The Issues Really Don't Favor Dan Newhouse, But Who's Paying Attention?

Dan Newhouse Cutting a Ribbon

Congressman Dan Newhouse’s 2020 election year activity seems to consist mostly of meaningless photo ops, something he's learned to do well in his 3 terms as the Representative of Washington's 4th Congressional District. Newhouse includes the following issues on his campaign website:

• Budget and Taxes
• Seniors
• Immigration
• Hanford
• Agriculture
• Veterans

Newhouse has a very brief blurb under each heading. Suffice it to say, his ideas about what matters in those areas aren't going to convince any Progressive voters that he's the man to represent them. An examination of what's actually happening under any one of these areas could give even the most committed Republican voter pause, consider "Budget and Taxes," for example. But most Republicans aren't even going to read what Newhouse has written. They'll just vote for him out of habit; historically about 65% of the vote in this district goes to the Republican candidate. Christine Brown did well to get 37.2% of the vote in 2018.

What might convince Independents to give McKinley (@Doug_McKinley) a second look, and might even cause some moderate Republicans to scratch their heads and rethink their unwavering support of good-ole Dan, is what's missing from Dan's list of issues, i.e.:

• Health care
• Trade
• Climate Change

These are issues that should concern any voter in the sprawling, ag-intense, rural, 4th District of Eastern Washington. 

 Health Care

Newhouse voted some 56 times with his Republican colleagues to “repeal and replace” the Affordable Care Act. Never happened, so they went about doing everything they could to undermine it. President Donald Trump has said multiple times he'd have a "beautiful, fantastic" plan in place, the last time it was before August of this year. That never happened, either. Now, Trump is suing to overturn the ACA. He’s installing a conservative justice to replace RBG, who already opined that the ACA was unconstitutional.

Rural hospitals/clinics in the 4th are practically broke. All while COVID-19 is raging. Even those who survive an attack, are likely to be left with pre-existing conditions. If the ACA goes, so goes coverage for them. Furthermore, Trump’s 2017 tax cut, taken together with the economic impact of the pandemic, means that big cuts are looming for Social Security and Medicare/Medicaid. If I read the census tables correctly, there are about 228,000 people in Newhouse’s district covered only by Medicare or Medicaid.

Trade

The retaliatory tariffs resulting from Trump’s trade war with China have hurt Washington’s farmers.  Dairy exports to China dropped by 75%, fruit exports dropped by over 16%, and wheat exports dropped by an amazing 94%. But Trump is buying off the farmers with massive taxpayer-funded bailouts; the Administration gave farmers across the country $12 billion in 2018 and another $16 billion in 2019, as part of the Market Facilitation Program (MFP), aka “socialism.” But  bailout money is distributed based on acreage and not a farmer’s need, so about half of the money (47%) went to the largest 10% of operations across the country.

Climate Change

Steve Ghan (@steveghan1), who leads the Tri-Cities chapter of the Citizens Climate Lobby has tried multiple times to get Newhouse to join the bipartisan House Climate Solutions Caucus. Newhouse won't do it. There is not one single Republican from Washington on the caucus. Agriculture accounts for $51 billion (13%) of Washington’s yearly economic activity. The counties that play the biggest role in the state’s agricultural economy are Grant and Yakima.

The Climate Impacts Group at the University of Washington has for some time assessed the consequences of a warming climate on Washington. In a 2019 report, “No Time to Waste,” they wrote, "Warming is expected to increase the number of very hot days and the chance of both droughts and floods, bring larger and more frequent wildfires to both sides of the Cascades and challenge agriculture through stresses on irrigation supplies and changing pests and diseases.” They went on identify health impacts, increased wildfires, impacts on water availing, etc. Why is Newhouse, like so many other Republicans,  ignoring this? Because of vested interests in a carbon-intensive economy.

Congressman Newhouse's demonstrated appreciation for environmental issues generally is reflected in the ratings he receives from various environmental NGOs, i.e.:

• Defenders of Wildlife -- 0%
• Clean Water Action -- 0%
• Washington Sierra Club -- 0%
• Environment America -- 3%
• League of Conservation Voters -- 4%
• National Parks Conservation Assoc. -- 4%

 Doug McKinley

Check out Doug McKinley's campaign website, and Facebook page. Attend one of his weekly town hall meeting via Zoom. Learn more about what Doug stands for and help give our district a better chance to choose a better candidate, donate to Doug's campaign.

