Obama suggests value-added tax may be an option????

What happened to his campaign pledge to block any tax increase on the 98 percent of taxpayers the administration has defined as the middle class.

The Wall Street Journal praised Paul Volcker, chairman of the newly formed Economic Recovery Advisory Board under President Barack Obama " for admitting what other Democrats also know but don't want to admit until after the November election: The political class is preparing to pass a European-style value-added tax." 

When will our governing body start listening to us???

AP – President Barack Obama waves as he boards Air Force One at Los Angeles International Airport in Los Angeles …

• Play VideoBarack Obama Video:Would VAT Break Obama Pledge? FOX News
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By CHARLES BABINGTON, Associated Press Writer – Wed Apr 21, 6:29 pm ET

WASHINGTON – President Barack Obama suggested Wednesday that a new value-added tax on Americans is still on the table, seeming to show more openness to the idea than his aides have expressed in recent days.

Before deciding what revenue options are best for dealing with the deficit and the economy, Obama said in an interview with CNBC, "I want to get a better picture of what our options are."

After Obama adviser Paul Volcker recently raised the prospect of a value-added tax, or VAT, the Senate voted 85-13 last week for a nonbinding "sense of the Senate" resolution that calls the such a tax "a massive tax increase that will cripple families on fixed income and only further push back America's economic recovery."

For days, White House spokesmen have said the president has not proposed and is not considering a VAT.

"I think I directly answered this the other day by saying that it wasn't something that the president had under consideration," White House press secretary Robert Gibbs told reporters shortly before Obama spoke with CNBC.

After the interview, White House deputy communications director Jen Psaki said nothing has changed and the White House is "not considering" a VAT.

Many European countries impose a VAT, which taxes the value that is added at each stage of production of certain commodities. It could apply, for instance, to raw products delivered to a mill, the mill's production work and so on up the line to the retailer.

In the CNBC interview, Obama said he was waiting for recommendations from a bipartisan fiscal advisory commission on ways to tackle the deficit and other problems.

When asked if he could see a potential VAT in this nation, the president said: "I know that there's been a lot of talk around town lately about the value-added tax. That is something that has worked for some countries. It's something that would be novel for the United States."

"And before, you know, I start saying 'this makes sense or that makes sense,' I want to get a better picture of what our options are," Obama said.

He said his first priority "is to figure out how can we reduce wasteful spending so that, you know, we have a baseline of the core services that we need and the government should provide. And then we decide how do we pay for that."

Volcker has said taxes might have to be raised to slow the deficit's growth. He said a value-added tax "was not as toxic an idea" as it had been in the past.

Since then, some GOP lawmakers and conservative commentators have said the Obama administration is edging toward a VAT.

Medical Schools Can't Keep Up

As Ranks of Insured Expand, Nation Faces Shortage of 150,000 Doctors in 15 Years

By SUZANNE SATALINE And SHIRLEY S. WANG

Getty Images

First-year resident Dr. Rachel Seay, third from left, circumcises a newborn in George Washington University Hospital's delivery wing on March 12.

The new federal health-care law has raised the stakes for hospitals and schools already scrambling to train more doctors.

Experts warn there won't be enough doctors to treat the millions of people newly insured under the law. At current graduation and training rates, the nation could face a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges.

That shortfall is predicted despite a push by teaching hospitals and medical schools to boost the number of U.S. doctors, which now totals about 954,000.

The greatest demand will be for primary-care physicians. These general practitioners, internists, family physicians and pediatricians will have a larger role under the new law, coordinating care for each patient.

The U.S. has 352,908 primary-care doctors now, and the college association estimates that 45,000 more will be needed by 2020. But the number of medical-school students entering family medicine fell more than a quarter between 2002 and 2007.

Proponents of the new health-care law say it does attempt to address the physician shortage. The law offers sweeteners to encourage more people to enter medical professions, and a 10% Medicare pay boost for primary-care doctors.A shortage of primary-care and other physicians could mean more-limited access to health care and longer wait times for patients.

Meanwhile, a number of new medical schools have opened around the country recently. As of last October, four new medical schools enrolled a total of about 190 students, and 12 medical schools raised the enrollment of first-year students by a total of 150 slots, according to the AAMC. Some 18,000 students entered U.S. medical schools in the fall of 2009, the AAMC says.

