Category ►►► Health Care Horrors

May 21, 2012

A Modernist Proposal to Make ObamaCare Better, Faster, and Stronger

Health Care Horrors , Presidential Peculiarities and Pomposities
Hatched by Dafydd

In the spirit of ObamaCare's mandate on all employers, including religious institutions that don't happen to be churches, to push contraceptives, abortifacients, and sterilization, Big Lizards hereby proposes a new mandate1.

It is well known that pork has gotten a bad rap over the years for being dirty, poisonous, and loaded with fat; hence the campaign, thwarted by conservatives, to dub pork "the other white meat"2.

It doesn't help that pork is associated with lower-income consumers who live in the South and is frequently cooked in barbecues by hot smoke; science has proven how dangerous smoking is!

Thus we propose the Safe Porcine Alternative Mandate: All restaurants and food stores, regardless of Kosher or non-Kosher status (except for all establishments owned, operated, or frequented by Moslems, which are of course completely and utterly exempt from this mandate), are required by regulation to carry a full line of pork products, both raw and also ready to eat, prominently displayed on the menu and on store shelves; the mandate requires that all employees, servers, owners, customers, and random passers-by enthusiastically cooperate with the mandate by using all forms of rhetoric, persuasion, threats, and brute force to induce consumers to purchase large and expensive lots of these pork products, whether they like it or not3.

The mandate applies to all businesses, corporations, facilities, retail outlets, convenience stores (whether connected to a gasoline service station or not), candy stores, movie theaters, primary and secondary schools whether secular or sectarian, vending machines, and private pot-luck parties4.

We trust this will satisfy those rightwing wingnuts who whine that we're always picking on Catholics; hey, did you know that "Middle Class" Joe Biden is Roman Catholic? And when we dump him from the reelection ticket, that also won't be because we're picking on Catholics again.

And if SPAM + GloTE do not satisfy some fringe religious bitter-clingers, we have re-education centers with full waterboarding facilities ready and waiting to persuade them, calmly and rationally, to see things our way.


1 There is no need for Congress to act on this mandate; it can be "deemed" (by regulatory fiat) to be an integral part of the Patient Protection and Affordable Care Act of 2010, and be implemented forthwith pursuant to Executive Order 13666 by President Barack "Very Big Stick, Massive Stick" Obama.

2 Or, if you're one of those vegetarians who insist that fish are just vegetables with eyes, "the other other white meat."

3 If price or inavailability make it difficult to obtain pork products, those subject to the mandate and who earn less than $200,000 and who also pay a higher effective income tax rate than Debbie Bosanek, Warren Buffett's secretary, can substitute products that mix meat and milk (e.g., McDonald's Toyless Cheesburgers™ or Campbell's Cream of Rodent™ soup) on a Global Traif Exchange (GloTE), which is also deemed enacted by Congress pursuant to the same Executive Order 13666 that enacts the SPAM itself.

4 Reform and Orthodox Jewish synogogues are exempted on Saturdays and on High Holy Days; Conservative Jewish synogogues are not exempt because, well, we just don't like their name.

Hatched by Dafydd on this day, May 21, 2012, at the time of 1:51 PM | Comments (3)

November 14, 2011

ObamaCare: Double-Edged Scalpel

Election Derelictions , Health Care Horrors , Supreme Beings of Sleazure
Hatched by Dafydd

Now that the U.S. Supreme Court has opted to rule on at least some of the issues anent the Patient Protection and Affordable Care Act of 2010 (a.k.a., ObamaCare), a rather sticky wicket arises. The decision will likely be announced in mid-2012, a few months before the election; most believe that any decision will affect Barack H. Obama's reelection chances... but the question is, which way?

The naïve analysis is that a decision overturning the individual mandate and perhaps other provisions (the expantion of Medicare, for example) would hurt Obama's chances at the voting booth because it makes him look feckless, foolish, and incompetent. But on the other hand, if the Supremes strike down ObamaCare in whole or in part, that might take some electoral pressure off of Obama, since ObamaCare would no longer loom over Americans' heads.

But on the next hand, many conservatives and independents might already believe absolutely that the Court is going to strike the law down. In this scenario, a decision upholding the law might drive more Americans to vote against Democrats, as that would become the only remaining path to undoing ObamaCare.

But on the fourth hand (in case you lost track), a decision more robustly overturning the law (6-3 or 7-2) would probably fuel the perception that the Obama administration is a lawless regime, thus mainstreaming the arguments of conservative activists. Contrariwise, a decision decisively upholding it would do the opposite, making conservatives who argue that it's unconstitutional seem more extremist and hysterical.

On yet another hand -- in politics, there's always one more hand! -- a 5-4 decision overturning could look nakedly political, since it would almost certainly split exactly along the lines of the president who appointed the justices: Chief Justice John Roberts and Justice Sam Alito, appointed by George W. Bush, would join Justice Clarence Thomas (George H.W. Bush) and Justices Antonin Scalia and Anthony Kennedy (Ronald Reagan) in the majority vs. Justices Sonia Sotomayor and Elena Kagan (Barack Obama) and Justices Ruth Bader Ginsburg and Stephen Breyer (Bill Clinton).

(The fact that Justice Kagan was Obama's Soliciter General before being elevated to the Court, and that she and may or may not have actually helped prepare the defense of ObamaCare in the District Court hearings, would certainly not help to dispel the notion of politicization.)

In that case, Democrats -- already dancing on the knife-edge of sanity merely by dint of being Democrats -- might be so enraged that they riot across the country (à la the Rodney King police-beating verdict in 1992, which sparked the L.A. riots); such "unrest" (violence and vandalism) would probably help the GOP. But such a verdict would also motivate more Democrats to the polls on November 6th, which would hurt the GOP's chances.

On the sixth hand, a 5-4 decision upholding ObamaCare, which would result from Justice Kennedy crossing over to the dark side, would likely enrage Republicans, who would see Kennedy as yet another RINO seizing his best opportunity to stab his supposed allies in the back. In this case, it would be the Republicans who would rise up en masse to throw the bums out, probably more determinedly than they would if the verdict upholding the law was more lopsided, with "real Republicans" joining the Democratic appointees.

Sadly, I really cannot predict which of these scenarios would play out, and I've run out of hands in any event. The case surely has to be heard; we must have clarity about such an urgent question: Can the federales demand Americans buy a government approved but privately offered commercial product, such as health insurance?

If so, then the list of what Congress can regulate under the "commerce clause" of the Constitution is virtually limitless... meaning we no longer have even the veneer of limited government; we will have become a de-facto parliamentary democracy, just like those in Europe.

Ergo, the Court must rule; but how such clarity will play out on the battlefield of the 2012 presidential and congressional elections is the flip of a coin or the turn of a card, thus fraught with peril for both sides.

Hatched by Dafydd on this day, November 14, 2011, at the time of 5:35 PM | Comments (3)

November 10, 2011

Your Future Under ObamaCare: Pain Panels

Health Care Horrors , Obamunism
Hatched by Dafydd

President Barack H. Obama himself has admitted that what he really wants for American health care is single-payer, one-size-fits-all socialized medicine. Well we have many examples to choose from, including Japan, Canada, and of course Great Britain's National Health Service (NHS).

We already know about the NHS's death panels; doctors and even nurses frequently write "do not resuscitate" on patients' charts -- without telling friends, family, or even the patient himself what won't happen if he has a cardiac arrest. Why bother to let patients know they've been marked for expiry? They would only intrude upon a decision that should only be made by experts!

The motive should be clear: When the government pays for all health care, it has an obvious conflict of interest; every patient allowed to die, rather than kept alive by "heroic efforts," is another load of medical outlays off the Health Minister's plate. Word is passed along to the government-controlled hospitals (typically by a nod and a wink), and doctors and nurses receive the message loudly and clearly.

But wait, we still have a problem... those wily patients who require medical treatment, including expensive painkilling medication, but who contrive to avoid having a heart attack by which they can be eased off the ministry's books and into the afterlife (where some higher ministry can pick up the tab). How can the NHS -- and the endgame for ObamaCare -- avoid all those nasty, expensive medical payments?

Very simply, and Britain's National Health Service leads the way: A government in financial trouble must foster an anti-treatment, anti-painkiller health-care culture. In clearer words, the NHS now needs pain panels to determine who gets painkillers (and how much), and who is left to suffer:

In Britain, the popular U.S. painkiller OxyContin is considered similar to morphine and used sparingly. Vicodin isn’t even licensed. And at most shops, remedies like ibuprofen are sold only in 16-pill packs.

To avoid risks including addiction, strong painkillers are often kept at arm’s length from patients -- even if that means some people will be left suffering....

For people seeking relief from everyday pains like headaches or sore muscles, painkillers like acetaminophen, sometimes sold as Tylenol, and ibuprofen are only sold in limited quantities. By law, most shops can only sell packs of 16 tablets and no one is allowed to buy more than 100 pills at once without a prescription.

The basic argument is pure utilitarianism; too many patients who require too much help, costing the ministry too much money, equals a major crackdown on expensive painkillers. Some physicians don't even bother to dissemble anymore. Here's my favorite, from "Dr. Anthony Ordman, founder of a pain clinic at London’s Royal Free Hospital":

Ordman also said British doctors may be less inclined to automatically do what their patients want. "In the U.S., doctors might wish to please their patients and prescribe them something because they’re clients," he said. "But in the U.K., the patient doesn’t pay the doctor directly so I can choose not to prescribe painkillers without the fear of suffering financially myself." [Emphasis added -- DaH]

(Which reminds me of Saturday Night Live's fake motto for Bell Telephone: "We don't care. We don't have to. We're the phone company.")

Not all doctors are on board the pain train:

"To make it harder to prescribe enough painkillers for a patient in agony is wrong and essentially a form of torture," said Dr. Michael Platt, lead clinician for pain services at St. Mary’s Hospital in London. "Either we need to treat the pain properly or we tell the patient they are just going to have to suffer."

After the next election, when ObamaCare fully kicks in, see if you can guess which of those two alternatives the administration will push. (Hint: Time to start hoarding aspirin, Motrin, and Tylenol.)

Hatched by Dafydd on this day, November 10, 2011, at the time of 3:28 PM | Comments (1)

November 3, 2009

Medical Tourism - Available Soon for Americans Should ObamaCare Pass!

Health Care Horrors
Hatched by Sachi

One of the fastest growing businesses in India is medical tourism. It's exactly what it sounds like: Patients who are unable to get medical care travel to India, at their own expense, to buy what they're denied in their home countries.

"Medical" tourism in India has been in existence for more than two centuries, with people from all over the world going to India seeking mystical oriental healing. But the new trend of medical tourism is something entirely different. The patients are not looking for Oriental mysticism or magic; they seek ordinary, reliable, modern Western medicine -- which is increasingly rationed or just plain not available in a number of supposedly civilized countries -- especially the United Kingdom and Canada.

And why would that be? What do those two countries in common? Government run "socialized" medicine, of course. In recent years, Europeans who cannot obtain necessary medical treatment in their own countries are booking flights to and reserving hospital beds in the world's second most populous country.

In the past few weeks, congressional Democrats and the administration of Barack H. Obama have hawked ObamaCare by trotting out scores of alleged patients to cry their tales of woe: The for-profit American health-insurance industry is corrupt and evil, taking years' worth of premiums while refusing to pay for medical care.

But such horror stories are not the norm; overwhelmingly, Americans with non-governmental health insurance are quite happy with it. The real insurance nightmares come from countries like Great Britain and Canada.

The health care systems in those two countries are so broken, a disturbingly large number of patients actually die while awaiting simple treaments; this of course reduces government expenditures, so the government medical providers are loathe to do anything about it. But the wait has gotten so bad, the Journal of the Royal Society of Medicine reports that Britain's Labour party is trying to reduce it -- down to a scant three months:

The current Labour government has now raised the stakes further. It has pledged that by 2008 there will be a maximum wait of only 18 weeks from any referral of a patient by a general practitioner to treatment in hospital if required. Such a target represents a large step up in expected performance. Current targets are that by the end of this year, no patient will wait more than 3 months for an outpatient appointment and a further 3 months for any inpatient or day-case treatment. Meeting the new target will require a massive effort, and despite considerable success to date, could it be a target too far?

Fed up with this nonsense, British patients are seeking treatment elsewhere. By a curious coincidence, so are many Oregonians, despite having a "public option" in their own state health-care system. (Or perhaps because of it.) For just one example, the "treatment" of choice by the Oregonian government bureaucrats is to offer only palliative care (relieving pain and other symptoms without actually curing the condition) -- plus a not so veiled hint that patients suffering from life-threatening cancer can always contact a physician for assisted suicide.

In Canada, the Globe and Mail (Toronto) reported last year that surgeries in the British Columbia city of Kelowna have been "postponed indefinitely" by Interior Health, the BC government health-care provider (private insurance is banned in Canada):

More than 1,000 orthopedic, gynecological and general surgery patients in Kelowna have been left wondering when their operations will take place because Interior Health has ended its contract with the private operating facility that was to do the procedures.

So many Europeans are going to India that the medical tourism industry is getting institutionalized; several travel agencies now specialize in the service, including Health Tourism India:

Some of the services that we can provide:
  • Suggesting Hospitals/Clinics as per treatment required/budget.
  • World-class Treatment by UK/USA trained Doctors in India.
  • Fixation of appointment with Chief Doctors on top priority prior to arrival
  • Arranging consultations with doctors
  • Assisting in planning treatment /check up with appointment fixing and travel scheduling.
  • No waiting time for surgical procedures
  • Packages offered only for Medical Treatment till discharge from hospital.
  • Coordinating all appointments
  • Nurses/Guide.
  • Online assistance to the Patients.

