Willful Blindness

Privacy concerns, tax implications, and the true motivation behind the Democrats’ health care reform agenda

With each passing day, it seems, we’re learning more and more about the size, scope and motivation behind the primary House health care reform bill, HB 3200.

Previously, we learned about end-of-life counseling not in the context of responsibly informing patients but rather in the context of a cost-cutting measure, about provisions that would permit government workers to visit American homes for the purpose of “usurping parental rights over child care and development,” and about plans to “make recommendations on the supply, diversity and geographic distribution of the healthcare workforce,” among other things. Now, we’re learning even more about the privacy implications of the legislation.

Take this excerpt, for example, from a CBS News report released late yesterday evening (emphasis mine):

Section 431(a) of the bill says that the IRS must divulge taxpayer identity information, including the filing status, the modified adjusted gross income, the number of dependents, and “other information as is prescribed by” regulation. That information will be provided to the new Health Choices Commissioner and state health programs and used to determine who qualifies for “affordability credits.”

Section 245(b)(2)(A) says the IRS must divulge tax return details — there’s no specified limit on what’s available or unavailable — to the Health Choices Commissioner. The purpose, again, is to verify “affordability credits.”

Section 1801(a) says that the Social Security Administration can obtain tax return data on anyone who may be eligible for a “low-income prescription drug subsidy” but has not applied for it.

First of all, where are the privacy advocates who were shouting to the rooftops about every encroachment of government during the Bush administration? Where is the ACLU?

And if someone decides to opt out of the public option for privacy reasons or otherwise, of course, they’d better be prepared to see another type of IRS-related ramification — in the form of a 2.5 percent adjusted gross income penalty for non-compliance.

The bureaucracy created by the Democrats’ health care reform plan is staggering. Even worse, though, is the privacy implications and the motivation behind it. The government filching the tax records of ordinary Americans to decide who exactly will be eligible for “affordability credits” and a “low-income prescription drug subsidy” just reeks of wealth redistribution and has no place in a health care bill.

It reminds me of Section 432 of the Waxman-Markey Cap-and-Trade bill — the “Energy Refund Program for Low-Income Consumers.” That program actually mandates that any family with a gross income of less than 150 percent of the poverty line receive a cash refund each and every month, transferred into the bank account of their choosing, at the expense of middle-income Americans like you and me who would be saddled with increased energy costs. These measures have nothing to do with the overall issues they are tasked to address, and only serve to highlight the underlying motivation behind the Democrats’ legislation and agenda.

Much like the cap-and-trade bill isn’t about energy independence or conservation, and is really just a thinly-veiled attempt at facilitating the death of American exceptionalism, the health care bill is again an effort to take the United States of America down a notch. If it weren’t, if health care reform was really intended to take care of the uninsured, why would the Democrats be okay with a bill which, as the Congressional Budget Office has reported, would still leave 36 million people uninsured after ten years?

Appropriately enough, I’m actually writing this piece from the waiting room of a prominent laser eye center on the outskirts of Philadelphia, as I adjusted my work schedule in order to be able to drive my father-in-law to and from a cataract-removal procedure. (Free wireless internet service is glorious.) Looking around me now I see a waiting room crowded with 32 people, most of which are likely older than 65 years of age, and I cannot help but wonder if they know exactly how this aspect of their lives would be affected by government-run health care systems in other nations — for instance, in Australia, where patients in the government-run system in 2005 were forced to wait more than a year for the opportunity to have cataract removal surgery; or in Britain where, in an effort to cut costs, a government health care board in 2006 decided that elderly patients with macular degeneration should be forced to wait until they went blind in one eye before being permitted to receive a costly new drug to save the other eye.

Oh, but it’s only cataract surgery, right? And it’s a so-called “elective surgery” to boot, right? So what’s the harm in waiting? Well, an April 2007 study by the Canadian Medical Association Journal found that patients who were forced to wait more than six months to receive cataract surgery “experienced more vision loss, a reduced quality of life and had an increased rate of falls” when compared with patients who only had to wait less than six weeks for the procedure. The scariest part of that CMAJ study, however, is not necessarily the results but the actual reason for which the study was put together:

The number of cataract surgeries performed in Ontario doubled between 1993 and 2003 and is projected to continue to increase since up to 21% of the population will be over 65 years of age by the year 2026. Cataracts are the most common eye disorder in North America: about 50% of people between 55 and 64 years of age and 85% of people over 75 years of age will develop cataracts within a 10-year period. Cataract surgery has a high level of efficacy, has minimal complications and is convenient for patients. Combined with the age-related demographic shift, these factors have led to a level of demand for this procedure that exceeds supply in many areas of the country.

