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Health Reform By Bleeding The Rich

WASHINGTON -- Democrats in the House of Representatives have unveiled a new health care bill that they say will deliver $30 billion in savings over the next 10 years. But the wealthiest Americans aren't likely to be any happier with it than they were when reform was first proposed months ago.

The reason: One way legislators are planning to pearl jewelry pay for the bill, estimated to cost $894 billion during the next decade, is still through a surtax on the rich. One might recall that this was a major objection to the original House bill in July. (See "ObamaCare: Who Gets Hit And How Hard.")

Three months later, the provision has been weakened. The bill would now apply a surtax on income above $500,000, whereas the original plan would have taxed income above $280,000. For couples, the new tax threshold is $1 million. The surtax rate stays the same for income at this level, 5.4%. Democrats say the new bill would affect just 1.2% of those with small-business income and only 0.3% of the wealthiest Americans overall.

According to an analysis from Deloitte Tax experts, a single tax filer with a modified adjusted gross income of $800,000 would see her annual taxes rise to $240,300 from $200,600. A married couple earning $5 million, with two kids, would see their taxes increase to $1.8 million from $1.4 million.

This assumes that Congress implements several ideas put forth in the president's budget proposal, including an expiration of the Bush tax cuts for the wealthiest Americans, a limit on itemized deductions and a phase-out of the personal exemption.

The so-called "millionaire's tax" provision is expected to raise $460.5 billion over the next 10 years, slightly more than half of the cost of the total bill. Other big revenue raisers include a $2,500 annual limit to contributions on health flexible spending accounts (right now there is no limit), meaning that employees could have more of their paycheck exposed to taxes. Medical devices would be subject to pearl jewelry wholesale a 2.5% excise tax. Like the original House bill, the legislation would delay the ability of U.S. based-companies with operations abroad to take greater advantage of foreign tax credits until 2020, raising $26.1 billion.

Smaller revenue raisers include a doubling of the current 10% penalty for making non-qualified deductions from health savings accounts. Businesses that can currently deduct federal subsidies for prescription drug plans (excluded from gross income) would no longer be allowed to take the deduction.

On cue, Republicans have already begun describing the bill as a fiscal disaster.

"Three things about Speaker Pelosi's health care bill are already clear," says Republican Minority Leader John Boehner of Ohio. "It will raise the cost of Americans' health insurance premiums; it will kill jobs with tax hikes and new mandates; and it will cut seniors' Medicare benefits."

The lobbying fight is also growing more intense. The National Association of Manufacturers says that nearly 70% of manufacturers pay the individual income tax rate because they are set up as S-corporations or similar entities. According to NAM President John Engler, the group's membership would be hit "especially hard" by the bill.

Anticipating this charge, the House Ways and Means Committee has compiled a fact sheet explaining that the health care surtax would only be applied on small-business net profits. (Anyway, the committee notes, "half of these 'business owners' derive more than two-thirds of their income from non-business sources.")

Despite President Obama's pledge to small business that "if you're happy with the insurance plan you have right now ... Nobody will make you change it," the private insurance lobby says this is a promise the president can't keep. If forced to compete with a government-run insurance option, which is included in the House proposal, private insurance companies might alter the types of plans they offer, the thinking goes.

"Estimates show that a government-run plan would cause millions of people to wholesale pearl jewelry lose their current coverage," says Karen Ignagni, president and chief executive officer of the industry group America's Health Insurance Plans. She argues that a public option would "bankrupt hospitals, dismantle employer coverage, exacerbate cost-shifting from Medicare and Medicaid, and ultimately increase the federal deficit."

Touché! (And count on sharper barbs to be hurled in the coming weeks.) The House health care bill is a big milestone in the overall health care reform effort. But it's also solidifying opposition among deep-pocketed insurers, manufacturers and millionaires.
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Don't Fear ObamaCare

Health care reform has been a priority in Washington since Barack Obama took office in January, and though the outcome of the effort is still far from determined, worries of thinner corporate profits have many investors steering clear of investments in the sector and possibly missing out on attractive opportunities.

Senate Majority Leader Harry Reid, D, Nev., said Monday that health care legislation headed to pearl jewelry wholesale the Senate floor will include a public option. The bill is being vetted by the Congressional Budget Office before lawmakers begin their debate. (See "Cost Estimate May Be Key For Public Option.") Investors have been worried that the money to fund a public option isn't in the future budget, and will have to be subsidized by the health care industry in some fashion. A framework put forth by Sen. Max Baucus, D, Mont., in September proposed a multi-billion dollar taxes on the pharmaceutical, medical device and insurance industries, spurring concerns that lean times in the sector will last beyond the current recession-caused struggles.