An article in the Daily Mail decries the serious shortage of qualified doctors willing to work outside business hours in Great Britain's National Health Service (NHS):

The huge extent to which the NHS needs foreign doctors to treat patients out of hours is revealed today.

A third of primary care trusts are flying in GPs from as far away as Lithuania, Poland, Germany, Hungary, Italy and Switzerland because of a shortage of doctors in Britain willing to work in the evenings and at weekends.

The stand-ins earn up to £100 an hour, and one trust paid Polish and German doctors a total of £267,000 in a year, a Daily Mail investigation has found.

It raises fresh concerns that British patients are being treated by exhausted doctors without a perfect command of English.

Without enough British doctors, more foreign doctors are being imported by "primary care trusts" -- which appear to be the first stop for health care through the NHS, hiring primary care physicians, referring patients to specialists, and contracting for privately owned health-care facilities. These doctors are often less qualified than their British counterparts -- and they make fatal mistakes:

Daniel Ubani had just three hours sleep after travelling from Germany before he went on duty in Cambridgeshire.

The Nigerian-born doctor injected 70-year-old kidney patient David Gray with ten times the maximum recommended dose of morphine, and an 86-year-old woman died of a heart attack after Ubani failed to send her to hospital.

It is extremely difficult to sue either these doctors or the NHS itself, because they are all considered government agencies. Oddly, however, Indian hospitals have no problem hiring highly qualified UK doctors. Perhaps it has something to do with payscales and workloads.

This month, the first ever medical tourism convention will be held in Toronto, Canada. The theme? India, of course:

This is a first of its kind conference to be held in Canada. It will provide an opportunity for the Indian Health Care industry, academics, industry researchers, market and industry analysts, government officials and policy makers, to present their services and exchange ideas and develop a new vision for the future of the Medical Tourism industry. Contributions to the progress of developing new ideas to stimulate this vital industry and provide new approaches to regulating are welcome.

850,000 Canadians are invited to regain their lives, lifestyle and dignity by availing world class medical facilities in India. This exhibition will showcase the variety of world class medical services and facilities available in India and all Canadians tired of waiting in the “System” are encouraged to visit.

The way things are heading, Americans may want to book tickets at this convention as well.

Hatched by Sachi on this day, November 3, 2009, at the time of 5:04 AM | Comments (2) | TrackBack

September 7, 2009

Health Care: Special Delivery

Health Care Horrors
Hatched by Dave Ross

During the town hall meeting where President Barack Obama compared the post office to Fed Ex and UPS, little did he know that one year later, the U.S. Postal Service would be put in charge of the nation’s first public option medical insurance -- and that its arch enemies would also decide to jump head first into health insurance!

President Obama had started the evening off by launching into his usual spiel about how evil doctors and even more wicked health care companies drive up the cost of premiums.

“Now say that someone bites off your finger and your doctor decides to amputate your thorax because he can get more money --“ He looked down at his leg where a Portuguese Water Dog was whining plaintively. “Now, Bo, stop begging! You can’t have a finger!”

He looked back up at the camera. “Anyway, that’s an example of how unscrupulous doctors inflate the cost of health care. In a government run health care system, you would not only save your finger, you’d get a refreshing spa treatment manicure that would leave your finger better than new! And if Granny needed a new heart we would save money by giving her an aspirin.”

During the question and answer period that followed, the president glanced away from the teleprompter for a split second and quipped that if you want an example of a government run business that does well, you need look no further than the post office. This led to a fateful chain of events…

Obama, of course, never intended that the Postmaster General should become the Postmaster-Surgeon General; however, one night at a Georgetown party, Speaker Nancy Pelosi and House Energy and Commerce Committee Chairman Henry Waxman were in a bedroom picking up their overcoats when they both leaned over the bed at the same time.

Their heads struck with a loud crack! They awoke several hours later in bed with twin headaches, with Pelosi snoring softly in Waxman’s arms. Both looked over at the same instant. Waxman saw Pelosi’s rictus smile, she saw his gap-toothed grimace. Both drew the same erroneous conclusions, both drew back in horror, and quickly gathered their belongings, muttering and refusing to look at each other as they fled down separate staircases.

The next morning Waxman and Pelosi were haunted by the horror of the night before; so when a computer glitch put language into the omnibus health care reform package that was actually intended to be bailout language for the post office, first Waxman (muttering “The horror! The horror!”) and then Pelosi (still too dazed and haunted to pay much attention) gave their assent.

Over the next few weeks, since no one actually read the 3,000-page bill, the fact that the USPS was put in charge of the public healthcare option was left unnoted.

Pelosi was later treated for post-traumatic stress syndrome. Waxman would have been also, however the waiting period for treatment was two years and he was instead shunted to end of life counseling.

Several months later, just as the public option was about to be unveiled in a White House ceremony, the President’s chief of staff walked into the oval office, bent over the president and whispered.

“Sir, I have some bad news.”

“Has Vice President Biden been appearing on TV again?”

“No sir, it’s worse. The post office has been put in charge of health care.”

“Well, thank God I’ve got my own doctor. Everybody else will just have to make the best of it, though, in the spirit of spreading the wealth around.”

The new Postmaster-Surgeon General, Wilford Higgenlooper, opened his press conference by announcing, “In order for the post office -- public option insurance company to be competitive, we are going to have to stop delivering babies on Saturdays. However, we have been listening to our customers; and we have introduced the “Forever Co-Pay”: You buy a co-pay from us now, and no matter how long you wait to use it, you never have to pay anything more.

“We are also going to introduce the ‘Cash For Tickers’ organ buying program. If you have an old, malfunctioning kidney, or a malfunctioning liver, even a bum heart, we will buy it back from you, as long as you promise to buy a brand new, less polluting organ.”

Because of the same unnoticed loophole in the law that put the post office in charge of health care, UPS and Fed Ex were allowed to compete in that same field.

Soon, Mr. Brown had painted a picture of the Stork on the side of his delivery truck, and had photographed one of its newly hired surgeons in shorts and a white lab coat triumphantly holding up a gall bladder and exclaiming, “When It Absolutely Has To Be Removed Overnight!”

Higgenlooper fought back by pointing out that Americans have long been used to standing in line to buy stamps and send packages, especially during the holidays. “Heck, we know people who held tailgating parties while waiting to buy a stamp. Some have met their life partners, spent enough time together that they were ready for a divorce, and still hadn't mailed their blasted special-delivery letters!”

He urged UPS to not employ unfair businesses practices such as operating more efficiently, then added ominously, “Many of us at the post office have assault rifles and we know how to use them.”

Hatched by Dave Ross on this day, September 7, 2009, at the time of 11:55 PM | Comments (0) | TrackBack

August 24, 2009

Healthcare is NOT a right

Health Care Horrors
Hatched by Dave Ross

Forty-eight million people don’t have health care. I have health care and I don’t want to risk losing it or any part of it to pay for someone else getting health care.

That may sound heartless to liberals who are used to thinking about every political issue with their hearts instead of their brains, but that is at the core of why so many of the grassroots are against ObamaCare, not that we really know what that is exactly.

Millions of people don’t have a car. I have a car. I wouldn’t be willing to pay more for my own car just so someone else could have a car. I also would not be willing to pay any more for my house in order to buy a house for someone else.

That’s because I don’t think that things like health care, cars and houses are somehow “rights” that the government can use its taxing powers to ensure that other people have.

Right now I can’t afford a new computer and I very badly need a new TV because mine in on the brink of ceasing to work altogether. Too bad for me! My desire or need for these electronic devices doesn’t mean that it is someone else’s responsibility to provide them to me.

But, Ross, you say, “Health care is a basic human right!”

Who says so?

Just because you put your hand on a rock and declaim that something is a “right” doesn’t make it so. I refuse to debate on an issue where it has already been determined that health care is a right. Liberals far too often get to set the debate on their own terms by making claims that “people have a right to work,” or “working mothers have a right to take family leave with pay” or “children have a right to preschool;” and many of us will look blankly and concede the point, when what we ought to do is hold out our hand, palm forward, and say loudly, “Hey, wait a minute!”

There was an article earlier this week by economist Bill Frezza that begins, “What is the moral foundation of your economic beliefs?”

He points out quite correctly that whatever “moral” beliefs we apply to economics will help shape our political beliefs. If we think that capitalism is basically an evil, heartless, dog-eat-dog system that unfairly victimizes the innocent and uplifts the undeserving -- or, at best, rewards the “winners of life’s lottery” to a disproportionate degree -- then we will take the position that people who can get health care (substitute anything else you think is a “right”) owe it to make sure that everyone can get it.

We live in a capitalist system. In such a system, not everyone can afford everything they want or need. That does not automatically create an obligation among the rest of us.

Hatched by Dave Ross on this day, August 24, 2009, at the time of 8:06 PM | Comments (5) | TrackBack

August 13, 2009

State Health Care Plan: Traveling Eternity Road - on a One-Way Ticket

Health Care Horrors , Health Insurance Insurrections , Liberal Lunacy , Obama Nation
Hatched by Dafydd

This is so stunning, I'm still not sure what to make of it.

Several states already have the equivalent of ObamaCare's "government option;" one of those is Oregon.

Oregon is a blue state... in the last two decades, a very blue state:

  • The last time it went for the Republican in a presidential race was a quarter century ago, for Ronald Reagan in 1984; Oregon even voted for Michael Dukakis in 1988.
  • The last time it elected a Republican governor was even longer: 31 years ago (Victor G. Atiyeh). Every major elected official in the executive branch is currently a Democrat.
  • Oregon has two Democratic senators, Ron Wyden, 100%, and Jeff Merkley, not yet rated; Merkley replaced about the most liberal of all "Republican" senators, Gordon Smith, 33%. (Smith's last rating from the liberal ADA was 60%, nearly twice his rating from the American Conservative Union.) [This bullet point corrected; Smith was defeated for reelection in 2008. Hat tip to commenter Fritz.]
  • Oregon has five representatives in Congress; four of them (80%) are Democrats. Rep. Greg Walden (R-OR, 75%) is the lone Republican, and he's hardly a conservative.
  • Democrats currently hold a 60% majority in both the Oregon State Senate and the Oregon House of Representatives.

So it's hardly surprising that Oregon enacted an assisted suicide law in 1994, and again in 1997, both times by a referendum of the citizens. And it's equally unsurprising -- but instructive -- that it also passed the Oregon Health Plan, created by doctor and Democratic state Sen. John Kitzhaber; it went into effect in 1994. Kitzhaber rode the health plan into the governor's officer, elected in 1994 and serving two terms.

The plan is called Oregon's Medicare/Medicaid program, but adults not qualified for either program can nevertheless be enrolled into OHP Standard.

The program has not exactly worked as intended; after costs nearly doubled in its first six years, new enrollments were frozen for four years, from 2004 through 2008; Oregon then held a lottery, in which tens of thousands of applicants applied -- for 3,000 slots.

The Oregon Health Plan, more or less a real-world model of ObamaCare, is under tremendous pressure to cut costs. They have found a unique way of doing so: They no longer pay for life-saving chemotherapy for cancer patients with less than a 5% chance of survival for five years... but they will pay to help kill them:

Barbara Wagner has one wish - for more time.

"I'm not ready, I'm not ready to die," the Springfield woman said. "I've got things I'd still like to do."

Her doctor offered hope in the new chemotherapy drug Tarceva, but the Oregon Health Plan sent her a letter telling her the cancer treatment was not approved.

Instead, the letter said, the plan would pay for comfort care, including "physician aid in dying," better known as assisted suicide.

"I told them, I said, 'Who do you guys think you are?' You know, to say that you'll pay for my dying, but you won't pay to help me possibly live longer?' " Wagner said. [Hat tip to Sachi]

Dear readers, this is your future under ObamaCare.

But why in the world would the Oregon Health Plan brazenly suggest that she kill herself? That's easily explained:

[Dr. William Toffler] said the state has a financial incentive to offer death instead of life: Chemotherapy drugs such as Tarceva cost $4,000 a month while drugs for assisted suicide cost less than $100.

[Dr. Som Saha, chairman of the commission that sets policy for the Oregon Health Plan] said state health officials do not consider whether it is cheaper for someone in the health plan to die than live. But he admitted they must consider the state's limited dollars when dealing with a case such as Wagner's.

"If we invest thousands and thousands of dollars in one person's days to weeks, we are taking away those dollars from someone," Saha said.

It's government medicine; poor Barbara Wagner has no place else to go.

Adding insult to accessory to manslaughter, it appears that the Oregon government health bureaucracy hasn't even kept up with the advance of modern medicine:

The Oregon Health Plan simply hasn't kept up with dramatic changes in chemotherapy, said Dr. David Fryefield of the Willamette Valley Cancer Center.

Even for those with advanced cancer, new chemotherapy drugs can extend life.

Yet the Oregon Health Plan only offers coverage for chemo that cures cancer -- not if it can prolong a patient's life.

"We are looking at today's ... 2008 treatment, but we're using 1993 standards," Fryefield said. "When the Oregon Health Plan was created, it was 15 years ago, and there were not all the chemotherapy drugs that there are today."

Surprise, surprise on the Jungle Cruise tonight. So... under government medicine, Barack H. Obama's grandmother shouldn't get a hip replacement, because she's going to die soon anyway; Sarah Palin's son Trig, who has Down Syndrome, wouldn't get long-term treatment because Down is incurable; and Barbara Wagner begs for cancer treatment -- and instead gets a not-so-subtle hint that she should contact a physician about how to "reduce the surplus population" by committing suicide.

