Agenda for Healthcare Meeting Americans for a Better Future - and -

1. Agenda for Healthcare Meeting Americans for a Better Future - and - Dallas Tea Party Zipcode 75229 Members September 22, 2009 6:30 Meet and Greet 7:00 Introduction of Attendees & Review of Recent Activities 7:10 Current Status of Legislation – House Bill and Baucus Bill 7:30 Alternatives to solve the Healthcare System Problems 8:00 Action to Influence Congress and Inform Citizens 8:15 Other Events and Issues 8:25 - Last Thoughts 8:30 - Adjourn See http://www.americansforabetterfuture.org/SearchResults.asp?Cat=23 to access House Bill HR3200, a 20-page of HR3200, and Max Baucus Senate Bill

2. RECENT TEA PARTY EVENTS The DC March –Mimi Buser and Donna Starnes, attendees The Ft Worth Rally – Carroll Rogers, attendee Tea Party Town Halls – Bryan Knox Impact of Our Actions – Bryan Knox

3. WASHINGTON DC – 9/12

4. WASHINGTON DC – 9/12

5. WASHINGTON DC – 9/12

6. FORTH WORTH – 9/12

7. HOUSE BILL – HR 3200 Health Advisory Commission – administration appointees authorized to make ALL the HC rules with primary objective to be cost control and with no outside oversight, no administrative appeal, no judicial review. HC plans standardized as to benefits without individual choice. Broad mandates in minimum plan – tobacco cessation, drug use disorder, mental health, marriage counseling, preventative services. Health Insurance Exchange where insurers all provide the same standard insurance plans and compete on price, with stated intent for all existing plans to migrate to exchange plans over time. Public option insurance plan to compete with private insurance, where public plan is subsidized and not subject to government taxes, and government makes rules favoring the public option. Mandated plans do not apply to unions, federal employees, Congress.

8. HOUSE BILL – HR 3200 Employers required to provide insurance or else pay a tax. Individuals required to have insurance or pay a tax. Ability to keep existing HC plan & doctor is very limited and contingent. New government HC facilities, HC workers and community services. Reduced payments to doctors and hospitals, especially specialists. Penalties on doctors and hospitals when patients are readmitted. No attempt to streamline current paperwork that doctors must deal with due to government regulations & insurance company requirements. New regulation and paperwork on doctors, hospitals, medical schools, individuals, employers, and insurance companies. Lots of data collection, analyses, reporting and oversight by the government -- no mention of oversight of government players.

9. HOUSE BILL – HR 3200 IRS to provide personal financial information to the Commission and IRS to have much expanded enforcement powers. No malpractice tort reform to alleviate high cost of malpractice insurance and reduction in unnecessary tests. No attempt to address shortage of specialists and shortage will increase. No stated restriction against abortion services and illegal alien benefits. Broad end of life planning with instructions to doctors and HC providers and included in Medicare handbook – supposedly going to be dropped. Reduction in Medicare funding ($500 to $600 billion) – supposedly from elimination of waste and fraud. Rationing -- inevitable due to increased demand and decreased providers and facilities -- in the form of delays, reduction of benefits, financial cost benefit analyses advocated by Obama’s HC advisors.

10. HOUSE BILL – HR 3200 Income & Wealth Redistribution Individual premium rates based on individual’s income. Premium credits for people with lower income. “Affordability” credits to cover out of pocket costs for lower income people. Employers to pay a fee to federal government which is a percentage of the employee wages (not related to the number of employees). An explicit fee (tax) to be paid by higher income individuals. Reduction in pay to physicians, especially specialists Lots of money to be paid in the form of grants, or provided in the form of low interest loans, to become physicians and other HC professionals. Stated preference to give grants and loans to minorities and people living in low income areas, to cover tuition and fees, plus a monthly stipend while they are in school and employment for several years (from 2 to 10 years). Physicians “prohibited” from future investing in healthcare facilities - also facilities with physician investment “prohibited” from expanding.