But medical colleges and hospitals warn that these efforts will hit a big bottleneck: There is a shortage of medical resident positions. The residency is the minimum three-year period when medical-school graduates train in hospitals and clinics.

There are about 110,000 resident positions in the U.S., according to the AAMC. Teaching hospitals rely heavily on Medicare funding to pay for these slots. In 1997, Congress imposed a cap on funding for medical residencies, which hospitals say has increasingly hurt their ability to expand the number of positions.

Medicare pays $9.1 billion a year to teaching hospitals, which goes toward resident salaries and direct teaching costs, as well as the higher operating costs associated with teaching hospitals, which tend to see the sickest and most costly patients.

Doctors' groups and medical schools had hoped that the new health-care law, passed in March, would increase the number of funded residency slots, but such a provision didn't make it into the final bill.

"It will probably take 10 years to even make a dent into the number of doctors that we need out there," said Atul Grover, the AAMC's chief advocacy officer.

While doctors trained in other countries could theoretically help the primary-care shortage, they hit the same bottleneck with resident slots, because they must still complete a U.S. residency in order to get a license to practice medicine independently in the U.S. In the 2010 class of residents, some 13% of slots are filled by non-U.S. citizens who completed medical school outside the U.S.

One provision in the law attempts to address residencies. Since some residency slots go unfilled each year, the law will pool the funding for unused slots and redistribute it to other institutions, with the majority of these slots going to primary-care or general-surgery residencies. The slot redistribution, in effect, will create additional residencies, because previously unfilled positions will now be used, according to the Centers for Medicare and Medicaid Services.

From the Archive

• Opinion: How to Fix the Doctor Shortage(01/04/10)
• Health Blog: Would Adding Residency Slots Solve the Primary-Care Shortage? (11/27/09)
• Opinion: The Coming Shortage of Doctors(11/06/09)
• Health Blog: Obama: 'Severe Shortage' of Primary Care Doctors (08/11/09)

Some efforts by educators are focused on boosting the number of primary-care doctors. The University of Arkansas for Medical Sciences anticipates the state will need 350 more primary-care doctors in the next five years. So it raised its class size by 24 students last year, beyond the 150 previous annual admissions.

In addition, the university opened a satellite medical campus in Fayetteville to give six third-year students additional clinical-training opportunities, said Richard Wheeler, executive associate dean for academic affairs. The school asks students to commit to entering rural medicine, and the school has 73 people in the program.Journal Community

• DISCUSS

“As a specialist physician I will suggest that until primary care physicians can earn 70-80% of what most specialists make without killing themselves, there will be no incentive for the best and the brightest to go into primary care.”

—Michael Brennan

"We've tried to make sure the attitude of students going into primary care has changed," said Dr. Wheeler. "To make sure primary care is a respected specialty to go into."

Montefiore Medical Center, the university hospital for Albert Einstein College of Medicine in New York, has 1,220 residency slots. Since the 1970s, Montefiore has encouraged residents to work a few days a week in community clinics in New York's Bronx borough, where about 64 Montefiore residents a year care for pregnant women, deliver children and provide vaccines. There has been a slight increase in the number of residents who ask to join the program, said Peter Selwyn, chairman of Montefiore's department of family and social medicine.

One is Justin Sanders, a 2007 graduate of the University of Vermont College of Medicine who is a second-year resident at Montefiore. In recent weeks, he has been caring for children he helped deliver. He said more doctors are needed in his area, but acknowledged that "primary-care residencies are not in the sexier end. A lot of these [specialty] fields are a lot sexier to students with high debt burdens."

Healthcare overhaul won't stop premium increases - latimes.com

I Got this from LA Times, so when I have said "Beware of this Bill!!!" I hope you now understand that I share on what is right or wrong with politicians, not to throw mud just because I am a crazy extremist.  

We were promised real reform. Instead we get a centralized healthcare money grab from the government which ultimately hurts us, especially those who can not currently afford the already expensive premiums. And here is another thought, I predicted and voiced concerns that big health insurance would actually benefit from a government mandated healthcare.