The Canadian federal and provincial governments have identified sight restoration as 1 of the 5 priority areas for developing evidence-based benchmarks for medically acceptable wait times. To set such wait times, we need to understand the relation between wait time and outcomes and to identify variables that modify this relation. Cataract surgery is the sight-restoration procedure with the greatest public health importance; thus, we systematically reviewed the body of literature addressing wait time and patient outcomes and asked 2 key questions: What is the relation between wait times and typical cataract-related outcomes? What variables modify this relation?

First, there’s the issue of demand exceeding supply, which in itself inevitably leads to long wait times and rationing along the lines of age and extrinsic quality-of-life circumstances. Second, there’s the overarching theme of whether or not we want the American federal government, at some point, actually commissioning studies intended to set “medically acceptable wait times.” My father-in-law noted that, from the time when his eye doctor recommended the procedure, he could have scheduled it for the next day. That’s right — the next day. And if this is for a ten-minute surgery known for its convenience, for its efficacy and for its lack of complications, what can be expected for more involved, more risky, more life-saving procedures?

At the end of the day, it all comes down to how much we want the government involved in our daily lives. Do we want federal employees assessing our income tax records in order to ascertain whether or not we are eligible for “affordability credits?” Do we want a government-run health care infrastructure so accustomed to exceedingly long wait times that it actually commissions studies to figure out exactly how bad such delays can be? More importantly, do we want our health care system, the envy of the world, to be fundamentally transformed by a group of elected officials pushing reform not for the sake of the health care system itself, but rather solely as a convenient vehicle through which to advance a leftist agenda?



  1. Rix says:

    He won, period. Elections have consequences. That's the price we are paying for stupidity of our fathers who extended the voting privilege to human refuse who, while perfectly healthy and of working age, are unable to pay their own expenses. Until bums and good-for-nothings are thrown off the ballot box rolls, they'll keep saddling us with obamas and pelosis just for a goodie bag that comes with a meal.

  2. Jeff Wahlen says:

    I was fortunate enough to have cataract surgery (age 55!) one eye at a time earlier this spring. I cannot imagine the sight loss one would have to tolerate if told to wait twelve months for said procedures.

    Thankfully, our medical community in this country still has the freedom and flexibility to accommodate such patients with haste. I truly understand the restrictive and intolerable ramifications of this HR 3200 firsthand. It must be defeated.

  3. RIX IS RIGHT says:

    Rix is quoting Jefferson, tho VERY paraphrased.

  4. D.A.Gust says:

    2004 thru 2007 there was story after story, probe after probe into the returning veterans' care with discriptions of horror being posted and printed weekly. IE; Long waits for anything and everythng, not enough staff to go around, building maintenace being put on the back burner, and generally an idea of a total unacceptible situation was brought to everyone's attention. (remember that?)… Now today – there are still the same problems, not 'as bad', I guess due to the new silence, but the problems foisted back in the day, are still quite evident. (I'm a participant)

    Notice how now the crowd that was once dedicated to tearing into the president, and his admin at the time, has suddenly changed thier song book.

    Hey! Did you know that govermnment care will be for all once enacted? Oh sure, it may take a bit to destory the other, but it's comming like a runaway frieght train.

    Some time ago someone told me: "A person is smart, but people are stupid"…

  5. Anonymous says:

    It is not the governments decision when to decide to end a persons life. It is our creators. Our veterans who fought for our very fredom can not get the best damn care there is because it is run by the government. The men and women who had fought for this country deserve the best in medical care. We see just by government intrusion as to how it will effect all of our lives. I say stay out of mine I go to work and pay the extortion taxes that these thugs place on society. Since when are they so concerned about health care when we have so many homeless people in our country. Wake up america it is not about health care its about the money and follow where it leads to.

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