奥巴马医疗改革的背后交易

昨天我说在PELOSI　BILL里民主党跟美国老百姓玩字眼游戏，不提禁止非法移民获得政府保险的条款，也拒绝GOP对此的修正案的讨论，想蒙混过关。一部进2000页的提案，里面说了什么，怎么说的，老百姓基本上是一头雾水。

今天，我们来看看奥巴马跟华盛顿利益集团的幕后交易。

为了推行他的政府保险计划，奥巴马告诉美国的老百姓，他的计划得到了美国退休人员协会AAAP和美国医疗协会AMO的支持。但他没有高速美国老百姓，这两个组织为什么会支持他，为什么不提美国医药界也支持他的计划，为什么美国医疗器械反对他，为什么保险业一开始支持他而现在又反对他了？

原来这里有背后的交易，具体如下：

1. The American Medical Association (AMA) was facing a 21 percent cut in physicians' reimbursements under the current law. Obama promised to kill the cut if they backed his bill. The cuts are the fruit of a law requiring annual 5 percent to 6 percent reductions in doctor reimbursements for treating Medicare patients. Bravely, each year Congress has rolled the cuts over, suspending them but not repealing them. So each year, the accumulated cuts threaten doctors. By now, they have risen to 21 percent. With this blackmail leverage, Obama compelled the AMA to support his bill...or else!

2. The AARP got a financial windfall in return for its support of the healthcare bill. Over the past decade, the AARP has morphed from an advocacy group to an insurance company (through its subsidiary company). It is one of the main suppliers of Medi-gap insurance, a high-cost, privately purchased coverage that picks up where Medicare leaves off. But President Bush-43 passed the Medicare Advantage program, which offered a subsidized, lower-cost alternative to Medi-gap. Under Medicare Advantage, the elderly get all the extra coverage they need plus coordinated, well-managed care, usually by the same physician. So more than 10 million seniors went with Medicare Advantage, cutting into AARP Medi-gap revenues.

3.The drug industry backed ObamaCare and, in return, got a 10-year limit of $80 billion on cuts in prescription drug costs. (A drop in the bucket of their almost $3 trillion projected cost over the next decade.) They also got administration assurances that it will continue to bar lower-cost Canadian drugs from coming into the U.S. All it had to do was put its formidable advertising budget at the disposal of the administration.

4. Insurance companies got access to 40 million potential new customers. But when the Senate Finance Committee lowered the fine that would be imposed on those who don't buy insurance from $3,500 to $1,500, the insurance companies jumped ship and now oppose the bill, albeit for the worst of motives.

The only industry that refused to knuckle under was the medical device makers. They stood for principle and wouldn't go along with Obama's blackmail. So the Senate Finance Committee retaliated by imposing a tax on medical devices such as automated wheelchairs, pacemakers, arterial stents, prosthetic limbs, artificial knees and hips and other necessary accoutrements of healthcare.

明白了吧，老百姓的利益就是这么被出卖的。