Ontario, Canada's most populous province, kicked off a fierce battle with drug companies and pharmacies when it said earlier this year it would halve generic drug prices and eliminate "incentive fees" to generic drug manufacturers.
British Columbia is replacing block grants to hospitals with fee-for-procedure payments and Quebec has a new flat health tax and a proposal for payments on each medical visit -- an idea that critics say is an illegal user fee.
It's almost as if, in health care, big government is not the solution, but part of the problem.
A great post at Legal Insurrection on the media's new phrase of choice for attempting to soft-pedal the countless disasters lurking in Obama's health care legislation passed by Congress: "little noticed." Some examples from a long, long list:
"A little-noticed provision in the new health care law may not only dramatically increase paperwork for small businesses, but also put them at a disadvantage against their larger competitors."
Effective for plan years beginning after Sept. 23, 2010, health plans that cover dependent children must continue to cover adult kids until they turn age 26. This little-noticed new requirement is a sure way to increase health insurance costs, which is exactly what Obama-care was supposed to prevent."
"The Obama administration is trying to encourage people to buy annuities to ensure that they don't outlive their savings. But a little-noticed provision of the new health care reform law will slap a 3.8% tax on payouts from annuities purchased by high-income earners outside their workplace."
"Little-noticed (well, except by me) is the fact that Congress has repealed the anti-trust exemption for health insurance and that the reform plan sets up the basics of a federal infrastructure for insurance regulation. The federal government doesn’t just drop by and visit, they move in. Memo to state insurance regulators: the feds are outside, and they have a HUGE moving van.
"As well as these and other major job-killing provisions, two little-noticed tax changes would also affect employment."
"Drug and device companies will soon have to report payments to physicians in a national database, thanks to a little noted section of the health care reform bill called the Physician Payments Sunshine Act."
"UV or not UV? A little-noticed provision in the new healthcare package adds a 10% levy to the cost of tanning sessions."
"A little-noticed provision in the House-passed health-care plan would strip billions of dollars out of privately run Medicare plans that emphasize wellness and are increasingly popular among retirees in Ohio and nationally."
The great mystery surrounding the historic health care bill is how the corporations that provide coverage for most Americans — coverage they know and prize — will react to the new law’s radically different regime of subsidies, penalties, and taxes. Now, we’re getting a remarkable inside look at the options AT&T, Deere, and other big companies are weighing to deal with the new legislation.
Internal documents recently reviewed by Fortune, originally requested by Congress, show what the bill’s critics predicted, and what its champions dreaded: many large companies are examining a course that was heretofore unthinkable, dumping the health care coverage they provide to their workers in exchange for paying penalty fees to the government.
. . . .
It’s not just the calculus of mandates and penalties that has employers considering the option of dumping health care and paying more in salaries instead. The mandate to keep “children” on plans until the age of 26 has employers seeing a steep cost curve. For Caterpillar alone, the 26-year-old mandate will cost over $20 million a year. Under those conditions, the penalties look pretty good. Add on the “Cadillac tax” on some health plans and the expected jump in medical costs from providers dealing with their own set of mandates, and health insurance looks like a very bad risk.
What will it cost the government to provide subsidies for tens of millions of Americans who used to get health insurance through their employers? No one really knows for sure, but Fortune takes a stab at it:
What does it mean for health care reform if the employer-sponsored regime collapses? By Fortune’s reckoning, each person who’s dropped would cost the government an average of around $2,100 after deducting the extra taxes collected on their additional pay. So if 50% of people covered by company plans get dumped, federal health care costs will rise by $160 billion a year in 2016, in addition to the $93 billion in subsidies already forecast by the CBO. . . . .
But some of us predicted that the numbers used by Democrats pushing ObamaCare bore little connection to reality — and that it would incentivize employers to destroy the net of employer-based health insurance. It looks like that day is fast approaching, and that’s no myth.
J.R. Dunn at American Thinker writes of Death by CAFE Standards:
Media discussions of the administration's new mileage rules have covered about everything except how many people they will kill.
Manipulating fuel efficiency standards has been a favored method of fulfilling environmental prerogatives for thirty years and more. Like most Green initiatives, it is essentially ritualistic. Rather than actually confront the problem at issue, it is instead intended to instill a sense of virtue (what economist Robert J. Samuelson calls "psychic benefits"), while at the same time acting as a punitive measure against those opposed to Green ideology. As is true of many environmentalist programs, it has the unintended side-effect of killing large numbers of unknowing individuals.