There is really no nice way to spin this.

Fortunately, the company that manufactures Tarceva, Genentech, has decided to let Wagner have it for free... for now. But what about all the other Barbara Wagners in Oregon?

ObamaCare: Change you could die for.

Cross-posted on Hot Air's rogues' gallery...

Hatched by Dafydd on this day, August 13, 2009, at the time of 2:34 AM | Comments (3) | TrackBack

August 11, 2009

Rules for Conservatives

Health Care Horrors
Hatched by Dave Ross

Early on in the classic biographical film Patton, the title character, played by George C. Scott, watches through binoculars as his forces rout the Afrika Korps, commanded by “the Desert Fox,” Field Marshal Erwin Rommel. As the Germans retreat, Patton exults, “Rommel, you magnificent bastard! I read your book!”

It is obvious from the intensity of the reaction by ordinary constituents to the health care plan Congress is debating (and Democrats are pushing), that the “right” has been reading the book on which the left has based its tactics for decades. They are skillfully using the tactics recommended by the book, and the left is crying “foul!”

The book is called Rules For Radicals, by Saul D. Alinsky; it is for “community organizers” what Niccolò Machiavelli’s the Prince was for power-seekers.

Alinsky and Machiavelli have a lot in common. Here are a few of Alinsky’s precepts: “In war the end justifies almost any means;” “Concern with ethics increases with the number of means available and vice versa;” and “You do what you can with what you have and clothe it with moral garments.”

Now that I think of it, Alinsky made Machievelli look like an innocent, cherub-faced boy by comparison.

But! The most telling comment Alinksy made that relates to our current situation -- in which Speaker Pelosi calls ordinary citizens who flood town hall meetings, hoisting AARP representatives by their own petards and rocking the likes of Steny Hoyer back on their haunches, “Un-American” and “mobs” -- is this: “Any effective means is automatically judged by the opposition as being unethical.”

No one is supposed to use their tactics, you see. They are patented. Only the Left is allowed to characterize those who disagree with them as Nazis, as it did consistently during the eight years of the Bush White House, and before that during Bush I and Reagan and Nixon and… Only the Left is allowed to attend meetings and shout down speakers without allowing them to speak; that’s called freedom of speech when practiced by them -- but Brownshirt tactics if practiced by others.

Speaking of Brownshirts, they were the uniformed thugs of the 1920s and 1930s in Germany who used to beat up people they disdained... which is just what happened to Kenneth Gladney, a black man handing out “Don’t tread on me” flags at a Missouri town meeting last week. Gladney was beaten by public-union thugs. Is he a “mob” member, or is the real mob the SEIU enforcers who put him in a wheel chair?

The White House put out three, count them, three appeals last week for supporters to start attending with enough numbers to overawe the opposition at “town hall” meetings held all over America during the August congressional recess. This from the master “community organizer” himself.

As I wrote this post I got an email from a left-wing community organizer responding to Obama’s call: “Republicans, insurance industry, and Tea Party agitators are disrupting proceedings in Democratic Town Hall meetings across the nation. The police even had to be called to one meeting over the weekend. GOP stooges are stooping to new lows in an effort to drown out debate on universal health care coverage.”

No, it’s not an attempt to drown out the debate. It’s a successful effort to put as many, if not more, boots on the ground (as our military friends say) as the lefties. The conservatives have learned how to use the internet, email and Twitter to organize, as Obama’s supporters did last year.

By the way, please don’t assume that I approve of tactics such as shouting down people at meetings; I think it’s reprehensible. I applaud opponents who can debate in a collegial atmosphere. However, I see the frustration of ordinary citizens whose congressmen treat them with condescension and disdain.

Discouraging tactics such as shouting down people you disagree with is like using poison gas in wartime. It only works if both sides refuse to use it. As long as the Left feels that it’s fair for it to disrupt meetings and shout down speakers, conservatives are going to do the same.

The one thing I won't do is shed tears about the breakdown of civil debate: That died years ago. The truth is that the Right is finally learning how to play hardball.

Hatched by Dave Ross on this day, August 11, 2009, at the time of 8:34 PM | Comments (3) | TrackBack

August 3, 2009

Wherein We Find That Britain's Government "Option" Is a Pain in the Back

Health Care Horrors , Health Insurance Insurrections , Obama Nation
Hatched by Dafydd

A crystal ball for America. Here is our future under ObamaCare:

Tens of thousands with chronic back pain will be forced to live in agony after a decision to slash the number of painkilling injections issued on the NHS, doctors have warned.

The Government's drug rationing watchdog says "therapeutic" injections of steroids, such as cortisone, which are used to reduce inflammation, should no longer be offered to patients suffering from persistent lower back pain when the cause is not known.

Instead the National Institute of Health and Clinical Excellence (NICE) is ordering doctors to offer patients remedies like acupuncture and osteopathy.

Acupuncture? Say, if that doesn't work, there's always cupping and bleeding. At least they're cutting pain treatment in a NICE way.

But wait a minute. What percent cut are we talking about? Surely this is just a small statistical adjustment, right?

The NHS currently issues more than 60,000 treatments of steroid injections every year. NICE said in its guidance it wants to cut this to just 3,000 treatments a year, a move which would save the NHS £33 million.

See? It's not a wholesale slashing of patient care; it's only a minor pruning... of 95% of all cortisone pain treatment. In any event, there is an obvious up-side to this: The National Health Service of the UK will save £33 million -- $56 million, a whopping $980 per patient cut from the program.

Here is the problem: When a government gets into financial trouble, there are only three things it can do:

  1. Run an increasingly large deficit;
  2. Raise taxes;
  3. Cut spending.

Number 1 is problematical, because large deficits produce inflation, which produces successful electoral challenges from the other party.

Number 2 doesn't work because of the Laffer curve, which demonstrates that a point exists beyond which increasing tax rates doesn't increase revenue, it reduces revenue. Few countries can resist increasing taxation right up to that point... and bitter experience teaches them that they cannot then increase government revenue by jacking up the tax rates again.

That leaves only number 3, cutting spending. But that itself carries several dangers to the sitting administration. There are only three ways to cut spending:

  1. The administration can cut porkbarrel spending;
  2. It can cut highly visible programs that have powerful champions in Congress;
  3. It can cut the costs of ongoing programs, over which it already has complete control of day to day spending, by a series of nearly invisible changes, none of which individually has strong support in Congress.

Number 1 is problematical, because pork is the primary way that members of Congress buy votes back home, so they jealously guard such spending from Executive monkeying.

Number 2 doesn't work, because powerful members of Congress can hold up all legislation until their own pet programs are restored and even increased.

That leaves only number 3, cutting that spending which is fixed by formula, by quietly manipulating some critical variable in that formula, which results in automatic "savings" -- for which no individual can later be blamed at the polls.

After all, it's not like Uncle Scrooge is simply slashing treatment in order to minimize costs; perish any such thought. The administration is not simply making up policy; the change comes direct from a panel of medical experts -- remote, anonymous, and unaccountable:

The NICE guidelines admit that evidence was limited for many back pain treatments, including those it recommended. Where scientific proof was lacking, advice was instead taken from its expert group. But specialists are furious that while the group included practitioners of alternative therapies, there was no one with expertise in conventional pain relief medicine to argue against a decision to significantly restrict its use.

Put everything together, and what do we get? That one of the easiest, least visible, and cheapest (in units of electoral retribution) way to appear to restore fiscal responsibility is for the president to order changes in a few small variables in spending formulas:

  • Reduce the percent of health-care charges for which the government plan will reimburse doctors and hospitals;
  • Reduce the allowable charges by doctors and hospitals for each procedure;
  • Ban or dramatically reduce certain more expensive procedures -- by declaring them "ineffective," for example;
  • Filter the patient pool by restricting treatment for those less likely to live much longer anyway, thus denying care to older or sicker patients;
  • Lowering the lifetime cap on medical benefits;
  • Funneling patients into particular favored health-care providers, who charge less and make it up in volume;
  • Reduce the amount of time doctors are allowed to spend with each patient (volume, volume, volume!);
  • Reduce the number of days patients are allowed to stay in hospital;
  • Require patients' families to provide some of the care, such as hygiene (bathing, bedpans) and physical therapy;
  • Reduce costs by skimping on ancillary expenses, such as nutrition, heating, and lighting;
  • Shunt more patients into relatively inexpensive hospice care by changing the standards for which conditions get hospital or doctor care and which do not.

Of course, many private or group insurance plans attempt these same cost-cutting measures; but they must deal with actual competition from other plans, so they don't have carte blanche. The more miserly they make their benefits, the less they can charge for coverage, lest they lose their customers.

But such market responses don't affect a government health-care plan, because it doesn't have to worry about competition; it can reduce benefits yet continue to charge the same amount. Consumers cannot jump ship for private competitors for a number of reasons:

  • A national plan can force everyone to pay for it by law; every major country that begins with a government "option" ends with the option being mandatory... so any private plan people obtain must be in addition to, not instead of, the government plan.
  • Even before that happens, the national plan can use its sheer size to force health-care providers, drug companies, and so forth to sell to them at any price the government health-care plan offers, undercutting smaller private plans;
  • It can set administrative standards in a way designed to drive out private companies -- for example, by requiring that every private plan duplicate the federal plan, or by preventing private plans from charging less than the national plan;
  • The national plan can operate at a loss and subsidize itself with taxes (see Amtrack);
  • And It can use its auditing authority to threaten and abuse potential competitors and intimidate them out of the business.

We see this same dynamic in every, single country that has either full-blown national health care, as in many Canadian provinces that actually prohibit private care or private insurance -- or even a "government option" that operates alongside a private health-insurance system, as in Japan and even (to a lesser extent) Great Britain.

A government "option" quickly gobbles up nearly all patients, becoming a de facto or even literal national health service. Typically, fewer than 10% of patients can afford to pay for private health insurance on top of the mandatory premiums and taxes they must pay for the national health service; only the rich can do so.

This sets up a two-tier system: Those with a lot of money get much better health care, the very "scandal" that is used to sell nationalized health care in the first place.

But there is some hope: Even in Canada, some provinces (such as Quebec) are struggling to reform their national health services by introducing a radical, new idea: Competition by private insurance!

So even if the Democrats manage to foist ObamaCare on the entire country, after a couple, three generations, we might possibly regain our senses and try to push it back -- a bit.

The new NICE policy of pain "management" in the United Kingdom illustrates the old saying about national health care: The government health-care policy is... don't get sick! And whatever you do in Merrie Olde England -- or soon to be Merrie Olde Obamastan -- don't let anyone or anything become a pain in the back, unless you don't mind being needled by the pinheads in D.C.

Hatched by Dafydd on this day, August 3, 2009, at the time of 3:56 PM | Comments (0) | TrackBack

May 14, 2009

The Raucous Baucus Max-Tax Flim-Flam Plan

Congressional Calamities , Health Care Horrors , Liberal Lunacy , Tax Attax
Hatched by Dafydd

Always, those in the public sector have eyed the private sector as Martians observing the Earth: "vast and cool and unsympathetic." They envy the money; gross domesic product is many times larger than the measley $3 to $4 trillion available to the feds even in the age of Obama. They envy the productivity, which puts government programs and R&D to shame. They envy the freedom of CEOs simply to make decisions -- while government bureaucrats can only write memos of recommendation and shunt them one notch up the chain of infinite regress that is the government heirarchy.

They cannot duplicate the success of Capitalism and entrepeneurship, quite naturally; those qualities are characteristic of liberty, while government is its antithesis. So as with everyone consumed by envy -- even H.G. Wells' Martians -- what they cannot duplicate they can at least destroy.

Which brings us around, by a commodious vicus of recirculation, to the Democrats and their government takeover of health care:

Senators are considering limiting -- but not eliminating -- the tax-free status of employer-provided health benefits to help pay for President Barack Obama's plan to provide coverage to 50 million uninsured Americans.

Mighty considerate of them not to offhandly eliminate it; having us that momentus favor, surely we cannot carp about a little, itty-bitty tax, can we? By the way, anent those "50 million uninsured"... the only way to reach that number is to include the huge number of young, healthy, and well-paid young workers, who voluntarily choose not to carry insurance because they think themselves indestructable.

(Thank goodness I'm finally going to subsidize them! I couldn't stand the guilt, knowing I have condemned by inaction those young adults to having to pay for what they use, just as if they were ordinary people.)

On the controversial question of taxing health benefits, [Senate Finance Committee Chairman Max] Baucus is staking out a position that could put him at odds with Obama.

The president adamantly opposed such taxes during the campaign, arguing they would undermine job-based coverage. Obama's aides now say he's open to suggestions from Congress, even if he criticized Republican presidential rival John McCain for proposing a sweeping version of the same basic idea.

Baucus said he wants to modify the tax break, not abolish it.

"We are not going to repeal it," he said.

Baucus suggested that the benefit could be limited by taxing health insurance provided to high-income individuals, although he did not specify at what income levels. He also said that plans offering rich benefits -- for example, no co-payments or deductibles -- might be taxed once their value exceeded a yet-to-be-determined threshold....

In government jargon, the tax-free status of health insurance is called the "tax exclusion."

Let's set aside the weasle words for a moment and just look at the extreme case; we can reason backwards from there. Suppose that, contrary to Baucus' (D-MT, 80%) hand-on-heart claim, he really does intend to "repeal" the "tax exclusion"... what would that mean to taxpayers?

