There's no way around it - support for the so-called "public option" in health care is flat lining. So now we're hearing from the Senate about a "consumer cooperative" or "co-op" as an alternative to the government plan.

However as the Heritage Foundation notes, if this “co-op” is not run and controlled directly by consumers, then it's simply a government-plan under a different name.

"If by health care 'co-op' Congress means allowing private associations to collectively buy health insurance for their members or operate a health insurance exchange, or allowing people to buy health insurance from a non-profit, member-owned private insurer, then those would be positive, pro-consumer developments.

"However, simply slapping the word 'cooperative' onto a new 'insurer,' but then specifying that the government — not the policyholders — picks the board of directors (as Sen. Schumer wants), or that taxpayers will subsidize it, or that it has to pay doctors and hospitals at Medicare rates, would just be an exercise in trying to disguise a 'public plan.'"

The American people won't be sold by smoke and mirrors. There's too much at stake here. And while it's not clear that the President and many Members of Congress are reading the bills, the people are.

One of the hot points of contention throughout the health care debate has been whether coverage will extend to illegal immigrants.

Roll Call reports that last Friday, leaders of the Congressional Hispanic Caucus (CHC) met with Speaker Pelosi to "reiterate that illegal immigrants should be covered under health care reform legislation" that comes out of the House.

"Asked if CHC leaders will ask Pelosi to specifically spell something out in the bill to address illegal immigrants, [one] Member said no. Rather, the Member said the CHC simply wants to make sure the bill — as drafted — doesn’t prohibit illegal immigrants from accessing care. 'Sometimes if you don’t say something, something happens,' said the Hispanic lawmaker."

Interesting. Especially when you put it in the context of the House Ways and Means Committee's party-line vote to reject a commonsense amendment that would have ensured that illegal immigrants are not covered. The amendment, offered by Nevada Republican Dean Heller, would have simply required that the same citizenship verification mechanisms used to screen welfare recipients be used to screen health benefits recipients.

The relationship between illegal immigrants and our nation's health care system is one that cannot be overlooked. In 2006, the Census Bureau reported that there were 46.6 million people without health insurance of which about 9.5 million were not United States citizens. The expense of illegal immigrants' health care in California, for instance, has become so unbearable that many municipalities had to eliminate this benefit to save tens of millions of dollars. Texas estimates that illegal immigrants cost hospitals there $1.3 billion in 2006 alone.

It's clear that a bill that is silent on eligibility means a bill that includes illegal immigrants.

Betsy McCaughey, founder of the Committee to Reduce Infection Deaths and a former New York lieutenant governor has blown the lid off of President Obama's vision of health care reform, revealing the real life ramifications of how one's age and level of ability will determine the kind of care and treatment they receive. To be blunt, the ramifications for senior citizens, the disabled, and the very sick are downright damning.

"THE health bills coming out of Congress would put the decisions about your care in the hands of presidential appointees. They'd decide what plans cover, how much leeway your doctor will have and what seniors get under Medicare.

"Yet at least two of President Obama's top health advisers should never be trusted with that power.

"Start with Dr. Ezekiel Emanuel, the brother of White House Chief of Staff Rahm Emanuel. He has already been appointed to two key positions: health-policy adviser at the Office of Management and Budget and a member of Federal Council on Comparative Effectiveness Research.

"Emanuel bluntly admits that the cuts will not be pain-free. 'Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality are merely 'lipstick' cost control, more for show and public relations than for true change,' he wrote last year (Health Affairs Feb. 27, 2008).

"Savings, he writes, will require changing how doctors think about their patients: Doctors take the Hippocratic Oath too seriously, 'as an imperative to do everything for the patient regardless of the cost or effects on others' (Journal of the American Medical Association, June 18, 2008).

"Yes, that's what patients want their doctors to do. But Emanuel wants doctors to look beyond the needs of their patients and consider social justice, such as whether the money could be better spent on somebody else.

"Many doctors are horrified by this notion; they'll tell you that a doctor's job is to achieve social justice one patient at a time.

"Emanuel, however, believes that 'communitarianism' should guide decisions on who gets care. He says medical care should be reserved for the non-disabled, not given to those 'who are irreversibly prevented from being or becoming participating citizens . . . An obvious example is not guaranteeing health services to patients with dementia' (Hastings Center Report, Nov.-Dec. '96).