Sam Stewart, the founder and chief investment strategist at Wasatch Funds, and Beth Lilly, portfolio manager of the Gabelli Woodland Small Cap Value Fund, agree that there is a palpable "fear of the unknown" in the health care space, but said it is likely creating opporutnities to scoop up high-quality investments that traders have been hesitant to jump into. Stewart, whose firm manages over $5 billion in assets, points out that worries over ObamaCare have in many ways kept health care stocks from fully participating in the broader equity market's rebound. To wit, the Health Care SPDR  ( XLV -  news  -  people ) exchange-traded fund is up about 28% since early March, a nice gain but relatively pedestrian compared with a 60% gain for the S&P 500. Many investors are treating health care stocks with kid gloves and Stewart said valuations are going to start looking pretty compelling compared with other more cyclical sectors that have set the tone for the rally.

Hedge fund manager Zeke Ashton of Centaur Capital Partners sees is great value in Laboratory Corp. of America Holdings ( LH - news - people ), a laboratory services company that hasn't fully participated in the equity resurgence. LabCorp. and rival Quest Diagnostics ( DGX - news - people ) are like the Coke and Pepsi of the lab services industry, Ashton said, and were hit hard by worry that a proposed tax in an early draft of health care reform would have created a $750 million annual tax on the industry, allocated by market share. The only problem? LabCorp. and Quest have about 66% of the independent lab business and only had about $1 billion in combined 2008 profits. The tax, which was struck from the reform bill in September, would have eliminated a a huge portion of the pair's profits . LabCorp. is up just 28% since early March even after beating top- and bottom-line estimates for pearl jewelry Chian the third quarter when it issued results Oct. 22; Quest is 27% higher.

In a presentation at the Value Investing Congress Oct. 20 that focused on stocks left behind by the rally, Ashton laid out his case for LabCorp., praising its acquisition of Monogram Biosciences ( MGRM - news - people ) earlier this year and highlighting its presence in genomic and esoteric testing, a growing business. That presence may help the company pick up some ground on Quest, which has about 40% of the laboratory services business conducted outside of hospitals and physicians offices.

Lilly, who has about 10 health care investments in her fund's portfolio, spotlighted three that she expects to do well regardless of the health care reform outcome. Home Diagnostics ( HDIX - news - people ), which sells private-label blood glucose monitors, is poised to capitalize on a rapidly growing diabetes problem that will not be halted by health care reform. Lilly expects the company to thrive independently or ultimately be acquired by a larger player looking to expand its product offering. She identified Perrigo Company ( PRGO - news - people ) as a potential suitor down the road.

Rochester Medical  ( ROCM -  news  -  people ) should thrive based on its new silicon catheters, which reduce hospital-based infections that often extend patient stays and drive up health care costs. Lilly points out that Rochester has $3 in cash per share on its balance sheet, not bad for a stock that's trading in the $10 range. She also Keishi pearl likes OSI Systems  ( OSIS -  news  -  people ), which makes airport screening devices in addition to patient monitoring machines for hospitals. In this case Lilly said improving visibility about hospital equipment spending is helping give a clearer picture of OSI's forward-looking earnings, and the companies two businesses are worth more than its current valuation, opening the door for a spinoff or sale at some point down the road.
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Be Prepared for the Worst

The large-scale government intervention in the economy is going to end badly.

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Any number of pundits claim that we have now passed the worst of the recession. Green shoots of recovery are supposedly popping up all around the country, and the economy is expected to cultured pearl jewlery resume growing soon at an annual rate of 3% to 4%. Many of these are the same people who insisted that the economy would continue growing last year, even while it was clear that we were already in the beginning stages of a recession.

A false recovery is under way. I am reminded of the outlook in 1930, when the experts were certain that the worst of the Depression was over and that recovery was just around the corner. The economy and stock market seemed to be recovering, and there was optimism that the recession, like many of those before it, would be over in a year or less. Instead, the interventionist policies of Hoover and Roosevelt caused the Depression to worsen, and the Dow Jones industrial average did not recover to 1929 levels until 1954. I fear that our stimulus and bailout programs have already done too much to prevent the economy from recovering in a natural manner and will result in yet another asset bubble.

Anytime the central bank intervenes to pump trillions of dollars into the financial system, a bubble is created that must eventually deflate. We have seen the results of Alan Greenspan's excessively low interest rates: the housing bubble, the explosion of subprime loans and the subsequent collapse of the bubble, which took down numerous financial institutions. Rather than allow the market to correct itself and clear away the worst excesses of the boom period, the Federal Reserve and the U.S. Treasury colluded to put taxpayers on the hook for trillions of dollars. Those banks and financial institutions that took on the largest risks and performed worst were rewarded with billions in taxpayer dollars, allowing them to survive and compete with their better-managed peers.

