1. You are young and don’t want health insurance? You are starting up a small business and need to minimize expenses, and one way to do that is to forego health insurance? Tough. You have to pay $750 annually for the “privilege.” (Section 1501)

2. You are young and healthy and want to pay for insurance that reflects that status? Tough. You’ll have to pay for premiums that cover not only you, but also the guy who smokes three packs a day, drink a gallon of whiskey and eats chicken fat off the floor. That’s because insurance companies will no longer be able to underwrite on the basis of a person’s health status. (Section 2701).

3. You would like to pay less in premiums by buying insurance with lifetime or annual limits on coverage? Tough. Health insurers will no longer be able to offer such policies, even if that is what customers prefer. (Section 2711).

4. Think you’d like a policy that is cheaper because it doesn’t cover preventive care or requires cost-sharing for such care? Tough. Health insurers will no longer be able to offer policies that do not cover preventive services or offer them with cost-sharing, even if that’s what the customer wants. (Section 2712).

5. You are an employer and you would like to offer coverage that doesn’t allow your employers’ slacker children to stay on the policy until age 26? Tough. (Section 2714).

6. You must buy a policy that covers ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services; chronic disease management; and pediatric services, including oral and vision care.
You’re a single guy without children? Tough, your policy must cover pediatric services. You’re a woman who can’t have children? Tough, your policy must cover maternity services. You’re a teetotaler? Tough, your policy must cover substance abuse treatment. (Add your own violation of personal freedom here.) (Section 1302).

7. Do you want a plan with lots of cost-sharing and low premiums? Well, the best you can do is a “Bronze plan,” which has benefits that provide benefits that are actuarially equivalent to 60% of the full actuarial value of the benefits provided under the plan. Anything lower than that, tough. (Section 1302 (d)(1)(A))

8. You are an employer in the small-group insurance market and you’d like to offer policies with deductibles higher than $2,000 for individuals and $4,000 for families? Tough. (Section 1302 (c) (2) (A).

9. If you are a large employer (defined as at least 101 employees) and you do not want to provide health insurance to your employee, then you will pay a $750 fine per employee (It could be $2,000 to $3,000 under the reconciliation changes). Think you know how to better spend that money? Tough. (Section 1513).
10. You are an employer who offers health flexible spending arrangements and your employees want to deduct more than $2,500 from their salaries for it? Sorry, can’t do that. (Section 9005 (i)).

11. If you are a physician and you don’t want the government looking over your shoulder? Tough. The Secretary of Health and Human Services is authorized to use your claims data to issue you reports that measure the resources you use, provide information on the quality of care you provide, and compare the resources you use to those used by other physicians. Of course, this will all be just for informational purposes. It’s not like the government will ever use it to intervene in your practice and patients’ care. Of course not. (Section 3003 (i))

12. If you are a physician and you want to own your own hospital, you must be an owner and have a “Medicare provider agreement” by Feb. 1, 2010. (Dec. 31, 2010 in the reconciliation changes.) If you didn’t have those by then, you are out of luck. (Section 6001 (i) (1) (A)).

13. If you are a physician owner and you want to expand your hospital? Well, you can’t (Section 6001 (i) (1) (B). Unless, it is located in a country where, over the last five years, population growth has been 150% of what it has been in the state (Section 6601 (i) (3) ( E)). And then you cannot increase your capacity by more than 200% (Section 6001 (i) (3) (C)).

14. You are a health insurer and you want to raise premiums to meet costs? Well, if that increase is deemed “unreasonable” by the Secretary of Health and Human Services it will be subject to review and can be denied. (Section 1003)

15. The government will extract a fee of $2.3 billion annually from the pharmaceutical industry. If you are a pharmaceutical company what you will pay depends on the ratio of the number of brand-name drugs you sell to the total number of brand-name drugs sold in the U.S. So, if you sell 10% of the brand-name drugs in the U.S., what you pay will be 10% multiplied by $2.3 billion, or $230,000,000. (Under reconciliation, it starts at $2.55 billion, jumps to $3 billion in 2012, then to $3.5 billion in 2017 and $4.2 billion in 2018, before settling at $2.8 billion in 2019 (Section 1404)). Think you, as a pharmaceutical executive, know how to better use that money, say for research and development? Tough. (Section 9008 (b)).