Oh and FYI, Congress forgot to protect their own healthcare program(LOL isn't that cathartic). Now the law makers who pushed this down our throats are pissed about the things not in this bill. They should have  read and considered the thing first(but that is just my opinion).

The following story: By Noam N. Levey April 13, 2010

The new law doesn't prevent rate hikes such as Anthem Blue Cross' double-digit increase last year. 'It is a very big loophole,' says Sen. Dianne Feinstein, who is pushing regulatory legislation.

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Reporting from Washington

Public outrage over double-digit rate hikes for health insurance may have helped push President Obama's healthcare overhaul across the finish line, but the new law does not give regulators the power to block similar increases in the future.

And now, with some major companies already moving to boost premiums and others poised to follow suit, millions of Americans may feel an unexpected jolt in the pocketbook.

Although Democrats promised greater consumer protection, the overhaul does not give the federal government broad regulatory power to prevent increases.

Many state governments -- which traditionally had responsibility for regulating insurance companies -- also do not have such authority. And several that do are now being sued by insurance companies.

"It is a very big loophole in health reform," Sen. Dianne Feinstein (D-Calif.) said. Feinstein and Rep. Jan Schakowsky (D-Ill.) are pushing legislation to expand federal and state authority to prevent insurance companies from boosting rates excessively.

At least in the short term, regulators will be able to do little more than require insurers to publicly explain why they want to raise rates. Consumer advocates think that will not be an effective deterrent against premium increases such as the 39% hike that Anthem Blue Cross sent some California customers last year.

"The irony here is that it was the Anthem rate increase that breathed new life into the healthcare bill," said Jerry Flanagan, medical policy director of Consumer Watchdog, a longtime supporter of tougher premium regulation. "But there is nothing in this bill to guarantee that it doesn't happen again."

The lack of muscle is stoking concerns that more rate jumps -- and an angry backlash from ratepayers -- could undermine support for implementing the healthcare overhaul.

Insurance industry officials say that talk of more regulation is misguided and have urged federal officials to focus instead on containing rising medical costs, which help drive up premiums.

"Politicians are much more comfortable looking at healthcare premiums," said Karen Ignagni, president of America's Health Insurance Plans, the industry's Washington-based lobbying arm.

Ignagni, as well as some independent healthcare experts, said policymakers should look at ways to control what hospitals and other providers charge, although few elected officials have shown much appetite for doing so.

Obama endorsed Feinstein's insurance proposal this year, including it in the healthcare blueprint he unveiled in February as Democrats were struggling to revive their proposals. But congressional rules prevented Democratic leaders from including the rate control provision in the final healthcare package.

Many consumer advocates think this enhanced regulation -- known in the industry as "prior approval" authority -- is the only real way to protect ratepayers from insurers, particularly for-profit companies under pressure to generate returns that satisfy Wall Street investors.

Prior approval requires insurers to submit proposed rate increases to regulators, who can then comb through companies' financial and actuarial data to see if the proposals are justified.

Insurers cannot raise premiums without explicit permission from the regulator.

Some states have given prior approval authority to their insurance commissions and have used it to force down premiums.

In New York, the state insurance department reduced nearly a quarter of the proposed premium increases between 1990 and 1995, according to a recent department analysis.

More recently, state regulators in Kansas successfully pushed Blue Cross Blue Shield of Kansas to reduce a proposed premium increase for some of its elderly customers, according to state Insurance Commissioner Sandy Praeger.

California, which does not have the power to block health plan increases, has been using similar authority to control property and auto insurance premiums for more than 20 years, said Dwight M. Jaffee, a real estate and finance professor at UC Berkeley's Haas School of Business. "It has been very successful," said Jaffee, who studied the state's experience.

Health insurance, however, is more complicated than property and auto coverage. And even the most active state regulators typically cannot investigate every proposed change in every segment of the insurance market.

In Maine, where an aggressive Bureau of Insurance reviewed 186 rate filings in 2009, regulators focus on the so-called individual market, where people buy coverage if it is not available through their jobs.

Maine is battling Anthem Blue Cross and Blue Shield, which regulators last year blocked from raising premiums an average of 18.5% on its individual customers.

Many states do far less, often requiring insurers only to file their proposed rate increases with the state insurance commissioner before passing them along to consumers. New York switched to that approach in 1996, a move that state regulators say resulted in "excessive rate increases."