"Translation: Don't give much care to a grandmother with Parkinson's or a child with cerebral palsy.

"He explicitly defends discrimination against older patients: 'Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years' (Lancet, Jan. 31)."

Continue reading at the New York Post website

We received good news this week from our nation's struggling automobile industry, as Ford reported a profit of $2.3 billion. What's more, according its CEO, Alan Mulally, as reported in the Wall Street Journal, "Ford remains on track to break even or even make money in 2011 and has sufficient liquidity to fund its turnaround plan."

I think Chrysler and GM could learn something from Ford's example.  Ford made the tough choice to restructure internally instead of taking an infusion of taxpayer bailout money and a government-run bankruptcy. They closed plants, eliminated different brands of cars, and had to cut about 40,000 employees.  And, they borrowed $23.5 billion from private lenders, " mortgaging almost everything of value in the company."  They made the tough choices, took the risks, and now they are on track to reap the rewards, branding themselves to be on track to be a vibrant, job-creating company once again.

On the other hand, we have the Chrysler and GM example.  Who knows what's next on their dance card having danced the bailout/bankruptcy two-step with the federal government.  What's more:  Who knows how these rival companies will fare against one another taking such radically different paths.  Will Ford find itself at a disadvantage for doing the right thing and living up to the American spirit of risk-taking, ingenuity, and innovation?  As the Wall Street Journal reports today, "Ford's decision to decline U.S. aid or file for bankruptcy protection may have created consumer goodwill, but rival GM was able to eliminate about $40 billion in debt.  Chrysler Group LLC similarly exited bankruptcy with lower financial obligations."

Henry Ford is responsible for the birth of the American auto industry.  It's encouraging to see that the spirit of America still lives on in Ford.

Tomorrow, just as Congress has mandated, the national minimum wage will increase 70 cents to $7.25 an hour, which on the surface, appears a positive step for those workers in this wage bracket. However, economist David Neumark of the University of California, Irvine "calculates that the 70-cent-per-hour minimum wage hike this month would kill 'about 300,000 jobs for those between the ages of 16-24.'"

The matter of increasing the minimum wage is typically contentious because, on the surface, at least, it's tough to see how workers making more money can be bad for the overall health of our economy or for those workers. But if you dig a little deeper, if employers are forced to pay all their employees more, then these same employers can't afford to hire as many workers leading to increased unemployment.  Particularly in an economy like this, the pie doesn’t get any bigger, so if you’re forced to hand-out larger slices, you’ll be handing out fewer of them.

Neumark along with William Wascher of the Federal Reserve Bank have done extensive research on the effects of minimum wage hikes on unemployment, and they have come to two conclusions:

1 - "A sizeable majority of the studies give a relatively consistent (though not always statistically significant) indication of negative employment effects.”

2 - "Studies that focus on the least-skilled groups [i.e., teens, and welfare moms] provide relatively overwhelming evidence of stronger disemployment effects."

As the Wall Street Journal points out: 

“[T]hat single mom can't collect those checks if she doesn't have a job, and the tragedy of a higher minimum wage is that it will prevent thousands of working moms striving to pull their families out of poverty from being hired in the first place.”

If raising the minimum wage leads to increased unemployment, then aren't we hurting more Americans than we're helping, especially when unemployment already sits at a staggering 9.5% and is only on the rise? One of the shortfalls of legislation that comes from Washington is that it's often too short-sighted and focused on emotion rather than logic.

The Troubled Asset Relief Program (also known as TARP, and most commonly known as the Wall Street bailout), signed into law several months ago was done so with a price tag of $700 billion. But on Monday, we heard that this number could be significantly higher - to the tune of $23.7 trillion - when all’s said and done. This according to Neil Barofsky, the Special Inspector General of the TARP.

As reported in Politico:

"Originally, TARP was intended, Barofsky writes, to facilitate 'the purchase, management, and sale of up to $700 billion of toxic assets, primarily troubled mortgages and mortgage-backed securities.'

"But that plan was soon rejected, and the TARP instead became a grab bag of bailout initiatives, including bailouts for GM, Chrysler and auto parts suppliers as the federal government struggled in real time to contain a spiraling economic disaster.

