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Soaking the poor

By Richard E. Ralston
web posted May 6, 2013

Under government-controlled health care, who gets the least amount of care and gets hit the hardest for it?

Politicians talk about making the "rich" pay their "fair share"-- then soak the rest of us.

Obamacare reduces employee deposits to pre-tax health savings plans to no more than $2,500 a year. That does not hurt the rich, for whom these accounts are not worth the paperwork. But it reduces savings and raises income taxes for the middle class.

And that at a time when millions of Americans will lose their insurance (or not see it offered on future jobs) from employers who can save money by paying a fine instead of costly premiums.

When these individuals buy their own insurance plan, they will have to pay for a policy that includes a long list of state-mandated treatments -- more than 40 in California -- whether they want to pay for them or not.

Further, the Department of Health and Human Services has now released a list of federally mandated treatments, which will add more cost to individual policies.

Still worse, insurance companies who offer multi-state plans must adhere to the requirements of each state.

So add to the cost of state-mandated treatments and procedures the cost of the federal government’s mandates and the mandates of the other states. This will rapidly escalate costs that can serve no conceivable purpose other than replacing private insurance, to make way for a single government system of controlled care -- from which the only people who can escape are the very wealthy.

Meanwhile, more regulations restrict mail-order pharmacies that can reduce prescription costs and the formularies that guide patients to more affordable, generic drugs. Legislators -- in response to lobbyists -- require higher processing fees for Medicaid drugs than private plans allow. Obamacare’s Independent Payment Advisory Board will rule out payment for drugs and procedures when they deem that the drugs do not benefit enough people or conform to "best practices." The rich who can afford the right private insurance will get them. No one else will.

Manufacturers are subject to a new tax on the sales of medical equipment and prescription drugs -- whether they make a profit or not. This will strangle the industry and increase consumer cost for rich and poor alike.

Last year, the voters of California were persuaded by Governor Jerry Brown to approve tax increases with Proposition 30. The governor praised the voters for rejecting the "Kool-Aid" of those who argued against the increases, casually equating them with Jim Jones, who murdered a thousand of his followers. (How mean would he have been if he had lost?)

Wealthy taxpayers were the primary target of the legislation, and the governor and others often praise taxing the top "one percent." But there are not enough rich people left in California to pay the state’s bills (which is conveniently never mentioned).

But that’s okay, because Prop. 30’s increase in sales tax on the rich is also a tax on orphans and widows. Little Timmy’s shoes will now cost more, and Grandma now pays more for a warm coat. Grandma will find it even harder to pay for that coat with interest earnings from her conservatively invested retirement savings, as the Federal Reserve Bank forces down interest rates.

Taking the credit for soaking the rich while actually sucking up to them distracts from soaking the poor -- and the fact that the redistribution of wealth means the redistribution from you to politicians. ESR

Richard E. Ralston is the executive director of Americans for Free Choice in Medicine, Newport Beach, California. Copyright © 2013 Americans for Free Choice in Medicine. All rights reserved.





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