How does it work? Your employer pays you a salary (taxed), and he also pays for your medical insurance; yes, the latter is technically "income;" but it's not really, because you have no choice in how it's spent, other than small variations that the insurance plan my allow you -- picking an HMO or a Preferred Payer Plan, for example. (The purpose of the putative tax exclusion was, of course, to encourage employers to offer such plans -- which is why nearly everybody who wants medical insurance has it today.)

Employer-provided health insurance is considered part of workers' compensation, but unlike wages, it is not taxed. The forgone revenue to the federal government amounts to about $250 billion a year.

You rich villains are stealing the government's money!

In a typical case, your employer may pay you $50,000 salary and may pay about $450 per month in health-insurance premiums; you yourself may have to pick up a smaller portion of the premium, perhaps $150 per month. That means the total payment is, let us say, $600 per month or $7,200 per year.

The employer-paid part of that ($5,400 per annum) is not taxed: The employer deducts it as a business expense and the employee doesn't have to declare it as income. If the employee itemizes his income tax (for example, if he's buying a house and wants to deduct the mortgage interest), he may be able to deduct all or part of his own share of the premiums ($1,800 per year). Thus, he doesn't have to pay tax on anywhere from $5,400 of his "income" to $7,200, depending on how much of his own payments are deductable.

Splitting the difference, he gets to "deduct" (deduct or not have to report) $6,300 from his income. Since this will clearly be a marginal deduction, it all comes out of the highest income tax he's paying (unless that drops him below the level for that tax rate). This rate is currently 35%, I believe, but the specifics are less important than the principle.

So the final tally is: The taxpayer pays $2,205 less to the government than he would were the "tax exclusion" repealed; that of course means that if it were repealed, he would have to cough up an additional $2,205 to the feds -- so that other people would get to use government-controlled health insurance for free.

Sweet, isn't it? You pay a couple grand extra per year for the privilege of having private health insurance; but if you drop it and take the government-run health care instead, you pay no extra tax. As the Romans say, "Cui bono?" Who benefits? The public sector does... at the expense of the private sector, of course: This is yet another way that ObamaCare will drive people out of private health-insurance plans and into the loving arms of Uncle Sugar.

Of course, Baucus says (yesterday) that the Democrat-controlled Congress doesn't want to completely eliminate the "tax exclusion"; they just want to levy an extra tax on some of your health-insurance premium, not all of it. So they're not actually stealing the full $2,200... just a portion.

Of course, it still means that you must pay an extra penalty for using private health insurance but not for using ObamaCare. Thus the perverse incentive for everybody to dump private insurance in favor of government-run health care remains; it's just not quite as strong as if they went the full Monte. (And who knows what they will say tomorrow? Especially as the bill-writing continues, and it becomes obvious that the numbers just won't add up.)

Democrats are trying to sell the bill as purely utilitarian:

Many experts say that Congress won't be able to come up with the kind of money needed to provide coverage for all unless limitations on the health care tax break are part of the mix.

"I don't see how you're going to put a package together ... unless you touch the exclusion," said Robert Greenstein, director of the Center on Budget and Policy Priorities, which advocates for low-income people [that is, welfare recipients].

(Note that the Center on Budget and Policy Priorities is heavily underwritten by the Democracy Alliance -- which itself is funded by George Soros and many other prominent radical lefties. Just thought you'd like to know.)

I am less and less willing to give any benefit of the doubt to this administration on any point touching politics, progressivism, liberal fascism, or attacks upon the "Right." If -- in addition to raising revenue -- a bill also tends to drive people away from a market-driven, capitalist solution and towards government nationalization of health care, I will naturally conclude that this, not revenue, is the real goal.

Some of the arguments by proponents of HillaryCare ObamaCare seem to be brazen attempts at misdirection:

Proponents of repealing the benefit say it encourages lavish health insurance plans that only add to waste in the health care system. And they argue that the benefit is unfair, since self-employed people don't get as big a tax break for health care.

First, who cares if some rich people are willing to pay through the nose for a plan that includes rhinoplasty? Evidently the Left does: They care so much, they want to repeal all differences in the level of medical care between rich and poor. Equality is so important to the bad stepchildren of George Soros that, instead of some having more than others, they would rather everybody be equally poor and equally miserable.

If carried to its logical conclusion, this "reasoning" leads to the destruction of all private property... the rich will have the money but be disallowed from spending any of it! The response by the rich would be to flee the country, quite obviously... taking all of their talent, drive, and money with them. This disincentivizes intelligence, courage, and entrepeneurship: Why bother starting up a company if you won't even be able to enjoy the increased money you might make?

And the second argument for government-controlled health care is even more specious: If it's true that "self-employed people don't get as big a tax break for health care," then for God's sake, give them a larger tax break! Don't take away the break enjoyed by ordinary, company-employed workers.

With every new day, everything about this administration and this Congress makes it more and more clear that they aim to fundamentally transform America away from what we have been for 220 years -- and turn us into something alien. This is not patriotic; this is unAmerican. This is French.

We must kill this bill before it kills us.

Hatched by Dafydd on this day, May 14, 2009, at the time of 7:14 AM | Comments (0) | TrackBack

April 29, 2008

Gee, He Really Is Conservative - Page 2: Health Care

Health Care Horrors , Presidential Campaign Camp and Porkinstance
Hatched by Dafydd

A week ago yesterday, we posted about John McCain's economic policy speech delivered at Carnegie Mellon. We summarized thus:

What was refreshingly unexpected was how fiscally conservative McCain is, particularly in comparison to the last few GOP presidential candidates... by some measures, McCain is more fiscally conservative than Ronald Reagan, who never made much of a move to rein in spending (Reagan was more concerned with winning the Cold War and lowering taxes).

Today, McCain delivered his next big policy speech, this time on fixing the health insurance... well, "crisis" would be too strong a word; but certainly there's a vast unease in the air. He spoke in Tampa, Florida, at the University of South Florida; specifically, at the H. Lee Moffitt Cancer Center & Research Institute. And once again, I believe most of us would agree that McCain's approach is not only more conservative than either Democrat running -- it's intrinsically conservative on its face, not merely by comparison.

(I have placed the transcript of McCain's entire speech in the "slither on.")

Personalizing health-insurance decisions

McCain begins with a strong denunciation of socialized medicine, or "a nationalized health care system," as he puts it. He notes that when families make their own health-care decisions, that alone reduces the cost of the system: Patients become more frugal of expenditures when they're paying for it themselves... either directly, via a health savings account (HSA), or indirectly through paying their own premiums.

So the first change McCain proposes is the biggest and most radical. Right now, most Americans (158 million, according to Hillary Clinton) get their insurance through their employers. Employers offer one or more health insurance plans, and the government gives a tax credit to the employer for each employee who enrolls. John McCain proposes that this employer credit be eliminated -- and the same credit given directly to each person or family instead; it works out to $2,500 for an individual or $5,000 for a family.

This money would only be available for use in paying medical premiums or for building up an HSA; from the transcript of the speech:

Americans need new choices beyond those offered in employment-based coverage. Americans want a system built so that wherever you go and wherever you work, your health plan is goes with you. And there is a very straightforward way to achieve this.

Under current law, the federal government gives a tax benefit when employers provide health-insurance coverage to American workers and their families. This benefit doesn't cover the total cost of the health plan, and in reality each worker and family absorbs the rest of the cost in lower wages and diminished benefits. But it provides essential support for insurance coverage. Many workers are perfectly content with this arrangement, and under my reform plan they would be able to keep that coverage. Their employer-provided health plans would be largely untouched and unchanged.

But for every American who wanted it, another option would be available: Every year, they would receive a tax credit directly, with the same cash value of the credits for employees in big companies, in a small business, or self-employed. You simply choose the insurance provider that suits you best. By mail or online, you would then inform the government of your selection. And the money to help pay for your health care would be sent straight to that insurance provider. The health plan you chose would be as good as any that an employer could choose for you. It would be yours and your family's health-care plan, and yours to keep.

The value of that credit -- 2,500 dollars for individuals, 5,000 dollars for families -- would also be enhanced by the greater competition this reform would help create among insurance companies. Millions of Americans would be making their own health-care choices again. Insurance companies could no longer take your business for granted, offering narrow plans with escalating costs. It would help change the whole dynamic of the current system, putting individuals and families back in charge, and forcing companies to respond with better service at lower cost.

This is clearly a step towards a freer market in health-insurance and health-care, thus a good, conservative approach. But of course, it brings up a problem: What about those with pre-existing conditions?

Under the current system, employers buy group plans that include all employees and their families (or a significant portion of them). That's good for insurance companies, because it reduces the otherwise staggering administrative overhead. But the payback is that insurers cannot refuse coverage to people who are bad health-insurance risks; even if you or your spouse has, say, a heart condition, the group-plan insurer must still take you -- even if it knows in advance that you're going to be a net financial loss. The rest of the plan makes up for it.

But when insurance plans are held by individuals, not groups, how do we (as a country) prevent insurers from simply refusing to accept any bad-risk patients? Since a great many of us have pre-existing conditions for which we must take prescription medicine, insurers would naturally want to drop us and take only healthy people who will be big money-makers for the insurance company.

McCain's solution to this is about the least statist possible. Both Hillary Clinton and Barack Obama promise simply to force insurers to accept poor-risk members, thus forcing the companies to act contrary to their own economic self-interest, wrecking any hope of a free market that could reduce costs. From the New York Times:

Unlike Mr. McCain, the presumptive Republican presidential nominee, both Senators Barack Obama and Hillary Rodham Clinton would both make it illegal for health insurance companies to deny an applicant because of age or health status. The two Democratic rivals argue that such regulation is needed to end discrimination against those with pre-existing medical conditions.

McCain has a different approach: He will work with the states to create a pool of high-risk patients. The administration would contract with insurers such as Blue Cross to offer pool members special insurance -- more expensive than for healthy people, but the rates limited to prevent companies from completely excluding people with pre-existing conditions. Here is McCain, from his speech:

Even so, those without prior group coverage and those with pre-existing conditions do have the most difficulty on the individual market, and we need to make sure they get the high-quality coverage they need. I will work tirelessly to address the problem. But I won't create another entitlement program that Washington will let get out of control. Nor will I saddle states with another unfunded mandate. The states have been very active in experimenting with ways to cover the "uninsurables." The State of North Carolina, for example, has an agreement with Blue Cross to act as insurer of "last resort." Over thirty states have some form of "high-risk" pool, and over twenty states have plans that limit premiums charged to people suffering an illness and who have been denied insurance.

Personalizing health-care decisions

McCain also calls for government to deregulate both insurance companies and doctors so that they can provide services across state lines; and he wants new "transparency" rules to force health-care providers (doctors, hospitals, hospices, clinics, and so forth) to clearly post the cost of medical treatment, their safety records, and so forth, thus allowing patients to become better shoppers... and again, allowing the market to come into play. We can choose to go to a lower-tier facility and pay significantly less, or pay premium rates for the best care available; we'll have access to all the information we need to make wise decisions.

Removing money-sinks from the system

McCain calls for major tort reform to stop out-of-control malpractice cases -- the kind that made former senator and failed presidential candidate John Edwards a multi-millionaire. Currently, they drain tens of billions of dollars out of the system; but that's not the worst effect.

Far more insidious is that lawsuit-fever and jackpot justice forces doctors to prescribe likely hundreds of billions of dollars of "defensive medicine" -- tests and procedures with no real medical value in that cast, performed solely to stave off lawsuits in the event that a medical risk occurs... even one that was well known and thoroughly disclosed to the patient in advance.

Fostering healthier habits

I don't know how important exercise and preventative care are to McCain's health-care policy; they are of course vital to an individual's health, but they're things each individual must do for himself.

In this case, McCain says he will "work with business and insurance companies to promote the availability and use of these programs." I get the feeling this is mostly lip service -- bully pulpit stuff -- so it's really not relevant to the McCain health-care policy. (Besides, I'm sure that all three candidates would "work with business and insurance companies, blah blah.")

Interconnecting to the future

I like this point McCain makes, particularly because it doesn't really cost anything but can have a gigantic payoff. I'll just let McCain speak for himself:

We can make tremendous improvements in the cost of treating chronic disease by using modern information technology to collect information on the practice patterns, costs and effectiveness of physicians. By simply documenting and disseminating information on best practices we can eliminate those costly practices that don't yield corresponding value. By reforming payment systems to focus on payments for best practice and quality outcomes, we will accelerate this important change.

Finally, he favors lots of experimenting with different kinds of health-care delivery. Again, everybody promises this; but I trust McCain actually to do it more than I trust either Democratic candidate.

Gravitas (bottom)

Simply put, this is a very presidential health-care policy; it is a clear break from the past, even from President George W. Bush's policies; and it is distinctively conservative: The centerpiece -- switching from employer-based to consumer-based insurance plans to put more power into the hands of patients and their families, thus keeping cost down -- is anathema to the Democrats. From AP:

Democratic rival Hillary Rodham Clinton said under McCain's plan, millions of Americans would lose their health care coverage through their jobs.

"The McCain plan eliminates the policies that hold the employer-based health insurance system together, so while people might have a 'choice' of getting such coverage, employers would have no incentive to provide it. This means 158 million Americans with job-based coverage today could be at risk of losing the insurance they have come to depend upon," Clinton said in a statement.

Right... we'll lose the insurance we have come to depend upon; but we'll gain insurance over which we have much more control, and which is better geared to our needs.