A handful of states, such as Missouri, do not even require insurers to publicly disclose rate hikes.

The new federal healthcare law would step up oversight of health insurers in states with such limited regulation.

The bill directs the secretary of Health and Human Services to work with state regulators to develop a process for reviewing proposed premium increases to determine if they are unreasonable.

Insurers that propose such hikes would be required to post justifications on their websites.

For the first time, all insurance companies would have to dedicate at least 75% of their premiums to paying medical claims; this would reduce the proportion of companies' revenue that could go to administrative expenses, such as executive salaries and stockholder dividends. Some analysts think that requirement could restrain premium growth.

"These provisions are powerful forces that will help end sky-high premium hikes," said Nick Papas, a spokesman for Health and Human Services Secretary Kathleen Sebelius.

On Monday, the department announced it would accelerate the development of new regulations.

But more intensive oversight would not begin until 2014, when states set up new regulated insurance markets, or exchanges, where consumers who do not get insurance at work would shop for coverage.

The healthcare bill allows regulators to ban insurers from the exchanges if their rates are deemed unjustified.

Even some regulators wary of greater Washington control over state affairs say that more federal protections may be needed before then.

"Some consistency there is probably warranted," said Praeger, a Republican and former head of the National Assn. of Insurance Commissioners. Praeger criticized Obama's original proposal to give the federal government authority to block rate increases.

But she said last week that the insurance commissioners association was now talking with the administration about how the federal government could set a stronger minimum national standard for regulating medical insurance companies.

That could encourage more states to require insurers to get state approval before raising premiums.

On Capitol Hill, Feinstein said she was looking at ways to move her premium regulation bill forward, perhaps by attaching it to other legislation with bipartisan support.

Stepping up regulation doesn't promise to be easy. Insurance companies in Maine and Massachusetts have sued state regulators who tried to block rate increases.

noam.levey@latimes.com

Healthcare overhaul won't stop premium increases - latimes.com

Wow, please get this guy out of the Senate!!!!!!!!!!!!!!!

This is a transcript from "On the Record," April 5, 2010

VAN SUSTEREN: Look, I'm all for paying doctors what they deserve and a lot of them work really hard. The only thing I'm curious about is that when someone tries to sell me what someone costs and exempt something that is obvious to me health care and going to happen and then tells me it brings down the debt, I'm suspicious.

REID: Let's assume you are right. That the doctor fix is going cost -- the numbers are not right. Let's say it costs $150 billion dollars. Many believe that it should be paid for. But even if it isn't, you deduct $150 billion from $1.3 trillion you are still safe a huge amount of money

VAN SUSTEREN: The way I understand the bill is now, and correct me if I'm wrong, is I could scam the system with the way it is. I could have no health insurance at all.

REID: Most people aren't going to be looking for ways to scam the system.

VAN SUSTEREN: You don't think so?

REID: I don't think so. I think that most people are going to comply with what the rules are. And the rules are that people should have insurance. I think people are not willing to do that gamble.

If I become a quadriplegic, they will take care of me. What happens if instead of making me a quadriplegic, they need some kind of surgery for example, I don't know maybe appendicitis or something, or something not as drastic that deals with paralysis. I just don't think people would game the system like that.

VAN SUSTEREN: I don't mean to be a cynic, but I can point to members in the Congress and the Senate who are gaming the system. And I don't want to name names, but you've got members on the House side under investigation for doing sort of things, allegations, not convictions, of shady things in economics.

We've got people in our country who are here not legally. You've got people cheating on income taxes. I would like to think that everyone is so noble as you say, although I'm a little suspicious.

REID: If what we have passed doesn't work out, well, the reason we didn't kick in everything immediately is it is going to take time. There will still have to be hearings. If we have problems of things that won't kick in until 2014, we can take care of those.

But what we do know is immediate there are some things we call deliverables that take effect immediately. Children will be able to say on their parents insurance until they are 26. We're going to close the donut hole. We're going to allow small businesses to get 35 percent on their insurance and soon 50 percent.

It is going to be wonderful things that will take place right now. And then some of the things that you brought up, if they don't work out right we'll take a look and maybe try time prove the bill.