Retrieved November 11th, 2009
5) “Wyden Is Causing Trouble Again (For Reid)“, Firedoglake, October 20th 2009, Retrieved November 11th, 2009
6) “Not Enough To Argue For The Public Option“, d-day.blogspot.com, July 17th 2009, Retrieved Nov. 11th, 2009
7) “House to unveil health bill Thursday“, The Washington Times, Oct. 29th 2009, Retrieved Nov. 11th, 2009
“Making Public Option Less Robust Is A Double Slap In The Face To Working Class Americans“, by Jon Walker (of FDL), Oct. 28th, 2009, Retrieved Nov. 11th, 2009
9) “The CBO and the House public option – saving money, lowering premiums“, by Jason Rosenbaum, Firedoglake November 4th 2009, Retrieved November 11th 2009
10) “CBO: Public Option Would Do Too Good A Job Of Providing High Quality, Low Hassle Health Insurance“, by Jon Walker, Firedoglake, October 30th, 2009, Retrieved Nov. 11th, 2009
11) Lynn Woolsey: IRS should scrutinize bishops, Representative Lynn Woolsey, Politico.com, November 9th 2009, Retrieved November 11th, 2009
12) Vatican City, Wikipedia, Retrieved November 11th 2009
13) Abortion: Health Considerations, Wikipedia, Retrieved November 11th 2009
14) “Healthcare provision seeks to embrace prayer treatments“, By Tom Hamburger and Kim Geiger, The LA Times, November 3rd 2009, Retrieved November 11th 2009
15) “Hyde Amendment“, Wikipedia, Retrieved November 11th 2009
16) “The Wedge Dividing Obama’s Health Coalition“, by Dana Goldstein, The Daily Beast, November 10th 2009, Retrieved November 11th 2009
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