But Obama is no better:

A spokesman for Democrat Barack Obama said McCain was "recycling the same failed policies that didn't work when George Bush first proposed them and won't work now. Instead of taking on the big health insurance companies and requiring them to cover Americans with preexisting conditions, Senator McCain wants to make it easier for them to reject your coverage, drop it, or jack up the price you pay."

In other words, both Mr. Change Agent and his cobelligerent argue against the McCain policy by saying we should reject substantive change towards a market-based system.

The Democratic position is Statism on parade. I don't know how he managed it, but McCain has somehow lured both his rivals into standing foursquare behind the current system... which everybody, even Democrats, know is inefficient, intrusive, impersonal, and ludicrously expensive.

Yet even while praising the status quo -- they continue to agitate for socialized medicine! I don't follow their point at all; a quick survey of socialized medicine in Great Britain, Canada, and Japan demonstrates that its most common result is to magnify all the bad parts of the current system, while adding no benefit (except for greater government control, which only seems like a benefit if you happen to be a member of Congress).

Socialized medicine is a twentith-century delusion for a twenty-first century problem; it simply doesn't fit. As I've seen many people put it, who wants to get his health care from the same kind, considerate, responsive, respectful people who staff the IRS?

Socialism: McCain denounces it; Democrats embrace it.

With every passing month and every new policy offering, McCain comes closer and closer to being a pure conservative on every issue except two: immigration and political speech. And even with those two, he is still more conservative than either Democrat who threatens to seize power in la Casablanca.

(Full text of McCain's speech is in the slither-on.)

Remarks By John McCain On Health Care On Day Two Of The "Call To Action Tour"

April 29, 2008

ARLINGTON, VA -- U.S. Senator John McCain will deliver the following remarks as prepared for delivery at the University of South Florida -- Lee Moffitt Cancer Center & Research Institute, in Tampa, FL, today at 10:00 a.m. EDT:

Thank you. I appreciate the hospitality of the University of South Florida, and this opportunity to meet with you at the Moffitt Cancer Center and Research Institute. Speaker Moffitt, Dr. Dalton, Dean Klasko, thank you for the invitation, and for your years of dedication that have made this campus a center of hope for cancer victims everywhere. It's good to see some other friends here, including your board member and my friend and former colleague Connie Mack. And my thanks especially to the physicians, administrators, and staff of this wonderful place.

Sometimes in our political debates, America's health-care system is criticized as if it were just one more thing to argue about. Those of you involved in running a research center like this, or managing the children's hospital that I visited yesterday in Miami, might grow a little discouraged at times listening to campaigns debate health care. But I know you never lose sight of the fact that you are each involved in one of the great vocations, doing some of the greatest work there is to be done in this world. Some of the patients you meet here are in the worst hours of their lives, filled with fear and heartache. And the confident presence of a doctor, the kind and skillful attentions of a nurse, or the knowledge that researchers like you are on the case, can be all they have to hold onto. That is a gift only you can give, and you deserve our country's gratitude.

I've had a tour here this morning, and though I can't say I absorbed every detail of the research I certainly understand that you are making dramatic progress in the fight against cancer. With skill, ingenuity, and perseverance, you are turning new technologies against one of the oldest enemies of humanity. In the lives of cancer patients, you are adding decades where once there were only years, and years where once there were only months. You are closing in on the enemy, in all its forms, and one day you and others like you are going to save uncounted lives with a cure for cancer. In all of this, you are showing the medical profession at its most heroic.

In any serious discussion of health care in our nation, this should always be our starting point -- because the goal, after all, is to make the best care available to everyone. We want a system of health care in which everyone can afford and acquire the treatment and preventative care they need, and the peace of mind that comes with knowing they are covered. Health care in America should be affordable by all, not just the wealthy. It should be available to all, and not limited by where you work or how much you make. It should be fair to all; providing help where the need is greatest, and protecting Americans from corporate abuses. And for all the strengths of our health-care system, we know that right now it falls short of this ideal.

Some 47 million individuals, nearly a quarter of them children, have no health insurance at all. Roughly half of these families will receive coverage again with a mother or father's next job, but that doesn't help the other half who will remain uninsured. And it only draws attention to the basic problem that at any given moment there are tens of millions of Americans who lost their health insurance because they lost or left a job.

Another group is known to statisticians as the chronically uninsured. A better description would be that they have been locked out of our health insurance system. Some were simply denied coverage, regardless of need. Some were never offered coverage by their employer, or couldn't afford it. Some make too little on the job to pay for coverage, but too much to qualify for Medicaid or other public programs. There are many different reasons for their situation. But what they all have in common is that if they become ill, or if their condition gets worse, they will be on their own -- something that no one wants to see in this country.

Underlying the many things that trouble our health care system are the fundamental problems of cost and access. Rising costs hurt those who have insurance by making it more expensive to keep. They hurt those who don't have insurance by making it even harder to obtain. Rising health care costs hurt employers and the self-employed alike. And in the end they threaten serious and lasting harm to the entire American economy.

These rising costs are by no means always accompanied by better quality in care or coverage. In many respects the system has remained less reliable, less efficient, more disorganized and prone to error even as it becomes more expensive. It has also become less transparent, in ways we would find unacceptable in any other industry. Most physicians groups and medical providers don't publish their prices, leaving Americans to guess about the cost of care, or else to find out later when they try to make sense of an endless series of "Explanation of Benefits" forms.

There are those who are convinced that the solution is to move closer to a nationalized health care system. They urge universal coverage, with all the tax increases, new mandates, and government regulation that come along with that idea. But in the end this will accomplish one thing only. We will replace the inefficiency, irrationality, and uncontrolled costs of the current system with the inefficiency, irrationality, and uncontrolled costs of a government monopoly. We'll have all the problems, and more, of private health care -- rigid rules, long waits and lack of choices, and risk degrading its great strengths and advantages including the innovation and life-saving technology that make American medicine the most advanced in the world.

The key to real reform is to restore control over our health-care system to the patients themselves. Right now, even those with access to health care often have no assurance that it is appropriate care. Too much of the system is built on getting paid just for providing services, regardless of whether those services are necessary or produce quality care and outcomes. American families should only pay for getting the right care: care that is intended to improve and safeguard their health.

When families are informed about medical choices, they are more capable of making their own decisions, less likely to choose the most expensive and often unnecessary options, and are more satisfied with their choices. We took an important step in this direction with the creation of Health Savings Accounts, tax-preferred accounts that are used to pay insurance premiums and other health costs. These accounts put the family in charge of what they pay for. And, as president, I would seek to encourage and expand the benefits of these accounts to more American families.

Americans need new choices beyond those offered in employment-based coverage. Americans want a system built so that wherever you go and wherever you work, your health plan is goes with you. And there is a very straightforward way to achieve this.

Under current law, the federal government gives a tax benefit when employers provide health-insurance coverage to American workers and their families. This benefit doesn't cover the total cost of the health plan, and in reality each worker and family absorbs the rest of the cost in lower wages and diminished benefits. But it provides essential support for insurance coverage. Many workers are perfectly content with this arrangement, and under my reform plan they would be able to keep that coverage. Their employer-provided health plans would be largely untouched and unchanged.

But for every American who wanted it, another option would be available: Every year, they would receive a tax credit directly, with the same cash value of the credits for employees in big companies, in a small business, or self-employed. You simply choose the insurance provider that suits you best. By mail or online, you would then inform the government of your selection. And the money to help pay for your health care would be sent straight to that insurance provider. The health plan you chose would be as good as any that an employer could choose for you. It would be yours and your family's health-care plan, and yours to keep.

The value of that credit -- 2,500 dollars for individuals, 5,000 dollars for families -- would also be enhanced by the greater competition this reform would help create among insurance companies. Millions of Americans would be making their own health-care choices again. Insurance companies could no longer take your business for granted, offering narrow plans with escalating costs. It would help change the whole dynamic of the current system, putting individuals and families back in charge, and forcing companies to respond with better service at lower cost.

It would help extend the advantages of staying with doctors and providers of your choice. When Americans speak of "our doctor," it will mean something again, because they won't have to change from one doctor or one network to the next every time they change employers. They'll have a medical "home" again, dealing with doctors who know and care about them.

These reforms will take time, and critics argue that when my proposed tax credit becomes available it would encourage people to purchase health insurance on the current individual market, while significant weaknesses in the market remain. They worry that Americans with pre-existing conditions could still be denied insurance. Congress took the important step of providing some protection against the exclusion of pre-existing conditions in the Health Insurance Portability and Accountability Act in 1996. I supported that legislation, and nothing in my reforms will change the fact that if you remain employed and insured you will build protection against the cost of treating any pre-existing condition.

Even so, those without prior group coverage and those with pre-existing conditions do have the most difficulty on the individual market, and we need to make sure they get the high-quality coverage they need. I will work tirelessly to address the problem. But I won't create another entitlement program that Washington will let get out of control. Nor will I saddle states with another unfunded mandate. The states have been very active in experimenting with ways to cover the "uninsurables." The State of North Carolina, for example, has an agreement with Blue Cross to act as insurer of "last resort." Over thirty states have some form of "high-risk" pool, and over twenty states have plans that limit premiums charged to people suffering an illness and who have been denied insurance.

As President, I will meet with the governors to solicit their ideas about a best practice model that states can follow -- a Guaranteed Access Plan or GAP that would reflect the best experience of the states. I will work with Congress, the governors, and industry to make sure that it is funded adequately and has the right incentives to reduce costs such as disease management, individual case management, and health and wellness programs. These programs reach out to people who are at risk for different diseases and chronic conditions and provide them with nurse care managers to make sure they receive the proper care and avoid unnecessary treatments and emergency room visits. The details of a Guaranteed Access Plan will be worked out with the collaboration and consent of the states. But, conceptually, federal assistance could be provided to a nonprofit GAP that operated under the direction of a board that i ncluded all stakeholders groups -- legislators, insurers, business and medical community representatives, and, most importantly, patients. The board would contract with insurers to cover patients who have been denied insurance and could join with other state plans to enlarge pools and lower overhead costs. There would be reasonable limits on premiums, and assistance would be available for Americans below a certain income level.

This cooperation among states in the purchase of insurance would also be a crucial step in ridding the market of both needless and costly regulations, and the dominance in the market of only a few insurance companies. Right now, there is a different health insurance market for every state. Each one has its own rules and restrictions, and often guarantees inadequate competition among insurance companies. Often these circumstances prevent the best companies, with the best plans and lowest prices, from making their product available to any American who wants it. We need to break down these barriers to competition, innovation and excellence, with the goal of establishing a national market to make the best practices and lowest prices available to every person in every state.

Another source of needless cost and trouble in the health care system comes from the trial bar. Every patient in America must have access to legal remedies in cases of bad medical practice. But this vital principle of law and medicine is not an invitation to endless, frivolous lawsuits from trial lawyers who exploit both patients and physicians alike. We must pass medical liability reform, and those reforms should eliminate lawsuits directed at doctors who follow clinical guidelines and adhere to patient safety protocols. If Senator Obama and Senator Clinton are sincere in their conviction that health care coverage and quality is their first priority, then they will put the needs of patients before the demands of trial lawyers. They can't have it both ways.

We also know from experience that coordinated care -- providers collaborating to produce the best health outcome -- offers better quality and can cost less. We should pay a single bill for high-quality disease care, not an endless series of bills for pre-surgical tests and visits, hospitalization and surgery, and follow-up tests, drugs and office visits. Paying for coordinated care means that every single provider is now united on being responsive to the needs of a single person: the patient. Health information technology will flourish because the market will demand it.

In the same way, clinics, hospitals, doctors, medical technology producers, drug companies and every other provider of health care must be accountable to their patients and their transactions transparent. Americans should have access to information about the performance and safety records of doctors and other health care providers and the quality measures they use. Families, insurance companies, the government -- whoever is paying the bill -- must understand exactly what their care costs and the outcome they received.

Families also place a high value on quickly getting simple care, and have shown a willingness to pay cash to get it. If walk-in clinics in retail outlets are the most convenient, cost-effective way for families to safely meet simple needs, then no policies of government should stand in their way. And if the cheapest way to get high quality care is to use advances in Web technology to allow a doctor to practice across state lines, then let them.

As you know better than I do, the best treatment is early treatment. The best care is preventative care. And by far the best prescription for good health is to steer clear of high-risk behaviors. The most obvious case of all is smoking cigarettes, which still accounts for so much avoidable disease. People make their own choices in this country, but we in government have responsibilities and choices of our own. Most smokers would love to quit but find it hard to do so. We can improve lives and reduce chronic disease through smoking cessation programs. I will work with business and insurance companies to promote the availability and use of these programs.

Smoking is just one cause of chronic diseases that could be avoided or better managed, and the national resources that could be saved by a greater emphasis on preventative care. Chronic conditions -- such as cancer, heart disease, high blood pressure, diabetes and asthma -- account for three-quarters of the nation's annual health-care bill. In so many cases this suffering could be averted by early testing and screening, as in the case of colon and breast cancers. Diabetes and heart disease rates are also increasing today with rise of obesity in the United States, even among children and teenagers. We need to create a "next generation" of chronic disease prevention, early intervention, new treatment models and public health infrastructure. We need to use technology to share information on "best practices" in health care so every physician is up-to-date. We need to adopt new treatment programs and fi nancial incentives to adopt "health habits" for those with the most common conditions such as diabetes and obesity that will improve their quality of life and reduce the costs of their treatment.