This is nothing less than the creation of another bubble. By attempting to cushion the economy from the worst shocks of the housing bubble's collapse, the Federal Reserve has ensured that the ultimate correction of its flawed economic policies will be more severe than it otherwise would have been. Even with the massive interventions, unemployment is near 10% and likely to freshwater pearl increase, foreigners are cutting back on purchases of Treasury debt and the Federal Reserve's balance sheet remains bloated at an unprecedented $2 trillion. Can anyone realistically argue that a few small upticks in a handful of economic indicators are a sign that the recession is over?

What is more likely happening is a repeat of the Great Depression. We might have up to a year or so of an economy growing just slightly above stagnation, followed by a drop in growth worse than anything we have seen in the past two years. As the housing market fails to return to any sense of normalcy, commercial real estate begins to collapse and manufacturers produce goods that cannot be purchased by debt-strapped consumers, the economy will falter. That will go on until we come to our senses and end this wasteful government spending.

Government intervention cannot lead to economic growth. Where does the money come from for Tarp (Treasury's program to buy bad bank paper), the stimulus handouts and the cash for clunkers? It can come only from taxpayers, from sales of Treasury debt or through the printing of new money. Paying for these programs out of tax revenues is pure redistribution; it takes money out of one person's pocket and gives it to someone else without creating any new wealth. Besides, tax revenues have fallen drastically as unemployment has risen, yet government spending continues to increase. As for Treasury debt, the Chinese and other foreign investors are more and more reluctant to buy it, denominated as it is in depreciating dollars.

The only remaining option is to have the Fed create new money out of thin air. This is inflation. Higher prices lead to wholesale pearl a devalued dollar and a lower standard of living for Americans. The Fed has already overseen a 95% loss in the dollar's purchasing power since 1913. If we do not stop this profligate spending soon, we risk hyperinflation and seeing a 95% devaluation every year.

Ron Paul is a Republican congressman from Texas.
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Bringing Health Care To The Masses

Anna Deveare Smith might be best known for her role as a bossy hospital administrator in the television show Nurse Jackie, but she is most acclaimed as a playwright, actress and documentarian whose scripts are based on her interviews with real people. "I put myself in people's words the way you think of putting yourself in someone's shoes," she says.

Smith's new one-woman play, Let Me Down Easy, in which she is performing off-Broadway in New York, focuses on health care.

The timing couldn't be better, with pearl beads House Democrats unveiling an $894 billion health care reform package Thursday, and health care a hot topic not just in Washington but at dinner tables across the U.S.

In the show, Smith portrays more than 20 people, some famous and others unknown. And as she steps into each character, Smith explores the myriad ways we cope with physical injury and illness in our current health care system. She also addresses how healing depends on more than well-trained doctors or advanced technology; it depends on each person's attitude about their bodies and their lives--and how they think about death.

In fact, one reason health care is such a prickly topic, she suggests, is that it prompts us to contemplate mortality, something most of us would rather avoid.

In an interview with ForbesWoman, Smith talked about what motivated her to create her new play and how performing it has altered her views on the health care system.

ForbesWoman: What led you to create this work?

Smith: I was commissioned by the Yale School of Medicine in the late 1990s to interview patients and staff, and I did a first performance--playing the people I'd talked with--on medical rounds. I was very drawn to the stories I heard, and have since interviewed 300 people in many countries.

Your characters run the gamut from Lance Armstrong and film critic Joel Siegel contemplating his mortality to the director of a South African orphanage who has comforted many children dying of AIDS. How did you find them?

I traveled to many places--a U.S. army hospital in Germany, New Orleans after Hurricane Katrina, Rwanda and all over the U.S.

What did you learn?

Not everyone gets the same health care. A lot depends on how much money you have or your station in life. Because [model] Lauren Hutton is beautiful, she knew someone influential who could help her when she needed medical help [after a serious motorcycle accident.] If you were a patient at Charity Hospital in New Orleans, however, when Hurricane Katrina hit, no one came to naughty castles evacuate you.

Doing this play, I learned to marvel more about the power of bodies--and the fact that we don't all have equal amounts of physical power. But there's also the power of the spirit: Some people have a great sense of determination and hope when coping with illness. They have the ability to keep looking for the possibility of everything being all right.

What's more important when dealing with illness--medical technology or inner strength and love?