11. HOUSE BILLS • Ways to Reduce Cost with Government Healthcare • Increase premiums to the insured • Increase patient deductible costs • Tax employers more • Tax high income people more • Decrease payments to physicians and hospitals • Reduce coverage and benefits • Increase rationing, especially in Medicare • Decrease administrative waste, fraud and abuse – (this is unlikely – history shows that it will probably increase) • Decrease profits of insurance companies – average now is 3% • Decrease unnecessary treatments – • Who decides what is necessary? Who is liable for not delivering “unnecessary” care that turns out to have been necessary? • HR 3200 says that the government is not liable.

12. Max Baucus Bill Status: Senate is taking up Baucus Bill today and hundreds of amendments are under consideration. Humana sent letter to Medicare Advantage customers advising them of the potential loss in benefits. Baucus complained and Humana was ordered to withdraw their letter (WSJ 9/22/2009) Improvements: Public option dropped in favor of co-ops – However, co-ops would be under government control and Health Commission and Health Insurance Exchange would remain, so federal government would still be controlling the healthcare system. (Amendment re-inserting public option to be voted on in committee next week (being pushed by Schumer and Rockefeller) Interstate compacts for insurance purchasing beginning in 2015 – Would allow insurers to provide national products, which would be exempt from state mandated benefits.

13. Max Baucus Bill Criticisms: Employer mandate of $400 tax on employees not insured. Punitive individual mandates to purchase minimum insurance – failure to comply could result in a fine as high as $3,800 for a family of four. (Fine has been reduced to $1,900) Mandate healthy lifestyles, as defined by government. Instruct doctors on best practices. Punish hospitals for readmitted patients. 35% excise tax imposed on health insurance plans that offer benefits in excess of $8,000 for individuals or $24,000 for families. Limits on Health Savings Accounts. Private coverage will gradually be replaced by public insurance. Tort reform is addressed through a “Sense of the Senate” resolution.

14. Max Baucus Bill Medicare and Medicaid: States to increase Medicaid eligibility to people at 133% of poverty level and to enroll single childless adults, with the states responsible for much of the cost . Estimated $500 billion cuts in Medicare are being billed as savings from waste, fraud, and abuse. Bill would cut payments to the Medicare Advantage program, and many insurers may stop participating in the program while others could increase premiums. So millions of seniors will likely be forced off their current plan and back into traditional Medicare.

15. ALTERNATIVES TO GOVERNMENT HEALTH CARE • Primary Problems to Address • Patients • Increasing premiums • Pre-existing conditions • Coverage dropping • Insurance limits / caps • Uninsured • Physicians and Other Healthcare Providers • Insurance paperwork and administration • High malpractice insurance • Defensive medicine cost • Difficulty in obtaining patient records (e.g. HIPPA) • Systemic - Increasing costs overwhelming the system in general and Medicare in particular

16. ALTERNATIVES TO GOVERNMENT HEALTH CARE • Reforms that have been Proposed • Health insurance tax deduction • Remove health insurance tax deduction for employees (which has destroyed individual insurance market) • OR Give everyone the same tax benefits, including early retirees and people not employed • OR Restrict to individuals with portable, long term insurance and high deductible plans • Other Legislation • Prohibit pre-existing conditions • Prohibit dropping coverage • Deregulation • Remove ban on cross-state insurance • Facilitate exchange of medical information (fix HIPPA and other privacy legislation).

17. ALTERNATIVES TO GOVERNMENT HEALTH CARE Reforms that have been Proposed Tort Reform Legislation: Cap the amount of damages awarded to winners Cap the amount of legal expenses for losers Institute loser pay in some circumstances Institute healthcare courts or panels Results: Lower malpractice insurance cost Eliminate tests doctors consider unnecessary Attract and keep doctors

18. ALTERNATIVES TO GOVERNMENT HEALTH CARE • Reforms that have been Proposed • New Insurance Products • Guarantee issue • Portable • Guaranteed renewable • Right to buy in the future at a fixed price • (Free up insurance companies to innovate & compete) • Health Savings Accounts – • let patients, not employers manage • Allow Health Plans owned by employees • Employers could contribute like they do to 401k plan • Employee takes plan with them when they go from one job to another, or in and out of the labor market

19. ALTERNATIVES TO GOVERNMENT HEALTH CARE Reforms that have been Proposed Medicare Improvements Provide Vouchers Do away with the 7000 tasks restriction Let physicians redefine and re-price Expand Support for Low Income People Expand Medicaid benefits Provide Vouchers Augment and subsidize public hospital services Enable tax deduction of insurance and medical expenses Cash and Counsel programs