Watch your diet, walk thirty or so minutes a day, and take a few other simple precautions, and you won't have to worry about these afflictions. But many of us never quite get around to it, and the wake-up call doesn't come until the ambulance arrives or we're facing a tough diagnosis.

We can make tremendous improvements in the cost of treating chronic disease by using modern information technology to collect information on the practice patterns, costs and effectiveness of physicians. By simply documenting and disseminating information on best practices we can eliminate those costly practices that don't yield corresponding value. By reforming payment systems to focus on payments for best practice and quality outcomes, we will accelerate this important change.

Government programs such as Medicare and Medicaid should lead the way in health care reforms that improve quality and lower costs. Medicare reimbursement now rewards institutions and clinicians who provide more and more complex services. We need to change the way providers are paid to focus their attention more on chronic disease and managing their treatment. This is the most important care for an aging population.

There have been a variety of state-based experiments such as Cash and Counseling or The Program of All-Inclusive Care for the Elderly (PACE) that are different from the inflexible approaches for delivering care to people in the home setting. Seniors are given a monthly allowance that they can use to hire workers and purchase care-related services and goods. They can get help managing their care by designating representatives, such as relatives or friends, to help make decisions. It also offers counseling and bookkeeping services to assist consumers in handling their programmatic responsibilities.

In these approaches, participants were much more likely to have their needs met and be satisfied with their care. Moreover, any concerns about consumers' safety appear misplaced. For every age group in every state, participants were no more likely to suffer care-related health problems.

Government can provide leadership to solve problems, of course. So often it comes down to personal responsibility -- the duty of every adult in America to look after themselves and to safeguard the gift of life. But wise government policy can make preventative care the standard. It can put the best practices of preventative care in action all across our health-care system. Over time that one standard alone, consistently applied in every doctor's office, hospital, and insurance company in America, will save more lives than we could ever count. And every year, it will save many billions of dollars in the health-care economy, making medical care better and medical coverage more affordable for every citizen in this country.

Good health is incentive enough to live well and avoid risks, as we're all reminded now and then when good health is lost. But if anyone ever requires further motivation, they need only visit a place like the Moffitt Center, where all the brilliance and resourcefulness of humanity are focused on the task of saving lives and relieving suffering. You're an inspiration, and not only to your patients. You're a reminder of all that's good in American health care, and we need that reminder sometimes in Washington. I thank you for your kind attention this morning, I thank you for the heroic work you have done here, and I wish you success in the even greater work that lies ahead.

Hatched by Dafydd on this day, April 29, 2008, at the time of 8:40 PM | Comments (5) | TrackBack

March 13, 2008

Democrats Reject "Slashing" Medicare Down to a Scant 5% Increase

Econ. 101 , Health Care Horrors , Liberal Lunacy , Tax Attax
Hatched by Dafydd

Here's a fun party game: Google the following phrase: budget 2009 slash

I got 135,000 hits... how about you?

Now, there are some false hits there -- "Lawmakers vote to slash Florida budget," for example. But if you just keep clicking Next, you'll see page after page of links with titles like "Bush Budget Slashes Women's Health Funding | Reproductive Health" and "Bush's 2009 Budget Calls For Slashing Public TV Funding"... but especially ones like "Bush budget would slash Medicaid, Medicare budgets."

If they don't say "slashes," nearly all these pieces generally include some equivalent; here's a typical example, from the Associated Press today, that talks about "huge cuts" rather than "slashes":

A Republican alternative that largely mirrored a plan by McCain to permanently extend Bush's tax cuts and eliminate the alternative minimum tax was expected to fail badly, with party moderates distancing themselves from the GOP plan's huge cuts in popular programs like Medicare, housing, community development, and the Medicaid health care program for the poor and disabled. Such cuts were needed to make room for big tax cuts and still project a balanced budget.

So why the obsession with how President Bush's budget or John McCain's budget "slashes" (or inflicts "huge cuts" -- get a bandage, ow!) in "popular programs like" [fill in a series of "entitlement" programs that Americans now rely upon, after decades of "liberal fascism" under both Democratic and Republican administrations]? Why is any cut -- rather, any reduction in the rate of increase -- denounced as draconian, ruinous, and thuggish? Read on to find out...

Pay no attention to that budgetary black hole behind the curtain!

Quite simply, the inflammatory rhetoric is designed to take our minds off of the real story:

  • Democrats fully intend to vastly raise taxes -- by stealth. Allowing the Bush tax cuts to expire at the end of 2010 will jack up income taxes by $683 billion over five years, or $137 billion per year. Yet even so, Democrats propose even more spending increases than the tax increases, so the deficit will explode as well, probably triggering a real, live recession (and lowering tax receipts even further).
  • Democrats have no intention whatsoever of doing anything to restrain the growth of putative "entitlement" programs -- Medicare, Medicaid, and Social Security. They will allow the programs to rise at more than double the inflation rate until the cows come home to roost.
  • Therefore, in fewer years than most folks realize, either Congress must enact tax increases on the level of trillions of dollars... or else the "entitlement" programs will grow to the point where they literally gobble up the entire rest of the budget. All revenues will go for entitlements, leaving nothing left over for anything else -- no more national defense, education, NASA, scientific research, or any other discretionary spending.

The Bush budget (unveiled last month) will at least "slash" the Medicare growth rate from 7.2% per year to 5% -- which is still more than inflation: Inflation has averaged 2.69% per year during Bush's presidency, but will probably rise to around 3.5% this year. This "huge cut" -- which still leaves the programs advancing more than retreating, even in constant dollars -- would trim about $10 trillion, about a third, off the unfunded liability of the program, currently estimated at $34 trillion.

But that still leaves the unfunded liabilities of Social Security, Medicaid, and other "entitlement" programs. Estimates vary, but a figure I've often seen is that all of them add up to about $75 trillion dollars... a staggering amount that equals the entire gross domestic product of the United States for 5.7 years. In budgetary terms, it represents the entire annual federal budget for a quarter century.

Unfunded liability stems from the fact that the cost of the programs rises so much faster than the inflation rate; this will only get worse as baby boomers begin to retire in mass numbers in 2011, just three years from now, and as retirees live longer and collect benefits for many more years.

John McCain has not yet proposed a serious solution to the problem, but there are quite a few very good ideas out there. I expect he will make entitlement reform the centerpiece of the domestic part of his campaign... because he has no choice. The retirement time-bomb is ticking, ticking, ticking; and neither Barack Obama nor Hillary Clinton has made -- or will make -- any serious proposal.

Social Security

There are two serious problems; eventually, Congress must fix both in order to make the program sustainable into the future:

  • The return on investment (ROI) for an individual's payroll-tax contribution to Social Security varies due to a number of factors, including lifespan, how much he contributed while working, when he retired, and so forth. But the Heritage Foundation calculates that the ROI for a person born in 2006 is no more than 1%... and it can even be negative, meaning you literally pay more than you ever receive. (This is especially true for men, who tend to have shorter life expectecies than women.)

    In other words, the Social Security Trust Fund is a terrible, miserable investment. Your retirement money would do better in virtually any private investment imaginable.

    The ROI may go up if lifespan increases significantly, as I expect it will; but that means the cost of the program will again become unsustainable, since it does not generate any wealth, as a real investment would, thus cannot pay for itself over the long run.

  • Even the pittance we earn on our "investment" (not much better than stuffing the money into a mattress) has been systematically raided by past Congresses, Democratic and Republican, to finance current expenses.

    There is no trust fund. There is no "lockbox." There is no money; there is only a wad of hand-scribbled IOUs.

    Social Security is a pay-as-you-go program. We paid as we went... but we also spent that money on a vast array of other "popular programs" besides Social Security, and it's all gone. C'est la vie.

Both problems can be solved by a single change... but it's going to hurt. Social Security must be fully privatized. Not the namby-pamby partial privatization proposed by President Bush (and shot down in a green-eyeshade second by the Republican Congress), but the whole kit and kaboodle. We do it like this:

Each payroll taxpayer gets an individual Social Security Retirement Account; the SSRA can be maintained by any brokerage firm, which sets up any number of SEC-approved investment funds... divided into three tiers of investment: 1 - Safe, 2 - Moderately Aggressive, and 3 - Aggressive.

All Social-Security "contributions" by a taxpayer are poured into his own personal SSRA. The taxpayer picks the tiers and the funds to invest in; when he retires, that's his own money -- to spend, to reinvest, or to pass along to his children.

And there you have it:

  • The ROI is the same as for a 401K, so the SSRAs will be self-sustaining;
  • And since they're in the name of the taxpayer, the government cannot raid them.

That's about the only way to permanently solve the problem -- as numerous countries have already discovered, including Argentina, Australia, El Salvadore, Great Britain, Hong Kong, Hungary, Mexico, Peru, Poland, Sweden, and many others.

The feds will have to skim off the top to partially subsidize the program for those folks who, for whatever reason, have SSRAs deemed too small to live... and also to pay the transition cost of all the past contributions by taxpayers into the current system, spread over some period of time to avoid bankrupting the country. Alas, the transition costs will be very, very high; payroll taxes will have to rise, though hopefully not damagingly so.

Such a fix would be market-positive, since it would increase America's "net worth." It's like paying to put a new roof on your house: The money you pay now will increase the value of the house for later resale by more than you put into it.

Will John McCain have the guts to propose it? I hope so; but I know for a fact that neither Hillary nor Obama will.


Medicare is basically health insurance for senior citizens of any income level. Medicaid is a group of needs-based state-run (under federal guidelines) medical welfare programs for the poor, which is currently gnawing away at state economies, gobbling up 20% to 30% of state budgets.

With these entitlement programs, the real problem is the rising cost of health care itself. But the cost is being driven to a large extent by factors external to medical care:

  • Medical malpractice lawsuits, which force doctors and hospitals to practice "defensive medicine," ordering unnecessary tests for the purpose of covering themselves in the event of a lawsuit.
  • The vile practice in other countries (especially Canada) of legally requiring prescription drugs to be sold to their citizens below manufacturer's cost... forcing Big Drug to jack up the price here to avoid going out of business.

    (Were we to follow suit -- an idea that McCain has flirted with in the past, alas -- we would likely lose many pharmaceutical manufacturers... and all the lifesaving and life-enhancing drugs they would have produced.)

  • Increasing lifespan: Just as with Social Security, when people live longer -- as they have been, due to medical advances, the decreased rate of smoking, and so forth -- the government must pay more money per person. Thus, if the taxes paid by future recipients don't rise as fast as the increased payments due to living longer, any system will eventually become insolvent.

The solution has several components. First, we need major tort reform, especially in the area of medical malpractice. The reforms must include loser pays; barring "expert witnesses" hired by the plaintiffs' attorneys (let them come from a pool hired by the court, with no financial incentive to lie); and ending the practice of expanding liability further and further outward until one finally reaches a parent company with enough money to satisfy the trial lawyer's greed.

Second, patients are just going to have to be responsible for more of their own medical costs; this will force them to budget their medical dollars more wisely. A very, very good first step is to introduce medical savings accounts (MSAs) into the Medicare system in a big way, particularly for affluent seniors. Getting fiscal responsibility into Medicaid is harder, because it is by definition a program for the poor; but we should put some thought into it.

Third, rather than pay doctors and hospitals directly, perhaps Medicare and Medicaid should pay the patient -- then let him pay the bills. If doctors charge more than the government pays, they will have to get the rest from the patient himself.

This gives patients a huge incentive to shop around and think twice about going to the doctor for minor problems; and it likewise gives doctors a huge incentive to reduce costs by bringing the free market into the equation. At the moment, they simply get paid according to a government "schedule"... which encourages medical professionals to spend money on lobbyists to increase the scheduled payment rates, rather than on finding ways to contain their own costs and remain competitive, as every other business must do.

Fiscal responsibility

If Republicans want to regain control of Congress someday -- and if John McCain wants to get elected president -- then both must offer bold, permanent solutions to the entitlement crisis. There is no more time for tepid "can-kicking."

Even if the Democrats shoot down the GOP proposals, that will give us a vital and future-oriented issue to run on, buttressing our claim to be the party of great new ideas. And this issue will be one that clearly differentiates between the European-style socialism of the Left and the American tradition of personal responsibility on the Right.

Let's hope that if the GOP can ride this issue back into power (this election or the next), that this time, the reality of Republican governance will actually live up to the stirring rhetoric of personal responsibility.

Hatched by Dafydd on this day, March 13, 2008, at the time of 8:14 PM | Comments (3) | TrackBack

October 15, 2007

Psst! Dems Hint They Haven't the Votes to Override SCHIP Veto

Health Care Horrors
Hatched by Dafydd

The Squeaker squirms

Speaker of the House Nancy Pelosi (D-Haight-Ashbury, 95%) has as much as admitted yet another Democratic failure: They don't have the votes to override President Bush's veto of the bloated and metastisized Democratic version of renewal of the State Children's Health Insurance Program, or SCHIP.

But let's not start backways-round; before we jump into the current Democratic travails, let us dress the stage...

We commence with the first oddity: In the current bill, the massive Democratic expansion of SCHIP into a middle-class entitlement program would be funded by an increase in the federal tax on cigarettes and cigars -- which, funnily enough, would be a very regressive tax that primarily hits the poor. Thus, under the new Democratic plan, the poor are taxed to subsidize the middle class.

Worse, if smokers respond to the tax hike by cutting back on smoking, the feds lose the revenue stream that is supposed to pay for the expansion; this would turn the federal government into a cheerleader for increased smoking.