16. The government will extract a fee of $2 billion annually from medical device makers. If you are a medical device maker what you will pay depends on your share of medical device sales in the U.S. So, if you sell 10% of the medical devices in the U.S., what you pay will be 10% multiplied by $2 billion, or $200,000,000. Think you, as a medical device maker, know how to better use that money, say for R&D? Tough. (Section 9009 (b)).
The reconciliation package turns that into a 2.9% excise tax for medical device makers. Think you, as a medical device maker, know how to better use that money, say for research and development? Tough. (Section 1405).

17. The government will extract a fee of $6.7 billion annually from insurance companies. If you are an insurer, what you will pay depends on your share of net premiums plus 200% of your administrative costs. So, if your net premiums and administrative costs are equal to 10% of the total, you will pay 10% of $6.7 billion, or $670,000,000. In the reconciliation bill, the fee will start at $8 billion in 2014, $11.3 billion in 2015, $1.9 billion in 2017, and $14.3 billion in 2018 (Section 1406).Think you, as an insurance executive, know how to better spend that money? Tough.(Section 9010 (b) (1) (A and B).)

18. If an insurance company board or its stockholders think the CEO is worth more than $500,000 in deferred compensation? Tough.(Section 9014).

19. You will have to pay an additional 0.5% payroll tax on any dollar you make over $250,000 if you file a joint return and $200,000 if you file an individual return. What? You think you know how to spend the money you earned better than the government? Tough. (Section 9015).
That amount will rise to a 3.8% tax if reconciliation passes. It will also apply to investment income, estates, and trusts. You think you know how to spend the money you earned better than the government? Like you need to ask. (Section 1402).

20. If you go for cosmetic surgery, you will pay an additional 5% tax on the cost of the procedure. Think you know how to spend that money you earned better than the government? Tough. (Section 9017).

Multi-year campaign targeting both Jews and non-Jews to include a $38 million marketing budget.

Talkbacks (3)
NEW YORK – Israel’s Tourism Ministry is joining forces with a major American Evangelical movement to boost travel to the Jewish state.

The partnership, with United Christians for Israel, comes amid a major tourism push outlined by Tourism Minister Stas Meseznikov during a recent visit to the United States. The multi-year campaign, which targets both Jews and non-Jews, will include a $38 million marketing budget – more than twice last year’s budget.

The US is Israel’s “No. 1 source country for incoming tourism,” Meseznikov said. “The segmented, focused and intensive marketing activities of the Tourism Ministry will lead to a slowing down of the decrease in tourism and a return to an increase in incoming tourism next year.”

Very Brief Perspectives on the “New Perspectives”
Posted By Jack Davis, Tuesday, August 11, 2009
Updated: Tuesday, August 11, 2009

John Jefferson Davis, PhD
Professor of Systematic Theology and Christian Ethics

N.T. Wright’s Justification: God’s Plan and Paul’s Vision (InterVarsity, 2009) is Wright’s latest and most definitive reply to his critics – including John Piper, The Future of Justification (Crossway, 2007) – in the ongoing debate on the “New Perspectives” on Paul. My general sense is that Wright is basically “right” in what he affirms – placing justification in the context of the Abrahamic covenant, and integrating it with the other crucial biblical themes of resurrection, adoption, the Spirit, and eschatology – but less than “right” in what he denies or appears to downplay: imputed righteousness, penal substitution, the active obedience of Christ, and righteousness as a moral quality (vs. “covenant faithfulness”) for both God and man.