No, Obama didn't lie

Dean Baker, ALTERNET

Terminated policies were introduced after ACA's passing -- often with insurers' knowledge they'd be scrapped.

President Obama has been getting a lot of grief in the last few weeks over his pledge that with the Affordable Care Act (ACA) in place, people would be able to keep their insurance if they like it. The media have been filled with stories about people across the country who are having their insurance policies terminated, ostensibly because they did not meet the requirements of the ACA. While this has led many to say that Obama was lying, there is much less here than meets the eye.

First, it is important to note that the ACA grand-fathered all the individual policies that were in place at the time the law was enacted. This means that the plans in effect at the time that President Obama was pushing the bill could still be offered even if they did not meet all the standards laid out in the ACA.

The plans being terminated because they don’t meet the minimal standards were all plans that insurers introduced after the passage of the ACA. Insurers introduced these plans knowing that they would not meet the standards that would come into effect in 2014. Insurers may not have informed their clients at the time they sold these plans that they would not be available after 2014 because they had designed a plan that did not comply with the ACA.

However if the insurers didn’t tell their clients that the new plans would only be available for a short period of time, the blame would seem to rest with the insurance companies, not the ACA. After all, President Obama did not promise people that he would keep insurers from developing new plans that will not comply with the provisions of the ACA.

In addition to the new plans that were created that did not comply with the terms of the ACA, there have been complaints that the grandfathering was too strict. For example, insurers can only raise their premiums or deductibles by a small amount above the rate of medical inflation. As a result, many of the plans in existence at the time of the ACA are losing their grandfathered status.

In this case also it is wrong to view the insurers as passive actors who are being forced to stop offering plans because of the ACA. The price increases charged by insurers are not events outside of the control of insurers. If an insurer offers a plan which has many committed buyers, then presumably it would be able to structure its changes in ways that are consistent with the ACA. If it decides not to do so, this is presumably because the insurer has decided that it is not interested in continuing to offer the plan.

As a practical matter, there are many plans that insurers will opt to drop for market reasons that may or may not have anything to do with the ACA. It’s hard to see how this could be viewed as a violation of President Obama’s pledge. After all, insurers change and drop plans all the time. Did people who heard Obama’s pledge understand it to mean that insurers would no longer have this option once the ACA passed?

If Obama’s pledge was understood as ensuring that every plan that was in existence in 2010 would remain in existence, then it would imply a complete federal takeover of the insurance industry. This would require the government to tell insurers that they must continue to offer plans even if they are losing money on them and even if the plans had lost most of their customers. This would at the least be a strange policy. It would be surprising if many people thought this was the meaning of President Obama’s pledge.

Finally, there will be many plans that insurers will stop offering in large part because of the changed market conditions created by the ACA. For example, last week the Washington Post highlighted a plan for the “hardest to insure” that was being cancelled by Pathmark Blue Cross of Pennsylvania.

This plan is likely being cancelled because it is unable to compete with the insurance being offered through the exchanges. The exchanges charge everyone the same rate regardless of their pre-existing health conditions. A plan that is especially designed for people who have serious health conditions would almost certainly charge a far higher rate. If these high-priced plans no longer exist because they cannot compete with the exchanges would this mean that President Obama had broken his pledge?

On closer inspection, the claim that President Obama lied in saying that people could keep their insurance looks like another Fox News special. In the only way that the pledge could be interpreted as being meaningful, the pledge is true. The ACA does not eliminate plans that were in existence at the time the bill was approved.

If we want to play Fox News, President Obama also promised people they could keep their doctor. Since 2010 tens of thousands of doctors have retired or even died. Guess the pledge that people could keep their doctor was yet another lie from the Obama administration

What Now?

Republicans seem to have given up hope of blackmailing the Obama Administration into repealing the Patient Protection and Affordable Care Act (ACA). They're still muddling around trying to figure out what they can wrangle out of the Administration for ending the government shutdown. So, what now?

Well, given that the Republican tactic for repealing/de-funding the ACA have so far failed, they are moving ahead with their parallel effort of undermining it, by stripping out provisions that would save money or bring in revenue (including taxes on high-cost health insurance plans, medical devices, tanning salons, and capital gains and dividends). They will then point to studies that show health care costs rising, and demand repeal all over again. Fanatics don't give up.