This element fits a growing Democratic-Party pattern: The use of taxes to force social change. Now, this is not the exclusive property of Democrats; consider the home mortgage interest tax deduction, the purpose of which is to get more people to buy homes instead of rent. Its origin in shrouded in mystery, but no Congress or president since, Democrat or Republican, has actually pushed for its abolition (several have talked the talk).

However, rather than use tax incentives to encourage good behavior, Democrats have made a fetish of using punitive taxation to punish behavior they don't like, such as smoking. But not just cigarettes:

  • Many Democrats (Mort Kondracke, for one) have argued in favor of huge taxes on gasoline to "force" people to drive less; similar ideas include a "gas-guzzler" tax or specifically an SUV tax.
  • The proposed "carbon tax" is suppose to punish people for using energy.
  • Democrats have also proposed taxes on fatty foods and transfats;
  • Guns and ammunition;
  • Luxuries (including the infamous yacht tax that led to a collapse of the yacht-building industry, resulting in mass layoffs of middle-income workers -- and the swift repeal of the yacht tax);
  • A proposed tax on houses larger than 3,000 square feet;
  • And taxes on alcohol.

In each case, Democrats have proposed the tax primarily for the purpose of controlling behavior, not raising revenue. (And except for the proposed taxes on fat or transfat, these nanny-state taxes are aimed squarely at Republicans.)

Punitive, behavior-modifying taxes distort the market, thereby damaging the economy. But that's not the worst market distortion caused by the Democrats' proposed expansion of SCHIP.

The program was originally intended to cover the gap between children below the poverty line, who can get health-care through Medicaid, and children whose families earn up to 200% of poverty (twice $21,000 per year, or $42,000) but still have a tough time paying for health insurance. But when it came up for renewal, Democrats forced through a massive expansion of the program to cover children whose families earn far above the previous ceiling -- in some cases, up to four times the poverty line, or $84,000 per year -- as well as covering these "children" well into their twenties. Thus, they took a program aimed at helping the working poor and transmogrified it into a new middle class entitlement program.

[Corrected Medicare to Medicaid above; thanks, commenter Cdquarles!]

Worse, analyses by many economists showed that with such an expansion, the most likely outcome would be that many upper-middle income families who already have private health insurance would simply drop it and take the much cheaper, smoker-subsidized SCHIP insurance instead; that is, the net effect would be to shift millions of families away from private health-care insurance and onto government-run health care -- basically, Medicaid for all.

Republicans argue that this was precisely the reason the Democrats want to expand SCHIP in the first place: To shift health insurance from the private to the public sector, thus vastly expanding the reach of government... and creating thousands more government workers, who will join the Service Employees International Union and raise more millions for Democrats.

SCHIP was originally crafted in 1997 by Sen. Ted Kennedy (D-MA, 100%) and then First Lady, now Sen. Hillary Clinton (D-Carpetbag, 95%); but the Politico recently reported about a White House memo from four years earlier, 1993, in the swirling aftermath of the failure of Hillary's first attempt to nationalize health care.

The memo was from Hillary's staff, arguing that the best way to push socialized medicine onto the American people was first to expand government health-care programs for poor children into the middle class, then use that as the camel's nose, pulling the rest of the beast into the tent:

In a section of the memo titled “Kids First,” Clinton’s staff laid out backup plans in the event the universal coverage idea failed.

And one of the key options was creating a state-run health plan for children who didn’t qualify for Medicaid but were uninsured....

“Under this approach, health care reform is phased in by population, beginning with children,” the memo says. “Kids First is really a precursor to the new system. It is intended to be freestanding and administratively simple, with states given broad flexibility in its design so that it can be easily folded into existing/future program structures.”

It's hard to read this memo, note the SCHIP program enacted three years later, and then study the expansion pushed by Democrats today, and not see a pattern unfolding, just as in the memo promises.

President Bush repeatedly warned Democrats during the current debate -- from which negotiations the administration was shut out -- that such an expansion and change from the original intent of SCHIP (covering poor kids) would force him to veto the bill. He kept his promise. This gave the Democrats what they appeared to want... a big confrontation with President Bush over health care.

The idea was that Republicans, frightened and gunshy of being attacked for wanting children to die through lack of health care, would vote to override, and Bush would be crushed. Certainly all the inside-the-beltway pundits, including those on the Right (such as the Republican side of the "Beltway Boys," Fred "the Grump" Barnes, and syndicated columnist Charles "the Sauerkraut" Krauthammer) opined that Republicans would be mauled so badly they would have to relent. The Democrats decided to delay the override vote by two weeks, to give the natural paranoia of Republican senators and representatives time to flood their nerve endings, reducing them to lime Jell-O.

But now it appears the opposite has happened: The two-week breathing space gave the GOP time to calm themselves, marshall their arguments, and find a spine... and the Democrats have as much as admitted they will lose the fight. From the AP article linked above:

House Democratic leaders said Sunday they were working to gather votes to override a veto on a popular children's health program, but pledged to find a way to cover millions without insurance should their effort fail....

In talk show interviews, Speaker Nancy Pelosi and Majority Leader Steny Hoyer did not dispute claims by Republican leaders that the GOP will have enough votes to sustain Bush's veto when the House holds its override vote on Thursday.

But the confrontation gets even more churlish -- and even more surreal. Consider this:

At the same time, the White House sought to chide the Democratic-controlled Congress as the obstructionists in reauthorizing the State Children's Health Insurance Program. It said Democrats were the ones who had shown unwillingness to compromise.

Deputy press secretary Tony Fratto quoted President Bush as saying he is "willing to work with members of both parties from both houses" on the issue....

Pelosi and Hoyer promised to pass another bipartisan bill if needed....

"We'll take one step at a time. And, again, we'll maintain our bipartisanship and our fiscal soundness," she said. "And we'll talk to the president at the right time, when he makes an overture to do so, but not an overture that says, 'This is the only thing I'm going to sign.'"

Fratto said it was untrue that Bush had never sought compromise in the vetoed legislation, contending that Democrats had shut out administration officials in the original negotiations. House Democrats have countered that they had already compromised enough because they wanted $50 billion [extra] for the program but dropped it down to $35 billion to appease Senate Republicans.

In other words, Democrats admit that they did not trouble to consult with the president while crafting the bill; they decided instead to treat him like a beggar at the window, presenting him with a take-it-or-leave-it fait accompli. Presumably, they thought this would be more likely to force a confrontation, which (at the time) they were confident of winning.

But now that they have failed, they still won't admit there was anything wrong with the first approach. Rather, they're trying to make lemonade out of a sow's ear by passing a completely new bill... on which they will presumably make the very compromises they refused to make on the first bill!

The tenure of Nancy Pelosi in the House and Senate Majority Leader Harry "Pinky" Reid (D-Caesar's Palace, 90%) has been disastrous for the Democrats. Rather than become a strong and effective voice opposing the White House and serving as a springboard for Democrat-written bipartisan legislation, the Not Ready for Prime Time Congress has become a laughingstock:

  • Failing to pass critical legislation (such as any of the appropriations bills required to run the government);
  • Frittering their time away with endless partisan "investigations" of the president's policies, attempting to criminalize political differences;
  • And lunging for more Legislative power at the expense of the Executive -- trying either to end or at least micromanage the Iraq and Afghanistan wars, creating huge new middle-class entitlement programs, and trying to conduct their own shadow foreign policy in opposition to the president's.

In 1994, when the Republicans led by Newt Gingrich took over Congress following Hillary's failed socialized-medicine coup d'état, they immediately set about passing actual bipartisan legislation... and they worked closely with President Bill Clinton on such critically needed reforms as tax cuts, protecting traditional marriage, reducing the welfare rolls, health-insurance portability from job to job, lobbying disclosure, and the first major telecommunications act in more than six decades. Each of these acts was passed by a Republican Congress with Democratic support and signed by a Democratic president.

But when the Democrats took over Congress last January, they appear to believe that meant the president and congressional Republicans were now irrelevant. Like the Jacobites of the French Revolution, the Democrats' battle cry seems to be "We are the masters now!"

And not unexpectedly, their results have been nonexistent and their impact nil. Democrats may still coast to a few more pickups in November 2008, though it's far to early to rule out Republicans recapturing one or both houses. But it's clear that Democrats are unable to do the heavy lifting and make the compromises necessary to turn their perfect-storm victory last year into a lasting majority: Their tenure will be brief and unremembered, like the two-year Senate interregnum caused by Jumpin' Jim Jeffords' defection.

The only legacy that will be left from the Pelosi-Reid Congress -- will be the Boehner-McConnell Congress.

Hatched by Dafydd on this day, October 15, 2007, at the time of 12:12 AM | Comments (22) | TrackBack

September 5, 2006

Schwarzenegger Will Veto California HillaryCare

Health Care Horrors , Politics - California
Hatched by Dafydd

According to famed Bee-blogger Daniel Weintraub, California Gov. Arnold Schwarzenegger will veto the ghastly socialized-medicine bill enacted by the sinister California legislature.

Thank goodness. There is no way the legislature can override the veto, and I doubt they'll even try -- as that would give the Republicans running for the Assembly and state Senate another good campaign issue.

As the dumb-looking guy in a fedora says (and I don't mean Roger L. Simon!), "developing...."

Hatched by Dafydd on this day, September 5, 2006, at the time of 3:29 PM | Comments (1) | TrackBack

August 31, 2006

How 2 Fix Soaring Health-Insurance Costs...

Health Care Horrors
Hatched by Dafydd 3 EZ lessons!

Having trashed the liberal-left proposal to "fix" the California health-care system by implementing Canadian, Swedish, Japanese-style socialized medicine, I would be remiss not to offer a counter plan; in fact, it would be Democratic.

("We have none but evidence for the prosecution and yet we have rendered the verdict. To my mind, this is irregular. It is un-English. It is un-American; it is French." -- Mark Twain, "Concerning the Jews.")

So here are my three modest proposals...

1 Encourage high-deductable "patient pays" plans via Medical Savings Accounts (MSAs).

One of the biggest factors raising insurance cost is the overuse of doctors, treatments, hospitals, and especially testing. Necessary medical care is -- well, necessary; annual physicals (or even biannual for older patients) are not only necessary, they actually reduce costs by catching problems early, when treatment is cheaper and more effective.

But running to the doctor for every small cut or sniffle is a luxury; and if you want that, you should pay for it yourself... not pass the cost along to everybody else on your insurance plan. The easiest way to bring this about and make patients think carefully about their treatment is to encourage widespread use of MSAs: tax-deductable savings accounts that can only be used for medical expenses. This way, patients can have a high deductable -- $5,000, say -- and use their $5,000 MSA to pay for increased deductables and for larger co-pays on minor medical expenses (office visits, gynecological exams, prescription drugs).

Since the MSA comprises money that they, personally, paid in, they will likely be more cautious about spending it... since they're the ones who will have to fill it up again.

Counter-intuitively, a huge chunk of insurance cost comes from small payments that would be well below a large deductable. With a high deductable, premiums drop enormously.

I went to the Blue Cross/Blue Shield website and worked through some quotes. Here are three plans, each a PPO (not an HMO). The coverage is more or less the same with one exception:

  • Each plan has a deductable that must be met before major expenses are covered; the deductables are listed on the table below.
  • Each plan requires a co-pay of about 30% for major expenses, up to an annual maximum.
  • Each plan has a total annual out-of-pocket maximum you must pay before the plan takes over competely; this maximum is the annual deductable plus the co-pay maximum (see below) and is shown in the table below.
  • The only major difference is that, with the non-MSA plans, the co-pay for minor expenses (office visits, pap smears, prescriptions, and such) is a fixed amount -- $35 for an office visit or gyno; $10 for generic drugs, $35 for brand-name -- while for the MSA plan, the minor expenses are also subject to the 30% co-pay.

I selected a family of two with no kids for all three plans. The point is not exactly how much the monthly premium is, but rather how the use of MSAs affect monthly premiums:

How MSAs affect premiums
Health-Care Plan Annual Deductable Total Annual Out-of-Pocket Monthly Premium
Shield Spectrum
PPO Plan 750
$750 per individual
$1,500 per family
$4,750 Individual
$9,500 Family
Blue Shield Life
PPO Plan 1500
$1,500 per individual
$3,000 per family
$6,000 Individual
$12,000 Family
Shield Spectrum
PPO Savings Plan 4800
(MSA eligible plan)
$4,800 per family $3,200 Individual
$5,800 Family

Wow, not only is the premium much, much lower with the MSA plan -- but the total annual maximum out-of-pocket expense is much lower, too! All this savings, and the only major difference is that the insurance company subsidizes office visits and prescription drugs much more substantively in the ordinary PPO than the high-deductable PPO coupled with a Medical Savings Account.

Isn't that amazing? In other words, a huge chunk of the money paid out by insurance companies are for those diddling, little office visits and prescription drugs.

The difference in monthly premium between the MSA plan (where you pay for the minor stuff yourself) and even the mid-range deductable plan is $551/month. In a single year, you save $6,612... which is more than your total yearly max out-of-pocket costs with the MSA plan. In other words, you could fill up your MSA with the difference during the first 10 months of the year. Since you're not likely to deplete the entire account every year, you will end up with a very significant monthly savings.

And the most important point is that, since each patient pays for his own medical needs (up to the deductable and co-pay maxima), he has a financial incentive to keep the cost down by avoiding unnecessary visits to the doctor, unnecessary testing, and unnecessary treatment.