"Barofsky reports that TARP has come to include 12 separate programs that include a total of as much as $3 trillion, 'including TARP funds, loans and guarantees from other agencies, and private money.'

"Barofsky’s calculation of a $23 trillion figure took into account a wide-ranging group of federal programs set up by disparate agencies within the federal bureaucracy.

"The special inspector general counted approximately 50 initiatives or programs launched since 2007 to fight the economic collapse."

What's worse is that these non-TARP activities cost more than TARP itself and do not require Congressional approval.  And, the Treasury Department continues to reject efforts to let the American people know how and where and why their money is being spent.  As Barofsky has said, “[Treasury] has repeatedly failed to adopt recommendations that SIGTARP believes are essential to providing basic transparency and fulfill Treasury’s stated commitment to implement TARP ‘with the highest degree of accountability and transparency possible.’”

Of course, even if Treasury won’t open up the books to the people, there are other ways for you to find out what’s happening with your money.  For instance, the Hill newspaper points out that "auto companies and eight of the country’s biggest banks that received tens of billions of dollars in federal bailout money spent more than $20 million on lobbying Washington lawmakers in the first half of this year….Six of the eight banks spent more to try to sway lawmakers in the first half of 2009 than over the same period in 2008, before the worst of the financial crisis took hold.”

At least lobbying disclosures give us a sneak peek into how the bailed out are spending their money. Sadly, lobbying is not what Americans had in mind when their hard-earned money was put on the line.

Yesterday, as the House Energy and Commerce Committee marked-up the Democrat's proposed health care reform legislation, Democrats made it clear that they are more than willing to put a Washington bureaucrat between you and your doctor.

Congressman Phil Gingrey (R-GA), a former ob-gyn who practiced for 26 years before being elected to Congress and a member of the Committee, offered an amendment that would prevent government bureaucrats at the proposed Center for Quality Improvement from dictating to physicians what treatments they can or can't offer.

As Committee Republicans have noted, "in the Democrat's legislation, the Center is tasked with determining what treatments and procedures are most cost effective. This manner of government sponsored research, in conjunction with the new Federal crowd-out health plan would represent the first step towards implementing a policy of bureaucrat health care rationing."

Rep. Gingrey's commonsense amendment was defeated by an almost straight party-line vote, with only one Democrat voting with all the Republicans.

Democrats also rejected another amendment that would have allowed state governments to decide what kind of insurance coverage to offer public employees.  So Minnesotans don’t want their state to pay for abortion services for state or local employees?  Republicans can respect that.  Democrats, on the other hand, want DC to dictate the very specifics of all these health care plans – and if states refuse, they’d have their funding withheld. 

As Congressman Henry Waxman, Chairman of the Committee, stated, ““We can’t tell states what to do directly.  We have to use whatever leverage we have over them.”

This is the point to their health care proposal?  Putting government right in the middle of the health decisions that should be made by you and your doctor? This is wrong, and not the path our nation should be following.

Looks like the Obama Administration is also going to great lengths to oppose H.R. 2743, the "Automobile Dealer Economic Rights Restoration Act of 2009."

I've talked extensively about how on July 6th GM dealers received a letter from the General Motors National Dealer Council urging them to sign a sort of petition to Congress immediately; no later than 5:00 p.m. the very next day, saying that they opposed passage of the bill.

I am a co-sponsor of H.R. 2743 along with 241 other Members of Congress.  If passed, it would essentially reinstate the economic and contract rights of dealers who were arbitrarily dropped by Chrysler and General Motors during their respective restructurings. In essence, H.R. 2473 makes these dealers whole instead of allowing their livelihoods to be taken from them with no legal recourse and no financial compensation.

According to TradingMarkets.com, the Obama Administration is urging opposition to this bill, too.  The White House has said that reversing the closings would set a "dangerous precedent, potentially raising legal concerns, to intervene into a closed judicial bankruptcy proceeding on behalf of one particular group at this point."

With all due respect:  Tell that to the retired teachers and police officers in Indiana whose pension funds were decimated when the Obama car czar leapfrogged the unsecured debts of the United Auto Workers ahead of the secured debts of these legitimate bondholders.

