Madfloridian's Journal - Obama's health care reformist, Zeke Emanuel, emerging from behind the scenes.

Orszag hired Zeke Emanuel to advise him. Zeke says to have 10% national tax to pay for health care. I am not very fond of Zeke Emanuel's health care plan which appears to consist of private plans and phasing out of Medicare and Medicaid as no new enrollees are allowed.

From ABC News

Obama's health care reformist

Ezekiel Emanuel, special health adviser at the U.S. Office of Management and Budget.
(Brendan Hoffman/Bloomberg News/Landov)

Eldest Emanuel Brother Steps Into Spotlight

Emanuel is the eldest brother of White House chief of staff Rahm Emanuel, 49, and Hollywood talent agent Ari Emanuel,48, no strangers to the media spotlight.

But when Zeke Emanuel, 51, was tapped by the Obama administration to be special health adviser to budget director Peter Orszag in February, the renowned medical ethicist, oncologist and policy wonk became the go-to guy for stakeholders who want a say in the Obama administration's effort to reform the nation's health care system.

He works closely with Orszag and Nancy-Ann DeParle, director of the White House Office of Health Reform, who is coordinating legislative efforts on Capitol Hill.

When the president held a White House meeting last month with the major health care players -- including many of the people who had worked to scuttle former President Bill Clinton's reform efforts -- medical establishment representatives rushed up to Emanuel afterwards to remind him how they knew him.

It doesn't hurt that he also has the ear of his chief of staff brother.

That is two Emanuels inside the White House. That's a lot of Emanuels advising. Sounds like they have the president's ear. I worry about Emanuel's plan and how he wants to fund it.

This article from the Washington Post defines the Value Added Tax which has confused me.

Once Considered Unthinkable, U.S. Sales Tax Gets Fresh Look

With budget deficits soaring and President Obama pushing a trillion-dollar-plus expansion of health coverage, some Washington policymakers are taking a fresh look at a money-making idea long considered politically taboo: a national sales tax. Common around the world, including in Europe, such a tax -- called a value-added tax, or VAT -- has not been seriously considered in the United States. But advocates say few other options can generate the kind of money the nation will need to avert fiscal calamity.

A White House spokesman said the tax is not likely. He said it is popular with academics but not with policy makers.

But Orszag has Zeke Emanuel as an advisor on health care, and this is part of Zeke's plan.

Still, Orszag has hired a prominent VAT advocate to advise him on health care: Ezekiel Emanuel, brother of White House chief of staff Rahm Emanuel and author of the 2008 book "Health Care, Guaranteed." Meanwhile, former Federal Reserve chairman Paul A. Volcker, chairman of a task force Obama assigned to study the tax system, has expressed at least tentative support for a VAT.

"Everybody who understands our long-term budget problems understands we're going to need a new source of revenue, and a VAT is an obvious candidate," said Leonard Burman, co-director of the Tax Policy Center, a joint project of the Urban Institute and the Brookings Institution, who testified on Capitol Hill this month about his own VAT plan. "It's common to the rest of the world, and we don't have it."

So while they are saying they are not considering it, they actually are considering it.

Here is Zeke's plan, and if the tax covers food and everyday services it could devastate the average people in the populace.

A VAT's Bottom Line

What would it cost? Emanuel argues in his book that a 10 percent VAT would pay for every American not entitled to Medicare or Medicaid to enroll in a health plan with no deductibles and minimal copayments. In his 2008 book, "100 Million Unnecessary Returns," Yale law professor Michael J. Graetz estimates that a VAT of 10 to 14 percent would raise enough money to exempt families earning less than $100,000 -- about 90 percent of households -- from the income tax and would lower rates for everyone else.

And in a paper published last month in the Virginia Tax Review, Burman suggests that a 25 percent VAT could do it all: Pay for health-care reform, balance the federal budget and exempt millions of families from the income tax while slashing the top rate to 25 percent. A gallon of milk would jump from $3.69 to $4.61, and a $5,000 bathroom renovation would suddenly cost $6,250, but the nation's debt would stabilize and everybody could see a doctor.

Here are some of the things about Zeke's plan that bother me. It leaves out the public option entirely as far as I can see. It appears to phase out Medicare and Medicaid.

Zeke might want to phase out Medicare and Medicaid

The Guaranteed Healthcare Access Plan will be administered by a National Health Board and regional boards modeled on the Federal Reserve System with fiscal, administrative, and political independence to make tough decisions based on the merits, not special interest lobbying. There will also be an Institute for Technology and Outcomes Assessment to assess the effectiveness of new drugs, devices, procedures, and other interventions. It will also assess and make publicly available data on the clinical outcomes of patients in different insurance companies. This will permit comparative shopping based on real quality results.

"No one (I think he means to say "anyone") receiving Medicare, Medicaid, or any other government program will not be forced out, but there will be no new enrollees. People who turn 65 will simply stay in the Guaranteed Healthcare Access Plan. The special tax benefits related to employer based coverage will be eliminated and most employers will stop offering health insurance."

I think about what happens to people who are in a program that is being phased out. The outlook for them is not bright. Programs that are "left behind" are not funded properly, and it sounds like Zeke has an inside track here in the WH and in the media coverage. Others who are advocating for other ways only get written about at blogs.