20. ALTERNATIVES TO GOVERNMENT HEALTH CARE • Proposed Reforms • System Efficiencies • Facilitate standards for electronic patient records maintained by physicians, hospitals and other healthcare providers • Facilitate standards for communication and exchange of patient information • Facilitate community networks • E prescriptions • Other efficiencies through process change & automation

21. WHAT WE DON’T WANT We don’t want a bureaucratic government commission defining coverage and benefit standards aimed primarily at reducing cost. We don’t want more regulation on doctors, hospitals, employers, insurance companies, healthcare facilities, & individuals. We don’t want government involved in end of life counseling in any way. We don’t want increased costs, increased deficits, increased taxes, and decreased paychecks. We don’t want to decrease payments to healthcare providers. We don’t want huge windfalls for the unions or forced unionization of the healthcare industry. We don’t want our healthcare providers to be federal employees under government management. We don’t want to increase the power of unaccountable federal government.

22. WHAT WE DO WANT We want a system that will focus on the quality of healthcare first. We want medical decisions to be between patient, family and doctor. We want to be free to choose an insurance plan that fits our needs and our financial means. We want the government to remove and relax regulations that burden our doctors, hospitals and other healthcare providers. We want physicians and healthcare providers to be free to innovate. We want to choose our own doctors. We want to be able to get second opinions where appropriate. We want patient-centered, market-based, deregulation-focused, result-driven policies. We want cost efficiencies based on market competition, personal responsibility, reasonable control over litigation costs, automation and process changes

23. Action • Send email, snail mail, faxes and phone calls to politicians • - Especially the Blue Dogs and Senators • - Tell them what we DO NOT want and what we DO want • Write into blogs • Make YouTube videos • - Send to politicians and friends and post on the website • - Topics: • - Big brother deciding our healthcare • - Healthcare workers forced into government unions • - Income redistribution (list examples in HR 3200) • - Healthcare quality under government healthcare • - Statement of a better approach – • Market-based, patient-centered solutions • With government to expand care for low income people

24. RECENT EVENTS • Congress voted to de-fund Acorn • Van Jones forced to resign as “green jobs” Czar • Missile shield in Eastern Europe to be abandoned • Senate version of healthcare bill – Max Baucus’ “chairman’s mark” • NEA developing “art” to support Obama policies, .. ….at direction of WH and funded by taxpayers • 35% Tariff on Chinese Tires to appease unions • Justice Department to investigate CIA terrorist practices • Confirmation of Cass Sunstein, regulatory Czar, …who advocates financial cost benefit analysis to decide HC benefits • Irving Kristol and Norman Bourlag died • San Joaquin Valley farmers without water - represents 60% ……of the richest farmland in California (Senate defeated bill to turn on water and was joined by Feinstein and Boxer)

25. EVENTS ON THE HORIZON • Government takeover of student loans – banning private student loans and enabling government to decide who should get loans and for what career choices • Bank Pay Regulation – for all employees in all banks over $1 billion • Net Neutrality – to enable the government to control the Internet • Card Check – to give unions advantage in forming new unions • Cap and Trade vote coming soon • Mandatory Civil Service to be proposed - for 3-4 years for ages 18-25 • Legalize illegal aliens so they can have healthcare • Bailouts for newspapers ??? • New World Economic Order being proposed at G20 • Decision on troop strength & potential new strategy in Afghanistan • Governor races in New Jersey and Virginia, vote is on Nov 3 • Amendments to Texas Constitution on ballot Nov 3 • See League of Women Voters - http://lwvrichardson.org/nov3-09.html

26. LAST THOUGHTS Need to address the fact that liberals / socialists / progressives are controlling our Public Schools and are indoctrinating our children with their political ideology Need to address that our universities are teaching socialist / progressive ideology and shutting out different opinions, even to the extent of punishing students that express different opinions Need to get more involved in power structures and positions of influence – school boards, teaching positions, city council, other local government, organizations of all kinds Look for true conservatives to serve as leaders Working session to Write Letters and Make Videos Making a Difference Visit www.AmericansforaBetterFuture.org Consider joining mailing listing of Americans for a Better Future – Linda Rogers, Executive Director