The fact is, health care costs in the U.S. are bound to increase initially as millions of people (some 44 million Americans have no health insurance) gain access to health care by virtue of obtaining affordable insurance. This has been born out by the experience in Massachusetts, where near universal health care was instituted in 2006, and the state's costs rose to 15% more per person than the national average (although there's no way to know how much costs might have risen anyway).

It will be difficult to assess the benefits to the economy of a healthy workforce, and fewer visits to the emergency room -- the most expensive way to obtain care. In addition, assessing the cost savings from fewer people having to be hospitalized because they now have routine care will only be possible in the aggregate and then only over the longer term.

Facets of the ACA that attempt to control costs, such as "accountable care organizations" (a system that gives doctors more incentive to better manage their patients' care) and the Independent Payment Review Board (an organization formed to review ways to reduce Medicare costs), were targets of Republican hyperbole, including the infamous reference to "death panels."

In fact, Republicans made all sorts of outlandish, patently false claims about "Obamacare" in their attempts to move the public to act against their own self-interests. They were quite successful in doing this. A recent pole showed that 43% of Americans oppose the law. Interestingly, more oppose "Obamacare," than oppose the Affordable Care Act. Further, more people support provisions of the ACA, such as preventing insurance companies from denying coverage for pre-existing conditions, when they aren't told the provision is part of Obamacare. People are funny about the idea of a black president, especially the people who aren't black.

It is unlikely that a reasoned debate will ever take place in the halls of congress -- not a natural state of affairs in American politics. If it did, one of the questions that might be asked is, "What's a life worth?" How much are we as a society willing to spend to improve a fellow citizen's quality and/or length of life? Take HIV as an example. Antiretroviral (ARV) treatment has transformed HIV from a death sentence to a chronic condition, allowing people with HIV to live longer and healthier lives (Linnemayr, et al, RAND 2012). But highly active ARV drugs are expensive, about $15,000 per year per patient (an examination of why ARV drugs are so expensive is beyond the scope of this essay, but suffice it to say, "free market economics" is not part of the equation). Before the development of ARV drugs (the first was developed in 1987), treating HIV was cheap -- you got HIV, then AIDS, then you died.

Washington policy makers aren't thrilled by the relatively inexpensive cost of saving the life of an HIV patient, they're outraged by the cost of Antiretroviral Therapy (ART). Thus, the debate centers on whether ART should be covered under Medicare, or Medicaid, or Social Security for people on disability (SSI / SSDI). Currently, fewer than one in five (17%) people living with HIV has private insurance and nearly 30% do not have any coverage. This will change dramatically under the Affordable Care Act, and many on the right (especially the religious right) see this as another reason to oppose ACA.

A critic of the Affordable Care Act, who worked on George W. Bush's health care proposals, Phillip Swagel, wrote recently that, "The goals of the Affordable Care Act are laudable. But achieving them will require an honest assessment of both successes and problems, and a willingness to make adjustments going forward." Swagel does not see President Obama as willing to make such an assessment.

I think Swagel is right on the first count, adjustments going forward, and wrong on the second. It's the TEA Party coalition in the Republican Party, and by extension, the party itself, that won't be willing to make an honest assessment of the ACA and will instead do everything in their power to either kill it or cause it to fail. Why? Because they prize their ideology over the health of millions of Americans.

The Changing Face of Health Care

We recently received a letter from our primary care physician of some 17 years inviting us to “enroll” in his new program, a nontraditional upscale approach to health care variously referred to as retainer practice, boutique medicine, or more commonly, “concierge care.” According to the service with which he’s affiliated, MDVIP, he will be the first primary care physician in our community, the Tri-Cities, Washington, making this change. I have the feeling he won’t be the last.

Why is my doctor doing this, and how will his decision, and if I’m right, the coming wave of Washington primary care physicians following suit, effect our health care choices?

Primary care physicians, faced with discounted HMO and Medicare fees (as well as managed care limitations) reportedly boost their patient load to maintain a satisfactory income. This can result in a patient spending 10 minutes or less actually consulting with the doctor. Often, patients may see only a nurse or physician assistant. Physicians are also doing their own lab tests, and operating weight loss clinics and “medical aesthetic services” in order to bring in extra dollars. All this takes away from the doctor’s original reason for entering the profession.