Wright’s reading of Romans and Galatians and the other Pauline epistles is certainly correct in calling fresh attention to Paul’s situating of justification squarely in the context of the Abrahamic covenant (Gen.15), and seeing this covenant as fulfilled in Christ, the true “seed” of Abraham, who fulfills the covenant through his atoning death and resurrection from the dead. Justification is not only a “courtroom” or forensic reality, but also dynamically and integrally connected with the resurrection of Jesus Christ (Rom.4:25) and the reception of the Holy Spirit through faith in the crucified and risen Messiah (Gal.3:2). The justified ones, who receive the Spirit, are indeed seen to be the true sons of Abraham, and heirs of the promise (Gal.3:26), full members of the one people of God. Systematic theologians need to give fresh attention to these important biblical-theological connections being highlighted by Wright and other “New Perspective” exegetes.

On the other hand, Wright seems to over-react to the “merit-theology” of late medieval Catholicism that constituted the historical context in which the Protestant reformers formulated their understanding of justification. The context in which Luther and Calvin read and applied the book of Romans was not a first-century context in which the main issues were the observance of circumcision and dietary laws as conditions of table fellowship between Jews and Gentiles; their context was one in which categories of merit, indulgences, purgatory, the sacrifice of the mass, and the grounds and nature of forgiveness of sins framed the burning soteriological issues of the day. As an exegete Wright is “right” to focus on the biblical texts in their first-century contexts; Luther and Calvin, as historical and systematic theologians, were right in applying the texts to the issues and categories of their own sixteenth-century time and culture. (At the very end, though, Wright does say that “Everything that Luther and Calvin wanted to achieve is within this glorious Pauline framework of thought” [as Wright understands it], p.252.)

The concept of imputation is well grounded in Paul (e.g., 9 occurrences of logizomai, “credit” in Rom.4). The “righteousness of God” indeed includes “covenant faithfulness”, but this expression of God’s righteousness is more fundamentally and essentially grounded in the eternal character and nature of God himself as a just and morally perfect being. This “righteousness of God” is expressed in scripture in many texts (e.g., Ps.9:8; 98:9; 99:4; 103:6) that portray God as the righteous judge who condemns the guilty and vindicates the innocent. The concept of righteousness is in fact connected with obedience in the Law of Moses (Deut.6:25: “If we are careful to obey all this law … as he has commanded us, that will be our righteousness”). At the human level righteousness can indeed describe a person’s moral and ethical character (e.g., Cornelius as a righteous Gentile, Acts 10:22). Christ did in fact obey all the divine requirements of the law of Moses, and our mystical union with him (“in Christ”) is the theological reality on the basis of which both the active and passive obedience of Christ can be credited to the believer.

Some of Wright’s critics have suggested that his highly nuanced reading of Paul’s doctrine of justification is so complicated that it is too difficult to preach and teach in the church. There may be some truth in this criticism. We could do well to follow the apostle’s own example of how to preach justification, as depicted by Luke in Acts 13:37,38, during the first missionary journey in the synagogue in Pisidian Antioch: “… through Jesus the forgiveness of sins in proclaimed to you. Through him everyone who believes is justified from everything you could not be justified from by the law of Moses.” Indeed, the “cash value” of justification is that through faith in Jesus Christ, as God’s crucified and risen Messiah, our sins are forgiven, and God the righteous judge declares us “not guilty” in the sight of the law. This is indeed good news for those who are welcomed back to the family of God as his forgiven sons and daughters, given the gift of the Spirit, and made heirs of all the promises given to Abraham, the father of us all

The vast majority of those crashes, 1.4 million annually, are caused by cellphone conversations, and 200,000 are blamed on text messaging, according to the report from the council, a nonprofit group recognized by congressional charter as a leader on safety.

Because of the extent of the problem, federal transportation officials unveiled a organization Tuesday, patterned after Mothers Against Drunk Driving, that will combat driver cellphone use. The group, FocusDriven, grew out of a meeting on distracted driving sponsored by the U.S. Department of Transportation in the District last year.

Virtually everyone owns a cellphone, and it’s evident to anyone who drives regularly that huge numbers of people, including some who support a ban, use them while driving. Persuading people to break that habit could be a tall order for FocusDriven.