One medical school dean told me, "We can look inside cells and genes now and diagnose in ways we never were able to before--but we've lost the understanding that the person sitting across from us is a full human being."

Do you think there's the will to improve the health care system in the U.S.?

There seems to be the will to fight about it, so there has to be a will to improve it. I hope there are creative people who are invested in our potential to be well instead of always equating health care with sickness and catastrophe.

When I was a child and doctors still made house calls, my parents would be angry if the doctor didn't actually do something, if he said "nothing's wrong." That should have been good news, but when that happened, they felt his house call was a waste of money.

We should celebrate being well.

How do you expect health and health care to look going forward?

We live in a global community now, so we'll come into contact with diseases we never knew about. But because we're global, we also have the opportunity to find out more about the mysteries of our bodies and spirits.

And what are your hopes for health and health care in the future?

In Uganda, I went to cultured akoya pearl a forest to watch healers collect herbs and, in the process, to come in touch with their ancestors. We have to look beyond science to find real healing. And we have to stop thinking about doctors as gods who can solve everything--or continue going to [more] doctors if we're dissatisfied with the care they give.
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Fed Up

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The Federal Reserve's recent and unprecedented actions in the realm of monetary policy have provoked a backlash among the American people. Trillions of dollars worth of loans and guarantees have been provided to Wall Street firms, while Main Street Americans suffocate under harsh taxation, the prospect of higher debt levels and increasing inflation. These events have awakened many Americans to gemstone necklace problems with the Fed's loose monetary policy, the bubbles it has created in the past and the potential hyperinflation it might cause in the future.

One of the fallacies of modern economics is the idea that a central bank is required in order to keep inflation low and promote economic growth. In reality, it is the central bank's monetary policy that causes inflation and depresses economic growth. Inflation is an increase in the supply of money, which in our day and age is directly caused or initiated by central banks. All other things being equal, inflation results in a rise in prices. A so-called "mild" rate of inflation of 3% per year leads to a 56% rise in prices over a 15-year period. Even a "low" rate of inflation of 2% per year leads to a 35% rise over that same period. How is that conducive to long-term growth?

A common misconception is that the Fed is completely independent of political pressures. While the Fed has far too much authority to make agreements with foreign governments and central banks, or create temporary liquidity facilities, the governors and--more important--the chairman, are appointed by the president.

The chairman is the dominant figure within the Board of Governors and the Federal Open Market Committee, the public face of the Fed, and he must be reappointed by the president every four years, with the advice and consent of the Senate. Thus, his job security as chairman is dependent on keeping the president and the Senate pleased. Every time the chairman acts, it is with the knowledge that within four years he will be called to the carpet to account for his actions. This necessarily leads to a focus on short-term economic growth, reflected in the Fed's attempt to manage and publicize certain statistical economic indicators.

While I am a proponent of eliminating the Federal Reserve System altogether, I believe that as long as the Federal Reserve exists it should be fully audited. According to current federal law, the Fed's agreements with foreign governments and central banks--and, more important, its open market and monetary policy operations--are exempt from an audit by the General Accounting Office. As the GAO observed in the 1970s, the last time the issue of an audit really came to pearl wholesale the fore, "We do not see how we can satisfactorily audit the Federal Reserve System without authority to examine the largest single category of financial transactions and assets that it has." The Fed has such broad power to intervene in the economy and to engage in agreements with foreign governments and central banks that it is unconscionable that such actions are exempt from oversight.

The Fed's open market operations are not at all neutral in allocating credit. The Fed creates new balances out of thin air and uses those new balances to purchase Treasury bills from banks. Thus the banking sector is the first to get the use of the new money created in these bank balances. As this new money circulates through the economy, prices rise, and individuals further down the chain experience a higher cost of living before their salaries rise.

The fact that a single entity, the Federal Reserve, engages in and has a monopoly on monetary policy has detrimental effects on the economy. As long as we try to keep up this fiction, that the Federal Reserve has a long-term focus, that attempting to fix interest rates will not distort the economy, and that the Fed can end a recession by injecting liquidity, we will never free ourselves from the booms and busts of the business cycle.

The necessary first step to restoring economic stability in this country is to audit the Fed, to find out the multitude of sectors in which it has involved itself and, once the audit has been completed, to analyze the results and determine how the Fed should be reined in. Proposals to push the Fed back into the shadows, or to give it an even greater role as a guarantor of systemic stability, are as misguided as they are harmful.

If Congress fails to freshwater pearl necklace scrutinize the Fed and the actions of its unelected bureaucrats, it will only have itself to blame as this country's economy crashes and burns.

U.S. Congressman Ron Paul represents the 14th district in Texas.

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