. . . .
Fuel standards are the longest-lived of an entirely futile array of attempts to address 1970s oil shortages. They first went into effect in the 1975 Energy Policy and Conservation Act as the Corporate Average Fuel Economy program, better known as CAFE. Under the CAFE standards, domestic and foreign automobile manufacturers had to meet a certain mileage standard in their cars and light trucks. They were allowed a very short time to carry this out before fines were levied, so they met the challenge in the easiest way possible: by designing small engines that used less fuel while lowering the size and weight of new vehicles to preserve performance.
The new standards had no success in lowering fuel consumption. Quite the contrary -- since it now cost less to fill the tank, people drove more. Within a few years, this "rebound effect" doubled average fuel usage. As a result, oil imports increased from 35% of consumption in 1975 to 52% by the year 2000.
The new regulations did accomplish one thing -- they killed drivers and passengers in large numbers. By lightening cars and removing material, auto companies were inadvertently discarding the armor that protected motorists in the event of a crash. Similarly, the compressed new models lacked space for impact forces to attenuate before causing damage and injury. Drivers in lightweight cars were as much as twelve times more likely to die in a crash. It was once said about American autos that they were "built like tanks." Many of the new models from the late '70s onward more closely resembled go-carts -- and proved to be about as sturdy.
Studies have repeatedly demonstrated the fatal results of mileage regulations, starting in 1989 with the Brookings Institution (in collaboration with the Harvard School of Public Health), followed by USA Today in 1999, the National Academy of Sciences in 2001, and at last the federal government's own National Highway Transportation and Safety Administration in 2003. This formidable lineup of organizations all came to the same conclusion: Fuel standards kill.
According to the Brookings Institution, a 500-lb weight reduction of the average car increased annual highway fatalities by 2,200-3,900 and serious injuries by 11,000 and 19,500 per year. USA Today found that 7,700 deaths occurred for every mile per gallon gained in fuel economy standards. Smaller cars accounted for up to 12,144 deaths in 1997, 37% of all vehicle fatalities for that year. The National Academy of Sciences found that smaller, lighter vehicles "probably resulted in an additional 1,300 to 2,600 traffic fatalities in 1993." The National Highway Transportation and Safety Administration study demonstrated that reducing a vehicle's weight by only one hundred pounds increased the fatality rate by as much as 5.63% for light cars, 4.70% for heavier cars, and 3.06% for light trucks. These rates translated into additional traffic fatalities of 13,608 for light cars, 10,884 for heavier cars, and 14,705 for light trucks between 1996 and 1999.
How many deaths have resulted? Depending on which study you choose, the total ranges from 41,600 to 124,800. To that figure we can add between 352,000 and 624,000 people suffering serious injuries, including being crippled for life. In the past thirty years, fuel standards have become one of the major causes of death and misery in the United States -- and one almost completely attributable to human stupidity and shortsightedness.
. . . .
But the mileage standards as applied by the Obama administration (not to forget the Bush administration before them) are different. They are different because everybody knows about them. No serious dissent exists concerning the fact that the CAFE standards have killed tens of thousands of Americans. If a private company were to be found responsible for even a small fraction of this level of fatalities, the sky would crack, Congress would go into twenty-four hour sessions, and John Edwards would experience a new lease on life. (Anyone doubting this should consider Toyota's recent travails. It is uncertain that anything, anything at all, is wrong with Toyota's products. Yet the media and government are tearing at the company like a pack of wolves after an injured deer.)
But in the case of fuel standards, the government itself is responsible -- and that's different. Governments get away with things that private companies can't. Even policies that enable deaths outnumbering those of all American wars of the past seventy years. Deaths that are unnecessary, deaths that can be avoided, deaths that are being encouraged in order to solve problems that can be overcome in any number of other ways. (Not to mention those problems -- such as global warming -- that can't even be demonstrated to exist.) Yet the topic doesn't even come up in debate. Did anyone involved in the health care "debate" ever mention how many people the British National Health Care system kills every year? That number is 95,000. The equivalent number for the U.S., adjusted for population, would be 450,000 a year. That's the "change" that's coming our way.
Such regulations embody the next step in the process by which the relationship between government and people begins to resemble that of a lawnmower and an anthill.
Regulations cost Americans a mind-boggling $1.2 trillion every year. But that is just part of the story. As the unintended but entirely predictable consequences of fuel efficiency standards demonstrate, federal regulations may also cost you your life.