The deal crafted by the Obama White House to quickly move along the restructing of Chrysler and GM trampled on the rights of pension fund creditors by giving a bigger share of the pie to more junior, non-secured parties - like the UAW.  Now, that’s a very ugly precedent for future investors.
 
Apparently, the Administration observes legal precedents only if doing so moves forward their priorities and agenda.

In April of this year, I introduced H.Res.373, a resolution expressing support for the designation of the month of September as "National Hydrocephalus Awareness Month."

Hydrocephalus is a very serious but all too often overlooked medical condition that affects approximately 1 in every 500 births, yet very few people are even aware of it.  Hydrocephalus is the excessive collection of fluid in the ventricles or cavities of the brain, and at any time, a ventricle could collapse and in a matter of hours, enough fluid could build up and put harmful pressure on the tissues of the brain resulting in irreversible damage, even death.

Sadly, the prognosis for individuals afflicted with hydrocephalus is difficult to predict and often fatal.  The most common form of treatment for hydrocephalus involves the insertion of a shunt in order to maintain the flow of fluid from the brain, but this practice is sorely outdated and often results in complications that can jeopardize the life of often very young patients. It’s my hope that through increased awareness and education, we can take the steps needed to modernize the treatment of hydrocephalus and move toward a cure.

Below is a letter from Michelle Janson, whose 9 year old daughter, Ally, developed hydrocephalus at 1 year of age. She sent this letter to my office in hopes that sharing it will create greater awareness of the disease among the general public. With greater research, she’s confident that it can be diagnosed more accurately, and treated more efficiently. I encourage you to take a minute and give it a read:

My name is Michelle Janson.  We have a 9 year old daughter, Ally, who developed hydrocephalus at 1 year of age.  The cause of her congenital hydrocephalus allowed her to be eligible for a fairly new procedure called a Third Ventriculostomy.  Although there was a lot of information at the time about shunts, very little was known about the Third Ventriculostomy.  After we researched our options and interviewed several neurosurgeons, Ally underwent a Third Ventriculostomy on July 9th, 2001.

This year Ally has reached 8 years as one of the lucky few who have not encountered infections, revisions or malfunctions as frequently seen with shunts.  Although she does have other rare medical conditions to complicate things, she is leading a fairly normal childhood.  She was the only one in her 3rd grade class to be chosen to participate in the Young Authors Club and maintained straight A’s throughout the school year.

Several years ago we searched for a support group, close to home, that would provide our family with support and education about the condition.  We became involved with a group which is currently based out of JFK; know as the Pediatric Hydrocephalus Foundation.  The visions of those involved have encouraged us to actively participate in educating, providing support and to raise funds for local communities and families in need.   The founders Michael and Kim Illions have also been active with government officials such as you, to initiate a resolution known as HR 373 to declare September National Hydrocephalus Awareness Month.

I am writing to thank you for your incredible dedication and support to make this resolution known.  Since you have sponsored our Foundations request, you have gone above and beyond the call of duty.  Your perseverance has obtained the signatures that were needed to move the resolution to the next level.  Compared with similar public health issues (i.e. autism) hydrocephalus receives minimal government funding and assistance.  Should the HRES bill pass, we hope that the future will provide opportunities for public awareness and education, as well as funding for research and treatment advancements.

Thank you again for your active role in providing the public with a Heads Up on Hydrocephalus.  This is a big step for our children’s future, and may God bless you for your stoic endeavor.

Please take a moment to learn more about hydrocephalus by visiting www.HydrocephalusKids.org, the website for the Pediatric Hydrocephalus Foundation.

In just the past few months, the U.S. House of Representatives has passed some of the most unprecedented pieces of legislation in our nation’s history – changing the course of our nation’s policy dramatically. June brought us the cap-and-trade national energy tax, and July may very well bring a dangerous overhaul to our nation’s health care system in the form of the so-called “government option.”

With issues of this magnitude, it is not only prudent, but incumbent upon each Member of Congress to know precisely what is in a piece of legislation before it’s voted on. This seems elementary and Congress 101 – but believe me – it doesn’t always happen. That’s why I have signed the Let Freedom Ring Health Care Reform Pledge that obligates the signee to oppose any health care proposal a Member has not read and that has not been publicly available for at least 72 hours before it is voted on by Congress.