According to the letter I received from my doctor, his primary motivation for making this change is enhanced patient wellness. Under the concierge care business model, my doctor’s patients will pay a retainer fee of $1650 annually and will receive “enhanced medical care,” including an annual physical exam from which a “personal wellness plan” will be developed. Patients will receive same-day or next day appointments that “start on time,” unhurried office visits that “last as long as you need,” and 24/7 access to the doctor. Office visits/consultations are not covered by the annual fee. Interestingly, this retainer-based medical practice model was pioneered in Seattle in 1996 by the former team doctor of the Seattle Supersonics.

How is my doctor able to provide this enhanced care? By drastically cutting his patient load -- by something like 75% (from 2500 to 600). And this is part of a doctor’s motivation for making the change. Under the concierge care model, doctors feel they are able to spend more quality time with patients. But concierge medicine has an added benefit for primary care physicians. They typically average about $175,000 per year; much lower than medical specialists. Working under MDVIP’s concierge care model could boost my doctor’s income by as much as $485,000 a year; a 277% increase.

What about the patients? How will they be effected by the change? Patients who can afford the retainer fee will probably feel better about their care. But those less well off, especially older patients on Medicare, and the poor, dependent on Medicaid, will find themselves looking for a different primary care physician, disrupting sometimes long-standing physician-patient relationships.

According to several journal articles, medical ethicists and consumer advocates are concerned that the move to concierge care creates a two-class system of medicine and, with the growth of concierge practice, selective rationing of health care services and expanding class distinction. Fewer and fewer medical school students are choosing to become primary care physicians and projections are that by 2020 there will be a shortage of from 90,000 to 200,000 primary care doctors.

One can understand that long hours and lower expectations concerning reimbursement may be drivers for a changing medical practice model, but is concierge care the solution to this problem, or another symptom of a broken health care system?

What's Driving Health Care Costs?

In 1973 in France, French tax inspectors barged into the offices of the 155 year-old Cruse et Fils Freres wine shippers and discovered that the shippers were passing off inferior wines from humble growing regions as superior wines from regions like the noble Bordeaux. One vat of exceptionally bad wine was labeled, "Salable to Americans as Beaujolais."

In testimony before the Senate Committee on the Budget in January 2008, the Congressional Budget Office stated that "future health care spending is the single most important factor determining the nation’s long-term fiscal condition." Given its importance, Americans would do well to understand what's driving burgeoning health care costs and what can reasonably be done about it -- we don't want to spend a lot of money buying bad wine.

The chart above shows where the health care dollar goes, but not necessarily where we can get the most bang for buck in slowing the rise in health care spending.

Some people argue that the rise in America's health care spending is due to an aging population. But it turns out that the bulk of the projected increase in spending on Medicare is not due to demographic changes (e.g., increases in the number of beneficiaries) but rather to on-going increases in costs per beneficiary. In other words, we're spending more on our seniors that we did in the past. Why?

The reason for this is the same reason we're spending more generally on health care -- we have more high technology and better medicine and we dispense it more readily. According to the CBO, “The most important factor driving the long-term growth of health care costs has been the emergence, adoption, and widespread diffusion of new medical technologies and services by the U.S. health care system.”

The problem is exacerbated (if you want to look at it that way) by the fact that Americans are better informed about available medical technology (god bless the Internet and TV) and more aggressive in requesting it from their doctor. If they aren't already asking for the latest drug to reduce their anxieties, they're told to do so by pharmaceutical company advertising, "Ask you doctor about Zofloat, today." Prescription drugs cost, on average, 30% to 50% more in the United States than in Europe. Under most of the health care bills under consideration in the House and Senate, the secretary of health and human services would be required to negotiate drug prices on behalf of Medicare beneficiaries, a proposal that is anathema to pharmaceutical companies.

Another major factor in rising health care costs -- perhaps the most significant -- is the nexus between how doctors are paid and the cost of high tech medical procedures, such as the myocardial perfusion nuclear stress test, a procedure I had recently. I don't have my bill yet, but tests like this can easily run over $1000.

In the United States, nearly all doctors are paid piecemeal, for each test or procedure they perform, rather than a flat salary. As a result, physicians have financial incentives to perform procedures that further drive up overall health care spending. Doctors in the United States earn two to three times as much as they do in other industrialized countries. Furthermore, doctors have become much more business savvy, and like other businesses are realizing the financial benefits of vertical integration. Why “outsource” lab work when you can open your own lab and supply it a ready source of customers – your patients?

