I’m Complex. Is That OK? (Part 2 of 2)

See here for Part 1.

PRICE CONTROLS AND TAX INCREASES

When the government limits by law what can be charged for health care, it limits what people are allowed to pay for health care. While everyone would prefer to pay less–or nothing–for health care (as for everything else), government price controls in fact prevent access to life-saving medical treatment that costs more to supply than the price set by the government. The same is true when price controls are imposed on what people are personally permitted to pay for health insurance.

(25) Would you oppose legislation that would impose price controls on health care?

NO

(26) Would you oppose legislation that would impose price controls on health insurance premiums?

NO

Maybe to both of these, depending on the specific legislation. Even before ObamaCare, over half of all health care in the U.S. was paid for by the government. As a result, we do not have a free market, so the law of supply and demand doesn’t work properly. For various reasons, there is little likelihood of the U.S. moving toward a freer market for health care, so the only real way to manage costs is with some market controls. Price controls are one method among several, and I am not willing to discard it.

A majority of Americans receive their health insurance through an employer-sponsored plan. Under current law, apart from the Excess Benefits Tax discussed above, what employers spend to obtain health insurance is not treated as taxable employee income. However, some have proposed to impose federal taxes on some or all of these insurance premiums, making it significantly harder to obtain adequate health insurance and, in effect, imposing a new tax on working Americans.

(27) Would you oppose legislation that would raise federal taxes on health insurance premiums?

YES

(28) Regardless of your answer to the preceding question, would you oppose and veto legislation raising taxes on health insurance premiums above a limit if that limit was not indexed to medical inflation?

(italics in original)

YES

Members of Congress do not have veto power, so I do not know why the question is phrased in that manner. My preference, instead of dealing with issues of price controls and tax rates, would be to move toward a single-payer government-provided health care system, or a hybrid system where the government provides basic services to everyone and premium services are available through an open market.

ADVANCE CARE PLANNING

Effective beginning in 2016, the Obama Administration has directed that Medicare funds pay health care professionals to provide “advance care planning” to senior citizens in which they are asked if they want to execute advance directives that limit or reject the life-preserving health care they will be provided. As documented in National Right to Life’s report, “The Bias Against Life-Preserving Treatment in Advance Care Planning,” available at http://www.nrlc.org/uploads/advancecareplanning/advanceplanningbias2015.pdf, in practice advance care planning typically uses unbalanced, distorted and often inaccurate information in an acknowledged effort to “nudge” those subjected to it to reduce health care spending on them by getting them to forego life-preserving treatment and assisted feeding and fluids.

(29) Would you support legislation to require the Department of Health and Human Services to take steps to ensure that advance care planning paid for with federal tax dollars neutrally assists beneficiaries to implement their own values and health choices, rather than using unbalanced information and counseling that pressures them into agreeing to reject life-preserving treatment and assisted living?

YES

I try really hard to not be a hypocrite. If I want complete and unbiased sex education for students, I cannot deny the elderly complete and unbiased advance care planning information.

The Medicare Choices Empowerment and Protection Act (S. 2297 and H.R. 4059 in the 114th Cong.) would help offset the widespread efforts to “nudge” people to agree to forego life-saving treatments. It would give Medicare beneficiaries and others online access to a website with state-specific model advance directives that choose life-saving treatment, food and fluids equally with those that reject them. It would require that certified online providers of advance directives provide access to the website and provide only forms that comply with relevant state laws, and in cases of dispute over treatment, give family members access to the patient’s actual advance directive, allowing them to dispute claims that the patient didn’t want life-saving treatment.

(30) Would you vote for the Medicare Choices Empowerment and Protection Act?

NO

Yes, but I’m not happy with section (8) of the bill:

“(8) ACCESS IN CASES OF DISPUTE OVER TREATMENT.—Under the Program:

“(A) SPECIAL ACCESS.—The Secretary shall establish a process whereby, with respect to a beneficiary with a certified advance directive, a person described in subparagraph (B) may obtain access to the beneficiary’s advance directive for the purposes of viewing and sharing such advance directive when—

“(i) the provisions of the advance directive have come into force under the applicable State’s law because the beneficiary has become incapable of making health care decisions or under other circumstances provided under State law; and

“(ii) at least one person described in subparagraph (B) is questioning or disputing the provision, withholding, or withdrawal of medical treatment, food, or fluids with respect to the beneficiary.

“(B) INTERESTED INDIVIDUALS.—A person described in this subparagraph, with respect to a beneficiary, is—

“(i) any individual who is a member of any class of persons who, under the applicable State’s law, would potentially be eligible to serve as a health care decision maker for the beneficiary if an advance directive had not been executed regardless of whether higher priority for such eligibility would be accorded to another individual or individuals; and

“(ii) if the applicable State’s law does not designate persons or classes of persons described in clause (i), any person related within the third degree of consanguinity or affinity to the beneficiary.