So how does the government help more people migrate to MSA plans? By getting out of the way! Currently, businesses can deduct from their taxable income what they pay in insurance premiums for their employees; but the employees cannot deduct what they pay. We need to allow people to deduct from their taxable income all payments into an MSA (up to the max for the plan), even if they take the standard deduction.

No new bureaucracy is required; just a couple of lines on the IRS 1040 form and on the equivalent state tax forms.

2 Reform malpractice tort law to lower physician costs and prevent unnecessary "defensive testing."

There are several elements of malpractice law -- and general tort law -- that are in dire need of reform or elimination, starting with...

  1. Completely eliminate the abomination of the class-action lawsuit: such settlements invariably do nothing but make millionaires of the attorneys, while each member of the class gets $48.65 and a couple free sample boxes of Viagra. There is no good reason that individual plaintiffs cannot combine their lawsuits into a single suit... but it should include only named plaintiffs, and it should not preclude other plaintiffs suing later.
  2. Create a list of neutral, court-appointed, medical expert witnesses: these doctors and medical researchers would be established experts in various fields of medicine, and they will be paid exactly the same regardless of whether their testimony helps the plaintiff or the defendant. When an expert witness makes his living testifying exclusively for plaintiffs' attorneys -- or for hospitals and doctors -- his testimony is irretrievably tainted by financial interest. But as a professional witness, he will be much better able to sway the jury than if he's just a doctor hired by an individual doctor to testify on his behalf. Thus, juries are inordinantly biased by people whose only incentive is to say whatever will win the case for one side or the other.

    Since doctor defendants typically have less money available to fight a lawsuit than the legal firms bringing the lawsuit -- the plaintiffs' lawyers expect to make millions, while the doctor's attorney only gets an hourly rate -- this generally means ruinous judgments against doctors and hospitals on dubious medical theories. Which leads to...

  3. Expunge "junk science" from courtroom testimony: "expert witnesses" of any kind will only be allowed to testify to theories that are the current consensus opinion of the relevant scientific or medical field. No more "power lines cause cancer" and "silicon breast implants cause connective-tissue disease" testimony, unfounded on any scientific study -- yet very persuasive from the mouths of professional witnesses.
  4. A hard cap on non-compensatory damages: pain and suffering, punitive, and so forth. A good cap would be a multiple of the proven compensatory damages; the exact multiple is beyond my competence.
  5. Loser pays: if you bring a malpractice lawsuit and you ultimately lose, or even if you prevail but the award is no more than the final settlement offer of the defendant, then you (the plaintiff and his attorneys jointly and severally) are responsible for all of defendant's and his attorneys' costs associated with the case, including his time, all of his witnesses' time and compensation, and any loss of business associated with the case -- but only that portion that wouldn't have occurred if the settlement offer had been accepted.

Note that all of these steps should be part of a general tort-reform package that would be applied to all civil suits, not just to medical malpractice; but the latter is the subject of this post.

These changes would have two salutory effects on medical costs:

  • Since good physicians will be in less danger of runaway juries socking them with cripping malpractice claims arising from perfectly acceptable care, their insurance premiums will be much less. Since annual premiums for surgeons currently (2001 figures) run from a low of $25,000 in California to a high of $111,000 (!) in Florida, and for OB-GYNs from $48,000 to $173,000 (!!), it's clear that high med-mal insurance costs are driving medical-care costs upward -- and also driving doctors out of business.

    Reduce the risk, and the med-mal premiums drop; reduce the doctor's cost, and the cost of medical care drops. (Also, if you reduce the number of doctors who leave the profession, then you have more doctors; increased supply of any commodity means lower cost.)

  • Doctors who are terrified about being sued for medical malpractice typically prescribe scores of unnecessary medical tests, for no purpose other than to mount as a legal defense in case a patient dies or is injured (despite proper care) and he or his heirs run to a lawyer. Each of these tests costs a bundle... and all that cost is of course passed along to the patient.

    Reduce the fear, and unnecessary testing drops; reduct unnecessary expenses, and medical cost drops.

And again, I call for no new "rights" suddenly discovered; I call for changes to existing law to make malpractice suits more balanced, rather than being so biased towards plaintiffs that in some localities, doctors -- especially OB-GYNs, have completely disappeared.

3 Eliminate government health-care "mandates."

Nearly every state in the United States, plus the federal government itself, mandates that health-care plan include coverage for a large and increasing number of conditions, including mental and emotional problems. Each individual mandate may only be appropriate for one narrow class of people; but the aggregate greatly increases the cost of coverage to the insurance company... and since a company that goes out of business doesn't cover anybody, that means the insurers must raise their premium costs.

That is another major source of high premiums. Eliminate the mandates and allow the market to decide what coverage is offered, and premiums will decline dramatically.

For people whose conditions make them medically uninsurable except for colossal premiums, it's probably cheaper for the government to subsidize those persons than to force insurers to accept them for lower premiums. But if not, then something akin to the "assigned risk" mandate for automobile insurance would likely work better than mandating that everybody receive coverage for every imaginable illness, condition, or emotional turmoil.

Yet a third time, this is a rollback of bureaucracy and government control; no statism here.

And no Democrats here, neither!

So there you go, the Big Lizards Grand Unified Plan for Everything Related to Health Insurance. And note please that not a single one of these suggestions requires the creation of any new federal or state bureaucracies, government programs, or the expansion of any "entitlement" programs. No pork; no earmarks; no opportunities for legalized bribery.

So I reckon it would have no constituency in Congress.

Hatched by Dafydd on this day, August 31, 2006, at the time of 4:59 PM | Comments (15) | TrackBack

August 30, 2006

California HillaryCare

Health Care Horrors , Media Madness , Politics - California
Hatched by Dafydd

As anyone who reads Captain's Quarters knows, the California Assembly just approved a bill, SB-840, which was previously approved by the state Senate, to implement "HillaryCare" style socialized medicine throughout California.

The bill was voted out of both chambers on essentially party-line votes, and you can find the complete text as amended here. The next stop is the state Senate again, where approval is pro-forma, and then to the desk of California Gov. Arnold Schwarzenegger... who is widely expected to veto it, thank goodness.

I'm astonished that there has been so little reporting about this. I live in California, and I had heard nothing about it until I read Captain Ed's piece, which he picked up from, which is the web version of the San Francisco Chronicle. Aside from the Comical:

  • The bill and vote was covered by the Sacramento Bee (Sacramento is the state capital), and it was covered by various other small newspapers;
  • But as of this moment, I can find absolutely nothing on the website of the Los Angeles Times, the largest newspaper by far in the entire state. (I'm sure Patterico is shocked at the utter incompetence of the L.A. Slimes);
  • The San Diego Union Tribune published an opinion piece in favor of this socialized-medicine bill by a representative of the main group that wrote it, Health Care For All - California; but I cannot find any actual news story about its passage;
  • The San Jose Mercury News put a story up yesterday -- under the marvelously opaque headline, Demo bills highlight contrasts. Yeah, that sure makes clear that the subject is socialized medicine!

    The other bill referred to by the Mockery News, just passed by the state Assembly, was -- no, really, I'm not making this up -- a bill to allow illegal aliens to obtain California drivers' licenses. In case anyone here doesn't know or has forgotten, that is the issue, more than any other, that led to the recall of our previous governor, Gray Davis. California Democrats... the gift that keeps on giving;

  • I can't imagine this wasn't carried on AP, Yahoo, and Reuters -- or at least on Agence France-Presse -- but darned if I saw it on any of the feeds I read, and I can't find any reference via Google... except for a press release from another "consumer rights" group that supports socialized medicine, the Foundation for Taxpayer and Consumer Rights, which Yahoo ran on Monday.

It is astonishing how low this bill and the illegal-alien drivers' license bill have flown under the radar. I make no doubt of the reason why: because Californians, while leaning liberal, notoriously despise both HillaryCare and also giving illegal aliens a government ID card they can use to fake legal residency. So no wonder the elite media -- which "has bones in the fight," as a (legal) immigrant friend of mine said a long time ago, when she was still learning English -- are doing their bestest to keep mum about the bills.

The Democrats will happily tout their leftism at the appropriate venues: fund raisers, rallies, and speeches to the nurses and prison-guard unions. No reason to let real voters find out just how radical their own state senators and assemblymen are!

It is absolutely critical that the governor veto this bill.

The following is an e-mail I sent to the Office of the Governor, where I hope it will buck Gov. Arnold Schwarzenegger up to veto this monstrosity of a bill (all emphasis added, since the e-mail form used by the Office of the Governor does not allow HTML code, for obvious reasons):

Dear Gov. Schwarzenegger;

I voted for you in 2003, and I intend to vote for you again -- but only if you veto this despicable socialized-medicine bill that just came out of the Assembly, SB-840. It's already been passed by the Senate once, and I'm sure it will be again... but even your opponent, Phil Angelides, opposes it!

It was sponsored by one of the most left-liberal state senators we suffer, Sen. Sheila James Kuehl. I loved her as "Zelda Gilroy" on the old Dobie Gillis TV show; but she's been a walking cat-5 hurricane in the legislature... and this bill is probably the worst thing she has ever foisted upon us long-suffering residents of the golden state.

As I'm sure you know, the bill establishes a "single payer" health-care system (that is, socialized health care)... but you may not have been told that it goes a lot farther: it actually BANS all private health-care plans and health insurance in the state. Don't believe me? This is from the actual text of the bill, pages 1-2:

The bill would prohibit health care service plan contracts or health insurance policies from being issued for services covered by the California Health Insurance System.

In other words, for any type of health care covered by California HillaryCare, my wife and I and every other Californian would be barred from obtaining any private health care plan or insurance. The moment it goes into effect, we're locked in; we lose our Blue Shield coverage and have only the government to turn to.

The bill "guarantees" that we can pick our own doctors and health-care facilities; but once the weenies in the lege gain total control, how long do you think that will last? How long until they decide that "cost containment" requires them to implement Hillary Clinton's original idea of "health-care alliances," which would decide which doctor to assign to each California resident?

This horrific bill -- passed by the Democrats on a party-line vote -- completely repudiates the entire theory of capitalism and competition: with one buyer (the state), we're just stuck with whatever coverage the Democrats think is best for everyone... "one size fits all."

If you happen to have needs not envisioned by the state legislature, tough. If you prefer less coverage in one area and more in another, too bad. You can't shop around, you can't change plans, you'll take what the Democrats give you -- and you'll like it.

Or else maybe you'll just get nothing at all.

Please, Governor, for God's sake, veto this abomination! The last thing California needs, in health care or any other arena, is a big, lumpy dose of Swedish-style socialism. Or does Sen. Kuehl have some wonderful examples in mind where more socialism solved an economic problem?

If you want to insure the poor, fine: insure the poor! Don't take choice away from everyone else in the name of "equality"... unless your idea of solving a problem is the Democratic way: make everyone equally poor and equally miserable -- and equally "socialized."

I am very sure that Schwarzenegger will veto this bill; and there are not enough Democrats in the Assembly, or (it appears) in the state Senate, to override a veto.

According to the story in the San Francisco Comical, the vote in the Assembly was 43 to 30; currently, the California State Assembly comprises 48 Democrats and 32 Republicans, with one vacancy.

Overriding a veto requires 2/3rds of each body, I believe, just as with the U.S. Congress. That requires 54 votes in the Assembly; but there are far fewer Democrats than that -- and not even all of them voted for this despicable bill: even assuming all 30 of the Nays were from Republicans, that means five Democrats (at the very least) abstained or failed to show up. If more than two Republicans failed to vote against SB-840, that means even more Democrats demurred.

Still, however, the main bulk of the Democrats don't want Sachi and me to be able to get the health-insurance plan that we want, but instead want to tell us what we'll get, good and hard.

The state Senate is dicier; but even there, with 40 members, you need 27 Ayes to override... and there are only 25 Democrats. There were 25 votes in favor of SB-804, and I wouldn't be surprised if those two groups, Democrats and Ayes, were coterminous.

Thus, for either body to vote to override a Schwarzenegger veto (assuming he's mensch enough to veto), the Democrats would have to lure some Republicans over to the dark side, to embrace socialism as the solution to our health-care woes, such as they are.

And really, the woes are neither deep nor wide: very few people are unable to find adequate health insurance; considerably more are unwilling... and as I noted in a previous post, given the current system, this may be a rational response for young singles or even married couples with no children and a reasonably high income.

And nobody has made a good argument why consolidating all health-care plans into a single buyer, that buyer being the state government, would make health insurance cheaper. The only pseudo-rationalization is the "argument by repeated assertion" used by the various socialist groups who push "health care for all": that everything will be cheaper because socialism eliminates all the "wasteful competition" you find in capitalist systems.

Yup; and it's worked great in Sweden, Mexico, Canada, Japan, the Democratic People's Republican of Korea, and of course the old Soviet Union, all of which have become absolute economic powerhouses. In fact, the only quasi-socialist countries with strong economic growth that I can think of are China and India... and both of those economies started growing only when they jettisoned much of their Marxist, Maoist, and fatalist socialist systems and embraced a significantly more robust capitalism than you find in the failed European social-welfare states of Scandanavia.

So yeah; brilliant conclusion, Mr. Democrat: let's solve our economic problems by becoming more like the economic basket cases of the world. That makes perfect sense -- to a liberal: if socialism fails everytime you try it, then the natural reaction is to redouble your efforts.

Let's hope that a single man, Arnold Schwarzenegger, a self-made capitalist, can see clearly enough to veto this bill... and the illegal-alien drivers' license bill as well.

Hatched by Dafydd on this day, August 30, 2006, at the time of 4:40 PM | Comments (7) | TrackBack

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