Americans generally don't begrudge doctors their high financial returns. It takes intelligence and hard work to become a doctor, to say nothing of the cost of medical school and setting up business (in fact, most new doctors start their profession in considerable debt). I don't have an opinion on whether doctors make too much money or not, but I do believe that a system that is designed to provide financial incentives to doctors to perform procedures rather than care for patients' well-being is a poorly conceived system.

It should also be noted that doctors make more from doing expensive, complex procedures. These procedures require specialists. Thus, an unintended consequence of our health care system is the over abundance of medical specialists and the growing shortage of primary care physicians.

Finally, the spectre of multimillion-dollar malpractice suits is a further incentive for doctors to practice "defensive medicine" and order expensive and often unnecessary tests.

Is it time to convert doctor's pay to a salary system? Many people think so. Most doctors don't.

Republican Richard 'Doc' Hastings Pulls the Euthanasia Rabbit Out of the Hat

The congressman for my district, District 4 in eastern Washington State, is Richard 'Doc' Hastings. Hastings, despite his nickname, is no doctor. His biography says he, "studied business administration at Columbia Basin College and at Central Washington University." Doc's lack of medical expertise hasn't stopped him from waxing poetic on health care reform. Like his fellow Republicans, Doc is against anything the Democrats may be for. At a Tri-City Regional Chamber of Commerce lunch on Wednesday, August 12th, Hastings responded to a question about how health care reform proposals will affect seniors by saying, "The biggest issue is the euthanasia part of this. If they are mandated to have euthanasia consulting ... I'm not for anything mandatory." You mean like seat belts, Doc?

The fact that there is no "euthanasia" consulting, mandatory or otherwise, seems to have escaped Doc's notice. Republicans, looking for things to scare us poor old folks with, found a provision on end-of-life care counseling in Section 1233 in the health bill passed by three House committees. The original provision on end-of-life planning was inserted in the Social Security Act by George H. W. Bush in 1990, and covered things like living wills, and durable powers of attorney, only meeting with a doctor to discuss such matters wasn't covered for seniors under Medicare. The new health care bill would have Medicare cover it. Scary, huh?

Where you hear Republicans coming up with this kind of malarky, you've got to ask,

Sarah Palin to Medical School

Erstwhile Alaska Gov and John McCain running mate Sarah Palin shown wearing a latex glove she’s just used to perform a digital rectal exam on a surprised supporter. “I believe in responsible health care for all Alaska’s citizens,” she pronounced, at the same time she told the red-faced woman that she should have a prostate biopsy.

Palin, who recently lamented that her parents and baby with Down Syndrome will have to step in front of a “death panel” under President Obama’s health care bill, has yet to reveal her future plans, but one can only assume she’s headed for medical school where, in all likelihood she’ll specialize in 'foot in mouth' disease.

If it ain't broke, don't fix it. If it is, fix it!

Factoring in costs borne by the government, the private sector, and individuals, the United States spends over $1.9 trillion annually on health care expenses, more than any other industrialized country.

Based on OECD analyses, the United States spends more per capita on health care than any other country, and has one of the highest growth rates in per capita health care spending since 1980 among higher income countries. The U.S. spent by far a higher share of its gross domestic product (GDP) on health care than any other industrialized country. Since 1980, the U.S. also has had among the highest average annual growth rates in per capita spending on health care. Despite this relatively high level of spending, the U.S. does not appear to provide substantially greater health resources to its citizens, or achieve substantially better health benchmarks, compared to other developed countries.

The United States spent 16 percent of its GDP in 2007 on health care, higher than any other developed nation. The nonpartisan Congressional Budget Office (CBO) estimates that number will rise to 25 percent by 2025.

A lot of people seem to believe that the reason the U.S. spends more than other countries is because we're a litigious society, i.e., they blame malpractice law suits. Others believe our health care costs more because it's more readily available (to those who can afford it). They claim people living in places with "socialized medicine" have to wait forever to see a doctor or have a procedure done. And yet a recent study by the John Hopkins School of Public Health found that neither one of these factors explain more than an insignificant fraction of the difference in health care costs. This study also showed that the U.S. citizens are paying more for comparable, or worse outcomes.

U.S. businesses, finding the cost of health care benefits for their employees too onerous, are out sourcing jobs overseas, and access to employer-sponsored health insurance has been on the decline.

No wonder it went bankrupt. General Motors covered more than 1.1 million employees and former employees, and the company said it spent roughly $5.6 billion on health care expenses in 2006. GM said health care costs added between $1,500 and $2,000 to the sticker price of every automobile it made.