I have seen too many cases where people do not trust their family members–justifiably–to make decisions about their financial or medical care. A proper living will designates a person or persons to make decisions in part to keep others from interfering. Section (8) opens the door to interference, and I cannot support that. The rest of the legislation is excellent.

POLITICAL SPEECH, GRASSROOTS ADVOCACY, AND RIGHT TO PETITION

President Obama, and some members of Congress, have pushed for enactment of legislation (such as the so-called “DISCLOSE Act”) that attempts to discourage donations to organizations (such as NRLC) that comment on the actions of elected federal officials, by requiring the publication of the identities of donors to such organizations. Such restrictions would harm organizations engaged in advocacy on contentious issues, because many businessmen and others would be deterred from supporting advocacy organizations for fear of harassment, abuse, or boycotts by people who do not share their political opinions.

(31) Would you oppose enactment of any legislation that would curb the right of private citizens to support advocacy organizations without being “outed” by the government?

NO

“Any.” See my explanation after the next question.

In its January 2010 ruling in Citizens United v. FEC, the U.S. Supreme Court ruled that the First Amendment protects the right of corporations (which includes nonprofit corporations, such as NRLC) to spend money to express viewpoints regarding those who hold or seek political office. Subsequently, President Obama, and some members of Congress, have advocated adoption of new restrictions to discourage corporations from exercising this right–for example, by telling corporations that if they engage in constitutionally protected speech on political matters, they will lose other rights.

(32) Would you oppose any legislation that would penalize corporations, including nonprofit corporations such as NRLC, for engaging in the types of free speech that the U.S. Supreme Court has ruled are protected by the First Amendment?

NO

“Any.” Citizens United is an abomination that has allowed money to flow unrestricted into political campaigns. I hesitate to restrict free speech, but there are severe structural issues when millions of anonymous dollars are spent to influence political campaigns. I have not studied the issue in depth enough to have ideas on potential solutions, but the status quo is unacceptable.

The federal Lobbying Disclosure Act is a law that already requires organizations that lobby Congress to report, on a quarterly basis, all of the legislative matters on which they contacted members of Congress or Executive Branch agencies, but the law does not require the reporting of specific lawmakers or officials with whom they communicated. In January 2010, President Obama urged Congress to adopt legislation under which every contact between lobbying organizations and lawmakers would be reported into a publicly accessible database. NRLC believes that such “contact reporting” is an infringement on the First Amendment right to petition government officials, is exceedingly burdensome, and serves no legitimate public policy purpose.

(33) Would you oppose any legislation that would require members of Congress or Executive Branch officials to report, into a public database, contacts they receive from an advocacy organization such as NRLC, or that would require an advocacy organization such as NRLC to report its contacts with individual elected officials?

NO

“Any.” I will record any contacts I receive from advocacy organizations, corporations, lobbyists, and individuals who are not residents of my Congressional district in a searchable database. I do not believe organizations should have to report contacts themselves. If other members of Congress have something to hide, that is between them and their constituents.

Under the Bipartisan Campaign Reform Act (McCain-Feingold), the Federal Election Commission promulgated new rules on defining what constitutes illegal “coordination” between candidates (including incumbent members of Congress and incumbent presidents) and citizen groups. The rules specifically do not require that there be “formal agreement or collaboration” with a member of Congress or other candidate in order for an expenditure by a citizen group or political action committee to be a “coordinated expenditure” and thus a campaign “contribution.”

Under the loose new definition of “coordination,” citizen groups and PACs that communicate with Congress on legislative matters and also conduct independent expenditures are at risk of being unintentionally “coordinated,” thereby making their independent expenditures illegal campaign “contributions.”

(34) Would you support regulatory reforms and/or new legislation to reestablish that “coordination” means only a formal agreement or collaboration on a specific project between a candidate and a citizen group or PAC?

NO

Maybe. I think requiring a formal agreement takes things too far, as a handshake deal can accomplish the same thing. I don’t want unintentional coordination to be punished, if it is truly unintentional, so some refinement is likely needed.

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Questions (35) on the Supreme Court and (36) on the CEDAW treaty are for Senate candidates only. I am not in favor of picking Supreme Court justices based on their opinions on any one issue. CEDAW (The Convention on the Elimination of All Forms of Discrimination Against Women) is an obvious sore spot for NRLC because of its requirements for access to family planning services. I would have to review CEDAW in detail to see if I would support it.

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There you have it. If there are any additional questions you have on my positions on abortion or health care, feel free to leave me a comment. If any other organizations want to know my positions, please contact me.