With an issue as big as the government take-over of our health care system, every single Member of Congress better know what they’re voting on. They say the devil is usually in the details; and a 1000-page bill has a lot of details.  Americans can not afford to let a crushing, big government proposal pass the House without proper oversight and review.

Here’s the harsh reality of what’s facing our nation. Since the recession began, 6,000,000 jobs have been lost.  Yet the Democrats’ health care plan includes hundreds of billions of dollars in new tax hikes on small businesses – our country’s job creation engine. And, despite claims their reform will reduce health care costs, CBO Director Elmendorf told Congress that the Democrats’ proposed reform will only INCREASE future federal spending on health care. Furthermore, an independent analysis by the non-partisan Lewin Group found that 114 million Americans would lose their current health insurance.

Earlier this year I reintroduced the Health Care Freedom of Choice Act, a bill that would improve America’s flawed health care model by increasing patient choice, lowering costs and breaking down barriers that restrict access to care. Under current law, businesses are allowed to deduct the cost of employee health care from their taxes, while individuals and families who purchase health care cannot take the same deductions. This bias against individual choice leads to higher health care costs and reduces accessibility to care. My legislation would erase this bias and extend the same tax incentives to businesses and individuals alike. This would not only make health care more affordable for those who purchase it themselves, but by injecting choice and competition into the health care market it would lower prices for all Americans.

Republicans want to expand access to affordable health care and give families the freedom to choose the health care that fits their needs – without imposing a job-killing tax hike on small businesses and working families. From what we’ve seen from the Democrats – they want to take those choices away.

Since January, the Democrats’ budget has increased spending by $2.6 trillion over the next ten years. Two million jobs have been lost since the Democrats passed their so-called “stimulus” package in February. Unemployment sits at 9.5% with 14.7 million Americans out of work and numbers on the rise, and our nation’s deficit is over $1 trillion, the highest it has ever been in our nation’s history.

Yet, the Democrats find it prudent to bring to the floor a bill that would spend $700 million on wild horses. I find it highly unlikely that the majority of Americans would say that wild horses takes precedence over issues like our rising unemployment rates or skyrocketing deficit and debt. 

Furthermore, the House voted on a similar bill last Congress.  This year’s bill is 20 pages long instead of the 13 lines of last year’s bill.  And, those extra pages will cost you 28,000% more.  Those must be some horses.

Yesterday, I came across a great piece in Investor's Business Daily about how the House Democrats' Health Care Reform bill released earlier this week would mark the end of individual private medical insurance if signed into law.

I've posted a part of it for you below, and I encourage you to read the entire piece. The bill as it's written would kill the market for private individual coverage by not letting any new policies be written after the government option becomes law.

As I've mentioned in previous posts, Republicans want to expand access to affordable health care and give families the freedom to choose the health care that fits their needs – without imposing a job-killing tax hike on small businesses and working families. From what we’ve seen from the Democrats – they want to take those choices away.

It's Not An Option

By INVESTOR'S BUSINESS DAILY | Posted Wednesday, July 15, 2009 4:20 PM PT

Congress: It didn't take long to run into an "uh-oh" moment when reading the House's "health care for all Americans" bill. Right there on Page 16 is a provision making individual private medical insurance illegal.

When we first saw the paragraph Tuesday, just after the 1,018-page document was released, we thought we surely must be misreading it. So we sought help from the House Ways and Means Committee.

It turns out we were right: The provision would indeed outlaw individual private coverage. Under the Orwellian header of "Protecting The Choice To Keep Current Coverage," the "Limitation On New Enrollment" section of the bill clearly states:

"Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day" of the year the legislation becomes law.

So we can all keep our coverage, just as promised — with, of course, exceptions: Those who currently have private individual coverage won't be able to change it. Nor will those who leave a company to work for themselves be free to buy individual plans from private carriers.

Read More

On July 6, GM auto dealers received an interesting letter from the General Motors National Dealer Council.  The letter informed them that the Council strongly opposes H.R. 2743, the Automobile Dealer Economic Rights Restoration Act of 2009.  This is the legislation that would protect the rights of the dealerships that had been arbitrarily closed or forced to discard portions of the business they worked so hard to build.