There are some 43 million Americans without health insurance. Uninsured persons accounted for nearly one-fifth of the 120 million hospital-based emergency department visits in 2006. The absolute number of people using emergency rooms has gone up as much as 20 to 30 percent in the last six to eight months due to the recession and people losing their jobs. Handling health care in the ER is the most inefficient, lest effective way of addressing America's health needs. The cost of ER care for uninsured patients doesn't disappear. It strains hospital budgets and can be indirectly shifted onto families and individuals that do have insurance coverage in a "hidden tax" of higher premiums. Estimates put the hidden tax somewhere between $1,000 and $1,300.

Of course the true cost of a broken health care system is in the quality of care that's afforded American citizens. Yes, it's broken. Let's fix it!

Killing Grandma

In fact, section 1233 of the House bill would allow Medicare for the first time to cover patient-doctor consultations about end-of-life planning, including discussions about drawing up a living will or planning hospice treatment. Patients would, of course, seek out such advice on their own -- they would not be required to. The provision would limit Medicare coverage to one consultation every five years.

But that's not what the Republicans are telling you.

Former Republican lieutenant governor of New York Betsy McCaughey said on a radio show on July 16, that she had read the health care bill and discovered that "Congress would make it mandatory... that every five years, people in Medicare have a required counseling session that will tell them how to end their life sooner, how to decline nutrition, how to decline being hydrated, how to go into hospice care... all to do what's in society's best interest... and cut your life short."

House Republican Leader John Boehner (R-Ohio) and Republican Policy Committee Chairman Thaddeus McCotter (R-Mich.) put out a statement on the section of the bill in question, Section 1233, that said, "This provision may start us down a treacherous path toward government-encouraged euthanasia if enacted into law."

And then there's Rush Limbaugh. Here's what he said on his July 28th radio show, “People at a certain age with certain diseases will be deemed not worth the investment, and they will just as Obama said, they’d give them some pain pills, and let them loop out till they die and they don’t even know what’s happened." Well, Rush is someone we've got to pay attention to when it comes to popping pills.

End-of-life planning is critical. Everyone should be knowledgeable about things like directives to physicians/living wills, do not resuscitate orders, medical powers of attorney, and the like.

It's completely irresponsible of Republicans to fear monger about this.

Health Care in the United States of America

America's health care system is riddled with inefficiencies, excessive administrative expenses, inflated prices, poor management, medical mistakes, and inappropriate care, waste and fraud.

Middle class Americans can't keep up with rising health insurance costs and even those with insurance dread the prospect of some serious/prolonged medical event that ends up bankrupting them. People without health insurance flood hospital emergency rooms where hospitals are only reimbursed for the cost of care by charging their insured patients more.

The cost of employee health care plans hurts the competitiveness of America's business and industry, and drives jobs overseas.

The US spends more on health care by far than any other industrialized nation, and yet health outcomes for Americans are no better and in many case far worse that nations with universal coverage for their citizens. Health care spending accounted for 10.9 percent of the GDP in Switzerland, 10.7 percent in Germany, 9.7 percent in Canada and 9.5 percent in France. It was 17% of GDP in the United States and it continues to grow.

You'd think that our leaders in Congress, Democrats and Republicans alike, would be working hard to correct this situation. Not the Republicans, who are playing to the fears of their fringe constituencies. Thus, the misleading and even patently false claims about the Obama health care reform plan:

Under the Obama plan, our "grandmothers will be encouraged to commit suicide." Give me a break! The bill includes a provision to cover minimal counseling on directives to physicians for end of life care and other helpful planning provisions to ensure people get the information they need to make sound decisions about their care.

"The Democrats want the government to pay for abortions." Absolutely false. Where do these people get these crap? None of the health care overhaul measures that have made it through the committee level in Congress say that abortion will be covered, and one of them explicitly says that no public funds will be used to finance the procedure.

The Obama plan will "lead to rationing of health care." No reasonable analysis leads to that conclusion, but rational isn't what these claims are about.

Republicans are working hard to defeat health care reform, any health care reform, because, and Republican leadership has said this, they want to make health care reform President Obama's "Waterloo." That's right; they're more concerned about getting back at Obama than getting Americans decent health care. Shame on them!

Be sure to fact check anything you hear from the GOP (The Party of 'No') by going to Factcheck.org.