This letter urged the dealers to sign a sort of petition to Congress immediately; no later than 5:00 p.m. the very next day, Tuesday, July 7, saying that they, too, do not support passage of the bill.
 
I am a co-sponsor of H.R. 2473, along with 241 other Members of Congress.  If passed, it would essentially reinstate the economic and contract rights of dealers who were arbitrarily dropped by Chrysler and General Motors during their respective restructurings. If dealers were financially sound to stand on their own, they could continue to remain in business. And those that don’t would at least have legal grounds to recoup a portion of the value of their taken assets.  In essence, H.R. 2473 makes these dealers whole instead of allowing their livelihoods to be taken from them with no legal recourse and no financial compensation.

It is reprehensible for this company to ask their dealers to cannibalize one another under what can only be considered a veiled threat.  After all, if they don’t sign, what will happen to their dealership?  Will they suddenly get a pink slip, too?  Senator Chuck Grassley put it best in a letter to GM when he called this “strong-arming,” and asked GM to assure him “and hundreds of dealers who employ thousands of workers that you will not retaliate against them if they do not sign this letter or do not lobby against the bill on behalf of GM executives.”

Given that the federal government now owns 61% of GM, the moniker that many have given GM – Government Motors – seems apropos.   And, that makes this “strong-arming” even more reprehensible.   With government running GM and Chrysler, politics will control their decision-making, not sound business principles. This letter is proof-positive that politics is prevailing.

Here are a couple of recent clips addressing the GM closures on the House Floor:

 

As Americans hit the road for their family vacations this summer, they're undoubtedly noticing the money they leave at the gas pump.  AAA's Fuel Gauge Report has the national average at $2.58 for regular gas.  That's a far cry from the $4.11 we were paying a year ago.  But, the need for an all-of-the-above strategy for energy independence remains just as great now as it did then.

So, it's puzzling that the Obama Administration is trying to restrict our ability to tap into American oil and natural gas resources.

Robert Bryce, Managing Editor for Energy Tribune, wrote in the Wall Street Journal on July 7, 2009 that President Obama is calling for the elimination of two tax incentives that encourage oil and natural gas exploration.  President Obama calls them "unjustifiable loopholes" for big, bad oil and gas.  The facts show that these two tax provisions more than pay their way all the while opening up American supplies that make us more energy independent.

One allows for the expensing of "intangible drilling costs," which are things like wages, fuel, and pipe.  The other provides an allowance for percentage depletion, so well owners can deduct a portion of the value of the production of their wells.  Together, these two provisions make up the bulk of the total $1.92 billion in federal oil and gas subsidies.  An investment banking firm, Tudor, Pickering, Holt & Co., analyzed the impact of eliminating the intangible drilling cost tax incentive and found that it alone could lead to an increase in the cost of U.S. natural gas by 50 cents per thousand cubic feet. 

But, together, these tax provisions helped us to make advances in energy technology and to tap into natural gas reserves in Texas and Pennsylvania that were previously thought to be too expensive to reach.  A report by the Department of Energy this April found that these newly available resources total 649 trillion cubic feet of gas.  That is the equivalent of 118.3 billion barrels of oil, which is more than the proven oil reserves of Iraq. 

As Bryce points out, "Simple arithmetic shows that eliminating the drilling subsidies that cost taxpayers less than $2 billion per year could result in an increased cost to consumers of $11.5 billion per year in the form of higher natural gas prices."

When you're gassing up the car for your next family outing, think about what it will take to make energy more affordable and energy independence more attainable.  It's got to be an all-of-the-above strategy.

You would think that any health care bill brought forth in Congress would actually be focused on reforming health care. Alas, it seems that both House and Senate proposals are packed with pork as well.

As the Boston Globe has reported, tucked into bills in both chambers are provisions funding what Senator Ted Kennedy’s staff calls “Community Transformation Grants.”  Essentially, we’re talking about federal funding for bike paths, lighting, jungle gyms, and even farmers markets.

In the House bill, at least the spending is capped -- $1.6 billion per year.  The Senate bill leaves the sky the limit – leaving the amount of spending up to the Obama Administration.

While these projects may have merit, they certainly don't belong in a health care reform package.  With priorities like this running amok on Capitol Hill, is there any doubt that health care costs will only continue to skyrocket under government-run health care?